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OBJECTIVE: Stereoelectroencephalography (SEEG) is increasingly utilized worldwide in epilepsy surgery planning. International guidelines for SEEG terminology and interpretation are yet to be proposed. There are worldwide differences in SEEG definitions, application of features in epilepsy surgery planning, and interpretation of surgical outcomes. This hinders the clinical interpretation of SEEG findings and collaborative research. We aimed to assess the global perspectives on SEEG terminology, differences in the application of presurgical features, and variability in the interpretation of surgery outcome scores, and analyze how clinical expert demographics influenced these opinions. METHODS: We assessed the practices and opinions of epileptologists with specialized training in SEEG using a survey. Data were qualitatively analyzed, and subgroups were examined based on geographical regions and years of experience. Primary outcomes included opinions on SEEG terminology, features used for epilepsy surgery, and interpretation of outcome scores. Additionally, we conducted a multilevel regression and poststratification analysis to characterize the nonresponders. RESULTS: A total of 321 expert responses from 39 countries were analyzed. We observed substantial differences in terminology, practices, and use of presurgical features across geographical regions and SEEG expertise levels. The majority of experts (220, 68.5%) favored the Lüders epileptogenic zone definition. Experts were divided regarding the seizure onset zone definition, with 179 (55.8%) favoring onset alone and 135 (42.1%) supporting onset and early propagation. In terms of presurgical SEEG features, a clear preference was found for ictal features over interictal features. Seizure onset patterns were identified as the most important features by 265 experts (82.5%). We found similar trends after correcting for nonresponders using regression analysis. SIGNIFICANCE: This study underscores the need for standardized terminology, interpretation, and outcome assessment in SEEG-informed epilepsy surgery. By highlighting the diverse perspectives and practices in SEEG, this research lays a solid foundation for developing globally accepted terminology and guidelines, advancing the field toward improved communication and standardization in epilepsy surgery.
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BACKGROUND: Sub-Saharan Africa is unlikely to achieve sustainable development goal (SDG) 3 on maternal and neonatal health due to perceived sub-standard maternal and newborn care in the region. This paper sought to explore the opinions of stakeholders on intricacies dictating sub-standard emergency obstetric and newborn care (EmONC) in health facilities in Northern Ghana. METHODS: Drawing from a qualitative study design, data were obtained from six focus group discussions (FGDs) among 42 health care providers and 27 in-depth interviews with management members, clients and care takers duly guided by the principle of data saturation. Participants were purposively selected from basic and comprehensive level facilities. Data analysis followed Braun and Clarke's qualitative thematic analysis procedure. RESULTS: Four themes and 13 sub-themes emerged as root drivers to sub-standard care. Specfically, the findings highlight centralisation of EmONC, inadequate funding, insufficient experiential training, delay in recruitment of newly trained essential staff and provider disinterest in profession. CONCLUSION: Setbacks in the training and recruitment systems in Ghana, inadequate investment in rural health coupled with extent of health provider inherent disposition to practice may be partly responsible for sub-standard obstetric care in the study area. Interventions targeting the afore-mentioned areas may reduce events of sub-standard care.
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Serviços Médicos de Emergência , Recém-Nascido , Feminino , Gravidez , Humanos , Gana , Tratamento de Emergência , Análise de Dados , FamíliaRESUMO
Aggressiveness is a concerning issue due to its contribution to road crashes. This study aims to provide an overview on how Spanish drivers perceive aggressive driving, analyzing how this perception is linked to sociodemographic features. Thus, a cross-sectional study was designed, where 1,079 Spanish drivers took part in a telephone survey on aggressiveness' importance, influence on traffic accidents, and frequency of performance. For data processing, Exploratory Data Analysis and Unifactorial Variance Analysis were conducted. The results showed that the perception of aggressive driving has a high valuation and a high-perceived risk, with differences for sex, age, and driving experience. The findings suggest that some groups perceive more aggressiveness than others, meaning it is necessary to develop measures to reduce biases through a gender perspective.
