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Mahoney KM, Bravo L, McAllister A, Bogar K, Hennessey S, Schreiber CA, Abernathy A. Health services provided at the time of abortion in the US: a scoping review of the qualitative and quantitative evidence. medRxiv 2024:2024.01.22.24301627. [PMID: 38343867 PMCID: PMC10854340 DOI: 10.1101/2024.01.22.24301627] [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] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Objectives While it is well documented that abortion access is associated with improved health, pregnancy-related, and socioeconomic outcomes, the association between abortion access and other reproductive health outcomes is less well described. Abortion-providing clinics also offer preventative reproductive health services. We conducted a scoping review to ascertain the extent to which preventive reproductive healthcare services (contraception, sexually transmitted infection testing and treatment, cervical cancer screening) are affected by abortion access in the United States. Methods Researchers screened articles and extracted data from PubMed, Embase, Scopus and CINAHL. We excluded articles that did not link abortion to contraception, sexually transmitted infection testing and treatment and cervical cancer screening; or took place outside the US. Results 5,359 papers were screened, 74 were included for full text review. Sixty-five were about contraception, seven on STIs, one on cervical cancer screening, and one on other services. The association between policies that restrict or protect abortion access and preventative health services has not been studied on a national scale. Drivers of variation were: insurance and billing policies; regulatory requirements of abortion-providing facilities, lack of staff training in clinics that did not specialize in abortion care; and limited follow up after abortion. Conclusions Abortion--providing clinics are a highly utilized access point for reproductive health services. More research is needed to determine the public health impact of constrained abortion access on contraceptive use, STI rates and cervical cancer in regions where many abortion-providing clinics have closed. Implications Attention should be paid to changing trends in contraceptive use, STI rates and cervical cancer as abortion-providing clinics close, this may reduce access to reproductive health services broadly.
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Affiliation(s)
- Katherine M Mahoney
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Licia Bravo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Arden McAllister
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, United States
| | - Kacie Bogar
- Center for Real-World Effectiveness and Safety of Therapeutics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Sean Hennessey
- Center for Real-World Effectiveness and Safety of Therapeutics, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Courtney A. Schreiber
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, United States
- Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, United States
| | - Alice Abernathy
- Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, United States
- Leonard Davis Institute of Health Economics, University of Pennsylvania, 3641 Locust Walk, Philadelphia, PA 19104, United States
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Baker CP, Purdy SC, Rakena TO, Bonnini S. It Sounds like It Feels: Preliminary Exploration of an Aeroacoustic Diagnostic Protocol for Singers. J Clin Med 2023; 12:5130. [PMID: 37568532 PMCID: PMC10420037 DOI: 10.3390/jcm12155130] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
To date, no established protocol exists for measuring functional voice changes in singers with subclinical singing-voice complaints. Hence, these may go undiagnosed until they progress into greater severity. This exploratory study sought to (1) determine which scale items in the self-perceptual Evaluation of Ability to Sing Easily (EASE) are associated with instrumental voice measures, and (2) construct as proof-of-concept an instrumental index related to singers' perceptions of their vocal function and health status. Eighteen classical singers were acoustically recorded in a controlled environment singing an /a/ vowel using soft phonation. Aerodynamic data were collected during a softly sung /papapapapapapa/ task with the KayPENTAX Phonatory Aerodynamic System. Using multi and univariate linear regression techniques, CPPS, vibrato jitter, vibrato shimmer, and an efficiency ratio (SPL/PSub) were included in a significant model (p < 0.001) explaining 62.4% of variance in participants' composite scores of three scale items related to vocal fatigue. The instrumental index showed a significant association (p = 0.001) with the EASE vocal fatigue subscale overall. Findings illustrate that an aeroacoustic instrumental index may be useful for monitoring functional changes in the singing voice as part of a multidimensional diagnostic approach to preventative and rehabilitative voice healthcare for professional singing-voice users.
