Non-health Professionals Research Articles

Contextual influences in decoding pain expressions: effects of patient age, informational priming, and observer characteristics

We aimed to examine the effects of contextual factors (ie, observers' training background and priming texts) on decoding facial pain expressions of younger and older adults. A total of 165 participants (82 nursing students and 83 nonhealth professionals) were randomly assigned to one of 3 priming conditions: (1) information about the possibility of secondary gain (misuse); (2) information about the frequency and undertreatment of pain in the older adult (undertreatment); or (3) neutral information (control). Subsequently, participants viewed 8 videos of older adults and 8 videos of younger adults undergoing a discomforting physical therapy examination. Participants rated their perception of each patient's pain intensity, unpleasantness, and condition severity. They also rated their willingness to help, sympathy level, patient deservingness of financial compensation, and how negatively/positively they feel towards the patient (ie, valence). Results demonstrated that observers ascribed greater levels of pain and other indicators (eg, sympathy and help) to older compared with younger patients. An interaction between observer type and patient age demonstrated that nursing students endorsed higher ratings of younger adults' pain compared with other students. In addition, observers in the undertreatment priming condition reported more positive valence towards older patients. By contrast, priming observers with the misuse text attenuated their valence ratings towards younger patients. Finally, the undertreatment prime influenced observers' pain estimates indirectly through observers' valence towards patients. In summary, results add specificity to the theoretical formulations of pain by demonstrating the influence of patient and observer characteristics, as well as informational primes, on decoding pain expressions.

Implementing mental health training programmes for non-mental health trained professionals: A qualitative synthesis.

IntroductionGiven the prevalence of mental health problems globally, there is an increasing need for the police and other non-mental health trained professionals to identify and manage situations involving individuals with mental health problems. The review aimed to identify and explore qualitative evidence on views and experiences of non-mental health professionals receiving mental health training and the barriers and facilitators to training delivery and implementation.MethodsA meta-synthesis of qualitative evidence on the barriers, facilitators and perceived impact of mental health training programmes for non-mental health trained professionals. Systematic literature searches were undertaken of the following databases: Criminal Justice s (CJA); MEDLINE; Embase; PsycINFO; ASSIA; CENTRAL; SSCI; ERIC; Campbell Library; Social Care Online and EPOC from 1995 to 2016. Records were independently screened for eligibility by two researchers, data extraction and quality appraisal of studies was also undertaken independently by two researchers. The CASP tool was used to quality appraise included studies. Included studies were synthesised using a meta-ethnographic approach as outlined by Noblit and Hare.Results10,282 records were identified and eight qualitative studies were included. A range of barriers and facilitators to training were identified and related to the delivery and content of training; the use of additional resources; and staff willingness to engage with training and organisational factors. The perceived impact of training was also discussed in terms of how it affects trainees; perceptions of mental health; self-perception; responses to situations involving mental health and the potential of training to reduce injury or physical harm in situations involving mental health. The value of training and how to measure its impact were also discussed.ConclusionFindings from this review have implications for those designing, implementing and evaluating mental health training programmes. It is recommended that research evaluating mental health training includes a qualitative component to ensure that the barriers and facilitators to training and its impact on trainees’ perceptions of mental health are understood.Protocol registration numberPROSPERO: CRD42015015981

Enhancing Resilience Among Providers of Trauma-Informed Care: A Curriculum for Protection Against Secondary Traumatic Stress Among Non-Mental Health Professionals

ABSTRACTAlthough the call to create trauma-informed services for youth has been clearly sounded, a relatively neglected part of this effort is the need to prepare non-mental health professionals to carry out trauma-informed programming in ways that protect them from secondary traumatic stress (STS). To this end, this article introduces Resilience for Trauma-Informed Professionals, a curriculum that introduces participants to techniques designed to promote resilience in the face of exposure to trauma-related material. Based on the existing evidence base regarding risk and protective factors for STS, six core elements targeted by the curriculum are described—appraisals, self-efficacy, emotional awareness, affect regulation, resilience, and prevention—as they are implemented across three stages: pre-exposure preparation, coping in the presence of trauma, and recovery in the aftermath of exposure.

