Organization Of Health Services Research Articles

The value of health service-based research to health service organisations: a qualitative study with senior health service executives

BackgroundResearch evidence has demonstrably improved health care practices and patient outcomes. However, systemic translation of evidence into practice is far from optimal. The reasons are complex, but often because research is not well aligned with health service priorities. The aim of this study was to explore the experiences and perspectives of senior health service executives on two issues: (1) the alignment between local research activity and the needs and priorities of their health services, and (2) the extent to which research is or can be integrated as part of usual health care practice.MethodsIn this qualitative study, semi-structured interviews were conducted with senior health leaders from four large health service organisations that are members of Sydney Health Partners (SHP), one of Australia’s nationally accredited research translation centres committed to accelerating the translation of research findings into evidence-based health care. The interviews were conducted between November 2022 and January 2023, and were either audio-recorded and transcribed verbatim or recorded in the interviewer field notes. A thematic analysis of the interview data was conducted by two researchers, using the framework method to identify common themes.ResultsSeventeen health executives were interviewed, including chief executives, directors of medical services, nursing, allied health, research, and others in executive leadership roles. Responses to issue (1) included themes on re-balancing curiosity- and priority-driven research; providing more support for research activity within health organisations; and helping health professionals and researchers discuss researchable priorities. Responses to issue (2) included identification of elements considered essential for embedding research in health care; and the need to break down silos between research and health care, as well as within health organisations.ConclusionsHealth service leaders value research but want more research that aligns with their needs and priorities. Discussions with researchers about those priorities may need some facilitation. Making research a more integrated part of health care will require strong and broad executive leadership, resources and infrastructure, and investing in capacity- and capability-building across health clinicians, managers and executive staff.

Exploration of Hospital Management and Organization Strategies: A Literature Review of Health Services

Background - Healthcare management strategy and organization encompasses the principles and practices used to operate healthcare facilities efficiently and effectively. It involves the planning, implementation, and coordination of various activities to ensure the delivery of high-quality patient care while optimising resource utilisation. The literature review in healthcare provides valuable insights into various aspects of hospital management strategy and organization. Objective - This article aims to find out the importance of management and organizational strategies in service businesses (hospitals) and related factors, so as to create improved human resource performance related to achieving effective and efficient organizational goals to face business competition and can be an organizational strategy in creating job satisfaction, can perform well and can create a competitive advantage for organizations in health services. Research Methode - The method used is the identification of previous articles with a total of 29 articles in the time span of 2000-2023. Search data for literature review was conducted in international journals to support the theory and take the topic of Management and Organizational articles, found 234,347 articles, scope Innovation, 2000-2023, Business, management and accounting, article, organization and management, English found 1,239 articles, Qualitative - 363 articles, Strategic - 134 articles, Performance - 95 articles, Effectiveness - 52 articles, Leadership, Health - 35 articles. Furthermore, articles that do not fit the topic will be ignored. Researchers only use data bases from Scopus and Web of Science because researchers only look for quality articles and the results are more accurate and very credible sources, because the results can be used as references and policies. Results - The importance of the role of management and organization in hospitals and can have a major impact on healthcare organizations. As explained in previous research that Management has a big role to improve hospital performance in an organization. The importance of management and organizational performance as they relate to each other. Human resources (HR) provide special attention in personal development and impact on performance in creating a health service. Conclusion - Management and organization are important in the hospital business because human resources are the driving force of the service business. Good management and organization can create professional and talented human resources results that can improve performance and will have an impact on organizational goals, and services to patients can run well which has an impact on the main objectives of the hospital. Management can be seen from several things including training and development, management practices, organizational climate, and other things that have a relationship in creating effective and efficient management so as to provide optimal results for the organization. Managerial Implications - The healthcare management needs to pay more attention to the evaluation of healthcare operational activities and feedback provided by patient families, the hospital management needs to increase the frequency of its discussions with employees to maintain excellent service quality for patient families, and the hospital management leaders need to set an example and encourage their employees to maintain a good organizational culture in order to maintain their service image.

