Implications for primary care providers of occupational health hazards on pregnant women and their infants

1980 ◽  
Vol 25 (4) ◽  
pp. 21-30 ◽  
Author(s):  
J GREENBERG
2019 ◽  
Vol 26 (1) ◽  
pp. e100013 ◽  
Author(s):  
Harshana Liyanage ◽  
John Williams ◽  
Rachel Byford ◽  
Simon de Lusignan

ObjectiveTo develop an ontology to identify pregnant women from computerised medical record systems with dissimilar coding systems in a primary care sentinel network.Materials and methodsWe used a three-step approach to develop our pregnancy ontology in two different coding schemata, one hierarchical and the other polyhierarchical. We developed a coding system–independent pregnancy case identification algorithm using the Royal College of General Practitioners Research and Surveillance Centre sentinel network database which held 1.8 million patients’ data drawn from 150 primary care providers. We tested the algorithm by examining individual patient records in a 10% random sample of all women aged 29 in each year from 2004 to 2016. We did an external comparison with national pregnancy data. We used χ2 test to compare results obtained for the two different coding schemata.Results243 005 women (median age 29 years at start of pregnancy) had 405 591 pregnancies from 2004 to 2016 of which 333 689 went to term. We found no significant difference between results obtained for two populations using different coding schemata. Pregnancy mean ages did not differ significantly from national data.DiscussionThis ontologically driven algorithm enables consistent analysis across data drawn from populations using different coding schemata. It could be applied to other hierarchical coding systems (eg, International Classification of Disease) or polyhierarchical systems (eg, SNOMED CT to which our health system is currently migrating).ConclusionThis ontological approach will improve our surveillance in particular of influenza vaccine exposure in pregnancy.


Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.


2005 ◽  
Vol 3 (1) ◽  
pp. 13-29 ◽  
Author(s):  
Hongtu Chen ◽  
Elizabeth Kramer ◽  
Teddy Chen ◽  
Jianping Chen ◽  
Henry Chung

Compared to all other racial and ethnic groups, Asian Americans have the lowest utilization of mental health services. Contributing factors include extremely low community awareness about mental health, a lack of culturally competent Asian American mental health professionals, and severe stigma associated with mental illness. This manuscript describes an innovative program that bridges the gap between primary care and mental health services. The Bridge Program, cited in the supplement to the Surgeon’s General’s Report on Mental Health: Culture, Race, and Ethnicity as a model for delivery of mental health services through primary care; (2) to improve capacity by enhancing the skills of primary care providers to identify and treat mental disorders commonly seen in primary care; and (3) to raise community awareness by providing health education on mental health and illness. Results are presented and the potential for replication is addressed.


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