A trinidadian cardiovascular medication adherence survey: the ADHERE TNT study

2017 ◽  
Vol 4 (10) ◽  
pp. 3601 ◽  
Author(s):  
Naveen Seecheran ◽  
Neval Nandlal ◽  
Sushanta Nankissoon ◽  
Cherisse Nancoo ◽  
Caniecea Nelson ◽  
...  
Keyword(s):  
Public Health ◽  
Medication Adherence ◽  
Trinidad And Tobago ◽  
Health Sector ◽  
Tertiary Hospital ◽  
Public Health Care ◽  
Sample Population ◽  
Cross Sectional ◽  
Level Of Education ◽  
Cardiovascular Medication

Background: This study aims to quantitatively estimate the level of cardiovascular medication adherence in Trinidad’s public health sector and to determine any correlating factors. The study was of a descriptive, cross-sectional design which was performed at a cardiology outpatient clinic located at a northern-central public health care tertiary hospital in Trinidad during the period November 2016 to June 2017. Methods: 595 persons in total were asked to participate, of whom, 535 agreed. Patients that were younger under the age of 18 years and those that declined participation were excluded from the study. Primary endpoints were the percentages of low, medium and high cardiovascular medication adherence. Secondary endpoints were the comorbidity prevalence rates and prevalence of cardiovascular medications prescribed to patients. Results: In total, 595 individuals were asked to participate in the study; of whom, 535 agreed with a resultant 90% response rate. The mean age of the sample population was 63.5 years. Approximately half of the respondents were females and over 75% had only primary and secondary level of education combined as well as a monthly income of <$5,000 Trinidad and Tobago dollars (TTD). Almost 75% of study participants had low and medium adherence levels, and conversely a little more than one-quarter had high adherence levels. There were no significant associations between adherence and any other demographic factor, however there was near-significance with respect to adherence and level of education (p= 0.061). Conclusions: Patients generally displayed a limited level of cardiovascular medication adherence which is likely to translate into a higher rate of cardiovascular events with their potentially devastating sequalae. This study underscores the imperative need of implementing comprehensive interventions to accentuate cardiovascular medication adherence in Trinidad and Tobago. Further comparable studies with reference national data are required to validate these findings. 

scholarly journals Epidemiologic insight into Trinidad’s awareness and prevention of heart disease. The EPITAPH study - a trinidadian cardiovascular health literacy survey

2017 ◽  
Vol 4 (4) ◽  
pp. 903 ◽  
Author(s):  
Naveen Seecheran ◽  
Stefan Baldeo ◽  
Khadia Balbosa ◽  
Salisha Baksh ◽  
Shantel Bethelmy ◽  
...  
Keyword(s):  
Public Health ◽  
Health Literacy ◽  
Cardiovascular Health ◽  
Response Rate ◽  
Tertiary Education ◽  
Health Sector ◽  
Educational Interventions ◽  
Public Health Care ◽  
Secondary Outcome ◽  
Cross Sectional

Background: The aim of the study is to assess the degree of CV health literacy in the Trinidadian public health sector and to identify any factors associated with it. Methods: The descriptive, cross-sectional study was conducted at a single, public health care tertiary hospital, cardiology outpatient clinic located in northern-central Trinidad. Participants: A total of 420 persons were approached, of whom, 390 agreed to participate. Participants included all sexes and ethnicities. The study only excluded patients who declined participation and those younger than 18 years of age. Primary and secondary outcome measures: The primary endpoints were the mean score and percentage of correctly answered items, and percentages of modest and high levels of knowledge. Secondary endpoints were the proportion of participants with tertiary or above level education. Results: The study had a response rate of approximately 93%. The domain of “risk factors” had the most correct responses (69.4%), whereas “medical knowledge” reflected the least correct (57.7%) responses. The overall mean score was 19.7 out of the 30-question questionnaire. This translated to a 65.8% correct response rate. The percentage of participants who scored less than 70% and greater than 70% of the questions correctly were 56.2% and 43.8% respectively. The study participants were found to be more knowledgeable about CVD if they reported “tertiary education,” OR 2.572 (95% CI 1.508-4.387) (p = .001).Conclusions: Respondents displayed a modest level of knowledge and key deficiencies were identified which could potentially translate into suboptimal CV clinical outcomes. The study underscores the paramount importance of establishing comprehensive educational interventions to improve overall CVD literacy in Trinidad and Tobago. Further studies are required to confirm and validate these findings. 

