scholarly journals Use of Salt-Restriction Spoons and Its Associations with Urinary Sodium and Potassium in the Zhejiang Province of China: Results of a Population-Based Survey

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1047
Author(s):  
Xiaofu Du ◽  
Di Zhao ◽  
Megan E. Henry ◽  
Le Fang ◽  
Jianwei Xu ◽  
...  

In China, a major source of sodium is salt added during cooking. In this context, use of a salt-restriction spoon (SRS) has been promoted in public health campaigns and by health care providers. To describe use of and factors associated with SRS use, knowledge of correct use, and actual correct use. This study is a population-based, representative survey of 7512 residents, aged 18 to 69 years, of China’s Zhejiang Province. The survey, which was conducted in 2017 using a multistage random sampling strategy, collected demographic information, SRS use, and physical measurements; a 24-h urine collection was obtained from 1,496 of the participants. The mean age of the participants was 44.8 years, 50.1% were females, and over 1/3 (35.3%) were classified as hypertensive. Mean 24-h urinary sodium and potassium excretions were 167.3(72.2) mmol/24 h and 38.2(18.2) mmol/24 h, respectively. Only 12.0% (899/7512) of participants once used or were currently using SRS; of the 899 users, 73.4% knew how to use the SRS correctly, and just 46.5% actually used it correctly. SRS use was more commonly associated with behavioral factors rather than socio-demographic factors. Initiation of SRS use by health care providers was associated with correct technical knowledge of SRS. Lower sodium-to-potassium ratio was associated with SRS use, while SRS use was not associated with urinary sodium and potassium excretion. Use of SRS was uncommon in Zhejiang Province of China. Given that a common source of sodium in China is salt added during cooking, use of SRS is an appealing strategy, ideally as part of a multi-component campaign.

Author(s):  
Megan B. Sands ◽  
Dianne L. O’Connell ◽  
Michael Piza ◽  
Jane M. Ingham

Despite the advances of modern medicine, many illnesses continue to evade cure. Chronic, progressive, incurable illness is a major cause of disability, distress, suffering, and, ultimately, death. This is true for many causes of cancer, progressive neurological disorders, AIDS, and other disorders of vital organs. Progressive chronic diseases of this ilk are most common in late adulthood and old age, but they occur in all ages. When cure is not possible, as often it is not, the relief of suffering is the cardinal goal of medicine. The clinical imperative to relive suffering requires a nuanced understanding of the factors that contribute to suffering and the interaction between the distress of the patient, family members, and health-care providers. This chapter reviews those concepts and offers an approach to the evaluation of suffering for patients requiring palliative care.


2007 ◽  
Vol 2 (3) ◽  
pp. 208-210 ◽  
Author(s):  
Valery L. Feigin ◽  
Harry McNaughton ◽  
Lorna Dyall

Studying ethnic particularities of stroke epidemiology may not only provide a clue to the causes of the observed racial/ethnic differences in stroke mortality but is also important for appropriate, culturally specific health care planning, prevention in stroke and improved health outcomes. This overview of published population-based stroke incidence studies and other relevant research in the multi-ethnic New Zealand population demonstrates an obvious ethnic disparity in stroke in New Zealand, with the greatest and increasing burden of stroke being imposed on Maori, who are indigenous, and Pacific people, who have migrated and settled in this country. These data warrant urgent and effective measures to be undertaken by health policy makers and health care providers to reverse the unfavourable trends in stroke and improve Maori and Pacific people's health.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S609-S609
Author(s):  
Alberto Zucchelli ◽  
Davide Vetrano ◽  
Giulia Grande ◽  
Amaia Calderon-Larranaga ◽  
Laura Fratiglioni ◽  
...  

Abstract Several indicators associated with poor outcomes in older persons have been developed, but a direct comparison of their accuracy is lacking. Knowing which indicator performs better in the prediction of specific outcomes could help health care providers to choose the most suitable one. We compared the accuracy in predicting different clinically-relevant outcomes of five indicators: frailty index (FI), frailty phenotype (FP), the Health Assessment Tool (HAT), walking speed (WS), and multimorbidity. Data from the Swedish National Study on Aging and Care in Kungsholmen, an ongoing population-based study including 3363 people 60+, were used. The ability of the five indicators to predict mortality (3- and 5-year), unplanned hospitalizations (1- and 3-year), and 2+ health provider contacts (6 months prior and after assessment) was compared using the area under the ROC curves (AUC). FI, WS, and HAT showed the best accuracy in the prediction of mortality (AUC for 3-year mortality: 0.84, 0.85, 0.87 respectively; AUC for 5-year mortality: 0.84, 0.85, 0.86 respectively; all p < 0.05). Unplanned hospitalizations were better predicted by the FI (AUC: 1-year 0.73; 3-year 0.72) and HAT (AUC: 1-year 0.73; 3-year 0.71).The most accurate predictor of multiple contacts with health providers was multimorbidity (AUC: 0.67; p < 0.05). All indicators, but multimorbidity, showed higher accuracy among older individuals (75+ years). Different indicators can be used to support physicians during their decision-making process. Some of these tools may also be used to forecast future use of health-care resources, including both hospital-based services and outpatient ones .


