scholarly journals Patients’ perspectives on the barriers to referral after telescreening for diabetic retinopathy in communities

2020 ◽  
Vol 8 (1) ◽  
pp. e000970 ◽  
Author(s):  
Xiaofeng Zhu ◽  
Yi Xu ◽  
Lina Lu ◽  
Haidong Zou
Keyword(s):  
Diabetic Retinopathy ◽  
Univariate Analysis ◽  
Education Level ◽  
Related Factors ◽  
Educational Support ◽  
Lower Education Level ◽  
Almost All ◽  
Referral Completion ◽  
Design And Methods ◽  
Physician Patient

ObjectiveTo understand the referral completion and explore the associated barriers to the referral after telescreening for diabetic retinopathy (DR) among people with vision-threatening DR (VTDR).Research design and methodsAll participants with VTDR after DR telescreening in the communities completed the self-reported questionnaires to assess referral completion and their perspectives on referral barriers. Sociodemographic characteristics and perceived barriers related to incomplete referrals were identified by conducting univariate analysis and multiple logistic regression model. The final model was then built to predict incomplete referral.ResultsOf the 3362 participants, 46.1% had incomplete referral. Old age and lower education level showed significant association with incomplete referral. Almost all participants had at least one barrier during the referral process. Knowledge-related and attitude-related barriers, including ‘Too old to want any more treatment’, ‘Difficulty in getting time to referral’, ‘No serious illness requiring treatment at present’, ‘My eyes are okay’, ‘Distrust the recommended hospital’ and ‘Have not been diagnosed or treated before’, and logistics-related barrier ‘Mobility or transportation difficulties’ showed significant association with incomplete referral.ConclusionsThe issue of incomplete referral after DR telescreening is serious among individuals with VTDR, particularly in the elder and low education level population. The negativity of knowledge-related and attitude-related factors might be more prominent than logistic barriers in predicting incomplete referral. Therefore, new strategies to improve the compliance with referral assist in optimizing the referral accessibility, and the ongoing educational support to improve the awareness of disease and increase the effectiveness of physician-patient communication.

scholarly journals Repeat Induced Abortion among Chinese Women Seeking Abortion: Two Cross Sectional Studies

2021 ◽  
Vol 18 (9) ◽  
pp. 4446
Author(s):  
Longmei Tang ◽  
Shangchun Wu ◽  
Dianwu Liu ◽  
Marleen Temmerman ◽  
Wei-Hong Zhang
Keyword(s):  
Negative Binomial ◽  
Induced Abortion ◽  
Education Level ◽  
Married Women ◽  
Negative Binomial Regression Model ◽  
Related Factors ◽  
Cross Sectional ◽  
Lower Education Level ◽  
Induced Abortions ◽  
Lower Education

Background: In China, there were about 9.76 million induced abortions in 2019, 50% of which were repeat abortions. Understanding the tendency of repeat induced abortion and identifying its related factors is needed to develop prevention strategies. Methods: Two hospital-based cross-sectional surveys were conducted from 2005–2007 and 2013–2016 in 24 and 90 hospitals, respectively. The survey included women who sought an induced abortion within 12 weeks of pregnancy. The proportion of repeat induced abortions by adjusting the covariates through propensity score matching was compared between the two surveys, and the zero-inflated negative binomial regression model was established to identify independent factors of repeat induced abortion. Results: Adjusting the age, occupation, education, marital status and number of children, the proportion of repeat induced abortions in the second survey was found to be low (60.28% vs. 11.11%), however the unadjusted proportion was high in the second survey (44.97% vs. 51.54%). The risk of repeat induced abortion was higher among married women and women with children [ORadj and 95% CI: 0.31 (0.20, 0.49) and 0.08 (0.05, 0.13)]; the risk among service industry staff was higher when compared with unemployed women [ORadj and 95% CI: 0.19 (0.07, 0.54)]; women with a lower education level were at a higher risk of a repeat induced abortion (ORadj < 1). Compared with women under the age of 20, women in other higher age groups had a higher frequency of repeat induced abortions (IRadj: 1.78, 2.55, 3.27, 4.01, and 3.93, separately); the frequency of women with lower education levels was higher than those with a university or higher education level (IRadj > 1); the repeat induced abortion frequency of married women was 0.93 (0.90, 0.98) when compared to the frequency of unmarried women, while the frequency of women with children was 1.17 (1.10, 1.25) of childless women; the induced abortion frequency of working women was about 60–95% with that of unemployed women. Conclusions: The repeat induced abortion proportion was lower than 10 years ago. Induced abortion seekers who were married, aged 20 to 30 years and with a lower education level were more likely to repeat induced abortions.

