51
|
Nissim NR, Fudge MR, Lachner C, Babulal GM, Allyse MA, Graff-Radford NR, Lucas JA, Day GS. Age-Specific Barriers and Facilitators to Research Participation Amongst African Americans in Observational Studies of Memory and Aging. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01741-z. [PMID: 37555913 PMCID: PMC10853486 DOI: 10.1007/s40615-023-01741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/15/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Black/African Americans experience a high burden of Alzheimer disease and related dementias yet are critically underrepresented in corresponding research. Understanding barriers and facilitators to research participation among younger and older African Americans is necessary to inform age-specific strategies to promote equity in studies of early- and late-onset neurodegenerative diseases. STUDY DESIGN Survey respondents (n = 240) rated barriers and facilitators of research participation. Age-specific differences were evaluated using nonparametric Kruskal-Wallis tests across respondents aged 18-44 years (n = 76), 45-64 years (n = 83), and ≥ 65 years (n = 81). Strategies to mitigate barriers and promote facilitators were further explored via community-based focus groups. Pooled frequency of common themes discussed in focus groups were evaluated and compared across different ages including ≥ 45 years, ≥ 65 years, and mixed ages ≥ 45 years. RESULTS Younger respondents (aged 18-44 and 45-64 years) expressed a greater need for flexibility in when, where, and how research testing takes place versus adults ≥ 65 years. Focus groups emphasized long-lasting consequences of systemic racism and the need to build and foster trust to resolve barriers and promote research engagement amongst African Americans. DISCUSSION Age-specific strategies are needed to increase engagement, address recruitment disparities, and promote retention of African American participants in memory and aging studies across the lifespan.
Collapse
Affiliation(s)
- Nicole R Nissim
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Michelle R Fudge
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Christian Lachner
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Megan A Allyse
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - John A Lucas
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA.
| |
Collapse
|
52
|
Mohamud M, Albarkani AA, Masuadi E, Alsahly AA, Alkudairy AI, Shalabi YF, Faqih A, Alaukili KA, Alsahli SJ. Knowledge, Attitude, and Practice of Qualitative Research Among Health Sciences Faculty. Cureus 2023; 15:e44041. [PMID: 37746473 PMCID: PMC10517692 DOI: 10.7759/cureus.44041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2023] [Indexed: 09/26/2023] Open
Abstract
Background The importance of qualitative research in health sciences is rising. Qualitative research needs more attention from healthcare practitioners. Hence, some questions in the healthcare field may only be answered through qualitative research methodologies. In this study, we aimed to assess the knowledge, practice, and attitude among health sciences faculty about qualitative research. Methodology This cross-sectional study was conducted at King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS). A convenient sampling technique was used to collect data from health sciences faculty participants. Participants were included from five different colleges, i.e., College of Medicine, Applied Health Sciences, Nursing, Pharmacy, and College of Dentistry. A 20-question, self-made questionnaire was given to each participant. The questionnaire had five attitude questions, 10 knowledge questions, and five practice questions. Results A total of 236 participants completed the study questionnaire. The majority of the study participants (198, 84%) had an overall poor knowledge of qualitative research methodologies. Most participants (214, 91%) agreed that qualitative research is important in health sciences. More than half of the participants had never attended a qualitative methods workshop (140, 59%). About three-quarters of the participants (175, 74%) had never participated in a qualitative research project. Conclusions The overall knowledge and practice of qualitative research methodologies were poor among KSAU-HS health sciences faculty while they had a good attitude toward its importance in health sciences.
Collapse
Affiliation(s)
| | - Alwaleed A Albarkani
- Medical School, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Emad Masuadi
- Research Unit, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
- Biostatistics, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Abdullaziz A Alsahly
- Medical School, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | | | - Yazeed F Shalabi
- Medical School, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Abdulrahman Faqih
- Medical School, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Khaled A Alaukili
- Medical School, Alfaisal University College of Medicine, Riyadh, SAU
| | | |
Collapse
|
53
|
Keke P, Mengxi G, Huijun C, Jinyao T, Yuqiu X, Feng J. Rural policing in China: Criminal investigation and policing resources for police officers. Heliyon 2023; 9:e18934. [PMID: 37600418 PMCID: PMC10432220 DOI: 10.1016/j.heliyon.2023.e18934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 07/30/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023] Open
Abstract
This study examines the state of policing resources in rural areas of central China and investigates how police officers conduct criminal investigations. Semi-structured interviews were conducted with 20 police officers who had experience in criminal investigations in rural areas. The study found that police officers have developed a well-established model of criminal investigation that is effective in responding to minor crimes such as theft, drink driving, and fighting. However, there may be compliance issues with the criminal investigation skills of police officers. Additionally, rural areas lack policing resources compared to urban areas and do not have access to necessary police information resources. The results of this study suggest that rural policing in areas where resources are scarce should focus on improving the compliance of criminal investigation skills among police officers and increasing the allocation of police resources to rural areas. Policymakers and practitioners can benefit from the insights provided by this study when addressing the challenges faced by rural policing in China and other countries with similar circumstances.
Collapse
Affiliation(s)
- Peng Keke
- Center for Capital Safety, People's Public Security University of China, Beijing 100038, China
- School of Criminology, People's Public Security University of China, Beijing 100038, China
| | - Gao Mengxi
- School of Public Order Science, People's Public Security University of China, Beijing 100038, China
| | - Chen Huijun
- School of Public Order Science, People's Public Security University of China, Beijing 100038, China
| | - Tang Jinyao
- School of Public Order Science, People's Public Security University of China, Beijing 100038, China
| | - Xing Yuqiu
- Department of Advanced Study, People's Public Security University of China, Beijing 100038, China
| | - Jiang Feng
- Center for Capital Safety, People's Public Security University of China, Beijing 100038, China
- School of Public Order Science, People's Public Security University of China, Beijing 100038, China
| |
Collapse
|
54
|
Rafiq MY, Krugman DW, Bapumia F, Enumah Z, Wheatley H, Tungaraza K, Gerrets R, Mfuko S, Hall BJ, Kasogela O, Litunu A, Winch P. Kansa talk: mapping cancer terminologies in Bagamoyo, Tanzania towards dignity-based practice. BMJ Glob Health 2023; 8:e012349. [PMID: 37580100 PMCID: PMC10432665 DOI: 10.1136/bmjgh-2023-012349] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/09/2023] [Indexed: 08/16/2023] Open
Abstract
This paper reports and examines the results of qualitative research on the use of local cancer terminology in urban Bagamoyo, Tanzania. Following recent calls to unify evidence and dignity-based practices in global health, this research locates local medical sociolinguistics as a key place of entry into creating epistemologically autonomous public health practices. We used semistructured ethnographic interviews to reveal both the contextual and broader patterns related to use of local cancer terminologies among residents of Dunda Ward in urban Bagamoyo. Our findings suggest that people in Bagamoyo employ diverse terms to describe and make meanings about cancer that do not neatly fit with biomedical paradigms. This research not only opens further investigation about how ordinary people speak and make sense of the emerging cancer epidemic in places like Tanzania, but also is a window into otherwise conceptualisations of 'intervention' onto people in formerly colonised regions to improve a health situation. We argue that adapting biomedical concepts into local sociolinguistic and knowledge structures is an essential task in creating dignity-based, evidence-informed practices in global health.
Collapse
Affiliation(s)
- Mohamed Yunus Rafiq
- Department of Social Sciences, New York University Shanghai, Shanghai, Shanghai, China
- Center for Global Health Equity, NYU Shanghai, Shanghai, Shanghai, People's Republic of China
| | - Daniel W Krugman
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Fatima Bapumia
- Research Fellow, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Zachary Enumah
- Department of Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA
| | | | - Kheri Tungaraza
- Oncology, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - René Gerrets
- Senior Research Fellow, Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Steve Mfuko
- Alliance for Women, Children, and Youth Survivors, Bagamoyo, Tanzania, United Republic of
| | - Brian James Hall
- Department of Social Sciences, New York University Shanghai, Shanghai, Shanghai, China
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Global Health Equity, NYU Shanghai, Shanghai, People's Republic of China
| | - Optatus Kasogela
- Alliance for Women, Children, and Youth Survivors, Bagamoyo, Tanzania, United Republic of
| | - Athumani Litunu
- Alliance for Women, Children, and Youth Survivors, Bagamoyo, Tanzania, United Republic of
| | - Peter Winch
- International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
55
|
Visintini E, Inzerillo M, Savaris M, Paravan G, Serafini M, Palese A. Factors triggering the progressive detachment of nurses toward the fundamental needs of patients: findings from a qualitative study. Intern Emerg Med 2023; 18:1349-1357. [PMID: 37142862 PMCID: PMC10158679 DOI: 10.1007/s11739-023-03289-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/22/2023] [Indexed: 05/06/2023]
Abstract
The progressive desensitization of nurses in relation to fundamental needs (FNs) has been documented in anecdotical, scientific, and policy literature with nurses spending limited time at the bedside, thus affecting the quality of care and clinical outcomes. A potential reason that has been recognized is the limited nursing staff available in the units. However, other cultural, social, and psychological factors which have not been investigated to date may have a role in triggering the phenomenon. To investigate nurses' perceptions of the reasons that progressively detach clinical nurses from the FNs of patients, was the main intent of the study. In 2020, a qualitative study based on grounded theory following the Standards for Reporting Qualitative Research guidelines was performed. Purposeful sampling was adopted, by including 22 clinical nurses designated as 'good nurses' according to the perception of nurses working in executive and academic position. All agreed to be interviewed face-to-face. The detachment of nurses from the patients' FNs has been explained by three main factors that are interconnected: namely 'Being personally and professionally convinced regarding the role of FNs', 'Being progressively detached from the FNs', and 'Being forced to be detached from FNs'. Nurses also identified a category including strategies aimed at preventing detachment and 'Rediscovering the FNs as the core of nursing'. Nurses are personally and professionally convinced about the relevance of the FNs. However, they distance themselves from the FNs due to: (a) factors mainly attributable to internal personal and professional forces, such as the emotional fatigue that daily work entails; and (b) external forces related to the work environment where nurses work. To prevent this detrimental process that may result in negative outcomes for patients and their relatives, several strategies at the individual, organizational, and educational levels should be implemented.
Collapse
Affiliation(s)
- Erica Visintini
- Department of Medicine (DAME), University of Udine, 33100, Udine, Italy
| | | | - Michele Savaris
- Department of Medicine (DAME), University of Udine, 33100, Udine, Italy
| | - Greta Paravan
- Department of Medicine (DAME), University of Udine, 33100, Udine, Italy
| | - Micol Serafini
- Department of Medicine (DAME), University of Udine, 33100, Udine, Italy
| | - Alvisa Palese
- Department of Medicine (DAME), University of Udine, 33100, Udine, Italy.
| |
Collapse
|
56
|
Kovanur Sampath K, Arumugam A, Yaghi E, Fairs E, Andersen P. Perception and knowledge of learners about the use of 3D technologies in manual therapy education - a qualitative study. BMC MEDICAL EDUCATION 2023; 23:509. [PMID: 37461000 DOI: 10.1186/s12909-023-04497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional 'See one, do one, teach one' approach. However, this 'teacher centred' approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education. METHODS An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis. RESULTS Six factors were identified which appeared to influence participants' perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants' perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions ('no role' (techstatic) versus a 'complete role' (techsavvy)). CONCLUSION Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.
Collapse
Affiliation(s)
- Kesava Kovanur Sampath
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand.
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Esra Yaghi
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand
| | - Emma Fairs
- Ara Institute of Canterbury, Christchurch, New Zealand
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Dow, QLD, 4556, Australia
- School of Nursing, Midwifery and Social Science, CQ University, Queensland, 4702, Australia
| |
Collapse
|
57
|
Marshall T, Viste D, Jones S, Kim J, Lee A, Jafri F, Krieg O, Ghosh SM. Beliefs, attitudes and experiences of virtual overdose monitoring services from the perspectives of people who use substances in Canada: a qualitative study. Harm Reduct J 2023; 20:80. [PMID: 37355610 DOI: 10.1186/s12954-023-00807-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/06/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Solitary use of substances is a risk factor for substance use-related mortality. Novel e-health harm reduction interventions such as virtual overdose monitoring services (VOMS) have emerged in North America to improve access to emergency overdose support for people who use substances (PWUS). To date, little research has been published, and the perspectives of PWUS are needed to inform evaluation and policy efforts. OBJECTIVE To explore the beliefs, values and perceptions of PWUS around using and accessing VOMS in Canada. METHODS A qualitative study following grounded theory methodology was conducted. Using existing peer networks, purposive and snowball sampling was conducted to recruit PWUS (≥ 18 years) with previous experience with VOMS. Thematic analysis was used to analyze twenty-three interviews. Several methods were employed to enhance rigor, such as independent data coding and triangulation. RESULTS Twenty-three one-on-one telephone interviews of PWUS with previous experience with VOMS were completed and analyzed. The following themes emerged: (1) feelings of optimism around VOMS to save lives; (2) privacy/confidentiality was highly valued due to stigma and fear of arrest; (3) concerns with reliable cell phones negatively impacting VOMS uptake; (4) concerns around emergency response times, specifically in rural/remote communities; (5) desire for trusting relationships with VOMS operators; (6) importance of mental health supports and referrals to psychosocial services; and (7) possible limited uptake due to low public awareness of VOMS. CONCLUSION This qualitative study provided novel insights about the VOMS from the perspectives of PWUS. PWUS generally felt optimistic about the potential of VOMS as a suitable harm reduction intervention, but several potential barriers around accessing VOMS were identified that may limit uptake. Future research is warranted.
