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Environmental Health Perspectives Jun 2024Most tools that measure environmental health literacy are broad in nature. Researchers have now developed a tool specific to phthalate awareness and behaviors as they...
Most tools that measure environmental health literacy are broad in nature. Researchers have now developed a tool specific to phthalate awareness and behaviors as they relate to reproductive health.
Topics: Phthalic Acids; Humans; Reproductive Health; Health Literacy; Environmental Health; Health Knowledge, Attitudes, Practice; Environmental Exposure; Female; Environmental Pollutants
PubMed: 38916968
DOI: 10.1289/EHP15126 -
Advances in Medical Education and... 2024Understanding and acknowledging cultural diversity in healthcare is essential in providing culturally competent care. Higher education institutions are critical to...
PURPOSE
Understanding and acknowledging cultural diversity in healthcare is essential in providing culturally competent care. Higher education institutions are critical to providing students with the necessary knowledge, attitudes, and skills to respond to cultural diversity in various contexts. Cultural competence teaching in ophthalmic dispensing education has emerged as an essential concept that needs to be included in the curriculum. This study explored ophthalmic dispensing lecturers' understandings, experiences, and attitudes in teaching cultural competence.
METHODS
This study used a qualitative approach within an interpretivist paradigm by conducting semi-structured interviews with lecturers (n = 7) in the ophthalmic dispensing program. Braun and Clarke's framework for thematic analysis was utilized. The research was conducted at an ophthalmic dispensing department at a South African university.
RESULTS
The analysis of the semi-structured interviews indicated three main themes of importance regarding factors influencing cultural competence education in the ophthalmic dispensing curriculum: the interplay between experiences and understandings of cultural competence, cross-cultural exposure and teaching practices, and inclusion of cultural competence into the curriculum. The participants recognized that cultural competence was not explicitly included in the curriculum. Including culture in education was rather unsystematic and, in most cases, unplanned.
CONCLUSION
Further training of lecturers on cultural competence skills and evidence-based teaching and assessment strategies are required to assist in developing curricula that include cultural competence.
PubMed: 38915926
DOI: 10.2147/AMEP.S438707 -
Frontiers in Nutrition 2024Professional and student-athletes are at risk of developing symptoms of eating disorders (ED), including drive for thinness and muscularity due to personal risk factors...
INTRODUCTION
Professional and student-athletes are at risk of developing symptoms of eating disorders (ED), including drive for thinness and muscularity due to personal risk factors (e.g., low self-esteem) and sport-specific characteristics (e.g., sport requirements). However, limited studies have focused on ED symptoms among NextGen athletes (identified in Canada as or ) who compete at the provincial, national, and international levels but are not yet part of national teams. As such, they have access to fewer financial resources and support from their sport federations, which can create additional stress for these athletes. The present study aimed to identify personal risk factors and types of sports associated with (a) drive for thinness and (b) drive for muscularity in NextGen athletes.
METHODS
These athletes ( = 254) aged between 14 and 25 years old completed an online questionnaire. Perfectionism, self-esteem in sport, drive for thinness, and drive for muscularity were, respectively, assessed by the Multidimensional Inventory of Perfectionism in Sport, the Sport State Self-Esteem Scale, the Eating Attitude Test-26, and the Drive for Muscularity Scale. Other personal risk factor (e.g., athletic status) were measured using in-house questions. Each personal risk factor was included in two multiple linear regressions, respectively, to determine which factors were most associated with drive for thinness and drive for muscularity.
RESULTS
Analyses revealed that perfectionist aspirations during training were linked to a stronger desire for thinness. In addition, not being in school or not having a job were also linked to a stronger desire for thinness. Several variables were found to be associated with a greater desire for muscularity: being a male athlete, playing team sport, weight category sport or endurance sport (as opposed to esthetic sport), having elite status, being less satisfied with one's current sporting performance and having higher perfectionist aspirations during training.
