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Hamaker M, Hyman N, Lodaria K, Jackson HB, Sewell TB, Chen K. Understanding Patients' Negative Experiences with Telehealth: A Content Analysis of Survey Data. J Patient Exp 2024; 11:23743735241240881. [PMID: 38699654 PMCID: PMC11064744 DOI: 10.1177/23743735241240881] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
Understanding differences in how demographic groups experience telehealth may be relevant in addressing potential disparities in telehealth usage. We seek to identify and examine themes most pertinent to patients' negative telehealth experiences by age and race in order to inform interventions to improve patients' future telehealth experiences. We performed a content analysis of Press Ganey patient experience surveys from adult patients at 17 primary care sites of a large, public healthcare system with visits from April 30, 2020 to August 27, 2021. We used sentiment analysis to identify negative comments. We coded for content themes and analyzed their frequency, stratifying by age and race. We analyzed 745 negative comments. Most frequent themes differed by demographic categories, but overall, the most commonly applied codes were "Contacting the Clinic" (n = 97), "Connectivity" (n = 84), and "Webside Manner" (n = 79). The top three codes accounted for >40% of the negative codes in each race category and >35% of the negative codes in each age category. While there were common negative experiences among groups, patients of different demographics highlighted different aspects of their telehealth experiences for potential improvement.
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Affiliation(s)
- Maya Hamaker
- Touro College of the Osteopathic Medicine, New York, New York, USA
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Nicholas Hyman
- Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Komal Lodaria
- Office of Quality and Safety, New York City Health+Hospitals, New York, NY, USA
| | - Hannah B. Jackson
- Office of Ambulatory Care and Population Health, New York City Health+Hospitals, New York, NY, USA
- Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA
| | - Taylor B Sewell
- Division of Critical Care and Hospital Medicine, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, New York, NY, USA
| | - Kevin Chen
- Office of Ambulatory Care and Population Health, New York City Health+Hospitals, New York, NY, USA
- Division of General Internal Medicine and Clinical Innovation, New York University Grossman School of Medicine, New York, NY, USA
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2
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Remer LM, Line K, Paolella A, Rozniak JM, Alessandrini EA. Use of Daily Web-Based, Real-Time Feedback to Improve Patient and Family Experience. J Patient Exp 2024; 11:23743735241226994. [PMID: 38601264 PMCID: PMC11005486 DOI: 10.1177/23743735241226994] [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] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
Abstract
Real-time feedback is a growing trend in patient- and family experience (PFE) work as it allows for immediate service recovery, though it typically requires a significant investment of time and financial resources. We describe a partnership with our "edutainment" system to administer an automated daily experience question (the "Daily Pulse Measure [DPM]") that allowed targeted just-in-time responses to low scores with minimal administrative cost. Through a series of Plan-Do-Study-Act cycles guided by family feedback, the question was created and modified, and the use of the question spread to all hospital units. The response rate was 23%, similar to our Hospital Consumer Assessment of Healthcare Providers and Systems survey response rate of 24% during the study period. Though the DPM did not have a consistent impact on the results of the 2 PFE survey questions we evaluated, units with improved PFE scores after the DPM roll-out tended to have more robust service recovery than those with low scores.
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Affiliation(s)
- Lisa M Remer
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kristin Line
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Alyssa Paolella
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Justin M Rozniak
- Department of Information Services, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Evaline A Alessandrini
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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Orchard C, Lin E, Rosella L, Smith PM. Using unsupervised clustering approaches to identify common mental health profiles and associated mental healthcare service use patterns in Ontario, Canada. Am J Epidemiol 2024:kwae030. [PMID: 38576175 DOI: 10.1093/aje/kwae030] [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: 03/24/2023] [Revised: 02/28/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
Mental health is a complex, multidimensional concept that goes beyond clinical diagnoses, including psychological distress, life stress and well-being. This study aims to use unsupervised clustering approaches to identify multidimensional mental health profiles that exist in the population, and their associated service use patterns. The data source for this study is the 2012 Canadian Community Health Survey- Mental Health linked to administrative healthcare data holdings, included were all Ontario adult respondents. We used a Partioning Around Medoids clustering algorithm with Gower's proximity to identify groups with distinct combinations of mental health indicators and described them by their sociodemographic and service use characteristics. We identified four groups with distinct mental health profiles, including one group who met the clinical threshold for a depressive diagnosis, with the remaining three groups expressing differences in positive mental health, life stress and self-rated mental health. The four groups had different age, employment and income profiles and exhibited differential access to mental healthcare services. This study represents the first step in identifying complex profiles of mental health at the population level in Ontario, Canada. Further research is required to better understand the potential causes and consequences of belonging to each of the mental health profiles identified.
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Affiliation(s)
- Christa Orchard
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Work & Health, Toronto, Ontario, Canada
- ICES, Ontario, Canada
| | - Elizabeth Lin
- ICES, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Laura Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Peter M Smith
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Work & Health, Toronto, Ontario, Canada
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Kasdorf A, Voltz R, Strupp J. Dying at home: What is needed? Findings from a nationwide retrospective cross-sectional online survey of bereaved people in Germany. Palliat Support Care 2024:1-9. [PMID: 38533612 DOI: 10.1017/s1478951524000440] [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] [Indexed: 03/28/2024]
Abstract
OBJECTIVES According to the "Last Year of Life in Cologne" study, 68% of patients with a serious and terminal illness wanted to die at home, but 42% died in hospital. Only 1 in 5 died at home. Most people want to spend their last days and hours at home, but the reality is that this is not always possible. Recommendations are needed on how best to support families to enable people to die at home - if this is their preferred place of death. Our aim was to identify the factors that make it possible for people to die at home and to analyze factors of dying at home. METHODS Germany-wide quantitative cross-sectional online survey of bereaved adult relatives. RESULTS The needs of 320 relatives of patients who wished to die at home were explored. Of these, 198 patients died at home and 122 did not. In the last 3 months of life, caregivers needed support in managing out-of-hours care (p < 0.001), financing (p = 0.012), preparing and organizing home care (both p < 0.001), communicating with the patient and medical staff (p = 0.012 and p = 0.009, respectively), and pain management (p < 0.001). Relatives whose next of kin did not die at home had higher needs, suggesting that these factors are key to home care of the dying. SIGNIFICANCE OF RESULTS The process of dying at home begins long before the actual dying phase. To minimize caregiver burden and improve symptom management, advanced home care plans are needed, with ongoing reassessment of family preferences and abilities.
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Affiliation(s)
- Alina Kasdorf
- Faculty of Medicine and University Hospital Cologne, Department of Palliative Medicine, University of Cologne, Cologne, Germany
| | - Raymond Voltz
- Faculty of Medicine and University Hospital Cologne, Department of Palliative Medicine, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Health Services Research, University of Cologne, Cologne, Germany
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf (CIO ABCD), University of Cologne, Cologne, Germany
| | - Julia Strupp
- Faculty of Medicine and University Hospital Cologne, Department of Palliative Medicine, University of Cologne, Cologne, Germany
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Washnock-Schmid E, Livingston N, Latack K, Wrobel N, Day CS. Orthopaedic Hand Patient Support Systems Have Valuable Insight to Patient Function and Pain. J Patient Exp 2024; 11:23743735241240876. [PMID: 38524386 PMCID: PMC10958802 DOI: 10.1177/23743735241240876] [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] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Patient-reported outcome measures (PROs) are increasingly used in clinical assessment. Research on how patient support systems contribute to physician understanding of patient condition is limited. Thus, insights from significant others may provide value, especially when concerns exist regarding patient response validity. Patients recruited from the pre-operative environment undergoing orthopaedic hand procedures responded to PROMIS-Pain Interference (PI), PROMIS-Upper Extremity (UE), PROMIS-Depression (D), and QuickDASH. They then selected a significant other (SO) to do the same. Patients and SOs were also asked to complete the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) as a measure of support-related responses. Patient and SO responses were compared, and support-related responses were added in subsequent analyses to examine their effect on SO PRO assessment.
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Affiliation(s)
| | | | | | - Nancy Wrobel
- University of Michigan-Dearborn, Dearborn, MI, USA
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Kogan I, Weißmann M, Dollmann J. Police discrimination and police distrust among ethnic minority adolescents in Germany. Front Sociol 2024; 9:1231774. [PMID: 38414507 PMCID: PMC10898247 DOI: 10.3389/fsoc.2024.1231774] [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] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/15/2024] [Indexed: 02/29/2024]
Abstract
In light of ongoing debates about racially motivated police violence, this paper examines two separate but interrelated phenomena: instances of police discrimination and mistrust in police and the judicial system among ethnic minorities in Germany. Analyses are carried out based on waves 1, 3, and 5 of the CILS4EU-DE data collected among 14 to 20 year-old respondents in Germany. The focus of the paper lies on young men from the Middle East, as well as Northern and Sub-Saharan Africa, who-as our study demonstrates-tend to disproportionally more often report discrimination experiences and particularly low levels of trust in police and courts compared to other ethnic minorities and the majority populations in Germany, and partially also in comparison to their female counterparts. We also show that more frequent experiences of police discrimination are associated with greater distrust of the police and partially also with courts among young men from the Middle East, North and Sub-Saharan Africa. Female adolescents from similar backgrounds are also more distrustful of the police, but this is not explained by their own experiences of police discrimination.
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Affiliation(s)
- Irena Kogan
- University of Mannheim, School of Social Sciences, Mannheim, Germany
- Mannheim Centre for European Social Research (MZES), University of Mannheim, Mannheim, Germany
| | - Markus Weißmann
- Mannheim Centre for European Social Research (MZES), University of Mannheim, Mannheim, Germany
- GESIS-Leibniz Institute for the Social Sciences, Cologne, Germany
| | - Jörg Dollmann
- Mannheim Centre for European Social Research (MZES), University of Mannheim, Mannheim, Germany
- DeZIM-German Center for Integration and Migration Research, Berlin, Germany
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Bhak Y, Ahn TK, Peterson TA, Han HW, Nam SM. Machine Learning Models for Low Back Pain Detection and Factor Identification: Insights From a 6-Year Nationwide Survey. J Pain 2024:S1526-5900(24)00378-X. [PMID: 38342191 DOI: 10.1016/j.jpain.2024.02.011] [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] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/13/2024]
Abstract
This study aimed to enhance performance, identify additional predictors, and improve the interpretability of biopsychosocial machine learning models for low back pain (LBP). Using survey data from a 6-year nationwide study involving 17,609 adults aged ≥50 years (Korea National Health and Nutrition Examination Survey), we explored 119 factors to detect LBP in individuals who reported experiencing LBP for at least 30 days within the previous 3 months. Our primary model, model 1, employed eXtreme Gradient Boosting (XGBoost) and selected primary factors (PFs) based on their feature importance scores. To extend this, we introduced additional factors, such as lumbar X-ray findings, physical activity, sitting time, and nutrient intake levels, which were available only during specific survey periods, into models 2 to 4. Model performance was evaluated using the area under the curve, with predicted probabilities explained by SHapley Additive exPlanations. Eleven PFs were identified, and model 1 exhibited an enhanced area under the curve .8 (.77-.84, 95% confidence interval). The factors had varying impacts across individuals, underscoring the need for personalized assessment. Hip and knee joint pain were the most significant PFs. High levels of physical activity were found to have a negative association with LBP, whereas a high intake of omega-6 was found to have a positive association. Notably, we identified factor clusters, including hip joint pain and female sex, potentially linked to osteoarthritis. In summary, this study successfully developed effective XGBoost models for LBP detection, thereby providing valuable insight into LBP-related factors. Comprehensive LBP management, particularly in women with osteoarthritis, is crucial given the presence of multiple factors. PERSPECTIVE: This article introduces XGBoost models designed to detect LBP and explores the multifactorial aspects of LBP through the application of SHapley Additive exPlanations and network analysis on the 4 developed models. The utilization of this analytical system has the potential to aid in devising personalized management strategies to address LBP.
