Relevant bibliographies by topics / Health services and systems not elsewhere classified

Academic literature on the topic 'Health services and systems not elsewhere classified'

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Published: 10 December 2022
Last updated: 22 April 2024

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Journal articles on the topic "Health services and systems not elsewhere classified"

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Bowen, Michael E., Deepa Bhat, Jason Fish, Brett Moran, Temple Howell-Stampley, Lynne Kirk, Stephen D. Persell, and Ethan A. Halm. "Improving Performance on Preventive Health Quality Measures Using Clinical Decision Support to Capture Care Done Elsewhere and Patient Exceptions." American Journal of Medical Quality 33, no. 3 (October 14, 2017): 237–45. http://dx.doi.org/10.1177/1062860617732830.

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Preventive services required for performance measurement often are completed in outside health systems and not captured in electronic medical records (EMRs). A before–after study was conducted to examine the ability of clinical decision support (CDS) to improve performance on preventive quality measures, capture clinician-reported services completed elsewhere, and patient/medical exceptions and to describe their impact on quality measurement. CDS improved performance on colorectal cancer screening, osteoporosis screening, and pneumococcal vaccination measures ( P < .05) but not breast or cervical cancer screening. CDS captured clinician-reported services completed elsewhere (2% to 10%) and patient/medical exceptions (<3%). Compared to measures using only within-system data, including services completed elsewhere in the numerator improved performance: pneumococcal vaccine (73% vs 82%); breast (69% vs 75%), colorectal (58% vs 70%), and cervical cancer (53% vs 62%); and osteoporosis (72% vs 75%) screening ( P < .05). Visit-based CDS can capture clinician-reported preventive services, and accounting for services completed elsewhere improves performance on quality measures.
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Starfield, Barbara. "The Future of Primary Care in a Managed Care Era." International Journal of Health Services 27, no. 4 (October 1997): 687–96. http://dx.doi.org/10.2190/fl2w-eljx-l54v-tykh.

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Health care reform in the United States and elsewhere raises many questions about equity and effectiveness of health services. Although the impetus has been cost containment, the reforms have often been justified on the grounds that they will enhance primary care. In this article, health care reform efforts are divided into two types: market-driven, demand-based systems versus systems predicated on meeting population health needs. The two “scenarios” are contrasted with regard to their likely impact on the attainment of primary care characteristics: first-contact care, longitudinality, comprehensive services, and coordination. Since the ultimate outcome of these reforms cannot be predicted, there is compelling need for evaluating them as they proceed.
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Halford, W. Kim. "Behaviour Therapy and Schizophrenia in Context: Challenges and Opportunities Provided within the Changing Mental Health System." Behaviour Change 12, no. 1 (March 1995): 41–50. http://dx.doi.org/10.1017/s081348390000437x.

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Research reported in the last two issues of Behaviour Change, and elsewhere, shows that cognitive behaviour therapy significantly improves a number of the problems suffered by people with schizophrenia. However, behaviour therapy alone does not constitute adequate care of schizophrenia, and inadequate mental health services undermine the effective implementation of behaviour therapy, in Australia, mental health services for people with severe psychiatric disorders such as schizophrenia are grossly inadequate, but are planned to change substantially in the late 1990s. Changes include a significant shift in resources toward community-based care, expansion of the range of treatment and rehabilitation services available, and increased integration of service provision across government and nongovernment sectors. These planned changes present a challenge to those interested in behaviour therapy to go beyond narrowly focused interventions to develop effective systems of rehabilitation.
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Bissell, Richard A., and Jean Conover. "International Emergency Health Care Systems Survey." Prehospital and Disaster Medicine 6, no. 2 (June 1991): 149–58. http://dx.doi.org/10.1017/s1049023x00028272.

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AbstractMedical emergencies occur in every country regardless of its level of socio-economic development. Little comparative data are available which define the characteristics of the system by which some emergencies are managed. Without such comparisons, it is difficult for countries to establish appropriate priorities within their geographic, cultural, and economic constraints. In an effort to gather some of these needed data, a survey was distributed to the participants in an International Conference on Emergency Health Care (EHC) Development convened in Washington, D. C, in August 1989. Each country participating was classified as Industrialized (INDUS), Developing (DC), or Least Developed (LDC) in accordance with World Health Organization definitions. Responses are expressed as proportion of total participants.There were 450 participants from 74 countries. Only 17% of the surveys were returned. The sample included 78 participants from 40 (57%) countries. (INDUS: 30%; DC: 48%; LDC: 22%). All showed considerable dependence on ambulance services, but DC and LDC indicated substantial reliance on friends, neighbors, community health workers, and physician's offices. Prehospital EHC services were available to 93% of INDUS, 63% of DC, and possibly one-third of the LDC. Emergency Health Care is taken to the patients in the same proportions as noted above. The types of manpower dispatched varied widely with a great proportion of the respondents from DC and LDC indicating that care was delivered by non-professionally trained individuals. Interestingly, INDUS had the greatest proportion of volunteers. Response and transport times were shorter for INDUS than for DC. When no prehospital EHC services were available, patients reached the receiving facilities by alternate means such as walking (33%), private automobile (48%), or public transportation (33%). Central emergency access was available for 80%. Considerable variation exists as to the mechanisms by which such services are financed: poorer countries depend more on government support than do INDUS who rely heavily on donations and fee-for-service. Lastly, regardless of level of economic development, cardiovascular disease, trauma, and medical illness comprise the most important reasons for accessing the EHC systems.This preliminary study points to the need for individualizing EHC systems in concert with the priorities of the country for which they are designed. Direct application of operational systems across countries does not seem an appropriate mechanism for the development of EHC. However, the delivery of EHC must be made an important element of overall health care in all the countries of the world.
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Van Teijlingen, Edwin, Cecilia Benoit, Ivy Bourgeault, Raymond DeVries, Jane Sandall, and Sirpa Wrede. "Learning from health care in other countries: the prospect of comparative research." Health Prospect 14, no. 1 (July 23, 2015): 8–12. http://dx.doi.org/10.3126/hprospect.v14i1.13036.

