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Moses AC, Dreyer AR, Robertson L. Factors associated with burnout among healthcare providers in a rural context, South Africa. Afr J Prim Health Care Fam Med 2024; 16:e1-e10. [PMID: 38299543 PMCID: PMC10839153 DOI: 10.4102/phcfm.v16i1.4163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/22/2023] [Accepted: 11/12/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Healthcare providers (HCPs) are at risk of burnout in sub-Saharan Africa. However, there is little research in rural and primary care settings. AIM To evaluate burnout and its associated factors among public sector HCPs in South Africa. SETTING Primary health care clinics, community health centres and district hospitals in Nkomazi Local Municipality, Mpumalanga province. METHODS Quantitative study design using a cross-sectional survey. Healthcare providers (n = 1139) working in Nkomazi Local Municipality were invited to participate. Burnout was assessed using the Maslach Burnout Inventory. A demographic and occupational questionnaire, the General Help-Seeking Questionnaire and the Health and Safety Executive Indicator Tool were used. RESULTS A total of 302 HCPs, between 23 and 61 years, mostly female (n = 252; 83.44%) and nurses (n = 235; 77.81%) participated. High burnout was observed for Emotional Exhaustion (median score 26 [IQR {interquartile range}: 34-16]) and Personal Accomplishment (median score 29 [IQR: 34-25]). Most participants (n = 215; 71.19%) would seek help if they had an emotional problem. Bivariate analysis revealed significant associations between workplace demands, control, management support, peer support, relationships, role and change with all subscales of burnout. Multivariate regression analysis found that Personal Accomplishment improved by 0.49 (95% CI: 0.10-0.89) for every point in improved work demands, by 0.84 (95% CI: 0.01-1.67) for every point towards improved management support and by 1.19 (95% CI: 0.48-1.90) for every point towards having an improved role. CONCLUSIONS During 2022, HCPs working in a rural area in South Africa displayed high levels of burnout for Emotional Exhaustion and Personal Accomplishment but not for Depersonalisation.Contributions: Improvements in work demands, managerial support and role clarity may reduce burnout among HCP in a rural, primary care setting.
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Affiliation(s)
- Alexandra C Moses
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
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de Sousa CR, Coutinho JFV, Marques MB, Barbosa RGB, Roriz JDS, Soares ES, Nogueira CB, Souza RLDP. Prevalence of characteristics associated with sarcopenia in elders: a cross-sectional study. Rev Bras Enferm 2023; 76:e20220209. [PMID: 36995822 PMCID: PMC10042476 DOI: 10.1590/0034-7167-2022-0209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 11/02/2022] [Indexed: 03/29/2023] Open
Abstract
Objectives: to identify the prevalence and characteristics associated with sarcopenia in elders in Primary Health Care Units. Methods: cross-sectional study with 384 elders. To evaluate sarcopenia, we measured: strength and muscle mass, and physical performance. The elderly were classified as having: probable sarcopenia; sarcopenia; or severe sarcopenia. The chi-squared test and the multinomial logistic regression method were used. Results: the prevalence of probable sarcopenia was 25.52%; of sarcopenia, 11.98%; and of severe sarcopenia, 9.90%. Probable sarcopenia is 1.75 times more prevalent in men; osteoporosis is 2.16 times more prevalent in people with severe sarcopenia; polypharmacy is 1.57 times more likely in individuals with probable sarcopenia; and calf circumference below 31 cm is 2.24 times more likely in patients with sarcopenia and 2.19 times more likely in patients with severe sarcopenia. Conclusions: the highest prevalence was of probable sarcopenia, and the characteristics associated with sarcopenia were sex, osteoporosis, polypharmacy, overweight, obesity, and calf circumference.
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Martínez García L, Samsó Jofra L, Alonso-Coello P, Ansuategi E, Asso Mistral L, Ballesteros M, Canelo-Aybar C, Casino G, Gallego Iborra A, Niño de Guzmán Quispe EP, Requeijo C, Roqué I Figuls M, Salas K, Ubeda M, Urreta I, Rosenbaum S. Teaching and learning how to make informed health choices: Protocol for a context analysis in Spanish primary schools. F1000Res 2021; 10:312. [PMID: 34631019 PMCID: PMC8474100 DOI: 10.12688/f1000research.51961.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction The Informed Health Choices (IHC) project developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore the educational context for teaching and learning critical thinking about health in Spanish primary schools. Methods During the 2020-2021 school year, we will conduct 1) a systematic assessment of educational documents and resources, and 2) semi-structured interviews with key education and health stakeholders. In the systematic assessment of educational documents and resources, we will include state and autonomous communities' curriculums, school educational projects, and commonly used textbooks and other health teaching materials. In the semi-structured interviews, we will involve education and health policy makers, developers of learning resources, developers of health promotion and educational interventions, head teachers, teachers, families, and paediatric primary care providers. We will design and pilot a data extraction form and a semi-structured interview guide to collect the data. We will perform a quantitative and a qualitative analysis of the data to explore how critical thinking about health is being taught and learned in Spanish primary schools. Conclusion We will identify opportunities for and barriers to teaching and learning critical thinking about health in Spanish primary schools. We will formulate recommendations-for both practice and research purposes-on how to use, adapt (if needed), and implement the IHC resources in this context.
