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Mondino E, Di Baldassarre G, Mård J, Ridolfi E, Rusca M. Public perceptions of multiple risks during the COVID-19 pandemic in Italy and Sweden. Sci Data 2020; 7:434. [PMID: 33303742 PMCID: PMC7729954 DOI: 10.1038/s41597-020-00778-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/19/2020] [Indexed: 12/03/2022] Open
Abstract
Knowing how people perceive multiple risks is essential to the management and promotion of public health and safety. Here we present a dataset based on a survey (N = 4,154) of public risk perception in Italy and Sweden during the COVID-19 pandemic. Both countries were heavily affected by the first wave of infections in Spring 2020, but their governmental responses were very different. As such, the dataset offers unique opportunities to investigate the role of governmental responses in shaping public risk perception. In addition to epidemics, the survey considered indirect effects of COVID-19 (domestic violence, economic crises), as well as global (climate change) and local (wildfires, floods, droughts, earthquakes, terror attacks) threats. The survey examines perceived likelihoods and impacts, individual and authorities' preparedness and knowledge, and socio-demographic indicators. Hence, the resulting dataset has the potential to enable a plethora of analyses on social, cultural and institutional factors influencing the way in which people perceive risk.
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Affiliation(s)
- Elena Mondino
- Centre of Natural Hazards and Disaster Science, Uppsala, Sweden.
- Department of Earth Sciences, Uppsala University, Uppsala, Sweden.
| | - Giuliano Di Baldassarre
- Centre of Natural Hazards and Disaster Science, Uppsala, Sweden
- Department of Earth Sciences, Uppsala University, Uppsala, Sweden
| | - Johanna Mård
- Centre of Natural Hazards and Disaster Science, Uppsala, Sweden
- Department of Earth Sciences, Uppsala University, Uppsala, Sweden
| | - Elena Ridolfi
- Centre of Natural Hazards and Disaster Science, Uppsala, Sweden
- Department of Earth Sciences, Uppsala University, Uppsala, Sweden
| | - Maria Rusca
- Centre of Natural Hazards and Disaster Science, Uppsala, Sweden
- Department of Earth Sciences, Uppsala University, Uppsala, Sweden
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Major P, Stefura T, Wysocki M, Małczak P, Rzepa A, Proczko-Stepaniak M, Szeliga J, Pędziwiatr M. Impact of SARS-CoV-2 pandemic on bariatric care in Poland: results of national survey. BMC Surg 2020; 20:314. [PMID: 33272221 PMCID: PMC7711258 DOI: 10.1186/s12893-020-00990-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/29/2020] [Indexed: 12/13/2022] Open
Abstract
Background The SARS-CoV-2 pandemic has reached Poland on March 4th, 2020 and undoubtedly affected all areas of life and medical care, including bariatric care. The study was planned to identify the impact of the SARS-CoV-2 pandemic on bariatric care in Poland. Methods The online survey was designed and distributed to bariatric surgeons. The questionnaire was divided into three parts: demographic characteristics of participants and their bariatric centers, examining the impact of the pandemic on the bariatric care and last part with questions about planned care after the pandemic. Results 49 surgeons participated in the survey. 27 (55%) participants worked in hospitals transformed into COVID-dedicated units. Only 9 (18%) respondents declared uninterrupted bariatric surgery during a pandemic. 91% of surgeons declared continuation of bariatric care with telemedicine techniques. All participants declared a high willingness to resume bariatric surgery after the SARS-CoV-2 pandemic and responded that bariatric procedures should resume immediately when World Health Organisation (WHO) announces the end of a pandemic regardless of oncological treatment. 90% of respondents believe that the pandemic will not affect the safety of bariatric procedures in the future. Conclusions Access to bariatric care during the pandemic is limited and redirected to telemedicine. Surgeons are ready to resume bariatric operations immediately after the pandemic, but its end is difficult to determine. In surgeons’ opinion pandemic will not affect the safety of bariatric surgery in the future. The extended waiting list and financial aspects will be the main issues after the pandemic.