scholarly journals Dietary glutamic acid and aspartic acid as biomarkers for predicting diabetic retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
So Young Park ◽  
Jieun Kim ◽  
Jung Il Son ◽  
Sang Youl Rhee ◽  
Do-Yeon Kim ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Glutamic Acid ◽  
Aspartic Acid ◽  
Education Level ◽  
Screening Rate ◽  
Food Records ◽  
Acid Intake ◽  
Lower Education Level ◽  
Lower Education

AbstractThe screening rate of diabetic retinopathy (DR) is low despite the importance of early diagnosis. We investigated the predictive value of dietary glutamic acid and aspartic acid for diagnosis of DR using the Korea National Diabetes Program cohort study. The 2067 patients with type 2 diabetes without DR were included. The baseline intakes of energy, glutamic acid and aspartic acid were assessed using a 3-day food records. The risk of DR incidence based on intake of glutamic acid and aspartic acid was analyzed. The DR group was older, and had higher HbA1c, longer DM duration, lower education level and income than non-DR group (all p < 0.05). The intake of total energy, glutamic acid and aspartic acid were lower in DR group than non-DR group (p = 0.010, p = 0.025 and p = 0.042, respectively). There was no difference in the risk of developing DR according to the intake of glutamic acid and ascorbic acid. But, aspartic acid intake had a negative correlation with PDR. Hence, the intake of glutamic acid and aspartic acid did not affect in DR incidence. However, lower aspartic acid intake affected the PDR incidence.

scholarly journals Lower Education Level is a Major Risk Factor for Peritonitis Incidence in Chronic Peritoneal Dialysis Patients: A Retrospective Cohort Study with 12-Year Follow-Up

2013 ◽  
Vol 33 (5) ◽  
pp. 552-558 ◽  
Author(s):  
Yahn-Bor Chern ◽  
Pei-Shan Ho ◽  
Li-Chueh Kuo ◽  
Jin-Bor Chen
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Univariate Analysis ◽  
Education Level ◽  
Time Dependent ◽  
Factors Associated ◽  
Lower Education Level ◽  
Lower Education

BackgroundPeritoneal dialysis (PD)-related peritonitis remains an important complication in PD patients, potentially causing technique failure and influencing patient outcome. To date, no comprehensive study in the Taiwanese PD population has used a time-dependent statistical method to analyze the factors associated with PD-related peritonitis.MethodsOur single-center retrospective cohort study, conducted in southern Taiwan between February 1999 and July 2010, used time-dependent statistical methods to analyze the factors associated with PD-related peritonitis.ResultsThe study recruited 404 PD patients for analysis, 150 of whom experienced at least 1 episode of peritonitis during the follow-up period. The incidence rate of peritonitis was highest during the first 6 months after PD start. A comparison of patients in the two groups (peritonitis vs null-peritonitis) by univariate analysis showed that the peritonitis group included fewer men (p = 0.048) and more patients of older age (≥65 years, p = 0.049). In addition, patients who had never received compulsory education showed a statistically higher incidence of PD-related peritonitis in the univariate analysis (p = 0.04). A proportional hazards model identified education level (less than elementary school vs any higher education level) as having an independent association with PD-related peritonitis [hazard ratio (HR): 1.45; 95% confidence interval (CI): 1.01 to 2.06; p = 0.045). Comorbidities measured using the Charlson comorbidity index (score >2 vs ≤2) showed borderline statistical significance (HR: 1.44; 95% CI: 1.00 to 2.13; p = 0.053).ConclusionsA lower education level is a major risk factor for PD-related peritonitis independent of age, sex, hypoalbuminemia, and comorbidities. Our study emphasizes that a comprehensive PD education program is crucial for PD patients with a lower education level.

