Prevalence and Impact of Fatigue in Children With Primary Immunodeficiency Disorders: A Quantitative Single Center Study

Abstract Although fatigue is a common symptom in adult patients with Primary Immunodeficiencies (PID), data in pediatric patients are limited. The goal of this study is to estimate the prevalence and impact of fatigue in children with PID as reported by patients, parents and health-care providers. A retrospective single center observational study was performed. Prevalence of fatigue was measured by reviewing medical charts of 54 children in our department who are on immunoglobulin substitution therapy. Both prevalence and impact were also measured by the PedsQL-Multidimensional Fatigue Scale (MFS). This comprises age-appropriate questionnaire for self-report in patients aged 5-18 years and parent proxy-reports for patients aged 2-18 years. General, cognitive, sleep-rest fatigue was measured and a total fatigue score was calculated. Means, standard deviation and Z-scores were calculated using age-specific reference values. Intraclass correlation coefficients (ICC) were calculated for comparison of scores provided by parents vs children’s self-reported scores.Both chart review data and PedsQL-MFS showed fatigue rates of 65%. Pediatric PID patients of all ages had significantly lower scores on all subscales and total score of the PedsQL-MFS compared to healthy children. General fatigue was the most affected subscale in PID patients; indicating fatigue of these patients is mainly physical. Seventy-four % of PID patients had a Z-score lower than -1 on the General fatigue subscale indicating severe fatigue. Child-parent concordance varied between 0.24 and 0.93. Our results show high prevalence and severity of fatigue in children with PID, addressing the importance of this issue in our patient care.

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Extended Breastfeeding in Poland: Knowledge of Health Care Providers and Attitudes on Breastfeeding Beyond Infancy

Journal of Human Lactation ◽

10.1177/0890334418819448 ◽

2018 ◽

Vol 35 (2) ◽

pp. 371-380 ◽

Cited By ~ 1

Author(s):

Barbara Baranowska ◽

Marta Malinowska ◽

Ewelina Stanaszek ◽

Dorota Sys ◽

Grażyna Bączek ◽

...

Keyword(s):

Health Care Providers ◽

Health Professionals ◽

Further Education ◽

Self Report ◽

Care Providers ◽

Online Questionnaire ◽

Cross Sectional ◽

Convenience Sample ◽

Level Of Knowledge ◽

The Relationship

Background: Extended breastfeeding is rare in Poland, and lack of acceptance and understanding is often evident in public opinion. The ability to provide reliable information about breastfeeding beyond infancy depends on health professionals’ levels of knowledge and attitudes. They are considered by most parents in Poland to be authorities in the field of child nutrition. Research aims: To determine (1) the level of knowledge and the attitudes of Polish health professionals towards extended breastfeeding; (2) the relationship between personal breastfeeding experience and attitudes towards extended breastfeeding; and (3) the relationship between knowledge about breastfeeding beyond twelve months and attitudes towards breastfeeding beyond infancy. Methods: A one-group prospective, cross-sectional, self-report style survey was used. The convenience sample ( N = 495) comprised gynaecologists, neonatologists and midwives. Data were collected via an online questionnaire and the results were analyzed with the use of descriptive statistics, a chi-square independence test, Fisher’s exact test, post-hoc testing, and two-part tables using SPSS. Results: Most of the respondents (76.7%; n = 384) had a low level of knowledge about the benefits of breastfeeding beyond twelve months and even emphasized that this nutritional choice could have negative impacts. There was a positive correlation ( F = 105.847; p = < .01) between levels of knowledge and respondents’ attitudes towards breastfeeding beyond infancy. Attitudes were also influenced by the length of time respondents had breastfed. Conclusion: Healthcare providers have an insufficient level of knowledge about extended breastfeeding and need further education in this area.

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The Effect of the E-Patuh Application on HIV/Aids Patients’ Adherence in Consuming Antiretroviral

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v7i1.809 ◽

2019 ◽

Vol 7 (1) ◽

Author(s):

Alfian Alfian ◽

Kusman Ibrahim ◽

Imas Rafiyah

Keyword(s):

