We conducted a qualitative study of the system for contagious disease surveillance in Norway. Semi-structured interviews were held with five general practitioners (GPs), including one person responsible for informing GPs in their region about potentially serious disease outbreaks. The interviews suggested that the existing system had several limitations, making it of little relevance to local epidemics or daily medical practice. Specifically, it was difficult and time-consuming for physicians to locate relevant information, and there was a substantial delay between reported diagnoses and eventual feedback about outbreaks. This resulted in information that was too old to be of value. The interviews also investigated design matters related to future realtime disease surveillance systems. The GPs expressed interest in a distributed system for realtime extraction and presentation of data from electronic record systems. They required that any such system be customizable to the specific needs of the doctor in order to be relevant in day-to-day practice, and that correct interpretation of data would be possible in the minimum of time.
A higher risk of common mental health disorders has been found for first-generation migrants in high income countries, but few studies have examined the use of mental health care. This study aimed to identify the level of antidepressant use amongst the largest first generation migrant groups resident in Finland.
This cohort study used record-based data linkage methodology to examine the hazard of antidepressant use between migrant groups in Finland using Cox proportional hazard models. Data was derived using socio-demographic and prescription data from Statistics Finland and the Finnish Population Registry. The cohort included a random sample of 33% of the working age population in 2007 (N?=?1,059,426, 49.8% women, 2.5% migrants) and dispensed antidepressant prescriptions from 2008 to 2014.
After adjustment for socio-demographic characteristics, results show higher antidepressant use for female migrants from North Africa and the Middle East compared to the Finland-born majority, a similar level of use for migrants from Western countries, and lower use for migrants from other non-Western countries.
The gender and country of origin dependent use of antidepressant medication is discussed in terms of socio-political and cultural between-group differences. Recommendations are made to address inequalities in accessing services, particularly for migrants from non-Western countries.
Aims: Higher incidence of psychotic disorders in high-income countries for migrants compared with the settled majority has been well established. However, it is less clear to what extent different migrants groups have accessed and utilised mental health care. This study aimed to identify the hazard of antipsychotic medication use in the largest migrant groups in Finland, compared with a Finnish-born comparison group, using high quality datasets maintained by Statistics Finland and Social Insurance Institution Finland, and linking socio-demographic and -economic characteristics to antipsychotic prescription purchases. Methods: The study draws on a representative sample of 33% of the adult working-age population of Finland in 2005 (n = 1,059,426, 50.2% male, 2.5% migrant). The use of antipsychotic drugs was followed-up from 2005 to 2014. Results: The results show that the hazard of antipsychotic medication purchases differed between migrant groups, with a higher hazard for migrants from North Africa and the Middle East before socio-economic adjustment (men HR 1.19, 95%?CI 1.04-1.37; women HR 1.37, 95%?CI 1.12-1.66), and a lower hazard for all migrant groups after adjustment for socio-economic characteristics compared with the Finland-born population. Conclusions: The findings suggest that attention should be paid to the lower use of medication for psychotic disorders in some migrant groups, as well as the potential role of social disadvantage for migrants from North Africa and Middle East.
Lack of a proper infrastructure of health care providers leads to the breaks in the health care process Informatization. This results in the manifestation of different data entry point. The different data sets that are entered in these different points tend to serve the same task. However, due to the different qualification of staff a consistency of data cannot be preserved. The paper presents an approach where data is split to the different levels.
An increasing number of ethnic minorities are expected to enter the United States workforce based on projected demographic changes. This includes American Indian/Alaskan Native (AI/AN) nurses. Sociocultural influences on sleep disturbances, sleepiness, and other aspects related to shift-work tolerance are of unrecognized importance. More minority nurses are needed to provide culturally congruent care; however, AI/AN nurses represent less than 1% of nurses located throughout the American workforce. This article aims to verify the feasibility of Internet data collection (Web-based survey) methods and instrument stability as the first part of a two-phase study comparing individual differences and shift-work-related sleep disturbances between AI/AN and White non-Hispanic (WNH) nurses. In the first phase, an Internet survey was used to reach a cross-section of AI/AN and WNH nurses. The on-line survey was composed of accepted shift-work-related instruments. Items estimating sleep disturbances, sociocultural choices, time awareness, polychronicity, morningness/ eveningness, ethnic identity, and demographic questions were asked. The survey was linked to a series of Web pages describing the study purpose, inclusion and exclusion criteria, consent form, Web survey, and the second phase of the study in which subjects were invited to participate in actigraphy measurements. The survey was pilot-tested for error codes, item confusion, length, and completion time. Forced-answer questions were added asking ethnicity, age group, license type, state where licensed, and legal name on nursing license before accessing the survey. Data were saved periodically, cued by the word "continue." The database was located on a secure server and password protected. Nurses were recruited using published articles and printed advertisements, hospital e-mail systems, national nursing organization Web sites (minoritynurse.com; NANAINA.org), nursing Web site discussion groups, snow-balling, and word of mouth. The site was accessed 656 times with the Internet survey being completed by 138 WNH and 56 AI/AN nurses meeting the inclusion criteria. Except for the polychronicity measure (PAI3), instruments measuring time awareness, chronotype, and situational sleepiness achieved acceptable reliability coefficients with Internet data collection. Using pull-down menus would improve questions asking specific times. Internet data collection with different ethnic groups is possible; however, accessing the target population may be difficult. Despite extensive recruitment efforts, few AI/AN nurses participated. Computer literacy and failing to relate to the study's purpose may have limited the interest of the AI/AN nurses. It is possible to recruit nurse shift workers and collect individual difference and sleep disturbance data through the Internet; however, the researcher must remain vigilant throughout the process.
In 2011, a panel of primary healthcare (PHC) providers in Nova Scotia rated 19 of 35 selected Canadian Institute for Health Information (2006) clinical quality indicators (QIs) as "acceptable." In this study, the authors explored the feasibility of extracting electronic medical record (EMR) data required to create these PHC QI measures.
To evaluate the quality of reports of complementary and alternative medicine (CAM) randomized controlled trials (RCTs) in the pediatric population. We also examined whether there was a change in the quality of reporting over time.
We used a systematic sample of 251 reports of RCTs that used a CAM intervention. The quality of each report was assessed using the number of CONSORT checklist items included, the frequency of unclear allocation concealment, and a 5-point quality assessment instrument.
Nearly half (40%) of the CONSORT checklist items were included in the reports, with an increase in the number of items included. The majority (81.3%) of RCTs reported unclear allocation concealment with no significant change over time. The quality of reports achieved approximately 40% of their maximum possible total score as assessed with the Jadad scale with no change over time. Information regarding adverse events was reported in less than one quarter of the RCTs (22%) and information regarding costs was mentioned in only a minority of reports (4%).
RCTs are an important tool for evidence based health care decisions. If these studies are to be relevant in the evaluation of CAM interventions it is important that they are conducted and reported with the highest possible standards. There is a need to redouble efforts to ensure that children and their families are participating in RCTs that are conducted and reported with minimal bias. Such studies will increase their usefulness to a board spectrum of interested stakeholders.
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