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Govier DJ, Niederhausen M, Takata Y, Hickok A, Rowneki M, McCready H, Smith VA, Osborne TF, Boyko EJ, Ioannou GN, Maciejewski ML, Viglianti EM, Bohnert ASB, O’Hare AM, Iwashyna TJ, Hynes DM. Risk of Potentially Preventable Hospitalizations After SARS-CoV-2 Infection. JAMA Netw Open 2024; 7:e245786. [PMID: 38598237 PMCID: PMC11007577 DOI: 10.1001/jamanetworkopen.2024.5786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/11/2024] [Indexed: 04/11/2024] Open
Abstract
Importance Research demonstrates that SARS-CoV-2 infection is associated with increased risk of all-cause hospitalization. However, no prior studies have assessed the association between SARS-CoV-2 and potentially preventable hospitalizations-that is, hospitalizations for conditions that can usually be effectively managed in ambulatory care settings. Objective To examine whether SARS-CoV-2 is associated with potentially preventable hospitalization in a nationwide cohort of US veterans. Design, Setting, and Participants This cohort study used an emulated target randomized trial design with monthly sequential trials to compare risk of a potentially preventable hospitalization among veterans with SARS-CoV-2 and matched comparators without SARS-CoV-2. A total of 189 136 US veterans enrolled in the Veterans Health Administration (VHA) who were diagnosed with SARS-CoV-2 between March 1, 2020, and April 30, 2021, and 943 084 matched comparators were included in the analysis. Data were analyzed from May 10, 2023, to January 26, 2024. Exposure SARS-CoV-2 infection. Main Outcomes and Measures The primary outcome was a first potentially preventable hospitalization in VHA facilities, VHA-purchased community care, or Medicare fee-for-service care. Extended Cox models were used to examine adjusted hazard ratios (AHRs) of potentially preventable hospitalization among veterans with SARS-CoV-2 and comparators during follow-up periods of 0 to 30, 0 to 90, 0 to 180, and 0 to 365 days. The start of follow-up was defined as the date of each veteran's first positive SARS-CoV-2 diagnosis, with the same index date applied to their matched comparators. Results The 1 132 220 participants were predominantly men (89.06%), with a mean (SD) age of 60.3 (16.4) years. Most veterans were of Black (23.44%) or White (69.37%) race. Veterans with SARS-CoV-2 and comparators were well-balanced (standardized mean differences, all <0.100) on observable baseline clinical and sociodemographic characteristics. Overall, 3.10% of veterans (3.81% of those with SARS-CoV-2 and 2.96% of comparators) had a potentially preventable hospitalization during 1-year follow-up. Risk of a potentially preventable hospitalization was greater among veterans with SARS-CoV-2 than comparators in 4 follow-up periods: 0- to 30-day AHR of 3.26 (95% CI, 3.06-3.46); 0- to 90-day AHR of 2.12 (95% CI, 2.03-2.21); 0- to 180-day AHR of 1.69 (95% CI, 1.63-1.75); and 0- to 365-day AHR of 1.44 (95% CI, 1.40-1.48). Conclusions and Relevance In this cohort study, an increased risk of preventable hospitalization in veterans with SARS-CoV-2, which persisted for at least 1 year after initial infection, highlights the need for research on ways in which SARS-CoV-2 shapes postinfection care needs and engagement with the health system. Solutions are needed to mitigate preventable hospitalization after SARS-CoV-2.
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Affiliation(s)
- Diana J. Govier
- Center to Improve Veteran Involvement in Care, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon
- Oregon Health & Science University–Portland State University School of Public Health, Portland
| | - Meike Niederhausen
- Center to Improve Veteran Involvement in Care, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon
- Oregon Health & Science University–Portland State University School of Public Health, Portland
| | - Yumie Takata
- College of Health, Oregon State University, Corvallis
| | - Alex Hickok
- Center to Improve Veteran Involvement in Care, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon
| | - Mazhgan Rowneki
- Center to Improve Veteran Involvement in Care, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon
| | - Holly McCready
- Center to Improve Veteran Involvement in Care, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon
| | - Valerie A. Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation, VA Durham Health Care System, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Thomas F. Osborne
- VA Palo Alto Health Care System, Palo Alto, California
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Edward J. Boyko
- Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington
| | - George N. Ioannou
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
- Division of Gastroenterology, Department of Medicine, University of Washington, Seattle
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation, VA Durham Health Care System, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Elizabeth M. Viglianti
- VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Amy S. B. Bohnert
- VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Ann M. O’Hare
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington
- Hospital and Specialty Medicine Service, VA Puget Sound Health Care System, Seattle, Washington
- Division of Nephrology, Department of Medicine, University of Washington, Seattle
| | - Theodore J. Iwashyna
- VA Center for Clinical Management Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
- Department of Medicine, University of Michigan Medical School, Ann Arbor
- School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Denise M. Hynes
- Center to Improve Veteran Involvement in Care, Veterans Affairs (VA) Portland Health Care System, Portland, Oregon
- College of Health, Oregon State University, Corvallis
- Center for Quantitative Life Sciences, Oregon State University, Corvallis, Oregon
- School of Nursing, Oregon Health & Science University, Portland
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202
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Singh A, Skolnik E, Miazga E, Nensi A. Impact of Health Literacy on Patient-Reported Outcomes in Benign Gynecology: A Systematic Review. Cureus 2024; 16:e58661. [PMID: 38774160 PMCID: PMC11105969 DOI: 10.7759/cureus.58661] [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] [Accepted: 04/20/2024] [Indexed: 05/24/2024] Open
Abstract
The objective of this study was to systematically review the relationship between low health literacy and patient-reported outcomes in patients with benign gynecologic conditions. In this specific population, we also sought to determine the current reported prevalence of low health literacy, examine demographic characteristics that may be related to low health literacy, and collate any health literacy interventions described in the literature. A systematic search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, The Cochrane Library, Web of Science, PubMed, and clinicaltrials.gov was performed on July 12, 2021, and repeated on October 13, 2023, for terms related to health literacy, specific health literacy measures, and benign gynecologic conditions. There were language or publication period restrictions. Inclusion required primary literature to report associations between health literacy and patient-reported outcomes, using validated tools to quantitatively measure each, in adult women with benign gynecologic conditions. Title screening, abstract screening, and full-text review were conducted with Covidence software (Melbourne, Australia) assisting with the review process. Of the 18,701 studies returned using our search strategy, 25 were selected for full-text review. Of these, no studies met inclusion criteria and reported an association between health literacy and patient-reported outcomes. This study identified a large gap in the literature. Future work should be directed at evaluating the association between health literacy and patient-reported outcomes in benign gynecology to inform patient-centered interventions and care provision.
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Affiliation(s)
- Ashmita Singh
- General Surgery, Northern Ontario School of Medicine, Sudbury, CAN
| | - Emma Skolnik
- Obstetrics and Gynecology, University of Toronto, Toronto, CAN
| | - Elizabeth Miazga
- Obstetrics and Gynecology, Trillium Health Partners - Credit Valley Hospital, Mississauga, CAN
| | - Alysha Nensi
- Obstetrics and Gynecology, St. Michael's Hospital, Toronto, CAN
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203
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Meng ZW, Ruan Y, Fisher S, Bishay K, Chau M, Howarth M, Cartwright S, Chen Y, Dixon E, Heitman SJ, Brenner DR, Forbes N. Development and validation of a practical clinical risk prediction model for post-endoscopic retrograde cholangiopancreatography pancreatitis. DEN OPEN 2024; 4:e355. [PMID: 38529515 PMCID: PMC10962486 DOI: 10.1002/deo2.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 03/27/2024]
Abstract
Background Pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) can lead to significant morbidity and mortality. We aimed to develop an accurate post-ERCP pancreatitis risk prediction model using easily obtainable variables. Methods Using prospective multi-center ERCP data, we performed logistic regression using stepwise selection on several patient-, procedure-, and endoscopist-related factors that were determined a priori. The final model was based on a combination of the Bayesian information criterion and Akaike's information criterion performance, balancing the inclusion of clinically relevant variables and model parsimony. All available data were used for model development, with subsequent internal validation performed on bootstrapped data using 10-fold cross-validation. Results Data from 3021 ERCPs were used to inform models. There were 151 cases of post-ERCP pancreatitis (5.0% incidence). Variables included in the final model included female sex, pancreatic duct cannulation, native papilla status, pre-cut sphincterotomy, increasing cannulation time, presence of biliary stricture, patient age, and placement of a pancreatic duct stent. The final model was discriminating, with a receiver operating characteristic curve statistic of 0.79, and well-calibrated, with a predicted risk-to-observed risk ratio of 1.003. Conclusions We successfully developed and internally validated a promising post-ERCP pancreatitis clinical prediction model using easily obtainable variables that are known at baseline or observed during the ERCP procedure. The model achieved an area under the curve of 0.79. External validation is planned as additional data becomes available.
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Affiliation(s)
- Zhao Wu Meng
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
| | - Yibing Ruan
- Department of OncologyCumming School of MedicineUniversity of CalgaryCalgaryCanada
- Department of Cancer Epidemiology and Prevention ResearchCancer Care Alberta, Alberta Health ServicesCalgaryCanada
| | | | - Kirles Bishay
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
| | - Millie Chau
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
| | - Megan Howarth
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
| | - Shane Cartwright
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
| | - Yen‐I Chen
- Department of Medicine, Division of Gastroenterology and HepatologyMcGill University Health CentreMontrealCanada
| | - Elijah Dixon
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
- Department of SurgeryUniversity of CalgaryCalgaryCanada
| | - Steven J. Heitman
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
| | - Darren R. Brenner
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
- Department of OncologyCumming School of MedicineUniversity of CalgaryCalgaryCanada
| | - Nauzer Forbes
- Department of Community Health SciencesUniversity of CalgaryCalgaryCanada
- Department of MedicineDivision of Gastroenterology and HepatologyUniversity of CalgaryCalgaryCanada
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MacLean JE. Neighborhood Disadvantage Impacts Symptoms and Quality of Life in Children with Habitual Snoring. Ann Am Thorac Soc 2024; 21:545-547. [PMID: 38557422 PMCID: PMC10995552 DOI: 10.1513/annalsats.202401-055ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- Joanna E MacLean
- Department of Pediatrics and Women & Children's Health Research Institute, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; and Stollery Children's Hospital, Edmonton, Alberta, Canada
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Van Wylick C, Lewis L, Mulder DJ. Distinct Patterns of Liver Chemistry Changes in Pediatric Acute Hepatitis of Unknown Origin and COVID-19 Patients: A Systematic Review. Cureus 2024; 16:e58307. [PMID: 38752102 PMCID: PMC11094484 DOI: 10.7759/cureus.58307] [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] [Accepted: 04/14/2024] [Indexed: 05/18/2024] Open
Abstract
In 2021 and 2022, there were noted to be clusters of pediatric acute hepatitis of unknown origin (AHUO) occurring across the globe. While there was not necessarily a global increase in cases, understanding the pattern of liver injury in AHUO is crucial to properly identify cases of this unexplained phenomenon, especially since it occurred simultaneously with a global resurgence of COVID-19. The objective of this study was to contrast the patterns in liver-relevant biochemical data from COVID-19 patients and AHUO. Studies reporting liver chemistries for cases of AHUO and COVID-19 were identified by a systematic review and search of the literature. For each case, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, direct bilirubin, and international normalized ratio (INR) levels were extracted as available. These were normalized to multiples of the upper limit of normal by patient age. There were statistically significant greater elevations of ALT and AST in patients with AHUO than in those with COVID-19. Only a subset of patients with COVID-19 had an AST or ALT greater than the normal range. INR elevation could be substantial for both conditions but was also statistically higher in the AHUO group. Liver chemistry changes were not statistically correlated with age. The pattern of liver chemistry changes between AHUO and COVID-19 have some distinctions, which suggests that AHUO is not a phenomenon driven primarily by SARS-CoV-2 infection alone. Differentiating AHUO and COVID-19 would be challenging based on patterns of liver chemistry changes alone.
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206
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Jennings G, Raffoul N, Nelson M, Australian Guideline For Assessing And Managing Cardiovascular Disease Risk ESGFT. Assessing, communicating and managing cardiovascular disease risk: a practical summary of the 2023 guideline. Aust Prescr 2024; 47:57-63. [PMID: 38737366 PMCID: PMC11081742 DOI: 10.18773/austprescr.2024.014] [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] [Indexed: 05/14/2024] Open
Abstract
The outdated cardiovascular disease risk calculator has been reported to overestimate cardiovascular disease risk for a contemporary Australian population, and does not include relevant variables, such as socioeconomic disadvantage, which has been shown to increase the incidence of both heart attack and stroke. The 2023 Australian Guideline for Assessing and Managing Cardiovascular Disease Risk marks a major milestone as the first update to Australia's cardiovascular disease prevention guideline in over a decade. The new guideline may help to refine and recategorise risk estimates, hence improving the discriminatory and predictive value of the new calculator. The new Australian Cardiovascular Disease Risk Calculator expresses risk scores as a percentage estimate of a person's probability of dying or being hospitalised due to cardiovascular disease within the next 5 years. The new calculator expresses risk scores as low (less than 5%), intermediate (5% to less than 10%), or high (10% or higher) risk over 5 years. Reclassification factors built into the new calculator are designed to help clinicians individualise risk estimates. These factors include ethnicity (e.g. First Nations status), family history of premature cardiovascular disease, severe mental illness, kidney disease and coronary artery calcium score. The new calculator also uses optional diabetes-specific variables (supporting a more granular cardiovascular disease risk assessment of people with type 2 diabetes). People who meet the clinically determined high-risk criteria (chronic kidney disease, familial hypercholesterolaemia) should not progress through the Australian Cardiovascular Disease risk calculator, but move straight to management. For a person with a cardiovascular disease risk score recorded from the outdated calculator, clinicians may want to reassess their risk using the new calculator the next time the person attends.
