Seeking Medical Assistance Research Articles

Determinants of Safe Pesticide Handling and Application Among Rural Farmers

The study investigated the determinants of safe pesticide handling and application among farmers in rural communities of Oyo State, ssouthwestern Nigeria. A cross-sectional design utilizing 2-stage cluster sampling techniques was used to select Ido and Ibarapa central Local Government Areas and to interview 383 farmers via a structured questionnaire. Data were analyzed using descriptive statistics and logistic regression at p = 0.05. Results showed that 41.8% of the farmers had been working with pesticides on farms for at least 5 years, 33.0% attended training on pesticide application, 73.5% had good safety and health knowledge, and 72.3% had safe pesticide handling and application practices. About half (50.2%) stated that they wear coveralls, gloves, and masks to protect their body, face, and hands when applying pesticides, 9.8% use empty pesticide containers for other purposes in the house/farm, while 11.5% blow the nozzle with their mouth to unclog it if it becomes blocked. The three major health symptoms reported by the participants were skin irritation (65.0%), itchy eyes (51.3%), and excessive sweating (32.5%). Having attended training on pesticide application and use enhanced (OR = 2.821; C.I = 1.513–5.261) practicing safe pesticide handling and application. Farmers with good knowledge (OR = 5.494; C.I = 3.385–8.919) were more likely to practice safe pesticide handling and application than those with poor knowledge about pesticide use. It is essential to develop and deliver mandatory comprehensive training programs for farmers on impacts of pesticides on health and environment, along with sustainable safe handling, application, and disposal of pesticides using proper waste management techniques and recognizing early signs and seeking medical assistance. The urgent need to strengthen policy to regulate pesticide use and limit farmers’ access to banned products is also key.

Parents' Medicine-Seeking Behavior and Their Beliefs About the Efficacy of Medicines.

Parents' medicine-seeking behavior is often influenced by their own experiences with illness. The purpose of this study was to investigate parents' medicine-seeking behavior and their beliefs regarding the efficacy of medicines. A cross-sectional study was conducted among parents in Mosul, Iraq. A convenience sampling method was used to select the parents who visited community pharmacies to buy medication for their ill children. A self-administered questionnaire was utilized to collect data from 380 parents who successfully completed the survey. The majority of parents (83.4%) stated that they read the labels of medications before giving them to their children, and more than half of the parents (57.9%) did not buy medicines for their children without consulting a doctor. In addition, 65% of the participants asked about the possible side effects of the medicines. Additionally, the majority of parents (73.2%) believed that branded medicines were more effective than generic medicines, and 63.4% of them believed that the efficacy of medicines is not related to the manufacturing countries. Furthermore, 62.9% of the parents believed that the efficacy of medicines is not related to their price, while 35.2% of them believed that injections were more effective than other dosage forms. Parents' medicine-seeking behavior and their beliefs about the efficacy of medicines were significantly associated with parents' higher education level and higher family income. There was inadequate information among parents concerning the use of medicines, including side effects, proper utilization, and the importance of seeking medical assistance. Furthermore, parents have false beliefs about the efficacy of medicines.

Мониторинг в управлении ВИЧ-сервисной некоммерческой организацией (на примере работы с уязвимыми группами населения)

HIV infection is a serious social problem affecting the health and ability to work of the population. Particularly, vulnerable population groups are instrumental in the spread of the Human Immunodeficiency Virus due to risk-prone behaviors and individual characteristics that create barriers to accessing preventive, testing, and treat-ment services for this disease. Consequently, these groups often become invisible to the state and refrain from seeking medical assistance from public healthcare facilities. This article presents a series of management de-cisions derived from the monitoring system implemented by the Charitable Foundation “For support of social initiatives and public health” (Support Foundation). The findings aim to enhance collaboration in engaging vul-nerable populations through the combined efforts of the state healthcare system and the non-profit sector. This collaborative approach leverages the expertise of specialists who have access to high-risk groups. In conclu-sion, by fostering a more inclusive approach to healthcare delivery, it is possible to improve access to crucial services, ultimately reducing the stigma and barriers that deter vulnerable individuals from seeking help.

