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People's expectations about the likely duration of common acute infections: a national survey of the Australian public 人们对常见急性感染可能持续时间的预期:对澳大利亚公众的全国调查
Pub Date : 2024-06-23 DOI: 10.1101/2024.06.22.24309159
Kwame Peprah Boaitey, Mina Bakhit, Mark Jones, Tammy Hoffmann
Objectives To explore people's expectations about the likely duration of acute infections that are commonly managed in primary care, and if care is sought for these infections, reasons for doing so.Design A cross-sectional online survey. Participants A nationwide sample of 589 Australian residents, 18 years or older with representative quotas for age and gender, recruited via an online panel provider. Outcome measures For eight acute infections, participants' estimated duration of each, time until they would seek care, and reasons for seeking care. Results For four infections, participants mean estimates of duration were within an evidence-based range - common cold (7.2 days), sore throat (5.2 days), acute otitis media (6.2 days), and impetigo (8.3 days); and >70% of participants estimated a duration within the range. However, participants estimated mean duration was shorter than evidence-based estimates for acute cough (7.6 days), sinusitis (5.6 days), conjunctivitis (5.7 days), and uncomplicated urinary tract infections (5.4 days); and >60% of participants underestimated the duration. Of the 589 participants, 365 (62%) indicated they were unlikely to routinely seek care for self-limiting infections. Most common reasons for care-seeking were severe or worsening symptoms, a desire for quick recovery, and fear of progression to complications. After being shown typical durations, the proportion of participants who reported having no concerns waiting for spontaneous resolution while managing symptoms with over-the-counter medications ranged across the infections and was highest for common cold (68%) and lowest for UTI (31%). Conclusion Participants underestimated the duration of some infections compared to evidence-based estimates and were accurate in their estimates for other infections. Many stated that they would not be concerned about waiting for illnesses to self-resolve after learning the typical duration. Communicating the expected duration of common acute infections during routine consultations can help manage patients' expectations of recovery and need to seek care.
目的 探讨人们对基层医疗机构通常处理的急性感染的可能持续时间的预期,以及如果这些感染需要治疗,这样做的原因。参与者 通过在线小组提供商在全国范围内抽样调查了 589 名 18 岁或以上的澳大利亚居民,其中年龄和性别配额具有代表性。结果 针对八种急性感染,参与者估计每种感染的持续时间、寻求治疗的时间以及寻求治疗的原因。结果 对于四种感染,参与者估计的平均持续时间均在循证范围内--普通感冒(7.2 天)、咽喉炎(5.2 天)、急性中耳炎(6.2 天)和脓疱疮(8.3 天);70% 的参与者估计的持续时间在范围内。然而,对于急性咳嗽(7.6 天)、鼻窦炎(5.6 天)、结膜炎(5.7 天)和非复杂性尿路感染(5.4 天),参与者估计的平均持续时间短于循证估计;60% 的参与者低估了持续时间。在 589 名参与者中,有 365 人(62%)表示他们不太可能因为自限性感染而定期就医。寻求治疗的最常见原因是症状严重或恶化、希望尽快康复以及担心发展成并发症。在向参与者展示了典型的持续时间后,表示在使用非处方药物控制症状的同时不担心等待症状自发缓解的参与者比例在各种感染中不尽相同,其中普通感冒的比例最高(68%),UTI 的比例最低(31%)。结论 与基于证据的估计相比,参与者低估了某些感染的持续时间,但他们对其他感染的估计是准确的。许多人表示,在了解了典型的持续时间后,他们不会担心等待疾病自行缓解。在常规咨询中告知常见急性感染的预期持续时间有助于管理患者对康复和就医需求的预期。
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引用次数: 0
Antipsychotic management in primary care: a longitudinal population-based study 基层医疗机构的抗精神病药物管理:基于人群的纵向研究
Pub Date : 2024-06-19 DOI: 10.1101/2024.06.18.24309122
Alan Woodall, Alex Gampel, Huw Collins, Lauren E Walker, Frances S Mair, Sally B Sheard, Pyers Symon, Iain Buchan
Background: The use of antipsychotics in primary care is increasing, and more are being used for non-psychotic illnesses. Long-term use of antipsychotics confers increased risk of cardiometabolic disease, so ongoing need should be reviewed regularly by psychiatrists. This study explored changes over time in antipsychotic management and prescribing in primary care, and proportions of patients (≥18 years) prescribed antipsychotics receiving psychiatrist review. Methods and Findings: This was a retrospective, population-based observational study using data from the Secure Anonymised Information Linkage databank of approximately 3 million people in Wales (2011 to 2020). Outcomes were prevalence of patients who had received ≥6 antipsychotic prescriptions per year, proportion of patients prescribed antipsychotics who had received psychiatrist review in the preceding 12 months, and proportion of patients prescribed antipsychotics who were registered on the UK Primary Care Serious Mental Illness, Depression and/or Dementia registers, or were not on these registers. The prevalence of adults prescribed antipsychotics increased from 1.06% (95%CI 1.04 to 1.07%) in 2011 to 1.45% (95%CI 1.43 to 1.46%) in 2020; 1 in 69 adults were prescribed antipsychotics in 2020. The proportion of adults taking antipsychotics solely managed by primary care increased from 40% (95%CI 39 to 41%) in 2011 to 48% (95%CI 47 to 49%) by 2020. The proportion of antipsychotics prescribed to patients not on the Serious Mental Illness register increased from 50% (95%CI 49 to 51%) in 2011 to 56% (95%CI 56 to 57%) by 2020, meaning many patients may not be monitored for the cardiometabolic risk from antipsychotics. Conclusions: Antipsychotic prescribing is increasing. More people are solely managed by general practitioners without psychiatrist review and are not on relevant disease registers, so are less are likely to undergo vital cardiometabolic monitoring. These trends pose risks for patients and need to be addressed urgently.
