scholarly journals Variation in Provider Identification of Obesity by Individual- and Neighborhood-Level Characteristics among an Insured Population

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Sara N. Bleich ◽  
Jeanne M. Clark ◽  
Suzanne M. Goodwin ◽  
Mary Margaret Huizinga ◽  
Jonathan P. Weiner
Keyword(s):  
Health Care Providers ◽  
Individual Characteristics ◽  
Outcome Variable ◽  
Obese Patients ◽  
Neighborhood Characteristics ◽  
Care Providers ◽  
Diagnosis Code ◽  
Individual Level ◽  
Logistic Regressions ◽  
To Receive

Objective. The purpose of this study was to examine whether neighborhood- and individual-level characteristics affect providers' likelihood of providing an obesity diagnosis code in their obese patients' claims.Methods. Logistic regressions were performed with obesity diagnosis code serving as the outcome variable and neighborhood characteristics and member characteristics serving as the independent variables (N= 16,151 obese plan members).Results. Only 7.7 percent of obese plan members had an obesity diagnosis code listed in their claims. Members living in neighborhoods with the largest proportions of Blacks were 29 percent less likely to receive an obesity diagnosis (P<.05). The odds of having an obesity diagnosis code were greater among members who were female, aged 44 or below, hypertensive, dyslipidemic, BMI ≥ 35 kg/m2, had a larger number of provider visits, or who lived in an urban area (allP<.05).Conclusions. Most health care providers do not include an obesity diagnosis code in their obese patients' claims. Rates of obesity identification were strongly related to individual characteristics and somewhat associated with neighborhood characteristics.

Biosimilars of Adalimumab in Inflammatory Bowel Disease: Are we Ready for that?

2019 ◽  
Vol 25 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Marjorie Argollo ◽  
Gionata Fiorino ◽  
Daniela Gilardi ◽  
Federica Furfaro ◽  
Giulia Roda ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Health Care Providers ◽  
Bowel Disease ◽  
Biological Treatment ◽  
Reference Product ◽  
European Medicines Agency ◽  
Care Providers ◽  
Inflammatory Bowel ◽  
To Receive ◽  
The Ideal

Introduction: Biosimilars present a considerable potential to reduce costs related to clinical management allowing health-care providers to reinvest this money, leading to a wider access to an effective biological treatment with monoclonal antibodies (mAb). Infliximab biosimilars have already been incorporated in daily clinical practice and are currently used in all indications for which the reference product (RP) was approved. Areas covered: In the next few years, also adalimumab biosimilars will become available for the treatment of inflammatory bowel disease (IBD). In fact, several of them (ABP501, BI 695501, GP2017, and SB5) have been approved by the European Medicines Agency (EMA) with the same indications of the reference product (Humira ®). Initial preclinical data proved a strong similarity between all biosimilars and the RP. Moreover, phase 3 studies in rheumatoid arthritis and psoriasis showed no differences in terms of efficacy, safety, and immunogenicity. Data on IBD patients are urgently needed. Expert opinion: Biosimilars of adalimumab showed equivalent clinical efficacy to the RP in other immunemediated diseases. However, defining the ideal patient’s profile to receive or to be switched to a biosimilar, choosing one biosimilar vs. another, or cross-switching among biosimilars, will become the next challenge in IBD.

scholarly journals Delirium and Antipsychotic Medications at Hospital Intake: Screening to Decrease Likelihood of Aggression in Inpatient Settings Among Unknown Patients With Dementia

2018 ◽  
Vol 34 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Tracy Wharton ◽  
Daniel Paulson ◽  
Kimberly Burcher ◽  
Heather Lesch
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Antipsychotic Medication ◽  
Care Providers ◽  
Antipsychotic Medications ◽  
Inpatient Settings ◽  
Logistic Regressions