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207
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Rodrigues DA, Herdeiro MT, Mateos-Campos R, Figueiras A, Roque F. Comparing AGS Beers 2019, STOPP version 2, and EU(7)-PIM list in Portuguese older adults in primary health care. Eur J Clin Pharmacol 2024; 80:603-612. [PMID: 38319349 PMCID: PMC10937751 DOI: 10.1007/s00228-024-03633-5] [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: 08/14/2023] [Accepted: 01/18/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE This study aims to identify PIM prevalence in older adults according to the 2019 Beers criteria, Screening Tool of Older Person's Prescriptions version 2 (STOPP v2) criteria, and the Portuguese EU(7)-PIM list and also to analyze the concordance between these criteria. METHODS A retrospective study was conducted among 1200 Portuguese older adults (≥ 65 years old), users of primary health care. Demographic, clinical, and pharmacological data were collected concerning the period between April 2021 and August 2022. A comparative analysis was performed between the three PIM identification criteria, and the concordance was determined according to the Lin concordance correlation coefficient. RESULTS The mean age was 76.3 (SD 7.7) years old and 57.6% of the older adults were females. Our findings indicate varying prevalence rates among these criteria with 63.8% (95% CI 61.0-66.6%), 66.8% (95% CI 64.1-69.5%), and 50.1% (95% CI 47.2-53.0%) of the older adults take at least one PIM according to the EU(7)-PIM list, Beers 2019, and STOPP v2 criteria, respectively. The highest prevalence observed was for proton pump inhibitors according to EU(7)-PIM list (30.1%, 95% CI 27.6-32.9) and Beers criteria (30.1%, 95% CI 27.6-32.9) and alprazolam according to STOPP v2 criteria (10.1%, 95% CI 8.4-11.9%). A poor concordance between criteria was observed (< 0.834). The highest concordance coefficient was found between the EU(7)-PIM list and the Beers criteria (0.833), and the lowest between the EU(7)-PIM list and STOPP criteria (0.735). CONCLUSION This study reveals varying prevalence rates of PIM in older adults, as assessed by different criteria, and highlights the need for targeted interventions and improved prescribing practices. In the future, studies should focus on the occurrence of negative outcomes in older adults associated with PIM consumption.
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Affiliation(s)
- Daniela A Rodrigues
- Research Laboratory on Epidemiology and Population Health, Polytechnic of Guarda (IPG), 6300-559, Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506, Covilhã, Portugal
- PhD Student, University of Salamanca, 37007, Salamanca, Spain
| | - Maria Teresa Herdeiro
- Department of Medical Sciences, Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193, Aveiro, Portugal
| | - Ramona Mateos-Campos
- Area of Preventive Medicine and Public Health, Department of Biomedical and Diagnostic Sciences, University of Salamanca, 37007, Salamanca, Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, 15702, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (IDIS), 15706, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiology and Public Health-CIBERESP), 28001, Madrid, Spain
| | - Fátima Roque
- Research Laboratory on Epidemiology and Population Health, Polytechnic of Guarda (IPG), 6300-559, Guarda, Portugal.
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506, Covilhã, Portugal.
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Cruz-Bañares A, Rojas-Carmona A, Aguilera-Mijares S, Martínez-Dávalos A, Bautista-Arredondo S, Vermandere H. Pre-exposure prophylaxis and telemedicine during coronavirus (COVID-19): a qualitative study of the experiences of health care professionals in Mexico. Sex Health 2024; 21:SH23206. [PMID: 38648372 DOI: 10.1071/sh23206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Background Telemedicine, which involves utilising technologies for remote health care delivery, proved useful to continue offering certain health services during the coronavirus disease 2019 (COVID-19) lockdown. However, the extent of its effectiveness in delivering pre-exposure prophylaxis services for HIV prevention remains underexplored from the viewpoint of health care providers. Therefore, this study aimed to assess the experiences of health care professionals in Mexico who utilised telemedicine for delivering pre-exposure prophylaxis services during the COVID-19 contingency. Methods A qualitative study was performed: 15 virtual interviews with health care professionals were conducted, transcribed and coded in ATLAS.ti. Results The results indicate that telemedicine effectively mitigated COVID-19 exposure, facilitated users' access to pre-exposure prophylaxis counselling, minimised waiting times and enhanced health care professionals' perceived control during sessions. While implementing remote services, certain organisational challenges, which were somewhat latent before the pandemic, became more apparent: colleagues recognised the necessity for more formal communication channels to disseminate information effectively. Additionally, there was a recognised need for electronic patient files to streamline data-sharing processes. An optimal approach would involve a blend of face-to-face and virtual services, contingent upon the availability of essential infrastructure, well-defined implementation protocols and comprehensive training programs. Conclusions Telemedicine streamlined certain processes, garnered positive acceptance from healthcare professionals and holds promise as a valuable post-pandemic tool for improving retention among pre-exposure prophylaxis users.
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Affiliation(s)
- A Cruz-Bañares
- Center for Evaluation Research and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - A Rojas-Carmona
- Center for Evaluation Research and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - S Aguilera-Mijares
- Center for Evaluation Research and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - A Martínez-Dávalos
- Center for Evaluation Research and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - S Bautista-Arredondo
- Center for Evaluation Research and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - H Vermandere
- Center for Evaluation Research and Surveys, National Institute of Public Health of Mexico, Cuernavaca, Mexico
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Neddermann-Carrillo S, Abidi L, Gea A, Bes-Rastrollo M, de la Fuente-Arrillaga C, Lahortiga-Ramos F, Martínez-González MÁ, Pardavila-Belio MI, Ruiz-Canela M. Tobacco and alcohol co-use: Lifestyle and sociodemographic factors, and personality aspects as potential predictors in the "Seguimiento Universidad de Navarra" cohort. Res Nurs Health 2024; 47:251-265. [PMID: 38217468 DOI: 10.1002/nur.22367] [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: 06/01/2023] [Revised: 11/08/2023] [Accepted: 12/24/2023] [Indexed: 01/15/2024]
Abstract
Tobacco and alcohol co-use are two major lifestyle modifiable risk factors. Understanding the determinants of both behaviors helps to develop interventions to prevent these exposures. However, previous studies have focused on predictors of individual tobacco or alcohol use. This study aims to explore the potential predictors of tobacco and alcohol co-use among Spanish university graduates from the "Seguimiento Universidad de Navarra" (SUN) cohort study. A total of 7175 participants who were co-users of tobacco and alcohol were selected for this cross-sectional analysis. Their mean age was 39.1 years (12.04 SD) and 57.3% were women. Univariate regression models were used to select the potential predictors of tobacco and alcohol co-use, and the areas under the ROC curves (AUC) were calculated. Multivariable logistic regression models were used to create a predictive model. Baseline potential predictors included sociodemographic factors, lifestyle habits, and perceived personality aspects. In the multivariable model, the main significant potential predictors of tobacco and alcohol co-use were driving under the influence of alcohol (odds ratio [OR] = 1.65 [1.43-1.90]), drinking 1-2 cups of coffee daily (OR = 1.50 [1.24-1.84]), drinking three or more cups of coffee daily (OR = 1.61 [1.35-1.91]), and doing more physical activity than recommended (OR = 1.18 [1.02-1.34]) when compared with the reference group. Conversely, those who were married (OR = 0.87 [0.75-0.99], ate at home 7 days a week (OR = 0.69 [0.60-0.80]), or had a high perceived level of competitiveness (OR = 0.83 [0.72-0.95]) had a lower risk of co-use (AUC 0.61 [confidence interval 95% 0.59-0.63]), compared to the reference group. These results could be used by healthcare professionals, especially nurses, to effectively assess patients at higher risk of tobacco and alcohol co-use. [Correction added on 16 February 2024, after first online publication: The abstract section has been revised to provide more clarity in this version.].
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Affiliation(s)
- Sofía Neddermann-Carrillo
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Latifa Abidi
- Department of Health Promotion, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Alfredo Gea
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, Pamplona, Navarra, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Maira Bes-Rastrollo
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, Pamplona, Navarra, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen de la Fuente-Arrillaga
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, Pamplona, Navarra, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Francisca Lahortiga-Ramos
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Psychiatry and Clinical Psycology, University Clinic of Navarra, Pamplona, Navarra, Spain
| | - Miguel Ángel Martínez-González
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, Pamplona, Navarra, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Miren Idoia Pardavila-Belio
- Department of Community Nursing and Maternal & Child Health Care, University of Navarra, Pamplona, Navarra, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Ruiz-Canela
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Navarra, Pamplona, Navarra, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
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Kopycka-Kedzierawski DT, Feng C, Billings RJ, Watson GE, Ragusa PG, Flint K, Wong CL, Gill SR, Manning S, O'Connor TG. Psychosocial Risk Exposure Limits Routine Pediatric Oral Health Care. AJPM FOCUS 2024; 3:100191. [PMID: 38357551 PMCID: PMC10864889 DOI: 10.1016/j.focus.2024.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Introduction This study aimed to identify social, psychological, and contextual factors that influenced attendance at routine oral health visits in a cohort of 189 preschool children who were followed over a 2-year period. Methods Generalized estimating equation was used to examine the association between clinic attendance and the predictors. ORs and 95% CIs were reported in the multiple logistic regression models. The study was conducted in Rochester, New York, between February 2016 and February 2021. Results Prior to the COVID-19 pandemic declaration, the rate of canceled and no-show appointments was greater for routine clinic visits (20% and 24%, respectively) than for research visits (14% and 9%, respectively) for the same participants; these rates increased during the pandemic. After adjusting for sociodemographic factors, the likelihood of a canceled or no-show appointment was associated with parental depression (OR=1.06, CI=1.03, 1.09), regardless of the type or occurrence of the visit. Conclusions Findings from this study demonstrate that attendance to oral health care in young children is reliably reduced with parental depression and that this may provide one mechanism for early emerging health inequalities of oral health.
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Affiliation(s)
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
- Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, New York
| | - Ronald J. Billings
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Gene E. Watson
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Pharmacology & Physiology, University of Rochester, Rochester, New York
- Department of Environmental Medicine, University of Rochester, Rochester, New York
| | - Patricia G. Ragusa
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Kimberly Flint
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Cynthia L. Wong
- Department of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Steven R. Gill
- Department of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Microbiology and Immunology, University of Rochester, Rochester, New York
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
| | - Thomas G. O'Connor
- Department of Psychiatry, University of Rochester, Rochester, New York
- Department of Psychology, University of Rochester, Rochester, New York
- Department of Neuroscience, University of Rochester, Rochester, New York
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
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Shin A, Banubakode S, Taveras Alam S, Gonzalez AO. Evaluating the Readability of Online Blood Cancer Education Materials Across Different Readability Measures. Cureus 2024; 16:e58488. [PMID: 38765438 PMCID: PMC11101262 DOI: 10.7759/cureus.58488] [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] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction The National Institutes of Health and the American Medical Association recommend patient education materials (EMs) be at or below the sixth-grade reading level. The American Cancer Society, Leukemia & Lymphoma Society, and National Comprehensive Cancer Network have accurate blood cancer EMs. Methods One hundred one (101) blood cancer EMs from the above organizations were assessed using the following: Flesch Reading Ease Formula (FREF), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Simple Measure of Gobbledygook Index (SMOG), and the Coleman-Liau Index (CLI). Results Only 3.96% of patient EMs scored at or below the seventh-grade reading level in all modalities. Healthcare professional education materials (HPEMs) averaged around the college to graduate level. For leukemia and lymphoma patient EMs, there were significant differences for FKGL vs. SMOG, FKGL vs. GFI, FKGL vs. CLI, SMOG vs. CLI, and GFI vs. CLI. For HPEMs, there were significant differences for FKGL vs. GFI and GFI vs. CLI. Conclusion The majority of patient EMs were above the seventh-grade reading level. A lack of easily readable patient EMs could lead to a poor understanding of disease and, thus, adverse health outcomes. Overall, patient EMs should not replace physician counseling. Physicians must close the gaps in patients' understanding throughout their cancer treatment.
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Affiliation(s)
- Ashley Shin
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Surbhi Banubakode
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Sara Taveras Alam
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
| | - Anneliese O Gonzalez
- Division of Hematology/Oncology, McGovern Medical School at UTHealth Houston, Houston, USA
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212
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Norberg BL, Johnsen TM, Kristiansen E, Krogh FH, Getz LO, Austad B. Primary care gatekeeping during the COVID-19 pandemic: a survey of 1234 Norwegian regular GPs. BJGP Open 2024; 8:BJGPO.2023.0095. [PMID: 37907336 PMCID: PMC11169974 DOI: 10.3399/bjgpo.2023.0095] [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: 05/24/2023] [Revised: 07/23/2023] [Accepted: 08/21/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND In the Nordic healthcare systems, GPs regulate access to secondary health services as gatekeepers. Limited knowledge exists about the gatekeeper role of GPs during public health crises seen from the perspective of GPs. AIM To document GPs' gatekeeper role and organisational changes during the initial COVID-19 lockdown in Norway. DESIGN & SETTING A cross-sectional online survey was addressed to all regular Norwegian GPs (n = 4858) during pandemic lockdown in spring 2020. METHOD Each GP documented how patients with potential COVID-19 disease were triaged and handled during a full regular workday. The survey also covered workload, organisational changes, and views on advice given by the authorities. RESULTS A total of 1234 (25.4%) of Norway's GPs participated. Together, they documented nearly 18 000 consultations, of which 65% were performed digitally (video, text, and telephone). Suspected COVID-19 symptoms were reported in 11% of the consultations. Nearly all these patients were managed in primary care, either in regular GP offices (55.7%) or GP-run municipal respiratory clinics (40.7%), while 3.7% (n = 73) were admitted to hospitals. The GPs proactively contacted an average of 0.8 at-risk patients per day. While 84% were satisfied with the information provided by the medical authorities, only 20% were able to reorganise their practice in accordance with national recommendations. CONCLUSION During the early stage of the COVID-19 pandemic in Norway, the vast majority of patients with COVID-19-suspected symptoms were handled in primary care. This is likely to have protected secondary health services from potentially detrimental exposure to contagion and breakdown of capacity limits.