背景:抗精神病药物在初级保健中的使用正在增加,而且越来越多地用于非精神病性疾病。长期使用抗精神病药物会增加罹患心脏代谢疾病的风险,因此精神科医生应定期检查是否需要继续使用。本研究探讨了基层医疗机构抗精神病药物管理和处方随时间推移而发生的变化,以及处方抗精神病药物的患者(≥18 岁)接受精神科医生复查的比例。方法和结果:这是一项基于人群的回顾性观察研究,使用的数据来自安全匿名信息链接数据库,涉及威尔士约 300 万人口(2011 年至 2020 年)。研究结果包括每年接受过≥6次抗精神病药物处方的患者比例、在过去12个月中接受过精神科医生复查的抗精神病药物处方患者比例,以及在英国初级医疗严重精神疾病、抑郁症和/或痴呆症登记册上登记或未登记的抗精神病药物处方患者比例。开具抗精神病药物处方的成人患病率从2011年的1.06%(95%CI为1.04%至1.07%)增至2020年的1.45%(95%CI为1.43%至1.46%);2020年,每69名成人中就有1人开具抗精神病药物处方。完全由基层医疗机构管理的服用抗精神病药物的成人比例从2011年的40%(95%CI为39%至41%)增加到2020年的48%(95%CI为47%至49%)。为未列入严重精神疾病登记册的患者开具抗精神病药物处方的比例从2011年的50%(95%CI为49%至51%)增加到2020年的56%(95%CI为56%至57%),这意味着许多患者可能无法监测到抗精神病药物带来的心脏代谢风险。结论抗精神病药物的处方量正在增加。越来越多的人只接受全科医生的管理,没有经过精神科医生的审查,也不在相关疾病登记册上,因此不太可能接受重要的心脏代谢监测。这些趋势给患者带来了风险,亟待解决。
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引用次数: 0
Pentavalent Vaccine: How Safe Is It Among Infants Accessing Immunization In Nigerian Health Facilities 五价疫苗:尼日利亚医疗机构为婴儿接种五联疫苗的安全性如何?
Pub Date : 2024-05-29 DOI: 10.1101/2024.05.28.24307998
Elemuwa Uchenna Geraldine, Enato Ehijie, Elemuwa Christopher Ononiwu, Elemuwa Tochukwu Daniel, Morufu Olalekan Raimi
Rationale Pentavalent vaccines offer significant public health benefits by protecting against five major diseases with a single injection. However, concerns have been raised in various studies regarding potential associations between combined vaccines and conditions such as autism, febrile seizures, sudden unexpected death in infancy, demyelinating disorders, and neurodevelopmental disorders.
理论依据 五价疫苗只需注射一次即可预防五种主要疾病,为公众健康带来巨大益处。然而,在多项研究中,人们对联合疫苗与自闭症、高热惊厥、婴儿期意外猝死、脱髓鞘疾病和神经发育障碍等疾病之间的潜在关联表示担忧。
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引用次数: 0
Nowhere to Go: A parallel convergent mixed methods study examining the health of people who experience emergency shelter service restrictions 无处可去:一项平行聚合混合方法研究,考察遭遇紧急避难所服务限制的人群的健康状况
Pub Date : 2024-05-08 DOI: 10.1101/2024.05.07.24306964
Suraj Bansal, Stephanie Di Pelino, Jammy Pierre, Kathryn Chan, Amanda Lee, Rachel Liu, Olivia Mancini, Avital Pitkas, Fiona Kouyoumdjian, Larkin Lamarche, Robin Lennox, Marcie McIlveen, Timothy O’Shea, Claire Bodkin
Background Emergency shelters offer temporary sleeping accommodation to people deprived of housing and connect them to services. Service restriction is the practice of limiting or denying someone access to emergency shelters. This parallel convergent mixed methods study describes the characteristics, healthcare utilization, and morbidity of people experiencing service restrictions in Hamilton, Ontario, and explores the relationship between health and service restriction.