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Affiliation(s)
- Piotr Major
- 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland
| | - Tomasz Stefura
- 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland.
| | - Michał Wysocki
- 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland
| | - Piotr Małczak
- 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland
| | - Anna Rzepa
- 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland
| | - Monika Proczko-Stepaniak
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Szeliga
- Department of General, Gastroenterological, and Oncological Surgery, Collegium Medicum Nicolaus Copernicus University, Torun, Poland
| | - Michał Pędziwiatr
- 2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2 st., 30-688, Krakow, Poland
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Harvey-Kelly LLW, Harrison H, Rossi SH, Griffin SJ, Stewart GD, Usher-Smith JA. Public attitudes towards screening for kidney cancer: an online survey. BMC Urol 2020; 20:170. [PMID: 33115457 PMCID: PMC7592501 DOI: 10.1186/s12894-020-00724-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/17/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Kidney cancer is often asymptomatic, leading to proposals for a screening programme. The views of the public towards introducing a new screening programme for kidney cancer are unknown. The aim of this study was to explore attitudes towards kidney cancer screening and factors influencing intention to attend a future screening programme. METHODS We conducted an online population-based survey of 1021 adults aged 45-77 years. The main outcome measure was intention to attend four possible screening tests (urine, blood, ultrasound scan, low-dose CT) as well as extended low-dose CT scans within lung cancer screening programmes. We used multivariable regression to examine the association between intention and each screening test. RESULTS Most participants stated that they would be 'very likely' or 'likely' to undergo each of the screening tests [urine test: n = 961 (94.1%); blood test: n = 922 (90.3%); ultrasound: n = 914 (89.5%); low-dose CT: n = 804 (78.8%); lung CT: n = 962 (95.2%)]. Greater intention to attend was associated with higher general cancer worry and less perceived burden/inconvenience about the screening tests. Less worry about the screening test was also associated with higher intention to attend, but only in those with low general cancer worry (cancer worry scale ≤ 5). Compared with intention to take up screening with a urine test, participants were half as likely to report that they intended to undergo blood [OR 0.56 (0.43-0.73)] or ultrasound [OR 0.50 (0.38-0.67)] testing, and half as likely again to report that they intended to take part in a screening programme featuring a low dose CT scan for kidney cancer screening alone [OR 0.19 (0.14-0.27)]. CONCLUSION Participants in this study expressed high levels of intention to accept an invitation to screening for kidney cancer, both within a kidney cancer specific screening programme and in conjunction with lung cancer screening. The choice of screening test is likely to influence uptake. Together these findings support on-going research into kidney cancer screening tests and the potential for combining kidney cancer screening with existing or new screening programmes.
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Affiliation(s)
- Laragh L. W. Harvey-Kelly
- University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0SP UK
| | - Hannah Harrison
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR UK
| | - Sabrina H. Rossi
- Department of Oncology, University of Cambridge, Addenbrooke’s Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ UK
| | - Simon J. Griffin
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR UK
| | - Grant D. Stewart
- Department of Surgery, University of Cambridge, Addenbrooke’s Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ UK
| | - Juliet A. Usher-Smith
- The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR UK
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Dunlop G, Ardern CL, Andersen TE, Lewin C, Dupont G, Ashworth B, O'Driscoll G, Rolls A, Brown S, McCall A. Return-to-Play Practices Following Hamstring Injury: A Worldwide Survey of 131 Premier League Football Teams. Sports Med 2020; 50:829-840. [PMID: 31595453 PMCID: PMC7069905 DOI: 10.1007/s40279-019-01199-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE Return-to-play (RTP) is an on-going challenge in professional football. Return-to-play related research is increasing. However, it is unknown to what extent the recommendations presented within research are being implemented by professional football teams, and where there are gaps between research and practice. The purposes of this study were (1) to determine if premier-league football teams worldwide follow a RTP continuum, (2) to identify RTP criteria used and (3) to understand how RTP decision-making occurs in applied practice. METHODS We sent a structured online survey to practitioners responsible for the RTP programme in 310 professional teams from 34 premier-leagues worldwide. The survey comprised four sections, based on hamstring muscle injury: (1) criteria used throughout RTP phases, (2) the frequency with which progression criteria were achieved, (3) RTP decision-making process and (4) challenges to decision-making. RESULTS One-hundred and thirty-one teams responded with a completed survey (42%). One-hundred and twenty-four teams (95%) used a continuum to guide RTP, assessing a combination of clinical, functional and psychological criteria to inform decisions to progress. One-hundred and five (80%) teams reported using a shared decision-making approach considering the input of multiple stakeholders. Team hierarchy, match- and player-related factors were common challenges perceived to influence decision-making. CONCLUSIONS General research recommendations for RTP and the beliefs and practices of practitioners appear to match with, the majority of teams assessing functional, clinical and psychological criteria throughout a RTP continuum to inform decision-making which is also shared among key stakeholders. However, specific criteria, metrics and thresholds used, and the specific involvement, dynamics and interactions of staff during decision-making are not clear.
