Rapid Changes in Telehealth Access among Vulnerable Populations Amid Covid-19 Policy Expansions: Cross-sectional Study (Preprint)

2020 ◽  
Author(s):  
Saif Khairat ◽  
Yuxiao Yao ◽  
Cameron Coleman ◽  
Christopher Shea ◽  
Barbara Edson ◽  
...  
Keyword(s):  
Data Collection ◽  
Vulnerable Populations ◽  
Cross Sectional Study ◽  
Study Data ◽  
Unintended Consequences ◽  
Primary Data ◽  
Emergency Rooms ◽  
Cross Sectional ◽  
Virtual Visits ◽  
Rural Patients

UNSTRUCTURED Objective To examine the effect of the Covid-19 policy expansions on telehealth access among vulnerable populations including uninsured, seniors, and rural patients. Data Sources Primary data collection of telehealth visits between January 21- April 19, 2020. Data Collection Study data was collected through the online platform and extracted from the institutional data warehouse for processing and analysis. Study Design We conducted a cross-sectional analysis of virtual visits through a state-wide telehealth center embedded in a large academic healthcare system. Primary outcomes of this study were changes in health access among vulnerable populations and changes in provider staffing to stabilize the telehealth practice. Principal Findings A total of 2132 telehealth visits were conducted, 1530(71.8%) patients were female, 1561(73.2%) were between the ages 18-50, 1576(74%) were uninsured, and 1225(57.5%) were from rural regions. A significant increase in access among senior (p<0.05), uninsured (p<0.001), and rural (p=0.001) patients, and video visits (p<0.001) occurred in response to the telehealth expansion. Post-expansion, the daily average number of telehealth visits and wait times increased by 229% and 436% respectively, which required an increase in telehealth providers by 228% to meet patient demands. The predictive model expected 394% increase in virtual visits through June, 2020 (95% CI: 2892-8579). Conclusions Recent telehealth policy expansions appear to expand access to vulnerable populations such as senior, uninsured, and rural patients while decompressing hospitals and emergency rooms and maintaining positive patient experiences. While the policy expansion displayed effectiveness, additional measures are needed. These include the need for regulations around virtual visits unintended consequences, certification of telehealth software, and guidelines for workforce training.

scholarly journals A study on assessment of effects of electronic gadgets on mental and physical health among medical students in Central India

2021 ◽  
Author(s):  
Priyesh Marskole ◽  
Rashmi Yadav ◽  
Soumitra Sethia ◽  
Sachin Parmar ◽  
Rinku Bhagora ◽  
...  
Keyword(s):  
Mental Health ◽  
Data Collection ◽  
Age Groups ◽  
Central India ◽  
Cross Sectional Study ◽  
Study Data ◽  
Physical And Mental Health ◽  
Laptop Computer ◽  
Cross Sectional ◽  
Waking Up

Background: Human race has witnessed enormous technological advancements especially in last few decades. Electronic gadgets are part of everyday lives of all individuals in all age groups. On one side they make our lives easier and convenient and on the other side their excessive usage is harmful. These gadgets effect physical as well as mental health. Present study was conducted to see the effects of electronic gadgets on physical and mental health of medical students.Methods: A cross-sectional study was conducted among MBBS students of Central India. Students who were present on the time of data collection were included in the study. For the study, data collection tool was a pre-designed, semi structured questionnaire, collected data was compiled in excel sheet and relevant analysis was done.Results: About 70% have habit of waking up between 6 to 8 AM. 95.5% of subjects were using smartphones, 61.5% of subjects using laptop/computer. 58% were spending time with gadgets less than 4 hours while 6.5% were spending more than 10 hours. We found out that 54% had ophthalmic health effects and 46.5% participants accepted feeling anxious, irritated or restless without their gadgets. The study revealed health problems of participants as headache (30%), migraine (1%), depression (7%) and other problems like backache, weakness, joint pain and others.Conclusions: The current and exiting data so far suggest that gadget have definite risk and adverse effects on the health of the general population.

Studying and More: Part-Time Employment as an Educational Challenge?

2020 ◽  
Vol 1 (1) ◽  
pp. 57-63
Author(s):  
Silke Heuse ◽  
Cathrin Dietze ◽  
Daniel Fodor ◽  
Edgar Voltmer
Keyword(s):  
Health Care ◽  
Perceived Stress ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Study Data ◽  
Future Health ◽  
Cross Sectional ◽  
Professional Students ◽  
Educational Challenge ◽  
Part Time

Background: Future health-care professionals face stress both during education and in later professional life. Next to educational trainings, many students are forced to assume part-time employment. Objective: Applying the Job Demands-Resources Model to the educational context, we investigate which role part-time employment plays next to health-care professional students’ education-specific demands and resources in the prediction of perceived stress. Method: In this cross-sectional study, data from N = 161 health-care students were analysed, testing moderation models. Results: Education-specific demands were associated with higher and education-specific resources with lower amounts of perceived stress. Part-time employment functioned as moderator, i.e. demands were less associated with stress experiences in students who were employed part-time. Conclusion: Identifying part-time employment as a resource rather than a demand illustrates the need to understand students’ individual influences on stress. Both educators and students will benefit from reflecting these resources to support students’ stress management.