Health Care ◽

Medication Adherence ◽

Health Care Providers ◽

Antiretroviral Treatment ◽

Intervention Group ◽

Self Report ◽

Care Providers ◽

Aids Patients ◽

Antiretroviral Adherence ◽

Hiv Aids

Medication adherence is behavior that refers to client obeys in following a medication, and makes lifestyle changes in accordance of recommendations from health care providers. Antiretroviral adherence is paramount for HIV/AIDS patients. The effects were often a problem in antiretroviral treatment and toxicity and often be the reason for replacing or stopping antiretroviral treatment. This study aimed to determine the “E-Patuh” Applications effect on antiretroviral adherence in patients Of HIV/AIDS In West Java. The research design was a quasi-experimental with nonequivalent control group design. The location of this research was in RSUD Kota Bandung and in RSUD Kota Banjar. The respondents was selected without randomization and used purposive sampling technique. Respondents in this study were 30 respondents. Data were obtained using self-report questionnaires. The intervention group was monitored a 30-day android-based E-Patuh application and monitored on an E-Patuh website and then measured adherence value with self-report. Data were analyzed using SPSS 22 with chi-square test. The results showed a significant difference between adherence value before and after application of E-Patuh in the intervention group with (p <0.05) with obtained p value = 0,006. The results of this study prove a positive effect on the using of E-Patuh applications against ARV medication adherence in the intervention group with the support system of the E-Patuh application. The used of E-Patuh is helpful in improving ARV adherence in HIV/AIDS patients. The features contained in E-Patuh were directly reminiscent of the timing of taking medication for PWLH. E-Patuh should be consideration for PLHIV and health care providers in hospitals to improve ARV adherence to reduce mortality rates in people living with HIV.

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Reported Problems and Adherence in Using Asthma Medications Among Adolescents and Their Caregivers

Annals of Pharmacotherapy ◽

10.1177/1060028018766603 ◽

2018 ◽

Vol 52 (9) ◽

pp. 855-861 ◽

Cited By ~ 5

Author(s):

Betsy Sleath ◽

Daniel Gratie ◽

Delesha Carpenter ◽

Scott A. Davis ◽

Charles Lee ◽

...

Keyword(s):

Health Care Providers ◽

Self Efficacy ◽

Persistent Asthma ◽

Outcome Expectations ◽

Self Report ◽

Care Providers ◽

Medical Visit ◽

Efficacy Outcome ◽

Controller Medications ◽

The Relationship

Background: Many factors affect youth adherence to asthma medications. Better understanding of the relationship between problems reported by youth in using asthma medications, self-efficacy, outcome expectations, and adherence is needed. Objective: The study examined the relationship between youth and caregiver problems in using asthma medications, asthma management self-efficacy, outcome expectations, and youth- and caregiver-reported adherence to asthma controller medications. Methods: Adolescents with persistent asthma and their caregivers were recruited at 4 pediatric practices. Youth were interviewed after their medical visit while caregivers completed a questionnaire. Multivariable linear regression was used to analyze the data. Results: Of 359 participating youth, 319 were on controller medications. Youth reported 60% average adherence, whereas caregivers reported 69%. Youth who reported difficulty using their inhaler correctly and youth who reported difficulty remembering to take their medications were significantly less likely to be adherent. Caregivers who reported that it was hard to remember when to give the asthma medications were significantly less likely to report their child being adherent. Both youth and caregivers with higher outcome expectations were significantly more likely to self-report being adherent. Conclusions: Pharmacists and other health care providers should consider asking youth and caregivers about problems in using asthma medications, self-efficacy in managing asthma, and outcome expectations for following treatment regimens, so that they can help youth overcome difficulties they might have in managing their asthma.

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Administration of the Third Dose of Oral Poliomyelitis Vaccine at 6 to 18 Months of Age

PEDIATRICS ◽

10.1542/peds.94.5.774 ◽

1994 ◽

Vol 94 (5) ◽

pp. 774-775 ◽

Cited By ~ 1

Author(s):

Keyword(s):