Collapse
Affiliation(s)
- Tyler Marshall
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dylan Viste
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | | | - Julia Kim
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Amanda Lee
- Department of Internal Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Farah Jafri
- Department of Internal Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - S Monty Ghosh
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
58
|
Avery RJ, Kalaji M, Niederdeppe J, Mathios A, Dorf M, Byrne S, Safi AG. Perceived threat and fear responses to e-cigarette warning label messages: Results from 16 focus groups with U.S. youth and adults. PLoS One 2023; 18:e0286806. [PMID: 37352255 PMCID: PMC10289367 DOI: 10.1371/journal.pone.0286806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 05/23/2023] [Indexed: 06/25/2023] Open
Abstract
AIMS A warning on e-cigarette packaging is one way the U.S. government can inform the public of known harms of e-cigarette use. Currently, the only required warning on these products is: "WARNING: This product contains nicotine. Nicotine is an addictive chemical." This exploratory study aims to inform potential future investigations and FDA decisions regarding alternative warnings that may generate fear in addition to being intentionally informational. METHOD Data were obtained from responses by 16 online focus groups with adult (N = 47, age range = 18-64) and youth (N = 32, age range 14-16) participants with various smoking and vaping experiences. We showed each focus group a set of hypothetical e-cigarette warning labels to determine how they respond to currently existing public statements that communicate information on the toxicity of ingredients in e-cigarettes, potential health risks, addiction to nicotine, and the uncertainty of the science regarding health effects of using these products. The focus group interviews were audio recorded and transcribed. Transcripts were subjected to a multiphase coding process to identify common response themes. Codes derived from the Extended Parallel Processing Model were then applied to understand impact of potentially fear-inducing language by warning category and age group. RESULTS For adults, all warnings-except those about addiction-gave rise to spontaneous danger control (intended) responses, such as quit intentions. Warnings highlighting cognitive and uncertain effects may be particularly promising for adult consumers of tobacco products because both gengerated danger control and response efficacy without evidence of fear control. However, responses also suggest that warnings risk discouraging some adults who use combustible cigarettes from transitioning to e-cigarettes for harm reduction. For youth, while evidence of response efficacy and danger control emerged among youth exposed to messages in all warning categories but one-addiction-unproductive reactions indicative of fear control were also prevalent among youth respondent across most warning types. On average, youth were more skeptical than adults about the harms of using e-cigarettes. POLICY IMPLICATIONS Implications of study findings for the development of future effective e-cigarette warning messages are explored.
Collapse
Affiliation(s)
- Rosemary J. Avery
- Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY, United States of America
| | - Motasem Kalaji
- Department of Communication Studies, California State University, Northridge, Los Angeles, CA, United States of America
| | - Jeff Niederdeppe
- Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY, United States of America
- Department of Communication, Cornell University, Ithaca, NY, United States of America
| | - Alan Mathios
- Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY, United States of America
- Department of Economics, Cornell University, Ithaca, NY, United States of America
| | - Michael Dorf
- Law School, Cornell University, Ithaca, NY, United States of America
| | - Sahara Byrne
- Department of Communication, Cornell University, Ithaca, NY, United States of America
| | - Amelia Greiner Safi
- Department of Communication, Cornell University, Ithaca, NY, United States of America
- Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, United States of America
| |
Collapse
|
59
|
O'Malley TL, Krier SE, Bainbridge M, Hawk ME, Egan JE, Burke JG. Women's perspectives on barriers to potential PrEP uptake for HIV prevention: HIV risk assessment, relationship dynamics and stigma. CULTURE, HEALTH & SEXUALITY 2023; 25:776-790. [PMID: 35839305 DOI: 10.1080/13691058.2022.2099016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 07/04/2022] [Indexed: 06/02/2023]
Abstract
HIV remains a significant health issue for women, and multiple overlapping factors shape women's HIV-related risk. Pre-exposure prophylaxis (PrEP) offers critical advantages over other existing options, yet it remains significantly underused among women in the USA where limited work has explored women's opinions on barriers to potential PrEP use. Using open-ended text responses from a sample of women seeking care at a US urban family planning health centre, this study aimed to understand perceptions of factors affecting potential PrEP use. Three themes concerning key factors impacting potential PrEP use emerged: HIV risk assessment, relationship dynamics, and anticipated stigma. Women's assessment of HIV risk suggests that identifying women in clinical settings as having low self-perceived risk may overlook the complexity of how women determine HIV-related risk and prevention needs. Women frequently referenced relationship dynamics when considering PrEP and discussed anticipated partner reactions about use contributing to non-use. Fear or worry of stigma were expressed as motivations to not use PrEP. Study results highlight the importance of public health and health care professionals normalising PrEP as a strategy in women's HIV prevention and sexual health decision-making. Woman-centred PrEP education, screening and communication strategies reflective of their unique HIV-related risk context are needed.
Collapse
Affiliation(s)
- Teagen L O'Malley
- Department of Infectious Diseases and Microbiology, School of Public Heath, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sarah E Krier
- Department of Infectious Diseases and Microbiology, School of Public Heath, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maura Bainbridge
- Department of Infectious Diseases and Microbiology, School of Public Heath, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary E Hawk
- Department of Behavioral and Community Health Sciences, School of Public Heath, University of Pittsburgh, Pittsburgh, PA, USA
| | - James E Egan
- Department of Behavioral and Community Health Sciences, School of Public Heath, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jessica G Burke
- Department of Behavioral and Community Health Sciences, School of Public Heath, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
60
|
Funnell JP, Noor K, Khan DZ, D'Antona L, Dobson RJB, Hanrahan JG, Hepworth C, Moncur EM, Thomas BM, Thorne L, Watkins LD, Williams SC, Wong WK, Toma AK, Marcus HJ. Characterization of patients with idiopathic normal pressure hydrocephalus using natural language processing within an electronic healthcare record system. J Neurosurg 2023; 138:1731-1739. [PMID: 36401545 DOI: 10.3171/2022.9.jns221095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Idiopathic normal pressure hydrocephalus (iNPH) is an underdiagnosed, progressive, and disabling condition. Early treatment is associated with better outcomes and improved quality of life. In this paper, the authors aimed to identify features associated with patients with iNPH using natural language processing (NLP) to characterize this cohort, with the intention to later target the development of artificial intelligence-driven tools for early detection. METHODS The electronic health records of patients with shunt-responsive iNPH were retrospectively reviewed using an NLP algorithm. Participants were selected from a prospectively maintained single-center database of patients undergoing CSF diversion for probable iNPH (March 2008-July 2020). Analysis was conducted on preoperative health records including clinic letters, referrals, and radiology reports accessed through CogStack. Clinical features were extracted from these records as SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) concepts using a named entity recognition machine learning model. In the first phase, a base model was generated using unsupervised training on 1 million electronic health records and supervised training with 500 double-annotated documents. The model was fine-tuned to improve accuracy using 300 records from patients with iNPH double annotated by two blinded assessors. Thematic analysis of the concepts identified by the machine learning algorithm was performed, and the frequency and timing of terms were analyzed to describe this patient group. RESULTS In total, 293 eligible patients responsive to CSF diversion were identified. The median age at CSF diversion was 75 years, with a male predominance (69% male). The algorithm performed with a high degree of precision and recall (F1 score 0.92). Thematic analysis revealed the most frequently documented symptoms related to mobility, cognitive impairment, and falls or balance. The most frequent comorbidities were related to cardiovascular and hematological problems. CONCLUSIONS This model demonstrates accurate, automated recognition of iNPH features from medical records. Opportunities for translation include detecting patients with undiagnosed iNPH from primary care records, with the aim to ultimately improve outcomes for these patients through artificial intelligence-driven early detection of iNPH and prompt treatment.
Collapse
Affiliation(s)
- Jonathan P Funnell
- 1Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London
- 2National Hospital for Neurology and Neurosurgery, London
| | - Kawsar Noor
- 3Institute for Health Informatics, University College London
- 4NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
| | - Danyal Z Khan
- 1Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London
- 2National Hospital for Neurology and Neurosurgery, London
| | - Linda D'Antona
- 2National Hospital for Neurology and Neurosurgery, London
- 5UCL Queen Square Institute of Neurology, University College London
| | - Richard J B Dobson
- 3Institute for Health Informatics, University College London
- 4NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
- 6Health Data Research UK London, University College London
- 7NIHR Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London
- 8Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London
| | - John G Hanrahan
- 1Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London
- 2National Hospital for Neurology and Neurosurgery, London
| | | | - Eleanor M Moncur
- 2National Hospital for Neurology and Neurosurgery, London
- 5UCL Queen Square Institute of Neurology, University College London
| | | | - Lewis Thorne
- 2National Hospital for Neurology and Neurosurgery, London
| | | | - Simon C Williams
- 1Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London
- 2National Hospital for Neurology and Neurosurgery, London
| | - Wai Keong Wong
- 4NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
- 6Health Data Research UK London, University College London
| | - Ahmed K Toma
- 2National Hospital for Neurology and Neurosurgery, London
- 4NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
- 5UCL Queen Square Institute of Neurology, University College London
| | - Hani J Marcus
- 1Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London
- 2National Hospital for Neurology and Neurosurgery, London
- 4NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
- 5UCL Queen Square Institute of Neurology, University College London
| |
Collapse
|
61
|
Lam JY, Howlett A, Stephen LM, Brindle ME. Parental perceptions and experiences of care in the surgical neonatal intensive care unit. Pediatr Surg Int 2023; 39:210. [PMID: 37261599 PMCID: PMC10234908 DOI: 10.1007/s00383-023-05484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Parents endure significant stress when their newborns require surgery while in the neonatal intensive care unit (NICU). Our study aims to explore the surgical NICU experience from the parents' perspective and identify areas that may improve this experience. A secondary objective was to integrate their feedback to refine the implementation strategy of the neonatal enhanced recovery after surgery (ERAS®) guideline. METHODS In December 2019, five surgical NICU parents participated in a focus group. Conversation surrounded parents' perspectives and experiences of the surgical NICU. Inductive analysis was performed to identify data, themes, and concepts that emerged from the discussion. RESULTS Participants identified four major interrelated themes that impacted the surgical parents' NICU experience. These themes include (1) parental state, both physical and emotional, (2) the altered parental caregiver role which necessitates identifying alternative meaningful parental experiences, (3) the care team dynamic, incorporating consistency and effective communication, and (4) the discharge process which may be significantly eased through graduated, hands-on training. CONCLUSION Key elements of the neonatal ERAS® guideline address major themes and stressors identified by parents. The parental perspective may help clinicians appreciate the parent surgical NICU experience and assist in improving family-centered care to surgical infants and their families.
Collapse
Affiliation(s)
- Jennifer Y Lam
- Division of Pediatric Surgery, Western University, Children's Hospital-London Health Sciences Centre, B1-188, 800 Commissioners Rd. E, London, ON, N6A 5W9, Canada.
| | - Alexandra Howlett
- Section of Neonatology, University of Calgary, Alberta Children's Hospital, 28 Oki Dr. NW, Calgary, AB, T3B 6A8, Canada
| | - Lori M Stephen
- Section of Neonatology, University of Calgary, Alberta Children's Hospital, 28 Oki Dr. NW, Calgary, AB, T3B 6A8, Canada
| | - Mary E Brindle
- Section of Pediatric Surgery, University of Calgary, Alberta Children's Hospital, 28 Oki Dr. NW, Calgary, AB, T3B 6A8, Canada
| |
Collapse
|
62
|
Gamble N, Holler B, Murata S. 'Swear by Thy Gracious Self': North American Medical Oath-Taking in 2014/2015. New Bioeth 2023; 29:121-138. [PMID: 36548109 DOI: 10.1080/20502877.2022.2150129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Over the past century, six studies - the most recent data from 2000 - and one review have comprehensively examined the content of medical oaths and oath-taking practices, all focusing on North America, providing an insight into the ethical beliefs of each era. Our study sought to establish a new point of reference. In 2014/2015, oaths from 150 of all 153 US and Canadian medical schools were collected and analyzed. All but one school administered medical oaths and most schools administered more than one. Since 2000, student-written oaths became more popular, and new themes, such as self-care and professionalism, were identified in the oaths for the first time. However, as was identified in 2000, the oaths' contents are disparate and even conflicting at times, raising questions as to whether medicine is being taught or practiced with a coherent ethical worldview.
Collapse
Affiliation(s)
- Nathan Gamble
- Department of Cardiology, University of Alberta, Edmonton, Canada
| | | | - Stephen Murata
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
63
|
Zhang Z, Zhang R, Peng Y, Zhai S, Zhang J, Jin Q, Zhou J, Li H, Chen J. Barriers and facilitators of family doctor contract services in caring for disabled older adults in Beijing, China: a mixed methods study. BMJ Open 2023; 13:e070130. [PMID: 37263682 DOI: 10.1136/bmjopen-2022-070130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE To evaluate the current state of family doctor contract services (FDCS) in Beijing, identify the roles of family doctors who have worked with disabled older adults and investigate the barriers and facilitators faced by family doctors in providing care for them. DESIGN A convergent mixed methods study was carried out from October 2020 to January 2021 to collect and analyse both quantitative and qualitative data. The integration strategies in this study were connecting the results of the quantitative phase to data collection of the qualitative phase. SETTING A multi-stage sampling strategy was used to select 15 community health centres (CHCs) in four districts of Beijing. Of the four districts, two were from urban areas and two were from rural areas. PARTICIPANTS The inclusion criteria for participants were (1) family doctors, (2) contracted with disabled older adults, (3) engaged in related work for disabled older adults more than 6 months. METHODS A cluster sampling of 283 family doctors was used in the questionnaire. A purposive sample of 30 family doctors from the same CHCs was selected during the same period. Frequency and rank, rank-sum test, Kruskal-Wallis test were conducted in qualitative data analysis, the views of the interviewees were analysed through the thematic framework method. RESULTS Currently, family doctors provided various services to satisfy the health needs of disabled older adults, while the usage of FDCS for disabled older adults is affected by many factors. The differences of the importance of family doctors' role (p<0.001) and service satisfaction (p=0.004) were significant among four districts. Compared with contracted health senior citizens, this study has identified five unique roles of family doctors, including 'psychological consultant', 'rehabilitation physiotherapist', 'health educator', 'health manager' and 'family health guardian'. Moreover, family doctors are confronted with a myriad of barriers (including high risks in the process of home visits, a lack of supervisory and incentive mechanisms, insufficiency of time and energy, etc) and facilitators (including establishing a doctor-patient trust relationship, developing humanistic care services, etc) in the FDCS for disabled older adults. CONCLUSIONS Family doctors play a pivotal role in the FDCS for disabled older adults, while the effect and quality of FDCS in China needs to be improved. It is suggested that further research needs to focus on solving existing barriers of FDCS to optimise the health of disabled older adults and improve the quality of their lives.
