RESUMEN
It is unclear how the prevalence of people who believe the gluten-free diet (GFD) to be generally healthy ("Lifestylers") is impacting the overall rates of self-reported gluten sensitivity (GS). We repeated a population survey from 2012 in order to examine how attitudes towards GS have changed over time. Our survey (N = 1004) was administered in Sheffield (UK) in 2015, replicating the 2012 experiment. The questionnaire included a food frequency survey and assessed self-reported GS as well as associated variables (prevalence, current diet, pre-existing conditions, etc.). The overall rates of key variables and chi-squared analysis in comparison to the previous survey were as follows: self-reported GS was 32.8% (previously 12.9%, p < 0.001), pre-existing coeliac disease (CD) was 1.2% (previously 0.8%, p = 0.370), following a GFD was 3.7% (previously 3.7%, p = 0.997). Self-reported GS was positively associated with some pre-existing conditions, including anxiety, depression, chronic fatigue, headaches, and other food allergies/intolerances (including irritable bowel syndrome (IBS); chi-squared analyses, all p < 0.001). Over a 3-year period, the fraction of people who self-reported GS increased by over 250%. Despite this, arguably more meaningful indications of underlying physiological GS remained comparable. This research suggests that the public perception of gluten is causing a marked increase in the number of people who erroneously believe they are sensitive to it.
Asunto(s)
Actitud Frente a la Salud , Enfermedad Celíaca/epidemiología , Dieta Sin Gluten/psicología , Intolerancia Alimentaria/epidemiología , Glútenes/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/psicología , Autoevaluación Diagnóstica , Encuestas sobre Dietas , Femenino , Intolerancia Alimentaria/diagnóstico , Intolerancia Alimentaria/psicología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Reino Unido/epidemiología , Adulto JovenRESUMEN
BACKGROUND: This study evaluated bedside reporting from the nurse's perspective regarding accountability, empowerment, work effectiveness, satisfaction, and communication. The aim was to examine the effects of an educational learning activity on bedside handoff reporting related to accountability and work effectiveness. The communication was used at change of shift between frontline nurses, with future interprofessional implementation. METHOD: A demographic questionnaire, the Specht and Ramler Accountability Index-Individual Referent and the Conditions for Workplace Effectiveness Questionnaire-II were administered pre-posteducational (learning activity) intervention. Of 184 RNs, 104 completed the pretest, with only 73 of those completing the posttest. RESULTS: Statistically significant differences were seen with empowerment, work effectiveness, communication, and nurse job satisfaction posttest; no statistically significant difference was found with accountability. The sample was ethnically diverse, with the majority being Latino pretest (n = 63, 55.8%) and posttest (n = 44, 60.3%). CONCLUSION: For medical-surgical units, incorporating bedside reporting can increase nurse satisfaction, accountability, and positive outcomes. J Contin Educ Nurs. 2018;49(10):460-466.
Asunto(s)
Educación Continua en Enfermería/organización & administración , Eficiencia Organizacional/normas , Personal de Enfermería en Hospital/educación , Personal de Enfermería en Hospital/psicología , Pase de Guardia/normas , Guías de Práctica Clínica como Asunto/normas , Adulto , Comunicación , Curriculum , Femenino , Florida , Humanos , Satisfacción en el Trabajo , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
INTRODUCTION: The stage at cancer diagnosis has a tremendous impact on type of treatment, recovery and survival. In most cases the earlier the cancer is detected and treated the higher the survival rate for the patient. The purpose of this study was to examine the impact of spatial access to healthcare services on late detection of female breast cancer diagnosis in Missouri, taking into account access and distance to the nearest mammography center and/or hospital. METHODS: This was a cross-sectional retrospective study of female breast cancer diagnosis in different geographic regions of Missouri. The sample was restricted to Missouri women diagnosed with breast cancer, whose cases had been reported to the Missouri Cancer Registry and Research Center between 2003 and 2008. A geographic information system network analysis was used to calculate distance traveled by road from the centroid of each county to the nearest healthcare facility. RESULTS: A total of 28 536 cases of female breast cancers were reported to the Missouri Cancer Registry and Research Center between 2003 and 2008. Of these 25 743 (90.2%) were Caucasian (white) while 2793 (9.8%) were African-American (black). Analysis showed that the proportion of African-Americans with late-stage detection exceeded that of whites in almost all rural and urban locations. From 2003 to 2005 more than 50% of all late-stage diagnoses of African-American women occurred in metropolitan (metro) medium (55.6%) and completely rural counties (66.7%). Other locations recorded a smaller number of late-stage detection among African-American women: metro small (42.3%), urban large (47.4%) and urban small (44.9%) counties. Most of the late-stage diagnoses of white women were reported in urban small (32.2%) and rural (32.3%) counties. Between 2006 and 2008, again, the proportion of late-stage diagnoses among black women was the highest. Access to hospitals is fairly distributed among all counties. Women from disadvantaged non-metro areas have the same level of access to hospitals as those in metro areas within a travel time of 15 to 30 minutes. However, although there are almost 180 mammography screening centers across the state, access to these services is not evenly distributed. A network analysis of the closest facility of the type showed that women living in 19 non-metro rural counties have to travel more than 45 minutes one way by car for mammography services. Thirteen of the 19 counties are classified as completely rural. CONCLUSIONS: Women with breast cancer living in areas with limited access to healthcare services are more likely to have been diagnosed with late-stage breast cancer.