For individuals with dementia, disorientation and both external and internal stimuli may trigger behaviors that are difficult to manage or dangerous to health-care providers. Identification of correlational risk factors to aggressive behavior in patients who are unknown to the hospital can allow providers to adapt patient care quickly. Records for patients aged 60+ who spent at least 24 hours at the hospital other than in the psychiatric unit were used (N = 14 080). The first 4000 records and every 10th person who met criteria (N = 5008) were searched for documentation of dementia (n = 505). Logistic regressions and χ2 tests were used to examine relationships between variables. Recognition of delirium ( P = .014, Exp(B) = 2.53), coupled with an existing prescription for antipsychotic medication at intake ( P < .001, Exp(B) < 4.37), may be a reliable means of screening for risk and intervening at the earliest possible contact, improving quality of care and safety in acute care for individuals with dementia.

Systematic Review of Preventing Suicide in Old Age: 2005–2010

2011 ◽  
Vol 26 (S2) ◽  
pp. 2020-2020
Author(s):  
C.A. de Mendonça Lima ◽  
R.M. Rodrigues
Keyword(s):  
Health Care ◽  
Old Age ◽  
Health Care Providers ◽  
The Elderly ◽  
Educational Interventions ◽  
List Type ◽  
Care Providers ◽  
Individual Level ◽  
Survivors Of Suicide ◽  
Somatic Disorders

Suicide is a typical phenomenon of the elderly and mainly among men. Besides the importance of suicide in terms of public health there is fewer interest to prevent suicide in old age. This can be explained by stigma, poor evaluation of the dimension of the problem and lack of politic will.Suicide prevention and the care of survivors of suicide depend on the mental health network of care. Interventions to reduce suicide can be made at individual level and at level of the development of policies and strategies. The detection of the persons at risk of suicide and the management of the suicide attempt are two main strategies to prevent suicide. Both received recently an important support from WHO with its publication mhGAP Intervention Guide which was conceived to be used in non-specialized health-care settings by health-care providers working at first- and second-level facilities. It includes guidance on evidence-based interventions to make the diagnosis and manage a number of priority conditions, including suicide.Our review of the literature pointed to the necessity to develop additional research to determine:•the role of somatic disorders as precipitant factor;•the role on suicide of the pre-morbid personality, cognitive functioning, social support and recent and chronic stressing events;•the participation of normal and pathological ageing on the expression of the suicide behavior;•the biological markers of suicide in old age;•the potential impact on suicide rates of educational interventions for the general public and for caregivers.

scholarly journals An Integrative Review of the Influences on Decision-Making of Young People About Human Papillomavirus Vaccine

2018 ◽  
Vol 35 (1) ◽  
pp. 39-50
Author(s):  
Helen Sisson ◽  
Yvonne Wilkinson
Keyword(s):  
Decision Making ◽  
Human Papillomavirus ◽  
Parental Involvement ◽  
Health Care Providers ◽  
Hpv Vaccine ◽  
Hpv Infection ◽  
School Nurses ◽  
Human Papillomavirus Vaccine ◽  
Care Providers ◽  
To Receive

The human papillomavirus (HPV) vaccine is a key intervention in the prevention of HPV infection and associated cancers. This review emphasizes the importance of understanding what influences decision-making about this vaccine. Guided by the work of Whittemore and Knafl, and Pluye and Hong, we identified 25 studies, from which four prominent themes emerged: fear and risk, pain, parental involvement, and involvement of others. Fear of cervical cancer was a strong motivation to receive the vaccine, and the extent of parental involvement also had an impact on decision-making. Recommendations to receive the vaccine by health-care providers were also an important influence. School nurses are fundamental to the promotion and delivery of the HPV vaccine and should stress the significant role that it plays in the prevention of cancer. Additionally, school nurses should ensure that discussions about HPV infection and vaccine include parents where appropriate and should distinctly recommend vaccination to those eligible.

