scholarly journals HIV service interruptions during the COVID-19 pandemic in China: the role of HIV service challenges and institutional response from healthcare professional's perspective

2021 ◽  
Author(s):  
Xueying Yang ◽  
Chengbo Zeng ◽  
Cheuk Chi Tam ◽  
Shan Qiao ◽  
Xiaoming Li ◽  
...  
Keyword(s):  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Care Service ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Hiv Care ◽  
Institutional Response ◽  
Service Interruptions ◽  
Service Interruption ◽  
Class 1

Background: The healthcare system in China was largely overwhelmed during the unprecedented pandemic of coronavirus disease (COVID-19). HIV-related services have been unavoidably interrupted and impacted. However, the nature and scope of HIV service interruptions due to COVID-19 has rarely been characterized in China and how HIV service challenges affect the service interruptions are also unclear. The current study aimed at characterize HIV service interruption levels and analyzed its associated factors related to service challenges and institutional response from HIV healthcare providers' viewpoint. Methods: A cross-sectional online survey was conducted among 1,029 HIV healthcare providers in Guangxi, China, from April to May 2020. Latent class analysis (LCA) was first used to identify HIV service interruption levels. Then hierarchical multinomial logistic regression was conducted to analyze the relationships of HIV care service challenges and institutional response with HIV service interruption levels. Simple slope analysis was employed to examine interaction effects between HIV service challenges and institutional response to COVID-19. Results: Four classes of HIV service interruption were identified using LCA, with 22.0% complete interruption (class 1), 15.4% moderate interruption (class 2), 21.9% minor interruption (class 3) and 40.7% almost no interruption (class 4). Using class 4 as a reference group, HIV care service challenges were positively associated with the probabilities of service interruptions (Class 1: AOR=1.23, 95%CI: 1.19~1.26; Class 2: AOR= 1.10, 95%CI: 1.08~1.13; Class 3: AOR= 1.10, 95%CI: 1.08~1.12). Institutional response to HIV healthcare delivery was negatively associated with the probabilities of being classified into Class 1 ("Complete interruption") (AOR=0.97, 95%CI: 0.93~1.00) and Class 3 ("minor interruption [Outreach service]") (AOR=0.96, 95%CI: 0.93~0.99) as compared to Class 4 ("almost no interruption"). Institutional response to HIV healthcare delivery moderated the association of HIV service challenges with complete interruption, but not with the moderate or minor interruption when comparing with no interruption group. Conclusions: A substantial HIV service interruptions occurs due to the COVID-19 pandemic, particularly services that require face-to-face interactions, such as VCT counselling, follow up and outreach services. HIV service challenges largely hinder the HIV service delivery. Institutional response to HIV healthcare delivery could marginally buffer the negative effect of service challenges on complete HIV service interruptions. To maintain continuity of core HIV services in face of a pandemic, build a resilient health care system with adequate preparedness is necessary.

scholarly journals Identifying classes of the pain, fatigue, and depression symptom cluster in long-term prostate cancer survivors—results from the multi-regional Prostate Cancer Survivorship Study in Switzerland (PROCAS)

2021 ◽  
Author(s):  
Salome Adam ◽  
Melissa S. Y. Thong ◽  
Eva Martin-Diener ◽  
Bertrand Camey ◽  
Céline Egger Hayoz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Depressive Symptoms ◽  
Cancer Survivorship ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Symptom Cluster ◽  
Depression Symptom ◽  
Class 1 ◽  
Eortc Qlq

