Patient evaluation of gynaecological information provision and preferences.

AIM: To evaluate gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. DESIGN: A descriptive cross-sectional survey design was used. METHODS: A total of 293 women accessing gynaecological services responded to the survey. Quantitative analysis included descriptive and inferential statistics. Content analysis was conducted on qualitative data. RESULTS: Health professionals were the most common and preferred sources of gynaecological health information. Enablers to information provision included positive communication strategies by health professionals, participants having prior knowledge and doing their own research. Despite its widespread availability, only 24.2% of women preferred the internet as an information source. Poor communication and inadequate information provision were identified as barriers to information access. Statistically significant associations were identified between location of residence, education level, year of birth, diagnostic group and health information preferences. Recommendations from women included improved communication strategies, system changes and provision of individualized information. CONCLUSION: Health professionals are central to women accessing information about gynaecological diagnoses. Areas for improvement include communication strategies, facilitating access to internet-based resources for information and consideration of women's preferences when providing health information. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: Consumer co-design of gynaecological health information and communication training for health professionals is recommended. Improved communication and facilitated use of internet-based resources may improve women's understanding of information. IMPACT: This study explored gynaecological patients' preferences and satisfaction regarding information provision, exploring enablers and barriers to information access. It was found that gynaecological patients preferred individualized information provided to them directly by health professionals and despite its widespread availability, the internet is an underutilized health information resource. These findings are applicable to health professionals and patients utilizing tertiary gynaecological health services in Australia but may be generalized if demographic data aligns with other jurisdictions. REPORTING METHOD: The STROBE reporting method was used in the preparation of the manuscript. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

The sexual and reproductive health knowledge of women in Australia: A scoping review.

ISSUE ADDRESSED: Sexual and reproductive health (SRH) knowledge influences health literacy and promotes positive health behaviours. This scoping review explores the SRH knowledge of women in Australia and reports on knowledge assessment, ways of learning, enablers and barriers, and interventions to improve knowledge. METHODS: Seven databases were searched for eligible articles published in English between 2012 and 2022. RESULTS: Eighty-five sources were included for analysis. Data were mapped by knowledge topic and population group and charted against four review objectives. Assessment of knowledge was the primary focus in 59% of sources. Two sources used a validated knowledge assessment tool. Knowledge was assessed using self-assessment, a measurement of correctness, or both. Women learnt about SRH through a range of sources, including healthcare providers, peers, family, internet, and school. Enablers and barriers spanned information content, delivery, timing, accessibility, interactions with those providing information, cultural and gendered norms, pre-migration experiences, and functional health literacy. Nine sources reported on interventions to facilitate SRH knowledge. CONCLUSIONS: This review identified topics, population groups, and gaps in assessment of SRH knowledge of women in Australia. Overall, the measurement of women's SRH knowledge is largely conducted using unvalidated tools focusing on specific topics. SO WHAT?: It is recommended a validated tool be developed to comprehensively assess the SRH knowledge of women in Australia allowing for intersectional population analysis and exploration of knowledge conceptualisation. This would enable assessment of interventions aiming to improve SRH knowledge thereby facilitating improved health literacy and outcomes.

Prevalence and potential predictors of gambling disorder among people living with HIV.

Specific subsets of the adult population are at an increased risk of problem gambling behaviors. Previous research among these subsets has found increased rates of disordered gambling among those with drug use, alcohol use, mood, anxiety, and personality disorders. To what extent this may apply to the HIV population, known to have a high burden of co-occurring substance use and mental disorders, is not known The current study also examined the effectiveness of The Brief Biosocial Gambling Screen (BBGS) for the diagnosis of gambling disorder. This study examined the prevalence of gambling behaviors and disordered gambling in patients enrolled in an urban HIV clinic. 100 people living with HIV (PLWH) were assessed on gambling behaviors, impulsivity, and criterion on disordered gambling. Screening for gambling disorder using the BBGS was compared to the American Psychiatric Association DSM-5 criterion. The mean age was 53, 44% were female, 60% completed high school or above, and 80% self-identified as unemployed/disabled. 13% met four or more criteria for gambling disorder according to DSM-5 criteria. Participants that met criteria were more likely to report marijuana (p = .044) and heroin (p = .002) use, and greater impulsivity (p < 0.00001) when compared to participants who did not meet criteria. The BBGS was able to effectively screen individuals for disordered gambling with a sensitivity of 100%, specificity of 90.8%, positive predictive value of 56.2%, and a negative predictive value of 100%. These results suggest that urban HIV clinics may need to consider actively screening for gambling disorders, and referring to appropriate counseling and treatment for those who screen positive.