“We just ignored them.” Adaptation strategies used by emergency department personnel in the face of workplace violence: A qualitative study

BackgroundWorkplace violence (WPV) can have adverse psychological, physical, and emotional effects on emergency department (ED) personnel. Adaptive strategies can help them better adapt to WPV. The study aimed to explore ED personnel’s experiences with adaptive strategies used in the face of WPV. MethodsIn this qualitative study, 22 ED personnel (nurses, doctors, services patient care assistants, and security guards) were selected using purposive sampling from Urmia city hospitals. Deep semi-structured individual face-to-face interviews were used to collect data. After recording and implementing interviews, conventional content analysis was used to extract concepts. ResultsData analysis led to extracting an overarching theme of “mastering the situation and avoiding harm.” Two categories that supported the main theme were: “effort to avoid violence” and “effort to escape suffering.” The seven subcategories supported main categories included “managing patients and companions, ”self-control,“ ”seeking support, “emotional discharge,” “thought diversion, ”tendency to spirituality,“ and ”seeking medical assistance.“ ConclusionGiven the experiences of ED personnel regarding strategies used, health managers and policymakers are recommended to develop and implement comprehensive programs to reduce violence and empower nurses before and after dealing with violence. The following programs will help: developing and implementing guidelines such as zero-tolerance WPV policy, criminalizing violence against personnel and punishing perpetrators; holding classes related to communication skills, self-control skills, and deviant thinking skills for ED personnel; raising public awareness of the prevailing conditions in the emergency through mass media, and counseling and treating violent ED personnel.

Disparities by sex in Hispanic patients with cutaneous melanoma: A national database analysis.

e23045 Background: Melanoma is the fifth most common form of malignancy in the United States.1 Studies have established that Hispanic patients have worse melanoma-specific survival compared to non-Hispanic White individuals.2 However, there is a paucity of literature investigating sex differences in patient characteristics and outcomes within Hispanic melanoma patients. Thus, the aim of this study is to further examine sex differences in melanoma characteristics and disease-specific survival within Hispanic patients. Methods: Individuals of Hispanic descent diagnosed with microscopically confirmed cases of cutaneous melanoma (ICD-O-3 codes 8720/3-8780/3; Primary Site codes C44.0-C44.9) between 2000 and 2020 were identified through the Surveillance, Epidemiology, and End Results (SEER) database. Statistical analyses involved Chi-squared tests, Kaplan-Meier and log-rank methods, and multivariate Cox regression, with significance set at a p-value < 0.05. Results: In a cohort of 12,328 Hispanic melanoma patients (43.3% male, 56.7% female), a significant association between sex and age was found (p < 0.001). The greatest proportion of males were in the 60-79 age group (39.7%), while females were predominantly in the 40-59 age group (39.0%). Greater number of males had truncal melanomas (31.4%) compared to females having lower extremity melanomas (35.2%) (p < 0.001). Females exhibited higher rates of localized disease (80.3% vs 70.2%) while males were more frequently diagnosed with regional (18.5% vs 13.8%) and distant disease (11.3% vs 5.9%) (p < 0.001). Males demonstrated greater mean Breslow thickness (1.80 vs 1.44; p < 0.001), elevated rates of lymph node positivity (37.2% vs 27.2%; p < 0.001), and metastatic disease (2.8% vs 1.6%; p < 0.001). On univariate Kaplan-Meier analysis, males demonstrated significantly reduced disease-specific survival (182.9 months) compared to females (214.2 months) (p < 0.001). After adjusting for age, disease stage, annual income, rural vs urban residence, and primary tumor site, male sex independently increased disease-specific mortality compared to females (HR = 1.31; 95% CI 1.16-1.48; p < 0.001). Conclusions: Our investigation reveals that Hispanic males tend to receive melanoma diagnoses at older ages, advanced-stage disease, and primarily on the trunk.3 Furthermore, our study is the first to highlight a significantly reduced disease-specific survival in males compared to females. The observed sex differences may arise from a complex interplay of behavioral factors and immunological, hormonal, or genetic influences.4 Men exhibit a lower likelihood of engaging in skin self-examinations and seeking medical assistance. Limitations to this study include use of data reported through a national database. Nonetheless, this study underscores the significance of sex-specific variations in presentation and disease-specific survival among Hispanic patients.

