scholarly journals P103: How knowledgeable are Canadian emergency physicians about the risk factors of completing suicide in patients presenting to the ED with suicidal thoughts?

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S102-S102
Author(s):  
J. Fernandes ◽  
A. Chakraborty ◽  
F. Scheuermeyer ◽  
S. Barbic ◽  
D. Barbic
Keyword(s):  
Risk Factors ◽  
Low Socioeconomic Status ◽  
Emergency Physicians ◽  
Suicidal Thoughts ◽  
Web Based ◽  
Personal Lives ◽  
Low Socioeconomic ◽  
Canadian Association ◽  
Attending Physician ◽  
Risk Factors For Suicide

Introduction: Suicide is the 9th leading cause of death in Canada, and a common reason for patients to present to Canadian emergency departments (ED). Little knowledge exists around Canadian emergency physicians (EPs) knowledge about the risk factors of completing suicide in patients presenting to the ED with suicidal thoughts. Methods: We developed a web-based survey on suicide knowledge, which was pilot tested by two emergency physicians and one psychiatrist for clarity and content. The survey was distributed via email to attending physician members of the Canadian Association of Emergency Physicians. Data were described using counts, means, medians and interquartile ranges. Results: 193 EPs responded to the survey (response rate 16%), with 42% of EPs practicing in Ontario. 35% of EPs were female, the mean age was 48 (95% CI 47.3-48.7), and mean years in practice was 17 (95% CI 16.3-17.7). Academic practice location was reported by 55% of EPs, and 81% reported access to an inpatient psychiatry service. Twenty four (12%) EPs had personally considered suicide, and 45% had experience with suicide in their personal lives. The top three risk factors for suicide identified by EPs were: intent for suicide (90%); a plan for suicide (89%); prior suicide attempt (88%). A majority of EPs were able to correctly identify the other risk factors for completion of suicide except for the following: diagnosis of anxiety disorder (25%), chronic substance use (43%), prior non-suicidal self-injury (37%), low socioeconomic status (34%). Conclusion: Canadian EPs have substantial personal experience with suicide. A majority of EPs were able to correctly identify known risk factors for suicide completion, yet important gaps in knowledge exist.

scholarly journals P102: What are Canadian emergency physicians’ attitudes toward, understanding of, and willingness to treat patients who have attempted suicide?

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S101-S102
Author(s):  
J. Fernandes ◽  
A. Chakraborty ◽  
F. Scheuermeyer ◽  
S. Barbic ◽  
D. Barbic
Keyword(s):  
Attempted Suicide ◽  
Healthcare Providers ◽  
Complete Agreement ◽  
Emergency Physicians ◽  
Inpatient Psychiatry ◽  
Web Based ◽  
Canadian Association ◽  
The Mean ◽  
Suicidal Patients ◽  
Attending Physician

Introduction: Suicide is the 9th leading cause of death in Canada, and a common reason for patients to present to Canadian emergency departments (ED). Little knowledge exists around Canadian emergency physicians (EPs) attitudes toward and understanding of individuals who have attempted suicide. Methods: We developed a web-based survey on attitudes around suicide, which was pilot tested by two EPs and one psychiatrist for clarity and content. The survey was distributed via email to attending physician members of the Canadian Association of Emergency Physicians. Data were described using counts, means, medians and interquartile ranges. We used the Understanding of Suicidal Patients (USP) Scale, an 11-point questionnaire utilized in previous studies to assess healthcare providers’ attitudes toward individuals who have attempted suicide. Each question was graded as a five-point Likert, with a score of 1 indicating complete agreement and a 5 indicating complete disagreement. A total USP score is calculated by adding together the score from each question and ranges from 11 to 55; a lower score indicates greater empathy and understanding of individuals who have attempted suicide. Results: 193 EPs responded to the survey, with 42% of EPs practicing in Ontario. 35% of EPs were female, the mean age was 48 (95% CI 47.3-48.7), and mean years in practice was 17 (95% CI 16.3-17.7). Academic practice location was reported by 55% of EPs, and 81% reported access to an inpatient psychiatry service. The mean USP score was 21.8 (95% CI 21.1-22.5) with a Cronbach's alpha of 0.75, the median was 22 [IQR 14-29]. The item that had most agreement from EPs was “I would like to help a person who has attempted suicide” (1.58, 95% CI 1.50-1.67), while the item that had the least agreement was “patients who have attempted suicide are usually treated well in my work unit” (2.54, 95% CI 2.40-2.69). Conclusion: Canadian EPs have a generally positive attitude toward treating individuals who have attempted suicide. EPs scored highly on a scale that measured willingness to provide care for and empathize with suicidal patients, yet identified that overall care for these patients could be improved.