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Eukane Ansuategi
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Osakidetza, OSI Donostialdea, University Hospital of Donostia, Library Service, Donostia, Spain
| | - Laia Asso Mistral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | - Monica Ballesteros
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Carlos Canelo-Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Gonzalo Casino
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marta Roqué I Figuls
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | - Karla Salas
- Health Services Research Group - Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Mar Ubeda
- Osakidetza, OSI Donostialdea, University Hospital of Donostia, Library Service, Donostia, Spain
| | - Iratxe Urreta
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain.,Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Rana R, Awasthi R, Sharma B, Kulkarni GT. Nanoantibiotic Formulations to Combat Antibiotic Resistance - Old Wine in a New Bottle. ACTA ACUST UNITED AC 2020; 13:174-183. [PMID: 31544718 DOI: 10.2174/1872211313666190911124626] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 01/03/2023]
Abstract
Antibiotic resistance is becoming one of the major obstacles to treatment success in various pathological conditions. Development process of a new antimicrobial agent is slow and difficult, whereas bacterial resistance is decreasing the arsenal of existing antibiotics. Therefore, there is a need to develop novel antibiotic formulations to combat the resistance of existing antibiotics. Nanoparticles are investigated as novel antibiotic formulation, but are often inefficient in practical applications. Nanotechnology presents a new frontier to overcome the issue of antibiotic resistance through the development of functionalized particles. Balance of physicochemical characteristics such as small particle size and high drug loading capacity along with improved stability are the challenges associated with large scale manufacturing of nanoantibiotic formulations. In the last 1-2 decades, a gradual increase in patents on nanoantibiotic formulations has been noted to address the resistance issues of antibiotic. The aim of this review is to consolidate recently-investigated nanoantibiotic formulations to combat antibiotic resistance.
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Affiliation(s)
- Rachna Rana
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
| | - Rajendra Awasthi
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
| | - Bhupesh Sharma
- Department of Pharmacology, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
| | - Giriraj T Kulkarni
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University Uttar Pradesh, Sec 125, Noida, 201303, Uttar Pradesh, India
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Nisa ZU, Zafar A, Zafar F, Pezaro S, Sher F. Adverse Drug Reaction Monitoring and Reporting Among Physicians and Pharmacists in Pakistan: A Cross-sectional Study. Curr Drug Saf 2020; 15:137-146. [PMID: 32338223 DOI: 10.2174/1574886315666200427120322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The success of a reporting system of adverse drug reaction (ADR) depends on the knowledge, attitudes, and practices of the health care professionals. However, due to a lack of knowledge and poor contribution by healthcare workers, ADR remains underreported. To improve safety, proper identification and ADR reporting is necessary. OBJECTIVE This study was carried out to determine knowledge, attitude, and practices of ADR among physicians and pharmacists working in Pakistan and the factors which encourage and discourage effective reporting. METHODS A cross-sectional study was conducted using a pretested questionnaire. Questionnaires were distributed among 333 physicians and 34 pharmacists with a 95.5% response rate. The Statistical Package for Social Science (SPSS) was used for data analysis. RESULTS Pharmacists have more knowledge regarding ADR compared to physicians (47.1% vs. 13.8%, p < 0.001). Pharmacists also have a positive attitude compared to physicians (97.1% vs. 76.3%, p < 0.001). No significant difference was noticed in ADR practice by physicians and pharmacists (12.3% vs. 11.8, p = 0.92). The seriousness of ADR was the main factor that encouraged nearly all pharmacists to report, whereas among physician's, seriousness and the unusualness of reaction, the new drug involvement, and confidence in diagnosis were the factors which encouraged them to report ADR. CONCLUSION Overall, pharmacists had more knowledge and a positive attitude regarding ADR reporting compared to physicians, but practices of ADR reporting remained the same among both. Therefore, it is suggested that educational interventions, along with training programs, should be developed.
