Incidence and outcomes of bulimia nervosa: a nationwide population-based study

2008 ◽  
Vol 39 (5) ◽  
pp. 823-831 ◽  
Author(s):  
A. Keski-Rahkonen ◽  
H. W. Hoek ◽  
M. S. Linna ◽  
A. Raevuori ◽  
E. Sihvola ◽  
...  
Keyword(s):  
Health Care ◽  
Bulimia Nervosa ◽  
Health Care Professionals ◽  
Psychological Symptoms ◽  
Population Based ◽  
Clinical Settings ◽  
Birth Cohorts ◽  
Clinical Recovery ◽  
Dsm Iv ◽  
First Time

BackgroundLittle is known about the epidemiology of bulimia nervosa outside clinical settings. We report the incidence, prevalence and outcomes of bulimia nervosa using for the first time a nationwide study design.MethodTo assess the incidence and natural course and outcomes of DSM-IV bulimia nervosa among women from the general population, women (n=2881) from the 1975–79 birth cohorts of Finnish twins were screened for lifetime eating disorders using a two-stage procedure consisting of a questionnaire screen and the Structured Clinical Interview for DSM-IV (SCID). Clinical recovery was defined as 1-year abstinence from bingeing and purging combined with a body mass index (BMI) ⩾19 kg/m2.ResultsThe lifetime prevalence of DSM-IV bulimia nervosa was 2.3%; 76% of the women suffered from its purging subtype and 24% from the non-purging subtype. The incidence rate of bulimia nervosa was 300/100000 person-years at the peak age of incidence, 16–20 years, and 150/100000 at 10–24 years. The 5-year clinical recovery rate was 55.0%. Less than a third of the cases had been detected by health-care professionals; detection did not influence outcome. After clinical recovery from bulimia nervosa, the mean levels of residual psychological symptoms gradually decreased over time but many women continued to experience significantly more body image problems and psychosomatic symptoms than never-ill women.ConclusionsFew women with bulimia nervosa are recognized in health-care settings. Symptoms of bulimia are relatively long-standing, and recovery is gradual. Many clinically recovered women experience residual psychological symptoms after attaining abstinence from bingeing and purging.

Achieving shared understanding in chronic care interactions: the role of caregivers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sarah Bigi
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Second Step ◽  
Original Research ◽  
Clinical Settings ◽  
Shared Understanding ◽  
Content Type

Purpose Within the context of a research program on the most relevant discourse types in chronic care medical encounters, this contribution reports on a qualitative study on the role caregivers play within the process of shared understanding occurring between health-care professionals and elderly patients. The purpose of the paper is to highlight one dimension of such complexity, by bringing to light the challenges connected to the achievement of shared understanding between health-care professionals and elderly patients when caregivers are involved in the conversation. Design/methodology/approach The paper reports on a two-step analysis of a corpus of transcripts of interactions in diabetes and hypertension settings. In the first step, caregivers’ contributions to deliberative sequences have been analyzed. In the second step, the analysis was extended to caregivers’ contributions to the whole encounter. Findings The results show that professionals’ ability to engage caregivers in deliberations during the encounter and, more generally, to assign a role to caregivers as legitimate participants in the consultation may favor the smooth development of the interaction and an effective process of shared understanding among all participants. Originality/value The paper further develops original research about the functions of the argumentative component in dialogues occurring in clinical settings.

scholarly journals Examination of Coping Strategies among On-Site Paramedics

2021 ◽  
Vol 16 (2) ◽  
pp. 184-195
Author(s):  
Vladimír Moskola ◽  
Ágnes Dóra Sándor ◽  
Éva Susánszky ◽  
Andrea Székely ◽  
István Hornyák ◽  
...  
Keyword(s):  
Health Care ◽  
Coping Strategies ◽  
Health Care Professionals ◽  
Psychological Symptoms ◽  
Health Behaviours ◽  
Patient Treatment ◽  
Negative Effects ◽  
Ambulance Personnel ◽  
Level Of Education ◽  
Ways Of Coping Questionnaire

