scholarly journals 980. Drexel Medicine Resident Knowledge, Practices and Attitudes Regarding Pre-exposure prophylaxis (PrEP)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S518-S518
Author(s):  
Jen E Mainville ◽  
Ed Gracely ◽  
Zsofia Szep
Keyword(s):  
Internal Medicine ◽  
Male Partner ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Major Barrier ◽  
Medicine Resident ◽  
Highly Effective ◽  
Prevention Method ◽  
Exposure Prophylaxis

Abstract Background Pre-exposure prophylaxis (PrEP) is a highly effective daily oral antiretroviral medication that was approved by the FDA in 2012 and has been shown to reduce the risk of HIV by 95% in real-world studies. Despite this, many healthcare providers are not offering PrEP to their patients who are at risk for HIV. Methods We performed a cross-sectional study among Drexel Internal Medicine, Family Medicine, and Obstetrics and Gynecology residents. The survey included questions about experience, knowledge, attitudes toward and barriers to using PrEP. The survey was adapted from previous studies regarding medical providers’ attitudes and knowledge about PrEP (Petroll, 2016; Seifman, 2016; Blumenthal, 2105). A Likert 5-point scale was used for attitude and barriers questions. Results Among 143 participants, 80% specialized in Internal Medicine. 43% of participants were in their first year of training and the mean age (+ SD) was 28.8 + 2. 76% reported never initiating a conversation about PrEP with a patient and only 18% reported ever prescribing PrEP to their patients. 92% reported being very or extremely willing to prescribe PrEP to a male with a current male partner known to be HIV positive. Only 43% of residents reported being moderately likely to prescribe PrEP to a patient coming in for a STI exposure. 68% of residents reported their knowledge about PrEP was a major barrier to prescribing PrEP. Conclusion We found that most residents have minimal experience with prescribing PrEP, and knowledge was identified as the largest barrier. Additional education and a better understanding of PrEP indications is necessary to ensure eligible PrEP patients have access to this highly effective HIV prevention method. Disclosures All Authors: No reported disclosures

scholarly journals Facilitators and barriers of 2-1-1 HIV pre-exposure prophylaxis

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251917
Author(s):  
Christina Camp ◽  
Parya Saberi
Keyword(s):  
Hiv Prevention ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Facilitators And Barriers ◽  
Sexual Encounters ◽  
Prevention Method ◽  
Sex With Men ◽  
Dosing Strategy ◽  
Exposure Prophylaxis

An alternative strategy for men who have sex with men (MSM) experiencing challenges with daily HIV pre-exposure prophylaxis (PrEP) includes 2-1-1 dosing. Understanding 2-1-1 PrEP facilitators and barriers, especially during the SARS-CoV-2 pandemic, may guide researchers and healthcare providers in future studies and clinical preparedness. We conducted a national cross-sectional study of MSM in the US who had taken 2-1-1 PrEP to examine facilitators and barriers of this on-demand PrEP dosing option. With the shelter-in-place orders in March 2020, this study was adapted to include questions on how the SARS-CoV-2 pandemic affected participants’ PrEP use. A total of 140 individuals participated in the survey, 106 of which completed questions pertaining to the SARS-CoV-2 pandemic. The most common reasons for switching from once-daily to 2-1-1 PrEP included having sex less frequently (63.6%) and wanting to take fewer pills (46.4%). Participants reported high medication adherence based on each component of 2-1-1 PrEP dosing (>84%). The most common barriers with 2-1-1 PrEP dosing included unplanned sexual encounters resulting in missing the double-dose pre-sex (43.6%) and trouble remembering doses post-sex (29.3%). Facilitators of the 2-1-1 PrEP dosing strategy included reductions in sexual encounters (63.6%), preference to take fewer pills (46.4%), need to reduce cost (22.1%), and desire to reduce side effects (19.3%). Challenges to receiving PrEP services during the pandemic included obtaining laboratory testing (25.5%) and PrEP refills (either receipt of a refill authorization from a healthcare provider or processing of a refill from the pharmacy) (18.9%). 2-1-1 PrEP is an effective HIV prevention method; therefore, understanding facilitators and barriers of this dosing strategy can result in continuous provision of HIV prevention efforts, particularly during a pandemic.

scholarly journals Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative

2015 ◽  
Vol 7 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Maureen D. Francis ◽  
Mark L. Wieland ◽  
Sean Drake ◽  
Keri Lyn Gwisdalla ◽  
Katherine A. Julian ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Linear Regression Analysis ◽  
Internal Medicine Resident ◽  
Cross Sectional Study ◽  
Analysis Of Covariance ◽  
Block Model ◽  
Cross Sectional ◽  
Educational Innovations ◽  
Medicine Resident ◽  
Multivariable Linear Regression Analysis

Abstract Background Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. Methods This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. Results UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Conclusions Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model.