Abstract Purpose Aside from urological and sexual problems, long-term (≥5 years after initial diagnosis) prostate cancer (PC) survivors might suffer from pain, fatigue, and depression. These concurrent symptoms can form a cluster. In this study, we aimed to investigate classes of this symptom cluster in long-term PC survivors, to classify PC survivors accordingly, and to explore associations between classes of this cluster and health-related quality of life (HRQoL). Methods Six hundred fifty-three stage T1-T3N0M0 survivors were identified from the Prostate Cancer Survivorship in Switzerland (PROCAS) study. Fatigue was assessed with the EORTC QLQ-FA12, depressive symptoms with the MHI-5, and pain with the EORTC QLQ-C30 questionnaire. Latent class analysis was used to derive cluster classes. Factors associated with the derived classes were determined using multinomial logistic regression analysis. Results Three classes were identified: class 1 (61.4%) – “low pain, low physical and emotional fatigue, moderate depressive symptoms”; class 2 (15.1%) – “low physical fatigue and pain, moderate emotional fatigue, high depressive symptoms”; class 3 (23.5%) – high scores for all symptoms. Survivors in classes 2 and 3 were more likely to be physically inactive, report a history of depression or some other specific comorbidity, be treated with radiation therapy, and have worse HRQoL outcomes compared to class 1. Conclusion Three distinct classes of the pain, fatigue, and depression cluster were identified, which are associated with treatment, comorbidities, lifestyle factors, and HRQoL outcomes. Improving classification of PC survivors according to severity of multiple symptoms could assist in developing interventions tailored to survivors’ needs.

scholarly journals Latent classes of delinquent behaviour associated with criminal social identity among juvenile offenders in Pakistan

2015 ◽  
Vol 17 (2) ◽  
pp. 117-126 ◽  
Author(s):  
Sonia Shagufta ◽  
Daniel Boduszek ◽  
Katie Dhingra ◽  
Derrol Kola-Palmer
Keyword(s):  
Social Identity ◽  
Juvenile Offenders ◽  
Latent Class ◽  
Multinomial Logistic Regression ◽  
Latent Class Model ◽  
Young Male ◽  
Latent Classes ◽  
Content Type ◽  
Delinquent Behaviour ◽  
Class 1

Purpose – The purpose of this paper is to examine the number and nature of latent classes of delinquency that exist among male juvenile offenders incarcerated in prisons in Pakistan. Design/methodology/approach – The sample consisted of 415 young male offenders incarcerated in prisons in Khyber Pakhtunkhwa (KPK) Pakistan. Latent class analysis was employed to determine the number and nature of delinquency latent classes. Multinomial logistic regression was used to estimate the associations between latent classes and the three factors of criminal social identity (cognitive centrality, in-group affect, and in-group ties) whilst controlling for criminal friends, period of confinement, addiction, age, and location. Findings – The best fitting latent class model was a three-class solution. The classes were labelled: “minor delinquents” (the baseline/normative class; Class 3), “major delinquents” (Class 1), and “moderate delinquents” (Class 2). Class membership was predicted by differing external variables. Specifically, Class 1 membership was related to having more criminal friends; while Class 2 membership was related to lower levels of in-group affect and higher levels of in-group ties. Practical implications – Findings are discussed in relation to refining current taxonomic arguments regarding the structure of delinquency and implications for prevention of juvenile delinquent behaviour. Originality/value – First, most previous studies have focused on school children, whereas, this paper focuses on incarcerated juvenile offenders. Second, this research includes delinquents from Pakistan, whereas, most previous research has examined delinquent behaviour in western cultures.

Knowledge and Communication of the National Core Standards Tool

2018 ◽  
Vol 20 (2) ◽  
Author(s):  
Winnie Thembisile Maphumulo ◽  
Busisiwe Bhengu
Keyword(s):  
Pearson Correlation ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Quality Of Healthcare ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Nurses

The National Department of Health in South Africa has introduced the National Core Standards (NCS) tool to improve the quality of healthcare delivery in all public healthcare institutions. Knowledge of the NCS tool is essential among healthcare providers. This study investigated the level of knowledge on NCS and how the NCS tool was communicated among professional nurses. This was a cross-sectional survey study. Purposive sampling technique was used to select hospitals that only offered tertiary services in KwaZulu-Natal. Six strata of departments were selected using simple stratified sampling. The population of professional nurses in the selected hospitals was 3 050. Systematic random sampling was used to recruit 543 participants. The collected data were analysed using SPSS version 25. The study showed that only 16 (3.7%) respondents had knowledge about NCS, using McDonald’s standard of learning outcome measured criteria regarding the NCS tool. The Pearson correlation coefficient between the communication and knowledge was r = 0.055. The results revealed that although the communication scores for the respondents were high their knowledge scores remained low. This study concluded that there is a lack of knowledge regarding the NCS tool and therefore healthcare institutions need to commit themselves to the training of professional nurses regarding the NCS tool. The findings suggest that healthcare institutions implement the allocation of incentives for nurses that attend the workshops for NCS.

