Community Presentations of Anaphylaxis in Tasmania: Who is administering the adrenaline?

Background: Anaphylaxis is a significant health concern within the community. The early administration of adrenaline to patients experiencing anaphylaxis has long been recognised as the cornerstone of treatment. Health-care providers, including general practitioners, nurses and paramedics, are well equipped to manage anaphylaxis through the administration of adrenaline. Patients themselves also often have adrenaline auto injectors, allowing early self-management. The objective of this study was to determine the rates of adrenaline administration and identify the administering persons for all anaphylaxis patients presenting to ambulance services in Tasmania from January 1st 2008 until December 31st 2011 by using a retrospective chart review. Methods: Ambulance Tasmania electronic case reports (n=226 421) from the period January 1st 2008 to December 31st 2011 were searched for all cases fitting the parameters of anaphylaxis, allergy or allergic reaction. Of these cases, 373 were given a final paramedic diagnosis of anaphylaxis and constituted the primary data for this report. Results: Ambulance Tasmania attended 373 patients during the study period that were given a final primary diagnosis of anaphylaxis - of these 59 (15.8%) were excluded, leaving 314 electronic records for analysis. Of the cases identified, 71.7% (n=225) were administered adrenaline according to paramedic records. Adrenaline was administered by a range of health professionals, including general practitioners (n=27), paramedics (n=159), ambulance volunteers (n=4), nurses (n=1) and other health professionals (n=3). Adrenaline was self-administered by 12.4% (n=28) of patients, with an additional 11.6% (n=26) receiving adrenaline from a non-health care worker (layperson). In 10.2% of cases (n=23) adrenaline was administered by more than one provider. Administration of adrenaline prior to paramedic arrival was evident in fewer than 10% of cases treated with adrenaline (n=22). Conclusion: The early administration of adrenaline in anaphylaxis is often vital for patient recovery. This study shows that adrenaline is administered by a number of different providers, with early administration accounting for only 9.8% of presentations treated with adrenaline. These findings raise the question, is adrenaline being administered early enough and often enough to improve health outcomes?

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Health literacy of Samoan mothers and their experiences with health professionals

Journal of Primary Health Care ◽

10.1071/hc19026 ◽

2020 ◽

Vol 12 (1) ◽

pp. 57 ◽

Cited By ~ 1

Author(s):

Fofoa H. Pio ◽

Vili Nosa

Keyword(s):

Health Care ◽

Health Literacy ◽

General Practitioners ◽

Health Care Providers ◽

Health Professionals ◽

Care Delivery ◽

Shared Responsibility ◽

Care Providers ◽

Structured Interviews ◽

Open Communication

ABSTRACT INTRODUCTIONPatient and health professional engagement is a crucial factor for the effectiveness of service delivery and the management of care. Low health literacy amongst Pacific peoples is likely to affect their engagement with health professionals. AIMTo explore the health literacy of Samoan mothers and their experiences with health professionals in primary care. METHODSTwenty Samoan mothers and caregivers living in Auckland were interviewed about their experiences when engaging with health professionals. Semi-structured interviews guided by open-ended questions were conducted with individual participants in either Samoan or English. The interviews were recorded, transcribed and analysed. RESULTSA key finding was the significance of the health professionals’ role, in particular general practitioners, in providing resources and information to participants. Many participants recognised their general practitioner as their primary source of information. The findings revealed the negative experiences participants faced while engaging with general practitioners and shared how this affected their ability to manage care. Themes about enablers of open communication with health professionals included mothers understanding their rights as patients and being acknowledged as an expert on their child’s health. Themes about barriers to open communication with health professionals included limited consultation time, language barriers, medical jargon, closed answers, power relations and the shame associated with not fully understanding. DISCUSSIONThis research can inform health care engagement practices with patients. This study is relevant to health-care providers, development of health resources, health researchers evaluating health-care communications between providers and patients, to inform culturally appropriate and effective health-care delivery. The importance of shared responsibility in addressing issues of health literacy is noted, shifting the focus to everyone involved in providing and receiving information and in making decisions and managing care.

