Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 30.979
Filtrar
1.
Braz. j. biol ; 84: e255916, 2024. tab, graf
Artigo em Inglês | LILACS-Express | MEDLINE, LILACSEXPRESS, LILACS, VETINDEX | ID: biblio-1364509

RESUMO

Abstract This study aims at reporting the indigenous knowledge of the medicinal flora from the inhabitants of surroundings of the World's largest artificial planted forest "Changa Manga", Pakistan. Data were collected by direct interviews and group meetings from 81 inhabitants including 32 local healers having information regarding the use of indigenous medicinal plants over a period of one year. Different statistical tools were applied to analyze the data including Frequency citation (FC), Relative frequency citation (RFC), Use Value, Factor of informants consensus and fidelity level. This study reported 73 plant species belonging to 37 plant families and 46 genera. The majority of plant species belong to compositae family. The most commonly used medicinal plants were P. hysterophorus L., P. dactylifera L., S. indicum L, P. harmala L., P. emblica L., and A. indica A.Juss. The greatest number of species was used to cure gastrointestinal disorders. The highest fidelity level (68.18%) was of E. helioscopia to cure gastrointestinal disorders. Maximum fresh uses (17) were reported by C. dactylon (L.) Pars. While the highest number of species reporting fresh uses in similar number was 13. In this study, five novel plants are being reported for the first time in Pakistan for their ethnomedicinal worth. Our data reflect unique usage of the medicinal plants in the study area. The statistical tools used in the study proved useful in pointing the most important and disease category specific plants. High use value plant and the new reported medicinal plants might prove an important source of the isolation of pharmacologically active compounds.


Resumo Este estudo tem como objetivo relatar o conhecimento indígena sobre a flora medicinal dos habitantes do entorno da maior floresta artificial plantada do mundo, a Changa Manga, no Paquistão. Os dados foram coletados por meio de entrevistas diretas e reuniões em grupo de 81 habitantes, incluindo 32 curandeiros locais, com informações sobre o uso de plantas medicinais indígenas durante o período de um ano. Diferentes ferramentas estatísticas foram aplicadas para analisar os dados, incluindo citação de frequência (FC), citação de frequência relativa (RFC), valor de uso, fator de consenso dos informantes e nível de fidelidade. Este estudo relatou 73 espécies de plantas pertencentes a 37 famílias de plantas e 46 gêneros. A maioria das espécies de plantas pertence à família Compositae. As plantas medicinais mais utilizadas foram P. hysterophorus L., P. dactylifera L., S. indicum L., P. harmala L., P. emblica L. e A. indica A. Juss. O maior número de espécies foi usado para curar distúrbios gastrointestinais. O maior nível de fidelidade (68,18%) foi de E. helioscopia para cura de distúrbios gastrointestinais. Os usos máximos em fresco (17) foram relatados por C. dactylon (L.) Pars. enquanto o maior número de espécies relatando usos frescos em número semelhante foi de 13. Neste estudo, cinco novas plantas estão sendo relatadas pela primeira vez no Paquistão por seu valor etnomedicinal. Nossos dados refletem o uso exclusivo das plantas medicinais na área de estudo. As ferramentas estatísticas utilizadas no estudo mostraram-se úteis para apontar as plantas mais importantes e específicas da categoria de doença. Plantas de alto valor de uso e as novas plantas medicinais relatadas podem ser uma importante fonte de isolamento de compostos farmacologicamente ativos.

2.
Cureus ; 14(2): e22629, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35371834

RESUMO

Healthcare simulation is a technique that creates a situation or environment that allows persons to experience a representation of a real health care event for the purpose of practice, learning, evaluation, or gaining an understanding of systems or human actions. The use of healthcare simulation has grown rapidly over the last decade. In this review, we describe the global healthcare simulation economy. We reviewed the literature describing the global healthcare simulation economy using four research databases (Google Scholar, MEDLINE, Embase, and EconLit) as well as alternative sources. The specific aims were to examine the major economic themes facing the healthcare simulation economy. We found that the global healthcare simulation market is segmented based on product & services, fidelity, end-user, and geography. The market has experienced new player entry over the last few years, with most businesses focused in North America, Europe, and Asia-Pacific. The global healthcare simulation market is expected to reach between $3.19 and $7.7 billion by 2027, with a compound annual growth rate of 14.6% to 17.8%. Political and trade issues between America and China may increase the cost of goods in the short term. There are no global regulations on the use of healthcare simulation for training, licensing, or certification. Therefore, individual countries, states, and healthcare specialties establish individual regulations. We conclude that the major economic issues facing the global healthcare simulation economy include market segmentation, the entry of new players, and differential global growth. These factors, plus recent political and trade issues, and lack of regulations, could impact decision-making.

