Predictors of Demand for Emergency Prehospital Care: An Australian Study

1999 ◽  
Vol 14 (3) ◽  
pp. 60-66 ◽  
Author(s):  
Michele J. Clark ◽  
Jennifer Purdie ◽  
Gerry J. FitzGerald ◽  
Noelene G. Bischoff ◽  
Peter K. O'Rourke
Keyword(s):  
Health Status ◽  
Confidence Interval ◽  
Medical Condition ◽  
Prehospital Care ◽  
Prevalence Ratio ◽  
Economic Incentive ◽  
Time Of Day ◽  
Insurance Status ◽  
Cross Sectional ◽  
Patient Disposition

AbstractIntroduction:Determining the predictors of demand for emergency prehospital care can assist ambulance services in undertaking policy and planning activities.Hypothesis:Demand for prehospital care can be explained by demographic, health status, and economic determinants.Methods:The study used a cross-sectional design to investigate the association of demographic, health status, and insurance factors with the use of prehospital, ambulance care. Core data items including age, gender, marital status, country of origin, triage score, diagnosis, time of presentation, method of arrival, and patient disposition were collected for every patient who pre-sented at the Emergency Department of the study hospital over a four-month period. Ambulance usage was analysed using Poisson regression.Results:For the 10,229 patients surveyed, only a small number were triaged as having the highest level of urgent medical need (0.8%), but the majority of these used prehospital emergency medical care (90.2%). Predictors of ambulance use included age >65years (Prevalence Ratio [Prevalence Ratio] = 2.92; 95% confidence interval [ Confidence Interval]: 2.35–3.63), being married or in a defacto relationship (Prevalence Ratio = 0.69; 95% Confidence Interval: 0.60–0.79) or divorced, separated, or widowed (Prevalence Ratio = 0.83; 95% Confidence Interval: 0.70–0.98), triage score level 1 or 2 (Prevalence Ratio = 1.95; 95% Confidence Interval: 1.68–2.28), or triage score level 3 (Prevalence Ratio = 1.54; 95% Confidence Interval: 1.38–1.72), diagnosis involving either mental (Prevalence Ratio = 4.29; 95% Confidence Interval: 1.84–10.01), nervous (Prevalence Ratio = 2.74; 95% Confidence Interval: 1.19–6.31) or trauma (Prevalence Ratio = 2.33; 95% Confidence Interval: 1.03–5.27) conditions, and insurance status (Prevalence Ratio =1.54; 95% Confidence Interval: 1.40–1.71). Ethnicity, gender, and time of day were not associated with usage.Conclusion:Demand for ambulance services can be predicted by a number of demographic, medical status, and insurance variables. Age and triage levels are key influences on demand for ambulance services. Ambulance insurance status provides an economic incentive to use ambulance services regardless of the urgency of the medical condition.

scholarly journals Prevalence of influenza and adherence to the anti-flu vaccination among elderly

2012 ◽  
Vol 45 (6) ◽  
pp. 670-674 ◽  
Author(s):  
Eduardo Yukio Nakamura ◽  
Luane Marques de Mello ◽  
Anderson Soares da Silva ◽  
Altacílio Aparecido Nunes
Keyword(s):  
Confidence Interval ◽  
Prevalence Ratio ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Flu Vaccination ◽  
Structured Questionnaire ◽  
The Ideal

INTRODUCTION: The flu, a condition that can affect the elderly by increasing the risk of serious complications can be prevented through vaccination. Estimate the prevalence of signs and symptoms suggestive of influenza in a group of elderly either vaccinated or unvaccinated against influenza was the objective this study. METHODS: This is a cross-sectional study performed in a Brazilian City. A structured questionnaire was employed to identify the presence of signs and symptoms of influenza in individuals aged 60 years or over. For analysis of associations between variables the prevalence ratio (PR) and its 95% confidence interval (95% CI) were used. RESULTS: One hundred ninety-six participants were interviewed, of whom 57.7% were female. The average age was 69.7 years. About 25% of the vaccinated and 20% of the unvaccinated in 2009, and 25% of the vaccinated and 22.5% of the unvaccinated in 2010 reported having the flu. Among the vaccinated and unvaccinated in 2009 and 2010, there was no verified association between vaccination and influenza (PR=1.24; [95% CI: 0.63-2.43] and PR=1.11; [95% CI: 0.59-2.09], respectively). CONCLUSIONS: This study suggests that, among the elderly selected, the vaccination coverage for influenza is below the ideal, even with projection of the best indices for 2011 (~ 84%). The data on vaccination and disease protection needs further research; however, the results point to the need for measures to better clarify to this population about the disease, its complications and the benefits of vaccination, in addition to combatting the stigma related to low adherence.

scholarly journals Is Distance to the Nearest Registered Public Automated Defibrillator Associated with the Probability of Bystander Shock for Victims of Out-of-Hospital Cardiac Arrest?