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It is widely accepted that policy-makers (in Nepal and elsewhere) can learn valuable lessons from the way other countries run their health and social services. We highlight some of the specific contributions the discipline of sociology can make to cross-national comparative research in the public health field. Sociologists call attention to often unnoticed social and cultural factors that influence the way national reproductive health care systems are created and operated. In this paper we address questions such as: ‘Why do these health services appear to be operating successfully in one country, but not another?’; ‘What is it in one country that makes a particular public health intervention successful and how is the cultural context different in a neighbouring country?’ The key examples in this paper focus on maternity care and sex education in the Netherlands and the UK, as examples to highlight the power of cross-national research. Our key messages are: a) Cross-national comparative research can help us to understand the design and running of health services in one country, say Nepal, by learning from a comparison with other countries, for example Sri Lanka or India. b) Cultural factors unique to a country affect the way that reproductive health care systems operate. c) Therefore,we need to understand why and how services work in a certain cultural context before we start trying to implement them in another cultural context.
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Fountoulakis, Konstantinos N. "The Contemporary Face of Bipolar Illness: Complex Diagnostic and Therapeutic Challenges." CNS Spectrums 13, no. 9 (September 2008): 763–79. http://dx.doi.org/10.1017/s1092852900013894.

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AbstractManic depression, or bipolar disorder, is a multifaceted illness with an inevitably complex treatment. The current article summarizes the current status of our knowledge and practice concerning its diagnosis and treatment. While the prototypic clinical picture concerns the “classic” bipolar disorder, today mixed episodes with incomplete recovery and significant psychosocial impairment are more frequent. The clinical picture of these mixed episodes is variable, eludes contemporary classification systems, and possibly includes a constellation of mental syndromes currently classified elsewhere. Treatment includes the careful combination of lithium, antiepileptics, atypical antipsychotics, and antidepressants, but not all of the agents in these broad categories are effective for the treatment of bipolar disorder.
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Campion, Thomas R., Evan T. Sholle, Jyotishman Pathak, Stephen B. Johnson, John P. Leonard, and Curtis L. Cole. "An architecture for research computing in health to support clinical and translational investigators with electronic patient data." Journal of the American Medical Informatics Association 29, no. 4 (November 30, 2021): 677–85. http://dx.doi.org/10.1093/jamia/ocab266.

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Abstract Objective Obtaining electronic patient data, especially from electronic health record (EHR) systems, for clinical and translational research is difficult. Multiple research informatics systems exist but navigating the numerous applications can be challenging for scientists. This article describes Architecture for Research Computing in Health (ARCH), our institution’s approach for matching investigators with tools and services for obtaining electronic patient data. Materials and Methods Supporting the spectrum of studies from populations to individuals, ARCH delivers a breadth of scientific functions—including but not limited to cohort discovery, electronic data capture, and multi-institutional data sharing—that manifest in specific systems—such as i2b2, REDCap, and PCORnet. Through a consultative process, ARCH staff align investigators with tools with respect to study design, data sources, and cost. Although most ARCH services are available free of charge, advanced engagements require fee for service. Results Since 2016 at Weill Cornell Medicine, ARCH has supported over 1200 unique investigators through more than 4177 consultations. Notably, ARCH infrastructure enabled critical coronavirus disease 2019 response activities for research and patient care. Discussion ARCH has provided a technical, regulatory, financial, and educational framework to support the biomedical research enterprise with electronic patient data. Collaboration among informaticians, biostatisticians, and clinicians has been critical to rapid generation and analysis of EHR data. Conclusion A suite of tools and services, ARCH helps match investigators with informatics systems to reduce time to science. ARCH has facilitated research at Weill Cornell Medicine and may provide a model for informatics and research leaders to support scientists elsewhere.
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Sices, Laura, Jeffrey S. Harman, and Kelly J. Kelleher. "Health-Care Use and Expenditures for Children in Special Education with Special Health-Care Needs: Is Dual Classification a Marker for High Use?" Public Health Reports 122, no. 4 (July 2007): 531–40. http://dx.doi.org/10.1177/003335490712200415.

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Objectives. Children with special health-care needs are an important group for policy and research planning. Special education engages a group of children with increased utilization of services related to education. While increased service utilization in education or health-care settings is often used to classify children as having special needs, considerable heterogeneity exists within each group. The extent to which being identified in two functionally defined systems—special education and health care—relates to health-care utilization is unknown. We sought to determine health-care and mental health utilization and expenditures for children dually classified as receiving special education and having special health-care needs (SHCN) compared with those who only have SHCN, only are in special education, or don't fall into either category. Methods. A nationally representative sample of children aged 5–17 years from the Medical Expenditure Panel Survey was used to compare mean health-care and mental health utilization and expenditures for the four groups. Results. Dually classified children had significantly higher mean utilization of health-care services than the other three groups ( p,0.05). Mean 12-month total health-care expenditures were highest for dually classified children ($3,891/year) ( p,0.05) and higher for children classified only as having SHCN ($1,426/year) than for children with neither classification ($644/year, p,0.05). Conclusions. Children dually classified as receiving special education and having SHCN represent a subgroup of children with SHCN with high levels of health-care utilization and expenditures. This information can assist policy makers in identifying characteristics that place children at risk for very high expenditures, and in allocating health-care resources.
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Worthington, Andrew, Lee Edwards, and Lauren Joiner. "Homelessness and head injury: Health, wellbeing and social integration in referrals to a neurocase management service." Neuropsychologist 1, no. 9 (April 2020): 47–54. http://dx.doi.org/10.53841/bpsneur.2020.1.9.47.

