Science.gov

Sample records for controlled cross-sectional survey

  1. Estimation of Transitional Probabilities of Discrete Event Systems from Cross-Sectional Survey and its Application in Tobacco Control

    PubMed Central

    Lin, Feng; Chen, Xinguang

    2009-01-01

    In order to find better strategies for tobacco control, it is often critical to know the transitional probabilities among various stages of tobacco use. Traditionally, such probabilities are estimated by analyzing data from longitudinal surveys that are often time-consuming and expensive to conduct. Since cross-sectional surveys are much easier to conduct, it will be much more practical and useful to estimate transitional probabilities from cross-sectional survey data if possible. However, no previous research has attempted to do this. In this paper, we propose a method to estimate transitional probabilities from cross-sectional survey data. The method is novel and is based on a discrete event system framework. In particular, we introduce state probabilities and transitional probabilities to conventional discrete event system models. We derive various equations that can be used to estimate the transitional probabilities. We test the method using cross-sectional data of the National Survey on Drug Use and Health. The estimated transitional probabilities can be used in predicting the future smoking behavior for decision-making, planning and evaluation of various tobacco control programs. The method also allows a sensitivity analysis that can be used to find the most effective way of tobacco control. Since there are much more cross-sectional survey data in existence than longitudinal ones, the impact of this new method is expected to be significant. PMID:20161437

  2. Relationship between parental locus of control and caries experience in preschool children - cross-sectional survey.

    PubMed

    Lencová, Erika; Pikhart, Hynek; Broukal, Zdenek; Tsakos, Georgios

    2008-06-12

    Due to high prevalence and serious impacts, childhood caries represents a public health issue. Behavioural risk factors such as locus of health control have been implicated in the development of the disease; however their association with childhood caries has not been thoroughly studied. The aim of this cross-sectional survey was to assess the relationship between parental locus of health control and caries experience and untreated caries of their preschool children in a representative sample in Czech Republic, adjusting for relevant sociodemographic characteristics. A representative sample of 285 preschool children and their parents was recruited. Study data included children's dental status recorded in nurseries and parental questionnaires with 13 attitudinal items regarding locus of control (LoC) in caries prevention. The association between parental locus of control and children's caries experience and level of untreated caries was analysed using logistic regression, adjusting for the effect of key sociodemographic variables. There was a statistically highly significant linear trend between increased parental LoC and higher probability of the children to be free from untreated caries, independent from the effect of sociodemographic variables of children and parents. A similar highly statistically significant trend, although not entirely linear, and independent from sociodemographic variables was observed with respect to the chance of the children to be free from caries experience with increasing strength of parental LoC. After full adjustment, children in the strongest parental LoC quintile were 2.81 (1.23-6.42, p< 0.05) times more likely to be free from untreated caries in comparison to the weakest parental LoC quintile and 2.32 (1.02-5.25, p< 0.05) times more likely to be free from caries experience in comparison to the weakest parental LoC quintile. The findings support the hypothesis that higher internal parental LoC is associated with better control of

  3. Psychological distress and cancer pain: Results from a controlled cross-sectional survey in China

    PubMed Central

    Li, Xiao-Mei; Xiao, Wen-Hua; Yang, Ping; Zhao, Hui-Xia

    2017-01-01

    We evaluated the pain associated with cancer and its impact on pain management, anxiety, and depression in Chinese patients using a controlled cross-sectional study. One hundred and twenty-six cancer outpatients were evaluated from January 2012 to June 2014; 64 reported pain and 62 did not. Patients with cancer eligible for this study were older than 18 years and able to effectively communicate with medical personnel. Patients were administered a questionnaire regarding their medical status. The information collected was used along with patient charts to complete a socio-demographic and clinical characteristic summary for each patient. Results showed that patients who reported pain had mean State-Trait Anxiety Inventory (STAI) scores of 46.38 for state anxiety and 44.64 for trait anxiety, as well as a mean BDI (Beck Depression Inventory) score of 19.17. The pain-free patient group had mean STAI scores of 40.73 for state anxiety and 42.87 for trait anxiety, and a mean BDI score of 15.35. In conclusion, patients who reported pain were more prone to anxiety and depression, with pain severity being a strong predictor of anxiety. Adequate pain assessment and adjustment proved necessary for pain management. PMID:28074915

  4. Longitudinal Weight Calibration with Estimated Control Totals for Cross Sectional Survey Data: Theory and Application

    ERIC Educational Resources Information Center

    Qing, Siyu

    2014-01-01

    The National Science Foundation (NSF) Survey of Doctorate Recipients (SDR) collects information on a sample of individuals in the United States with PhD degrees. A significant portion of the sampled individuals appear in multiple survey years and can be linked across time. Survey weights in each year are created and adjusted for oversampling and…

