scholarly journals Self-Management Maintenance Inhalation Therapy With eHealth (SELFIE): Observational Study on the Use of an Electronic Monitoring Device in Respiratory Patient Care and Research (Preprint)

2019 ◽  
Author(s):  
Esther Kuipers ◽  
Charlotte C Poot ◽  
Michel Wensing ◽  
Niels H Chavannes ◽  
Peter AGM de Smet ◽  
...  
Keyword(s):  
Observational Study ◽  
Positive Predictive Value ◽  
Health Care Providers ◽  
Predictive Value ◽  
Electronic Monitoring ◽  
False Negative ◽  
Inhalation Therapy ◽  
Care Providers ◽  
Convenience Sample ◽  
Patient Reported

BACKGROUND Electronic inhalation monitoring devices (EIMDs) are available to remind patients with respiratory diseases to take their medication and register inhalations for feedback to patients and health care providers as well as for data collection in research settings. OBJECTIVE This study aimed to assess the validity as well as the patient-reported usability and acceptability of an EIMD. METHODS This observational study planned to include 21 community pharmacies in the Netherlands. Patient-reported inhalations were collected and compared to EIMD registrations to evaluate the positive predictive value of these registrations as actual patient inhalations. Patients received questionnaires on their experiences and acceptance. RESULTS A convenience sample of 32 patients was included from across 18 pharmacies, and 932 medication doses were validated. Of these, 796 registrations matched with patient-reported use (true-positive, 85.4%), and 33 inhalation registrations did not match with patient-reported use (false-positive, 3.5%). The positive predictive value was 96.0%, and 103 patient-reported inhalations were not recorded in the database (false-negative, 11.1%). Overall, patients considered the EIMD to be acceptable and easy to use, but many hesitated to continue its use. Reminders and motivational messages were not appreciated by all users, and more user-tailored features in the app were desired. CONCLUSIONS Patients’ interaction with the device in real-world settings is critical for objective measurement of medication adherence. The positive predictive value of this EIMD was found to be acceptable. However, patients reported false-negative registrations and a desire to include more user-tailored features to increase the usability and acceptability of the EIMD.

scholarly journals Men’s perceptions of sexual and reproductive health education within the context of pregnancy and HIV in Zambia: a descriptive qualitative analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tulani Francis L. Matenga ◽  
Joseph Mumba Zulu ◽  
Sharon Nkwemu ◽  
Perfect Shankalala ◽  
Karen Hampanda
Keyword(s):  
Reproductive Health ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Sexual And Reproductive Health ◽  
Decision Makers ◽  
Care Providers ◽  
Convenience Sample ◽  
Essential Information ◽  
Women Living With Hiv ◽  
The Family

Abstract Background Although health care providers are beginning to focus on men’s roles as fathers and husbands, there is limited understanding of how men view their ability to promote sexual and reproductive health in families affected by HIV and their experiences with receiving education through antenatal care. This paper aims to explore men’s perceptions of the education they need regarding sexual and reproductive health within the family in the context of HIV. Methods We interviewed a convenience sample of 18 male partners of pregnant women living with HIV in Lusaka, Zambia. Atlas.ti was used to facilitate data management and content analysis. Results Men reported being the primary decision-makers regarding sexual and reproductive issues in the family; however, they admitted far-reaching unmet needs in terms of information on sexual and reproductive health in the context of HIV. Most men felt that antenatal care was not a conducive setting to fully educate men on sexual and reproductive health because it is a woman’s space where their health concerns were generally neglected. There was a strong desire for more education that was specific to men’s sexual and reproductive health, especially because all the couples were affected by HIV. Men especially requested education on sexual preparedness, safe sex, the use of condoms in sero-concordant and sero-discordant relationships and general health information. Although men stated they were the main decision-makers regarding sexual and reproductive issues such as pregnancy, most men were not confident in their ability to promote sexual and reproductive health in the family because of limited knowledge in this area. Conclusion There is need to change the environment and messaging of antenatal care, as well as offer relevant education opportunities outside health facility settings to empower men with essential information for meaningful involvement in sexual and reproductive health in the context of HIV.

scholarly journals Evaluation of the Carba NP Test for Rapid Detection of Carbapenemase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

2013 ◽  
Vol 57 (9) ◽  
pp. 4578-4580 ◽  
Author(s):  
Nathalie Tijet ◽  
David Boyd ◽  
Samir N. Patel ◽  
Michael R. Mulvey ◽  
Roberto G. Melano
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Rapid Detection ◽  
False Negative ◽  
Bacterial Extract ◽  
Content Type ◽  
Negative Results ◽  
False Negative Results

