Pub Date : 2017-01-01DOI: 10.4172/2471-9846.1000192
M. M. Nyamusi, J. M. M'imunya, C. Muvunyi, Michael Habtu
Background: Hepatitis B virus (HBV) is the commonest cause of chronic viral hepatitis which is responsible for up to 80% of primary liver cancers. Pregnant women who are carriers of the virus pose a significant risk to their health and unborn babies. Majority of countries in developing world have not yet adopted universal screening for pregnant women. Therefore, this study aimed at determining the prevalence and associated risk factors of hepatitis B surface antigen (HBsAg) among pregnant women in Kigali. Methods: A multicenter, facility based cross-sectional study was conducted on 385 pregnant women visiting antenatal care between May and August 2013. Data on socio-demographic information and possible risk factors of HBV were collected using a pretested structured questionnaire. Blood samples were collected for the detection of HBsAg using a standard diagnostics INC Bioline HBsAg test device followed by confirmatory ELISA for the positive samples. The results were analyzed using descriptive statistics and binary logistic regression. Crude and adjusted odds ratios with corresponding 95% confidence interval (CI) were calculated. A p-value of less than 0.05 was considered significant. Results: Of the 385 pregnant women enrolled in this study, 3.1% (95% CI=1.4% to 4.8%) were found to be seropositive for HBsAg. Pregnant women who ever worked in hospital (AOR=12.7; 95% CI=2.21-72.57; P=0.004) and had history of gestational diabetes (AOR=10.9; 95% CI=1.87-63.52; P=0.008) were independently associated with HBsAg seropositivity. Though, history of HBV infection in family member was significantly associated during bivariate analysis, it was insignificant in multivariable analysis. Conclusion: This study indicates that Kigali has intermediate endemicity of HBV among pregnant women. Considering the severity of the infection, HBV is important public health issue in the study area that needs to be addressed. Universal and free ante-natal screening and/or vaccination should be adopted. Moreover, awareness and vaccination coverage to be expanded for healthcare staff, gestational diabetes and family contacts of infected individuals.
{"title":"Factors Associated with Hepatitis B Surface Antigen Seropositivity among Pregnant Women in Kigali, Rwanda: A Cross Sectional Study","authors":"M. M. Nyamusi, J. M. M'imunya, C. Muvunyi, Michael Habtu","doi":"10.4172/2471-9846.1000192","DOIUrl":"https://doi.org/10.4172/2471-9846.1000192","url":null,"abstract":"Background: Hepatitis B virus (HBV) is the commonest cause of chronic viral hepatitis which is responsible for up to 80% of primary liver cancers. Pregnant women who are carriers of the virus pose a significant risk to their health and unborn babies. Majority of countries in developing world have not yet adopted universal screening for pregnant women. Therefore, this study aimed at determining the prevalence and associated risk factors of hepatitis B surface antigen (HBsAg) among pregnant women in Kigali. Methods: A multicenter, facility based cross-sectional study was conducted on 385 pregnant women visiting antenatal care between May and August 2013. Data on socio-demographic information and possible risk factors of HBV were collected using a pretested structured questionnaire. Blood samples were collected for the detection of HBsAg using a standard diagnostics INC Bioline HBsAg test device followed by confirmatory ELISA for the positive samples. The results were analyzed using descriptive statistics and binary logistic regression. Crude and adjusted odds ratios with corresponding 95% confidence interval (CI) were calculated. A p-value of less than 0.05 was considered significant. Results: Of the 385 pregnant women enrolled in this study, 3.1% (95% CI=1.4% to 4.8%) were found to be seropositive for HBsAg. Pregnant women who ever worked in hospital (AOR=12.7; 95% CI=2.21-72.57; P=0.004) and had history of gestational diabetes (AOR=10.9; 95% CI=1.87-63.52; P=0.008) were independently associated with HBsAg seropositivity. Though, history of HBV infection in family member was significantly associated during bivariate analysis, it was insignificant in multivariable analysis. Conclusion: This study indicates that Kigali has intermediate endemicity of HBV among pregnant women. Considering the severity of the infection, HBV is important public health issue in the study area that needs to be addressed. Universal and free ante-natal screening and/or vaccination should be adopted. Moreover, awareness and vaccination coverage to be expanded for healthcare staff, gestational diabetes and family contacts of infected individuals.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315566","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}
Pub Date : 2017-01-01DOI: 10.4172/2471-9846.1000148
S. Hardy, X. White