2018 ◽  
Vol 33 (2) ◽  
pp. 153-159 ◽  
Author(s):  
Joel Neves Briard ◽  
Luc de Montigny ◽  
Dave Ross ◽  
François de Champlain ◽  
Eli Segal
Keyword(s):  
Cardiac Arrest ◽  
Urban Areas ◽  
Prehospital Care ◽  
Time Of Day ◽  
Publication Type ◽  
Cross Sectional ◽  
Automated External Defibrillators ◽  
Life Saving ◽  
Sectional Analysis ◽  
Hospital Cardiac Arrest

AbstractIntroductionRapid access to defibrillation is a key element in the management of out-of-hospital cardiac arrests (OHCAs). Public automated external defibrillators (PAEDs) are becoming increasingly available, but little information exists regarding the relation between the proximity to the arrest and their usage in urban areas.MethodsThis study is a retrospective, observational, cross-sectional analysis of non-traumatic OHCA during a 24-month period in the greater Montreal area (Quebec, Canada). Using logistic regression, bystander shock odds are described with regards to distance from the OHCA scene to the nearest PAED, adjusted for prehospital care arrival delay and time of day, and stratifying for type of location.ResultsOut of a total of 2,443 OHCA victims identified, 77 (3%) received bystander PAED shock, 622 (26%) occurred out-of-home, and 743 (30%) occurred during business hours. When controlling for time (business hours versus other hours) and minimum response delay for prehospital care arrival, a marginal negative association was found between bystander shock and distance to the nearest PAED in logged meters (aOR=0.80; CI, 0.64-0.99) for out-of-home cardiac arrests. No significant association was found between distance and bystander shock for at-home arrests. Out-of-home victims had significantly higher odds of receiving bystander shock up to 175 meters of distance to a PAED inclusively (aOR=2.52; CI, 1.07-5.89).ConclusionFor out-of-home cardiac arrests, proximity to a PAED was associated with bystander shock in the greater Montreal area. Strategies aiming to increase accessibility and use of these life-saving devices could further expand this advantage by assisting bystanders in rapidly locating nearby PAEDs.Neves BriardJ, de MontignyL, RossD, de ChamplainF, SegalE. Is distance to the nearest registered public automated defibrillator associated with the probability of bystander shock for victims of out-of-hospital cardiac arrest?Prehosp Disaster Med. 2018;33(2):153–159.

scholarly journals A cross-sectional study of the health status of Swiss primary care physicians

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Sebo ◽  
Thierry Favrod-Coune ◽  
Liv Mahler ◽  
Amir Moussa ◽  
Christine Cohidon ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Psychological Health ◽  
Primary Care Physicians ◽  
Medical Condition ◽  
Good Health ◽  
Cross Sectional Study ◽  
Cardiovascular Disorders ◽  
Cross Sectional ◽  
The Past

AbstractThere is limited data on the general health of primary care physicians (PCPs). We aimed to assess the physical and psychological health of Swiss PCPs. We selected a random sample of 1000 PCPs in Western Switzerland. They were asked about their self-rated health status, all medical conditions experienced in the past five years, and the number of days they were hospitalized and off work in 2019. They were also asked whether they had their own general practitioner (GP) and seen a psychiatrist/psychologist in the past 12 months. A total of 503 PCPs were included in the study (women = 51%, GPs = 67%, pediatricians = 19%, gynecologists = 14%). Ninety-four percent considered themselves in good or very good health. In the past five years, PCPs suffered mostly from depression/anxiety (21%), burnout (21%), dyslipidemia (19%) and hypertension (17%). Male and older PCPs had more often cardiovascular disorders, younger PCPs and GPs had more often psychiatric disorders. They were 9% to have been hospitalized (15% for PCPs over 60) and 20% to have been off work (32% for PCPs under 45). Only 47% had their own GP (37% for GPs). They were 16% (mostly female and younger PCPs) to have consulted a psychiatrist/psychologist. In conclusion, although PCPs considered themselves to be in good health, a substantial proportion suffered from a medical condition, mainly psychiatric (depression or burnout) and/or cardiovascular disorders, or were recently hospitalized or off work. Only half had a GP for themselves. These results may be useful for implementing specific health strategies targeting PCPs.