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Affiliation(s)
- YoungMin Bhak
- Department of Biomedical Engineering, College of Information and Biotechnology, Ulsan National Institute of Science and Technology (UNIST), Ulsan, Republic of Korea
| | - Tae-Keun Ahn
- Department of Orthopedic Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Thomas A Peterson
- UCSF REACH Informatics Core, Department of Orthopaedic Surgery, Bakar Computational Health Sciences Institute, University of California San Francisco, San Francisco, California
| | - Hyun Wook Han
- Department of Biomedical Informatics, CHA University, Seongnam, Republic of Korea; Institute for Biomedical Informatics, CHA University, Seongnam, Republic of Korea
| | - Sang Min Nam
- Department of Biomedical Informatics, CHA University, Seongnam, Republic of Korea; Institute for Biomedical Informatics, CHA University, Seongnam, Republic of Korea; Daechi Yonsei Eye Clinics, Seoul, Republic of Korea
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Weiss NM, Martin S, Onal SO, McDaniel N, Leider JP. Public health workforce survey data (2016-2021) related to employee turnover: proposed methods for harmonization and triangulation. Front Public Health 2024; 11:1306274. [PMID: 38249360 PMCID: PMC10796527 DOI: 10.3389/fpubh.2023.1306274] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/11/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Public health workforce numbers are unsustainable at best and dire at worst: based on 2017 and 2019 data, 80,000 FTEs needed to be hired by health departments to provide basic public health foundational services before COVID-19 hit, suggesting that the situation is worse after the mass exodus of public health officials due to the pandemic. As such, a better understanding of public health workforce turnover is critical to improving recruitment and retention in the discipline. Methods This methods report details how the authors harmonized four public health workforce surveys-the Public Health Workforce Interests and Needs Survey (PH WINS), the National Association of County and City Health Officials (NACCHO) Profile, the NACCHO Forces of Change survey, and the Association of State and Territorial Health Officials (ASTHO) Profile-in order to examine employee turnover. Results We found that 31% of the public health workforce reported considering leaving their positions at some time in the future. Furthermore, the majority of agencies reported that zero vacancies had been filled in both 2018 and 2019. Discussion These findings suggest that retention, recruitment, and onboarding may be areas upon which to focus evaluation and quality improvement endeavors, allowing public health organizations to better attract and retain the most qualified candidates.
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Affiliation(s)
- Nicole M. Weiss
- Center for Public Health Systems, Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, United States
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Jalowsky M, Hauber B, Scott MJ, Arkin S, Coulter JR, Watt SJ, Kelly LMG, Valentine A. Priority Outcomes in Sickle Cell Disease Treatment: Co-Creation and Implementation of a Preference Exercise With Patients and Caregivers to Inform Drug Development. J Patient Exp 2023; 10:23743735231213767. [PMID: 38026068 PMCID: PMC10652801 DOI: 10.1177/23743735231213767] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Involving patients as co-leaders and co-creators in research is key to reflecting the patient's voice in decision-making. However, co-creation of patient-centered data to inform decisions is rare, especially in early drug development where patient input is critical to prioritizing patient-relevant outcomes and endpoints for use in clinical trials. Despite the industry's growing commitment to patient centricity, most patients are excluded from sharing their expertise in research; more inclusive methods of engaging patients as research partners are needed. We describe a collaboration between a pharmaceutical company and a patient organization in co-leading and co-creating a program to understand priorities of patients and caregivers for treatment features and outcomes in sickle cell disease to inform endpoint selection in clinical development. The results of this program will be used as a basis for continued interaction between patients and the sponsor and to inform ongoing clinical development and evidence-generation activities. This case study demonstrates an approach to meaningful collaborations between patient organizations and pharmaceutical companies aimed at including the patient's voice early in the medical product lifecycle.
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Moschella A, Burrows K. Patient Experience With Primary Care Physician Assistants in Ontario, Canada: Impact of Trust, Knowledge, and Access to Care. J Patient Exp 2023; 10:23743735231211782. [PMID: 37928961 PMCID: PMC10623992 DOI: 10.1177/23743735231211782] [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] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Physician assistants (PAs) have been integrated into primary care settings to reduce wait times and to optimize continuity of care. Though previous studies suggest that PA utilization leads to improved healthcare access, few studies have investigated patient experience with primary care PAs in Canada. The objective of this study is to explore patient perspectives on primary care PAs in Ontario. A patient survey was developed and distributed to patients seen by PAs in 4 family medicine practices across Ontario, Canada. Results demonstrate that many patients are highly satisfied with their experience including the PA's ability to address their medical needs, establish rapport, and provide fast access to care (including same-day and after-hours appointments). Despite preferring to see a physician for more complex concerns, participants felt that PAs demonstrate similar medical knowledge, competencies, and scope of practice as family physicians. Patients demonstrated a solid understanding of the PA role and recognized the collaborative PA-physician relationship. These findings describe successful patient awareness and acceptance of the PA profession, largely due to positive PA-patient interactions in family medicine settings.
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Affiliation(s)
- Alexa Moschella
- Physician Assistant Education Program, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kristen Burrows
- Physician Assistant Education Program, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
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Nyberg ST, Elovainio M, Pentti J, Frank P, Ervasti J, Härmä M, Koskinen A, Peutere L, Ropponen A, Vahtera J, Virtanen M, Airaksinen J, Batty GD, Kivimäki M. Predicting long-term sickness absence with employee questionnaires and administrative records: a prospective cohort study of hospital employees. Scand J Work Environ Health 2023; 49:610-620. [PMID: 37815247 PMCID: PMC10882516 DOI: 10.5271/sjweh.4124] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Indexed: 10/11/2023] Open
Abstract
OBJECTIVE This study aimed to compare the utility of risk estimation derived from questionnaires and administrative records in predicting long-term sickness absence among shift workers. METHODS This prospective cohort study comprised 3197 shift-working hospital employees (mean age 44.5 years, 88.0% women) who responded to a brief 8-item questionnaire on work disability risk factors and were linked to 28 variables on their working hour and workplace characteristics obtained from administrative registries at study baseline. The primary outcome was the first sickness absence lasting ≥90 days during a 4-year follow-up. RESULTS The C-index of 0.73 [95% confidence interval (CI) 0.70-0.77] for a questionnaire-only based prediction model, 0.71 (95% CI 0.67-0.75) for an administrative records-only model, and 0.79 (95% CI 0.76-0.82) for a model combining variables from both data sources indicated good discriminatory ability. For a 5%-estimated risk as a threshold for positive test results, the detection rates were 76%, 74%, and 75% and the false positive rates were 40%, 45% and 34% for the three models. For a 20%-risk threshold, the corresponding detection rates were 14%, 8%, and 27% and the false positive rates were 2%, 2%, and 4%. To detect one true positive case with these models, the number of false positive cases accompanied varied between 7 and 10 using the 5%-estimated risk, and between 2 and 3 using the 20%-estimated risk cut-off. The pattern of results was similar using 30-day sickness absence as the outcome. CONCLUSIONS The best predictive performance was reached with a model including both questionnaire responses and administrative records. Prediction was almost as accurate with models using only variables from one of these data sources. Further research is needed to examine the generalizability of these findings.
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Affiliation(s)
- Solja T Nyberg
- University of Helsinki, Clinicum, Faculty of Medicine, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Finland.
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Frederiksen KS, Hesse M, Pedersen MU. Problematic parental substance use, childhood family structures and adverse outcomes in young adulthood. Nordisk Alkohol Nark 2023; 40:502-519. [PMID: 37969903 PMCID: PMC10634387 DOI: 10.1177/14550725221143177] [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] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/17/2022] [Indexed: 11/17/2023] Open
Abstract
Aim: The aim of the present study was to investigate the association between childhood family structures, including the presence or absence of problematic parental substance use (PPSU), and adverse outcomes during adolescence/young adulthood. Methods: The study population included 9,770 young people (aged 15-25 years) from samples drawn for two national surveys in Denmark during 2014-2015. By combining surveys with national register data, five types of childhood family structures were constructed based on whether the child experienced PPSU and/or family separation and the number of years the child lived with a parent with substance use problems. Using binary logistic regression models, the relationships between family structure and adverse outcomes in young adulthood (i.e., hospital admissions, mental disorders and criminality) were investigated. Results: Young people who experienced PPSU and did not live with both parents had higher odds of the different long-term adverse outcomes compared with young people who did not experience PPSU, and similar odds of the outcomes compared to youth who had not experienced PPSU and did not live with both parents. The highest odds of adverse outcomes were found among young people who experienced PPSU and lived with the parent with substance use problems for less than five years. Conclusions: Living with both parents protected against adverse outcomes in young adulthood, and if PPSU was present, the odds of adverse outcomes increased. The hypothesis that there would be a positive association between years living with a parent with substance use problems and adverse outcomes in young adulthood was not supported. Awareness should be raised in health service, educational and legal institutions about the risk for young people from families with PPSU who do not live with both parents.
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Amos RLM, Cresswell K, Hughes K, Bellis MA. ACEtimation-The Combined Effect of Adverse Childhood Experiences on Violence, Health-Harming Behaviors, and Mental Ill-Health: Findings across England and Wales. Int J Environ Res Public Health 2023; 20:6633. [PMID: 37681773 PMCID: PMC10487644 DOI: 10.3390/ijerph20176633] [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] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Adverse childhood experiences (ACEs) encompass various adversities, e.g., physical and/or emotional abuse. Understanding the effects of different ACE types on various health outcomes can guide targeted prevention and intervention. We estimated the association between three categories of ACEs in isolation and when they co-occurred. Specifically, the relationship between child maltreatment, witnessing violence, and household dysfunction and the risk of being involved in violence, engaging in health-harming behaviors, and experiencing mental ill-health. Data were from eight cross-sectional surveys conducted in England and Wales between 2012 and 2022. The sample included 21,716 adults aged 18-69 years; 56.6% were female. Exposure to child maltreatment and household dysfunction in isolation were strong predictors of variant outcomes, whereas witnessing violence was not. However, additive models showed that witnessing violence amplified the measured risk beyond expected levels for being a victim or perpetrator of violence. The multiplicative effect of all three ACE categories demonstrated the highest level of risk (RRs from 1.7 to 7.4). Given the increased risk associated with co-occurring ACEs, it is crucial to target individuals exposed to any ACE category to prevent their exposure to additional harm. Implementing universal interventions that safeguard children from physical, emotional, and sexual violence is likely to mitigate a range of subsequent issues, including future involvement in violence.
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Affiliation(s)
| | - Katie Cresswell
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
| | - Karen Hughes
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham LL13 7YP, UK;
| | - Mark A. Bellis
- School of Medical and Health Sciences, Bangor University, Wrexham LL13 7YP, UK; (K.C.); (M.A.B.)
- World Health Organization Collaborating Centre on Investment for Health and Well-Being, Public Health Wales, Wrexham LL13 7YP, UK;
- Faculty of Health, Liverpool John Moores University, Liverpool L2 2ER, UK
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Dorsey Holliman B, Stransky M, Dieujuste N, Morris M. Disability doesn't discriminate: health inequities at the intersection of race and disability. Front Rehabil Sci 2023; 4:1075775. [PMID: 37484601 PMCID: PMC10357509 DOI: 10.3389/fresc.2023.1075775] [Citation(s) in RCA: 1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/02/2023] [Indexed: 07/25/2023]
Abstract
Objectives Given the prevalence of discrimination experienced by racial and ethnic minorities living with disabilities, it is likely that racism experienced by Black, Indigenous, and people of color (BIPOC) is compounded by the ableism experienced by people with disabilities, widening disparities in health and healthcare outcomes. To address this, we described unmet healthcare needs of a sample of Black, non-Hispanic, and Hispanic adults with and without disabilities. The following research question was examined exploratively: Are Black and Hispanic adults with disabilities at increased risk of unmet healthcare needs compared to Black and Hispanic adults without disabilities according to the 2018 National Health Interview Survey? Methods Survey data was examined from the 2018 National Health Interview Survey (NHIS), a nationally representative survey of community-dwelling adults in the United States. Results Black and non-Hispanic adults most commonly reported mobility only disabilities. People with disabilities were significantly more likely to delay or forego care than their peers without disabilities within each racial/ethnic group. Among non-Hispanic Black and Hispanic adults, nearly 30% of people with disabilities forewent services due to cost compared to persons without disabilities. Conclusions Black and Hispanic adults with disabilities experience greater disparities in access to healthcare than Black and Hispanic adults without disabilities. Therefore, health disparities experienced by racial and ethnic minorities living with disabilities is likely influenced by the dual systemic factors of racism and ableism.