Health and social care staff work in complex workplace cultures that expose them to human suffering, distress and ‘dis-ease’. To defend themselves from emotional and physical pain, staffs undertake tasks, rituals, customs and practices to ameliorate discomfort. This serves as psychological and physical protection from their clients; alien to the ethos of person centred compassionate care. The dance of caring persons is a metaphor for the physical and emotional interaction of a caring relationship. Being facilitated through each of the dance steps offers one way to reignite caring professions. We outline a workshop process aimed to re-engage care staff with an intention to care. Self-care is the first step, which at an intentional, meaningful level requires a moment of mindfulness as internal bodily awareness. Noticing one’s emotional state increases self-awareness and an ability to focus on the here and now, from which to relish the breadth and depth of human experience. The second step includes a moment of performance; through intentional use of non-verbal communication to welcome and engage with others. The third step of the dance is active and effective verbal communication used to purposefully enter into a caring relationship. The fourth step is critical creative discussion, following mutual reflection of what has gone before. Step five is resonance; delving deeper into understanding the emotional and body senses, exploring the words exchanged, their intention and ‘true’ meaning. Step six is the creation of a ‘collage of caring’. Fragments of mutual learning, emotive expression and reactions (impact) are captured in the final exchange undertaken by all involved in the caring process. The dance of caring persons aims to identify the dance steps each person contributes to the context of caring. Such a compendium of caring provokes a deeper understanding of self in relation to the other, within the context of health and social care interactions.
{"title":"Promoting Care Giving Interventions through the Dance of Caring Persons (After Pross et al.)","authors":"S. Hardy, X. White","doi":"10.4172/2471-9846.1000148","DOIUrl":"https://doi.org/10.4172/2471-9846.1000148","url":null,"abstract":"Health and social care staff work in complex workplace cultures that expose them to human suffering, distress and ‘dis-ease’. To defend themselves from emotional and physical pain, staffs undertake tasks, rituals, customs and practices to ameliorate discomfort. This serves as psychological and physical protection from their clients; alien to the ethos of person centred compassionate care. The dance of caring persons is a metaphor for the physical and emotional interaction of a caring relationship. Being facilitated through each of the dance steps offers one way to reignite caring professions. We outline a workshop process aimed to re-engage care staff with an intention to care. Self-care is the first step, which at an intentional, meaningful level requires a moment of mindfulness as internal bodily awareness. Noticing one’s emotional state increases self-awareness and an ability to focus on the here and now, from which to relish the breadth and depth of human experience. The second step includes a moment of performance; through intentional use of non-verbal communication to welcome and engage with others. The third step of the dance is active and effective verbal communication used to purposefully enter into a caring relationship. The fourth step is critical creative discussion, following mutual reflection of what has gone before. Step five is resonance; delving deeper into understanding the emotional and body senses, exploring the words exchanged, their intention and ‘true’ meaning. Step six is the creation of a ‘collage of caring’. Fragments of mutual learning, emotive expression and reactions (impact) are captured in the final exchange undertaken by all involved in the caring process. The dance of caring persons aims to identify the dance steps each person contributes to the context of caring. Such a compendium of caring provokes a deeper understanding of self in relation to the other, within the context of health and social care interactions.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000148","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315529","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}
Pub Date : 2017-01-01DOI: 10.4172/2471-9846.1000196
Tina Ramineni, C. Merz
Cardiovascular disease remains the leading cause of death in the U.S for women, accounting for nearly 400,000 deaths [1]. Recent studies have shown declining mortality rates from cardiovascular disease within those over 65 years of age; however, mortality rates have remained nearly stagnant within younger women [2]. As sex and gender-based differences in presentation, pathophysiology and outcomes of CVD are becoming more understood, the lack of awareness of such differences must be addressed.