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Affiliation(s)
- Calvin Peter Baker
- Speech Science, School of Psychology, University of Auckland, Auckland 1023, New Zealand;
- School of Music, University of Auckland, Auckland 1010, New Zealand;
| | - Suzanne C. Purdy
- Speech Science, School of Psychology, University of Auckland, Auckland 1023, New Zealand;
| | - Te Oti Rakena
- School of Music, University of Auckland, Auckland 1010, New Zealand;
| | - Stefano Bonnini
- Department of Economics & Management, University of Ferrara, 44121 Ferrara, Italy;
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Hayakawa S, Pan Y, Marian V. Using a Foreign Language Changes Medical Judgments of Preventative Care. Brain Sci 2021; 11:1309. [PMID: 34679374 PMCID: PMC8534006 DOI: 10.3390/brainsci11101309] [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] [Received: 08/26/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/01/2022] Open
Abstract
Every day, multilinguals around the world make important healthcare decisions while using a foreign language. The present study examined how the use of a native vs. non-native language shapes evaluations and decisions about preventative care. Bilinguals were randomly assigned to evaluate a series of medical scenarios in either their native or non-native language. Each scenario described potential adverse effects of a medical condition and a preventative treatment, as well as the population risk of disease- or treatment-related complications. Participants judged the perceived negativity and likelihood of experiencing adverse effects and indicated how willing they would be to accept the preventative treatment. We found that bilinguals using a foreign language perceived disease symptoms and treatment side effects to be less negative than those using their native tongue. Foreign language users were also more likely to account for the objective risks associated with medical conditions and treatments when making decisions about preventative care. We conclude that the use of a native vs. foreign language changes how people evaluate the consequences of accepting and declining preventative treatment, with potential implications for millions of providers and patients who routinely make medical choices in their non-native tongue.
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Affiliation(s)
- Sayuri Hayakawa
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA;
| | - Yue Pan
- Samuel Curtis Johnson Graduate School of Management, Cornell University, Ithaca, NY 14850, USA;
| | - Viorica Marian
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA;
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4
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Visvanathan R, Ranasinghe DC, Lange K, Wilson A, Dollard J, Boyle E, Jones K, Chesser M, Ingram K, Hoskins S, Pham C, Karnon J, Hill KD. Effectiveness of the Wearable Sensor based Ambient Intelligent Geriatric Management System (AmbIGeM) in Preventing Falls in Older People in Hospitals. J Gerontol A Biol Sci Med Sci 2021; 77:155-163. [PMID: 34153102 PMCID: PMC8751806 DOI: 10.1093/gerona/glab174] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/14/2020] [Indexed: 12/02/2022] Open
Abstract
Background The Ambient Intelligent Geriatric Management (AmbIGeM) system augments best practice and involves a novel wearable sensor (accelerometer and gyroscope) worn by patients where the data captured by the sensor are interpreted by algorithms to trigger alerts on clinician handheld mobile devices when risk movements are detected. Methods A 3-cluster stepped-wedge pragmatic trial investigating the effect on the primary outcome of falls rate and secondary outcome of injurious fall and proportion of fallers. Three wards across 2 states were included. Patients aged ≥65 years were eligible. Patients requiring palliative care were excluded. The trial was registered with the Australia and New Zealand Clinical Trials registry, number 12617000981325. Results A total of 4924 older patients were admitted to the study wards with 1076 excluded and 3240 (1995 control, 1245 intervention) enrolled. The median proportion of study duration with valid readings per patient was 49% ((interquartile range [IQR] 25%-67%)). There was no significant difference between intervention and control relating to the falls rate (adjusted rate ratio = 1.41, 95% confidence interval [0.85, 2.34]; p = .192), proportion of fallers (odds ratio = 1.54, 95% confidence interval [0.91, 2.61]; p = .105), and injurious falls rate (adjusted rate ratio = 0.90, 95% confidence interval [0.38, 2.14]; p = .807). In a post hoc analysis, falls and injurious falls rate were reduced in the Geriatric Evaluation and Management Unit wards when the intervention period was compared to the control period. Conclusions The AmbIGeM system did not reduce the rate of falls, rate of injurious falls, or proportion of fallers. There remains a case for further exploration and refinement of this technology given the post hoc analysis findings with the Geriatric Evaluation and Management Unit wards. Clinical Trials Registration Number: 12617000981325
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Affiliation(s)
- Renuka Visvanathan
- Aged & Extended Care Services and Basil Hetzel Institute, The Queen Elizabeth Hospital, Central Adelaide Local Health Network and Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, Australia
| | | | - Kylie Lange
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Australia
| | - Anne Wilson
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, SA, Australia.,School of Medicine, Flinders University of South Australia, Bedford Park, Australia
| | - Joanne Dollard
- Adelaide Geriatrics Training and Research with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, Australia