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AIM OF STUDY: We aimed to compare knowledge, opinions, and clinical experiences among Czech, Slovak, and Italian neurologists to identify potential educational gaps and unify understanding. CLINICAL RATIONALE FOR STUDY: Functional neurological disorder (FND) is a disabling condition characterised by motor, sensory, or cognitive symptoms which are incompatible with other neurological disorders. Novel diagnostic and treatment approaches have improved FND management. However, the extent of their adoption, and any differences or similarities across European communities, remain to be established. MATERIAL AND METHODS: Members of the Czech and Slovak Neurological Societies were invited via e-mail to participate in a 14- -item web-based survey investigating their approach to FND. This data was compared to results from a previous study involving 492 Italian neurologists. RESULTS: 232 questionnaires were completed by Czech and Slovak neurologists (CZ-SK). Similarities were found between CZ- -SK and Italian neurologists in their preference for the term 'FND' over other psychological-related terms and in explaining symptoms as due to abnormal functioning of the nervous system rather than attributing them to mental illness. However, only fewer than 5% in both groups thought that simulation was highly unlikely. Both groups reported relying on positive signs (e.g. inconsistency, distractibility) according to the current diagnostic criteria, but also a tendency to perform additional tests to exclude other causes. However, some differences were observed: Italian neurologists placed a greater emphasis on psychological factors including litigation. CZ-SK neurologists were more likely to suggest physiotherapy as a treatment option and to provide educational intervention for patients and their relatives. CONCLUSIONS: Overall, our findings suggest that although Czech, Slovak, and Italian neurologists have adopted some new developments in the field of FND, significant gaps still exist in their understanding and common practices regarding conceptualisation, diagnosis, and treatment. CLINICAL IMPLICATIONS: Our results suggest that promoting knowledge through postgraduate curricula and teaching courses for neurologists is necessary to optimise patient management in various European countries.
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OBJECTIVE: To analyze the effects and tolerability of physiotherapeutic methods with optical radiation (phototherapy) in acute respiratory diseases (ARD) on the basis of the modern scientific literature data and the results of doctors and patients survey. MATERIAL AND METHODS: An analysis of regulatory sources and modern scientific literature on the subject of research, survey of 200 patients with ARD and 100 primary care physicians of the Central Federal District on their sociomedical status and awareness of phototherapeutic treatment methods were conducted. RESULTS: Phototherapy in ARD have demonstrated chromogenic, immunostimulating, photosensitizing, vitamin-forming, trophostimulating, anti-inflammatory, analgesic, desensitizing, bactericidal and mycocidal, metabolic, coagulo-correcting therapeutic effects. Patients and doctors have been insufficiently aware of phototherapy methods and used them in practice relatively rare. A significant proportion of patients had ARD risk factors, namely teamwork, tobacco smoking and chronic diseases. CONCLUSION: 1. The therapeutic effects of all types of phototherapy in acute respiratory infections are interrelated with their etiopathogenesis. 2. Patients and doctors are insufficiently informed and relatively rarely use phototherapy methods. 3. A significant proportion of patients have risk factors for acute respiratory infections: teamwork (88%), tobacco smoking (68%) and chronic diseases (52%).
