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Feasibility and efficacy of a pilot family model of diabetes self-management intervention in the Republic of the Marshall Islands
امکان سنجی و کارایی یک مدل خانواده آزمایشی مداخله خودمدیریتی دیابت در جمهوری جزایر مارشال-2021 Background: The Republic of the Marshall Islands (RMI) faces numerous health disparities, including one of the
highest prevalence of type 2 diabetes mellitus (T2DM) in the world. Diabetes self-management education and
support (DSMES) has shown efficacy in improving glycemic control and through increases in knowledge and selfmanagement activities; however, there is limited research on DSMES in the RMI. This study evaluated the
feasibility and efficacy of a culturally adapted family model of DSMES (F-DSMES) in the RMI. The F-DSME
included 8 h of group educational classes delivered in churches by a community health worker.
Methods: This pilot study assessed retention and dosage rates (e.g., class attendance) among the participants with T2DM (n = 41). Efficacy was evaluated by examining pre- and post-intervention differences in HbA1c, knowledge, family support, and self-management activities among those who completed the post-intervention data collection (n = 23). Results: The results indicate completion of post-intervention data collection and attendance were associated; 70% of participants who completed the post-intervention data collection received at least 6 h of intervention compared to 3 h for those who did not. Although the reduction in HbA1c was not statistically significant, participants demonstrated statically significant increases in knowledge, family support, and an increase in selfmanagement including in checking of blood glucose and feet. Conclusions: This study provides important information to help address T2DM disparities in the RMI, including the feasibility and efficacy of F-DSMES. Additional research will help in understanding how to translate improvements in knowledge, family support, and self-management activities into improvements in HbA1c. This may include addressing social ecological factors that affect glycemic control. keywords: Type 2 diabetes mellitus | Diabetes self-management education | HbA1c | Pre- and post-intervention | Marshallese |
مقاله انگلیسی |
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Recognition and Management of Protracted Bacterial Bronchitis in Australian Aboriginal Children
شناخت و مدیریت برونشیت باکتریایی طولانی در کودکان بومی استرالیا-2021 BACKGROUND: Chronic wet cough in children is the hallmark symptom of protracted bacterial
bronchitis (PBB) and if left untreated can lead to bronchiectasis, which is prevalent in
Indigenous populations. Underrecognition of chronic wet cough by parents and clinicians
and underdiagnosis of PBB by clinicians are known.
RESEARCH QUESTION: We aimed to improve recognition and management of chronic wet cough in Aboriginal children using knowledge translation (KT), a methodologic approach that can be adapted for use in Indigenous contexts to facilitate effective and sustained translation of research into practice. STUDY DESIGN AND METHODS: A mixed-methods KT study undertaken at a remote-based Aboriginal primary medical service (February 2017 to December 2019). Our KT strategy included the following: (1) culturally secure (ie, ensuring Aboriginal people are treated regarding their unique cultural needs and differences) knowledge dissemination to facilitate family health seeking for chronic wet cough in children, and (2) an implementation strategy to facilitate correct diagnosis and management of chronic wet cough and PBB by physicians. RESULTS: Post-KT, health seeking for chronic wet cough increased by 184% (pre ¼ eight of 630 children [1.3%], post ¼ 23 of 636 children [3.6%]; P ¼ .007; 95% CI, 0.7%-4.0%). Physician proficiency in management of chronic wet cough improved significantly as reflected by improved chronic cough-related quality of life (P < .001; 95% CI, 0.8-3.0) and improved physician assessment of cough quality (P < .001; 95% CI, 10.4%-23.0%), duration (P < .001; 95% CI, 11.1%-24.1%), and appropriate antibiotic prescription (P ¼ .010; 95% CI, 6.6%-55.7%). INTERPRETATION: Health seeking for children with chronic wet cough can be facilitated through provision of culturally secure health information. Physician proficiency in the management of PBB can be improved with KT strategies which include training in culturally informed management, leading to better health outcomes. Comprehensive strategies that include both families and health systems are required to ensure that chronic wet cough in children is detected and optimally managed. CHEST 2021; 159(1):249-258 KEYWORDS: bronchiectasis | community health | cough | health-care disparities | pediatrics |
