890 research outputs found

    Effect of a Robust Electronic Medical Record Order Set on Hepatitis C Screening Rate at a Community Hospital

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    Background: Hepatitis C Virus (HCV) infection is a liver infection that typically begins as an acute infection and if left untreated, can become a chronic infection. One-time HCV testing is recommended by the CDC and United States Preventive Services Task Force (USPSTF) for asymptomatic individuals based on evaluated exposure or other circumstances that increase HCV exposure (HCV Guidance, 2018); (CDC, 2012). Patients with severe mental disorders, such as schizophrenia and bipolar disorders are particularly at risk for HCV infection with past studies finding approximately 6.2 - 29.8% of patients with severe mental disorders having comorbid HCV (Ayano et al., 2018) – up to 9 times higher than the general US population (Rifai, Gleason, & Sabouni, 2010). This study focuses on the effectiveness of an established universal HCV screening protocol utilizing the electronic medical record (EMR) “EPIC” in the Psychiatric and Addiction Recovery Center (PARC) at Pen Bay Medical Center (PBMC) for an at-risk population, evaluating the rate of screening, diagnosis, and follow-up care of HCV

    Understanding barriers to women seeking and receiving help for perinatal mental health problems in UK general practice: development of a questionnaire

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    Aim To develop a questionnaire to measure quantitatively barriers and facilitators to women’s disclosure of perinatal mental health problems in UK primary care. To pilot and evaluate the questionnaire for content validity and internal consistency. Background Around 15% of women develop a mental illness in the perinatal period, such as depression, anxiety or PTSD. In the United Kingdom, 90% of these women will be cared for in primary care, yet currently in as many as 50% of cases, no discussion of this issue takes place. One reason for this is that women experience barriers to disclosing symptoms of perinatal mental illness in primary care. These have previously been explored qualitatively, but no tool currently exists with which to measure these barriers quantitatively. Methods Questionnaire items, drawn from qualitative literature and accounts of women’s experiences, were identified, refined iteratively, and arranged in themes. The questionnaire was piloted using cognitive debriefing interviews to establish content validity. Women completed a refined version online. Responses were analysed using descriptive statistics. Internal consistency of subscales was calculated using Cronbach’s alpha. Findings Cognitive debriefing interviews with five women showed the majority of questionnaire items were relevant, appropriate and easy to understand. The final questionnaire was completed by 71 women, and the majority of subscales had good internal consistency. The barrier scoring most highly was fear and stigma, followed by willingness to seek help and logistics of attending an appointment. Family/partner support and GPs’ reaction were the lowest scoring barriers. Factors facilitating disclosure were GPs being empathetic and non-judgemental, and listening during discussions. In the future this questionnaire can be used to examine which barriers are most important for particular groups of women. This may enable development of strategies to improve acknowledgement and discussion, and prevent under-recognition and under-treatment, of perinatal mental health problems in primary care

    Subjective Mapmaking: Visual Interviews in Spitalfields

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    The maps represent a method of co-creating maps with members of the public through interview. Working with illustrator Hannah McNally we visualised a series of conversations live with members of the public that explored their experiences of space, history and community in and around Spitalfields Market. Over the days we built up over multiple layers of mapped information about Spitalfields. The maps were on display to the public in the market space for the 4 days of the event. They generated conversations, debate and differences of opinion. They also allowed people to look at the area from other people’s perspective, offering alternative narratives, histories and experiences of the same space

    Trends in silicosis prevalence and the healthy worker effect among gold miners in South Africa: a prevalence study with follow up of employment status.

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    BACKGROUND: Given the intimate association between silicosis and tuberculosis, understanding the epidemiology of the South African gold mining industry silicosis epidemic is essential to current initiatives to control both silicosis and tuberculosis in this population, one of the most heavily affected globally. The study's objectives were to compare the prevalence of silicosis among working black gold miners in South Africa during 2004-2009 to that of previous studies, including autopsy series, and to analyse the influence of silicosis and/or tuberculosis on exiting employment. METHODS: Routine chest radiographs from a cohort of gold miners were read for silicosis by an experienced reader (I), and a subset re-read by a B-trained reader (II). Two methods of presenting the readings were used. Additionally, with baseline status of silicosis and previous or active tuberculosis as predictors, survival analysis examined the probability of exiting the workforce for any reason during 2006-2011. RESULTS: Reader I read 11 557 chest radiographs and reader II re-read 841. Overall, silicosis prevalence (ILO ≥ 1/0: 5.7 and 6.2% depending on reader method) was similar to the age adjusted prevalence found in a large study in 1984 (5.0%). When comparison was restricted to a single mine shaft previously studied in 2000, a decline in prevalence (ILO ≥ 1/1) was suggested for one of the reading methods (duration adjusted 20.5% vs. 13.0% in the current study). These findings are discordant with a long-term rising autopsy prevalence of silicosis over this period. Overall, relative to miners with neither disease, the adjusted hazard ratio for exiting employment during the follow-up period was 1.54 for baseline silicosis [95% confidence interval (CI) 1.17, 2.04], 1.71 for tuberculosis (95% CI 1.51, 1.94) and 1.53 for combined disease (95% CI 1.20, 1.96). CONCLUSIONS: This study found, a) there was no significant decline in overall silicosis prevalence among working black miners in the South African gold mining industry between 1984 and 2004-2009, and b) a possible decline at one mine shaft more recently. In the absence of evidence of declining respirable silica concentrations between the 1980s and 2000s, the trends found are plausibly due to a healthy worker survivor effect, which may be accelerating

    Correlating incidences of Dreissena polymorpha colonization with trematode larvae infection in Stagnicola emarginata snails.

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    General EcologyThe invasive zebra mussel (Dreissena polymorpha), has negatively impacted many northern Michigan aquatic species in the past 20 years (Strayer, 2009). One of the species affected has been Stagnicola emerginata, a freshwater snail. This species of snail also acts as the intermediate host for the larvae of a number of trematode species which increase the size of the snail, possibly making them more vulnerable to zebra mussel colonization (Horak and Adema, 2002).The purpose of this study was the determination of a correlation between schistosome parasitism, and Dreissena polymorpha colonization on Stagnicola emerginata. Over 2000 snails were collected from Burt Lake MI, and where individually examined for cercarial emergence using fluorescent lighting to induce shedding. Rates of schistosome parasitism were correlated with presence or absence of D. polymorpha on each specimen. Based upon the analysis of these data, it has been concluded that no link, positive or negative, between schistosome parasitism and D. polymorpha colonization on the snails may be supported. The lack of negative effects on the S. emerginata seems to indicate prudent parasitism by the larvae.http://deepblue.lib.umich.edu/bitstream/2027.42/64865/1/Boumediene_Zackariah_2009.pd
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