scholarly journals Association between Chronotype and Nutritional, Clinical and Sociobehavioral Characteristics of Adults Assisted by a Public Health Care System in Brazil

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2260
Author(s):  
Juliana C. Reis-Canaan ◽  
Marcelo M. Canaan ◽  
Patrícia D. Costa ◽  
Tamires P. Rodrigues-Juliatte ◽  
Michel C. A. Pereira ◽  
...  
Keyword(s):  
Public Health ◽  
Heart Diseases ◽  
Principal Component ◽  
Public Health Care ◽  
Noncommunicable Diseases ◽  
Behavioral Risk ◽  
Omega 3 ◽  
Cross Sectional ◽  
Omega 6 ◽  
Sodium Zinc

Chronotype (CT) has been associated with predisposition to chronic noncommunicable diseases (CNCDs), such as diabetes mellitus and obesity. However, the effects of CT on individuals assisted by public health systems (PHSs) in middle-up economies are still poorly explored. The objective of this study was to evaluate the relationship between CT and clinical, sociobehavioral and nutritional aspects in adults assisted by a PHS in Brazil. This is a population-based cross-sectional study. The sample consisted of 380 individuals, selected through probabilistic sampling by clusters, in all health units in a city of approximately 100 thousand inhabitants. Data collection was performed during home visits, by means of general and nutritional interviews, anthropometric measurements and the Morningness–Eveningness Questionnaire (MEQ). Statistical analysis comprised chi-square test and principal component analysis (CPA) followed by Fisher’s discriminant analysis to determine aspects associated with each CT (morning, evening or intermediate). With the aim of explaining the variation in the CT scores, the consumption of micronutrients (corrected to the total energy intake) and other individual and sociodemographic variables were used as explanatory factors in the adjustment of a linear regression model. The morning group was characterized by older men, with less than eight years of schooling, with low body mass index (BMI) and with low intake of omega-6, omega-3, sodium, zinc, thiamine, pyridoxine and niacin. The evening group, on the other hand, was composed of younger individuals, with a high consumption of these same nutrients, with high BMI and a higher frequency of heart diseases (p < 0.05). It was concluded that most morning CT individuals were elderly thin males with lower consumption of omega-6 and -3, sodium, zinc, thiamine, pyridoxine and niacin, whereas evening individuals were younger, had higher BMI and had higher consumption of the studied micronutrients. The identification of circadian and behavioral risk groups can help to provide preventive and multidisciplinary health promotion measures.

Predictors of Dental Caries Among Adults Attending Public Oral Health Facilities in Two Districts in KwaZulu-Natal, South Africa: A Cross Sectional study

2020 ◽  
Author(s):  
Jimmy Mthethwa ◽  
Ozayr Mahomed
Keyword(s):  
Public Health ◽  
Dental Caries ◽  
Secondary Level ◽  
Cross Sectional Study ◽  
Dental Public Health ◽  
Sectional Study ◽  
Cross Sectional ◽  
Level Of Education ◽  
Kwazulu Natal ◽  
Unhealthy Diet