‘It’s a delicate topic’: Stigma, capabilities and young people’s mental health in post-conflict Colombia

ABSTRACT Young people in Colombia present high rates of mental health problems, to which the country’s history of armed internal conflict contributes in complex ways. Mental health services in Colombia are fragmented, inadequate, and difficult to access for many. Young people’s help-seeking is often hindered by mental health stigma and/or poor experiences with services. This paper presents a thematic analysis of qualitative data from a mixed-methods study aimed at developing and testing a mental health intervention for Colombian youths. We draw upon theoretical lenses from scholarly work on stigma and Sen’s ‘capabilities approach’ to inform our analysis of interviews and group discussions with staff and young people involved in the state-funded human capital building programme ‘Jovenes en Acción’ (JeA). By illustrating how study participants talked about stigma, vulnerability, mental health services organisation, and the challenges of discussing mental health topics in a learning environment, we illuminate aspects of mental health support and anti-stigma interventions that might need enhancing. In particular, we suggest that more emphasis on ‘community competencies’ as complementary to and interrelated with individual competencies would strengthen young people’s individual and collective resources for mental wellbeing while being in line with the sociocritical principles of existing human capital-enhancing programmes.

Decentralization and immunization program in a single-party state: the case of the Lao People’s Democratic Republic

BackgroundThe Lao People’s Democratic Republic (Lao PDR), a lower-middle-income country, lags behind other Southeast Asian countries in immunization coverage for children under two years of age. The organization of health services is a key determinant of the functionality of immunization programs. However, this aspect, and in particular its decentralization component of the healthcare system, has never been studied.MethodsA case study in the Lao National Immunization Program was performed using a neo-institutional theory-based conceptual framework, highlighting the structure (rules, laws, resources, etc.) and interpretative schemes (dominant beliefs and ideas) that underlie the state of decentralization of the healthcare system that support the conduct of the immunization program. Twenty-two semi-structured interviews were conducted with representative actors from various government levels, external donors, and civil society, in four provinces. Data were complemented with information retrieved from relevant documents.ResultsThe Lao healthcare system has a deconcentrated form of decentralization. It has a largely centralized structure, albeit with certain measures promoting the decentralization of its immunization programs. The structure underlying the state of centralization of immunization services provided is coherent with a shared dominant interpretive scheme. However, the rapid economic, technical, and educational changes affecting the country suggest that the coherence between structure and interpretative schemes is bound to change.ConclusionUnprecedented opportunities to access quality higher education and the use of social networks are factors in Lao PDR that could affect the distribution of responsibilities of the different levels of government for public health programs such as the National Immunization Program.

Risk mitigations to prevent methotrexate dispensing errors in English hospitals: a mixed-methods exploratory study