Nigerian physiotherapists’ perception of direct access and patients’ self-referral

2015 ◽  
Author(s):  
Chidozie Emmanuel Mbada ◽  
Kayode D. Ojetola ◽  
Rufus Adesoji Adedoyin ◽  
Udoka A. C. Okafor ◽  
Olubusola E. Johnson ◽  
...  
Keyword(s):  
Public Support ◽  
Cross Sectional Study ◽  
Study Data ◽  
Professional Autonomy ◽  
Direct Access ◽  
Cross Sectional ◽  
Major Barrier ◽  
Physiotherapy Practice ◽  
South West ◽  
Validated Questionnaire

Background: The global advocacy for Direct Access (DA) and Patients’ Self-Referral (PSR) to physiotherapy is consistent with the quest for promoting professional autonomy and recognition. It was hypothesized in this study that the attainment of this clarion call in Nigeria may be hamstrung by challenges similar or different from those reported in other climes. Objective: This study assessed the perception of DA and PSR among Physiotherapists (PTs) in South-West, Nigeria. Methods: One hundred PTs from ten purposely selected public-funded out-patient facilities from South-West, Nigeria responded in this cross-sectional study, yielding a response rate of 75% (100/150).  A previously validated questionnaire for World Confederation of Physical Therapists (WCPT) on the global view of DA and PSR for physical therapy was used in this study. Data was analyzed using descriptive statistics. Results: There was a high awareness on legislation regulating practice (91%) and scope (84%) of the profession. Respondents assert that the extant legislation allows for DA (49%) and PSR (97%). However, 40% of the respondents opined that the baccalaureate qualification of PTs was inadequate for competence in DA and PSR; and a post-professional residency programme was mostly recommended (52%). Public support for DA and PSR to physiotherapy was rated more than the advocacy role of the Nigeria Society of Physiotherapy (60% vs. 40%). Physicians’ (71%) and politicians’ (65%) views were rated the major barrier to achieving DA and PSR status in physiotherapy. Similarly, physicians’ (90%) and politicians’ (88%) support was perceived as the major facilitator.  Conclusion: Physiotherapy practice in Nigeria has the semblance of autonomy in DA and PSR but is devoid of legislative support. Most Nigerian physiotherapists assume professional autonomy but were not aware of the lack of legal support for DA and PSR. The current entry-level academic curricula were considered to be deficient and inadequate for autonomous practice in Nigeria.  Physicians and politicians were the most important barrier or facilitator to achieving legal support for DA and PSR in physiotherapy in Nigeria.

Hepatitis A Seroprevalence Among Patients with Chronic Hepatitis B Infection: A Cross-Sectional Study in Iran During 2016-2017

2020 ◽  
Vol 20 (5) ◽  
pp. 748-751
Author(s):  
Seyed Ali Dehghan Manshadi ◽  
Neda Alijani ◽  
Mohammadreza Salehi ◽  
Omid Dadras ◽  
SeyedAhmad SeyedAlinaghi ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatitis A ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Cross Sectional ◽  
Reasonable Approach ◽  
The Difference ◽  
Prevention Method

Introduction: The aim of this study was to determine the prevalence of exposure to hepatitis A by means of serologic markers in chronic hepatitis B patients, with the secondary aim of finding the best prevention method for hepatitis A infection in susceptible groups of our setting. Methods: During the period between 2016 and 2017, we recruited 403 hepatitis B patients aged more than 14 years and regularly attending the infectious diseases clinic at a referral university hospital, Tehran, Iran. A blood sample was collected from all the patients and tested for hepatitis A IgG. The data was analyzed by SPSS v.19. Results: Although none of the patients had previously received hepatitis A vaccine, the results for serologic level of hepatitis A IgG, demonstrated positive results in 379 (94%) cases. The mean age of patients with negative and positive IgG was 29.17 and 42.46 years, respectively; the difference was statistically significant (P≤0.001). The majority of seronegative patients were young adults aged < 25 years and 25 to 35 years (P <0.001). Conclusion: Seroprevalence of hepatitis A in chronic HBV patients in Iran is high. As HBV infected patients younger than 35 years could be seronagative for HAV infection, evaluation of these patients for HAV infection and vaccination of seronegative patients would be a reasonable approach.

COVID-19: knowledge, awareness and perceived stress among Jordanian healthcare providers (Preprint)

2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  
Keyword(s):  
Social Media ◽  
Psychological Stress ◽  
Health Care Providers ◽  
Best Practice ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Source Of Information

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.

