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Barriers that practitioners face when initiating insulin therapy in general practice settings and how they can be overcome

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World Journal of Diabetes 2017年第1期8卷 28-39页

作者： Abdulaziz Bin rsheed Ian Chenoweth department of Family and community medicine Prince Sultan Military Medical City department of General Practice School of Primary Health Care Faculty of MedicineNursing and Health Sciences Monash University

AIM To explore primary care physicians' perspectives on possible barriers to the use of *** This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eight electronic databases were searched(between January 1, 1994 and August 31, 2014) for relevant studies. A search for grey literature and a review of the references in the retrieved studies were also conducted. Studies that focused on healthcare providers' perspectives on possible barriers to insulin initiation with type 2 diabetic patients were included, as well as articles suggesting solutions for these barriers. Review articles and studies that only considered patients' perspectives were excluded. RESULTS A total of 19 studies met the inclusion criteria and were therefore included in this study: 10 of these studies used qualitative methods, 8 used quantitative methods and 1 used mixed methods. Studies included a range of different health care settings. The findings are reported under four broad categories: The perceptions of primary care physicians about the barriers to initiate insulin therapy for type 2 diabetes patients, how primary care physicians assess patients prior to initiating insulin, professional roles and possible solutions to overcome these barriers. The barriers described were many and covered doctor, patient, system and technological aspects. Interventions that focused on doctor training and support, or IT-based decision support were few, and did not result in significant improvement. CONCLUSION Primary care physicians' known delay in insulin initiation is multifactorial. Published reports of attempts to find solutions for these barriers were limited in number.

关键词： Diabetes Insulin Initiation Delay Barriers Primary care physicians

Telemedicine and public health–pearls and pitfalls

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World Journal of Methodology 2025年第2期15卷 177-179页

作者： Ranjeet Kumar Sinha Sony Sinha Prateek Nishant Arvind Kumar Morya Arshi Singh department of community medicine Patna Medical CollegePatna 800004BiharIndia department of Ophthalmology-Vitreo-Retina Neuro-Ophthalmology and OculoplastyAll India Institute of Medical SciencesPatna 801507BiharIndia department of Ophthalmology ESIC Medical CollegePatna 801103BiharIndia department of Ophthalmology All India Institute of Medical SciencesHyderabad 508126TelanganaIndia department of Ophthalmology Guru Nanak Eye CenterNew Delhi 110001India

We hereby comment on the interesting systematic review by Grewal et al where they have provided an overall picture of the current status of available tele-health programs in the United States with emphasis on the Amazon *** analysis is an appreciable effort in discovering the features available and features lacking in these tele-health *** concept of tele-health originated to curtail the need for physical attendance of patients at health clinics,and has been beneficial during the coronavirus disease 2019 *** implore that the pearls and pitfalls of these programs have to be understood by policymakers prior to forming a consensus regarding the availability,accessibility and affordability of these programs as methods of healthcare *** proliferation of tele-health programs in their current form may pose threats to patient and provider safety and medicolegal ***,patients and providers must work together to improve them to meet their expectations and enable them to provide the best care for the ailing public.

关键词： Telemedicine Remote Access Availability Accessibility Affordability Ethics Privacy Medicolegal liability

health problems among street children seeking care in the Center for Social and Preventive medicine in Egypt

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World Journal of Pediatrics 2017年第5期13卷 503-507页

作者： Hoda Ibrahim Rizk Nihal Mohamed El Rifai Hana Mohamed Aboulghar Public health and community medicine department Faculty of MedicineCairo UniversityCairoEgypt Pediatrics department Faculty of MedicineCairo UniversityCairoEgypt

Background:In Egypt,around 1 million children are on the *** children's health is an issue that is not well *** objective of the current study was to determine the health problems of a targeted group of street children seeking medical care and to generate a hypothesis about the positive/negative role of street children care ***:A cross-sectional study was done on 2169 street children who sought medical care at El-Basma clinic at the Center for Social and Preventive medicine in Cairo University Children Hospital from January 2011 to July ***:Respiratory illnesses and skin problems were the most prevalent conditions,affecting 485 (22.4%) and 359 (16.6%) of the patients,*** issues and trauma were significantly higher among the adolescent *** and gastrointestinal problems were significantly higher among children aged less than 2 *** and cardiac problems were significantly higher among those referred from organizations whereas trauma was significantly higher among those coming directly from the streets.A significant proportion of children at the extremes of the studied age spectrum were coming directly from the *** transmitted infections were rare ***:Respiratory and skin diseases were the major morbidity problems among street children,especially adolescent *** afforded opportunities for access to different health care services.