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Fototerapia , Humanos , Fototerapia/métodos , Doença Aguda , Masculino , Feminino , Adulto , Doenças Respiratórias/terapia , Infecções Respiratórias/terapia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Treatment guidelines for acute otitis media (AOM) have changed over the past 20 years. Watchful waiting is often recommended as an option for antibiotic treatment and the use of proper pain medication is emphasised. OBJECTIVE: To study parental experiences and opinions regarding the management of AOM and compare our findings with our previous questionnaire submitted in 2006. METHODS: We sent an online survey link through day-care centres and Facebook parental groups in Turku area. Children <4 years of age attending day care were included in the analysis. We asked about the child's history of AOM, parental opinions about AOM treatment, and antibiotic resistance. Results of 2019 were compared with those of 2006. RESULTS: Altogether 84% (320/381) and 83% (568/681) of children had had at least 1 episode of AOM in 2019 and 2006, respectively. In 2019, more children had been treated without antibiotics (30% vs. 13%, P < 0.001) and fewer parents thought that antibiotics are necessary for the treatment of AOM (70% vs. 85%, P < 0.001) compared with 2006. The use and knowledge of painkillers had increased over the past 13 years. Painkillers had been given at least once to 93% (296/320) of children in 2019 and 80% (441/552) of children in 2006 (P < 0.001). CONCLUSIONS: Today, more parents accept watchful waiting as a treatment option for AOM and give painkillers to their children, which indicates that the education about optimal management of AOM has reached parents.
Ear infection, or acute otitis media (AOM), is one of the most common infections in young children. Studies have shown that antibiotics are effective in treating AOM, but some children may recover well without antibiotics. Antibiotic use may cause adverse events and increase bacterial resistance. We asked Finnish parents for their experiences and opinions regarding AOM management. We sent the same questionnaire in 2006 and 2019 and compared the responses. We found that more children had been treated without antibiotics in 2019, which is in line with the changes in clinical practice guidelines. We also found that parents had given painkillers more often in 2019 than in 2006.
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BACKGROUND: Understanding public perceptions of the health risks of climate change is critical to inform risk communication and support the adoption of adaptive behaviours. In Canada, very few studies have explored public understandings and perceptions of climate impacts on health. The objective of this study was to address this gap by exploring perceptions of the link between climate change and health. METHODS: We conducted a survey of Canadians (n = 3,014) to address this objective. The 116-question survey measured prior consideration of the link between climate change and health, affective assessment of climate health impacts, unprompted knowledge of climate health impacts, and concern about a range of impacts. ANOVA tests were used to assess differences among sociodemographic groups. RESULTS: Overall, Canadian's have a similar level of concern about health impacts of climate change compared with concern about other impacts (e.g. biophysical, economic, and national security). Among health-related impacts, respondents were more concerned about impacts on water, food and air quality, compared with impacts on mental health, infectious diseases and heat-related illnesses. There were differences among sociodemographic groups; women were significantly more concerned than men about all of the health-related impacts; respondents with a high school level of education were significantly less concerned about all health-related impacts compared with respondents with more education; and respondents on the political left were more concerned with those in the political centre, who were more concerned than those on the political right. CONCLUSION: There is emerging literature suggesting that framing communication around climate change in terms of the health risks it poses may increase perceptions of the proximity of the risks. These results suggest that it is important to be specific in the types of health risks that are communicated, and to consider the concerns of the target sociodemographic groups. The differential knowledge, awareness, and concern of climate health impacts across segments of the Canadian population can inform targeted communication and engagement to build broader support for adaptation and mitigation measures.
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Aclimatação , Mudança Climática , Masculino , Humanos , Feminino , Canadá , Escolaridade , Adaptação PsicológicaRESUMO
BACKGROUND: Over the course of the COVID-19 pandemic, colleges and universities have focused on creating policies, such as mask mandates, to minimize COVID-19 transmission both on their campuses and in the surrounding community. Adherence to and opinions about these policies remain largely unknown. METHODS: The Centers for Disease Control and Prevention (CDC) developed a cross-sectional study, the Mask Adherence and Surveillance at Colleges and Universities Project (MASCUP!), to objectively and inconspicuously measure rates of mask use at institutes of higher education via direct observation. From February 15 through April 11, 2021 the University of Colorado Boulder (CU, n = 2,808 observations) and Colorado State University Fort Collins (CSU, n = 3,225 observations) participated in MASCUP! along with 52 other institutes of higher education (n = 100,353 observations) spanning 21 states and the District of Columbia. Mask use was mandatory at both Colorado universities and student surveys were administered to assess student beliefs and attitudes. RESULTS: We found that 91.7%, 93.4%, and 90.8% of persons observed at indoor locations on campus wore a mask correctly at University of Colorado, Colorado State University, and across the 52 other schools, respectively. Student responses to questions about masking were in line with these observed rates of mask use where 92.9% of respondents at CU and 89.8% at CSU believe that wearing masks can protect the health of others. Both Colorado universities saw their largest surges in COVID-19 cases in the fall of 2020, with markedly lower case counts during the mask observation window in the spring of 2021. CONCLUSION: High levels of mask use at Colorado's two largest campuses aligned with rates observed at other institutes across the country. These high rates of use, coupled with positive student attitudes about mask use, demonstrate that masks were widely accepted and may have contributed to reduced COVID-19 case counts. This study supports an emerging body of literature substantiating masks as an effective, low-cost measure to reduce disease transmission and establishes masking (with proper education and promotion) as a viable tactic to reduce respiratory disease transmission on college campuses.
