Gender Inequalities in the Management of Angina Pectoris: Cross-Sectional Survey in Primary Care

2005 ◽  
Vol 50 (4) ◽  
pp. 154-158 ◽  
Author(s):  
M A Crilly ◽  
P E Bundred
Keyword(s):  
Primary Care ◽  
Gender Differences ◽  
Angina Pectoris ◽  
Clinical Care ◽  
Gender Inequalities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Exercise Ecg ◽  
Gp Care ◽  
To Receive

Background and Aims: To determine the extent of gender differences in the routine clinical care of patients with angina pectoris in primary care. Methods: A cross-sectional survey of general practitioner (GP) medical records undertaken by trained data managers in 6 GP practices. 925 adults (489 men) with a clinical diagnosis of angina (prevalence= 2.4%, 95%CI 2.3–2.6). Data extracted included: level of care; risk factor recording; prescribed medication; exercise ECG and coronary revascularisation. Adjusted male-to-female odds ratios (AOR) adjusted for age, angina duration, and previous myocardial infarction, (MI). Results: Women with angina were older than men (71 v 65 years) with a lower prevalence of MI (30% v 43%), but a longer duration of angina (5 v 4 years). Men were more likely to receive once daily aspirin (AOR = 2.07, 95% CI 1.56–2.74) and be prescribed triple anti-anginal therapy (1.58, 95% CI 1.03–2.42). Men were also significantly more likely to undergo exercise ECG (1.56, 95% CI 1.14–2.15) and surgical revascularisation (1.71, 95% CI 1.03–2.85). Women tended to receive GP care alone (AOR = 0.64, 95% CI 0.46–0.89), whilst men received specialist cardiac care (1.47, 95% CI 1.09–2.00). Beta-blocker use following MI was similar (0.99, 95% CI 0.59–1.69). Conclusion: Differences in the management of men and women are unaccounted for by differences in age, previous MI or duration of angina. Gender differences in management of CHD reported from secondary care may also exist in primary care.

scholarly journals Evolution of the Output–Workforce Relationship in Primary Care Facilities in China from 2009 to 2017

2020 ◽  
Vol 17 (9) ◽  
pp. 3043 ◽  
Author(s):  
Shan Lu ◽  
Liang Zhang ◽  
Niek Klazinga ◽  
Dionne Kringos
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Latent Class ◽  
Clinical Care ◽  
Public Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Facilities ◽  
Facility Level ◽  
Latent Class Growth

This study evaluates trends in workforce supply compared with those in the volume of service delivery (output) for basic clinical care (CC) and public health (PH) services from 2009 to 2017 in China. A cross-sectional survey (2018) was combined with retrospective data (2009–2017) from 785 primary care (PC) facilities in six provinces. Measures for the output of clinical care and of public health services were aggregated into a single (weighted) index for both service profiles. The output–workforce relationship was measured by its ratio. Latent class growth analysis and logistic regression analysis were applied to classify trajectories and determine associations with facility-level, geographic, and economic characteristics. From 2009 to 2017, the proportion of PC to overall healthcare workforce decreased from 24.25% to 18.57%; the proportion of PH to PC providers at PC facilities increased from 23.6% to 29.5%, while the proportion of PH output increased from 44.3% to 65.9%. Four trajectories of the output–workforce relationship were identified for CC, and five trajectories for PH services of which 85.3% of the facilities showed initially increasing and then slightly decreasing trends. Geographic characteristics impacted different trajectories. The PC workforce falls behind hospital workforce. The expansion in workload of PH services is unbalanced with that of workforce.

scholarly journals The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

2021 ◽  
Author(s):  
Alex Bató ◽  
Valentin Brodszky ◽  
L. Hunor Gergely ◽  
Krisztián Gáspár ◽  
Norbert Wikonkál ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Hidradenitis Suppurativa ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Life Quality ◽  
Measurement Properties ◽  
Economic Evaluations ◽  
Health State ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

scholarly journals Prepared and highly committed despite the risk of COVID-19 infection: a cross-sectional survey of primary care physicians’ concerns and coping strategies in Singapore

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jerrald Lau ◽  
David Hsien-Yung Tan ◽  
Gretel Jianlin Wong ◽  
Yii-Jen Lew ◽  
Ying-Xian Chua ◽  
...  
Keyword(s):  
Primary Care ◽  
Coping Strategies ◽  
Stress Management ◽  
Primary Care Physicians ◽  
Well Being ◽  
Pandemic Preparedness ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Accessible Information ◽  
And Coping

