scholarly journals A refinement of clinical tumour marker monitoring - why not use an inverse value of doubling time?

2021 ◽  
Author(s):  
Gintaras Zaleskis ◽  
Paulius Bosas ◽  
Albertas Ulys ◽  
Daiva Dabkevičiene ◽  
Neringa Dobrovolskiene ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Doubling Time ◽  
Specific Antigen ◽  
Elimination Rate ◽  
Life Time ◽  
Tumour Marker ◽  
Growth Fraction ◽  
Care Providers ◽  
Primary Health Care Providers ◽  
Large Numbers

The aim of this study was to compare prostate specific antigen (PSA) kinetics – half life time (HT), doubling time (DT) and elimination rate PSA (ePSA) in prostate cancer monitoring. We report that implementation of inverse value (ePSA) rather than HT or DT has distinct advantages: (1) values are valid when PSA is unchanged (ePSA equals zero), (2) the concept of ePSA is easily comprehendible – it is a growth fraction, (3) ePSA fluctuates in a narrow range – easy to interpret, no large numbers, (4) no mathematical flaws (no positive skewing). Exploring ePSA norm as < 0% might help to timely spot a biochemical recurrence (BCR). Primary health care providers (PHCP) tend to habitually use an irrelevant PSA threshold – 4.0 ng/ml in postoperative follow-up. The delayed referrals of patients in remission might be reduced if PHCPs adopt an ePSA.

Risk factors for glaucoma: what do they really mean?

2011 ◽  
Vol 17 (3) ◽  
pp. 233 ◽  
Author(s):  
Anthea Worley ◽  
Karen Grimmer-Somers
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Risk Factor ◽  
Health Care Providers ◽  
Management Strategies ◽  
Care Providers ◽  
Reference Guide ◽  
Future Assessment ◽  
Primary Health Care Providers ◽  
Patient’S History

Glaucoma is an insidious eye disease, potentially putting 4% of older Australians at risk of blindness, unless detected sufficiently early for initiation of effective treatment. This paper reports on the strengths of evidence and glaucoma risk factors that can be identified by primary health care providers from a patient’s history. A comprehensive search of peer-reviewed databases identified relevant secondary evidence published between 2002 and 2007. Risk factors that could be determined from a patient’s history were identified. A novel glaucoma risk factor reference guide was constructed according to evidence strength and level of concern regarding risk of developing glaucoma. The evidence is strong and consistent regarding the risk of developing glaucoma, and elevated intraocular pressure, advancing age, non-Caucasian ethnicity and family history of glaucoma. There is moderate evidence of association with glaucoma, and migraine, eye injury, myopia and long-term use of corticosteroids. There is conflicting evidence for living in a rural location, high blood pressure, diabetes and smoking. Early detection of people at risk of developing glaucoma can be initiated using our risk factor guide coupled with a comprehensive patient history. Timely future assessment and subsequent management strategies for at-risk individuals can then be effectively and efficiently actioned.

scholarly journals MALAYSIAN DIABETES PATIENTS’ PERCEPTIONS, ATTITUDES AND PRACTICES IN RELATION TO SELF-CARE AND ENCOUNTERS WITH PRIMARY HEALTH CARE PROVIDERS

2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Attitudes And Practices ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Primary Healthcare Clinics ◽  
Diabetes Patients

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.

scholarly journals Non-invasive prenatal testing: what an obstetrician needs to know

2020 ◽  
Vol 9 (12) ◽  
pp. 5200
Author(s):  
Mishu Mangla
Keyword(s):  
Health Care Providers ◽  
Prenatal Screening ◽  
Prenatal Testing ◽  
High Sensitivity ◽  
Target Population ◽  
Care Providers ◽  
Advantages And Disadvantages ◽  
Non Invasive ◽  
Primary Health Care Providers ◽  
First Choice