关键词： Egypt health problems street children

Diagnosis of pervasive developmental disorders:when and how?An area-based study about health care providers

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World Journal of Pediatrics 2015年第1期11卷 48-53页

作者： Silvia Manea Laura VisonàDalla Pozza Monica Mazzucato Oliviana Gelasio Paola Facchin Veneto Region Child&Mother health Observatory Epidemiology and Community Medicine UnitDepartment of PediatricsPadua University

Background:Pervasive developmental disorders(PDDs)can be very difficult to diagnose in children and to communicate such a diagnosis to their *** of children with PDD learn of their child's diagnosis long after the first symptoms are noted in the child's ***:An area-based survey was conducted to assess all social and health care providers taking care of patients with PDDs in the Veneto Region(North-East Italy).Results:Only 28%of health care providers arrived at a definite diagnosis when the child was in his/her first year of age,51%when the child was 2-3 years old and 21%from age of 4 years and *** average,the latency between the time of the diagnosis and its communication to the family was 6.9 ***,a number of families did not ever have a diagnosis communicated to ***,68%of the providers did not communicate a PDDs diagnosis to patient's families,and 4%of them quite ***:The well-known delay in making a diagnosis of PDDs has two distinct components:one relating to the difficulty of confirming a diagnosis of PDDs,the other,hitherto unrecognized,relating to the family being notified.

关键词： autism,pervasive development disorders classification system communication diagnosis

The antitumor effect of tanshinone IIA on antiproliferation and decreasing VEGF/VEGFR2 expression on the human non-small cell lung cancer A549 cell line

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Acta Pharmaceutica Sinica B 2015年第6期5卷 554-563页

作者： Jun Xie Jiahui Liu Heng Liu Shihui Liang Meigui Lin Yueyu Gu Taoli Liu Dongmei Wang Hui Gee Sui-lin Mo department of Traditional Chinese medicine The First Affiliated HospitalSun Yat-sen University Huanghuagang Street community health Service Center Liwan District Shiweitang Street community health Service Center School of Pharmaceutical Sciences Sun Yat-sen UniversityGuangzhou Higher Education Mega Center health care and Physical Examination Center The First Affiliated HospitalSun Yat-sen University

The effects of tanshinone IIA on the proliferation of the human non-small cell lung cancer cell line A549 and its possible mechanism on the VEGFNEGFR signal pathway were investigated. The exploration of the interaction between tanshinone IIA and its target proteins provides a feasible platform for studying the anticancer mechanism of active components of herbs. The CCK-8 assay was used to evaluate the proliferative activity of A549 cells treated with tanshinone IIA (2.5-80 mu mol/E) for 24, 48 and 72 h, respectively. Flow cytometry was used for the detection of cell apoptosis and cell cycle perturbation. VEGF and VEGFR2 expression were studied by Western blotting. The binding mode of tanshinone IIA within the crystal stmcture of the VEGFR2 protein was evaluated with molecular docking analysis by use of the CDOCKER algorithm in Discovery Studio 2.1. The CCK-8 results showed that tanshinone IIA can significantly inhibit A549 cell proliferation in a dose- and time-dependent manner. Flow cytometry results showed that the apoptosis rate of tested group was higher than the vehicle control, and tanshinone IIA-treated cells accumulated at the S phase, which was higher than the vehicle control. Furthermore, the expression of VEGF and VEGFR2 was decreased in Western blot Finally, molecular docking analysis revealed that tanshinone IIA could be stably docked into the kinase domain of VEGFR2 protein with its unique modes to form H-bonds with Cys917 and pi-pi stacking interactions with Va1848. In conclusion, tanshinone IIA may suppress A549 proliferation, induce apoptosis and cell cycle arrest at the S phase. This drug may suppress angiogenesis by targeting the protein kinase domains of VEGF/VEGFR2. (C) 2015 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.

