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Pryce-Miller M, Bliss E, Airey A, Garvey A, Pennington CR. The lived experiences of racial bias for Black, Asian and Minority Ethnic students in practice: A hermeneutic phenomenological study. Nurse Educ Pract 2023; 66:103532. [PMID: 36563599 DOI: 10.1016/j.nepr.2022.103532] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 11/08/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
AIM This study explored the lived experiences of racial bias for Black, Asian and Minority Ethnic students undertaking an undergraduate or post-graduate degree in nursing, midwifery and allied health courses in the United Kingdom. BACKGROUND Previous research indicates that students from Black, Asian and Minority Ethnic groups have fewer opportunities to succeed at university and this has brought about a race awarding gap in their degree attainment. The reasons for this awarding gap are complex and multi-factorial and it is crucial that the lived experiences of racial bias are explored from the student perspective. DESIGN A hermeneutic phenomenological approach was adopted to elicit individual and collective experiences in the practice environment, a mandatory component of the student's degree. METHODS A focus group and individual semi-structured interviews were conducted to collect data from sixteen participants and analysed using thematic analysis RESULTS: Three encompassing themes were identified which included a sense of not belonging, trauma impact on mental health and understanding covert and overt racism. Participants reported incidences of racism and appeared to be traumatised by their experiences within practice and the university. They also reported poor mental health and well-being as shared experiences and a lack of confidence in the university and practice to mitigate racial issues. CONCLUSIONS Meaningful action must be taken by universities and practice partners to advance racial inequality initiatives by having robust anti-racism action plans and processes. These should be co-created with students and staff to reduce the race awarding gap.
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Affiliation(s)
| | - Eleanore Bliss
- University of the West of England, Bristol BS16 1XL, United Kingdom.
| | - Alisha Airey
- Asian and Minority Ethnic Project Consultant, University of the West of England, Bristol BS16 1XL, United Kingdom.
| | - Annette Garvey
- Asian Minority Ethnic Healthcare Student Support in Practice (HSSP) Project Manager & Senior Lecturer in Midwifery, University of the West of England, Bristol BS16 1XL, United Kingdom.
| | - Charlotte R Pennington
- Aston University, Birmingham B4 7ET, United Kingdom; Aston Institute of Health & Neurodevelopment, Aston University, United Kingdom.
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van der Plaat DA, Madan I, Coggon D, van Tongeren M, Edge R, Muiry R, Parsons V, Cullinan P. Risks of COVID-19 by occupation in NHS workers in England. Occup Environ Med 2022; 79:176-183. [PMID: 34462304 PMCID: PMC8414768 DOI: 10.1136/oemed-2021-107628] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 08/10/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England. METHODS We used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression. RESULTS With adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in 'additional clinical services' (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater. CONCLUSIONS After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations. TRIAL REGISTRATION NUMBER ISRCTN36352994.
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Affiliation(s)
| | - Ira Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - David Coggon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - Rhiannon Edge
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Rupert Muiry
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Vaughan Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
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Zhao L, Ismail SJ, Tunis MC. Ranking the relative importance of COVID-19 vaccination strategies in Canada: a priority-setting exercise. CMAJ Open 2021; 9:E848-E854. [PMID: 34493551 PMCID: PMC8428895 DOI: 10.9778/cmajo.20200241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND When vaccine supplies are anticipated to be limited, necessitating the vaccination of certain groups earlier than others, the assessment of values and preferences of stakeholders is an important component of an ethically sound vaccine prioritization framework. The objective of this study was to conduct a priority-setting exercise to establish an expert stakeholder perspective on the relative importance of COVID-19 vaccination strategies in Canada. METHODS The priority-setting exercise included a survey of stakeholders that was conducted from July 22 to Aug. 14, 2020. Stakeholders included clinical and public health expert groups, provincial and territorial committees and national Indigenous groups, patient and community advocacy representatives and experts, health professional associations and federal government departments. Survey results were analyzed to identify trends. RESULTS Of 155 stakeholders contacted, 76 surveys were received for a participation rate of 49%. During a period of anticipated initial vaccine scarcity for all pandemic scenarios, stakeholders generally considered the most important vaccination strategy to be protecting those who are most vulnerable to severe illness and death from COVID-19. This was followed in importance by strategies to protect health care capacity, minimize transmission of SARS-CoV-2 and protect critical infrastructure. INTERPRETATION This priority-setting exercise established that there is general alignment in the values and preferences across stakeholder groups: the most important vaccination strategy at the time of limited initial vaccine availability is to protect those who are most vulnerable. The findings of this priority-setting exercise provided a timely expert perspective to guide early public health planning for COVID-19 vaccines.
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Affiliation(s)
- Linlu Zhao
- Centre for Immunization and Respiratory Infectious Diseases (Zhao, Ismail, Tunis), Public Health Agency of Canada, Ottawa, Ont.; Metro City Medical Clinic (Ismail), Edmonton, Alta.
| | - Shainoor J Ismail
- Centre for Immunization and Respiratory Infectious Diseases (Zhao, Ismail, Tunis), Public Health Agency of Canada, Ottawa, Ont.; Metro City Medical Clinic (Ismail), Edmonton, Alta
| | - Matthew C Tunis
- Centre for Immunization and Respiratory Infectious Diseases (Zhao, Ismail, Tunis), Public Health Agency of Canada, Ottawa, Ont.; Metro City Medical Clinic (Ismail), Edmonton, Alta
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Steeb DR, Brock TP, Dascanio SA, Drain PK, Squires A, Thumm M, Tittle R, Haines ST. Entrustable Professional Activities (EPAs) for Global Health. Acad Med 2021; 96:402-408. [PMID: 33239533 PMCID: PMC7899746 DOI: 10.1097/acm.0000000000003856] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
PURPOSE As global health education and training shift toward competency-based approaches, academic institutions and organizations must define appropriate assessment strategies for use across health professions. The authors aim to develop entrustable professional activities (EPAs) for global health to apply across academic and workplace settings. METHOD In 2019, the authors invited 55 global health experts from medicine, nursing, pharmacy, and public health to participate in a multiround, online Delphi process; 30 (55%) agreed. Experts averaged 17 years of global health experience, and 12 (40%) were from low- to middle-income countries. In round one, participants listed essential global health activities. The authors used in vivo coding for round one responses to develop initial EPA statements. In subsequent rounds, participants used 5-point Likert-type scales to evaluate EPA statements for importance and relevance to global health across health professions. The authors elevated statements that were rated 4 (important/relevant to most) or 5 (very important/relevant to all) by a minimum of 70% of participants (decided a priori) to the final round, during which participants evaluated whether each statement represented an observable unit of work that could be assigned to a trainee. Descriptive statistics were used for quantitative data analysis. The authors used participant comments to categorize EPA statements into role domains. RESULTS Twenty-two EPA statements reached at least 70% consensus. The authors categorized these into 5 role domains: partnership developer, capacity builder, data analyzer, equity advocate, and health promoter. Statements in the equity advocate and partnership developer domains had the highest agreement for importance and relevance. Several statements achieved 100% agreement as a unit of work but achieved lower levels of agreement regarding their observability. CONCLUSIONS EPAs for global health may be useful to academic institutions and other organizations to guide the assessment of trainees within education and training programs across health professions.