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Affiliation(s)
- Gordon Dunlop
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
- Edinburgh Napier University, Sport Exercise and Health Science Research Group, School of Applied Sciences, Edinburgh, UK
| | - Clare L Ardern
- Department of Medical and Health Sciences, Division of Physiotherapy, Linkoping University, Linkoping, Sweden
| | - Thor Einar Andersen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Centre, Oslo, Norway
| | | | - Gregory Dupont
- Medical Department, French Football Federation, Paris, France
| | - Ben Ashworth
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
| | - Gary O'Driscoll
- Performance Department, AC Sparta Prague Football Club, Prague, Czech Republic
| | - Andrew Rolls
- Sport Science and Medical Department, Bristol City Football Club, Bristol, UK
| | - Susan Brown
- Edinburgh Napier University, Sport Exercise and Health Science Research Group, School of Applied Sciences, Edinburgh, UK
| | - Alan McCall
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK.
- Edinburgh Napier University, Sport Exercise and Health Science Research Group, School of Applied Sciences, Edinburgh, UK.
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Ficial B, Corsini I, Fiocchi S, Schena F, Capolupo I, Cerbo RM, Condò M, Doni D, La Placa S, Porzio S, Rossi K, Salvadori S, Savoia M. Survey of PDA management in very low birth weight infants across Italy. Ital J Pediatr 2020; 46:22. [PMID: 32059689 PMCID: PMC7023762 DOI: 10.1186/s13052-020-0773-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/12/2020] [Indexed: 11/29/2022] Open
Abstract
Background The optimal management of PDA in very low birth weight (VLBW) infants is still controversial. Aim of our study was to investigate the management of PDA in the Italian neonatal intensive care units (NICU). Methods We conducted an on-line survey study from June to September 2017. A 50-items questionnaire was developed by the Italian Neonatal Cardiology Study Group and was sent to Italian NICUs. Results The overall response rate was 72%. Diagnosis of PDA was done by neonatologists, cardiologists or both (62, 12 and 28% respectively). PDA significance was assessed by a comprehensive approach in all centers, although we found a heterogeneous combination of parameters and cut-offs used. None used prophylactic treatment. 19% of centers treated PDA in the first 24 h, 60% after the first 24 h, following screening echocardiography or clinical symptoms, 18% after the first 72 h and 2% after the first week. In the first course of treatment ibuprofen, indomethacin and paracetamol were used in 87, 6 and 7% of centers respectively. Median of surgical ligation was 3% (1–6%). Conclusions Significant variations exist in the management of PDA in Italy. Conservative strategy and targeted treatment to infants older than 24 h with echocardiographic signs of hemodynamic significance seemed to be the most adopted approach.
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Affiliation(s)
- Benjamim Ficial
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria Integrata di Verona, P.le Stefani 1, 37126, Verona, Italy.
| | - Iuri Corsini
- Division of Neonatalogy, Careggi University Hospital of Florence, Florence, Italy
| | - Stefano Fiocchi
- Neonatologia e Terapia Intensiva Neonatale, Ospedale Valduce, Como, Italy
| | - Federico Schena
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Irma Capolupo
- Neonatal Intensive Care Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Rosa Maria Cerbo
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Manuela Condò
- Neonatal Intensive Care Unit, Ospedale A. Manzoni, Lecco, Italy
| | - Daniela Doni
- Neonatal Intensive Care Unit, FMBBM San Gerardo, Monza, Italy
| | | | | | - Katia Rossi
- Neonatal Intensive Care Unit, Policlinico di Modena, Modena, Italy
| | - Sabrina Salvadori
- Neonatal Intensive Care Unit, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Marilena Savoia
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria S Maria della Misericordia, Udine, Italy
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Falciglia GH, Murthy K, Holl JL, Palac HL, Woods DM, Robinson DT. Low prevalence of clinical decision support to calculate caloric and fluid intake for infants in the neonatal intensive care unit. J Perinatol 2020; 40:497-503. [PMID: 31813935 PMCID: PMC7042157 DOI: 10.1038/s41372-019-0546-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Clinical decision support (CDS) improves nutrition delivery for infants in the neonatal intensive care unit (NICU), however, the prevalence of CDS to support nutrition is unknown. METHODS Online surveys, with telephone and email validation of responses, were administered to NICU clinicians in the Children's Hospital Neonatal Consortium (CHNC). We determined and compared the availability of CDS to calculate calories and fluid received in the prior 24 h, stratified by enteral and parenteral intake, using McNemar's test. RESULTS Clinicians at all 34 CHNC hospitals responded with 98 of 108 (91%) surveys completed. NICUs have considerably less CDS to calculate enteral calories received than enteral fluid received (32% vs. 82%, p < 0.001) and less CDS to calculate parenteral calories received than parenteral fluid received (29% vs. 82%, p < 0.001). DISCUSSION Most CHNC NICUs are unable to reliably and consistently monitor caloric intake delivered to critically ill infants at risk for growth failure.