The occurrence of physical and psychological symptoms that negatively influence everyday activities, efficient job performance, and professional patient treatment are common among paramedic workers. Aim: We uncovered the characteristic coping strategies applied by on-site paramedics and searched for correlations between these strategies and demographic, socio-economic characteristics, as well as factors related to work, workplace, and health behaviours. Sample and methodology: The survey was conducted between March 1, 2018, and February 28, 2019, among employees of the DG National Ambulance Service and participants of the Chamber of Hungarian Health Care Professionals. We used an abbreviated version of the Ways of Coping Questionnaire that contains 22 items (WOC-22). Descriptive statistics, independent samples T-tests, correlation calculations, analysis of variance with the Games-Howell post-hoc test were also carried out. Results: Tension reduction was a more common coping strategy among female and/or single paramedics as well as also being characteristic of people who work as paramedic officers. Problem-oriented coping stood out as a characteristic of people who have a higher level of education and/or are more satisfied with their financial situation. Risk-seeking appears dominantly among those who are not religious and/or have a lower level of education. Conclusions: Although paramedics are basically characterized by problem-oriented coping strategies, they quite often apply non-adaptive strategies as well; consequently, the chance of developing anxiety remains higher for them. Our aim is to use effective intervention methods for curbing the development of anxiety conditions among the ambulance personnel that have long-lasting negative effects on health care. To achieve this goal, we recommend including a questionnaire about coping strategies into the admission process of would-be paramedics; also, completing such questionnaires among the whole emergency workforce.

Triumph of the Heart

2009 ◽  
Author(s):  
Jie Jack Li
Keyword(s):  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Health Care Professionals ◽  
Heart Attack ◽  
Life Saving ◽  
Human Side ◽  
First Time ◽  
Important Drug ◽  
The U.S

Over 25 million people in the U.S. alone have benefited from statins--such drugs as Lipitor, Zocor, Crestor, Pravachol, and other cholesterol-lowering medicines--in preventing stroke, heart attack, and other forms of coronary heart disease. But how did these remarkable, life-saving drugs come into being? In Triumph of the Heart, Dr. Jie Jack Li, a medicinal chemist and expert on drug discovery, tells for the first time the fascinating story of statins. Drawn from discussions with many scientists involved in the discovery and development of these drugs, the book illuminates the human side of science by revealing the role played by persistence, luck, and sudden insight that characterize major discoveries. For scientists in the drug industry, health care professionals, students of medicine, and all those intrigued by the basic human drive to explore and discover, Triumph of the Heart offers a compelling view of one of the most important drug discoveries of our time.

Body symbolics, obstetric practices, and the improvement of maternal health in Cambodia

2020 ◽  
pp. 450-471
Author(s):  
Clémence Schantz
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Participant Observation ◽  
The Body ◽  
Clinical Settings ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Phnom Penh ◽  
Frequent Use

Cambodia is one of the nine countries worldwide to have reduced its maternal mortality rate by more than 75 per cent between 1990 and 2015. Whilst prior to the 2000s, childbirth in Cambodia used to be a private event, it has now become a biomedical event for women and their families. This chapter describes the findings of mixed-method research challenging the idealized vision of the United Nations regarding maternal health in Cambodia by describing obstetrical practices on the ground, from an empirical study led in several clinical settings in Phnom Penh, through participant observation, semi-structured interviews with health-care professionals and patients, questionnaires with pregnant women, to the examination of medical records from four Phnom Penh maternity wards. The findings demonstrate that the biomedicalization of childbirth in Cambodia has been accompanied by technologized delivery with extremely frequent use of surgical practices. In order to understand the population’s adherence to these practices, the chapter draws out a number of anthropological and demographic arguments. These biomedical practices are part of a symbolism of the body where the body is conceived as a receptacle, where the body humours must be able to circulate appropriately, and where the hot/cold balance must be respected. Childbirth as an opening of the body represents a danger for women because it threatens this equilibrium.

Use of Alternative Treatments by People with Multiple Sclerosis

1999 ◽  
Vol 13 (4) ◽  
pp. 243-254 ◽  
Author(s):  
Cathy S. Berkman ◽  
Monica G. Pignotti ◽  
Pamela F. Cavallo ◽  
Nancy J. Holland
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Professionals ◽  
Complementary Therapies ◽  
Psychological Symptoms ◽  
Alternative Treatments ◽  
Disease Characteristics ◽  
Specific Alternative ◽  
National Multiple Sclerosis Society ◽  
Treatment Use

The prevalence, predictors, and description of alternative treatment use among peo ple with multiple sclerosis (MS) have not been well studied despite interest and con cern about such use among health care professionals and people with MS. The goal of this study was to describe the prevalence of the use of specific alternative treatments by people with MS, the sociodemographic and disease characteristics of those most likely to use alternative treatments, perceived benefits and harms from use of these treatments, and the reasons for their use. Almost three-fifths of the study sample of 240 people diagnosed with MS from two chapters of the National Multiple Sclerosis Society had used alternative treatments. Most (90 percent) of those who had used al ternative treatments did so in combination with traditional treatments. Only 7.1 per cent used any treatments considered to be high risk or dangerous. The primary reason for using alternative treatments was to obtain relief from physical and psychological symptoms. Implications of these findings for health care professionals are discussed. Key Words: Multiple sclerosis—Alternative therapies—Complementary therapies— Alternative medical practices—Unconventional medicine.

