ABSTRACT Prioritizing Diseases, Disorders and Disabilities and the Relative Importance of Skin Cancer: A Public Health Faculty Survey By James Thomas Sandwich, MD April 21, 2016 INTRODUCTION: Academic faculty in public health have diverse career interests and occupy positions of considerable influence. They play an important role in setting curriculum and training the future public health workforce. However, there is little published scholarly information regarding which public health diseases, disorders, and disabilities are most important to them. Skin cancer is a major public health problem that has been declared an epidemic. AIM: The Aim of this study is to discover which public health disorders are of highest concern and to determine the relative priority of skin cancer to public health faculty. METHODS: The primary design of the study was that of a non-experimental opinion based survey. Subjects were faculty members of national academic, public health programs. To obtain the broadest distribution, primary and secondary faculty as defined by the ASPPH were included. A 19 question survey document was administered electronically through Qualtrics. There were 15 questions on the importance of specific disorders and five questions on skin cancer. Responses were categorized ranked and compared. RESULTS: Obesity ranked the highest among all concerns with cardiovascular disease and cancer also receiving high priority. Cancer, diabetes, and cardiovascular disease led in secondary outcomes. Tertiary outcomes were nearly evenly split between cardiovascular disease, cancer, and mental health. Priorities varied by regions, age, gender and race. The majority placed skin cancer in the second quartile of importance and believed it to be appropriately ranked. CONCLUSION: Public health faculty prioritize disorders similarly in spite of diverse interests with minor differences across regions and demographics. National Funding as a proxy for importance does not cleanly align with faculty priorities. Public health faculty express familiarity with skin cancer, however, do not generally considered it of highest priority compared to other disorders. Increased faculty emphasis on interventions that prevent skin cancer may improve awareness and reduce negative sequela.

No

No

INTRODUÇÃO: A evolução natural da escoliose idiopática do adolescente (EIA) foi extensamente estudada e já foram identificados diversos fatores que podem determinar a gravidade e a progressão da doença em diferentes populações. Apesar dos esforços, ainda não existe uma ferramenta prática que englobe conjuntamente os principais fatores que determinam a gravidade da doença. OBJETIVOS: Elaborar uma escala de pontuação simples, baseada em evidências, que apresente correlação com a qualidade de vida do paciente e que seja capaz de estratificar os pacientes com escoliose idiopática, priorizando os fatores de risco de progressão e de gravidade. MATERIAL E MÉTODOS: Foi desenvolvida, a partir de revisão narrativa da literatura, uma escala de pontuação possível de ser aplicada em todos os pacientes portadores de escoliose idiopática que se encontram em fila de espera para tratamento cirúrgico, no Instituto de Ortopedia e Traumatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, centro de referência de tratamento da EIA do Brasil. Numa segunda etapa, foi aplicada a escala desenvolvida em conjunto com o questionário de qualidade de vida SRS30. Foram correlacionadas estatisticamente as duas escalas através do teste de Pearson, assim como os valores do Cobb, o escore obtido pela escala proposta e os domínios do questionário de qualidade de vida. RESULTADOS: Verificou-se um grupo homogêneo com relação à idade e sexo, com média de idade de 15,29 + 2,47 anos, 86,7% do sexo feminino. A média do ângulo de Cobb inicial (momento de entrada na fila) foi de 55,4 graus e a média do Cobb atual (data da análise) 74,54 graus, com evolução média de 19,12 graus. A escala desenvolvida apresentou pontuação mínima de 6 e máxima de 16 com média de 11,27. O teste de Pearson entre as escalas SSS-IOT e o ângulo de Cobb mostrou significância estatística (p = 0,005), com P=0,434 demonstrando correlação entre a escala e progressão das curvas. CONCLUSÃO: A escala proposta foi diretamente proporcional ao risco para progressão de curvas principais na escoliose idiopática do adolescente e apresentou correlação clínica com o questionário de qualidade de vida SRS-30, sendo maior seu valor de progressão correlacionado a pior qualidade de vida. Mais estudos são necessários para validação e aplicação em ampla escala da classificação / INTRODUCTION: The natural evolution of adolescent idiopathic scoliosis (AIS) has been extensively studied and several factors have been identified that may determine the severity and progression of the disease in different populations. Despite efforts, there is still no practical tool that collectively encompasses the key factors that determine the severity of the disease. OBJECTIVES: To develop a simple, evidence-based score scale that correlates with the patient\'s quality of life and is capable of stratifying patients with idiopathic scoliosis, prioritizing risk factors for progression and severity. MATERIAL AND METHODS: From a literature review, a scoring scale was developed that could be applied to all patients with idiopathic scoliosis who are waiting for surgical treatment at the Orthopedic and Traumatology Institute of Clinics Hospital at Faculdade de Medicina from São Paulo University a large reference center for the treatment of AIS in Brazil. In a second step, the developed scale and the SRS30 quality of life questionnaire were applied. The two scales were statistically correlated through the Pearson correlation test, as well as the Cobb values, the score obtained by the proposed scale and the domains of the quality of life questionnaire. RESULTS: There was a homogeneous group with respect to age and sex, with a mean age of 15.29 + 2.47 years, 86.7% female. The mean Cobb angle (queue entry time) was 55.4 degrees and the current Cobb average (date of analysis) was 74.54 degrees, with an average evolution of 19.12 degrees. The developed scale had a minimum score of 6 and a maximum of 16 with an average of 11.27. The Pearson correlation test between the SSS-IOT scales and the Cobb angle showed statistical significance (p = 0.005), with a magnitude of P=0.434, demonstrating the evolutionary character of the scale. CONCLUSIONS: The proposed scale is directly proportional to the risk for progression of major curves in adolescent idiopathic scoliosis and presents a clinical correlation with the SRS-30 quality of life questionnaire, with a higher progression value is correlated with worse quality of life. More studies are needed for validation and wide-scale application of the classification