{"title":"The Current Awareness and Knowledge of the Impact of Gender on Cardiovascular Health","authors":"Tina Ramineni, C. Merz","doi":"10.4172/2471-9846.1000196","DOIUrl":"https://doi.org/10.4172/2471-9846.1000196","url":null,"abstract":"Cardiovascular disease remains the leading cause of death in the U.S for women, accounting for nearly 400,000 deaths [1]. Recent studies have shown declining mortality rates from cardiovascular disease within those over 65 years of age; however, mortality rates have remained nearly stagnant within younger women [2]. As sex and gender-based differences in presentation, pathophysiology and outcomes of CVD are becoming more understood, the lack of awareness of such differences must be addressed.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000196","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315653","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}
Pub Date : 2017-01-01DOI: 10.4172/2471-9846.1000199
Katie Koerner, Barbara Douglas
Healthcare organizations are under pressure to produce high quality outcomes while in turn, decrease costs. Because leaders within healthcare, direct care providers and policy makers are instrumental in transforming the way patient care is delivered, they must remodel care delivery to advocate on behalf of patients. Both formal and informal leaders are in a position to streamline care delivery across healthcare settings. The establishment of collaborative partnerships throughout the community to address practice differences can be effective in developing educational programs for patients and caregivers, establishing standards and guidelines in caring for multiple patient populations, and creating formal care paths to enhance care delivery. Developments in regards to transitional care practices have the potential to enhance quality outcomes and optimize healthcare spending.
{"title":"Leading Change throughout the Continuum of Care","authors":"Katie Koerner, Barbara Douglas","doi":"10.4172/2471-9846.1000199","DOIUrl":"https://doi.org/10.4172/2471-9846.1000199","url":null,"abstract":"Healthcare organizations are under pressure to produce high quality outcomes while in turn, decrease costs. Because leaders within healthcare, direct care providers and policy makers are instrumental in transforming the way patient care is delivered, they must remodel care delivery to advocate on behalf of patients. Both formal and informal leaders are in a position to streamline care delivery across healthcare settings. The establishment of collaborative partnerships throughout the community to address practice differences can be effective in developing educational programs for patients and caregivers, establishing standards and guidelines in caring for multiple patient populations, and creating formal care paths to enhance care delivery. Developments in regards to transitional care practices have the potential to enhance quality outcomes and optimize healthcare spending.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315783","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}
Pub Date : 2016-11-30DOI: 10.4172/2471-9846.1000145
Bonnie Jerome D’Emilia, P. Suplee, Sherry A Burrell
The purpose of this study was to examine the association between insurance status, primary care utilization and expectations of an underserved population. Two hundred thirty men and women participated. Having Medicaid increased the use of primary care services in a population that would otherwise be uninsured (p=0.01). Health status was not related to utilization of care. New practice models, such as nurse-managed health clinics, are well suited to fill the gaps of the primary care infrastructure in underserved urban areas. Nurse practitioners are in unique positions to lead and manage these new emerging practice models.
{"title":"Primary Care Expectations in an Underserved Population","authors":"Bonnie Jerome D’Emilia, P. Suplee, Sherry A Burrell","doi":"10.4172/2471-9846.1000145","DOIUrl":"https://doi.org/10.4172/2471-9846.1000145","url":null,"abstract":"The purpose of this study was to examine the association between insurance status, primary care utilization and expectations of an underserved population. Two hundred thirty men and women participated. Having Medicaid increased the use of primary care services in a population that would otherwise be uninsured (p=0.01). Health status was not related to utilization of care. New practice models, such as nurse-managed health clinics, are well suited to fill the gaps of the primary care infrastructure in underserved urban areas. Nurse practitioners are in unique positions to lead and manage these new emerging practice models.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315955","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}
Pub Date : 2016-11-30DOI: 10.4172/2471-9846.1000143
E. Eshbaugh, L. Stratton
Objective: Although the majority of care for those with Alzheimer’s is provided by informal rather than formal caregivers, family caregivers may lack knowledge about the disease. We sought to better understand the level and predictors of knowledge among family caregivers. Design: Several Alzheimer’s area support group facilitators were asked to forward a survey to their support groups via electronic mail. An email that accompanied the survey invited participants to forward the survey to others who had family members affected by Alzheimer’s disease. One-hundred forty-two total participants completed the survey. Measurements: This study examined the level of knowledge 142 family members had about the disease using the Alzheimer’s Disease Knowledge Scale (ADKS). Results: Scores on the ADKS were positively correlated with self-reported knowledge of Alzheimer’s, and family members with higher levels of education were more likely to be knowledgeable about the disease. Conclusion: Our research suggests that years of education is a predictor of Alzheimer’s knowledge among caregivers. It appears that family members, particularly those with lower levels of education, have a need for more knowledge about Alzheimer’s.
