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1.
The aim of this study was to examine if citizen science contributes to gaining insight into community health and to the health of the citizen scientists themselves. Therefore, thirteen citizens in four deprived neighbourhoods were trained as citizen scientists to conduct research in their own communities. Results showed that the citizen scientists identified forty (health related) themes in their communities. The citizen scientists reported an increase in their overall self-perceived health which, however, was not significantly demonstrated in the prequestionnaire and postquestionnaire.  相似文献   
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Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists’ perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the ?patient-centred communication” concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations.  相似文献   
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Interventions that involve key aspects of community organizing, such as quantitative community assessments and organizational partnership support for the community, may promote residents' health. We evaluated the effectiveness of this form of intervention on mortality and its variability across individual-level household equivalized income tertiles, comparing 52,858 residents aged 65 and above in 12 intervention municipalities to 39,006 residents in nine control municipalities in Japan. During 1,166 days of follow-up, the adjusted hazard ratio for cumulative mortality among men in the intervention municipalities was 0.92 (95% confidence interval: 0.86, 0.99) compared to those in the control group, with similar results being observed across all income levels. Active utilization of data to evaluate communities and building intersectoral partnerships might lower older male residents’ mortality risk, regardless of their income status.  相似文献   
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Childhood community acquired pneumonia (CAP) is the leading cause of mortality in children under 5 years worldwide. Clinical practice guidelines (CPGs) may be limited by method of development, scope of recommendations and the quality of supporting evidence. This study systematically identified, appraised and compared the recommendations of CPGs for the management of paediatric CAP using the AGREE II tool.The systematic review yielded 1409 non-duplicate results, of which 14 CPGs were appraised. Four of the fourteen CPGs were deemed high quality. Most CPGs were considered low-medium quality with ‘rigour of development’ and ‘applicability’ the weakest domains. These areas should be considered in deriving CPGs in the future. Recommendations were generally similar across all guidelines; however, there was notable heterogeneity in three areas. This suggests the need for further evidence to guide management decisions on oxygen saturation thresholds for admission, the utility of investigations such as acute phase reactants, and the duration of antibiotic therapy.  相似文献   
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PurposeAccording to the social determinants of health framework, income inequality is a potential risk factor for adverse mental health. However, few studies have explored the mechanisms suspected to mediate this relationship. The current study addresses this gap through a mediation analysis to determine if social support and community engagement act as mediators linking neighbourhood income inequality to maternal anxiety and depressive symptoms within a cohort of new mothers living in the City of Calgary, Canada.MethodsData collected at three years postpartum from mothers belonging to the All Our Families (AOF) cohort were used in the current study. Maternal data were collected between 2012 and 2015 and linked to neighbourhood socioeconomic data from the 2006 Canadian Census. Income inequality was measured using Gini coefficients derived from 2006 after-tax census data. Generalized structural equation models were used to quantify the associations between income inequality and mental health symptoms, and to assess the potential direct and indirect mediating effects of maternal social support and community engagement.ResultsIncome inequality was not significantly associated with higher depressive symptoms (β = 0.32, 95%CI = −0.067, 0.70), anxiety symptoms (β = 0.11, 95%CI = −0.39, 0.60), or lower social support. Income inequality was not associated with community engagement. For the depression models, higher social support was significantly associated with lower depressive symptoms (β = −0.13, 95%CI = −0.15, −0.097), while community engagement was not significantly associated with depressive symptoms (β = 0.059, 95%CI = −0.15, 0.27). Similarly, for the anxiety models, lower anxiety symptoms were significantly associated with higher levels of social support (β = −0.17, 95%CI = −0.20, −0.13) but not with higher levels of community engagement (β = 0.14, 95%CI = −0.14, 0.41).ConclusionThe current study did not find clear evidence for social support or community engagement mediating the relationship between neighbourhood income inequality and maternal mental health. Future investigations should employ a broader longitudinal approach to capture changes in income inequality, potential mediators, and mental health symptomatology over time.  相似文献   