scholarly journals Emergency physicians’ attitudes and perceived barriers to the implementation of take-home naloxone programs in Canadian emergency departments

CJEM ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Lauren Lacroix ◽  
Lisa Thurgur ◽  
Aaron M. Orkin ◽  
Jeffrey J. Perry ◽  
Ian G. Stiell
Keyword(s):  
At Risk ◽  
Perceived Barriers ◽  
Face Validity ◽  
Opioid Overdose ◽  
Emergency Physicians ◽  
Web Based ◽  
Health Crisis ◽  
Canadian Association ◽  
National Public Health

AbstractObjectivesRates of opioid-related deaths have reached the level of national public health crisis in Canada. Community-based opioid overdose education and naloxone distribution (OEND) programs distribute naloxone to people at risk, and the emergency department (ED) may be an underutilized setting to deliver naloxone to these people. The goal of this study was to identify Canadian emergency physicians’ attitudes and perceived barriers to the implementation of take-home naloxone programs.MethodsThis was an anonymous Web-based survey of members of the Canadian Association of Emergency Physicians. Survey questions were developed by the research team and piloted for face validity and clarity. Two reminder emails were sent to non-responders at 2-week intervals. Respondent demographics were collected, and Likert scales were used to assess attitudes and barriers to the prescription of naloxone from the ED.ResultsA total of 459 physicians responded. The majority of respondents were male (64%), worked in urban tertiary centres (58.3%), and lived in Ontario (50.6%). Overall, attitudes to OEND were strongly positive; 86% identified a willingness to prescribe naloxone from the ED. Perceived barriers included support for patient education (57%), access to follow-up (44%), and inadequate time (37%). In addition to people at risk of overdose, 77% of respondents identified that friends and family members may also benefit.ConclusionsCanadian emergency physicians are willing to distribute take-home naloxone, but thoughtful systems are required to facilitate opioid OEND implementation. These data will inform the development of these programs, with emphasis on multidisciplinary training and education.

scholarly journals Factors associated to breastfeeding in the first hour of life: systematic review

2014 ◽  
Vol 48 (4) ◽  
pp. 697-708 ◽  
Author(s):  
Tania Maria Brasil Esteves ◽  
Regina Paiva Daumas ◽  
Maria Inês Couto de Oliveira ◽  
Carlos Augusto de Ferreira de Andrade ◽  
Iuri Costa Leite
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Low Socioeconomic Status ◽  
Maternal Education ◽  
Family Income ◽  
Home Delivery ◽  
Access To Health Services ◽  
Low Socioeconomic ◽  
Poor Access ◽  
Independent Risk Factors

OBJECTIVE To identify independent risk factors for non-breastfeeding within the first hour of life.METHODS A systematic review of Medline, LILACS, Scopus, and Web of Science electronic databases, till August 30, 2013, was performed without restrictions on language or date of publishing. Studies that used regression models and provided adjusted measures of association were included. Studies in which the regression model was not specified or those based on specific populations regarding age or the presence of morbidities were excluded.RESULTS The search resulted in 155 articles, from which 18 met the inclusion criteria. These were conducted in Asia (9), Africa (5), and South America (4), between 1999 and 2013. The prevalence of breastfeeding within the first hour of life ranged from 11.4%, in a province of Saudi Arabia, to 83.3% in Sri Lanka. Cesarean delivery was the most consistent risk factor for non-breastfeeding within the first hour of life. “Low family income”, “maternal age less than 25 years”, “low maternal education”, “no prenatal visit”, “home delivery”, “no prenatal guidance on breastfeeding” and “preterm birth” were reported as risk factors in at least two studies.CONCLUSIONS Besides the hospital routines, indicators for low socioeconomic status and poor access to health services were also identified as independent risk factors for non-breastfeeding within the first hour of life. Policies to promote breastfeeding, appropriate to each context, should aim to reduce inequalities in health.