ABSTRACTThe Carba NP test was evaluated against a panel of 244 carbapenemase- and non-carbapenemase-producingEnterobacteriaceaeandPseudomonas aeruginosaisolates. We confirmed the 100% specificity and positive predictive value of the test, but the sensitivity and negative predictive value were 72.5% and 69.2%, respectively, and increased to 80% and 77.3%, respectively, using a more concentrated bacterial extract. False-negative results were associated with mucoid strains or linked to enzymes with low carbapenemase activity, particularly OXA-48-like, which has emerged globally in enterobacteria.

scholarly journals Preferences and Perceptions of Patients Attending Emergency Departments with Low Acuity Problems in Hong Kong

2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer
Keyword(s):  
Health Care ◽  
Hong Kong ◽  
Health Care Providers ◽  
Waiting Time ◽  
Health Care Professionals ◽  
Waiting Times ◽  
Medical Advice ◽  
Care Providers ◽  
Convenience Sample ◽  
Waiting Area

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

Extended Breastfeeding in Poland: Knowledge of Health Care Providers and Attitudes on Breastfeeding Beyond Infancy

2018 ◽  
Vol 35 (2) ◽  
pp. 371-380 ◽  
Author(s):  
Barbara Baranowska ◽  
Marta Malinowska ◽  
Ewelina Stanaszek ◽  
Dorota Sys ◽  
Grażyna Bączek ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Professionals ◽  
Further Education ◽  
Self Report ◽  
Care Providers ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Level Of Knowledge ◽  
The Relationship

Background: Extended breastfeeding is rare in Poland, and lack of acceptance and understanding is often evident in public opinion. The ability to provide reliable information about breastfeeding beyond infancy depends on health professionals’ levels of knowledge and attitudes. They are considered by most parents in Poland to be authorities in the field of child nutrition. Research aims: To determine (1) the level of knowledge and the attitudes of Polish health professionals towards extended breastfeeding; (2) the relationship between personal breastfeeding experience and attitudes towards extended breastfeeding; and (3) the relationship between knowledge about breastfeeding beyond twelve months and attitudes towards breastfeeding beyond infancy. Methods: A one-group prospective, cross-sectional, self-report style survey was used. The convenience sample ( N = 495) comprised gynaecologists, neonatologists and midwives. Data were collected via an online questionnaire and the results were analyzed with the use of descriptive statistics, a chi-square independence test, Fisher’s exact test, post-hoc testing, and two-part tables using SPSS. Results: Most of the respondents (76.7%; n = 384) had a low level of knowledge about the benefits of breastfeeding beyond twelve months and even emphasized that this nutritional choice could have negative impacts. There was a positive correlation ( F = 105.847; p = < .01) between levels of knowledge and respondents’ attitudes towards breastfeeding beyond infancy. Attitudes were also influenced by the length of time respondents had breastfed. Conclusion: Healthcare providers have an insufficient level of knowledge about extended breastfeeding and need further education in this area.

scholarly journals FALSE-NEGATIVE DENGUE CASES IN RORAIMA, BRAZIL: AN APPROACH REGARDING THE HIGH NUMBER OF NEGATIVE RESULTS BY NS1 AG KITS

2014 ◽  
Vol 56 (5) ◽  
pp. 447-450 ◽  
Author(s):  
Pablo O. A. Acosta ◽  
Fabiana Granja ◽  
Cátia A. Meneses ◽  
Ismael A. S. Nascimento ◽  
Débora D. Sousa ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Secondary Infection ◽  
Dengue Infection ◽  
False Negative ◽  
Laboratory Data ◽  
Detection Methods ◽  
Lower Sensitivity ◽  
Care Providers ◽  
Qrt Pcr ◽  
Ns1 Antigen