Abstract Background: Dental caries is the most common chronic oral condition affecting millions of people worldwide. There are several predictors of dental caries that include amongst others water source, fluoride use, smoking status, alcohol use, employment status, level of education, diet and socioeconomic status. Aim: The aim of this study was to determine the risk factors and or predictors associated with dental caries among adults attending dental clinics at public health facilities in eThekwini and uMgungundlovu districts in the KwaZulu-Natal (KZN) province of South AfricaSetting: The study took place at thirteen dental public health clinics in eThekwini and six from uMgungundlovu districts in KZN province, South AfricaMethods: An observational cross-sectional study was conducted over a 5-month period from November 2018 to the end of March 2019 with a sample of 4716 patients of all adults 18 years and above age groups. A clinical examination as well as a close-ended questionnaire on the diagnosis, basic demographics data, socioeconomic status (SES), as well as lifestyle-related questions such as smoking, alcohol use and dietary choices, was administered to all consenting participants. Bivariate analysis and multivariate analysis using logistical regression were used to measure the association.Results: Females participants OR 1.4 (95% CI 1.2-1.6) p < 0.001**, patients consuming an unhealthy diet OR1.2 (95% CI 1.2-1.6) p < 0.001** were more likely to develop dental caries. Patients Achieving more than secondary level education were OR 0.8 (95% CI 0.7-0.9) p = 0.02* less likely to develop dental caries. Despite showing a slightly increased odds ratio OR 1.25 (95% CI 0.93-1.67) p = 0.14, lack of access to water was not a statistically significant contributor to dental caries.Conclusion: This study showed that female sex, consumption of an unhealthy diet and lower than a secondary level of education were the predictors of dental caries. It is hoped that these findings will contribute in influencing dental public health policy planning to ensure that planning for dental services takes a more comprehensive approach that includes health promotion, primary prevention, secondary prevention and tertiary prevention at appropriate levels of the health system.

Knowledge and Attitude toward Medication Error among Pharmacists

2020 ◽  
pp. 001857872096541
Author(s):  
Ruzmayuddin Mamat ◽  
Siti Asarida Awang ◽  
Siti Azlina Mohd Ariffin ◽  
Zahida Zakaria ◽  
Mastura Hanim Che Zam ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Medication Error ◽  
Cross Sectional Study ◽  
Public Health Care ◽  
Favorable Attitude ◽  
Cross Sectional ◽  
Survey Knowledge ◽  
Health Care Institutions ◽  
Knowledge And Attitude

Objective: This study aimed to evaluate knowledge and attitude toward medication error (ME) among pharmacists working in public health care institutions. Methods: A cross-sectional study was conducted among pharmacists working in public health care institutions. Respondents were randomly recruited from 5 hospitals and 25 primary healthcare clinics in the state of Pahang, Malaysia. A set of self-administered questionnaires was used to assess their knowledge and attitude, distributed as a web-based survey. Knowledge and attitude toward ME reporting were assessed using five-point Likert-scale. This study was conducted between May and July 2019. Results: A total of 186 respondents participated in the study. A majority of respondents were female (n = 144). About 90% of the respondents had good score on knowledge on ME. Only 25.4% of the respondents had favorable attitude toward ME reporting. Female pharmacists ( P = .001), more experienced pharmacists ( P = .012) and those working in primary health clinics ( P = .014) were associated with more favorable attitude. Knowledge did not correlate well with attitude toward ME reporting (r = 0.08, P = .29). Conclusion: Despite having good knowledge on ME, the attitude toward ME reporting was still very poor among the pharmacists.

scholarly journals Rapid assessment of expansion of nursing, paramedical and public health education and it?s implication on quality of education

2013 ◽  
Vol 34 (3) ◽  
pp. 21-27
Author(s):  
Md HK Talukder ◽  
R Nazneen ◽  
Md Z Hossain ◽  
N Akther ◽  
IJ Chowdury ◽  
...  
Keyword(s):  
Public Health ◽  
Health Education ◽  
Rapid Assessment ◽  
Health Sector ◽  
Public Health Education ◽  
Present Situation ◽  
Quality Of Education ◽  
Institute Of Medicine ◽  
Cross Sectional