The Efforts to Enhance Gender-Based Health Promotion Among Beneficiary Families of the Family Hope Program (PKH) in Sukoharjo Regency

This research aims to elucidate genderbased health promotion within the Family Hope Program (PKH). The research methodology employed is qualitative descriptive, utilizing data from secondary sources and related studies. Analysis reveals that the program targets beneficiary families. The focus of healthcare access for PKH recipients traditionally centers around seeking medical assistance when ill, pregnant, or during childbirth, necessitating a shift towards promoting healthy lifestyles for all family members with a gender equality perspective. Sukoharjo Regency has yet to receive the Parahita Ekapraya Award (APE) unlike other areas in Central Java. Training and advocacy for officials within the Regional Apparatus Organization (OPD) remain suboptimal. The research recommends utilizing families as the intervention base and adopting a fresh perspective in programs to instigate behavioral changes toward gender equality. The novelty of this research lies in its empirical, methodological, and theoretical dimensions, where gender theory serves as a primary component in program evaluation.

Abstract PO4-10-03: Relationship Between Insurance Status and Breast Cancer Care in Young Mexican Women

Abstract BACKGROUND In Mexico, 71% of the population is covered by public health insurance, while 2% are privately insured and 27% are uninsured. Previous studies have demonstrated differences in breast cancer (BC) care according to type of healthcare coverage in the United States and Latin America. Most studies have observed that privately insured patients are diagnosed at earlier stages, have less symptom-to-diagnosis and treatment delays, and have better overall outcomes. The aim of this analysis was to evaluate whether differences in BC care exist among young women with breast cancer (YWBC), ≤40 years at diagnosis, depending on their insurance status in Mexico. METHODS Data was collected from the Mexican prospective cohort of YWBC Joven & Fuerte. Patient surveys and researcher follow-ups were used to collect data related to clinicopathologic features, time from symptom onset to seeking medical assistance and treatment, and perceived quality of information received and medical staff support. Results were analyzed using SPSS. RESULTS Information about health insurance status was available for 608 patients: 565 (93%) had public coverage and 43 (7%) had private coverage. Table 1 describes the clinicopathologic characteristics of both groups. Patients with private insurance were diagnosed at earlier stages, 0-II vs. III-IV (81% vs. 16%), than those with public insurance (50% vs. 45%) (p< 0.001). No difference was found on the distribution of BC subtypes among both groups. A total of 573 (94%) patients had registered information regarding the time from symptom onset to contacting a medical professional. Only 18 (3%) were diagnosed with imaging studies (5% and 3% with private and public coverage, respectively). More privately insured patients (95%) contacted a healthcare professional during the first 3 months since symptom onset than publicly insured patients (74%) (p=0.003). Information regarding the time from contacting a healthcare professional to treatment start was available for 472 (78%) patients. There was no difference in the proportion of patients who started treatment ≤3 months after arriving with a healthcare professional according to type of health insurance (76% private vs. 67% public coverage; p=0.2). The majority of patients (96%) considered having adequate support from the medical staff (100% private vs. 94% public). Compared to those with public coverage, more privately insured patients perceived receiving adequate information about their treatment (79% private vs. 50% public; p< 0.001). There were no differences between groups regarding the perceived quality of information regarding their diagnosis (p=0.06) and continuous BC care (p=0.6). CONCLUSION Patients with private coverage were diagnosed at earlier stages, reported contacting a healthcare professional earlier, and perceived receiving adequate information regarding their treatment more often than patients with public coverage. These results coincide with previously reported differences between patients with private and public health insurance. Interestingly, there were no differences between the delays from the first visit to treatment initiation and perceived support from the medical staff depending on type of healthcare coverage. Given the observed differences between privately and publicly insured patients, population-based interventions to increase awareness of alarm signs for BC and widespread access to quality patient education resources could help decrease the disparities between these groups. Table 1. Clinicopathologic features of BC depending on insurance status Citation Format: David G Gonzalez-Sanchez, Arantxa Ramirez-Cisneros, Alejandra Platas, Alejandra Platas, Daniela Vazquez-Juarez, Fernanda Mesa-Chavez, Ana Ferrigno, Alejandro Mohar, Alan Fonseca, Cynthia Villarreal-Garza. Relationship Between Insurance Status and Breast Cancer Care in Young Mexican Women [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-10-03.