Abstract Background Primary care physicians (PCPs) are first points-of-contact between suspected cases and the healthcare system in the current COVID-19 pandemic. This study examines PCPs’ concerns, impact on personal lives and work, and level of pandemic preparedness in the context of COVID-19 in Singapore. We also examine factors and coping strategies that PCPs have used to manage stress during the outbreak. Methods Two hundred and sixteen PCPs actively practicing in either a public or private clinic were cluster sampled via email invitation from three primary care organizations in Singapore from 6th to 29th March 2020. Participants completed a cross-sectional online questionnaire consisting of items on work- and non-work-related concerns, impact on personal and work life, perceived pandemic preparedness, stress-reduction factors, and personal coping strategies related to COVID-19. Results A total of 158 questionnaires were usable for analyses. PCPs perceived themselves to be at high risk of COVID-19 infection (89.9%), and a source of risk (74.7%) and concern (71.5%) to loved ones. PCPs reported acceptance of these risks (91.1%) and the need to care for COVID-19 patients (85.4%). Overall perceived pandemic preparedness was extremely high (75.9 to 89.9%). PCPs prioritized availability of personal protective equipment, strict infection prevention guidelines, accessible information about COVID-19, and well-being of their colleagues and family as the most effective stress management factors. Conclusions PCPs continue to serve willingly on the frontlines of this pandemic despite the high perception of risk to themselves and loved ones. Healthcare organizations should continue to support PCPs by managing both their psychosocial (e.g. stress management) and professional (e.g. pandemic preparedness) needs.

scholarly journals Patient-reported experience and outcomes from orthodontic treatment

2020 ◽  
Vol 47 (2) ◽  
pp. 107-115
Author(s):  
Elizabeth Bradley ◽  
Andrew Shelton ◽  
Trevor Hodge ◽  
David Morris ◽  
Hilary Bekker ◽  
...  
Keyword(s):  
Secondary Care ◽  
Orthodontic Treatment ◽  
Clinical Care ◽  
Patient Treatment ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Fixed Appliance ◽  
Treatment Experience ◽  
Patient Reported ◽  
Pre Treatment

Objective: To measure patient-reported impact of orthodontic treatment in terms of pre-treatment concerns, treatment experience and treatment outcome. Setting: Four sites in Yorkshire, including two secondary care settings (Leeds Dental Institute and St Luke’s Hospital, Bradford) and two specialist orthodontic practices. Design: Cross-sectional survey. Participants: NHS orthodontic patients (aged 12+ years) who have completed comprehensive orthodontic treatment, excluding orthognathic surgery and craniofacial anomalies. Methods: Participants were opportunistically identified by the direct clinical care team during scheduled appointments and those eligible were invited to participate. Data were collected using the Orthodontic Patient Treatment Impact Questionnaire (OPTIQ), a validated 12-item measure with questions relating to pre-treatment experience, impact of treatment and outcome from treatment. Results: Completed questionnaires for analysis included 120 from primary care and 83 from secondary care. The most common pre-treatment concerns were alignment (89%) and being embarrassed to smile (63%). The most common expectations from orthodontic treatment were improved confidence to eat (87%) and smile (72%) in front of others, improved appearance of teeth (85%) and reduced teasing/bullying (63%). Only 67% respondents recalled receiving written information and the lowest recall related to retainer type and length of retention. The most commonly reported complications were sore mouth (68%), fixed appliance breakage (61%) and gingivitis (39%). Treatment caused greatest impact in relation to pain, limitations in eating and effect on speech. Overall satisfaction with orthodontic treatment was reported by 96% of respondents, 87% would have orthodontic treatment again (if needed) and 91% would recommend treatment to a friend. Conclusions: The OPTIQ is a useful patient-reported tool to identify pre-treatment concerns and expectations, treatment experience and outcome. Orthodontic treatment leads to high levels of satisfaction.

scholarly journals Assessment of U.S. health care personnel (HCP) attitudes towards COVID-19 vaccination in a large university health care system

2021 ◽  
Author(s):  
Jana Shaw ◽  
Telisa Stewart ◽  
Kathryn B Anderson ◽  
Samantha Hanley ◽  
Stephen J Thomas ◽  
...  
Keyword(s):  
Health Care ◽  
Vaccine Development ◽  
Direct Care ◽  
Healthcare Personnel ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Vaccination Programs ◽  
To Receive