| | - Eileen Boyle
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Katherine Jones
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia
| | - Michael Chesser
- School of Computer Science, University of Adelaide, Adelaide, SA, Australia
| | - Katharine Ingram
- Department of Rehabilitation and Aged Care, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Stephen Hoskins
- Aged & Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville South, SA, Australia
| | - Clarabelle Pham
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Jonathan Karnon
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA, Australia.,Rehabilitation, Ageing and Independent Living and mi(RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
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5
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Takahashi S, Ojima T, Kondo K, Shimizu S, Fukuhara S, Yamamoto Y. Social participation and the combination of future needs for long-term care and mortality among older Japanese people: a prospective cohort study from the Aichi Gerontological Evaluation Study (AGES). BMJ Open 2019; 9:e030500. [PMID: 31719076 PMCID: PMC6858158 DOI: 10.1136/bmjopen-2019-030500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Our study aimed to examine the longitudinal association between social participation and both mortality and the need for long-term care (LTC) simultaneously. DESIGN A prospective cohort study with 9.4 years of follow-up. SETTING Six Japanese municipalities. PARTICIPANTS The participants were 15 313 people who did not qualify to receive LTC insurance at a baseline based on the data from the Aichi Gerontological Evaluation Study (AGES, 2003-2013). They received a questionnaire to measure social participation and other potential confounders. Social participation was defined as participating in at least one organisation from eight categories. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were classified into three categories at the end of the 9.4 years observational period: living without the need for LTC, living with the need for LTC and death. We estimated the adjusted OR (AOR) using multinomial logistic regression analyses with adjustment for possible confounders. RESULTS The primary analysis included 9741 participants. Multinomial logistic regression analysis revealed that social participation was associated with a significantly lower risk of the need for LTC (AOR 0.82, 95% CI 0.69 to 0.97) or death (AOR 0.78, 95% CI 0.70 to 0.88). CONCLUSIONS Social participation may be associated with a decreased risk of the need for LTC and mortality among elderly patients.
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Affiliation(s)
- Sei Takahashi
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
- Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Sayaka Shimizu
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shunichi Fukuhara
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, Fukushima, Japan
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan
- Department of General Medicine, Shirakawa Satellite Teaching and Research (STAR), Fukushima Medical University, Fukushima, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan
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6
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Kulmala J, Ngandu T, Havulinna S, Levälahti E, Lehtisalo J, Solomon A, Antikainen R, Laatikainen T, Pippola P, Peltonen M, Rauramaa R, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M. The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People. J Am Geriatr Soc 2019; 67:1138-1144. [PMID: 30809801 DOI: 10.1111/jgs.15837] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 01/25/2019] [Accepted: 01/25/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the effect of a 2-year multidomain lifestyle intervention on daily functioning of older people. DESIGN A 2-year randomized controlled trial (ClinicalTrials.gov, NCT01041989). SETTING Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. PARTICIPANTS A total of 1260 older adults, with a mean age of 69 years at the baseline, who were at risk of cognitive decline. INTERVENTION A multidomain intervention, including simultaneous physical activity intervention, nutritional counseling, vascular risk monitoring and management, and cognitive training and social activity. MEASUREMENTS The ability to perform daily activities (activities of daily living [ADLs] and instrumental ADLs) and physical performance (Short Physical Performance Battery). RESULTS The mean baseline ADL score was 18.1 (SD = 2.6) points; the scale ranges from 17 (no difficulties) to 85 (total ADL dependence). During the 2-year intervention, the ADL disability score slightly increased in the control group, while in the intervention group, it remained relatively stable. Based on the latent growth curve model, the difference in the change between the intervention and control groups was -0.95 (95% confidence interval [CI] = -1.61 to -0.28) after 1 year and -1.20 (95% CI = -2.02 to -0.38) after 2 years. In terms of physical performance, the intervention group had a slightly higher probability of improvement (from score 3 to score 4; P = .041) and a lower probability of decline (from score 3 to scores 0-2; P = .043) for chair rise compared to the control group. CONCLUSION A 2-year lifestyle intervention was able to maintain the daily functioning of the at-risk older population. The clinical significance of these results in this fairly well-functioning population remains uncertain, but the study results hold promise that healthy eating, exercise, and cognitive and social activity may have favorable effects on functional independence in older people.