Why do women with cardiac symptoms delay seeking medical help? Insights from a qualitative study among Jewish Israeli women.

The delay time from onset of symptoms of a myocardial infarction to seeking medical assistance can have life-threatening consequences. Women delay significantly more often than men do in calling for medical help, once symptoms of a myocardial infarction occur. The current qualitative study's main aim was to explore psychosocial factors that contribute to Israeli women's delaying calls for medical assistance and, by contrast, the motivational factors that encourage them to do so. A qualitative study. In total, 12 women were interviewed shortly after experiencing a myocardial infarction. Qualitative data were subjected to thematic analysis. Two major themes emerged describing barriers to seeking help: (1) the use of denial as a defense mechanism and (2) the need for control. The motivational factor which enhanced help-seeking was "fear of death." These findings may help in designing gender-sensitive interventions with the aim of minimizing the symptom onset to call time and thus preventing irreversible and life-threatening health damage.

“Is it urgent?”: seeking medical assistance for mental health during a pandemic

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EXPERIENCE OF USING OPTICAL COHERENCE TOMOGRAPHY IN CORNEAL INJURIES

Background. Eye trauma is one of the most common causes of monocular visual impairment and blindness worldwide. Modern classification divides eye trauma into two groups: open (penetrating) and closed (non-penetrating) eye trauma. During the diagnostic phase, it is important to thoroughly examine and establish the correct diagnosis according to the existing classification, which affects the further patient management and treatment outcomes. Optical coherence tomography (OCT) allows for real-time imaging of eye tissues with high resolution. In our study, we present our experience in using optical coherence tomography in cases of traumatic corneal injuries as an additional method for assessing the depth and extent of damage and monitoring corneal erosion healing.
 Aim. To utilize optical coherence tomography of the anterior segment of the eye for the diagnosis and assessment of corneal wound healing processes.
 Materials and Methods. The research involved 46 patients with non-penetrating corneal injuries who were observed at the clinics of Bogomolets National Medical University. A control group consisting of 15 healthy patients was also included in the study. Data collection included patient demographic information, occupation, mechanism and duration of the trauma, the presence of recurrences, and the period of seeking medical assistance. All patients underwent visual acuity assessment, biomicroscopy, evaluation of the conjunctiva and corneal condition, and fluorescein testing. Using Optical Coherence Tomography (OCT) of the anterior segment, we monitored corneal thickness and the size of the epithelial defect before and after treatment.
 Results. In optical coherence tomography of traumatic corneal erosion, in most cases, a defect in the epithelium of irregular shape with uneven edges, an irregular mixed anterior surface of the stroma, non-uniform reflectivity of the stroma, and corneal thinning were visualized. After treatment, the results corresponded to corneal epithelialization: thick intact epithelium, hyperreflective stroma, and a demarcation line confirming the wound healing process. After treatment, the corneal thickness was restored to (529 ± 144 μm), which is comparable to the thickness of a healthy cornea.
 Conclusion. Optical Coherence Tomography (OCT) is an informative supplementary diagnostic method for corneal injuries, allowing for the assessment of corneal morphology, including the condition of the basal membrane, corneal thickness, and epithelialization. Based on these findings, we can predict the course of corneal trauma and its potential consequences, enabling us to adjust treatment strategies to prevent the development of fibrosis and minimize the long-term effects of the injury.

