scholarly journals Determinants of non adherence to tuberculosis treatment in Argentina: barriers related to access to treatment

2015 ◽  
Vol 18 (2) ◽  
pp. 287-298 ◽  
Author(s):  
María Belén Herrero ◽  
Silvina Ramos ◽  
Silvina Arrossi
Keyword(s):  
Health Care ◽  
Social Protection ◽  
Health Care Facilities ◽  
Tuberculosis Treatment ◽  
Care Process ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Protection Measures ◽  
Increased Risk ◽  
The Impact

OBJECTIVE: To identify the association between non-adherence to tuberculosis treatment and access to treatment. METHODS: A cross-sectional study was carried out in the Metropolitan Area of Buenos Aires, Argentina. One hundred twenty three patients notified in 2007 (38 non adherent and 85 adherents) were interviewed regarding the health care process and socio-demographic characteristics. Factors associated to non-adherence were assessed through logistic regression analysis. RESULTS: An increased risk of non-adherence with to treatment was found in male patients (OR = 2.8; 95%CI 1.2 - 6.7), patients who had medical check-ups at hospitals (OR = 3.4; 95%CI 1.1 - 10.0) and those who had difficulties with transportation costs (OR = 2.5; 95%CI 1.1 - 5.9). CONCLUSION: Risk of non-adherence increases as a result of economic barriers in accessing health care facilities. Decentralization of treatment to primary health care centers and social protection measures for patients should be considered as priorities for disease control strategies in order to lessen the impact of those barriers on adherence to treatment.

Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran

2021 ◽  
pp. 1-7
Author(s):  
Behrad Pourmohammadi ◽  
Ahad Heydari ◽  
Farin Fatemi ◽  
Ali Modarresi
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Mitigation Measures ◽  
Health Staff ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Wide Range ◽  
Care Facilities ◽  
The Impact

Abstract Objectives: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. Methods: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. Results: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. Conclusions: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

scholarly journals Impact of the COVID-19 Pandemic on Cancer Care: A Global Collaborative Study

2020 ◽  
pp. 1428-1438
Author(s):  
Abdul Rahman Jazieh ◽  
Hakan Akbulut ◽  
Giuseppe Curigliano ◽  
Alvaro Rogado ◽  
Abdullah Ali Alsharm ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Health Care Systems ◽  
Collaborative Study ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Cross Sectional ◽  
Staff Shortage ◽  
Patients With Cancer ◽  
The Impact

PURPOSE The COVID-19 pandemic affected health care systems globally and resulted in the interruption of usual care in many health care facilities, exposing vulnerable patients with cancer to significant risks. Our study aimed to evaluate the impact of this pandemic on cancer care worldwide. METHODS We conducted a cross-sectional study using a validated web-based questionnaire of 51 items. The questionnaire obtained information on the capacity and services offered at these centers, magnitude of disruption of care, reasons for disruption, challenges faced, interventions implemented, and the estimation of patient harm during the pandemic. RESULTS A total of 356 centers from 54 countries across six continents participated between April 21 and May 8, 2020. These centers serve 716,979 new patients with cancer a year. Most of them (88.2%) reported facing challenges in delivering care during the pandemic. Although 55.34% reduced services as part of a preemptive strategy, other common reasons included an overwhelmed system (19.94%), lack of personal protective equipment (19.10%), staff shortage (17.98%), and restricted access to medications (9.83%). Missing at least one cycle of therapy by > 10% of patients was reported in 46.31% of the centers. Participants reported patient exposure to harm from interruption of cancer-specific care (36.52%) and noncancer-related care (39.04%), with some centers estimating that up to 80% of their patients were exposed to harm. CONCLUSION The detrimental impact of the COVID-19 pandemic on cancer care is widespread, with varying magnitude among centers worldwide. Additional research to assess this impact at the patient level is required.

scholarly journals Acute psychological effects of Coronavirus Disease 2019 outbreak among healthcare workers in China: a cross-sectional study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ying Wang ◽  
Simeng Ma ◽  
Can Yang ◽  
Zhongxiang Cai ◽  
Shaohua Hu ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Protective Factor ◽  
Early Period ◽  
Psychological Effects ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Protection Measures ◽  
Event Scale ◽  
Increased Risk ◽  
The Impact

Abstract To study the acute psychological effects of Coronavirus Disease 2019 (COVID-19) outbreak among healthcare workers (HCWs) in China, a cross-sectional survey was conducted among HCWs during the early period of COVID-19 outbreak. The acute psychological effects including symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) were assessed using the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder (GAD-7) questionnaire, and the Impact of Event Scale-Revised (IES-R). The prevalence of depression, anxiety, and PTSD was estimated at 15.0%, 27.1%, and 9.8%, respectively. Having an intermediate technical title, working at the frontline, receiving insufficient training for protection, and lacking confidence in protection measures were significantly associated with increased risk for depression and anxiety. Being a nurse, having an intermediate technical title, working at the frontline, and lacking confidence in protection measures were risk factors for PTSD. Meanwhile, not worrying about infection was a protective factor for developing depression, anxiety, and PTSD. Psychological interventions should be implemented among HCWs during the COVID-19 outbreak to reduce acute psychological effects and prevent long-term psychological comorbidities. Meanwhile, HCWs should be well trained and well protected before their frontline exposure.