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背景 2020年3月,上海市卫生健康委提出在基层医疗卫生机构设置发热哨点诊室,以局部应急处置与常态化疫情防控相结合的原则,应对疫情零星散发。 目的 探索并构建一套普适、规范的发热哨点诊室运行评价指标体系。 方法 2021年1—4月,采用目的性抽样法,分别从上海市中心城区、郊区、城郊结合地区选取1家发热哨点诊室,通过实地考察、对来自3家发热哨点诊室的10名工作人员进行两轮半结构化深度访谈,获得原始资料,借助ROST CM6软件整理访谈资料,采用Charmaz建构主义扎根理论的范式分析资料。采用目的抽样法,邀请熟悉发热哨点诊室运行特征的专家(发热哨点诊室管理者、高校研究人员、相关协会学者、卫生发展研究机构人员等)12名作为函询对象,于2021年5—6月采用专家函询法对其进行两轮函询,并运用层次分析法确定各级指标权重、检验各级指标逻辑一致性,最终形成发热哨点诊室运行评价指标体系。 结果 基于扎根理论构建而成的发热哨点诊室运行评价指标体系由5个一级指标、13个二级指标、29个三级指标组成。两轮专家函询问卷的有效回收率均为100.0%,专家权威系数均为0.81,Kendall's W系数分别为0.265(χ2=163.768,P<0.001)、0.320(χ2=130.323,P<0.001)。最终形成的发热哨点诊室运行评价指标体系由5个一级指标(功能和职责、诊室设置要求、人员配备、工作流程和工作规范)、13个二级指标和25个三级指标构成,5个一级指标的权重分别为0.033 7、0.056 4、0.392 6、0.377 8、0.139 5。各层级指标的一致性比率(CR值)为0.056 5、0.032 5、0.042 4(<0.100 0)。 结论 将扎根理论运用于发热哨点诊室运行评价指标体系的构建具有较强的操作性,构建的评价指标体系具有一定的科学性和应用价值。后续随着政策的迭代,可借助扎根理论对评价指标体系进行进一步补充和完善。  相似文献   
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背景严重精神障碍患者因自知力欠缺及高复发性、高致残性等特点,对社会稳定造成严重威胁。做好社区面访管理工作意义重大,通过定期面访患者本人,可以更好地综合评估患者病情,以便及时采取措施,提高管理服务质量。目的了解社区严重精神障碍患者规律面访情况及其影响因素,为提高社区患者的面访服务管理质量提供参考依据。方法2020年10—12月,利用2019年底江苏省严重精神障碍管理系统中建档管理的无锡市严重精神障碍患者基础档案及随访管理信息,分析当年度无锡市社区严重精神障碍患者规律面访情况,采用Logistic回归分析规律面访的影响因素。结果共纳入27 778例研究对象,其规律面访率为81.08%(22 523/27 778)。Logistic回归分析结果显示,非本地户籍〔OR(95%CI)=0.704(0.640,0.775)〕、年龄≤44岁〔OR(95%CI)=0.522(0.472,0.578)〕、学历为高中及以上〔高中/中专OR(95%CI)=0.493(0.446,0.545),大专及以上OR(95%CI)=0.470(0.415,0.532)〕、目前有正式工作〔OR(95%CI)=0.715(0.668,0.766)〕、未婚〔OR(95%CI)=0.746(0.665,0.838)〕、经济状况为非贫困〔OR(95%CI)=0.587(0.517,0.666)〕、没有进行抗精神病药物治疗〔OR(95%CI)=0.491(0.440,0.548)〕、服药时长0~10年〔OR(95%CI)=0.881(0.778,0.998)〕、不是"以奖代补"监护补助对象〔OR(95%CI)=0.807(0.704,0.926)〕、不参加社区康复服务〔OR(95%CI)=0.844(0.716,0.996)〕是患者规律面访的消极影响因素(P<0.05)。结论无锡市社区严重精神障碍患者规律面访率尚需进一步提高,应重点关注非本地户籍、年龄≤44岁、高中及以上学历、目前有正式工作、未婚、经济非贫困、没有进行抗精神病药物治疗、服药时长0~10年、不是监护补助对象和不参加社区康复服务的社区严重精神障碍患者。可通过制定倾斜性政策、开展宣传教育、降低患者病耻感、改善患者疾病认知、加强患者社会支持等措施提高患者规律面访率。  相似文献   
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BackgroundMedication Assisted Treatment for Opioid Dependence (MATOD) is clinically effective and cost effective, yet a lack of MATOD prescribers in the community limits access to this treatment in Australia. These shortages are often greatest in regional and rural areas.Objective(s)The Enhancing Pharmacist Involvement in Care (EPIC)-MATOD study will evaluate clinical and implementation outcomes among people with opioid dependence receiving MATOD through a collaborative pharmacist-prescriber model of care across multiple sites in a regional location (encompassing a mix of metropolitan and non-metropolitan areas) of Victoria, Australia.Methods and analysisThe EPIC-MATOD study is a prospective, multisite, implementation trial of collaborative MATOD care. Pharmacists and prescribers will be recruited through the local network of opioid pharmacotherapy providers. Patients will be recruited through participating healthcare providers. After induction into the collaborative care model, patients and healthcare professionals will be followed up over 6- (patients) and 12-months (pharmacists and prescribers) in a hybrid implementation-efficacy study, with outcomes mapped to the RE-AIM framework. The primary clinical efficacy endpoint is patient retention in treatment at 26 weeks. The primary implementation outcome is treatment capacity, based on prescriber time required to provide treatment through collaborative care compared with traditional care. Secondary clinical endpoints include attendance for dosing and clinical reviews, substance use, mental and physical health and overall well-being. Implementation costs, acceptability, and provider engagement in collaborative care will be used as secondary implementation outcome indicators. Time and costs associated with collaborative care, and health service utilisation, will also be estimated.Project impactThe study will provide important information on outcomes and acceptability of collaborative care for MATOD, as well as the cost and key considerations in delivering a collaborative model of care in Australia and other countries where similar treatment barriers exist.  相似文献   
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