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This paper describes the setting up of a pilot community neurocase management service for homeless adults with a brain injury. Whilst homelessness is a major problem in the UK and elsewhere, to date few brain injury or homelessness services have considered the complex medical, psychological and social factors affecting this population specifically. Investment of resources in service provision should be based upon evidence of the presenting needs and best practice in meeting these. This paper addresses the first of these two requirements, focusing on the initial cohort referred into our service. More detail about the interventions received and outcomes achieved, along with a discussion of the challenges encountered in providing the service will be provided in a follow-up paper. The need for psychologically-informed services to promote social inclusion is supported by our data which revealed concerning levels of community estrangement. Our data also confirm that homelessness often occurs in the context of multiple comorbidities which traverse conventional boundaries across medical, social care and criminal justice systems, meaning that collaborative working is essential. The argument for neuropsychological input in designing and delivering support alongside other services is clear.
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Dutt, Priyanka, Anna Godfrey, Sara Chamberlain, and Radharani Mitra. "Using behavioural design and theories of change to integrate communication solutions into health systems in India: evolution, evidence and learnings from practice." Integrated Healthcare Journal 4, no. 1 (December 2022): e000139. http://dx.doi.org/10.1136/ihj-2022-000139.

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Between 2011 and 2019, an integrated communication programme to address reproductive, maternal, neonatal and child health was implemented in the Indian state of Bihar. Along with mass media, community events and listening groups, four mobile health services were co-designed with the government of Bihar. These wereMobile Academy—a training course for frontline health workers (FLHWs) supporting them as the last mile of the health system;Mobile Kunji—a job aid to support FLHWs’ interactions with families;Kilkari—a maternal messaging service delivering information directly to families’ mobile phones, encouraging families to seek public health services through their FLHWs; andGupShup Potli—mobile audio stimulus used by FLHWs in community events. WhileMobile KunjiandGupShup Potliscaled to other states (two and one, respectively), neither was adopted nationally. The Government of India adoptedKilkariandMobile Academyand scaled to 12 additional states by 2019. In this article, we describe the programme’s overarching person-centred theory of change, reflect on how the mHealth services supported integration with the health system and discuss implications for the role of health communication solutions in supporting families to navigate healthcare systems. Evaluations ofKunji, AcademyandGupShup Potliwere conducted in Bihar between 2013 and 2017. Between 2018-2020, an independent evaluation was conducted involving a randomised controlled trial forKilkariin Madhya Pradesh; qualitative research onKilkariandAcademyand secondary analyses of call record data. While the findings from these evaluations are described elsewhere, this article collates key findings for all the services and offers implications for the role digital and non-digital communication solutions can play in supporting joined-up healthcare and improving health outcomes.
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Dissertations / Theses on the topic "Health services and systems not elsewhere classified"

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Kane, Ros. "Providing sexual health services in England : meeting the needs of young people." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2005. http://eprints.lincoln.ac.uk/11992/.

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There is an on-going debate among health professionals, policy-makers and politicians, as to the optimal way of delivering sexual health services to young people. There is as yet, no consensus on their best patterns of organisation or configuration. This study uses qualitative and quantitative research methods, to explore both the views of young people accessing sexual health services, expressed through in-depth interview, and variations in client satisfaction with different characteristics of service delivery, expressed through completion of a questionnaire. The key research questions are:  How does young people’s satisfaction with sexual health services vary with the age-dedication of the service; that is, whether it serves young people only, or all ages?  How does young people’s satisfaction with sexual health services vary with the integration of the service; that is, whether family planning and genito-urinary services are offered separately, or together?  How does young people’s satisfaction with sexual health services vary with the location of the service; that is, in community or hospital based services? In the qualitative component, in-depth interviews were conducted with 25 young people recruited from a purposively selected sample of young people’s services. In the survey, a total sample of 1166 was achieved. Of these, 36% were attending an integrated contraceptive and STI service and 64% were attending a more traditional ‘separate’ service. 48% attended a service dedicated to young people and 52% an all-age service. 50% attended a hospital-based service and 50% a service located in the community. Of the total sample, 22% were male and 78% female. The analysis has been done not on a comparison of services in their entirety, but on a comparison of key features of their organisation, that is, whether they are provided separately as contraceptive and STI sessions or services, or whether these aspects of sexual health provision are integrated in sessions or services (integration); on whether they are run exclusively for young people or for all ages (dedication); and on whether they are located in the community or in a hospital setting (location). Recommendations are made for future service development and delivery and implications for policy are discussed.
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Quynh, L. "Evaluation of E-Health." Thesis, Honours thesis, University of Tasmania, 2007. https://eprints.utas.edu.au/1414/1/evaluation-ehealth.pdf.

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The aims of this paper are to: 1)-Introduce current evaluation framework; 2)- Explore methods/tools used in E-Health evaluation; 3)- Identify research methods/tools used in E-Health evaluation; and 4)- Develop an evaluation plan for a systemic E-Health initiative.
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Davy, Carol. "Primary health care: knowledge development and application in Papua New Guinea." 2009. http://arrow.unisa.edu.au/vital/access/manager/Repository/unisa:38312.

