scholarly journals Health Concerns of Adolescents and Adults With Spina Bifida

2021 ◽  
Vol 12 ◽  
Author(s):  
Jessica Starowicz ◽  
Caitlin Cassidy ◽  
Laura Brunton
Keyword(s):  
Spina Bifida ◽  
Health Care Providers ◽  
Clinical Service ◽  
Transition To Adult Care ◽  
Care Providers ◽  
Coordinated Care ◽  
Health Concerns ◽  
Medical Needs ◽  
Number Of Patients ◽  
Adolescents And Adults

Due to advancements in medical care, people with spina bifida (SB) are surviving well into adulthood, resulting in a growing number of patients transitioning to an adult sector unequipped to care for people with chronic rehabilitative and medical needs. The Transitional and Lifelong Care (TLC) program is a multidisciplinary clinical service that compensates for this gap, providing comprehensive, coordinated care to adolescents, and adults with SB. As a relatively new clinical service, objective data about the patients using the service and their needs is scant. This study sought to identify the most common health concerns among TLC patients with SB at initial clinical consultation. A retrospective chart review of 94 patient charts was performed. Following data extraction, descriptive analyses were completed. The mean age of the sample was 29.04 ± 13.8 years. One hundred individual concerns and 18 concern categories were identified. On average, patients or care providers identified nine health concerns across various spheres of care, with care coordination being the most prevalent concern identified (86%). Patients also commonly had concerns regarding neurogenic bladder (70%), medications (66%), assistive devices (48%), and neurogenic bowel (42%). The numerous and wide-ranging health concerns identified support the need for individualised, coordinated care and a “medical home” for all adolescents and adults with SB during and following the transition to adult care. Health care providers caring for this population should continue to address well-documented health concerns and also consider raising discussion around topics such as sexual health, mental health, and bone health. Further research is required to understand how best to address the complex medical issues faced by adults with SB to maximise health and quality of life and improve access to healthcare.

The Special Perils of Being Old and Sick in Prison

2020 ◽  
Vol 32 (5) ◽  
pp. 276-284
Author(s):  
William J. Jefferson
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
The United States ◽  
United States Constitution ◽  
Care Providers ◽  
Medical Practitioners ◽  
Medical Needs ◽  
Access To Medical Care

The United States Supreme Court declared in 1976 that deliberate indifference to the serious medical needs of prisoners constitutes the unnecessary and wanton infliction of pain…proscribed by the Eighth Amendment. It matters not whether the indifference is manifested by prison doctors in their response to the prisoner’s needs or by prison guards intentionally denying or delaying access to medical care or intentionally interfering with treatment once prescribed—adequate prisoner medical care is required by the United States Constitution. My incarceration for four years at the Oakdale Satellite Prison Camp, a chronic health care level camp, gives me the perspective to challenge the generally promoted claim of the Bureau of Federal Prisons that it provides decent medical care by competent and caring medical practitioners to chronically unhealthy elderly prisoners. The same observation, to a slightly lesser extent, could be made with respect to deficiencies in the delivery of health care to prisoners of all ages, as it is all significantly deficient in access, competencies, courtesies and treatments extended by prison health care providers at every level of care, without regard to age. However, the frailer the prisoner, the more dangerous these health care deficiencies are to his health and, therefore, I believe, warrant separate attention. This paper uses first-hand experiences of elderly prisoners to dismantle the tale that prisoner healthcare meets constitutional standards.

scholarly journals Nurses' performance on hospital discharge: patients' point of view

2007 ◽  
Vol 20 (3) ◽  
pp. 345-350 ◽  
Author(s):  
Daniele Alcalá Pompeo ◽  
Maria Helena Pinto ◽  
Claudia Bernardi Cesarino ◽  
Renilda Rosa Dias Ferreira de Araújo ◽  
Nadia Antonia Aparecida Poletti
Keyword(s):  
Health Care ◽  
Hospital Discharge ◽  
Health Care Providers ◽  
Clinical Care ◽  
Educational Process ◽  
Discharge Process ◽  
Care Providers ◽  
Discharge Instructions ◽  
Effective Discharge ◽  
Number Of Patients