背景 紧急避难所为没有住房的人提供临时住宿,并为他们提供服务。服务限制是指限制或拒绝他人进入紧急避难所的做法。这项平行收敛混合方法研究描述了安大略省汉密尔顿市服务限制人群的特征、医疗保健使用情况和发病率,并探讨了健康与服务限制之间的关系。
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引用次数: 0
Distress and factors for maintaining good mental health among general practitioners during the SARS-CoV-2 pandemic: Results from the cross-sectional PRICOV-19 study in Austria SARS-CoV-2 大流行期间全科医生的压力和保持良好心理健康的因素:奥地利 PRICOV-19 横向研究的结果
Pub Date : 2024-05-01 DOI: 10.1101/2024.04.30.24306629
Kathryn Hoffmann, Florian O. Stummer, Esther van Poel, Sara Willems, Silvia Wojczewski
Background The COVID-19 pandemic has had a significant negative impact on the physical and mental health of healthcare workers worldwide. The aim of the paper is to measure the frequency of distress and wellbeing among general practitioners (GPs) in Austria during the pandemic and to identify key levers that could mitigate the risks of distress.
背景 COVID-19 大流行对全球医护人员的身心健康造成了严重的负面影响。本文旨在测量大流行期间奥地利全科医生(GPs)的痛苦频率和健康状况,并找出可减轻痛苦风险的关键因素。
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引用次数: 0
Effects of the Covid-19 pandemic on the continuity of sexual and reproductive health care in the maternity ward of a health and social promotion centre in Burkina Faso: a qualitative study Covid-19 大流行对布基纳法索卫生和社会促进中心产科病房性保健和生殖保健连续性的影响:定性研究
Pub Date : 2024-04-15 DOI: 10.1101/2024.04.10.24305634
Patrice Ngangue, Mariam Ahmat Mahamat, Danièle Sandra Yopa, Gbètogo Maxime Kiki, Nestor Bationo, Douglas Mbang Massom, Josiane Seu, Birama Apho Ly
Background The COVID-19 pandemic has significantly impacted the continuity of maternity care in Burkina Faso. This study aimed to compare the volumes of in-person visits and to explore the experiences of healthcare providers and users regarding the continuity of healthcare in the maternity ward of a Health and Social Promotion Center (HSPC) before, during and after the lockdown during the COVID-19 pandemic in Ouagadougou, Burkina Faso.
背景 COVID-19 大流行严重影响了布基纳法索产科护理的连续性。本研究旨在比较亲自到访的人数,并探讨医疗服务提供者和使用者在布基纳法索瓦加杜古 COVID-19 大流行期间封锁之前、期间和之后在卫生和社会促进中心(HSPC)产科病房的医疗服务连续性方面的经验。
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引用次数: 0
Judgements about carer assessments for carers of people with dementia: case vignette study 对痴呆症患者照护者的照护者评估的判断:案例研究
Pub Date : 2024-04-13 DOI: 10.1101/2024.04.11.24305691
Paul Clarkson, Lucie Mills, Asif Butt, Baber Malik, Ruth Eley, Cecilia Toole, Caroline Sanders, Ian Sheriff
Objectives UK carer assessments, in primary and social care, intend to discover what carers need in their caring roles and more widely. Evidence points to these not being configured sufficiently around carers of people with dementia, with potentially their breadth of needs not being recognised. We evaluated the extent of agreement, between carers of people with dementia, primary care, and social care professionals, on their recommendations from assessing carers’ needs in a range of circumstances. It is intended for findings to be taken forward as recommendations for policy and practice.
