A Focus Group on Dental Pain Complaints with General Medical Practitioners: Developing a Treatment Algorithm

Objective. The differential diagnosis of pain in the mouth can be challenging for general medical practitioners (GMPs) as many different dental problems can present with similar signs and symptoms. This study aimed to create a treatment algorithm for GMPs to effectively and appropriately refer the patients and prescribe antibiotics. Design. The study design is comprised of qualitative focus group discussions. Setting and Subjects. Groups of GMPs within the Gold Coast and Brisbane urban and city regions. Outcome Measures. Content thematically analysed and treatment algorithm developed. Results. There were 5 focus groups with 8-9 participants per group. Addressing whether antibiotics should be given to patients with dental pain was considered very important to GMPs to prevent overtreatment and creating antibiotic resistance. Many practitioners were unsure of what the different forms of dental pains represent. 90% of the practitioners involved agreed that the treatment algorithm was useful to daily practice. Conclusion. Common dental complaints and infections are seldom surgical emergencies but can result in prolonged appointments for those GMPs who do not regularly deal with these issues. The treatment algorithm for referral processes and prescriptions was deemed easily downloadable and simple to interpret and detailed but succinct enough for clinical use by GMPs.

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Wading through Molasses: A qualitative examination of the experiences, perceptions, attitudes, and knowledge of Australian medical practitioners regarding medical billing

10.1101/2020.05.26.20113324 ◽

2020 ◽

Author(s):

Margaret Faux ◽

Jon Adams ◽

Simran Dahiya ◽

Jon Wardle

Keyword(s):

Qualitative Data ◽

Current System ◽

Health Financing ◽

Daily Practice ◽

Medical Practitioners ◽

Grass Roots ◽

Legal Literacy ◽

Fit For Purpose ◽

General Medical Practitioners ◽

Medical Billing

AbstractBackgroundThe WHO has stated that all health systems haemorrhage money, citing one of the causes of financial leakage as non-compliant billing and fraud. In Australia, it has been estimated that leakage from Medicare caused by non-compliant medical billing may be 10-15% of the scheme’s total cost. Despite a growing body of international research suggesting that rather than deliberately abusing the health financing systems they operate within, medical practitioners may be struggling to understand complex and highly interpretive medical billing rules, there is a lack of research in this area in Australia. The aim of this study was to address this research gap by examining the experiences of Australian medical practitioners as they interact with Australia’s Medicare by engaging in conversations with them about their lived experiences conducting medical billing in grass roots practice.MethodThis study interviewed 27 specialist and general medical practitioners who claim Medicare reimbursements in their daily practice. Interviews were recorded, transcribed, and analysed using thematic analysis.ResultsThe qualitative data revealed five themes including inadequate induction, poor legal literacy, absence of reliable advice and support, fear and deference, and unmet opportunities for improvement.ConclusionThe qualitative data presented in this study suggest Australian medical practitioners are ill-equipped to manage their Medicare compliance obligations, have low levels of legal literacy and desire education, clarity and certainty around complex billing standards and rules. Non-compliant medical billing under Australia’s Medicare scheme is a nuanced phenomenon that may be far more complex than previously thought. Strategies to address the barriers and deficiencies identified by participants in this study will require a multi-pronged approach. The data suggest that the current system of ensuring compliance by Australian medical practitioners is not fit for purpose.

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Barriers and facilitators to the timely diagnosis of endometriosis in primary care in the Netherlands

Family Practice ◽

10.1093/fampra/cmz041 ◽

2019 ◽

Vol 37 (1) ◽

pp. 131-136 ◽

Cited By ~ 1

Author(s):

Moniek van der Zanden ◽

Doreth A M Teunissen ◽

Inger W van der Woord ◽

Didi D M Braat ◽

Willianne L D M Nelen ◽

...