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Affiliation(s)
- Gustave H. Falciglia
- 0000 0001 2299 3507grid.16753.36Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL USA ,0000 0004 0388 2248grid.413808.6Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
| | - Karna Murthy
- 0000 0001 2299 3507grid.16753.36Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL USA ,0000 0004 0388 2248grid.413808.6Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA ,Children’s Hospital Neonatal Consortium, Kansas City, MO USA
| | - Jane L. Holl
- 0000 0004 0388 2248grid.413808.6Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA ,0000 0001 2299 3507grid.16753.36Center for Health Services & Outcomes Research, Northwestern University, Feinberg School of Medicine, Chicago, IL USA
| | | | - Donna M. Woods
- 0000 0001 2299 3507grid.16753.36Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL USA ,0000 0001 2299 3507grid.16753.36Center for Health Services & Outcomes Research, Northwestern University, Feinberg School of Medicine, Chicago, IL USA
| | - Daniel T. Robinson
- 0000 0001 2299 3507grid.16753.36Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL USA ,0000 0004 0388 2248grid.413808.6Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, USA
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Corsini I, Ficial B, Fiocchi S, Schena F, Capolupo I, Cerbo RM, Condò M, Doni D, La Placa S, Porzio S, Rossi K, Salvadori S, Savoia M. Neonatologist performed echocardiography (NPE) in Italian neonatal intensive care units: a national survey. Ital J Pediatr 2019; 45:131. [PMID: 31640752 PMCID: PMC6805655 DOI: 10.1186/s13052-019-0721-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/21/2019] [Indexed: 11/21/2022] Open
Abstract
Background Neonatologist performed echocardiography (NPE) has increasingly been used to assess the hemodynamic status in neonates. Aim of this survey was to investigate the utilization of NPE in Italian neonatal intensive care units (NICUs). Methods We conducted an on-line survey from June to September 2017. A questionnaire was developed by the Italian neonatal cardiology study group and was sent to each Italian NICU. Results The response rate was 77%. In 94% of Italian NICUs functional echocardiography was used by neonatologists, cardiologists or both (57, 15 and 28% respectively). All the respondents used NPE in neonates with patent ductus arteriosus and persistent pulmonary hypertension, 93% in neonates with hypotension or shock, 85% in neonates with perinatal asphyxia, 78% in suspicion of cardiac tamponade, and 73% for line positioning. In 30% of center, there was no NPE protocol. Structural echocardiography in stable and critically ill neonates was performed exclusively by neonatologists in 46 and 36% of center respectively. Conclusions NPE is widely used in Italian NICUs by neonatologists. Structural echocardiography is frequently performed by neonatologists. Institutional protocols for NPE are lacking. There is an urgent need of a formal training process and accreditation to standardize the use of NPE.
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Affiliation(s)
- Iuri Corsini
- Neonatal Intensive Care Unit, Division of Neonatology, Careggi University Hospital of Florence, Florence, Italy.