Service Uptake Challenges Experienced by Pasifika Communities during COVID-19 Lockdowns in New Zealand

Background: New Zealand was one of the first countries to adopt an elimination strategy based on a four-tier Alert Level system that included strict lockdowns at levels three and four. The lockdowns meant shutting out external social networks and being confining to individual household ‘bubbles’ only. This presented challenges for minority Pasifika communities in New Zealand as their cultural values are based on social bonding, interconnectedness, community engagement and caring for each other. The aim of this research was to conduct a small-scale pilot study to test and refine the study design and identify the major challenges faced by Pasifika communities in relation to accessing health, social and mental services while in lockdown. Methods: This exploratory study was designed using an online anonymous questionnaire survey targeting people who identified as Pasifika. A total of eighty-seven respondents were included in our analyses following the questionnaire survey. Results: Five main barriers to accessing health, social and mental health services during lockdowns were identified; (1) unavailability of or limited services; (2) fear of contracting the virus; (3) perception of high costs associated with seeking medical assistance; (4) transportation difficulties; and (5) lack of time. Almost a quarter of the respondents reported losing their jobs, 80% indicated a decline in their household income and more than half experienced some form of psychosocial distress while in lockdown. Conclusions: The findings of this research highlight existing challenges faced by Pasifika communities in adequately accessing essential services. Future research can focus on the key barriers to access identified in this research to gain a deeper understanding of services and its interaction with Pasifika communities during lockdowns.

Exploring health seeking behaviors for common cold management

BackgroundThe prevalence of common cold can impose financial burden on the healthcare systems, despite its simple and self-limiting symptoms. ObjectiveThis study examines the behavior of patients suffering from symptoms of the common cold and explores the factors that may influence such behaviors. MethodsA descriptive-analytic cross-sectional study was conducted in 2019, in Tehran, Iran, using cluster sampling in socioeconomically diverse areas within the city. The participants' behaviors and related factors were evaluated using a 10-item questionnaire. Data collection process involved selecting 5 shopping centers and 404 individuals participated the study. SPSS version 24 was used for analysis. ResultsThe results showed that 42.1% of the respondents would consult a physician immediately upon experiencing cold symptoms, while 11.4% would consult a pharmacist.In addition, 14.3% would try self-medication, 28.3% relied on traditional home remedies, and 15%indicated not to make use of any remedies or interventions. The study indicated a correlation between people's behaviors concerning the common cold and their level of health self-confidence, knowledge of the common cold, lifestyle, gender, marital status, occupational status, insurance status, and average family spending. ConclusionThe findings of this study are significant in that they shed light on the behaviors of individuals and associated factors related to seeking medical assistance for the common cold. This knowledge can assist healthcare systems in developing strategies aimed at enhancing treatment outcomes, and decreasing costs.

(386) Emotional Aspects of Patients After Treatment of Penile Cancer: A Qualitative Aproach With Patients Accompanied at Urology Oncology Service of a Public Hospital

Abstract Introduction The penile cancer is a rare neoplasia affecting mostly the lower income and scholarship socioeconomic levels. Patients with penile cancer live for several months, even years, with the symptoms before seeking a urologist. The delay of seeking medical assistance is mainly due to the fact of poor own recognition of having a serious disease, fear of treatment and surgery. Delayed treatment affects the severity of prognostic and quality of life of patients. For the advanced stages, penectomy is still the best available treatment. Objective This study aims to comprehend the meaning of the experience of patients with penile cancer who underwent partial or total penectomy. Methods The medical records of patients who were surgically treated due to this neoplasia were reviewed using the hospital database. After reviewing the data, the researchers contacted the patients and offered an interview with the psychologist of the Oncology Urology outpatient clinic. On the scheduled return day, patients met with the same psychologist, which applied semi-structured interviews seeking the meaning of the lived experience. After conducting the interview, the literal transcription and subsequent synthesis of what was transcribed was carried out. From the collected data, two more syntheses were made in search of the units of meaning and then analysis of the collected speeches, seeking to understand the meaning of the lived experience of each of the intervewees. The final step is to seek the shared experience of the studied phenomenom, in this case the penile cancer. After completion of the process, the syntheses were submitted to 2 independent psychologist colleagues for a better understanding of the described phenomena. Results Were interviewed 7 men who had penile cancer and underwent treatment, with total or partial penectomy. The average age of participants is 57,3 years. Of the interviewed patients, 4 are married, 2 are single but in a relationship, and 1 is divorced. All patients reported unfavorable sociocultural and socioeconomic aspects, lacking basic information on self-care and on who cared for them. The results are in a qualitative analysis. There are indications of significant themes, such as: Doubts about own masculinity and virility; Denial of pain and discomfort caused by symptoms of the penile cancer; Refusal of care; Resignation towards fate, lack of meaning in life; Sadness of having lost what makes a man normal; Ambivalence between the concern to remain a man and the concern for survival; Indiscriminate feelings, cultural precariousness; “Lack of care and waiting for the problem to go away”: characteristic culturally attributed to men. Conclusions The integrative look allows the scientific community to approach how the person feels when going through the experience and caring for the patient with a broader and more attentive look. It can be seen, even with the preliminary results, that this is an extremely painful experience that affects deep layers of human experience, and that access to information, culture and sex education could be of great help in preventing the disease. Disclosure No