Evaluation of an appraisal regarding the establishment of Drug Information Service Center in the medical institution

Background: India has an exploding drug market in generic and brand name products with variable cost. Many doctors tend to rely on pharmaceutical representatives for their prescribing information. Now it is agreed that the major objectives of DISC are to provide a rational basis for choosing and using drugs skilfully to relieve patient’s ailments. This is becoming more and more important as the practicing doctors is now confronted with so called “newer drugs” at such a great pace that even a full- time pharmacologist sometimes finds it difficult to keep abreast of their merits and demerits. The DISC provides the knowledge of number of drugs for practical application while prescribing. To provide healthcare professionals and patients with immediate access to accurate, concise and unbiased information on drug therapy problems.Methods: This is randomized study is to be conducted to determine the opinions of doctors, medical students, nurses, patients, other non-medical staff and general public as a patient representation from our institute campus regarding necessity of drug information. They are provided written feedback forms to be filled. The drug information service center (DISC) routinely responds to queries/inquiries regarding various drug related information. A structured eleven points questionnaire containing both open and close ended questions is prepared for opinion poll in feed-back form.Results: Large majority of the health and non-health professionals of opinion poll are in favour of reforms &innovations. They also suggested their own suggestions regarding the refreshing the subjects.Conclusions: It is essential to create awareness of the services provided by the DISC among physician’s pharmacists, nurses and consumers so that they should come forward to utilize these services.

Impact of a Patient-Facing Enhanced Genomic Results Report to Improve Understanding, Engagement, and Communication

“The objective of this study was to” test the effectiveness of an enhanced genomic report on patient-centered outcome domains including communication, engagement and satisfaction. “Study design utilized” a prospective, randomized, mixed-methods desctiptive study of a whole genome sequencing results report, GenomeCOMPASS™, that was accessed by providers through the electronic health record and by patients through the associated patient portal. “The study was set in” an integrated healthcare delivery system in central Pennsylvania. “Eighty-four” parents of 46 children with undiagnosed Intellectual Disability, Autism Spectrum Disorder and/or multiple congenital anomalies who had participated in a previous study offering whole genome sequencing for their affected child were invited to enroll. Fifty-two parents enrolled. Following a traditional genetics results informing visit, the study coordinator stratified families by diagnostic result and uninformative result and then randomized families within each group to an intervention arm to receive the GenomeCOMPASS™ report or to the usual care arm to receive a summary letter from the medical geneticist. A letter inviting enrollment included a baseline survey, which once returned, constituted enrollment. Surveys were administered at 3 months post-genetics visit. At 6 months, the usual care arm crossed over to receive the intervention and were administered an additional survey at 3 months. Qualitative interviews were conducted following survey completion to augment the survey data regarding the patient centered outcomes of interest. Patient reported outcomes including communication, engagement, empowerment and satisfaction. In the intervention arm, GenomeCOMPASS™ reports were released to 14 families (N = 28 parents) and of those 21 (75%) returned 3 month surveys. In the usual care arm, 12 families (N = 24 parents) received usual care summary letters and of those 20 (83%) returned 3 month surveys. At crossover, GenomeCOMPASS™ reports were released to 20 individuals and 15 (75%) returned 3 month surveys. Qualitative interviews were conducted with 5 individuals. Use of the GenomeCOMPASS™ report was reported by this small group of parents to improve communication with providers and non-health professionals such as educators and therapists and led to increased engagement and high satisfaction. Providers and others involved in the children’s care also endorsed the report’s effectiveness. Reports that addressed negative findings, i.e. uninformative results, were not found to be useful. Although the number of users was small, this study supports that customizable template reports may provide a useful and durable source of information that can support and enhance the information provided by genetics professionals in traditional face-to-face encounters. Trial registration: Clinicaltrials.gov (Record 2013–0594).