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Affiliation(s)
- David R. Steeb
- D.R. Steeb is clinical assistant professor and director, Global Engagement, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0002-7802-5422
| | - Tina P. Brock
- T.P. Brock is professor of pharmacy education and practice, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; ORCID: https://orcid.org/0000-0001-7455-4063
| | - Sarah A. Dascanio
- S.A. Dascanio is a global engagement fellow, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, North Carolina; ORCID: https://orcid.org/0000-0001-8999-4539
| | - Paul K. Drain
- P.K. Drain is associate professor, Department of Global Health, Department of Medicine (infectious diseases), and Department of Epidemiology, and associate director, Tuberculosis Research and Training Center, University of Washington, Seattle, Washington; ORCID: https://orcid.org/0000-0003-3300-3817
| | - Allison Squires
- A. Squires is associate professor, New York University Rory Meyers College of Nursing, New York, New York, and she is currently the distinguished nurse scholar in residence, National Academy of Medicine; ORCID: https://orcid.org/0000-0002-5238-2122
| | - Melissa Thumm
- M. Thumm is an independent global health consultant and former senior technical advisor, Management Sciences for Health, Denver, Colorado
| | - Robin Tittle
- R. Tittle is assistant professor, Oregon Health and Science University, Portland, Oregon, and curriculum director, University of California, San Francisco, HEAL Initiative, Oakland, California
| | - Stuart T. Haines
- S.T. Haines is professor of pharmacy practice and director, Division of Pharmacy Professional Development, University of Mississippi School of Pharmacy, Oxford, Mississippi; ORCID: https://orcid.org/0000-0001-8217-1871
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Irby DM, O'Brien BC, Stenfors T, Palmgren PJ. Selecting Instruments for Measuring the Clinical Learning Environment of Medical Education: A 4-Domain Framework. Acad Med 2021; 96:218-225. [PMID: 32590472 DOI: 10.1097/acm.0000000000003551] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Learning environments shape the experiences of learners and practitioners, making them an important component of program evaluation. However, educators find it challenging to decide whether to measure clinical learning environments with existing instruments or to design their own new instrument and, if using an existing instrument, which to choose. To assist educators with these decisions, the authors compared clinical learning environment instruments based on their characteristics, underlying constructs, and degree to which items reflect 4 domains (personal, social, organizational, material) from a recently developed model for conceptualizing learning environments in the health professions. Building on 3 prior literature reviews as well as a literature search, the authors identified 6 clinically oriented learning environment instruments designed for medical education. They collected key information about each instrument (e.g., number of items and subscales, conceptual frameworks, operational definitions of the learning environment) and coded items from each instrument according to the 4 domains. The 6 instruments varied in number of items, underlying constructs, subscales, definitions of clinical learning environment, and domain coverage. Most instruments focused heavily on the organizational and social domains and less on the personal and material domains (half omitted the material domain entirely). The variations in these instruments suggest that educators might consider several guiding questions. How will they define the learning environment and which theoretical lens is most applicable (e.g., personal vitality, sociocultural learning theory)? What aspects or domains of the learning environment do they most wish to capture (e.g., personal support, social interactions, organizational culture, access to resources)? How comprehensive do they want the instrument to be (and correspondingly how much time do they expect people to devote to completing the instrument and how frequently)? Whose perspective do they wish to evaluate (e.g., student, resident, fellow, attending, team, patient)? Each of these considerations is addressed.
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Affiliation(s)
- David M Irby
- D.M. Irby is professor emeritus of medicine and education scientist, Center for Faculty Educators, University of California, San Francisco, San Francisco, California, and affiliate faculty member, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; ORCID: http://orcid.org/0000-0001-5753-8918
| | - Bridget C O'Brien
- B.C. O'Brien is professor of medicine and education scientist, Center for Faculty Educators, University of California, San Francisco, San Francisco, California; ORCID: http://orcid.org/0000-0001-9591-5243
| | - Terese Stenfors
- T. Stenfors is associate professor, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; ORCID: http://orcid.org/0000-0002-0854-8631
| | - Per J Palmgren
- P.J. Palmgren is university lecturer and educational scientist, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; ORCID: http://orcid.org/0000-0001-7499-9329
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van Schalkwyk S, O'Brien BC, van der Vleuten C, Wilkinson TJ, Meyer I, Schmutz AMS, Varpio L. Exploring perspectives on health professions education scholarship units from sub-Saharan Africa. Perspect Med Educ 2020; 9:359-366. [PMID: 32930985 PMCID: PMC7718360 DOI: 10.1007/s40037-020-00619-8] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION There has been a marked increase in institutional structures developed to support health professions education scholarship recently. These health professions education scholarship units (HPESUs) engage in a diverse range of activities. Previous work provided insight into factors that influence the functioning of such units, but data from European, Asian, Latin American, and African contexts was absent, potentially leading to a single world-view informing international standards for HPESUs. This aim of this study was to explore perspectives from sub-Saharan Africa (SSA) in response to this omission. METHODS Situated within an interpretivist paradigm, the research team conducted semi-structured interviews with nine HPESU leaders in SSA, exploring how participants experienced and understood the functioning of their units. Despite efforts to have representation from across the region, most participants were from South Africa. The researchers analysed data thematically using the theory of institutional logics as an analytical frame. RESULTS Several aspects of the HPESUs aligned with the previously identified logics of academic research, service and teaching; and of a cohesive education continuum. By contrast, leaders described financial sustainability as a more prominent logic than financial accountability. DISCUSSION The similarities identified in this study may reflect isomorphism-a process which sees institutions within a similar field becoming more alike, particularly as newer institutions seek to acquire legitimacy within that field. An important caveat, however, is that isomorphism tends to occur across similar institutional contexts, which was not the case in this study. Understanding these differences is key as these HPESUs move to foster scholarship that can respond to the region's unique context.
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Affiliation(s)
- Susan van Schalkwyk
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa.
| | - Bridget C O'Brien
- Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, CA, USA
| | - Cees van der Vleuten
- Department of Educational Development and Research, Maastricht University, Maastricht, The Netherlands
| | | | - Ilse Meyer
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Anna M S Schmutz
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Lara Varpio
- Department of Medicine and Center for Health Professions Education, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Resiliency and Self-Care Behaviors in Health Professional Schools: Quantitative Research. J Holist Nurs 2020; 38:382-3. [PMID: 33203324 DOI: 10.1177/0898010120973824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
IMPORTANCE The population impact of modifying obesity and other key risk factors for hyperuricemia has been estimated in cross-sectional studies; however, the proportion of incident gout cases (a clinical end point) that could be prevented by modifying such factors has not been evaluated. OBJECTIVE To estimate the proportion of incident gout cases that could be avoided through simultaneous modification of obesity and other key risk factors. DESIGN, SETTING, AND PARTICIPANTS The Health Professionals Follow-up Study is a US prospective cohort study of 51 529 male health professionals enrolled in 1986 and followed up through questionnaires every 2 years through 2012. Self-reported gout cases were confirmed through June 2015. Clean and complete data used for this analysis were available in June 2016, with statistical analyses performed from July 2016 to July 2019. EXPOSURES From data collected in the validated questionnaires, men were categorized to low-risk groups according to combinations of the following 4 factors: normal body mass index (BMI [calculated as weight in kilograms divided by height in meters squared]; <25), no alcohol intake, adherence to Dietary Approaches to Stop Hypertension (DASH)-style diet (highest quintile of DASH diet score), and no diuretic use. MAIN OUTCOMES AND MEASURES Population attributable risks (PARs) for incident gout meeting the preliminary American College of Rheumatology survey criteria, overall and stratified by BMI. RESULTS We analyzed 44 654 men (mean [SD] age, 54.0 [9.8] years) with no history of gout at baseline. During 26 years of follow-up, 1741 (3.9%) developed incident gout. Among all participants, PAR for the 4 risk factors combined (BMI, diet, alcohol use, and diuretic use) was 77% (95% CI, 56%-88%). Among men with normal weight (BMI <25.0) and overweight (BMI 25.0-29.9), we estimated that more than half of incident gout cases (69% [95% CI, 42%-83%] and 59% [95% CI, 30%-75%], respectively) may have been prevented by the combination of DASH-style diet, no alcohol intake, and no diuretic use. However, among men with obesity (BMI ≥30), PAR was substantially lower and not significant (5% [95% CI, 0%-47%]). CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that addressing excess adiposity and other key modifiable factors has the potential to prevent the majority of incident gout cases among men. Men with obesity may not benefit from other modifications unless weight loss is addressed.