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Research into the use of information by health care professionals has generally been conducted in countries dominated by the biomedical model. In these contexts, illness is considered to have a scientifically identifiable physical cause, and treatment practices within the formal health care sector are prescribed and managed in accordance with this definition. Yet there are also contexts where other belief systems inform and guide the way that people think about their health. In comparison to the biomedical model, these contexts have contributed very little to our understanding of how health professionals develop their knowledge. This research investigates how primary health care workers (PHCWs) in one such context, Papua New Guinea (PNG), develop their knowledge about the health services they provide. In order to discover and understand the differing views of these PHCWs, 69 semi-structured interviews were conducted in three culturally and geographically diverse regions of PNG. In explaining the diagnostic and treatment practices they use, these participants provided insights into not only how PHCWs engage with information but also how it informs their professional practice. These data were analysed, interpreted and discussed using a framework consisting of four, primary but interconnecting aspects: the context in which information was provided, the interactions with the sources of information, the processes by which information was understood, and the outcomes realized as a result of the information being used. Findings indicated that the majority of participants in this study acknowledged, if not incorporated, information pertaining to biomedicine, Christianity and Indigenous belief systems into their diagnostic and treatment practices. Even when these belief systems clearly contradicted each other, PHCWs did not in general feel the need to make a conscious choice between them. From their comments it would appear that four factors contributed to this ability to incorporate diverse and often conflicting ideas into the way that patients were cared for. First, all of the belief systems were considered legitimate by at least one group of people connected to the community in which the PHCW worked. Second, although varying in degrees of availability and accessibility, members of these groups were able to disseminate information pertaining to the belief system they supported. Third, the PHCW had no particular affiliation with any one of these groups but instead regularly interacted with a range of different people. Lastly, the PHCW worked in situations where health practices were not generally well supervised by their employers and therefore they were relatively free to choose between various diagnostic and treatment practices. The qualitative interpretive approach adopted in this thesis contributes to the field of human information behavior by affirming that conflict is in the eye of the beholder. When a number of belief systems coexist and all are considered legitimate, information about them is freely available, and the recipients actions are neither constrained by their own dogma, nor imposed upon by others, individuals may quite comfortably embrace diverse beliefs. These findings may also contribute to a better understanding of health management practices in developing countries by suggesting that health professionals are not merely personifications of a biomedical model. Instead, the study demonstrates that multiple belief systems can be combined by PHCWs, and that in turn this benefits the formal health care sector through increased treatment options that are both appropriate and effective in such circumstances.
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(9809054), Raghavendra Kankanady. "Information economics: The disconnect between information communication technology and strategic intent." Thesis, 2020. https://figshare.com/articles/thesis/Information_economics_The_disconnect_between_information_communication_technology_and_strategic_intent/13416416.

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The dynamic nature and rapid evolution of Information and Communications Technology (ICT) in the last decade (which is also referred to as the digital revolution or industrial revolution 4.0) has given little time for organisations to evaluate the nature of the technological change to their business. This research project aims to identify if there is a disconnection between organisational strategic intent and ICT use, such as, analyze ICT adoption and use issues from various perspectives concerning digital evolution, strategic outcomes and long-term objectives of the organisation, and report findings. The study also aims to identify the alignment factors for technology use with strategic intent. In today's digital age, the healthcare industry has been undergoing a transformational change in patient care pathways and patient safety with the help of digital technologies. Digital technologies such as electronic medical records, mobile applications, telehealth, assisted diagnosis, and prevention have been changing the ways healthcare services are being delivered to patients. But little success has been achieved in implementing these transformations due to the complexity of ICT requirements in healthcare. This challenge in achieving successful digital transformation has given rise to a knowledge gap requiring further research. Until now, a review of the literature reveals few studies have been undertaken to understand connections and disconnections between strategic intent and technology use in healthcare. Therefore, this study aims to understand if there is a disconnect between organisational strategic intent and technology used in the digital age. The primary audience for this research is senior policy and decision-makers in healthcare and senior ICT staff. This research is designed to understand the technology use and its impact on organisational strategic intent from the perspective of clinical staff, non-clinical staff, and executive management. The multi-stage mixed-method design has been used in this study. The findings indicate that technology should be part of strategic intent, and technology adoption should flow from the edge inwards. The findings will enhance the delivery of digital transformation initiatives in healthcare and enable more successful digital transformations with lesser technology adoption, and use issues.
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(12873187), Mee Yong Ho. "The study of Queensland nurses' attitude and behaviour towards computerisation in the workplace." Thesis, 2004. https://figshare.com/articles/thesis/The_study_of_Queensland_nurses_attitude_and_behaviour_towards_computerisation_in_the_workplace/20069591.

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The purpose of this thesis is to analyse the attitude, intention and behaviour of Queensland nurses towards computerisation in their workplace using quantitative and qualitative survey methods. It also identifies possible mediators and moderators of this relationship using the Theory of Reasoned Action in a path model. Other moderating variables such as age group, previous computing experience, computing ability, computer usage, educational levels and gender were used in this study.

The Theory of Reasoned Action is used by Fishbein and Ajzen to predict volitional behaviour and to assist in understanding psychological determinants. One thousand questionnaires were distributed to registered nurses in Queensland and 330 (33%) valid responses were received. A qualitative telephone survey (n = 40) was also employed to validate the quantitative survey. The results of this study found that positive attitudes were found to influence the intention of nurses to use computers in the workplace.