Abstract Introduction Oral methotrexate is indicated for paediatric cancer indications and autoimmune diseases. Unfortunately, cases of inadvertent overdose due to confusion between 2.5mg and 10mg tablet strengths are widely documented. National guidance is available to prevent such errors; indeed, the overdose of methotrexate for non-cancer treatment is a Never Event.[1] At our organisation, the main mitigations to reduce the risk of dispensing errors were to segregate tablet strengths and restrict 10mg tablets to cancer indications.[2] Adherence had not been evaluated, and alternative risk mitigations had not been explored. Aim We aimed to 1) determine whether methotrexate 10mg tablets were restricted to cancer indications; and 2) explore strategies to prevent errors associated with methotrexate tablet strength at a sample of hospitals. Methods First, an audit approach was used to determine use of 10mg tablets; standards were derived from local policy.[2] The setting was a large teaching hospital providing acute, specialist, paediatric and cancer care. Dispensing transactions of 10mg tablets on the electronic pharmacy dispensing system between April 2022 and March 2023 were included. Details of prescription, dispensed quantity, dose instructions and speciality were recorded onto the data collection tool. Data were analysed descriptively. Second, a survey was conducted with a sample of twenty English hospitals (including the study site). These comprised ten large teaching hospitals and specialist paediatric cancer centres. A relevant pharmacist was contacted by email at each trust and asked a series of open questions about local risk strategies associated with methotrexate 10mg tablets. Notes were taken and data summarised descriptively. Results There were 79 dispensing issues for methotrexate 10mg tablets. Of those, 65 issues were for 13 cancer patients; the other 14 were erroneous issues where 10mg were dispensed instead of 2.5mg for non-cancer indications. Whilst most errors were rectified (n=13), one patient received a weekly dose of 40mg instead of 10mg, a four-times overdose. Nineteen (95%) trusts responded to our survey. There were three broad strategies reported: to only use 2.5mg tablets (n=9); isolate dispensing of 10mg tablets to dedicated cancer or paediatric dispensaries (n=5); or reliance on local protocol and physical segregation of 2.5mg and 10mg tablets within multi-service dispensaries (n=5). Conclusion It was encouraging that 10mg tablets were solely intended for cancer indications. However, the incidental discovery of errors highlighted the need for improvement. Findings suggest that eliminating 10mg tablets from practice was a feasible strategy, even for organisations providing cancer services. Findings have limited generalisability due to the small sample sizes, and detail provided in survey responses was variable. Nevertheless, the audit was effective in identifying a previously unknown Never Event. National Health Service organisations should acknowledge the risk associated with keeping 2.5mg and 10mg methotrexate tablets, particularly within dispensaries servicing multiple specialties. Dedicated cancer dispensaries are not commonplace, therefore eliminating 10mg tablets altogether should be considered. Indeed, the principle of limiting strengths is a well-established and effective medication risk management strategy. Further research should explore the potential negative implications for patients, such as increased tablet burden, if 2.5mg tablets are used exclusively for all indications. This may further inform national strategy to prevent Never Events.

Transsexual men and pregnancy: an integrative literature review.

Promoting sexual and reproductive health in the context of transmasculinity constitutes a new issue for health service organisation. This integrative review sought to understand the current evidence on pregnancy in transsexual men in the context of sexual and reproductive health care. From a search of the BVS, PubMed, Science Direct, Scopus, Capes, SciELO and PEPSIC databases, from 2010 to 2020, a sample of 11 articles was selected, treated by content analysis and grouped into four analytical categories: health services - positive experiences; cis heteronormative health services; implications of pregnancy for transsexual bodies; and repercussions of gender-affirming therapy and pregnancy. A cis heteronormative logic was found to predominate in health care, leading to negative experiences during antenatal care and childbirth among transsexual men. Their unique health needs during the pregnancy-puerperium cycle should include mental health care. It is suggested that strategies be adopted to build capacity in health professionals with a view to respectful, inclusive perinatal care for this population group, as well as further studies on the subject.

Impact of short-notice accreditation assessments on hospitals' patient safety and quality culture-A scoping review: A scoping review of the current literature to understand the impact of short-notice accreditation processes on health service organizations patient safety and quality culture.

To explore the published evidence describing the impact of short-notice accreditation assessments on hospitals' patient safety and quality culture. Arksey and O'Malley (2005)'s scoping study framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping reviews (PRISMA-ScR). A scoping review was conducted to identify papers that provided an evaluation of short-notice accreditation processes. All reviewers independently reviewed included papers and thematic analysis methods were used to understand the data. PubMed/MEDLINE, CINAHL, and ProQuest databases were searched to identify papers published after 2000. Totally, 3317 records were initially identified with 64 full-text studies screened by the reviewers. Five studies were deemed to meet this scoping review's inclusion criteria. All five studies reported variable evidence on the validity of health service or hospital accreditation processes and only three considered the concept of patient safety and quality culture in the context of accreditation. None of the five included studies report the impact of a short-notice accreditation process on a hospital's patient safety and quality culture. Limited evidence exists to report on the effectiveness of hospital short-notice accreditation models. No study has been undertaken to understand the impact of short-notice accreditation on patient safety and quality cultures within hospital settings. Understanding this topic will support improved hospital quality, safety, policy, and governance. To provide an understanding of the current knowledge base of short-notice accreditation models and its impact on hospital patient safety and quality culture. PRISMA reporting guidelines have been adhered to. No patient or public contribution.