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Affiliation(s)
- Brooke Dorsey Holliman
- Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO, United States
| | - Michelle Stransky
- Department of Medicine, Boston Medical Center, Boston, MA, United States
| | - Nathalie Dieujuste
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO, United States
- Department of Psychology, University of Denver, Denver, CO, United States
| | - Megan Morris
- Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO, United States
- Department of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, United States
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15
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Bünning M, Schlomann A, Memmer N, Tesch-Römer C, Wahl HW. Digital Gender Gap in the Second Half of Life is Declining: Changes in Gendered Internet Use Between 2014 and 2021 in Germany. J Gerontol B Psychol Sci Soc Sci 2023:7176037. [PMID: 37218293 PMCID: PMC10394992 DOI: 10.1093/geronb/gbad079] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVES The main purpose of the study has been to examine changes in Internet use among men and women in three age groups (mid-life, early old age, and advanced old age) between 2014 and 2021. We tested two hypotheses: The complementary hypothesis posits that online activities reproduce gender differences in offline activities. The compensatory hypothesis posits that women are catching up over time in male-typed activities as Internet access approaches saturation for both genders. METHODS We used representative, longitudinal data from the German Ageing Survey (DEAS) collected in 2014, 2017, 2020, and 2021 (n=21,505, age rage 46-90 years). We ran logistic regressions on Internet access and Internet use for four differently gender-typed activities: social contact (female-typed), shopping (gender neutral), entertainment (male-typed), and banking (male-typed). RESULTS Between 2014 and 2021, women drew level with men in Internet access. Gender differences in all four forms of Internet use declined considerably between 2014 and 2021. Women overtook men in using the Internet for social contact. In older age groups, men held the lead regarding online banking. During the COVID-19 crisis, women caught up to men in Internet use, especially for entertainment. DISCUSSION Overall time trends support the complementary hypothesis. By contrast, the finding that women have been catching up in in some male-typed online activities during the COVID-19 pandemic, supports the compensatory hypothesis.
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Affiliation(s)
| | - Anna Schlomann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | - Nicole Memmer
- Network Aging Research, Heidelberg University, Heidelberg, Germany
| | | | - Hans-Werner Wahl
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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16
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Chandra M, Hertel M, Cahill S, Sakaguchi K, Khanna S, Mitra S, Luke J, Khau M, Mirabella J, Cropper A. Prevalence of Self-Reported Kidney Disease in Older Adults by Sexual Orientation: Behavioral Risk Factor Surveillance System Analysis (2014-2019). J Am Soc Nephrol 2023; 34:682-693. [PMID: 36735807 PMCID: PMC10103302 DOI: 10.1681/asn.0000000000000065] [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: 05/04/2022] [Accepted: 12/04/2022] [Indexed: 02/05/2023] Open
Abstract
SIGNIFICANCE STATEMENT Studies discusses CKD disparities by age, race and ethnicity, and socioeconomics. However, despite well-documented disparities in CKD risk factors in LGBT+ adults, limited literature addresses CKD prevalence in this population. This analysis uses Behavioral Risk Factor Surveillance System (2014-2019) data to compare self-reported kidney disease prevalence in LGBT+ older adults (older than 50 years) with their heterosexual peers. Our findings indicate that LGBT+ older adults have higher rates of self-reported kidney disease and a higher incidence of CKD risks including smoking, activity limitations, adverse health outcomes, and limited access to health care, housing, and employment. These results support increasing access to screening for CKD risk factors, providing culturally responsive health care, and addressing societal drivers of vulnerability in older LGBT+ adults. BACKGROUND Existing research documents disparities in CKD by age, race and ethnicity, and access to health care. However, research on CKD in lesbian, gay, bisexual, and trans (LGBT+) older adults, despite their higher rates of diabetes, heart disease, smoking, and alcohol use, is limited. METHODS Pooled data from the Behavioral Risk Factor Surveillance System (2014-2019) for 22,114 LGBT+ adults and 748,963 heterosexuals aged 50 and older were used to estimate the prevalence of self-reported kidney disease. Logistic regressions were used to compare older adults by sexual orientation. RESULTS Older LGBT+ men (adjusted odds ratio=1.3; 95% confidence interval [CI], 1.09-1.54) were more likely than their heterosexual counterparts to report kidney disease, after controlling for sociodemographic factors, health behaviors, access to health care, and self-reported coronary heart disease, HIV, and diabetes; LGBT+ men and women also reported higher incidences of known risk factors for CKD. For example, both LGBT+ men (odds ratio [OR]=1.39; [95% CI], 1.26-1.54) and LGBT+ women (OR=1.39; [95% CI], 1.25-1.55) were more likely to be smokers and have a higher incidence of activity limitations, adverse health outcomes, and limited access to health care, housing, and employment. CONCLUSION These results support increasing access to screenings for CKD risk factors, providing preventative education and culturally responsive and affirming care, and addressing other societal drivers of vulnerability in older LGBT+ adults. The findings also support the value of interventions that address the interaction between CKD risk factors and the social marginalization that older LGBT+ adults experience.
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Affiliation(s)
| | - Mollie Hertel
- NORC at the University of Chicago, Chicago, Illinois
| | | | | | - Saumya Khanna
- NORC at the University of Chicago, Chicago, Illinois
| | | | - Jordi Luke
- Office of Minority Health, Centers for Medicare & Medicaid Services, Baltimore, Maryland
| | - Meagan Khau
- Office of Minority Health, Centers for Medicare & Medicaid Services, Baltimore, Maryland
| | - Jack Mirabella
- Office of Minority Health, Centers for Medicare & Medicaid Services, Baltimore, Maryland
| | - Avareena Cropper
- Office of Minority Health, Centers for Medicare & Medicaid Services, Baltimore, Maryland
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17
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Semakula M, Niragire F, Faes C. Spatio-Temporal Bayesian Models for Malaria Risk Using Survey and Health Facility Routine Data in Rwanda. Int J Environ Res Public Health 2023; 20:4283. [PMID: 36901291 PMCID: PMC10001932 DOI: 10.3390/ijerph20054283] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/24/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Malaria is a life-threatening disease ocuring mainly in developing countries. Almost half of the world's population was at risk of malaria in 2020. Children under five years age are among the population groups at considerably higher risk of contracting malaria and developing severe disease. Most countries use Demographic and Health Survey (DHS) data for health programs and evaluation. However, malaria elimination strategies require a real-time, locally-tailored response based on malaria risk estimates at the lowest administrative levels. In this paper, we propose a two-step modeling framework using survey and routine data to improve estimates of malaria risk incidence in small areas and enable quantifying malaria trends. METHODS To improve estimates, we suggest an alternative approach to modeling malaria relative risk by combining information from survey and routine data through Bayesian spatio-temporal models. We model malaria risk using two steps: (1) fitting a binomial model to the survey data, and (2) extracting fitted values and using them in the Poison model as nonlinear effects in the routine data. We modeled malaria relative risk among under-five-year old children in Rwanda. RESULTS The estimation of malaria prevalence among children who are under five years old using Rwanda demographic and health survey data for the years 2019-2020 alone showed a higher prevalence in the southwest, central, and northeast of Rwanda than the rest of the country. Combining with routine health facility data, we detected clusters that were undetected based on the survey data alone. The proposed approach enabled spatial and temporal trend effect estimation of relative risk in local/small areas in Rwanda. CONCLUSIONS The findings of this analysis suggest that using DHS combined with routine health services data for active malaria surveillance may provide provide more precise estimates of the malaria burden, which can be used toward malaria elimination targets. We compared findings from geostatistical modeling of malaria prevalence among under-five-year old children using DHS 2019-2020 and findings from malaria relative risk spatio-temporal modeling using both DHS survey 2019-2020 and health facility routine data. The strength of routinely collected data at small scales and high-quality data from the survey contributed to a better understanding of the malaria relative risk at the subnational level in Rwanda.
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Affiliation(s)
- Muhammed Semakula
- I-BioStat, Hasselt University, 3500 Hasselt, Belgium
- Centre of Excellence in Data Science, Bio-Statistics, College of Business and Economics, University of Rwanda, Kigali 4285, Rwanda
- Rwanda Biomedical Center, Kigali 7162, Rwanda
- KIT Royal Tropical Institute of Amsterdam, 1092 AD Amsterdam, The Netherlands
| | - François Niragire
- Department of Applied Statistics, University of Rwanda, Kigali 4285, Rwanda
| | - Christel Faes
- I-BioStat, Hasselt University, 3500 Hasselt, Belgium
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18
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Creedon TB, Wayne GF, Progovac AM, Levy DE, Cook BL. Trends in cigarette use and health insurance coverage among US adults with mental health and substance use disorders. Addiction 2023; 118:353-364. [PMID: 36385708 DOI: 10.1111/add.16052] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 09/10/2022] [Indexed: 11/18/2022]
Abstract
AIMS To estimate recent trends in cigarette use and health insurance coverage for United States adults with and without mental health and substance use disorders (MH/SUD). DESIGN Event study analysis of smoking and insurance coverage trends among US adults with and without MH/SUD using 2008-19 public use data from the National Survey on Drug Use and Health, an annual, cross-sectional survey. SETTING USA. PARTICIPANTS A nationally representative sample of non-institutionalized respondents aged 18-64 years (n = 448 762). MEASUREMENTS Outcome variables were three measures of recent cigarette use and one measure of past-year health insurance coverage. We compared outcomes between people with and without MH/SUD (MH disorder: past-year mental illness, predicted from Kessler-6 and the World Health Organization-Disability Assessment Schedule impairment scale; SUD: met survey-based DSM-IV criteria for past-year alcohol, cannabis, cocaine or heroin use disorder) and over time. FINDINGS Comparing pooled data from 2008 to 2009 and from 2018 to 2019, current smoking rates of adults with MH/SUD decreased from 37.9 to 27.9% while current smoking rates of adults without MH/SUD decreased from 21.4 to 16.3%, a significant difference in decrease of 4.9 percentage points (pts) [95% confidence interval (CI) = 3.3-6.6 pts]. Daily smoking followed similar patterns (difference in decrease of 3.9 pts (95% CI = 2.3-5.4 pts). Recent smoking abstinence rates for adults with MH/SUD increased from 7.4 to 10.9%, while recent smoking abstinence rates for adults without MH/SUD increased from 9.6 to 12.0%, a difference in increase of 1.0 pts (95% CI = -3.0 to 0.9 pts). In 2018-19, 11% of net reductions in current smoking, 12% of net reductions in daily smoking and 12% of net increases in recent smoking abstinence coincided with greater gains in insurance coverage for adults with MH/SUD compared to those without MH/SUD. CONCLUSIONS Improvements in smoking and abstinence outcomes for US adults with mental health and substance use disorders appear to be associated with increases in health insurance coverage.