How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham
Keyword(s):  
Health Information ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
The United States ◽  
Personal Health Information ◽  
Personal Health ◽  
Business Associations ◽  
Electronic Information ◽  
Healthcare Delivery System ◽  
Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

Latent Class Analysis of Nonsuicidal Self-Injury Among Justice-Involved Juveniles: Association With Motivational and Emotional Aspects of Self-Harm Behavior

2021 ◽  
pp. 009385482199841
Author(s):  
Melinda Reinhardt ◽  
Zsolt Horváth ◽  
Boglárka Drubina ◽  
Gyöngyi Kökönyei ◽  
Kenneth G. Rice
Keyword(s):  
Latent Class Analysis ◽  
Latent Class ◽  
Juvenile Detention ◽  
Class Analysis ◽  
Detention Centers ◽  
Self Injury ◽  
Class 1 ◽  
Emotional Aspects ◽  
Self Harm ◽  
Nonsuicidal Self Injury

Significantly higher rates of nonsuicidal self-injury (NSSI) have been discovered among justice-involved juveniles. Our study aimed to discriminate homogeneous subgroups of justice-involved youth with different self-harm behavior characteristics based on latent class analysis. A total of 244 adolescents (92.6% boys; Mage = 16.99, SD = 1.28) in Hungarian juvenile detention centers completed measures of NSSI and dissociation. High-NSSI (Class 1; 9%), moderate-NSSI (Class 2; 42.6%), and low-NSSI (Class 3; 48.4%) profiles were detected relating to different forms of NSSI. Multiple comparisons showed that girls were members of Class 1 and 2 at higher rates and these subgroups showed significantly higher dissociation proportions than Class 3. Our findings pointed out diversity in self-harm profiles with different characteristics in terms of methods and severity of self-harm, experienced emotions, and other emotion regulation tendencies among justice-involved adolescents. These results suggest sophisticated treatment approaches to match variations in severity and presentation.

scholarly journals Integrating Social Determinants of Health to Precision Medicine through Digital Transformation: An Exploratory Roadmap

2021 ◽  
Vol 18 (9) ◽  
pp. 5018
Author(s):  
Ik-Whan G. Kwon ◽  
Sung-Ho Kim ◽  
David Martin
Keyword(s):  
Precision Medicine ◽  
Social Determinants Of Health ◽  
Population Health ◽  
Social Determinants ◽  
Information Technologies ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Determinants Of Health ◽  
Collaborative Tools ◽  
High Level

The COVID-19 pandemic has altered healthcare delivery platforms from traditional face-to-face formats to online care through digital tools. The healthcare industry saw a rapid adoption of digital collaborative tools to provide care to patients, regardless of where patients or clinicians were located, while mitigating the risk of exposure to the coronavirus. Information technologies now allow healthcare providers to continue a high level of care for their patients through virtual visits, and to collaborate with other providers in the networks. Population health can be improved by social determinants of health and precision medicine working together. However, these two health-enhancing constructs work independently, resulting in suboptimal health results. This paper argues that artificial intelligence can provide clinical–community linkage that enhances overall population health. An exploratory roadmap is proposed.

To err is system; a comparison of methodologies for the investigation of adverse outcomes in healthcare

2021 ◽  
pp. 251604352199026
Author(s):  
Peter Isherwood ◽  
Patrick Waterson
Keyword(s):  
Patient Safety ◽  
System Performance ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Real Life ◽  
Adverse Outcomes ◽  
System Level ◽  
Future Performance ◽  
System A ◽  
Regulatory Bodies

Patient safety, staff moral and system performance are at the heart of healthcare delivery. Investigation of adverse outcomes is one strategy that enables organisations to learn and improve. Healthcare is now understood as a complex, possibly the most complex, socio-technological system. Despite this the use of a 20th century linear investigation model is still recommended for the investigation of adverse outcomes. In this review the authors use data gathered from the investigation of a real life healthcare near incident and apply three different methodologies to the analysis of this data. They compare both the methodologies themselves and the outputs generated. This illustrates how different methodologies generate different system level recommendations. The authors conclude that system based models generate the strongest barriers to improve future performance. Healthcare providers and their regulatory bodies need to embrace system based methodologies if they are to effectively learn from, and reduce future, adverse outcomes.