scholarly journals Childhood family income, adolescent violent criminality and substance misuse: quasi-experimental total population study

2014 ◽  
Vol 205 (4) ◽  
pp. 286-290 ◽  
Author(s):  
Amir Sariaslan ◽  
Henrik Larsson ◽  
Brian D'Onofrio ◽  
Niklas Långström ◽  
Paul Lichtenstein
Keyword(s):  
Risk Factors ◽  
Low Socioeconomic Status ◽  
Substance Misuse ◽  
Family Income ◽  
Familial Risk ◽  
Income Quintile ◽  
Low Socioeconomic ◽  
Quasi Experimental ◽  
Familial Risk Factors ◽  
Family Based

BackgroundLow socioeconomic status in childhood is a well-known predictor of subsequent criminal and substance misuse behaviours but the causal mechanisms are questioned.AimsTo investigate whether childhood family income predicts subsequent violent criminality and substance misuse and whether the associations are in turn explained by unobserved familial risk factors.MethodNationwide Swedish quasi-experimental, family-based study following cohorts born 1989–1993 (ntotal = 526 167, ncousins = 262 267, nsiblings = 216 424) between the ages of 15 and 21 years.ResultsChildren of parents in the lowest income quintile experienced a seven-fold increased hazard rate (HR) of being convicted of violent criminality compared with peers in the highest quintile (HR = 6.78, 95% CI 6.23–7.38). This association was entirely accounted for by unobserved familial risk factors (HR = 0.95, 95% CI 0.44–2.03). Similar pattern of effects was found for substance misuse.ConclusionsThere were no associations between childhood family income and subsequent violent criminality and substance misuse once we had adjusted for unobserved familial risk factors.

The accumulation of problems of social functioning as a long-term process: Women and men compared

2000 ◽  
Vol 24 (4) ◽  
pp. 442-450 ◽  
Author(s):  
Anna Rönkä ◽  
Ulla Kinnunen ◽  
Lea Pulkkinen
Keyword(s):  
Risk Factors ◽  
Social Functioning ◽  
Low Socioeconomic Status ◽  
Structural Equation ◽  
Childhood And Adolescence ◽  
School Problems ◽  
Low Socioeconomic ◽  
Drinking Problems ◽  
Parental Drinking ◽  
Early Timing

Structural equation modelling was used to analyse the developmental processes involved in the accumulation of problems of social functioning from age 8 to age 36 in men ( n = 152) and women ( n = 145). The accumulation of risk factors in childhood and adolescence, including low control of emotions (aggressiveness and anxiety), school problems (poor adjustment, success, and motivation), and problems in the family (parental drinking and low socioeconomic status), predicted career instability, early timing of parenthood, and a sense of failure at age 27 in both sexes. Similarly, the accumulation of problems of social functioning (e.g. poor financial standing, poor intimate relationships, and drinking problems) tended to continue from age 27 to 36, and be reciprocally associated with career instability at a corresponding age in both men and women. Risk factors in childhood and adolescence directly explained the accumulation of problems of social functioning at age 27 only in men. For women, the relationship was indirect: Asense of failure and the early timing of motherhood mediated risk factors to problems of social functioning at age 36.

scholarly journals Incidence and Risk Factors of Rachitic Genu Varus in Preschool Children in a Paediatric Health Institute in Egypt as One of the Developing Countries

2016 ◽  
Vol 10 (1) ◽  
pp. 412-419 ◽  
Author(s):  
Sherif N.G. Bishay ◽  
Mostafa H. A. El-Sherbini ◽  
Amre A. Azzam ◽  
Ashraf A. Lotfy
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Pregnant Women ◽  
Low Socioeconomic Status ◽  
Family Income ◽  
Cultural Practices ◽  
Clinical Laboratory ◽  
Low Socioeconomic ◽  
Egyptian Children ◽  
Genu Varus