Serum samples from 150 NS1-negative (Platelia ELISA) patients presumptively diagnosed with dengue were analyzed by the TaqMan probed real-time reverse transcription PCR (TaqMan qRT-PCR) method. The qRT-PCR positive samples were tested for serotype by semi-nested RT-PCR and a qualitative immunochromatographic assay for IgG and IgM. Molecular detection methods showed 33 (22%) positive samples out of 150 NS1-antigen negative samples. Of these, 72% were collected up to day 2 after the onset of symptoms, when diagnostic sensitivity of NS1-antigen test assays is significantly enhanced. Most of the cases were not characterized as secondary infection. Twenty-eight samples were successfully serotyped, 75% of which for DENV-4, 14% for DENV-2, 7% for DENV-3 and 4% for DENV-1. These findings reaffirm the hyperendemic situation of the state of Roraima and suggest a lower sensitivity of the NS1 test, mainly when DENV-4 is the predominant serotype. Health care providers should therefore be aware of samples tested negative by NS1 antigen assays, especially when clinical symptoms and other laboratory data results show evidence of dengue infection.

scholarly journals Outcome and complications of self-administration of over-the-counter abortion pills: an observational study in a tertiary care hospital of a medical college in New Delhi

2021 ◽  
Vol 10 (8) ◽  
pp. 3148
Author(s):  
Anjali Singh ◽  
Sruthi Bhaskaran ◽  
Anshuja Singla
Keyword(s):  
Observational Study ◽  
Health Care Providers ◽  
Tertiary Care ◽  
New Delhi ◽  
Care Hospital ◽  
Care Providers ◽  
Self Administration ◽  
Over The Counter ◽  
Gynecology And Obstetrics ◽  
Medical Termination

Background: Due to unrestricted free availability of abortion pills, despite of national policies, guidelines and medical termination of pregnancy (MTP) act, unsafe abortions by self-administration of these drugs for termination of unwanted pregnancies without prescription are becoming common in our country, leading to associated morbidity and mortality.Methods: A prospective Observational study was done at Guru Teg Bahadur hospital, university college of medical sciences, New Delhi, from November 2019 to April 2020, in the department of gynecology and obstetrics, on women visiting the outpatient department and casualty department with the history of self-administration of medical termination pills without prescription. This study was done to study the outcome and complications occurring due to self-administration of over-the-counter abortion pills that are freely available in the market. 95 women were included in study and data was collected regarding age, education level, parity, presenting complaints, complications and their management. Descriptive analysis of the collected data was done.Results: In this study 95 women were included 71.6% took pills before 8 weeks of gestation, 1% took in second trimester. 46.3% landed up in incomplete abortion and 33.68% needed surgical evacuation, 8.42% had ectopic out, 2.1% had scar site pregnancy and 7.36% needed laparotomy, 1.05% had rupture uterus followed by abortion pill intake while 1.05% suffered from acute kidney injury (AKI). There was no ICU admission nor any mortality.Conclusions: There is urgent need of strict legislation to curtail this bad practice and free availability of over-the-counter abortion pills which leads to unexpected morbidity and mortality, such drugs should be given only by health care providers under supervision, there is need of community level awareness so as to impart knowledge regarding this problem. 

scholarly journals “Take the treatment and be brave”: Care experiences of pregnant women with rifampicin-resistant tuberculosis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242604
Author(s):  
Marian Loveday ◽  
Sindisiwe Hlangu ◽  
Jennifer Furin
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Health Care System ◽  
Health Care Providers ◽  
Physical Symptoms ◽  
Coding System ◽  
Care Providers ◽  
Convenience Sample ◽  
Care System

Background There are few data on the on the care experiences of pregnant women with rifampicin-resistant TB. Objective To describe the treatment journeys of pregnant women with RR-TB—including how their care experiences shape their identities—and identify areas in which tailored interventions are needed. Methods In this qualitative study in-depth interviews were conducted among a convenience sample from a population of pregnant women receiving treatment for RR-TB. This paper follows COREQ guidelines. A thematic network analysis using an inductive approach was performed to analyze the interview transcripts and notes. The analysis was iterative and a coding system developed which focused on the care experiences of the women and how these experiences affected their perceptions of themselves, their children, and the health care system in which treatment was received. Results Seventeen women were interviewed. The women described multiple challenges in their treatment journeys which required them to demonstrate sustained resilience (i.e. to “be brave”). Care experiences required them to negotiate seemingly contradictory identities as both new mothers—“givers of life”—and RR-TB patients facing a complicated and potentially deadly disease. In terms of their “pregnancy identity” and “RR-TB patient identity” that emerged as part of their care experiences, four key themes were identified that appeared to have elements that were contradictory to one another (contradictory areas). These included: 1) the experience of physical symptoms or changes; 2) the experience of the “mothering” and “patient” roles; 3) the experience of the care they received for their pregnancy and their RR-TB; and 4) the experience of community engagement. There were also three areas that overlapped with both roles and during which identity was negotiated/reinforced and they included: 1) faith; 2) socioeconomic issues; and 3) long-term concerns over the child’s health. At times, the health care system exacerbated these challenges as the women were not given the support they needed by health care providers who were ill-informed or angry and treated the women in a discriminatory fashion. Left to negotiate this confusing time period, the women turned to faith, their own mothers, and the fathers of their unborn children. Conclusion The care experiences of the women who participated in this study highlight several gaps in the current health care system that must be better addressed in both TB and perinatal services in order to improve the therapeutic journeys for pregnant women with RR-TB and their children. Suggestions for optimizing care include the provision of integrated services, including specialized counseling as well as training for health care providers; engagement of peer support networks; provision of socioeconomic support; long-term medical care/follow-up for children born to women who were treated for RR-TB; and inclusion of faith-based services in the provision of care.

