scholarly journals Anticipated help-seeking for cancer symptoms before and after the coronavirus pandemic: results from the Onco-barometer population survey in Spain

2021 ◽  
Author(s):  
Dafina Petrova ◽  
Marina Pollán ◽  
Miguel Rodriguez-Barranco ◽  
Dunia Garrido ◽  
Josep M. Borrás ◽  
...  
Keyword(s):  
Poisson Regression ◽  
Help Seeking ◽  
Regression Models ◽  
Population Survey ◽  
Waiting Times ◽  
Perceived Barriers ◽  
Older Individuals ◽  
Cancer Symptoms ◽  
Before And After ◽  
Diagnostic Delays

Abstract Background The patient interval—the time patients wait before consulting their physician after noticing cancer symptoms—contributes to diagnostic delays. We compared anticipated help-seeking times for cancer symptoms and perceived barriers to help-seeking before and after the coronavirus pandemic. Methods Two waves (pre-Coronavirus: February 2020, N = 3269; and post-Coronavirus: August 2020, N = 1500) of the Spanish Onco-barometer population survey were compared. The international ABC instrument was administered. Pre–post comparisons were performed using multiple logistic and Poisson regression models. Results There was a consistent and significant increase in anticipated times to help-seeking for 12 of 13 cancer symptoms, with the largest increases for breast changes (OR = 1.54, 95% CI 1.22–1–96) and unexplained bleeding (OR = 1.50, 1.26–1.79). Respondents were more likely to report barriers to help-seeking in the post wave, most notably worry about what the doctor may find (OR = 1.58, 1.35–1.84) and worry about wasting the doctor’s time (OR = 1.48, 1.25–1.74). Women and older individuals were the most affected. Conclusions Participants reported longer waiting times to help-seeking for cancer symptoms after the pandemic. There is an urgent need for public interventions encouraging people to consult their physicians with symptoms suggestive of cancer and counteracting the main barriers perceived during the pandemic situation.

scholarly journals Symptom appraisal, help-seeking and perceived barriers to healthcare seeking in Uganda: an exploratory study among women with potential symptoms of breast and cervical cancer

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041365
Author(s):  
Amos Deogratius Mwaka ◽  
Fiona M Walter ◽  
Suzanne Scott ◽  
Jane Harries ◽  
Henry Wabinga ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Help Seeking ◽  
Perceived Barriers ◽  
African Women ◽  
Health Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Breast And Cervical Cancer ◽  
Symptom Appraisal

ObjectiveWe assessed the process of recognising abnormal bodily changes, interpretations and attributions, and help-seeking behaviour among community-based Ugandan women with possible symptoms of breast and cervical cancer, in order to inform health interventions aiming to promote timely detection and diagnosis of cancer.DesignQualitative in-depth interviews.SettingRural and urban communities in Uganda.ParticipantsWomen who participated in the African Women Awareness of CANcer cross-sectional survey who disclosed potential breast and cervical cancer symptoms were eligible; recruitment was purposive. Interviews were conducted in women’s homes, lasted between 40 and 90 min, were audio-recorded, transcribed verbatim and translated to English. Thematic analysis was used to identify themes and subthemes, underpinned by the conceptual framework of the Model of Pathways to Treatment.Results23 women were interviewed: 10 had potential symptoms of breast cancer and 13 of cervical cancer. Themes regarding symptom appraisal and help-seeking included the: (1) detection and interpretation of abnormal bodily sensations; (2) lay consultations regarding bodily changes; (3) iterative process of inferring and attributing illnesses to the bodily changes; (4) restricted disclosure of symptoms to lay people due to concerns about privacy and fear of stigmatisation; (5) help-seeking from multiple sources including both traditional and biomedical health practitioners, and (6) multiple perceived barriers to help-seeking including long waiting times, lack of medicines, absenteeism of healthcare professionals, and lack of money for transport and medical bills.ConclusionWomen with potential symptoms of breast and cervical cancer undergo complex processes of symptom interpretation, attributing symptoms or inferring illness, and lay consultations before undertaking help-seeking and management. Increasing community understanding of breast and cervical cancer symptoms, and tackling perceived barriers to health-seeking, could lead to prompt and appropriate symptom appraisal and help-seeking, and contribute to improving cancer outcomes.

scholarly journals Safety Impact Analysis of Lane Conversion on Selected Highway Corridor

2021 ◽  
Author(s):  
Swathy P Mohan ◽  
Archana S ◽  
Ebin Sam S
Keyword(s):  
Significant Relationship ◽  
Poisson Regression ◽  
Regression Models ◽  
Impact Analysis ◽  
Black Spot ◽  
Segment Length ◽  
Weighted Sum ◽  
Before And After ◽  
Spot Analysis

The safety impact analysis of a widened corridor stretch of NH 66 was carried out in this study. A before and after black spot analysis was conducted using Arc Map 10.6 to identify significant hotspots using spatial joining and Getis Ord analysis. Two Poisson regression models were formulated for the weighted sum of fatal and grievous accidents for both pre lane widening as well as post lane widening conditions. The weighted sum of accidents showed a significant relationship with AADT value and black spot segment length in both models. It was found that 40-50 % reduction of crashes due to the lane conversion was estimated at a selected AADT range.