3.
Front Psychiatry ; 13: 833865, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35370861

RESUMO

Objective: This paper used meta-regression to analyze the heterogenous factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) in China under the COVID-19 crisis. Method: We systematically searched PubMed, Embase, Web of Science, and Medrxiv and pooled data using random-effects meta-analyses to estimate the prevalence rates, and ran meta-regression to tease out the key sources of the heterogeneity. Results: The meta-regression results uncovered several predictors of the heterogeneity in prevalence rates among published studies, including severity (e.g., above severe vs. above moderate, p < 0.01; above moderate vs. above mild, p < 0.01), type of mental symptoms (PTSD vs. anxiety, p = 0.04), population (frontline vs. general HCWs, p < 0.01), sampling location (Wuhan vs. Non-Wuhan, p = 0.04), and study quality (p = 0.04). Conclusion: The meta-regression findings provide evidence on the factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) to guide future research and evidence-based medicine in several specific directions. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=220592, identifier: CRD42020220592.

4.
Front Psychiatry ; 13: 874729, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35492723

RESUMO

Healthcare workers face numerous occupational stressors, including some that may challenge personal and shared morals and values. This is particularly true during disasters and crises such as the COVID-19 pandemic, which require critical decisions to be made with little time and information often under personal distress and situational constraints. Consequently, healthcare workers are at risk for moral injuries characterized by stress-related and functional impacts. Although research on the evaluation and treatment of moral injury among military veterans burgeoned in the recent decade, addressing moral injury in healthcare workers and other civilians remains an important gap. In this perspective piece, we identify research gaps and make recommendations to advance future work on assessment, prevention, and treatment of moral injury in healthcare workers. We draw on empirical studies of moral injury in veterans, limited studies of moral injury in health professionals, and our clinical experiences with healthcare workers affected by moral injury.

5.
J Occup Rehabil ; 32(2): 157-160, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35657442

RESUMO

The systems that societies construct to support work disability prevention can have powerful effects on both the experiences of people with work disability as well as their health and employment outcomes. Comparative studies between jurisdictions provide an opportunity to gain insights into these system level impacts, by comparing system features, processes and experiences; and by determining if jurisdictional variation affects outcomes. In turn, this can prompt policy and practice reform. Reflecting the diversity of work disability systems globally, there is growing interest in cross-jurisdiction comparative research in the field. This special series presents seven articles addressing important methodological and conceptual aspects of comparative research in work disability prevention, and presents practical examples of how jurisdictions vary and the impact this can have on workers.


Assuntos
Pessoas com Deficiência , Emprego , Humanos
6.
Environ Res ; 213: 113609, 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35667403

RESUMO

BACKGROUND: Polychlorinated biphenyls and organochlorine pesticides are persistent organic pollutants (POPs) that had been banned or restricted in many countries, including Spain. However, their ubiquity still poses environmental and human health threats. OBJECTIVE: To longitudinally explore public healthcare costs associated with long-term exposure to a mixture of 8 POPs in a cohort of residents of two areas of Granada Province, Southern Spain. METHODS: Longitudinal study in a subsample (n = 385) of GraMo adult cohort. Exposure assessment was performed by analyzing adipose tissue POP concentrations at recruitment. Average primary care (APC) and average hospital care (AHC) expenditures of each participant over 14 years were estimated using the data from their medical records. Data analyses were performed by robust MM regression, weighted quantile sum regression (WQS) and G-computation analysis. RESULTS: In the adjusted robust MM models for APC, most POPs showed positive beta coefficients, being Hexachlorobenzene (HCB) significantly associated (ß: 1.87; 95% Confidence interval (95%CI): 0.17, 3.57). The magnitude of this association increased (ß: 3.72; 95%CI: 0.80, 6.64) when the analyses were restricted to semi-rural residents, where ß-HCH was also marginally-significantly associated to APC (ß: 3.40; 95%CI: -0.10, 6.90). WQS revealed a positive but non-significant mixture association with APC (ß: 0.14; 95%CI: -0.06, 0.34), mainly accounted for by ß-HCH (54%) and HCB (43%), that was borderline-significant in the semi-rural residents (ß: 0.23; 95%CI: -0.01, 0.48). No significant results were observed in G-Computation analyses. CONCLUSION: Long-term exposure to POP mixtures might represent a modifiable factor increasing healthcare costs, thus affecting the efficiency of the healthcare systems. However, and owing the complexity of the potential causal pathways and the limitations of the present study, further research is warranted to fully elucidate ascertain whether interventions to reduce human exposure should be considered in healthcare policies.