DISCUSSION
This study offers initial insights into the factors influencing EDs among NextGen athletes, which provides a foundation for deeper exploration and the creation or modification of targeted interventions. These findings can guide sport organizations in creating guidelines and programs to better support the next generation of national athletes (e.g., create programs to help athletes maintain investments outside).
PubMed: 38915858
DOI: 10.3389/fnut.2024.1392064 -
Frontiers in Public Health 2024When thinking about major health concerns in the U.S. and around the world, eye care ranks lower compared to cardiovascular disease, cancer, and diabetes. However,...
When thinking about major health concerns in the U.S. and around the world, eye care ranks lower compared to cardiovascular disease, cancer, and diabetes. However, people do not think about the direct connection between diabetes and eye health. Untreated diabetes can lead to visual impairments such as blindness or difficulty seeing. Studies have found that eye health associated with nutrition, occupational exposure, diabetes, high blood pressure, and heart disease are some of the known risk factors. This study aimed to identify the potential risk factors that are associated with visual impairment (VI). The data used for this analysis were obtained from the Centers for Disease Control and Prevention (CDC) - Behavioral Risk Factor Surveillance System (BRFSS) from 2018 to 2021. We found important characteristics, such as the U.S. region, general health perception, employment status, income status, age, and health insurance source, that are associated with VI. Our study confirmed that the common demographical factors including age, race/ethnicity, the U.S. region, and gender are associated with VI. The study also highlights associations with additional risk factors such as health insurance source, general health perceptions, employment status, and income status. Using this information, we can reach out to communities with large numbers of individuals experiencing vision challenges and help educate them on prevention and treatment protocols, thereby effectively addressing VI and blindness challenges within our communities, neighborhoods, and finally, the broader society.
Topics: Humans; United States; Behavioral Risk Factor Surveillance System; Risk Factors; Male; Female; Adult; Middle Aged; Centers for Disease Control and Prevention, U.S.; Aged; Adolescent; Vision Disorders; Patient Acceptance of Health Care; Young Adult
PubMed: 38915755
DOI: 10.3389/fpubh.2024.1335427 -
Frontiers in Public Health 2024Health statistics on dengue are virtually non-existent, despite the fact that the virus is circulating in Togo. This study aimed to assess the knowledge, attitudes, and...
Knowledge, attitudes, and practices of health care professionals regarding dengue fever: need for training and provision of diagnostic equipment in Togo in 2022, a cross-sectional study.
BACKGROUND
Health statistics on dengue are virtually non-existent, despite the fact that the virus is circulating in Togo. This study aimed to assess the knowledge, attitudes, and practices (KAP) of health professionals in the Kara health region.
METHODS
A cross-sectional study was conducted from March to June 2022 among healthcare professionals who had worked in the Kara region of northern Togo were selected using an exhaustive recruitment method. Data were collected by trained resident doctors with a face-to-face interview using a standardized, pretested questionnaire based on the WHO 2009 dengue guide. Three multivariate regression models were utilized to investigate factors associated with knowledge, attitudes and, and practices.
RESULTS
A total of 464 respondents (37.1% female), median age 35 years, interquartile range (29-43 years) were included. Only (3.0%) of the participants had received training on dengue fever diagnosis, treatment and prevention in the last 3 years, and 10.3% had dengue rapid diagnostic tests available at their hospital. Half of the respondents (49.1%) had good knowledge of dengue fever, compared with 30.0% who had positive attitudes. Of a total of 256 professionals who had encountered a case of dengue fever in their practice, only 24 (9.4%) had appropriate practices for diagnosing and treating dengue fever. In multivariate analysis, the healthcare professionals who had taken part in ongoing training on dengue fever were more likely to have adequate dengue diagnosis and treatment practice aOR = 8.1; CI 95% = [1.7-36.0].