Relationship between Paternal Involvement and Child Malnutrition in a Rural Area of Vietnam

2008 ◽  
Vol 29 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Bich Huu Tran
Keyword(s):  
Nutritional Status ◽  
Health Care Providers ◽  
Paternal Care ◽  
Public Health Problem ◽  
Paternal Involvement ◽  
Health Programs ◽  
Outcome Variable ◽  
Care Providers ◽  
Cross Sectional ◽  
Nutritional Status Of Children

Background Malnutrition is a public health problem in Vietnam. Child health and the status of women have been targets for various health programs in the country. In general, reports in the literature suggest that care is positively correlated with positive nutritional status of children. In the household, the father is considered a resource for care. However, the role of paternal care in health programs has not received the attention it deserves. Objective To identify associations between the involvement of fathers in child care and housework and the nutritional status of children under 3 years of age. Methods This cross-sectional study was based on a random sample of 547 children under 3 years of age from intact families and their biological parents. The main outcome variable was child nutrition. Predictor variables represented two domains of father's involvement. Multivariable general linear modeling and multivariable logistic regression modeling were performed with the use of a combination of stepwise and hierarchical approaches in data analysis. Results The overall prevalence of underweight among children was 19.1%, and the prevalence of stunting was 14.4%. Children whose fathers did not bring them to a medical facility for immunization were about 1.7 times more likely to be underweight and stunted than those whose fathers did bring them for immunization after child's age, household economic status, and mother's education were controlled for. Father's involvement in housework was not found to be related to the prevalence of malnutrition. Conclusions Paternal involvement in child immunization should be encouraged by health-care providers who manage immunization programs.

scholarly journals Knowledge of Surgical Informed Consent and Associated Factors among Patients Undergone Obstetric and Gynecologic Surgery at Jimma Medical Center, Jimma, Oromia Region, Ethiopia, 2020. An Institutional Based Cross-Sectional Study.

2021 ◽  
Author(s):  
Belete Fenta Kebede ◽  
Tsegaw Biazin Tesfaye ◽  
Aynalem Yetwale Hiwot
Keyword(s):  
Informed Consent ◽  
Health Care Providers ◽  
Associated Factors ◽  
Medical Center ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Outcome Variable ◽  
Gynecologic Surgery ◽  
Care Providers ◽  
Cross Sectional

Abstract Introduction: The practice of informed consent before any surgical procedure should form the fundamental element that serves to protect both patient and surgeon from prosecution. Several factors can affect the process of surgical informed consent. Knowledge towards surgical informed consent is one important factor. It is worth mentioning that patients’ understanding of the information provided in the consent form is a prerequisite for obtaining valid informed consent, otherwise, it will be only symbolic. The study aimed to assess knowledge of surgical informed consent and associated factors among patients who undergone obstetric and gynecologic surgery at Jimma Medical Center, Jimma, Oromia Region, EthiopiaMethodology: Institutional based crossectional study was conducted among systematically selected women undergo obstetrics and gynecologic surgery in Jimmy medical center from April 1 to May 30, 2020. The collected data were coded, entered into Epi data version 3.1, and analyzed using SPSS version 25. Bivariate and multivariate regression was carried out to determine the association between an outcome variable and an independent variable. Tables, pie -charts, and texts were used to report the result.Results: This study revealed that the mean age of the respondents was 29.5 ±3.5 years and the majority of them (83.3%) were married. The respondents had significantly poor overall knowledge of surgical informed consent 77.2 %( 95%CI: 72.8-81.2).Patient educational status (AOR: 1.22 (95%CI: 1.1-2.47), satisfaction level (AOR: 1.823(95%CI: 1.061-3.134).and patient- provider relation-ship (AOR: 0.472(95%CI: 0.271-0.822) were associated with knowledge of surgical informed consent.Conclusion: in this study, the overall level of knowledge regarding surgical informed consent was significantly poor than the other national and international figures. Patient Education, satisfaction, and patient-provider relation-ship were associated with knowledge of surgical informed consent. Health care providers should provide adequate information before surgery to improve patients’ knowledge regarding surgical informed consent and provide adequate input on ways to improve the consent process to make it better suited to fit the needs of all patients.