7.
Front Public Health ; 10: 787844, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35669757

RESUMO

Background: The negative consequences of childbearing on mothers are called the motherhood penalty, and it manifests in the aspects of women's physical and mental health. In May 2021, China relaxed its birth policy that allowed a married couple to have three children. It gives women the opportunity to have more children, but also may increase more risks to mothers' physical and mental health. Objectives: The objectives of this study were to clarify the relationships between the fertility and the physical/mental health of women of childbearing age and empirically confirm the existence of the motherhood health penalty in China. Materials and Methods: Using a nationally representative dataset from the China Labor-force Dynamics Survey 2018, we examined the effects of fertility on the physical and mental health of Chinese women of childbearing age. Physical health was self-rated, and mental health was assessed according to the Center for Epidemiological Studies Depression scale. The instrumental variable approach and the models of inverse probability of treatment weighting of propensity scores and regression adjustment were employed to overcome the endogeneity between fertility and health of women. Results: The empirical results showed that the total number of births had significant adverse impacts on the physical and mental health of women of childbearing age, which empirically demonstrated the existence of the motherhood health penalty in China. The results of heterogeneity analysis indicated that the physical and mental health of the rural women was more easily affected by childbearing compared with that of the urban samples. In a mechanism analysis, the pathways of income and the multiple roles played by mothers were found to mediate the impacts of the total number of births on the physical and mental health of women. The robustness checks showed that the results of this study were robust. Conclusions: The findings of this study extend the motherhood penalty to the health domain, and they have important implications for improving healthcare policy for women of childbearing age in China and other countries and regions and promoting gender equality in the healthcare field.


Assuntos
Fertilidade , Saúde Mental , Criança , China/epidemiologia , Feminino , Humanos , Casamento , População Rural
8.
Artigo em Inglês | MEDLINE | ID: mdl-35682394

RESUMO

INTRODUCTION: The SARS-CoV-2 pandemic has involved healthcare workers (HCWs) both as caregivers and as patients. This study is a retrospective cross-sectional analysis of the HCWs working in a third-level hospital in Central Italy who were infected with COVID-19 from March 2020 to April 2021. This research aims at identifying the physical and mental health outcomes of HCWs infected with COVID-19 who returned to work after the infection, the determinants of those outcomes, such as age and sex, and the identification of possible vulnerable professional groups. METHODS: A questionnaire about the acute illness, the experience of returning to work, and health perceptions after the disease was administered to 427 healthcare workers 3 months after recovering from the SARS-CoV-2 infection. RESULTS: The majority interviewed (84.5%) reported symptoms at the time of the positive test, with no significant differences regarding age or sex, while a significant difference in the mean age was found regarding hospitalization (p < 0.001). At 3 months after the infection, females (p = 0.001), older workers (p < 0.001), and healthcare assistants (p < 0.001) were more likely to report persistent symptoms. Sex (p = 0.02) and age (p = 0.006) influenced the quality of sleep after the infection. At work, the nurses group reported increase in workload (p = 0.03) and worse relationships (p = 0.028). At 3 months after the infection, female workers perceived worse physical (p = 0.002) and mental (p < 0.001) health status according to the SF-12. A negative correlation was found between age and PCS score (p < 0.001) but not MCS score (p = 0.86). A significant difference in PCS score was found between nurses and physicians (p = 0.04) and between residents and all other groups (p < 0.001). Finally, the group of workers reporting sleep alterations showed lower PCS and MCS scores (p < 0.001) and working relationships had an impact on MCS scores (p < 0.001). CONCLUSIONS: Age, sex, and type of job had an impact on physical and mental outcomes. Organizing specific interventions, also tailored to professional sub-groups, should be a target for healthcare systems to protect and boost the physical and mental health of their workers.


Assuntos
COVID-19 , COVID-19/epidemiologia , Estudos Transversais , Feminino , Pessoal de Saúde/psicologia , Humanos , Saúde Mental , Estudos Retrospectivos , Retorno ao Trabalho , SARS-CoV-2
9.
Intensive Crit Care Nurs ; 72: 103266, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35688751