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Affiliation(s)
- Natalie McCormick
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Sharan K. Rai
- Arthritis Research Canada, Richmond, British Columbia, Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Na Lu
- Arthritis Research Canada, Richmond, British Columbia, Canada
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chio Yokose
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Gary C. Curhan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Division of Renal (Kidney) Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Hyon K. Choi
- Clinical Epidemiology Program, Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Boston
- The Mongan Institute, Department of Medicine, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
- Arthritis Research Canada, Richmond, British Columbia, Canada
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Roberts LW. Foreword: Snapshot 2020. Acad Med 2020; 95:S1. [PMID: 33626631 DOI: 10.1097/acm.0000000000003494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Ben Jemâa A, Ismail S, Baraketi E, Khouja N, Ayadi A, Grissa O, Hsinet J, Benzarti A. Occupational health in the face of the COVID-19 pandemic. Tunis Med 2020; 98:596-599. [PMID: 33480012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Rising KL, Powell RE, Cameron KA, Salzman DH, Papanagnou D, Doty AM, Latimer L, Piserchia K, McGaghie WC, McCarthy DM. Development of the Uncertainty Communication Checklist: A Patient-Centered Approach to Patient Discharge From the Emergency Department. Acad Med 2020; 95:1026-1034. [PMID: 32101919 PMCID: PMC7302334 DOI: 10.1097/acm.0000000000003231] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Clear communication with patients upon emergency department (ED) discharge is important for patient safety during the transition to outpatient care. Over one-third of patients are discharged from the ED with diagnostic uncertainty, yet there is no established approach for effective discharge communication in this scenario. From 2017 to 2019, the authors developed the Uncertainty Communication Checklist for use in simulation-based training and assessment of emergency physician communication skills when discharging patients with diagnostic uncertainty. This development process followed the established 12-step Checklist Development Checklist framework and integrated patient feedback into 6 of the 12 steps. Patient input was included as it has potential to improve patient-centeredness of checklists related to assessment of clinical performance. Focus group patient participants from 2 clinical sites were included: Thomas Jefferson University Hospital, Philadelphia, PA, and Northwestern University Hospital, Chicago, Illinois.The authors developed a preliminary instrument based on existing checklists, clinical experience, literature review, and input from an expert panel comprising health care professionals and patient advocates. They then refined the instrument based on feedback from 2 waves of patient focus groups, resulting in a final 21-item checklist. The checklist items assess if uncertainty was addressed in each step of the discharge communication, including the following major categories: introduction, test results/ED summary, no/uncertain diagnosis, next steps/follow-up, home care, reasons to return, and general communication skills. Patient input influenced both what items were included and the wording of items in the final checklist. This patient-centered, systematic approach to checklist development is built upon the rigor of the Checklist Development Checklist and provides an illustration of how to integrate patient feedback into the design of assessment tools when appropriate.
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Affiliation(s)
- Kristin L. Rising
- K.L. Rising is associate professor and director of acute care transitions, Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Rhea E. Powell
- R.E. Powell is associate professor, Department of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, and senior researcher, Mathematica, Princeton, New Jersey
| | - Kenzie A. Cameron
- K.A. Cameron is research professor, Department of Medical Education and Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - David H. Salzman
- D.H. Salzman is associate professor, Department of Emergency Medicine and Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Dimitrios Papanagnou
- D. Papanagnou is associate professor and vice chair for education, Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Amanda M.B. Doty
- A.M.B. Doty is a research coordinator, Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lori Latimer
- L. Latimer is a research coordinator, Department of Emergency Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Katherine Piserchia
- K. Piserchia is a clinical research coordinator, Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - William C. McGaghie
- W.C. McGaghie is professor, Department of Medical Education, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Danielle M. McCarthy
- D.M. McCarthy is associate professor, Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Middleton L, Tanuvasa AF, Pledger M, Grace N, Smiler K, Loto-Su'a TT, Cumming J. Corrigendum to: Widening participation of Māori and Pasifika students in health careers: evaluation of two health science academies. AUST HEALTH REV 2020; 43:360. [PMID: 32171337 DOI: 10.1071/ah17170_co] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective The aim of the present study was to evaluate the short-term outcomes of two health science academies established by a district health board in South Auckland, New Zealand, to create a health workforce pipeline for local Māori and Pasifika students.Methods A mixed-methods approach was used, involving background discussions with key informants to generate an initial logic model of how the academies work, followed by secondary analysis of students' records relating to retention and academic achievement, a survey of senior academy students' interest in particular health careers and face-to-face interviews and focus groups with students, families and teachers.Results Academy students are collectively achieving better academic results than their contemporaries, although selection decisions are likely to contribute to these results. Academies are retaining students, with over 70% of students transitioning from Year 11 to Years 12 and 13. Senior students are expressing long-term ambitions to work in the health sector.Conclusions Health science academies show promise as an innovative approach to supporting Māori and Pasifika students prepare for a career in the health professions. Evaluating the long-term outcomes of the academies is required to determine their contribution to addressing inequities in the local health workforce.What is known about the topic? Despite progress in health workforce participation for underrepresented indigenous and ethnic minority groups in New Zealand, significant disparities persist. Within this context, a workforce development pipeline that targets preparation of secondary school students is recommended to address identified barriers in the pursuit of health careers.What does this paper add? We provide an evaluation of an innovative district health board initiative supporting high school students that is designed to ensure their future workforce is responsive to the needs of the local community.What are the implications for practitioners? The findings have implications for decision makers in health workforce planning regarding the benefits of investing at an early stage of the workforce development pipeline in order to build an equitable and diverse health professions workforce.
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Affiliation(s)
- Laura Weiss Roberts
- Editor-in-chief, Academic Medicine Associate editor, Academic Medicine, and professor, Departments of Psychiatry and Medical Ethics, Baylor College of Medicine, Houston, Texas
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Lam JR, Liu B, Bhate R, Fenwick N, Reed K, Duffy JMN, Khalil A. Research priorities for the future health of multiples and their families: The Global Twins and Multiples Priority Setting Partnership. Ultrasound Obstet Gynecol 2019; 54:715-721. [PMID: 31600847 DOI: 10.1002/uog.20858] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 08/17/2019] [Accepted: 08/23/2019] [Indexed: 05/27/2023]
Affiliation(s)
- J R Lam
- Twins Research Australia, The University of Melbourne, Melbourne, Australia
| | - B Liu
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - R Bhate
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
| | - N Fenwick
- Twins and Multiple Births Association, London, UK
| | - K Reed
- Twins and Multiple Births Association, London, UK
| | - J M N Duffy
- Institute for Women's Health, University College London, London, UK
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - A Khalil
- Fetal Medicine Unit, St George's University Hospitals NHS Foundation Trust, University of London, London, UK
- Vascular Biology Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
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Downer MK, Kenfield SA, Stampfer MJ, Wilson KM, Dickerman BA, Giovannucci EL, Rimm EB, Wang M, Mucci LA, Willett WC, Chan JM, Van Blarigan EL. Alcohol Intake and Risk of Lethal Prostate Cancer in the Health Professionals Follow-Up Study. J Clin Oncol 2019; 37:1499-1511. [PMID: 31026211 PMCID: PMC6599404 DOI: 10.1200/jco.18.02462] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2019] [Indexed: 12/27/2022] Open
Abstract
PURPOSE It is unknown whether alcohol intake is associated with the risk of lethal (metastatic or fatal) prostate cancer. We examine (1) whether alcohol intake among men at risk of prostate cancer is associated with diagnosis of lethal prostate cancer and (2) whether intake among men with nonmetastatic prostate cancer is associated with metastasis or death. METHODS This prospective cohort study uses the Health Professionals Follow-Up Study (1986 to 2012). Our analysis of alcohol intake among men at risk of prostate cancer included 47,568 cancer-free men. Our analysis of alcohol intake among men with prostate cancer was restricted to 5,182 men diagnosed with nonmetastatic prostate cancer during follow-up. We examine the association of total alcohol, red and white wine, beer, and liquor with lethal prostate cancer and death. Multivariate Cox proportional hazards regression estimated hazard ratios (HRs) and 95% CIs. RESULTS Alcohol drinkers had a lower risk of lethal prostate cancer (any v none: HR, 0.84 [95% CI, 0.71 to 0.99]) without a dose-response relationship. Total alcohol intake among patients with prostate cancer was not associated with progression to lethal prostate cancer (any v none: HR, 0.99 [95% CI, 0.57 to 1.72]), whereas moderate red wine intake was associated with a lower risk (any v none: HR, 0.50 [95% CI, 0.29 to 0.86]; P trend = .05). Compared with none, 15 to 30 g/d of total alcohol after prostate cancer diagnosis was associated with a lower risk of death (HR, 0.71 [95% CI, 0.50 to 1.00]), as was red wine (any v none: HR, 0.74 [95% CI, 0.57 to 0.97]; P trend = .007). CONCLUSION Cancer-free men who consumed alcohol had a slightly lower risk of lethal prostate cancer compared with abstainers. Among men with prostate cancer, red wine was associated with a lower risk of progression to lethal disease. These observed associations merit additional study but provide assurance that moderate alcohol consumption is safe for patients with prostate cancer.