Comprehension and usefulness of Spanish language health information about depression treatment.

US Latine adults who prefer the Spanish language for healthcare encounter communication have high risk of health disparitiesm in part from low organizational health literacy, mental health stigma and discrimination. Organizational health literacy includes the provision of culturally responsive, language concordant health information, which supports good comprehension and usefulness and could mitigate some health disparities. We conducted a pilot study to assess commonly provided patient health information handouts about depression treatment and antidepressant consumer medication information sheets. Thirty Latine adults with a Spanish language preference and a history of depression and antidepressant use participated in one phone interview. Descriptive statistics and thematic analysis were used to assess comprehension and usefulness of selected sections extracted verbatim from these documents. Overall, 83% (n = 25) participants reported that all sections were easy to understand, and 97% (n = 29) said that they were useful. Yet, responses to open-ended questions for 53% (n = 16) of participants revealed 'confusing' terminology in at least one section, and 10% (n = 3) expressed concerns about or misunderstood an idiomatic phrase as reinforcing mental health stigma. The seriousness of the organizational health literacy-based issues identified in this and previous studies require that government and health service organizations make necessary and timely revisions to address them.

Discipline, caregiving, and identity work of frontline professionals: Talking about the acts of compliance and resistance in the everyday practices of social workers

Abstract This article investigates how the identities of frontline professionals are (re)constructed in their talk about their everyday work activities. Based on a study of a mental health and addiction counselling service organization in Ontario, we illustrate that when talking about acting in accordance with their organizational policies, the social workers’ identities are disciplined by and appropriated from addressing the practices of documentation and regular meetings with their supervisors that constitute the routine processes of organizing. However, when discussing instances where they override the organizationally sanctioned rules, their identities are disciplined by the aspiration of fabricating a client-centred caregiver identity adopted from the dominant discourse in their profession. We, therefore, counterbalance the understanding that professionals’ identity work related to their deliberate micro-emancipation acts are merely an expression of agency and argue that their preferred resistant identities pertaining to their self-declared apparent deviation from the organizational order are also made within frameworks of disciplinary power. By delineating that both discursive conformity and resistance cut across the boundaries between acting in alignment with and against organizational guidelines, we unveil an underexplored complexity of conducting professional identity work associated with the interrelationships between practices of talk and action that has largely been overlooked in prior scholarship. We, therefore, offer an action-related analysis of discursive identity work that extends beyond the context of this study and informs future research.

DISCLOSURE OF MEDICAL RECORD INFORMATION TO GUARANTEE LEGAL ASPECTS OF CONFIDENTIALITY OF MEDICAL RECORDS IN TIRTAYASA PUSKESMAS