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Affiliation(s)
- Timothy B Creedon
- Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, Washington, DC, USA
| | | | - Ana M Progovac
- Health Equity Research Laboratory, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Douglas E Levy
- Mongan Institute, Health Policy Research Center, Massachusetts General Hospital, Boston, MA, USA.,Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Benjamin Lê Cook
- Health Equity Research Laboratory, Department of Psychiatry, Cambridge Health Alliance, Cambridge, MA, USA.,Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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19
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Capano G, Verzichelli L, Vicentini G. European Political Science versus the Pandemic: Patterns of Professional Adaptation. Polit Stud Rev 2023; 21:63-81. [PMID: 37038604 PMCID: PMC10076962 DOI: 10.1177/14789299211052896] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/24/2021] [Indexed: 06/19/2023]
Abstract
The emergence of the COVID-19 outbreak can be considered a potential driver of changes not only in academic disciplines but also, as most observers underline, in the teaching mission of higher education. This raises the main question of this article, that is, exactly whether and how an external shock such as COVID-19 can impact the comprehensive profile of academic disciplines. By focusing on European political science, the article assesses the differences among scholars in this community in terms of potential long-term reactions. The study, based on the outcomes of an original survey conducted among 1400 European professional political scientists (EPSs) at the end of 2020, aims at detecting the "predisposition to adaptation" of the community, by examining the attitudes revealed by EPSs during the early phase of pandemic. In this regard, we focus on the explanations of different aspects of 'professional adaptation', discussing three dimensions that seem to be present in our sample, although with very different weights: passive, proactive and innovative adaptation.
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Affiliation(s)
- Giliberto Capano
- Department of Political and Social Sciences, University of Bologna, Bologna, Italy
| | - Luca Verzichelli
- Department of Social, Political and Cognitive Sciences, University of Siena, Siena, Italy
| | - Giulia Vicentini
- Department of Social, Political and Cognitive Sciences, University of Siena, Siena, Italy
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20
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Garg A, Subramain M, Barlow PB, Garvin L, Hoth KF, Dukes K, Hoffman RM, Comellas AP. Patient Experiences with a Tertiary Care Post-COVID-19 Clinic. J Patient Exp 2023; 10:23743735231151539. [PMID: 36698619 PMCID: PMC9869203 DOI: 10.1177/23743735231151539] [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] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PASC) is a complex condition with multisystem involvement. We assessed patients' experience with a PASC clinic established at University of Iowa in June 2020. A survey was electronically mailed in June 2021 asking about (1) symptoms and their impact on functional domains using the Patient-Reported Outcomes Measurement Information System (PROMIS) measures (Global Health and Cognitive Function Abilities) (2) satisfaction with clinic services, referrals, barriers to care, and recommended support resources. Survey completion rate was 35% (97/277). Majority were women (67%), Caucasian (93%), and were not hospitalized (76%) during acute COVID-19. As many as 50% reported wait time between 1 and 3 months, 40% traveled >1 h for an appointment and referred to various subspecialities. Participants reported high symptom burden-fatigue (77%), "brain fog" (73%), exercise intolerance (73%), anxiety (63%), sleep difficulties (56%) and depression (44%). On PROMIS measures, some patients scored significantly low (≥1.5 SD below mean) in physical (22.7%), mental (15.9%), and cognitive (17.6%) domains. Approximately 61% to 93% of participants were satisfied with clinical services. Qualitative analysis added insight to their experience with healthcare. Participants suggested potential strategies for optimizing recovery, including continuity of care, a co-located multispecialty clinic, and receiving timely information from emerging research. Participants appreciated that physicians validated their symptoms and provided continuity of care and access to specialists.
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Affiliation(s)
- Alpana Garg
- Department of Internal Medicine, Division of General Internal Medicine, University of Iowa, Iowa City, IA, USA,Alpana Garg, Department of Internal Medicine, University of Iowa, 105 East 9th Street, 4631 IRL Coralville, Iowa City, IA 52241, USA.
| | - Maran Subramain
- Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Patrick B Barlow
- Department of Internal Medicine, Division of General Internal Medicine, University of Iowa, Iowa City, IA, USA,Institute for Clinical and Translational Science, University of Iowa, Iowa City, IA, USA
| | - Lauren Garvin
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Karin F Hoth
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA,Iowa Neuroscience Institute, University of Iowa, Iowa City, IA, USA
| | - Kimberly Dukes
- Department of Internal Medicine, Division of General Internal Medicine, University of Iowa, Iowa City, IA, USA,Center for Access and Delivery Research and Evaluation (CADRE), Iowa City Veterans Affair Healthcare system (ICVAHCS), Iowa City, IA, USA,Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Richard M Hoffman
- Department of Internal Medicine, Division of General Internal Medicine, University of Iowa, Iowa City, IA, USA,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, USA
| | - Alejandro P Comellas
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Occupational Medicine, University of Iowa, Iowa City, IA, USA
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21
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Sparks JR, Flanagan EW, Kebbe M, Redman LM. Understanding Barriers and Facilitators to Physical Activity Engagement to Inform a Precision Prescription Approach during Pregnancy. Am J Lifestyle Med 2023; 17:108-122. [PMID: 36636400 PMCID: PMC9830245 DOI: 10.1177/15598276221108669] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Physical activity during pregnancy is an important health behavior. However, many pregnant individuals are provided with little-to-no guidance to adequately engage in physical activity. The purpose of this quantitative and quasi-qualitative study of currently or previously pregnant women was to examine physical activity behaviors in pregnancy and understand barriers and facilitators to achieving physical activity recommendations. Overall, 431 women (18+ years), White/Caucasian (84.5%), married (84.9%), and currently pregnant (66.6%), completed an online survey study. Most women (69.4%) reported engaging in cardio-based physical activity and willing to engage in physical activity to meet guidelines between 2 and 5 days per week (77.4 -88.8%). The most frequently reported barriers were feeling too tired (72.8%) or uncomfortable (71.8%) and childcare needs (57.8%). Being able to choose time of day (96.0%), accessing home workouts (92.9%), and having a personalized prescription (95.6%) were the most reported facilitators. Open comment feedback resulted in additional barriers, such as ensuring proper energy intake, while motivation and support from other pregnant individuals were fundamental facilitators. Individualized physical activity prescription is lacking in routine prenatal care. To support pregnant individuals to achieve physical activity recommendations, developing a prescription with suitable modalities, at-home options, and consideration for physical activity timing are required.
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Affiliation(s)
- Joshua R. Sparks
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research
Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | | | | | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research
Center, Louisiana State University, Baton Rouge, Louisiana, USA
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22
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Ramsden M, Furiosi M, Debenedettis P, Stojacic I, Mendes M, Munier-Jolain N, Caffi T. Development of an online pan-European Integrated Pest Management Resource Toolbox. Open Res Eur 2022; 2:72. [PMID: 37645315 PMCID: PMC10445940 DOI: 10.12688/openreseurope.14679.2] [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] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 08/31/2023]
Abstract
The IPM WORKSIPM Resource Toolbox (Toolbox) has been developed as an interactive, online repository of integrated pest management (IPM) resources. Populated with high priority resources for farmers and their advisors during the project, its structure enables additional resources added over time. The repository is a public interactive website, available to anyone looking to access, understand, and implement IPM. Built on an open-source content management system, the toolbox is designed to require minimal post-production site maintenance and support, while being easily expanded to integrate resources from future initiatives. To ensure an efficient but comprehensive website design, population, maintenance, a survey of target user needs was conducted. Different type of IPM stakeholders, both internal and external to the IPMworks project, ranked the key requirements for the Toolbox, such as practical information about diseases and pests' management and economic thresholds: 343 feedbacks and answers from a survey of 10 questions, carried out across Europe in four languages, provided the key elements and foundation for the IPM Resource Toolbox website development and specification. The Toolbox resources are explained in different languages, with images, divided by topics, with the possibility to find additional details and accessible by smartphone.
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Affiliation(s)
- Mark Ramsden
- RSK ADAS Ltd., ADAS Boxworth, Cambridgeshire, UK
| | - Margherita Furiosi
- DIPROVES, Catholic University of the Sacred Heart, Via E. Parmense 84, Piacenza, 29122, Italy
| | - Paolo Debenedettis
- DIPROVES, Catholic University of the Sacred Heart, Via E. Parmense 84, Piacenza, 29122, Italy
| | - Isidora Stojacic
- BioSense Institute, University of Novi Sad, Dr Zorana Djindjica 1, Novi Sad, 21000, Serbia
| | - Marta Mendes
- Consulai, Consultoria Agroindustrial Lda, Rua da Junqueira, 61 G, Lisboa, 1300-307, Portugal
| | | | - Tito Caffi
- DIPROVES, Catholic University of the Sacred Heart, Via E. Parmense 84, Piacenza, 29122, Italy
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23
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Stewart-Tufescu A, Struck S, Taillieu T, Salmon S, Fortier J, Brownell M, Chartier M, Yakubovich AR, Afifi TO. Adverse Childhood Experiences and Education Outcomes among Adolescents: Linking Survey and Administrative Data. Int J Environ Res Public Health 2022; 19:11564. [PMID: 36141833 PMCID: PMC9517426 DOI: 10.3390/ijerph191811564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
It is well established that adverse childhood experiences (ACEs) are associated with detrimental health outcomes in adulthood. Less is known about the relationships between ACEs and education outcomes and among adolescents. The aim of this study was to examine the associations between ACEs and adolescents' self-reported education outcomes and provincial education assessments among adolescents in Manitoba, Canada. Data were gathered from 1002 adolescents who participated in the Well-Being and Experiences (WE) Study. A subsample of the adolescents (84%) consented to having their WE survey data linked to administrative education databases. Binary and multinomial logistic regression models were computed to examine associations between ACE history and self-reported education outcomes and provincial education assessments, adjusting for sociodemographic variables. Adolescents with an ACE history had significantly increased likelihood of having ever been suspended from school (adjusted odds ratio (aOR) = 3.33, 95% CI 1.60-6.92), of lower grades (adjusted relative risk ratio (aRRR) = 3.21, 95% CI 1.42-7.29), and of chronic school absenteeism (aRRR = 2.45, 95% CI 1.28-4.68) compared with adolescents without an ACE history after adjusting for sociodemographic variables. Findings from this study illuminate the important relationship between childhood adversity and poor education outcomes assessed directly by adolescents. Increasing awareness of the public health risk associated with ACEs and education outcomes may inform education policy and school-based interventions.
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Affiliation(s)
- Ashley Stewart-Tufescu
- Faculty of Social Work and Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Shannon Struck
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Samantha Salmon
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Janique Fortier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | - Marni Brownell
- Department of Community Health Sciences, Manitoba Centre for Health Policy, and Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Mariette Chartier
- Department of Community Health Sciences, Manitoba Centre for Health Policy, and Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Alexa R. Yakubovich
- Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS B3H 1V7, Canada
| | - Tracie O. Afifi
- Departments of Community Health Sciences and Psychiatry, Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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24
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Geissler KH, Evans EA, Johnson JK, Whitehill JM. A Scoping Review of Data Sources for the Conduct of Policy-Relevant Substance Use Research. Public Health Rep 2022; 137:944-954. [PMID: 34543133 PMCID: PMC9379843 DOI: 10.1177/00333549211038323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 06/28/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Existing administrative and survey data are critical for understanding the effects of exigent policies on population health outcomes related to opioid, cannabis, and other substance use disorders (SUDs). The objective of this study was to determine the state of the data available for evaluating SUD-related health outcomes. METHODS We performed a scoping review of national and state government data sources to measure and evaluate the effects of state policy changes on substance use and SUD-related health outcomes and health care use. We used Massachusetts as a case study for availability of relevant state-level data as well as national datasets with state-level indicators available to measure outcomes. We compared key features of each dataset to assess their usefulness for research and policy evaluation. We conducted our review during November 2018-March 2019, and we updated data availability as of March 2019 for all data sources. RESULTS We identified 11 survey datasets, 12 national administrative datasets, and 10 state administrative datasets as being suitable for policy-relevant research and practice purposes. These datasets varied substantially in their usefulness for evaluation and research. Despite substantial data limitations, including prohibitive regulatory and monetary costs to obtain the data and limited availability, these data can be mined to examine a diversity of policy-relevant questions. CONCLUSIONS Findings provide a comprehensive resource for using survey and administrative data to evaluate the health effects of SUD-related policies and interventions. The construction of state-level public health data warehouses or record linkage projects connecting individual-level information in state data sources is valuable for analyzing the effects of policy changes. Understanding strengths and limitations of available data sources is important for ongoing research and evaluation.