Background:Rachitic genu varus is one of the common conditions among the Egyptian children, despite the shinning sun of Egypt all the year.Purpose:The aim of the study was to estimate the incidence of rachitic genu varus among the Egyptian children, and to assess the risk factors contributing to it.Patients and Methods:This prospective study recruited a total of 250 consecutive children, being 130 males and 120 females, with rachitic bow legs or genu varus, between 2 - 4 years of age, together with 250 controls of the same age group, out of a total number of 1900 children with other types of rickets, and other children's orthopaedic diseases, who presented to the National Institute of Neuromotor System in Egypt between September 2014 to September 2015. The cases and the controls were subjected to clinical, laboratory biochemical, and plain radiographic examinations. Their parents were subjected to epidemiological, maternal, and nutritional questionnaires.Results:The calculations revealed high incidence (13.1%) of rachitic genu varus. The risk factors were low socioeconomic status, insufficient family income, poor housing conditions, lack of exposure to sunlight due to cultural practices, sole breast feeding, and inadequate supplementation of vitamin D to the children and the pregnant women. Thepvalue was <0.05.Conclusion:Vitamin D deficiency rachitic genu varus is a multifactorial condition in Egypt. Raising the standard of living, level of education, housings, and dietary supplementation of vitamin D to the pregnant women and infants are the solution.

scholarly journals Outcomes of Equity-Oriented, Web-Based Parenting Information in Mothers of Low Socioeconomic Status Compared to Other Mothers: Participatory Mixed Methods Study

10.2196/22440 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e22440
Author(s):  
Pierre Pluye ◽  
Reem El Sherif ◽  
Araceli Gonzalez-Reyes ◽  
Emmanuelle Turcotte ◽  
Tibor Schuster ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Socioeconomic Status ◽  
Information Needs ◽  
Consumer Health Information ◽  
Low Ses ◽  
Consumer Health ◽  
Web Based ◽  
Low Socioeconomic ◽  
And Behavior ◽  
Short Narrative

Background Typically, web-based consumer health information is considered more beneficial for people with high levels of education and income. No evidence shows that equity-oriented information offers equal benefits to all. This is important for parents of low socioeconomic status (SES; low levels of education and income and usually a low level of literacy). Objective This study is based on a conceptual framework of information outcomes. In light of this, it aims to compare the perception of the outcomes of web-based parenting information in low-SES mothers with that of other mothers and explore the perspective of low-SES mothers on contextual factors and information needs and behavior associated with these outcomes. Methods A participatory mixed methods research was conducted in partnership with academic researchers and Naître et grandir (N&G) editors. N&G is a magazine, website, and newsletter that offers trustworthy parenting information on child development, education, health, and well-being in a format that is easy to read, listen, or watch. Quantitative component (QUAN) included a 3-year longitudinal observational web survey; participants were mothers of 0- to 8-year-old children. For each N&G newsletter, the participants’ perception regarding the outcomes of specific N&G webpages was gathered using a content-validated Information Assessment Method (IAM) questionnaire. Differences between participants of low SES versus others were estimated. Qualitative component (QUAL) was interpretive; participants were low-SES mothers. The thematic analysis of interview transcripts identified participants’ characteristics and different sources of information depending on information needs. Findings from the two components were integrated (QUAN+QUAL integration) through the conceptual framework and assimilated into the description of an ideal-typical mother of low SES (Kate). A narrative describes Kate’s perception of the outcomes of web-based parenting information and her perspective on contextual factors, information needs, and behavior associated with these outcomes. Results QUAN—a total of 1889 participants completed 2447 IAM responses (50 from mothers of low SES and 2397 from other mothers). N&G information was more likely to help low-SES participants to better understand something, decrease worries, and increase self-confidence in decision making. QUAL—the 40 participants (21 N&G users and 19 nonusers) used 4 information sources in an iterative manner: websites, forums, relatives, and professionals. The integration of QUAN and QUAL findings provides a short narrative, Kate, which summarizes the main findings. Conclusions This is the first study comparing perceptions of information outcomes in low-SES mothers with those of other mothers. Findings suggest that equity-oriented, web-based parenting information can offer equal benefits to all, including low-SES mothers. The short narrative, Kate, can be quickly read by decision policy makers, for example, web editors, and might encourage them to reach the underserved and provide and assess trustworthy web-based consumer health information in a format that is easy to read, listen, or watch.

scholarly journals Prevalence and Risk Factors of Food Insecurity among Mexican University Students’ Households