RESUMO

INTRODUCTION: Mobile phones have become indispensable accessories of both our social and professional lives. They increase the quality of healthcare by providing fast communication, and easy access to laboratory results, imaging and patients' files. Simultaneously however, they may act as vectors for potentially pathogenic micro-organisms and as such hold a potential risk for nosocomial infection. OBJECTIVES: To assess the risk of mobile phones as vectors for nosocomial infection and the impact of disinfecting mobile phones on infection risks. METHODS: The MEDLINE and Embase database were searched from January 2000 - January 2019 for a systematic review according to PRISMA guidelines. Eligible studies of any design were critically appraised by two independent reviewers. RESULTS: We identified 50 studies, of which 12 were interventional. Data for a total of 5425 microbiological samples resulted in a prevalence of potentially pathogenic micro-organisms from 0% to 100%. The 2 most commonly found micro-organisms were coagulase-negative staphylococci (most commonly found in 30 studies) and Staphylococcus aureus (most commonly found in 10 studies). The frequency of microbial growth varied across studies. CONCLUSIONS: The use of mobile phones by healthcare workers without proper disinfection may imply a risk for nosocomial infection. A direct relationship however, remains unproven. Healthcare workers are recommended to include proper handling of mobile phones in their 'classic' hand hygiene routine as proposed by the World Health Organisation.


Assuntos
Telefone Celular , Infecção Hospitalar , Higiene das Mãos , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Atenção à Saúde , Pessoal de Saúde , Humanos
10.
J Comp Eff Res ; 11(11): 815-828, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35699096

RESUMO

Aim: To analyze the impact of the COVID-19 pandemic on US healthcare resource utilization. Methods: Optum claims data were used to compare all-cause healthcare visits and healthcare spending for selected diseases between the prepandemic and pandemic periods. Telemedicine use was only assessed for the pandemic period owing to data availability. Results: During the first wave of the pandemic, all-cause healthcare visits across all selected disease areas displayed a rapid decline compared with the prepandemic period, followed by a period of recovery. A reduction in outpatient and home healthcare spending was observed, whereas inpatient and prescription spending increased. Conclusion: Changes in healthcare resource utilization trends were observed during the pandemic. The magnitude of these changes can inform subsequent studies that utilize COVID-19-era data.


Assuntos
COVID-19 , COVID-19/epidemiologia , Atenção à Saúde , Humanos , Pacientes Ambulatoriais , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Estudos Retrospectivos , Estados Unidos/epidemiologia
11.
Mult Scler Relat Disord ; 63: 103921, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35700674

RESUMO

BACKGROUND: Infections in people with multiple sclerosis (PwMS) may have a detrimental effect on disease progression, risk of hospitalization, and healthcare resource utilization (HRU). The infection risk and HRU costs may vary between disease-modifying therapies (DMTs); however, the individual risks and differences associated with DMTs are not well characterized. Some DMTs may increase the risk for infections in PwMS; however, previous studies have reported an intact humoral immune response in dimethyl fumarate (DMF)-treated patients. The objective was to compare infection-related HRU and healthcare costs (HCCs) between PwMS treated with DMF or ocrelizumab (OCR). METHODS: Eligible patients were identified from the Optum US claims database between April 2017 and September 2020 (DMF n = 1429; OCR n = 3170). Patients were followed from index date to first occurrence of: (1) end of study, (2) end of insurance eligibility, (3) discontinuation of index DMT, or (4) switch from index DMT to another DMT. Outcomes were annualized rate of infection encounters (defined as infection encounters [n] during follow-up window / days followed [n] × 365); annualized infection-related HCCs (defined as aggregated costs of infection encounters during follow-up window / days followed [n] × 365); location-specific infections, and overall infection-related events. Propensity score matching (PSM) 1:1 method was used; PS was calculated via logistic regression for probability of DMF treatment conditional on demographics and comorbidities. Mean differences (MD) were reported for infection encounter measures. RESULTS: After PSM, DMF and OCR cohorts (n = 1094 in each cohort) were balanced based on baseline characteristics (standardized MD of adjusted baseline characteristics <0.1). Mean (standard deviation) follow-up was 296 (244) days for DMF patients and 297 (243) for OCR patients. DMF patients experienced lower annualized rates of overall infection encounters vs OCR patients (MD -0.51 [95% confidence interval (CI): -0.92 to -0.11], p = 0.01). When stratified by type of infection encounter, DMF patients experienced significantly lower annualized rates of outpatient (MD [95% CI]: -0.44 [-0.80 to -0.08], p = 0.02) and inpatient/hospitalization infection encounters (-0.08 [-0.14 to -0.02], p<0.01) vs OCR patients. A trend towards a shorter duration of infection-related hospitalization in the DMF vs the OCR group was observed (MD [95% CI]: -2.20 [-4.73 to 0.26] days, p = 0.08). The most common infection types in both DMT groups were urinary tract infections, sepsis, and pneumonia. DMF patients experienced lower annualized infection-related HCCs (MD [95% CI]: -$3642 [-$6380 to -$904], p < 0.01) vs OCR patients, which were driven largely by infection-related hospitalization costs (-$3639 [-$6019 to -$1259], p < 0.01). CONCLUSION: DMF-treated patients PS-matched with OCR patients experienced lower annualized rates of infection encounters and lower infection-related HCCs.