scholarly journals Multimorbidity patterns and memory trajectories in older adults: Evidence from the English Longitudinal Study of Ageing

2021 ◽  
Author(s):  
Rebecca Bendayan ◽  
Yajing Zhu ◽  
A D Federman ◽  
R J B Dobson
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Latent Class ◽  
Health Behaviours ◽  
Health Conditions ◽  
Delayed Recall ◽  
Class 1 ◽  
English Longitudinal Study ◽  
Psychiatric Problems

Abstract Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.

scholarly journals ‘Not just a piece of skin in front of you’—a qualitative exploration of the experiences of adolescents with eczema and psoriasis with healthcare professionals

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041108
Author(s):  
Isabella Joy de Vere Hunt ◽  
Abigail McNiven ◽  
Amanda Roberts ◽  
Himesh Parmar ◽  
Tess McPherson
Keyword(s):  
Young People ◽  
Skin Disease ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Secondary Analysis ◽  
Emotional Impact ◽  
Skin Conditions ◽  
The Uk ◽  
Qualitative Exploration

BackgroundThere is little qualitative research in the UK focussing on adolescents’ experience of their healthcare providers, and inflammatory skin conditions are a common heath problem in adolescence.AimTo explore the experiences of adolescents with eczema and psoriasis with healthcare professionals, and to distil the participants’ key messages for their healthcare providers.DesignThis is a secondary thematic analysis of interviews with adolescents with eczema or psoriasis.ParticipantsThere were a total of 41 text transcripts of interviews with young people with eczema or psoriasis who had given permission for secondary analysis; 23 of the participants had eczema, and 18 psoriasis. Participants were living in the UK at time of interview, and aged 15–24 years old.ResultsWe have distilled the following key messages from young people with eczema and psoriasis for healthcare providers: (1) address the emotional impact; (2) give more information, with the subtheme and (3) appreciate patient research. We identified the following eczema-specific themes: (ECZ-4) ‘It’s not taken seriously’; (ECZ-5) offer choice in treatment and (ECZ-6) lack of structure/conflicting advice. Two psoriasis-specific themes were identified: (PSO-4) feeling dehumanised/treat me as a person; and (PSO-5) think about how treatments will affect daily life.ConclusionThis qualitative data analysis highlights the need for greater recognition of the emotional impact of skin disease in adolescence, and for more comprehensive provision of information about the conditions. We call for greater sensitivity and flexibility in our approach to adolescents with skin disease, with important implications for healthcare delivery to this group.

A Tenuous Pas de Deux: Examining University Dancers’ Access to and Satisfaction with Healthcare Delivery

2018 ◽  
Vol 33 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Tina J Wang ◽  
Jeffrey A Russell
Keyword(s):  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Injury Rate ◽  
Medical Attention ◽  
Informal Networks ◽  
Online Questionnaire ◽  
Negative Experience ◽  
Post Secondary ◽  
Dance Teachers ◽  
Art Form

BACKGROUND: Dance is a rigorous art form and athletic activity accompanied by a high injury rate. The purpose of this study was to gather injury and healthcare availability information from university dancers to better understand dancers’ access to professional medical attention and their satisfaction with the medical advice they receive. METHODS: An author-designed online questionnaire about dance-related injury (DRI), access to healthcare, and satisfaction with healthcare was distributed to dancers at 102 American post-secondary institutions in 2 states that offer programs in dance; 211 dancers completed the survey. RESULTS: 75% of dancers reported seeking healthcare advice from dance teachers. A majority (55%) who visited healthcare professionals for a DRI disclosed negative experiences; the top reasons stemmed from the professionals’ not understanding dancers (70%), providing unhelpful advice (43%), or not spending enough time in the healthcare consultation (33%). Of dancers who reported positive experiences, they most commonly discovered the provider by word-of-mouth (89%) or through the provider’s affiliation with their institution (41%). CONCLUSION: Dancers tend to access healthcare when it is available to them but find the lack of relevant and applicable advice from healthcare practitioners the biggest contributors to their negative experience with the healthcare system. When confronted with DRIs, dancers tend to seek advice from their dance instructors. To ensure proper evaluation, instructors should refer dancers to licensed healthcare providers, and dance medicine practitioners should make themselves known to dancers through both formal and informal networks.

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