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Affiliation(s)
- Børge Lønnebakke Norberg
- Norwegian Centre for E-health Research (NSE) and General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- TillerTorget Medical Centre, Trondheim, Norway
| | - Tor Magne Johnsen
- Norwegian Centre for E-health Research (NSE) and General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Midtbyen Medical Centre, Trondheim, Norway
| | - Eli Kristiansen
- Norwegian Centre for E-health Research (NSE) and General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Frode Helgetun Krogh
- Norwegian Centre for E-health Research (NSE) and General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Linn Okkenhaug Getz
- Norwegian Centre for E-health Research (NSE) and General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Bjarne Austad
- Norwegian Centre for E-health Research (NSE) and General Practice Research Unit, Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Green N, Miller F, Khanna D. Barriers to Eye Care for Adults in the United States and Solutions for It: A Literature Review. Cureus 2024; 16:e59071. [PMID: 38800137 PMCID: PMC11128266 DOI: 10.7759/cureus.59071] [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: 02/26/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Vision loss and blindness is a significant public health concern that has had a profound impact on various communities in the United States. Both anticipated and unforeseen barriers have been linked to the rising rates of vision loss and blindness in the country. Extensive research has identified numerous barriers that put many Americans at a disadvantage when trying to seek high-quality eye care services. Not only do the barriers to eye care services create problems for eye health, but also create a poor quality of life. Therefore, understanding and identifying barriers to eye healthcare services is incredibly important. In addition to understanding and identifying barriers, it is also important to identify solutions to the problems created by these barriers. A systematic review of articles characterizing the barriers to eye care was completed which resulted in the identification of the major barriers that affect Americans. The review of previous research was also used to identify available solutions for problems associated with the barriers to eye care services. The major barriers identified were cost, insurance, transport and accessibility, eye health care literacy, and communication. Because of the identification of the major barriers, solutions were also identified. Health education and increased vision screenings were found to be the most used forms of solutions by healthcare professionals promoting good eye health. Telemedicine has also been cited as a possible solution to the growing problem of visual impairment and blindness within the American population.
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Affiliation(s)
- Nicholas Green
- Public Health, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Faythe Miller
- Public Health, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Deepesh Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Jagelaviciute G, Bouwsema M, Walker M, Steer M, Dagnone D, Brennan E. "I am the doctor": gender-based bias within the clinical practice of emergency medicine in Canada-a thematic analysis of physician and trainee interview data. CAN J EMERG MED 2024; 26:249-258. [PMID: 38519829 DOI: 10.1007/s43678-024-00672-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/29/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES While women comprise about half of current Canadian medical students and physicians, only 31% of emergency medicine physicians identify as women and women trainees are less likely to express interest in emergency medicine compared to men. Gender-based bias continues to negatively impact the career choice, progress, and well-being of women physicians/trainees. Although instances of gender-based bias are well documented within other medical specialties, there remains a gap in the literature addressing the role of gender specific to the Canadian emergency medicine clinical environment. METHODS Using a qualitative study with a thematic analytical approach, participants were purposively and snowball sampled from a cross-section of centers across Canada and included emergency medicine attending physicians and trainees. A thematic analysis using an inductive and deductive approach was undertaken. All data were double coded to improve study trustworthiness. Descriptive statistics were used to characterize the study population. RESULTS Thirty-four individuals (17 woman-identifying and 17 man-identifying) from 10 different institutions across 4 provinces in Canada participated in the study. Six themes were identified: (1) women experience gender bias in the form of microaggressions; (2) women experience imposter syndrome and question their role in the clinical setting; (3) more women provide patient care to women patients and vulnerable populations; (4) gender-related challenges with family planning and home responsibilities affect work-life balance; (5) allyship and sponsorship are important for the support and development of women physicians and trainees; and (6) women value discussing shared experiences with other women to debrief situations, find mentorship, and share advice. CONCLUSIONS Gender inequity in emergency medicine affects women-identifying providers at all levels of training across Canada. Described experiences support several avenues to implement change against perceived gender bias that is focused on education, policy, and supportive spaces. We encourage institutions to consider these recommendations to achieve gender-equitable conditions in emergency medicine across Canada.
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Affiliation(s)
- Gabriele Jagelaviciute
- Undergraduate Medical Education, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada.
| | - Melissa Bouwsema
- Department of Emergency Medicine, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Melanie Walker
- Undergraduate Medical Education, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
- Department of Emergency Medicine, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
- Department of Public Health Sciences, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Molly Steer
- Undergraduate Medical Education, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Damon Dagnone
- Department of Emergency Medicine, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
| | - Erin Brennan
- Department of Emergency Medicine, Faculty of Health Sciences, School of Medicine, Queen's University, Kingston, ON, Canada
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Naja F, Abdulmalik M, Ayoub J, Mahmoud A, Nasreddine L. Dietary patterns and their associations with postpartum weight retention: results of the MINA cohort study. Eur J Nutr 2024; 63:809-820. [PMID: 38180505 DOI: 10.1007/s00394-023-03305-7] [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: 05/02/2023] [Accepted: 12/08/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE To examine the association of prepregnancy dietary patterns with postpartum weight retention at 6 months (PPWR6) among Lebanese and Qatari women. METHODS Data for this study were derived from the Mother and Infant Nutrition Assessment (MINA) prospective cohort study conducted in Lebanon and Qatar. Pregnant women were recruited during their first trimester and were followed up for three years. For the purpose of this study, data belonging to sociodemographic characteristics of participants, prepregnancy dietary intake, prepregnancy BMI as well as weight retention at 6 months were used. Dietary intake was examined using a 98-item food frequency questionnaire. Principal component analysis was used for the derivation of dietary patterns. The associations of dietary patterns with PPWR6 were examined using simple and multiple linear regressions. RESULTS Data was available for 177 participants (Lebanon: 93; Qatar: 84). Mean PPWR6 was 4.05 ± 5.29 kg. Significantly higher PPWR6 was observed among participants with pre-pregnancy overweight/obesity and among those with excessive gestational weight gain. Two dietary patterns were identified: the "Western" and the "Varied" patterns. After adjustment for confounders, a positive association was observed between the 'Western' pattern scores and PPWR6 (ß = 1.27; 95% CI 0.68-1.86; p value: < 0.0001). CONCLUSION Higher adherence to the Western pattern was associated with higher PPWR6 amongst women, hence underscoring the importance of public health interventions aimed at fostering healthier dietary habits during this crucial stage of the lifecycle.
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Affiliation(s)
- Farah Naja
- Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences (RIMHS), College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Jennifer Ayoub
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Amira Mahmoud
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Golden BN, Elrefaay S, McLemore MR, Alspaugh A, Baltzell K, Franck LS. Midwives' experience of telehealth and remote care: a systematic mixed methods review. BMJ Open 2024; 14:e082060. [PMID: 38553065 PMCID: PMC10982796 DOI: 10.1136/bmjopen-2023-082060] [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] [Received: 11/13/2023] [Accepted: 03/14/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION Increasing the midwifery workforce has been identified as an evidence-based approach to decrease maternal mortality and reproductive health disparities worldwide. Concurrently, the profession of midwifery, as with all healthcare professions, has undergone a significant shift in practice with acceleration of telehealth use to expand access. We conducted a systematic literature review to identify and synthesize the existing evidence regarding how midwives experience, perceive and accept providing sexual and reproductive healthcare services at a distance with telehealth. METHODS Five databases were searched, PubMed, CINHAL, PsychInfo, Embase and the Web of Science, using search terms related to 'midwives', 'telehealth' and 'experience'. Peer-reviewed studies with quantitative, qualitative or mixed methods designs published in English were retrieved and screened. Studies meeting the inclusion criteria were subjected to full-text data extraction and appraisal of quality. Using a convergent approach, the findings were synthesized into major themes and subthemes. RESULTS After applying the inclusion/exclusion criteria, 10 articles on midwives' experience of telehealth were reviewed. The major themes that emerged were summarized as integrating telehealth into clinical practice; balancing increased connectivity; challenges with building relationships via telehealth; centring some patients while distancing others; and experiences of telehealth by age and professional experience. CONCLUSIONS Most current studies suggest that midwives' experience of telehealth is deeply intertwined with midwives' experience of the response to COVID-19 pandemic in general. More research is needed to understand how sustained use of telehealth or newer hybrid models of telehealth and in-person care are perceived by midwives.
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Affiliation(s)
- Bethany N Golden
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Shaimaa Elrefaay
- Department of Community Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Monica R McLemore
- Child, Family, and Population Health Nursing Department, University of Washington, Seattle, Washington, USA
| | - Amy Alspaugh
- The University of Tennessee Knoxville College of Nursing, Knoxville, Tennessee, USA
| | - Kimberly Baltzell
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Linda S Franck
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
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Elendu C, Amaechi DC, Amaechi EC, Chima-Ogbuiyi NL, Afuh RN, Arrey Agbor DB, Abdi MA, Nwachukwu NO, Oderinde OO, Elendu TC, Elendu ID, Akintunde AA, Onyekweli SO, Omoruyi GO. Diagnostic criteria and scoring systems for thyroid storm: An evaluation of their utility - comparative review. Medicine (Baltimore) 2024; 103:e37396. [PMID: 38552097 PMCID: PMC10977538 DOI: 10.1097/md.0000000000037396] [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] [Received: 10/01/2023] [Accepted: 02/06/2024] [Indexed: 04/02/2024] Open
Abstract
A thyroid storm is a life-threatening endocrine emergency characterized by severe hyperthyroidism and many systemic manifestations. Prompt recognition and treatment are essential for patient survival. This study evaluates the utility of existing diagnostic criteria and scoring systems for thyroid storm. A comprehensive literature review encompassed articles published up to December 2023. Various diagnostic criteria and scoring systems, such as the Burch-Wartofsky Point Scale and the Japanese Thyroid Association criteria, were critically assessed based on their sensitivity, specificity, and clinical applicability. Our findings reveal that existing diagnostic criteria and scoring systems, although valuable tools, exhibit limitations. They may lack sensitivity in identifying milder cases of thyroid storm or fail to differentiate it from other critical conditions. Furthermore, some criteria rely heavily on subjective clinical Judgment, which can vary among healthcare providers. Future research should focus on refining existing criteria and developing more objective and universally applicable diagnostic tools to address these limitations. Incorporating advanced laboratory markers and modern imaging techniques may enhance diagnostic accuracy. Additionally, a standardized scoring system approach could improve clinical practice consistency. In conclusion, while current diagnostic criteria and scoring systems provide a foundation for identifying thyroid storm, their utility has shortcomings. Advancements in diagnostic methods and a collaborative effort to establish standardized criteria are imperative to enhance the accuracy and reliability of thyroid storm diagnosis, ultimately improving patient outcomes.
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218
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Edwards GF, Mierisch C, Mutcheson B, Strauss A, Coleman K, Horn K, Parker SH. Developing medical simulations for opioid overdose response training: A qualitative analysis of narratives from responders to overdoses. PLoS One 2024; 19:e0294626. [PMID: 38547079 PMCID: PMC10977769 DOI: 10.1371/journal.pone.0294626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/06/2023] [Indexed: 04/02/2024] Open
Abstract
Medical simulation offers a controlled environment for studying challenging clinical care situations that are difficult to observe directly. Overdose education and naloxone distribution (OEND) programs aim to train potential rescuers in responding to opioid overdoses, but assessing rescuer performance in real-life situations before emergency medical services arrive is exceedingly complex. There is an opportunity to incorporate individuals with firsthand experience in treating out-of-hospital overdoses into the development of simulation scenarios. Realistic overdose simulations could provide OEND programs with valuable tools to effectively teach hands-on skills and support context-sensitive training regimens. In this research, semi-structured interviews were conducted with 17 individuals experienced in responding to opioid overdoses including emergency department physicians, first responders, OEND program instructors, and peer recovery specialists. Two coders conducted qualitative content analysis using open and axial thematic coding to identify nuances associated with illicit and prescription opioid overdoses. The results are presented as narrative findings complemented by summaries of the frequency of themes across the interviews. Over 20 hours of audio recording were transcribed verbatim and then coded. During the open and axial thematic coding process several primary themes, along with subthemes, were identified, highlighting the distinctions between illicit and prescription opioid overdoses. Distinct contextual details, such as locations, clinical presentations, the environment surrounding the patient, and bystanders' behavior, were used to create four example simulations of out-of-hospital overdoses. The narrative findings in this qualitative study offer context-sensitive information for developing out-of-hospital overdose scenarios applicable to simulation training. These insights can serve as a valuable resource, aiding instructors and researchers in systematically creating evidence-based scenarios for both training and research purposes.
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Affiliation(s)
- G. Franklin Edwards
- Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, Virginia, United States of America
| | - Cassandra Mierisch
- Department of Basic Science Education, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States of America
| | - Brock Mutcheson
- Office of Assessment and Program Evaluation, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States of America
| | - Allison Strauss
- Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States of America
| | - Keel Coleman
- Department of Emergency Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States of America
- Department of Emergency Medicine, Carilion Clinic, Roanoke, Virginia, United States of America
| | - Kimberly Horn
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, Virginia, United States of America
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, United States of America
| | - Sarah Henrickson Parker
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, United States of America
- Department of Health Systems and Implementation Science, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, United States of America
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Werz O, Stettler H, Theurer C, Seibel J. The 125th Anniversary of Aspirin-The Story Continues. Pharmaceuticals (Basel) 2024; 17:437. [PMID: 38675399 PMCID: PMC11054228 DOI: 10.3390/ph17040437] [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: 02/27/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
The year 2024 marks the 125th anniversary of aspirin, still one of the most frequently used drugs worldwide. Despite its veritable age, it is still relevant in pharmacotherapy and its use has spread to new areas over time. Due to aspirin's multiple pharmacological actions unified in one single molecule (i.e., analgesic, antipyretic, anti-inflammatory, antithrombotic, and antiviral effects), it continues to attract considerable attention in the scientific community and is subject to intense basic and clinical research. In fact, recent results confirmed aspirin's potential role as an antiviral drug and as an agent that can block harmful platelet functions in inflammatory/immunological processes. These features may open up new horizons for this ancient drug. The future of aspirin looks, therefore, bright and promising. Aspirin is not yet ready for retirement; on the contrary, its success story continues. This 125th anniversary paper will concisely review the various therapeutic uses of aspirin with a particular emphasis on the latest research results and their implications (e.g., use as an antiviral agent). In addition, the reader is provided with future perspectives for this remarkable drug.
