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  • ISSN: 2379-0547
    Early Online
    Volume 5, Issue 1
    Michael A. Ward*
    Venous Thromboembolism is the third most common cause of vascular death following acute myocardial infarction and stroke [1]. Men appear to have a 2 fold higher incidence of VTE after correcting for estrogen as a confounder [2] and an individuals lifetime risk approaches 8% from the age of 45. Without ongoing prophylaxis, almost 30% of all VTE patients will have a recurrent episode within ten years [3].
    Camille R. Quinn*
    Primary care providers should consider historical trauma as a part of their overall approach to patient care. Descending from an initial description of the experience of children of the Holocaust, historical trauma prompts a traditional question of Massai warriors And how are the children? or Kasserian Ingera [1].
    Short Communication
    Forough Saadatmand*, Roderick J. Harrison, Deanna Crouse, Marjorie Douglas, and Jennifer Bronson
    This research examines the prevalence of family violence among African American young adults, ages 18 to 25, who lived in socioeconomically disadvantaged areas of Washington, DC. We focused on nine questions from a 34 items question in the juvenile victimization questionnaire (JVQ), which measures the prevalence of childhood exposure to violence in the family before age 18. The results show that a relatively large percentage of African-American young adults in the sample were exposed to family violence. Nearly a third of the participants (30%) were physically abused by a grown-up in their life. About 20% said they were neglected as children and 29% said they had experienced emotional abuse.
    Research Article
    Noel Kulik*, Margaret McKeough, Stephanie Kendzierski, Ebonite Guyton, and Stacey Leatherwood
    Pediatrics remains as a recognized discipline for the referral of weight loss management amongst children and their family. The purpose of this study was to identify the key provider, patient and process factors that influence physician referrals to a weight management program for children and families. We performed a cross-sectional analysis of data collected from pediatricians and family medicine physicians using both online and paper-and-pencil formats. Data collected include demographic and training information; attitude, knowledge and self-efficacy for obesity treatment; and influences on referral practices to an evidence-based weight management program for children and families. Pearson ?2 and Spearman correlations examined bivariate relationships between training, knowledge; self-efficacy, behavior and referral variables, and independent samples t-tests were used to examine differences between types of physician. Fifty-two physicians completed the survey and have been in practice 22.0 8.8 years. Physicians perceive a lack of patient interest in the program as the biggest influence on their referral practices; however lower levels of overall referrals were associated with a lack of physician knowledge and training in the referral process (r(39) = -0.39, p = .015), and by physicians concern over the amount of time spent with each family during the referral process (r(37) = -0.42, p = .011). Physicians own healthy eating behavior was associated with their confidence in assisting families with healthy eating and physical activity behaviors. Conclusions: In our sample of pediatricians and family medicine physicians from a large health system, findings suggest that building physician self-efficacy in counseling and referral practices to evidence-based programs must be a priority when working toward long-term improved obesity prevention and treatment.
    O OArije, Timothy Alabi*, and OS Olowookere
    Background: A critical step in solving the challenge of poor health facility utilization is getting feedback from users of the services on the quality of services they or their family receive at the health care facilities.
    Objective: This study explores perceptions of users on quality of child health services as the first phase for the development and validation of a quantitative tool for the assessment of perceived quality of child health services in primary health care (PHC) facilities.
    Method: Focus group discussions were conducted with male and female caregivers of under-five year old children from purposively selected catchment communities to assess their perception about the quality of health services in PHC facilities in South West Nigeria. Thematic content analysis was used to identify convergent and divergent opinions and to synthesis the perceptions of discussants through various combinations of open, axial and selective coding along with constant comparisons.
    Result: Availability of drugs, health workers being always available, spending quality time with the children, and the children recovering from their illnesses when treated were the most commonly cited markers of high quality of care in PHC facilities. Insufficiency of chairs for patients/caregivers, and dirty environment of the health facility amongst others were markers of low quality of child health care.
    Conclusion: In all there were 132 exchanges relating to perception of quality of child health care. These exchanges were organized into 39 quality related items to feed into the next phase of development of the scale for assessing users perception of quality of child health care in PHC facilities.
    Research Article
    Adeola Sonaike* and Scott McDoniel
    Epidemiologic surveillance indicates increased susceptibility to obesity among children with special health care needs (SHCN) in comparison to children without SHCN. Focusing on the impact that patient-provider interactions have on health behaviors and health outcomes, this paper explores clinician-initiated obesity management counseling received by children with SHCN by conducting a retrospective medical review. An independent two-tailed sample t-test compared the incidence of obesity management counseling received by children with and without SHCN over a 2-year timeframe. This t-test revealed a statistically significant difference between the frequency of weight management counseling received by youth with SHCN in the 2-year timeframe (M= 1.0, SD =0.46498) and the frequency of weight management counseling received by youth without SHCN in the 2-year timeframe (M = 2.0, SD = 0.74975), t(100) = 7.826, p = 0.000, a = 0.05. This paper supports the theory that disparities in obesity-related health outcomes experienced by children with SHCN can be partially attributed to limitations in standardized clinician-initiated health practices for specialized populations. As disparities in health outcomes for people with SHCN continue to grow, it is recommended that standardized preventive health practices and diagnosis-specific preventive health screening tools be developed and provided to current and future general health practitioners.