CONCLUSION
Strengthening healthcare professionals' dengue-related skills through ongoing training and the provision of dengue diagnostic tests could help improve early detection practices and management of dengue fever in Togo.
Topics: Humans; Cross-Sectional Studies; Togo; Female; Male; Adult; Dengue; Health Knowledge, Attitudes, Practice; Surveys and Questionnaires; Health Personnel; Middle Aged
PubMed: 38915751
DOI: 10.3389/fpubh.2024.1375773 -
Frontiers in Public Health 2024Death anxiety and maladaptive coping accompany breast cancer diagnoses. The coping mechanisms and death anxiety among Palestinian patients with breast cancer have not...
BACKGROUND
Death anxiety and maladaptive coping accompany breast cancer diagnoses. The coping mechanisms and death anxiety among Palestinian patients with breast cancer have not been studied.
AIM
To assess the prevalence of death anxiety and its relationship with coping strategies among Palestinian women with breast cancer who are treated in Beit Jala Governmental Hospital in Bethlehem.
METHOD
A cross-sectional design was used, and 214 breast cancer patients who visited the Beit Jala Governmental Hospital in Bethlehem were recruited. Templer's Death Anxiety Scale and the Brief COPE Scale were used. To investigate the relationship between coping strategies and death anxiety, frequency, percentages, chi-square tests, and Pearson's correlation tests were utilized.
RESULTS
The results indicated that 58.40% of the patients experienced death anxiety. The participants who used positive reframing (adjusted odds ratio (AOR) = 1.487, = < 0.026), self-blame (AOR = 1.309, = < 0.023), and religion (AOR = 1.260, = < 0.031) as coping mechanisms were more likely to experience death anxiety. Conversely, the participants who adopted substance use (AOR = 0.657, < 0.005) and active coping (AOR = 0.629, < 0.007) as coping strategies had a lower likelihood of experiencing death anxiety.
CONCLUSION
The study revealed that breast cancer patients tended to use a combination of functional and emotional coping strategies and that a significant proportion of these patients (58.4%) experienced symptoms of death anxiety. This study emphasizes the significance of screening for death anxiety and understanding the coping strategies utilized by the patients. Gaining this understanding will assist in identifying patients who need more guidance and support.
Topics: Humans; Female; Cross-Sectional Studies; Adaptation, Psychological; Breast Neoplasms; Arabs; Middle Aged; Anxiety; Adult; Attitude to Death; Surveys and Questionnaires; Prevalence; Aged; Coping Skills
PubMed: 38915747
DOI: 10.3389/fpubh.2024.1420306 -
Frontiers in Psychology 2024In the emerging post-pandemic era (the 'wavelet' era), humans must coexist with viruses for the foreseeable future, and personal protective behaviors will largely...
In the emerging post-pandemic era (the 'wavelet' era), humans must coexist with viruses for the foreseeable future, and personal protective behaviors will largely replace national-level preventive measures. In this new normal, encouraging the public to implement proper personal protective behaviors against the coronavirus disease (COVID-19) is vital to the sustainable development of cities and communities. This knowledge-attitude-practice (KAP) survey conducted in Chengdu ( = 900) narrowed the knowledge gap regarding post-pandemic public practices of protective behavior. Findings show that:(1) approximately 1/3 of the respondents are currently not concerned about COVID-19 at all; (2) respondents with different demographics and individual COVID-19-related factors showed significant differences in practice behaviors indoors and outdoors; (3) vulnerable groups performed better in practice behavior indoors/outdoors; (4) because the public may relax their vigilance outdoors, public places may become a transmission threat in the next outbreak; (5) attitudes are important, but limited incentives for practice; and (6) when knowledge increases beyond a threshold (68.75-75% in this study), protective behaviors decrease. Our results suggest that authorities must continue to educate and motivate the public, extending measures to cover personal protective practices, and have targeted policies for specific demographics to ensure equity in healthcare in the event of another pandemic (COVID-19 and alike crisis). Besides, comparing the results of the current study with similar studies conducted in other parts of the world can provide insights into how different populations respond to and adopt COVID-19 protective behaviors. The epidemiologists can use the data collected by this and other KAP surveys to refine epidemiologic models, which can help predict the spread of the virus and the impact of interventions in different settings.