Mandatory regulation of our sector remains a myth

Journal of Aesthetic NursingVol. 6, No. 9 EditorialsFree AccessMandatory regulation of our sector remains a mythNatasha DevanNatasha DevanSearch for more papers by this authorNatasha DevanPublished Online:7 Nov 2017https://doi.org/10.12968/joan.2017.6.9.457AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail No matter who you make conversation with in aesthetics, there is always one topic of discussion that is inescapable—regulation. Over the past few years, Health Education England (HEE), the Joint Council for Cosmetic Practitioners (JCCP), and its body for setting standards, the Cosmetic Practice Standards Authority (CPSA), have dedicated an immense amount time and effort to establishing aesthetic medicine as a reputable branch of healthcare. But complying with HEE's education and qualification requirements and registering with the JCCP is voluntary, and the flurry of recommendations from Government-endorsed bodies has caused much confusion.HEE proposed that those who wish to provide cosmetic injectables have to be qualified at ‘level 7’. As a result, several training companies set up so-called level 7, ‘accredited’ courses for dermal fillers and botulinum toxin. However, during a panel discussion at Aesthetic Medicine North, interim executive support for the JCCP Paul Burgess said (Aesthetic Business Transformations (ABT), 2017): ‘There are thousands of programmes out there offering a level 7 qualification. It comes with a major health warning—you must check whether it is an officially recognised qualification or not.’Formally accredited courses will be listed on the JCCP's register for education and training providers, but this can only be put in place when the CPSA's standards have been finalised. The standards for non-surgical cosmetic procedures were published in draft form for consultation in September (CPSA, 2017a), and the deadline for comments has now passed; however, the JCCP is welcoming further submissions.There are many aspects of the standards that should be celebrated. As a publication founded on evidence-based practice, the Journal of Aesthetic Nursing (JAN) fully supports the importance placed on data collection for procedures and adverse events. JAN also welcomes the focus on working as a team, as opposed to practising in isolation as so many do. As a first draft, however, there is much room for improvement.The proposed supervision matrix (CPSA, 2017b) suggests that non-prescribing nurses need to be supervised at all times (i.e. immediately available within the premises, with the ability to intervene in the case of a procedure-related complication, adverse event or emergency) when administering botulinum toxin. This will have a drastic impact on the way these nurses, who may have been practising aesthetics for decades without supervision, work, and could put them off from engaging with the standards as a whole.As registered health professionals, nurses, doctors and dentists are bound by their relevant regulatory body's code of conduct, which requires them to, as the CPSA (2017a) standards require, ‘have strong moral principles and act with honesty and integrity’. Non-health professionals, on the other hand, are not regulated and therefore will not be held accountable for complying with the need to practise ethically and prioritise the patient's best interests over financial gain.Although mandatory regulation may arise in the future, at present it does not exist in any shape or form. As Burgess said (ABT, 2017): ‘Nobody has to take these qualifications, and you can just carry on as you are if that's what you want to do’. Whether you choose to embrace the new standards or not, you should always practise ethically and responsibly, and be relentless with raising standards. References Aesthetic Business Transformations. Facebook live video post (23 October 2017). 2017. http://tinyurl.com/y7ljnu56 (accessed 27 October 2017) Google ScholarCosmetic Practice Standards Authority. CPSA clinical and practice standards. 2017a. http://tinyurl.com/yd3dx783 (accessed 27 October 2017) Google ScholarCosmetic Practice Standards Authority. CPSA supervision matrix. 2017b. http://tinyurl.com/ybfwchz6 (accessed 27 October 2017) Google Scholar FiguresReferencesRelatedDetails 2 November 2017Volume 6Issue 9ISSN (print): 2050-3717ISSN (online): 2052-2878 Metrics History Published online 7 November 2017 Published in print 2 November 2017 Information© MA Healthcare LimitedPDF download

Design and implementation of an empowering program for the gypsy population in the Basque country