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Affiliation(s)
- Kimberley H. Geissler
- Department of Health Promotion and Policy, School of Public
Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA,
USA
| | - Elizabeth A. Evans
- Department of Health Promotion and Policy, School of Public
Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA,
USA
| | | | - Jennifer M. Whitehill
- Department of Health Promotion and Policy, School of Public
Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA,
USA
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25
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Hutchins H, Robinson L, Charania S, Ghandour R, Hirsh-Pasek K, Zubler J. Psychometric Assessment of Pilot Language and Communication Items on the 2018 and 2019 National Survey of Children's Health. Acad Pediatr 2022; 22:1133-1141. [PMID: 34968678 PMCID: PMC9694117 DOI: 10.1016/j.acap.2021.12.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Until recently, normative data on language and communication development among children in the United States have not been available to inform critical efforts to promote language development and prevent impairments. This study represents the first psychometric assessment of nationally representative data derived from a National Survey of Children's Health (NSCH) pilot measure of language and communication development among children ages 1 to 5 years. METHODS We analyzed 14,573 parent responses to language and communication items on the 2018 and 2019 NSCH to evaluate whether the newly added 11 items represent a single latent trait for language and communication development and to determine normative age of success on each item. We applied weighted, one-parameter Item Response Theory to rate and cluster items by difficulty relative to developmental language ability. We examined differential item functioning (DIF) using weighted logistic regression by demographic factors. RESULTS Together, exploratory factor analysis resulting in a single factor > 1 and explaining 93% of the variance and positive correlations indicated unidimensionality of the measure. Item characteristic curves indicated groupings were overall concordant with proposed milestone ages and representative of an approximate 90% success cut-point by child age. Indicated normative age cut-points for 3 of the items differed slightly from proposed milestone ages. Uniform DIF was not observed and potential nonuniform DIF was observed across 5 items. CONCLUSIONS Results have the potential to enhance understanding of risk and protective factors, inform efforts to promote language and communication development, and guide programmatic efforts on early detection of language delays.
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Affiliation(s)
- Helena Hutchins
- Child Development Studies Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (H Hutchins and L Robinson), Atlanta, Ga; Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Research Participation Programs (H Hutchins), Oak Ridge, Tenn.
| | - Lara Robinson
- Child Development Studies Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (H Hutchins and L Robinson), Atlanta, Ga
| | - Sana Charania
- Early Hearing Detection and Intervention Team, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (S Charania), Atlanta, Ga
| | - Reem Ghandour
- Office of Epidemiology and Research, Maternal and Child Health Bureau, Health Resources and Services Administration (R Ghandour), Rockville, Md
| | - Kathy Hirsh-Pasek
- Department of Psychology, Temple University (K Hirsh-Pasek), Philadelphia, Pa; Brookings Institution (K Hirsh-Pasek), Washington, DC
| | - Jennifer Zubler
- Eagle Global Scientific (J Zubler), San Antonio, Tex; Learn the Signs, Act Early Program, Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (J Zubler), Atlanta, Ga
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26
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Vranckx M, Faes C, Molenberghs G, Hens N, Beutels P, Van Damme P, Aerts J, Petrof O, Pepermans K, Neyens T. A spatial model to jointly analyze self-reported survey data of COVID-19 symptoms and official COVID-19 incidence data. Biom J 2022; 65:e2100186. [PMID: 35818698 PMCID: PMC9349774 DOI: 10.1002/bimj.202100186] [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] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 05/06/2022] [Accepted: 05/21/2022] [Indexed: 01/17/2023]
Abstract
This work presents a joint spatial modeling framework to improve estimation of the spatial distribution of the latent COVID-19 incidence in Belgium, based on test-confirmed COVID-19 cases and crowd-sourced symptoms data as reported in a large-scale online survey. Correction is envisioned for stochastic dependence between the survey's response rate and spatial COVID-19 incidence, commonly known as preferential sampling, but not found significant. Results show that an online survey can provide valuable auxiliary data to optimize spatial COVID-19 incidence estimation based on confirmed cases in situations with limited testing capacity. Furthermore, it is shown that an online survey on COVID-19 symptoms with a sufficiently large sample size per spatial entity is capable of pinpointing the same locations that appear as test-confirmed clusters, approximately 1 week earlier. We conclude that a large-scale online study provides an inexpensive and flexible method to collect timely information of an epidemic during its early phase, which can be used by policy makers in an early phase of an epidemic and in conjunction with other monitoring systems.
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Affiliation(s)
- Maren Vranckx
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium
| | - Christel Faes
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium
| | - Geert Molenberghs
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium,L‐BioStatDepartment of Public Health and Primary CareFaculty of MedicineKU LeuvenLeuvenBelgium
| | - Niel Hens
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium,Center for Health Economics Research and Modeling Infectious DiseasesVaccine and Infectious Disease InstituteUniversity of AntwerpAntwerpBelgium
| | - Philippe Beutels
- Center for Health Economics Research and Modeling Infectious DiseasesVaccine and Infectious Disease InstituteUniversity of AntwerpAntwerpBelgium
| | - Pierre Van Damme
- Center for Health Economics Research and Modeling Infectious DiseasesVaccine and Infectious Disease InstituteUniversity of AntwerpAntwerpBelgium
| | - Jan Aerts
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium
| | - Oana Petrof
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium
| | - Koen Pepermans
- Faculty of Social SciencesUniversity of AntwerpAntwerpBelgium
| | - Thomas Neyens
- I‐BioStatData Science InstituteHasselt UniversityHasseltBelgium,L‐BioStatDepartment of Public Health and Primary CareFaculty of MedicineKU LeuvenLeuvenBelgium
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Abstract
The aim of this study was to describe the impact of the COVID-19 pandemic on dementia care from a multiple stakeholder perspective. We used a multi-method design, with a cross-sectional survey followed by focus groups/interviews. Surveys were completed by people living with dementia (n = 27), family caregivers (n = 161), and health and social care professionals (n = 77). A sub-sample (n = 55) participated in an interview or one of 9 focus groups. Surveys were analyzed with descriptive statistics and focus group/interview data were analyzed using a thematic approach. Participants reported an impact of COVID-19 on dementia care, including less access to care and resources for care. Telehealth and tele-support/education were reported to be effective alternatives to support care. Themes from the qualitative data about dementia care were: (1) planning and providing care, (2) making choices around risk and safety, (3) experiences of loss, and (4) technology and dementia care. The results of this study present opportunities to improve the quality of care through addressing inequities and identifying improved and innovative approaches to address social isolation and virtual care for this vulnerable population.
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Affiliation(s)
- Carole L. White
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative
Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Sara S. Masoud
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Ashlie A. Glassner
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Shanae Rhodes
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Mayra Mendoza
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
| | - Kylie Meyer
- Caring for the Caregiver Program, School of Nursing, UT Health San Antonio, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative
Diseases, UT Health San Antonio, San Antonio, TX, USA
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Yoo JE, Rho M. Large-Scale Survey Data Analysis with Penalized Regression: A Monte Carlo Simulation on Missing Categorical Predictors. Multivariate Behav Res 2022; 57:642-657. [PMID: 33703972 DOI: 10.1080/00273171.2021.1891856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
With the advent of the big data era, machine learning methods have evolved and proliferated. This study focused on penalized regression, a procedure that builds interpretive prediction models among machine learning methods. In particular, penalized regression coupled with large-scale data can explore hundreds or thousands of variables in one statistical model without convergence problems and identify yet uninvestigated important predictors. As one of the first Monte Carlo simulation studies to investigate predictive modeling with missing categorical predictors in the context of social science research, this study endeavored to emulate real social science large-scale data. Likert-scaled variables were simulated as well as multiple-category and count variables. Due to the inclusion of the categorical predictors in modeling, penalized regression methods that consider the grouping effect were employed such as group Mnet. We also examined the applicability of the simulation conditions with a real large-scale dataset that the simulation study referenced. Particularly, the study presented selection counts of variables after multiple iterations of modeling in order to consider the bias resulting from data-splitting in model validation. Selection counts turned out to be a necessary tool when variable selection is of research interest. Efforts to utilize large-scale data to the fullest appear to offer a valid approach to mitigate the effect of nonignorable missingness. Overall, penalized regression which assumes linearity is a viable method to analyze social science large-scale survey data.
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Affiliation(s)
- Jin Eun Yoo
- Department of Education, Korea National University of Education
| | - Minjeong Rho
- Department of Education, Korea National University of Education
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29
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Withagen-Koster AA, van Kleef RC, Eijkenaar F. Selection Incentives in the Dutch Basic Health Insurance: To What Extent Does End-of-Life Spending Contribute to Predictable Profits and Losses for Selective Groups? Med Care Res Rev 2022; 79:819-833. [PMID: 35677989 DOI: 10.1177/10775587221099731] [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] [Indexed: 11/15/2022]
Abstract
Existing risk-equalization models in individual health insurance markets with premium-rate restrictions do not completely compensate insurers for predictable profits/losses, confronting insurers with risk selection incentives. To guide further improvement of risk-equalization models, it is important to obtain insight into the drivers of remaining predictable profits/losses. This article studies a specific potential driver: end-of-life spending (defined here as spending in the last 1-5 years of life). Using administrative (N = 16.9 m) and health survey (N = 384 k) data from the Netherlands, we examine the extent to which end-of-life spending contributes to predictable profits/losses for selective groups. We do so by simulating the predictable profits/losses for these groups with and without end-of-life spending while correcting for the overall spending difference between these two situations. Our main finding is that-even under a sophisticated risk-equalization model-end-of-life spending can contribute to predictable losses for specific chronic conditions.
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Affiliation(s)
| | | | - F Eijkenaar
- Erasmus University Rotterdam, The Netherlands
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30
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Skafida V, Morrison F, Devaney J. Prevalence and Social Inequality in Experiences of Domestic Abuse Among Mothers of Young Children: A Study Using National Survey Data from Scotland. J Interpers Violence 2022; 37:NP9811-NP9838. [PMID: 33416002 PMCID: PMC9136476 DOI: 10.1177/0886260520980392] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Domestic abuse is a pernicious societal issue that has both short- and long-term consequences for those who are victimized. Research points to motherhood being linked to women's victimization, with pregnancy being a particular point of risk. Across UK jurisdictions, new legislation aims to extend the criminalization of domestic abuse to include coercive control. Less clear is the relationship between mothers' victimization of different "types" of abuse and other factors such as age, socioeconomic status, and level of education. The article makes an original contribution to knowledge by addressing these limitations of the existing literature. Using nationally representative data from a Scottish longitudinal survey (N = 3,633) into children's development this article investigates the social stratification of mothers' exposure to different types of abuse, including coercive control, physical abuse, and threats. Overall, 14% of mothers report experiencing any type of domestic abuse since the birth of the study child (age 6), of which 7% experienced physical abuse. Compared to mothers in the highest income households, mothers in the lowest income quintile were far more likely to experience any form of abuse (Logistic Regression, OR = 3.55), more likely to have experienced more types of abuse and to have experienced these more often (OR = 5.54). Age had a protective effect, with mothers aged 20 or younger at most risk of abuse (OR = 2.60 compared to mothers aged 40+). Interaction effects between age and income suggested that an intersectional lens may help explain the cumulative layers of difficulty which young mothers on low incomes may find themselves in when it comes to abusive partners. The pattern of social stratification remained the same when comparing different types of abuse. Mothers of boys were more likely to experience abuse, and to experience more types of abuse, more often. We reflect on how these findings could inform existing policy interventions.