Introduction: Bangladesh is facing many challenges in health care that are similar to other developing countries. In Bangladesh standard of paramedical, nursing, pharmacy and public health education are expanding rapidly which needs to call for assessment and evaluation to be up to date in the respective fields. Study aims to assess the expansion of Nursing, Paramedical & Public health Education in Govt. & non Govt. sectors & its implication on quality of education. Methods: This was a descriptive type of cross sectional explorative study, conducted among the teachers and student of different institutes. Questionnaire was developed and a FGD was done. Then the data was analyzed. Results: At present situation, the numbers of non govt. organizations are more than govt. organizations (127 vs. 85). SWOT analyses showed the overall strength of the institutions were the scope for further improvements and the political commitments for expansion. Weaknesses lie in the lack of adequate infrastructure, suboptimal technical and laboratory facilities and teaching staffs. Opportunities were, increasing demand and provision of jobs at home and abroad. Possible threats were loss of quality services, recognition and registration of the institutes. Regarding the overall organization of the courses, 43% of the students voted as good and 100% of the teachers showed positive opinion. Regarding the teaching-learning procedure, 41% of the teachers strongly agreed about the perfect selection of the students. 48.3% teachers agreed about the adequacy of the number of teachers. 47.8% students also agreed with the competency of the teachers. Nearly one third teachers as well as students agreed about the good physical environment of the institute. About 35% and 36% of the teachers and the students respectively agreed about the transparency of the assessment systems. Conclusions: Present Bangladesh Govt. has implemented various initiatives regarding health sector reform. Proper funding, management, monitoring and evaluation can improve present situation and thus help in the development of better institutional output. DOI: http://dx.doi.org/10.3126/joim.v34i3.8912   Journal of Institute of Medicine, December, 2012; 34:21-27

scholarly journals It never happened to me, so I don’t know if there are procedures”: identification and case management of torture survivors in the reception and public health system of Rome, Italy

2018 ◽  
Vol 28 (2) ◽  
pp. 38-55
Author(s):  
Caterina Spissu ◽  
Gianfranco De Maio ◽  
Rafael Van den Bergh ◽  
Engy Ali ◽  
Emilie Venables ◽  
...  
Keyword(s):  
Public Health ◽  
Case Management ◽  
Health System ◽  
Public Health System ◽  
Health Sector ◽  
Linkage To Care ◽  
Public Health Care ◽  
Prise En Charge ◽  
Correct Identification ◽  
Torture Survivors

Background: Access and linkage to care for migrant torture survivors is contingent on their identification and appropriate referral. However, appropriate tools for identification of survivors are not readily available, and the (staff of) reception systems of host countries may not always be equipped for this task. This study explores practices in the identification and case management of torture survivors in the reception structures and in the public health sector in Rome, Italy. Method: Data were analysed manually and codes and themes generated. Results: A non-homogeneous level of awareness and experience with torture survivors was observed, together with a general lack of knowledge on national and internal procedures for correct identification of torture survivors. Identification and case management of torture survivors was mainly carried out by non-trained staff. Participants expressed the need for training to gain experience in the identification and management of torture survivors’ cases, as well support and increased resources at both the reception and public health system levels. Conclusions: The crucial process of identification and prise en charge of survivors of torture among migrant and refugee populations is relegated to nontrained and inexperienced professionals at different levels of the reception system and public health care sector, which may carry a risk of non-identification andpossible harm to survivors. Additional resources and structured interventions are urgently needed, in the form of developing procedures, training, and adapted multidisciplinary services.

scholarly journals Patients’ Perception towards General and Pelvic Examination by Male Medical Students: A Cross-sectional Study in a Multi-ethnic Population

2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Valliammai Jayanthi Thirunavuk Arasoo ◽  
Nisha Angela Dominic ◽  
Vanassa Ratnasingam ◽  
Md Inzamum Ul Islam ◽  
Erin Ziyi Lee ◽  
...  
Keyword(s):  
Medical Students ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Public Health Care ◽  
Male Students ◽  
Pelvic Examination ◽  
Sectional Study ◽  
Health Care Centre ◽  
Cross Sectional ◽  
History Of