Evaluating the impact of a specialized and centralized online medical consultation system for paramedics: pilot study.

INTRODUCTION: There are many limitations to utilizing on-duty emergency department (ED) physicians as Base Hospital Physicians for paramedic telephone consultations. We aimed to examine the impact of a specialized and centralized Online Medical Consultation program for paramedic consultations on system-relevant performance. METHODS: This is a before-after study with concurrent control using health record review of audio recordings over a 6-month period before and after implementation of the Online Medical Consultation program. The primary outcome was the duration of paramedic consultation calls. The secondary outcomes included number of calls with orders that contradicted existing medical directives, number of calls with orders outside of paramedic scope of practice, number of calls with Base Hospital Physician requiring clarification on medical directives, and number of calls with Base Hospital Physician interrupting the paramedic during the call. RESULTS: We included 220 consultation calls. The patients' mean age was 54.5 years. Most consultation calls (70.5%) were for mandatory consultations and 22.7% were voluntary. Most consultations were related to cardiac arrest (43.6%), combative patients (15.0%), and analgesia (13.6%). Before-after comparisons for total call duration showed that mean call duration decreased in Ottawa from 4:28 to 4:05 min (p = 0.77) and decreased in Kingston from 4:50 to 4:13 min (p = 0.49). There were no significant differences in our secondary outcomes. CONCLUSIONS: The Online Medical Consultation program was implemented and removed the responsibility of responding to online medical consultations for on-duty emergency physicians in Ottawa. The total call duration was not significantly different between groups. Additional time intervals and adherence to protocol benefits were also not statistically significant due to low baseline incidence.

RéSUMé: INTRODUCTION: Il existe de nombreuses limites à l'utilisation des médecins en service d'urgence (DE) comme médecins de base pour les consultations téléphoniques des ambulanciers paramédicaux. Nous avons cherché à examiner l'impact d'un programme de consultation médicale en ligne spécialisé et centralisé pour les consultations paramédicales sur le rendement pertinent du système. MéTHODES: Il s'agit d'une étude avant-après avec contrôle simultané utilisant l'examen du dossier de santé des enregistrements audio sur une période de 6 mois avant et après la mise en œuvre du programme de consultation médicale en ligne. Le principal résultat était la durée des appels de consultation des paramédicaux. Les résultats secondaires comprennent le nombre d'appels avec des ordonnances qui contredisent les directives médicales existantes, le nombre d'appels avec des ordonnances en dehors du champ de pratique paramédical, le nombre d'appels avec un médecin de l'hôpital de base demandant des éclaircissements sur les directives médicales, et nombre d'appels avec le médecin de l'hôpital de base interrompant le paramédical pendant l'appel. RéSULTATS: Nous avons inclus 220 consultations. L'âge moyen des patients était de 54,5 ans. La plupart des consultations (70,5 %) étaient obligatoires et 22,7 % volontaires. La plupart des consultations étaient liées à l'arrêt cardiaque (43,6 %), aux patients combatifs (15,0 %) et à l'analgésie (13,6 %). Les comparaisons avant-après pour la durée totale des appels ont montré que la durée moyenne des appels a diminué à Ottawa de 4 h 28 à 4 h 05 min (p=0,77) et à Kingston de 4 h 50 à 4 h 13 min (p=0,49). Il n'y avait pas de différences significatives dans nos résultats secondaires. CONCLUSIONS: Le programme de consultation médicale en ligne a été mis en œuvre et a éliminé la responsabilité de répondre aux consultations médicales en ligne pour les médecins urgentistes en service à Ottawa. La durée totale de l'appel n'était pas significativement différente entre les groupes. Les intervalles de temps supplémentaires et l'adhésion aux avantages du protocole n'étaient pas non plus statistiquement significatifs en raison de la faible incidence initiale.