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Affiliation(s)
- Jenni Kulmala
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Seinäjoki, Finland
| | - Tiia Ngandu
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Satu Havulinna
- Ageing, Disability and Functioning Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Esko Levälahti
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Jenni Lehtisalo
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
| | - Riitta Antikainen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland.,Oulu City Hospital, Oulu, Finland
| | - Tiina Laatikainen
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Joensuu, Finland
| | | | - Markku Peltonen
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Timo Strandberg
- Center for Life Course Health Research, University of Oulu, Oulu, Finland.,University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,National School of Public Health, Madrid, Spain
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, United Kingdom
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7
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Belshaw Z, Robinson NJ, Brennan ML, Dean RS. Developing practical recommendations for preventative healthcare consultations involving dogs and cats using a Delphi technique. Vet Rec 2019; 184:348. [PMID: 30765500 PMCID: PMC6589460 DOI: 10.1136/vr.104970] [Citation(s) in RCA: 5] [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] [Received: 04/09/2018] [Revised: 10/19/2018] [Accepted: 01/14/2019] [Indexed: 01/14/2023]
Abstract
Preventive healthcare is the focus of a large proportion of UK small animal veterinary consultations. The evidence base for how to optimise these consultations is limited. Therefore, evidence-based practical recommendations are needed for veterinary surgeons conducting these consultations. The aim of this study was to use an evidence-based methodology to develop the first consensus recommendations to improve dog and cat preventative healthcare consultations (PHCs). Evidence from multiple sources was systematically examined to generate a list of 18 recommendations. Veterinary surgeons and pet owners with extensive experience of PHCs were recruited to an anonymous panel to obtain consensus on whether these recommendations would improve PHCs. A Delphi technique was followed during three rounds of online questionnaire, with consensus set at 80 per cent agreement or disagreement with each recommendation. Thirteen of the original 18 recommendations reached consensus (>80per cent agreement), while the five remaining recommendations did not reach consensus. Globally, these are the first evidence-based recommendations developed specifically in relation to small animal general practice PHCs, generated via a Delphi panel including both veterinary surgeons and pet owners. Future work is needed to understand how these recommendations can be implemented in a range of veterinary practice settings.
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Affiliation(s)
- Zoe Belshaw
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | - Natalie Jane Robinson
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| | - Marnie Louise Brennan
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
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Sop J, Gustafson M, Rorrer C, Tager A, Annie FH. Undiagnosed Diabetes in Patients Admitted to a Clinical Decision Unit from the Emergency Department: A Retrospective Review. Cureus 2018; 10:e3390. [PMID: 30533325 PMCID: PMC6279010 DOI: 10.7759/cureus.3390] [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: 09/04/2018] [Accepted: 10/01/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives Diabetes is a debilitating disease that affects the way the body uses or produces insulin. Research evaluating the usefulness in screening patients admitted to a clinical decision unit (CDU) from the emergency department (ED) has been limited. Methods A retrospective chart review of patients admitted to a CDU from the ED was performed. Patients included were > 18-year-old who were observed in the CDU, had blood glucose drawn greater than eight hours after admission, and who had not been previously diagnosed with diabetes. Age, sex, and fasting glucose level were collected. The analysis was done to evaluate the percentage of patients undiagnosed and at risk for diabetes mellitus by assessing fasting blood glucose the morning after admission. Results Study revealed that 27.8% of the patients analyzed in this study had fasting blood glucose levels meeting or exceeding the diagnostic threshold of 126 mg/dL and could potentially have undiagnosed diabetes. Conclusion Screening patients admitted to a CDU from the emergency department identified that 27.8% had fasting plasma glucose levels ≥ 126 mg/dL. Consideration should be made to obtain a fasting blood glucose level in those without a previous diagnosis of diabetes who are observed overnight in a CDU.