Author(s):  
Hoda Fathy ◽  
Raghda El-Hawy ◽  
Raghda Hassan

Aims: To show the levels of awareness, attitude, practices and socioeconomic factors related to consuming herbal products among Alexandrian citizen visiting pharmacies. The findings of this study are meant also to show the practices and beliefs of healthcare providers regarding using herbal remedies in treatment, including advising patients, reporting adverse effects and possessing knowledge about specific herb-drug interactions. Study Design:  people visiting pharmacies as well as pharmacists in their pharmacies and physicians in their clinics were invited to complete a questionnaire about their knowledge and personal experience in the consumption of herbal remedy. Anonymity was guaranteed. Questionnaire consists of three parts: demographic data, personal experience and a part concerning health care providers. Place and Duration of Study: Study area is the city of Alexandria, Egypt from the 1st July through September 2018. Methodology: This is a descriptive cross-sectional study that used a self-administered, questionnaire from 213 participants (153+ 60 health care providers HCPs). Results: Almost half the respondents preferred to be treated with herbs because they believed that herbs are safe. But they are not the proper choice to cure chronic diseases. Only 25% of herb users recorded suffering from side effects. The most common source of information about herbs was via internet, followed by family and friends, television and other types of media. Herbal remedies were purchased mainly from outlets other than pharmacies. The willingness to buy such products was not affected by participants’ education level or their monthly income. The public didn’t feel it’s important to mention any herbal remedy they consume to their physician; similarly HCPs did not ask them. Generally, it was shown that HCPs have inadequate knowledge about herbs. Conclusion: The prevalence of herb usage is moderate among the Alexandrian population. And it is imperative to educate HCPs about the benefits, risks and interactions of herbal supplements.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 53s-53s
Author(s):  
A. Kedar ◽  
R. Hariprasad ◽  
R. Kanan ◽  
R. Mehrotra

Background: India is facing noncommunicable diseases epidemic with cancer as one of the main reasons of mortality. To bring this epidemic under control and as a measure of secondary prevention, government of India has rolled out operational framework for population cancer screening. As cancer screening is a new concept for Indian health care providers, this study focuses on the attitudes and perceptions of HCP from a district in Assam. Aim: To know the attitudes and perceptions of healthcare providers in Assam about the implementation of population based cancer screening program in India. Methods: This study was a part of ongoing Indian Council of Medical Research project at Cachar district, Assam. The study was conducted at Silchar, Assam and the study participants were attendees of the master trainers' workshop which was conducted for the pilot cancer screening program rolled out in Cachar district, Assam. Self-administered questionnaires were used to collect data from the health care providers on the last day of the training. Data were gathered from 58 participants. The participants were medical officers, auxillary nurse midwives (ANM), accredited social health activists (ASHA), staff nurses, nongovernmental organization (NGO) representatives and other health care providers from public health facilities. Results: Majority of the study participants agreed with the concept of screening. Half of the study participants stated that they could conduct screening comfortably along with their other responsibilities. Lack of human resources and an overburdened human resource were the main challenges foreseen in the implementation of the program. 91% of the participants wanted GOI to implement the cancer screening program. Majority of the health personnel were in favor of primary health center (PHC) as the first preferable site of population cancer screening followed by subcenter being second on preference for screening. One-third of study participants opined that screening should be done by specialist doctors. Almost one fifth of participants stated that ASHA should do the screening and almost same number of participants thought that medical officer at PHC should do the screening. Conclusion: This is the first pilot study on the population based cancer screening guidelines released by the government of India. The organized screening program is yet to be rolled out in the country. Though many challenges were foreseen by the healthcare providers in carrying out the population based cancer screening, majority were optimistic for the implementation of this screening program.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 160s-160s
Author(s):  
R. Hariprasad ◽  
R. Babu ◽  
S. Arora ◽  
R. Mehrotra

Background and context: Three most common cancers in India are breast, uterine cervix and oral cavity, together accounting for approximately 34% of all cancers. Ministry of Health and Family Welfare, India has released an operational guidelines for cancer screening last year and has urged all the states to roll out population based cancer screening at various health care levels. As per these guidelines, the existing health care providers (HCPs) at various facilities would be rolling out the population based cancer screening in the country. However, the existing HCPs lack the skills and are not trained in cancer screening. Considering the size of the country, it is neither a feasible nor economically viable to provide in-person training for all cadres of HCPs. The limitation is comprehensively overcome by ECHO (Extension for Community Healthcare Outcomes) model provides a cost effective way to exponentially expand the capacity to mentor and train these HCPs in cancer screening best practices. ECHO as per the motto to “move knowledge rather than patients or doctors”, uses widely available one to many video-conferencing technology, didactic presentations and case based learning techniques to mentor and support HCPs to implement best practices in the field. In teleECHO clinics expert teams at an academic “hub” partner with willing participants to participate in knowledge networks in which all teach and all learn. Aim: To train the health care providers in cancer screening through technology assisted learning. Strategy/Tactics: A structured training program was designed using ECHO platform for all HCPs in separate batches that included, gynecologists, dentists and community health workers (CHWs), by virtual training to address all issues while they roll out cancer screening in their communities. Program/Policy process: A structured course of 20 week-sessions' virtual (online) cancer screening training program for various cadres of health care providers was undertaken. A typical one hour of ECHO session consisted of 25-30 minutes of didactics by the expert followed by 2 case presentations by the spokes. A “Beginner´s program” was well received by the participants who requested us to take it ahead with “Advanced training program” for specialists. Outcomes: 58 participants completed the course in cancer screening. The pre- and posttraining knowledge evaluation demonstrated a significant increase in the knowledge gained by participants. What was learned: In a resource constrained environment it is feasible to develop a basic curriculum in cancer screening program and train and support, all cadres of HCPs. Rolling out a technology enabled model such as ECHO for teaching and training can enable the development of a population based cancer screening program.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0249998
Author(s):  
Mamadou Dioulde Balde ◽  
Sarah O’Neill ◽  
Alpha Oumar Sall ◽  
Mamadou Bailo Balde ◽  
Anne Marie Soumah ◽  
...  