OBJECTIVE: To know the hospital discharge process in place and the nurses' performance in preparing patients for discharge. METHODS: A descriptive study using semi-structured interviews was used to collect data from 43 patients of medical-surgical units of a major teaching hospital in the state of São Paulo, Brazil. RESULTS: The majority of patients (83.72%) received tailored discharge instructions. However, a great number of patients (72.08%) reported discharge instructions were not given by nurses. Almost a half of patients (48.84%) reported that discharge instructions were given by their physicians. CONCLUSION: The findings of this study provide insights to improve the educational process of new nurses and their preparation to provide effective discharge instructions. There is also a need to design and implement a hospital discharge process that promotes the participation of interdisciplinary health care providers who are involved in patient clinical care. This discharge process might be an effective way to change health care providers' attitude toward discharge instructions.

Health Care Services in Shopping Centers: A Routine Mass-Gathering Event

2020 ◽  
Vol 35 (6) ◽  
pp. 669-675
Author(s):  
Mehmet Ali Ceyhan ◽  
Gültekin Günhan Demir
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Shopping Centers ◽  
Medical Conditions ◽  
Care Providers ◽  
Care Services ◽  
Number Of Patients ◽  
Number Of Customers

AbstractBackground:Shopping centers (SCs) are social areas with a group of commercial establishments which attract customers of numerous people every day. However, analysis of urgent health conditions and provided health care in SCs has not been performed so far.Objective:The aim of the study was to perform a comparative analysis of clients visiting SCs and demographics, complaints, and health care of patients admitted to Emergency Medical Intervention Units (EMIU) located in grand SCs in Ankara, Turkey.Methods:Customer and health care records of nine grand SCs in Ankara from January 1, 2018 through December 31, 2018 were evaluated retrospectively. Health care services in EMIUs of SCs were provided by employed medical staff. Data including demographic characteristics, complaints, treatment protocols, discharge, and referral to hospital of the patients were retrospectively analyzed from medical registration forms.Results:Medical records of nine grand SCs were analyzed. Number of customers could not be obtained in three SCs due to privacy issues and were not included in patient presentation rate (PPR) and transport-to-hospital rate (TTHR) calculation. Total number of customers in the remaining six SCs were 53,277,239. The total number of patients seeking medical care was 6,749. The number of patients seeking health care in six SCs with known number of customers was 4,498 and PPR ranged from 0.018 to 0.381 patients per 1,000 attendants. The median age of the recorded 4,065 patients (60.2%) was 28 (interquartile range [IQR]: 38-21), and 3,611 (53.5%) of the patients admitted to EMIUs were female. The number of patients treated in the SC was 4,634 (68.6%) and 189 patients (2.8%) were transferred-to-hospital by ambulance for further evaluation and treatment. Transportation to hospital was required in 125 patients who sought medical care in six SCs which provided total number of customers, and TTHR ranged from 0.000 to 0.005 patients per 1,000 attendants. No sudden cardiac death was seen. Medical conditions were the primary reasons for seeking health care. The most frequent causes of presentation were laceration and abrasions (639 patients, 9.4%).Conclusion:The PPR and TTHR in SCs are low. The most common causes of presentation are minor conditions and injuries. Majority of urgent medical conditions in SCs can be managed by health care providers in EMIUs.

scholarly journals Challenges and approaches to implementing master/basket trials in oncology

2019 ◽  
Vol 3 (14) ◽  
pp. 2237-2243 ◽  
Author(s):  
Amy Burd ◽  
Richard L. Schilsky ◽  
John C. Byrd ◽  
Ross L. Levine ◽  
Vassiliki A. Papadimitrakopoulou ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Therapeutic Option ◽  
Clinical Trial Design ◽  
Care Providers ◽  
Rare Mutation ◽  
Medical Institutions ◽  
Number Of Patients ◽  
The Right ◽  
Tumor Types ◽  
Basket Trials