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de Oliveira C, Mondor L, Wodchis WP, Rosella LC. Looking beyond Administrative Health Care Data: The Role of Socioeconomic Status in Predicting Future High-cost Patients with Mental Health and Addiction. Can J Psychiatry 2022; 67:140-152. [PMID: 33792407 PMCID: PMC8892069 DOI: 10.1177/07067437211004882] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Previous research has shown that the socioeconomic status (SES)-health gradient also extends to high-cost patients; however, little work has examined high-cost patients with mental illness and/or addiction. The objective of this study was to examine associations between individual-, household- and area-level SES factors and future high-cost use among these patients. METHODS We linked survey data from adult participants (ages 18 and older) of 3 cycles of the Canadian Community Health Survey to administrative health care data from Ontario, Canada. Respondents with mental illness and/or addiction were identified based on prior mental health and addiction health care use and followed for 5 years for which we ascertained health care costs covered under the public health care system. We quantified associations between SES factors and becoming a high-cost patient (i.e., transitioning into the top 5%) using logistic regression models. For ordinal SES factors, such as income, education and marginalization variables, we measured absolute and relative inequalities using the slope and relative index of inequality. RESULTS Among our sample, lower personal income (odds ratio [OR] = 2.11, 95% confidence interval [CI], 1.54 to 2.88, for CAD$0 to CAD$14,999), lower household income (OR = 2.11, 95% CI, 1.49 to 2.99, for lowest income quintile), food insecurity (OR = 1.87, 95% CI, 1.38 to 2.55) and non-homeownership (OR = 1.34, 95% CI, 1.08 to 1.66), at the individual and household levels, respectively, and higher residential instability (OR = 1.72, 95% CI, 1.23 to 2.42, for most marginalized), at the area level, were associated with higher odds of becoming a high-cost patient within a 5-year period. Moreover, the inequality analysis suggested pro-high-SES gradients in high-cost transitions. CONCLUSIONS Policies aimed at high-cost patients with mental illness and/or addiction, or those concerned with preventing individuals with these conditions from becoming high-cost patients in the health care system, should also consider non-clinical factors such as income as well as related dimensions including food security and homeownership.
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Affiliation(s)
- Claire de Oliveira
- Centre for Health Economics, University of York, United Kingdom.,Hull York Medical School, University of York, United Kingdom.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Health System Performance Network (HSPN), Toronto, Ontorio, Canada
| | - Luke Mondor
- ICES, Toronto, Ontario, Canada.,Health System Performance Network (HSPN), Toronto, Ontorio, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Health System Performance Network (HSPN), Toronto, Ontorio, Canada.,Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Laura C Rosella
- Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.,Population Health Analytics Laboratory, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
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32
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Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has posed a significant influence on public mental health. Current efforts focus on alleviating the impacts of the disease on public health and the economy, with the psychological effects due to COVID-19 relatively ignored. In this research, we are interested in exploring the quantitative characterization of the pandemic impact on public mental health by studying an online survey dataset of the United States. Methods The analyses are conducted based on a large scale of online mental health-related survey study in the United States, conducted over 12 consecutive weeks from April 23, 2020 to July 21, 2020. We are interested in examining the risk factors that have a significant impact on mental health as well as in their estimated effects over time. We employ the multiple imputation by chained equations (MICE) method to deal with missing values and take logistic regression with the least absolute shrinkage and selection operator (Lasso) method to identify risk factors for mental health. Results Our analysis shows that risk predictors for an individual to experience mental health issues include the pandemic situation of the State where the individual resides, age, gender, race, marital status, health conditions, the number of household members, employment status, the level of confidence of the future food affordability, availability of health insurance, mortgage status, and the information of kids enrolling in school. The effects of most of the predictors seem to change over time though the degree varies for different risk factors. The effects of risk factors, such as States and gender show noticeable change over time, whereas the factor age exhibits seemingly unchanged effects over time. Conclusions The analysis results unveil evidence-based findings to identify the groups who are psychologically vulnerable to the COVID-19 pandemic. This study provides helpful evidence for assisting healthcare providers and policymakers to take steps for mitigating the pandemic effects on public mental health, especially in boosting public health care, improving public confidence in future food conditions, and creating more job opportunities. Trial registration This article does not report the results of a health care intervention on human participants. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-021-01411-w.
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Affiliation(s)
- Jingyu Cui
- Department of Statistical and Actuarial Sciences, Western University, London, Ontario, N6A 5B7, Canada
| | - Jingwei Lu
- Department of Statistical and Actuarial Sciences, Western University, London, Ontario, N6A 5B7, Canada
| | - Yijia Weng
- Department of Statistical and Actuarial Sciences, Western University, London, Ontario, N6A 5B7, Canada
| | - Grace Y Yi
- Department of Statistical and Actuarial Sciences, Western University, London, Ontario, N6A 5B7, Canada. .,Department of Computer Science, Western University, London, Ontario, N6A 5B7, Canada.
| | - Wenqing He
- Department of Statistical and Actuarial Sciences, Western University, London, Ontario, N6A 5B7, Canada
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Parikka S, Martelin T, Karvonen S, Levälahti E, Kestilä L, Laatikainen T. Early childhood family background predicts meal frequency behaviour in children: Five-year follow-up study. Scand J Public Health 2021; 50:1199-1207. [PMID: 34904484 DOI: 10.1177/14034948211058544] [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] [Indexed: 11/17/2022]
Abstract
AIMS Childhood nutrition patterns have an important role in later health. We studied the role of family type, other family background factors and their changes over a five-year follow-up with respect to meal frequency among children. METHODS Longitudinal data were collected in 2007-2009 and 2013-2014. A nationally representative sample of Finnish children (n = 1822) aged 0.5-5 years at baseline and 5-10 years at follow-up and their families were used. The participation rate was 83% at baseline and 54% at follow-up. Meal frequency was defined as four to six meals per day. The associations of meal frequency with family background factors over a five-year follow-up period were examined by bivariate and multivariate regression analyses. RESULTS Eighty-nine per cent of the 5-10-year-old boys and girls had the recommended meal frequency at follow-up. Living in a single-parent family at baseline increased the risk of not eating the recommended number of meals compared with those living in intact families. After adjustments, a mother's low level of education (OR 0.51, CI 0.29-0.93) and a decrease in income sufficiency (OR 0.54, CI 0.35-0.84) during the follow-up period were unfavourably associated with the recommended meal frequency. The difference between children in stable single-parent, reconstituted or joint physical custody families and those living in stable intact families remained significant when controlling for other variables. CONCLUSIONS Single-parent families with a low socioeconomic position represent important target groups for interventions designed to promote regular meal frequency.
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Affiliation(s)
- Suvi Parikka
- Finnish Institute for Health and Welfare, Department of Welfare, Finland
| | - Tuija Martelin
- Finnish Institute for Health and Welfare, Department of Welfare, Finland
| | - Sakari Karvonen
- Finnish Institute for Health and Welfare, Department of Welfare, Finland
| | - Esko Levälahti
- Finnish Institute for Health and Welfare, Department of Welfare, Finland
| | - Laura Kestilä
- Finnish Institute for Health and Welfare, Department of Welfare, Finland
| | - Tiina Laatikainen
- Finnish Institute for Health and Welfare, Department of Welfare, Finland.,University of Eastern Finland, Institute of Public Health and Clinical Nutrition, Finland.,Joint Municipal Authority for North Karelia Social and Health Services, Finland
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Strizek J, Uhl A, Schaub M, Malischnig D. Alcohol and Cigarette Use among Adolescents and Young Adults in Austria from 2004-2020: Patterns of Change and Associations with Socioeconomic Variables. Int J Environ Res Public Health 2021; 18:ijerph182413080. [PMID: 34948689 PMCID: PMC8701464 DOI: 10.3390/ijerph182413080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/06/2021] [Accepted: 12/07/2021] [Indexed: 11/18/2022]
Abstract
Background: Adolescents and young adults are a crucial target group for preventing harm related to substance use. Recently, declining alcohol and tobacco consumption in young people has been observed in many countries. Based on survey data from 2004 to 2020, we describe time trends for several subgroups of adolescents and young adults (based on consumption levels and socioeconomic variables) and analyze associations between the level of alcohol per capita consumption or daily smoking and socioeconomic variables. Methods: Time trends for males and females are analyzed by a two-way ANOVA and predictors of use by using multivariate regression and logistic regression. Results: Alcohol per capita consumption decreased significantly for both sexes in the 16-year period, with male and female consumption levels converging. Daily smoking was equally prevalent for young males and females and decreased to a similar degree for both sexes. Being male and living in rural areas are associated with a higher level of alcohol consumption. Daily smoking is associated with a low level of education and is more prevalent among young adults who have already started to work. Conclusions: The decline in alcohol use and daily smoking among adolescents and young adults is taking place simultaneously. However, higher levels of alcohol consumption and daily smoking occur in different groups of adolescents and young adults, which should be considered in prevention strategies.
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Affiliation(s)
- Julian Strizek
- Gesundheit Österreich GmbH (Austrian Public Health Institute), 1010 Vienna, Austria;
- Correspondence: (J.S.); (D.M.); Tel.: +43-1-51561-148 (J.S.); +43-1-4000-87321 (D.M.)
| | - Alfred Uhl
- Gesundheit Österreich GmbH (Austrian Public Health Institute), 1010 Vienna, Austria;
- Faculty of Psychotherapy Science, Sigmund Freud University Vienna, 1020 Vienna, Austria
| | - Michael Schaub
- Swiss Research Institute of Public Health and Addiction (ISGF), University of Zürich, 8006 Zurich, Switzerland;
| | - Doris Malischnig
- Institute for Addiction Prevention, Office of Addiction and Drug Policy of Vienna, 1030 Vienna, Austria
- Correspondence: (J.S.); (D.M.); Tel.: +43-1-51561-148 (J.S.); +43-1-4000-87321 (D.M.)
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Afifi TO, Bolton SL, Mota N, Marrie RA, Stein MB, Enns MW, El-Gabalawy R, Bernstein CN, Mackenzie C, VanTil L, MacLean MB, Wang JL, Patten S, Asmundson GJG, Sareen J. Rationale and Methodology of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): A 16-year Follow-up Survey: Raison D'être Et Méthodologie De L'enquête De Suivi Sur La Santé Mentale Des Membres Des Forces Armées Canadiennes Et Des Anciens Combattants, 2018 (ESSMFACM). Can J Psychiatry 2021; 66:942-950. [PMID: 33624524 PMCID: PMC8649811 DOI: 10.1177/0706743720974837] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Knowledge is limited regarding the longitudinal course and predictors of mental health problems, suicide, and physical health outcomes among military and veterans. Statistics Canada, in collaboration with researchers at the University of Manitoba and an international team, conducted the Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS). Herein, we describe the rationale and methods of this important survey. METHOD The CAFVMHS is a longitudinal survey design with 2 time points (2002 and 2018). Regular Force military personnel who participated in the first Canadian Community Health Survey Cycle 1.2-Mental Health and Well-Being, Canadian Forces Supplement (CCHS-CFS) in 2002 (N = 5,155) were reinterviewed in 2018 (n = 2,941). The World Mental Health Survey-Composite International Diagnostic Interview was used with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. RESULTS The CAFVMHS includes 2,941 respondents (66% veterans; 34% active duty) and includes data on mental disorder diagnoses, physical health conditions, substance use, medication use, general health, mental health services, perceived need for care, social support, moral injury, deployment experiences, stress, physical activity, military-related sexual assault, childhood experiences, and military and sociodemographic information. CONCLUSIONS The CAFVMHS provides a unique opportunity to further understand the health and well-being of military personnel in Canada over time to inform intervention and prevention strategies and improve outcomes. The data are available through the Statistics Canada Research Data Centres across Canada and can be used cross-sectionally or be longitudinally linked to the 2002 CCHS-CFS data.