关键词： Non-small cell lung cancer Tanshinone IIA VEG/VEGFR signal pathway Molecular docking

Personality Traits, Medication Beliefs &Adherence to Medication among Diabetic Patients Attending the Diabetic Clinic in a Teaching Hospital in Southwest Nigeria

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Journal of Diabetes Mellitus 2015年第4期5卷 319-329页

作者： Adeyinka Adeniran Modupe Akinyinka Kikelomo O. Wright Omowumi Q. Bakare Olayinka O. Goodman Yetunde A. Kuyinu Olumuyiwa O. Odusanya Akin Osibogun department of community health and Primary health care College of Medicine Lagos State University Lagos Nigeria department of community health and Primary care College of Medicine University of Lagos Lagos Nigeria

Background: Non-adherence to drug therapy is an important cause of treatment failure among patients with chronic conditions like diabetes. Previous researches have presented associations among personality traits, medication beliefs and adherence to long-term medication treatment in individuals with different chronic diseases. However, there is limited knowledge about associations among personality traits, medication belief and adherence to diabetic treatment in Africa. It was on this basis that this study was undertaken to assess the personality traits and personal beliefs of patients on medication for Diabetes Mellitus (DM) and to also assess adherence to treatment. Methodology: This study was a descriptive cross sectional study. Using a systematic random sampling technique, 223 patients attending the diabetic clinic of Lagos State University Teaching Hospital, Lagos were selected over a period of 12 weeks. Patients were interviewed using the Big Five-factor Personality Inventory, Medication Belief Questionnaire and the Medication Adherence Report Scale. Data were statistically analyzed using descriptive statistics, Student’s t-tests, Chi Square Tests and Pearson’s correlations analysis. Results: Non-adherence was estimated to be 40.8%. Non-adherent respondents had lower mean score of neuroticism personality traits compared to adherent respondents. Pearson’s correlation analysis showed a weak negative relationship between neuroticism personality trait and adherence behaviour (P healthcare providers should therefore pay more attention to the personality traits an

关键词： Personality Traits Medication Beliefs Adherence to Medication Diabetes

Attitude, Practice, and Factors Affecting Contraceptive Use among Women Attending Postnatal care in a Tertiary health Facility in Jos North LGA, Plateau State, Nigeria

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 814-831页

作者： Kingsley Chinedu Okafor David Victor Omeiza Lucy Ochanya Idoko Effiong Anne Inyangobong Ochuma Emmanuel Unubi Amos Paul Bassi department of community medicine & Primary health care Bingham University Karu Nigeria community health and Primary health care Bingham University Karu Nigeria

The high population growth rate has been associated with the increased level of poverty, morbidity, mortality, and decreased life expectancy. Modern contraception is an important factor in controlling fertility through prevention of unintended and unwanted pregnancies. Contraception (birth control) prevents pregnancy by interfering with the normal process of ovulation, fertilization, and implantation. Contraceptive use is still very low in Nigeria and Sub-Saharan Africa (SSA), where the levels of fertility and unmet need for family planning are high. The attitude of women toward contraception will usually affect the practice and utilization of contraceptives. The objective of this study is to assess the attitude, prevalence, and factors affecting contraceptive use among women attending Postnatal care in a tertiary health facility in Jos North L. G. A Plateau State, Nigeria. There was a descriptive cross-sectional study done between September to October 2019, with a sample size of 250 women. Respondents were determined using a multi-stage sampling method. Data collection was done using an interviewer-administered, pre-tested, structured questionnaire. The data was collected, entered, and analyzed using IBM Statistical package for social sciences (SPSS) version 20.0. Most women have a positive attitude 162 (64.8%) toward contraception while 88 (35.2%) had negative attitude toward contraception. Three quarters (75.2%) of women are willing to use contraception. The prevalence of contraceptive use among respondents was 35.6% while the prevalence of previous use of contraceptives among the respondents was 71.2%. Fifty (27.9%) used condom (barrier method), 40 (22.9%) used withdrawal method. Majority of the other respondents were spread across OCPs, injectables and implants. Major factors affecting the use of contraceptives were majorly attributed to informed choice with 60.1%, Partner’s decision (44.1%) and mild or no adverse reaction (12.8%). While major factors preventin

关键词： Attitude Contraception Postnatal Women

Qualitative Assessment of Knowledge, Attitude, and Practice of Contraceptives among Women Attending Postnatal care in a health Facility in Jos, Plateau State, Nigeria