Nigerian physiotherapists’ perception of direct access and patients’ self-referral

2015 ◽  
Author(s):  
Chidozie Emmanuel Mbada ◽  
Kayode D. Ojetola ◽  
Rufus Adesoji Adedoyin ◽  
Udoka A. C. Okafor ◽  
Olubusola E. Johnson ◽  
...  
Keyword(s):  
Public Support ◽  
Cross Sectional Study ◽  
Study Data ◽  
Professional Autonomy ◽  
Direct Access ◽  
Cross Sectional ◽  
Major Barrier ◽  
Physiotherapy Practice ◽  
South West ◽  
Validated Questionnaire

Background: The global advocacy for Direct Access (DA) and Patients’ Self-Referral (PSR) to physiotherapy is consistent with the quest for promoting professional autonomy and recognition. It was hypothesized in this study that the attainment of this clarion call in Nigeria may be hamstrung by challenges similar or different from those reported in other climes. Objective: This study assessed the perception of DA and PSR among Physiotherapists (PTs) in South-West, Nigeria. Methods: One hundred PTs from ten purposely selected public-funded out-patient facilities from South-West, Nigeria responded in this cross-sectional study, yielding a response rate of 75% (100/150).  A previously validated questionnaire for World Confederation of Physical Therapists (WCPT) on the global view of DA and PSR for physical therapy was used in this study. Data was analyzed using descriptive statistics. Results: There was a high awareness on legislation regulating practice (91%) and scope (84%) of the profession. Respondents assert that the extant legislation allows for DA (49%) and PSR (97%). However, 40% of the respondents opined that the baccalaureate qualification of PTs was inadequate for competence in DA and PSR; and a post-professional residency programme was mostly recommended (52%). Public support for DA and PSR to physiotherapy was rated more than the advocacy role of the Nigeria Society of Physiotherapy (60% vs. 40%). Physicians’ (71%) and politicians’ (65%) views were rated the major barrier to achieving DA and PSR status in physiotherapy. Similarly, physicians’ (90%) and politicians’ (88%) support was perceived as the major facilitator.  Conclusion: Physiotherapy practice in Nigeria has the semblance of autonomy in DA and PSR but is devoid of legislative support. Most Nigerian physiotherapists assume professional autonomy but were not aware of the lack of legal support for DA and PSR. The current entry-level academic curricula were considered to be deficient and inadequate for autonomous practice in Nigeria.  Physicians and politicians were the most important barrier or facilitator to achieving legal support for DA and PSR in physiotherapy in Nigeria.

Psychosocial Impact of Covid-19 Pandemic on Frontline Healthcare Workers in Pakistan: A Cross-Sectional Study

2020 ◽  
Author(s):  
Quratul-Ain Zafar
Keyword(s):  
Data Collection ◽  
Emotional Distress ◽  
Healthcare Workers ◽  
Cross Sectional Study ◽  
Psychosocial Impact ◽  
Control Group ◽  
Study Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Frontline Healthcare Workers

Objective: The purpose of this study was to evaluate the impact of the COVID-19 pandemic on frontline healthcare workers in Pakistan in terms of psychological factors emotional distress, insomnia, and burnout. Study Design: Observational cross-sectional study. Place and Duration of Study: This study was conducted at different hospitals across Pakistan and data collection was carried out from 15th June 2020 till 15th August 2020. Material and Methods: This was a questionnaire-based study aiming to compare the levels of burnout and emotional distress between frontline COVID-19 and non-COVID-19 healthcare workers. Any physician, nurse, and other healthcare workers were recruited from emergency care units and Covid-19 care units (target group), and non-COVID-19 care units (control group). Participation was voluntary and participants had to complete self-reported questionnaires and scales. A mixed-mode data collection was carried out, either in paper or web-based form to ensure maximum participation. Results: The independent t-test showed a statistically significant difference between the two groups regarding depression, stress, and insomnia. The study group showed higher scores for these factors than the control group. Chi-square test of association revealed significant scores of burnout and professional fulfillment in both groups. There was a higher prevalence of burnout in the study group than in the control group. Conclusion: This study concludes that there was a significant psychosocial impact of the Covid-19 pandemic in the frontline healthcare workers measured in terms of emotional distress, insomnia, and burnout.