Diss. Linköping : Univ., 2001.

The purpose of this descriptive phenomenological study was to give voice to an underserved and vulnerable population in Uganda, Africa to advocate for health priorities. Nineteen members of the village of Namagera, identified as a leper colony, were selected by community members and volunteered to participate in every element of this study. Descriptive phenomenology was the guiding philosophy and community-based participatory research methods and photovoice provided the lens for social action. Leininger’s theory of culture care diversity and universality (Leininger & McFarland, 2006) anchored the study in cultural caring and the community nursing practice model (Parker et al., 2020) kept the researcher grounded in the purpose of advancing the science of caring in community nursing. The research team included the researcher, the 19 participants, and six research assistants, who also served as language facilitators. Using photovoice methods, participants identified strengths and needs and used digital cameras to capture health concerns in the community. Eighty photos were analyzed by the participants and priorities were determined. The selected photos were placed on a photo board and shared with the whole community for input. Community members selected the health priorities and ranked them in importance: access to clean water, sanitation, disease, challenges for the elderly and disabled, lack of medical treatment, transportation, unemployment, and protection of the environment. The participants categorized the health priorities into three clusters of themes: basic needs, safety, and social/environmental. The themes were further incorporated into action plans identifying impeding factors for which the community would require outside assistance and promoting factors for which the community could solve themselves. Findings of this study illuminate the emergence of community empowerment: Community members found their voices, identified health priorities, and advocated for solutions. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

This thesis research contributes to national health Information Management/Information Technology (IM/IT) planning and therefore strategy development and implementation research, as well as to health information science. An examination into the national health IM/IT plans of several countries provides knowledge into identifying the typical IM/IT priorities that selected countries are focusing upon for healthcare improvement. Second, a systematic literature review of the current challenges, barriers and/or issues (referred to as ‘challenges’ hereafter) facing IM/IT priority implementation in healthcare settings provides insight on where nations should perhaps be focusing their attention, in order to enable more successful healthcare IM/IT implementations. Lastly, a study on national health IM/IT priorities contributes to the body of evidence that national level IM/IT direction is necessary for better patient care and health system reform across the world. In this investigation, the national health IM/IT priorities, which are reflected in the national health IM/IT strategic plans of five countries were assessed. To this end, the study: 1) Developed a set of measures to select four countries to study in addition to Canada; 2) Described the national health IM/IT priorities of Canada and four other countries; 3) Performed a systematic literature review of the challenges to overcome for successful implementation of IM/IT into healthcare settings; 4) Developed and administered a questionnaire where participants were asked to give their opinions on the progress their country has achieved in dealing with such challenges; and 5) Performed an analysis of the questionnaire results with respect to the countries’ national health IM/IT priorities. The systematic literature review uncovered a large number of challenges that the health informatics and healthcare community face when attempting to implement IM/IT into healthcare settings. iii The priority comparison highlighted that there is no right or wrong answer for what countries should focus their national health IM/IT energies upon. The findings indicate that nations focus their resources (time, money, personnel etc.) on the priorities they feel they should, whether those stem from needs analyses or politics. However, by learning about what other nations are prioritizing, a country can use that knowledge to help focus their own national health IM/IT priorities. The questionnaire results drew attention to the most frequently encountered challenges the five countries face in moving their national health IM/IT agendas forward. The feedback from the respondents provided individual reflections on how IM/IT implementations are actually progressing in their country, where problems are being encountered, including the nature of those problems, and in some cases, respondents offered insight on how to better deal with the challenges they face. The findings indicate that nations encounter similar problems in implementing IM/IT into healthcare settings. Currently, the world is facing many of the same healthcare system issues: shortages of healthcare processionals, long surgical and diagnostic imaging waitlists, ‘skyrocketing’ pharmaceutical drug pricing, healthcare funding practices, and challenges with implementing healthcare IM/IT priorities to name a few. If countries are facing similar health system problems, then it would be logical to assume that solutions to deal with such problems would be similar across nations. Thus, it is recommended that international fora and conferences be held to further discuss the types of health system IM/IT priorities that countries are implementing at a nation scale, the kinds of challenges they face and the solutions or conclusions that they have formulated in response to these challenges.