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Affiliation(s)
- Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruth Ann Marrie
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Faculty of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Murray B Stein
- Department of Psychiatry, UCSD School of Medicine, California, USA.,The Harold Wertheim School of Public Health and Human Longevity Science, UCSD, California, USA.,Altman Clinical and Translational Research Institute, UCSD School of Medicine, California, USA
| | - Murray W Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesia, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Corey Mackenzie
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Linda VanTil
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Mary Beth MacLean
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Jian Li Wang
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
| | - Scott Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - Jitender Sareen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
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Han MM, Hsueh J, Chen AX, Greenlee TE, Conti TF, Rose SL, Singh RP, Rachitskaya AV. Ophthalmology Provider Ratings and Patient, Disease, and Appointment Factors. J Patient Exp 2021; 8:23743735211033750. [PMID: 34395846 PMCID: PMC8358496 DOI: 10.1177/23743735211033750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of the current study is to examine how nonmodifiable sociodemographic, disease, appointment, management, and survey factors correlate with provider rating. This was a retrospective cross-sectional study conducted on 29 857 patient Clinician and Group Consumer Assessment of Healthcare Providers and Systems surveys collected from January 2017 to January 2019 at a tertiary eye center. We included surveys of patients aged 18 years or older, who answered at least 4 of 6 subfield questions, and completed the survey within 90 days of the appointment. The main outcome was the odds of receiving top box score (TBS) of 10/10 on the survey question regarding overall provider rating. The results showed that the variables with higher odds of TBS included higher overall appointment attendance (odds ratio [OR]: 2.66 [95% CI: 1.23-5.75], P = .013); older patient age (OR 2.44 [95% CI: 2.08-2.87], P < .001]; higher percentage of survey questions completed (OR: 2.02 [95% CI: 1.79-2.27], P < .001); better best corrected visual acuity (OR: 1.85 [95% CI: 1.3-2.64], P = .001); optometry clinic visit (OR: 1.25 [95% CI: 1.15-1.36], P < .001); having procedures (OR: 1.19 [95% CI: 1.04-1.36], P = .013), surgery scheduled (OR: 1.18 [95% CI: 1.03-1.36], P = .020], or refraction done (OR: 1.16 [95% CI: 1.08-1.25], P < .001); being seen by male providers (OR: 1.11 [95% CI: 1.04-1.17], P = .001); and having additional eye testing performed (OR: 1.06 [95% CI: 1.00-1.13], P = .048). Variables associated with lower odds of TBS included longer time to complete survey (OR: 0.42 [95% CI: 0.3-0.58], P = .001); new patient encounter (OR: 0.62 [95% CI: 0.58-0.65], P < .001); and glaucoma (OR: 0.66 [95% CI: 0.59-0.75], P < .001), cornea (OR: 0.79 [95% CI: 0.71-0.87], P < .001), or comprehensive clinic visits (OR: 0.86 [95% CI: 0.79-0.94], P < .001). Thus, nonmodifiable factors may affect the provider rating, and these factors should be studied further and accounted for when interpreting the results of patient experience surveys.
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Affiliation(s)
- Michael M Han
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jessica Hsueh
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Andrew X Chen
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tyler E Greenlee
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Thais F Conti
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Susannah L Rose
- Office of Patient Experience, Center for Bioethics, Clinical Transformation, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Rishi P Singh
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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Oben P, Corliss M. The Difference Between HCAHPS and the Patient Experience and its Implications for Physicians, Experience Leaders, and Health Executives. J Patient Exp 2021; 8:23743735211034026. [PMID: 34368430 PMCID: PMC8299887 DOI: 10.1177/23743735211034026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Fyhri A, Karlsen K, Sundfør HB. Paint It Red - A Multimethod Study of the Nudging Effect of Coloured Cycle Lanes. Front Psychol 2021; 12:662679. [PMID: 34149556 PMCID: PMC8206533 DOI: 10.3389/fpsyg.2021.662679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022] Open
Abstract
Many countries colour their cycle lanes, but there is still a lack of research into the impact of this policy. Rather than constraining or regulating movement, coloured asphalt conveys information, and can serve as a good example of a “nudge”. In transport, there are few good examples of effective nudges for improved safety or sustainability. We used a multi-method approach to study the behaviour and experiences of cyclists before and after cycle lanes were coloured using red asphalt. Video data were collected and analysed to measure the extent to which motorists stopped in the cycle lane; motorist distance from the cycle lane on passing; and bicycle placement in the cycle lane. Cyclists (n = 1583) were asked how they experienced the cycle lane in field surveys. GPS data from cyclists (n = 2448) was used to measure whether colouring the cycle lanes resulted in a change of cyclists’ route choice. Video data showed no significant decrease in the share of passing motorists who stopped in the cycle lane. However, there was a significant decrease in the share of motorists stopping in the cycle lane rather than in the car lane or on the pavement. After recoating, motorists also kept a greater distance from the cycle lane; a greater share of cyclists chose to cycle in the cycle lane and a lower share cycled on the pavement. Analysis of survey data showed that visibility, perceived safety and ease of visualisation improved more in the recoated streets than in control streets. Analysis of the GPS data revealed a significant increase in cycling in the first streets to get red asphalt, with mixed results for the later streets. We discuss possible mechanisms behind the effects observed, and whether coloured cycle lanes can be considered as a form of nudging.
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Affiliation(s)
- Aslak Fyhri
- Department of Security, Safety and Behaviour, Institute of Transport Economics, Oslo, Norway
| | - Katrine Karlsen
- Department of Security, Safety and Behaviour, Institute of Transport Economics, Oslo, Norway
| | - Hanne B Sundfør
- Department of Security, Safety and Behaviour, Institute of Transport Economics, Oslo, Norway
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Ahmed B, Altarawni M, Ellison J, Alkhaffaf BH. Serious Impacts of Postponing Bariatric Surgery as a Result of the COVID-19 Pandemic: The Patient Perspective. J Patient Exp 2021; 8:23743735211008282. [PMID: 34179425 PMCID: PMC8205418 DOI: 10.1177/23743735211008282] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The global COVID-19 pandemic has resulted in the widespread suspension of bariatric surgical programs. Although this rapid adaption was initially necessary, the implications of delaying the most effective treatment for weight loss in a population at risk from this crisis are not well known. Moreover, as the health care trusts plan the reintroduction of elective services, it is vital to also consider the patient’s perspectives, to adequately weigh up the benefits and risks of this recommencement in the current climate. Objectives: We aimed to investigate the impacts that postponing bariatric surgery has had on patients, and their priorities when restarting elective surgery. Methods: An online survey of patients awaiting surgery was undertaken, examining the physical and psychological impacts of pandemic isolation policies and postponing surgery, and exploring patient preferences regarding surgery during the pandemic. Results: Of 71 patients, 67.6% gained a median of 4 kg (interquartile range: 2.6-6.4), and 74.6% had adverse psychological effects; 93.0% were keen to proceed with surgery. Thematic analysis of qualitative data revealed delays have worsened physical symptoms, increased anxiety, and delayed secondary life-altering treatments. Conclusion: From the patient’s perspective, postponing surgery has been deleterious and efforts to safely reintroduce bariatric programs should be promoted.
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Affiliation(s)
- Babur Ahmed
- Department of Oesophago-Gastric and Bariatric Surgery, Salford Royal NHS Foundation Trust, United Kingdom
| | - Mohammad Altarawni
- Department of Oesophago-Gastric and Bariatric Surgery, Salford Royal NHS Foundation Trust, United Kingdom
| | - Jodi Ellison
- Department of Oesophago-Gastric and Bariatric Surgery, Salford Royal NHS Foundation Trust, United Kingdom
| | - Bilal H Alkhaffaf
- Department of Oesophago-Gastric and Bariatric Surgery, Salford Royal NHS Foundation Trust, United Kingdom.,The University of Manchester, United Kingdom
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40
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Jørgensen SE, Michelsen SI, Andersen A, Tolstrup JS, Thygesen LC. Identifying and Characterizing Children of Parents with a Serious Illness Using Survey and Register Data. Clin Epidemiol 2021; 13:253-263. [PMID: 33833582 PMCID: PMC8021136 DOI: 10.2147/clep.s294919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/14/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To estimate the prevalence and characterize children and adolescents aged 0–21 years with a physically or mentally ill parent based on registers. Further, to explore the use of register and survey data to identify parental serious illness. Methods The study is based on: 1) a 20% register sample of children and adolescents aged 0–21 in 2014; and 2) survey data from the Danish Youth Profile 2014 including 63,437 youth education students linked to registers. In registers, parental physical illness comprised hospital diagnoses included in the Charlson Comorbidity Index, and parental mental illness encompassed all mental diagnosis in the registers. Information about socioeconomic and demographic characteristics and use of health care services was retrieved from national registers. In the survey, students were asked if they had experienced serious illness of a parent. Results In the register sample of 0–21-year-olds, 25.3% had a parent with a physical or mental diagnosis, the prevalence increasing with age of the child. Compared to children without parental illness, children with an ill parent more frequently had unemployed parents, lower parental educational level, and a chronic medical condition. Analyses of the discrepancies between register and survey data revealed that 9% of the adolescents were identified as having an ill parent in both data sources and 64.1% had no identified ill parents. Moreover, a higher frequency of parental primary health care service use was seen for adolescents with an ill parent, across identification method, indicating that both methods identify adolescents with an ill parent. Conclusion The social inequality and elevated frequency of health problems among children and adolescents with an ill parent, underline the vulnerability of this population. Parental illness can be identified from both parental hospital diagnoses as well as self-reported by adolescents, however the two methods detect different populations. Both methods have several limitations and would benefit from further refinement and validation.
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Affiliation(s)
| | - Susan I Michelsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, 1455, Denmark
| | - Anette Andersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, 8200, Denmark
| | - Janne S Tolstrup
- National Institute of Public Health, University of Southern Denmark, Copenhagen, 1455, Denmark
| | - Lau C Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, 1455, Denmark
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Abstract
Previous studies show that survey-based reports of Medicaid participation are measured with error, but no prior study has examined measurement error in an important segment of the Medicaid population-low-income adults enrolled in Medicare. Using the Medicare Current Beneficiary Survey, we examine whether respondent self-reports of Medicaid enrollment match administrative records and present several key findings. First, among low-income Medicare beneficiaries, the false negative rate is 11.5% when the self-report is interpreted as full Medicaid and 3.7% when the self-report is interpreted as full or partial Medicaid. Second, the likelihood of a false negative report is systematically associated with respondent traits. Third, systematic measurement error results in biased coefficient estimates in models of Medicaid participation defined from self-reports, and the bias is more significant when the researcher interprets self-reports as full Medicaid coverage only. Researchers should use caution when interpreting survey reports as pertaining to full Medicaid coverage only.
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Millstein J, Agarwal A. Developing Actionable Survey Questions to Improve Patient Experience. J Patient Exp 2021; 8:2374373521999597. [PMID: 34179410 PMCID: PMC8205374 DOI: 10.1177/2374373521999597] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patient experience surveys should be concise, with questions that give us the most insight into our patients' needs and how successfully they were addressed during visits. Survey questions are most valuable if answers are actionable, connect more clearly with skill sets and identify issues which improve care.
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Affiliation(s)
- Jeffrey Millstein
- Regional Physician Practices of Penn Medicine, Woodbury Heights, NJ, USA
| | - Anish Agarwal
- Department of Emergency Medicine, University of Pennsylvania, Penn Medicine Center for Health Care Innovation, Philadelphia, PA, USA
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Key T, Kulkarni A, Kandhari V, Jawad Z, Hughes A, Mohanty K. The Patient Experience of Inpatient Care During the COVID-19 Pandemic: Exploring Patient Perceptions, Communication, and Quality of Care at a University Teaching Hospital in the United Kingdom. J Patient Exp 2021; 8:2374373521997742. [PMID: 34179394 PMCID: PMC8205368 DOI: 10.1177/2374373521997742] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has necessitated many rapid
changes in the provision and delivery of health care in hospital. This study
aimed to explore the patient experience of inpatient care during COVID-19
pandemic. An electronic questionnaire was designed and distributed to inpatients
treated at a large University Health Board over a 6-week period. It focused on
hospital inpatients’ experience of being cared for by health care professionals
wearing personal protective equipment (PPE), explored communication, and
patients’ perceptions of the quality of care. A total of 704 patients completed
the survey. Results demonstrated that patients believe PPE is important to
protect the health of both patients and staff and does not negatively impact on
their care. In spite of routine use of PPE, patients were still able to identify
and communicate with staff. Although visiting restrictions were enforced to
limit disease transmission, patients maintained contact with their relatives by
using various electronic forms of communication. Overall, patients rated the
quality of care they received at 9/10. This single-center study demonstrates a
positive patient experience of care at an unprecedented time.