Keyword(s):

The Netherlands ◽

Interdisciplinary Collaboration ◽

Diagnostic Delay ◽

Signs And Symptoms ◽

Daily Practice ◽

Patient Characteristics ◽

Barriers And Facilitators ◽

Reproductive Age ◽

Group Discussions ◽

Timely Diagnosis

Abstract Background Endometriosis is an invalidating gynaecological condition in women of reproductive age, and a frequent cause of infertility. Unfortunately, the condition is characterized by a long interval between onset of symptoms and diagnosis. GPs in the Netherlands are educated to provide basic gynaecological care and serve as gatekeepers for specialist medical care. Therefore, it is of great importance that they recognize signs and symptoms possibly caused by endometriosis to initiate adequate actions. Objective The main objective of this study was to identify barriers and facilitators to the timely diagnosis of endometriosis from the GPs’ perspective. Methods Semi-structured focus group discussions with GPs were organized throughout the Netherlands. The participants were encouraged to brainstorm about their perspective on daily practice regarding endometriosis and suggestions for interventions to enable early diagnosis and treatment. Analysis was based on grounded theory methodology. Results Forty-three GPs participated in six focus groups. Analysis of the transcripts revealed relevant determinants of practice in four main themes: professionals’ experience and competence, patient characteristics, guideline factors and professional collaboration. A lack of knowledge and awareness appeared to result in a low priority for establishing the diagnosis of endometriosis, especially in young women. Infertility, patient engagement and a recent serious case or training facilitated referral. Conclusion Several factors in daily primary health care contribute to the diagnostic delay in endometriosis. Future interventions to reduce this delay may be aimed at increasing awareness by means of education, incorporating the subject into national clinical guidelines and improvements in interdisciplinary collaboration.

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Dari Idealisme ke Pragmatisme: Pergeseran Paradigma dalam Pengembangan Hukum Ekonomi Syariah di Indonesia

Al-Manahij Jurnal Kajian Hukum Islam ◽

10.24090/mnh.v14i2.3408 ◽

2020 ◽

Vol 14 (2) ◽

pp. 191-210

Author(s):

Addiarrahman Addiarrahman ◽

Illy Yanti

Keyword(s):

Focus Group ◽

Focus Group Discussions ◽

Group Discussions ◽

Business World ◽

Key Informants ◽

The Public ◽

Financial Products ◽

Legal Consideration ◽

Economic Law ◽

Islamic Economic

This study seeks to understand the pragmatism of the development of sharia economic law, and its implications for Islamic financial products in Indonesia. The data comes from the results of interviews and focus group discussions with key informants from academics, practitioners, authorities, and the public. This research finds that pragmatism in the development of Islamic economic law is an approach that still dominates the DSN-MUI fatwas. The pragmatism style used is complex-eclectic pragmatism which is represented through makhārij al-fiqhiyyah, which is to choose a mild opinion by sticking to the strongest method or also called "taysīr al-manhajī". The use of this method is intended to ensure that the fatwa is truly able to answer the needs of the business world, as well as being in line with sharia principles. DSN-MUI also does not use maslahah as a legal consideration in a free or liberal way. Rather, it returns maslahah in consideration of the method, so that it is permissible to use the bay’ al-'inān contract only in a forced state (ḍarurah).

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An Update on Airway Management

10.2174/97898114323851200301 ◽

2020 ◽

Keyword(s):

Airway Management ◽

Surgical Techniques ◽

Daily Practice ◽

Postoperative Management ◽

Diagnostic Methods ◽

Emergency Rooms ◽

Specific Patient ◽

Medical Practitioners ◽

Preoperative Diagnostic ◽

Airway Devices

In recent years, there have been many advances in the safe management of the patient's airway, a cornerstone of anesthetic practice. An Update on Airway Management brings forth information about new approaches in airway management in many clinical settings. This volume analyzes and explains new preoperative diagnostic methods, algorithms, intubation devices, extubation procedures, novelties in postoperative management in resuscitation and intensive care units, while providing a simple, accessible and applicable reading experience that helps medical practitioners in daily practice. The comprehensive updates presented in this volume make this a useful reference for anesthesiologists, surgeons and EMTs at all levels. Key topics reviewed in this reference include: New airway devices, clinical management techniques, pharmacology updates (ASA guidelines, DAS algorithms, Vortex approach, etc.), Induced and awake approaches in different settings Updates on diagnostic accuracy of perioperative radiology and ultrasonography Airway management in different settings (nonoperating room locations and emergency rooms) Airway management in specific patient groups (for example, patients suffering from morbid obesity, obstetric patients and critical patients) Algorithms and traditional surgical techniques that include emergency cricothyrotomy and tracheostomy in ‘Cannot Intubate, Cannot Ventilate’ scenarios. Learning techniques to manage airways correctly, focusing on the combination of knowledge, technical abilities, decision making, communication skills and leadership Special topics such as difficult airway management registry, organization, documentation, dissemination of critical information, big data and databases

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“Stages of change, smoking behavior and acceptability of a textmessaging intervention for tobacco cessation among cigarette, dokha and shishasmokers: A qualitative research study.”