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Affiliation(s)
- Mary K. Downer
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Stacey A. Kenfield
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
- University of California, San Francisco, San Francisco, CA
| | - Meir J. Stampfer
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Kathryn M. Wilson
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | | | - Edward L. Giovannucci
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Eric B. Rimm
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Molin Wang
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lorelei A. Mucci
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Walter C. Willett
- Harvard T.H. Chan School of Public Health, Boston, MA
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - June M. Chan
- University of California, San Francisco, San Francisco, CA
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Affiliation(s)
- Lorelei Lingard
- Health Sciences Addition, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
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18
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Wise J. Baby care: RCOG finds average of seven factors behind each stillbirth, neonatal death, and brain injury. BMJ 2018; 363:k4792. [PMID: 30420410 DOI: 10.1136/bmj.k4792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kurtz DLM, Janke R, Vinek J, Wells T, Hutchinson P, Froste A. Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: a literature review. Int J Med Educ 2018; 9:271-285. [PMID: 30368488 PMCID: PMC6387770 DOI: 10.5116/ijme.5bc7.21e2] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [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: 03/31/2018] [Accepted: 10/17/2018] [Indexed: 05/23/2023]
Abstract
OBJECTIVES To review the research literature on cultural safety education within post-secondary health science programs. METHODS We conducted health and social science database searches from 1996-2016, using combined keywords: cultural competence or safety; teaching or curriculum; universities, polytechnics or professional programs; and Aboriginal or Indigenous. In dyads, authors selected, and reviewed studies independently followed by discussion and consensus to identify thematic linkages of major findings. RESULTS A total of 1583 abstracts and 122 full-text articles were reviewed with 40 selected for final inclusion. Publications from Australia, Canada, New Zealand and the United States described curriculum development and delivery. A variety of evaluation approaches were used including anecdotal reports, focus groups, interviews, course evaluations, reflective journals, pre-post surveys, critical reflective papers, and exam questions. Duration and depth of curricular exposure ranged from one day to integration across a six-year program. Changes in student knowledge, attitude, self-confidence, and behaviour when working with Indigenous populations were reported. Cultural safety education and application to practice were shown to be linked to improved relationships, healthier outcomes, and increased number of Indigenous people entering health education programs and graduates interested in working in diverse communities. CONCLUSIONS This review provides a summary of multidisciplinary didactic and experiential instructional approaches to cultural safety education and the impact on students, educators and Indigenous people. Institutional support, strategic planning and cultural safety curriculum policy within post-secondary settings and community engagement are imperative for positive student experiences, advocacy, and actions toward health equity and improved health for Indigenous people and communities.
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Affiliation(s)
- Donna Lee Marie Kurtz
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Robert Janke
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Jeanette Vinek
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Taylor Wells
- School of Nursing, Faculty of Health and Social Development, University of British Columbia Okanagan Kelowna, Canada
| | - Pete Hutchinson
- First Nations, Inuit and Métis Cancer Control, Canadian Partnership Against Cancer
| | - Amber Froste
- Okanagan Indian Band, Community Services and Development, Vernon, Canada
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Sreeramareddy CT, Ramakrishnareddy N, Rahman M, Mir IA. Prevalence of tobacco use and perceptions of student health professionals about cessation training: results from Global Health Professions Students Survey. BMJ Open 2018; 8:e017477. [PMID: 29804056 PMCID: PMC5988057 DOI: 10.1136/bmjopen-2017-017477] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Health professionals play an important role in providing advice to their patients about tobacco prevention and cessation. Health professionals who use tobacco may be deterred from providing cessation advice and counselling to their patients. We aimed to provide prevalence estimates of tobacco use among student health professionals and describe their attitudes towards tobacco cessation training. METHODS Country-wise aggregate data from the Global Health Professions Student Survey on 'current cigarette smoking' (smoking cigarettes on 1 or more days during the past 30 days), and 'current use of tobacco products other than cigarettes' (chewing tobacco, snuff, bidis, cigars or pipes, 1 or more days during the past 30 days) were analysed. For each WHO region, we estimated mean prevalence rates of tobacco use weighted by the population of the sampling frame and aggregate proportions for 'health professionals' role' and 'cessation training' indicators using 'metaprop' command on Stata V.11. RESULTS A total of 107 527 student health professionals participated in 236 surveys done in four health profession disciplines spanning 70 countries with response rates ranging from 40% to 100%. Overall, prevalence of smoking was highest in European countries (20% medical and 40% dental students) and the Americas (13% pharmacy to 23% dental students). Other tobacco use was higher in eastern Mediterranean (10%-23%) and European countries (7%-13%). In most WHO regions, ≥70% of the students agreed that health professionals are role models, and have a role in advising about smoking cessation to their patients and the public. Only ≤33% of all student health professionals in most WHO regions (except 80% dental students in the Eastern Mediterranean region) had received formal training on smoking cessation approaches and ≥80% of all students agreed that they should receive formal cessation training. CONCLUSIONS Tobacco control should take place together with medical educators to discourage tobacco use among student health professionals and implement an integrated smoking cessation training into health professions' curricula.
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Affiliation(s)
| | - N Ramakrishnareddy
- Department of Community Medicine, Bangalore Medical College and Research Institute, Fort, Bangalore, India
| | - Mahbubur Rahman
- Disease Control & Research (IEDCR), Institute of Epidemiology, Dhaka, Mohakali, Bangladesh
| | - Imtiyaz Ali Mir
- Physiotherapy, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia
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Oranye NO, Bennett J. Prevalence of work-related musculoskeletal and non-musculoskeletal injuries in health care workers: the implications for work disability management. Ergonomics 2018; 61:355-366. [PMID: 28756736 DOI: 10.1080/00140139.2017.1361552] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 11/21/2016] [Accepted: 07/24/2017] [Indexed: 06/07/2023]
Abstract
To compare the prevalence of musculoskeletal and non-musculoskeletal injuries in a cohort of workers in Manitoba health care sector, who made injury claims between 2002 and 2012. A retrospective study, using secondary data from WCB Manitoba. Logistic regression was used to determine odds ratios for nature of work-related injuries among different groups of workers. Idiopathic work-related musculoskeletal disorders (WMSD) constituted 74.6% of all the injury claims. Injury risks varied between worker groups, and a significant difference was found within the female group, χ2 = 13.4, p = 0.0094, but not among the males. Compared to the married, single workers were more likely to experience traumatic than idiopathic injuries (OR = 1.72, CI, 1.28, 2.29), and much higher risk of traumatic injuries than non-WMSD (OR = 1.93, CI, 1.31, 2.84). Work-related injury risks vary significantly across occupations and worker groups, with idiopathic injuries being higher in high physical tasks. Practitioner Summary: To compare musculoskeletal and non-musculoskeletal injuries among workers in health care sector, and explore the implications for work disability management. Retrospective study, using workers' compensation claims data. The risk of idiopathic work-related musculoskeletal disorders continue to be high compared to traumatic and non-musculoskeletal disorders, particularly in tasks that involved high physical activities.
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Affiliation(s)
- Nelson Ositadimma Oranye
- a Department of Occupational Therapy, College of Rehabilitation Sciences , University of Manitoba , Winnipeg , Canada
| | - Jayson Bennett
- a Department of Occupational Therapy, College of Rehabilitation Sciences , University of Manitoba , Winnipeg , Canada
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Mougeot F, Occelli P, Buchet-Poyau K, Robelet M, Touzet S, Michel P. The emergence of patient safety issues in France. Sante Publique 2017; 29:869-877. [PMID: 29473401 DOI: 10.3917/spub.176.0869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION The objective of this study was to elucidate the conditions of emergence of patient safety issues in the public debate and the limits to implementation of patient safety in the current health system. METHOD A narrative review of the international literature was conducted by searching PubMed, Cairn and Persée databases. RESULTS The database search retrieved 2,206 documents, 48 of which were included in the study. The theme of patient safety has spread worldwide, but emerged late in France. The delayed emergence of patient safety in France is essentially related to the euphemistic approach to the problem of patient safety, the difficulty of adopting systematic reasoning, the lack of human resources management levers and the ambiguous position of patients in relation to patient safety.