  5. Longitudinal Weight Calibration with Estimated Control Totals for Cross Sectional Survey Data: Theory and Application

    ERIC Educational Resources Information Center

    Qing, Siyu

    2014-01-01

    The National Science Foundation (NSF) Survey of Doctorate Recipients (SDR) collects information on a sample of individuals in the United States with PhD degrees. A significant portion of the sampled individuals appear in multiple survey years and can be linked across time. Survey weights in each year are created and adjusted for oversampling and…

  6. Awareness of dengue and practice of dengue control among the semi-urban community: a cross sectional survey.

    PubMed

    Naing, Cho; Ren, Wong Yih; Man, Chan Yuk; Fern, Koh Pei; Qiqi, Chua; Ning, Choo Ning; Ee, Clarice Wong Syun

    2011-12-01

    Primary prevention is the most effective measure in dengue prevention and control. The objectives were (i) to determine the level of knowledge and practice of dengue control amongst the study community, and (ii) to explore the factors affecting practice of dengue control in the study area. A cross-sectional study was conducted in a semi-urban Town of Malaysia, using a structured questionnaire covering sociodemography, knowledge related to dengue, knowledge related to Aedes mosquito and preventive measures against the disease. For comparison of survey responses, chi-square test was applied for categorical data. To explore the factors affecting the practice of dengue control, a linear regression model was introduced. Almost all of the respondents (95%) had heard about dengue. Overall, misconceptions of dengue transmission were identified and the practice of dengue control in the study population was insufficient. About half (50.5%) had misconceptions that Aedes can breed in dirty water and the preferred biting time is dusk or sunset (45.6%). Only 44.5% of the households surveyed had covered their water containers properly. Significant associations were found between knowledge scores of dengue and age (P = 0.001), education level (P = 0.001), marital status (P = 0.012), and occupation (P = 0.007). In regression analysis, only the knowledge of dengue was significantly and positively associated with practice on dengue control. A future study with larger samples and more variables to assess the knowledge, attitudes and practices of dengue control is recommended.

  7. Nursing education and beliefs towards tobacco cessation and control: a cross- sectional national survey (GHPSS) among nursing students in Greece.

    PubMed

    Patelarou, Evridiki; Vardavas, Constantine I; Ntzilepi, Penelope; Warren, Charles W; Barbouni, Anastasia; Kremastinou, Jenny; Connolly, Gregory N; Behrakis, Panagiotis

    2011-05-06

    Within the healthcare system, nurses have the ability to influence their patients' smoking habits through counselling. Therefore, it is of great importance to appropriately train health professionals on smoking cessation strategies with the aim to help them provide advice to their patients. In light of the above, the objective of this study was to assess the association between Greek nursing students' beliefs towards tobacco control/smoking cessation and the professional training received. During February 2009, we conducted a cross sectional national survey among all 3rd year nursing students of the two university based nursing departments in Greece (University of Athens, University of the Peloponnese). The Global Health Professional Student Survey (GHPSS) questionnaire was applied and following written informed consent 73% provided a completed questionnaire (n = 192/263 enrolled students). Overall, 33% were current active smokers, while 74% reported ever to experiment smoking. In regards to their beliefs towards tobacco control policies, non smokers were more positive in regards to banning smoking in restaurants (94% vs. 61%, p < 0.001), in bars and cafes (82% vs. 34%, p < 0.001), and all public places (93% vs. 51%, p < 0.001) when compared to current smokers. In comparison with students who had not received training on the importance of asking patients about their smoking habits, those that did were more likely to believe that nurses should have a role in smoking cessation and should act as role models for their patients. Resources should be invested in improving the quality of undergraduate education in nursing departments in Greece with respect to tobacco control and smoking cessation.

  8. Relationship between parental locus of control and caries experience in preschool children – cross-sectional survey

    PubMed Central

    Lenčová, Erika; Pikhart, Hynek; Broukal, Zdeněk; Tsakos, Georgios

    2008-01-01

    Background Due to high prevalence and serious impacts, childhood caries represents a public health issue. Behavioural risk factors such as locus of health control have been implicated in the development of the disease; however their association with childhood caries has not been thoroughly studied. The aim of this cross-sectional survey was to assess the relationship between parental locus of health control and caries experience and untreated caries of their preschool children in a representative sample in Czech Republic, adjusting for relevant sociodemographic characteristics. Methods A representative sample of 285 preschool children and their parents was recruited. Study data included children's dental status recorded in nurseries and parental questionnaires with 13 attitudinal items regarding locus of control (LoC) in caries prevention. The association between parental locus of control and children's caries experience and level of untreated caries was analysed using logistic regression, adjusting for the effect of key sociodemographic variables. Results There was a statistically highly significant linear trend between increased parental LoC and higher probability of the children to be free from untreated caries, independent from the effect of sociodemographic variables of children and parents. A similar highly statistically significant trend, although not entirely linear, and independent from sociodemographic variables was observed with respect to the chance of the children to be free from caries experience with increasing strength of parental LoC. After full adjustment, children in the strongest parental LoC quintile were 2.81 (1.23–6.42, p< 0.05) times more likely to be free from untreated caries in comparison to the weakest parental LoC quintile and 2.32 (1.02–5.25, p< 0.05) times more likely to be free from caries experience in comparison to the weakest parental LoC quintile. Conclusion The findings support the hypothesis that higher internal parental Lo