Attention behavior and hyperactivity and concurrent neurocognitive and social competence functioning in 4-year-olds from two population-based birth cohorts

2011 ◽  
Vol 26 (6) ◽  
pp. 381-389 ◽  
Author(s):  
J. Julvez ◽  
M. Forns ◽  
N. Ribas-Fitó ◽  
M. Torrent ◽  
J. Sunyer
Keyword(s):  
Social Competence ◽  
Regression Models ◽  
Neuropsychological Functioning ◽  
Population Based ◽  
Adhd Symptoms ◽  
Older Children ◽  
Birth Cohorts ◽  
Hyperactivity Disorder ◽  
Symptom Scores ◽  
Dsm Iv

AbstractObjectiveWe studied the associations between Attention Deficit Hyperactivity Disorder (ADHD) symptoms and the neurobehavioral status in two population-based birth cohorts.MethodsChildren (n = 467) were assessed by psychologists and teachers for neuropsychological functioning (McCarthy Scales, MCSA), inattention-hyperactivity symptoms (ADHD-DSM-IV form list) and social behavior (California Preschool Social Competence Scale, CPSCS). Regression models were used with covariate adjustment.ResultsSixteen percent of children had ADHD-DSM-IV symptoms. MCSA scores were linearly associated with ADHD symptom scores (general cognitive Beta = −0.6 [−1.0; −0.3] per symptom), specifically inattention scores (general cognitive Beta = −1.8 [−2.3; −1.2]). CPSCS scores were associated with ADHD symptoms (Beta = −2.19 [−2.5; −1.9]). MCSA scores of executive function, perceptive-performance and quantitative sub-areas had stronger associations with ADHD symptoms.ConclusionsPreschooler ADHD symptoms are associated with concurrent decrements in neurocognitive and social competence functioning. The association patterns are similar to those found in older children with ADHD symptomology (Marks et al., 2005 [36], Seidman, 2006 [46], Sonuga-Barke et al., 2003 [48], Yochman et al., 2006 [53]).

scholarly journals Distrust in the End-of-Life Care Provided to a Parent and Long-Term Negative Outcomes Among Bereaved Adolescents: A Population-Based Survey Study

2017 ◽  
Vol 35 (27) ◽  
pp. 3136-3142 ◽  
Author(s):  
Kim Beernaert ◽  
Ulrika Kreicbergs ◽  
Carl Johan Fürst ◽  
Tommy Nyberg ◽  
Gunnar Steineck ◽  
...  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Professionals ◽  
Severe Depression ◽  
Nationwide Survey ◽  
Population Based ◽  
Survey Study ◽  
Negative Outcomes ◽  
Long Term Outcomes

Purpose Previous research shows that the death of a parent places children at risk for a number of negative outcomes. The role of trust in health care at the end of life has been acknowledged as crucial for patients and adult family members. However, the consequences of children’s distrust in the care provided to their parents remain unknown. Therefore, we investigated the negative long-term outcomes of cancer-bereaved sons’ and daughters’ distrust in the care that was provided to a dying parent. Methods We used a population-based nationwide survey to investigate self-reported distrust in the care provided and possible negative outcomes in 622 (73%) participants who had lost a parent as a result of cancer 6 to 9 years earlier, at ages 13 to 16 years. All participants were 18 years or older at the time of the survey. Results In those who reported no or little trust (ie, distrust) in the health care provided to their dying parents, we found statistically significantly higher risks of various negative outcomes at the time of survey: bitterness toward health care professionals for not having done everything that was possible (crude risk ratio [RR], 3.5; 95% CI, 2.3 to 5.1) and for having stopped treatment (RR, 3.4; 95% CI, 2.1 to 6.0), self-destructiveness (eg, self-injury [RR, 1.7; 95% CI, 1.2 to 2.4]), and psychological problems (eg, moderate to severe depression according to the Patient Health Questionnaire–9 [RR, 2.3; 95% CI, 1.5 to 3.5]). Conclusion In cancer-bereaved former adolescents, distrust in the health care provided to the dying parent is associated with a higher risk of negative long-term outcomes. The health care professionals involved in this care might play an important role in safeguarding the trust of adolescents.