BMJ Open ◽

10.1136/bmjopen-2019-029144 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029144 ◽

Cited By ~ 2

Author(s):

Yusra Elhidaia Elobaid ◽

Andrea Leinberger Jabari ◽

Aisha Al Hamiz ◽

Abdul Rizzak Al Kaddour ◽

Sherif Bakir ◽

...

Keyword(s):

Qualitative Research ◽

Smoking Cessation ◽

Focus Group ◽

United Arab Emirates ◽

Text Messaging ◽

Tobacco Cessation ◽

Text Messages ◽

Controlled Study ◽

Focus Group Discussions ◽

Group Discussions

ObjectivesTo explore: (A) the underlying motivators and barriers to smoking cessation among young Arabic speaking smokers and (B) to examine the suitability and preferences for tobacco cessation interventions (specifically text messages) and study the possibility of enrollment methods for a randomised controlled study using text messages as an intervention for tobacco cessation.DesignQualitative research using focus group discussions and content analysis.Setting(s)Two universities, one of them is the first and foremost comprehensive national university in the United Arab Emirates (UAE). The third setting is the largest hospital in the UAE and the flagship institution for the public health system in the emirate of Abu Dhabi.ParticipantsSix focus group discussions with a total of 57 participants. Forty-seven men and 10 women. Fifty-three of them were current smokers.ResultsThe analysis of six focus groups was carried out. Main themes arose from the data included: preferences for tobacco cessation interventions and acceptability and feasibility of text messaging as tobacco cessation intervention. Different motives and barriers for quitting smoking including shisha and dokha were explored.ConclusionInterventions using text messaging for smoking cessation have not been used in the Middle East and they could potentially be effective; however, tailoring and closely examining the content and acceptability of text messages to be used is important before the conduction of trials involving their use. Social media is perceived to be more effective and influential, with a higher level of penetration into communities of young smokers.

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Perspectives of future pharmacists on the potential for development and implementation of pharmacist prescribing in Qatar

International Journal of Clinical Pharmacy ◽

10.1007/s11096-019-00946-9 ◽

2020 ◽

Vol 42 (1) ◽

pp. 110-123

Author(s):

Mohammad Issam Diab ◽

Angham Ibrahim ◽

Oraib Abdallah ◽

Alla El-Awaisi ◽

Monica Zolezzi ◽

...

Keyword(s):

Focus Group ◽

Treatment Options ◽

Developed Countries ◽

Focus Group Discussions ◽

Cross Sectional Survey ◽

Group Discussions ◽

Cross Sectional ◽

Pharmacist Prescribing ◽

Barriers To Implementation ◽

Special Training Program

AbstractBackground Pharmacists in many developed countries have been granted prescribing authorities under what is known as “non-medical prescribing” or “pharmacist prescribing”. However, such prescribing privileges are not available in many developing countries. Objective The objective of this study was to determine the perspectives of future pharmacists (recent pharmacy graduates and pharmacy students) on pharmacist prescribing and its potential implementation in Qatar. Methods A convergent parallel mixed-methods design was used: (1) a cross-sectional survey using a pre-tested questionnaire and; (2) focus group discussions to allow for an in-depth understanding of the issue, with a focus on pharmacists prescribing competencies as well as barriers for its implementation. Main outcome measures Future pharmacists’ perspectives and attitudes towards pharmacist prescribing in Qatar. Results The majority of the respondents (94.4%) indicated awareness of the prescribing competency related to selecting treatment options. Furthermore, the majority (92.4%) believed that pharmacists should undergo prescribing training and accreditation before been legally allowed to prescribe, a point that was reiterated in the focus group discussions. Participants generally expressed support for collaborative and supplementary prescribing models when developing prescribing frameworks for Qatar. Four categories emerged under the theme barriers to implementation of pharmacist prescribing: lack of prescribing competency, pharmacist mindset, lack of accessibility to patient records and counseling rooms, and diversity of education and training background. Conclusion The majority of recent pharmacy graduates and students were in favor of pharmacist prescribing been implemented in Qatar. However, a special training program was deemed necessary to qualify pharmacists to prescribe safely and effectively.