scholarly journals Education level and risk of postpartum depression: results from the Japan Environment and Children’s Study (JECS)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Kenta Matsumura ◽  
◽  
Kei Hamazaki ◽  
Akiko Tsuchida ◽  
Haruka Kasamatsu ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Postpartum Depression ◽  
Reference Group ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Education Level ◽  
Odds Ratios ◽  
Symptom Dimensions ◽  
Lower Education Level ◽  
Lower Education

Abstract Background Lower socioeconomic status is often thought to be associated with an elevated risk of postpartum depression; however, this relationship exhibits noticeable heterogeneity between studies. The present study examined this relationship in Japan. Methods Data were obtained from 90,194 mothers in an ongoing birth cohort of the Japan Environment and Children’s Study. Socioeconomic status was assessed based on the mothers’ highest education level during pregnancy. Postpartum depression was identified at 1 and 6 months postpartum based on an Edinburgh Postnatal Depression Scale score of ≥9, and analyses were also performed based on the sub-scores for anxiety, depression, and anhedonia symptoms. Logistic and generalized linear regression model analyses were used to calculate odds ratios for postpartum depression according to education level with the highest education group (≥16 years of education) defined as the reference group, while controlling for covariates in a stepwise fashion. Results Univariate analysis revealed that a lower education level was associated with a higher prevalence of postpartum depression and related symptoms. Although these relationships weakened in the fully adjusted models, odds ratios for cases and related symptoms remained significant at 1 and 6 months postpartum. Among three symptom dimensions, the relationship was strongest and weakest in the depressive and anxiety symptoms, respectively. Conclusions A lower education level was an independent risk factor for postpartum depression. In view of the low mobility of the education level, this finding suggests the potential importance of collecting information regarding education levels at the earliest opportunity.

scholarly journals Prevalence and Related Factors of Insomnia Among Chinese Medical Staff in the Middle and Late Stage of COVID-19

2020 ◽  
Vol 11 ◽  
Author(s):  
Dianying Liu ◽  
Shaohua Liu ◽  
Lin Zhu ◽  
Dongbin Li ◽  
Donghua Huang ◽  
...  
Keyword(s):  
Medical Staff ◽  
Working Hours ◽  
Education Level ◽  
Health Staff ◽  
Psychological Resilience ◽  
Related Factors ◽  
Lower Education Level ◽  
Younger Age ◽  
Lower Education ◽  
Somatic Diseases

Background: The outbreak of novel coronavirus disease (COVID-19) has brought serious psychological pressure to people, especially medical health staff. At present, there are few studies on insomnia and related factors of medical health staff in the middle and late stage of the epidemic of COVID-19. Therefore, the purpose of this study was to investigate the prevalence of insomnia and its related risk factors among medical workers in China in the middle and later stage of COVID-19 epidemic, as well as the relationship between insomnia and psychological resilience.Methods: From February 14 to March 29, 2020, a cross-sectional survey was conducted among 606 medical staff in China through Ranxing Technology's “SurveyStar” network platform. All subjects were assessed with the Insomnia Severity Index (ISI) and simplified Chinese version of Connor-Davidson Resilience scale (CD-RISC-10).Results: In the middle and later stages of the COVID-19 outbreak, the incidence of insomnia among medical staff was 32.0%. Compared with non-insomnia group, the insomnia group had younger age, lower education level, longer daily working hours and less psychological resilience. In addition, the prevalence of insomnia was higher in medical staff with a history of somatic diseases. The severity of insomnia of Chinese medical staff was associated with age, education level, daily working hours, psychological resilience and somatic diseases.Conclusions: Our study shows that nearly 1/3 of Chinese medical workers suffer from insomnia nearly a month after the COVID-19 outbreak. Compared with the general population, medical staff who are working with COVID are more prone to insomnia. Risk factors for insomnia include younger age, lower education level, longer working hours per day, and physical illness. The tenacious dimension of psychological resilience is a protective factor for insomnia.