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Affiliation(s)
- Zaka Un Nisa
- Faculty of Medicine, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Ayesha Zafar
- Institute of Biochemistry and Biotechnology, University of the Punjab, Lahore 54590, Pakistan
| | - Fatima Zafar
- Institute of Biochemistry and Biotechnology, University of the Punjab, Lahore 54590, Pakistan
| | - Sally Pezaro
- School of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 5FB, United Kingdom
| | - Farooq Sher
- Faculty of Engineering, Environment and Computing, Coventry University, Coventry, CV1 2JH, United Kingdom
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 11/04/2023] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) a workshop with the teachers, and 2) lessons to the students. The data collection will include: 1) initial assessment of the resources by the teachers, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers, 5) treatment claim assessment by the students, and 6) final assessment of the resources by the teachers. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. We will publish the study results in a peer-reviewed journal and in several Internet resources (web pages, electronic bulletins, and social media), and we will present them to the different users of interest in conferences, workshops, and meetings. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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7
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2020] [Indexed: 11/04/2023] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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Martínez García L, Alonso-Coello P, Asso Ministral L, Ballesté-Delpierre C, Canelo Aybar C, de Britos C, Fernández Rodríguez A, Gallego Iborra A, Leo Rosas V, Llaquet P, Niño de Guzmán Quispe EP, Pérez-Gaxiola G, Requeijo C, Salas-Gama K, Samsó Jofra L, Terres J, Urreta I, Rosenbaum S. Learning to make informed health choices: Protocol for a pilot study in schools in Barcelona. F1000Res 2019; 8:2018. [PMID: 32528654 PMCID: PMC7268153 DOI: 10.12688/f1000research.21292.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: The Informed Health Choices (IHC) project has developed learning resources to teach primary school children (10 to 12-year-olds) to assess treatment claims and make informed health choices. The aim of our study is to explore both the students' and teachers' experience when using these resources in the context of Barcelona (Spain). Methods: During the 2019-2020 school year, we will conduct a pilot study with 4 th and 5 th-year primary school students (9 to 11-year-olds) from three schools in Barcelona. The intervention in the schools will include: 1) a workshop with the teachers, and 2) lessons to the students. The data collection will include: 1) assessment of the IHC resources by the teachers before the lessons, 2) non-participatory observations during the lessons, 3) semi-structured interviews with the students after a lesson, 4) assessment of the lessons by the teachers after a lesson, 5) treatment claim assessment by the students at the end of the lessons, and 6) assessment of the IHC resources by the teachers at the end of the lessons. We will use ad hoc questionnaires and guides to register the data. We will perform a quantitative and qualitative analysis of the data to explore understandability, desirability, suitability, usefulness, facilitators and barriers of the resources. The most relevant results will be discussed and some recommendations on how to use, how to adapt (if needed), and how to implement the IHC resources to this context will be agreed. The findings of the contextualization activities could inform the design of a cluster-randomised trial, to determine the effectiveness of the IHC resources in this context prior to scaling-up its use. Ethical considerations: The study protocol has obtained an approval exemption from the Ethics Committee of the Hospital de la Santa Creu i Sant Pau (Barcelona, Spain).
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Affiliation(s)
- Laura Martínez García
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | - Laia Asso Ministral
- Maternal and Child Health Service, General Subdirectorate of Health Promotion, Public Health Agency of Catalonia, Barcelona, Spain
| | | | - Carlos Canelo Aybar
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Barcelona, Spain
| | | | | | | | - Victoria Leo Rosas
- Iberoamerican Cochrane Centre (IbCC) - Sant Pau Biomedical Research Institute (IIB-Sant Pau), Barcelona, Spain
| | | | | | | | - Carolina Requeijo
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Karla Salas-Gama
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Laura Samsó Jofra
- Epidemiology and Public Health Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Iratxe Urreta
- Clinical Epidemiology and Research Unit, University Hospital of Donostia, Donostia, Spain
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public Health, Oslo, Norway
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9
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Aldossari M, Aljoudi A, Celentano D. Health issues in the Hajj pilgrimage: a literature review. East Mediterr Health J 2019; 25:744-753. [PMID: 31774140 DOI: 10.26719/2019.25.10.744] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 03/08/2018] [Indexed: 11/09/2022]
Abstract
The Hajj pilgrimage to Mecca, Saudi Arabia, is one of the largest annual mass gatherings in the world, and has a strong impact on international public health. This paper presents an overview from a systematic search of the published literature on health risks and services in the Hajj for 2005-2014, with the aim of providing health policy recommendations to prevent health risks. Of the 335 studies initially identified, 60 met the inclusion criteria for the review. Studies identified were diverse in methodology and focus. The results were classified into 3 main categories: communicable diseases, noncommunicable diseases and health services. Although, improvement was observed throughout the years, there are always new public health challenges in each Hajj season. There is a need to improve health management of the Hajj, particularly by strengthening international collaboration.