Introduction Male medical students globally have difficulty in obtaining consent to perform pelvic examination. We sought to identify independent factors influencing women consenting to male medical students performing general and pelvic examination under supervision. Methods This cross-sectional study conducted at a tertiary hospital and a public health care centre in Johor Bahru, Malaysia recruited 369 women above 18 years old who have had  sexual intercourse before and no prior hysterectomy. A validated self-administered bilingual questionnaire was used to collect data on factors that influence them consenting to male medical students examining them and performing pelvic examination when indicated. Results The respondents were largely below 30 years old (52.9%), Malays (73.4%) and Muslims (75.3%). The consent rates for general and pelvic examination were 27.4% and 18.9%, respectively. Being a Muslim, having an occupation and being introduced by a male medical specialist increased the likelihood of women consenting to general examination. However, a history of being examined by male students decreased the likelihood by 64%. Believing that male doctors should have the skills to treat patients in women's health was the only independent factor that increased the likelihood for women to consent for pelvic examination to be conducted by male medical students.  Conclusion Believing that male doctors should be skilled in treating women positively influences decision to consent. Explaining earnestly to women on how they aid in developing the skills of future doctors should be prioritised. Keywords: patients’ perception; male medical students; pelvic examination

scholarly journals Sexually Transmitted Infections in A Tertiary Hospital of Kathmandu: A Retrospective Study

2021 ◽  
Vol 19 (2) ◽  
pp. 44-48
Author(s):  
Sushil Paudel ◽  
Niraj Parajuli ◽  
Sudip Dahal ◽  
Sudarshan Paudel
Keyword(s):  
Sexually Transmitted Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Level Of Education ◽  
Sexually Transmitted

Introduction: Sexually transmitted infections (STIs) are the diseases that are transmitted by sexual contact if a partner is infected with agent known to cause infection of genitalia. This group of diseases pose a huge public health problem. This study aims to provide an insight on the prevalence of STIs in a tertiary care center dedicated to civil servants. Methods: This is a retrospective cross-sectional study. All patients diagnosed with STI in a dermatology out-patient of Civil Service Hospital, a tertiary care hospital situated in Kathmandu over a period of two years from January 1 2018 to December 30 2019 were included in the study. The diagnosis was made by clinical and laboratory investigations. Results: The total number 157 cases of STIs were enrolled in this study, of which 119 (75.8%) were males and 38(24.2%) were females. The mean age of patients was 27.8±8.8 years, ranging from 15 to 60 years. Seventy three (46.5%) patients were married, while 81 (51.6%) patients were unmarried. Unmarried males were significantly more vulnerable to acquire STIs (p=0.005). Males were having significantly more premarital or extramarital sexual exposures as compared to females (p<0.001). The most common presentation was condyloma acuminata in 84(53.5%) patients. Consistent use of condom was reported only in 3 (2.5%) males and 1 (2.6%) females in this study. No association was noted between the education level attained to the practice of safe sexual methods (p=0.535). Conclusion: The proportion of males was higher than females in our study which might be due to the reluctances of female to see doctor for sexual problems. The level of education did not seem to make people aware of practicing safe sex. Sexual education seems must in all level of education.

scholarly journals Seropositivity of syphilis among individuals screened in a tertiary hospital in the Eastern Province of Saudi Arabia

2021 ◽  
Vol 41 (1) ◽  
pp. 8-13
Author(s):  
Nahid H. O. Wanni ◽  
Reem Al Dossary ◽  
Obeid E. Obeid ◽  
Nourah Hasan Al Qahtani ◽  
Zaheenul Islam Siddiqui ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Treponema Pallidum ◽  
Public Health Problem ◽  
Tertiary Hospital ◽  
Screening Tests ◽  
Cross Sectional ◽  
Major Health Problem ◽  
Curative Therapy ◽  
Chi Square Analysis