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COVID-19 , Humanos , Atitude , Colorado/epidemiologia , COVID-19/prevenção & controle , COVID-19/epidemiologia , Estudos Transversais , Máscaras , Pandemias/prevenção & controle , Estudantes , UniversidadesRESUMO
INTRODUCTION: A National Cancer Information System is planned for phased implementation in Irish cancer centres to enable electronic prescribing (ePrescribing) of systemic anti-cancer therapy. This study aimed to capture the opinions of healthcare professionals in a hospital setting relating to the current paper-based workflow for systemic anti-cancer therapy prescribing and their attitudes and expectations of the new ePrescribing system to develop recommendations, which assist in the planning and implementation of future ePrescribing systems. METHODS: A mixed methods study of concurrent design was conducted. Interviews with healthcare professionals primarily aimed to evaluate processes and identify areas requiring improvement within the current paper-based workflow for systemic anti-cancer therapy prescribing. An online questionnaire adapted from the Information Systems Expectations and Experiences tool primarily aimed to capture expectations of the new ePrescribing system and attitudes towards the transition. RESULTS: Twelve healthcare professionals were interviewed, and 50 healthcare professionals responded to the online questionnaire (response rate: 33.3%). Eight major themes emerged from interview transcripts relating to opinions on the paper-based workflow. Questionnaire respondents reported positive attitudes towards ePrescribing implementation and had high expectations for workflow improvements and functionalities of the new system. Seven recommendations for ePrescribing implementation were developed: (1) prioritise specific processes; (2) plan for changes in communication; (3) repeat research in the post-implementation setting; (4) ensure good information technology infrastructure and system support; (5) ensure optimum training; (6) outline limitations of clinical decision support; (7) provide clear instructions on local configurability. CONCLUSION: This study identifies potential challenges in transitioning to ePrescribing and provides recommendations, which assist stakeholders in ensuring safe and effective transitions, thus informing future ePrescribing systems' implementation in haematology/oncology settings.