scholarly journals FRI0322 INSULIN RESISTANCE IN NON-DIABETES PATIENTS WITH SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 752.2-753
Author(s):  
J. C. Quevedo-Abeledo ◽  
F. Genre ◽  
J. Rueda-Gotor ◽  
A. Corrales ◽  
V. Hernández-Hernández ◽  
...  
Keyword(s):  
Cell Function ◽  
Inflammatory Diseases ◽  
Univariate Analysis ◽  
Serum Levels ◽  
Β Cell ◽  
Related Factors ◽  
C Peptide ◽  
Related Data ◽  
Β Cell Function ◽  
Beta Coefficient

Background:Insulin resistance (IR) is a state in which a given concentration of insulin is associated with a subnormal glucose response. IR constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this sense, several reports have confirmed that inflammation worsens IR and impairs pancreatic β-cell function in inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus.Objectives:In this study we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) compared to controls, and whether IR can be explained by disease-related features in SpA patients.Methods:Study of 577 subjects, 306 patients diagnosed with SpA according to ASAS criteria and 271 controls. Insulin and C-peptide serum levels, IR and β-cell function (%B) indexes by homeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariate regression analysis was performed to evaluate the differences in IR indexes between patients and controls and to determine how IR is associated with disease-related characteristics.Results:SpA patients showed higher serum levels of insulin (8.7 [4.8-15.9] vs. 8.0 [5.7-11.2] uU/ml, p=0.001) and C peptide (1.4 [0.7-2.5] vs. 1.2 [0.7-1.7] ng/ml, p=0.000) than controls in the univariate analysis. Similarly, HOMA2-B% and IR were all significantly higher in SpA patients. These differences were still evident when the comparisons were made after the multivariate analysis had been adjusted for traditional IR-related factors (sex, age, BMI, hypertension, dyslipidemia, smoking and, cholesterol), glucocorticoids intake, insulin and C-peptide. Moreover, HOMA2-B% and HOMA2-IR scores, both calculated with insulin or C-peptide, yielded statistically higher significant values in SpA patients than controls.Classic IR-related factors (age, BMI, waist circumference, hypertension, obesity, dyslipidemia, atherogenic index, and triglycerides), as well as CRP serum levels, were all related, to a greater or lesser degree, with IR and β-cell function. Regarding disease-related data, ASDAS-CRP, BASFI and BASMI scores were positively associated with IR; and BASMI and BASDAI scores were positively related to HOMA2-%B-C peptide. Moreover, the use of NSAID and prednisone were, respectively, positive and negatively related to β-cell function. However, only some of the associations of the univariate analysis were maintained after adjusting for confounders. In this sense, disease duration (beta coefficient 2 [95% CI 1-3], p=0.001) and positivity for HLA-B27 (beta coefficient 30 [95% CI 12-49], p=0.002) were associated with higher β-cell functionality after the multivariate analysis.Conclusion:Patients with SpA have an increased IR compared to controls. SpA disease-related data like disease duration and HLA-B27 are independently associated with β-cell dysfunction.Disclosure of Interests:Juan Carlos Quevedo-Abeledo Speakers bureau: Abbvie, Fernanda Genre: None declared, Javier Rueda-Gotor: None declared, Alfonso Corrales Speakers bureau: Abbvie, Vanessa Hernández-Hernández Speakers bureau: Pfizer, Abbvie, MSD, Natalia Fañanas-Rodríguez: None declared, Bernardo Lavín-Gómez: None declared, delgado frias esmeralda Speakers bureau: Pfizer, Abbvie, MSD, Antonia de Vera-González: None declared, Alejandra Delgado-González: None declared, Laura de Armas-Rillo: None declared, Maria Teresa García-Unzueta: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Iván Ferraz-Amaro Grant/research support from: Pfizer, Abbvie, Speakers bureau: Pfizer, Abbvie, MSD.