United States ◽

Health Care Providers ◽

The United States ◽

Preschool Age ◽

Healthy Children ◽

Care Providers ◽

Wild Type ◽

The Third ◽

Primary Series ◽

Poliomyelitis Vaccine

This statement describes a modification of the recommended routine schedule for administering trivalent oral poliomyelitis vaccine (OPV). The American Academy of Pediatrics previously has recommended that healthy children receive a three-dose primary series of OPV at 2, 4, and 15 to 18 months of age and a fourth dose at the time of school entry (4 to 6 years of age).1 Available data indicate that the response rates to the third dose of OPV administered at 6 months of age are as good as the rates following administration of this dose at 15 to 18 months of age. Completion of the three-dose primary series at an earlier age will help health care providers induce immunity against poliomyelitis at an early age. Although wild type poliomyelitis has not caused disease in the United States for many years, the virus remains prevalent in many countries. Continued introduction of the virus into the United States by travelers could result in transmission and disease if high levels of immunity are not maintained in preschool age children. For example, wild type poliovirus type 3 was recently introduced into Canada by a religious sect that did not believe in immunization.2 The virus was probably imported from the Netherlands, where a small epidemic of poliomyelitis occurred in members of the same sect in 1992 and 1993.3 SERUM ANTIBODY RESPONSE FOLLOWING OPV ADMINISTRATION After two doses of OPV are administered at 2 and 4 months of age, 89 to 100% of children vaccinated in the United States have evidence of humoral immunity to poliomyelitis types 1 and 3, and 99 to 100% have immunity to type 2 (Table).

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Transgender Intimate Partner Violence and Help-Seeking Patterns

Journal of Interpersonal Violence ◽

10.1177/0886260519880171 ◽

2019 ◽

pp. 088626051988017 ◽

Cited By ~ 1

Author(s):

Victoria Kurdyla ◽

Adam M. Messinger ◽

Milka Ramirez

Keyword(s):

Intimate Partner Violence ◽

Health Care Providers ◽

Sexual Minority ◽

Partner Violence ◽

Help Seeking ◽

The United States ◽

Intimate Partner ◽

Self Report ◽

Care Providers ◽

Convenience Sample

Intimate partner violence (IPV) against transgender individuals is highly prevalent and impactful, and thus research is needed to examine the extent to which survivors are able to reach needed assistance and safety. To our knowledge, no U.S.-based quantitative studies have explored transgender utilization patterns and perceptions regarding a broad range of help-giving resources (HGRs). The present article fills this gap in the literature by exploring help-seeking attitudes and behaviors of a convenience sample of 92 transgender adults and 325 cisgender sexual minority adults in the United States. Results from an online questionnaire indicate that, among the subsample experiencing IPV ( n = 187), help-seeking rates were significantly higher among transgender survivors (84.1%) than cisgender sexual minority survivors (67.1%). In addition, transgender survivors most commonly sought help from friends (76.7%), followed by mental health care providers (39.5%) and family (30.2%), whereas formal HGRs such as police, IPV telephone hotlines, and survivor shelters had low utilization rates. Among all transgender participants, IPV survivors were significantly less likely than nonsurvivors to perceive family, medical doctors, and survivor hotlines as helpful HGRs for other survivors in general. Finally, transgender survivors were significantly less likely than nonsurvivors to self-report a willingness to disclose any future IPV to family. Although replication with larger, probability samples is needed, these findings suggest that friends often represent the primary line of defense for transgender survivors seeking help, and thus bystander intervention trainings and education should be adapted to address not just cisgender but also transgender IPV. Furthermore, because most formal HGR types appear to be underutilized and perceived more negatively by transgender survivors, renewed efforts are needed to tailor services, service advertising, and provider trainings to the needs of transgender communities. Directions for future research are reviewed.

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SUN-LB14 Trans and Non-Binary Youth Accessing Gender Affirming Medical Care in Canada: New Research From the Trans Youth CAN!

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2153 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Arati Mokashi ◽

Margaret L Lawson ◽

Sandra Gotovac ◽

Greta R Bauer

Keyword(s):