Collapse
Affiliation(s)
- Zhiying Zhang
- School of Medical Humanities, Capital Medical University, Beijing, China
| | - Ruyi Zhang
- Ethics Committee Office, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yingchun Peng
- School of Medical Humanities, Capital Medical University, Beijing, China
| | - Shaoqi Zhai
- School of Medical Humanities, Capital Medical University, Beijing, China
| | - Jiaying Zhang
- School of Medical Humanities, Capital Medical University, Beijing, China
| | - Qilin Jin
- Cardiac Surgery Department, People's Hospital of Beijing Daxing District, Beijing, China
| | - Jiaojiao Zhou
- Medical Department, Fengtai District Xiluoyuan Community Health Service Center, Beijing, China
| | - Hanlin Li
- School of Basic Medical Science, Capital Medical University, Beijing, China
| | - Jingjing Chen
- Administrative Office, Huairou District Liulimiao Community Health Service Center, Beijing, China
| |
Collapse
|
64
|
Del Fernandes R, Relke N, Soleas E, Braund H, Lui CJPM, Zevin B. A Canadian survey of residency applicants' and interviewers' perceptions of the 2021 CaRMS R1 virtual interviews. BMC MEDICAL EDUCATION 2023; 23:392. [PMID: 37248475 DOI: 10.1186/s12909-023-04397-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/25/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND All Canadian Residency Matching Service (CaRMS) R1 interviews were conducted virtually for the first time in 2021. We explored the facilitators, barriers, and implications of the virtual interview process for the CaRMS R1 match and provide recommendations for improvement. METHODS We conducted a cross-sectional survey study of CaRMS R1 residency applicants and interviewers across Canada in 2021. Surveys were distributed by email to the interviewers, and by email, social media, or newsletter to the applicants. Inductive thematic analysis was used for open-ended items. Recommendations were provided as frequencies to demonstrate strength. Close-ended items were described and compared across groups using Chi-Square Fisher's Exact tests. RESULTS A total of 127 applicants and 400 interviewers, including 127 program directors, responded to the survey. 193/380 (50.8%) interviewers and 90/118 (76.3%) applicants preferred virtual over in-person interview formats. Facilitators of the virtual interview format included cost and time savings, ease of scheduling, reduced environmental impact, greater equity, less stress, greater reach and participation, and safety. Barriers of the virtual interview format included reduced informal conversations, limited ability for applicants to explore programs at different locations, limited ability for programs to assess applicants' interest, technological issues, concern for interview integrity, limited non-verbal communication, and reduced networking. The most helpful media for applicants to learn about residency programs were program websites, the CaRMS/AFMC websites, and recruitment videos. Additionally, panel interviews were preferred by applicants for their ability to showcase themselves and build connections with multiple interviewers. Respondents provided recommendations regarding: (1) dissemination of program information, (2) the use of technology, and (3) the virtual interview format. CONCLUSIONS Perceptions of 2021 CaRMS R1 virtual interviews were favourable among applicants and interviewers. Recommendations from this study can help improve future iterations of virtual interviews.
Collapse
Affiliation(s)
| | - Nicole Relke
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Eleftherios Soleas
- Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Heather Braund
- Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | | | - Boris Zevin
- Department of Surgery, Queen's University, Kingston General Hospital, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.
| |
Collapse
|
65
|
Zhou L, Wei L, Chu Y, Xie Q. College Graduates' Negative Life Experiences, Coping Strategies and Enlightenment During the COVID-19 Pandemic: A Qualitative Study in China. Psychol Res Behav Manag 2023; 16:1811-1829. [PMID: 37215701 PMCID: PMC10199699 DOI: 10.2147/prbm.s406987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/22/2023] [Indexed: 05/24/2023] Open
Abstract
Objective The current study aimed to explore comprehensively college graduates' negative life experiences, coping strategies, and enlightenment in a qualitative way. Methods This was a qualitative study. Purposeful sampling was used to select 31 college graduates majoring in various subjects from a Chinese University. The one-on-one semi-structured interviews were conducted online through Tencent QQ/WeChat and were recorded and transcribed verbatim. A phenomenological approach was used to guide this research in the data collection and analysis. Thematic analysis was used to identify themes across interviews around their negative life experiences, coping strategies, and enlightenment. Results College graduates' negative life experiences were mainly focused on three aspects: negative work experience (eg, lack of adaptation, busy schedule, low salary), negative personal life experience (eg, multiple pressure, psychological problems, the hardship of life), and negative social life experience (eg, the incomprehension of those around you, complex interpersonal relationship, social complexity). The coping strategies they used can be classified into two categories: emotion-focused strategies (eg, accepting reality, self-persuasion, keeping a positive attitude), and problem-focused strategies (eg, goal-setting, asking for help to solve the problem, persistence). As for life enlightenment, six themes emerged: accept life, strive to life, love life, cherish life, recognize life, and learn to live. Conclusion College graduates' negative experiences came from multiple levels, and they use multiple coping strategies to deal with the challenges. Our results provide important guidance for researchers and policymakers to design effective and targeted intervention programs to improve college graduates' coping abilities in response to negative life experiences and help them better transition from school to work. Specifically, future research and intervention to promote college graduates' mental health should target various social-ecological levels, focus on promoting coping from an ecological perspective, as well as facilitate post-traumatic growth to help them grow from negative life experiences and cope positively.
Collapse
Affiliation(s)
- Li Zhou
- Department of Health Management, School of Management, Zunyi Medical University, Zunyi, People’s Republic of China
| | - Lai Wei
- Department of Health Management, School of Management, Zunyi Medical University, Zunyi, People’s Republic of China
| | - Yalin Chu
- Department of Health Management, School of Management, Zunyi Medical University, Zunyi, People’s Republic of China
| | - Qinhong Xie
- Center for Mental Health Research, School of Management, Zunyi Medical University, Zunyi, People’s Republic of China
| |
Collapse
|
66
|
Bade C, Olsacher A, Boehme P, Truebel H, Fehring L. Reasons for supply side driven drug shortages - A mixed-methods study on first-level, higher-level, and root causes from the perspective of marketing authorization holders. Res Social Adm Pharm 2023:S1551-7411(23)00271-1. [PMID: 37225602 DOI: 10.1016/j.sapharm.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/21/2023] [Accepted: 05/09/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Drug shortages impact multiple stakeholders and are detrimental to patient safety. Additionally, drug shortages are an extensive financial burden. In Germany, drug shortages, according to data from the federal ministry for drug and medical products (BfArM), have been increasing by 18% between 2018 and 2021. Studies show that shortages are most frequently supply side driven and that often reasons remain unknown. OBJECTIVE The aim is to develop a holistic understanding of supply side causes for drug shortages in Germany from marketing authorization holders' perspectives and to derive implications for shortage mitigation. METHODS A mixed-methods research design, with a grounded theory approach based on a structured literature review, BfArM data analysis, and semi-structured interviews, was used. RESULTS Input factor supply issues, manufacturing issues, logistics issues, product recalls, and product discontinuations were identified as first-level causes. Furthermore, a theory on their connection to higher-level causes related to business decision-making, as well as root causes linked to regulations, company values, internal processes, market dynamics, external shocks, and macroeconomic factors, was developed. CONCLUSION Actions to mitigate drug shortages in Germany (e.g., improving business processes, diversifying tender criteria) were derived. These may thus increase patient safety and decrease the financial burden on the healthcare system.
Collapse
Affiliation(s)
- Celina Bade
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58455, Witten, Germany.
| | - Alexandra Olsacher
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58455, Witten, Germany.
| | - Philip Boehme
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58455, Witten, Germany.
| | - Hubert Truebel
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58455, Witten, Germany; The Knowledge House GmbH, Breite Straße 22, 40213, Düsseldorf, Germany.
| | - Leonard Fehring
- Faculty of Health, School of Medicine, Witten/Herdecke University, 58455, Witten, Germany; Helios Universitätsklinikum Wuppertal, Medizinische Klinik für Gastroenterologie, Hepatologie Endokrionologie und Diabetoloige, Heusnerstraße 40, Wuppertal, Germany.
| |
Collapse
|
67
|
Francis-Oliviero F, Driollet B, Alla F. Pediatric health professionals' perceptions of social health inequalities and proportionate universalism in a French academic hospital: a qualitative study. Eur J Pediatr 2023:10.1007/s00431-023-05005-0. [PMID: 37171520 PMCID: PMC10176283 DOI: 10.1007/s00431-023-05005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 05/13/2023]
Abstract
To describe healthcare professionals' perceptions of social health inequalities in the context of pediatric chronic disease and their insights regarding proportionate universalism as a potential solution to reduce them. Semi-directive interviews were conducted with healthcare professionals from different pediatric chronic disease departments of a single French academic hospital. This qualitative study was based on an inductive thematic analysis; an interview topic guide was used for the interviews and the analysis. In this study, we highlighted three main themes: the healthcare professionals' perceptions of social health inequalities in their practices, their beliefs regarding the causality of those inequalities, and potential solutions proposed by healthcare professionals to reduce them. Healthcare professionals very often associated inequalities with socio-economic precariousness or geographical disparities but were not familiar with the notion of a social gradient. Paradoxically, while they claimed not to differentiate among patients in their practice, they did report adapting care, depending on the social situation. For healthcare professionals, inequalities were the result of misunderstood problems, a lack of family support, a failure of the prevention system, and a lack of financial resources. CONCLUSION We still need to develop solutions to tackle those inequalities at every level of the healthcare system, and healthcare professionals must be more actively involved in this effort. One approach is to adapt public health principles such as proportionate universalism to individual care. WHAT IS KNOWN • Social health inequalities exist in pediatric care and a social gradient has been shown in many clinical situations. • Exploring health professionals' perceptions of social health inequalities can lead to solutions to tackle them. WHAT IS NEW • Pediatricians and pediatric nurses were not fully aware of the social gradient of health. • Although they claimed not to differentiate between patients in their practice, healthcare professionals did adapt care when complicated social situations arose.
Collapse
Affiliation(s)
- Florence Francis-Oliviero
- Centre INSERM U1219, University of Bordeaux, ISPED, Bordeaux Population Health, Bordeaux, France.
- Pôle de Santé Publique, Service d'Information Médicale, CHU de Bordeaux, Bordeaux, France.
| | - Bénédicte Driollet
- Centre INSERM U1219, University of Bordeaux, ISPED, Bordeaux Population Health, Bordeaux, France
| | - François Alla
- Centre INSERM U1219, University of Bordeaux, ISPED, Bordeaux Population Health, Bordeaux, France
- Pôle de Santé Publique, Service de Soutien Méthodologique et d'Innovation en Prévention, CHU de Bordeaux, Bordeaux, France
| |
Collapse
|
68
|
Flory JH, Guelce D, Goytia C, Li J, Min JY, Mushlin A, Orloff J, Mayer V. Prescriber Uncertainty as Opportunity to Improve Care of Type 2 Diabetes with Chronic Kidney Disease: Mixed Methods Study. J Gen Intern Med 2023; 38:1476-1483. [PMID: 36316625 PMCID: PMC10160326 DOI: 10.1007/s11606-022-07838-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/05/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Over 5 million patients in the United States have type 2 diabetes mellitus (T2D) with chronic kidney disease (CKD); antidiabetic drug selection for this population is complex and has important implications for outcomes. OBJECTIVE To better understand how providers choose antidiabetic drugs in T2D with CKD DESIGN: Mixed methods. Interviews with providers underwent qualitative analysis using grounded theory to identify themes related to antidiabetic drug prescribing. A provider survey used vignettes and direct questions to quantitatively assess prescribers' knowledge and preferences. A retrospective cohort analysis of real-world prescribing data assessed the external validity of the interview and survey findings. PARTICIPANTS Primary care physicians, endocrinologists, nurse-practitioners, and physicians' assistants were eligible for interviews; primary care physicians and endocrinologists were eligible for the survey; prescribing data were derived from adult patients with serum creatinine data. MAIN MEASURES Interviews were qualitative; for the survey and retrospective cohort, proportion of patients receiving metformin was the primary outcome. KEY RESULTS Interviews with 9 providers identified a theme of uncertainty about guidelines for prescribing antidiabetic drugs in patients with T2D and CKD. The survey had 105 respondents: 74 primary care providers and 31 endocrinologists. Metformin was the most common choice for patients with T2D and CKD. Compared to primary care providers, endocrinologists were less likely to prescribe metformin at levels of kidney function at which it is contraindicated and more likely to correctly answer a question about metformin's contraindications (71% versus 41%) (p < .05). Real-world data were consistent with survey findings, and further showed low rates of use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists (<10%) in patients with eGFR below 60 ml/min/1.73m2. CONCLUSIONS Providers are unsure how to treat T2D with CKD and incompletely informed as to existing guidelines. This suggests opportunities to improve care.
Collapse
Affiliation(s)
- James H Flory
- Endocrinology Service, Department of Subspecialty Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Dominique Guelce
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | | | - Jing Li
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Jea Young Min
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Al Mushlin
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | - Jeremy Orloff
- Department of Population Health Sciences, Weill Cornell Medical College, New York, NY, USA
| | | |
Collapse
|
69
|
Winograd DM, Hyde JK, Bloeser K, Santos SL, Anastasides N, Petrakis BA, Pigeon WR, Litke DR, Helmer DA, McAndrew LM. Exploring the acceptability of behavioral interventions for veterans with persistent "medically unexplained" physical symptoms. J Psychosom Res 2023; 167:111193. [PMID: 36822031 DOI: 10.1016/j.jpsychores.2023.111193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/01/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE This study evaluated the factors that led to enrollment in, and satisfaction with, behavioral interventions for Veterans living with Gulf War Illness (GWI). METHODS One-on-one interviews were conducted pre- and post-intervention with participants randomized to receive either telephone delivered problem-solving treatment (n = 51) or health education (N = 49). A total of 99 Veterans were interviewed pre-intervention and 60 post-intervention. Qualitative data were thematically coded and similarities in themes across the two interventions were examined. RESULTS Before the study began, participants reported desiring to learn new information about their GWI, learn symptom-management strategies, and support improvements to care for other patients with GWI. After the intervention, Veterans felt positively about both interventions because they built strong therapeutic relationships with providers, their experiences were validated by providers, and they were provided GWI information and symptom-management strategies. Results also suggested that interventions do not have to be designed to meet all of the needs held by patients to be acceptable. A minority of participants described that they did not benefit from the interventions. CONCLUSION The results suggest that satisfaction with behavioral interventions for GWI is driven by a strong therapeutic relationship, validating patient's experiences with GWI, and the intervention meeting some of the patient's needs, particularly increasing knowledge of GWI and improving symptom management.