scholarly journals Cardio-metabolic and socio-demographic risk factors associated with dependency in basic and instrumental activities of daily living among older Iranian adults: Bushehr elderly health program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kazem Khalagi ◽  
Akram Ansarifar ◽  
Noushin Fahimfar ◽  
Mahnaz Sanjari ◽  
Safoora Gharibzdeh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Education Level ◽  
Lower Education Level ◽  
History Of ◽  
Elderly Health ◽  
Lower Education ◽  
Demographic Risk ◽  
Demographic Risk Factors

Abstract Background Iran’s population is aging. Disability is a major public health problem for older adults, not only in Iran but all over the world. The purpose of this study was to investigate the relationship between cardio-metabolic and socio-demographic risk factors and disability in people 60 years and older in Iran. Methods The baseline (cross-sectional) data of 2426 samples from the Bushehr Elderly Health (BEH) program was included in the analysis. The participants were selected through multi-stage random sampling in Bushehr, southern Iran. Socio-demographic characteristics, as well as the history of diabetes and other chronic diseases, and smoking were measured using standardized questionnaires. Anthropometric measurements and laboratory tests were performed under standard conditions. Dependency was determined by the questionnaires of basic activities of daily living (BADL) and instrumental activities of daily living (IADL) using Barthel and Lawton scales respectively. Multiple logistic regression was used in the analysis. Results Mean (Standard Deviation) of the participants’ age was 69.3 (6.4) years (range: 60 and 96 years), and 48.1% of the participants were men. After adjusting for potential confounders, being older, being female (OR (95%CI): 2.3 (1.9–2.9)), having a lower education level, a history of diabetes mellitus (OR: 1.4 (1.2–1.7)) and past smoking (OR: 1.3 (1.0–1.6)), and no physical activity (OR: 1.5 (1.2–1.9)) were significantly associated with dependency in IADL. Also, being older and female (OR: 2.4 (1.9–3.0)), having a lower education level, no physical activity (OR: 2.2 (1.6–2.9)) and daily intake of calories (OR: 0.99 (0.99–0.99)) were associated with dependency in BADL. Conclusion Dependency in older adults can be prevented by increasing community literacy, improving physical activity, preventing and controlling diabetes mellitus, avoiding smoking, and reducing daily calorie intake.

scholarly journals Diabetic Retinopathy Screening and Registration in Europe—Narrative Review

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 745
Author(s):  
Elitsa Hristova ◽  
Darina Koseva ◽  
Zornitsa Zlatarova ◽  
Klara Dokova
Keyword(s):  
Diabetic Retinopathy ◽  
Healthcare Services ◽  
The European Union ◽  
Specialist Care ◽  
Screening Programs ◽  
Diabetic Retinopathy Screening ◽  
Remote Assessment ◽  
Narrative Literature ◽  
Narrative Literature Review ◽  
Almost All

Diabetic retinopathy (DR) is a leading cause of preventable vision impairment and blindness in the European Region. Despite the fact that almost all European countries have some kind of prophylactic eye examination for people with diabetes, the examinations are not properly arranged and are not organized according to the principles of screening in medicine. In 2021, the current COVID-19 pandemic moved telemedicine to the forefront healthcare services. Due to that, a lot more patients could benefit from comfortable and faster access to ophthalmology specialist care. This study aimed to conduct a narrative literature review on current DR screening programs and registries in the European Union for the last 20 years. With the implementation of telemedicine in daily medical practice, performing screening programs became much more attainable. Remote assessment of retinal pictures simultaneously saves countries time, money, and other resources.