| | - Benjamim Ficial
- Neonatal Unit, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Stefano Fiocchi
- Neonatologia e Terapia Intensiva Neonatale, Ospedale Valduce, Como, Italy
| | - Federico Schena
- Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | - Irma Capolupo
- Neonatal Intensive Care Unit, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Rosa Maria Cerbo
- Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Manuela Condò
- Neonatal Intensive Care Unit, Ospedale A. Manzoni, Lecco, Italy
| | - Daniela Doni
- Neonatal Intensive Care Unit, FMBBM San Gerardo, Monza, Italy
| | | | | | - Katia Rossi
- Neonatal Intensive Care Unit, Policlinico di Modena, Modena, Italy
| | - Sabrina Salvadori
- Neonatal Intensive Care Unit, Azienda Ospedaliera-Università di Padova, Padova, Italy
| | - Marilena Savoia
- Neonatal Intensive Care Unit, Azienda Ospedaliera Universitaria S Maria della Misericordia, Udine, Italy
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Impact of Surgical Lighting on Intraoperative Safety in Low-Resource Settings: A Cross-Sectional Survey of Surgical Providers. World J Surg 2018; 41:3055-3065. [PMID: 29051968 DOI: 10.1007/s00268-017-4293-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Safe surgery requires high-quality, reliable lighting of the surgical field. Little is reported on the quality or potential safety impact of surgical lighting in low-resource settings, where power failures are common and equipment and resources are limited. METHODS Members of the Lifebox Foundation created a novel, non-mandatory, 18-item survey tool using an iterative process. This was distributed to surgical providers practicing in low-resource settings through surgical societies and mailing lists. RESULTS We received 100 complete responses, representing a range of surgical centres from 39 countries. Poor-quality surgical field lighting was reported by 40% of respondents, with 32% reporting delayed or cancelled operations due to poor lighting and 48% reporting electrical power failures at least once per week. Eighty per cent reported the quality of their surgical lighting presents a patient safety risk with 18% having direct experience of poor-quality lighting leading to negative patient outcomes. When power outages occur, 58% of surgeons rely on a backup generator and 29% operate by mobile phone light. Only 9% of respondents regularly use a surgical headlight, with the most common barriers reported as unaffordability and poor in-country suppliers. CONCLUSIONS In our survey of surgeons working in low-resource settings, a majority report poor surgical lighting as a major risk to patient safety and nearly one-third report delayed or cancelled operations due to poor lighting. Developing and distributing robust, affordable, high-quality surgical headlights could provide an ideal solution to this significant surgical safety issue.
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Hereditary cancer gene panel test reports: wide heterogeneity suggests need for standardization. Genet Med 2018; 20:1438-1445. [DOI: 10.1038/gim.2018.23] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/23/2018] [Indexed: 02/07/2023] Open
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ACMT Recommends Against Use of Post-Chelator Challenge Urinary Metal Testing. J Med Toxicol 2017; 13:352-354. [PMID: 28726084 DOI: 10.1007/s13181-017-0624-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 11/29/2022] Open
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Mold F, de Lusignan S. Patients' Online Access to Their Primary Care Electronic Health Records and Linked Online Services: Implications for Research and Practice. J Pers Med 2015; 5:452-69. [PMID: 26690225 PMCID: PMC4695865 DOI: 10.3390/jpm5040452] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 11/23/2015] [Accepted: 11/30/2015] [Indexed: 11/25/2022] Open
Abstract
Online access to medical records and linked services, including requesting repeat prescriptions and booking appointments, enables patients to personalize their access to care. However, online access creates opportunities and challenges for both health professionals and their patients, in practices and in research. The challenges for practice are the impact of online services on workload and the quality and safety of health care. Health professionals are concerned about the impact on workload, especially from email or other online enquiry systems, as well as risks to privacy. Patients report how online access provides a convenient means through which to access their health provider and may offer greater satisfaction if they get a timely response from a clinician. Online access and services may also result in unforeseen consequences and may change the nature of the patient-clinician interaction. Research challenges include: (1) Ensuring privacy, including how to control inappropriate carer and guardian access to medical records; (2) Whether online access to records improves patient safety and health outcomes; (3) Whether record access increases disparities across social classes and between genders; and (4) Improving efficiency. The challenges for practice are: (1) How to incorporate online access into clinical workflow; (2) The need for a business model to fund the additional time taken. Creating a sustainable business model for a safe, private, informative, more equitable online service is needed if online access to records is to be provided outside of pay-for-service systems.
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Affiliation(s)
- Freda Mold
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7TE, UK.
| | - Simon de Lusignan
- Department of Health Care Management and Policy, University of Surrey, Guildford GU2 7XH, UK.