Collapse
Affiliation(s)
- Darren M Winograd
- Veterans Affairs New Jersey Healthcare System, 385 Tremont Ave. East Orange, NJ 07018, USA; University at Albany, State University of New York, Albany, NY, USA
| | - Justeen K Hyde
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA; Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Katharine Bloeser
- Veterans Affairs New Jersey Healthcare System, 385 Tremont Ave. East Orange, NJ 07018, USA; Silberman School of Social Work at Hunter College, The City University of New York, New York, NY, USA
| | - Susan L Santos
- Veterans Affairs New Jersey Healthcare System, 385 Tremont Ave. East Orange, NJ 07018, USA
| | - Nicole Anastasides
- Veterans Affairs New Jersey Healthcare System, 385 Tremont Ave. East Orange, NJ 07018, USA
| | - Beth Ann Petrakis
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, MA, USA
| | - Wilfred R Pigeon
- VISN 2 Center of Excellence for Suicide Prevention, Veterans Affairs Finger Lakes Healthcare System, Canandaigua, NY, USA; Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - David R Litke
- Veterans Affairs New Jersey Healthcare System, 385 Tremont Ave. East Orange, NJ 07018, USA; Department of Rehabilitation Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Drew A Helmer
- Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA; Baylor College of Medicine, Houston, TX 77030, USA
| | - Lisa M McAndrew
- Veterans Affairs New Jersey Healthcare System, 385 Tremont Ave. East Orange, NJ 07018, USA.
| |
Collapse
|
70
|
Elkholly D, Fraser A, Booth R, O'Neill D, Mateus A, Brunton L, Brodbelt D. Antimicrobial usage in farm animal practices in the UK: A mixed-methods approach. Prev Vet Med 2023; 213:105870. [PMID: 36841042 DOI: 10.1016/j.prevetmed.2023.105870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 01/11/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023]
Abstract
Antimicrobial resistance (AMR) is a growing One Health problem. Monitoring antimicrobial usage in farm animals is crucial for tackling AMR. A cohort study using the electronic clinical records during 2019 from 23 farm animal veterinary practices across the UK belonging to two corporate groups, with a range of 2-14 veterinarians per practice, estimated the usage of antimicrobials and highest priority critically important antimicrobials (HP-CIAs). Risk factors for using HP-CIAs were evaluated using hierarchical mixed-effects logistic regression modelling with practice ID and farm ID added as random effects. Using a qualitative approach, veterinarians from one of the participating practice groups were recruited for a qualitative study to explore the barriers and facilitators in relation to antimicrobial use. Semi-structured interviews were conducted with participants and analysed thematically. During the year 2019, 98,824 antimicrobial prescribing events overall were recorded from the treatment records of the 23 participating practices. The median count of antimicrobial events per practice was 3226 (range 263-22,159). There were 17,111/98,824 (17.3%) HP-CIAs events overall, with a median of 15.4% at practice level (range 4.8-22.1%). Penicillins were the most frequently used antimicrobials 29,539/98,824 (29.9%) followed by tetracyclines 19,015/98,824 (19.2%). HP-CIA use was strongly clustered, with more clustering seen at the farm level (intraclass correlation coefficient (ICC)= 0.56) than at the practice level (ICC= 0.32). Country, route of administration, season and practice type were significantly associated with the usage of HP-CIAs. Four main themes were identified from the analysis of the veterinarians' interviews: pressure from the industry, drug-related factors, knowledge level of veterinarians and clinical factors. Supermarket contracts and farm assurance schemes were facilitators for reducing antimicrobial use and the use of HP-CIAs. Ease of administration and the withdrawal period of the antimicrobials influenced veterinarians' choice of antimicrobials. The clinical condition and clinical signs presented on farm were reported to influence participating veterinarians' prescribing decision. Participants showed a good understanding of AMR, responsible use of antimicrobials and the term 'critically important antimicrobials'. In conclusion, integrating the quantitative and qualitative findings can inform policymaking on antimicrobials stewardship in farm practice. By estimating the relative levels of clustering of antimicrobial use at the practice and farm level, as well as identifying major risk factors for using HP-CIAs, more targeted interventions can be designed to promote responsible antimicrobial use in farm practice. Furthermore, better understanding the industry pressures on farms to reduce antimicrobials usage could reduce the barriers for responsible antimicrobial use by veterinarians.
Collapse
Affiliation(s)
- D Elkholly
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom.
| | - A Fraser
- King's Business School, King's College London, London, United Kingdom
| | - R Booth
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - D O'Neill
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - A Mateus
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - L Brunton
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| | - D Brodbelt
- The Royal Veterinary College, Pathobiology and Population Science, London university, London, United Kingdom
| |
Collapse
|
71
|
Ivankovic D, Garel P, Klazinga N, Kringos D. Data-Driven Collaboration between Hospitals and Other Healthcare Organisations in Europe During the COVID-19 Pandemic: An Explanatory Sequential Mixed-Methods Study among Mid-Level Hospital Managers. Int J Integr Care 2023; 23:28. [PMID: 37333773 PMCID: PMC10275210 DOI: 10.5334/ijic.6990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 06/06/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Data and digital infrastructure drive collaboration and help develop integrated healthcare systems and services. COVID-19 induced changes to collaboration between healthcare organisations, which previously often happened in fragmented and competitive ways. New collaborative practices relied on data and were crucial in managing coordinated responses to the pandemic. In this study, we explored data-driven collaboration between European hospitals and other healthcare organisations in 2021 by identifying common themes, lessons learned and implications going forward. Methods Study participants were recruited from an existing Europe-wide community of mid-level hospital managers. For data collection, we ran an online survey, conducted multi-case study interviews and organised webinars. Data were analysed using descriptive statistics, thematic analysis and cross-case synthesis. Results Mid-level hospital managers from 18 European countries reported an increase in data exchange between healthcare organisations during the COVID-19 pandemic. Data-driven collaborative practices were goal-oriented and focused on the optimisation of hospitals' governance functions, innovation in organisational models and improvements to data infrastructure. This was often made possible by temporarily overcoming system complexities, which would otherwise hinder collaboration and innovation. Sustainability of these developments remains a challenge. Discussion Mid-level hospital managers form a huge potential of reacting and collaborating when needed, including rapidly setting up novel partnerships and redefining established processes. Major post-COVID unmet medical needs are linked to hospital care provision, including diagnostic and therapeutic backlogs. Tackling these will require rethinking of the position of hospitals within healthcare systems, including their role in care integration. Conclusion Learning from COVID-19-induced developments in data-driven collaboration between hospitals and other healthcare organisations is important to address systemic barriers, sustain resilience and further build transformative capacity to help build better integrated healthcare systems.
Collapse
Affiliation(s)
- Damir Ivankovic
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Quality of Care, Amsterdam, The Netherlands
| | - Pascal Garel
- The European Hospital and Healthcare Federation, Brussels, Belgium
| | - Niek Klazinga
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Quality of Care, Amsterdam, The Netherlands
| | - Dionne Kringos
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health research institute, Quality of Care, Amsterdam, The Netherlands
| |
Collapse
|
72
|
Patel Chavez CP, Godinez Leiva E, Bagautdinova D, Hidalgo J, Hartasanchez S, Barb D, Danan D, Dziegielewski P, Edwards C, Hughley B, Srihari A, Subbarayan S, Castro MR, Dean D, Morris J, Ryder M, Stan MN, Hargraves I, Shepel K, Brito JP, Bylund CL, Treise D, Montori V, Singh Ospina N. Patient feedback receiving care using a shared decision making tool for thyroid nodule evaluation-an observational study. Endocrine 2023; 80:124-133. [PMID: 36534326 PMCID: PMC10292116 DOI: 10.1007/s12020-022-03277-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To characterize the feedback of patients with thyroid nodules receiving care using a shared decision making (SDM) tool designed to improve conversations with their clinicians related to diagnostic options (e.g. thyroid biopsy, ultrasound surveillance). METHODS Investigators qualitatively analyzed post-encounter interviews with patients to characterize their feedback of a SDM tool used during their clinical visits. Additionally, investigators counted instances of diagnostic choice awareness and of patients' expression of a diagnostic management preference in recordings of clinical encounters of adult patients presenting for evaluation of thyroid nodules in which the SDM tool was used. RESULTS In total, 53 patients (42 (79%) women); median age 62 years were enrolled and had consultations supported by the SDM tool. Patients were favorable about the design of the SDM tool and its ability to convey information about options and support patient-clinician interactions. Patients identified opportunities to improve the tool through adding more content and improve its use in practice through training of clinicians in its use. There was evidence of diagnostic choice awareness in 52 (98%) of these visits and patients expressed a diagnostic management preference in 40 (76%). CONCLUSION User centered design including feedback from patients and real life observation supports the use of the SDM tool to facilitate collaboration between patients and clinicians.
Collapse
Affiliation(s)
| | - Eddison Godinez Leiva
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Diliara Bagautdinova
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Jessica Hidalgo
- Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA
| | - Sandra Hartasanchez
- Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA
| | - Diana Barb
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Deepa Danan
- Department of Otolaryngology, University of Florida, Gainesville, FL, USA
| | | | - Catherine Edwards
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Brian Hughley
- Department of Otolaryngology, University of Florida, Gainesville, FL, USA
| | - Ashok Srihari
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Sreevidya Subbarayan
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Diana Dean
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - John Morris
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Mabel Ryder
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Marius N Stan
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Ian Hargraves
- Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA
| | - Kathryn Shepel
- Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA
| | - Juan P Brito
- Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Carma L Bylund
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Debbie Treise
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Victor Montori
- Knowledge and Evaluation Research Unit in Endocrinology (KER_Endo), Mayo Clinic, Rochester, MN, USA
- Division of Endocrinology, Mayo Clinic, Rochester, MN, USA
| | - Naykky Singh Ospina
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
73
|
Talegaonkar S, Chitlangia A, Pradhan V, More S, Salunke S. Uncovering Caregiver Concerns: 5 key issues that still remain unresolved in administration of oral medicines for children in India. Eur J Pharm Biopharm 2023; 187:166-174. [PMID: 36965592 DOI: 10.1016/j.ejpb.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION Administration devices play a very crucial role in achieving a drug's therapeutic effect. Children are often dosed with oral liquids, but dosing devices don't have the accuracy needed, putting them at risk of inaccurate and suboptimal dosing. The availability and use of administration devices may vary throughout the world. Multiple surveys in UK, Europe and Japan have shown diverging practices by parents/caregivers. The aim of the present investigation was to conduct a larger Pan-India study through a series of workshops to understand the use and challenges of traditional devices and assess the need of innovative administration devices for liquid orals in India. METHODS The methodology used for the workshop was contextual inquiry and survey questionnaire were used to record the responses. Parents for the workshop were recruited by advertising the survey on various social media platforms. Informed consent was taken from the parents or caregivers for their participation in the survey. Workshops were conducted pan India and both middle class and urban worker families in the occupational category were included in the study. During the workshop, the parents were briefed about the background and purpose of the study. Certain global innovative devices such as oral syringes, syringes with pacifiers were shown to the parents. Their views and opinions were taken through survey questionnaire and via interactive sessions. The questions were themed for the interactive session on 1) challenges faced, 2) willingness to use innovative devices and 3) the factors influencing their decision on the use of innovative devices. RESULTS Across the four regions (4 metro cities) involved in the study, 271 caregivers agreed to participate in the workshops. 17.7% administered solid dosage forms, 81.2% administered liquid dosage form and the remaining 1.1% opted for others. Traditional devices: Caregivers reported the use of measuring cups (41.4%) followed by household spoons (25.8%), droppers (15.3%), measuring spoons (2.6%), and other dosing devices (5.5%) for measuring oral liquids. 8.0% did not use any of the dosing devices as they were administrating tablets and/or capsules. The ease-of-use score was the highest for the dropper (2.67 ± 0.68) and the lowest for the measuring spoon (2.00 ± 1.00). The reported challenges were categorised into five categories which also influences the preference of using administration devices. This includes device design, user experience and usability, sociocultural factors, such as beliefs, knowledge and education, regulatory, and market/distribution. Innovative devices: The majority of the caregivers (86.7%) were not aware of any of the innovative devices shown to them. 58.7% were willing to use it if was recommended by the doctor, 1.5% of caregivers would use it on pharmacists' recommendation and 37.6% parents would use it if came along with the medicine. The criteria considered by the parents for use of the innovative devices in the descending order were Doctor's recommendation> Quality> Cost> Packed in medicine> Ease of use > Availability/accessibility. There were no differences observed among the low and high socioeconomic status of caregviers regarding the use of traditional devices, challenges faced and awareness about innovative devices. Overall, the study revealed heterogeneity in the SES for the use of administration devices in the four zones. The association of SES and opinion on the use of administration devices was demonstrated with no statistically significant interaction between caregiver SES and the use of administration devices. CONCLUSION The workshop revealed the prevalence of traditional dosing devices like measuring cups, household spoons among the caregivers. It highlighted key issues with the use of appropriate administration devices for correct and accurate dosing in children that remain unresolved and prevalent in India. This study reflects on the needs of the target community; thus hope will help facilitate the development of locally sustainable solutions to improve the administration of medicines in children in India.