scholarly journals Elderly persons who live alone in Brazil and their lifestyle

2018 ◽  
Vol 21 (5) ◽  
pp. 523-531 ◽  
Author(s):  
Etienne Larissa Duim Negrini ◽  
Carla Ferreira do Nascimento ◽  
Alexandre da Silva ◽  
José Leopoldo Ferreira Antunes
Keyword(s):  
Health Status ◽  
Confidence Interval ◽  
Eating Habits ◽  
Prevalence Ratio ◽  
National Health Survey ◽  
Geographic Region ◽  
Living Alone ◽  
Elderly Persons ◽  
Characteristics Method ◽  
Health Related

Abstract Objective: to assess the prevalence of elderly persons living alone in Brazil, based on covariates of health status, behavior and socio-demographic characteristics. Method: data from 11,967 individuals (aged 60 or over) were obtained from the National Health Survey (Brazil, 2013). Living alone was defined as residing in a one-person household. The prevalence of individuals living alone was stratified by socio-demographic conditions and geographic region. Living alone was also assessed as a factor for outcomes of physical functioning, behavior and health conditions. Poisson regression models were used to evaluate the prevalence ratios and a 95% confidence interval was applied. Results: in Brazil, 15.3% of people aged 60 years and over live alone. This condition is more prevalent in higher income regions; however, more lower-income individuals were affected. Prevalence was higher among women and individuals aged 75 years or more. Living alone was associated with difficulties in instrumental activities of daily living (prevalence ratio 1.15; 95% confidence interval 1.04-1.28); the reporting of an illness in the two prior to the study (PR=1.35; 95%CI=1.16-1.57); watching television (five or more hours daily) (PR=1.40; 95%CI=1.26-1.56) and falls in the previous year (PR=1.35; 95%CI=1.10-1.66). Elderly persons living alone also had worse eating habits, with a less frequent intake of meat, beans and salads than their counterparts who lived with others. Conclusion: elderly persons living alone in Brazil have a worse health status and health-related habits. These findings represent a challenge and should motivate social and health policies aimed at fulfilling the greater needs of adults who grow old alone.

scholarly journals Changes in substance use among young adults during a respiratory disease pandemic

2020 ◽  
Vol 8 ◽  
pp. 205031212096532
Author(s):  
Pravesh Sharma ◽  
Jon O Ebbert ◽  
Jordan K Rosedahl ◽  
Lindsey M Philpot
Keyword(s):  
Substance Use ◽  
Young Adults ◽  
Confidence Interval ◽  
Affective State ◽  
Prevalence Ratio ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Crisis ◽  
Use Patterns ◽  
Product Use

Background: News articles, commentaries, and opinion articles have suggested that ongoing social distancing measures coupled with economic challenges during COVID-19 may worsen stress, affective state, and substance use across the globe. We sought to advance our understanding of the differences between individuals who change their substance use patterns during a public health crisis and those who do not. Methods: Cross-sectional survey of young adults (18–25 years of age) assessing respondent characteristics and vaping, tobacco, alcohol, and/or marijuana use. We calculated prevalence estimates, prevalence changes, and prevalence ratios with associated 95% confidence intervals and looked for differences with the chi-square test. Results: Of the total sample, 53.2% ( n = 542/1018) young adults reported vaping or using tobacco, alcohol, and/or marijuana. Among the 542 respondents reporting use, 34.3% reported a change in their use patterns. Among respondents reporting changes in substance use patterns during the pandemic ( n = 186), 68.8% reported an increase in alcohol use, 44.0% reported a decrease in vaping product use, and 47.3% reported a decrease in tobacco product use due to COVID-19. Substance use changed significantly for respondents with increasing degree of loneliness (continuous loneliness score: prevalence ratio = 1.12, 95% confidence interval = 1.01–1.25), anxiety (prevalence ratio = 1.45, 95% confidence interval = 1.14–1.85), and depression (prevalence ratio = 1.44, 95% confidence interval = 1.13–1.82). Conclusion: Self-reported substance use among young adults was observed to change during a pandemic, and the degree of loneliness appears to impact these changes. Innovative strategies are needed to address loneliness, anxiety, depression, and substance use during global health crises that impact social contact.