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New Syphilis Cases in Older Adults, 2004–2019: An Analysis of Surveillance Data From South China

Frontiers in Medicine ◽

10.3389/fmed.2021.781759 ◽

2021 ◽

Vol 8 ◽

Author(s):

Cheng Wang ◽

Peizhen Zhao ◽

Mingzhou Xiong ◽

Joseph D. Tucker ◽

Jason J. Ong ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Health Care Providers ◽

Temporal Trends ◽

Health Concern ◽

Targeted Prevention ◽

Care Providers ◽

Annual Percent Change ◽

Syphilis Infection ◽

Over Time

Background: Sexual health among older adults is a major public health concern globally. The syphilis burden is increasing in older adults in China. This study aimed to describe factors associated with syphilis infection and diagnosis among older adults in China during a 16 year period.Methods: Using 16 years of data (2004–2019) from the syphilis case report system of Guangdong, China, we compared data from older adults (aged ≥50 years) with those from younger people (aged 15–49 years). We compared the two age group with the Chi-square test for difference, and Joinpoint regression models to assess the temporal trends.Results: During the study period, 242,115 new syphilis diagnoses were reported in older adults. The mean notification rate of new diagnoses was 64.1 per 100,000 population across the entire 16-year period, which significantly increased over time (average annual percent change [AAPC] 16.2%, 95% CI 13.7–18.7). Syphilis diagnoses increased significantly over time among less developed cities and older women. In 2019, compared with younger adults, newly diagnosed older adults were more likely to be male, native to reporting city, had unknown transmission routes, and were diagnosed late.Conclusion: Our findings call for an urgent need to deliver more targeted prevention interventions for older adults, such as strengthen awareness among health care providers, and integration of syphilis services and primary health care for older adults.

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Providing gender-affirming hormone therapy through primary care: Service users' and health professionals' experiences of a pilot clinic

10.26686/wgtn.12693110.v1 ◽

2020 ◽

Author(s):

A Ker ◽

Gloria Fraser ◽

Antonia Lyons ◽

C Stephenson ◽

T Fleming

Keyword(s):

Primary Care ◽

Health Care ◽

New Zealand ◽

Hormone Therapy ◽

Health Care Providers ◽

Health Professionals ◽

Care Service ◽

Gender Diversity ◽

Service Users ◽

Care Providers

© 2020 CSIRO Publishing Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a. INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand. AIM: To evaluate service users' and health professionals' experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington's Student Health and Counselling Service) that provided gender-affirming hormones through primary care. METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were identified in service users' interviews, who discussed receiving affirming care due to the clinic's accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals' interviews, who described how the clinic involves partnership, affirms users' gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care. DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times.

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Level of physical activity and its correlates among health care workers in Ethiopia, 2019

10.21203/rs.2.19544/v1 ◽

2019 ◽

Author(s):

Tigist Demssew Adane ◽

Birhan Gebresillassie Gebregiorgis ◽

Elda Mekonnen Nigussie ◽

Abate Dargie Wubetu

Keyword(s):

Physical Activity ◽

Health Care ◽

Health Care Providers ◽

Health Care Workers ◽

Health Professionals ◽

Associated Factors ◽

P Value ◽

Care Providers ◽

Care Workers ◽

Study Participants

Abstract Background These days, engaging at sufficient regular physical activity strongly recommended for good health and physical functioning. Physical activity can increase the self-confidence of the health professionals and they would become fit for daily activities with patients. Knowing the level of physical activity can help health care professionals to plan for physical activity programs. This study aimed to measure the level of physical activity and associated factors among adult health professionals at Tirunesh Beijing general hospital.Objective The aim of this study was to assess the level of physical activity and associated factors among health care workers in Ethiopia, 2019.Methods Institution based cross-sectional study conducted level of physical activity and associated factors among health care workers in Ethiopia, 2019. Two hundred nighty seven adult health professionals were participated, which was a 97.4% response rate. The global physical activity questionnaire used to measure the level of physical activity. Descriptive statistics and binary logistic regression analyses was done to affirm the variables characteristics. A predictor variable with a p-value of less than 0.2 exported to multivariate analysis. During multivariate analysis, statistical significance declared at a p-value of < 0.05.Results In general, the majority of the study participants, 89.2% (95% CI: 85.9-92.6) were achieved recommended levels of physical activity. Regarding the intensity of the physical activity, the overall mean time score was 518.4 mints per week or 2352.6 MET/week. For moderate-intensity physical activity, 83.5% of the study participants were physically active, (≥150 minutes/week). In the case of vigorous activity, about 32.7% of the study participants were physically active and engaged in vigorous physical activity (≥75 minutes /week). The study participants, who had self-motivation for physical activity, had a BMI of less than 25 kg/m2 and aged < 40 years were physically active.Conclusions Health care providers’ habit of physical activity improved as compared with the previous studies. However, the current level of physical activity of health professionals is not adequate. Health care providers’ age, body mass index and self-motivation attribute to physical activity. The level of physical activity can increase by enhancing staff motivation towards physical activity.