目标 英国初级和社会护理中的照护者评估旨在发现照护者在其照护角色和更大范围内的需求。有证据表明,这些评估并没有充分围绕痴呆症患者的照护者进行配置,他们的广泛需求可能没有被认识到。我们评估了痴呆症患者的照护者、初级护理人员和社会护理专业人员之间就评估照护者在各种情况下的需求所提出的建议达成一致的程度。我们希望将评估结果作为政策和实践建议。
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引用次数: 0
Telehealth versus face-to-face delivery of speech language pathology services: a systematic review and meta-analysis 远程医疗与面对面提供言语病理学服务:系统回顾与荟萃分析
Pub Date : 2024-04-10 DOI: 10.1101/2024.04.08.24305455
Anna Mae Scott, Justin Clark, Magnolia Cardona, Tiffany Atkins, Ruwani Peiris, Hannah Greenwood, Rachel Wenke, Elizabeth Cardell, Paul Glasziou
Background There is an increasing demand for the provision of speech language pathology (SLP) services via telehealth. Therefore, we systematically reviewed randomized controlled trials comparing telehealth to face-to-face provision of SLP services.
背景 通过远程医疗提供言语病理学(SLP)服务的需求日益增长。因此,我们系统回顾了比较远程医疗与面对面提供 SLP 服务的随机对照试验。
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引用次数: 0
Reach and effectiveness of a HEARTS hypertension control pilot project in Guatemala 危地马拉 HEARTS 高血压控制试点项目的覆盖面和有效性
Pub Date : 2024-04-05 DOI: 10.1101/2024.04.03.24305304
Irmgardt Alicia Wellmann, José Javier Rodríguez, Benilda Batzin, Guillermo Hegel, Luis Fernando Ayala, Kim Ozano, Meredith P. Fort, Walter Flores, Lesly Ramirez, Eduardo Palacios, Mayron Martínez, Manuel Ramirez-Zea, David Flood
The World Health Organization’s HEARTS Technical Package aims to improve the primary care management of hypertension and other cardiovascular risk disease factors at the population level. This study describes the first HEARTS implementation project in the Ministry of Health primary care system in Guatemala. This pilot project was implemented from April to December 2022 in 6 primary health facilities in 3 rural, Indigenous municipalities. The project consisted of HEARTS-aligned strategies that were adapted to foster program sustainability in Guatemala. Outcomes were defined using the RE-AIM framework. The primary reach outcome was treatment rate, defined as the absolute number of patients each month receiving medication treatment for hypertension. The primary effectiveness outcomes were mean systolic blood pressure (BP), mean diastolic BP, and proportion with BP control. In the first month of the post-implementation period, there was a significant increase of 25 patients treated (P=0.002), followed by a significant increase thereafter of 2.4 additional patients treated each month (P=0.007). The mean change in systolic BP was -4.4 (95 CI -8.2 to -0.5, P=0.028) mmHg and mean change in diastolic BP was -0.9 (95 CI -2.8 to 1.1, P=0.376) mmHg. The proportion of the cohort with BP control increased from 33.4% at baseline to 47.1% at 6 months (adjusted change of 13.7% [95 CI 2.2% to 25.2%, P=0.027]). These findings support the feasibility of implementing the HEARTS model for blood pressure control in the Guatemalan MOH primary care system where the vast majority of hypertension patients seek care.
世界卫生组织的 HEARTS 技术包旨在改善基层医疗机构对高血压和其他心血管疾病危险因素的管理。本研究介绍了危地马拉卫生部基层医疗系统的首个 HEARTS 实施项目。该试点项目于 2022 年 4 月至 12 月在 3 个农村土著市镇的 6 家初级医疗机构实施。该项目包括与 HEARTS 一致的战略,这些战略经过调整,以促进项目在危地马拉的可持续性。项目成果采用 RE-AIM 框架进行定义。主要达标结果是治疗率,即每月接受药物治疗的高血压患者的绝对人数。主要有效性结果是平均收缩压(BP)、平均舒张压和血压得到控制的比例。在实施后的第一个月,接受治疗的患者人数显著增加了 25 人(P=0.002),此后每月接受治疗的患者人数显著增加了 2.4 人(P=0.007)。收缩压的平均变化为-4.4(95 CI -8.2至-0.5,P=0.028)毫米汞柱,舒张压的平均变化为-0.9(95 CI -2.8至1.1,P=0.376)毫米汞柱。人群中血压得到控制的比例从基线时的 33.4% 增加到 6 个月时的 47.1%(调整后的变化为 13.7% [95 CI 2.2% 至 25.2%,P=0.027])。这些研究结果表明,在危地马拉卫生部的初级保健系统中实施 HEARTS 血压控制模式是可行的,因为绝大多数高血压患者都在该系统中就医。
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引用次数: 0
A grounded theory study of beliefs underlying use of ancestral spirits for healing among Baganda traditional spiritual healers in Central Uganda 对乌干达中部巴干达传统精神治疗师利用祖先灵魂进行治疗的基本信念的基础理论研究
Pub Date : 2024-04-03 DOI: 10.1101/2024.04.03.24304941
Yahaya H. K. Sekagya, Charles Muchunguzi, Payyappallimana Unnikrishnan, Edgar M. Mulogo
The increasing global sensitivity to spirituality in medicine and sociology has elevated the relevance of beliefs in ancestral spirits as an integral element in Africa’s multi-ethnic society and biocultural diversity for health management. However, ancestral spirituality in healthcare in the local context, remains sparse and elusive since most literature relates spirituality with religion and religious practices. The study sought to explore the beliefs in ancestral spirits utilized for health management among practicing Baganda traditional spiritual healers (Balubaale). Qualitative data were gathered through semi-structured in-depth interviews and partial integration observation methods from twelve (10M, 2F) purposively selected and recruited Balubaale from Central Uganda between 15th July 2019 and 29th April 2020, and we prospectively interacted with them for 24 months. Transcribed data was coded and thematically analyzed using ATLAS ti. 22 computer software based on grounded theory approach. Data revealed themes related to beliefs in spiritual powers of categories of ancestral spirits, sacred places, living plants and animals, non-living things such as fire, water, the Sun, and non-materials such as symbols and colors. Spiritual powers can be potentiated through rituals, sacrifice and communal activities all of which are utilized during health managements. In conclusion, Balubaale believe that illness and health management are influenced by ancestral spirits and spiritual powers contained in nature and creation therein. We recommend more exploratory studies among spiritualists of other tribes to contrast the findings.