No field in obstetrics has seen such fast advancement, as the field of prenatal screening and diagnosis. A wide variety of tests are available today, and this at times becomes confusing both for the patient and the treating doctor that which screening test would be best suited in the given circumstances. Non-invasive prenatal screening, with its numerous advantages is rapidly becoming the test of first choice, especially in the affording set of population.  Although, the test has a very high sensitivity and a very good positive predictive value, this too suffers from some disadvantages which should be clear to the obstetrician ordering the test. A good knowledge about the test, the ideal target population in which this should be offered as the primary screening tool and limitations of the test should be known to all practicing obstetricians and primary health care providers. The current review aims to provide a simplified and updated knowledge regarding non-invasive prenatal testing (NIPT), its major advantages and disadvantages and summarizes the role of ultrasound in patients with negative NIPT.

scholarly journals IUCD-Related Knowledge, Attitudes and Practice among Primary Health Care Providers in Oman: Areas for Improvement

2020 ◽  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Side Effects ◽  
Health Care Providers ◽  
Factual Knowledge ◽  
Care Providers ◽  
Primary Health ◽  
Attitude And Practice ◽  
Primary Health Care Providers ◽  
Knowledge Attitude And Practice

Objectives: The primary objective of this study is to assess three domains - the knowledge, attitude and practice related to the Intrauterine Contraceptive Device (IUCD) among primary health care providers (physicians and nurses) in Oman. The secondary objective is to compare the IUCD-related knowledge, attitude and practice of health care providers in primary health care between physicians and nurses. Methods: A descriptive cross-sectional survey was conducted in primary health care centers in Muscat region of Oman from May, 2014 until September, 2015. The survey was a self-administered questionnaire contained questions to assess factual knowledge, attitudes and practice of IUCD. The questionnaire was distributed to female health care providers only. Data was collected by researchers and analyzed using SPSS version 20. Results: Total 269 primary health care providers completed the questionnaire. 109 (40.52%) participants had good and 131 (48.70%) had average actual knowledge related to IUCD. The main reasons providers cited for not recommending the IUCD were concerns about the side effects; 174 (64.68%) mentioned that it causes bleeding and 127 (47.21%) reported that it needs service provider. Only 140 (52.43%) of the providers would routinely recommend IUCD to their clients. Conclusion: Future educational programs for health care providers should address the educational needs in the identified areas including misconceptions with regards to IUCD failure rate and side effects. Future training programs are also required to increase the technical competence of insertion and confidence in handling the side effects of IUCD.

Evaluation of the Risk of Therapy-Associated Complications in Survivors of Hodgkin Lymphoma

Hematology ◽  
2007 ◽  
Vol 2007 (1) ◽  
pp. 192-196 ◽  
Author(s):  
Lois B. Travis
Keyword(s):  
Hodgkin Lymphoma ◽  
Health Care Providers ◽  
Late Effects ◽  
Disease Risk ◽  
Risk Measures ◽  
Epidemiologic Study ◽  
Incidence Rates ◽  
Care Providers ◽  
Large Numbers ◽  
Study Designs

Abstract Given the improvements in survival of patients with Hodgkin lymphoma (HL) in the last three decades, quantification of the late effects of successful treatment has become critical. Since the highest incidence rates of HL occur at ages 20 to 34 years, large numbers of patients remain at lifelong risk for the late effects of treatment. Deaths due to second cancers are now the most common cause of mortality among long-term survivors of HL, followed by cardiac disease. Risk measures of these and other late sequelae, however, can vary markedly between investigations, depending on the types of treatment, the rigor with which epidemiologic study designs are applied, ascertainment of events of interest, the duration and completeness of follow-up, and consideration of competing risks. Further, numerous influences apart from therapy can affect late effects, including patient age, sex, race, lifestyle factors (tobacco, alcohol, diet), comorbidities, and the underlying cancer process. In the future, it will become increasingly important for health-care providers to be able to critically evaluate the risk of late effects in HL survivors, which will include a working knowledge of various epidemiologic study designs and risk measures and an ability to judiciously review the medical literature. In this article, the methods, significance and caveats in calculating and reporting risks of complications of treatment for HL are reviewed.

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