Assessment of knowledge about oral cancer: study with students of public education

RSBO ◽  
2016 ◽  
Vol 12 (1) ◽  
pp. 41 ◽  
Author(s):  
Elisabete Rabaldo Bottan ◽  
Iara Fiorentin Comunello ◽  
Constanza Marín ◽  
Eduardo Mazzetti Subtil
Keyword(s):  
Public Schools ◽  
Oral Cancer ◽  
Target Population ◽  
Cross Sectional Study ◽  
Primary Data ◽  
First Year ◽  
Research Subjects ◽  
Cross Sectional ◽  
Adequate Knowledge ◽  
Level Of Knowledge

Introduction and Objective: To evaluate the level of knowledge about oral cancer of students attending public school in one city of Santa Catarina (Brasil). Material and methods: A descriptive cross-sectional study, using primary data collection. Students of last year of elementary school and first year of high school, enrolled in public schools in the city of Itajaí (SC), in 2012, were the target population. The non-probability sample was obtained by convenience. Data were collected through a self-administered questionnaire structured with 13 questions divided into three fields. The level of knowledge was made based on pre-established scores. Results: 1149 instruments were analyzed (80.8% of the target population). The average age of the group was 15.5 years and 54.5% were female. The majority (78%) never had received information about oral cancer. Only 27.9% had cognizance about self-examination of the oral cavity. With regard to knowledge, 87.5% classified as unsatisfactory. For most issues the cognitive field did not identify a significant correlation between knowledge and the variables gender and education. When asked if they would like to participate in educational and preventive activitiesabout oral cancer and other issues related to health, 72.6% expressed interest. Conclusion: The group did not have adequate knowledge on the subject of oral cancer. Facing this reality, and the positive attitude of respondents, the researchers designed and offered an educational program to the research subjects.

scholarly journals Bedtime Oral Hygiene Behaviours, Dietary Habits and Children’s Dental Health

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 416
Author(s):  
George Kitsaras ◽  
Michaela Goodwin ◽  
Michael P. Kelly ◽  
Iain A. Pretty
Keyword(s):  
Oral Hygiene ◽  
Dietary Habits ◽  
Dental Health ◽  
Cross Sectional Study ◽  
Study Data ◽  
General Anaesthetic ◽  
Dental Disease ◽  
Cross Sectional ◽  
Important Relationship ◽  
Bedtime Routine

Background: Oral hygiene behaviours as well as dietary habits before bed can affect children’s dental health resulting in higher prevalence of dental disease. Dental disease can affect children’s health, development and even school performance. If left untreated, dental disease can progress and it can lead to extractions under general anaesthetic causing further distress for children and families. Consistent and appropriate oral hygiene behaviours and dietary habits can prevent dental diseases from occurring in the first place. Objective: This cross-sectional study examines the relationship between oral hygiene behaviours, dietary habits around bedtime and children’s dental health. Methods: A total of 185 parents with children between the ages of 3 and 7 years from deprived areas participated in the study. Data on bedtime routine activities were collected using an automated text-survey system. Children’s dental health status was established through examination of dental charts and dmft (decayed, missed, filled teeth) scores. Results: In total, 52.4% of parents reported that their children’s teeth were brushed every night. The majority of children (58.9%) had dmft scores over zero. In total, 51 (46.7% of children with dmft score over 0 and 27.5% of all children) children had active decay. The mean dmft score for those experiencing decay was 2.96 (SD = 2.22) with an overall mean dmft score of 1.75 (SD = 2.24). There were significant correlations between frequency of tooth brushing, frequency of snacks/drinks before bed and dmft scores (r = −0.584, p < 0.001 and r = 0.547, p = 0.001 respectively). Finally, higher brushing frequency was associated with a lower likelihood of a dmft score greater than 0 (Exp(B) = 0.9). Conclusions: Despite families implementing oral hygiene behaviours as part of their bedtime routines those behaviours varied in their consistency. Results of this study highlight the need for additional studies that consider bedtime routine-related activities and especially the combined effects of oral hygiene practices and dietary habits due to their potentially important relationship with children’s dental health.

scholarly journals Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
Study Data ◽  
Patient Specific ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medications

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.

scholarly journals The association between clinical laboratory data and chest CT findings explains disease severity in a large Italian cohort of COVID-19 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Simone Canovi ◽  
◽  
Giulia Besutti ◽  
Efrem Bonelli ◽  
Valentina Iotti ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Laboratory Data ◽  
Organ Damage ◽  
Cross Sectional Study ◽  
Chest Ct ◽  
Arterial Oxygen ◽  
Emergency Rooms ◽  
Cross Sectional ◽  
Ct Findings ◽  
Patient Prognosis