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Budke CA, Ferguson JA. Data Integration and e-Commerce Threats Challenging Providers. Mo Med 2017; 114:419-423. [PMID: 30228652 PMCID: PMC6139979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Graham YNH, Mansour D, Small PK, Hinshaw K, Gatiss S, Mahawar KK, McGarry K, Wilkes S. A Survey of Bariatric Surgical and Reproductive Health Professionals' Knowledge and Provision of Contraception to Reproductive-Aged Bariatric Surgical Patients. Obes Surg 2017; 26:1918-23. [PMID: 26801788 DOI: 10.1007/s11695-015-2037-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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] [Indexed: 01/14/2023]
Abstract
BACKGROUND Over 80 % of bariatric surgical patients are women with obesity in their reproductive years. Obesity adversely affects fertility; the rapid weight loss following bariatric surgery can increase fecundity. Current guidelines recommend avoiding pregnancy for up to 24 months following surgery, but little is known about current contraceptive care of women who undergo bariatric surgery. Two surveys were undertaken with bariatric surgical and contraceptive practitioners in England to establish current contraceptive practices in both groups. METHODS Two anonymous on-line surveys were sent to all 382 members of the British Obesity and Metabolic Surgery Society (BOMSS) and an estimated 300 contraceptive practitioners in the North East of England. RESULTS The BOMSS survey elicited a response rate of 17 % (n = 65), mainly from bariatric surgeons (n = 24 (36 %)). Most respondents (97 %) acknowledged the need to educate patients, but contraceptive information was only provided by 7 % (n = 4) of respondents in bariatric surgical clinics. Less than half of respondents were confident discussing contraception, and the majority requested further training, guidance and communication with contraceptive practitioners. The majority of respondents to the contraceptive practitioner survey were general practitioners (28 %, n = 20). Three quarters of respondents reported little knowledge of bariatric surgery, and many reported not seeing women with obesity requiring contraception before (66 %, n = 45) or after surgery (71 %, n = 49). CONCLUSIONS There is a need to increase knowledge levels of contraception within bariatric surgical teams and to understand why, despite increasing levels of bariatric surgery, women do not seem to be appearing for advice in contraceptive settings.
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Affiliation(s)
- Yitka N H Graham
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, Tyne and Wear, UK.
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK.
| | - Diana Mansour
- Department of Sexual Health, New Croft Centre, Newcastle upon Tyne NHS Hospitals Foundation Trust, Newcastle Upon Tyne, Tyne and Wear, UK
| | - Peter K Small
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Kim Hinshaw
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, Tyne and Wear, UK
- Department of Obstetrics and Gynaecology, Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Sarah Gatiss
- Department of Obstetrics and Gynaecology, Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Kamal K Mahawar
- Department of General Surgery, Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Ken McGarry
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, Tyne and Wear, UK
| | - Scott Wilkes
- Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, Tyne and Wear, UK
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Surgenor LJ, Diesfeld K, Kersey K, Ip M. Practitioner Health Issues Featuring Before New Zealand’s Health Practitioners Disciplinary Tribunal: An Analysis of Cases 2003-2014. J Law Med 2017; 24:590-596. [PMID: 30137755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Increasingly, the health and wellbeing of professionals is causing concern, particularly when it compromises the interests of those they serve. Often their health issues are reported when their conduct results in professional disciplinary action. In New Zealand, health practitioners who appeared before the Health Practitioners Disciplinary Tribunal for misconduct reported a range of physical and mental health conditions. This study of 288 decisions revealed the professions that reported diverse health issues, including categories of health issues, in published decisions between 2004 and 2014. The study also identified how frequently practitioners self-reported impairment or submitted health evidence from others of their physical and/or mental health status and/or their substance dependence. The study’s findings may be applied preventatively for the benefit of practitioners and the people they serve, thereby promoting the Health Practitioners Competence Assurance Act 2003 (NZ)’s emphasis on public safety.
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Gulumian M, Verbeek J, Andraos C, Sanabria N, de Jager P. Systematic Review of Screening and Surveillance Programs to Protect Workers from Nanomaterials. PLoS One 2016; 11:e0166071. [PMID: 27829014 PMCID: PMC5102462 DOI: 10.1371/journal.pone.0166071] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 10/21/2016] [Indexed: 12/25/2022] Open
Abstract
Background Screening and surveillance approaches for workers exposed to nanomaterials could aid in early detection of health effects, provide data for epidemiological studies and inform action to decrease exposure. The aim of this review is to identify such screening and surveillance approaches, in order to extract available data regarding (i) the studies that have successfully been implemented in present day, (ii) identification of the most common and/or toxic nano-related health hazards for workers and (iii) possible exposure surveillance markers. This review contributes to the current understanding of the risk associated with nanomaterials by determining the knowledge gap and making recommendations based on current findings. Methods A systematic review was conducted. PubMed and Embase were searched to identify articles reporting on any surveillance-related study that described both exposure to nanomaterials and the health indicators that were measured. Four reviewers worked in pairs to independently assess the eligibility of studies and risk of bias before extraction of data. Studies were categorised according to the type of study and the medical surveillance performed, which included the type of nanomaterial, any exposure details provided, as well as health indicators and biomarkers tested. Results Initially 92 studies were identified, from which 84 full texts were assessed for eligibility. Seven studies met all the inclusion criteria, i.e. those performed in Taiwan, Korea, Czech Republic and the US. Of these, six compared health indicators between exposed and unexposed workers and one study described a surveillance program. All studies were at a high risk of bias. Workers were exposed to a mix of nanomaterials in three studies, carbon-based nanomaterials in two studies, nano-silver in one study and nano-titanium oxide in the other study. Two studies did not find a difference in biomarkers between exposed and unexposed workers. In addition, differences in early effects on pulmonary function or neurobehavioral tests were not observed. One study found an increased prevalence of allergic dermatitis and “sneezing” in the exposed group. Conclusions This review of recently published data on surveillance studies proves that there is a gap in the current knowledge, where most of the surveillance-related studies reported do not follow a set format that provides the required information on ENM characterisation, the type of exposure and the measured indicators/biomarkers. Hence, there is very low quality evidence that screening and surveillance might detect adverse health effects associated with workplace exposure. This systematic review is relevant because it proves that, although surveillance programs have been initiated and preliminary results are being published, the current studies are actually not answering the important questions or solving the overall problem regarding what the potential health hazards are among workers either handling or potentially exposed to ENMs. The recommendations, thus proposed, are based on an obvious need for (i) exposure registries, where longitudinal follow-up studies should inform surveillance, (ii) known exposure measurements or summary indices for ENMs as a reference (iii) validation of candidate biomarkers and (iv) studies that compare the effects of these surveillance approaches to usual care, e.g. those commonly followed for bulk-size hazardous materials.
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Affiliation(s)
- Mary Gulumian
- Department of Toxicology and Biochemistry, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
- * E-mail:
| | - Jos Verbeek
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Charlene Andraos
- Department of Toxicology and Biochemistry, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Natasha Sanabria
- Department of Toxicology and Biochemistry, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
| | - Pieter de Jager
- Department of Epidemiology and Surveillance, National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa
- School of Public Health, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
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Menichetti J, Libreri C, Lozza E, Graffigna G. Giving patients a starring role in their own care: a bibliometric analysis of the on-going literature debate. Health Expect 2016; 19:516-26. [PMID: 25369557 PMCID: PMC5055237 DOI: 10.1111/hex.12299] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patient-centred care has been advocated as a key component of high-quality patient care, yet its meanings and related actions have been difficult to ascertain. OBJECTIVE To map the use of different terms related to the process of giving patients a starring role in their own care and clarify the possible boundaries between terms that are often mixed. METHODS A literature search was conducted using different electronic databases. All records containing the search terms 'patient engagement', 'patient activation', 'patient empowerment', 'patient involvement', 'patient adherence', 'patient compliance' and 'patient participation' were collected. Identified literature was then analysed using the Statistical Package for Social Science (SPSS). The number of yearly publications, most productive countries, cross-concepts articles and various scientific fields dealing with the multidisciplinary concepts were identified. RESULTS Overall, 58 987 papers were analysed. Correspondence analysis revealed three temporal trends. The first period (2002-2004) focused on compliance and adherence, the second period (2006-2009) focused on the relationship between participation and involvement, and the third one (2010-2013) emphasized empowerment. Patient activation and patient engagement followed the temporal development trend connected to the 'immediate future'. DISCUSSION AND CONCLUSIONS The bibliometric trend suggests that the role of patient in the health-care system is changing. In the last years, the patient was viewed as a passive receptor of medical prescription. To date, the need to consider patients as active partners of health-care planning and delivery is growing. In particular, the term patient engagement appears promising, not only for its increasing growth of interest in the scholarly debate, but also because it offers a broader and better systemic conceptualization of the patients' role in the fruition of health care. To build a shared vocabulary of terms and concepts related to the active role of patients in the health-care process may be envisaged as the first operative step towards a concrete innovation of health-care organizations and systems.