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Disclosure of herbal medicine use to health care providers among pregnant women in Nepal: a cross-sectional study

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03142-9 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mansoor Ahmed ◽

Hyea Bin Im ◽

Jung Hye Hwang ◽

Dongwoon Han

Keyword(s):

Health Care ◽

Herbal Medicine ◽

Pregnant Women ◽

Health Care Providers ◽

Healthcare Providers ◽

Cross Sectional Study ◽

Health Concern ◽

Care Providers ◽

Sectional Study ◽

Cross Sectional

Abstract Background Pregnant women’s disclosure of herbal medicine (HM) use to their health care providers during pregnancy is crucial, as misuse of HM can have a detrimental effect on both pregnant woman and the fetus. However, the lack of disclosure of HM use to physicians remains a public health concern in developing countries such as Nepal. Methods A cross-sectional study was conducted among 400 postpartum women admitted at Maternity and Women’s Hospital located in Kathmandu, Nepal. The survey instrument included 30 questions on the use of HM during pregnancy, sociodemographic and health characteristics, and pregnancy outcomes. Chi-square test and logistic regression were conducted for data analysis using SPSS ver. 21.0., and a p-value of less than 0.05 was considered statistically significant for all analyses. Results 60.3% of respondents used at least one herbal remedy during their previous pregnancy, and the overall disclosure rate of HM use to healthcare providers was 54.6%. Women with secondary education level and four or more antenatal care visits were more likely to disclose their HM use to healthcare providers. Conclusions This study highlights that despite the popular use of HM among pregnant women in Nepal, most women obtained HM-related information from informal sources and did not disclose their HM use to physicians. To ensure the safe use of HM, physicians should integrate questions regarding patients’ HM use into their routine patient assessments to facilitate active communication and improve the quality of care.

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Hispanics, Mental Health, and Suicide: Brief Report

Hispanic Health Care International ◽

10.1177/1540415319843072 ◽

2019 ◽

Vol 17 (3) ◽

pp. 133-136 ◽

Cited By ~ 2

Author(s):

Francisco Brenes

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Providers ◽

Hispanic Americans ◽

Social Issues ◽

The United States ◽

Health Concern ◽

Care Providers ◽

Provider Attitudes ◽

Health Crisis

A global health crisis exists surrounding suicide. In the United States, suicide rates have increased by nearly 30% in most states since 1999. Although the suicide rate among Hispanic Americans is significantly lower than non-Hispanic Whites, reasons for the lower rate are unclear. Current literature suggests that the lower rate may be due to underreporting, a lack of suicide screening and a number of complex social issues, including the stigma surrounding suicide in Hispanic culture. Health care provider attitudes toward suicidal individuals may also negatively affect mental health outcomes. This brief report focuses on suicide as a public health concern, addresses key issues arising from the phenomenon, and provides a perspective on health care providers’ attitudes toward suicide. Recommendations for future research, as well as implications for clinical practice and policy, are suggested.