Although normative beliefs and motivation to comply were found to have a direct influence on subjective norm, subjective norm was not found to be significantly associated with one's intention to perform the behaviour. However, a positive outcome evaluation and behavioural beliefs were found to be directly associated with one's behaviour which were mediated through positive attitudes. It was also demonstrated that all positive intentions produced positive behaviour (action of using computers at work).

The study demonstrated the positive effect of prior computing experiences before starting nursing and the effect of high computer usage frequency on one's intention. An inverse effect was demonstrated between nurses who had good experiences with computer and their intention to use computer. In addition, the study found that older, less educated female nurses demonstrated a higher intention to use computers in the workplace. The qualitative study also supported the quantitative study. The qualitative study provided the researcher with reasoning as to why nurses behave a certain way towards computerisation in the workplace. It was used as a reasoning tool to confirm some of the respondents' actions.

This research has its own limitations. It was conducted in late 1999 and computerisation has since then penetrated Australian hospitals to a greater extent than ever before. In addition, the survey tool could also be tested for its construct and criterion related validity. This would improve the sensitivity of the survey tool. Notwithstanding that, the results from this study would significantly benefit management in the identification of groups of nurses who are likely to resist the computerisation process in the workplace.

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(9815639), Lydia Mainey. ""Doing the wrong thing for the right reason" Australian nurses' and midwives' experience of providing abortion care to people victimised by gender-based violence." Thesis, 2022. https://figshare.com/articles/thesis/_Doing_the_wrong_thing_for_the_right_reason_Australian_nurses_and_midwives_experience_of_providing_abortion_care_to_people_victimised_by_gender-based_violence/22273498.

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When a pregnancy-capable person is assaulted, abused, or killed, it is usually at the hands of a male partner or family member. Fatal and non-fatal injuries, chronic health conditions and risky behaviours are all outcomes of gender-based violence (GBV); furthermore, GBV can often lead to unplanned pregnancies. Abortion is, therefore, a predictable outcome for this population. Nurses and midwives are intrinsically involved in the care of pregnant people victimised by GBV. They could be instrumental in providing reproductive justice outcomes such as early intervention, support, and coordination of support services. However, limited research exists to explain how this occurs within abortion care. Effective GBV responses often require a multiagency approach; therefore, services across a range of Australian sectors such as health, women’s safety, and law enforcement could benefit from understanding how nurses and midwives provide abortion care to people victimised by GBV. To address this gap, I aimed to 1) explain the process through which Australian nurses and midwives provide abortion care to people victimised by GBV and 2) explore how the elements of the broader healthcare situation affect the provision of abortion care to people victimised by GBV. I approached the research with a third-wave feminist lens, designing a two-phased multiple methods study combining constructivist grounded theory and situational analysis—such an approach located research participants’ actions in the larger social and power contexts. To assist readers in understanding the scope of the research topic, I commenced the thesis with a scoping literature review of the role and scope of nurses and midwives in the provision of abortion care. The review demonstrates that abortion care is a common procedure performed across many healthcare settings and shows that nurses and midwives provide technical and psychosocial care within their roles. However, the review also highlights that the scope of practice of nurses and midwives within abortion care is probably unnecessarily restrictive. Notably (and foreshadowing the findings of this thesis study), it exposes a lack of person-centred models of abortion care. My research reveals that the Australian abortion arena is expansive and contains multiple sites of power and contested action, which contributed to the research participants’ belief that people seeking abortions in the context of GBV were mostly uncatered for. Participants described a workforce unprepared to provide abortion care generally, or a GBV safety-net more specifically. Pro-life colleagues were seen to centre conscientious objection over patient care, and the workplace environment placed clinicians’ and patients’ safety at risk. Consequently, participants underwent a process I labelled working with or against the system contingent on the degree to which the system was person-centred. When participants encountered barriers to person-centred abortion care, they bent or broke the law, local policy, and cultural norms to facilitate timely holistic care. Though many participants felt professionally compromised, their resolve to continue working against the system continued. They were aided by larger social groups – Smugglers, Navigators, Marie Stopes Australia, and the Family Safety Framework – which came together to resist systemic oppression in an attempt to achieve reproductive/social justice. I used the theoretical conceptualisation of resistance in health and healthcare to unify the findings of the thesis project. My thesis findings support a cultural shift and reorientation of health services to support reproductive justice. First and foremost, my findings support the involvement of nurses and midwives in the creation of healthcare policy, programming, and legislation. This includes their involvement in pro-choice hiring policies, design and facilitation of GBV and abortion care training, and the implementation and evaluation of comprehensive abortion care frameworks, that cater for diversity and offer trauma-informed and flexible care. Furthermore, expanding the scope of nurses and midwives to provide medical abortion, particularly in primary care, would address the current service gap, which compels these clinicians to undermine the current system. Many of these changes could be achieved if health services adopted the World Health Organisation’s technical and policy guidelines for abortion care. However, this will require amendments to regulatory structures, funding models and relaxation of prescribing and abortion procurement restrictions. My findings also highlight a dual loyalty issue between the Nursing and Midwifery Board of Australia’s (NMBA) requirement for clinicians to provide person-centred care and comply with legislation, regulations, policies, and guidelines. A key recommendation is that the NMBA reconsider their position where such complicity would lead to human/reproductive rights violations. This thesis has made a significant contribution to the body of knowledge concerning abortion care of marginalised people. Looking forward, the thesis findings and recommendations could be implemented at the practice level and beyond to improve reproductive justice outcomes for people in Australia.
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(8799200), Jessica L. Ma. "Hemodynamic and Geometric Changes of the Female Reproductive System in Health and Disease." Thesis, 2020.