PubMed: 38915426
DOI: 10.3389/fpsyg.2024.1411055 -
Journal of Pharmacy & Pharmaceutical... 2024Treatment for diabetes includes anti-diabetic medication in addition to lifestyle improvements through diet and exercise. In Japan, protocol-based pharmacotherapy...
Investigating the effect of prescribing status and patient characteristics on the therapeutic outcomes in patients with diabetes using a leftover drug adjustment protocol.
Treatment for diabetes includes anti-diabetic medication in addition to lifestyle improvements through diet and exercise. In Japan, protocol-based pharmacotherapy management allows drug treatment to be provided through cooperation between physicians and pharmacists, based on a protocol that is prepared and agreed upon in advance. However, there are no studies to clarify the relationship between patient characteristics and therapeutic effects after pharmacist intervention in protocol-based pharmacotherapy management for patients with diabetes. Therefore, this study aimed to use protocol-based reports from pharmacies to understand the status of outpatient diabetes medication compliance. We classified patients with diabetes on the basis of patient characteristics that can be collected in pharmacies and investigated the characteristics that impacted diabetes treatment. Patients were prescribed oral anti-diabetic drugs at outpatient clinics of Hitachinaka General Hospital, Hitachi, Ltd., from April 2016 to March 2021. Survey items included patient characteristics (sex, age, number of drugs used, observed number of years of anti-diabetic drug prescription, number of anti-diabetic drug prescription days, and presence or absence of leftover anti-diabetic drugs) and HbA1c levels. Graphical analyses indicated the relationship between each categorised patient characteristic using multiple correspondence analyses. Subsequently, the patients were clustered using K-means cluster analysis based on the coordinates obtained for each patient. Patient characteristics and HbA1c values were compared between the groups for each cluster. A total of 1,910 patients were included and classified into three clusters, with clusters 1, 2, and 3 containing 625, 703, and 582 patients, respectively. Patient characteristics strongly associated with Cluster 1 were ages between 65 and 74 years, use of three or more anti-diabetic drugs, use of 3 years or more of anti-diabetic drugs, and leftover anti-diabetic drugs. Furthermore, Cluster 1 had the highest number of patients with worsening HbA1c levels compared with other clusters. Using the leftover drug adjustment protocol, we clarified the patient characteristics that affected the treatment course. We anticipate that through targeted interventions in patients exhibiting these characteristics, we can identify those who are irresponsibly continuing with drug treatment, are not responding well to therapy, or both. This could substantially improve the efficacy of their anti-diabetic care.
Topics: Humans; Male; Female; Hypoglycemic Agents; Aged; Middle Aged; Diabetes Mellitus; Treatment Outcome; Drug Prescriptions; Glycated Hemoglobin; Pharmacists; Medication Adherence; Japan; Aged, 80 and over; Adult
PubMed: 38915418
DOI: 10.3389/jpps.2024.12886 -
Frontiers in Immunology 2024Psoriasis vulgaris is associated with a significant healthcare burden, which increases over time as the disease progresses. The aim of this retrospective,...
INTRODUCTION AND AIM
Psoriasis vulgaris is associated with a significant healthcare burden, which increases over time as the disease progresses. The aim of this retrospective, population-based registry study was to characterize healthcare resource utilization (HCRU) in patients with psoriasis using biologics and oral immunosuppressants (conventionals) in Finland.
MATERIALS AND METHODS
The study cohort included all patients with a diagnosis of psoriasis vulgaris in the secondary healthcare setting between 2012-2018, who initiated a biologic (n=1,297) or conventional (n=4,753) treatment between 2013-2017. Data on primary and secondary HCRU were collected from nationwide healthcare registries.