Bakgrund: Fetma är ett kroniskt hälsotillstånd som ökat kraftigt i alla delar av samhället. Det leder till en rad hälsoproblem såsom hjärt- och kärlsjukdomar och diabetes. Studier visar att patienter med fetma ofta utsätts för stigmatisering i vården och att det påverkar vårdkvalitén. För att kunna ge optimal vård är det av vikt att förstå vårdpersonalens erfarenheter av att vårda patienter med fetma. Syfte: Syftet med litteraturöversikten var att beskriva vårdpersonals erfarenheter av att vårda patienter med övervikt och fetma. Metod: En litteraturstudie baserad på nio kvalitativa studier publicerade 2010–2020. Litteratursökning gjordes i databaserna PubMed och CINAHL. Analysen gjordes enligt Fribergs femstegsmodell. Resultat: Utifrån analysen skapades två huvudteman med tre underteman vardera. Resultatets huvudteman är: Kunskap och färdigheter samt Rädsla, osäkerhet och frustration.  Konklusion: Vårdpersonal upplever vårdandet av patienter med fetma som svårt och det försvåras ytterligare av organisation och samhällsaspekter. En högre prioritering av fetma, tydliga riktlinjer och samarbete inom vård och samhälle behövs för att förbättra vårdupplevelsen för både vårdpersonal och patient. Mer forskning och en aktiv debatt kring vårdandet av patienter med fetma behövs       Nyckelord: Erfarenheter, fetma, hälso- och sjukvårdsprioriteringar, vård av fetma, vårdpersonal-patientrelationer / Background: Obesity is a chronic health condition that has increased in all parts of society in later years. Obesity leads to many health issues such as cardiovascular diseases and diabetes. Studies has shown that patients with obesity are often stigmatized in a health care setting, which effects the quality of the care provided. It is of importance to understand health care professionals’ experiences of providing care to patients with obesity. Aim: The aim of this study was to describe health care professionals’ experiences of providing care to overweight and obese patients. Methods: A literature review based on nine qualitative studies published 2010-2020. Studies were found in the databases PubMed and CINAHL. The analysis was conducted using Freberg's five step model. Results: The analysis provided two main themes with three subthemes each. The themes were: Knowledge and skills and Fear, insecurity and frustration. Conclusion: Health care personnel experience providing care to patients with obesity as being difficult and made harder by organizational and societal aspects. A higher priority of obesity as well as clear guidelines and increased cooperation in health care and society is needed to improve both the care provided and the experience of providing care.  More research and an active debate relating obesity care is needed.         Keywords: Experience, Health Priorities, obesity, obesity care, professional-patient relations