Psychological Distress ◽

Medical Care ◽

Health Care Providers ◽

Hormone Treatment ◽

Self Report ◽

Wait Times ◽

Parental Conflict ◽

Care Providers ◽

Conversion Therapy ◽

Trans Youth

Abstract Little is known about youth accessing gender-affirming care in Canada. Trans Youth CAN! is a prospective 24-month cohort study of youth referred for puberty suppression/gender affirming hormones, examining pathways to care, medical, social, and family outcomes. Eligible participants were pubertal, aged <16, naïve to puberty blockers/cross-sex hormones, and recruited at their first endocrine appointment, along with their parent/caregiver (P/C), from clinics in 10 Canadian cities. Baseline sociodemographic, health, and family data were collected from interviewer-assisted youth surveys, self-completed (P/C) surveys, and clinic medical records. Youth data included day-to-day discrimination (InDI-D), depression, (MDS), psychological distress (Kessler-6), gender distress (TYC-GDS), gender positivity (TYC-GPS), and P/C support (self-report by youth and P/C). Pathways to accessing gender-affirming medical care included wait times, prior providers seen, length of time seeking care, and age accessing care. P/C data included parental conflict and consideration/involvement in conversion therapy. Baseline data were collected from 09/2017 to 06/2019 on 174 youth and 160 P/Cs. 78.7% of youth were assigned female at birth. 8.1% of those assigned female at birth, and 8.3% of those assigned male at birth, reported a primarily non-binary identity. 25.7% of youth had one or more immigrant P/Cs; 20.5% were Indigenous; and 15.5% were from rural areas. In the past year, 52.9% of youth reported engaging in self-harm, 32.6% had suicidal ideation, and 13.8% had attempted suicide. Bivariate correlations showed that longer wait times were associated with being older when youth first spoke to someone about their gender, seeing more provider types before first endocrine appointment, P/C report of time spent seeking hormone treatment, and lifetime discrimination. Youth with higher current P/C support were younger at their first appointment. Older youth at first appointment had also been older when they first met with someone outside the family about their gender, and had spent a longer time seeking hormone treatment. These youth also had higher gender distress, lower gender positivity, higher psychological distress, higher depression, experienced higher lifetime and past-year discrimination, and had lower average P/C support. P/Cs reported 8.8% of youth had participated in conversion therapy, while an additional 9.7% had considered having their youth participate. Current or past parental conflict about youths’ gender identity was reported by 40.1%, but was not associated with age of accessing care, types of providers seen, length of time accessing care, or age at first appointment. This research will help fill gaps in knowledge for health care providers about youth accessing gender affirming medical care, enhancing gender-affirming care and support for these youth and their parents/families.

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Buprenorphine/naloxone addiction in a pharmacist as a result of migraine self-treatment

Mental Health Clinician ◽

10.9740/mhc.2016.05.127 ◽

2016 ◽

Vol 6 (3) ◽

pp. 127-130

Author(s):

Merrill Norton ◽

Ah Young Cho ◽

Courtney Giebler ◽

Taylor Smith ◽

Kathryn Walton

Keyword(s):

Health Care ◽

Health Care Providers ◽

Prescription Drugs ◽

Health Care Professionals ◽

Hospital Pharmacist ◽

Self Report ◽

Drug Misuse ◽

Treatment Center ◽

Care Providers ◽

Migraine Headaches

Abstract Objective: A unique case report is presented to demonstrate addiction in a pharmacist through the use of buprenorphine/naloxone film for the self-prescribed treatment of migraine headaches. Case Summary: A 35-year-old female hospital pharmacist was admitted to treatment for opioid use disorder for using buprenorphine/naloxone film to self-medicate her migraine headaches. After daily use of sublingual buprenorphine/naloxone, and several failed attempts to discontinue use, the pharmacist was admitted to a partial hospitalization treatment program. She was prescribed sumatriptan subcutaneous injection for her migraines, while maintaining buprenorphine/naloxone abstinence. Upon completion, the pharmacist transitioned to the aftercare program, where she maintains sobriety and uses her story to help aid in other patients' recoveries at the treatment center. Discussion: Addiction and substance abuse affect a substantial number of health care professionals. Pharmacists are particularly vulnerable to prescription drug misuse and addiction as a result of their direct access and vast pharmacologic knowledge. In a 2004 self-report survey of a random sample of health care providers, 58.7% of pharmacists reported using nonprescribed prescription drugs at least once in their lifetime. This case is a story of rehabilitation and recovery of a pharmacist who has a desire to return to the practice of pharmacy through the use of effective pharmacologic and behavioral interventions.

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Knowledge and awareness among nursing students regarding the COVID-19: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20202536 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2518

Author(s):

K. P. Joshi ◽

Leena Madhura ◽

Deepak Jamadar

Keyword(s):

Health Care ◽

Nursing Students ◽

Health Care Providers ◽

Educational Interventions ◽

Self Report ◽

Basic Knowledge ◽

Care Providers ◽

Snowball Sampling ◽

Outbreak Response ◽

Cross Sectional

Background: The health care providers are at the front line of the outbreak response of current pandemic of COVID-19 and exposed to hazards that put them at risk of infection. Rapid spread of the COVID-19 pandemic has become a major cause of concern for the healthcare profession in all over the world. All health care professional must stay aware of the latest information on the COVID-19 outbreak. This research paper deals with the knowledge and awareness about COVID-19 among nursing students.Methods: By non-probability snowball sampling method the sample size was 407. Predesigned and pretested questionnaire was used in this study. Questions were related to knowledge and awareness about current COVID-19. The participant was directed to complete the self-report survey by online. The data was tabulated and analysed statistically. MS-Excel and Statistical Package for Social Sciences version 22.0 used for all statistical analysis.Results: A total of 407 nursing students participated in this study. Over all 75.58±3.21 participants showed good knowledge and awareness about COVID-19. Around 87.47% respondents were aware about high risk age group for COVID-19. 83.54% participants were aware about concept of hand hygiene and 83.37% were well aware of PPE for suspected or confirmed COVID-19 cases.Conclusions: The study participants showed adequate basic knowledge and awareness of COVID-19. There is a strong need to implement periodic educational interventions and training programs on infection control practices and other updates of COVID-19 across all healthcare professions including nursing students.