  9. Barriers to care in patients with diabetes and poor glycemic control-A cross-sectional survey.

    PubMed

    McBrien, Kerry A; Naugler, Christopher; Ivers, Noah; Weaver, Robert G; Campbell, David; Desveaux, Laura; Hemmelgarn, Brenda R; Edwards, Alun L; Saad, Nathalie; Nicholas, David; Manns, Braden J

    2017-01-01

    To determine and quantify the prevalence of patient, provider and system level barriers to achieving diabetes care goals; and to examine whether barriers were different for people with poor glycemic control (HbA1c ≥ 10%; 86 mmol/mol) compared to fair glycemic control (7 to <8%; 53-64 mmol/mol). We administered a survey by telephone to community-dwelling patients with diabetes, to examine patient-reported barriers and facilitators to care. We compared responses in individuals with HbA1c ≥ 10% (86 mmol/mol) against those with HbA1c between 7-8% (53-64 mmol/mol). We examined associations between HbA1c group and barriers to care, adjusting for sociodemographic factors and diabetes duration. The survey included 805 people with HbA1c ≥ 10% (86 mmol/mol), and 405 people with HbA1c 7-8% (53-64 mmol/mol). Participants with HbA1c ≥ 10% (86 mmol/mol) reported good access to care, however 20% of participants with HbA1c ≥ 10% (86 mmol/mol) felt that their care was not well-coordinated and 9.6% reported having an unmet health care need. In adjusted analysis, patients with HbA1c ≥10% (86 mmol/mol) were more likely to report lack of confidence and inadequate social support, compared to patients with HbA1c 7-8% (53-64 mmol/mol). They were also significantly more likely not to have drug insurance nor to have received recommended treatments because of cost. These results reinforce the importance of an individualized, yet multi-faceted approach. Specific attention to financial barriers seems warranted. These findings can inform the development of programs and initiatives to overcome barriers to care, and improve diabetes care and outcomes.

  10. Attitudes Toward Obese Persons and Weight Locus of Control in Chinese Nurses: A Cross-sectional Survey.

    PubMed

    Wang, Yan; Ding, Ye; Song, Daoping; Zhu, Daqiao; Wang, Jianrong

    2016-01-01

    Obese individuals frequently experience weight-related bias or discrimination-even in healthcare settings. Although obesity bias has been associated with several demographic factors, little is known about the association of weight locus of control with bias against overweight persons or about weight bias among Chinese health professionals. The aim of the study was to examine attitudes toward obese patients in a sample of Chinese registered nurses (RNs) and the relationship between weight bias and nurses' weight locus of control. RNs working in nine community health service centers across Shanghai, China, answered three self-report questionnaires: The Attitudes Toward Obese Persons Scale (ATOP), the External Weight Locus of Control Subscale (eWLOC) from the Dieting Belief Scale, and a sociodemographic profile. Hierarchical, stepwise, multiple regression was used to predict ATOP scores. From among 385 invited, a total of 297 RNs took part in the study (77.1% response rate). Participants scored an average of 71.04 on the ATOP, indicating slightly positive attitudes toward obese persons, and 30.08 on the eWLOC, indicating a belief in the uncontrollability of body weight. Using hierarchical, stepwise, multiple regression, two predictors of ATOP scores were statistically significant (eWLOC scores and status as a specialist rather than generalist nurse), but explained variance was low. Chinese RNs seemed to have relatively neutral or even slightly positive attitudes toward obese persons. Those nurses who believed that obesity was beyond the individual's control or worked in specialties were more likely to have positive attitudes toward obese people. Improved understanding of the comprehensive etiology of obesity is needed.

  11. Low back pain among endurance athletes with and without specific back loading--a cross-sectional survey of cross-country skiers, rowers, orienteerers, and nonathletic controls.