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Robinson RF, Dillard DA, Hiratsuka VY, Smith JJ, Tierney S, Avey JP, Buchwald DS. Formative Evaluation to Assess Communication Technology Access and Health Communication Preferences of Alaska Native People. INTERNATIONAL JOURNAL OF INDIGENOUS HEALTH 2015; 10:88-101. [PMID: 27169131 DOI: 10.18357/ijih.102201515042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Information technology can improve the quality, safety, and efficiency of healthcare delivery by improving provider and patient access to health information. We conducted a nonrandomized, cross-sectional, self-report survey to determine whether Alaska Native and American Indian (AN/AI) people have access to the health communication technologies available through a patient-centered medical home. METHODS In 2011, we administered a self-report survey in an urban, tribally owned and operated primary care center serving AN/AI adults. Patients in the center's waiting rooms completed the survey on paper; center staff completed it electronically. RESULTS Approximately 98% (n = 654) of respondents reported computer access, 97% (n = 650) email access, and 94% (n = 631) mobile phone use. Among mobile phone users, 60% had Internet access through their phones. Rates of computer access (p = .011) and email use (p = .005) were higher among women than men, but we found no significant gender difference in mobile phone access to the Internet or text messaging. Respondents in the oldest age category (65-80 years of age) were significantly less likely to anticipate using the Internet to schedule appointments, refill medications, or communicate with their health care providers (all p < .001). CONCLUSION Information on use of health communication technologies enables administrators to deploy these technologies more efficiently to address health concerns in AN/AI communities. Our results will drive future research on health communication for chronic disease screening and health management.
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de Lusignan S, Mold F, Sheikh A, Majeed A, Wyatt JC, Quinn T, Cavill M, Gronlund TA, Franco C, Chauhan U, Blakey H, Kataria N, Barker F, Ellis B, Koczan P, Arvanitis TN, McCarthy M, Jones S, Rafi I. Patients' online access to their electronic health records and linked online services: a systematic interpretative review. BMJ Open 2014; 4:e006021. [PMID: 25200561 PMCID: PMC4158217 DOI: 10.1136/bmjopen-2014-006021] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 07/11/2014] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To investigate the effect of providing patients online access to their electronic health record (EHR) and linked transactional services on the provision, quality and safety of healthcare. The objectives are also to identify and understand: barriers and facilitators for providing online access to their records and services for primary care workers; and their association with organisational/IT system issues. SETTING Primary care. PARTICIPANTS A total of 143 studies were included. 17 were experimental in design and subject to risk of bias assessment, which is reported in a separate paper. Detailed inclusion and exclusion criteria have also been published elsewhere in the protocol. PRIMARY AND SECONDARY OUTCOME MEASURES Our primary outcome measure was change in quality or safety as a result of implementation or utilisation of online records/transactional services. RESULTS No studies reported changes in health outcomes; though eight detected medication errors and seven reported improved uptake of preventative care. Professional concerns over privacy were reported in 14 studies. 18 studies reported concern over potential increased workload; with some showing an increase workload in email or online messaging; telephone contact remaining unchanged, and face-to face contact staying the same or falling. Owing to heterogeneity in reporting overall workload change was hard to predict. 10 studies reported how online access offered convenience, primarily for more advantaged patients, who were largely highly satisfied with the process when clinician responses were prompt. CONCLUSIONS Patient online access and services offer increased convenience and satisfaction. However, professionals were concerned about impact on workload and risk to privacy. Studies correcting medication errors may improve patient safety. There may need to be a redesign of the business process to engage health professionals in online access and of the EHR to make it friendlier and provide equity of access to a wider group of patients. A1 SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42012003091.
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Affiliation(s)
- Simon de Lusignan
- Department of Health Care Management and Policy, University of Surrey, Guildford, UK
| | - Freda Mold
- Department of Health Care Management and Policy, University of Surrey, Guildford, UK
| | - Aziz Sheikh
- Centre for Population Health Sciences, University of Edinburgh, Medical School, Edinburgh, UK
| | - Azeem Majeed
- Department of Primary Care & Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Jeremy C Wyatt
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Tom Quinn
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Mary Cavill
- The Clinical Innovation & Research Centre (CIRC), Royal College of General Practitioners, London, UK
| | | | | | - Umesh Chauhan
- School of Health, University of Central Lancashire, Preston, Lancashire, UK
| | | | - Neha Kataria
- Department of Health Care Management and Policy, University of Surrey, Guildford, UK
| | - Fiona Barker
- Department of Health Care Management and Policy, University of Surrey, Guildford, UK
| | - Beverley Ellis