scholarly journals Evaluation of Emergency Health-Care Initiatives to Reduce Overcrowding in a Referral Medical Complex, Jeddah, Saudi Arabia

2021 ◽  
pp. 1-6
Author(s):  
Khalid Alabbasi ◽  
Estie Kruger ◽  
Marc Tennant
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Public Hospital ◽  
Waiting Times ◽  
Care Centre ◽  
Health Care Centre ◽  
Transfer Policy ◽  
Primary Health ◽  
Before And After ◽  
Ed Visits

<b><i>Purpose:</i></b> Excessive delays and emergency department (ED) overcrowding have become an increasingly major problem for public health worldwide. This study was to assess the key strategies adopted by an ED, at a public hospital in Jeddah, to reduce delays and streamline patient flow. <b><i>Materials and Methods:</i></b> This study was a service evaluation for a Saudi patient population of all age-groups who attended the ED of a public hospital for the period between June 2016 and July 2019. The Saudi initiative to reduce the ED visits at the King Abdullah Medical Complex hospital has started on August 7, 2018. The initiative was to apply an urgency transfer policy which outlines the procedures to follow when patients arrive to the ED where they are reviewed based on the Canadian Triage and Acuity Scale (CTAS). Patients with less-urgent conditions (category 4 and 5) are referred to a primary health-care practice (where a family medicine consultant is available). Patients with urgent conditions (category 1–3) are referred to a specialized health-care centre if the service is not currently provided. To test the effectiveness of ED initiative on reducing the overcrowd, data were categorized into before and after the initiative. The bivariate analysis χ<sup>2</sup> tests and 2 sample <i>t</i>-tests were run to explore the relationship of gender and age with dependent variable emergency. <b><i>Results:</i></b> A total of 233,998 patients were included in this study, 61.8% of them were males and the average age of ED patients were 35.5 ± 18.6 years. The majority of cases were those classified as “less urgent” (CTAS 4), which accounted for 65.4%. Number of ED visits before and after the initiative was 67 and 33%, respectively. ED waiting times after the initiative have statistically significantly decreased across all acuity levels compared to ED waiting times before the initiative. <b><i>Conclusion and Implication:</i></b> The findings suggest that the majority of patients arrive to the ED with less-urgent conditions and arrived by walking-in. The number of cases attending the ED significantly decreased following the introduction of the urgency transfer policy. Referral for less-urgent patients to primary health-care centre may be an important front-end operational strategy to relieve congestion.

scholarly journals Psychosocial influences on help-seeking behaviour for cancer in low-income and lower middle-income countries: a mixed-methods systematic review

2021 ◽  
Vol 6 (2) ◽  
pp. e004213
Author(s):  
Grace McCutchan ◽  
Bahr Weiss ◽  
Harriet Quinn-Scoggins ◽  
Anh Dao ◽  
Tom Downs ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Cancer Treatment ◽  
Help Seeking ◽  
Middle Income ◽  
Cancer Symptoms ◽  
Middle Income Countries ◽  
Help Seeking Behaviour ◽  
Psychosocial Influences

IntroductionStarting cancer treatment early can improve outcomes. Psychosocial factors influencing patients’ medical help-seeking decisions may be particularly important in low and lower middle-income countries (LMIC) where cancer outcomes are poor. Comprehensive review evidence is needed to understand the psychosocial influences on medical help-seeking for cancer symptoms, attendance for diagnosis and starting cancer treatment.MethodsMixed-methods systematic review registered on PROSPERO (CRD42018099057). Peer-reviewed databases were searched until April 2020 for studies assessing patient-related barriers and facilitators to medical help-seeking for cancer symptoms, diagnosis and treatment in adults (18+ years) living in LMICs. Quality of included studies was assessed using the Critical Appraisal Skills Programme tool. Data were synthesised using meta-analytic techniques, meta-ethnography or narrative synthesis as appropriate.ResultsOf 3963 studies identified, 64 were included. In quantitative studies, use of traditional, complementary and alternative medicine (TCAM) was associated with 3.60 higher odds of prolonged medical help-seeking (95% CI 2.06 to 5.14). Qualitative studies suggested that use of TCAM was a key barrier to medical help-seeking in LMICs, and was influenced by causal beliefs, cultural norms and a preference to avoid biomedical treatment. Women face particular barriers, such as needing family permission for help-seeking, and higher stigma for cancer treatment. Additional psychosocial barriers included: shame and stigma associated with cancer such as fear of social rejection (eg, divorce/disownment); limited knowledge of cancer and associated symptoms; and financial and access barriers associated with travel and appointments.ConclusionDue to variable quality of studies, future evaluations would benefit from using validated measures and robust study designs. The use of TCAM and gender influences appear to be important barriers to help-seeking in LMIC. Cancer awareness campaigns developed with LMIC communities need to address cultural influences on medical help-seeking behaviour.

scholarly journals Examining the Effects of the Sacramento Dockless E-Bike Share on Bicycling and Driving