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Affiliation(s)
- Mae Aldossari
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Abdullah Aljoudi
- Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, Massachussetts, United States of America
| | - David Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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10
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da Silva DRP, Werneck AO, Collings P, Fernandes RA, Ronque ERV, Sardinha LB, Cyrino ES. Identifying children who are susceptible to dropping out from physical activity and sport: a cross-sectional study. SAO PAULO MED J 2019; 137:329-335. [PMID: 31691765 PMCID: PMC9744009 DOI: 10.1590/1516-3180.2018.0333050719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/05/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although the benefits of physical activity are clear, adherence to physical activity programs is a challenge, especially during transitional phases of life. OBJECTIVE We aimed to identify adolescents who were more likely to drop out from physical activity and sports participation, from childhood to adolescence. DESIGN AND SETTING This was a cross-sectional study on retrospective data regarding childhood activity among 803 Brazilian adolescents. The study was conducted at public schools in Londrina, Paraná, in 2011. METHODS Habitual physical activity, sports participation during childhood, parental physical activity, socioeconomic status and perception of social relationships were self-reported. Cardiorespiratory fitness was estimated via a 20-m shuttle-run test and somatic maturation was estimated from the age at peak height velocity. RESULTS Our results provided evidence that girls (physical activity: odds ratio, OR: 4.37 [95% confidence interval, CI: 1.86-10.3]; sports: OR: 2.65 [95% CI: 1.39-5.05]) and adolescents with low cardiorespiratory fitness (physical activity: OR: 1.77 [95% CI: 1.13-2.78]; sports: OR: 1.62 [95% CI: 1.15-2.26]) were more likely to drop out from active behaviors. Children with inactive mothers and inactive fathers (OR: 3.55 [95% CI: 1.12-11.3]) also showed a higher dropout rate from physical activity. Adolescents with negative perceptions of friendships (OR: 2.33 [95% CI: 1.21-4.47]) were more likely to drop out from sports. CONCLUSIONS Higher dropout rates from active lifestyles during childhood were observed among girls and adolescents with low cardiorespiratory fitness. Parental inactivity and negative perceptions of friendships were also potential risk factors for discontinuation of childhood physical activity and sports.
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Affiliation(s)
| | - André Oliveira Werneck
- BSc. Master’s Student, Department of Physical Education, Universidade Estadual Paulista “Júlio de Mesquita Filho” (UNESP), Presidente Prudente (SP), Brazil.
| | - Paul Collings
- PhD. Research Fellow, Bradford Institute for Health Research, Bradford NHS Foundation Trust, Bradford, United Kingdom.
| | - Rômulo Araújo Fernandes
- PhD. Full Professor, Scientific Research Group Relating to Physical Activity (GICRAF), Laboratory of Exercise Investigation (LIVE), Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente (SP), Brazil.
| | - Enio Ricardo Vaz Ronque
- PhD. Full Professor, Physical Activity and Health Laboratory, Department of Physical Education, Londrina State University, Londrina (PR), Brazil.
| | - Luís Bettencourt Sardinha
- PhD. Full Professor, Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.
| | - Edilson Serpeloni Cyrino
- PhD. Full Professor, Study and Research Group on Metabolism, Nutrition and Exercise (GEPEMENE), Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil.
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AlMatar M, Makky EA, AlMandeal H, Eker E, Kayar B, Var I, Köksal F. Does the Development of Vaccines Advance Solutions for Tuberculosis? Curr Mol Pharmacol 2018; 12:83-104. [PMID: 30474542 DOI: 10.2174/1874467212666181126151948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/06/2018] [Accepted: 10/17/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Mycobacterium tuberculosis (Mtb) is considered as one of the most efficacious human pathogens. The global mortality rate of TB stands at approximately 2 million, while about 8 to 10 million active new cases are documented yearly. It is, therefore, a priority to develop vaccines that will prevent active TB. The vaccines currently used for the management of TB can only proffer a certain level of protection against meningitis, TB, and other forms of disseminated TB in children; however, their effectiveness against pulmonary TB varies and cannot provide life-long protective immunity. Based on these reasons, more efforts are channeled towards the development of new TB vaccines. During the development of TB vaccines, a major challenge has always been the lack of diversity in both the antigens contained in TB vaccines and the immune responses of the TB sufferers. Current efforts are channeled on widening both the range of antigens selection and the range of immune response elicited by the vaccines. The past two decades witnessed a significant progress in the development of TB vaccines; some of the discovered TB vaccines have recently even completed the third phase (phase III) of a clinical trial. OBJECTIVE The objectives of this article are to discuss the recent progress in the development of new vaccines against TB; to provide an insight on the mechanism of vaccine-mediated specific immune response stimulation, and to debate on the interaction between vaccines and global interventions to end TB.