scholarly journals Optimized and Non-Optimized Personal Protective Equipment Use during the COVID-19 Pandemic in Thailand: A National Cross-Sectional Survey in a Resource-Limited Setting

2021 ◽  
Vol 15 ◽  
pp. 117863022110135
Author(s):  
Visal Moolasart ◽  
Weerawat Manosuthi ◽  
Varaporn Thienthong ◽  
Uajai Jaemsak ◽  
Winnada Kongdejsakda ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Negative Pressure ◽  
Symptom Severity ◽  
Univariate Analysis ◽  
Education Level ◽  
Health Concern ◽  
Protective Equipment ◽  
Global Public Health ◽  
Cross Sectional ◽  
Infection Control Program

Introduction: Coronavirus disease (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV2). COVID-19 is highly contagious, potentially fatal, and a global public health concern. Combining optimized personal protective equipment (PPE) use and hand hygiene is the best strategy for preventing COVID-19 in health care workers (HCWs). Methods: We conducted a national cross-sectional web-based survey of HCWs in the infection control program (IPC) in Thailand between May 5, 2020 and May 15, 2020. The primary objective was the prevalence of optimized PPE use amongst HCWs. The secondary objective was identification of the independent predictors of optimized PPE use. Results: We received a response from 46% of HCWs (756/1650), and all those who responded were nurse or HCWs who were registered in the IPC network. Five HCWs were excluded because of missing data, and 751 were included in the final analysis. The prevalences of PPE use were 22% (168/751) for optimized PPE use, 78% (583/751) for non-optimized PPE use, 35% (263/751) for PPE overuse, and 43% (320/751) for PPE underused. In univariate analysis, optimized PPE use was significantly associated with age, education level, knowledge of appropriate negative pressure room selection, and knowledge of apparently milder symptom severity in children than adults. In multivariate analysis, independent predictors of optimized PPE use were knowledge of appropriate negative pressure room selection (aOR = 1.95, 95% CI = 1.18-3.22), the difference in symptom severity between children and adults (aOR = 0.55, 95% CI = 0.37-0.81), and education level (aOR = 1.54, 95% CI = 1.04-2.27). Conclusion: The prevalence of optimized PPE use amongst HCWs was 22%. Independent predictors of optimized PPE use were COVID-19 knowledge-based factors and education level. Therefore, the continued education training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.

PATHOPHYSIOLOGY OF ONCOLOGICAL PAIN: REVIEW OF LITERATURE

2020 ◽  
Vol 7 (1) ◽  
pp. 59-61
Author(s):  
Lucas Yago Souza Schmidt ◽  
Ana Flávia de Oliveira Castro ◽  
João Gabriel Lopes Siqueira ◽  
Dowglas Pereira De Oliveira ◽  
Welma Rezende Fuso De Assis
Keyword(s):  
Cancer Metastasis ◽  
Advanced Disease ◽  
Primary Site ◽  
Anxiety And Depression ◽  
Review Of Literature ◽  
Biological Mechanisms ◽  
Related Factors ◽  
Educational Support ◽  
Health Team

Despite the contributions to the diagnosis and treatment of cancer, the disease continues to present an adverse effect on patients' quality of life, with pain being a frequent complaint, with a prevalence varying from 50 to 53% in cancer patients at all stages and up to 70 % in cases of advanced disease. Cancer pain ismanifested by the primary site of cancer, metastasis, bone involvement, proximity to the nervous system, production of pain-promoting chemicals, and patient-related factors such as anxiety and depression. Because it is subjective, not palpable, and an individual experience and difficult to evaluate, requires for the health team educational support, knowledge and instruments that contribute to their understanding, being the elucidation of its biological mechanisms object of this literature review.

Sign in / Sign up

Export Citation Format

Share Document