- School of Health, University of Central Lancashire, Preston, Lancashire, UK
| | | | | | - Mary McCarthy
- Belvidere Medical Practice, Shrewsbury, Shropshire, UK
| | - Simon Jones
- Department of Health Care Management and Policy, University of Surrey, Guildford, UK
| | - Imran Rafi
- The Clinical Innovation & Research Centre (CIRC), Royal College of General Practitioners, London, UK
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14
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Liang TH. Matrix analysis of the digital divide in eHealth services using awareness, want, and adoption gap. J Med Internet Res 2012; 14:e11. [PMID: 22329958 PMCID: PMC3374548 DOI: 10.2196/jmir.1670] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 10/13/2011] [Accepted: 10/25/2011] [Indexed: 11/19/2022] Open
Abstract
Background The digital divide usually refers to access or usage, but some studies have identified two other divides: awareness and demand (want). Given that the hierarchical stages of the innovation adoption process of a customer are interrelated, it is necessary and meaningful to analyze the digital divide in eHealth services through three main stages, namely, awareness, want, and adoption. Objective By following the three main integrated stages of the innovation diffusion theory, from the customer segment viewpoint, this study aimed to propose a new matrix analysis of the digital divide using the awareness, want, and adoption gap ratio (AWAG). I compared the digital divide among different groups. Furthermore, I conducted an empirical study on eHealth services to present the practicability of the proposed methodology. Methods Through a review and discussion of the literature, I proposed hypotheses and a new matrix analysis. To test the proposed method, 3074 Taiwanese respondents, aged 15 years and older, were surveyed by telephone. I used the stratified simple random sampling method, with sample size allocation proportioned by the population distribution of 23 cities and counties (strata). Results This study proposed the AWAG segment matrix to analyze the digital divide in eHealth services. First, awareness and want rates were divided into two levels at the middle point of 50%, and then the 2-dimensional cross of the awareness and want segment matrix was divided into four categories: opened group, desire-deficiency group, perception-deficiency group, and closed group. Second, according to the degrees of awareness and want, each category was further divided into four subcategories. I also defined four possible strategies, namely, hold, improve, evaluate, and leave, for different regions in the proposed matrix. An empirical test on two recently promoted eHealth services, the digital medical service (DMS) and the digital home care service (DHCS), was conducted. Results showed that for both eHealth services, the digital divides of awareness, want, and adoption existed across demographic variables, as well as between computer owners and nonowners, and between Internet users and nonusers. With respect to the analysis of the AWAG segment matrix for DMS, most of the segments, except for people with marriage status of Other or without computers, were positioned in the opened group. With respect to DHCS, segments were separately positioned in the opened, perception-deficiency, and closed groups. Conclusions Adoption does not closely follow people’s awareness or want, and a huge digital divide in adoption exists in DHS and DHCS. Thus, a strategy to promote adoption should be used for most demographic segments.
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Affiliation(s)
- Te-Hsin Liang
- Department of Statistics and Information Sciences, College of Management, Fu Jen Catholic University, New Taipei County, Taiwan.
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15
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Markman M, Luce R. Impact of the cost of cancer treatment: an internet-based survey. J Oncol Pract 2010; 6:69-73. [PMID: 20592778 DOI: 10.1200/jop.091074] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2009] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Despite considerable discussion in the medical literature and lay press regarding the increasing cost of cancer care, there is limited information available on the perceived impact of treatment costs on individual patients and their families. METHODS To directly address this issue, patients with cancer who had participated in an Internet-based oncology decision-support program and agreed to receive information concerning potential future surveys were asked via e-mail to complete a questionnaire dealing with treatment-related medical expenses. RESULTS Of 39,882 invitations sent to patients with cancers of the breast, colon, lung, and prostate, 1,767 (4.4%) were returned, which included a wide spectrum of disease, demographics, and annual incomes. Since diagnosis, 20% and 4% of patients reported having spent out of pocket more than $10,000 and more than $50,000, respectively, on treatment and medical care. Overall, 19% of patients and 39% of individuals with a yearly income of less than $40,000 reported the financial costs of treating their cancer had caused a "large amount of distress." Furthermore, although overall, 9% of patients stated they had decided "to not have a recommended cancer treatment because it was too expensive," this percentage increased to 25% for individuals with an income of less than $40,000. CONCLUSION This survey suggests that a substantial proportion of patients and their families experience considerable distress associated with the cost of cancer care delivery. Furthermore, these costs affect the decision of patients with cancer to receive recommended treatment. This is a particularly serious issue for individuals with a modest annual income.