Collapse
Affiliation(s)
- Sushama Talegaonkar
- School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University (DPSRU), MB Road, New Delhi, 110017, India
| | - Ayushi Chitlangia
- Society for Paediatric Medicines and Healthcare Initiative, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga East, Mumbai - 400 019, India
| | - Varsha Pradhan
- Society for Paediatric Medicines and Healthcare Initiative, Institute of Chemical Technology, Nathalal Parekh Marg, Matunga East, Mumbai - 400 019, India
| | - Supriya More
- Rochiram Thadhani High School for the Hearing Handicapped, Mumbai, India
| | - Smita Salunke
- University College London School of Pharmacy, 29-39 Brunswick Square, London WC1N 1AX, United Kingdom
| |
Collapse
|
74
|
Fischer JM, Kandil FI, Karst M, Zager LS, Jeitler M, Kugler F, Fitzner F, Michalsen A, Kessler CS. Patient Experiences With Prescription Cannabinoids in Germany: Protocol for a Mixed Methods, Exploratory, and Anonymous Web-Based Survey. JMIR Res Protoc 2023; 12:e38814. [PMID: 36943359 PMCID: PMC10131879 DOI: 10.2196/38814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Medical cannabinoids are controversial. Their use is comparatively rare, but it is rising. Since 2017, cannabinoids can be prescribed in Germany for a broader range of indications. Patient surveys on these drugs are hampered by the stigmatization of cannabinoids and their (still) low prevalence in medical contexts. Against this background, patients' willingness to provide information is limited. Moreover, it is logistically challenging to reach them with a survey. A thorough knowledge of currently ongoing therapies and their effects and side effects, however, is important for a more appropriate and effective use of cannabinoids in the future. OBJECTIVE This study is an exploratory data collection using a representative sample. The main goal is to provide a detailed picture of the current use of medical cannabinoids in Germany. It is intended to identify subgroups that may benefit particularly well or poorly. METHODS We are conducting a representative, anonymous, cross-sectional, one-time, web-based survey based on mixed methods in 3 German federal states. Health conditions under cannabinoid therapy and before are documented with validated, symptom-specific questionnaires. This allows an estimation of the effect sizes of these therapies. The selection of parameters and questionnaires was based on the results of independent qualitative interviews in advance. Representative samples of the hard-to-reach study population are obtained by cluster sampling via contracted physicians of the statutory health insurance companies. RESULTS Recruitment was ongoing until the end of June 2022, with 256 enrolled participants. Validated questionnaires on pain, spasticity, anorexia or wasting, multiple sclerosis, nausea or vomiting, depression, and attention deficit hyperactivity disorder (ADHD) were selected. Symptom scores are being assessed for both current conditions under cannabinoid therapy and conditions prior to this therapy (in retrospect). Validated questionnaires are also used for treatment satisfaction and general quality of life. These are supplemented by existing diagnoses, a detailed medication history, any previous experiences with cannabis or illegal substances, experiences with the prescription process, and sociodemographic data. Based on the results of the previous qualitative interviews, questions were added regarding prior experience with relaxation methods and psychotherapy, personal opinions about cannabinoids, pre-existing or symptom-related psychological trauma, and different experiences with different cannabis-based therapies. CONCLUSIONS The exploratory mixed methods approach of this project is expected to provide valid and relevant data as a basis for future clinical research. The study design may be representative for a large proportion of outpatients treated with cannabinoids in the German federal states studied. It may have less bias toward social desirability and may provide valuable information in addition to existing studies. Due to the observational and cross-sectional nature of this study, various limitations apply. Causal relations cannot be drawn. TRIAL REGISTRATION German Clinical Trials Register DRKS00023344; https://drks.de/search/en/trial/DRKS00023344. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38814.
Collapse
Affiliation(s)
- Jan Moritz Fischer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Farid-Ihab Kandil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matthias Karst
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, Hannover Medical School, Hannover, Germany
| | - Laura Sophie Zager
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michael Jeitler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Felix Kugler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Franziska Fitzner
- Department of Anesthesiology and Intensive Care Medicine, Pain Clinic, Hannover Medical School, Hannover, Germany
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
| | - Christian S Kessler
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Internal and Integrative Medicine, Immanuel Hospital Berlin, Berlin, Germany
| |
Collapse
|
75
|
Rolf LR, Vestal L, Moore AC, Lobb Dougherty N, Mueller N, Newland JG. Psychosocial work environment stressors for school staff during the COVID-19 pandemic: Barriers and facilitators for supporting wellbeing. Front Public Health 2023; 11:1096240. [PMID: 36992895 PMCID: PMC10040557 DOI: 10.3389/fpubh.2023.1096240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/24/2023] [Indexed: 03/14/2023] Open
Abstract
IntroductionAfter periods of remote and/or hybrid learning as a result of the COVID-19 global pandemic, the return to in-person learning has been beneficial for both students and teachers, but it has not been without challenges. This study was designed to assess the impact of the return to in-person learning on the school experience, and efforts made to ease the transition in furthering a positive in-person learning environment.Materials and methodsWe conducted a series of listening sessions with 4 stakeholder groups: students (n = 39), parents (n = 28), teachers/school staff (n = 41), and a combination of listening sessions and semi-structured interviews with building level and district administrators (n = 12), focusing on in-school experiences during the 2021–2022 school year amidst the COVID-19 pandemic. A primarily deductive qualitative analysis approach was employed to code the data followed by a primarily inductive thematic analysis, followed by thematic aggregation, thus providing depth and identification of nuances in the data.ResultsThree main themes emerged around school staff experiences: (1) increased levels of stress and anxiety manifested in key ways, including students' challenges with personal behavior management contributing to increased aggression and staff shortages; (2) school staff described key contributors to stress and anxiety, including feeling excluded from decision making and challenges with clear and consistent communication; and (3) school staff described key facilitators that supported their management of anxiety and stress, including adaptability, heightened attention and resources to wellbeing, and leveraging interpersonal relationships.DiscussionSchool staff and students faced significant stress and anxiety during the 2021–2022 school year. Further exploration and identification of approaches to mitigate key contributors to increased stress and anxiety for school staff, along with increased opportunities for implementing key facilitators that were identified as important in managing and navigating the increased stress and anxiety offer valuable opportunities for helping to create a supportive work environment for school staff in the future.
Collapse
Affiliation(s)
- Liz R. Rolf
- Brown School Evaluation Center, Washington University in St. Louis, Saint Louis, MO, United States
- *Correspondence: Liz R. Rolf
| | - Liz Vestal
- Brown School Evaluation Center, Washington University in St. Louis, Saint Louis, MO, United States
| | - Ashley C. Moore
- Brown School Evaluation Center, Washington University in St. Louis, Saint Louis, MO, United States
| | - Nikole Lobb Dougherty
- Brown School Evaluation Center, Washington University in St. Louis, Saint Louis, MO, United States
| | - Nancy Mueller
- Office of the Provost, Washington University in St. Louis, Saint Louis, MO, United States
| | - Jason G. Newland
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, United States
| |
Collapse
|
76
|
Mery CM, Well A, Taylor K, Carberry K, Colucci J, Ulack C, Zeiner A, Mizrahi M, Stewart E, Dillingham C, Cook T, Hartounian A, McCullum E, Affolter JT, Van Diest H, Lamari-Fisher A, Chang S, Wallace S, Teisberg E, Fraser CD. Examining the Real-Life Journey of Individuals and Families Affected by Single-Ventricle Congenital Heart Disease. J Am Heart Assoc 2023; 12:e027556. [PMID: 36802928 PMCID: PMC10111463 DOI: 10.1161/jaha.122.027556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Background The lifetime journey of patients with single-ventricle congenital heart disease is characterized by long-term challenges that are incompletely understood and still unfolding. Health care redesign requires a thorough understanding of this journey to create and implement solutions that improve outcomes. This study maps the lifetime journey of individuals with single-ventricle congenital heart disease and their families, identifies the most meaningful outcomes to them, and defines significant challenges in the journey. Methods and Results This qualitative research study involved experience group sessions and 1:1 interviews of patients, parents, siblings, partners, and stakeholders. Journey maps were created. The most meaningful outcomes to patients and parents and significant gaps in care were identified across the life journey. A total of 142 participants from 79 families and 28 stakeholders were included. Lifelong and life-stage specific journey maps were created. The most meaningful outcomes to patients and parents were identified and categorized using a "capability (doing the things in life you want to), comfort (experience of physical/emotional pain/distress), and calm (experiencing health care with the least impact on daily life)" framework. Gaps in care were identified and classified into areas of ineffective communication, lack of seamless transitions, lack of comprehensive support, structural deficiencies, and insufficient education. Conclusions There are significant gaps in care during the lifelong journey of individuals with single-ventricle congenital heart disease and their families. A thorough understanding of this journey is a critical first step in developing initiatives to redesign care around their needs and priorities. This approach can be used for people with other forms of congenital heart disease and other chronic conditions. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04613934.
Collapse
Affiliation(s)
- Carlos M Mery
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Andrew Well
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX.,Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Kate Taylor
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Kathleen Carberry
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - José Colucci
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Christopher Ulack
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Adam Zeiner
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Michelle Mizrahi
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Eileen Stewart
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Pediatrics The University of Texas at Austin Dell Medical School Austin TX
| | - Christine Dillingham
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX
| | - Taylor Cook
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Arotin Hartounian
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Elizabeth McCullum
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| | - Jeremy T Affolter
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Pediatrics The University of Texas at Austin Dell Medical School Austin TX
| | - Heather Van Diest
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Health Social Work The University of Texas at Austin Dell Medical School Austin TX
| | - Alexandra Lamari-Fisher
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Psychiatry and Behavioral Sciences The University of Texas at Austin Dell Medical School Austin TX
| | - Stacey Chang
- Design Institute for Health The University of Texas at Austin Dell Medical School and College of Fine Arts Austin TX
| | - Scott Wallace
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Elizabeth Teisberg
- Value Institute for Health and Care The University of Texas at Austin Dell Medical School and McCombs School of Business Austin TX
| | - Charles D Fraser
- Texas Center for Pediatric and Congenital Heart Disease UT Health Austin/Dell Children's Medical Center Austin TX.,Department of Surgery and Perioperative Care The University of Texas at Austin Dell Medical School Austin TX
| |
Collapse
|
77
|
Gallagher S. Graduate radiographers' experience of learning MRI practice: A pilot study using constructivist grounded theory methodology. J Med Imaging Radiat Sci 2023; 54:51-57. [PMID: 36460580 DOI: 10.1016/j.jmir.2022.10.198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Traditionally radiographers, specialising in MRI practice, would have first worked in a general imaging department, however due to the shortage of MRI radiographers within the UK, opportunities have now arisen for graduate radiographers to enter MRI practice directly. There are no requirements to undertake formal MRI qualifications or competency frameworks for UK MRI practitioners. Consequently, training is often conducted in house by other MRI practitioners and is not regulated or audited. The aim of this pilot study was to explore graduate radiographers' experiences of learning MRI practice. METHODS A constructivist grounded theory methodology was implemented. Purposeful sampling was employed, and participants were recruited via social media. Participants (n3) had all entered MRI practice directly from graduation within the last 5 years and were currently working in the UK. Data was collected through semi-structured interviews, undertaken virtually and audio recorded. Analysis of the data was conducted using the constructivist grounded theory process, as set out by Charmaz and NVivo software was used to manage the data. RESULTS Five core categories emerged from the data, 1) aspirations to enter MRI practice, 2) engaging in the learning process, 3) influences of the learning environment, 4) confidence in competence, 5) identification of the need for further learning. These core categories describe the stages of the participants' experience of learning MRI practice. CONCLUSION The results of this pilot study demonstrate the pathway taken by graduate MRI radiographers through their MRI educational experience. Undergraduate placements, within MRI, influenced their choice to enter MRI practice, however it did not sufficiently prepare them and further education was necessary. All the participants were provided with a structure to their learning and assessment of competence was required, although the complexity of which varied between participants. Despite feeling competent to undertake MRI imaging examinations all participants sought out opportunities to engage with more formalised MRI radiographer education. Consequently, there may be a need for a standardised national training programme for MRI radiographers to ensure consistency of training and assessment. Further research with a larger participant size is required to consolidate these findings.
Collapse
|
78
|
A Qualitative Study Exploring Professional Perspectives of a Challenging Rehabilitation Environment for Geriatric Rehabilitation. J Clin Med 2023; 12:jcm12031231. [PMID: 36769879 PMCID: PMC9918066 DOI: 10.3390/jcm12031231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
There is a trend towards the formalization of the rehabilitation process for older rehabilitants in a Challenging Rehabilitation Environment (CRE). This concept involves the comprehensive organization of care, support, and environment on rehabilitation wards. So far, literature on the principles of the CRE is scarce. This study aims to explore the perspectives regarding the CRE of healthcare professionals through a qualitative study. Therefore, between 2018 and 2020, six international and 69 Dutch professionals were interviewed in focus groups, and 180 professionals attended workshops on two Dutch congresses. Data were thematically analyzed using ATLAS.ti. Seven themes emerged regarding the rehabilitation processes: (1) rehabilitant (attention for cognitive functioning and resilience); (2) goals (setting personal goals); (3) exercise (increasing exercise intensity); (4) daily schedule (following the daily rhythm); (5) involving the client system (involving informal caregivers); (6) nutrition (influences rehabilitation capability); and (7) technology (makes rehabilitation more safe and challenging). Regarding organizational aspects, four main themes were identified: (1) environmental aspects (encourages exercises); (2) staff aspects (interdisciplinary team); (3) organizational aspects (implementing CRE requires a shared vision); and (4) factors outside the ward (a well-prepared discharge process). To offer effective rehabilitation, all elements of the CRE should be applied. To improve the CRE, specific interventions need to be developed and implemented. Consequently, the effectiveness and efficiency of the CRE need to be measured with validated tools.
Collapse
|
79
|
Tan CSS, Wong YJ, Tang KF, Lee SWH. Diabetes, Ramadan, and driving - Ensuring patient safety while respecting religious autonomy: A qualitative study. Diabetes Metab Syndr 2023; 17:102724. [PMID: 36791634 DOI: 10.1016/j.dsx.2023.102724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND AIMS Hypoglycaemia due to fasting during Ramadan may affect the ability to perform complex activities among people with type 2 diabetes mellitus (T2D), but it is unclear how this affects one's ability to drive. This study aims to explore driving experiences and coping strategies to ensure safe driving among people with T2D who fast during Ramadan. METHODS We conducted an exploratory qualitative study and purposefully selected people with T2D who drove and fasted during the past Ramadan period in 2019. In-depth face-to-face interviews were conducted and transcribed verbatim. Data were analysed thematically using a constant comparative method until saturation was achieved (n = 16). RESULTS Two major themes were identified, namely: (1) knowing oneself and (2) voluntary self-restriction. Participants described the importance of understanding how Ramadan fasting affected them and their level of alertness. As such, participants often adjusted their daily activities and tested their blood glucose levels to prevent experiencing hypoglycaemia. Other coping strategies reported include adjusting their medications and driving restrictions or driving in the mornings when they were more alert. Findings from this study shed light on participants' experiences and coping mechanisms while driving during Ramadan. CONCLUSION Given the risks and effects of hypoglycaemia among those who fast, there is a need to provide appropriate and focused patient education during Ramadan to people with T2D to ensure they can perform complex activities such as driving safely, especially in Muslim majority countries.