    PubMed

    Bahr, Roald; Andersen, Stig Ove; Løken, Sverre; Fossan, Bjørn; Hansen, Torger; Holme, Ingar

    2004-02-15

    Cross-sectional survey among athletes competing at the national elite level in cross-country skiing, rowing, and orienteering, as well as a matched nonathletic control group. To compare the prevalence of symptoms of low back pain between endurance sports with different loading characteristics on the lumbar region: cross-country skiing, rowing, and orienteering, as well as a nonathletic control group. Although it is claimed that back pain is a frequent problem in endurance sports loading the lower spine such as rowing or cross-country skiing, the prevalence of low back problems in such sports has not been compared with relevant control groups. Self-reported questionnaire on low back pain adapted for sports based on standardized Nordic questionnaires for musculoskeletal symptoms. Responders were 257 cross-country skiers (response rate: 100%), 199 rowers (99.5%), and 278 orienteerers (99.3%), and 197 control subjects (66%). Low back pain was reported to be somewhat more common among cross-country skiers and rowers than orienteerers and nonathletic controls. The prevalence among cross-country skiers of reported low back pain ever (65.4%) and low back pain during the previous 12 months (63.0%) was higher than nonathletic controls (OR [95% CI]: 1.94 [1.29-2.92]). Rowers (25.6%) reported missing training because of low back pain more frequently than orienteerers did (13.7%, OR: 2.16 [1.25-3.74]). The athletes reported more low back pain during periods when training and competition load was higher, and cross-country skiers more frequently reported having low back problems using classic than freestyle skiing techniques. Low back pain appears to be somewhat more common in endurance sports that specifically load the low back during training and competition. The relationship between seasonal training patterns and specific skiing techniques indicate that there is a relationship between low back pain and the specific loading patterns of skiing and rowing.

  12. Job control, work-family balance and nurses' intention to leave their profession and organization: A comparative cross-sectional survey.

    PubMed

    Yamaguchi, Yoshiko; Inoue, Takahiro; Harada, Hiroko; Oike, Miyako

    2016-12-01

    The shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses' intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors' levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes. This study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables' levels and effect size on nurses' intention to leave their organization or profession between these care settings. The research design was cross-sectional. Participating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses' intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%). The level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables' effect on nurses' intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses' intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively. Interventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses' work-family conflict will increase nurse retention. Regarding

  13. Hypertension prevalence, awareness, treatment and control among older people in Latin America, India and China: a 10/66 cross-sectional population-based survey.

    PubMed

    Prince, Martin J; Ebrahim, Shah; Acosta, Daisy; Ferri, Cleusa P; Guerra, Mariella; Huang, Yueqin; Jacob, K S; Jimenez-Velazquez, Ivonne Z; Rodriguez, Juan L; Salas, Aquiles; Sosa, Ana L; Williams, Joseph D; Gonzalez-Viruet, Maribella; Jotheeswaran, Amuthavilli T; Liu, Zhaorui

    2012-01-01

    To estimate the prevalence, social patterning, treatment and control of hypertension among older people in the 10/66 Dementia Research Group developing country sites. Cross-sectional surveys of SBP, hypertension, and hypertension awareness, treatment and control among 17 014 people aged 65 years and over in eight urban and four rural sites in Latin America, India and China. Hypertension prevalence was higher in urban (range 52.6-79.8%) than rural sites (range 42.6-56.9%), and lower in men than women [pooled prevalence ratio 0.89, 95% confidence interval (CI) 0.85-0.93]. Educational attainment was positively associated with hypertension in rural and least-developed sites. Age-standardized morbidity ratios, compared to USA (100), were higher in urban sites in Cuba (105), Dominican Republic (109), and Venezuela (107), similar in Puerto Rico (105), urban Mexico (99) and urban India (101), and lower in urban (75) and rural (61) Peru, rural Mexico (81), urban (91) and rural (84) China and rural India (65). In most Latin American centres, and urban China just over one-third of those with hypertension were controlled (BP < 140/90). Control was poor in rural China (2%), urban India (12%) and rural India (9%). The proportion controlled, not compositional factors (age, sex, education and obesity), explained most of the between-site variation in SBP. Uncontrolled hypertension is common among older people in developing countries, and may rise further during the demographic and health transitions. It is a major determinant of population SBP level. Strengthening primary care to improve hypertension management is necessary for primary prevention.

  14. Perceptions of malaria control and prevention in an era of climate change: a cross-sectional survey among CDC staff in China.

    PubMed

    Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Liu, Xiaobo; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

    2017-03-31

    Though there was the significant decrease in the incidence of malaria in central and southwest China during the 1980s and 1990s, there has been a re-emergence of malaria since 2000. A cross-sectional survey was conducted amongst the staff of eleven Centers for Disease Control and Prevention (CDC) in China to gauge their perceptions regarding the impacts of climate change on malaria transmission and its control and prevention. Descriptive analysis was performed to study CDC staff's knowledge, attitudes, perceptions and suggestions for malaria control in the face of climate change. A majority (79.8%) of CDC staff were concerned about climate change and 79.7% believed the weather was becoming warmer. Most participants (90.3%) indicated climate change had a negative effect on population health, 92.6 and 86.8% considered that increasing temperatures and precipitation would influence the transmission of vector-borne diseases including malaria. About half (50.9%) of the surveyed staff indicated malaria had re-emerged in recent years, and some outbreaks were occurring in new geographic areas. The main reasons for such re-emergence were perceived to be: mosquitoes in high-density, numerous imported cases, climate change, poor environmental conditions, internal migrant populations, and lack of health awareness. This study found most CDC staff endorsed the statement that climate change had a negative impact on infectious disease transmission. Malaria had re-emerged in some areas of China, and most of the staff believed that this can be managed. However, high densities of mosquitoes and the continuous increase in imported cases of malaria in local areas, together with environmental changes are bringing about critical challenges to malaria control in China. This study contributes to an understanding of climate change related perceptions of malaria control and prevention amongst CDC staff. It may help to formulate in-house training guidelines, community health promotion

  15. Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia.