Background Medical Record according to Permenkes No.269/Menkes/Per/III/2008, Medical Record is a file that contains notes and documents about the patient's identity, examination results, treatment that has been given to the patient. Health facilities are responsible for protecting health information contained in medical records against possible loss, damage, falsification and unauthorized access. Maintaining information security, accuracy of information and ease of access to information are demands of health service organizations and health practitioners as well as authorized third parties. Meanwhile, parties who need information must always respect patient privacy. Overall, security, privacy, confidentiality and safety are devices that fortify information in medical records [1]. The purpose of this study was to determine the review of the release of medical record information in ensuring the legal aspects of the confidentiality of medical records at Kencana Hospital. Research method The research design used is descriptive research, which is a research method whose purpose is to present a complete picture of the social setting by describing a number of variables that are relevant to the problem and the unit under study among the phenomena being tested. This type of research is used to determine the process of providing medical record information and guaranteeing the legal aspects of medical record confidentiality at Kencana Hospital. The population in this study were all officers involved in the process of providing medical record information at Kencana Hospital which had 8 employees, which were divided into 3 medical record officers (1 head of medical records and 2 people served as distribution and retrieval officers), 2 people who handles related to insurance and 2 officers handles related to BPJS. In this study, the sample used was the party from the medical record unit, namely the medical record officer who has the authority in the process of providing patient medical information to a third party. The instruments used are Checklist Sheets and interview guidelines. In this study, the sampling used was purposive sampling technique because in sampling the authors considered certain things related to the research, The results of the research on StandardOperating Procedures related to providing patient medical information at the Kencana Hospital have an SOP. This SOP contains points for the process of releasing patient medical information, each point with a slightly different procedure depending on who the 3rd party is requesting. What is meant by 3rd parties here are patients, insurance companies, and legal institutions (courts). Each of these 3rd parties has made their respective procedures. The parties involved in the process of releasing patient medical information at Kencana Hospital are all medical record officers totaling15 people (8 officers in the filing section), (2 people in the distribution of medical record files), and (5 people in the registration section). The information released is in the form of a photocopy of a medical resume sheet. At Kencana Hospital, the only party who can decide on the release of patient medical information is the medical record officer. Kencana Hospital does not yet have special security related to the process of releasing patient medical information, but if a patient is represented in the process of requesting release of information, the representative must have a power of attorney from the patient concerned. If the request for release of information is not represented, the patient will be given a release approval form from the medical record unit. Suggestion It is better to make Standard Operating Procedures related to the Release of Patient Medical Information referring to the Regulation of the Minister of Health of the Republic of Indonesia Number 36 of 2012 concerning Medical Secrets and Guidelines for the Implementation and Procedures of Indonesian Hospital Medical Records issued by the Director General of Yanmed.

Driving innovation in health care: exploring the impact of ambidextrous leadership on creative performance among frontline health professionals in Norway

BackgroundIn recent years, there has been an increasing focus on enhancing frontline health professionals’ ability to think and act innovatively, also known as their creative performance. However, previous research has had two limitations. First, only a few leadership styles and their associations with this capability have been examined. Second, there has been a lack of research on identifying potential process mediators and examining their role in the relationship between leadership styles and the professionals’ capability. To address this knowledge gap, our study investigates the impact of ambidextrous leadership, a relatively new leadership style, on frontline health professionals’ creative performance. Additionally, we explore whether frontline health professionals’ learning orientation (an individual factor) and relationship learning (an organizational factor) act as process mediators in this association. No previous research has focused on these relationships. Thus, the study offers a unique contribution to health services research.MethodsThis is a cross-sectional study with a convenience sample of N = 258 health professionals in nine Norwegian municipalities. The results of this study were analyzed using PLS-SEM with SmartPLS 3 software. The study examined both direct and indirect relationships through bootstrapping.ResultsThe results reveal a positive link between health professionals’ creative performance and ambidextrous leadership \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ (\\beta $$\\end{document} = 0.224). Both relationship learning and learning orientation were found to operate as complementary process-mediating factors between health professionals’ creative performance and ambidextrous leadership. The strength of the two individual relationships that constitute the process-mediating factors indicates that ambidextrous leadership has a stronger impact on relationship learning than on learning orientation \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ (\\beta $$\\end{document} = 0.504 versus \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\beta $$\\end{document} = 0.276). However, when we examined the individual associations between the two factors and creative performance, the strength of the relationships was quite different. The findings reveal that learning orientation is significantly more positively associated with creative performance than relationship learning \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ (\\beta $$\\end{document} = 0.302 versus \\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$ \\beta $$\\end{document} = 0.163). Ambidextrous leadership, learning orientation, and relationship learning explain 26% (R2 = 0.262) of the variance in professionals’ creative performance.ConclusionsThis study suggests that ambidextrous leadership can facilitate health professionals’ creative performance directly and indirectly through the two process-mediating factors: relationship learning and learning orientation. Thus, a practical implication is the importance for health service organizations of clear awareness of the numerous advantages of having leaders who actively practice an ambidextrous leadership style.

Six ways to get a grip on patient and family centered care during the undergraduate medical years.

