Knowledge Gaps among Patients and Providers in HPV-Related Oropharyngeal Cancer: A Systematic Review

2020 ◽  
Vol 162 (5) ◽  
pp. 612-621 ◽  
Author(s):  
Sean M. Parsel ◽  
Blair M. Barton ◽  
Sydney Beatty ◽  
Paul L. Friedlander
Keyword(s):  
Health Care ◽  
General Population ◽  
Health Care Providers ◽  
English Language ◽  
Human Subjects ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Case Series ◽  
Primary Outcome Measure ◽  
Care Providers

Objective To describe the level of knowledge of human papillomavirus (HPV) and HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) among the general population and health care providers. Data Sources Systematic search was performed on December 20, 2018, using MEDLINE (1966 to December 2018), EMBASE (1975 to December 2018), Web of Science (1900 to December 2018), and CENTRAL (1996 to December 2018) databases. English-language literature involving human subjects was used, and studies were limited to case series, case-control, cohort, and randomized controlled trial designs. Review Methods Studies were included if they assessed knowledge of HPV and HPV-associated OPSCC. The primary outcome measure was the knowledge of HPV-associated OPSCC among the general population and with health care providers. Meta-analysis of proportions was attempted using random-effects model. The PRISMA guidelines were used for accuracy of reporting. Results Thirty-two studies were included with 17,288 participants. There was a high degree of heterogeneity preventing completion of a meta-analysis. Knowledge of HPV and HPV-associated OPSCC varied between the general population and health care providers. The proportion of the general population and health care providers with knowledge of HPV ranged from 16% to 75% and 21% to 84%, respectively. Knowledge of HPV-associated OPSCC was greater in health care providers and ranged from 22% to 100% compared with the general population, which ranged from 7% to 57%. Conclusion There is a knowledge gap of HPV-associated OPSCC for both the general population and health care providers. Additional education may not only increase awareness but may also result in prevention and earlier detection.

Creating Comics to Address Well-Being and Resilience During the COVID-19 Pandemic

2021 ◽  
pp. 152483992110654
Author(s):  
Kathryn West ◽  
Karen R. Jackson ◽  
Tobias L. Spears ◽  
Brian Callender
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Case Series ◽  
Narrative Medicine ◽  
Well Being ◽  
Small Scale ◽  
Care Providers ◽  
Graphic Medicine ◽  
Racial Injustice ◽  
Pilot Implementation

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

The prevalence rate of smoking among Veterans: A forgotten epidemic

2021 ◽  
Vol 7 (2) ◽  
pp. 16-25
Author(s):  
Salome K. Mshigeni ◽  
Champagne Moore ◽  
Nicole L. Arkadie
Keyword(s):  
Health Care ◽  
General Population ◽  
Cognitive Processing ◽  
Health Care Providers ◽  
Stress Reduction ◽  
Prevalence Rate ◽  
Behavioral Therapy ◽  
Cognitive Processing Therapy ◽  
Care Providers ◽  
Quit Smoking

LAY SUMMARY The purpose of this study was to learn more about the smoking habits of U.S. Veterans compared with the rest of the population and to find the best ways to help Veterans quit smoking. This study found that Veterans tend to smoke more than the general population and that some groups of Veterans smoke more than others. When helping Veterans to quit smoking, health care providers should use approaches that are based on evidence, such as cognitive behavioral therapy, cognitive processing therapy, mindfulness-based stress reduction, and biofeedback in addition to the traditional 3A cessation model (ask, advise, refer).

scholarly journals Iranian general populations' and health care providers' preferences for benefits and harms of statin therapy for primary prevention of cardiovascular disease

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hassan Saadati ◽  
Hamid Reza Baradaran ◽  
Goodarz Danaei ◽  
Afshin Ostovar ◽  
Farzad Hadaegh ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiovascular Diseases ◽  
Primary Prevention ◽  
General Population ◽  
Statin Therapy ◽  
Health Care Providers ◽  
Urban Areas ◽  
Block Design ◽  
Healthcare Providers ◽  
Care Providers

Abstract Background The use of statins for primary prevention of cardiovascular diseases is associated with different benefit and harm outcomes. The aime of this study is how important these outcomes are for people and what people's preferences are. Methods We conducted a preference-eliciting survey incorporating a best–worst scaling (BWS) instrument in Iran from June to November 2019. The relative importance of 13 statins-related outcomes was assessed on a sample of 1085 participants, including 913 general population (486 women) and 172 healthcare providers from the population covered by urban and rural primary health care centers. The participants made trade-off decisions and selected the most and least worrisome outcomes concurrently from 13 choice sets; each contains four outcomes generated using the balanced incomplete block design. Results According to the mean (SD) BWS scores, which can be (+ 4) in maximum and (− 4) in minimum, in the general population, the most worrisome outcomes were severe stroke (3.37 (0.8)), severe myocardial infarction (2.71(0.7)), and cancer (2.69 (1.33)). While myopathy (− 3. 03 (1.03)), nausea/headache (− 2.69 (0.94)), and treatment discontinuation due to side effects (− 2.24 (1.14)) were the least worrisome outcomes. Preferences were similar between rural and urban areas and among health care providers and the general population with overlapping uncertainty intervals. Conclusion The rank of health outcomes may be similar in various socio-cultural contexts. The preferences for benefits and harms of statin therapy are essential to assess benefit-harm balance when recommending statins for primary prevention of cardiovascular diseases.