Assuntos
Fumarato de Dimetilo , Esclerose Múltipla , Anticorpos Monoclonais Humanizados/efeitos adversos , Fumarato de Dimetilo/uso terapêutico , Custos de Cuidados de Saúde , Humanos , Esclerose Múltipla/induzido quimicamente , Esclerose Múltipla/complicações , Esclerose Múltipla/tratamento farmacológico , Estudos Retrospectivos
12.
J Med Econ ; 25(1): 870-879, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35703058

RESUMO

AIMS: Acute respiratory tract infections (ARTIs) are common in hematopoietic stem cell transplantation (HSCT) recipients, however, data is limited regarding epidemiology and economic burden of ARTI in HSCT recipients in Japan. We evaluated the incidence of ARTI in HSCT recipients, associated economic burden, and ARTI-related treatments post-HSCT. MATERIALS AND METHODS: Patients receiving HSCT between July 2017 and December 2018, and those enrolled in the JMDC Claims Database for ≥6 months before index month (month when latest medical procedure code of HSCT recorded) were included. The outcomes included demographics, ARTI incidence, healthcare resource utilization (HCRU), direct costs, and ARTI-related treatments. RESULTS: In 330 analyzed patients, the ARTI incidence rate was 85.5% during total follow-up, consisting of post-HSCT hospitalization of mean 2.1 months and post-discharge periods of mean 17.6 months (post-HSCT hospitalization: 44.8%; post-discharge: 77.6%). For ARTI vs non-ARTI patients during post-HSCT hospitalization, length of hospitalization was significantly longer (mean [SD] months; 2.40 [1.73] vs 1.84 [1.09]; p = 0.0004), and median cost was significantly higher (JPY; 6,250,120.00 vs 4,774,570.00; p = 0.0096). The cost of outpatient visits during post-discharge periods, drug-related and non-drug-related costs of outpatient visits were generally higher for ARTI vs non-ARTI patients. In ARTI vs non-ARTI patients, utilization of any symptom relievers (decongestants, antitussives, and antipyretics), bronchodilators, immunoglobulin G, antibiotics, antivirals, and oxygen supply were numerically higher during post-HSCT hospitalization and post-discharge periods. The proportion of patients and mean prescription days for immunosuppressants during post-HSCT hospitalization were higher in ARTI vs non-ARTI patients. LIMITATIONS: This administrative claims study lacks clinical data and contains only direct medical costs. Patients were retained if they had at least 1 month of enrollment post-HSCT. CONCLUSIONS: In HSCT recipients, ARTI leads to substantial incremental HCRU and direct costs for management in real-world settings in Japan.


People receiving hematopoietic stem cell transplantation (HSCT) commonly suffer from acute respiratory infections (ARTIs). The real-world data on its incidence and economic impact in Japan is limited. In this study, using the JMDC Claims Database 330 HSCT recipients were identified during July 2017 and December 2018. Of these patients, 85.5% developed ARTI either during post-HSCT hospitalization (44.8%, within mean 2.1 months) or post-discharge period (77.6%, within mean 17.6 months). Patients with ARTI had longer hospital stays (2.40 months vs 1.84 months) and higher in-patient treatment costs (6,250,120.00 JPY vs 4,774,570.00 JPY) than those without ARTI. The costs associated with out-patient treatment, both drug-related and non-drug-related, were also higher for ARTI patients than non-ARTI patients. The use of medicines for stuffy nose (decongestants), dry cough (antitussives), and fever (antipyretics), and other medicines to treat respiratory infections (such as bronchodilators, immunoglobulin G, antibiotics, antivirals, and oxygen supply) was generally high with ARTI patients both during post-HSCT hospitalization and during post-discharge periods. The use of immunosuppressants was also more in patients who acquired ARTI as compared with non-ARTI patients during post-HSCT hospitalization. This study demonstrates the significant impact of ARTI in terms of economic and healthcare resource utilization in HSCT recipients in Japan.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Infecções Respiratórias , Assistência ao Convalescente , Análise de Dados , Estresse Financeiro , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Transplante de Células-Tronco Hematopoéticas/métodos , Humanos , Incidência , Japão/epidemiologia , Alta do Paciente , Infecções Respiratórias/tratamento farmacológico , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos
13.
Int J Equity Health ; 21(1): 89, 2022 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-35751059