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Affiliation(s)
- Manaf AlMatar
- Department of Biotechnology, Institute of Natural and Applied Sciences (Fen Bilimleri Enstitusu) Cukurova University, Adana, Turkey
| | - Essam A Makky
- Department of Biotechnology, Faculty of Industrial Sciences and Technology, Universiti Malaysia Pahang (UMP), Kuantan, Malaysia
| | - Husam AlMandeal
- Freiburg Universität, Moltkestraße 90, 76133 karlsruhe Augenklinik, Germany
| | - Emel Eker
- Department of Medical Microbiology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Begüm Kayar
- Department of Medical Microbiology, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Işıl Var
- Department of Food Engineering, Agricultural Faculty, Cukurova University, Adana, Turkey
| | - Fatih Köksal
- Department of Medical Microbiology, Faculty of Medicine, Cukurova University, Adana, Turkey
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Fernandes AC, Oliveira RC, Proença RPC, Curioni CC, Rodrigues VM, Fiates GMR. Influence of menu labeling on food choices in real-life settings: a systematic review. Nutr Rev 2017; 74:534-48. [PMID: 27358442 DOI: 10.1093/nutrit/nuw013] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
CONTEXT Evidence that menu labeling influences food choices in real-life settings is lacking. Reviews usually focus on calorie counts without addressing broader issues related to healthy eating. OBJECTIVE This systematic review assessed the influence of diverse menu-labeling formats on food choices in real-life settings. DATA SOURCES Several databases were searched: Cochrane Library, Scopus, MEDLINE, Web of Science, Food Science and Technology Abstracts, Biological Abstracts, CAB Abstracts, EconLit, SciELO, and LILACS. STUDY SELECTION Articles reporting experiments, quasi-experiments, and observational studies using control or preintervention groups were selected blindly by two reviewers. DATA EXTRACTION Data was extracted using a standard form. Analyses differentiated between foodservice types. The quality of the 38 included studies was assessed blindly by two reviewers. DATA ANALYSIS The results were mixed, but a partial influence of menu labeling on food choices was more frequent than an overall influence or no influence. Menu labeling was more effective in cafeterias than in restaurants. Qualitative information, such as healthy-food symbols and traffic-light labeling, was most effective in promoting healthy eating. In general, the studies were of moderate quality and did not use control groups. CONCLUSIONS Calorie labeling in menus is not effective to promote healthier food choices. Further research in real-life settings with control groups should test diverse qualitative information in menu labeling.
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Affiliation(s)
- Ana C Fernandes
- A.C. Fernandes, R.C. Oliveira, R.P.C. Proença, V.M. Rodrigues, and G.M.R. Fiates are with the Nutrition Postgraduate Program (Programa de Pós-graduação em Nutrição), Nutrition in Foodservice Research Centre (Núcleo de Pesquisa de Nutrição em Produção de Refeições - NUPPRE), Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC), Florianópolis, Santa Catarina, Brazil. C.C. Curioni is with the Department of Social Nutrition, Institute of Nutrition, University of the State of Rio de Janeiro (Universidade do Estado do Rio de Janeiro - UERJ), Rio de Janeiro, Brazil
| | - Renata C Oliveira
- A.C. Fernandes, R.C. Oliveira, R.P.C. Proença, V.M. Rodrigues, and G.M.R. Fiates are with the Nutrition Postgraduate Program (Programa de Pós-graduação em Nutrição), Nutrition in Foodservice Research Centre (Núcleo de Pesquisa de Nutrição em Produção de Refeições - NUPPRE), Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC), Florianópolis, Santa Catarina, Brazil. C.C. Curioni is with the Department of Social Nutrition, Institute of Nutrition, University of the State of Rio de Janeiro (Universidade do Estado do Rio de Janeiro - UERJ), Rio de Janeiro, Brazil
| | - Rossana P C Proença
- A.C. Fernandes, R.C. Oliveira, R.P.C. Proença, V.M. Rodrigues, and G.M.R. Fiates are with the Nutrition Postgraduate Program (Programa de Pós-graduação em Nutrição), Nutrition in Foodservice Research Centre (Núcleo de Pesquisa de Nutrição em Produção de Refeições - NUPPRE), Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC), Florianópolis, Santa Catarina, Brazil. C.C. Curioni is with the Department of Social Nutrition, Institute of Nutrition, University of the State of Rio de Janeiro (Universidade do Estado do Rio de Janeiro - UERJ), Rio de Janeiro, Brazil.