HP-03-008 Transphobia and homophobia levels in gender dysphoric individuals, general population and health care providers

2016 ◽  
Vol 13 (5) ◽  
pp. S124 ◽  
Author(s):  
A.D. Fisher ◽  
G. Castellini ◽  
E. Fanni ◽  
H. Casale ◽  
M. Tagliagambe ◽  
...  
Keyword(s):  
Health Care ◽  
General Population ◽  
Health Care Providers ◽  
Care Providers

PS-01-001 Transphobia and homophobia levels in gender dysphoric individuals, general population and health care providers

2017 ◽  
Vol 14 (4) ◽  
pp. e107
Author(s):  
G. Castellini ◽  
J. Ristori ◽  
A. Fisher ◽  
J. Ristori ◽  
H. Casale ◽  
...  
Keyword(s):  
Health Care ◽  
General Population ◽  
Health Care Providers ◽  
Care Providers

scholarly journals Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

2018 ◽  
Vol 5 ◽  
Author(s):  
A. Akol ◽  
F. Makumbi ◽  
J. N. Babirye ◽  
J. S. Nalugya ◽  
S. Nshemereirwe ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Randomized Controlled Trial ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Child And Adolescent ◽  
Care Providers ◽  
Randomized Controlled ◽  
Primary Health

Background.Integrating child and adolescent mental health (CAMH) into primary health care (PHC) using the WHO mental health gap action program (mhGAP) is recommended for closing a mental health treatment gap in low- and middle-income countries, but PHC providers have limited ability to detect CAMH disorders. We aimed to evaluate the effect of PHC provider mhGAP training on CAMH disorder identification in Eastern Uganda.Methods.Thirty-six PHC clinics participated in a randomized controlled trial which compared the proportion of intervention (n= 18) to control (n= 18) clinics with a non-epilepsy CAMH diagnosis over 3 consecutive months following mhGAP-oriented CAMH training. Fisher's exact test and logistic regression based on intention to treat principles were applied. (clinicaltrials.gov registration NCT02552056).Results.Nearly two thirds (63.8%, 23/36) of all clinics identified and recorded at least one non-epilepsy CAMH diagnosis from 40 692 clinic visits of patients aged 1–18 recorded over 4 months. The proportion of clinics with a non-epilepsy CAMH diagnosis prior to training was 27.7% (10/36, similar between study arms). Training did not significantly improve intervention clinics’ non-epilepsy CAMH diagnosis (13/18, 72.2%) relative to the control (7/18, 38.9%) arm,p= 0.092. The odds of identifying and recording a non-epilepsy CAMH diagnosis were 2.5 times higher in the intervention than control arms at the end of 3 months of follow-up [adj.OR 2.48; 95% CI (1.31–4.68);p= 0.005].Conclusion.In this setting, mhGAP CAMH training of PHC providers increases PHC clinics’ identification and reporting of non-epilepsy CAMH cases but this increase did not reach statistical significance.

Systematic review of interventions to facilitate advance care planning (ACP) in cancer patients.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 21-21 ◽  
Author(s):  
Bryan Chan ◽  
Hao-Wen Sim ◽  
Camilla Zimmermann ◽  
Monika K. Krzyzanowska
Keyword(s):  
Systematic Review ◽  
Health Care Providers ◽  
Study Design ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Small Sample ◽  
Study Quality ◽  
Care Providers ◽  
Documentation System ◽  
Code Status