Patient and family-centered care and patient engagement practices have strong evidence-based links with quality and safety for both patients and health care providers. Expectations for patient and family-centered care have advanced beyond hearing the patient perspective and taking patient wishes into account. A participatory approach including patients as partners in their care journey is expected, but attitudes toward patient and family-centered care remain barriers in practice. As health service organizations shift from a system-centered approach to a patient and family-centered care delivery model, black ice occurs. In this Black Ice article, we present some practical tips for medical educators to improve opportunities for medical students to develop knowledge, attitudes, and skills that support patient and family-centered care.

Faktor yang berhubungan dengan Rujukan Pasien Peserta BPJS di Puskesmas Bangkala Kota Makassar Tahun 2023

The health service referral system is the organization of health services that regulates the delegation of duties and responsibilities of health services reciprocally both vertically and horizontally. The purpose of this study was to determine the factors related to patient referral participants (BPJS) at the Bangkala Health Center, Makassar City in 2023. . This type of research is a quantitative observational study using a cross sectional approach. The population in this study is the BPJS participant community who visited the Bangkala Health Center in Makassar City in the last month of 2022 with a total of 956 participants. The samples in this study were 282 samples. The sampling technique is using probability sampling method with accidental sampling technique. The results showed that there was no relationship with knowledge (p=0.873). Meanwhile, the variables significantly related to BPJS patient referrals were the availability of medicines (p=0.000) and the availability of medical devices (p=0.000). The conclusion from this study is that there is a relationship between the availability of medicines, the availability of medical devices and BPJS referrals. While the knowledge variable is not related to BPJS patient referrals.

The impact of reduced routine community mental healthcare on people from minority ethnic groups during the COVID-19 pandemic: qualitative study of stakeholder perspectives.

Enduring ethnic inequalities exist in mental healthcare. The COVID-19 pandemic has widened these. To explore stakeholder perspectives on how the COVID-19 pandemic has increased ethnic inequalities in mental healthcare. A qualitative interview study of four areas in England with 34 patients, 15 carers and 39 mental health professionals from National Health Service (NHS) and community organisations (July 2021 to July 2022). Framework analysis was used to develop a logic model of inter-relationships between pre-pandemic barriers and COVID-19 impacts. Impacts were largely similar across sites, with some small variations (e.g. positive service impacts of higher ethnic diversity in area 2). Pre-pandemic barriers at individual level included mistrust and thus avoidance of services and at a service level included the dominance of a monocultural model, leading to poor communication, disengagement and alienation. During the pandemic remote service delivery, closure of community organisations and media scapegoating exacerbated existing barriers by worsening alienation and communication barriers, fuelling prejudice and division, and increasing mistrust in services. Some minority ethnic patients reported positive developments, experiencing empowerment through self-determination and creative activities. During the COVID-19 pandemic some patients showed resilience and developed adaptations that could be nurtured by services. However, there has been a reduction in the availability of group-specific NHS and third-sector services in the community, exacerbating pre-existing barriers. As these developments are likely to have long-term consequences for minority ethnic groups' engagement with mental healthcare, they need to be addressed as a priority by the NHS and its partners.

The impact of leader member exchange quality and differentiation on counterproductive and citizenship behavior in health care teams.

Organizational citizenship behavior (OCB) may increase service quality. In contrast, counterproductive work behavior (CWB) may undermine patient safety. Efforts to increase OCB and reduce CWB rely on a good understanding of their antecedents, yet there is a lack of research in health care to inform such endeavors. The aim of this study was to investigate the role of leadership, specifically leader-member exchange (LMX), in reducing CWB and increasing OCB in health care teams. Team survey data were collected from 75 teams in U.S. health services organizations. Polynomial regression and response surface analysis was used to investigate our hypotheses. For OCB, the response surface along the line of incongruence (a3) was positive and significant, and for CWB, a3 was negative and significant. The results of polynomial regression and response surface analysis indicate that OCB increases when LMX quality is high and that LMX differentiation is comparatively lower. In contrast, CWB increases when LMX differentiation is high, whereas LMX quality is lower. These findings provide useful suggestions to promote valuable extra-role behaviors in health care teams. Health care team leaders should aim to develop strong exchange relationships with all members if they wish to increase citizenship behavior and decrease counterproductive behavior. Building positive exchange relationships with only a few team members is likely to undermine citizenship behavior and increase counterproductive behavior.