The interaction between parental concern and socioeconomic status in pediatric hydrocephalus management

2021 ◽  
Vol 27 (1) ◽  
pp. 16-22
Author(s):  
Rebecca A. Reynolds ◽  
Makayla Dixon ◽  
Stephen Gannon ◽  
Shilin Zhao ◽  
Christopher M. Bonfield ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Status ◽  
Medical Condition ◽  
Medical Center ◽  
Pediatric Neurosurgery ◽  
Cross Sectional Study ◽  
Third Ventriculostomy ◽  
Parental Concern ◽  
Cross Sectional ◽  
Patient Reported

OBJECTIVEParent or guardian involvement is implicit in the care of pediatric patients with hydrocephalus. Some parents and guardians are more engaged than others. The relationship between socioeconomic status (SES), the level of parental concern about their child’s hydrocephalus management and future, and overall health status has not been clearly delineated. In this study, the authors sought to clarify this connection using hydrocephalus patient-reported health outcomes.METHODSThis cross-sectional study included children with surgically managed hydrocephalus whose parent or guardian completed the validated Hydrocephalus Outcome Questionnaire (HOQ) and Hydrocephalus Concern Questionnaire for parents (HCQ-P) on a return visit to the pediatric neurosurgery clinic at Vanderbilt University Medical Center between 2016 and 2018. Patients were excluded if the questionnaires were not completed in full. The calculated Overall Health Score (OHS) was used to represent the child’s global physical, emotional, cognitive, and social health. The HCQ-P was used to assess parental concern about their child. Type of insurance was a proxy for SES.RESULTSThe HOQ and HCQ-P were administered and completed in full by 170 patient families. In the cohort, 91% of patients (n = 155) had shunt-treated hydrocephalus, and the remaining patients had undergone endoscopic third ventriculostomy. The mean (± SD) patient age was 12 ± 4 years. Half of the patients were male (n = 90, 53%), and most were Caucasian (n = 134, 79%). One in four patients lived in single-parent homes or with a designated guardian (n = 45, 26%). Public insurance and self-pay accounted for 38% of patients (n = 64), while the remaining 62% had private or military insurance. In general, parents with higher concern about their child’s medical condition indicated that their son or daughter had a higher OHS (χ2 = 17.07, p < 0.001). Patients in families with a lower SES did not have different OHSs from those with a higher SES (χ2 = 3.53, p = 0.06). However, parents with a lower SES were more worried about management of their child’s hydrocephalus and their child’s future success (χ2 = 11.49, p < 0.001). In general, parents were not preoccupied with one particular aspect of their child’s hydrocephalus management.CONCLUSIONSMore engaged parents, regardless of their family’s SES, reported a better OHS for their child. Parents with public or self-paid insurance were more likely to report higher concern about their child’s hydrocephalus and future, but this was not associated with a difference in their child’s current health status.

Diabetes and anxiety symptoms: A systematic review and meta-analysis

2019 ◽  
pp. 009121741983740 ◽  
Author(s):  
Sohrab Amiri ◽  
Sepideh Behnezhad
Keyword(s):  
Confidence Interval ◽  
Publication Bias ◽  
Odds Ratio ◽  
Medical Condition ◽  
Meta Analysis ◽  
Cross Sectional Study ◽  
Anxiety Symptoms ◽  
Forest Plot ◽  
Screening Process ◽  
Cross Sectional

Although some studies have been conducted on the association between diabetes and anxiety symptoms, the data on this association remain controversial. The purpose of this meta-analysis was to examine the association between diabetes and anxiety symptoms. The authors systematically searched PubMed, Scopus, and Google Scholar databases until July 2018. After the screening process, 23 studies were included in the meta-analysis. Stata-14 was used for meta-analyzing. Forest plot was calculated for the whole 23 studies and subgroups, and publication bias was also examined. Overall, diabetes was positively associated with anxiety; pooled odds ratio was equal to1.48; 95% confidence interval was 1 .27–1.74. In cross-sectional study, the result was odds ratio = 1.50; 95% confidence interval = 1.26–1.77, and in prospective-cohort study, the result was odds ratio = 1.34; 95% confidence interval = 1.21–1.49. There was small evidence of publication bias. Overall, our findings indicate that diabetes is a risk factor for anxiety symptoms. Therefore, having a healthy medical condition can be an anxiety prevention agent.

scholarly journals Depression in young HIV-positive patients is associated with anemia

2013 ◽  
Vol 94 (4) ◽  
pp. 445-450
Author(s):  
G R Khasanova ◽  
O I Bikkinina ◽  
V A Anokhin
Keyword(s):  
Depressive Symptoms ◽  
Confidence Interval ◽  
Scale Score ◽  
Severe Depression ◽  
Hemoglobin Concentration ◽  
Prevalence Ratio ◽  
Hiv Positive ◽  
Family Status ◽  
Cross Sectional ◽  
Prevalence Of Depression