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The Relationships between Maternal Feeding Practices and Food Neophobia and Picky Eating

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17113894 ◽

2020 ◽

Vol 17 (11) ◽

pp. 3894 ◽

Cited By ~ 1

Author(s):

Hebah Alawi Kutbi

Keyword(s):

Health Care Providers ◽

Feeding Strategy ◽

Feeding Practices ◽

Dietary Behaviors ◽

Feeding Practice ◽

Healthy Children ◽

Care Providers ◽

Picky Eating ◽

Food Neophobia ◽

Maternal Feeding Practices

Food neophobia and picky eating (FNPE) are dietary behaviors that have been frequently reported to coexist in children. Parental concerns about these dietary behaviors may influence the feeding practices employed. In this cross-sectional study, we investigated the bidirectional associations of maternal feeding practices with children’s FNPE behaviors. Using a convenience sampling technique, mothers of 195 healthy children aged 1–7 years were invited to complete a sociodemographic questionnaire, rate their child’s FNPE, and rate the extent to which each feeding practice was employed with the child. Maternal reports indicated that 37.4% (n = 73) of the children exhibited severe FNPE. Multiple linear regression analyses showed positive two-way associations between the “pressure to eat” feeding strategy and FNPE, and negative two-way associations between a healthy home food environment and FNPE. However, maternal practices of teaching and monitoring were not found to be associated with FNPE. Given the bidirectional relationships observed between FNPE and maternal feeding practices, primary health care providers should address the feeding practices used with a child and indicate that coercive feeding practices are counterproductive. Intervention studies targeting mothers of children with FNPE are needed to investigate whether specific maternal practices are more effective than others.

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Trajetórias Relacionais e Reprodutivas Conducentes à Gravidez na Adolescência: a Realidade Nacional e Regional Portuguesa

Acta Médica Portuguesa ◽

10.20344/amp.4902 ◽

2014 ◽

Vol 27 (5) ◽

pp. 543 ◽

Cited By ~ 2

Author(s):

Raquel Pires ◽

Joana Pereira ◽

Anabela Araújo Pedrosa ◽

Teresa Bombas ◽

Duarte Vilar ◽

...

Keyword(s):

Adolescent Pregnancy ◽

Sex Education ◽

Health Care Providers ◽

Romantic Relationship ◽

Self Report ◽

Care Providers ◽

Public Health Services ◽

Multiple Sexual Partners ◽

Contraceptive Failure ◽

Nationally Representative

Introduction: The current study aimed to describe the relational and reproductive trajectories leading to adolescent pregnancy in Portugal, and to explore whether there were differences in this process according to adolescents’ place of residence. Material and Methods: Data were collected between 2008 and 2013 in 42 public health services using a self-report questionnaire developed by the researchers. The sample consisted of a nationally representative group of pregnant adolescents (n = 459). Results: Regardless of having had one (59.91%) or multiple sexual partners (40.09%), the majority of adolescents became pregnant in a romantic relationship, using contraception at the time of the conception and knowing the contraceptive failure which led to pregnancy (39.22%). In some regions other trajectories were highly prevalent, reflecting options such as planning the pregnancy (Alentejo Region/ Azores Islands), not using contraception (Centro Region/Madeira Islands) or using it incorrectly, without identifying the contraceptive failure (Madeira Islands). On average, romantic relationships were longer than 19 months and adolescents’ partners were older than themselves (> 4 years) and no longer in school (75.16%); these results were particularly significant when the pregnancy was planned. Discussion: The knowledge gained in this study shows that prevention efforts must be targeted according to the adolescents’ needs in each region and should include high-risk male groups. Conclusion: Our results may enable more efficient health policies to prevent adolescent pregnancy in different country regions and support educators and health care providers on sexual education and family planning efforts. Keywords: Adolescent; Contraception; Sex Education; Pregnancy in Adolescence; Portugal.

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