RESULTS
The results indicated a remarkable decrease in contacts with a dermatologist after the treatment initiation among patients starting biologic (mean annual number of contacts 5.4 per person before and 2.3 after the initiation), but not conventional (3.3 and 3.2) treatment. For conventional starters there was a high level of contacts with a dermatologist surrounding times of treatment switching, which was not observed for biologic starters.
CONCLUSION
Overall, primary and other secondary care contacts did not decrease after the initiation or switch of treatment. The results highlight the importance of thorough consideration of the most optimal treatment alternatives, considering the overall disease burden to patients and healthcare systems.
Topics: Humans; Psoriasis; Finland; Female; Male; Middle Aged; Adult; Retrospective Studies; Biological Products; Patient Acceptance of Health Care; Registries; Aged; Immunosuppressive Agents; Health Resources; Young Adult; Adolescent
PubMed: 38915400
DOI: 10.3389/fimmu.2024.1374829 -
Trials Jun 2024The Movethehip trial investigates the effectiveness of an exercise and patient education intervention for adults with acetabular dysplasia. The intervention involves...
An exercise and patient education intervention to reduce pain and physical limitations in adults with acetabular dysplasia: study protocol for a process evaluation integrated within a randomised controlled trial (the MovetheHip trial).
BACKGROUND
The Movethehip trial investigates the effectiveness of an exercise and patient education intervention for adults with acetabular dysplasia. The intervention involves eight tailored one-to-one sessions with trained providers who employ supportive feedback tools. The present protocol reports a planned process evaluation, which aims to determine how the intervention functions by examining the implementation of the intervention (process, dose and reach), its acceptability, mechanisms of change and the influence of contextual factors.
METHODS
Two hundred trial participants aged 18-50 years will be recruited from a University Hospital in Denmark and randomised to the intervention or control group. Approximately ten providers will deliver the intervention. The process evaluation adopts a concurrent mixed-methods design. The implementation will be assessed using self-report questionnaires (at baseline and 6-month follow-up), training records and semi-structured focus group interviews with intervention providers (n = 10) and healthcare managers (n = 4-6). The mechanisms of change will be explored through semi-structured one-to-one interviews (at baseline and 6-month follow-up) with 15-20 purposefully sampled participants and by measuring changes in health outcomes (self-reported pain, physical functioning and quality of life completed at baseline and at 3- and 6-month follow-up). Additionally, change will be measured through an explorative examination of associations between dose and change in health outcomes, applying simple linear regression models. The acceptability of the intervention and the influence of contextual factors will be explored through one-to-one participant interviews and focus group interviews with 4-6 healthcare managers. The interviews will focus on expectations, experiences, events, personal understandings and interaction with interpersonal and organisational aspects. Interview data will be analysed using theoretical thematic analyses, and findings will be merged with quantitative data and reported jointly on a theme-by-theme basis.
DISCUSSION
The process evaluation conducted as part of the MovetheHip trial will illuminate how the intervention functions, and if the intervention is proven effective, the findings of the evaluation will contribute to pinpoint how the intervention may be optimised to facilitate future up-scaling and implementation.
TRIAL REGISTRATION
The MovetheHip protocol was approved by the Committee on Health Research Ethics in the Central Denmark Region. ClinicalTrials, NCT04795843. Registered on 20 March 2021.
Topics: Humans; Adolescent; Patient Education as Topic; Denmark; Exercise Therapy; Adult; Middle Aged; Randomized Controlled Trials as Topic; Treatment Outcome; Young Adult; Acetabulum; Female; Time Factors; Male; Pain Measurement; Functional Status; Health Knowledge, Attitudes, Practice; Quality of Life; Hospitals, University; Disability Evaluation; Recovery of Function
PubMed: 38915128
DOI: 10.1186/s13063-024-08262-y