| | - Cintia C Curioni
- A.C. Fernandes, R.C. Oliveira, R.P.C. Proença, V.M. Rodrigues, and G.M.R. Fiates are with the Nutrition Postgraduate Program (Programa de Pós-graduação em Nutrição), Nutrition in Foodservice Research Centre (Núcleo de Pesquisa de Nutrição em Produção de Refeições - NUPPRE), Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC), Florianópolis, Santa Catarina, Brazil. C.C. Curioni is with the Department of Social Nutrition, Institute of Nutrition, University of the State of Rio de Janeiro (Universidade do Estado do Rio de Janeiro - UERJ), Rio de Janeiro, Brazil
| | - Vanessa M Rodrigues
- A.C. Fernandes, R.C. Oliveira, R.P.C. Proença, V.M. Rodrigues, and G.M.R. Fiates are with the Nutrition Postgraduate Program (Programa de Pós-graduação em Nutrição), Nutrition in Foodservice Research Centre (Núcleo de Pesquisa de Nutrição em Produção de Refeições - NUPPRE), Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC), Florianópolis, Santa Catarina, Brazil. C.C. Curioni is with the Department of Social Nutrition, Institute of Nutrition, University of the State of Rio de Janeiro (Universidade do Estado do Rio de Janeiro - UERJ), Rio de Janeiro, Brazil
| | - Giovanna M R Fiates
- A.C. Fernandes, R.C. Oliveira, R.P.C. Proença, V.M. Rodrigues, and G.M.R. Fiates are with the Nutrition Postgraduate Program (Programa de Pós-graduação em Nutrição), Nutrition in Foodservice Research Centre (Núcleo de Pesquisa de Nutrição em Produção de Refeições - NUPPRE), Federal University of Santa Catarina (Universidade Federal de Santa Catarina - UFSC), Florianópolis, Santa Catarina, Brazil. C.C. Curioni is with the Department of Social Nutrition, Institute of Nutrition, University of the State of Rio de Janeiro (Universidade do Estado do Rio de Janeiro - UERJ), Rio de Janeiro, Brazil
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Leonardsen ACL, Del Busso L, Grøndahl VA, Ghanima W, Jelsness-Jørgensen LP. General practitioners' perspectives on referring patients to decentralized acute health care. Fam Pract 2016; 33:709-714. [PMID: 27543796 DOI: 10.1093/fampra/cmw087] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Municipality acute wards (MAWs) have recently been introduced in Norway. Their mandate is to provide treatment for patients who otherwise would have been hospitalized. Even though GPs are key stakeholders, little is known about how they perceive referring patients to these wards. The aim of this study was to investigate GPs' perspectives on factors relevant for their decision-making when referring patients to MAWs. METHODS We used a qualitative approach, conducting semi-structured interviews with 23 GPs from five different MAW catchment areas in the southeastern part of Norway. The data were analysed using thematic analysis. RESULTS The GPs experienced challenges in deciding which patients were suitable for treatment at a MAW, including whether patients could be regarded as medically clarified, and whether these services were sufficient and safe. GPs were also under pressure from several other stakeholders when deciding where to refer their patients. Moreover, the MAWs were viewed not merely as an alternative to hospitals, but also as a service in addition to hospitals. CONCLUSION This study improves our understanding of how GPs experience decentralized acute health care services, by identifying factors that influence and challenge their referral decisions. For these services to be used as intended in the collaboration reform, integrating the perspectives of GPs in the development and implementation of these services may be beneficial.