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Affiliation(s)
- Oliver Werz
- Department of Pharmaceutical/Medicinal Chemistry, Institute of Pharmacy, Friedrich Schiller University Jena, 07743 Jena, Germany;
| | - Hans Stettler
- Bayer Consumer Care AG, Peter Merian-Strasse 84, 4002 Basel, Switzerland;
| | - Christoph Theurer
- Bayer Vital GmbH, Kaiser-Wilhelm-Allee 70, 51373 Leverkusen, Germany;
| | - Jens Seibel
- Bayer Vital GmbH, Kaiser-Wilhelm-Allee 70, 51373 Leverkusen, Germany;
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Babazadeh T, Ranjbaran S, Pourrazavi S, Latifi A, Maleki Chollou K. Impact of health literacy and illness perception on medication adherence among older adults with hypertension in Iran: a cross-sectional study. Front Public Health 2024; 12:1347180. [PMID: 38601507 PMCID: PMC11004473 DOI: 10.3389/fpubh.2024.1347180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/14/2024] [Indexed: 04/12/2024] Open
Abstract
Background Adherence to medication is an essential factor in controlling and reducing the side effects of non-communicable diseases, particularly hypertension. Medication adherence varies in older adults due to the effects of various factors. The research aimed to examine the determinants of medication adherence among older adults with hypertension. Methods This cross-sectional study was performed among 300 people aged 60 years or older referring to health centers in Sarab, Iran, between February and May 2023. To collect data, valid and reliable tools were applied. Results There was a significant association between age groups, level of education, and monthly income status with adherence to medication (p-value <0.05). According to the results of hierarchical regression, demographic variables collectively explained 3.2% of the variance in adherence to therapeutic regimens (p-value = 0.143). The inclusion of illness perception at step 2, along with demographic variables, led to a further significant increase in 9.6% of the variance (p-value <0.001). In the final step, health literacy dimensions were added, which explained an additional 8.7% of the variance (p-value <0.001). In total, demographic variables, illness perception, and HL dimensions explained 21.5% of the variance in adherence to therapeutic regimens. Conclusion According to the results, demographic variables, illness perception, and HL dimensions were the main determinants of medication adherence among older adults. Health educators should focus on creating interventions that improve medication adherence by addressing illness perception and health literacy dimensions in this particular population.
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Affiliation(s)
- Towhid Babazadeh
- Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Soheila Ranjbaran
- Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, Iran
| | - Sara Pourrazavi
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Arman Latifi
- Department of Public Health, School of Public Health, Research Center for Evidence-Based Health Management, Maragheh University of Medical Sciences, Maragheh, Iran
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Sapbamrer R, Sittitoon N, Thongtip S, Chaipin E, Sutalangka C, La-up A, Thirarattanasunthon P, Thammachai A, Suwannakul B, Sangkarit N, Kitro A, Panumasvivat J, Srisookkum T. Socio-demographic, agricultural, and personal protective factors in relation to health literacy among farmers from all regions of Thailand. Front Public Health 2024; 12:1364296. [PMID: 38590809 PMCID: PMC10999635 DOI: 10.3389/fpubh.2024.1364296] [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] [Received: 01/02/2024] [Accepted: 03/07/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Farmers are vulnerable to adverse health effects from pesticide exposure due to their health literacy (HL). Therefore, this study aims to investigate HL among farmers in four main regions of Thailand, investigating socio-demographics, agricultural, and personal protective factors to their HL. Methods This cross-sectional design study was conducted on 4,035 farmers from January to July 2023. The European Health Literacy Survey Questionnaire-47 items were used to measure HL. Results Thai farmers had a mean HL score of 34.7 ± 8.7, and the farmers in the North region of Thailand had the highest frequency of limited HL (75.8%). Socio-demographic factors that were associated with HL included gender, region of living, marital status, education level, co-morbidity, and number of family members. Agricultural factors associated with HL included planting status, working hours on farm, spraying pesticides, harvesting crops, pesticide use of >1 type, access information from government officers, access information from posters/brochures, information from online multimedia, and access information from neighbors. Personal protective factors that were associated with HL included wearing a hat, goggles, a rubber apron, and a long-sleeved shirt. Discussion Our study recommends that strategies and interventions to enhance the HL of farmers should be focused on the target populations, which include men, widows, or divorced, those with low levels of education, those who have co-morbidities, and those who applied pesticides of more than 1 type and improper personal protective equipment (PPE) use. The primary emphasis needs to be on the North region of Thailand, making that the target area to improve health equity in Thailand. These efforts would enhance the HL of farmers and sustainably improve pesticide safety behavior. Additionally, there is an urgent need for supportive measures aimed at altering on-farm practices and promoting education on alternative pest management strategies, particularly non-chemical crop protection, to ensure sustainable agriculture.
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Affiliation(s)
- Ratana Sapbamrer
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nalin Sittitoon
- School of Environmental Health, Institute of Public Health, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Sakesun Thongtip
- Department of Environmental Health, School of Public Health, University of Phayao, Phayao, Thailand
| | - Eakasit Chaipin
- Department of Public Health, Faculty of Science, Rajabhat Lampang University, Lampang, Thailand
| | - Chatchada Sutalangka
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Aroon La-up
- Nakhonsawan Campus, Mahidol University, Nakhonsawan, Thailand
| | | | - Ajchamon Thammachai
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Boonsita Suwannakul
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Noppharath Sangkarit
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Amornphat Kitro
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jinjuta Panumasvivat
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Environmental and Occupational Medicine Excellence Center (EnOMEC), Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Taweewun Srisookkum
- Department of Community Health, School of Public Health, University of Phayao, Phayao, Thailand
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Haruta J, Goto R. Exploring factors associated with healthcare professionals' subjective perceptions of complex issues in primary care in Japan: a self-administered survey study on confidence, satisfaction and burden levels. BMJ Open 2024; 14:e081328. [PMID: 38531578 DOI: 10.1136/bmjopen-2023-081328] [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: 03/28/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore factors associated with healthcare professionals' subjective perceptions of complex issues in primary care settings in Japan. DESIGN Cross-sectional survey conducted through a self-administered web-based questionnaire. SETTING Japan, from June to October 2020. PARTICIPANTS Healthcare professionals recruited via an email list from the Japan Primary Care Association. MEASURES The questionnaire assessed subjective perception of satisfaction, confidence and burden regarding complex issues using a 100 mm Visual Analogue Scale (VAS). Explanatory variables included the Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), basic demographic information, administrative experience and an organisational climate scale. This scale comprised the 'Plan, Do, See' (PDS) factor for management and the 'Do' factor in a leader-centred direction for those working under compulsion. Factors associated with subjective perceptions were analysed using binomial logistic regression analysis and Bonferroni analysis (p<0.017). RESULTS Data from 593 participants (average age of 41.2 years, including 133 nurses, 128 physicians and 120 social workers) were analysed. Median (quartile) VAS scores for satisfaction, confidence and burden were 50 (36-70), 52 (40-70) and 50 (30-66), respectively. Higher satisfaction group was significantly associated with PDS factor, Do factor and JASSIC Score. Greater confidence group associated with older age, male, Do factor, administrative experience and JASSIC Score. No factors were significantly associated with the higher perceived burden. CONCLUSION These findings reveal that interprofessional competency self-assessment influence perceptions of complex issues among healthcare professionals. Moreover, satisfaction with complex issues might be enhanced by a manageable organisational climate, while confidence might be influenced by personal attributes.
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Affiliation(s)
- Junji Haruta
- Center for General Medicine Education, Keio University, Shinjuku-ku, Tokyo, Japan
| | - Ryohei Goto
- Department of Primary Care and Medical Education, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Hsu SH, Lin YL, Koo M, Creedy DK, Tsao Y. Health-literacy, self-efficacy and health-outcomes of patients undergoing haemodialysis: Mediating role of self-management. J Ren Care 2024. [PMID: 38522017 DOI: 10.1111/jorc.12493] [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: 10/26/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Health literacy, self-efficacy and self-management are known to influence health-related well-being. However, the precise influence of self-management, health literacy and self-efficacy on health outcomes in Asian countries is under-researched. OBJECTIVES To examine the impact of health literacy and self-efficacy (independent variables) and self-management (mediator) on patients' health outcomes (dependent variable). DESIGN An observational, cross-sectional design was conducted between 1 March 2022 and 31 August 2022. PARTICIPANTS Outpatients receiving haemodialysis (n = 200) at a Taiwanese medical centre were assessed. MEASUREMENTS The survey included demographic questions and standardised scales: the 3-item Brief Health Literacy Screen, the 8-item Perceived Kidney/Dialysis Self-Management Scale as a measure of self-efficacy, and the 20-item Haemodialyses Self-Management Instrument. Health outcomes were responses on the 12-item Short-Form Health Survey version 2 and clinical blood results from the past 3 months. RESULTS Participants aged over 60 exhibited common comorbidities, with 34% showing low health literacy. Biochemical markers (e.g., haemoglobin and albumin) significantly correlated with physical and mental health scores. Mediating coefficients revealed that self-management significantly influenced associations between health outcomes, health literacy (β = 0.31; p < 0.01), and self-efficacy (β = 0.19; p < 0.01). IMPLICATIONS FOR PRACTICE Self-management can modify the overall influence of health literacy and self-efficacy on patients' quality of physical and emotional health. When managing a chronic condition, 'knowing' how to self-manage does not always result in 'doing so' by the patient. Continuous monitoring and promoting self-management behaviours and support by nurses are crucial to enhance health outcomes.
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Affiliation(s)
- Shu-Hua Hsu
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yu-Li Lin
- Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Malcolm Koo
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Debra K Creedy
- School of Nursing & Midwifery, Griffith University, Griffith, Australia
| | - Ying Tsao
- Department of Nursing, Tzu-Chi University, Hualien, Taiwan
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D'Souza K, Singh S, Westgard CM, Barnhardt S. A qualitative assessment of barriers and facilitators of telemedicine volunteerism during the COVID-19 pandemic in India. HUMAN RESOURCES FOR HEALTH 2024; 22:21. [PMID: 38520012 PMCID: PMC10958920 DOI: 10.1186/s12960-024-00897-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/30/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The COVID-19 pandemic further propelled the recent growth of telemedicine in low-resource countries, with new models of telemedicine emerging, including volunteer-based telemedicine networks. By leveraging existing infrastructure and resources to allocate health personnel more efficiently, these volunteer networks eased some of the pandemic burden placed on health systems. However, there is insufficient understanding of volunteer-based telemedicine models, especially on the human resources engagement on such networks. This study aims to understand the motivations and barriers to health practitioner engagement on a volunteer telemedicine network during COVID-19, and the mechanisms that can potentially sustain volunteer engagement to address healthcare demands beyond the pandemic. METHODS In-depth qualitative interviews were conducted with health practitioners volunteering on an Indian, multi-state telemedicine network during the COVID-19 pandemic. Data were analyzed using thematic content analysis methods. RESULTS Most practitioners reported being motivated to volunteer by a sense of duty to serve during the pandemic. Practitioners suggested organizational-level measures to make the process more efficient and facilitate a more rewarding provider-patient interaction. These included screening calls, gathering patient information prior to consultations, and allowing for follow-up calls with patients to close the loop on consultations. Many practitioners stated that non-financial incentives are enough to maintain volunteer engagement. However, practitioners expressed mixed feelings about financial incentives. Some stated that financial incentives are needed to maintain long-term provider engagement, while others stated that financial incentives would devalue the volunteer experience. Most practitioners highlighted that telemedicine could increase access to healthcare, especially to the rural and underserved, even after the pandemic. Practitioners also expressed an interest in continuing to volunteer with the network if the need arose again. CONCLUSION Our study findings suggest that practitioners are highly intrinsically motivated to volunteer during large healthcare emergencies and beyond to address the healthcare needs of the underserved. Following the recommendations presented in the study, telemedicine networks can more successfully engage and maintain volunteer practitioners. Volunteer-based telemedicine networks have the potential to bridge shortages of health personnel in resource-constrained settings both in times of crises and beyond.
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Affiliation(s)
- Karishma D'Souza
- Department of Health Policy & Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1101B McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC, 27599, USA.
| | - Saksham Singh
- School of Human Ecology, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Christopher M Westgard
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sharon Barnhardt
- Centre for Social and Behaviour Change, Ashoka University, Rajiv Gandhi Education City, Sonipat, Haryana, 131029, India
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Marasović Šušnjara I, Mijaković M, Jurčev Savičević A. The Influence of the COVID-19 Pandemic on Hospitalizations for Ambulatory Care-Sensitive Conditions in Split-Dalmatia County, Croatia. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:523. [PMID: 38674169 PMCID: PMC11052272 DOI: 10.3390/medicina60040523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: We aimed to explore whether the COVID-19 pandemic influenced hospitalizations for ambulatory care-sensitive conditions (ACSCs) in Split-Dalmatia County, Croatia. Materials and Methods: We performed a cross-sectional comparative study using two different time periods, the pre-pandemic (from March 2019 to February 2020) and the pandemic period (from March 2020 to February 2021), to explore the possible influences that the COVID-19 pandemic had on hospitalizations for ACSCs. The ACSCs were classified into the categories of vaccine-preventable, chronic, and acute disease. The indicators were statistically analyzed. Results: During the pandemic, a decrease in the total number of hospitalizations and ACSC hospitalizations was recorded. The relative risk for having any ACSC hospitalization in the pandemic period compared to the pre-pandemic period was 0.67 (95% CI, 0.64-0.71; p = 0). The risk reduction was seen in all three categories of vaccine-preventable ACSCs, chronic disease, and acute disease. Large reductions were found in the relative risk of hospitalization for COPD and asthma. Considering the mode of discharge, there was a statistically significantly higher risk of ACSCs with fatal outcomes during the pandemic than in the pre-pandemic period (relative risk 1.31; 95% CI, 1.01-1.7; p = 0.0197). Conclusions: The results of this study show that the COVID-19 pandemic influenced the total number of hospitalizations as well as hospitalizations relating to ACSCs. Certainly, one of the reasons for these changes was due to organizational changes in the working of the entire health system due to the COVID-19 pandemic.
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Affiliation(s)
- Ivana Marasović Šušnjara
- Teaching Public Health Institute of Split-Dalmatia County, 21000 Split, Croatia; (I.M.Š.); (M.M.)
- University Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Marijana Mijaković
- Teaching Public Health Institute of Split-Dalmatia County, 21000 Split, Croatia; (I.M.Š.); (M.M.)
| | - Anamarija Jurčev Savičević
- Teaching Public Health Institute of Split-Dalmatia County, 21000 Split, Croatia; (I.M.Š.); (M.M.)