FIRST AID AND TREATMENT FOR CHILDREN ACCIDENT INJURY IN BUON MA THUOT CITY, DAK LAK PROVINCE 2014

2017 ◽  
pp. 69-74
Author(s):  
Van Hung Nguyen ◽  
Van Thang Vo
Keyword(s):  
Health Care ◽  
Intervention Program ◽  
First Aid ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Health Staff ◽  
Cross Sectional ◽  
Care Facilities ◽  
Accident Injuries ◽  
Accident Injury

Background: Accident injuries caused has been serious heatlth problem in developing coutries. Children is vulnerable group with accident injury beucase of lacking knowlegde and exposing with risk factors in eviromental household. The treatment outcome for accident injury of children usually has more serious than other groups. The aims of this study to describle some characteristics of first aid and the outcome of treatment for children accident in Buon Ma Thuot, Dak Lak provice in 2014. Methodology: A cross-sectional study was conducted total 2,273 household which was 4,505 children aged under 16 in 8 communes, Buon Ma Thuot city, Daklak province. Interview technique with structural questionnaire and household observation methods were used for data collection. Results: The propotion of first aid was 75.9%; not received any first aid (23.8%); mortality at accident place (0.3%). At the time accident: The highest personal involving first aid was pedestrians 54.1%; 25% of health staff, self- first aid was 14.5%. Two main of first aid methods were hemostasis and bandeged with 45.5%; 28% respectiviely. After first aid, there was 80% delivering to health care facilities. The transport methods were motocycle (91.8%), car (5.6%) and ambulance (0.4%). The rate of approach health care facilities around early 6 hours were 86.7%. The characteristics of damages: sub-damages (scratches, dislocations, sprains...) were 36.9 %, deep damages (fractures, open wounds) accounted for 44.6%. Inpatient treatment was 23.9%; 91.5% medical therapy, surgery of 8.2%. The outcome of treatment were good (97.2%), sequelae/disability 2.6%. Conclusion: First aid activities for children at time and properly right were demonstrated effectively for prevented seriously outcome. There should be an intervention program for children with the appropriate models to reduce accident injuries in children; improvement first aid to communities and health care worker. Key words: accident injury, first aid, capacity first care, children under 16 years old

scholarly journals COVID-19 Psychological Impact on Health Care Workers in Saudi Arabia

2021 ◽  
Vol 18 (11) ◽  
pp. 6076
Author(s):  
Hasan S. Alamri ◽  
Wesam F. Mousa ◽  
Abdullah Algarni ◽  
Shehata F. Megahid ◽  
Ali Al Bshabshe ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Health Care Workers ◽  
Psychological Impact ◽  
Psychological Outcomes ◽  
Cross Sectional Survey ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
Care Workers ◽  
The Impact

Objective: Little is known about the impact of Coronavirus (COVID-19) among the health care workers in Saudi Arabia. Therefore, the present study aimed to assess the psychological impact of COVID-19 among the health care workers. Methods: A cross-sectional survey was conducted from May till mid-July among 389 health care workers from government and private hospitals in Saudi Arabia. Data was collected using a pre-structured online questionnaire that measured adverse psychological outcomes, including the Patient Health Questionnaire-9 (PHQ-9) scale and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The Pearson chi-square test was used to assess the distribution of depression and anxiety among health care workers. Results: A high level of anxiety was recorded among the health care workers, and 69.3% of health care workers below the age of 40 were found to have depression. There was a significant increase in depression among staff with chronic health problems (72.1% vs. 61.9%; p = 0.048). High anxiety levels were detected among young staff compared to others (68.7% vs. 43.8%; p = 0.001). Moreover, 82.1% of the female staff were anxious, as compared to 55.6% of the males (p = 0.001). Conclusions: We found increased prevalence of adverse psychological outcomes among the health care workers in Saudi Arabia during the outbreak of COVID-19. Therefore, there is a need for proper screening and development of corresponding preventive measures to decrease the adverse psychological outcomes.

scholarly journals What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Study Protocol ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Increased Risk ◽  
Review Study ◽  
The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

scholarly journals N-CDAD in Canada: Results of the Canadian Nosocomial Infection Surveillance Program 1997 N-CDAD Prevalence Surveillance Project

2001 ◽  
Vol 12 (2) ◽  
pp. 81-88 ◽  
Author(s):  
Meaghen Hyland ◽  
Marianna Ofner-Agostini ◽  
Mark Miller ◽  
Shirley Paton ◽  
Marie Gourdeau ◽  
...  
Keyword(s):  
Health Care ◽  
Nosocomial Infection ◽  
Toxin Production ◽  
Health Care Facilities ◽  
Surveillance Program ◽  
Prevention Measures ◽  
Case Definitions ◽  
Infection Surveillance ◽  
Positive Stool ◽  
The Impact