    PubMed

    Fletcher, Tom E; Gulzhan, Abuova; Ahmeti, Salih; Al-Abri, Seif S; Asik, Zahide; Atilla, Aynur; Beeching, Nick J; Bilek, Heval; Bozkurt, Ilkay; Christova, Iva; Duygu, Fazilet; Esen, Saban; Khanna, Arjun; Kader, Çiğdem; Mardani, Masoud; Mahmood, Faisal; Mamuchishvili, Nana; Pshenichnaya, Natalia; Sunbul, Mustafa; Yalcin, Tuğba Y; Leblebicioglu, Hakan

    2017-01-01

    Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.

  16. Acquiring credentials in bedside ultrasound: a cross-sectional survey

    PubMed Central

    Lewiss, Resa E; Saul, Turandot; Del Rios, Marina

    2013-01-01

    Objective Although there are training guidelines to credential emergency physicians in bedside ultrasound, many faculty groups have members who completed residency without a mandatory curriculum. These physicians are therefore required to learn bedside ultrasound while out in practice. The objective of this descriptive report is to illustrate a single academic facility's experience with acquiring credentials for emergency physicians in bedside ultrasound and the faculty's impressions on the motivators of and barriers to completion of the requirements. Design Cross-sectional survey. Setting Two urban teaching hospitals with a combined volume of 170 000 visits a year. Participants 41 emergency medicine attending physicians. Intervention Emergency medicine attending physicians underwent training and credentialing in the applications of aorta and pelvic ultrasound over a 9-month period. Outcome measure After the credentialing period, we conducted a survey to evaluate the physicians’ perceptions of this process. Results There were 41 faculty members during the credentialing survey period. 11 of the faculty members were exempt from ultrasound training. We asked attending physicians (N=41 exempt and non-exempt) to complete a web-based survey after the completion of the credentialing period. Questions about the potential barriers and incentives were listed and responders were asked to rank answers on a five-point Likert scale. Of the 31 respondents, 21 (67.7%) completed the credentialing requirements by the 9-month deadline. 19 of 26 emergency medicine residency trained physicians completed the requirements compared with 2/5 of those that were not emergency medicine residency trained. Our pilot study data suggest an association between fewer years in practice and completion of the requirements. Conclusions This is a report on a single academic institution's experience with a faculty credentialing programme in bedside ultrasound for physicians with a diversity of prior

  17. Psychiatric problems in children with hemiplegia: cross sectional epidemiological survey.

    PubMed

    Goodman, R; Graham, P

    1996-04-27

    To examine the prevalence and predictors of psychiatric problems in children with hemiplegia. Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later. 428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed. Psychiatric symptom scores and the occurrence of psychiatric disorder. Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power. Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented.

  18. Psychiatric problems in children with hemiplegia: cross sectional epidemiological survey.

    PubMed Central

    Goodman, R.; Graham, P.

    1996-01-01

    OBJECTIVE--To examine the prevalence and predictors of psychiatric problems in children with hemiplegia. DESIGN--Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later. SUBJECTS--428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed. MAIN OUTCOME MEASURES--Psychiatric symptom scores and the occurrence of psychiatric disorder. RESULTS--Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power. CONCLUSION--Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented. PMID:8616413

  19. Child abuse: Cross-sectional survey of general dentists

    PubMed Central

    Kaur, Harsimran; Chaudhary, Seema; Choudhary, Nidhi; Manuja, Naveen; Chaitra, T.R.; Amit, Sinha Ashish

    2015-01-01

    Background Child abuse continues to be a social menace causing both physical and emotional trauma to benevolent children. Census has shown that nearly 50–75% of child abuse include trauma to mouth, face, and head. Thus, dental professionals are in strategic position to identify physical and emotional manifestations of abuse. Aim A cross-sectional survey was undertaken to assess knowledge and attitude of dental practitioners regarding child abuse and to identify the barriers in reporting the same. Methods With prior consent, a 20-question survey including both multiple choice and dichotomous (Yes/No) questions was mailed to 120 state-registered general dentists, and the data collected were subjected to statistical analysis. Results Overall response rate to the questionnaires was 97%. Lack of knowledge about dentist's role in reporting child abuse accounted to 55% in the reasons for hesitancy to report. Pearson chi-square test did not show any significant difference between male and female regarding reason for hesitancy to report and legal obligation of dentists. Conclusion Although respondent dentists were aware of the diagnosis of child abuse, they were hesitant and unaware of the appropriate authority to report. Increased instruction in the areas of recognition and reporting of child abuse and neglect should be emphasized. PMID:27195209

