scholarly journals Understanding parents’ experiences of disease course and influencing factors: a 3-year follow-up qualitative study among parents of children with functional abdominal pain

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037288
Author(s):  
Mette Brekke ◽  
Anne Brodwall
Keyword(s):  
Abdominal Pain ◽  
Rural Areas ◽  
Specific Treatment ◽  
Common Symptom ◽  
Functional Abdominal Pain ◽  
Open Questions ◽  
Urban And Rural Areas ◽  
Southern Norway ◽  
Parents Experiences

ObjectiveFunctional abdominal pain is a common symptom in children and adolescents. Three years ago, we investigated the experiences among parents whose children had chronic abdominal pain but no somatic diagnosis. The aim of the present follow-up study was to explore those families’ current situations.DesignInterviews with open questions about the families’ current pain situations were carried out by the first author. Interviews were audio-recorded and transcribed, and subsequently analysed using descriptive content analysis.SettingUrban and rural areas in two municipalities in Southern Norway.ParticipantsParents of children with abdominal pain who had been referred to a local hospital by their general practitioner and had been discharged without a somatic diagnosis. Fifteen parents of 14 children aged 8–17 years who had also been interviewed in 2016.ResultsNine of the children had recovered from their abdominal pain. During the pain period, the parents reported frustration with not having a diagnosis nor a specific treatment for their child’s abdominal pain. The siblings in some families received less attention and were afraid that something serious might happen to their sister or brother. The parents wished that their child’s school cared more about the child when they had weeks of absence. All parents maintained that their child’s pain was physical, although they thought that psychological aspects might have influenced the symptoms. The parents stated that they, as well as their children, needed guidance from professionals to understand the complex pain situation.

scholarly journals The effect of COVID-19 pandemic and lockdown on consultation numbers, consultation reasons and performed services in primary care: results of a longitudinal observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ingmar Schäfer ◽  
Heike Hansen ◽  
Agata Menzel ◽  
Marion Eisele ◽  
Daniel Tajdar ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Rural Areas ◽  
Longitudinal Observational Study ◽  
Multivariable Analyses ◽  
Gastrointestinal Complaints ◽  
Urban And Rural Areas ◽  
Quota Sampling ◽  
Primary Care Practices

Abstract Objectives The aims of our study were to describe the effect of the COVID-19 pandemic and lockdown on primary care in Germany regarding the number of consultations, the prevalence of specific reasons for consultation presented by the patients, and the frequency of specific services performed by the GP. Methods We conducted a longitudinal observational study based on standardised GP interviews in a quota sampling design comparing the time before the COVID-19 pandemic (12 June 2015 to 27 April 2017) with the time during lockdown (21 April to 14 July 2020). The sample included GPs in urban and rural areas 120 km around Hamburg, Germany, and was stratified by region type and administrative districts. Differences in the consultation numbers were analysed by multivariate linear regressions in mixed models adjusted for random effects on the levels of the administrative districts and GP practices. Results One hundred ten GPs participated in the follow-up, corresponding to 52.1% of the baseline. Primary care practices in 32 of the 37 selected administrative districts (86.5%) could be represented in both assessments. At baseline, GPs reported 199.6 ± 96.9 consultations per week, which was significantly reduced during COVID-19 lockdown by 49.0% to 101.8 ± 67.6 consultations per week (p < 0.001). During lockdown, the frequency of five reasons for consultation (-43.0% to -31.5%) and eleven services (-56.6% to -33.5%) had significantly decreased. The multilevel, multivariable analyses showed an average reduction of 94.6 consultations per week (p < 0.001). Conclusions We observed a dramatic reduction of the number of consultations in primary care. This effect was independent of age, sex and specialty of the GP and independent of the practice location in urban or rural areas. Consultations for complaints like low back pain, gastrointestinal complaints, vertigo or fatigue and services like house calls/calls at nursing homes, wound treatments, pain therapy or screening examinations for the early detection of chronic diseases were particularly affected.