Social relationships, neighbourhood poverty and cumulative biological risk: findings from a multi-racial US urban community

2019 ◽  
Vol 51 (6) ◽  
pp. 799-816
Author(s):  
Alana M. W. LeBrón ◽  
Amy J. Schulz ◽  
Graciela B. Mentz ◽  
Barbara A. Israel ◽  
Carmen A. Stokes
Keyword(s):  
Social Support ◽  
Social Relationships ◽  
Social Cohesion ◽  
Multilevel Models ◽  
Individual Characteristics ◽  
Outcome Variable ◽  
Biological Risk ◽  
Individual Level ◽  
Neighbourhood Satisfaction ◽  
Neighbourhood Level

AbstractPrior research has established associations between neighbourhood poverty and cumulative biological risk (CBR). CBR is conceptualized as indicative of the effects of stress on biological functioning, and is linked with increased morbidity and mortality. Studies suggest that supportive social relationships may be health protective, and may erode under conditions of poverty. This study examines whether social relationships are inversely associated with CBR and whether associations between neighbourhood poverty and CBR are mediated through social relationships. Data were from a stratified probability sample community survey (n=919) of residents of Detroit, Michigan, USA (2002–2003) and from the 2000 US Census. The outcome variable, CBR, included anthropometric and clinical measures. Independent variables included four indicators of social relationships: social support, neighbourhood satisfaction, social cohesion and neighbourhood participation. Multilevel models were used to test both research questions, with neighbourhood poverty and social relationships included at the block group level, and social relationships also included at the individual level, to disentangle individual from neighbourhood effects. Findings suggest some associations between social relationships and CBR after accounting for neighbourhood poverty and individual characteristics. In models that accounted for all indicators of social relationships, individual-level social support was associated with greater CBR (β=0.12, p=0.04), while neighbourhood-level social support was marginally significantly protective of CBR (within-neighbourhood: β=−0.36, p=0.06; between-neighbourhood: β=−0.24, p=0.06). In contrast, individual-level neighbourhood satisfaction was protective of CBR (β=−0.10, p=0.02), with no within-neighbourhood (β=0.06, p=0.54) or between-neighbourhood association (β=−0.04, p=0.38). Results indicate no significant association between either social cohesion or neighbourhood participation and CBR. Associations between neighbourhood poverty and CBR were not mediated by social relationships. These findings suggest that neighbourhood-level social support and individual-level neighbourhood satisfaction may be health protective and that neighbourhood poverty, social support and neighbourhood satisfaction are associated with CBR through independent pathways.

scholarly journals Residential transience among US adolescents: association with depression and mental health treatment

2019 ◽  
Vol 28 (6) ◽  
pp. 682-691 ◽  
Author(s):  
C. Glasheen ◽  
V. Forman-Hoffman ◽  
S. Hedden ◽  
T. Ridenour ◽  
J. Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Mental Health Treatment ◽  
Representative Sample ◽  
Care Providers ◽  
Health Treatment ◽  
The Past ◽  
Significant Difference ◽  
Nationally Representative ◽  
To Receive