Impact of the COVID-19 pandemic on women's perinatal mental health and its association with personality traits: An observational study.

The burden of perinatal mental health problems was expected to increase during the COVID-19 pandemic. We prospectively investigated the impact of the COVID-19 pandemic on the mental health of pregnant and postpartum women in Norway and explored associations with their sociodemographic characteristics and personality traits. Sociodemographic information and the self-reported impact of pandemic on wellbeing of pregnant women was collected using an online survey. To assess women's mental health, two validated questionnaires, the Edinburgh Postpartum Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 item Scale (GAD-7), were used prenatally and postnatally. Personality traits were evaluated using HumanGuide, a web-based ipsative psychological evaluation instrument. 772 women were included prenatally, of which 526 also responded to the survey 4-6 weeks postnatally. The median age was 29 years, 53.6% of the women were nulliparous when enrolled, and 35.1% worked in the healthcare sector. The median EPDS (6.0; interquartile range [IQR] 3.0-10.0 vs 6.0; IQR: 3.0-10.0) and the median GAD-7 (5.0; IQR 2.0-9.0 vs 5.0; IQR 2.0-9.0) were similar pre-and postnatally. Prenatally, the proportion of women scoring ≥13 on EPDS and ≥10 on GAD-7 was 14.5% (112/772) and 21.5% (166/772), whereas the postnatal figures were 15.6% (82/526) and 21.5% (113/526), respectively. The differences were not significant (P=0.59 and P=0.99). Being <25 years of age, being on pre-pregnancy psychotherapy or psychotropic medication, frequent voluntary isolation, perception of maternity care not proceeding normally, avoiding seeking medical assistance due to fear of infection and having negative economic consequences during the COVID19 pandemic significantly increased the risk of both anxiety (GAD-7 ≥10) and depression (EPDS ≥13). Nullipara had a higher risk of anxiety, whereas being a healthcare worker had a lower risk. The personality trait factors Power (P=0.008), Quality (P=0.008), Stability (P < 0.001) and Contacts (P < 0.001) were significant predictors of depression among pregnant women, whereas the Quality (P=0.005) and Contacts (P=0.003) were significant predictors of anxiety. During the initial phase of the COVID-19 pandemic, the prevalence of depression (EPDS ≥ 13) and anxiety (GAD-7 ≥ 10) was 14.5% and 21.5%, respectively, among Norwegian pregnant women. Certain sociodemographic characteristics and personality traits were significant predictors of depression and anxiety.

Prevalence and associations of challenging, difficult or distressing experiences using classic psychedelics