  20. Cross-sectional survey of users of Internet depression communities

    PubMed Central

    Powell, John; McCarthy, Noel; Eysenbach, Gunther

    2003-01-01

    Background Internet-based depression communities provide a forum for individuals to communicate and share information and ideas. There has been little research into the health status and other characteristics of users of these communities. Methods Online cross-sectional survey of Internet depression communities to identify depressive morbidity among users of Internet depression communities in six European countries; to investigate whether users were in contact with health services and receiving treatment; and to identify user perceived effects of the communities. Results Major depression was highly prevalent among respondents (varying by country from 40% to 64%). Forty-nine percent of users meeting criteria for major depression were not receiving treatment, and 35% had no consultation with health services in the previous year. Thirty-six percent of repeat community users who had consulted a health professional in the previous year felt that the Internet community had been an important factor in deciding to seek professional help. Conclusions There are high levels of untreated and undiagnosed depression in users of Internet depression communities. This group represents a target for intervention. Internet communities can provide information and support for stigmatizing conditions that inhibit more traditional modes of information seeking. PMID:14664725

  1. GP registrar well-being: a cross-sectional survey

    PubMed Central

    2010-01-01

    Objectives To investigate the major stressors affecting GP registrars, how those at risk can be best identified and the most useful methods of managing or reducing their stress. Design, setting and participants Cross-sectional postal questionnaire of all GP registrars in one large regional training provider's catchment area. Main outcome measures The Depression, Anxiety and Stress Scale (DASS), a specifically developed Registrar Stressor Scale consisting of five subscales of potential stressors, plus closed questions on how to identify and manage stress in GP registrars. Results Survey response rate of 51% (102/199). Rural difficulties followed by achieving a work/life balance were the principal stressors. Ten percent of registrars were mildly or moderately depressed or anxious (DASS) and 7% mild to moderately anxious (DASS). Registrars preferred informal means of identifying those under stress (a buddy system and talks with their supervisors); similarly, they preferred to manage stress by discussions with family and friends, debriefing with peers and colleagues, or undertaking sport and leisure activities. Conclusions This study supports research which confirms that poor psychological well-being is an important issue for a significant minority of GP trainees. Regional training providers should ensure that they facilitate formal and informal strategies to identify those at risk and assist them to cope with their stress. PMID:20181138

  2. The clinical use of Kampo medicines (traditional Japanese herbal treatments) for controlling cancer patients’ symptoms in Japan: a national cross-sectional survey

    PubMed Central

    2012-01-01

    Background Kampo medicines are traditional Japanese medicines produced from medicinal plants and herbs. Even though the efficacy of Kampo medicines for controlling cancer-related symptoms is being reported, their actual nationwide clinical use has not been comprehensively investigated. We aimed to investigate physicians’ recognition of Kampo medicines and their clinical use for cancer patients in the field of palliative care. Methods A cross-sectional self-administered anonymous questionnaire was distributed to 549 physicians working in palliative care teams at 388 core cancer treatment hospitals and 161 certified medical institutions that have palliative care units (PCUs). Results Valid responses were obtained from 311 physicians (response rate, 56.7%) who were evenly distributed throughout the country without significant geographical biases. Kampo medicines were prescribed for controlling cancer-related symptoms by 64.3% of the physicians. The symptoms treated with Kampo medicines were numbness/hypoesthesia (n = 99, 49.5%), constipation (n = 76, 38.0%), anorexia/weight loss (n = 72, 36%), muscle cramps (n = 71, 35.5%) and languor/fatigue (n = 64, 32.0%). Regarding open issues about prescription, 60.7% (n = 173) of the physicians raised the issue that the dosage forms need to be better devised. Conclusions To increase the clinical use of Kampo medicines, more evidence from clinical studies is necessary. In addition, their mechanisms of action should be clarified through laboratory studies. PMID:23167528