An introduction: The life expectancy of the general population in the Basque Country is around 80 years, while in the case of gypsy it is below 60 years. A number of unhealthy eating habits and hygiene habits very common in the gypsy community are among the reasons for these marked differences. These have been some of the triggers for the Basque Government's Department of Health, Osakidetza and the Basque Gypsy community to work together in the development of an initiative that improves education and contributes to the empowerment of the Gypsy community. Short description of practice change implemented: The Active Patient Program (APP) is a self-care education program that contributes to raising the status of chronic patients. During 2016, a working group with representatives of the APP and the gypsy associations has worked on adapting the course Caring for my health to the socio-cultural context of the Gypsy people, emerging in the Caring for the of the Gypsy people new course. One of the key points is that the workshops are facilitated by two trained leaders, both of whom are non-health professionals belonging to the gypsy community, so it is easier for the message to reach its objectives and increase attendees’ motivation to improve their living habits. Aim and theory of change: Health education and specifically the empowerment of patients and citizens through structured educational interventions have proven to be a very effective action in engaging in the self-management of their own conditions. Targeted population, stakeholders and timeline: All the Gypsy associations of the Basque Country were invited to participate in the initiative. During November and December 2016, 24 gypsies, all of them very active members of Gypsy associations in the Basque Country, have been accredited as facilitators of the workshop Caring for the of the Gypsy people. There are 12 workshops scheduled for the first quarter of 2017, expected to be attended by around 150 gypsies. Highlights: The training experience has been very positive for both the workshop trainers and the future facilitators. Lessons learned: This new program is aimed at of gypsy ethnicity who want to improve their general status. Discussions: Once the results have been evaluated in terms of acquired knowledge, perceived utility and overall satisfaction with the workshop, it will be assessed whether it is worthwhile to extend the program to other groups of gypsies and with what characteristics it should be done. Comments on sustainability and transferability: In a first phase we plan to implement the program in the Basque Country and, if the experience is positive, it could be transferred to other Autonomous Communities of Spain. Conclusions: They consider this methodology very useful for working with any kind of community, althouh some adaptations appeared as necessary for any particular cultural group. We show you a video made to show the program between them https://youtu.be/H4ulZUXI_ZA

Interprofessional Collaborative Practice and School Nursing: A Model for Improved Health Outcomes

Effective communication, teamwork, and interprofessional collaboration, or teams of health and non-health professionals working together, are critical to improving the patient experience of care; improving population health; and reducing healthcare costs (i.e., the Triple Aim). In 2016, the Interprofessional Education Collaborative (IPEC) Expert Panel updated its Core Competencies for Interprofessional Collaborative Practice. As health professionals who collaborate with an extensive network of health and non-health professionals, school nurses embody the aims of interprofessional collaboration (IPC). This article briefly reviews the background of interprofessional collaboration and describes ways that school nurse practice aligns with IPC core competencies to incorporate interprofessional collaboration. We discuss successes, such as case management and care coordination, and include challenges to IPC in the school setting. In conclusion, through case management and collaborative care, school nurse expertise in effective IPC fosters knowledge through which core competencies can be strengthened, with benefits for both patients and other healthcare providers.

Improving preconception health and care: a situation analysis

BackgroundThe purpose of this situation analysis was to explore the views of health and non-health professionals working with women of childbearing age on current and future delivery of preconception care in one National Health Service (NHS) Board area in Scotland.MethodsThe situation analysis was undertaken using a mixed methods approach. Six focus groups were conducted organised by profession – general practitioners (GPs), practice nurses, health visitors, family nurses, guidance teachers and youth workers. Existing evidence of effective preconception care interventions informed focus group guides. A survey was undertaken with community pharmacists which provided qualitative data for analysis. Focus group transcripts were analysed by two researchers using a thematic analysis approach.ResultsThere was lack of awareness of preconception health and its importance amongst the target group. Levels of unplanned pregnancy hampered efforts to deliver interventions. Professional knowledge, capacity and consistency of practice were viewed as challenges, as was individual compliance with preconception care advice. Improvement requires multifaceted action, including ensuring the school curriculum adequately prepares adolescents for future parenthood, increasing awareness through communication and marketing, supporting professional knowledge and practice and capitalising on existing opportunities for preconception care, and ensuring services are equitable and targeted to need.ConclusionsDelivery of preconception care needs to be improved both before and between pregnancies to improve outcomes for women and infants. Action is required at individual, organisational and community levels to ensure this important issue is at the forefront of preventative care and preventative spending.