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BACKGROUND: In 2022, NHS England announced plans to ensure that all adult primary care patients in England would have full online access to new data added to their general practitioner (GP) record. However, this plan has not yet been fully implemented. Since April 2020, the GP contract in England has already committed to offering patients full online record access on a prospective basis and on request. However, there has been limited research into UK GPs' experiences and opinions about this practice innovation. OBJECTIVE: This study aimed to explore the experiences and opinions of GPs in England about patients' access to their full web-based health record, including clinicians' free-text summaries of the consultation (so-called "open notes"). METHODS: In March 2022, using a convenience sample, we administered a web-based mixed methods survey of 400 GPs in the United Kingdom to explore their experiences and opinions about the impact on patients and GPs' practices to offer patients full online access to their health records. Participants were recruited using the clinician marketing service Doctors.net.uk from registered GPs currently working in England. We conducted a qualitative descriptive analysis of written responses ("comments") to 4 open-ended questions embedded in a web-based questionnaire. RESULTS: Of 400 GPs, 224 (56%) left comments that were classified into 4 major themes: increased strain on GP practices, the potential to harm patients, changes to documentation, and legal concerns. GPs believed that patient access would lead to extra work for them, reduced efficiency, and increased burnout. The participants also believed that access would increase patient anxiety and incur risks to patient safety. Experienced and perceived documentation changes included reduced candor and changes to record functionality. Anticipated legal concerns encompassed fears about increased litigation risks and lack of legal guidance to GPs about how to manage documentation that would be read by patients and potential third parties. CONCLUSIONS: This study provides timely information on the views of GPs in England regarding patient access to their web-based health records. Overwhelmingly, GPs were skeptical about the benefits of access both for patients and to their practices. These views are similar to those expressed by clinicians in other countries, including Nordic countries and the United States before patient access. The survey was limited by the convenience sample, and it is not possible to infer that our sample was representative of the opinions of GPs in England. More extensive, qualitative research is required to understand the perspectives of patients in England after experiencing access to their web-based records. Finally, further research is needed to explore objective measures of the impact of patient access to their records on health outcomes, clinician workload, and changes to documentation.
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Clínicos Gerais , Adulto , Humanos , Estudos Prospectivos , Atitude do Pessoal de Saúde , Pesquisa Qualitativa , Inquéritos e Questionários , Atenção Primária à SaúdeRESUMO
The COVID-19 pandemic has resulted in a proliferation of conflicting opinions on physical distancing across various media platforms, which has had a significant impact on human behavior and the transmission dynamics of the disease. Inspired by this social phenomenon, we present a novel UAP-SIS model to study the interaction between conflicting opinions and epidemic spreading in multiplex networks, in which individual behavior is based on diverse opinions. We distinguish susceptibility and infectivity among individuals who are unaware, pro-physical distancing and anti-physical distancing, and we incorporate three kinds of mechanisms for generating individual awareness. The coupled dynamics are analyzed in terms of a microscopic Markov chain approach that encompasses the aforementioned elements. With this model, we derive the epidemic threshold which is related to the diffusion of competing opinions and their coupling configuration. Our findings demonstrate that the transmission of the disease is shaped in a significant manner by conflicting opinions, due to the complex interaction between such opinions and the disease itself. Furthermore, the implementation of awareness-generating mechanisms can help to mitigate the overall prevalence of the epidemic, and global awareness and self-awareness can be interchangeable in certain instances. To effectively curb the spread of epidemics, policymakers should take steps to regulate social media and promote physical distancing as the mainstream opinion.
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PURPOSE: We examined whether medical students' opinions on the acceptability of a behaviour were influenced by previously encountering a similar professionally challenging situation, assessed the magnitude of effect of 'experience' compared to other demographic factors which influence medical students' opinions, and evaluated whether opinions regarding some situations/behaviours were more susceptible to 'experience' bias? METHODS: Confidential, on-line survey for medical students distributed to Australian and New Zealand (AUS/NZ) medical schools. Students submitted de-identified demographic information, provided opinions on the acceptability of a wide range of student behaviours in professionally challenging situations, and whether they had encountered similar situations. RESULTS: 3171 students participated from all 21 Aus/NZ medical schools (16% of registered students). Medical students reported encountering many of the professionally challenging situations, with varying opinions on what was acceptable behaviour. The most significant factor influencing acceptability towards a behaviour was whether the student reported encountering a similar situation. The professional dilemmas most significantly influenced by previous experience typically related to behaviours that students could witness in clinical environments, and often involved breaches of trust. CONCLUSIONS: Our results demonstrate the relationship between experience and medical students' opinions on professional behaviour- the 'Schweitzer effect'. When students encounter poor examples of professional behaviour, especially concerning trust breaches, it significantly influences their perception of the behaviour. These results highlight the importance of placing students in healthcare settings with positive professional role modelling/work cultures.