- University Department of Health Studies, University of Split, 21000 Split, Croatia
- School of Medicine, University of Split, 21000 Split, Croatia
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226
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Kavanagh KT, Cormier LE, Pontus C, Bergman A, Webley W. Long COVID's Impact on Patients, Workers, & Society: A review. Medicine (Baltimore) 2024; 103:e37502. [PMID: 38518038 PMCID: PMC10957027 DOI: 10.1097/md.0000000000037502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/14/2024] [Indexed: 03/24/2024] Open
Abstract
The incidence of long COVID in adult survivors of an acute SARS-CoV-2 infection is approximately 11%. Of those afflicted, 26% have difficulty with day-to-day activities. The majority of long COIVD cases occur after mild or asymptomatic acute infection. Children can spread SARS-CoV-2 infections and can also develop long-term neurological, endocrine (type I diabetes), and immunological sequelae. Immunological hypofunction is exemplified by the recent large outbreaks of respiratory syncytial virus and streptococcal infections. Neurological manifestations are associated with anatomical brain damage demonstrated on brain scans and autopsy studies. The prefrontal cortex is particularly susceptible. Common symptoms include brain fog, memory loss, executive dysfunction, and personality changes. The impact on society has been profound. Fewer than half of previously employed adults who develop long COVID are working full-time, and 42% of patients reported food insecurity and 20% reported difficulties paying rent. Vaccination not only helps prevent severe COVID-19, but numerous studies have found beneficial effects in preventing and mitigating long COVID. There is also evidence that vaccination after an acute infection can lessen the symptoms of long COVID. Physical and occupational therapy can also help patients regain function, but the approach must be "low and slow." Too much physical or mental activity can result in post-exertional malaise and set back the recovery process by days or weeks. The complexity of long COVID presentations coupled with rampant organized disinformation, have caused significant segments of the public to ignore sound public health advice. Further research is needed regarding treatment and effective public communication.
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Affiliation(s)
| | | | | | | | - Wilmore Webley
- Department of Microbiology, University of Massachusetts Amherst, Amherst, MA
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227
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Gao Y, Ma Y, Feng D, Zhang F, Wang B, Liu X, Zhu B, Xie H, Zhao L, Long X, Chen Y, Wang B, Jiang J, Zhu Z, Zhang Y, Cui A, Xia B, Mao N. Epidemiological Characteristics of Human Parainfluenza Viruses Infections - China, 2019-2023. China CDC Wkly 2024; 6:235-241. [PMID: 38633430 PMCID: PMC11018516 DOI: 10.46234/ccdcw2024.047] [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: 09/11/2023] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction A retrospective study based on sentinel surveillance was conducted in 10 provincial-level administrative divisions (PLADs) in China to enhance the understanding of the epidemiological characteristics of human parainfluenza viruses (HPIVs). Methods From January 2019 to June 2023, respiratory specimens were collected from individuals with acute respiratory infections (ARIs) and screened for four HPIVs serotypes and other common respiratory viruses using multiplex real-time polymerase chain reaction (PCR). This study analyzed the association of HPIVs infections with seasonal patterns, geographical distribution, demographic profiles, clinical features, and co-infection status. Results During the study period, a total of 12,866 ARIs were included. The overall detection rate of HPIVs was 6.15%, varying from 5.04% in 2022 to 9.70% in 2020. The median age of HPIVs-infected patients was 3 years. HPIV2 was more prevalent among individuals aged 5-17 years (42.57%), while HPIV4 was more common in those over 65 years (12.24%). HPIV3 (54.16%) and HPIV1 (27.18%) were the predominant serotypes, and their prevalence exhibited significant seasonal fluctuations post- coronavirus disease 2019 (COVID-19) pandemic. The peak of HPIV3 shifted three months later in 2020 compared to 2019 and returned to a summer peak thereafter. Two peaks of HPIV1 were observed in 2021 following the peak of HPIV3. Additionally, co-infections were frequent in HPIVs cases (overall rate: 22.12%), with human rhinovirus being the most common co-infecting virus. Conclusions The prevalence of HPIVs in China was predominantly due to HPIV3 and HPIV1, and their seasonal patterns were altered by pandemic restrictions. Hence, continuous surveillance of HPIVs is essential.
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Affiliation(s)
- Yixuan Gao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Yingwei Ma
- Precision Medicine Research Center, Children’s Hospital of Changchun, Changchun City, Jilin Province, China
| | - Daxing Feng
- Henan Provincial Center for Disease Control and Prevention, Zhengzhou City, Henan Province, China
| | - Feng Zhang
- Laboratory of Viral Diseases, Qingdao Municipal Centre for Disease Control and Prevention, Qingdao City, Shandong Province, China
| | - Biao Wang
- Virus Laboratory, Gansu Provincial Center for Disease Control and Prevention, Lanzhou City, Gansu Province, China
| | - Xiaoqing Liu
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang City, Gansu Province, China
| | - Bing Zhu
- Virus Laboratory, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou City, Guangdong Province, China
| | - Hui Xie
- Institute for Immunization and Prevention, Beijing Center for Disease Prevention and Control, Academy for Preventive Medicine, Institute of Tuberculosis Control Research and Prevention, Beijing, China
| | - Linqing Zhao
- Laboratory of Virology, Beijing Key Laboratory of Etiology of Viral Diseases in Children, Capital Institute of Pediatrics, Beijing, China
| | - Xiaoru Long
- Department of Infection, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Chen
- Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot City, Inner Mongolia Autonomous Region, China
| | - Bing Wang
- Shenyang Prefecture Center for Disease Control and Prevention, Shenyang City, Liaoning Province, China
| | - Jie Jiang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Zhen Zhu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Yan Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Aili Cui
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Baicheng Xia
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
| | - Naiying Mao
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention; Beijing, China
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228
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Jancey J, Crawford G, Bowman E, Wolf K, Leaver T, Bialous S, McCausland K. Perceptions of social media harms and potential management strategies: vaping case study. BMC Public Health 2024; 24:876. [PMID: 38515083 PMCID: PMC10958968 DOI: 10.1186/s12889-024-18362-8] [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: 12/11/2023] [Accepted: 03/14/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The social media landscape is now ubiquitous in people's everyday lives. It is a space where culture, politics, economics and sociological and public health discourses occur. There is mounting evidence that e-cigarette products are being promoted and advertised on social media, a media platform particularly popular with young people. Our research aimed to understand industry professionals' perceptions of social media harms and potential management strategies using vaping as a case study. METHODS A critical realist perspective guided reflexive thematic analysis of the qualitative in depth, semi structured interviews. Data collection occurred in January and February 2023 with 13 participants working in the areas of public health, digital media, law, governance, tobacco control and advocacy. RESULTS Two superordinate themes emerged from the data: (1) Fathoming a complex system (social media) that contained the subordinate themes of Traversing Boundaries (crossing borders, crossing sectors) and Ungovernable (global and local landscapes, vested interests, self-regulation and opacity). (2) Addressing complexity (social media)- that contained the subordinate themes of Strengthening Institutions (global to local, policy and legislation, individuals and organisations); Defanging Industry (responsibility and transparency, moderation and algorithms, complaints); and Engaging Citizens (raising awareness, framing messaging). CONCLUSIONS There was consensus among participants that e-cigarette related social media content can be harmful and government action is urgently needed. There was an identified need for the development of government led national-level regulatory frameworks, with government led appropriate legislation; identification of an organisation or organisations with suitable levels of regulatory power and resources to monitor, enforce and penalise noncompliant social media companies; accompanied by increased community awareness raising of harmful social media content and improved digital literacy.
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Affiliation(s)
- Jonine Jancey
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia.
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Elizabeth Bowman
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Katharina Wolf
- School of Management and Marketing, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Tama Leaver
- School of Media, Creative Arts and Social Inquiry, Curtin University, Kent Street, Perth, WA, 6102, Australia
| | - Stella Bialous
- School of Nursing, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Kent Street, Perth, WA, 6102, Australia
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229
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Quistberg DA. Potential of artificial intelligence in injury prevention research and practice. Inj Prev 2024; 30:89-91. [PMID: 38307714 PMCID: PMC11003389 DOI: 10.1136/ip-2023-045203] [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: 12/08/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
There is increasing interest and use of artificial Intelligence algorithms and methods in biomedical research and practice, particularly as the technology has made significant advances in the past decade and become more accessible to more disciplines. This editorial briefly reviews this technology and its potential for injury prevention research and practice, proposing ways that it can be used to advance the discipline, as well as the potential pitfalls, concerns and biases that accompany it.
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Affiliation(s)
- D Alex Quistberg
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
- Environmental & Occupational Health, Drexel University, Philadelphia, Pennsylvania, USA
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230
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Sila T, Suriyaamorn W, Toh C, Rajborirug S, Surasombatpattana S, Thongsuksai P, Kongkamol C, Chusri S, Sornsenee P, Wuthisuthimethawee P, Chaowanawong R, Sangkhathat S, Ingviya T. Factors associated with the worsening of COVID-19 symptoms among cohorts in community- or home-isolation care in southern Thailand. Front Public Health 2024; 12:1350304. [PMID: 38572011 PMCID: PMC10987961 DOI: 10.3389/fpubh.2024.1350304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction This study aimed to investigate factors associated with time-to-referral due to worsening symptoms in patients with laboratory-confirmed COVID-19 in southern Thailand. While underlying diseases have been evaluated to assess COVID-19 severity, the influence of vaccinations and treatments is also crucial. Methods A cohort of 8,638 patients quarantined in home or community isolation with laboratory-confirmed COVID-19 was analyzed. Survival analysis and the Cox proportional hazard ratio were employed to assess factors influencing time-toreferral. Results Age ≥ 60 years, neurologic disorders, cardiovascular disease, and human immunodeficiency virus infection were identified as significant risk factors for severe COVID-19 referral. Patients who received full- or booster-dose vaccinations had a lower risk of experiencing severe symptoms compared to unvaccinated patients. Notably, individuals vaccinated during the Omicron-dominant period had a substantially lower time-to-referral than those unvaccinated during the Delta-dominant period. Moreover, patients vaccinated between 1 and 6 months prior to infection had a significantly lower risk of time-to-referral than the reference group. Discussion These findings demonstrate early intervention in high-risk COVID-19 patients and the importance of vaccination efficacy to reduce symptom severity. The study provides valuable insights for guiding future epidemic management strategies and optimising patient care during infectious disease outbreaks.
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Affiliation(s)
- Thanit Sila
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Health Science and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Wisanuwee Suriyaamorn
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chanavee Toh
- Department of Health Science and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Songyos Rajborirug
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | | | - Paramee Thongsuksai
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Health Science and Clinical Research, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chanon Kongkamol
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sarunyou Chusri
- Department of Internal Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Phoomjai Sornsenee
- Faculty of Medicine, Department of Family Medicine and Preventive Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Prasit Wuthisuthimethawee
- Department of Emergency Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Raya Chaowanawong
- Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkla, Thailand
| | - Surasak Sangkhathat
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Faculty of Medicine, Translational Medicine Research Center, Prince of Songkla University, Songkhla, Thailand
| | - Thammasin Ingviya
- Division of Digital Innovation and Data Analytics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
- Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Tucknott S, McAteer H. Equity, expense, and expertise in biologic commissioning: adding the patient to the equation. Expert Opin Biol Ther 2024:1-9. [PMID: 38509688 DOI: 10.1080/14712598.2024.2326646] [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: 04/06/2023] [Accepted: 02/29/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Immune-mediated inflammatory diseases (IMIDs) are increasingly managed effectively with biologic medicines. However, with relatively high unit costs, there remains a meaningful pressure to ensure streamlined, equitable, and inclusive prescription of biologics in the UK. Despite an increased awareness of the benefits of patient-centric shared decision making, patients remain on the periphery of biologic selection for the treatment of IMIDs. AREAS COVERED We provide a patient perspective on core issues in the commissioning, prescription, and decision making around biologics for IMIDs in the UK, focusing on England. In particular, the crucial aspect of determining 'value' for different stakeholders, who necessarily have different priorities, is considered. EXPERT OPINION There are disparities in commissioning, access to, and prescription of biologics for IMIDs in the UK. This creates an unequal treatment model and drives patient dissatisfaction with an 'experience lottery' for the management of disease. A more transparent approach to prescribing decisions, made in close consultation with patients, is essential for improving equity and experience with biologic treatment of IMIDs.
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Otte JA, Llargués Pou M. Enablers and barriers to a quaternary prevention approach: a qualitative study of field experts. BMJ Open 2024; 14:e076836. [PMID: 38508616 PMCID: PMC10952943 DOI: 10.1136/bmjopen-2023-076836] [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] [Received: 06/17/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE There is a growing concern about the sustainability of healthcare and the impacts of 'overuse' on patients and systems. Quaternary prevention (P4), a concept promoting the protection of patients from medical interventions in which harms outweigh benefits, is well positioned to stimulate reflection and inspire solutions, yet has not been widely adopted. We sought to identify enablers and barriers to a P4 approach, according to field experts and advocates in one health system. DESIGN Qualitative methodology, using semistructured interviews and a grounded theory approach facilitated thematic analysis and development of a conceptual model. SETTING Virtual interviews, conducted in British Columbia, Canada. PARTICIPANTS 12 field experts, recruited based on their interest and work related to P4 and related concepts. RESULTS Four factors were seen as promoting or hindering P4 efforts depending on context: relationship between patient and clinician, education of clinicians and the public, health system design and influencers. We extracted four broad enablers of P4: evidence-based medicine, personal experiences and questioning attitude, public P4 campaigns and experience in resource-poor contexts. There were six barriers: peer pressure between clinicians, awareness and screening campaigns, cognitive biases, cultural factors, complexity of the problem and industry influence. CONCLUSIONS Elicited facilitators and impediments to the application of P4 were similar to those seen in existing literature but framed uniquely; our findings place increased emphasis on the clinician-patient relationship as central to decision-making and position other drivers as influencing this relationship. A transition to a model of care that explicitly integrates conscious protection of patients by reducing overtesting, overdiagnosis and overtreatment will require changes across health systems and society.