    Ekram W. Abd El-Wahab* and Noha S. Moustafa
    Background: Smoking is an avoidable behavioral cause of premature morbidity and mortality. The initiation, continuation and dependence of smoking are associated with several personal, environmental and socio-cultural factors which vary between age groups and geographical regions.
    Objective: To investigate the pattern of smoking cessation and the extent of the smoking dependence among smokers in urban and rural societies in Egypt.
    Methods: A cross-sectional study was conducted targeting a random sample of 552 adult smokers aging 11-75 years. All participants were inquired about their demographic features, life style and behaviors, motives for smoking cessation and quitting attempts using a predesigned interviewing questionnaire. Nicotine dependence was assessed using Fagerstrm scoring scale.
    Results: About 28.1% of the participants admitted a motivation to quit smoking and about 61.1% had at least an attempt. The longest duration of quitting was =5 years as reported by utmost 4.0% of the smokers. The drive to quit smoking was advice of a family member (39.9%) or a doctor (30.1%), concerns about smoking hazards (19.7%) or due to financial limitations (12.7%). The more frequently used method to quit smoking were cold turkey (23.4%), gradual reduction (15.9%), and the use of nicotine replacement therapy (12.5%). Moderate and high nicotine dependence was achieved by 46.7% and 24.6% respectively. Moderate and high nicotine dependence was achieved by 46.7% and 24.6% respectively. Male gender was the single predictor of smoking dependence. Motivation to stop smoking was associated with the presence of social support and having low dependence score.
    Conclusion: Nicotine dependence was significant at younger ages. Therefore, smoking cessation program should be a top priority and targeted to prevent smoking in adolescence. Appropriate interventions addressing individuals motives and considering pharmacotherapy are needed to encourage successful quit attempts.
    Enabulele O, Ajokpaniovo J, and Enabulele JE*
    Background: Waiting time is an important indicator of patient satisfaction and the operational effectiveness and efficiency of a health facility. This study assessed patient waiting and consultation time in the General Practice Clinic of the University of Benin Teaching Hospital as well as assessed the association between waiting time and patient satisfaction with care received.
    Materials and Methods: This was a cross-sectional analytic study conducted in the General Practice Clinic of University of Benin Teaching Hospital, Nigeria. Analysis was done using Chi-square test, Mann Whitney U test, Kruskal Wallis test to test the association between waiting and consultation times with care satisfaction. We used binary logistic regression to evaluate the independent predictors of care satisfaction.
    Results: A total of 336 participants were recruited for the study. Participants comprised of 216 females and 120 males. The waiting time spent by the patients before they had their first contact with the medical doctor ranged from 11-354 minutes with a mean of146.7555.38 minutes. The consultation time ranged from 3-88 minutes with a mean of 22.4312.12 minutes. Those who rated the medical care as poor were observed to have had longer waiting time (mean waiting time of 219.8865.95 minutes). While, those who rated the medical care received as excellent had the highest mean consulting time of 25.5713.23 minutes.
    Conclusion: Compared to the recommended average patient waiting time of 30 minutes, patient waiting time in this study was prolonged and was a significant independent predictor of satisfaction with medical care.
    However, the consultation time was close to the recommended average consultation time of 15 minutes. This study advocates the need for future studies to assess the reasons responsible for the prolonged waiting time in order to provide remedial solutions aimed at improving the quality of care rendered to patients.
    Zemenu Shiferaw* and Liyew Mekonen
    Background: Currently, Ethiopia is placed heavy emphasis on the rationale of family planning. Although contraceptives prevalence has been increasing; switching and discontinuation still remains high. Examining factors of contraceptive switching is important in order to reduce switching rate which in turn, can impact levels of unintended pregnancy, induced abortion, and fertility rates.
    Objective: This study assessed prevalence and factors affecting contraceptive switching among women of Child bearing age (15-49) in Jijiga town, Eastern Ethiopia, 2015.
    Methods: A community based cross- sectional study design was conducted in Jijiga town among 537 women whoever had contraceptive use history in the last three years before the survey. Systematic random sampling was employed. The data was collected using pretested structured questionnaire and analyzed using SPSS version 21 and MS-Excel. Life table analysis and Cox-regressions was done.
    Results: A total of 703 contraceptive segments and 537 women were analyzed in the life table. At the end of 12 month of use 19% of use segments were discontinued and 16% were switched, i.e. switching accounts 86.8% of discontinuation. Type of contraceptive method (AHR: 3.62 95% CI: 2.5, 5.13), use intention (AHR: 1.43, 95% CI: 1.00, 2.05), parity (AHR: 2.09 95% CI: 1.31, 3.35) and quality of service with counseling (AHR: 2.49, 95% CI: 1.704, 3.65) were found to be predictors of contraceptive method switching.
    Conclusion: Majority of discontinued contraceptive use segments were switched to the other method. Lack of proper counseling, use of short acting methods, and high parity were predictors of switching. Side effects, need of more effective method and method inconvenience were widely reported reasons for switching. Hence, family planning programs need to emphasize on eminence of FP counseling, lowering fertility rates and increase access and use of long acting contraception.
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