Medical students report encountering a wide range of professionally challenging situations, and have varying opinions on acceptable professional behavioursAlthough medical students' opinions on professional behaviours are influenced by their demography, the most significant factor influencing the acceptability towards a behaviour was whether the student reported encountering a similar professional dilemmaStudents appear to be susceptible to normalising counter productive work behaviours, particularly those related to breaches of trustBy placing students in toxic work culture environments with poor role models, we may inadvertently enable healthcare systems to perpetuate poor professional behaviour.
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G20 countries, account for the majority of global carbon emissions, need to take the lead in mitigating climate change. However, there are differences in economic, political and sociocultural backgrounds amongst G20 countries, especially between China and other G20 countries. Since the implementation of climate policies largely require domestic public support, it is vital to explore similarities and differences of public opinions on climate issues between China and other G20 countries. However, little research has investigated the micro-level climate concerns from the perspective of cross-country differences. Therefore, based on big data and text mining analysis, this study crawled user-generated data on Sina Weibo (N = 271,487) and Twitter (N = 4,874,546) from 2008 to 2019 to comprehensively catalog and compare climate opinions. Results show that climate change has become a salient issue in China and other G20 countries, with climate-related surges in public opinions always occurring after major natural, social and political events. Moreover, in China, there has been a significant shift in public attention from climate impacts to climate mitigation strategies, but in other G20 countries, people are more radical by emphasizing the climate movement and calling for authoritative actions. This study provides "snapshots" of climate communication and offers a quantification-based reference for promoting climate actions and collaborative governance.
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Mudança Climática , Opinião Pública , Humanos , ChinaRESUMO
Controversy has existed since the 1960s on the difficult issue of the subject matter upon which psychologists should be permitted to offer expert opinions to the courts. A particularly problematic aspect of the controversy has been evidence by psychologists about diagnoses which generally is given by reference to the two main taxonomies of diagnosis, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and the World Health Organization's International Classification of Diseases. This column reviews the leading decisions on the issue in the United States, the United Kingdom and Australia, including a 2021 Queensland Court of Appeal decision. It argues that the trend of recent case law is in favour of psychologists being permitted to give such evidence but only, on a case-by-case basis, when sufficient specialised knowledge is established in relation to the specific diagnosis proposed by a psychologist.
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Prova Pericial , Humanos , Estados Unidos , Austrália , Queensland , Reino UnidoRESUMO
Background and Objective: The role of the pharmacist in healthcare society is unique, since they are providers of health information and medication counseling to patients. Hence, this study aimed to evaluate Awareness, Perceptions, and Opinions towards Artificial intelligence (AI) among pharmacy undergraduate students at King Saud University (KSU), Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional, questionnaire-based study was conducted between December 2022 and January 2023 using online questionnaires. The data collection was carried out using convenience sampling methods among senior pharmacy students at the College of Pharmacy, King Saud University. Statistical Package for the Social Sciences version 26 was used to analyze the data (SPSS). Results: A total of one hundred and fifty-seven pharmacy students completed the questionnaires. Of these, most of them (n = 118; 75.2%) were males. About 42%, (n = 65) were in their fourth year of study. Most of the students (n = 116; 73.9%) knew about AI. In addition, 69.4% (n = 109) of the students thought that AI is a tool that helps healthcare professionals (HCP). However, more than half 57.3% (n = 90) of the students were aware that AI would assist healthcare professionals in becoming better with the widespread use of AI. Furthermore, 75.1% of the students agreed that AI reduces errors in medical practice. The mean positive perception score was 29.8 (SD = 9.63; range-0-38). The mean score was significantly associated with age (p = 0.030), year of study (p = 0.040), and nationality (p = 0.013). The gender of the participants was found to have no significant association with the mean positive perception score (p = 0.916). Conclusions: Overall, pharmacy students showed good awareness of AI in Saudi Arabia. Moreover, the majority of the students had positive perceptions about the concepts, benefits, and implementation of AI. Moreover, most students indicated that there is a need for more education and training in the field of AI. Consequently, early exposure to content related to AI in the curriculum of pharmacy is an important step to help in the wide use of these technologies in the graduates' future careers.