Risk factors and features of stroke among young persons in urban and rural areas of the Tambov Region

2021 ◽  
pp. 45-52
Author(s):  
Ekaterina B. Zvonareva ◽  
Lubov I. Grigorova
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Cerebral Circulation ◽  
Young Patients ◽  
Clinical Hospital ◽  
Regional Features ◽  
Urban And Rural Areas ◽  
Concomitant Factors ◽  
Causes And Risk Factors

Since 2011 according to the national project “Health” the Regional Vascular Center has been operating on the basis of the Tambov Regional Clinical Hospital. This is a ward for patients with acute cerebral circulation disorder. Since 2017 there has been an increase in patients due to an increase in the number of attached population to Tambov Regional Clinical Hospital and, accordingly, unfortunately, the mortality rate from acute cerebral circulation disorder has been increasing. Between 2016 and 2020, a study was conducted based on the follow-up of young patients with hemorrhagic and ischemic stroke. In the study we emphasized the research of regional features of the structure, causes, and risk factors of stroke in persons in the city of Tambov and the districts of the Tambov Region. We verified pathogenetic subtypes of stroke among young patients. We identified and considered main and concomitant factors determining stroke outcome, degree of neurological deficiency, and disabled patients. We identified the leading causes of stroke in persons, the main of which were: arterial hypertension, cardiac pathology, atherosclerosis.

scholarly journals INTREPID II: protocol for a multistudy programme of research on untreated psychosis in India, Nigeria and Trinidad

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e039004
Author(s):  
Tessa Roberts ◽  
Oye Gureje ◽  
Rangaswamy Thara ◽  
Gerard Hutchinson ◽  
Alex Cohen ◽  
...  
Keyword(s):  
Rural Areas ◽  
Help Seeking ◽  
Psychotic Disorders ◽  
Global South ◽  
Ethical Review ◽  
Target Populations ◽  
Key Stakeholders ◽  
Pilot Work ◽  
Urban And Rural Areas

IntroductionThere are few robust and directly comparable studies of the epidemiology of psychotic disorders in the Global South. INTREPID II is designed to investigate variations in untreated psychotic disorders in the Global South in (1) incidence and presentation (2) 2-year course and outcome, (3) help-seeking and impact, and (4) physical health.MethodsINTREPID II is a programme of research incorporating incidence, case–control and cohort studies of psychoses in contiguous urban and rural areas in India, Nigeria and Trinidad. In each country, the target samples are 240 untreated cases with a psychotic disorder, 240 age-matched, sex-matched and neighbourhood-matched controls, and 240 relatives or caregivers. Participants will be followed, in the first instance, for 2 years. In each setting, we have developed and are employing comprehensive case-finding methods to ensure cohorts are representative of the target populations. Using methods developed during pilot work, extensive data are being collected at baseline and 2-year follow-up across several domains: clinical, social, help-seeking and impact, and biological.Ethics and disseminationInformed consent is sought, and participants are free to withdraw from the study at any time. Participants are referred to mental health services if not already in contact with these and emergency treatment arranged where necessary. All data collected are confidential, except when a participant presents a serious risk to either themselves or others. This programme has been approved by ethical review boards at all participating centres. Findings will be disseminated through international conferences, publications in international journals, and through local events for key stakeholders.

Long-Term Follow-Up of Gut-Directed Hypnotherapy vs. Standard Care in Children With Functional Abdominal Pain or Irritable Bowel Syndrome

2012 ◽  
Vol 107 (4) ◽  
pp. 627-631 ◽  
Author(s):  
Arine M Vlieger ◽  
Juliette M T M Rutten ◽  
Anita M A P Govers ◽  
Carla Frankenhuis ◽  
Marc A Benninga
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Standard Care ◽  
Functional Abdominal Pain ◽  
Long Term Follow Up ◽  
Irritable Bowel

scholarly journals Functional Abdominal Pain in Childhood: Background Studies and Recent Research Trends

2012 ◽  
Vol 17 (6) ◽  
pp. 413-417 ◽  
Author(s):  
Rona L Levy ◽  
Miranda AL van Tilburg
Keyword(s):  
Abdominal Pain ◽  
Clinical Practice ◽  
Present Article ◽  
Research Program ◽  
Physical State ◽  
Research Trends ◽  
Major Research ◽  
Functional Abdominal Pain ◽  
The Past

The present review summarizes many of the major research trends investigated in the past five years regarding pediatric functional abdominal pain, and also summarizes the primary related findings from the authors’ research program. Specific areas discussed based on work within the authors’ group include familial illness patterns, genetics, traits, and mechanisms or processes related to abdominal pain. Topics covered from research published in the past five years include prevalence and cost, longitudinal follow-up, overlap with other disorders, etiology and mechanisms behind functional abdominal pain and treatment studies. It is hoped that findings from this work in abdominal pain will be interpreted as a framework for understanding the processes by which other pain phenomena and, more broadly, reactions to any physical state, can be developed and maintained in children. The present article concludes with recommendations for clinical practice and research.