RESUMO

BACKGROUND: Medical neutrality is a normative arrangement that differentiates a zone of medical treatment disconnected from the field of politics. While medical neutrality aims to ensure impartial healthcare for all and to shield the healthcare personnel from political demands, it can also divert attention away from conflicts and their effects on health inequity. This article analyzes how healthcare professionals understand and negotiate the depoliticized space of the emergency department (ED) through their views on neutrality. It also examines how medical staff use depoliticized concepts of culture to account for differences in the health status of patients from disadvantaged groups. These questions are examined in the context of the Israeli-Palestinian conflict. METHODS: Twenty-four in-depth, semi-structured interviews were conducted with healthcare personnel in a Jerusalem hospital's ED. All but one of the participants were Jewish. The interviews were analyzed using qualitative content analysis and Grounded Theory. RESULTS: The ED staff endorsed the perspective of medical neutrality as a nondiscriminatory approach to care. At the same time, some medical staff recognized the limits of medical neutrality in the context of the Israeli-Palestinian conflict and negotiated and challenged this concept. While participants identified unique health risks for Arab patients, they usually did not associate these risks with the effects of conflict and instead explained them in depoliticized terms of cultural and behavioral differences. Culture served as a non-controversial way of acknowledging and managing problems that have their roots in politics. CONCLUSIONS: The normative demand for neutrality works to exclude discussion of the conflict from clinical spaces. The normative exclusion of politics is a vital but under-appreciated aspect of how political conflict operates as a structural determinant of health. Healthcare personnel, especially in the ED, should be trained in structural competency. This training may challenge the neglect of issues that need to be solved at the political level and enhance health equity, social justice, and solidarity.


Assuntos
Judeus , Determinantes Sociais da Saúde , Árabes , Serviço Hospitalar de Emergência , Humanos , Israel , Condições Sociais
14.
Comput Biol Med ; 146: 105656, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35751186

RESUMO

Home healthcare (HHC) is a beneficial choice for many people and especially an essential alternative to clinics and hospitals for infection prevention during the COVID-19 pandemic. Moreover, patient trust in HHC providers is critical to care success and highly affects patient satisfaction. In this paper, an intelligent algorithm is proposed to assess the performance of an HHC center considering trust indicators. For this purpose, the effect of these indicators on patient satisfaction was examined. First, the required data is collected from patients who received care from the HHC service under study through two validated questionnaires containing items related to trust and patient satisfaction. Efficiency scores for each decision-making unit were computed using an artificial neural network and statistical methods. Based on each trust indicator, sensitivity analysis and statistical tests were conducted to evaluate the (in) appropriateness of HHC center performance. In addition, a strengths-weaknesses-opportunities-threats analysis is conducted to suggest strategies for improving the HHC center performance. The algorithm was validated using the data envelopment analysis method. As far as we know, this is the first study to evaluate the performance of HHC centers based on trust indicators, and the model presented in this study can be implemented in other healthcare units to enhance patient satisfaction.


Assuntos
COVID-19 , Confiança , Algoritmos , COVID-19/epidemiologia , Humanos , Pandemias , Satisfação do Paciente
15.
J Pak Med Assoc ; 72(6): 1025-1030, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35751302

RESUMO

Objectives: To assess knowledge, attitude and practice of medical and paramedical staff about cervical cancer as well as its screening and prevention. METHODS: The descriptive cross-sectional study was conducted at the Jinnah Post-graduate Medical Centre, Karachi, from March 1 to August 30, 2019, and comprised women medical and paramedical staff randomly selected from different specialties. Data was collected using a structured questionnaire. Data was analysed using SPSS 20. RESULTS: Of the 347 participants 144(41.5%) were nurses and 203(58.5%) were doctors. The overall mean age was 26.22±6.38 years. Of the total, 108(30%) respondents were married and 239(68%) were single. Overall, 239(68.8%) were well aware of Pap smear being the screening test; 85(24.5%) were aware of the true guidelines to repeat the test; 152(43.8%) had an idea of the exact use of visual Inspection with acetic acid; 61(17.6%) had got a Pap smear done; and 156(45%) thought they were at risk of developing carcinoma cervix. The common risk factors identified were multiple sexual partners 254(73.2%), age at first sexual intercourse 160(46%), smoking 131(37.8%), foul-smelling discharge 221(63.7%), and post-coital bleeding 231(66.6%). CONCLUSIONS: Cervical cancer prevalence is rising due to inadequate knowledge and awareness among healthcare personals. Improvement can be brought by regular use of Pap smear.