Abstract Background Laboratory data and computed tomography (CT) have been used during the COVID-19 pandemic, mainly to determine patient prognosis and guide clinical management. The aim of this study was to evaluate the association between CT findings and laboratory data in a cohort of COVID-19 patients. Methods This was an observational cross-sectional study including consecutive patients presenting to the Reggio Emilia (Italy) province emergency rooms for suspected COVID-19 for one month during the outbreak peak, who underwent chest CT scan and laboratory testing at presentation and resulted positive for SARS-CoV-2. Results Included were 866 patients. Total leukocytes, neutrophils, C-reactive protein (CRP), creatinine, AST, ALT and LDH increase with worsening parenchymal involvement; an increase in platelets was appreciable with the highest burden of lung involvement. A decrease in lymphocyte counts paralleled worsening parenchymal extension, along with reduced arterial oxygen partial pressure and saturation. After correcting for parenchymal extension, ground-glass opacities were associated with reduced platelets and increased procalcitonin, consolidation with increased CRP and reduced oxygen saturation. Conclusions Pulmonary lesions induced by SARS-CoV-2 infection were associated with raised inflammatory response, impaired gas exchange and end-organ damage. These data suggest that lung lesions probably exert a central role in COVID-19 pathogenesis and clinical presentation.

scholarly journals Evaluation of Patient Experience During Virtual and In-Person Urgent Care Visits: Time and Cost Analysis

2021 ◽  
Vol 8 ◽  
pp. 237437352098148
Author(s):  
Saif Khairat ◽  
Xi Lin ◽  
Songzi Liu ◽  
Zhaohui Man ◽  
Tanzila Zaman ◽  
...  
Keyword(s):  
Patient Experience ◽  
Care Delivery ◽  
Turnaround Time ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Urgent Care ◽  
Cross Sectional ◽  
Significant Difference ◽  
Virtual Visits ◽  
One Year

Urgent care (UC) is one of the fastest growing venues of health care delivery for nonemergent conditions. This study compared the patient experience during virtual and in-person urgent care visits. We conducted a cross-sectional study of patients with the same diagnosis during Virtual Urgent Care (VUC) and in-person UC visits with the same diagnosis with regard to time and cost over a period of one year. We recorded and analyzed 16 685 urgent care visits: In-person UC (n = 14 734), VUC (n = 1262). Significant differences were found in the average total time for a visit in an in-person UC (70.89 minutes), and VUC (9.38 minutes). The average total cost of VUC ($49) and in-person UC ($142.657) differed significantly. Significant difference was found between UC turnaround time and VC turnaround time (Dependent variable (DV): 53.77, P < .01). We found significant differences in cost and time between in favor of virtual visits. Our findings suggest additional policy reform to expand the use of virtual care among target populations to improve access, reduce costs, meet the needs of patients, and reduce emergency department visits.

scholarly journals Knowledge of conjunctivitis among high school students in Pokhara valley of Western Nepal

2020 ◽  
Vol 13 (1) ◽  
pp. 19-22
Author(s):  
Sarita Tuladhar ◽  
Jamuna Gurung
Keyword(s):  
High School ◽  
High School Students ◽  
Health Education ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Study Data ◽  
School Students ◽  
Government Schools ◽  
Cross Sectional ◽  
Pokhara Valley

Introduction: Conjunctivitis is a common health problem in Nepal. It is inflammation of conjunctiva presenting as red eye. It is a communicable eye disease. Health education to the students and proper management can help spread of the disease. Knowledge of conjunctivitis among school students will help in prevention of the disease. So the study was carried out to assess the knowledge of conjunctivitis among high school students in Pokhara valley of Western Nepal. Materials/ Methods: A school based cross sectional study was performed among six government schools in western Nepal from May 2019 to June 2019. Students from grade eight, nine and ten were included in the study. Data was collected using structured questionnaire including demographic data, knowledge regarding sign symptoms of conjunctivitis, treatment, prevention, complication of conjunctivitis. Data was analysed using SPSS version 11.6. Result: A total of 523 students were included in the study. The mean age of the students was 14.7 ± 1.2 years with majority of females (53%). Nearly 2/3rd of the students (61.6%) had heard of conjunctivitis. Majority of the students (87.4%) of the students mentioned that it is communicable while 80.3% of the students correctly mentioned its etiology. Majority of the students (97.9%) mentioned that it is curable with treatment as first option (97.5%). Majority of the students (98.3%) correctly responded to the preventive measures but majority of the students (83.2%) wrongly mentioned mode of transmission. Conclusion: Secondary school students in Western Nepal have poor knowledge of conjunctivitis. Appropriate eye health education should be given to school students to prevent rapid spread of infective conjunctivitis.  

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