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Nairobi Early Childcare in Slums (NECS) Study Protocol: a mixed-methods exploration of paid early childcare in Mukuru slum, Nairobi

BMJ Paediatrics Open ◽

10.1136/bmjpo-2020-000822 ◽

2020 ◽

Vol 4 (1) ◽

pp. e000822

Author(s):

Robert C Hughes ◽

Patricia Kitsao-Wekulo ◽

Sunil Bhopal ◽

Elizabeth W Kimani-Murage ◽

Zelee Hill ◽

...

Keyword(s):

Mixed Methods ◽

Focus Group ◽

Early Years ◽

Epidemiological Methods ◽

Focus Group Discussions ◽

Group Discussions ◽

Early Childcare ◽

Depth Interviews ◽

Childcare Providers

IntroductionThe early years are critical. Early nurturing care can lay the foundation for human capital accumulation with lifelong benefits. Conversely, early adversity undermines brain development, learning and future earning.Slums are among the most challenging places to spend those early years and are difficult places to care for a child. Shifting family and work structures mean that paid, largely informal, childcare seems to be becoming the ‘new normal’ for many preschool children growing up in rapidly urbanising Africa. However, little is known about the quality of this childcare.AimsTo build a rigorous understanding what childcare strategies are used and why in a typical Nairobi slum, with a particular focus on provision and quality of paid childcare. Through this, to inform evaluation of quality and design and implementation of interventions with the potential to reach some of the most vulnerable children at the most critical time in the life course.Methods and analysisMixed methods will be employed. Qualitative research (in-depth interviews and focus group discussions) with parents/carers will explore need for and decision-making about childcare. A household survey (of 480 households) will estimate the use of different childcare strategies by parents/carers and associated parent/carer characteristics. Subsequently, childcare providers will be mapped and surveyed to document and assess quality of current paid childcare. Semistructured observations will augment self-reported quality with observable characteristics/practices. Finally, in-depth interviews and focus group discussions with childcare providers will explore their behaviours and motivations. Qualitative data will be analysed through thematic analysis and triangulation across methods. Quantitative and spatial data will be analysed through epidemiological methods (random effects regression modelling and spatial statistics).Ethics and disseminationEthical approval has been granted in the UK and Kenya. Findings will be disseminated through journal publications, community and government stakeholder workshops, policy briefs and social media content.

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The usability of Jordan stillbirths and neonatal deaths surveillance (JSANDS) system: results of focus group discussions

Archives of Public Health ◽

10.1186/s13690-021-00551-1 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Yousef S. Khader ◽

Khulood K. Shattnawi ◽

Nihaya Al-Sheyab ◽

Mohammad Alyahya ◽

Anwar Batieha

Keyword(s):

Focus Group ◽

System Performance ◽

Surveillance System ◽

Healthcare Professionals ◽

Qualitative Approach ◽

Focal Points ◽

Focus Group Discussions ◽

Group Discussions ◽

Neonatal Deaths ◽

Technical Issues

Abstract Background Jordan Stillbirths and Neonatal Deaths Surveillance system (JSANDS) is a newly developed system and is currently implemented in five large hospitals in Jordan. This study aimed at exploring the healthcare professionals’ perception about the usability of JSANDS. Methods A descriptive qualitative approach, using focus group discussions, was adopted. A total of 5 focus groups including 23 focal points were conducted in five participating hospitals in Jordan. Results Data analysis identified nine main issues related to the JSANDS system: the system usefulness, the system performance, data quality, the system limitations, human rights, female empowerment, nurses’ competencies strengthened, the sustainability of the JSANDS, and COVID-19 impact on the system. Users reported that JSANDS data were useful, the system was simple and easy to use, and the data were accurate and complete. However, some users reported that some technical issues need to be enhanced. Conclusions JSANDS was perceived positively by the current users. According to them, it provides a formative and comprehensive data on stillbirths and neonatal deaths and their causes, and therefore, was recommended to be adopted by its users and scaled up.

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A comparative assessment of two tools designed to support patient safety culture in UK general practice

BMC Family Practice ◽

10.1186/s12875-021-01438-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Ian Litchfield ◽

Kate Marsden ◽

Lucy Doos ◽

Katherine Perryman ◽

Anthony Avery ◽

...