Assuntos
Recursos Humanos de Enfermagem , Neoplasias do Colo do Útero , Adulto , Estudos Transversais , Detecção Precoce de Câncer , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Rastreamento , Teste de Papanicolaou , Inquéritos e Questionários , Centros de Atenção Terciária , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Esfregaço Vaginal , Adulto Jovem
16.
BMC Geriatr ; 22(1): 525, 2022 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-35752763

RESUMO

BACKGROUND: Mobile X-ray services (MXS) could be used to investigate clinical issues in aged care residents within familiar surroundings, reducing transfers to and from emergency departments and enabling healthcare to be delivered in residential aged care facilities. There is however little research exploring consumer perspectives about such services. The objective of this research was to explore the perspectives and preferences of residents about the provision of MXS in residential aged care facilities, including their knowledge about the service, perceived benefits, and factors that require consideration for effective implementation. METHODS: A qualitative study design was used. The setting for the study included four residential aged care facilities of different sizes from different parts of a South Australian city. Purposive sampling was used to recruit participants. 16 residents participated in semi-structured interviews that were audio-recorded and transcribed verbatim. Data were inductively derived using thematic analysis. RESULTS: Participants had a mean age of 85 years, 56% were female, 25% had dementia and 25% had had a mobile X-ray in the last 12 months. Four themes were developed. Participants preferred mobile X-rays, provided as healthcare-in-place, to improve accessibility to them and minimize physical and psychological discomfort. Participants had expectations about the processes for receiving mobile X-rays. Costs of X-rays to people, family and society were a consideration. Decision making required residents be informed about mobile X-rays. CONCLUSIONS: Residents have positive views of MXS as they can receive healthcare-in-place, with familiar people and surroundings. They emphasised that MXS delivered in residential aged care facilities need to be of equivalent quality to those found in other settings. Increased awareness of mobile X-ray services is required.


Assuntos
Instituição de Longa Permanência para Idosos , Casas de Saúde , Idoso , Idoso de 80 Anos ou mais , Austrália , Atenção à Saúde , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Instituições Residenciais , Raios X
17.
Int J Equity Health ; 21(1): 90, 2022 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-35752790

RESUMO

BACKGROUND: In 2013, Dubai implemented the Insurance System of Advancing Health in Dubai (ISAHD) law which required mandatory health insurance for all residents of Dubai effective in 2016. This study compares the effect of the ISAHD on the utilization and out-of-pocket (OOP) expenditures for low and high socio-economic status sub-groups. METHODS: The study used the 2014 and 2018 Dubai Household Health Survey (DHHS) a representative survey of Dubai stratified as: 1) Nationals; 2) Non-nationals in households; 3) Non-nationals in collective housing; and 4) Non-nationals in labor camps. The probability that each household would have expenditures was calculated, then multiplied by a weighted estimate of the average total OOP expenditure. RESULTS: Overall Dubai's health spending rose from 12.8 billion AED (3.4 billion US $) in 2014 to 16.8 billion AED (4.6 billion US $) in 2017. Concurrently, the OOP share in total health spending in Dubai fell from 25% in 2014 to 13% in 2017. From 2014 to 2018, there were increases in the utilization of inpatient, outpatient and discretionary services for all groups except non-nationals living in camps. In 2018, nationals spent a total of 1064.65 AED, non-nationals in households spent 675.01 AED, collective households spent 82.35 AED, and labor camps spent 100.32 AED out-of-pocket per capita for healthcare expenditures. During and after the implementation of ISAHD, there was a substantial growth in the OOP expenditure per capita for nationals and non-nationals in households due to increased utilization. OOP spending did not rise for the lower-income non-National households. CONCLUSION: Dubai has been successful in reducing the household share of OOP expenditures by shifting the financial burden to government and employers. Emiratis and expatriate households increased their health service utilization after ISAHD but blue-collar workers did not. Remaining non-financial barriers to care for Dubai's blue-collar workers must be identified and addressed.


