No abstract

Sixty-six cases of Q fever were diagnosed in people affiliated with a goat-farming co-operative in rural Newfoundland in the spring of 1999. Follow-up studies which included administration of the Short Form 36 Health Survey (SF-36) were conducted 3 and 27 months after the initial outbreak to prospectively follow the effects of acute Q fever on the quality of life of the participants. Twenty-seven months after the outbreak 51% of those who had Q fever reported persistent symptoms including seven participants whose symptoms had initially resolved 3 months after the outbreak. Individuals with Q fever had significantly lower scores on five of the eight scales in the SF-36 and lower scores in the mental and physical summary scales compared to uninfected controls. Although this supports the hypothesis of a ‘post Q fever fatigue syndrome’ (QFFS), further study is warranted.

Children and youth in foster care often have increased medical and behavioral needs, as a result of maltreatment experiences. As primary caregivers, foster parents serve a critical role in ensuring their medical and behavioral health needs are met, yet there is little research depicting foster parents' experiences with such services. This study examined perspectives of 442 foster parents regarding their experiences with children's behavioral and medical health services,through closed and open-ended survey questions, to provide further insight into how to best meet the needs of children in the foster care system. Findings suggest that foster parents are generally satisfied with medical services. They were particularly pleased when they perceived caseworkers were efficient with paperwork and provided comprehensive information at intake. They appreciated providers who were able to make appointments on short notice and were patient with children with a variety of needs. Foster parents were less satisfied with behavioral health services. They cited concerns about the timeliness of acquiring behavioral health services, lack of individualized services, and how turnover impacted consistency and progress of services.Consistently, foster parents provided examples of their role in advocating for the needs of the children in their care and described the need to be heard, consulted, and included in assessment and treatment. This study offers important implications for service providers and policy makers to review implementation of current practice and policies, and demonstrates the commitment foster parents have to ensuring the health and behavioral health needs of our most vulnerable children are met. Navigating a complicated system of care: Foster Parent Satisfaction with Behavioral and Medical Health ServicesAccording to the 2014 AFCARS Preliminary Report, more than half (53%) of children in foster care nationally are placed with a licensed non-relative foster family (U.S. Department of Health and Human Services, 2014). Foster parents serve a critical role in the child welfare system, caring for children and youth who experienced maltreatment, many of whom present with significant behavioral health and medical needs. Foster parents' ability to care for the emotional, medical, and dental needs of children in their care is dependent on the availability and delivery of quality services. However, previous studies indicate that foster parents report having little say in decision-making and services for the children in their care (Buehler, Rhodes, Orme, & Cuddeback, 2006; Hudson & Lavasseur, 2002). This is concerning as foster parents can provide unique insight into the behaviors, progress, and service needs as they interact with the children and service providers on a regular basis. There is a need to understand the perspectives of foster parents regarding their experiences with children's behavioral, dental, and medical health services, to promote positive examples of service provision as well as offer important considerations...

Renal services need to assist patients to adhere to their regimens. Initially, this service will examine strategies to maximise the likelihood of patients attending all of their dialysis sessions. Such an outcome will help to delay deterioration in the patients' health status, while minimising additional strain on the health service.

We aimed to study the knowledge of health care acquired infections (HAIs) held by patients in Australian hospitals. Studies of patients' beliefs about HAIs exist, 1-3 but none have specifically assessed the beliefs of an Australian population. We piloted a British questionnaire 3 in 2 North Queensland hospitals: 1 large tertiary-level facility and 1 small, remote facility. After ethics approvals (HREC/13/QTHS/29) were secured, we recruited a small convenience sample of adult surgical inpatients, including Torres Strait Islander people, in the small hospital. The large hospital's culturally diverse population was appropriate and expected for Australian city hospitals. The questionnaire was left with participants, and if required, we read the questions and assisted in recording responses. In the large hospital, questionnaires were distributed during a 4-week period during April 2013; in the remote facility, questionnaires were distributed between April 2013 and April 2014 whenever surgical patients were present. Information regarding nonparticipation was not collected.Twenty-nine men and 22 women responded: 42 participants (82.4%) were from the large hospital (average age 56 years [range, 20-92 years]. Retired persons made up 27.5% of the respondents. Most (n ¼ 32; 62.8%) had been an inpatient within the previous 2 years and were aware of the risk of HAIs (n ¼ 42; 82.4%). They reported having accessed multiple sources of informationdseveral mentioned nurse friends or family as information sources and 2 mentioned the Internet. Most reported they had enough information (n ¼ 36; 70.6%) and enough understanding (n ¼ 41; 80.4%), about HAIs. Thirty-three (64.7%) believed the media did not portray HAIs accurately and 8 (15.7%) did not answer this question. When asked if HAIs were preventable, responses were mixed: 21 (41.1%) replied "yes," 25 (49.0%) replied "no," 1 replied "unsure," 1 replied "both," and 3 (5.9%) did not answer. Participants mentioned options for decreasing the risk of contracting an HAI. The use of alcoholbased handrub for visitors (n ¼ 34; 67%) and staff (n ¼ 33; 65%), involving patients more in their own care (n ¼ 33, 65%), increase domestic/cleaning staff (n ¼ 28; 55%), better staff compliance with infection control measures (n ¼ 27; 53%), stop the movement of patients from ward to ward (n ¼ 23; 45%), and restrict the number of visitors (n ¼ 9; 18%) were all suggested.Respondents listed specific bacteria-causing HAIs, including Staphylococcus ("MRSA," "staph," and "golden staph") (n ¼ 8; 15.7%) and Legionella (n ¼ 3; 5.9%). Of the 15 participants (29.4%) who were unable to name any bacteria, 6 stated "staph,"