Mental health literacy survey of non-mental health professionals in six general hospitals in Hunan Province of China.

BackgroundMental illness has brought great economic burden related to misdiagnosis by non-mental health professionals in general hospitals. The aim of this study was to explore non-mental health professionals’ conceptions related to the identification of mental illness and perceived treatments, first aid and prognosis.MethodsIn 2014–2015, we presented 1123 non-mental health professionals from six general hospitals in Hunan Province with one of three vignettes describing a person with schizophrenia, depression, or generalized anxiety disorder. Identification rates, beliefs about various interventions, best methods, and the prognosis with or without treatment were measured.ResultsLess than 60% of the non-mental health professionals could identify the mental disorders correctly. Psychiatrists and psychologists were considered to be the people who would be most helpful in all vignettes. Over 70% of participants identified the correct medication for each vignette. Participants gave higher ratings to lifestyle interventions than to psychological and medical interventions, especially in the depression and generalized anxiety disorder vignettes. For the question about how the person could best be helped, about half of the participants rated listening or talking with the person more highly than accompanying the person to professional help or encouraging the person to visit a psychiatrist or psychologist. Participants believed that, with professional help, the people in the vignettes would fully recover but that problems would probably reoccur and that, without professional help, the people described would get worse.ConclusionsThe beliefs that non-mental health professionals hold about mental disorders are inadequate to provide appropriate help. There is an urgent need for mental health education campaigns to improve non-mental health professionals’ mental health knowledge in mainland China in order to provide better support for mental health service users.

Mental health training programmes for non-mental health trained professionals coming into contact with people with mental ill health: a systematic review of effectiveness

BackgroundThe police and others in occupations where they come into close contact with people experiencing/with mental ill health, often have to manage difficult and complex situations. Training is needed to equip them to recognise and assist when someone has a mental health issue or learning/intellectual disability. We undertook a systematic review of the effectiveness of training programmes aimed at increasing knowledge, changing behaviour and/or attitudes of the trainees with regard to mental ill health, mental vulnerability, and learning disabilities.MethodsDatabases searched from 1995 onwards included: ASSIA, Cochrane Central Register of Controlled Clinical Trials (CENTRAL), Criminal Justice s, Embase, ERIC, MEDLINE, PsycINFO, Social Science Citation Index. Courses, training, or learning packages aimed at helping police officers and others who interact with the public in a similar way to deal with people with mental health problems were included. Primary outcomes were change in practice and change in outcomes for the groups of people the trainees come into contact with. Systematic reviews, randomised controlled trials (RCTs) and non- randomised controlled trials (non-RCTs) were included and quality assessed. In addition non-comparative evaluations of training for police in England were included.ResultsFrom 8578 search results, 19 studies met the inclusion criteria: one systematic review, 12 RCTs, three prospective non-RCTs, and three non-comparative studies.The training interventions identified included broad mental health awareness training and packages addressing a variety of specific mental health issues or conditions. Trainees included police officers, teachers and other public sector workers.Some short term positive changes in behaviour were identified for trainees, but for the people the trainees came into contact with there was little or no evidence of benefit.ConclusionsA variety of training programmes exist for non-mental health professionals who come into contact with people who have mental health issues. There may be some short term change in behaviour for the trainees, but longer term follow up is needed. Research evaluating training for UK police officers is needed in which a number of methodological issues need to be addressed.Trial registrationProtocol registration number: PROSPERO: CRD42015015981.