Learning Electrocardiogram Interpretation: Insights from Residents and a Proposed Solution in an Observational Study (Preprint)

2020 ◽  
Author(s):  
Mohammad Alakchar ◽  
Abdisamad M. Ibrahim ◽  
Mohsin Salih ◽  
Mukul Bhattarai ◽  
Nitin Tandan ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Correlation Coefficient ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Resident Attitudes ◽  
Internal Medicine Residents ◽  
Life Threatening ◽  
Degree Of Participation ◽  
Electrocardiogram Interpretation

BACKGROUND Interpretation of electrocardiograms (EKG) is an essential tool for every physician. Despite this, the diagnosis of life-threatening pathology on EKG remains suboptimal in trainees. The purpose of this study is to study resident attitudes and behaviours towards EKGs, and describe an innovative way to teach EKGs. OBJECTIVE Study attitudes and behaviours towards EKGs. Describe an innovative way to teach EKGs. METHODS Design: An observational cross-sectional study through an anonymous online survey of resident attitudes and comfort with EKG interpretation. This was followed by creation of a WhatsApp group for discussion and interpretation of EKGs with peers. At the end of the day, the official EKG interpretation was posted. Setting: Internal medicine residency at Southern Illinois University. Participants: Internal medicine residents Interventions: Creation of WhatsApp group to aid with EKG interpretation Measurements: A 17 item questionnaire, followed by detection of degree of participation in a WhatsApp group. RESULTS Forty-one out of 63 residents (65%) completed the survey. 85% of respondents thought that an interactive way to teach EKGs is the best method of teaching, and 73% did not feel confident interpreting EKGs. 30% often rely on automated EKG interpretation. Further analysis indicated that PGY-1 residents reported ordering fewer EKGs (correlation coefficient -0.399, p = 0.012) and were uncomfortable diagnosing QT prolongation on an EKG (correlation coefficient -0.310, p = 0.049). Residents in the third or greater year of training ordered more EKGs (correlation coefficient 0.379, p = 0.015), less frequently relied on the computer for EKG diagnosis (correlation coefficient 0.399, p = 0.010), and were comfortable diagnosing an acute myocardial infarction and atrial arrhythmias. CONCLUSIONS In conclusion, most IM trainees do not feel comfortable interpreting EKG, however, this does improve with PGY year. WhatsApp is a possible platform for teaching EKGs.

scholarly journals Knowledge of non-healthcare individuals towards cardiopulmonary resuscitation: a cross-sectional study in Riyadh City, Saudi Arabia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Reema M. Alhussein ◽  
Mansoor M. Albarrak ◽  
Abdulaziz A. Alrabiah ◽  
Nawfal A. Aljerian ◽  
Hashim M. Bin Salleeh ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Cardiopulmonary Resuscitation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Major Barrier ◽  
Riyadh City ◽  
Resuscitation Training ◽  
The Media

Abstract Background Most sudden cardiac arrests occur at home, with low rates of bystander cardiopulmonary resuscitation being performed. We aimed to assess knowledge of cardiopulmonary resuscitation among individuals in Riyadh City, Saudi Arabia, who are not involved in health care. Methods A community-based cross-sectional study was conducted between January and February 2020 in 4 different areas in Riyadh City: North, South, East, and West. The participants were surveyed using a validated self-administered questionnaire. The Statistical Package for Social Sciences version 25.0 was used for inferential statistics and binary logistic regression analysis. Results A total of 856 participants completed the questionnaire, 51.8% were unaware of cardiopulmonary resuscitation. Only 4.4% of the participants had attended a formal cardiopulmonary resuscitation training course, 5.1% were campaign attendees, and 38.7% acquired their experience through the media. Having a higher level of education was positively associated with having knowledge of cardiopulmonary resuscitation. The main concern among attendees of cardiopulmonary resuscitation training courses and campaigns was legal issues, whereas inadequate knowledge was the major barrier for those who had learned about cardiopulmonary resuscitation through the media. Conclusion The level of knowledge of cardiopulmonary resuscitation among non-health care individuals in Riyadh City was found to be insufficient. Therefore, coordinated efforts among different authorities should be considered to implement a structured strategy aiming to increase awareness and knowledge of cardiopulmonary resuscitation among non-health care individuals.

scholarly journals Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal

2021 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Rita Baptista ◽  
Ryane Englar ◽  
Berta São Braz ◽  
Rodolfo Oliveira Leal
Keyword(s):  
General Practitioners ◽  
Healthcare Providers ◽  
Small Animal ◽  
Cross Sectional Study ◽  
Online Forums ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Current Trends ◽  
Therapeutic Value

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.

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