Collapse
Affiliation(s)
| | - Yen Jun Wong
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Kar Foong Tang
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia; School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia.
| |
Collapse
|
80
|
Tijsen LMJ, Derksen EWC, Achterberg WP, Buijck BI. A Qualitative Study Exploring Rehabilitant and Informal Caregiver Perspectives of a Challenging Rehabilitation Environment for Geriatric Rehabilitation. J Patient Exp 2023; 10:23743735231151532. [PMID: 36687166 PMCID: PMC9850128 DOI: 10.1177/23743735231151532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
There is a trend toward formalization of the rehabilitation process for older rehabilitants in a Challenging Rehabilitation Environment (CRE). This concept involves the comprehensive organization of care, support, and environment in rehabilitation wards. So far, literature about the principles of CRE is scarce. This study aims to explore the opinions of rehabilitants and informal caregivers regarding CRE, through a qualitative study between 2019 and 2020. Three telephone interviews were conducted with informal caregivers, and also 3 focus groups with 15 rehabilitants and 3 informal caregivers, all with recent experience in rehabilitation. Nine themes emerged regarding the rehabilitation process: (1) rehabilitant (attention for resilience, motivation, cognitive and emotional aspects), (2) rehabilitant centered (goal setting, physical and cognitive functioning and coping), (3) informal caregivers (involving and attention for resilience and relation), (4) communication (aligning the rehabilitation process), (5) exercise (increasing intensity by using task-oriented exercise, patient-regulated exercise, and group training), (6) peer support (learning experiences and recognition), (7) daily schedule (influence on the planning and activities outside therapy), (8) nutrition (energy for rehabilitation), and (9) eHealth (makes rehabilitation more challenging and fun). Regarding organizational processes, 4 themes were identified: (1) environmental aspects (single bedrooms, shared room for activities and therapy options on the ward), (2) staff aspects (small team with an emphatic supportive and motivating attitude), (3) organizational aspects (organized in an efficient way), and (4) return home (the discharge process should be well prepared for instance with home visits). Organizing excellent rehabilitation care requires a thorough understanding of the concept of CRE, as it is a complex and comprehensive concept that concerns the whole rehabilitation process. Its effectiveness and efficiency should be researched in prospective studies.
Collapse
Affiliation(s)
- Lian M J Tijsen
- Department of Public Health and Primary Care, Leiden University
Medical Center, Leiden, The Netherlands,Oktober, Bladel, The Netherlands,De Zorgboog, Bakel, The Netherlands,Lian M J Tijsen, LUMC, Department Public
Health and Primary Care, Postzone V0-P, Postbus 9600, 2300 RC Leiden, The
Netherlands.
| | - Els W C Derksen
- Department of Primary and Community Care, Radboud University Medical
Center, Nijmegen, The Netherlands
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University
Medical Center, Leiden, The Netherlands
| | - Bianca I Buijck
- Oktober, Bladel, The Netherlands,De Zorgboog, Bakel, The Netherlands
| |
Collapse
|
81
|
Iqbal J, Shaikh AA, Jamal WN, Akhtar K, Rahim R, Kousar S. Exploring the generic skills required for the employability and professional wellbeing of Pakistani Millennials: The employers' perspective. Front Psychol 2023; 13:1070267. [PMID: 36687932 PMCID: PMC9849802 DOI: 10.3389/fpsyg.2022.1070267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/21/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction This study aims to elucidate the employers' perspectives on the key generic employability skills which would enable them to seek graduate jobs and will ensure their professional wellbeing once they enter the job market after acquiring a University degree. Methods In order to pursue this objective, an exploratory qualitative inquiry was deployed which involved two panel-based discussions. The respondents of each panel discussion were invited through the platforms of the Bahawalpur Chamber of Commerce and Industry (BCCI), and the Chamber of Commerce Rahim Yar Khan. These respondents represented Pharmaceuticals, Agrichemical manufacturers (fertilizers, pesticides), Livestock, Cotton, textiles, and apparel industry which are the main industries in Southern Punjab, Pakistan. Results and discussion For the purpose of analysis, a thematic analysis was done in the context of grounded theory. Resultantly, the findings of the study reveal an employers' perspective on 10 key generic employability skills as must-have for a Pakistani Millennial graduate including various soft and hard skills, such as-Emotional Intelligence, Flexibility and Adaptability, Multitasking, Computer Literacy and Digital Skills, Information Literacy and Data Analytics, Oral and Written Communication in English and Urdu, Critical Thinking, Positive Politics, Work Ethics and Professionalism, and Commercial awareness. Hence, the study produces implications for the employability stakeholders, including government and academia for a much needed shift from a mere subject-based curriculum to a skill-oriented curriculum and training in the Universities, particularly in the region of Southern Punjab, and all across Pakistan as well.
Collapse
|
82
|
de Guex KP, Augustino D, Mejan P, Gadiye R, Massong C, Lukumay S, Msoka P, Sariko M, Kimathi D, Vinnard C, Xie Y, Mmbaga B, Pfaeffle H, Geba M, Heysell SK, Mduma E, Thomas TA. Roadblocks and resilience: A qualitative study of the impact of pediatric tuberculosis on Tanzanian households and solutions from caregivers. Glob Public Health 2023; 18:2196569. [PMID: 37021699 PMCID: PMC10228591 DOI: 10.1080/17441692.2023.2196569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 03/24/2023] [Indexed: 04/07/2023]
Abstract
Distinct from quantifying the economic sequelae of tuberculosis (TB) in adults, data are scarce regarding lived experiences of youth and their caregivers seeking and sustaining TB treatment in low income communities. Children ages 4-17 diagnosed with TB and their caregivers were recruited from rural and semi-urban northern Tanzania. Using a grounded theory approach, a qualitative interview guide was developed, informed by exploratory research. Twenty-four interviews were conducted in Kiswahili, audio-recorded and analyzed for emerging and consistent themes. Dominant themes found were socioemotional impacts of TB on households, including adverse effects on work productivity, and facilitators and obstacles to TB care, including general financial hardship and transportation challenges. The median percentage of household monthly income spent to attend a TB clinic visit was 34% (minimum: 1%, maximum: 220%). The most common solutions identified by caregivers to mitigate adverse impacts were transportation assistance and nutrition supplementation. To end TB, healthcare systems must acknowledge the total financial burden shouldered by low wealth families seeking pediatric TB care, provide consultations and medications locally, and increase access to TB-specific communal funds to mitigate burdens such as inadequate nutrition.Trial registration: planned sub-study of the registered prospective study, NCT05283967.Trial registration: ClinicalTrials.gov identifier: NCT05283967.
Collapse
Affiliation(s)
- Kristen Petros de Guex
- University of Virginia, Division of Infectious Diseases and International Health, Charlottesville, USA
| | | | - Paulo Mejan
- Haydom Global Health Research Center, Haydom, Tanzania
| | - Rehema Gadiye
- Haydom Global Health Research Center, Haydom, Tanzania
| | | | | | - Perry Msoka
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | | | | | | | - Yingda Xie
- Rutgers New Jersey Medical School, Division of Infectious Diseases, Newark, USA
| | | | | | - Maria Geba
- University of Virginia, Division of Infectious Diseases and International Health, Charlottesville, USA
| | - Scott K. Heysell
- University of Virginia, Division of Infectious Diseases and International Health, Charlottesville, USA
| | - Estomih Mduma
- Haydom Global Health Research Center, Haydom, Tanzania
| | - Tania A. Thomas
- University of Virginia, Division of Infectious Diseases and International Health, Charlottesville, USA
| |
Collapse
|
83
|
Phillips C, Pechmann C, Calder D, Prochaska JJ. Understanding Hesitation to Use Nicotine Replacement Therapy: A Content Analysis of Posts in Online Tobacco-Cessation Support Groups. Am J Health Promot 2023; 37:30-38. [PMID: 35817548 PMCID: PMC9755690 DOI: 10.1177/08901171221113835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE We aimed to better understand hesitancy to use nicotine replacement therapy (NRT) to quit smoking. DESIGN We content coded and analyzed NRT-related posts in online quit smoking support groups to understand NRT-use hesitancy and to examine associations with health outcomes. SETTING NRT posts were analyzed in unmoderated social-media support groups with free NRT. SAMPLE Adults who smoked daily (n = 438) and posted about NRT were studied, 339 of whom reported on NRT usage and 403 reported on smoking abstinence. MEASURES Surveys at 1-month post-quit date assessed NRT usage and smoking abstinence. ANALYSIS Relationships among NRT posts, NRT usage and smoking abstinence were analyzed using GEE models accounting for support group and covariates. RESULTS Nearly all (96.17%) participants reported using the study-provided NRT once, most (70.21%) used NRT during the past week, but less than half (45.72%) used NRT daily for the full month as recommended. Nearly two-thirds (65.34%) of NRT posts were negative. Posts reflecting dislike or no longer needing NRT were associated with a lower likelihood of using NRT in the past week at least once (B = -.66, P = .005 and B = -.37, P = .045), use occasions (B = -1.86, P = .018 and B = -1.10, P = .016) and used daily for full month (B = -.56, P = .044 and B = -.53, P = .009). Posts related to the effectiveness of NRT related to past-week NRT used at least once (B = .15, P = .023), used daily for full month (B = .25, P = .001), and smoking abstinence (B = .27, P = .002). CONCLUSION Strategies are needed to address dislike of NRT and strengthen perceptions of NRT efficacy, especially on social media where posts may be amplified.
Collapse
Affiliation(s)
- Connor Phillips
- Paul Merage School of Business, University of California Irvine, Irvine, CA, USA
| | - Cornelia Pechmann
- Paul Merage School of Business, University of California Irvine, Irvine, CA, USA
| | - Douglas Calder
- Paul Merage School of Business, University of California Irvine, Irvine, CA, USA
| | - Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| |
Collapse
|
84
|
D'Alessandro DM, Shah NH, Riss RR, Darden AG. Defining Their Own Success: Scholars' Views After a Faculty Development Program. Acad Pediatr 2023; 23:193-200. [PMID: 35914731 DOI: 10.1016/j.acap.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/13/2022] [Accepted: 07/23/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Educator roles in medicine are expanding yet career paths and definitions of successful careers are not uniformly agreed upon. Educator success from their own perspective has not been broadly explored as these studies usually occur from the institutional or organizational viewpoint. This study examined the impact of a national educational faculty development program (FDP) for academic pediatricians on educators' self-description of their own professional and personal success. METHODS This was a cross-sectional, qualitative study of FDP alumni between 2019-2021. Interviews explored participants perspectives on their professional success, and supports and barriers. Using an iterative process, thematic analysis of the data identified 6 themes. RESULTS Fourteen scholars were interviewed. All felt they were successful citing both outcome and impact measures categorized into 6 themes: personal attributes, adequate resources and barriers, foundational skill development, experiencing strong mentoring and networking, engaging, and being connected to a community of practice and self-identifying as a medical educator. To view the data holistically, a model incorporating 3 frameworks was developed. CONCLUSIONS These educators viewed themselves as successful academic educators. While papers, promotions and positions were important, educators viewed impact in mentoring and collaborations with others, along with acquired expertise and an expanded viewpoint of the field and themselves as equally important. Educators and leaders could use these elements for their own self-assessment and support, FDP development and enhancement, and for investment in programs and faculty educators.
Collapse
Affiliation(s)
| | - Neha H Shah
- Associate Professor of Pediatrics (NH Shah), The George Washington University School of Medicine and Health Sciences, Washington DC
| | - Robert R Riss
- Associate Professor of Pediatrics (RR Riss), University of Missouri, Kansas City, Mo
| | - Alix G Darden
- Professor of Pediatrics (AG Darden), University of Oklahoma, Oklahoma City, Okla
| |
Collapse
|
85
|
Kobritz M, Nofi CP, Demyan L, Farno E, Fornari A, Kalyon B, Patel V. Implementation and Assessment of Mentoring and Professionalism in Training (MAP-IT): A Humanistic Curriculum as a Tool to Address Burnout in Surgical Residents. JOURNAL OF SURGICAL EDUCATION 2023; 80:17-29. [PMID: 36437162 DOI: 10.1016/j.jsurg.2022.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 10/02/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Mentoring and Professionalism in Training (MAP-IT), a humanistic mentorship program, has demonstrated positive impact in non-surgical fields. This study assesses the feasibility of implementing MAP-IT in surgical residency and adapts MAP-IT to include residents-as-teachers (RAT). We hypothesize that MAP-IT will benefit surgical residents by building humanistic teaching skills, increasing resilience, reducing burnout, and improving connectedness. DESIGN MAP-IT was implemented monthly during protected educational time. Faculty surgeons who had previously completed MAP-IT served as facilitators. Small groups consisted of 12 trainees, two faculty facilitators, and one resident facilitator. Each session comprised 60 minutes of reflection, readings, and discussion surrounding humanistic mentoring skills. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS), Connor Davidson Resilience Scale (CD-RISC), and Humanistic Teaching Practices Effectiveness Questionnaire (HTPE) were administered before and after participation in MAP-IT. Qualitative interviews and surveys assessed residents' perspectives of the MAP-IT program. SETTING MAP-IT was implemented at Northwell-North Shore/LIJ in Manhasset, NY in a general surgery residency program hosted by two tertiary care hospitals within a large health system. PARTICIPANTS 55 residents participated as learners, five residents served as resident-facilitators, and 10 surgical faculty served as paired-facilitators of the MAP-IT course. RESULTS 31.6% of residents had participated in a reflective medicine curriculum prior to MAP-IT, and these residents reported greater resilience and less burnout. This disparity was eliminated after participation in MAP-IT. Frequency of burnout was reduced from 64.1% to 46.1% after MAP-IT participation. Post-program, residents reported greater effectiveness in humanistic teaching practices when compared to baseline assessments. Quantitative and qualitative feedback demonstrated that MAP-IT was well received by resident participants and addressed a gap in their surgical training. CONCLUSIONS A humanistic mentorship program involving RAT can be effectively implemented in surgical residency, is well-received by residents, and addresses a need surgical training by building skills and improving resident well-being.