全球对医学和社会学中的灵性越来越敏感,这提升了对祖先神灵信仰的相关性,将其视为非洲多民族社会和生物文化多样性中健康管理的一个组成部分。然而,由于大多数文献都将灵性与宗教和宗教习俗联系在一起,因此在当地医疗保健中的祖先灵性仍然很少且难以捉摸。本研究试图探索巴干达传统精神治疗师(Balubaale)在健康管理中对祖先神灵的信仰。在 2019 年 7 月 15 日至 2020 年 4 月 29 日期间,我们通过半结构式深度访谈和部分整合观察法,从乌干达中部有目的地挑选和招募了 12 名巴鲁巴莱人(10 名男性,2 名女性)收集定性数据,并与他们进行了长达 24 个月的前瞻性互动。我们使用 ATLAS ti.22 计算机软件进行了主题分析。数据揭示的主题涉及对祖先神灵、圣地、动植物、非生物(如火、水、太阳)以及非物质(如符号和颜色)等类别的精神力量的信仰。精神力量可以通过仪式、祭祀和集体活动得到加强,所有这些在健康管理中都得到了利用。总之,巴卢巴莱人认为,疾病和健康管理受到祖先神灵和大自然及造物中蕴含的精神力量的影响。我们建议对其他部落的灵媒进行更多的探索性研究,以对比研究结果。
{"title":"A grounded theory study of beliefs underlying use of ancestral spirits for healing among Baganda traditional spiritual healers in Central Uganda","authors":"Yahaya H. K. Sekagya, Charles Muchunguzi, Payyappallimana Unnikrishnan, Edgar M. Mulogo","doi":"10.1101/2024.04.03.24304941","DOIUrl":"https://doi.org/10.1101/2024.04.03.24304941","url":null,"abstract":"The increasing global sensitivity to spirituality in medicine and sociology has elevated the relevance of beliefs in ancestral spirits as an integral element in Africa’s multi-ethnic society and biocultural diversity for health management. However, ancestral spirituality in healthcare in the local context, remains sparse and elusive since most literature relates spirituality with religion and religious practices. The study sought to explore the beliefs in ancestral spirits utilized for health management among practicing Baganda traditional spiritual healers (<em>Balubaale</em>). Qualitative data were gathered through semi-structured in-depth interviews and partial integration observation methods from twelve (10M, 2F) purposively selected and recruited <em>Balubaale</em> from Central Uganda between 15<sup>th</sup> July 2019 and 29<sup>th</sup> April 2020, and we prospectively interacted with them for 24 months. Transcribed data was coded and thematically analyzed using ATLAS ti. 22 computer software based on grounded theory approach. Data revealed themes related to beliefs in spiritual powers of categories of ancestral spirits, sacred places, living plants and animals, non-living things such as fire, water, the Sun, and non-materials such as symbols and colors. Spiritual powers can be potentiated through rituals, sacrifice and communal activities all of which are utilized during health managements. In conclusion, <em>Balubaale</em> believe that illness and health management are influenced by ancestral spirits and spiritual powers contained in nature and creation therein. We recommend more exploratory studies among spiritualists of other tribes to contrast the findings.","PeriodicalId":501023,"journal":{"name":"medRxiv - Primary Care Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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medRxiv - Primary Care Research
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