scholarly journals Why People Living With and Beyond Cancer Use the Internet

2019 ◽  
Vol 18 ◽  
pp. 153473541982983 ◽  
Author(s):  
Michelle Marie Holmes
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Psychological Symptoms ◽  
Treatment Options ◽  
Information Provision ◽  
Self Management ◽  
The Internet ◽  
Wide Range ◽  
Complementary And Alternative

People living with and beyond cancer suffer with a wide range of physical and psychological symptoms. To manage the challenges associated with cancer, patients use a variety of self-management resources, including the Internet. People living with and beyond cancer use the Internet to make decisions regarding their self-care, through information provision, online communities, and support groups. Using the Internet may empower patients, enabling them to feel they have the required knowledge to discuss complementary and alternative treatment options with their health care team. Patients use the Internet because of its practicality; however, there are also several barriers affecting patients with cancer using the Internet, such as lack of information technology skills, lack of computer access, and concerns over the quality of information. Health care professionals need to be aware that the information available on the Internet plays a factor in the decision-making processes regarding using complementary and alternative medicine for self-management. With the use of the Internet as a tool for self-management continuing to grow, it is recommended that more emphasis is placed on health care professionals discussing the role the Internet plays in the decision-making process, to further support their patients regarding self-management for living with and beyond cancer.

scholarly journals Rapid prototyping and clinical testing of a reusable face shield for health care workers responding to the COVID-19 pandemic

2020 ◽  
Author(s):  
Arash Mostaghimi ◽  
M.-J. Antonini ◽  
Deborah Plana ◽  
Philip D. Anderson ◽  
Brandon Beller ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Medical Center ◽  
Academic Medical Center ◽  
Clinical Settings ◽  
Hospital Administrators ◽  
Incident Command ◽  
Academic Medical ◽  
Survey Results ◽  
Materials Used

AbstractDue to supply chain disruption, the COVID-19 pandemic has caused severe shortages in personal protective equipment (PPE) for health care professionals. Local fabrication based on 3D printing is one way to address this challenge, particularly in the case of simple products such as protective face shields. As a consequence, many public domain designs for face shields have become available. No clear path exists, however, for introducing a locally fabricated and unapproved product into a clinical setting. In a US health care setting, face shields are regulated by the Food and Drug Administration (FDA); similar policies exist in other countries. We describe a research protocol under which rapid iteration on an existing design, coupled with clinical feedback and real-world testing in an emergency department, allowed a face shield to be implemented by the members of the incident command team at a major academic medical center. We describe our design and testing process and provide an overview of regulatory considerations associated with fabrication and testing of face shields and related products. All designs, materials used, testing protocols, and survey results are reported in full to facilitate the execution of similar face shield efforts in other clinical settings. Our work serves as a case study for development of a robust local response to pandemics and other health care emergencies, with implications for healthcare professionals, hospital administrators, regulatory agencies and concerned citizens.

scholarly journals The Knowledge and Perception of Hand Hygiene Among Health Care Workers in Clinical Settings in Khartoum State - Sudan

2020 ◽  
Vol 1 (2) ◽  
pp. 15-28
Author(s):  
Ragda M. BaderAldeen ◽  
Salah I. Kheder
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Hospital Staff ◽  
Good Knowledge ◽  
P Value ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Care Workers

Objective This study conducted to assess health care practitioners’ knowledge and perceptions of hand hygiene among health professional working in clinical settings in Khartoum State - Sudan. with the specific objective of determining the association between their stance on hand hygiene and the general demographic characteristics of these health-care professionals. Methodology This is a cross-sectional study conducted between July and November 2017 using a modified form of WHO questionnaire for knowledge and perception that was included 22 items was sent online to health care workers via social media. The data obtained entered and analyzed by SPSS version 24. Chi-square and test of independence were used as a test of significance. A p-value of < 0.05 was considered statistically significant for all purposes. Result 437 hospital staff were responded to the questionnaire. (99.3%) was found to have good knowledge. 197(45.2%) had good perception and 239(54.8%) had fair perception. Formal hand hygiene training was found to have no association with knowledge levels of hand hygiene, but the fair perception was higher in the respondents who didn’t receive formal training. Conclusion The present study highlights the hand hygiene knowledge and perception. Most health care workers were found to have good knowledge, and the majority was found to have a fair perception. Formal hand hygiene training courses were found to have no association with knowledge but it may be reflected in practice. The importance of training sessions regarding hand hygiene was noticed in the perception level.

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