<p> </p><p><strong>Aim.</strong> To describe patients who have got a recommendation by a telenurse to visit the emergency department and how many of these patients could have received care in the primary health care instead. Further on, the aim was to describe if there are patients not following the recommendations.</p><p><strong>Methods.</strong> Quantitative, descriptive study, with an examination of medical records of the patients, which the telenurses recommended to visit the emergency department, during one week. Assessments whether the patient could seek medical care at the primary health care was made, firstly based on the telenurses documentation and secondly on both the telenurses and the emergency department´s documentation.<strong></strong></p><p><strong>Results.</strong> 15 % of the patients could have gotten care at the primary health care center, based on the first assessment. 33 % could have gotten care at the primary health care center, according to the second assessment. One fifth of the patients chose not to visit the emergency department even though the telenurses recommended it.<strong></strong></p><p><strong>Conclusion.</strong> The telenurses recommended the patients to the right level of care in seven out of ten cases. We consider the telenurses' assessments to work well.<strong> </strong></p><p> </p> / <p> </p><p><strong>Syfte. </strong>Att beskriva vilka patienter som blir rekommenderade av sjukvårdsrådgivningen att söka till akutmottagningen, samt hur stor andel av dessa patienter som hade kunnat få vård i primärvården istället. Syftet var vidare att beskriva vilka och hur många patienter som blivit rekommenderade av sjukvårdsrådgivningen till akutmottagningen som inte följer denna rekommendation.</p><p><strong>Metod. </strong>Kvantitativ, beskrivande studie, med journalgranskning av de patienter som rekommenderas till akutmottagningen av sjukvårdsrådgivningen under en veckas tid. Bedömning av huruvida patienten kunde söka vård i primärvården gjordes, först utifrån sjukvårdsrådgivningen dokumentation och sedan utifrån både sjukvårdsrådgivningens och akutmottagningens dokumentationen.</p><p><strong>Resultat. </strong>Sjutton av de 111 patienterna (15 %) hade kunnat få vård i primärvården, bedömt utifrån sjukvårdsrådgivningens dokumentation. 33 % hade kunnat få vård i primärvården, bedömt utifrån både sjukvårdsrådgivningens och akutmottagningens dokumentation. En femtedel av patienterna valde att inte komma till akutmottagningen trots att sjukvårdsrådgivningen rådde dem till detta.</p><p><strong>Slutsats.</strong> Totalt sett rekommenderade telefonsjuksköterskorna patienterna till rätt vårdnivå i sju fall av tio, trots de svårigheter som rådgivning och bedömning via telefon medför. Därför anser vi att sjukvårdsrådgivningens bedömningar fungerar bra. En femtedel av patienterna valde att inte komma trots rekommendationen och till detta har vi inte funnit något särskilt skäl.</p><p> </p>

Aim. To describe patients who have got a recommendation by a telenurse to visit the emergency department and how many of these patients could have received care in the primary health care instead. Further on, the aim was to describe if there are patients not following the recommendations. Methods. Quantitative, descriptive study, with an examination of medical records of the patients, which the telenurses recommended to visit the emergency department, during one week. Assessments whether the patient could seek medical care at the primary health care was made, firstly based on the telenurses documentation and secondly on both the telenurses and the emergency department´s documentation. Results. 15 % of the patients could have gotten care at the primary health care center, based on the first assessment. 33 % could have gotten care at the primary health care center, according to the second assessment. One fifth of the patients chose not to visit the emergency department even though the telenurses recommended it. Conclusion. The telenurses recommended the patients to the right level of care in seven out of ten cases. We consider the telenurses' assessments to work well. / Syfte. Att beskriva vilka patienter som blir rekommenderade av sjukvårdsrådgivningen att söka till akutmottagningen, samt hur stor andel av dessa patienter som hade kunnat få vård i primärvården istället. Syftet var vidare att beskriva vilka och hur många patienter som blivit rekommenderade av sjukvårdsrådgivningen till akutmottagningen som inte följer denna rekommendation. Metod. Kvantitativ, beskrivande studie, med journalgranskning av de patienter som rekommenderas till akutmottagningen av sjukvårdsrådgivningen under en veckas tid. Bedömning av huruvida patienten kunde söka vård i primärvården gjordes, först utifrån sjukvårdsrådgivningen dokumentation och sedan utifrån både sjukvårdsrådgivningens och akutmottagningens dokumentationen. Resultat. Sjutton av de 111 patienterna (15 %) hade kunnat få vård i primärvården, bedömt utifrån sjukvårdsrådgivningens dokumentation. 33 % hade kunnat få vård i primärvården, bedömt utifrån både sjukvårdsrådgivningens och akutmottagningens dokumentation. En femtedel av patienterna valde att inte komma till akutmottagningen trots att sjukvårdsrådgivningen rådde dem till detta. Slutsats. Totalt sett rekommenderade telefonsjuksköterskorna patienterna till rätt vårdnivå i sju fall av tio, trots de svårigheter som rådgivning och bedömning via telefon medför. Därför anser vi att sjukvårdsrådgivningens bedömningar fungerar bra. En femtedel av patienterna valde att inte komma trots rekommendationen och till detta har vi inte funnit något särskilt skäl.