21 Background: ACP refers to the process of consideration, documentation and communication of preferences for future care. ACP is crucial for patients (pts) with advanced cancer as it can guide substitute decision makers (SDM) and health care providers (HCP) to align care with preferences, thus improving quality of end-of-life care. Methods: We performed a systematic review of MEDLINE, EMBASE, CINAHL, PsycINFO and Cochrane (Systematic Review and Clinical Trial) databases (1995 to 2015) to identify interventions that facilitate ACP for cancer pts (documentation or discussion of advance directives, SDM or code status). We extracted data on study design, setting, subject numbers, interventions and outcomes. Study quality was assessed using a modified Downs and Black checklist. Results: Of the 64,196 unique citations identified, 10 studies met inclusion criteria for testing interventions using a pre-post or controlled trial design (median sample size 134, range 48-9105). Interventions were categorized based on target audience: health system (n = 4), pts and caregivers (n = 3) or HCP (n = 3). Types of interventions included: introduction of ACP facilitators (n = 4), reminders or prompts (n = 2), and HCP training, videos, website or pt screening (n = 1 each). Heterogeneity in study design, outcome measures and small sample sizes limited study quality and precluded meta-analysis. Prompts such as medical record or email reminders were most consistently associated with improved ACP documentation. System changes incorporating the use of ACP facilitators also improved ACP documentation in 3 out of 4 studies. Interactive HCP training significantly improved confidence to initiate ACP discussions which has been identified as a barrier to timely ACP. Pilot trials showed no significant increase in ACP with educational videos/websites directed at pts. Passive HCP education and one-off reminders were also ineffective. Conclusions: The complexity of ACP is reflected in the multitude of interventions that have been evaluated but none are ready for wide-scale adoption. Further studies of interventions such as prompts and ACP facilitators are needed to inform the best approach to improve ACP uptake in cancer pts.

Evidence-based training in treatment treatments: The case of pediatric psychopharmacology

2011 ◽  
Vol 26 (S2) ◽  
pp. 2048-2048
Author(s):  
P.S. Jensen
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Controlled Trial ◽  
Evidence Based ◽  
Care Providers ◽  
Clinical Practices ◽  
High Quality ◽  
Health Care Practitioners ◽  
Evidence Based Treatments

IntroductionDespite major research advances in pediatric psychopharmacology and psychotherapy over the last 20 years, the lack of well-trained specialists has posed almost insurmountable barriers to many children and families from receiving high-quality, evidence-based assessment and treatments. The REACH Institute, an international non-profit organization dedicated to disseminating evidence-based treatments, has developed portable, effective methods to train primary care and specialty health providers in pediatric psychopharmacology and psychotherapies.ObjectivesTo develop effective, scientifically-proven methods for teaching and disseminating evidence-based treatments.AimsTo develop, disseminate, and evaluate high quality approaches for teaching primary care and specialty mental health practitioners in pediatric psychopharmacology.MethodsUsing novel approaches grounded in scientific behavioral change technologies, over 700 health care providers have been trained in evidence-based pediatric psychopharmacology in sites across multiple countries, including the US, Canada, and Norway. All trainings are rigorously evaluated for changes in health care practitioners' behaviors and clinical practices, including within an NIH-funded randomized controlled trial (RCT).ResultsTrainings have been very well-received across multiple countries, requiring only minor adaptations. These trainings have been effective in yielding changes in health care practitioners abilities and actual clinical practices, enabling more children to access appropriate pediatric psychopharmacology.ConclusionsEffective and disseminable methods for changing health care practitioners behaviors in applying pediatric psychopharmacology treatments are possible, and can be adapted to different countries, languages, and cultural contexts.

scholarly journals Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Woldu Aberhe ◽  
Abrha Hailay ◽  
Kidane Zereabruk ◽  
Guesh Mebrahtom ◽  
Teklehaimanot Haile
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Meta Analysis ◽  
Cochrane Review ◽  
World Health ◽  
Care Providers ◽  
Asthmatic Patients ◽  
Inconsistency Index ◽  
National Prevalence

Abstract Background Medication non-adherence is one of a common problem in asthma management and it is the main factor for uncontrolled asthma. It can result in poor asthma control, which leads to decreased quality of life, increase hospital admission, increased health care utilization, lost productivity, and mortality. To date, there have been no studies and protocols that estimated the pooled national prevalence of non-adherence to inhaled anti-asthmatic medications in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among asthmatic patients in Ethiopia. Methods Different database searching engines including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization afro library, and Cochrane review were systematically searched by using keywords such as “prevalence, non-adherence to inhaled medications, inhaled corticosteroids, and asthmatic patients” and their combinations. Six published observational studies that report the prevalence of non-adherence to inhaled medications were finally selected. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of non-adherence to inhale anti-asthmatic medications. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows. Results The pooled national prevalence of non-adherence to inhaled medications among asthmatic patients was 29.95% (95% CI, 19.1, 40.8%). The result of this meta-analysis using the random-effects model revealed that there is high heterogeneity across the included studies. The result of subgroup analysis indicates that one out of three in the Oromia region and one out of five in the Amhara region asthmatic patients was non-adherent to their inhaled anti-asthmatic medications. Conclusion the prevalence of non-adherence to inhaled anti-asthmatic medications was high. Thus, our finding suggests that one out of four asthmatic patients were non-adherent to inhaled medications. The ministry of health, health policymakers, clinicians, and other health care providers should pay attention to strengthening the adherence levels to inhaled anti-asthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to inhaled anti-asthmatic medications.

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