2021 ◽  
Vol 13 (1) ◽  
pp. 368
Author(s):  
Dillon T. Fitch ◽  
Hossain Mohiuddin ◽  
Susan L. Handy
Keyword(s):  
Travel Behavior ◽  
Regression Models ◽  
Population Level ◽  
Panel Survey ◽  
Multilevel Regression ◽  
Combine Data ◽  
Cross Sectional ◽  
Individual Level ◽  
Before And After ◽  
Bike Share

One way cities are looking to promote bicycling is by providing publicly or privately operated bike-share services, which enable individuals to rent bicycles for one-way trips. Although many studies have examined the use of bike-share services, little is known about how these services influence individual-level travel behavior more generally. In this study, we examine the behavior of users and non-users of a dockless, electric-assisted bike-share service in the Sacramento region of California. This service, operated by Jump until suspended due to the coronavirus pandemic, was one of the largest of its kind in the U.S., and spanned three California cities: Sacramento, West Sacramento, and Davis. We combine data from a repeat cross-sectional before-and-after survey of residents and a longitudinal panel survey of bike-share users with the goal of examining how the service influenced individual-level bicycling and driving. Results from multilevel regression models suggest that the effect of bike-share on average bicycling and driving at the population level is likely small. However, our results indicate that people who have used-bike share are likely to have increased their bicycling because of bike-share.

Characteristics Associated With Migration Among Older Women and Men in Rural Malawi

2017 ◽  
Vol 25 (4) ◽  
pp. 283-308 ◽  
Author(s):  
Jacob Kendall ◽  
Philip Anglewicz
Keyword(s):  
Physical Health ◽  
Older Women ◽  
Religious Affiliation ◽  
Older Men ◽  
Household Size ◽  
Sub Saharan Africa ◽  
Older Individuals ◽  
Before And After ◽  
Sub Saharan ◽  
And Migration

The older population in sub-Saharan Africa is growing rapidly, but little is known about the migration patterns of older individuals in this setting. In this article, we identify the determinants of migration for older individuals in a rural African setting. To do so, we use rare longitudinal data with information for older individuals both before and after migration. We first identify premigration factors associated with moving in the future and then identify differences in characteristics between migrants and nonmigrants after migration. In addition to basic sociodemographic information, we examine differences between migrants and nonmigrants in land ownership, number of lifetime marriages, number of living offspring, previous migration experience, household size, social and religious participation, and religious affiliation. Results show that (a) migration in older age is related to marriage, health and HIV status, household size, and religion; (b) older women who are HIV-positive are more likely to move, and older men with better physical health are more likely to move; (c) older female migrants have worse postmigration physical health; and (d) the relationship between health and migration for older men disappears after migration.

Do quadratic and Poisson regression models help to predict monthly rainfall?

2021 ◽  
Vol 215 ◽  
pp. 288-318
Author(s):  
Youssef Kassem ◽  
Hüseyin Gökçekuş
Keyword(s):  
Poisson Regression ◽  
Regression Models ◽  
Monthly Rainfall

Changes in tobacco depictions after implementation of tobacco-free film and TV rules in Bollywood films in India: a trend analysis

2021 ◽  
pp. tobaccocontrol-2021-056629
Author(s):  
Gaurang P Nazar ◽  
Monika Arora ◽  
Nitika Sharma ◽  
Surbhi Shrivastava ◽  
Tina Rawal ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Trend Analysis ◽  
Poisson Regression ◽  
Poisson Regression Analysis ◽  
Free Film ◽  
Rule Compliance ◽  
Increasing Trend ◽  
Before And After ◽  
Year 2013

BackgroundIndia’s tobacco-free film and TV rules were implemented from 2012. To assess the effect of the rules, we studied tobacco depictions in top-grossing Bollywood films released between 2006 and 2017 and rule compliance after 2012.MethodsTobacco incidents and brand appearances were coded in 240 top-grossing Bollywood films (2006–2017) using the Breathe California method. Trends in number of tobacco incidents per film per year were studied before and after implementation of the rules using Poisson regression analysis. Compliance with rules over the years was studied using Pearson product-moment correlations.ResultsForty-five films were U-rated (all ages), 162 were UA-rated (below age 12 years must be adult-accompanied), and 33 were A-rated (age 18+ years only). Before implementation of the rules, the number of tobacco incidents per film was increasing by a factor of 1.1/year (95% CI 1.0 to 1.2, p=0.002). However, beginning year 2013, the number of incidents per film started falling significantly by a factor of 0.7/year (95% CI 0.6 to 0.9; p=0.012) compared with the previous increasing trend. The percentage of youth-rated (U and UA) films with any tobacco incidents also declined from a peak of 76% in 2012 to 35% in 2017. The percentage of films complying with the rules (audio-visual disclaimers, health spots, static warnings) did not change significantly from 2012 to 2017.ConclusionIndia’s 2012 rules were followed by a reduction in tobacco depictions in Bollywood films. Enhanced monitoring of compliance is needed to ensure the continued effectiveness of the rules.

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