Transcutaneous Bilirubin Measurements in Full-Term Infants

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 464-467 ◽  
Author(s):  
M. Jeffrey Maisels ◽  
Sarah Conrad
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Positive ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
False Negative ◽  
Full Term ◽  
Bilirubin Concentration ◽  
Term Infants ◽  
Transcutaneous Bilirubin

A total of 292 transcutaneous bilirubin (TcB) measurements were performed in 157 white full-term infants: 157 were obtained from the forehead and 135 from the midsternum. TcB measurements correlated well with serum bilirubin determinations (r = .93, P &lt; .0001). The sensitivity of the test was 100% and the specificity 97%. It was possible to establish guidelines for the TcB measurement which identified all infants whose serum bilirubin concentrations exceeded 12.9 mg/100 ml (221 µmoles/liter) with no false-negative and only five false-positive determinations (3%). The positive predictive value for the TcB measurements was 58%. This implies that, in our population, an infant with a TcB index ≥24 has a 58% chance of having a serum bilirubin concentration &gt;12.9 mg/100 ml. The negative predictive value was 100%. Thus, a negative test will correctly predict the absence of hyperbilirubinemia in all cases. As these measurements were obtained prospectively in a well-baby population with a prevalence of hyperbilirubinemia (&gt;12.9 mg/100 ml) of 4.5%, the positive predictive value should be applicable to other similar populations and will, in fact, increase in populations with a higher prevalence of hyperbilirubinemia. TcB measurements can be recommended for the identification of significant neonatal jaundice in full-term infants. It is important to recognize, however, that because of potential variations in TcB meters as well as serum bilirubin measurements in different laboratories, each institution should establish its own criteria for the use of this instrument.

Providing medical care for suspected human trafficking victims: Perceptions among a cohort of health care providers in Myanmar

2020 ◽  
Author(s):  
Sybil Zachariah ◽  
Ashish Sharma ◽  
Corey B Bills ◽  
Htoo Ma (Tony) Ohn ◽  
Rebecca Walker
Keyword(s):  
Health Care ◽  
Human Trafficking ◽  
Health Care Providers ◽  
Sex Trafficking ◽  
Healthcare Providers ◽  
Forced Labor ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Convenience Sample ◽  
Trafficking Victims

Abstract Background: Myanmar is a source country for men, women, and children who are subject to human trafficking and forced labor. Given that human trafficking and forced labor victims frequently experience physical and mental health concerns, healthcare practitioners have a unique opportunity to identify and assist victims. This study aims to understand the attitudes, perspectives, and levels of comfort for healthcare providers in caring for victims of human trafficking. It also seeks to understand the types of additional educational resources that could better equip medical personnel to improve care for survivors of human trafficking.Methods: A 20-question survey collected data anonymously from a convenience sample of healthcare providers that attended a one-day emergency care conference in Yangon, Myanmar.Results: While a significant number (70%) of medical professionals surveyed reported that they feel the problem of abuses for labor or sex in the community was "serious" or "very serious", a majority of them felt neutral or uncomfortable about identifying patients that are currently being abused in some way. Only 2% of respondents felt comfortable identifying victims of abuse. Over half of the healthcare workers surveyed indicated they would be interested in attending conferences, symposia, or lectures specific to human trafficking and receiving training in identifying victims and assisting victims of exploitation.Conclusions: Health care providers in Myanmar consider labor and sex trafficking as a significant problem in their community, but do not feel adequately trained to identify and help victims of exploitation. Given that even brief educational interventions can increase providers knowledge and self-reported recognition of human trafficking victims, there is a window of opportunity in Myanmar to provide training to currently practicing health providers.

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