Perceptions of health disparities among neurologists treating Black patients with epilepsy: A survey study in the United States.

Disparities in Vision Health and Eye Care: Where Do We Go from Here?

Epilepsy is a global public health problem affecting people of all ages, sex, races, nations and social class. The majority of the 50 million people with epilepsy live in developing countries, with a prevalence rate of five to 10 people per 1000. The disease poses an enormous psychological, social and economic burden on patients. An estimated 90% of people with epilepsy in developing countries do not receive treatment due to sociocultural, economic and political factors. Current treatment interventions are limited to the clinical management of the disease and are largely driven by the healthcare provider's perspective, ignoring the experiences of people living with epilepsy (PLWE). The aim of this review was to identify, critically appraise, extract, synthesize and present the best and most current available evidence on the experiences of PLWE in developing countries. • What are the experiences of PLWE regarding the causes of their condition?• What are the experiences of PLWE regarding treatment of epilepsy?• How has epilepsy shaped the social relationships of the affected persons? People living with epilepsy in developing countries (Africa, Asia, Eastern Europe and Latin America).The experiences of PLWE in developing countries with particular attention on the causes, treatment and its impact on their social relationships.Primary research studies with a qualitative design not limited to phenomenology, ethnography, grounded theory, ethnomethodology, phenomenography, critical theory, interpretative or feminist analysis, case study, narrative studies and action research. Qualitative studies conducted in hospitals and community settings in developing countries. A three-step search strategy was used to identify published and unpublished studies in the English language from the 1990s to the present. Identified studies that met the inclusion criteria were retrieved and critically appraised by two independent reviewers prior to their inclusion using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). Data were extracted from included papers using the recommended data extraction form embedded in the JBI-QARI. Findings, where possible, were pooled using the JBI-QARI. It involved the meta-aggregation of findings to generate a set of statements that represented that aggregation, through assembling the findings rated according to their quality, and categorizing these findings on the basis of similarity in meaning. From the 13 studies included in the review, 113 findings were extracted to create categories. Eight categories were created from which three synthesized findings were produced. The synthesized findings were: SYNTHESIZED FINDING 1: People living with epilepsy believed that the disease was caused by factors such as fever, demonic power, beatings, witchcraft, curses and God. Patients also had differing views as to whether the disease was contagious or hereditary. They indicated that the disease manifested as seizures, triggered by fever, stress, depression and anger. SYNTHESIZED FINDING 2: People living with epilepsy used biomedical and traditional methods to treat epilepsy and also developed strategies for coping with the disease beyond seeking treatment. SYNTHESIZED FINDING 3: People living with epilepsy had negative and positive experiences in their social relationships. The negative experiences were linked to the social, psychological and economic burden of the disease on patients, whereas the social support they got from friends, peers, family and community members were the positive aspects. People living with epilepsy attribute the cause of the disease to agents like fever, demonic power and witchcraft. Patients use biomedical and traditional methods to treat the disease and have also developed various coping strategies (like prayers and concealment) alongside treatment. Epilepsy has negative effects on the social relationships of patients and is a social, psychological and economic burden for patients. However, there are some positive effects like the social support they receive from family members, friends and the community.

Using design thinking to strengthen the community pharmacist’s role in epilepsy care

ObjectiveThe objective of the study was to assess level of knowledge and attitudes of SUDEP among people living with epilepsy (PLWE) and healthcare workers providing epilepsy care in Uganda.MethodsThis cross‐sectional study of 48 PLWE and 19 epilepsy care providers used a tailored questionnaire to evaluate epilepsy and SUDEP knowledge, frequency of SUDEP discussion, reasons for not discussing SUDEP, timing of SUDEP discussions, and perceived patient reactions to being provided information on SUDEP.ResultsMedian PLWE sample age was 25 (IQR; 19‐34) years, 10 (20.8%) were male, median age of onset of epilepsy 12 (IQR; 6‐18) years. Half of the PLWE reported that they had never heard of SUDEP. Most PLWE desired detailed information regarding SUDEP and preferred this information during the subsequent visits. Healthcare provider sample mean age was 35.7 (22.8) years, 12 (63.2%) were male and composed of 4 physicians (21.1%). Only 15% (3/20) of providers discussed SUDEP with their patients while 85% (17/20) have never discussed it. The main reasons for not discussing SUDEP were not knowing enough about SUDEP (89.5%) and no adequate support network available (30%). Providers that discussed SUDEP (100%) reported that negative reactions were the most common patient response.SignificanceIn this Ugandan sample, most PLWE are not aware of SUDEP and epilepsy care providers rarely discuss SUDEP with their patients or patient caregivers. Negative reactions to SUDEP discussions are common but not universal. There is an urgent need for epilepsy educational programs in clinics and targeted communities addressing SUDEP.

Quality of life, fatigue and seizure severity in people living with epilepsy in a selected Nigerian population

Community integration of people living with epilepsy in a Nigerian population

Important knowledge items with regard to the benefits of exercise for patients with epilepsy: Findings of a qualitative study from Palestine

Health Systems Need to Transform Data Collection to Advance Health Equity.

Structural Justice Ethics in Health Care

Addressing Social Determinants of Mental Health in Pediatrics During the Coronavirus Disease 2019 Pandemic.

Co-morbidities in people living with epilepsy: Hospital based case–control study from a resource-poor setting

Health disparities in regional anesthesia and analgesia for the management of acute pain in trauma patients.

Health Disparities in Pulmonary Arterial Hypertension and the Impact of the COVID-19 Pandemic

Epilepsy is a neurological condition affecting millions worldwide, especially in low- and middle-income countries. This condition is poorly understood, and various misconceptions surround it, leading to stigma toward people living with epilepsy (PLWE). In rural areas, cultural beliefs and practices significantly shape attitudes toward health and illness, exacerbating the stigma associated with epilepsy. This proposed book addresses the pervasive stigma experienced by individuals living with epilepsy in rural communities. Through a review of relevant literature and case studies, this chapter examines how stigma affects the lives of people with epilepsy in rural areas. The chapter also explores strategies for reducing stigma, including community-based education and awareness programmes and the role of healthcare providers in promoting understanding and acceptance of epilepsy. In general, this chapter aims to highlight the need for increased awareness and understanding of epilepsy and its impact on those living with the condition in rural communities. It is believed that by tackling the stigma associated with epilepsy and promoting inclusivity, the quality of life of people living with epilepsy may be improved.

The future of health professions education: Emerging trends in the United States.