Outcomes in people with eating disorders: a transdiagnostic and disorder-specific systematic review, meta-analysis and multivariable meta-regression analysis.

Eating disorders (EDs) are known to be associated with high mortality and often chronic and severe course, but a recent comprehensive systematic review of their outcomes is currently missing. In the present systematic review and meta-analysis, we examined cohort studies and clinical trials published between 1980 and 2021 that reported, for DSM/ICD-defined EDs, overall ED outcomes (i.e., recovery, improvement and relapse, all-cause and ED-related hospitalization, and chronicity); the same outcomes related to purging, binge eating and body weight status; as well as mortality. We included 415 studies (N=88,372, mean age: 25.7±6.9 years, females: 72.4%, mean follow-up: 38.3±76.5 months), conducted in persons with anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), other specified feeding and eating disorders (OSFED), and/or mixed EDs, from all continents except Africa. In all EDs pooled together, overall recovery occurred in 46% of patients (95% CI: 44-49, n=283, mean follow-up: 44.9±62.8 months, no significant ED-group difference). The recovery rate was 42% at <2 years, 43% at 2 to <4 years, 54% at 4 to <6 years, 59% at 6 to <8 years, 64% at 8 to <10 years, and 67% at ≥10 years. Overall chronicity occurred in 25% of patients (95% CI: 23-29, n=170, mean follow-up: 59.3±71.2 months, no significant ED-group difference). The chronicity rate was 33% at <2 years, 40% at 2 to <4 years, 23% at 4 to <6 years, 25% at 6 to <8 years, 12% at 8 to <10 years, and 18% at ≥10 years. Mortality occurred in 0.4% of patients (95% CI: 0.2-0.7, n=214, mean follow-up: 72.2±117.7 months, no significant ED-group difference). Considering observational studies, the mortality rate was 5.2 deaths/1,000 person-years (95% CI: 4.4-6.1, n=167, mean follow-up: 88.7±120.5 months; significant difference among EDs: p<0.01, range: from 8.2 for mixed ED to 3.4 for BN). Hospitalization occurred in 26% of patients (95% CI: 18-36, n=18, mean follow-up: 43.2±41.6 months; significant difference among EDs: p<0.001, range: from 32% for AN to 4% for BN). Regarding diagnostic migration, 8% of patients with AN migrated to BN and 16% to OSFED; 2% of patients with BN migrated to AN, 5% to BED, and 19% to OSFED; 9% of patients with BED migrated to BN and 19% to OSFED; 7% of patients with OSFED migrated to AN and 10% to BN. Children/adolescents had more favorable outcomes across and within EDs than adults. Self-injurious behaviors were associated with lower recovery rates in pooled EDs. A higher socio-demographic index moderated lower recovery and higher chronicity in AN across countries. Specific treatments associated with higher recovery rates were family-based therapy, cognitive-behavioral therapy (CBT), psychodynamic therapy, and nutritional interventions for AN; self-help, CBT, dialectical behavioral therapy (DBT), psychodynamic therapy, nutritional and pharmacological treatments for BN; CBT, nutritional and pharmacological interventions, and DBT for BED; and CBT and psychodynamic therapy for OSFED. In AN, pharmacological treatment was associated with lower recovery, and waiting list with higher mortality. These results should inform future research, clinical practice and health service organization for persons with EDs.

Incidence of young-onset dementia in Italy: The Brescia register study.