مقاله انگلیسی |
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Technology-enabled knowledge management for community healthcare workers: The effects of knowledge sharing and knowledge hiding
مدیریت دانش دانش تکنولوژی برای کارکنان بهداشت و درمان جامعه: اثرات به اشتراک گذاری دانش و پنهان کردن دانش-2021 The objective of this study is to explore different facet (dark and bright sides) of technology-enabled knowledge
management (KM) for rural lay healthcare workers who belong to the bottom of pyramid (BoP) population in
India. Data were collected through multiple rounds of engagements and semi-structured interviews with 37
Accredited Social Health Activists (ASHAs). Findings indicate the existence of spirals of value that are shaped by
KM practices in such settings. Technology-enabled KM through knowledge-sharing is supporting an upward
spiral of value creation at three different levels, i.e., the micro-level in the form of empowerment of ASHAs, the
meso-level in the form of better healthcare for the rural Indian population, and the macro-level in the form of an
effective public health policy outcome as envisioned by the government. Contrary to the technology-enabled KM
through knowledge-sharing, technology-enabled KM through knowledge-hiding is eroding value resulting in
failed attempts to use technology and reduced self-efficacy of ASHAs at the micro level. Technology-enabled KM
through knowledge-hiding at the macro level is promoting stratification and marginalization within rural
communities in India. Study leaves key implications for healthcare researchers, policymakers and businesses. keywords: بهداشت روستایی | فعالان بهداشت اجتماعی | اقتصادهای نوظهور | تحقیق کیفی | پنهان کردن دانش | به اشتراک گذاری دانش | هندوستان | Rural healthcare | Social health activists | Emerging economies | Qualitative research | Knowledge-hiding | Knowledge-sharing | India |
مقاله انگلیسی |
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Community health education re-envisioned: The value of partnership with the local food bank
آموزش بهداشت جامعه مجددا پیش بینی شده است : ارزش مشارکت با بانک مواد غذایی محلی-2020 Baccalaureate-prepared nurses must be prepared to fulfill expanding role and skill expectations in community
settings to improve population health. The use of non-traditional community clinical sites provides opportunities
for students to learn and use a broad skill set such as leadership, communication, research, teaching,
project management, and critical thinking. Students explore utilization of epidemiological systems and nursing
theories to assist groups and communities to meet their nursing and community health needs. An example of a
successful non-traditional partnership was established between our school and the regional food bank. This
symbiotic relationship provides two-way benefits: students are afforded some flexibility and creativity in
completion of required course assignments, and the food bank gains additional workers to help accomplish
their strategic goals. It is a community health clinical resource that is accessible to schools of nursing in every
community. Keywords: Community health | Baccalaureate nursing education | Community partnership | Food bank | Clinical placement |
مقاله انگلیسی |
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Health marketing in an emerging market: The critical role of signaling theory in breast cancer awareness
بازاریابی بهداشتی در یک بازار در حال ظهور: نقش حیاتی نظریه سیگنالینگ در آگاهی سرطان پستان-2017 In India, breast cancer is the most commonly diagnosed type of cancer among women in cities and urban areas,
yet women seek medical care extremely late due to lack of awareness about self-examination. This study explores
the health marketing literature via signaling theory, to uncover the unique social, economic, cultural and in
stitutional challenges and opportunities faced by health marketers and consumers in breast cancer awareness
(BCA) in an emerging economy – India. An interpretive-inductive method, alongside a grounded theory ap
proach via focus groups with medical professionals and interviews with women is employed. Findings reveal
complex challenges at national, state and community levels which impact negatively on the reputation of Indias
health sector. Social marketing strategies could be leveraged to raise BCA via community health activists.
Propositions are suggested and a conceptual framework is developed to assist health marketers to manage BCA in
an emerging economy.
Keywords: Health marketing | Breast cancer awareness | Signaling theory | India | Emerging economy |
مقاله انگلیسی |