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Preterm birth is the leading cause of newborn mortality, with 15 million babies born premature worldwide every year. Children that do survive early delivery are more likely to develop cognitive abnormalities, motor deficits, heart disease, cerebral palsy, and more. While little is known about the pathophysiology of preterm birth, several pregnancy-related complications are related to preterm birth, namely cervical insufficiency and preeclampsia. In the former, premature cervical remodeling and softening can result in the shortening of the cervix, increasing a woman’s risk of preterm birth; this condition is called cervical insufficiency (CI), which is the inability of the cervix to remain closed as a result of weakened tissues. CI is currently measured by a one-dimensional sonographic cervical length, where < 25 mm indicates shortening. Preeclampsia is a disorder that can be explained through the Page kidney phenomenon: compression of the left renal vein (LRV) causes renal venous outflow obstruction, leading to elevated intrarenal pressure and hypertension. The supine pressor test (SPT) is a diagnostic tool for preeclampsia where a positive test is defined by an increase of 20 mmHg in diastolic blood pressure (BP) when shifting from the left lateral recumbent to the supine position. Due to the intense risk of morbidity and mortality for both the mother and the fetus, the need to monitor BP changes is critical. Currently, there is an unmet clinical need to characterize the hemodynamic and geometric properties of the female reproductive organs throughout gestation. Utilizing ultrasound imaging can increase our knowledge about the 3D anatomy and systemic changes during pregnancy, unravel risk factors, establish preventative methods, and standardize treatment plans. In this thesis research, we developed a murine model to 1) examine the pathophysiology of renal vein stenosis, and 2) investigate the effects of stenosis on various cervical dimensions. Renal vein stenosis was found to greatly impact blood flow velocities, as well as cervical width (p<0.05). LRV and cervical area and height also trend towards significance, and there is negative damage to the left kidney and placentae within the stenosed cohort. We also conducted a human study that showed reduced change in postural BP in patients with higher body mass index (BMI). Systolic and diastolic BP in the supine position was significantly greater than in the lateral position for all BMIs with a baseline increase in BP of approximately 9-14 mmHg. These findings suggest that therapeutic positioning and close monitoring of BP could mitigate the risk of developing related disorders in pregnancy.

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(6623699), Juan Carlos Orozco. "Analysis of Energy Efficiency in Truck-Drone “Last Mile” Delivery Systems." Thesis, 2019.

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Truck-drone delivery systems have the potential to improve how the logistics industry approaches the “last mile problem”. For the purposes of this study, the “last mile” refers to the portion of the journey between the last transportation hub and the individual customer that will consume the product. Drones can deliver packages directly, without the need for an underlying transportation network but are limited by their range and payload capacity. Studies have developed multiple truck-drone configurations, each with different approaches to leverage the benefits and mitigate the limitations of drones. Existing research has also established the drone’s reduction to package delivery time over the traditional truck only model. Two key model factors that have not been considered in previous research are the distribution of package demand, and the distribution of package weight. This study analyzes the drone’s impact to the energy efficiency of a package delivery system, which has taken a backseat to minimizing delivery time. Demand distribution dictates the travel distances required for package delivery, as well as the proportion of delivery locations that are in range for drone delivery. Package weight determines the energy consumption of a delivery and further restricts the proportion of drone eligible packages. The major contributions of this study are the development of a truck-drone tandem mathematical model which minimizes energy consumption, the construction of a population-based package demand distribution, a realistic package weight distribution, and a genetic algorithm used to solve the mathematical model developed for problems that are too computationally expensive to be solved optimally using an exact method. Results show that drones can only have a significant impact to energy efficiency in package delivery systems if implemented under the right conditions. Using truck-drone tandem systems in areas with lower package demand density affords the drone the potential for larger energy savings as larger portions of the truck distance can be replaced. Further, the lower density translates to greater differences between the road-restricted driving distance and the flying distance between delivery points. Finally, energy savings are highly dependent on the underlying package weight distribution of the system. A heavier average package weight increases the energy consumption of the system, but more importantly the portion of packages above the drone’s payload capacity severely limit the savings afforded by the incorporation of drones.


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(9183161), Sariya Udayachalerm. "Opioid Prescribing and Health Outcomes in Opioid Naive Patients in Indiana: Analysis of A Statewide Health Information Exchange Database." Thesis, 2020.

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Widespread use of prescription opioids has been a major public health concern since 1999. Many consequences are associated with the problem, such as opioid misuse, abuse, and drug overdose deaths. Opioids are not the only medications involved with drug overdose deaths. Due to stricter control of prescription opioids, those who misused opioids are associated with initiation of another illicit drug abuse. This results in increased drug overdose death involving heroin and semisynthetic/synthetic opioids. Another risk factor for increased overdose death is concurrent use of opioids with other central nervous system (CNS) depressants and some anticonvulsants. Concurrent use of opioids and benzodiazepine, z-drugs (zolpidem and zaleplon), gabapentin, and/or pregabalin is associated with increased risk of respiratory depression and drug overdose death. To combat problematic opioid use, many mitigation strategies were introduced. However, opioid-related problems remain.

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Collins, MB. "Competency to practice in pharmacy - development and evaluation of a self-assessment tool." Thesis, 2007. https://eprints.utas.edu.au/5001/1/Competency_in_pharmacy_practice_thesis_Sept_2007.pdf.