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Affiliation(s)
| | - Lilliana Del Busso
- Faculty of Health and Social Studies, Østfold University College, Fredrikstad, Norway and
| | - Vigdis A Grøndahl
- Faculty of Health and Social Studies, Østfold University College, Fredrikstad, Norway and
| | - Waleed Ghanima
- Department of Research, Østfold Hospital Trust, Sarpsborg, Norway.,Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lars-Petter Jelsness-Jørgensen
- Department of Research, Østfold Hospital Trust, Sarpsborg, Norway.,Faculty of Health and Social Studies, Østfold University College, Fredrikstad, Norway and
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Yavich N, Báscolo EP, Haggerty J. Comparing the performance of the public, social security and private health subsystems in Argentina by core dimensions of primary health care. Fam Pract 2016; 33:249-60. [PMID: 27377651 PMCID: PMC5439348 DOI: 10.1093/fampra/cmw043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Most Latin American health systems are comprised of public (PubS), social security (SSS) and private (PrS) subsystems. These subsystems coexist, causing health care fragmentation and population segmentation. OBJECTIVE To estimate the extent of subsystem cross-coverage in a geographically bounded population (Rosario city) and to compare the subsystems' performance on primary health care (PHC) dimensions. METHODS Through a cross-sectional, interviewer-administered survey to a representative sample (n = 822) of the Rosario population, we measured the percentage of cross-coverage (people with usual source of care in one subsystem but also covered by another subsystem) and the health services' performance by core PHC dimensions, as reported by each subsystem's usual users. We compared the subsystems' performance using chi-square analysis and one-way analysis of variance testing. We analyzed whether the observed differences were coherent with the predominant institutional and organizational features of each subsystem. RESULTS Overall, 39.3% of the population was affiliated with the PubS, 44.8% with the SSS and 15.9% with the PrS. Cross-coverage was reported by 40.6% of respondents. The performance of the PubS was weak on accessibility but strong on person-and-community-oriented care, the opposite of the PrS. The SSS combined the strengths of the other two subsystems. CONCLUSION Rosario's health system has a high percentage of cross-coverage, contributing to issues of fragmentation, segmentation, financial inequity and inefficiency. The overall performance of the SSS was better than that of the PrS and PubS, though each subsystem had a particular performance pattern with areas of strength and weakness that were consistent with their institutional and organizational profiles.
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Affiliation(s)
- Natalia Yavich
- National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET), Center for Interdisciplinary Studies (Centro de Estudios Interdisciplinarios), National University of Rosario (Universidad Nacional de Rosario), Rosario, Argentina and
| | - Ernesto Pablo Báscolo
- National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET), Center for Interdisciplinary Studies (Centro de Estudios Interdisciplinarios), National University of Rosario (Universidad Nacional de Rosario), Rosario, Argentina and
| | - Jeannie Haggerty
- Department of Family Medicine, St. Mary's Hospital Research Centre, McGill University, Montréal, Quebec, Canada
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Hou Z, Meng Q, Zhang Y. Hypertension Prevalence, Awareness, Treatment, and Control Following China's Healthcare Reform. Am J Hypertens 2016; 29:428-31. [PMID: 26232034 PMCID: PMC4886484 DOI: 10.1093/ajh/hpv125] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 05/20/2015] [Accepted: 07/06/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In 2009, China started an impressive national healthcare system reform. One of the key components is to promote equity in access to essential healthcare services including chronic disease management. We assessed the changes in hypertension management and its equity before and after China's healthcare reform in 2009. METHODS We used data from the 2008 and 2012 waves of the China Health and Retirement Longitudinal Study (CHARLS). The surveys were conducted in Zhejiang and Gansu provinces, containing 1,961 and 1,836 respondents aged 45 and older in 2008 and 2012 respectively. We measured the prevalence of hypertension, and proportions of respondents with hypertension aware of their conditions, receiving treatment and under effective control, separately for 2008 and 2012. We also reported these measures in provinces and rural/urban areas. RESULTS From 2008 to 2012, the age standardized prevalence of hypertension was steady at 46.2%, but hypertension management improved substantially. Among those with hypertension, the proportion of patients aware of their conditions increased from 57.8% to 69.9%, the proportion of patients receiving treatment increased from 38.1% to 56.1%, and the proportion of patients with hypertension under effective control increased from 21.7% to 36.4%. The highest improvement was found in rural areas of the underdeveloped province, which indicated that the inequity across regions declined over time. CONCLUSIONS Among Chinese population aged 45 and older in Zhejiang and Gansu provinces, hypertension management improved following healthcare reform. The rate of improvement was faster in rural and underdeveloped areas, possibly related to additional governmental subsidies to these areas.