758 Long Term Follow-up of Gut-Directed Hypnotherapy Versus Standard Care in Children With Functional Abdominal Pain or Irritable Bowel Syndrome

2012 ◽  
Vol 142 (5) ◽  
pp. S-134 ◽  
Author(s):  
Arine M. Vlieger ◽  
Juliette M. Rutten ◽  
Anita M. Govers ◽  
Carla Frankenhuis ◽  
Marc A. Benninga
Keyword(s):  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Standard Care ◽  
Functional Abdominal Pain ◽  
Long Term Follow Up ◽  
Irritable Bowel

scholarly journals Knowledge and attitudes of Subcarpathian Province's inhabitants towards organ transplantation

2019 ◽  
Vol 18 (2) ◽  
pp. 123-131
Author(s):  
Małgorzata Moskal-Szybka ◽  
Justyna Borek
Keyword(s):  
Organ Transplantation ◽  
Rural Areas ◽  
Urban Areas ◽  
Social Acceptance ◽  
Public Awareness ◽  
Specific Treatment ◽  
Knowledge And Attitudes ◽  
Willingness To Donate ◽  
Level Of Knowledge ◽  
Urban And Rural Areas

AbstractIntroduction. Transplantation (from Latin transplantare – transplant and plantare – plant), also called organ transplantation, is a safe, effective, and in some cases the only available treatment method giving hope for recovery for patients with end-stage organ failure (such as failure of heart, liver, lungs, kidneys, pancreas). It involves replacement of a diseased organ or tissue with healthy one obtained from another person. It is a specific treatment that requires social acceptance. Despite the efforts being made by the Polish transplantation community, low public awareness and lack of knowledge on organ donation are still significant barriers to the development of transplantation program in Poland [1].Objective. Recognition of knowledge and attitudes of Subcarpathian Province’s inhabitants towards organ transplantation.Material and methods. The survey conducted in 2018 included 187 inhabitants of urban and rural areas of the Subcarpathian Province with non-medical background. A method of diagnostic survey with a questionnaire was used. The research tool was a proprietary questionnaire containing mostly single-choice questions. The questions in the survey were closed-ended.Results and conclusons. The level of knowledge of most respondents (56.9% of the respondents from urban areas and 57.4% of the respondents from rural areas) was moderate. High level of knowledge was presented by fewer respondents: 34.7% of those from urban areas and 31.3% of those from rural areas. Low level of knowledge was reported by 8.3% and 11.3% of the respondents from urban and rural areas, respectively. No significant differences in knowledge of organ transplantation were seen between the respondents from urban and rural areas. The results of this research show insufficient knowledge concerning organ transplantation in the surveyed population. Most respondents declare their willingness to donate organs when needed. Both our research presented in this paper and reports by other authors suggest the need for educating the public in order to encourage broad social acceptance for transplant medicine.

scholarly journals Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Dinesh Visva Gunasekeran ◽  
Zhenghong Liu ◽  
Win Jim Tan ◽  
Joshua Koh ◽  
Chiu Peng Cheong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Controlled Trial ◽  
Common Symptom ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Video Consultation

BACKGROUND The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. OBJECTIVE The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. METHODS The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). RESULTS A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (<i>P</i>&gt;.99) and efficacy (<i>P</i>&gt;.99) between the two groups. CONCLUSIONS The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. CLINICALTRIAL ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556.

scholarly journals Evaluating Safety and Efficacy of Follow-up for Patients With Abdominal Pain Using Video Consultation (SAVED Study): Randomized Controlled Trial

10.2196/17417 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e17417 ◽  
Author(s):  
Dinesh Visva Gunasekeran ◽  
Zhenghong Liu ◽  
Win Jim Tan ◽  
Joshua Koh ◽  
Chiu Peng Cheong ◽  
...  
Keyword(s):  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Abdominal Pain ◽  
Acute Abdominal Pain ◽  
Controlled Trial ◽  
Common Symptom ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Video Consultation