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Affiliation(s)
- Julia Menichetti
- Faculty of PsychologyUniversitá Cattolica del Sacro CuoreMilanoItaly
| | - Chiara Libreri
- Faculty of PsychologyUniversitá Cattolica del Sacro CuoreMilanoItaly
| | - Edoardo Lozza
- Faculty of PsychologyUniversitá Cattolica del Sacro CuoreMilanoItaly
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Jaunin-Stalder N. [Of women and health]. Rev Med Suisse 2015; 11:2201. [PMID: 26742247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Durieux-Paillard S, Gaspoz JM. [Response]. Rev Med Suisse 2015; 11:2201. [PMID: 26742248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Boekeloo BO, Jones C, Bhagat K, Siddiqui J, Wang MQ. The Role of Intrinsic Motivation in the Pursuit of Health Science-Related Careers among Youth from Underrepresented Low Socioeconomic Populations. J Urban Health 2015; 92:980-94. [PMID: 26369541 PMCID: PMC4608932 DOI: 10.1007/s11524-015-9987-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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] [Indexed: 10/23/2022]
Abstract
A more diverse health science-related workforce including more underrepresented race/ethnic minorities, especially from low socioeconomic backgrounds, is needed to address health disparities in the USA. To increase such diversity, programs must facilitate youth interest in pursuing a health science-related career (HSRC). Minority youth from low socioeconomic families may focus on the secondary gains of careers, such as high income and status, given their low socioeconomic backgrounds. On the other hand, self-determination theory suggests that it is the intrinsic characteristics of careers which are most likely to sustain pursuit of an HSRC and lead to job satisfaction. Intrinsic and extrinsic motivation for pursuing an HSRC (defined in this study as health professional, health scientist, and medical doctor) was examined in a cohort of youth from the 10th to 12th grade from 2011 to 2013. The sample was from low-income area high schools, had a B- or above grade point average at baseline, and was predominantly: African American (65.7 %) or Hispanic (22.9 %), female (70.1 %), and children of foreign-born parents (64.7 %). In longitudinal general estimating equations, intrinsic motivation (but not extrinsic motivation) consistently predicted intention to pursue an HSRC. This finding provides guidance as to which youth and which qualities of HSRCs might deserve particular attention in efforts to increase diversity in the health science-related workforce.
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Affiliation(s)
- Bradley O Boekeloo
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 255 Valley Drive, Room 2360, College Park, MD, 20742, USA.
| | - Chandria Jones
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 255 Valley Drive, Room 2360, College Park, MD, 20742, USA
| | - Krishna Bhagat
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 255 Valley Drive, Room 2360, College Park, MD, 20742, USA
| | - Junaed Siddiqui
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 255 Valley Drive, Room 2360, College Park, MD, 20742, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland School of Public Health, 255 Valley Drive, Room 2360, College Park, MD, 20742, USA
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Durieux-Paillard S, Gaspoz JM. [Women and women's health]. Rev Med Suisse 2015; 11:1731. [PMID: 26591784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Andreotti G, Hoppin JA, Hou L, Koutros S, Gadalla SM, Savage SA, Lubin J, Blair A, Hoxha M, Baccarelli A, Sandler D, Alavanja M, Beane Freeman LE. Pesticide Use and Relative Leukocyte Telomere Length in the Agricultural Health Study. PLoS One 2015. [PMID: 26196902 PMCID: PMC4510132 DOI: 10.1371/journal.pone.0133382] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Some studies suggest that telomere length (TL) may be influenced by environmental exposures, including pesticides. We examined associations between occupational pesticide use reported at three time points and relative telomere length (RTL) in the Agricultural Health Study (AHS), a prospective cohort study of pesticide applicators in Iowa and North Carolina. RTL was measured by qPCR using leukocyte DNA from 568 cancer-free male AHS participants aged 31-94 years with blood samples collected between 2006 and 2008. Self-reported information, including pesticide use, was collected at three time points: enrollment (1993-1997) and two follow-up questionnaires (1998-2003, 2005-2008). For each pesticide, we evaluated cumulative use (using data from all three questionnaires), and more recent use (using data from the last follow-up questionnaire). Multivariable linear regression was used to examine the associations between pesticide use (ever, lifetime days, intensity-weighted lifetime days (lifetime days*intensity score)) and RTL, adjusting for age at blood draw and use of other pesticides. Of the 57 pesticides evaluated with cumulative use, increasing lifetime days of 2,4-D (p-trend=0.001), diazinon (p-trend=0.002), and butylate (p-trend=0.01) were significantly associated with shorter RTL, while increasing lifetime days of alachlor was significantly associated with longer RTL (p-trend=0.03). Only the association with 2,4-D was significant after adjustment for multiple comparisons. Of the 40 pesticides evaluated for recent use, malathion was associated with shorter RTL (p=0.03), and alachlor with longer RTL (p=0.03). Our findings suggest that leukocyte TL may be impacted by cumulative use and recent use of certain pesticides.
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Affiliation(s)
- Gabriella Andreotti
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
- * E-mail:
| | - Jane A. Hoppin
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Lifang Hou
- Department of Preventive Medicine and Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Shahinaz M. Gadalla
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Sharon A. Savage
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Jay Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Mirjam Hoxha
- Department of Clinical Sciences and Community Health, Center of Molecular and Genetic Epidemiology, University of Milan, Milan, Italy
| | - Andrea Baccarelli
- Laboratory of Environmental Epigenetics, Exposure Epidemiology and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Dale Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH/DHHS, Research Triangle Park, North Carolina, United States of America
| | - Michael Alavanja
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States of America
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Barsky E. [A new directory of health careers]. Soins 2015:7. [PMID: 26126361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Chevillotte J. [Nurse, a profession that has a hard time moving forward]. Rev Infirm 2015; 64:1. [PMID: 26145415 DOI: 10.1016/j.revinf.2015.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Warnet S. [State of the art in health professions]. Rev Infirm 2014:6. [PMID: 26043529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Stephenson J, Patel D, Barrett G, Howden B, Copas A, Ojukwu O, Pandya P, Shawe J. How do women prepare for pregnancy? Preconception experiences of women attending antenatal services and views of health professionals. PLoS One 2014; 9:e103085. [PMID: 25058333 PMCID: PMC4109981 DOI: 10.1371/journal.pone.0103085] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/27/2014] [Indexed: 11/30/2022] Open
Abstract
MAIN OBJECTIVE To determine the extent to which women plan and prepare for pregnancy. METHODS Cross-sectional questionnaire survey of pregnant women attending three maternity services in London about knowledge and uptake of preconception care; including a robust measure of pregnancy planning, and phone interviews with a range of health care professionals. MAIN RESULTS We recruited 1173/1288 (90%) women, median age of 32 years. 73% had clearly planned their pregnancy, 24% were ambivalent and only 3% of pregnancies were unplanned. 51% of all women and 63% of those with a planned pregnancy took folic acid before pregnancy. 21% of all women reported smoking and 61% reported drinking alcohol in the 3 months before pregnancy; 48% of smokers and 41% of drinkers reduced or stopped before pregnancy. The 51% of all women who reported advice from a health professional before becoming pregnant were more likely to adopt healthier behaviours before pregnancy [adjusted odds ratios for greatest health professional input compared with none were 2.34 (95% confidence interval 1.54-3.54) for taking folic acid and 2.18 (95% CI 1.42-3.36) for adopting a healthier diet before pregnancy]. Interviews with 20 health professionals indicated low awareness of preconception health issues, missed opportunities and confusion about responsibility for delivery of preconception care. SIGNIFICANCE OF THE FINDINGS Despite a high level of pregnancy planning, awareness of preconception health among women and health professionals is low, and responsibility for providing preconception care is unclear. However, many women are motivated to adopt healthier behaviours in the preconception period, as indicated by halving of reported smoking rates in this study. The link between health professional input and healthy behaviour change before pregnancy is a new finding that should invigorate strategies to improve awareness and uptake of pre-pregnancy health care, and bring wider benefits for public health.