Readability comparison of pro- and anti-HPV-vaccination online messages in Japan

ObjectiveIn Japan, the HPV vaccination rate has sharply fallen to nearly 0% due to a series of sensational media reports of adverse events. Online anti-HPV-vaccination activists often warn readers of the vaccine’s dangers. We aimed to examine distribution and readability of pro-and anti-vaccination online messages with relation to these authors’ professional expertise. MethodsWe conducted online searches via two major search engines. Identified sites were classified as “anti,” “pro,” or “neutral” depending on their claims, and “health professional” or “non-health professional” depending on their authors’ expertise. Readability was determined using a validated measure of Japanese readability. Statistical analysis was conducted using two-way analysis of variance and Tukey’s test. ResultsOf the total 270 sites analyzed, up to 137 (50.7%) were deemed anti- and 101 (37.4%) pro-HPV-vaccination. Of the pro-vaccination sites 71% were written by health professionals. Anti-vaccination messages were found to be considerably easier to read than pro-vaccination ones; both among those by health professionals and non-health professionals. ConclusionOur findings substantiate concern that the anti messages may serve to prolong the HPV vaccination crisis. Practice implicationsWe recommend that health professionals use readability assessment tools and improve the text for easier reading if necessary.

Awareness among a Saudi Arabian university community of Middle East respiratory syndrome coronavirus following an outbreak.

This study aimed to measure the level of awareness of faculty members, staff and students in a female Saudi Arabian university community towards Middle East respiratory syndrome coronvirus (MERS-CoV) following an outbreak. A self-administered questionnaire containing knowledge questions was distributed and completed by the 1541 participants. The overall knowledge score was 43.2%. It was only significantly higher in participants from the health colleges (50.6%). The majority (78.9%) of the respondents recognized the typical symptoms of MERS-CoV but only 67.1% knew the recommended preventive hygiene practices. Awareness of disease epidemiology, severity, fatality rate and treatment was very low. The knowledge of health care workers/ students of the recommended precautions that should be applied when dealing with patients was poor (55.5%). Significant improvement in educational programmes for both the health care and non-health care professionals is warranted, particularly in crowded educational institutions or workplaces.

Barriers to medical help-seeking among older men with prostate cancer

ABSTRACTObjective: Men's disinclination to seek medical help has been linked to higher rates of morbidity and mortality compared to women. However, previous studies were conducted predominantly with healthy, young, and middle-aged men. We explored the perceived medical barriers to help-seeking in older men with prostate cancer. Method: 20 men with prostate cancer took part in semistructured interviews, which were analyzed using thematic analysis. Results: Three themes were identified related to negative attitudes toward help-seeking: male gender role; fear of the health condition, medical and treatment procedures; and embarrassment as a consequence of medical examinations, communication with health (and nonhealth) professionals, and the disclosure of sexual-related symptoms. Conclusion: The barriers identified in our study strengthen the evidence for the impact of traditional masculinity on help-seeking in men.

Evaluation of a Commercially Delivered Weight Management Program for Adolescents

To evaluate a commercially available, structured short-term weight management program designed for adolescents with obesity delivered by nonhealth professionals. A multisite parallel-group randomized controlled trial was conducted to evaluate a commercial 12-week lifestyle behavioral program in commercial weight management centers in Australia. Eligible participants (13-17 years, body mass index (BMI) z score ?1.282 with no presenting morbidities) were randomized (n?=?88) to intervention or wait-list, and the program was delivered by consultants at participating weight management centers. The primary outcome was change in BMI z score. Secondary outcomes included the psychometric variables quality of life, body-esteem, and self-esteem. Data was analyzed according to intention-to-treat principles. Of 74 participants who consented to enter the study, 66 provided baseline anthropometric data and 12-week data were available for 55 individuals (74%). A significantly greater decrease in BMI z score in the intervention group (n?=?32) was observed when compared with the wait-list control group, mean difference (MD)?=??0.27?kg/m2; 95% CI, ?0.37,?0.17; P?<?.001). Participants allocated to receive the lifestyle intervention reported a greater improvement in body esteem (MD = 1.7, 95% CI, 0.3, 3.1; P?=?.02) and quality of life (MD?=?5.9, 95% CI, 0.9, 10.9; P?=?.02) compared with the wait-list control group. A structured lifestyle intervention delivered by a commercial provider in an adolescent population can result in clinically relevant weight loss and improvements in psychosocial outcomes in the short term. Further research is required to evaluate long-term outcomes. International Clinical Trials Registry: ISRCTN13602313.