The goal of the present work was to assess the incidence of dementia with onset before the age of 65 years (i.e., young-onset dementia [YOD]) and define the frequencies of young-onset Alzheimer's disease (AD), frontotemporal lobar degeneration (FTLD), and dementia with Lewy bodies (DLB) in the general population. The study was conducted from January 1, 2019 to December 31, 2019 in Brescia province (population: 1,268,455). During the study period, all new YOD cases (incident YOD) were counted, and all patients' records reviewed. The incidence was standardized to the Italian general population in 2019. A total of 29 YOD patients were diagnosed. The age-sex standardized incidence rate was 4.58 (95% confidence interval, 3.07-6.58) per 100,000 person-years. No difference in incidence rate between YOD due to AD or FTLD (P=0.83) and between sexes (P=0.81) was observed. YOD incidence increased with age, reaching its peak after 60 years. Presenting neurodegenerative YOD phenotypes encompasses both AD and FTLD. Improved knowledge on YOD epidemiology is essential to adequately plan and organize health services.

Assessment of Dementia in Minority Ethnic Groups in Scotland: Results of a Survey of Cognitive Specialists.

Minority ethnic groups (MEGs) in Europe receive suboptimal dementia evaluation, yet related research in Scotland is lacking. This research examined the evaluation of dementia in MEGs in Scotland and compared it with previous research to highlight the changes in the clinical evaluation of dementia over the decade. A self-administered survey was created online and emailed to 14 Heads of the boards under the Scottish National Health Service and dementia-associated settings and organizations. Most surveyed centers (85.6%) received MEG referrals. Although 92.9% of the centers used professional translators when needed, 85.7% thought assessing dementia in MEGs was difficult, mostly due to the suitability of test instruments and rating scales and patients' linguistic abilities. Very few found their skills to be good in evaluating MEGs. There was no mention of specialized dementia services for MEGs. The lack of culturally appropriate instruments and specialized dementia services reveals that the services are not ready to meet the demand for evaluating patients from diverse cultural and language backgrounds. Inadequate clinical evaluation may lead to misdiagnoses. Therefore, although significant work has been carried out in the past few years, improvements must be continued to enhance the current practices and apply suitable evaluation methods for MEGs.

ASPECTS REGARDING EFFICIENT PRACTICES IN MAINTAINING HEALTH STATUS

The paper is focused on individual experiences regarding the the realization of a strategy for monitoring medical assistance and preventing diseases, for the well-being of patients. Personal involvement in various procedures performed in a rural dental office led to the selection of the best options regarding the management of oral health problems and the follow-up of patients. The novelty of the material is found in the design of the research, which brings both theoretical and practical aspects by identifying the specific conditions to be addressed, individualizing the treatment and managing the patient in order to maintain the state of oral health and also a better quality of life. The purpose of the paper is to highlight the organization and quality of dental health services directly involved in improving the quality of life with reference to the ability of patients to perform their usual activities without physical and mental discomfort. An opinion questionnaire was used for a number of 200 patients who called for office consultations and who answered a predetermined set of questions. The results of the study lead to the idea that a beneficial balance of the state of healthcare and implicitly the quality of life mainly refers to the communication between the medical staff and the patient, the addressing pathology, the type of ailments and treatments, the satisfaction of the therapeutic act.

Towards an AI-Enhanced sustainable health system: inferences from healthcare management research

Health management literature is critical in facilitating effective leadership and management in the health sector by imparting the knowledge and understanding required in health service planning, organization, coordination, and management. Through an exhaustive bibliometric examination, the current state of the “healthcare management” literature was assessed in this study, illuminating potential future developments in the field. By utilizing an extensive compilation of articles from the Web of Science (WoS) database, this study endeavors to scrutinize patterns in scientific inquiry, assess advancements made on subjects, and underscore significant fields of cooperation and scholarly input. An in-depth, extensive analysis revealed that three decades of research yielded over 46,000 publications; the number of publications has increased by six, particularly in the last ten years, and the United States and the United Kingdom produced most of the publications. Analysis identifying influential journals and authors in the field revealed that it is the focus of attention of health professionals, especially nurses. Although the COVID-19 pandemic has been recognized as the primary public health concern, scholarly attention has shifted towards a sustainable health system incorporating technology-supported preventive health practices and intelligence. To thoroughly comprehend the theoretical progression of health management research, its capacity to tackle worldwide issues, and its growth potential, the study’s findings are a valuable scholarly resource that offers practitioners, policymakers, and researchers a comprehensive overview.