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Affiliation(s)
- Jessica Sop
- Emergency Medicine, Charleston Area Medical Center, Charleston, USA
| | - Mark Gustafson
- Emergency Medicine, Charleston Area Medical Center, Charleston, USA
| | - Clyde Rorrer
- Emergency Medicine, Charleston Area Medical Center, Charleston , USA
| | - Alfred Tager
- Emergency Medicine, Charleston Area Medical Center, Charleston, USA
| | - Frank H Annie
- Cardiology, Charleston Area Medical Center, Charleston, USA
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9
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Belshaw Z, Robinson NJ, Dean RS, Brennan ML. "I Always Feel Like I Have to Rush…" Pet Owner and Small Animal Veterinary Surgeons' Reflections on Time during Preventative Healthcare Consultations in the United Kingdom. Vet Sci 2018; 5:E20. [PMID: 29419766 PMCID: PMC5876559 DOI: 10.3390/vetsci5010020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/30/2018] [Accepted: 02/05/2018] [Indexed: 12/05/2022] Open
Abstract
Canine and feline preventative healthcare consultations can be more complex than other consultation types, but they are typically not allocated additional time in the United Kingdom (UK). Impacts of the perceived length of UK preventative healthcare consultations have not previously been described. The aim of this novel study was to provide the first qualitative description of owner and veterinary surgeon reflections on time during preventative healthcare consultations. Semi-structured telephone interviews were conducted with 14 veterinary surgeons and 15 owners about all aspects of canine and feline preventative healthcare consultations. These qualitative data were thematically analysed, and four key themes identified. This paper describes the theme relating to time and consultation length. Patient, owner, veterinary surgeon and practice variables were recalled to impact the actual, versus allocated, length of a preventative healthcare consultation. Preventative healthcare consultations involving young, old and multi-morbid animals and new veterinary surgeon-owner partnerships appear particularly susceptible to time pressures. Owners and veterinary surgeons recalled rushing and minimizing discussions to keep consultations within their allocated time. The impact of the pace, content and duration of a preventative healthcare consultation may be influential factors in consultation satisfaction. These interviews provide an important insight into the complex nature of preventative healthcare consultations and the behaviour of participants under different perceived time pressures. These data may be of interest and relevance to all stakeholders in dog and cat preventative healthcare.
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Affiliation(s)
- Zoe Belshaw
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Natalie J Robinson
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Rachel S Dean
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Marnie L Brennan
- Centre for Evidence-based Veterinary Medicine, University of Nottingham, Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
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10
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Belshaw Z, Robinson NJ, Dean RS, Brennan ML. Owners and Veterinary Surgeons in the United Kingdom Disagree about What Should Happen during a Small Animal Vaccination Consultation. Vet Sci 2018; 5:E7. [PMID: 29346332 PMCID: PMC5876577 DOI: 10.3390/vetsci5010007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 11/16/2022] Open
Abstract
Dog and cat vaccination consultations are a common part of small animal practice in the United Kingdom. Few data are available describing what happens during those consultations or what participants think about their content. The aim of this novel study was to investigate the attitudes of dog and cat owners and veterinary surgeons towards the content of small animal vaccination consultations. Telephone interviews with veterinary surgeons and pet owners captured rich qualitative data. Thematic analysis was performed to identify key themes. This study reports the theme describing attitudes towards the content of the consultation. Diverse preferences exist for what should be prioritised during vaccination consultations, and mismatched expectations may lead to negative experiences. Vaccination consultations for puppies and kittens were described to have a relatively standardised structure with an educational and preventative healthcare focus. In contrast, adult pet vaccination consultations were described to focus on current physical health problems with only limited discussion of preventative healthcare topics. This first qualitative exploration of UK vaccination consultation expectations suggests that the content and consistency of adult pet vaccination consultations may not meet the needs or expectations of all participants. Redefining preventative healthcare to include all preventable conditions may benefit owners, pets and veterinary surgeons, and may help to provide a clearer structure for adult pet vaccination consultations. This study represents a significant advance our understanding of this consultation type.
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Affiliation(s)
- Zoe Belshaw
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Natalie J Robinson
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Rachel S Dean
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
| | - Marnie L Brennan
- Centre for Evidence-based Veterinary Medicine, School of Veterinary Medicine and Science, University of Nottingham Sutton Bonington Campus, Leicestershire LE12 5RD, UK.
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Cooper S, Cant R, Browning M, Robinson E. Preparing nursing students for the future: Development and implementation of an Australian Bachelor of Nursing programme with a community health focus. Contemp Nurse 2015; 49:68-74. [PMID: 25549746 DOI: 10.5172/conu.2014.49.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This paper focuses on changes in the educational preparation of undergraduate nurses in line with contemporary primary and preventative healthcare models. We evaluated a new Australian nursing and community care degree programme using focus groups with 38 students in their first years of study, and quantitative performance data (regarding entry, performance and course attrition). Four main themes were identified related to students' course experience: 'I think community health should be an elective'; 'Focus on relevance to practice'; 'Teaching by non-nursing academics' and 'Access to support during transition to university.' Overall pass rates were 94% (first year) and 97% (second year) with a low 11% attrition rate. We conclude that based on prior experiences and stereotypical views, students may be ambivalent about the inclusion of primary and preventative care models which nevertheless are essential to enhance practice and to prepare the future nursing workforce.
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Affiliation(s)
- Simon Cooper
- School of Nursing and Midwifery, Monash University, Berwick, VIC, Australia
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