BackgroundExperts have suggested that intersectoral partnerships between prayer camps and biomedical care providers may be an effective strategy to address the overwhelming shortage of mental health care workers in Africa and other low-income settings. Nevertheless, previous studies have not explored whether the prayer camp and biomedical staff beliefs and practices provide sufficient common ground to enable cooperative relationships. Therefore, we sought to examine the beliefs and practices of prayer camp staff and the perspective of biomedical care providers, with the goal of characterizing interest in—and potential for—intersectoral partnership between prayer camp staff and biomedical care providers.MethodsWe conducted 50 open-ended, semi-structured interviews with prophets and staff at nine Christian prayer camps in Ghana, and with staff within Ghana’s three public psychiatric hospitals. We used the purposive sampling method to recruit participants and the constant comparative method for qualitative data analysis.ResultsPrayer camp staff expressed interest in collaboration with biomedical mental health care providers, particularly if partnerships could provide technical support introducing medications in the prayer camp and address key shortcomings in their infrastructure and hygienic conditions. Nevertheless, challenges for collaboration were apparent as prayer camp staff expressed strong beliefs in a spiritual rather than biomedical explanatory model for mental illness, frequently used fasting and chained restraints in the course of treatment, and endorsed only short-term use of medication to treat mental illness—expressing concerns that long-term medication regimens masked underlying spiritual causes of illness. Biomedical providers were skeptical about the spiritual interpretations of mental illness held by faith healers, and were concerned by the use of chains, fasting, and the lack of adequate living facilities for patients in prayer camps; many, however, expressed interest in engaging with prayer camps to expand access to clinical care for patients residing in the camps.ConclusionsThe findings demonstrate that biomedical care providers are interested in engaging with prayer camps. Key areas where partnerships may best improve conditions for patients at prayer camps include collaborating on creating safe and secure physical spaces and delivering medication for mental illness to patients living in prayer camps. However, while prayer camp staff are willing to engage biomedical knowledge, deeply held beliefs and routine practices of faith and biomedical healers are difficult to reconcile Additional discussion is needed to find the common ground on which the scarce resources for mental health care in Ghana can collaborate most effectively.

Compared with the landmark technique, ultrasound guidance was associated with an increased first-attempt success rate, a reduced number of puncture attempts, and fewer complications during central venous catheter placement in critically ill children.

Background Numerous studies have been conducted specifically to target “fever phobia” and inappropriate fever management skills. However, despite educational intervention, caregivers continue to adopt inappropriate and non‐evidence‐based practices. Aims To collect and examine peer‐reviewed literature for active educational interventions aimed at improving fever management in children and profile them based on: who provided the training, training location, how the intervention was delivered, outcomes of training, and how it was measured. Design Scoping Review. Methods MEDLINE, EMBASE, CINAHL, PubMED, PsycINFO, and IPA were searched from January 1980–December 2016. Study location, type of intervention, intervention target, study aim(s), sample size, instruments, outcome measures, and results were extracted. Results Thirty‐seven studies met the inclusion criteria. Most targeted parents with the remainder focused on healthcare professionals. The interventions and their outcome measures varied significantly from structured group training sessions to video interventions and many using a combination of methods. Most interventions reported a positive impact in outcomes such as knowledge, health service use, or fever management skills. Conclusion More standardized educational platforms targeted at both caregivers and healthcare professionals with appropriate evaluation methods should be developed and made widely available.

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Aim The symptoms of childhood fever are often inappropriately managed by care givers resulting in overuse of health resources and medication errors. Understanding care giver's knowledge, attitudes and beliefs about fever management using a validated questionnaire is warranted. The aim of this study was to develop and validate a comprehensive Fever Management Questionnaire. Methods The questionnaire items were developed through a content analysis of the literature and current fever management guidelines. For the knowledge component, a multidisciplinary panel of 12 experts assessed content validity of items (n = 35) through a one‐round Delphi process. The construct validity of the attitudes and belief items (19 items) were assessed using principal components analysis utilising response data collected from 149 Australian parents and care givers. Results Based on the responses from the panel of experts, six items were removed, six items required substantive modification, 13 items required minor modification with the remaining eight items retained in original form. For the Attitudes and Beliefs items, a parsimonious solution with three principal components resulted after removal of six cross‐loading items. The factor loadings of each item displayed a strong correlation to one of three components with scores ranging from 0.791 down to 0.541. The resulting Cronbach's α for the tool was 0.729. Conclusion Psychometric testing of this two‐part Fever Management Questionnaire has resulted in a tool with acceptable validity and reliability. This tool should now be used to gather the knowledge and attitudes of care givers surrounding fever management to further understand factors that lead to inappropriate fever management.

Objective. Fever is a common childhood symptom of illness often mismanaged by caregivers.Community pharmacies can provide an influential role in the education and management of fever.This study aimed to ascertain how pharmacy students (novices) and pharmacy staff (experts) respond to a childhood fever scenario.Methods. Data were collected from 65 second year students and 51 fourth (final) year students in an over-the-counter fever scenario during assessment tasks. Data from pharmacy staff were collected via mystery shopping conducted over nine weeks between March-October 2015. All encounters were immediately scored by the trained simulated client, and immediate feedback was provided for pharmacy staff and fourth year students. Questioning scores (WHAT) and proportions of competent participants were collected in all groups. Statistical comparative analyses were made between fourth year students and pharmacy staff. Pharmacy staff scores were also tracked over time.Results. Second year students performed well when questioning, achieving a median WHAT score of 100%. Conversely, pharmacy staff scored 22%. A large proportion of the fourth year students and pharmacy staff achieved appropriate outcomes (92% and 65% respectively), however a smaller proportion of second years performed well (52%). The pharmacy staff achieved statistical improvements over time for median WHAT scores (p<0.001). Conclusions.Protocol compliant questioning appears to decline with experience. However, experienced counsellors are more likely to provide appropriate patient advice. Further improvements in outcomes can also occur when staff are provided feedback and coaching. Mystery shopping simulations can be used as a valuable educational tool.

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