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Competency to practise has become an essential part of a health professional’s lifelong journey. It is defined in many ways to encompass the intellectual and experiential elements of training along with a person’s efforts to keep up-to-date. Many would describe competency as ‘fit for purpose’ to do the job, ensuring that the public are protected and given the professional service that meets their expectation. One of the conundrums of the regulators of pharmacy practice is how the competency of pharmacists can be measured and monitored to fulfil their statutory obligations to the public. Many agree that the best way of determining competency would be to observe people in their day-to-day practice. However, this would be a prohibitively costly exercise. This thesis originated from the question of how competency could be assessed in a form that would give regulators confidence and that was cost effective. Most assessment methods used are de facto methods of measurement. However, regulators need to have confidence that the assessments are able to accurately measure the standard of a person’s professional practice.
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Books on the topic "Health services and systems not elsewhere classified"

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Omaswa, Francis, and Nigel Crisp. Introduction to Part 4: Making the best use of all the talents. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780198703327.003.0011.

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Chapter 11 discusses the greatest shortage in Africa—skilled health workers. It provides the background in terms of numbers, distribution, and migration of health workers, and goes on to describe some of the imaginative solutions that health leaders in Africa and elsewhere have developed to tackle these shortages. It sets the scene for the following chapters in which African health leaders describe how they have dealt with these issues, whilst developing services and professional education in tandem. It concludes with a short chapter on Indigenous Knowledge Systems.
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Mitchell, Stuart, Marc Sampson, and Anthony Bateman, eds. Structured Clinical Management (SCM) for Personality Disorder. Oxford University Press, 2021. http://dx.doi.org/10.1093/med-psych/9780198851523.001.0001.

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The original manual for structured clinical management (SCM) was first published 8 years ago. Since then, there have been changes in classification, understanding, and treatment of borderline personality disorder (BPD). In parallel to these changes, generalist treatments for BPD such as SCM have been fully implemented in many organizations across the United Kingdom, Europe, and elsewhere. However, implementation of treatments and treatment approaches in clinical services are fraught with difficulties and clinical leads, operational managers, and practitioners alike grapple with how to implement SCM across complex mental health systems. The aim of this book is to provide guidance on how clinical teams, services, and organizations may implement SCM in clinical services. A range of clinical experts, researchers, service users, carers, and practitioners of SCM have contributed chapters from across the United Kingdom and Europe. Each chapter outlines a core aspect of the SCM model or its adaptation and delivery in clinical services. Key principles are highlighted in each chapter with clinical examples of application.
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Book chapters on the topic "Health services and systems not elsewhere classified"

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Masaud-Wahaishi, AbdulMutalib, and Hamada Ghenniwa. "Privacy-Based Multiagent Brokering Architecture for Ubiquitous Healthcare Systems." In Ubiquitous Health and Medical Informatics, 296–328. IGI Global, 2010. http://dx.doi.org/10.4018/978-1-61520-777-0.ch015.

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Ubiquitous healthcare is an emerging technology that promises increases in efficiency, accuracy and availability of medical treatment; however it also introduces the potential for serious abuses including major privacy violations. Brokering is a capability-based coordination approach for ubiquitous healthcare Systems (UHS). A major challenge of brokering in open environments is to support privacy. Within the context of brokering, the authors model privacy in terms of the entities’ ability to hide or reveal information related to its identities, requests, and/or capabilities. This work presents a privacy-based multi-agent brokering architecture that supports different privacy degrees. Unlike traditional approaches, the brokering is viewed as a set of services in which the brokering role is further classified into several sub-roles each with a specific architecture and interaction protocol that is appropriate to support a required privacy degree. To put the formulation in practice, a prototype of the proposed architecture has been implemented to support information-gathering capabilities in healthcare environments using FIPA-complaint platform (JADE).
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Heyes, Kim. "Socialization or Social Isolation?" In Advances in Healthcare Information Systems and Administration, 28–55. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-2958-3.ch002.

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This research project specifically examines the experience of online community support groups as reported by users. The project began out of concern that healthcare providers in the Global North are directing people with mental health problems to online services, without seemingly understanding the impact that this may have on the individuals. The research findings will be of particular interest to mental health practitioners and service providers in the UK and elsewhere in the Global North, and aims to influence decisions made for policies around developing new online mental health services.
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Nykänen, Pirkko. "eHealth Systems, Their Use and Visions for the Future." In Medical Informatics in Obstetrics and Gynecology, 346–53. IGI Global, 2009. http://dx.doi.org/10.4018/978-1-60566-078-3.ch019.

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eHealth refers to use of information and communication technologies to improve or enable health and healthcare. eHealth broadens the scope of health care delivery, citizens are in the center of services and services are offered by information systems often via the Internet. In this chapter eHealth systems are classified on the basis of their use and their functionality and the use is discussed from the viewpoints of citizens and health professionals. Citizens are increasingly using Internet and eHealth systems to search for medicine or health related information, and they become better informed and may take more responsibility of their own health. Health professionals are more reluctant to use the Internet and eHealth systems in physician-patient communication due to power and responsibility problems of decisions. In the future the socio-technical nature of eHealth should be considered and future systems developed for real use and user environment with user acceptable technology.
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Burns, Tom. "Planning and providing mental health services for a community." In New Oxford Textbook of Psychiatry, 1452–63. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199696758.003.0185.