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Affiliation(s)
- Jessica Anneliese Otte
- Department of Family Practice and Division of Palliative Care, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Therapeutics Initiative, Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Maria Llargués Pou
- Sta. Mª de Palautordera Primary Healthcare Center (CAP) - Baix Montseny Primary Healthcare Team (EAP), Institut Català de la Salut, Barcelona, Catalonia, Spain
- Emergency Department, University General Hospital of Granollers, Barcelona, Catalonia, Spain
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Barnawi NA, Al-Otaibi H, Alkhudairy AI, Alajlan MA, Alajlan RA, Alay SM, Alqahtani SM, Bushnak IA, Abolfotouh MA. Awareness, Knowledge, Attitude, and Skills (AKAS) of Telemedicine and Its Use by Primary Healthcare Providers. Int J Gen Med 2024; 17:1047-1058. [PMID: 38532847 PMCID: PMC10964027 DOI: 10.2147/ijgm.s452641] [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: 12/11/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
Background This study aimed to determine the rate of telemedicine (TM) use and the levels of awareness, knowledge, attitude, and skills of TM among primary healthcare (PHC) providers. Methods In a cross-sectional study, 104 PHC providers were subjected to a validated AKAS scale via Survey Monkey. The tool consists of 4 parameters that users can respond to using a 4-point Likert scale to assess their awareness (12 statements), knowledge (11 statements), attitude (11 statements), and skills (13 statements) on TM. Total and percentage mean scores (PMS) were calculated for each parameter. Participants were categorized in each parameter into three categories: low (≤ 49% score), average (50-70% score), and high (≥ 71% score) levels. The association of AKAS levels with personal characteristics and TM use was investigated. The significance was set at p<0.05. Results One-half of participants (51%) reported current use of TM, and two-thirds (63.5%) reported a high level of AKAS, with a PMS of 72.9±14.7, 95% CI: 70.1-75.7. There were significant associations between the following: years of experience and levels of knowledge (Χ2LT = 6.77, p= 0.009) and skills (Χ2LT = 4.85, p = 0.028), respectively; and total household income and levels of skills (Χ2LT = 6.91, p= 0.009). The rate of TM use was significantly associated with awareness levels (Χ2LT = 6.14, p = 0.013). Lack of training ranked as the first barrier (45.5%), followed by connection problems and tools' unavailability (35.1% each). The participants recommended providing TM training (41.1%) and stabilization of connection and networking signals (30.1%). Conclusion Despite their high level of TM awareness, the rate of TM use by PHC providers is less than satisfactory. Establishing standardized TM training and supporting the network signals are recommended. A large-scale study on the impact of TM integration with PHC services is necessary.
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Affiliation(s)
- Najla A Barnawi
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- College of Nursing, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Hazza Al-Otaibi
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Pharmaceutical Care Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz I Alkhudairy
- College of Medicine, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Mohammed A Alajlan
- College of Medicine, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | - Renad A Alajlan
- College of Medicine, Imam Muhammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Saeed M Alay
- College of Pharmacy, King Saud Bin Abdul-Aziz University for Health Science (KSAU-HS), Riyadh, Saudi Arabia
| | | | - Ibraheem A Bushnak
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mostafa A Abolfotouh
- King Abdullah International Medical Research Center (KAIMRC)/King Saud Bin Abdulaziz University for Health Sciences/Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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Boston D, Hwang J, Lucas JA, Marino M, Larson Z, Sun E, Giebultowicz S, Crookes DM, Rodriguez CJ, Heintzman J. Latino-White Disparities in Identification and Control of Elevated Blood Pressure Among Adults With Hypertension. J Am Heart Assoc 2024; 13:e033151. [PMID: 38456400 PMCID: PMC11010015 DOI: 10.1161/jaha.123.033151] [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: 10/18/2023] [Accepted: 02/02/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Studies analyzing blood pressure (BP) management using the hypertension control cascade have consistently shown disparities in hypertension awareness, treatment, and BP control between Latino patients and non-Latino White patients. We analyze this cascade using electronic health record data from a multistate network of community health centers. METHODS AND RESULTS Data from 790 clinics in 23 US states from 2012 to 2020, including 1 270 174 patients, were analyzed to compare BP documentation in the electronic health record, clinician acknowledgment (diagnosis or treatment) of incident hypertension (BP ≥140/90), medication prescription, and BP control between non-Latino White patients, English-preferring Latino patients, and Spanish-preferring Latino patients, adjusted for patient-level covariates, and clustered on patients' primary clinics. Among the 429 182 patients with elevated BP (≥140/90) during ambulatory visits from 2012 to 2020, we found that clinician acknowledgment of hypertension was more likely in Spanish-preferring and English-preferring Latino patients versus non-Latino White patients (adjusted odds ratio [aOR], 1.17 [95% CI, 1.11-1.24]; aOR, 1.07 [95% CI, 1.02-1.12], respectively). In addition, Spanish-preferring Latino patients were more likely to receive a medication versus non-Latino White patients (aOR, 1.21 [95% CI, 1.16-1.28]). Among those receiving medication, Latino patients were as likely as non-Latino White patients to have their BP controlled (<140/90). CONCLUSIONS In a large retrospective study of community health center patients with incident hypertension, the expected disparities in hypertension management between Spanish-preferring Latino, English-preferring Latino, and non-Latino White patients were not identified. These findings add to the hypertension control cascade by examining robust electronic health record data from community health centers and may provide clues to reducing disparities in hypertension management.
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Affiliation(s)
| | - Jun Hwang
- Department of Family MedicineOregon Health & Science UniversityPortlandORUSA
| | - Jennifer A. Lucas
- Department of Family MedicineOregon Health & Science UniversityPortlandORUSA
| | - Miguel Marino
- Department of Family MedicineOregon Health & Science UniversityPortlandORUSA
| | | | | | | | | | | | - John Heintzman
- Department of Family MedicineOregon Health & Science UniversityPortlandORUSA
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Dhas BN, Fox J, Bright B, El Haj DB, James AP, Bu Hazaa HAHJ, Al Abdulla SSH. "Switching Hats": Insights From Experienced Clinical Interviewers Turned Novice Research Interviewers. QUALITATIVE HEALTH RESEARCH 2024:10497323241234008. [PMID: 38497200 DOI: 10.1177/10497323241234008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Health professionals/clinicians interview people regularly as part of their role. However, a qualitative research interview differs considerably to a clinical interview. If clinicians approach qualitative research interviewing based on their expertise in clinical interviewing, it could cause insufficiencies in qualitative data generation. In this reflection article, we, a team of four experienced clinical occupational therapists with no previous experience in qualitative research interviewing, share our experiences while learning to become qualitative research interviewers before undertaking our first qualitative research project. We engaged in self-directed reading, formal training on qualitative interviewing, and practice interviews and used peer feedback and reflection to prepare ourselves to conduct qualitative interviews. We drew upon the work-role transitions theory to work through our adjustment to the new role. Although we set out to "switch hats" as the research topic itself was not clinical, interviewing people on health-related topics will mean bringing our clinical instincts into our research role, while still recognizing the difference between a clinical and research interview. This article can inform experienced clinicians/novice qualitative researchers as they develop this new skillset.
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Affiliation(s)
- Brightlin N Dhas
- Discipline of Occupational Therapy, University of Northampton, Northampton, UK
| | - Jackie Fox
- Discipline of Occupational Therapy, School of Health Sciences, University of Galway, Galway, Ireland
| | - Benshamir Bright
- Department of Occupational Therapy, Hamad Medical Corporation, Doha, Qatar
| | - Dina B El Haj
- Department of Occupational Therapy, Hamad Medical Corporation, Doha, Qatar
| | - Abraham P James
- Department of Occupational Therapy, Hamad Medical Corporation, Doha, Qatar
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Elyoseph Z, Levkovich I. Comparing the Perspectives of Generative AI, Mental Health Experts, and the General Public on Schizophrenia Recovery: Case Vignette Study. JMIR Ment Health 2024; 11:e53043. [PMID: 38533615 PMCID: PMC11004608 DOI: 10.2196/53043] [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] [Received: 09/24/2023] [Revised: 01/24/2024] [Accepted: 02/11/2024] [Indexed: 03/28/2024] Open
Abstract
Background The current paradigm in mental health care focuses on clinical recovery and symptom remission. This model's efficacy is influenced by therapist trust in patient recovery potential and the depth of the therapeutic relationship. Schizophrenia is a chronic illness with severe symptoms where the possibility of recovery is a matter of debate. As artificial intelligence (AI) becomes integrated into the health care field, it is important to examine its ability to assess recovery potential in major psychiatric disorders such as schizophrenia. Objective This study aimed to evaluate the ability of large language models (LLMs) in comparison to mental health professionals to assess the prognosis of schizophrenia with and without professional treatment and the long-term positive and negative outcomes. Methods Vignettes were inputted into LLMs interfaces and assessed 10 times by 4 AI platforms: ChatGPT-3.5, ChatGPT-4, Google Bard, and Claude. A total of 80 evaluations were collected and benchmarked against existing norms to analyze what mental health professionals (general practitioners, psychiatrists, clinical psychologists, and mental health nurses) and the general public think about schizophrenia prognosis with and without professional treatment and the positive and negative long-term outcomes of schizophrenia interventions. Results For the prognosis of schizophrenia with professional treatment, ChatGPT-3.5 was notably pessimistic, whereas ChatGPT-4, Claude, and Bard aligned with professional views but differed from the general public. All LLMs believed untreated schizophrenia would remain static or worsen without professional treatment. For long-term outcomes, ChatGPT-4 and Claude predicted more negative outcomes than Bard and ChatGPT-3.5. For positive outcomes, ChatGPT-3.5 and Claude were more pessimistic than Bard and ChatGPT-4. Conclusions The finding that 3 out of the 4 LLMs aligned closely with the predictions of mental health professionals when considering the "with treatment" condition is a demonstration of the potential of this technology in providing professional clinical prognosis. The pessimistic assessment of ChatGPT-3.5 is a disturbing finding since it may reduce the motivation of patients to start or persist with treatment for schizophrenia. Overall, although LLMs hold promise in augmenting health care, their application necessitates rigorous validation and a harmonious blend with human expertise.
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Affiliation(s)
- Zohar Elyoseph
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- The Center for Psychobiological Research, Department of Psychology and Educational Counseling, Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College, Kiryat Tiv'on, Israel
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Vílchez-Román C, Paucar-Caceres A, Quispe-Prieto S. The impact of research on health education/health literacy on policymaking in Latin America and the Caribbean Region. AIMS Public Health 2024; 11:330-348. [PMID: 39027398 PMCID: PMC11252583 DOI: 10.3934/publichealth.2024017] [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: 12/11/2023] [Revised: 02/19/2024] [Accepted: 01/28/2024] [Indexed: 07/20/2024] Open
Abstract
Background In this study, we addressed the gap between health research and policymaking in Latin America and the Caribbean (LAC), focusing on health education/health literacy. Despite growing research, translating findings into effective policies needs to be improved. We explored the factors that make research on health education and health literacy to be referenced and mentioned in policy documents in LAC (and in Peru). We proposed a model based on the hypothesis that the relationship between research and policymaking depends on the research strength of scientific evidence, timing, and social media activity. Methods A mixed-methods approach was employed, combining quantitative and qualitative data analysis. Quantitative data sources included multidisciplinary databases, altmetric data, and citations of policy documents. For data analysis, we obtained descriptive statistics to identify patterns and then verified the association between variables using χ2. The negative binomial regression was used to test the empirical model introduced above. Quantitative analysis was complemented by analysis of responses to a set of open questions from a sample of Peruvian health policymakers. Results We found that timing, strength of evidence, and social media activity were significant predictors of research cited in policy documents. Policy documents tended to rely more on qualitative evidence. A positive correlation between timing and cites in policy documents highlighted the importance of timely dissemination, whereas social media activity, while having an impact, had a relatively minor effect. Peruvian policymakers' responses emphasized the role of political context, the relevance of results, and policymakers' commitment to incorporating research into policies. Conclusion Strength of evidence, social media engagement, and publication timing are key predictors of citations for health education/literacy research in LAC policy documents. However, qualitative findings highlight challenges, including some distrust in research findings, together with limited access to relevant research. The findings offer opportunities to enhance evidence-informed health education/health literacy policy decisions. Implications To increase the influence on health policymakers, researchers should prioritize the timely dissemination of solid evidence, considering both traditional and digital platforms. Policymakers should focus on the quality and relevance of evidence when formulating policies.
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Affiliation(s)
- Carlos Vílchez-Román
- Research Department, CENTRUM Católica Graduate Business School (CCGBS), Pontificia Universidad Católica del Perú (PUCP), Lima 15023, Perú
| | - Alberto Paucar-Caceres
- Department for Operations, Technology, Events and Hospitality Management, Manchester Metropolitan University, Manchester, M15 6BH, United Kingdom
| | - Silvia Quispe-Prieto
- School of Nursing, Faculty of Health Sciences, Universidad Nacional Jorge Basadre Grohmann, Grohmann, Tacna 23000, Perú
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Duignan M, Drennan J, Mc Carthy VJC. Work characteristics, job satisfaction and intention to leave: a cross-sectional survey of advanced nurse practitioners. Contemp Nurse 2024:1-13. [PMID: 38489485 DOI: 10.1080/10376178.2024.2327353] [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: 12/01/2023] [Accepted: 03/01/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Advanced Nurse Practitioners (ANPs) are highly skilled health care professionals with the potential to play a major role in improving the quality and accessibility of health care services. However, there is emerging evidence of disquiet among nurse practitioners who often work in suboptimal work environments. Therefore, it is important to understand the elements that contribute to ANPs' job satisfaction and retention in healthcare services. AIM To examine the effects of commitment to the workplace, work engagement, and influence at work on job satisfaction and intention to leave of ANPs. METHODS A total of 153 ANP's on the advanced practice section of the Nursing and Midwifery Board of Ireland register completed a web survey between July and August 2020. Independent variables (commitment to the workplace, work engagement, and influence at work) were measured using the Copenhagen Psychosocial Questionnaire (COPSOQ). Multivariable logistic regression models were used to investigate the association between dependent and independent variables. RESULTS Participants who reported higher levels of influence at work and higher levels of commitment to the workplace were also satisfied in their job (OR 1.05, 95% CI 1.01-1.09, p = 0.025), (OR 1.10, 95% CI 1.06-1.14, p < 0.001) respectively. Additionally, ANPs with higher levels of commitment to work were significantly less likely to leave their role (OR 0.94, 95% CI .92-.96, p < 0.001). CONCLUSION Healthcare organisations can improve job satisfaction and decrease intention to leave by creating environments in which ANPs are supported by their colleagues and supervisors, and facilitate their practice to the full extent of their capabilities.