Previous studies have investigated challenging, difficult, or distressing classic psychedelic experiences, but little is known about the prevalence and associations of such experiences. Using nationally representative data of the US adult population (N = 2822), this study examined the prevalence and associations of challenging, difficult, or distressing experiences using classic psychedelics, in a subsample of respondents who reported lifetime classic psychedelic use (n = 613). Of the 613 respondents who reported lifetime classic psychedelic use, the majority of them (59.1 %) had never had a challenging, difficult, or distressing experience using a classic psychedelic, but 8.9 % of respondents reported functional impairment that lasted longer than one day as a result of such experiences. Notably, 2.6 % reported seeking medical, psychiatric, or psychological assistance in the days or weeks following their most challenging, difficult, or distressing classic psychedelic experience. In covariate-adjusted regression models, co-use of lithium, co-use of other mood stabilizers, and six set and setting variables (no preparation, disagreeable physical environment, negative mindset, no psychological support, dose was too large, major life event prior to experience) were associated with the degree of difficulty; and co-use of lithium, co-use of other mood stabilizers, and three set and setting variables (negative mindset, no psychological support, major life event prior to experience) were associated with overall risk of harm. In summary, this study provides insight into the prevalence and associations of challenging, difficult, or distressing classic psychedelic experiences. The findings broadly correspond with findings from previous studies and can inform harm reduction efforts and future experimental research designs.

Is oral health literacy associated with conceptions of care and behavior related to the prevention of COVID-19?

The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

Characteristics of events in which police responded to overdoses: an examination of incident reports in Rhode Island

BackgroundNarrow or non-existent Good Samaritan Law protections and harsh drug selling statutes in the USA have been shown to deter bystanders from seeking medical assistance for overdoses. Additionally, little is known about the actions that police take when responding to overdose events. The objectives of this study were to assess the prevalence and correlates of naloxone administration by police, as well as to examine overdose events where arrests were made and those in which the person who overdosed was described as combative.MethodsWe analyzed incident reports of police responding to an overdose between September 1, 2019, and August 31, 2020 (i.e., 6 months prior to and during the COVID-19 pandemic), from a city in Rhode Island. We examined characteristics of incidents, as well as individual characteristics of the person who overdosed. Correlates of police naloxone administration were assessed using Wilcoxon rank sum tests and Fisher’s exact tests, and we examined incidents where arrests occurred and incidents in which the person who overdosed was described as combative descriptively.ResultsAmong the 211 incidents in which police responded to an overdose during the study period, we found that police administered naloxone in approximately 10% of incidents. In most incidents, police were the last group of first responders to arrive on scene (59%), and most often, naloxone was administered by others (65%). Police were significantly more likely to administer naloxone when they were the first professionals to arrive, when naloxone had not been administered by others, and when the overdose occurred in public or in a vehicle. Arrests at overdose events were rarely reported (1%), and people who overdosed were rarely (1%) documented in incident reports as being ‘combative.’ConclusionsConsidering these findings, ideally, all jurisdictions should have sufficient first responder staffing and resources to ensure a rapid response to overdose events, with police rarely or never dispatched to respond to overdoses. However, until this ideal can be achieved, any available responders should be dispatched concurrently, with police instructed to resume patrol once other professional responders arrive on scene; additionally, warrant searches of persons on scene should be prohibited.

Does COVID-19 Vaccination Cause Storage Lower Urinary Tract Symptoms?

We investigated the storage lower urinary tract symptoms (LUTS) before and after the first dose of coronavirus disease 2019 (COVID-19) vaccine and the association between pre-vaccinated overactive bladder (OAB) and the worsening of storage LUTS following COVID-19 vaccination. This cross-sectional study in a third-level hospital in Taiwan used the validated pre- and post-vaccinated Overactive Bladder Symptom Score (OABSS). Diagnosis of OAB was made using pre-vaccinated OABSS. The deterioration of storage LUTS was assessed as the increased score of OABSS following vaccination. Of 889 subjects, up to 13.4% experienced worsened storage LUTS after vaccination. OAB was significantly associated with an increased risk of worsening urinary urgency (p = 0.030), frequency (p = 0.027), and seeking medical assistance due to urinary adverse events (p < 0.001) after vaccination. The OAB group faced significantly greater changes in OABSS-urgency (p = 0.003), OABSS-frequency (p = 0.025), and total OABSS (p = 0.014) after vaccination compared to those observed in the non-OAB group. Multivariate regression revealed that pre-vaccinated OAB (p = 0.003) was a risk for the deterioration of storage LUTS. In conclusion, storage LUTS may deteriorate after vaccination. OAB was significantly associated with higher risk and greater changes in worsening storage LUTS. Storage LUTS should be closely monitored after COVID-19 vaccination, especially in those OAB patients.