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Inteligência Artificial , Estudantes de Farmácia , Masculino , Humanos , Feminino , Arábia Saudita , Estudos Transversais , Estudantes de Farmácia/psicologia , Atenção à SaúdeRESUMO
PURPOSE: In this study, the purpose was to uncover the views of medical students about online anatomy education adopted during the COVID-19 pandemic period. It was also aimed to determine whether medical school students found online education suitable for anatomy lectures and which materials they desired to use during teaching anatomy practice lectures in this process. METHODS: A survey form that was prepared with the Google Survey application was administered to the Medical Faculty Term 1 and 2 students who received anatomy courses at Istanbul Yeni Yüzyil University in the spring semester of the 2019-2020 academic year. RESULTS: A total of 180 students, 53.89% of whom were 1st graders and 46.11% 2nd graders participated in the study, and 43.89% of the students stated that they found online education suitable for anatomy theoretical courses, and 12.78% for anatomy practice courses. Also, 43.75% of Term 1 and 41.77% of Term 2 students stated that the pandemic negatively affected the teaching of anatomy theoretical courses. It was found that students considered that anatomy practice courses were more affected by the pandemic before and during the pandemic (P<0.001). CONCLUSIONS: This study uncovered that the pandemic process negatively affected anatomy education and students made more use of face-to-face education. We believe that the results obtained in the study will shed light on the views of anatomists on the teaching of anatomy in the online education process.
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Anatomia , COVID-19 , Estudantes de Medicina , Humanos , Pandemias , Docentes de Medicina , COVID-19/epidemiologiaRESUMO
BACKGROUND: Ethiopia is a low-income country located in the horn of Africa's sub-Saharan region, with very high incidences of maternal and neonatal mortality. Quality antenatal care improves perinatal health outcomes. The USAID funded Transform: Primary Health Care Activity in collaboration with the Ministry of Health and GE Healthcare introduced Vscan limited obstetric ultrasound services in 120 health centers in Ethiopia. So far, the experiences and opinions of midwives on their use have not been explored and described within the local context. This study therefore aims to explore and describe the experiences and opinions of midwives on Vscan limited obstetric ultrasound services at health centers within Ethiopia. METHODS: An exploratory and descriptive qualitative study was conducted in Amhara, Oromia, and Southern Nations, Nationalities and Peoples' (SNNP) regions of Ethiopia. Twenty-four participants were selected through a purposeful sampling technique. In-depth individual interviews with trained midwives with practical hands-on limited obstetric ultrasound service provision experience were conducted. The thematic analysis was conducted manually. RESULTS: The qualitative data analysis on the experiences and opinions of midwives revealed three themes, namely: individual perception of self-efficacy, facilitators, and barriers of limited obstetric ultrasound services. The basic ultrasound training, which was unique in its organization and arrangement, prepared and built the self-efficacy of trainees in executing their expected competencies. Support of health systems and health managers in dedicating space, availing essential supplies, and assigning human resources emerged as facilitators of the initiated limited obstetric ultrasound services, whereas high workload on one or two ultrasound trained midwives, interruption of essential supplies like paper towels, gel, and alternative power sources were identified as barriers for limited ultrasound services. CONCLUSION: This study explored the experiences and opinions of midwives who were trained on the provision of limited obstetric ultrasound services and served the community in health centers in rural parts of Ethiopia. The results of this study revealed the positive impacts of the intervention on the perceived self-efficacy, facilitation, and breaking-down of barriers to obstetric ultrasound services. Before scaling-up limited obstetric ultrasound interventions, health managers should ensure and commit to availing essential supplies (e.g., paper towels, ultrasound gel, and large memory hard discs), arranging private rooms, and training other mid-level health professionals. In addition, improving pregnant women's literacy on the national schedule for ultrasound scanning services is recommended.