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3426
Author(s):  
Pablo Alejandro Nava-Amante ◽  
Alejandra Betancourt-Núñez ◽  
Barbara Vizmanos ◽  
Miguel Amaury Salas-García ◽  
María Fernanda Bernal-Orozco ◽  
...  
Keyword(s):  
Risk Factors ◽  
University Students ◽  
Food Insecurity ◽  
Low Socioeconomic Status ◽  
Sociodemographic Factors ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Low Socioeconomic ◽  
Indigenous Group ◽  
Sectional Analysis

Household food insecurity (FI) remains a major public health challenge worldwide. Data about perceived FI and its risk factors in Mexican university students are lacking. We aimed to assess FI’s prevalence and factors affecting it among university students’ households in Mexico. This cross-sectional analysis involved 7671 university students’ households using the 2018 Mexican National of Household Income and Expenditure Survey data. Variables analyzed included sociodemographic characteristics, and the 12-item validated Mexican Scale for Food Security (EMSA). Multivariable logistic regression modelling was performed to identify FI risk factors. The overall household FI prevalence was 30.8%. According to FI severity, prevalence rates were 16.3% for mild-FI, 8.8% for moderate-FI, and 5.7% for severe-FI. Low socioeconomic status (OR = 2.72; 95%CI: 2.09–3.54), low education level of household’s head (OR = 2.36; 95%CI: 1.90–2.94), self-ascription to an indigenous group (OR = 1.59; 95%CI: 1.41–1.79), attending public university (OR = 1.27; 95%CI: 1.13–1.43), female-headed household (OR = 1.26; 95%CI: 1.13–1.40), having worked recently (OR = 1.19; 95%CI: 1.07–1.33), and being in second year of studies (OR = 1.17; 95%CI: 1.03–1.33), were significantly related to FI. Our results confirm that FI is highly prevalent among Mexican university students’ households and that sociodemographic factors are essential in addressing this concern. Findings highlight the need for preventive programs and policies to alleviate FI.

scholarly journals Risk factors for sleep problems in infants

2020 ◽  
Vol 60 (4) ◽  
pp. 186-91
Author(s):  
Hesti Lestari ◽  
Audrey Mety Iriani Wahani ◽  
Rocky Wilar ◽  
Permatami Herwansyah
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Multivariate Analysis ◽  
Sleep Disorders ◽  
Low Socioeconomic Status ◽  
Exclusive Breastfeeding ◽  
Maternal Education ◽  
Electronic Media ◽  
Sleeping Position ◽  
Low Socioeconomic

Background Sleep disorders in infants can cause developmental problems, suboptimal growth, behavioral disorders, fatigue, irritability, impulsiveness, and poor mother-infant bonding. Objective To evaluate possible risk factors for sleep disorders in infants. Methods This cross-sectional study was conducted in healthy infants aged 3-6 months. Subjects were selected using proportional random sampling from four different primary healthcare facilities in Manado, North Sulawesi. Their parents completed the Brief Infant Sleep Questionnaire. Sleep disorder was defined as the presence of one or more conditions including sleep duration less than 9 hours at night (from 19.00 until 07.00), waking up at night (from 22.00 until 06.00) more than 3 times, and more than 1 hour waking at night. Results Of 112 subjects, 58 (51.8%) were male. Subjects’ mean age was 4.21 (SD 0.829) months and 76 (67.86%) experienced sleep disorders. Sleep disorders had significant associations with low socioeconomic status (OR 17; 95%CI 3.8 to 75.8), middle school or lower maternal education (OR 44.5; 95%CI 9.8 to 202), non-supine sleeping position (OR 8.8; 95%CI 1.9 to 39.7), parental use of electronic devices (OR 156.2; 95%CI 35.1 to 692.9), and non-exclusive breastfeeding (OR 85.2; 95%CI 21.1 to 344.2). Correlative analyses also revealed that electronic media usage had the strongest association with sleep disorders, followed by breastfeeding pattern, maternal education, socioeconomic status, and sleeping position ( 0.839, 0.771, 0.624, 0.433, and 0.309, respectively).  However, there were no significant correlations upon  multivariate analysis. Conclusion Parental use of electronic media before sleeping is the strongest risk factor for sleep disorders among infants, followed by non-exclusive breastfeeding pattern, low maternal education, low socioeconomic status, and non-supine sleeping position. However, none of these correlations were significant upon multivariate analysis, this show that all these factors influence sleep together

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