778 research outputs found

    A qualitative study of patients' views on quality of primary care consultations in Hong Kong and comparison with the UK CARE Measure

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    <b>Background</b> Patients' priorities and views on quality care are well-documented in Western countries but there is a dearth of research in this area in the East. The aim of the present study was to explore Chinese patients' views on quality of primary care consultations in Hong Kong and to compare these with the items in the CARE measure (a process measure of consultation quality widely used in the UK) in order to assess the potential utility of the CARE measure in a Chinese population.<p></p> <b>Methods</b> Individual semi-structured interviews were conducted on 21 adult patients from 3 different primary care clinics (a public primary healthcare clinic, a University health centre, and a private family physician's clinic). Topics discussed included expectations, experiences, and views about quality of medical consultations. Interviews were typed verbatim, and a thematic approach was taken to identify key issues. These identified issues were then compared with the ten CARE measure items, using a CARE framework: Connecting (Care Measure items 1–3), Assessing (item 4), Responding (items 5,6), and Empowering (items 7–10).<p></p> <b>Results</b> Patients judged doctors in terms of both the process of the consultation and the perceived outcomes. Themes identified that related to the interpersonal process of the consultation fitted well under the CARE framework; Connecting and communicating (18/21 patients), Assessing holistically (10/21 patients), Responding (18/21 patients) and Empowering (19/21 patients). Patients from the public clinic, who were generally of lower socio-economic status, were least likely to expect holistic care or empowerment. Two-thirds of patients also judged doctors on whether they performed an adequate physical examination, and three-quarters on the later outcomes of consultation (in terms of relief or cure and/or side-effects of prescribed drugs).<p></p> <b>Conclusion</b> These findings suggest that Chinese patients in Hong Kong value engaged, empathic primary care doctors and judge the quality of consultations largely on these human skills and the attitudes and values that underpin them, as well as on the perceived outcomes of treatment. The match between themes relating to consultation process and the CARE Measure items suggests utility of this measure in this population, but further quantitative validation is required

    Watchfully checking rapport with the Primary Child Health Care nurses - a theoretical model from the perspective of parents of foreign origin

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    <p>Abstract</p> <p>Background</p> <p>Worldwide, multicultural interaction within health care seems to be challenging and problematic. This is also true among Primary Child Health Care nurses (PCHC nurses) in the Swedish Primary Child Health Care services (PCHC services). Therefore, there was a need to investigate the parents' perspective in-depth.</p> <p>Aim</p> <p>The aim of the study was to construct a theoretical model that could promote further understanding of the variety of experiences of parents of foreign origin regarding their interaction with the PCHC nurses at PCHC services.</p> <p>Method</p> <p>The study used Grounded Theory Methodology. Twenty-one parents of foreign origin in contact with PCHC servicies were interviewed.</p> <p>Results</p> <p>In our study parents were watchfully checking rapport, i.e. if they could perceive sympathy and understanding from the PCHC nurses. This was done by checking the nurse's demeanour and signs of judgement. From these interviews we created a theoretical model illustrating the interactive process between parents and PCHC nurses.</p> <p>Conclusion</p> <p>We found it to be of utmost importance for parents to be certain that it was possible to establish rapport with the PCHC nurse. If not, disruptions in the child's attendance at PCHC services could result. PCHC nurses can use the theoretical model resulting from this study as a basis for understanding parents, avoiding a demeanour and judgements that may cause misunderstandings thus promoting high-quality interaction in PCHC services.</p

    How effective are on-farm conservation land management strategies for preserving ecosystem services in developing countries? A systematic map protocol

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    Background An extensive body of literature in the field of agro-ecology claims to show the positive effects that maintenance of ecosystem services can have on sustainably meeting future food demand, by making farms more productive and resilient, and contributing to better nutrition and livelihoods of farmers. In Africa alone, some research has estimated a two-fold yield increase if food producers capitalize on new and existing knowledge from science and technology. Site-specific strategies adopted with the aim of improving ecosystem services may incorporate principles of multifunctional agriculture, sustainable intensification and conservation agriculture. However, a coherent synthesis and review of the evidence of these claims is largely absent, and the quality of much of this literature is questionable. Moreover, inconsistent effects have commonly been reported, while empirical evidence to support assumed improvements is largely lacking. Objectives This systematic map is stimulated by an interest to (1) collate evidence on the effectiveness of on-farm conservation land management for preserving and enhancing ecosystem services in agricultural landscapes, by drawing together the currently fragmented and multidisciplinary literature base, and (2) geographically map what indicators have been used to assess on-farm conservation land management. For both questions, we will focus on 74 low-income and developing countries, where much of the world’s agricultural expansion is occurring, yet 80% of arable land is already used and croplands are yielding well below their potential. Methods/Design To this end, reviewers will systematically search bibliographic databases for peer-reviewed research from Web of Science, SCOPUS, AGRICOLA, AGRIS databases and CAB abstracts, and grey literature from Google Scholar, and 22 subject-specific or institutional websites. Boolean search operators will be used to create search strings where applicable. Ecosystem services included in the study are pollination services; pest-, carbon-, soil-, and water-regulation; nutrient cycling; medicinal and aromatic plants; fuel wood and cultural services. Outputs of the systematic map will include a database, technical report and an online interactive map, searchable by topic. The results of this map are expected to provide clarity about synergistic outcomes of conservation land management, which will help support local decision-making

    Measurement of exclusive pion pair production in proton–proton collisions at √s=7 TeV with the ATLAS detector

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    Search for resonant WZ production in the fully leptonic final state in proton–proton collisions at √s=13 TeV with the ATLAS detector