A readability comparison of anti- versus pro-influenza vaccination online messages in Japan.

Historically, anti-vaccination sentiment has existed in many populations. Mass media plays a large role in disseminating and sensationalizing vaccine objections, especially via the medium of the Internet. Based on studies of processing fluency, we assumed that anti-influenza vaccination online messages to be more readable and more fluently processed than pro-influenza vaccination online messages, which may consequently sway the opinions of some audiences. The aim of this study was to compare readability of anti- and pro-influenza vaccination online messages in Japan using a measure of readability.Web searches were conducted at the end of August 2016 using two major Japanese search engines (Google.jp and Yahoo!.jp). The included websites were classified as “anti”, “pro”, or “both” depending on the claims, and “health professional” or “non-health professional” depending on the writers' expertise. Readability was determined using a validated measure of Japanese readability (the Japanese sentence difficulty discrimination system). Readability of “health professional” websites was compared with that of “non-health professional” websites, and readability of “anti” websites was compared with that of “pro” websites, using the t-test.From a total of 145 websites, the online messages written by non-health professionals were significantly easier to read than those written by health professionals (p = 0.002, Cohen's d = 0.54). Anti-influenza vaccination messages were significantly easier to read than pro-influenza vaccination messages (p < 0.001, Cohen's d = 0.74).When health professionals prepare pro-influenza vaccination materials for publication online, we recommend they check for readability using readability assessment tools and improve the text for easy reading if necessary.

Abstract WMP96: Stroke Warning Signs In Spanish Speaking Communities: Camaleon Strategy Proposal

Introduction: early recognition of stroke signs lead to a better opportunity for acute management, to decrease morbidity and mortality impact. Public awareness campaigns have been developed with English language acronyms for recognition of these signs, but language and cultural differences should be taken into account for these educational strategies. Hypothesis: we assessed the hypothesis that there is a need for a validated tool for Spanish speaking population for early recognition of stroke warning signs. Material and methods: a 12-item electronic and paper-based survey for non-health related professionals evaluated the knowledge of early stroke signs in a Costa Rican sample. Using data from the FAST acronym, we developed a Spanish based acronym focused on the 3 most common symptoms, which was evaluated with medical professionals and non-medical population for clarity of message and informative content through a 10-item survey. Results: 706 non-medical professional subjects answered the evaluation survey (56.7% female, median age 33 years [IQR 24-43 years]), with 76.2% answering that they were not capable of diagnose an acute stroke, and 97.2% considering the necessity of develop an educational campaign for acute stroke signs recognition. CAMALEON acronym (CAra [face], MAno/brazo [hand/arm], LEnguaje [language] and teléfONo [telephone]) was created adapting FAST acronym to Spanish. 25 medical professionals evaluated the medical content of the Spanish acronym (based on an educational video) with a 95% of acceptance of its content to explain medical symptoms; also 91% of 100 non-medical subjects were able to recognize adequately the symptoms after viewing the video material. This academic initiative is endorsed by the World Stroke Academy from the World Stroke Organization. Conclusion: CAMALEON strategy is an adequate acronym for early recognition of acute stroke signs for Spanish speaking countries that should be validated in stroke awareness campaigns.

Experiences and perceptions regarding clinical breast exam screening by trained laywomen in Malawi.

Despite the increasing burden, breast cancer control in sub-Saharan Africa is insufficient. Late diagnosis and lack of early detection and screening services contribute to high mortality. Clinical breast exam (CBE) screening can be valuable in low-income countries, including use of community health workers and non-health professionals to conduct exams. We assessed experiences of women who underwent CBE screening by trained laywomen in Lilongwe, Malawi, as part of a pilot program. The pilot study invited women attending urban health clinics to a breast cancer educational talk followed by CBE screening by trained laywomen. We purposively sampled participants from the pilot study and interviewed them about the screening experience and future cancer education programs and services. Overall participants had positive experiences and were willing to undergo CBE screening by trained laywomen. Participants were motivated by the educational talk, shared newly acquired cancer knowledge with their social networks, and encouraged others to seek screening. Screened women suggested strategies for future interventions including combining breast and cervical cancer screening, using female providers, partnering with community leaders to increase uptake, and expanding services into the community. Asymptomatic Malawian women accepted CBE screening by trained laywomen and considered breast cancer an important health issue. Women appreciated combined education and screening services and proposed further linkage of breast and cervical cancer screening. Based on our results, training laywomen to educate the public on breast cancer and conduct CBE is a feasible breast cancer control strategy in sub-Saharan Africa.