Keyword(s):

General Practice ◽

Patient Safety ◽

Focus Group ◽

Safety Culture ◽

Improve Patient Safety ◽

Patient Safety Culture ◽

Focus Group Discussions ◽

Group Discussions ◽

Staff Members ◽

Practice Team

Abstract Background The NHS has recognised the importance of a high quality patient safety culture in the delivery of primary health care in the rapidly evolving environment of general practice. Two tools, PC-SafeQuest and MapSaf, were developed with the intention of assessing and improving patient safety culture in this setting. Both have been made widely available through their inclusion in the Royal College of General Practitioners’ Patient Safety Toolkit and our work offerss a timely exploration of the tools to inform practice staff as to how each might be usefully applied and in which circumstances. Here we present a comparative analysis of their content, and describe the perspectives of staff on their design, outputs and the feasibility of their sustained use. Methods We have used a content analysis to provide the context for the qualitative study of staff experiences of using the tools at a representative range of practices recruited from across the Midlands (UK). Data was collected through moderated focus groups using an identical topic guide. Results A total of nine practices used the PC-SafeQuest tool and four the MapSaf tool. A total of 159 staff completed the PC-SafeQuest tool 52 of whom took part in the subsequent focus group discussions, and 25 staff completed the MapSaf tool all of whom contributed to the focus group discussions. PC-SafeQuest was perceived as quick and easy to use with direct questions pertinent to the work of GP practices providing useful quantitative insight into important areas of safety culture. Though MaPSaF was more logistically challenging, it created a forum for synchronous cross- practice discussions raising awareness of perceptions of safety culture across the practice team. Conclusions Both tools were able to promote reflective and reflexive practice either in individual staff members or across the broader practice team and the oversight they granted provided useful direction for senior staff looking to improve patient safety. Because PC SafeQuest can be easily disseminated and independently completed it is logistically suited to larger practice organisations, whereas the MapSaf tool lends itself to smaller practices where assembling staff in a single workshop is more readily achieved.

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Sexual and reproductive health of Syrian refugee adolescent girls: a qualitative study using focus group discussions in an urban setting in Lebanon

Reproductive Health ◽

10.1186/s12978-021-01178-9 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Rayan Korri ◽

Sabine Hess ◽

Guenter Froeschl ◽

Olena Ivanova

Keyword(s):

Focus Group ◽

Reproductive Health ◽

Sexual Harassment ◽

Qualitative Study ◽

Adolescent Girls ◽

Sexual And Reproductive Health ◽

Urban Setting ◽

Focus Group Discussions ◽

Group Discussions ◽

To Receive

Abstract Background The war in Syria caused the forced displacement of millions of Syrians to neighboring countries. Lebanon is the host country with the largest overall number of Syrian refugees per capita. Adolescent refugee girls experience a unique level of vulnerability during human emergencies and are at increased risk of suffering from poor sexual and reproductive health (SRH) outcomes. We conducted an exploratory qualitative study to learn about the SRH perceptions and experiences of refugee adolescent girls living in Bourj Hammoud, an urban setting in Lebanon. Methods We employed a qualitative design with eight focus group discussions (FGDs) conducted with 40 Syrian Arab and Syrian Kurdish adolescent girls between January and March 2020. Every FGD consisted of five participants aged 13 to 17 years. A semi-structured guide was used covering multiple themes: menstruation, puberty, SRH awareness, and sexual harassment. FGDs were transcribed and analyzed using thematic analysis. Findings The participants discussed adolescent girls’ health and named six elements of good health, such as healthy activities and self-protection. The majority of the FGD participants reported a lack of awareness about menstruation when they experienced it for the first time and the social stigma associated with menstruation. When defining puberty, they indicated its social link to a girl’s readiness for marriage and her need to become cautious about sexual harassment. Most FGD participants had very poor knowledge of the female reproductive system. Mothers were the most approached persons to receive information on SRH issues; however, the girls indicated a wish to receive advice from specialists in a comfortable and private atmosphere. All the girls reported that either they themselves, or an acquaintance, had experienced some type of sexual harassment. The girls rarely reported those incidents due to fear of being blamed or subjected to mobility restrictions, or forced to drop out of school. Conclusions The findings show the refugee girls need for satisfactory knowledge on SRH issues and interventions to prevent sexual and gender-based violence that take into consideration the complexity of urban settings.

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