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Affiliation(s)
- Martin Duignan
- Health Service Executive, Our Lady's Hospital, Navan, Co., Meath, Ireland
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Jonathan Drennan
- School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
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Hampton F, Larson J, Hobson A, Hughes D. The Role of Telemedicine in Rural Specialty Care: Priorities and Recommendations From Rural Primary Care Physicians. Kans J Med 2024; 17:6-10. [PMID: 38694180 PMCID: PMC11060778 DOI: 10.17161/kjm.vol17.21290] [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: 09/11/2023] [Accepted: 02/23/2024] [Indexed: 05/04/2024] Open
Abstract
Introduction The study goal was to understand telemedicine's role in improving access to rural specialty care. Other outcomes included assessing specialty availability and frequency of referrals at rural sites. Methods This mixed methods study included surveys and semi-structured interviews of rural primary care physicians (PCPs). Survey data were analyzed with summary statistics and cross-tabulations. Interview transcripts were inductively thematically analyzed. Results Of the 19 PCPs who completed the survey, 37% agreed/strongly agreed current telemedicine practices connected patients to better specialty care; 90% agreed/strongly agreed it had such potential. Interviews revealed telemedicine could improve care when local specialists were unavailable and provided the most benefit in acute care settings or specialist follow-ups. Most survey respondents reported outreach specialists were highly effective in addressing rural specialty care needs. Respondents reported cardiology, general surgery, orthopedic surgery, ENT/otolaryngology, and dermatology as the most frequently referred-to specialties. In-person neurology, gastroenterology, and dermatology were unavailable in many communities. Respondents identified psychiatry as a high priority for telemedicine and discussed clinic-to-clinic visits to optimize telemedicine use. Conclusions The perceived discrepancy between the current and potential roles of telemedicine in rural specialty care suggests that telemedicine may not fully align with the needs of rural patients and could be optimized for rural practice settings. While local, in-person access to specialists remains a priority, telemedicine can reduce patient burdens and improve care when in-person specialists are unavailable. Telemedicine proponents can identify high-priority areas for implementation through quantitative assessment of specialty care utilization and access as reported by PCPs.
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Affiliation(s)
- Faith Hampton
- University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Jeremy Larson
- University of Kansas School of Medicine-Kansas City, Kansas City, KS
| | - Alyssa Hobson
- University of Kansas School of Medicine-Kansas City, Kansas City, KS
| | - Dorothy Hughes
- University of Kansas School of Medicine-Kansas City, Kansas City, KS
- Department of Population Health
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Bognich G, Howell N, Butler E. Fate-and-transport modeling of SARS-CoV-2 for rural wastewater-based epidemiology application benefit. Heliyon 2024; 10:e25927. [PMID: 38434294 PMCID: PMC10904236 DOI: 10.1016/j.heliyon.2024.e25927] [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: 07/26/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Wastewater-based epidemiology (WBE) for the detection of agents of concern such as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been prevalent in literature since 2020. The majority of reported research focuses on large urban centers with few references to rural communities. In this research the EPA-Storm Water Management Model (EPA-SWMM) software was used to describe a small sewershed and identify the effects of temperature, temperature-affected decay rate, flow rate, flush time, fecal shedding rate, and historical infection rates during the spread of the Omicron variant of the SARS-CoV-2 virus within the sewershed. Due to the sewershed's relative isolation from the rest of the city, its wastewater quality behavior is similar to a rural sewershed. The model was used to assess city wastewater sampling campaigns to best appropriate field and or lab equipment when sampling wastewater. An important aspect of the assessment was the comparison of SARS-CoV-2 quantification methods with specifically between a traditional microbiological lab (practical quantitation limit, PQL, 1 GC/mL) versus what can be known from a field method (PQL 10 GC/mL). Understanding these monitoring choices will help rural communities make decisions on how to best implement the collection and testing for WBE agents of concern. An important outcome of this work is the knowledge that it is possible to simulate a WBE agent of concern with reasonable precision, if uncertainties are incorporated into model sensitivity. These ideas could form the basis for future mixed monitoring-modeling studies that will enhance its application and therefore adoption of WBE techniques in communities of many sizes and financial means.
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Affiliation(s)
- Gabrielle Bognich
- Holland School of Sciences and Mathematics, Hardin-Simmons University, Abilene, TX, USA
| | - Nathan Howell
- College of Engineering, West Texas A&M University, Canyon, TX, USA
| | - Erick Butler
- College of Engineering, West Texas A&M University, Canyon, TX, USA
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Mukthapuram S, Johnson BA, Slagle C, Erickson J, Kamath-Rayne BD, Brady JM. Design and Implementation of a Didactic Curriculum in a Large Neonatal-Perinatal Medicine Fellowship Program: A Single-center Experience. Am J Perinatol 2024. [PMID: 38490252 DOI: 10.1055/s-0044-1782599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
OBJECTIVE Although the Accreditation Council for Graduate Medical Education and American Board of Pediatrics (ABP) provide regulations and guidance on fellowship didactic education, each program establishes their own didactic schedules to address these learning needs. Wide variation exists in content, educators, amount of protected educational time, and the format for didactic lectures. This inconsistency can contribute to fellow dissatisfaction, a perceived poor learning experience, and poor attendance. Our objective was to create a Neonatal-Perinatal Medicine (NPM) fellow curriculum based on adult learning theory utilizing fellow input to improve the perceived fellow experience. STUDY DESIGN A needs assessment of current NPM fellows at Cincinnati Children's Hospital was conducted to guide the development of a new curriculum. Fellow perception of educational experience and board preparedness before and after introduction of the new curriculum was collected. Study period was from October 2018 to July 2021. RESULTS One hundred percent of the fellows responded to the needs assessment survey. A response rate of 100 and 87.5% were noted on mid-curriculum survey and postcurriculum survey, respectively. Key themes identified and incorporated into the curriculum included schedule structure, content, and delivery mode. A new didactic curriculum implementing a consistent schedule of shorter lectures grouped by organ system targeting ABP core content was created. After curriculum implementation, fellows had higher self-perception of board preparedness, and overall improved satisfaction. CONCLUSION Our positive experience in implementing this curriculum provides a framework for individual programs to implement similar curricula, and could be utilized to aid in development of national NPM curricula. KEY POINTS · Fellowship didactic education varies significantly resulting in learner dissatisfaction and poor attendance.. · Widespread need to restructure didactic curricula exists.. · Our study provides a framework for future curricula..
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Affiliation(s)
| | - Beth Ann Johnson
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Cara Slagle
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - John Erickson
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Beena D Kamath-Rayne
- Global Child Health and Life Support, American Academy of Pediatrics, Itasca, Illinois
| | - Jennifer M Brady
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Tariq MU, Ismail SB. Deep learning in public health: Comparative predictive models for COVID-19 case forecasting. PLoS One 2024; 19:e0294289. [PMID: 38483948 PMCID: PMC10939212 DOI: 10.1371/journal.pone.0294289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/28/2023] [Indexed: 03/17/2024] Open
Abstract
The COVID-19 pandemic has had a significant impact on both the United Arab Emirates (UAE) and Malaysia, emphasizing the importance of developing accurate and reliable forecasting mechanisms to guide public health responses and policies. In this study, we compared several cutting-edge deep learning models, including Long Short-Term Memory (LSTM), bidirectional LSTM, Convolutional Neural Networks (CNN), hybrid CNN-LSTM, Multilayer Perceptron's, and Recurrent Neural Networks (RNN), to project COVID-19 cases in the aforementioned regions. These models were calibrated and evaluated using a comprehensive dataset that includes confirmed case counts, demographic data, and relevant socioeconomic factors. To enhance the performance of these models, Bayesian optimization techniques were employed. Subsequently, the models were re-evaluated to compare their effectiveness. Analytic approaches, both predictive and retrospective in nature, were used to interpret the data. Our primary objective was to determine the most effective model for predicting COVID-19 cases in the United Arab Emirates (UAE) and Malaysia. The findings indicate that the selected deep learning algorithms were proficient in forecasting COVID-19 cases, although their efficacy varied across different models. After a thorough evaluation, the model architectures most suitable for the specific conditions in the UAE and Malaysia were identified. Our study contributes significantly to the ongoing efforts to combat the COVID-19 pandemic, providing crucial insights into the application of sophisticated deep learning algorithms for the precise and timely forecasting of COVID-19 cases. These insights hold substantial value for shaping public health strategies, enabling authorities to develop targeted and evidence-based interventions to manage the virus spread and its impact on the populations of the UAE and Malaysia. The study confirms the usefulness of deep learning methodologies in efficiently processing complex datasets and generating reliable projections, a skill of great importance in healthcare and professional settings.
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Affiliation(s)
- Muhammad Usman Tariq
- Abu Dhabi University, Abu Dhabi, United Arab Emirates
- Universiti Tun Hussein Onn Malaysia (UTHM), Parit Raja, Malaysia
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243
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Pham TV, Kincade M, Vranceanu AM. Culturally Adapting Mind-Body Interventions for Black Individuals with Chronic Pain: Arguments and Recommendations Towards a Task-Sharing Approach. Adv Mind Body Med 2024; 37:12-19. [PMID: 38466049 PMCID: PMC11168092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Compared to non-Hispanic White individuals, non-Hispanic Black Individuals report worse chronic pain from a variety of medical issues. Among the options for non-pharmacological pain treatment, mind-body interventions (MBI) are a promising modality to help Black individuals manage their chronic pain effectively. MBIs such as mindfulness meditation improve chronic pain and chronic pain-related outcomes by shifting the individual's perception of pain away from stress-related cognitive appraisals, emotional reactions, and behaviors. MBIs may also address disparities in chronic pain outcomes between Black and White individuals because of their contextual overlap with (1) centering and contemplative prayer, (2) racial empowerment, and (3) social support. Despite this overlap, the demand for MBIs among Black individuals has generally been low due to lingering access and acceptability barriers. To reduce these barriers for Black individuals with chronic pain, we must adopt a community-engaged approach and culturally adapt MBIs for the specific historic, environmental, financial, and psychosocial needs of Black individuals. Example adaptations include increasing Black representation among MBI instructors, reducing geographical access barriers, accommodating the financial and personal realities of Black adults, and explicitly allowing relevant attitudes, practices, and terms.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital
| | - Michael Kincade
- Center for Alzheimer's Research and Treatment, Massachusetts Alzheimer's Disease Research Center
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244
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Dowding C, Mikocka-Walus A, Skvarc D, O'Shea M, Olive L, Evans S. Learning to cope with the reality of endometriosis: A mixed-methods analysis of psychological therapy in women with endometriosis. Br J Health Psychol 2024. [PMID: 38467518 DOI: 10.1111/bjhp.12718] [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: 03/05/2023] [Accepted: 02/22/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVES Despite the need and uptake of mental health support by women with endometriosis, no research to date has explored their experience of psychological therapy. We aimed to understand the factors that predict engagement in psychological therapy by Australian women with endometriosis and to qualitative explore their experience of psychological support. DESIGN Mixed-methods design. METHODS A total of 200 women with self-reported endometriosis were recruited from the community. We explored; (1) the demographic and clinical predictors of engagement in psychological therapy, (2) the psychological approaches that seem most valuable to women in the management of endometriosis and (3) their experience engaging in psychological therapy for endometriosis. RESULTS Nearly half of women reported to have seen a psychologist within the past year, particularly for pain. Younger age (OR, .94; 95% CI, .886-.993), depressive symptoms (OR, 1.05; 95% CI, 1.002-1.099), and working part time compared to full time (OR, 2.17, 95% CI, 1.012-4.668), increased the likelihood of engaging in psychological therapy. Template thematic analysis identified three themes; (1) endometriosis and pain have multi-faceted psychological effects, (2) psychological support is sought to adjust and live with endometriosis and (3) there are helpful and unhelpful psychological tools for women with endometriosis. CONCLUSIONS Our findings support the use of psychological therapy in the management of endometriosis, and the need for psychological therapy to acknowledge the chronicity and impact of symptoms, to enlist multidisciplinary support and to consider alternative options. Further advocacy is required to educate women on the benefits of psychological therapy for endometriosis.
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Affiliation(s)
- Charlotte Dowding
- Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Antonina Mikocka-Walus
- Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - David Skvarc
- Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Melissa O'Shea
- Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Lisa Olive
- Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
- IMPACT, the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Subhadra Evans
- Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
- Centre for Social and Early Emotional Development, Faculty of Health, School of Psychology, Deakin University, Geelong, Victoria, Australia
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245
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Sansom K, Reynolds A, Windred D, Phillips A, Dhaliwal SS, Walsh J, Maddison K, Singh B, Eastwood P, McArdle N. The interrelationships between sleep regularity, obstructive sleep apnea, and hypertension in a middle-aged community population. Sleep 2024; 47:zsae001. [PMID: 38180870 PMCID: PMC10925954 DOI: 10.1093/sleep/zsae001] [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: 07/23/2023] [Revised: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
STUDY OBJECTIVES Little is known about the interrelationships between sleep regularity, obstructive sleep apnea (OSA) and important health markers. This study examined whether irregular sleep is associated with OSA and hypertension, and if this modifies the known association between OSA and hypertension. METHODS Six hundred and two adults (age mean(SD) = 56.96(5.51) years, female = 60%) from the Raine Study who were not evening or night shift workers were assessed for OSA (in-laboratory polysomnography; apnea-hypopnea index ≥ 15 events/hour), hypertension (doctor diagnosed, or systolic blood pressure ≥140 mmHg and/or diastolic ≥90 mmHg) and sleep (wrist actigraphy for ≥5 days). A sleep regularity index (SRI) was determined from actigraphy. Participants were categorized by tertiles as severely irregular, mildly irregular, or regular sleepers. Logistic regression models examined the interrelationships between SRI, OSA and hypertension. Covariates included age, sex, body mass index, actigraphy sleep duration, insomnia, depression, activity, alcohol, smoking, and antihypertensive medication. RESULTS Compared to regular sleepers, participants with mildly irregular (OR 1.97, 95% confidence intervals [CI] 1.20 to 3.27) and severely irregular (OR 2.06, 95% CI: 1.25 to 3.42) sleep had greater odds of OSA. Compared to those with no OSA and regular sleep, OSA and severely irregular sleep combined had the highest odds of hypertension (OR 2.34 95% CI: 1.07 to 5.12; p for interaction = 0.02) while those with OSA and regular/mildly irregular sleep were not at increased risk (p for interaction = 0.20). CONCLUSIONS Sleep irregularity may be an important modifiable target for hypertension among those with OSA.