Osteoporosis Knowledge and Related Health Behavior among Women in Jazan Region, Kingdom of Saudi Arabia.

Osteoporosis is a systemic bone disease that can be prevented to some extent by awareness of its risk factors and related health behavior. The aim of this study was to collect information about knowledge and awareness of osteoporosis among women living in Jazan and to describe the type of food habits, sociodemographic characteristics, and other osteoporosis-related health behavior. Self-administered questionnaires were used for data collection. The total participants were 546 women: 88 (16.1%) were health professionals and 458 (83.9%) non health professionals in the age range ≤20 to 50 years. Data collection was facilitated by a trained intern female doctor of dentistry whose task was to administer the distribution and collection of the questionnaires. In total, 61.9% of health professionals and 54.3% of nonhealth professionals scored highly on knowledge of osteoporosis. The respondents of osteoporosis preventive food items were also highly knowledgeable with 50.6 and 52.6% of health and nonhealth professionals respectively. About 48.1% of health professional and 44.2% of nonhealth professional scored low on knowledge of osteoporosis behavior and attitude, vitamin supplements, and sunlight exposure. The age effect on osteoporosis knowledge was 33.8% in young age group and 30.7% in old age group. Our study shows that Jazan women were highly knowledgeable and aware about osteoporosis and its related health behavior and that health professionals and nonhealth professionals were equally aware about osteoporosis-related health matters. Awareness and preventive behavior of osteoporosis can prevent or slow the development of the disease.

Use of hormones and nutritional supplements among gyms' attendees in Riyadh.

BACKGROUND:Worldwide, studies have shown a high prevalence of hormones and nutritional supplement use by athletes and gym members. Many athletes consume unproven, potentially harmful or even banned supplements.OBJECTIVES:To assess the prevalence of the use of hormones and nutritional supplements by people who exercise in gyms in Riyadh, Saudi Arabia, and the types of supplements they most commonly use and to obtain a general view of the main reasons for using these enhancements.MATERIALS AND METHODS:A cross-sectional study using a self-administered questionnaire was conducted at gyms in Riyadh that were selected randomly from different sectors of the city. The sample size was estimated at 289, but the actual number of randomly selected participants in the study was 457.RESULTS:The number of gym members who participated in this study was 457. Approximately 47.9% of the sample reported an intake of nutritional supplements and 7.9% reported that they took hormones. Protein powder was consumed by 83.1% of the participants. Approximately 16.8% of supplement users had noticed some side effects, and 25.7% of those who took hormones had stopped taking them because of adverse effects. Only half of the hormone users (54.2%) reported that they had had medical checkups. The major source of information on supplement and hormone use was non-health professionals; friends being major source (40%) of information on the use of hormones. The use of nutritional supplements was significantly associated with BMI (OR = 1.89, CI = 1.06–3.39), duration of daily exercise (OR = 4.23, CI = 2.06–8.68), and following a special diet (OR = 8.42, CI = 5.37–13.2). There was a very strong association between nutritional supplement consumption and hormone use (P < 0.001).CONCLUSION:Approximately half of the participants who regularly exercised in gyms took nutritional supplements, and most had received their information from nonhealth professionals. There was an association between the duration of exercise and the use of hormones and supplements. Fewer than half of hormone users had obtained a health-care provider's advice before taking it. The atmosphere in the gym can play an important role in members' decisions. Educating gym employees and members may have a positive influence on the use of supplements and hormones.