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Atitude do Pessoal de Saúde , Tocologia/educação , Cuidado Pré-Natal/métodos , Ultrassonografia Pré-Natal/instrumentação , Adulto , Centros Comunitários de Saúde , Etiópia , Feminino , Humanos , Masculino , Pesquisa Qualitativa , População RuralRESUMO
BACKGROUND: The aim of the present survey was to investigate newly discharged hospital patients' opinions on secondary use of their hospital data and biospecimens within the context of health research in general and, more specifically, on genetic research, data sharing across borders and cooperation with the health industry. METHODS: A paper questionnaire was sent to 1049 consecutive newly discharged hospital patients. RESULTS: The vast majority of the respondents preferred to be informed (passive consent) or to receive no notification at all for secondary research on their health data and biospecimens (88% and 91% for data and biospecimens respectively). The rest wanted to be asked for active consent. The same trend applied for the other aspects also. 81% of respondents were positive towards genetic research without active consent. 95% were positive towards cooperating with the health industry, and 90% were positive towards data sharing. CONCLUSIONS: These results suggest that hospital patients generally are very positive to secondary research and support the concept of opting out rather than opting in.
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Disseminação de Informação , Consentimento Livre e Esclarecido , Humanos , Inquéritos e QuestionáriosRESUMO
COVID-19 has highlighted the importance of health information for prevention of communicable disease. Knowledge about groups that have high risk is important to prevent disease transmission. In Sweden, immigrants have been identified as one such group. Yet, little is known about where they have sourced information about COVID-19 and their opinions toward it. The aim of this study was to describe the COVID-19 information sources used by immigrants with limited proficiency in Swedish as well as their opinions on how comprehensive the information has been, the importance of the recommendations and their possibility to follow them. A cross-sectional survey was conducted via introductory Swedish language classes in Region Uppsala (n = 855). The results showed the immigrants were using different information sources, with the majority using school, media and social media. The immigrants' opinions about COVID-19 information differed. Most reported they knew where to find information; however, over two-fifths reported the recommendations from the authorities should be more extensive. The majority reported it is important to follow the recommendations, whereas the possibility to follow the recommendations was more mixed. Age differences in opinions toward COVID-19 information were detected. Although the results were largely positive, there still appears to be a need for improvement in how immigrant groups with limited ability in the host country´s language are reached. Effective health communication that engages the whole nation is an important factor authorities should commit to as we face the current pandemic. This research suggests that an approach tailored by age could be helpful.
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COVID-19 , Emigrantes e Imigrantes , COVID-19/epidemiologia , Estudos Transversais , Humanos , Idioma , Suécia/epidemiologiaRESUMO
Introduction: Second medical opinions (SOs) can strengthen patients' certainty in decision making. In Germany, both personally delivered and telemedical SOs (often based on documents only) are provided. Our aim was to analyze the experiences of people who obtained telemedical SOs. We also investigated different routes of SO delivery (personally/by phone/documents only). Materials and Methods: German residents who obtained a telemedical SO via an online portal between January 2016 and February 2019 (n = 1,247) were contacted by post between August and November 2019 up to three times. The results were analyzed descriptively. Results: The 368 participants (response rate 30%) were 54% male, 95% statutory health insured, and 61 years old (median; interquartile range 51-72). Approximately 75% were (rather) satisfied with obtaining the SO via the online portal. The most preferred route of SO delivery was a personally delivered SO, which 80% would (rather) consider, followed by 70% (rather) considering SOs based on documents only and 48% (rather) considering SOs by phone. The most often mentioned advantage of telemedical SOs was independence of time and place, while the most important disadvantage was the standardized process resulting in a lack of direct and personal contact between the patient and the physician. Discussion: Although our results show that SOs (based on documents only) support patients and that patient satisfaction was high, personally delivered SOs were still preferred. Future research on the use of SOs based on documents only (in which patient population and in what situations) is needed.