  3. Vaccine hesitancy in Austria : A cross-sectional survey.

    PubMed

    Sandhofer, Michael J; Robak, Oliver; Frank, Herbert; Kulnig, Johannes

    2017-01-01

    Vaccine hesitancy is an emerging phenomenon particularly in industrialized nations. It has led to repeated epidemic outbreaks of otherwise vaccine-preventable, infectious diseases. Compared to other countries very low rates of influenza and measles vaccination rates have been reported in Austria. We performed a single-center cross-sectional, questionnaire-based survey. A total of 350 adult patients attending our emergency room participated in this survey. We assessed knowledge and attitudes towards vaccination and the associated infectious diseases. Out of 350 participants 40 (11.4 %) declared that they deliberately refused vaccinations. Most common reasons for non-vaccination were fear of adverse effects (35.9 %), doubt of effectiveness of vaccines (35.9 %) and distrust towards the pharmaceutical industry (23.1 %). Of all 350 participants only 148 (42.3 %) thought themselves to be sufficiently informed about national vaccination recommendations as stated in the Austrian National Vaccination Program (ANVP). General practitioners (GP) were the primary source of healthcare-related information for 256 (73.1 %) participants. Furthermore, GPs as well as hospital-based physicians achieved the highest level of trust in this study population. The results of our study underline the necessity of comprehensive informational campaigns on the merits of vaccination. A lack of knowledge about the benefits of vaccination, uncertainty and unfounded fears seem to prevent the achievement of recommended vaccination rates. Family GPs enjoyed the highest levels of trust in our study population. We believe that additional information communicated by GPs could help boost the low vaccination rates. This study underlines the important role of primary care practitioners in informing patients about vaccines and healthcare topics.

  4. Awareness of surgical costs: a multicenter cross-sectional survey.

    PubMed

    Bade, Kim; Hoogerbrug, Jonathan

    2015-01-01

    Resource scarcity continues to be an important problem in modern surgical practice. Studies in North America and Europe have found that medical professionals have limited understanding of the costs of medical care. No cost awareness studies have been undertaken in Australasia or specifically focusing on the surgical team. This study determined the cost of a range of commonly used diagnostic tests, procedures, and hospital resources associated with care of the surgical patient. The surgical teams' awareness of these costs was then assessed in a multicenter cross-sectional survey. In total, 14 general surgical consultants, 14 registrars, and 25 house officers working in three New Zealand hospitals were asked to estimate the costs of 14 items commonly associated with patient care. Cost estimations were considered correct if within 25% plus or minus of the actual cost. Accuracy was assessed by calculating the median, mean, and absolute percentage discrepancy. A total of 57 surveys were completed. Of which, four were incomplete and were not included in the analysis. Cost awareness was generally poor, and members of the surgical team were rarely able to estimate the costs to within 25%. The mean absolute percentage error was 0.87 (95% CI: 0.58-1.18) and underestimates were most common. There was no significant difference in estimate accuracy between consultants, registrars, or house officers, or between consultants working in both public/private practice compared with those working in public practice alone. There is poor awareness of surgical costs among consultant surgeons, registrars, and junior physicians working in Australasia. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Pulmonary Rehabilitation in Ontario: A Cross-Sectional Survey

    PubMed Central

    Bowen, James M; Campbell, Kaitryn; Sutherland, Simone; Bartlett, Ann; Brooks, Dina; Qureshi, Riaz; Goldstein, Roger; Gershon, Andrea S; Prevost, Shelley; Samis, Lorelei; Kaplan, Alan G; Hopkins, Robert B; MacDougald, Craig; Nunes, Erica; O'Reilly, Daria J; Goeree, Ron

    2015-01-01

    Background Pulmonary rehabilitation (PR) is a comprehensive intervention of exercise training, education, and behaviour change to improve the physical and psychological condition of people with chronic respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and to promote long-term adherence to health-enhancing behaviours. Although PR is considered the standard of care for patients with COPD who remain symptomatic despite bronchodilator therapies, current evidence suggests that only 1.15% of COPD patients across Canada have access to PR facilities for care. Objectives The objectives of this study were to identify the number of health care facilities across Ontario providing PR services for patients with COPD, describe the scope of those services, and determine the province's current capacity to provide PR services relative to need, for the province as a whole and by local health integration network (LHIN). Methods The Pulmonary Rehabilitation Programs in Ontario (PRO) Survey was a province-wide, descriptive, cross-sectional survey of health care facilities (hospitals, family health teams, and community health centres). It was distributed to 409 facilities to collect information on various aspects of PR services in the province. Results Between April 2013 and February 2014, 187 facilities responded to the survey (46% response rate). Most responding centres (144) did not offer PR services, and only 43 were full PR sites providing a comprehensive program. Hospital-based programs made up the majority of sites offering full PR services (67%), followed by programs based at family health teams (19%) and community health centres (14%). More than 90% of PR programs are outpatient-based. The average wait time for outpatient PR was 6.9 weeks, and 58% of programs provide services 5 days per week. More than 80% of patients attending PR complete the full program. Across all program types, the total estimated provincial capacity for PR outpatient care is 4