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Affiliation(s)
- Thomas Key
- Cardiff & Vale University Health Board, Cardiff, United Kingdom
| | | | - Vikram Kandhari
- Cardiff & Vale University Health Board, Cardiff, United Kingdom
| | - Zayd Jawad
- Cardiff & Vale University Health Board, Cardiff, United Kingdom
| | - Angela Hughes
- Cardiff & Vale University Health Board, Cardiff, United Kingdom
| | - Khitish Mohanty
- Cardiff & Vale University Health Board, Cardiff, United Kingdom
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Olivari BS, Baumgart M, Taylor CA, McGuire LC. Population measures of subjective cognitive decline: A means of advancing public health policy to address cognitive health. Alzheimers Dement (N Y) 2021; 7:e12142. [PMID: 33681450 PMCID: PMC7919133 DOI: 10.1002/trc2.12142] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
Subjective cognitive decline (SCD) is receiving increasing attention as studies have suggested that SCD status is associated with risk of future cognitive decline and dementia. Population-based measures of SCD can be extremely useful to the public health community, health-care providers, researchers, and policymakers. A large population-based SCD measure now exists through the state-based Behavioral Risk Factor Surveillance System (BRFSS). All 50 states have included the cognitive decline module, which asks about SCD, to their BRFSS survey one or more times. Population measures of SCD can aid researchers in designing clinical studies by better estimating the populations that may be at risk for more severe cognitive decline based on their SCD status to ensure that the optimal groups are targeted. Population-level estimates of SCD can also help to inform health-care providers' decisions about initiating cognitive assessments, managing other conditions among those with memory problems, and identifying the needs of caregivers.
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Affiliation(s)
- Benjamin S Olivari
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
| | | | - Christopher A Taylor
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
| | - Lisa C McGuire
- Division of Population Health National Center for Chronic Disease Prevention and Health Promotion Centers for Disease Control and Prevention (CDC) Atlanta Georgia USA
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Goldstein JZ, Alesbury HS. Self-reported levels of occupational stress and wellness in forensic practitioners: Implications for the education and training of the forensic workforce. J Forensic Sci 2021; 66:1307-1315. [PMID: 33645737 DOI: 10.1111/1556-4029.14699] [Citation(s) in RCA: 4] [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: 12/10/2020] [Revised: 01/28/2021] [Accepted: 02/11/2021] [Indexed: 11/29/2022]
Abstract
While there is extensive research into wellness and mental health risks for police officers and other first responders, a smaller portion of research has considered how forensic practitioners are affected. This study surveyed 211 forensic practitioners from the American Academy of Forensic Sciences membership, the Clark County Office of the Coroner/Medical Examiner, and the New York City Office of Chief Medical Examiner to assess current wellness perceptions within forensics. The 22-question survey focused on (a) how the demands of daily casework affect self-perceived burnout levels, (b) whether mental health issues are adequately addressed during the education and training of the forensic workforce, and (c) whether forensic professionals are getting the wellness support that they themselves feel that they need. Basic descriptive statistics, chi-square (χ2 ) cross tabulations, and correlation analyses were constructed to assess relevant relationships within survey responses. Results indicate that forensic professionals report a high level of burnout and a lack of sufficient wellness resources in their current professional climate. While professionals feel fulfilled from their work, the majority of respondents (73.9%) felt that common mental health issues that exist in their profession were not adequately addressed during their workplace training, academic schooling, or professional certification. Despite the uniformly weak correlations observed between variables, chi-square analyses reveal practically and statistically significant trends that warrant further investigation, particularly in the context of vicarious trauma. Overall, this study provides an important baseline for future wellness research to support the specialized needs of forensic scientists during their training and education.
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Affiliation(s)
| | - Helen S Alesbury
- Forensic Operations, New York City Office of Chief Medical Examiner, New York, NY, USA
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Alshaibari KS, Hasan ER, Dammaj MZ, Sharaf Adeen IA. Mothers' Views About Lumbar Puncture for Their Children in a Maternity and Children's Hospital in Najran, Saudi Arabia. Pediatric Health Med Ther 2021; 12:91-99. [PMID: 33658883 PMCID: PMC7920614 DOI: 10.2147/phmt.s292671] [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] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Refusal rates for offered pediatric lumbar puncture (LP) are high in many parts of the world, potentially hindering diagnosis and treatment for thousands of children. There is relatively little research about why such rates are so high. Understanding the formation and development of mothers' opinions about LP could help identify barriers to accessing this modality to improve diagnostic and treatment outcomes in children with neurological and systemic diseases. METHODS We surveyed mothers of hospitalized children in the Maternity and Children's Hospital in Najran in November and December 2018. We queried their familiarity with LP and their decision to accept or refuse LP when it was offered. The team recorded demographic data on survey respondents, as well as their stated reasons for their LP decisions, and used chi-square tests to evaluate the correlation between patient or parent characteristics and the decision to accept or refuse LP. RESULTS A total of 202 mothers responded to the survey, with a mean age of 30.7 (± 6.9); nearly all women were stay-at-home mothers (93.1%). Most (61.4%) lived in urban settings. Four in 10 respondents (40.6%) were not familiar with LP. A sizable minority of 89 mothers (44.0%) refused LP for their children when offered, most commonly citing fear of paralysis (39.3%) as the reason for refusal. Those who accepted LP were more likely to do so following physician advice than for any other reason (p <0.001). CONCLUSION Lumbar puncture refusal rates may be even higher than previously reported, and there is a pressing need to educate women on the diagnostic and therapeutic benefits of LP for their children. Maternal education from physicians may help improve acceptance rates for the procedure.
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Affiliation(s)
| | | | - Mayasa Zaid Dammaj
- Department of Pediatrics, College of Medicine, Najran University, Najran, Saudi Arabia
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Abstract
The Fraser Health heart function clinics explored patient satisfaction using a survey with the goal of understanding and improving care and service delivery. Data were collected from 124 respondents at 3 ambulatory care sites in the region. Patient satisfaction scores were high, with an average score of 8.85 out of 10 and 95% of respondents rating the service higher than 6 out of 10. The results highlighted the importance of multidisciplinary teams, good communication, adequate information, and emphasis on how a patient is treated. The patient's understanding of the information provided and of their heart health treatment plan were identified as two areas that require greater awareness.
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Affiliation(s)
- Clare Koning
- Fraser Health Authority, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | | | - Judy Bushe
- Fraser Health Authority, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Charles Guo
- Fraser Health Authority, Royal Columbian Hospital, New Westminster, British Columbia, Canada
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48
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Abstract
Objective: Sleep disturbance is a key contributor to posthospital syndrome; a transient period of vulnerability following discharge from hospital. We sought to examine the relationship between patient-reported hospital quietness at night, via a validated survey, and unplanned hospital readmissions among hospitalized seniors (ages 65 and older) in Alberta, Canada. Design: Retrospective, cross-sectional analysis of survey responses, linked with administrative inpatient records. Setting: Using the Canadian Patient Experiences Survey—Inpatient Care and Discharge Abstract Database, patients aged 65 and older, and living with one or more chronic conditions were identified. Participants: Of all, 25 674 respondents discharged from hospital between April 2014 and December 2017. Main Outcome Measure: All-cause, unplanned readmission within 30 or 90 days (yes vs no). Results: Approximately half (50.5%) of the respondents reported that the area around their room was always quiet at night. Eight (8.1%) percent of respondents (2066) were readmitted within 30 days (2241 total readmissions), while 15.6% (4000) were readmitted within 90 days (5070 total readmissions). When controlling for a variety of demographic and clinical factors, patients not reporting “always” to the survey question regarding hospital quietness at night had slightly greater odds of readmission within 30 (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI]: 1.20-1.45) and 90 days (aOR = 1.14, 95% CI: 1.06-1.23). Conclusion: Our results demonstrate a clear association between patient-reported hospital quietness at night and subsequent readmission within the first 30 and 90 days following discharge. Efforts to minimize hospital noise, particularly at night, may help promote a restful environment, while reducing readmissions among older patients living with chronic conditions.
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Affiliation(s)
- Kyle A Kemp
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Paul Fairie
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Maria J Santana
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
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Kittel B, Kritzinger S, Boomgaarden H, Prainsack B, Eberl JM, Kalleitner F, Lebernegg NS, Partheymüller J, Plescia C, Schiestl DW, Schlogl L. The Austrian Corona Panel Project: monitoring individual and societal dynamics amidst the COVID-19 crisis. Eur Polit Sci 2021; 20. [PMCID: PMC7579903 DOI: 10.1057/s41304-020-00294-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Systematic and openly accessible data are vital to the scientific understanding of the social, political, and economic consequences of the COVID-19 pandemic. This article introduces the Austrian Corona Panel Project (ACPP), which has generated a unique, publicly available data set from late March 2020 onwards. ACPP has been designed to capture the social, political, and economic impact of the COVID-19 crisis on the Austrian population on a weekly basis. The thematic scope of the study covers several core dimensions related to the individual and societal impact of the COVID-19 crisis. The panel survey has a sample size of approximately 1500 respondents per wave. It contains questions that are asked every week, complemented by domain-specific modules to explore specific topics in more detail. The article presents details on the data collection process, data quality, the potential for analysis, and the modalities of data access pertaining to the first ten waves of the study.
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Affiliation(s)
- Bernhard Kittel
- Department of Economic Sociology, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Sylvia Kritzinger
- Department of Government, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Hajo Boomgaarden
- Department of Communication, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Barbara Prainsack
- Department of Political Science, University of Vienna, Universitätsstraße 7, 1010 Vienna, Austria
| | - Jakob-Moritz Eberl
- Department of Communication, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Fabian Kalleitner
- Department of Economic Sociology, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Noëlle S. Lebernegg
- Department of Communication, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Julia Partheymüller
- Vienna Center for Electoral Research, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Carolina Plescia
- Department of Government, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - David W. Schiestl
- Department of Economic Sociology, University of Vienna, Kolingasse 14-16, 1090 Vienna, Austria
| | - Lukas Schlogl
- Department of Political Science, University of Vienna, Universitätsstraße 7, 1010 Vienna, Austria
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Piesse A, Opsomer J, Dohrmann S, DiGaetano R, Morganstein D, Taylor K, Carusi C, Hyland A. Longitudinal Uses of the Population Assessment of Tobacco and Health Study. TOB REGUL SCI 2021; 7:3-16. [PMID: 33860066 DOI: 10.18001/trs.7.1.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives The Population Assessment of Tobacco and Health (PATH) Study is a nationally representative study of the US population on tobacco use and its effects on health, with 3 waves of data collection between 2013 and 2016. Prior work described the methods of the first wave. In this paper, we describe the methods of the subsequent 2 waves and provide recommendations for how to conduct longitudinal analyses of PATH Study data. Methods We use standard survey quality metrics to evaluate the results of the follow-up waves of the PATH Study. The recommendations and examples of longitudinal and cross-sectional analyses of PATH Study data follow a design-based statistical inference framework. Results The quality metrics indicate that the PATH Study sample of approximately 40,000 continuing respondents remains representative of its target population. Depending on the intended analysis, different survey weights may be appropriate. Conclusion The PATH Study data are a valuable resource for regulatory scientists interested in longitudinal analysis of tobacco use and its effects on health. The availability of multiple sets of specialized survey weights enables researchers to target a wide range of tobacco-related analytic questions.
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