Ocular surface indicators and biomarkers in chronic ocular graft-versus-host disease: a prospective cohort study.

This longitudinal cohort study compared ocular surface indicators in forty allogeneic hematopoietic stem cell transplant (HSCT) subjects with twenty healthy controls at baseline and identified changes in ocular graft-versus-host disease (oGVHD). Outcome measures included: Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer's test, Oxford corneal staining score, tear break-up time (TBUT), and tear and serum biomarkers (IFN-γ, IL-10, MMP-9, IL-12, IL-13, IL-17α, IL-1ß, IL-2, IL-4, IL-6, IL-8, CXCL10, MCP-1, MIP-1α, RANTES, TNF-α). At baseline the HSCT group had higher median Oxford corneal staining score (1.7 vs. 0.0; P < 0.0001), higher tear TNF-α (20.0 vs. 11.2 pg/mL; P < 0.0001), lower tear RANTES (70.4 vs. 190.2 pg/mL; P < 0.0001), higher serum IL-8 (10.2 vs. 4.5 pg/mL; P = 0.0008), and higher serum TNF-α (8.7 vs. 4.2 pg/mL; P < 0.0001). The incidence of oGVHD was 62% and associated changes included increased Oxford corneal staining score (4.6 vs. 1.8, P = 0.0001), decreased Schirmer's test (3.0 vs. 10.0; P < 0.0001), and decreased TBUT (4.7 vs. 9.0 s; P = 0.0004). Baseline differences in ocular surface indicators suggest a tendency toward ocular dryness in individuals with hematologic disorders preparing for HSCT. Individuals who developed oGVHD showed changes in corneal staining score, Schirmer's test, and TBUT.

"Why Me?" Understanding the HCV Care Continuum Among People With Serious Mental Illness.

OBJECTIVE: Despite possible cure rates of >90% with new treatment, people with serious mental illness are rarely screened for hepatitis C virus (HCV). A colocated approach may help patients navigate the care continuum. METHODS: This study used a mixed-methods approach to increase understanding of the HCV care continuum for people with mental illness (N=170). Quantitative data included laboratory testing, risk assessments, and chart reviews. Qualitative interviews (N=9) were conducted to gain a broader understanding. RESULTS: Thirty-one (18%) patients tested positive for HCV; 13 were cured of HCV, and 10 are still receiving treatment. Qualitative interviews revealed that fear of the diagnosis may be an important treatment barrier. CONCLUSIONS: Those with serious mental illness who were diagnosed as having HCV and received the colocated prevention and treatment program were able to navigate the continuum of care for HCV treatment. Fear of diagnosis may be an important consideration for future efforts.

Trends by age in youth physical activity: Youth Media Campaign Longitudinal Survey.

PURPOSE: This study aimed to characterize longitudinal age trajectories across 5 yr in the prevalence of free-time and organized physical activity participation among US youth by sex, race, and parental education. METHODS: Study participants were a nationally representative sample of youth, 9-13 yr old in 2002, who participated in the Centers for Disease Control and Prevention's Youth Media Campaign Longitudinal Survey. Baseline data were collected in 2002. Attrition for the next 4 yr resulted in an overall response rate of 23% by 2006 (n = 1623). The survey collected information concerning respondents' frequency of participation in free-time and organized physical activities outside school. Organized activities were defined as activities involving a coach, instructor, or other leader. Orthogonal polynomial contrasts were used to test for linear and quadratic trends in respondents' participation free-time and organized physical activity sessions during the previous 7 d over ages 9-17. Pairwise t-tests were used to determine whether age-specific estimates of participation rates differed significantly by sex, race, and parental education level. RESULTS: Free-time physical activity participation prevalence declined linearly from ages 9 to 17 in both sexes but also demonstrated a quadratic trajectory in boys, peaking at age 13. Organized physical activity demonstrated a quadratic trajectory and declined most notably after age 14 in both sexes. Free-time physical activity participation was lower in girls compared with boys between ages 12 and 16 (difference range = 12-17 percentage points). Both non-white youth and those with less educated parents had lower organized physical activity participation at most ages (difference range = 15-29 percentage points). CONCLUSIONS: Free-time and organized physical activity exhibit different trajectories between ages 9 and 17 and are subject to dissimilar demographic level variation.