AbstractAimsResidential instability, including transience (i.e. unusually frequent mobility), is associated with higher risk for emotional and behavioural problems in children and young adults. However, most studies have not compared the effect of recent v. more distal moves on mental health or on mental health treatment. This study examined associations between recent (past year) and distal (past 2–4 years) residential transience and past year major depressive episode (MDE) and mental health treatment in a nationally representative sample of US adolescents aged 12–17.MethodsData are from the 2010–2014 National Surveys on Drug Use and Health (n = ~107 300 adolescents). T-tests were used to examine the prevalence of MDE by number of moves in the past 5 years among a nationally representative sample of adolescents. Additionally, multivariable logistic regression models were used to evaluate the adjusted association between recent (⩾2 moves in the past year) and distal (⩾4 moves in the past 5 years, but no recent transience) and (1) past year MDE and (2) past year mental health treatment among adolescents with MDE.ResultsMDE prevalence increased linearly with number of moves in the past 5 years (p < 0.001). The adjusted odds of MDE were greater among youths with distal transience (adjusted odds ratio (AOR) = 1.25, 95% confidence interval (CI) = 1.09–1.44) and among those with proximal transience (AOR = 1.31, 95% CI = 1.17–1.46), compared with those without transience in the past 5 years. The MDE prevalence did not differ between those with distal and proximal transience (p = 0.163). In youths with past year MDE, the prevalence of past year mental health treatment was greater among those with proximal transience compared with those without transience (AOR = 1.40, 95% CI = 1.15–1.70), but there was no significant difference in treatment among those with distal v. no transience.ConclusionsDistal and recent transience are associated with past year MDE among adolescents. Adolescents with MDE who had recent transience were more likely to receive past year mental health treatment compared with those without transience. However, those with only distal transience were not more likely to receive treatment. Parents, school officials and health care providers should be aware that residential mobility in the past 5 years may indicate increased odds of depression among adolescents even among adolescents whose housing stability has improved in the past year.

Dignity and palliative end-of-life care

2015 ◽  
Author(s):  
Harvey Max Chochinov ◽  
Susan E. McClement ◽  
Maia S. Kredentser
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
End Of Life Care ◽  
Vulnerable Groups ◽  
Clinical Settings ◽  
Life Care ◽  
Care Providers ◽  
Key Aspects ◽  
To Receive

The concept of dignity continues to receive attention in health care, with particular implications for end-of-life care. This chapter reviews current conceptualizations of dignity, integrating medical, philosophical, and ontological perspectives. The centrality of dignity to palliative care is discussed, exploring empirical findings, which examine what dignity means to patients and families in the context of illness and end-of-life care. The chapter provides an overview of validated tools, evidence-based therapies, and practical ‘everyday’ communication skills that health-care providers in diverse clinical settings can use to enhance patient dignity. Suggestions are provided for extending existing research into the notion of dignity as it relates to vulnerable groups, and how interventions aimed at supporting patient dignity can impact family members. Dignity subsumes many key aspects of comprehensive care, which can guide health-care providers towards improving end-of-life experiences for patients and families.

Immersive Virtual Environments, Avatars, and Agents for Health

2017 ◽  
Author(s):  
Sun Joo (Grace) Ahn ◽  
Jesse Fox
Keyword(s):  
Virtual Environments ◽  
Health Care Providers ◽  
Sensory Information ◽  
Physical World ◽  
Autism Spectrum ◽  
Current Treatment ◽  
Care Providers ◽  
Individual Level ◽  
Immersive Virtual Environments ◽  
Treatment Regimens

Immersive virtual environments (IVEs) are systems comprised of digital devices that simulate multiple layers of sensory information so that users experience sight, sound, and even touch like they do in the physical world. Users are typically represented in these environments in the form of virtual humans and may interact with other virtual representations such as health-care providers, coaches, future selves, or treatment stimuli (e.g., phobia triggers, such as crowds of people or spiders). These virtual representations can be controlled by humans (avatars) or computers algorithms (agents). Embodying avatars and interacting with agents, patients can experience sensory-rich simulations in the virtual world that may be difficult or even impossible to experience in the physical world but are sufficiently real to influence health attitudes and behaviors. Avatars and agents are infinitely customizable to tailor virtual experiences at the individual level, and IVEs are able to transcend the spatial and temporal boundaries of the physical world. Although still preliminary, a growing number of studies demonstrate IVEs’ potential as a health promotion and therapy tool, complementing and enhancing current treatment regimens. Attempts to incorporate IVEs into treatments and intervention programs have been made in a number of areas, including physical activity, nutrition, rehabilitation, exposure therapy, and autism spectrum disorders. Although further development and research is necessary, the increasing availability of consumer-grade IVE systems may allow clinicians and patients to consider IVE treatment as a routine part of their regimen in the near future.

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