{"title":"Knowledge of Alzheimer's Disease Among Family Caregivers","authors":"E. Eshbaugh, L. Stratton","doi":"10.4172/2471-9846.1000143","DOIUrl":"https://doi.org/10.4172/2471-9846.1000143","url":null,"abstract":"Objective: Although the majority of care for those with Alzheimer’s is provided by informal rather than formal caregivers, family caregivers may lack knowledge about the disease. We sought to better understand the level and predictors of knowledge among family caregivers. \u0000Design: Several Alzheimer’s area support group facilitators were asked to forward a survey to their support groups via electronic mail. An email that accompanied the survey invited participants to forward the survey to others who had family members affected by Alzheimer’s disease. One-hundred forty-two total participants completed the survey. \u0000Measurements: This study examined the level of knowledge 142 family members had about the disease using the Alzheimer’s Disease Knowledge Scale (ADKS). \u0000Results: Scores on the ADKS were positively correlated with self-reported knowledge of Alzheimer’s, and family members with higher levels of education were more likely to be knowledgeable about the disease. \u0000Conclusion: Our research suggests that years of education is a predictor of Alzheimer’s knowledge among caregivers. It appears that family members, particularly those with lower levels of education, have a need for more knowledge about Alzheimer’s.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315907","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}
Pub Date : 2016-11-30DOI: 10.4172/2471-9846.1000146
O. Oyekunle, J. Fulton, C. Hayes
This review aimed to find the most effective intervention for the management of dental anxiety among adults by way of a systematic review of Randomised controlled trials. Compared to European and US counterparts, the number of studies concerning the management of dental anxiety in the United Kingdom is limited. Several interventions have been reported with varying modes of action and duration. Two main groups of interventions: pharmacological and psychological/behavioural have been implemented. The pharmacological interventions employ the use of centrally acting sedatives whereas the psychological/behavioural interventions serve to change the behavioural and learning effects of dental anxiety. A third group operationally defined as “Complementary” for the purpose of this review consists of holistic therapies such as acupuncture, music distraction and aromatherapy for in the management of dental anxiety. Although reduction of dental anxiety before and after dental treatment has been recorded historically in the majority of trials, these have mainly investigated psychological/behavioural interventions. Exploring more recent trials, this study uncovers the benefits of complementary interventions for managing dental anxiety in adults and computer based variants of psychological/behavioural interventions. None compared the efficacy of one type or group against the other. Also, outcomes such as avoidance of dental treatment and economic implication of interventions were scarcely evaluated thus evidence on this remains inconclusive. The need for further investigation of these outcomes as well as those in Complementary Therapies is justified.
