BACKGROUND Postgraduate medical trainees are not well prepared difficult conversations about goals of care with patients and families in the acute care clinical setting. While contextual nuances within the workplace can impact communication, research to date has largely focused on individual communication skills. Our objective was to explore contextual factors that influence conversations betwe...

OBJECTIVES To identify, and compare relative importance of, factors associated with antenatal care (ANC) utilization in rural Balochistan, toward framing a policy to increase such utilization. METHODS This cross sectional study was conducted among 513 pregnant women in Jhal Magsi District, Balochistan, in 2011. A standardized interviewer-administered questionnaire was used. Predisposing, enab...

OBJECTIVE To examine the effects of predisposing, enabling, and need factors on physician and hospital use among older Mexican Americans. DESIGN A two-year prospective cohort study. SETTING Five Southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS A population-based sample of 1987 non-institutionalized Mexican American men and women age > or =65 years. ...

Reflective practice is an inherently personal and relational process, occurring privately within people, publicly, between people. Consequently, given it positively impacts on professional practice, has become a requirement for bodies accrediting practitioners. This literature synthesis aims to consolidate understanding around the factors facilitating reflection by generating insights from vari...