Collapse
Affiliation(s)
- Molly Kobritz
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork; Northwell Health North Shore/Long Island Jewish Department of Surgery, Manhasset, NewYork.
| | - Colleen P Nofi
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork; Northwell Health North Shore/Long Island Jewish Department of Surgery, Manhasset, NewYork
| | - Lyudmyla Demyan
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork; Northwell Health North Shore/Long Island Jewish Department of Surgery, Manhasset, NewYork
| | - Erfan Farno
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork
| | - Alice Fornari
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork
| | - Bilge Kalyon
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork; Northwell Health North Shore/Long Island Jewish Department of Surgery, Manhasset, NewYork
| | - Vihas Patel
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NewYork; Northwell Health North Shore/Long Island Jewish Department of Surgery, Manhasset, NewYork
| |
Collapse
|
86
|
Mullen N, Ashby S, Haskins R, Osmotherly P. The perceptions of individuals with musculoskeletal disorders towards prognosis: An exploratory qualitative study. Musculoskeletal Care 2022. [PMID: 36567482 DOI: 10.1002/msc.1728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 12/27/2022]
Abstract
QUESTION(S) How do individuals living with musculoskeletal disorders perceive the concept of prognosis? DESIGN Exploratory phenomenological study. PARTICIPANTS Individuals aged 18 years or older currently experiencing a musculoskeletal disorder. DATA ANALYSIS Single semi-structured one-on-one interviews were conducted. Data was analysed using inductive coding and thematic analysis. RESULTS Five themes were identified. First, participants defined prognosis as the likely outcome associated with their diagnosis. Their prognosis was often associated with outcomes related to pain, tissue health, and function. Second, participants perceived pain as having a negative impact on their prognosis by limiting their function and having a psychological impact. Third, participants held biomedical views in that tissue health was perceived as a cause for their pain and that tissue healing was essential for pain cessation. It was also difficult for participants to distinguish between pain related to tissue damage, and pain that was not. Fourth, participants use their ability to complete leisure and functional activities to determine the success of their recovery. Finally, participants perceived receiving individual prognoses for pain, tissue health, and function that may be simultaneously occurring as both important and beneficial. CONCLUSION Overall, participants viewed receiving prognostic information as important and beneficial. When constructing their views on prognosis participants perceived that pain, tissue health, and functional ability could all impact upon prognosis, whilst having a prognosis of their own. Physiotherapists should consider conceptualising and discussing prognosis in terms of pain, tissue health, and function when managing musculoskeletal disorders.
Collapse
Affiliation(s)
- Nicholas Mullen
- School of Health Sciences, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Samantha Ashby
- School of Health Sciences, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Robin Haskins
- John Hunter Hospital Outpatient Service, Hunter New England Health, Newcastle, New South Wales, Australia
| | - Peter Osmotherly
- School of Health Sciences, The University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
87
|
Voices on Zika: Reproductive Autonomy and Shared Decision-Making During an Evolving Epidemic. Womens Health Issues 2022:S1049-3867(22)00141-4. [PMID: 36566090 DOI: 10.1016/j.whi.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 11/09/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION We aimed to understand the degree to which pregnant individuals exposed to emerging infections, such as Zika, are engaged by providers in shared decision-making and explore potential barriers to inform strategies to improve care for those most at risk for inequities. Studies have demonstrated that Latinx and Black people are less likely to engage in shared decision-making and are less engaged by providers. Limited research explores factors impacting shared decision-making in prenatal care and in the setting of recent epidemics. METHODS We conducted an exploratory qualitative study of individuals eligible for prenatal screening owing to Zika exposure during pregnancy. Given an established connection between autonomy and shared decision-making, we used the Reproductive Autonomy Scale and the Three Talk Model for shared decision-making to inform our semistructured interview guide. Interviews were conducted in Spanish or English. and participants were recruited from a federally qualified health center and a tertiary care obstetric clinic until thematic saturation was achieved. Interviews were recorded, translated, and transcribed and two coders used modified grounded theory to generate themes. RESULTS We interviewed 18 participants from May to December 2017. Participant narratives demonstrated reproductive autonomy in pregnancy decision-making, with decision support from families, fatalism in pregnancy planning, and limited engagement by providers around decisions and implications of Zika virus testing. Hierarchy in provider dynamics, perceived stigma around emigration and travel, and language barriers impacted participant engagement in shared decision-making. CONCLUSIONS Participants demonstrated personal autonomy in reproductive decision-making, but demonstrated limited engagement in shared decision-making with regard to prenatal Zika testing. Provider promotion of shared decision-making using culturally centered decision tools to elicit underlying beliefs and deepen context for option, choice, and decision talk is critical in prenatal counseling to support equitable outcomes during evolving pandemics.
Collapse
|
88
|
Kushniruk A, VanHouten CB, Willis VC, Rosario BL, South BR, Sands-Lincoln M, Brotman D, Lenert J, Snowdon JL, Jackson GP. Understanding a Care Management System's Role in Influencing a Transitional-Aged Youth Program's Practice: Mixed Methods Study. JMIR Hum Factors 2022; 9:e39646. [PMID: 36525294 PMCID: PMC9804088 DOI: 10.2196/39646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 09/29/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Extended foster care programs help prepare transitional-aged youth (TAY) to step into adulthood and live independent lives. Aspiranet, one of California's largest social service organizations, used a social care management solution (SCMS) to meet TAY's needs. OBJECTIVE We aimed to investigate the impact of an SCMS, IBM Watson Care Manager (WCM), in transforming foster program service delivery and improving TAY outcomes. METHODS We used a mixed methods study design by collecting primary data from stakeholders through semistructured interviews in 2021 and by pulling secondary data from annual reports, system use logs, and data repositories from 2014 to 2021. Thematic analysis based on grounded theory was used to analyze qualitative data using NVivo software. Descriptive analysis of aggregated outcome metrics in the quantitative data was performed and compared across 2 periods: pre-SCMS implementation (before October 31, 2016) and post-SCMS implementation (November 1, 2016, and March 31, 2021). RESULTS In total, 6 Aspiranet employees (4 leaders and 2 life coaches) were interviewed, with a median time of 56 (IQR 53-67) minutes. The majority (5/6, 83%) were female, over 30 years of age (median 37, IQR 32-39) with a median of 6 (IQR 5-10) years of experience at Aspiranet and overall field experience of 10 (IQR 7-14) years. Most (4/6, 67%) participants rated their technological skills as expert. Thematic analysis of participants' interview transcripts yielded 24 subthemes that were grouped into 6 superordinate themes: study context, the impact of the new tool, key strengths, commonly used features, expectations with WCM, and limitations and recommendations. The tool met users' initial expectations of streamlining tasks and adopting essential functionalities. Median satisfaction scores around pre- and post-WCM workflow processes remained constant between 2 life coaches (3.25, IQR 2.5-4); however, among leaders, post-WCM scores (median 4, IQR 4-5) were higher than pre-WCM scores (median 3, IQR 3-3). Across the 2 study phases, Aspiranet served 1641 TAY having consistent population demographics (median age of 18, IQR 18-19 years; female: 903/1641, 55.03%; race and ethnicity: Hispanic or Latino: 621/1641, 37.84%; Black: 470/1641, 28.64%; White: 397/1641, 24.19%; Other: 153/1641, 9.32%). Between the pre- and post-WCM period, there was an increase in full-time school enrollment (359/531, 67.6% to 833/1110, 75.04%) and a reduction in part-time school enrollment (61/531, 11.5% to 91/1110, 8.2%). The median number of days spent in the foster care program remained the same (247, IQR 125-468 years); however, the number of incidents reported monthly per hundred youth showed a steady decline, even with an exponentially increasing number of enrolled youth and incidents. CONCLUSIONS The SCMS for coordinating care and delivering tailored services to TAY streamlined Aspiranet's workflows and processes and positively impacted youth outcomes. Further enhancements are needed to better align with user and youth needs.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Gretchen P Jackson
- IBM Watson Health, Cambridge, MA, United States.,Department of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN, United States.,Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States.,Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, United States.,Intuitive Surgical, Sunnyvale, CA, United States
| |
Collapse
|
89
|
Feng J, Guo Z, Ai L, Liu J, Zhang X, Cao C, Xu J, Xia S, Zhou XN, Chen J, Li S. Establishment of an indicator framework for global One Health Intrinsic Drivers index based on the grounded theory and fuzzy analytical hierarchy-entropy weight method. Infect Dis Poverty 2022; 11:121. [PMID: 36482389 PMCID: PMC9733012 DOI: 10.1186/s40249-022-01042-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 11/03/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND One Health has become a global consensus to deal with complex health problems. However, the progress of One Health implementation in many countries is still relatively slow, and there is a lack of systematic evaluation index. The purpose of this study was to establish an indicator framework for global One Health Intrinsic Drivers index (GOH-IDI) to evaluate human, animal and environmental health development process globally. METHOD First, 82 studies were deeply analyzed by a grounded theory (GT) method, including open coding, axial coding, and selective coding, to establish a three-level indicator framework, which was composed of three selective codes, 19 axial codes, and 79 open codes. Then, through semi-structured interviews with 28 health-related experts, the indicators were further integrated and simplified according to the inclusion criteria of the indicators. Finally, the fuzzy analytical hierarchy process combined with the entropy weight method was used to assign weights to the indicators, thus, forming the evaluation indicator framework of human, animal and environmental health development process. RESULTS An indicator framework for GOH-IDI was formed consisting of three selective codes, 15 axial codes and 61 open codes. There were six axial codes for "Human Health", of which "Infectious Diseases" had the highest weight (19.76%) and "Injuries and Violence" had the lowest weight (11.72%). There were four axial codes for "Animal Health", of which "Animal Epidemic Disease" had the highest weight (39.28%) and "Animal Nutritional Status" had the lowest weight (11.59%). Five axial codes were set under "Environmental Health", among which, "Air Quality and Climate Change" had the highest weight (22.63%) and "Hazardous Chemicals" had the lowest weight (17.82%). CONCLUSIONS An indicator framework for GOH-IDI was established in this study. The framework were universal, balanced, and scientific, which hopefully to be a tool for evaluation of the joint development of human, animal and environmental health in different regions globally.
Collapse
Affiliation(s)
- Jiaxin Feng
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Zhaoyu Guo
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Lin Ai
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Jingshu Liu
- grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Xiaoxi Zhang
- grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Chunli Cao
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Jing Xu
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Shang Xia
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Xiao-Nong Zhou
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Jin Chen
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China
| | - Shizhu Li
- grid.508378.1National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, 200025 China ,grid.16821.3c0000 0004 0368 8293School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| |
Collapse
|
90
|
Heo S, Chan AY, Diaz Peralta P, Jin L, Pereira Nunes CR, Bell ML. Impacts of the COVID-19 pandemic on scientists' productivity in science, technology, engineering, mathematics (STEM), and medicine fields. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:434. [PMID: 36530543 PMCID: PMC9734604 DOI: 10.1057/s41599-022-01466-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
While studies suggested adverse impacts of COVID-19 on scientific outputs and work routines for scientists, more evidence is required to understand detailed obstacles challenging scientists' work and productivity during the pandemic, including how different people are affected (e.g., by gender). This online survey-based thematic analysis investigated how the pandemic affected scientists' perception of scientific and academic productivity in the science, technology, engineering, and mathematics (STEM) and medicine fields. The analysis examined if inequitable changes in duties and responsibilities for caregiving for children, family, and/or households exist between scientists who are mothers compared to scientists who are fathers or non-parents. The survey collected data from 2548 survey responses in six languages across 132 countries. Results indicate that many scientists suffered from delays and restrictions on research activities and administrations due to the lockdown of institutions, as well as increased workloads from adapting to online teaching environment. Caregiving responsibility for children and family increased, which compromised time for academic efforts, especially due to the temporary shutdown of social supports. Higher percentages of female parent participants than male parent participants expressed such increased burdens indicating unequal divisions of caregiving between women and men. A range of physical and mental health issues was identified mainly due to overworking and isolation. Despite numerous obstacles, some participants reported advantages during the pandemic including the efficiency of online teaching, increased funding for COVID-related research, application of alternative research methodologies, and fluidity of the workday from not commuting. Findings imply the need for rapid institutional support to aid various academic activities and diminish gender inequity in career development among academicians, highlighting how crisis can exacerbate existing inequalities.
Collapse
Affiliation(s)
- Seulkee Heo
- School of the Environment, Yale University, New Haven, CT USA
| | - Alisha Yee Chan
- School of the Environment, Yale University, New Haven, CT USA
- Department of Chemical and Environmental Engineering, School of Engineering and Applied Science, Yale University, New Haven, CT USA
| | - Pedro Diaz Peralta
- School of the Environment, Yale University, New Haven, CT USA
- Administrative Law Department, School of Law, Universidad Complutense de Madrid, Madrid, Spain
| | - Lan Jin
- School of Public Health, Yale University, New Haven, CT USA
| | - Claudia Ribeiro Pereira Nunes
- School of the Environment, Yale University, New Haven, CT USA
- Graduate Program in Law, School of Law, Federal University of Amazon, Manaus, Amazonas Brazil
| | | |
Collapse
|
91
|
Zhang M, Huang Y, Wu F, Liu D, Wei C, Qin Y. Improving occupational health for health workers in a pilot hospital by application of the HealthWISE international tool: An interview and observation study in China. Front Public Health 2022; 10:1010059. [PMID: 36530713 PMCID: PMC9751410 DOI: 10.3389/fpubh.2022.1010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/14/2022] [Indexed: 12/04/2022] Open
Abstract
Objective For a safe and healthy workplace in the health sector, the International Labor Organization (ILO) and the World Health Organization (WHO) jointly developed HealthWISE, an international technical tool that helps health workers (HWs) to identify workplace hazards and apply low-cost solutions. This study sought to gather experiences and lessons from a Chinese pilot hospital for the scale-up application of HealthWISE. Methods A qualitative study was undertaken at a Chinese public hospital with a ≥5-year application of HealthWISE through in-depth interviews with targeted HWs who participated in the Training-of-Trainer (TOT) workshops, and observations were gathered using evidence from photos and publications, then, thematic analysis was formulated. Results Driven by motivation, the participants learned from the HealthWISE TOT workshop alongside the favorite and worst parts of it. Positive changes and results of occupational health for HWs occurred after the workshop, the participants trained others and planned to implement HealthWISE within their responsibility. During the COVID-19 Pandemic, the Hospital acted the approaches of protecting the health, safety and well-being of HWs with significant results. Further suggestions on workshop and HealthWISE implementing as well as the national policies were collected. The study indicated the Hospital's experience of leadership and participation, supporting and facilitating, system establishment, and culture creation. The suggestion included keeping staff engaged under a positive safety and health culture, promoting recognition of HealthWISE among public health institutions nationwide, developing online courses for medical colleges, focusing on the alignment among various law systems, and adopting measures under the principle of the hierarchy of occupational hazards controls. Conclusion This study has demonstrated the systematic improvement of occupational health for HWs by HealthWISE implementation in the Chinese hospital. The valuable experiences and lessons derived here can be shared with other hospitals in China and beyond, especially under the unprecedented challenges of the COVID-19 pandemic, to achieve the goals of safety, health, and well-being for HWs by building a resilient health system.