Background The benefits of telemedicine include cost savings and decentralized care. Video consultation is one form that enables early detection of deteriorating patients and promotion of self-efficacy in patients who are well but anxious. Abdominal pain is a common symptom presented by patients in emergency departments. These patients could benefit from video consultation, as it enables remote follow-up of patients who do not require admission and facilitates early discharge of patients from overcrowded hospitals. Objective The study aimed to evaluate the safety and efficacy of the use of digital telereview in patients presenting with undifferentiated acute abdominal pain. Methods The SAVED study was a prospective randomized controlled trial in which follow-up using existing telephone-based telereview (control) was compared with digital telereview (intervention). Patients with undifferentiated acute abdominal pain discharged from the emergency department observation ward were studied based on intention-to-treat. The control arm received routine, provider-scheduled telereview with missed reviews actively coordinated and rescheduled by emergency department staff. The intervention arm received access to a platform for digital telereview (asynchronous and synchronous format) that enabled patient-led appointment rescheduling. Patients were followed-up for 2 weeks for outcomes of service utilization, efficacy (compliance with their disposition plan), and safety (re-presentation for the same condition). Results A total of 70 patients participated, with patients randomly assigned to each arm (1:1 ratio). Patients were a mean age of 40.0 (SD 13.8; range 22-71) years, predominantly female (47/70, 67%), and predominantly of Chinese ethnicity (39/70, 56%). The telereview service was used by 32 patients in the control arm (32/35, 91%) and 18 patients in the intervention arm (18/35, 51%). Most patients in control (33/35, 94%; 95% CI 79.5%-99.0%) and intervention (34/35, 97%; 95% CI 83.4%-99.9%) arms were compliant with their final disposition. There was a low rate of re-presentation at 72 hours and 2 weeks for both control (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 2/35, 6%, 95% CI 1.0%-20.5%) and intervention (72 hours: 2/35, 6%; 95% CI 1.0%-20.5%; 2 weeks: 3/35, 9%, 95% CI 2.2%-24.2%) arms. There were no significant differences in safety (P>.99) and efficacy (P>.99) between the two groups. Conclusions The application of digital telereview for the follow-up of patients with abdominal pain may be safe and effective. Future studies are needed to evaluate its cost-effectiveness and usefulness for broader clinical application. Trial Registration ISRCTN Registry ISRCTN28468556; http://www.isrctn.com/ISRCTN28468556.

scholarly journals 1299. Iowa TelePrEP: Preliminary Experience with a Public Health-Partnered, Telemedical PrEP Delivery Model in a Rural State

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S397-S397 ◽  
Author(s):  
Angela Hoth ◽  
Cody Shafer ◽  
Dena Dillon ◽  
Constanza Scheetz ◽  
Seth Owens ◽  
...  
Keyword(s):  
Public Health ◽  
Rural Areas ◽  
Local Treatment ◽  
Linkage To Care ◽  
University Of Iowa ◽  
Transmitted Infection ◽  
Delivery Model ◽  
Sexually Transmitted ◽  
Urban And Rural Areas

Abstract Background Access to HIV pre-exposure prophylaxis (PrEP) is often poor in small urban and rural areas due to long distances to PrEP providers and stigma. In 2017, the Iowa Department of Public Health (IDPH), University of Iowa (UI), and community representatives collaborated to develop a public health-partnered telemedical PrEP delivery model to overcome these barriers (TelePrEP). IDPH personnel working in five sexually transmitted infection (STI) clinics and partner services (PS) programs in Eastern Iowa screened clients for PrEP indications and referred those with need to TelePrEP pharmacist providers at UI. Via collaborative practice, pharmacists completed initial and follow-up PrEP home video visits with clients on smart phones and laptops. Clients obtained laboratory monitoring and STI screening in public health-affiliated and local laboratories in accordance with USPHS/CDC guidelines, and received PrEP medication by mail. PS personnel linked TelePrEP clients with newly-identified STIs to local treatment. Methods Using the PrEP continuum as framework, we used IDPH databases and UI medical records to conduct a retrospective process evaluation of the TelePrEP model (February 2017–April 2018). Results TelePrEP received 44 referrals from public health and 59 self-referrals via advertising. Pharmacists completed 84 initial visits (81% of referrals), including 37 visits (84%) with clients referred by public health. Most (94%) started emtricitabine/tenofovir after initial visits. Retention in TelePrEP at 6 months was 87%. 96% of guideline-indicated laboratory tests (HIV, creatinine, STI, hepatitis) were completed at baseline and follow-up. Rates of extragenital chlamydia and gonorrhea screening were lower (74 of 104 completed screens) due to variable availability of swabs at local laboratories. 15 clients were diagnosed with 20 STIs on screening (6 syphilis, four gonorrhea, 10 chlamydia) and one unrecognized pregnancy was identified. PS linked all clients with STIs on screens to treatment within 14 days (80% in 3 days). Conclusion Using telemedicine, healthcare systems can partner with public health administered STI clinics and PS programs to create virtual PrEP delivery models in rural settings. Public health partnerships enhance client identification and ensure linkage to care for new STI diagnoses in telemedicine programs. Disclosures A. Hoth, Gilead Sciences, Inc.: Research team member, Research support. M. Ohl, Gilead Sciences, Inc.: Grant Investigator, Research grant.

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