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Affiliation(s)
- Zhiyuan Hou
- Department of Social Medicine, School of Public Health, National Key Laboratory of Health Technology Assessment (Ministry of Health), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, Shanghai, China;
| | - Qingyue Meng
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yuting Zhang
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Ahnfeldt-Mollerup P, dePont Christensen R, Halling A, Kristensen T, Lykkegaard J, Nexøe J, Barwell F, Spurgeon P, Søndergaard J. Medical engagement and organizational characteristics in general practice. Fam Pract 2016; 33:69-74. [PMID: 26502810 DOI: 10.1093/fampra/cmv085] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale (MES) was developed by Applied Research Ltd (2008) on the basis of emerging evidence that medical engagement is critical for implementing radical improvements. OBJECTIVES To study the importance of medical engagement in general practice and to analyse patterns of association with individual and organizational characteristics. DESIGN AND SETTING A cross-sectional study using a sampled survey questionnaire and the official register from the Danish General Practitioners' Organization comprising all registered Danish GPs. METHOD The Danish version of the MES Questionnaire was distributed and the survey results were analysed in conjunction with the GP register data. RESULTS Statistically adjusted analyses revealed that the GPs' medical engagement varied substantially. GPs working in collaboration with colleagues were more engaged than GPs from single-handed practices, older GPs were less engaged than younger GPs and female GPs had higher medical engagement than their male colleagues. Furthermore, GPs participating in vocational training of junior doctors were more engaged than GPs not participating in vocational training. CONCLUSION Medical engagement in general practice varies a great deal and this is determined by a complex interaction between both individual and organizational characteristics. Working in collaboration, having staff and being engaged in vocational training of junior doctors are all associated with enhanced levels of medical engagement among GPs.
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Affiliation(s)
- Peder Ahnfeldt-Mollerup
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark,
| | - René dePont Christensen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Anders Halling
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Troels Kristensen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Lykkegaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jørgen Nexøe
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Fred Barwell
- Applied Research Ltd, Warley, West Midlands, UK and
| | - Peter Spurgeon
- Institute of Clinical Leadership, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Abstract
BACKGROUND In the UK, early years policy emphasizes that all families should have access to support tailored to their individual needs. Knowledge of the determinants of health service use should help to inform rational and equitable planning and delivery of services to parents. OBJECTIVES We seek to investigate the determinants of primary care service use in families with preschool children. METHODS Determinants of service use in two population cohorts (families with children aged 0-1 and 2-3 years) from the Growing Up in Scotland study are presented. Services related to use of the family doctor or health visitor for information on the child's health or behaviour in the last year. RESULTS A range of socio-demographic determinants were significant predictors of service use on multivariate analysis. Determinants of service use differed between the health visitor and family doctor. CONCLUSIONS The analysis provides an insight into the determinants and patterns of health service use by families with young children at two stages of development. While some of our findings are expected or supported by previous research, others highlight areas that require further investigation.
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Affiliation(s)
- Claire Wilson
- Faculty of Medicine, University of Glasgow, Wolfson Medical School Building, University Avenue, Glasgow, G12 8QQ
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Abstract
INTRODUCTION Hypertension is an independent risk factor for cardiovascular disease. It is known that essential hypertension begins at a very early age. Recently, there have been reports of an increase in childhood hypertension, which has been attributed to an increase in the prevalence of childhood obesity. Obesity-dependent or independent asymptomatic hypertension can only be determined by random blood pressure measurements in children. OBJECTIVE In this study, we aimed to investigate the prevalence of obesity and asymptomatic hypertension among children living in Bursa, Turkey. METHODS One thousand children living in Nilüfer district and being served by the Fethiye Bulvar Family Health Care Center were enrolled in this study. All seven family physicians working at the centre participated in the study. RESULTS Eighty-five children (8.5%) were determined to be hypertensive. One hundred and twelve children (11.2%) were obese. Blood pressure and body mass index (BMI) increased with age, with peak prevalence of hypertension at age 12 and of obesity at age 10. CONCLUSIONS The prevalence of obesity and hypertension is high among school-age children in Turkey. Family physicians should consistently perform blood pressure and BMI measurements as a part of well child visits through late childhood.
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Affiliation(s)
- Hakan Demirci
- Department of Family Medicine, Sevket Yilmaz Training and Research Hospital, Bursa
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Abstract
BACKGROUND Physicians' prescribing patterns depend on fixed and influence-sensitive factors. The latter include the influence of interactions with the pharmaceutical industry. OBJECTIVE To determine whether the assessment of pharmaceutical sales representatives (PSRs) by family physicians was associated with their actual prescribing index. METHODS Cross-sectional anonymous postal study. We included all family physicians working in practice settings in Slovenia in 2011. SETTINGS Slovenian family physicians' surgeries. MAIN OUTCOME MEASURE Prescribing index of Slovenian family physicians. RESULTS We received 247 responses (27.6% response rate). A prescribing index >100% was present in 57 (23.1%) of the respondents. Multivariate analysis revealed that working in regions of Slovenia other than the central region might be associated with a prescribing index >100%. Assessment of PSRs by family physicians was not significantly associated with a prescribing index >100%. CONCLUSION The assessment of PSRs by family physicians does not have any substantial correlations with their prescribing index.
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Affiliation(s)
- Zalika Klemenc-Ketis
- Department of Family Medicine, University of Ljubljana and Maribor, Ljubljana, Slovenia.
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