Assuntos
Gastos em Saúde , Cobertura Universal do Seguro de Saúde , Inquéritos Epidemiológicos , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Classe Social
18.
BMC Med Educ ; 22(1): 495, 2022 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-35752816

RESUMO

BACKGROUND: Testicular cancer is a relatively rare form of cancer but curable. In Nigeria, late presentation hinders treatment due to limited resources for diagnosis and treatment. Testicular self-examination enables men to identify the presence of lumps and any abnormality in their testes. This can facilitate early detection and presentation at hospitals. The purpose of this study was to examine the awareness and practice of testicular self-examination by students at a College of Health Sciences in a Nigerian university. METHODS: A cross-sectional study was conducted. The target population were second-sixth year students in the College of Health Sciences. The respondents were conveniently selected to complete a 38-item, self-administered questionnaire. The paper-based questionnaire was distributed to 280 respondents in classrooms and dormitories. Descriptive statistics (such as percentages and frequencies) were used to summarize the frequency of categorical data. RESULTS: Of the 277 respondents, only 53.4% (n = 148) have heard about testicular self-examination. The mean age was 20.6 (± 4.51) years. Out of the 148 respondents, only 11.6% practiced it regularly. For majority of the respondents, the barriers mitigating the practice of testicular self-examination are the fear of discovering a lump and lack of knowledge. CONCLUSION: It is necessary for the importance of testicular self-examination to be emphasized in the training of nurses, medical doctors, and other healthcare professionals and its practice should be encouraged among health science students. This will equip these students with the knowledge and skills for their health and to educate their patients and the society on the relevance of testicular self-examination.


Assuntos
Neoplasias Testiculares , Adulto , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Nigéria , Autoexame , Estudantes , Inquéritos e Questionários , Neoplasias Testiculares/diagnóstico , Adulto Jovem
19.
Syst Rev ; 11(1): 131, 2022 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-35754052

RESUMO

BACKGROUND: Cytomegalovirus (CMV) is transmitted by direct contact with body fluids from infected individuals. Transmission of CMV in households, particularly those with young children, contributes significantly to CMV infection in the general population. However, little is known about the contribution of occupational healthcare or childcare exposure to risk of CMV infection. OBJECTIVES: To determine CMV seroprevalence, incidence of primary infection, and associated risk factors in healthcare and childcare workers. METHODS: Six electronic databases were searched systematically for publications on CMV infection in healthcare and childcare workers until March 7, 2022. Two authors independently evaluated the literature for quality and inclusion in our analyses. The pooled results for seroprevalence, incidence, and relative risk (RR) were determined using a random effects model. Heterogeneity among studies was quantified and further investigated in subgroup analysis and meta-regression. Publication bias was assessed using funnel plot. Statistical analyses were preformed using R version 4.05. RESULTS: Forty-eight articles were included in this meta-analysis (quality assessment: 18 good, 14 fair, and 16 poor). Pooled CMV seroprevalence was 59.3% (95% CI: 49.8-68.6) among childcare workers and 49.5% (95% CI: 40.3-58.7) among healthcare workers, and pooled incidences of primary CMV infection per 100 person-years were respectively 7.4 (95% CI: 3.9-11.8) and 3.1 (95% CI: 1.3-5.6). RR for primary infection compared to controls were 3.4 (95% CI: 1.3-8.8) and 1.3 (95% CI: 0.6-2.7) for healthcare and childcare workers, respectively. The odds of CMV seropositivity were 1.6 (95% CI: 1.2-2.3) times higher for childcare workers compared to controls, but not significantly different between healthcare workers and controls (0.9; 95% CI: 0.6-1.2). CMV seropositivity in both groups was significantly associated with having one or more children residing at home, marital status, ethnicity, and age. CONCLUSIONS: Childcare workers, but not healthcare workers, have an increased risk of prevalent and incident CMV infection, a risk that is further increased with the presence of at least one child living at home. These findings suggest that enforcing simple, conventional hygienic measures in childcare settings could help reduce transmission of CMV, and that special precautionary measures for preventing CMV infection may not be required for pregnant healthcare workers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020139756.


Assuntos
Cuidado da Criança , Infecções por Citomegalovirus , Criança , Pré-Escolar , Citomegalovirus , Infecções por Citomegalovirus/epidemiologia , Atenção à Saúde , Feminino , Humanos , Incidência , Gravidez , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos
20.
Front Public Health ; 10: 935608, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35757602

RESUMO

Access to information and resources through the Internet has become an increasingly critical aspect of contemporary life. Based on the WHO Health Equity Assessment Toolkit (HEAT) and cross-country panel data, this paper investigates the effect of Internet access on health inequality across different income groups. The results indicate that access to the Internet significantly improves the average health condition and alleviates health inequality. In addition, employing cross-country data from the Global Burden of Disease (GBD) database, this paper further examines the social and economic determinants of access to healthcare. Specifically, it is found that Internet access significantly facilitates healthcare access and mitigates the negative impact of income inequality on healthcare access. Considered together, these findings shed light on the importance of the Internet in reducing health inequality and improving healthcare access.


Assuntos
Acesso aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Humanos , Renda , Internet , Fatores Socioeconômicos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...