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Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions

The Canadian Journal of Psychiatry ◽

10.1177/0706743716684793 ◽

2016 ◽

Vol 62 (6) ◽

pp. 374-380 ◽

Cited By ~ 30

Author(s):

Dorothy L. Espelage ◽

Jun Sung Hong

Keyword(s):

Health Care ◽

Health Care Providers ◽

Current Knowledge ◽

Online Communication ◽

Health Concern ◽

Current Status ◽

Future Research ◽

Care Providers ◽

Prevention And Intervention ◽

Technological Advances

Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents’ use of social media, and online communication platforms have exposed adolescents to another mode of bullying— cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

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Farmers’ contact with health care services prior to suicide: evidence for the role of general practitioners as an intervention point

Australian Journal of Primary Health ◽

10.1071/py13077 ◽

2015 ◽

Vol 21 (1) ◽

pp. 102 ◽

Cited By ~ 7

Author(s):

Katerina Kavalidou ◽

Samara McPhedran ◽

Diego De Leo

Keyword(s):

Mental Health ◽

Health Care ◽

General Practitioners ◽

Health Care Providers ◽

Health Care Services ◽

Agricultural Workers ◽

Health Providers ◽

Care Providers ◽

Care Services ◽

Intervention Point

Suicide in Australian rural communities has received significant attention from researchers, health practitioners and policymakers. Farmers and agricultural workers have been a focus of particular interest, especially in relation to levels of help seeking for mental health concerns. A less explored area, however, is the level of contact that Australian farming and agriculture workers who die by suicide have had with health providers for physical, rather than mental, health conditions. It is often assumed that farmers and agricultural workers have lower levels of contact with health care services than other rural residents, although this assumption has not been well tested. Using data from the Queensland Suicide Register, this paper describes levels of contact with health care providers in the 3 months before death by suicide among men in farming and agriculture occupations and other occupations in rural Queensland. No significant differences were found in farming and agricultural workers’ levels of contact with a general practitioner when compared with other rural men in Queensland. The current findings lend weight to the view that rural general practitioners represent an important intervention point for farming and agriculture workers at risk of suicide (whether or not those individuals exhibit accompanying psychiatric illness).

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Are Fenestrated Tracheostomy Tubes Still Valuable?

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0187 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1019-1028

Author(s):

Vinciya Pandian ◽

Sarah E. Boisen ◽

Shifali Mathews ◽

Therese Cole

Keyword(s):

Health Care ◽

Patient Safety ◽

Health Care Providers ◽

Tracheostomy Tube ◽

Chart Review ◽

Retrospective Chart Review ◽

Primary Reason ◽

Care Providers ◽

Airway Protection ◽

Tracheostomy Tubes

Purpose The purpose of this clinical focus article is to describe the frequency, indications, and outcomes of fenestrated tracheostomy tube use in a large academic institution. Method A retrospective chart review was conducted to evaluate the use of fenestrated tracheostomy tubes between 2007 and 2017. Patients were included in the study if they were ≥ 18 years of age and received a fenestrated tracheostomy tube in the recent 10-year period. Results Of 2,000 patients who received a tracheostomy, 15 patients had a fenestrated tracheostomy tube; however, only 5 patients received a fenestrated tracheostomy tube at the study institution. The primary reason why the 15 patients received a tracheostomy was chronic respiratory failure (73%); other reasons included airway obstruction (20%) and airway protection (7%). Thirteen (87%) patients received a fenestrated tracheostomy tube for phonation purposes. The remaining 2 patients received it as a step to weaning. Of the 13 patients who received a fenestrated tracheostomy tube for phonation, only 1 patient was not able to phonate. Nine (60%) patients developed some type of complications: granulation only, 2 (13.3%); granulation and tracheomalacia, 2 (13.3%); granulation and stenosis, 4 (26.7%); and granulation, tracheomalacia, and stenosis, 1 (6.7%). Conclusions Fenestrated tracheostomy tubes may assist with phonation in patients who cannot tolerate a 1-way speaking valve; however, the risk of developing granulation tissue, tracheomalacia, and tracheal stenosis exists. Health care providers should be educated on the safe use of a fenestrated tracheostomy tube and other options available to improve phonation while ensuring patient safety.

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Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

BioMed Research International ◽

10.1155/2020/8412957 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Abel Mekonne ◽

Benyam Seifu ◽

Chernet Hailu ◽

Alemayehu Atomsa

Keyword(s):

Health Care ◽

Health Insurance ◽

Willingness To Pay ◽

Health Care Providers ◽

Health Professionals ◽

Addis Ababa ◽

Social Health Insurance ◽

Social Health ◽

Care Providers ◽

The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

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