Abstract The appetite for cutting-edge cancer research, across medical institutions, scientific researchers, and health care providers, is increasing based on the promise of true breakthroughs and cures with new therapeutics available for investigation. At the same time, the barriers for advancing clinical research are impacting how quickly drug development efforts are conducted. For example, we know now that under a microscope, patients with the same type of cancer and histology might look the same; however, the reality is that most cancers are driven by genomic, transcriptional, and epigenetic changes that make each patient unique. Additionally, the immunologic reaction to different tumor types is distinct among patients. The challenge for researchers developing new therapies today is vastly different than it was in the era of cytotoxics. Today, we must identify a sufficient number of patients harboring a rare mutation or other characteristic and match this to the right therapeutic option. This summary provides a guide to help inform the scientific cancer community about the benefits and challenges of conducting umbrella or basket trials (master trials), and to create a roadmap to help make this new and evolving form of clinical trial design as effective as possible.

Why Do Patients Choose Chemotherapy Near the End of Life? A Review of the Perspective of Those Facing Death From Cancer

2006 ◽  
Vol 24 (21) ◽  
pp. 3490-3496 ◽  
Author(s):  
Robin Matsuyama ◽  
Sashidhar Reddy ◽  
Thomas J. Smith
Keyword(s):  
Health Care ◽  
Adverse Effects ◽  
End Of Life ◽  
Health Care Providers ◽  
Decision Aids ◽  
Good Choice ◽  
Care Providers ◽  
Number Of Patients ◽  
Small Benefit ◽  
Realistic Information

Purpose The number of patients receiving chemotherapy near the end of life is increasing, as are concerns about goals of treatment, toxicity, and costs. We sought to determine the available sources of knowledge, the choices, and concerns of actual patients, and how patients balanced competing issues. Methods We used a literature search from 1980 to present. Results Available patient sources provide little information about prognosis, choices, alternatives, consequences, or how to choose. Many patients would choose chemotherapy for a small benefit in health outcomes, and for a smaller benefit than perceived by their health care providers for their own treatment. Adverse effects are less a concern for patients than for their well health care providers. There are no decision aids to assist patients with metastatic disease in making their choices, such as there are for adjuvant breast therapy. Conclusion The perspective of the patient is different from that of a well person. Patients are willing to undergo treatments that have small benefits with major toxicity. Receiving realistic information about the different options of care and the likelihood of successful treatment or adverse effects is difficult. These factors may explain some of the increased use of chemotherapy near the end of life. Decision aids and honest, unbiased sources to inform patients of their prognosis, choices, consequences, typical outcomes, and ways to make decisions are needed. More prospective information about how patients make their choices, and what they would consider a good choice, would assist informed decision making.

scholarly journals A Needs Assessment of Latino Men’s Health Concerns

2008 ◽  
Vol 4 (1) ◽  
pp. 22-32 ◽  
Author(s):  
Terry Peak ◽  
Julie Gast ◽  
Denice Ahlstrom
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Information ◽  
Health Care Providers ◽  
Low Cost ◽  
Care Providers ◽  
Latino Men ◽  
Health Concerns ◽  
Traditional Health ◽  
The Impact

Historically, Latino men are an understudied group. Researchers know little about the impact of culture or gender on health concerns. In this study, focus groups with Latino men were held that investigated their health concerns, barriers, motivators, and access to health information and health services. Additionally, the researchers wished to determine if a church-based design might help reach men who might not be responsive to more traditional health education or public health routes. Results included that the Latino male participants in this study wanted health information but wanted it to be more specific and in an accessible format. They also desired more Spanish-speaking health care providers and were acutely interested in low-cost health care. Prevention was not of much interest to these participants. Church-attending participants were interested in church-based health education.

scholarly journals Number needed to treat: A primer for neurointerventionalists

2019 ◽  
Vol 25 (6) ◽  
pp. 613-618 ◽  
Author(s):  
Juan Carlos Martinez-Gutierrez ◽  
Thabele Leslie-Mazwi ◽  
Ronil V Chandra ◽  
Kevin L Ong ◽  
Raul G Nogueira ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Mechanical Thrombectomy ◽  
Clinical Trial Data ◽  
Number Needed To Treat ◽  
Care Providers ◽  
Key Stakeholders ◽  
Number Of Patients ◽  
Study Results ◽  
Statin Drugs