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Affiliation(s)
- Kelly Sansom
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute - Sleep Health, Adelaide, SA, Australia
| | - Amy Reynolds
- Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute - Sleep Health, Adelaide, SA, Australia
| | - Daniel Windred
- School of Psychological Sciences, Monash University, Turner Institute for Brain and Mental Health, Clayton, VIC, Australia
| | - Andrew Phillips
- School of Psychological Sciences, Monash University, Turner Institute for Brain and Mental Health, Clayton, VIC, Australia
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
- Office of the Provost, Singapore University of Social Sciences, Clementi, Singapore
- Duke-NUS Medical School, National University of Singapore, Singapore
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Jennifer Walsh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Kathleen Maddison
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Bhajan Singh
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Peter Eastwood
- Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Nigel McArdle
- Centre for Sleep Science, School of Human Sciences, University of Western Australia, Perth, WA, Australia
- Queen Elizabeth II Medical Centre, West Australian Sleep Disorders Research Institute, Nedlands, WA, Australia
- Department of Pulmonary Physiology and Sleep Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
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246
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Goussault-Capmas P, Panjo H, Pelletier-Fleury N. Gender awareness among general practitioners in France: a cross sectional study using the Nijmegen Gender Awareness in Medicine Scale (N-GAMS). Sci Rep 2024; 14:5733. [PMID: 38459178 PMCID: PMC10924088 DOI: 10.1038/s41598-024-56396-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/06/2024] [Indexed: 03/10/2024] Open
Abstract
Gender is a key determinant of health and healthcare use. The question of whether physicians are aware of gender issues is important to avoid gender bias in medical practice. This study aimed to validate the Nijmegen Gender Awareness in Medicine Scale (N-GAMS) in a representative population of French general practitioners (GPs) and to analyze their gender sensitivity and the presence of gender stereotypes among them. The N-GAMS, already validated in medical students, measures gender awareness through 3 subscores: gender sensitivity (GS) and gender-role ideology towards patients (GRIP) and doctors (GRID) (gender stereotypes). After translation into French, it was distributed to 900 GPs. The scale was validated through exploratory factor analysis (EFA). Psychometric properties were tested. Multivariate linear regressions were conducted to explore the associations between GPs' characteristics and N-GAMS subscores. EFA identified 3 meaningful factors consistent with prior theory. Subscores exhibited good internal consistency. The main findings were that GRIP was significantly higher in older physicians, in male physicians, among those who less involved their patients in decisions, and those who were not training supervisors. For GRID, results were quite similar to those of GRIP. GS was significantly higher for physicians working in health centres or medical homes and for those with gynecological practices but lower when they less involved patients in medical decisions. This study suggests that it is necessary to teach gender issues not only in medical schools but also as part of continuing medical education.
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Affiliation(s)
- Perrine Goussault-Capmas
- CESP - Centre de Recherche en Epidémiologie et Santé des Populations, U1018 INSERM, Hôpital Paul Brousse, Université Paris Saclay, Université Versailles Saint Quentin, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
- Service Gynécologie Obstétrique, Hôpital de Bicêtre, 78 Avenue du Général Leclerc, 94275, Le Kremlin Bicêtre Cedex, France
| | - Henri Panjo
- CESP - Centre de Recherche en Epidémiologie et Santé des Populations, U1018 INSERM, Hôpital Paul Brousse, Université Paris Saclay, Université Versailles Saint Quentin, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France
| | - Nathalie Pelletier-Fleury
- CESP - Centre de Recherche en Epidémiologie et Santé des Populations, U1018 INSERM, Hôpital Paul Brousse, Université Paris Saclay, Université Versailles Saint Quentin, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France.
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Carollo M, Boccardi V, Crisafulli S, Conti V, Gnerre P, Miozzo S, Omodeo Salè E, Pieraccini F, Zamboni M, Marengoni A, Onder G, Trifirò G. Medication review and deprescribing in different healthcare settings: a position statement from an Italian scientific consortium. Aging Clin Exp Res 2024; 36:63. [PMID: 38459218 PMCID: PMC10923734 DOI: 10.1007/s40520-023-02679-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/17/2023] [Indexed: 03/10/2024]
Abstract
Recent medical advancements have increased life expectancy, leading to a surge in patients affected by multiple chronic diseases and consequent polypharmacy, especially among older adults. This scenario increases the risk of drug interactions and adverse drug reactions, highlighting the need for medication review and deprescribing to reduce inappropriate medications and optimize therapeutic regimens, with the ultimate goal to improving patients' health and quality of life. This position statement from the Italian Scientific Consortium on medication review and deprescribing aims to describe key elements, strategies, tools, timing, and healthcare professionals to be involved, for the implementation of medication review and deprescribing in different healthcare settings (i.e., primary care, hospital, long-term care facilities, and palliative care). Challenges and potential solutions for the implementation of medication review and deprescribing are also discussed.
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Affiliation(s)
- Massimo Carollo
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy
| | - Virginia Boccardi
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Salvatore Crisafulli
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy
| | - Valeria Conti
- Clinical Pharmacology Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy
| | | | - Simonetta Miozzo
- Italian Society of General Medicine and Primary Care, Florence, Italy
| | - Emanuela Omodeo Salè
- Division of Pharmacy, IEO European Institute of Oncology IRCCS, Milan, Italy
- IRCCS Centro Cardiologico Monzino, Milan, Italy
| | | | - Mauro Zamboni
- Department of Medicine-Geriatric Division, University of Verona, Verona, Italy
| | - Alessandra Marengoni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Graziano Onder
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, P.Le L.A. Scuro 10, 37124, Verona, Italy.
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248
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Muhl C, Mulligan K, Bayoumi I, Ashcroft R, Ross-White A, Godfrey C. Social prescribing for children and youth: A scoping review protocol. PLoS One 2024; 19:e0297535. [PMID: 38457470 PMCID: PMC10923428 DOI: 10.1371/journal.pone.0297535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 01/03/2024] [Indexed: 03/10/2024] Open
Abstract
Social prescribing is suited to all age groups, but it is especially important for children and youth, as it is well understood that this population is particularly vulnerable to the effects of the social determinants of health and health inequities, and that intervening at this stage of life has the greatest impact on health and wellbeing over the life course. While this population has largely been neglected in social prescribing research, policy, and practice, several evaluations of social prescribing for children and youth have emerged in recent years, which calls for a review of the evidence on this topic. Thus, the objective of this scoping review is to map the evidence on the use of social prescribing for children and youth. This review will be conducted in accordance with the JBI methodology for scoping reviews and will be reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The search strategy will aim to locate both published and unpublished literature. No language or date restrictions will be placed on the search. The databases to be searched include MEDLINE (Ovid), CINAHL (EBSCO), Embase (Ovid), PsycINFO (Ovid), AMED (Ovid), ASSIA (ProQuest), Sociological Abstracts (ProQuest), Global Health (Ovid), Web of Science (Clarivate), Epistemonikos, JBI EBP Database (Ovid), and Cochrane Library. Sources of gray literature to be searched include Google, Google Scholar, Social Care Online (Social Care Institute for Excellence), SIREN Evidence and Resource Library (Social Interventions Research and Evaluation Network), and websites of social prescribing organizations and networks. Additionally, a request for evidence sources will be sent out to members of the Global Social Prescribing Alliance. Two independent reviewers will perform title and abstract screening, retrieval and assessment of full-text evidence sources, and data extraction. Data analysis will consist of basic descriptive analysis. Results will be presented in tabular and/or diagrammatic format alongside a narrative summary.
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Affiliation(s)
- Caitlin Muhl
- School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Kate Mulligan
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Imaan Bayoumi
- School of Medicine, Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Rachelle Ashcroft
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Amanda Ross-White
- Bracken Health Sciences Library, Queen’s University, Kingston, Ontario, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University, Kingston, Ontario, Canada
| | - Christina Godfrey
- School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University, Kingston, Ontario, Canada
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249
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Islam MA, Nahar MT, Siddiquee T, Toma AS, Hoque F, Hossain MZ. Prevalence and determinants of utilizing skilled birth attendance during home delivery of pregnant women in India: Evidence from the Indian Demographic and Health Survey 2015-16. PLoS One 2024; 19:e0295389. [PMID: 38452023 PMCID: PMC10919655 DOI: 10.1371/journal.pone.0295389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 11/21/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Utilization of skilled birth attendance during home delivery of pregnant women is proven to reduce complications during and after childbirth. Though the utilization of skilled birth attendance (SBA) during home delivery has increased significantly in recent times, the rate of utilizing skilled birth attendance is still low in several regions across India. The objective of this study is to analyze the prevalence and to identify the determinants of the utilization of skilled birth attendance during home delivery of pregnant women in India. METHODS To conduct this study, data and information from the Indian Demographic and Health Survey 2015-16 have been utilized. The sample size for this study is a weighted sample of 41,171 women. The sample consisted of women who had given a live birth in the three years preceding the survey. For women with more than one child, only the first live birth was considered. The binary logistic regression model and the log-binary logistic regression analysis have been applied as the adjusted odds ratios (AORs) with 95% confidence intervals for identifying the determinants of home-based skilled birth attendance during delivery. That allows us to select the most appropriate model for our study objective by ensuring that the determinants of skilled birth attendance for home delivery are accurately assessed based on the characteristics of the data. RESULTS The analyses show that only 18.8% of women had utilized skilled birth attendance during delivery. Women residing in urban areas are more likely to utilize skilled birth attendance during home delivery (AOR: 1.14; 95% CI: 1.08-1.20). Women having higher education levels are associated with increased use of SBA during home delivery (AOR: 1.15; 95% CI: 1.04-1.28). Exposure to media is associated with increased utilization of SBA (AOR: 1.17; 95% CI: 1.11-1.23). Overweight women are also more likely to avail the SBA during home delivery (AOR: 1.11; 95% CI: 1.03-1.19). Women belonging to affluent households have higher odds of utilizing skilled birth attendance (AOR: 1.41; 95% CI: 1.33-1.49). Having 3+ tetanus injections is associated with the utilization of SBA (AOR: 1.56; 95% CI: 1.43-1.69). Women having 4+ antenatal care visits were more likely to utilize SBA (AOR: 1.81; 95% CI: 1.71-1.92). Women belonging to the Hindu religion were 1.12 times more likely to utilize SBA (AOR: 1.12; 95% CI: 1.07-1.18). Women with 1 to 3 birth orders were 1.40 times more likely to utilize skilled birth attendance during home delivery (AOR: 1.40; 95% CI: 1.30-1.51). CONCLUSION The percentage of women utilizing skilled birth attendance during home delivery is still very low which is a matter of serious concern. Several factors have been found to be associated with the utilization of SBA during home delivery in India. As skilled birth attendance has significant positive health outcomes for pregnant women and newborns, efforts to increase the rate of SBA utilization during home delivery should be undertaken.
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Affiliation(s)
- Md. Akhtarul Islam
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Mst. Tanmin Nahar
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Tanjim Siddiquee
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Afrina Sultana Toma
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Farhana Hoque
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Md. Zobayer Hossain
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
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250
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Chien SY, Wong AMK, Tseng W, Hu HC, Cho HY. Feasibility and Design Factors for Home-Based Pulmonary Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease and Chronic Lung Diseases Based on a People-Object-Environment Framework: Qualitative Interview Study. JMIR Hum Factors 2024; 11:e51150. [PMID: 38452366 PMCID: PMC10958338 DOI: 10.2196/51150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/01/2023] [Accepted: 01/24/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The feasibility of implementing home-based pulmonary rehabilitation (PR) can be assessed from the perspectives of patients with chronic lung disease and health care professionals involved in PR. OBJECTIVE Through a qualitative inquiry using interviews and the adoption of the people-object-environment framework, this study aims to understand the influences of interpersonal, environmental, and situational factors on the perceptions and considerations of individuals involved in home-based PR for patients with chronic lung disease. METHODS One-on-one interviews were conducted with 20 patients with chronic lung disease and 20 health care professionals for investigating their attitudes and opinions based on their experiences regarding home-based PR as well as for identifying the key factors affecting the benefits and drawbacks of such therapies. This study further evaluates the feasibility of using digital tools for medical diagnosis and treatment by examining the technology usage of both parties. RESULTS The 4 key issues that all participants were the most concerned about were as follows: distance to outpatient medical care, medical efficiency, internet connectivity and equipment, and physical space for diagnosis and treatment. Interviews with patients and health care professionals revealed that the use of technology and internet was perceived differently depending on age and area of residence. Most participants reported that digital tools and internet connectivity had many benefits but still could not solve all the problems; moreover, these same digital tools and network transmission could lead to problems such as information security and digital divide concerns. This study also emphasizes the significant impact of human behavior and thinking on shaping the design of health care interventions and technologies. Understanding user perspectives and experiences is crucial for developing effective solutions for unmet needs. CONCLUSIONS The results of this study indicate that despite the different perspectives of patients and health care professionals, their considerations of the key issues are very similar. Therefore, the implementation of plans related to telemedicine diagnosis, treatment, or rehabilitation should take the suggestions and considerations of both parties into account as crucial factors for telehealth care design.
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Affiliation(s)
- Shih-Ying Chien
- Department of Industrial Design, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Alice May-Kuen Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Winston Tseng
- Division of Community Health Sciences, School of Public Health, University of California, Berkeley, CA, United States
| | - Han-Chung Hu
- Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Respiratory Therapy, Lin-Kou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hsiu-Ying Cho
- Department of Respiratory Therapy, Lin-Kou Chang Gung Memorial Hospital, Taoyuan, Taiwan
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