Investigation of Mortality of Hereditary Angioedema in a Reference Center in Brazil

Hereditary angioedema (HAE) is known for mortality when it is not treated properly. Many advances have occurred over the past decades that affected patients' lives. However, not all patient populations have access to the same diagnosis and treatment resources. To evaluate mortality from HAE in a large cohort in a reference center in Brazil. Furthermore, the research intended to describe patients' life span, the asphyxia evolution, and factors related to the fatal outcome. A cohort of 433 patients from 46 families was evaluated in this prospective and retrospective study. Families were organized in clusters and were given a verbal autopsy to arrange data collection for the deaths and analyze symptoms during life. Causes of death were classified as deaths from laryngeal edema (LE) or other causes. Of 433 patients evaluated, 254 were not given the diagnosis of HAE. A total of 75 fatal events were evaluated. Only 10 of 75 patients were given the diagnosis of HAE before death, and the HAE diagnosis was made after death in 65 of 75 patients using verbal autopsy. The final cause of death after the investigation was asphyxiation owing to LE in 39 of 75 (52%) and deaths owing to other causes in 36 of 75 (48%). Ten deaths had occurred in the past decade. Time from onset of symptoms to seeking medical assistance was a median of 4 hours, and the time to death was a median of 8 hours. Three patients received fresh-frozen plasma and none received medications specific to HAE attacks. Throat pain or discomfort was the most common symptom, experienced by 71.8% of patients. The most common mistaken diagnosis at the original death certificate was allergy or anaphylaxis. The life span of patients who died of LE was reduced by 20 years compared with those who died of other causes. Hereditary angioedema remains a threat to life in the studied population. The large number of patients who do not receive a diagnosis makes the situation even more severe and is responsible for most deaths. Death analyses add knowledge to an understanding of the diseases and their impact on patients' lives, improving the targeting of public health efforts.

Sexual aspects of patients after treatment of penile cancer: Reports of patients accompanied at Urology Oncology service of a public hospital

ABSTRACT The penile cancer is a rare neoplasia affecting mostly the lower income and scholarship socioeconomic levels. Patients with penile cancer live for several months with the symptoms before seeking a urologist. The delay of seeking medical assistance is mainly due to the fact that own recognition of having a serious disease, fear of treatment and surgery. Delayed treatment affects the severity of prognostic and quality of life of patients. For the advanced stages, penectomy is still the best available treatment. This study aims to comprehend the meaning of the experience of patients with penile cancer who underwent partial or total penectomy. The medical records of patients who were surgically treated due to this neoplasia were reviewed in the hospital database. After reviewing the data, the researchers contacted the patients and offered the interview with the psychology group of the Oncology Urology outpatient clinic. On the scheduled return day, patients met with the psychologist, which applied semi-structured interviews seeking the meaning of the lived experience. After conducting the interview, the literal transcription and subsequent synthesis of what was transcribed was carried out. From the collected data, two more syntheses will be made in search of the units of meaning and then analysis of the collected speeches, seeking to understand the meaning of the lived experience. After completion of the process, the syntheses will be submitted to 2 independent psychologist colleagues for a better understanding of the described phenomena. Were interviewed 7 men who had penile cancer and underwent treatment, with total or partial penectomy. The average age among survey participants is 57,3 years. Of the interviewed patients, 4 are married, 2 are single but in a relationship, and 1 is divorced. All patients reported unfavorable sociocultural and socioeconomic aspects, lacking basic information on self-care and on who cared for them. The research was developed considering the ethics principles of confidentiality and privacy. This study does not offer any physical or psychological risk for the participants. Prior to the interview the “Termo de Consentimento Livre e Esclarecido (TCLE)” was provided, as well as every detail of the research. It is also explained that participation is voluntary and that the participant can leave the research at any time, without causing harm to their treatment and monitoring. The results are in a qualitative analysis. There are indications of significant themes, such as heredity, fear, faith, acceptance, care, neglect and suffering. Disclosure Work supported by industry: no.