Abstract Background As a priority group, healthcare personnel (HCP) will be key to success of COVID-19 vaccination programs. The purpose of this study was to assess HCP willingness to get vaccinated and identify specific concerns that would undermine vaccination efforts. Methods We conducted a cross-sectional survey of HCP, including clinical and non-clinical staff, researchers, and trainees between November 23 rd ,2020 and December 5 th ,2020. The survey evaluated attitudes, beliefs and willingness to get vaccinated. Results A total of 5287 respondents had a mean age of 42.5 years (SD=13.56), and were 72.8% female (n=3842). Overall 57.5 % of individuals expressed intent to receive COVID-19 vaccine. 80.4% were physicians and scientists representing the largest group. 33.6% of registered nurses, 31.6% of allied health professionals, and 32% of master’s level clinicians were unsure they would take the vaccine (p&lt;.001). Respondents who were older, males, White, or Asian were more likely to get vaccinated compared to other groups. Vaccine safety, potential adverse events, efficacy and speed of vaccine development dominated concerns listed by participants. Fewer (54.0%) providers of direct care vs. non-care providers (62.4%), and 52.0% of those who had provided care for COVID-19 patients (vs. 60.6% of those who had not) indicated they would take the vaccine if offered (p&lt;.001). Conclusions We observed that self-reported willingness to receive vaccination against COVID-19 differs by hospital roles, with physicians and research scientists showing the highest acceptance. These findings highlight important heterogeneity in personal attitudes among HCPs around COVID-19 vaccines and highlight a need for tailored communication strategies.

scholarly journals Willingness to receive future COVID-19 vaccines following the COVID-19 epidemic in Shanghai, China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yehong Zhou ◽  
Junjie Zhang ◽  
Wenwen Wu ◽  
Man Liang ◽  
Qiang-Song Wu
Keyword(s):  
Vaccine Safety ◽  
Older Individuals ◽  
Regression Analyses ◽  
Pharmacological Interventions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
History Of ◽  
Potential Factors ◽  
To Receive

Abstract Background There are no pharmacological interventions currently available to prevent the transmission of SARS-CoV-2 or to treat COVID-19. The development of vaccines against COVID-19 is essential to contain the pandemic. we conducted a cross-sectional survey of Shanghai residents to understand residents’ willingness to be vaccinated with any future COVID-19 vaccines and take measures to further improve vaccination coverage. Methods We conducted a cross-sectional survey using self-administered anonymous questionnaires from 1 July to 8 September 2020. The main outcome was willingness of participants, and any children or older individuals living with them, to receive future COVID-19 vaccines. Logistic regression analyses were used to explore potential factors associated with vaccination willingness. Results A total of 1071 participants were asked about their willingness to receive future COVID-19 vaccines, for themselves and at least 747 children and 375 older individuals (≥60 years old) living with them. The highest proportion of expected willingness to vaccinate was among participants (88.6%), followed by children (85.3%) and older individuals (84.0%). The main reasons for reluctance to vaccinate among 119 participants were doubts regarding vaccine safety (60.0%) and efficacy (28.8%). Participants with a self-reported history of influenza vaccination were more likely to accept COVID-19 vaccines for themselves [adjusted odds ratio (OR) = 1.83; 95% confidence interval (CI): 1.19–2.82], their children (adjusted OR = 2.08; 95%CI: 1.30–3.33), and older individuals in their household (adjusted OR = 2.12; 95%CI: 1.14–3.99). Participants with older individuals in their families were less willing to vaccinate themselves (adjusted OR = 0.59; 95%CI: 0.40–0.87) and their children (adjusted OR = 0.58; 95%CI: 0.38–0.89). Conclusions Participants were more reluctant to accept COVID-19 vaccines for older individuals living with them. The presence of older individuals in the home also affected willingness of participants and their children to be vaccinated.

Willingness and uptake of the COVID-19 testing and vaccination in urban China: an online cross-sectional survey at early 2021 (Preprint)

2021 ◽  
Author(s):  
Suhang Song ◽  
Shujie Zang ◽  
Liubing Gong ◽  
Cuilin Xu ◽  
Leesa Lin ◽  
...  
Keyword(s):  
Online Survey ◽  
Demographic Characteristics ◽  
Urban China ◽  
Low Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Risk Period ◽  
Two Measures ◽  
Higher Educational Attainment ◽  
To Receive

BACKGROUND Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Few studies have focused on COVID-19 testing and vaccination uptake may change as the pandemic continues. OBJECTIVE To examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China. METHODS A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents’ willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate the factors associated with willingness and uptake of the two measures. RESULTS In early 2021, 52.45% of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) were willing to receive testing. 63.28% of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants, having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated. CONCLUSIONS Chinese adults expressed almost universal willingness of COVID-19 testing and relatively low willingness of COVID-19 vaccination at the low-risk period of the COVID-19 pandemic, independent from their socio-demographic characteristics. Maintaining willingness of COVID-19 vaccination is key especially when the pandemic evolved into a low-risk period.

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