Background Guinea has a high prevalence of female genital mutilation (FGM) (95%) and it is a major concern affecting the health and the welfare of women and girls. Population-based surveys suggest that health care providers are implicated in carrying out the practice (medicalization). To understand the attitudes of health care providers related to FGM and its medicalization as well as the potential role of the health sector in addressing this practice, a study was conducted in Guinea to inform the development of an intervention for the health sector to prevent and respond to this harmful practice. Methodology Formative research was conducted using a mixed-methods approach, including qualitative in-depth interviews with health care providers and other key informants as well as questionnaires with 150 health care providers. Data collection was carried out in the provinces of Faranah and Labé and in the capital, Conakry. Results The majority of health care providers participating in this study were opposed to FGM and its medicalization. Survey data showed that 94% believed that it was a serious problem; 89% felt that it violated the rights of girls and women and 81% supported criminalization. However, within the health sector, there is no enforcement or accountability to the national law banning the practice. Despite opposition to the practice, many (38%) felt that FGM limited promiscuity and 7% believed that it was a good practice. Conclusion Health care providers could have an important role in communicating with patients and passing on prevention messages that can contribute to the abandonment of the practice. Understanding their beliefs is a key step in developing these approaches.


Author(s):  
Lisa Ishiguro ◽  
Refik Saskin ◽  
J. Charles Victor

ABSTRACTBackgroundThe Institute for Clinical Evaluative Sciences (ICES) is a not-for-profit organization that conducts research to evaluate health care delivery and outcomes. Established in 1992, ICES houses a vast and secure array of linkable, coded health-related data on more than 13 million Ontarians, including health services data, health care provider data, registries and population-based health surveys. ICES has a reputation for generating strong evidence-based knowledge to inform policy and practice, however the use of the data was restricted to ICES’ purposes. In March 2014, ICES launched the Data & Analytic Services (DAS) platform with the primary objective of increasing access to its data to publicly-funded researchers, health care providers and administrators, policymakers and students. MethodDAS provides access to highly de-identified, risk-reduced datasets created from ICES’ data holdings; analytic support; and complete data analysis and report writing services. DAS also enables the importation of external data for linkage to ICES’ data holdings. Research objectives and methodology are led by the requestor and ICES analysts rely on their subject matter expertise to direct the deliverables. ResultsSince launch, over 200 requests from Canada, United States and United Kingdom have been adjudicated, of which 187 have been deemed feasible and eligible. Over the same period of time, ICES as an organization had over 700 active projects of which 348 were initiated, an increase in capacity of 26%. Though Toronto-based researchers represent the majority of the requests (62%), there have been requests from outside Ontario interested in comparing aspects of Ontario’s healthcare to their home province. Research topics have varied and include assessments of health care provision by sector, disease prevalence and treatment, and statistical methods. An unexpected outcome of increasing access has been the large interest from small physician groups and knowledge users who are not typically involved in research for academic purposes. Access to ICES’ data holdings provides an opportunity to examine a larger cohort of patients who share the same characteristics as their clinic patients or group. Furthermore, by enabling remote access to the data, DAS is able to leverage the capabilities of ICES’ data holdings and increase research capacity in a short period of time. ConclusionIn making one of the most comprehensively linked health administrative data repositories in the world widely available to the broader research and healthcare community, DAS engages investigators involved in front-line care, stimulates new avenues of research and fosters collaboration that was previously unachievable.


2018 ◽  
Vol 7 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Chungyi Chiu ◽  
Malachy Bishop ◽  
Bradley McDaniels ◽  
Byung-Jin Kim ◽  
Lebogang Tiro

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and (3) access to an MS center or specialized MS clinic with MS health-care professionals together in one place. Participants receiving care in an MS center rated the quality and their satisfaction with care higher than those receiving care in other settings. Although having the opportunity to evaluate their health-care quality was important to the participants, only 36.4% had been provided the opportunity in the past year. Conclusions: This study identifies health-care priorities and concerns for Americans with MS.


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