{"title":"What is the Most Effective Intervention for the Management of Dental Anxiety among Adults? A Systematic Review of Interventions","authors":"O. Oyekunle, J. Fulton, C. Hayes","doi":"10.4172/2471-9846.1000146","DOIUrl":"https://doi.org/10.4172/2471-9846.1000146","url":null,"abstract":"This review aimed to find the most effective intervention for the management of dental anxiety among adults by way of a systematic review of Randomised controlled trials. Compared to European and US counterparts, the number of studies concerning the management of dental anxiety in the United Kingdom is limited. Several interventions have been reported with varying modes of action and duration. Two main groups of interventions: pharmacological and psychological/behavioural have been implemented. The pharmacological interventions employ the use of centrally acting sedatives whereas the psychological/behavioural interventions serve to change the behavioural and learning effects of dental anxiety. A third group operationally defined as “Complementary” for the purpose of this review consists of holistic therapies such as acupuncture, music distraction and aromatherapy for in the management of dental anxiety. Although reduction of dental anxiety before and after dental treatment has been recorded historically in the majority of trials, these have mainly investigated psychological/behavioural interventions. Exploring more recent trials, this study uncovers the benefits of complementary interventions for managing dental anxiety in adults and computer based variants of psychological/behavioural interventions. None compared the efficacy of one type or group against the other. Also, outcomes such as avoidance of dental treatment and economic implication of interventions were scarcely evaluated thus evidence on this remains inconclusive. The need for further investigation of these outcomes as well as those in Complementary Therapies is justified.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315993","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}
Pub Date : 2016-11-30DOI: 10.4172/2471-9846.1000E116
B. Pajk
When I look back, I believe that in the past we didn’t think about ethical issues in dementia care so much. We just did what we thought is best for our patient. I remember we were often quite astonished when we got the patient with dementia with a broken hip back from the surgery without being operated, because he wasn’t able to sign the informed consent for the procedure. Or further more we didn’t discussed a lot when we prolonged patient’s life in the terminal stage of dementia, administrating infusions, antibiotics, feeding tubes, and not to mention giving CPR. Everything to save a life, because this is what health care workers do, and most of relatives want to hear: “We did everything possible to save him”. But what would that certain individual with dementia want? Well he/she could no longer tell.
{"title":"Decision Making and Ethical Issues in Dementia","authors":"B. Pajk","doi":"10.4172/2471-9846.1000E116","DOIUrl":"https://doi.org/10.4172/2471-9846.1000E116","url":null,"abstract":"When I look back, I believe that in the past we didn’t think about ethical issues in dementia care so much. We just did what we thought is best for our patient. I remember we were often quite astonished when we got the patient with dementia with a broken hip back from the surgery without being operated, because he wasn’t able to sign the informed consent for the procedure. Or further more we didn’t discussed a lot when we prolonged patient’s life in the terminal stage of dementia, administrating infusions, antibiotics, feeding tubes, and not to mention giving CPR. Everything to save a life, because this is what health care workers do, and most of relatives want to hear: “We did everything possible to save him”. But what would that certain individual with dementia want? Well he/she could no longer tell.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000E116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70316979","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}
Pub Date : 2016-11-28DOI: 10.4172/2471-9846.1000144
R. Ramsey, Susan B. Matt
This research analysis focuses on palliative care approaches common within the United States and aims to show strengths, weaknesses, areas for improvement and research gaps to be closed by future studies. Ultimately, the end goal is to build a feasible, appropriate and actionable government policy proposal to ensure that all chronically ill Americans, in particular infants, children, and adolescents, receive the best care possible. This research involves briefly analyzing and assessing, using value theory and meta-ethical considerations, the unique palliative care systems in the United Kingdom, Canada and Belgium. The onion research paradigm and techniques provide the framework for this study. The research strongly suggests that the American palliative care system in general, and pediatric palliative care system in particular, are woefully lacking and in need of significant changes and improvements. Recommendations include: moving from a particular category consideration to a holistic approach that involves integrating many disciplines and family members into the treatment plans of adults and children alike; providing more robust and palliative-specific training programs; increasing funding for palliative care research, options, programs, education, and organizations; placing a stronger emphasis on networking with community spiritual, emotional, medical, and human resources; establishing units specifically designed to treat infants, children, and adolescents and catering to their and their families’ needs; and creating campaigns to ensure that all Americans are familiar with palliative care options.