Background The number needed to treat is a commonly used statistical term in modern neurointerventional practice. It represents the number of patients that need to be treated for one patient to benefit from an intervention. Given its growing popularity in reflecting study results, understanding the basics behind this statistic is of practical value to the neurointerventionalist. Methods Here, we review the basic theory and calculation of the number needed to treat, its application to stroke interventions, and its limitations. In addition, we demonstrate several simple methods of calculating the number needed to treat utilizing recent thrombectomy trial results. By presenting the number needed to treat as a universal metric, we provide a comprehensive comparative of the number needed to treat for key stroke therapies, including mechanical thrombectomy, tissue plasminogen activator, carotid endarterectomy, and prevention with antiplatelet and statin drugs. Conclusions In comparison with available stroke therapies, mechanical thrombectomy stands out as the most effective acute intervention in patients with emergent large-vessel occlusions. Understanding how the number needed to treat is derived and its implications helps provide perspective to clinical trial data, identify health-care resource priorities, and improve communication with patients, health-care providers, and additional key stakeholders.

scholarly journals Psychosexual Care of Adolescent and Young Adult (AYA) Cancer Survivors

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1058
Author(s):  
Laura Reinman ◽  
Helen L. Coons ◽  
Jenna Sopfe ◽  
Robert Casey
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Sexual Health ◽  
Health Care Providers ◽  
Adolescent And Young Adult ◽  
Medical Team ◽  
Care Providers ◽  
Medical Needs ◽  
Contextual Framework ◽  
Open Discussion

Adolescent and young adult (AYA) survivors of cancer have diverse psychosocial and medical needs, including those related to fertility and sexual health. Much of the focus of care around issues such as fertility and sexual health tends to be filtered through a biomedical lens. However, it is essential that health care providers assess and support AYA survivors using a biopsychosocial and contextual framework to ensure the most comprehensive and accurate understanding of AYA survivor needs, especially those related to psychosexual health. A trusting relationship between the multi-disciplinary medical team and the AYA survivor that allows for open discussion about the physical and psychosocial components of sexual health is key to providing best care and outcomes.

scholarly journals Evaluating usability, effectiveness, and usage of telehealth technologies

2014 ◽  
Author(s):  
◽  
Mirna Becevic
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Health Care Providers ◽  
New Technologies ◽  
Care Delivery ◽  
Traditional Approach ◽  
Additional Stress ◽  
Care Providers ◽  
Medical Specialties ◽  
Number Of Patients

Affordable Care Act (ACA) has allowed more patients that did not previously have health care insurance to have coverage and access to care. This increase in the number of patients seeking medical care will only add additional stress to the existing disproportion of supply and demand for health care providers. In addition, rising health care costs have major effect on how, where, and even if consumers will get needed care. This study examined three different telehealth platforms in three different medical specialties in order to evaluate the perception that they would be appropriate vehicles for increasing access to care. I also wanted to find out what the users' perceptions of these technologies are, as that can be a driving factor in adoption of new technologies. The first study examined the usability and acceptance of new mobile application in teledermatology clinic. The second study focused on usability and acceptance of ICU Robots in a medical ICU. Finally, the third study evaluated if children and youth currently using telepsychiatry as a care delivery method would have other in-person options if telehealth was not available. The results of these three studies point at the complexity and richness of telehealth. The adoption and acceptance of mHealth was very fast and streamlined. In the same fashion, children might not have other appropriate options for care if telepsychiatry was not available in rural Missouri. Interestingly, though, the provider acceptance of ICU Robots was slow, with some provider disengagements observed. This research contributes to the field of health informatics and medical informatics by evaluating adoption and usability of technologies from the provider perspective, vs. the more traditional approach of examining patient satisfaction, or even provider satisfaction without fully understanding the implications of attitudes on the adoption itself. This study has focused purposefully on different groups of providers using different types of telehealth technologies so we could try to see the bigger picture of how telehealth actually contributes to the health care organizational structure.

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