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Affiliation(s)
- Judith Stephenson
- Reproductive Medicine, Institute of Women's Health, UCL, London, United Kingdom
| | - Dilisha Patel
- Reproductive Medicine, Institute of Women's Health, UCL, London, United Kingdom
| | - Geraldine Barrett
- Health Sciences and Social Care, Brunel University, Uxbridge, United Kingdom
| | - Beth Howden
- Reproductive Medicine, Institute of Women's Health, UCL, London, United Kingdom
| | - Andrew Copas
- Infection & Population Health, Institute of Epidemiology, UCL, London, United Kingdom
| | - Obiamaka Ojukwu
- Reproductive Medicine, Institute of Women's Health, UCL, London, United Kingdom
| | - Pranav Pandya
- University College London Hospitals, London, United Kingdom
| | - Jill Shawe
- Reproductive Medicine, Institute of Women's Health, UCL, London, United Kingdom
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Herzog J, Pohn B, Forjan M, Sauermann S, Urbauer P. Education for eHealth--a status analysis. Stud Health Technol Inform 2014; 198:172-179. [PMID: 24825700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
eHealth is not only a growing market, but also an important factor for new healthcare systems. National and European initiatives implicitly demand a higher level of knowledge in the areas of healthcare, engineering and management. As part of the eLearning4eHealth project an initial web based study was performed concentrating on European and global eHealth related educational programs. The results show that eHealth related courses do not evenly exist for the identified professions. 43% of the offered programs are focused on the engineering sector, whereas only 21% are available for the management sector. In order to offer compatible and comparable state of knowledge in the identified fields of profession and knowledge, further educational programs may be necessary. Despite the found shortcomings, results have shown that international activities have started in order to close the gaps and improve the quality of knowledge in the interdisciplinary field of eHealth.
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Affiliation(s)
- Juliane Herzog
- Department of Information Engineering & Security, University of Applied Sciences Technikum Wien, Austria
| | - Birgit Pohn
- Department of Information Engineering & Security, University of Applied Sciences Technikum Wien, Austria
| | - Mathias Forjan
- Department of Biomedical Engineering, University of Applied Sciences Technikum Wien, Austria
| | - Stefan Sauermann
- Department of Biomedical Engineering, University of Applied Sciences Technikum Wien, Austria
| | - Philipp Urbauer
- Department of Information Engineering & Security, University of Applied Sciences Technikum Wien, Austria
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Sopoaga F, Zaharic T, Kokaua J, Ekeroma AJ, Murray G, van der Meer J. Pacific students undertaking the first year of health sciences at the University of Otago, and factors associated with academic performance. N Z Med J 2013; 126:96-108. [PMID: 24162634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM To describe Pacific students in the first year of health sciences at tertiary level, their academic performance, and factors associated with academic outcomes. METHOD Routinely collected data for students who enrolled in the Health Sciences First Year (HSFY) programme at the University of Otago between 2007 and 2011, including their school National Certificate in Educational Achievement (NCEA) results were obtained in anonymous form. Descriptive statistics were calculated and regression analyses were undertaken using SAS v9.2 software. RESULTS A small but increasing number of Pacific students are enrolling in health sciences at tertiary level. Pacific students had poorer performance compared to non-Pacific students in both NCEA and the HSFY programme. Factors associated with academic performance were gender, NCEA results, school decile, accommodation type, ethnicity, international status and disability. CONCLUSION Pacific students are under-represented in health sciences and would benefit from better preparation from school. Pacific solutions are required to improve academic outcomes over and above mainstream policy solutions. Tertiary institutions need to engage prospective students earlier to ensure they are well informed of requirements, and are appropriately prepared for study at the tertiary level.
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Affiliation(s)
- Faafetai Sopoaga
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.
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Affiliation(s)
- Ara Tekian
- associate professor and director of international affairs, University of Illinois at Chicago associate professor, Uniformed Services University of the Health Sciences
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Abstract
BACKGROUND High occupational suicide rates are often linked to easy occupational access to a method of suicide. This study aimed to compare suicide rates across all occupations in Britain, how they have changed over the past 30 years, and how they may vary by occupational socio-economic group. Method We used national occupational mortality statistics, census-based occupational populations and death inquiry files (for the years 1979-1980, 1982-1983 and 2001-2005). The main outcome measures were suicide rates per 100 000 population, percentage changes over time in suicide rates, standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs). RESULTS Several occupations with the highest suicide rates (per 100 000 population) during 1979-1980 and 1982-1983, including veterinarians (ranked first), pharmacists (fourth), dentists (sixth), doctors (tenth) and farmers (thirteenth), have easy occupational access to a method of suicide (pharmaceuticals or guns). By 2001-2005, there had been large significant reductions in suicide rates for each of these occupations, so that none ranked in the top 30 occupations. Occupations with significant increases over time in suicide rates were all manual occupations whereas occupations with suicide rates that decreased were mainly professional or non-manual. Variation in suicide rates that was explained by socio-economic group almost doubled over time from 11.4% in 1979-1980 and 1982-1983 to 20.7% in 2001-2005. CONCLUSIONS Socio-economic forces now seem to be a major determinant of high occupational suicide rates in Britain. As the increases in suicide rates among manual occupations occurred during a period of economic prosperity, carefully targeted suicide prevention initiatives could be beneficial.
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Affiliation(s)
- S E Roberts
- College of Medicine, Swansea University, Swansea, UK.
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Abstract
This study examined the motivations for entering the field and sexual attitudes, experiences, and behavior of an international group of sexuality professionals. Participants were 252 individuals attending the XVII World Congress of Sexology who completed a questionnaire in English, Spanish or French. Most participants' reported professional rather than personal motivations for entering the field in addition to interest. On average, participants reported little sexual communication with their parents as children. About one-third had experienced unwanted sexual activity as a child. Participants were mostly accepting of a range of sexual activities, although they were less accepting of some behaviors than of others. Twelve of the participants who had engaged in sexual activity with a casual or anonymous partner in the previous 2 years had not used a condom consistently. Participants reported high sexual satisfaction and good sexual communication with their partner. Nevertheless, 45% of the women and 35% of the men reported regularly experiencing one or more sexual problems. Few participants reported that their profession affected their sexual functioning negatively; in contrast most reported that it had positive effects on their sexual functioning. These results suggest that there are few differences between sexuality professionals and the general public.
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Affiliation(s)
- Mijal Luria
- Hadassah University Hospital, Jerusalem, Israel
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Paliadelis PS, Parmenter G, Parker V, Giles M, Higgins I. The challenges confronting clinicians in rural acute care settings: a participatory research project. Rural Remote Health 2012; 12:2017. [PMID: 22803581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION In Australia, as in many other developed countries, the current healthcare environment is characterised by increasing differentiation and patient acuity, aging of patients and workforce, staff shortages and a varied professional skills mix, and this is particularly so in rural areas. Rural healthcare clinicians are confronted with a broad range of challenges in their daily practice. Within this context, the challenges faced by rural acute care clinicians were explored and innovative strategies suggested. This article reports the findings of a study that explored these challenges across disciplines in acute healthcare facilities in rural New South Wales (NSW), Australia. METHODS A mixed method approach, involving a consultative, participatory 3 stage data collection process was employed to engage with a range of healthcare clinicians from rural acute care facilities in NSW. Participants were invited to complete a survey, followed by focus group discussions and finally facilitated workshops using nominal group technique. RESULTS The survey findings identified the respondents' top ranked challenges. These were organised into four categories: (1) workforce issues; (2) access, equity and opportunity; (3) resources; and (4) contextual issues. Participants in the focus groups were provided with a summary of the survey findings to prompt discussion about the challenges identified and impact of these on their professional and personal lives. The results of the final workshop stage of the study used nominal group process to focus the discussion on identifying strategies to address identified challenges. CONCLUSIONS This study builds on research conducted in a large metropolitan tertiary referral hospital. While it was found that rural clinicians share some of the challenges identified by their metropolitan counterparts, some identified challenges and solutions were unique to the rural context and require the innovative solutions suggested by the participants. This article provides insight into the working world of rural healthcare clinicians and offers practical solutions to some of the identified issues. The findings of this study may assist rurally based healthcare services to attract and retain clinical staff.