BACKGROUND:A 1996 preproject survey among Canadian Hospital Epidemiology Committee (CHEC) sites revealed variations in the prevention, detection, management and surveillance ofClostridium difficile-associated diarrhea (CDAD). Facilities wanted to establish national rates of nosocomially acquired CDAD (N-CDAD) to understand the impact of control or prevention measures, and the burden of N-CDAD on health care resources. The CHEC, in collaboration with the Laboratory Centre for Disease Control (Health Canada) and under the Canadian Nosocomial Infection Surveillance Program, undertook a prevalence surveillance project among selected hospitals throughout Canada.OBJECTIVE:To establish national prevalence rates of N-CDAD.METHODS:For six weeks in 1997, selected CHEC sites tested all diarrheal stools from inpatients for eitherC difficiletoxin orC difficilebacteria with evidence of toxin production. Questionnaires were completed for patients with positive stool assays who met the case definitions.RESULTS:Nineteen health care facilities in eight provinces participated in the project. The overall prevalence of N-CDAD was 13.0% (95% CI 9.5% to 16.5%). The mean number of N-CDAD cases were 66.3 cases/100,000 patient days (95% CI

Do regulations protect workers from occupational exposures to carcinogenic, mutagenic and reprotoxic (CMR) agents in France?

2017 ◽  
Vol 75 (5) ◽  
pp. 389-397
Author(s):  
Nathalie Havet ◽  
Alexis Penot ◽  
Morgane Plantier ◽  
Barbara Charbotel ◽  
Magali Morelle ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Occupational Exposures ◽  
International Agency ◽  
The European Union ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Protection Measures ◽  
Limit Value ◽  
Logistic Regressions ◽  
The Impact

ObjectiveThis article explores the impact of regulations on the implementation of collective protections in France to occupational exposure to carcinogenic, mutagenic and reprotoxic (CMR) agents.MethodsIndividual data from the French national cross-sectional survey of occupational hazards conducted in 2010 were analysed. We investigated whether stricter regulations and longer exposures were associated with higher level of collective protection using multivariate logistic regressions.ResultsGeneral ventilation, for which effect is limited as collective protection for CMR products, was present in 19% of situations involving CMR agents while isolation chambers, the most effective form of protection, were only very rarely implemented. Multilevel logistic regressions show that exposure situations to products classified as category 1 or 2 by the European Union do not have a higher probability of benefiting from a collective protection measures. Exposures to products with a Binding Occupational Exposure Limit Value selectively benefited from a better level of protection. Exposures to agents entered on the International Agency for Research on Cancer (IARC) list of proven or probable carcinogens benefited more from effective collective protections than products suspected to be carcinogens but not yet classified by IARC.ConclusionsThese results suggest that the dissemination of evaluations of carcinogens by the IARC translate into improved protective measures even though the IARC classification has no mandatory impact on regulations.

scholarly journals Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-214
Author(s):  
Michael McKee ◽  
Yunshu Zhou ◽  
Joshua Ehrlich ◽  
Elham Mahmoudi ◽  
Jennifer Deal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Self Care ◽  
Household Activity ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk ◽  
Lower Mobility ◽  
Independent Effects ◽  
The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

scholarly journals P070: Mixed effectiveness of emergency department diversion strategies: a systematic review

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S102
Author(s):  
S.W. Kirkland ◽  
A. Soleimani ◽  
B.H. Rowe ◽  
A.S. Newton
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Emergency Department ◽  
Health Care Services ◽  
Grey Literature ◽  
Study Data ◽  
Care Utilization ◽  
Alternative Source ◽  
Increased Risk ◽  
The Impact

Introduction: Diverting patients away from the emergency department (ED) has been proposed as a solution for reducing ED overcrowding. The objective of this systematic review is to examine the effectiveness of diversion strategies designed to either direct patients seeking care at an ED to an alternative source of care. Methods: Seven electronic databases and grey literature were searched. Randomized/controlled clinical trials and cohort studies assessing the effectiveness of pre-hospital and ED-based diversion interventions with a comparator were eligible for inclusion. Two reviewers independently screened the studies for relevance, inclusion, and risk of bias. Intervention effects are reported as proportions (%) or relative risks (RR) with 95% confidence intervals (CI). Methodological and clinical heterogeneity prohibited pooling of study data. Results: From 7,306 citations, ten studies were included. Seven studies evaluated a pre-hospital diversion strategy and three studies evaluated an ED-based diversion strategy. The impact of diversion on subsequent health services was mixed. One study of paramedic practitioners reported increased ED attendance within 7 days (11.9% vs. 9.5%; p=0.049) but no differences in return visits for similar conditions (75.2% vs. 72.1%; p=0.64). The use of paramedic practitioners was associated with an increased risk of subsequent contact with health care services (RR=1.21, 95% CI 1.06, 1.38), while the use of deferred care was associated with no increase in risk of subsequently seeking physician care (RR=1.09, 95% CI 0.23, 5.26). While two studies reported that diverted patients were at significantly reduced risk for hospitalization, two other studies reported no significant differences between diverted or standard care patients. Conclusion: The evidence regarding the impact of pre-hospital and ED-based diversion on ED utilization and subsequent health care utilization is mixed. Additional high-quality comparative effectiveness studies of diversion strategies are required prior to widespread implementation.

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