Collapse
Affiliation(s)
- Min Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,*Correspondence: Min Zhang
| | - Yiming Huang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengyao Wu
- Nanning Fourth People's Hospital, Nanning, China
| | - Dongmei Liu
- Nanning Fourth People's Hospital, Nanning, China
| | - Caiyun Wei
- Nanning Fourth People's Hospital, Nanning, China
| | - Yaqin Qin
- Nanning Fourth People's Hospital, Nanning, China
| |
Collapse
|
92
|
Boas H. Beyond Altruism – The Moral Economy of Israelis Who Donated A Kidney to Strangers. THE AMERICAN SOCIOLOGIST 2022; 53:644-662. [DOI: doi.org/10.1007/s12108-022-09538-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/20/2023]
|
93
|
Miller P, Romero-Hernandez F, Mora RV, Hughes D, Babicky M, Warner S, Alseidi A, Visser B, Maynard EC, Katariya N, Washington K, Ball CG, Moulton CA. AHPBA senior leaders' assessments of strengths, weaknesses, opportunities, and threats facing fellowship training in HPB surgery: "We need to standardize our training experiences". HPB (Oxford) 2022; 24:2054-2062. [PMID: 36270938 DOI: 10.1016/j.hpb.2022.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Multiple fellowship programs in North America prepare surgeons for a career in Hepato-Pancreatico-Biliary (HPB) surgery. Inconsistent operative experiences and disease process exposures across programs and pathways produces variability in training product and therefore, lack of clarity around what trained HPB surgeons are prepared to do in early practice. Thus, a strengths, weaknesses, opportunities, and threats (SWOT) analysis of AHPBA fellowship training was conducted. METHODS This was a mixed-methods, cross-sectional study. Eleven AHPBA-Founding Members (FM) and 24 current or former Program Directors (PD) of programs eligible for AHPBA certificates were surveyed and interviewed. Grounded theory principles and thematic network analysis were used to analyze interview transcripts. Descriptive statistics were used to analyze survey data. RESULTS Three main themes were identified: (i) Concern for training rigor and consistency (ii) Desire to standardize curricula and broaden training requirements and, (iii) Need to validate both the value of training and job marketability via certification. DISCUSSION Based on the themes identified, the strengths of AHPBA-certified HPB programs include superior technical training and case volumes. Areas of improvement included elevating baseline competencies by increasing required case volume and breadth to ensure minimally invasive experience, operative autonomy, and multidisciplinary care coordination.
Collapse
Affiliation(s)
- Phoebe Miller
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | | | - Rosa V Mora
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Dorothy Hughes
- Departments of Population Health and Surgery, University of Kansas School of Medicine- Salina, Salina, KS, USA
| | - Michele Babicky
- The Oregon Clinic, Providence Portland Medical Center, Portland, OR, USA
| | | | - Adnan Alseidi
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Brendan Visser
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
| | -
- Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | | | | | | | | | | |
Collapse
|
94
|
Asquith-Heinz Z, Kim S, Lewis JP. Alaska native successful ageing in Northwest Alaska: how family impacts how one ages in a good way. Int J Circumpolar Health 2022; 81:2147127. [PMID: 36415162 PMCID: PMC9704093 DOI: 10.1080/22423982.2022.2147127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
aged well, yet today they experience high rates of illness and lower access to care because of colonisation. Aand this research explores successful ageing from an AN perspective or what it means to achieve "Eldership" in the rural Northwest Alaska. A community-based participatory research approach was used to engage participants at every stage of the research process. Semi-structured interviews were conducted with 16 AN men and 25 women and the interviews were professionally transcribed. Kleinman's explanatory model served as the foundation of the questionnaire to gain a sense of the beliefs about ageing and guide the thematic analysis to establish an AN understanding of successful ageing. The foundation of the Norton Sound southern sub-region Model of Successful Ageing is the reciprocal relationship between Elders and family which enables Elders to access meaningful activities, including Native ways of life, physical health, spirituality, and emotional well-being. Community-based interventions should foster opportunities for Elders to share their Native way of life alongside family and community members, which will enable them to remain physically active, maintain healthy emotional well-being, continue engaging in spiritual practices, and contribute to the health and well-being of families.
Collapse
Affiliation(s)
- Zayla Asquith-Heinz
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, USA
| | - Steffi Kim
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, USA
| | - Jordan P. Lewis
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, USA
| |
Collapse
|
95
|
Gilbert LR, Starks S, Gray J, Reitzel LR, Obasi EM. Exploring the provider and organization level barriers to medication for opioid use disorder treatment for Black Americans: A study protocol. PUBLIC HEALTH IN PRACTICE 2022; 4:100308. [PMID: 36570391 PMCID: PMC9773041 DOI: 10.1016/j.puhip.2022.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 12/27/2022] Open
Abstract
Objectives This study seeks to examine the provider and organizational factors that could be limiting the treatment of Opioid Use Disorder (OUD) for Black Americans in Texas. Formative research at the provider and organizational level will assist in understanding the current facilitators, potential barriers, and capacity for OUD treatment for Black Americans. Study design Using the exploration phase of the Explore, Preparation, Implementation, Sustainment (EPIS) framework, the project will be a formative assessment of local factors that influence Medication for OUD (MOUD) treatment availability for Black Americans to guide the design of a culturally and locally relevant multi-level intervention strategy. Methods and analysis: This project will utilize emergent mixed methods to identify and clarify the problems that are obstructing treatment for Black patients with OUD. First, the perspectives of individual providers in their openness and willingness to provide MOUD treatment to Black Americans diagnosed with OUD will be explored through in-depth interviews. The organizational capacity factors associated with increased availability to treatment for Black American OUD patients will be examined with the organizational leaders using an exploratory sequential mixed-methods design. Leader and program managers of organizations that provide MOUD will be invited to participate in an online survey, with the option to participate in a follow-up in-depth interview. All qualitative data from the provider and organization staff interviews will be analyzed with a thematic analysis approach. The analysis of the two different types of qualitative data will be analyzed together, as a form of triangulation. Conclusions This project will assess the understandings of individual providers as well as the organizational-level awareness of the cultural contexts of MOUD intervention for Black Americans. This formative research seeks to highlight the current status of the opioid crisis in the Black community, and what additional supports are needed.
Collapse
Affiliation(s)
- Lauren R Gilbert
- University of Houston, College of Medicine, USA.,Humana Integrated Health System Sciences Institute at the University of Houston, USA
| | | | | | - Lorraine R Reitzel
- HEALTH Center for Addictions Research & Cancer Prevention at the University of Houston, USA
| | - Ezemenari M Obasi
- HEALTH Center for Addictions Research & Cancer Prevention at the University of Houston, USA
| |
Collapse
|
96
|
Schøler PN, Søndergaard J, Barfod S, Nielsen AS. Danish feasibility study of a new innovation for treating alcohol disorders in primary care: the 15-method. BMC PRIMARY CARE 2022; 23:34. [PMID: 35227207 PMCID: PMC8884098 DOI: 10.1186/s12875-022-01639-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/01/2022] [Indexed: 11/23/2022]
Abstract
Background The 15-method: a new brief intervention tool for alcohol problems in primary care has shown promising results in Sweden for mild to moderate alcohol use disorders. The present study evaluated the 15-method’s usability, organizational integration, and overall implementation feasibility in Danish general practice in preparation for a large-scale evaluation of the method’s effectiveness in identifying and treating alcohol problems in general practice. Methods Five general practices in the Central and Southern Region of Denmark participated: seven general practitioners (GPs), eight nurses. Participants received a half day of training in the 15-method. Testing of implementation strategies and overall applicability ran for 2 months. A focus group interview and two individual interviews with participating GPs along with five individual patient interviews concluded the study period. Results Results indicate that implementation of the 15-method is feasible in Danish general practice. The healthcare professionals and patients were positive about the method and its possibilities. The method was considered a new patient centered treatment offer and provided structure to a challenging topic. An interdisciplinary approach was much welcomed. Results indicate that the method is ready for large scale evaluation. Conclusions Implementation of the 15-method is considered feasible in Danish general practice and large-scale evaluation is currently being planned.
Collapse
|
97
|
Alami S, Roren A, Hervouet L, Azouvi P, Desjeux D, Graciès JM, Lefèvre-Colau MM, Poiraudeau S, Sanchez K, Rannou F, Nguyen C. Challenges and opportunities for implementing research and science in physical and rehabilitation medicine. Ann Phys Rehabil Med 2022; 66:101701. [PMID: 35977675 DOI: 10.1016/j.rehab.2022.101701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/02/2022] [Accepted: 08/04/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Sophie Alami
- Cabinet d'Études Sociologiques Interlis, 75006 Paris, France
| | - Alexandra Roren
- AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014 Paris, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, 75004 Paris, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, 75013 Paris, France
| | - Lucile Hervouet
- IRIS (UMR 8156) CNRS 997 - INSERM - EHESS - Institut de Recherche Interdisciplinaires sur les enjeux Sociaux, 93017 Bobigny, France
| | - Philippe Azouvi
- AP-HP. Université Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, 92380 Garches, France; HANDIReSP EA 4047, Université Paris-Saclay, 78423 Montigny-Le-Bretonneux, France
| | - Dominique Desjeux
- Université de Paris, Faculté de Sciences Humaines et Sociales, 75006 Paris., France
| | - Jean-Michel Graciès
- AP-HP. Hôpitaux Universitaires Henri-Mondor, Service de Rééducation Neurolocomotrice, Unité de Neurorééducation, 94010 Créteil, France; EA 7377 BIOTN, Laboratoire Analyse et Restauration du Mouvement, Université Paris-Est Créteil (UPEC), 94010 Créteil, France
| | - Marie-Martine Lefèvre-Colau
- AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014 Paris, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, 75004 Paris, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, 75013 Paris, France; Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006 Paris, France
| | - Serge Poiraudeau
- AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014 Paris, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité, 75004 Paris, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, 75013 Paris, France; Université Paris Cité, Faculté de Santé, UFR de Médecine, 75006 Paris, France
| | - Katherine Sanchez
- AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014 Paris, France
| | - François Rannou
- AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014 Paris, France; AP-HP. Université Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, 92380 Garches, France; INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France
| | - Christelle Nguyen
- AP-HP. Centre-Université Paris Cité, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpital Cochin, 75014 Paris, France; AP-HP. Université Paris-Saclay, Service de Médecine Physique et de Réadaptation, Hôpital Raymond-Poincaré, 92380 Garches, France; INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Campus Saint-Germain-des-Prés, 75006 Paris, France.
| |
Collapse
|
98
|
Chua AY, Liew H. Sharing economy research: a research agenda for knowledge management scholars. VINE JOURNAL OF INFORMATION AND KNOWLEDGE MANAGEMENT SYSTEMS 2022. [DOI: 10.1108/vjikms-04-2022-0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose
This paper aims to provide a research agenda for knowledge management (KM) scholars interested in the sharing economy.
Design/methodology/approach
A total of 342 articles published between 2012 and 2021 are analysed to identify the topics examined, how the sharing economy was conceptualized, the academic disciplines of authors and the methods used.
Findings
Based on the findings, research gaps and conceptualization issues relevant to KM scholars are discussed. Collaboration opportunities and methodological challenges are also identified.
Originality/value
By facilitating KM scholars’ engagement with the sharing economy, this paper contributes to a better understanding of this emerging phenomenon and helps uncover potential KM trends.
Collapse
|
99
|
Limbacher SA, Mazanec SR, Frame JM, Connolly MC, Park S, Rosenzweig MQ. Early-stage breast cancer menopausal symptom experience and management: exploring medical oncology clinic visit conversations through qualitative analysis. Support Care Cancer 2022; 30:9901-9907. [DOI: 10.1007/s00520-022-07446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/30/2022] [Indexed: 11/26/2022]
|
100
|
Factors influencing compliance in RRD patients with the face-down position via grounded theory approach. Sci Rep 2022; 12:20320. [PMID: 36433997 PMCID: PMC9700789 DOI: 10.1038/s41598-022-24121-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022] Open
Abstract
Patients with rhegmatogenous retinal detachment (RRD) require face-down positioning (FDP) for 3-6 months or longer after pars plana vitrectomy (PPV) combined with silicone oil (SO) tamponade. This paper aimed to identify the factors that influenced FDP compliance. This study adopted semi-structured interviews with patients who require FDP after SO tamponade. Constructivist grounded theory was utilized in this study. The qualitative data was analyzed and coded via NVivo 11.0 through open coding, axial coding and selective coding. Twenty-four RRD patients were involved. The interviews yielded five main themes that defined home FDP compliance were identified: posture discomfort, doctor-patient communication, psychological factors, occupational character, and family factors. A theoretical model of the influencing factors of postural compliance of FDP was constructed based on the interview analysis. A variety of factors can affect FDP conformity. We can increase compliance of RRD patients by enhancing comfort, encouraging doctor-patient communication, providing comprehensive care, promoting community-based intervention, and strengthening family education.
Collapse
|