Aim. To examine the interrelation between depression and anemia in HIV-positive patients. Methods. A cross-sectional study included 99 HIV-positive patients. Anemia was defined as hemoglobin concentration below 12 g/dL in women and 13 g/dL in men. Depressive symptoms were measured using the Beck Hopelessness Scale. Results. Anemia was registered in 30.3% of patients. In 54.5% of patients depression was detected (Beck Scale score ≥10). In patients with anemia the prevalence of depression was 76.7% including severe depression in 20% of patients. Mean Beck Scale score in anemia group was significantly higher compared to the group without anemia (17.57±12.90%, 95% confidence interval 13.5-20.5 and 10.06±8.07, 95% confidence interval 7.7-12.3, t=3.2, p=0.007 relevantly). Moderate reverse correlation between Beck scale scores and hemoglobin level was revealed ((r=-0.24, p=0.019). After stratification and adjusting for potential confounders, anemia was found to be associated with higher prevalence of depression in patients younger than 40 years old. The prevalence ratio for depression in patients with anemia, comparing to patients without anemia was 1.827 (95% confidence interval 1.28-2.61, λ2=8.85, p=0.0029) in this age group. Detected association did not depend on sex, family status, disease duration, CD4-level and treatment with antiretrovirals. Conclusion. Depressive symptoms are associated with anemia in HIV-patients younger than 40 years old.

Are There Ethnic Disparities in Exposure to Workplace Hazards Among New Zealand Migrants to Australia?

2021 ◽  
pp. 101053952110076
Author(s):  
Renee N. Carey ◽  
Sonia El-Zaemey ◽  
Alison Daly ◽  
Lin Fritschi ◽  
Deborah C. Glass ◽  
...  
Keyword(s):  
New Zealand ◽  
Confidence Interval ◽  
Telephone Survey ◽  
Job Strain ◽  
Ethnic Disparities ◽  
Prevalence Ratio ◽  
Ethnic Discrimination ◽  
Cross Sectional ◽  
Workplace Hazards ◽  
Current Health

Disparities in exposure to workplace hazards exist between Māori and non-Māori workers in New Zealand, with Māori workers generally incurring poorer conditions. This study aimed to determine if these ethnic disparities are similar after migration to Australia. A national cross-sectional telephone survey asked participants what tasks they undertook in their job to assess exposure to carcinogens as well as whether they experienced ethnic discrimination, bullying, job precariousness, or job strain. A total of 389 New Zealand Caucasians and 152 Māori/Pasifika workers were recruited. After adjustment, 79% of Māori/Pasifika compared with 67% of New Zealand Caucasian workers were assessed as being exposed to at least one carcinogen at work (adjusted prevalence ratio [aPR] = 1.2, 95% confidence interval [CI] = 1.1-1.4). Māori/Pasifika workers were also more likely to report ethnic discrimination (aPR = 6.9, 95% CI = 2.6-18.3) and fair or poor current health (aPR = 1.9, 95% CI = 1.1-3.2) than New Zealand Caucasians. Some ethnic disparities in exposure to workplace hazards in New Zealand are apparent after migration to Australia.

Lipophilic Statin Use and Suicidal Ideation in a Sample of Adults With Mood Disorders

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 278-282 ◽  
Author(s):  
Karen M. Davison ◽  
Bonnie J. Kaplan
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorders ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptom Scores ◽  
Unit Increase ◽  
Predominantly Female ◽  
Lipophilic Statin

Background: Mood disorders are associated with a high risk of suicide. Statin therapy has been implicated in this relationship. Aims: To further clarify reported associations between suicide and cholesterol in mental health conditions, we conducted an analysis of dietary, clinical, and suicidal ideation measures in community-living adults with mood disorders. Method: Data were used from a cross-sectional study of a randomly selected community-based sample (> 18 years; n = 97) with verified mood disorders. Dietary (e.g., fat, iron, vitamin intakes), clinical (e.g., current depression and mania symptoms, medications), and sociodemographic (age, sex, and income) measures were analyzed using bivariate statistics and Poisson regression with robust variance. Results: Participants were predominantly female (71.1%) with bipolar disorder (59.8%); almost one-third (28.9%) were taking lipophilic statins. The prevalence of suicidal ideation was more than 2.5 times in those taking statins, PR = 2.59, 95% CI 1.27–5.31, p < .05. The prevalence ratio for suicidal ideation was 1.10, 95% CI 1.06–1.15, p < .001, for each unit increase in mania symptom scores. No associations between suicidal ideation and dietary intake measures were identified. Conclusion: Individuals with mood disorders may be susceptible to neuropsychiatric effects of cholesterol-lowering drugs, which warrants further research.

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