BACKGROUND: Sexually transmitted infections are a serious public health problem. Syphilis, a multistage, curable chronic disease caused by the spirochete Treponema pallidum , remains a major health problem worldwide. The disease re-emerged in the era of HIV in many countries despite the accessibility of curative therapy and continuing public health efforts to eliminate it. OBJECTIVE: Analyse the seropositivity for syphilis. DESIGN: Retrospective cross-sectional. SETTING: Tertiary hospital. PATIENTS AND METHODS: We retrospectively studied individuals who underwent screening tests for syphilis between January 2014 and December 2018. The samples that were positive by both screening and confirmatory tests were considered as confirmed positive for syphilis. MAIN OUTCOME MEASURES: Syphilis positivity identified by chemiluminescence immunoassay, the rapid plasma reagin test, and specific antibodies against Treponema pallidum . SAMPLE SIZE: 11 832. RESULTS: Of the 11 832, 54 (0.45%) were confirmed as seropositive for syphilis. Thirty-three (61.1%) were non-Saudi; 21 (38.9%) were Saudis. Thirty (55.6%) cases were males. Twenty-two (40.74%) were married and 29 (53.70%) were unmarried. Of the 54 diagnosed as syphilis positive, 28 (51.9%) were expatriate workers screened for pre-employment. The percentage of syphilis among Saudis was 0.36%. In an overall chi-square analysis, a P <.0001 indicated a difference among nationalities in the frequency of syphilis. A post-hoc analysis showed that Somalians ( P =.004) and Sudanese ( P =.005) differed significantly from other nationalities. CONCLUSION: The study showed that syphilis was low among the screened population. More than half of the syphilis positive cases in this study were household employees. Screening for syphilis assists in planning complementary services for target populations and improves syphilis control. LIMITATIONS: Retrospective design. Hospital-based findings may not be representative of the seroprevalence of syphilis in the general population. CONFLICT OF INTEREST: None.

scholarly journals Patterns and predictors of private and public health care utilization in an informal settlement in Nairobi, Kenya: A cross-sectional study

2020 ◽  
Author(s):  
Elvis Wambiya ◽  
Peter O Otieno ◽  
Martin Kavao Mutua ◽  
Hermann Pythagore Pierre Donfouet ◽  
Shukri F Mohamed
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Utilization ◽  
Informal Settlement ◽  
Cross Sectional Study ◽  
Public Health Care ◽  
Care Utilization ◽  
Health Seeking ◽  
Cross Sectional ◽  
Explanatory Variables

Abstract BackgroundKnowledge of health care utilization is particularly crucial in low-and middle-income countries where inequalities in burden of disease and access to primary health care exist. Inconclusive evidence exists on health-seeking and utilization of health facilities in the informal settlements in Kenya. This study assessed the patterns and predictors of private and public health care utilization in an urban informal settlement in Kenya.MethodsThis cross-sectional study used data from the Lown scholars study conducted between June and July 2018. It was nested within the Nairobi Urban Health and Demographic Surveillance System. Households were selected using simple random sampling and data obtained for all household members who reported having sought care for an illness in the 12 months preceding the study. Data were collected on health-seeking behaviour and explanatory variables (predisposing, enabling, and need) using an adaptation of Andersen’s conceptual framework. Health care utilization patterns by explanatory variables were described using proportions and multinomial logistic regression used to identify the predictors of private or public health care use.ResultsThree hundred and sixty-four members from 300 households sought care for an illness in the 12 months preceding the study. Almost half (47%) of the respondents sought care from private facilities while about 33% and 20% used public and other facilities, respectively. Health care utilization was influenced by enabling and need factors. Health insurance coverage was associated with private health facility use (aOR 3.06; 95% CI 1.48 – 6.31). Satisfaction with the quality of care was associated with lower use of public facilities (aOR 0.31; CI 0.11 – 0.84) while satisfaction with cost of care was associated with higher use of public facilities (aOR 2.09; CI 1.01 – 4.29). Members who reported an acute infection were more likely to use private facilities (aOR 3.07; 95% CI 1.52 – 6.18).ConclusionsHealth care utilization in the urban informal settlements favours private health facility use. As Kenya commits to achieving universal health coverage, interventions to improve health care access in informal and low-resource settlements should be modelled around enabling and need factors, particularly health care financing and quality of health care provision.

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