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 706-718页

作者： Kingsley Chinedu Okafor Lucy Ochanya Idoko Emmanuel Unubi Ochuma Anne Inyangobong Effiong David Victor Omeiza Amos Paul Bassi department of community medicine & Primary health care Bingham University Karu Nigeria community health and Primary health care Bingham University Karu Nigeria

Background: Contraceptive acceptance and utilization in society has been a huge challenge for communities in developing countries. There is a need to support the increase in the utilization of contraception and family planning services. In all this, good knowledge and practice of contraception services will enable women to select the best methods. The study seeks to qualitatively assess the knowledge, attitude, and practice of contraceptive use among women attending postnatal care in a health facility in Jos, Plateau State, Nigeria. Methods: This qualitative study was conducted in Bingham University Teaching Hospital, Jos, Plateau State in September 2019. This study utilized Focus Group Discussions among 36 women recruited using the purposive sampling technique. There were four (4) sessions involving nine (9) women per session. Findings: Of the 36 women, a majority (88.9%) had positive perception regarding contraception, all agreed that contraception and family planning is beneficial to families and communities. A majority felt that communities are yet to accept contraception. Most (83.3%) of the women had good knowledge of contraception. Three-quarters (77.8%) of the women have used contraception in the past, and about half (41.7%) are using it currently. Attitude towards adoption of contraceptives after current pregnancy was generally good. About half (52.7%) of the participants stated they required spousal approval before they adopt a method of contraception. Conclusion: There is a need for health agencies, development partners, and government to continue the health education, community sensitization, and support towards making contraception and family planning commodities available and accessible.

关键词： Contraception Family Planning Knowledge Practice Women

Latest incidence and electrocardiographic predictors of atrial fibrillation:a prospective study from China

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Chinese Medical Journal 2023年第3期136卷 313-321页

作者： Yong Wei Genqing Zhou Xiaoyu Wu Xiaofeng Lu Xingjie Wang Bin Wang Caihong Wang Yahong Shen Shi Peng Yu Ding Juan Xu Lidong Cai Songwen Chen Wenyi Yang Shaowen Liu department of Cardiology Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghai 200080China Shihudang community health care Center Shanghai 201604China Dongjing community health care Center Shanghai 201619China Xinbang community health care Center Shanghai 201605China Maogang community health care Center Shanghai 201607China

Background:China bears the biggest atrial fibrillation(AF)burden in the ***,little is known about the incidence and predictors of *** study aimed to investigate the current incidence of AF and its electrocardiographic(ECG)predictors in general community individuals aged over 60 years in ***:This was a prospective cohort study,recruiting subjects who were aged over 60 years and underwent annual health checkups from April to July 2015 in four community health centers in Songjiang District,Shanghai,*** subjects were then followed up from 2015 to 2019 *** on sociodemographic characteristics,medical history,and the resting 12-lead ECG were ***–Meier curve was used for showing the trends in AF incidence and calculating the predictors of *** of ECG abnormalities and AF incidence were examined using Cox proportional hazard ***:This study recruited 18,738 subjects,and 351(1.87%)developed *** overall incidence rate of AF was 5.2/1000 person-years during an observation period of 67,704 *** Cox regression analysis indicated age(hazard ratio[HR],1.07;95%confidence interval[CI]:1.06–1.09;P<0.001),male(HR,1.30;95%CI:1.05–1.62;P=0.018),a history of hypertension(HR,1.55;95%CI:1.23–1.95;P<0.001),a history of cardiac diseases(HR,3.23;95%CI:2.34–4.45;P<0.001),atrial premature complex(APC)(HR,2.82;95%CI:2.17–3.68;P<0.001),atrial flutter(HR,18.68;95%CI:7.37–47.31;P<0.001),junctional premature complex(JPC)(HR,3.57;95%CI:1.59–8.02;P=0.002),junctional rhythm(HR,18.24;95%CI:5.83–57.07;P<0.001),ventricular premature complex(VPC)(HR,1.76;95%CI:1.13–2.75,P=0.012),short PR interval(HR,5.49;95%CI:1.36–22.19;P=0.017),right atrial enlargement(HR,6.22;95%CI:1.54–25.14;P=0.010),and pacing rhythm(HR,3.99;95%CI:1.57–10.14;P=0.004)were independently associated with the incidence of ***:The present incidence of AF was 5.2/1000 person-years in the studied population aged over 60 years in China.

关键词： Atrial fibrillation Incidence Predictor Electrocardiogram