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Affiliation(s)
- Maurie Markman
- The University of Texas M. D. Anderson Cancer Center, Houston, TX, and NexCura, Seattle, WA
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16
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Bonnar-Kidd KK, Black DR, Mattson M, Coster D. Online physical activity information: will typical users find quality information? HEALTH COMMUNICATION 2009; 24:165-175. [PMID: 19280460 DOI: 10.1080/10410230802676763] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study evaluated physical activity Web sites to determine quality, accuracy, and consistency with principles of the extended parallel process model (EPPM). Three keyword searches were conducted using 4 search engines to find a sample of N = 41 Web sites. Three raters evaluated the Web sites using the JAMA benchmarks to assess quality and American College of Sports Medicine and Centers for Disease Control and Prevention recommendations for physical activity to determine accuracy, as well as checking for inclusion of EPPM variables. Data were analyzed using descriptive statistics and analysis of variance with least squares means. Only 22% of the sites were high quality, none were highly accurate, and most were consistent with the EPPM. Quality ratings were weakly associated with accuracy. Educational and .net sites were rated significantly higher in quality and accuracy, and government sites were most consistent with the EPPM. Quality Web sites were more often found by using Yahoo and Google. "Exercise" yielded more accurate results, whereas "physical activity" and "fitness" produced more Web sites consistent with the EPPM. It is encouraging that most sites incorporated EPPM concepts; however, quality and accuracy were poor, leaving physical activity information seekers at risk for disease and injury.
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Affiliation(s)
- Kelly K Bonnar-Kidd
- Department of Community Health, State University of New York-Potsdam, Potsdam, NY 13676, USA.
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17
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Castrén J, Huttunen T, Kunttu K. Users and non-users of web-based health advice service among Finnish university students - chronic conditions and self-reported health status (a cross-sectional study). BMC Med Inform Decis Mak 2008; 8:8. [PMID: 18237414 PMCID: PMC2262883 DOI: 10.1186/1472-6947-8-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Accepted: 01/31/2008] [Indexed: 11/10/2022] Open
Abstract
Background The Internet is increasingly used by citizens as source of health information. Young, highly educated adults use the Internet frequently to search for health-related information. Our study explores whether reported chronic conditions or self-reported health status differed among Finnish university students using the Finnish Student Health Services web-based health advice service compared with those not using the service. Methods Cross-sectional study performed by a national postal survey in 2004. Material: A random sample (n = 5 030) of a population of 101 805 undergraduate Finnish university students aged 19–35. The response rate: 63% (n = 3 153). Main outcome measures: Proportion of university students reporting use a of web-based health advice service, diagnosed chronic conditions, and self-reported health status of users and non-users of a web-based health advice service. Statistical methods: Data were presented with frequency distributions and cross-tabulations and the χ2 test was used. Results 12% (n = 370) of Finnish undergraduate students had used the web-based health advice service and were identified as 'users'. The proportion of male students reporting allergic rhinitis or conjunctivitis was greater among users than non-users (24%, n = 22 vs. 15%, n = 154, χ2, P = .03). The proportion of female students reporting chronic mental health problems was greater among users than non-users (12%, n = 34 vs. 8%, n = 140, χ2, P = .03). There was no statistical significance between the group differences of male or female users and non-users in self-reported health status (good or fairly good, average, rather poor or poor). Conclusion Among young, highly educated adults the use of a web-based health advice service is not associated with self-reported health status. However, a web-based health advice service could offer support for managing several specific chronic conditions. More research data is needed to evaluate the role of web-based health advice services that supplement traditional forms of health services.
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Affiliation(s)
- Johanna Castrén
- Medical School, Department of General Practice, 33014 University of Tampere, Finland.
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18
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Al Kassam Martínez M, Magaña Pintiado M, Ordóñez Fernández L, Gómez Álvarez M. Internet, un medio de comunicación bidireccional con el paciente externo infrautilizado en nuestro país. FARMACIA HOSPITALARIA 2007; 31:192-3. [DOI: 10.1016/s1130-6343(07)75369-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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19
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Ohrstrøm P, Dyhrberg J. Ethical problems inherent in psychological research based on internet communication as stored information. THEORETICAL MEDICINE AND BIOETHICS 2007; 28:221-41. [PMID: 17690996 DOI: 10.1007/s11017-007-9037-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This paper deals with certain ethical problems inherent in psychological research based on internet communication as stored information. Section 1 contains an analysis of research on Internet debates. In particular, it takes into account a famous example of deception for psychology research purposes. In section 2, the focus is on research on personal data in texts published on the Internet. Section 3 includes an attempt to formulate some ethical principles and guidelines, which should be regarded as fundamental in research on stored information.
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Affiliation(s)
- Peter Ohrstrøm
- Department of Communication and Psychology, Aalborg University, Kroghstraede 3, 9220 Aalborg Øst, Denmark.
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