{"title":"Policy Review and Recommendations: Palliative Care for Pediatric Patients in the United States of America","authors":"R. Ramsey, Susan B. Matt","doi":"10.4172/2471-9846.1000144","DOIUrl":"https://doi.org/10.4172/2471-9846.1000144","url":null,"abstract":"This research analysis focuses on palliative care approaches common within the United States and aims to show strengths, weaknesses, areas for improvement and research gaps to be closed by future studies. Ultimately, the end goal is to build a feasible, appropriate and actionable government policy proposal to ensure that all chronically ill Americans, in particular infants, children, and adolescents, receive the best care possible. This research involves briefly analyzing and assessing, using value theory and meta-ethical considerations, the unique palliative care systems in the United Kingdom, Canada and Belgium. The onion research paradigm and techniques provide the framework for this study. The research strongly suggests that the American palliative care system in general, and pediatric palliative care system in particular, are woefully lacking and in need of significant changes and improvements. Recommendations include: moving from a particular category consideration to a holistic approach that involves integrating many disciplines and family members into the treatment plans of adults and children alike; providing more robust and palliative-specific training programs; increasing funding for palliative care research, options, programs, education, and organizations; placing a stronger emphasis on networking with community spiritual, emotional, medical, and human resources; establishing units specifically designed to treat infants, children, and adolescents and catering to their and their families’ needs; and creating campaigns to ensure that all Americans are familiar with palliative care options.","PeriodicalId":92236,"journal":{"name":"Journal of community & public health nursing","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2471-9846.1000144","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70315942","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}
Pub Date : 2016-11-19DOI: 10.4172/2471-9846.1000141
M. Rana, M. Joane, Sacre Yonna
Background: Poverty in developing and low socioeconomic areas has an important consequence on women’s food supply. Therefore, food security and eating behavior among individuals living in these conditions could be altered due to social and economic status. Consequently, it is crucial to evaluate the “Food security, eating behavior and awareness of Lebanese women living in low socio-economic areas-Akkar”. Objective: The purpose of this analysis is to evaluate these factors in women living in low socioeconomic areas in order to assess and compare their food intake to the food pyramid recommendations and to determine their awareness level regarding the healthy eating habits and how it is affecting their food choices. Methods: A cross sectional study was conducted on randomly selected 340 women living in Akkar-North Lebanon, aging between 20 and 60 years old and showing a crowding index above 1. Data were collected through a validated questionnaire. Statistical analysis was carried out using the Statistical Package for Social Science (SPSS, version 16) with p<0.05. Several bivariate and multivariate models were used to evaluate the association between some independent variables and the food security, eating behavior and awareness of the study population. Results: Among the participants whose average of body mass index is 25.76 ± 5.241 kg/m2, 99.1% are food insecure and are unable to access food. Factors such as age, women’s type of work, husband’s salary, crowding index and others affect food security and eating behavior. In addition, 96.2% of the study sample is adopting unhealthy eating behavior which could potentially lead to chronic health problems. Moreover, 71.5% are showing a low awareness level concerning the health importance of good eating habits; thus, this poor awareness level is significantly affecting the population food choices. Conclusion: Future national studies and programs could be settled to increase the awareness about food security and good eating practices among this specific category of the Lebanese population and reduce food insecurity risk in this specific population.
背景:发展中国家和低社会经济地区的贫困对妇女的粮食供应有重要影响。因此，生活在这些条件下的个人的粮食安全和饮食行为可能会因社会和经济地位而改变。因此，评估“生活在低社会经济地区- akkar的黎巴嫩妇女的粮食安全、饮食行为和意识”至关重要。目的:本分析的目的是评估生活在低社会经济地区的妇女的这些因素，以便评估和比较她们的食物摄入量与食物金字塔建议，并确定她们对健康饮食习惯的认识水平及其如何影响她们的食物选择。方法:随机选取居住在Akkar-North Lebanon地区、年龄在20 ~ 60岁、拥挤指数大于1的340名妇女进行横断面研究。通过有效的问卷调查收集数据。采用社会科学统计软件包(SPSS, version 16)进行统计分析，p<0.05。使用了几个双变量和多变量模型来评估一些自变量与研究人群的食品安全、饮食行为和意识之间的关系。结果:平均体重指数为25.76±5.241 kg/m2的参与者中，99.1%的人存在食物不安全，无法获得食物。年龄、女性的工种、丈夫的工资、拥挤指数等因素都会影响食品安全和饮食行为。此外，96.2%的研究样本正在采取可能导致慢性健康问题的不健康饮食行为。此外，71.5%的人对良好饮食习惯对健康的重要性认识不高;因此，这种意识水平的低下严重影响了人们的食物选择。结论:未来的国家研究和计划可以在这一特定类别的黎巴嫩人口中提高对粮食安全和良好饮食习惯的认识，并减少这一特定人群的粮食不安全风险。
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