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The aim of this chapter is to assist clinicians and managers review and plan services effectively for their local population. Severe psychiatric disorders manifest themselves in social relations and often disrupt social structures; they have wide-ranging consequences and services need to be comprehensive. Health and social care have been intertwined in psychiatry from its origins—it is neither feasible nor sensible to ignore the wider context of their management. The last 30 years have seen an explosion of Mental Health Services Research alongside the shrinking and closure of mental hospitals (see Chapter 7.6). Policy considerations, particularly cost containment and public safety, have influenced the research agenda which is disproportionately Anglophone (from the United States, United Kingdom, and Australasia) and focused on new services developed as alternatives to institutional care with staffing and motivation that are not easily generalizable. More routine practices, crucial for safe and effective care, have been relatively neglected by researchers. This chapter is mainly devoted to describing the essential components of a mental health service—its ‘building blocks’. It will then consider how they relate to one another, how they can be prioritized, and how integrated into an effective local service linking into other essential services. Lastly it will stress how their inevitable evolution should be monitored. Services for adults (increasingly referred to as ‘adults of working age’ indicating 18–65 years) will be used as the template. In many settings these may be the only services, stretching to accommodate all comers. In better resourced health care systems a range of specialized services have evolved from this basic model and are described elsewhere in this section (refugees 7.10.1, homeless 7.10.2, and ethnic minorities 7.10.3).
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Ho, Wing Tung, and Ben Yuk Fai Fong. "Public-Private Partnership in Health and Long-Term Care." In Sustainable Health and Long-Term Care Solutions for an Aging Population, 103–24. IGI Global, 2018. http://dx.doi.org/10.4018/978-1-5225-2633-9.ch006.

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An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.
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Ho, Wing Tung, and Ben Yuk Fai Fong. "Public-Private Partnership in Health and Long-Term Care." In Healthcare Policy and Reform, 276–97. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-6915-2.ch014.

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An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.
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Sharma, Aayushi, and Dr Jagajeet Prasad Singh. "INVESTIGATION OF OPD PATIENT CONVERSIONS TO DIAGNOSTIC SERVICES AT COCOON HOSPITAL." In HEALTHCARE HORIZONS: EXPLORING MANAGEMENT PRACTICES. KAAV PUBLICATIONS, 2023. http://dx.doi.org/10.52458/9789388996853.2023.eb.ch-12.

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The Outpatient Department (OPD) serves as a critical reflection of every hospital, being the initial point of patient interaction. Patients visit the OPD for various reasons, including consultations, medications, lab tests, day care treatment, admissions, and post-discharge follow-ups. Hospitals aim to offer comprehensive facilities within their premises, encompassing services such as labs, pharmacies, and admissions, thereby discouraging patients from seeking these services elsewhere. Patients have the flexibility to choose from a range of services, both within and outside the hospital, based on their health needs. According to the referral management company Fibroblast, approximately 62% of health systems experience an annual revenue loss of at least 20% [1].
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Grant, Marquis C. "An Analytical Study of the Provision of Mental Health Services for Students With Disabilities in Public School Settings." In Advances in Educational Marketing, Administration, and Leadership, 278–91. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-5695-5.ch011.

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Students with disabilities often do not receive supportive services if they have coexisting mental health disorders. Students classified with emotional or behavioral disorders for an individualized education plan may be supported by a functional behavior assessment and, in some cases, a behavior intervention plan, but mental health is not included as a related service. Without appropriate mental health services, students face poorer outcomes. Results from a survey of special education teachers and behavior support specialists along with a secondary analysis of existing data revealed that respondents did not receive any mental health training that would allow them to support students with mental health needs. Moreover, funding, legal issues, and policies were emerging themes that likely contributed to the lack of appropriate mental health support in public school systems.
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Hou, Zhiyuan, and Na He. "Governance and management of public health programmes." In Oxford Textbook of Global Public Health, edited by Roger Detels, Quarraisha Abdool Karim, Fran Baum, Liming Li, and Alastair H. Leyland, 391–408. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198816805.003.0051.

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Governance is central to improve health systems performance and achieve Universal Health Coverage. Good governance can enable the effective use of health finances, workforce, medicines, and information to deliver better health services and outcomes. Theories of principal-agent and network governance are introduced to better understand health governance at system level. In health governance system, the government, private sector, and civil society are the governing triangle, and form a whole-of-society governance approach for health. We introduce the governing triangle and its role in health governance, governance mechanisms and tools, and the levels of governance, respectively. The triangle plays health governance functions at four levels to collectively pursue health goals: the supranational or national or organizational or programme levels. At each level, tools of governance are central to health governance functions and enabling relationships among triangles. Tools of governance can be classified into nine governance dimensions: accountability, regulation, participation, and consensus in decision-making, formulating policy/strategic direction, organizational adequacy/system design, generating information/intelligence, partnerships for coordination and collaboration, engagement of community, communication, and transparency. Assessment frameworks are further introduced for evaluating whether health governance is effective. And several cases of health governance are introduced for better understanding.
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Jamieson, Anne. "Home care in Europe: background and aims." In Home care for older People in Europe, 3–12. Oxford University PressNew York, NY, 1991. http://dx.doi.org/10.1093/oso/9780192620507.003.0001.

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Abstract This book forms part of a major study into care delivery systems in Europe, known as ‘Age Care Research Europe’. The study has been funded by the European Community as a concerted action programme, in which research teams from nine countries have participated: Belgium, Denmark, France, Greece, Germany, Ireland, Italy, the Netherlands, and the UK. The study resulted from a research proposal and a research design formulated by Professor Illsley of the UK (who subsequently became Project Leader) and Dr Robert van Zonneveld of the Netherlands. The design is described in some detail elsewhere (Illsley 1987) and will only be briefly summarized here. From earlier discussions with policy makers and research workers, Illsley and van Zonneveld were aware that all countries were encountering difficulties in adapting the pattern of services and the distribution of resources to meet the increased demand on health and social services in a period of limited growth, and in the face of resistance from other service sectors.
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Reports on the topic "Health services and systems not elsewhere classified"

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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.

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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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