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Affiliation(s)
- Penny S Paliadelis
- School of Health, University of New England, Armidale, New South Wales, Australia.
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Gaujoux-Viala C, Knevel R, Mandl P, Nagy G, Frank M, Machado P, Hatemi G, Buch MH, Aletaha D, Gossec L. Who are the young professionals working in the field of rheumatology in Europe and what are their needs? An EMEUNET (EMerging EUlar NETwork) survey. Ann Rheum Dis 2012; 71:1432-3. [PMID: 22586170 DOI: 10.1136/annrheumdis-2011-201266] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Vlasova EM, Alekseev VB. [Features of bone and muscular diseases in accordance with physical exertion level in workers]. Med Tr Prom Ekol 2012:36-39. [PMID: 23461189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The authors studied changes in development and structure of bone and muscular disorders in industrial workers of Perm area. The workers' examination considered features of physical overload during the working process. The authors revealed developmental peculiarities of bone and muscular system in various occupational groups of metallurgists, oil extractors, machinery building workers. The article shows necessity of interdisciplinary approach and observation of the workers to prevent progression of bone and muscular disorders.
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SNM 2020 Task Force Assesses Environment for Profession, Society. J Nucl Med 2011; 52:18N. [PMID: 22144509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
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Casas I, Esteve M, Guerola R, García-Olivé I, Ruiz-Manzano J. [A study of tuberculosis infection in workers at a university general hospital: associated factors and evolution in 20 years]. Arch Bronconeumol 2011; 47:541-6. [PMID: 21944896 DOI: 10.1016/j.arbres.2011.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 07/01/2011] [Accepted: 07/09/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the prevalence of tuberculous infection (TI) in the health-care workers of a hospital over the course of a 20-year period and analyze the associated risk factors. SUBJECTS AND METHODS A cross-sectional, descriptive study of the workers of a general hospital from 1988 until 2007, using a tuberculin test (TT) and questionnaire. RESULTS 2,179 workers were studied (mean age 32.4 years (SD 8.4). 24.5% worked in areas at risk for tuberculosis (TB). 8.1% (174) were vaccinated with BCG. The prevalence of positive baseline TT was 25.7% (95% confidence interval: 23.8-27.4%). There was a greater percentage of positive TT in the 1988-1992 period (44.2%) and a smaller percentage (15.8%) in the 2003-2007 period (P<.0001). The prevalence of TI was 1.53 times greater in males and 1.89 in those vaccinated with BCG. When compared with resident physicians, the prevalence of TI was greater in the rest of the professional categories, while increasing 1.03 times per year that age increases and 1.05 times per year of professional activity. CONCLUSIONS The data provide relevant information about the evolution of TI in hospital professionals over the course of a 20-year period. The prevalence decreased during the study period, probably due to a decrease in the incidence of TB in the reference community and to improved prevention measures and nosocomial control.
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Affiliation(s)
- Irma Casas
- Servicio de Medicina Preventiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
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Puett RC, Hart JE, Suh H, Mittleman M, Laden F. Particulate matter exposures, mortality, and cardiovascular disease in the health professionals follow-up study. Environ Health Perspect 2011; 119:1130-5. [PMID: 21454146 PMCID: PMC3237347 DOI: 10.1289/ehp.1002921] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Accepted: 03/31/2011] [Indexed: 04/14/2023]
Abstract
BACKGROUND The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes. OBJECTIVES In this study we explored these associations in the all-male Health Professionals Follow-Up Study prospective cohort. METHODS The same spatiotemporal exposure estimation models, similar outcomes, and biennially updated covariates were used as those previously applied in the female Nurses' Health Study cohort. RESULTS Among 17,545 men residing in the northeastern and midwestern United States, there were 2,813 deaths, including 746 cases of fatal coronary heart disease (CHD). An interquartile range change (4 µg/m3) in average exposure to PM ≤ 2.5 µm in diameter in the 12 previous months was not associated with all-cause mortality [hazard ratio (HR) = 0.94; 95% confidence interval (CI), 0.87-1.00] or fatal CHD (HR = 0.99; 95% CI, 0.87-1.13) in fully adjusted models. Findings were similar for separate models of exposure to PM ≤ 10 µm in diameter and PM between 2.5 and 10 µm in diameter and for copollutant models. CONCLUSIONS Among this cohort of men with high socioeconomic status living in the midwestern and northeastern United States, the results did not support an association of chronic PM exposures with all-cause mortality and cardiovascular outcomes in models with time-varying covariates. Whether these findings suggest sex differences in susceptibility or the protective impact of healthier lifestyles and higher socioeconomic status requires additional investigation.
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Affiliation(s)
- Robin C Puett
- South Carolina Cancer Prevention and Control Program and Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
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Proiskos A, Loukidou E, Kamposioras K, Bristianou M, Zina V, Pliadi O, Karakatsanis A, Alexiou G, Gkougkoutsi A, Mauri D. Screening chest radiography in primary care: An underestimated belief. Eur J Gen Pract 2010; 11:76-7. [PMID: 16392781 DOI: 10.3109/13814780509178242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kleszczewska E, Łogwiniuk K, Jaszczuk A. [The evaluation study of knowledge and attitudes related to smoking habit among students of Cosmetology]. Przegl Lek 2010; 67:969-971. [PMID: 21360939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Modern European health education programmes place particular emphasis on the issue of tobacco-related diseases. It is a direct result of research studies showing that nicotine dependence and its consequences are a very important problem of modern European societies. In Poland the epidemic of chronic noncontagious diseases related to the inhalation of cigarette smoke remains a major health problem and a threat to public health condition. It is confirmed by a high number of premature deaths and complications following the course of malicious tumors, cardiovascular diseases, nonneoplastic respiratory diseases and by the deaths of infants born to mothers smoking during pregnancy. In 2006, first survey concerning smoking among university students was held at the Institute of Cosmetology and Health Care in Bialystok. Given all these arguments and the fact that the School is a medical university, in the 2006/2007 academic year a preventive health programme called "Healthy Bialystok 2006-2009" was introduced. It is addressed to both regular and extramural students of the following courses: Cosmetology, Emergency Medical, Nursing and Physiotherapy at the Institute of Cosmetology and Health Care in Bialystok. The main objective is to encourage students either not to smoke or give up smoking, and if this is impossible- to minimize the effects of smoking and to promote a healthy lifestyle. In the 2009/2010 academic year, the survey covered all first year students majoring in Cosmetology at the Institute of Cosmetology and Health Care in Bialystok. Test-takers were guaranteed anonymity. The questionnaire consisted of questions about the origins and reasons of smoking, number of cigarettes smoked per day, environment of the surveyed, knowledge of tobacco-related diseases and attempts to give up the habit.
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Affiliation(s)
- Ewa Kleszczewska
- Katedra Kosmetologii, Wyzsza Szkoła Kosmetologii i Ochrony Zdrowia, Białystok.
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Schoenfisch AL, Dement JM, Rodríguez-Acosta RL. Demographic, clinical and occupational characteristics associated with early onset of delivery: findings from the Duke Health and Safety Surveillance System, 2001-2004. Am J Ind Med 2008; 51:911-22. [PMID: 18942663 DOI: 10.1002/ajim.20637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND This cross-sectional study explores associations between preterm delivery and demographic, clinical and occupational characteristics of women employed within a university and health system. METHODS A comprehensive surveillance system linking individual-level data from Human Resources, medical insurance claims and a job-exposure matrix was used to identify women with a single live birth between 2001 and 2004 and describe maternal characteristics during pregnancy. RESULTS Preterm delivery occurred in 7.1% (n = 74) of the 1,040 women, a lower preterm delivery prevalence than observed in the general U.S. population. Nearly all (>99.5%) women utilized prenatal care services. Prevalence of preterm delivery was highest for inpatient nurses, nurses' aides and office staff. In multivariate analyses, preterm delivery was positively associated with several clinical conditions: placenta previa, diabetes and cardiovascular disorder/disease. CONCLUSIONS We observed associations between preterm delivery and several previously indicated clinical conditions. Further study of the effect of job characteristics on preterm delivery is warranted.
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Affiliation(s)
- Ashley L Schoenfisch
- Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27705, USA.
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