  6. Cross-sectional Survey of Canadian Pediatric Critical Care Transport.

    PubMed

    Kawaguchi, Atsushi; Gunz, Anna; de Caen, Allan

    2016-08-20

    This study aimed to better understand the unique aspects of pediatric critical care transport programs across Canada by characterizing the current workforce of each transport program. A cross-sectional questionnaire was sent to the 13 medical directors of Canada's pediatric critical care transport teams, and to 2 nonhospital-affiliated transport services. If a children's hospital did not have a dedicated team for pediatric transport, the regional transport team providing this service was identified. Eight of the 13 pediatric intensive care units surveyed have unit-based pediatric transport teams. The median annual transport volume for the 8 hospital-based teams was 371 (range, 45-2300) with a total of 5686 patients being transported annually. Among patients transported by the 8 teams, 45% (2579 patients) were pediatric patients (older than 28 days and younger than 18 years) and 40% (1022 patients) of the pediatric patients were admitted to the pediatric intensive care units. Eighty-eight percent of the responding teams also transported neonates (older than 28 days), and 38% transported premature infants.A team composition of registered nurse-respiratory therapist-physician was used by 6/13 teams (75%); however, it accounted for only a small proportion of the transports for most of the teams (median, 2%; range, 2%-100%).The average transport time from dispatch (from team home site) to arrival at receiving facility was reported by 6 teams, and has a median of 195 minutes (range, 90-360 minutes). The median distance from home site to the farthest referral site in the catchment area was 700 km (range, 15-2500 km). This is the first Canadian nationwide study of pediatric critical care transport programs. It revealed a complexity and variability in transport team demographics, transport volume, team composition, and decision-making process.

  7. Eating patterns of Turkish adolescents: a cross-sectional survey

    PubMed Central

    2010-01-01

    Background Adolescence is a crucial period for development of dietary behaviors that continue into adulthood and influence the risk of chronic diseases later in life. The aim of this study was to determine the eating patterns of adolescents' and their compliance with the Food Guide Pyramid. Methods 625 students, aged between 11-15 years, from an elementary school in Istanbul, Turkey were enrolled in this cross-sectional survey. A questionnaire of eating patterns (QEP) was administered to all participants. QEP is consisted of questions assessing the knowledge and behaviors on healthy eating, factors affecting food choice, physical activity status and demographical variables. Height and weight of all participants were measured. Physical activity status was determined by questioning about participation in regular sport activities, how much time spent watching TV, playing computer games or doing homework. Results The mean age of the participants was 12.15 ± 1.15 and 50.5% were female. According to body mass index (BMI) percentiles, 8.3% (52) were obese and 10.2% were overweight. 51% had breakfast every day and only 1.9% met all the recommendations of the Food Guide Pyramid. Among the participants, 31% have fast food at least once every day and 60.8% skip meals. When participants were asked to rate the factors effecting their food choice according to a 10 point Likert scale, the highest mean scores (high impact on food choice) were for the factors; family, health, body perception, teachers and friends; 7.5 ± 3.1, 7.4 ± 3.1, 6.1 ± 3.2, 4.8 ± 3.3 and 4.2 ± 3.0 respectively. Total mean time spent on all passive activities (TV, computer, reading homework etc) per day was 9.8 ± 4.7 hours. Conclusions In this study we have demonstrated that, adolescents do not have healthy eating patterns. Educational interventions should be planned to decrease the health risks attributable to their eating behaviors. PMID:21167070

  8. Eating patterns of Turkish adolescents: a cross-sectional survey.

    PubMed

    Akman, Mehmet; Akan, Hülya; Izbirak, Güldal; Tanriöver, Özlem; Tilev, Sırma Mine; Yildiz, Anil; Tektaş, Simge; Vitrinel, Ayça; Hayran, Osman

    2010-12-19

    Adolescence is a crucial period for development of dietary behaviors that continue into adulthood and influence the risk of chronic diseases later in life. The aim of this study was to determine the eating patterns of adolescents' and their compliance with the Food Guide Pyramid. 625 students, aged between 11-15 years, from an elementary school in Istanbul, Turkey were enrolled in this cross-sectional survey. A questionnaire of eating patterns (QEP) was administered to all participants. QEP is consisted of questions assessing the knowledge and behaviors on healthy eating, factors affecting food choice, physical activity status and demographical variables. Height and weight of all participants were measured. Physical activity status was determined by questioning about participation in regular sport activities, how much time spent watching TV, playing computer games or doing homework. The mean age of the participants was 12.15 ± 1.15 and 50.5% were female. According to body mass index (BMI) percentiles, 8.3% (52) were obese and 10.2% were overweight. 51% had breakfast every day and only 1.9% met all the recommendations of the Food Guide Pyramid. Among the participants, 31% have fast food at least once every day and 60.8% skip meals. When participants were asked to rate the factors effecting their food choice according to a 10 point Likert scale, the highest mean scores (high impact on food choice) were for the factors; family, health, body perception, teachers and friends; 7.5 ± 3.1, 7.4 ± 3.1, 6.1 ± 3.2, 4.8 ± 3.3 and 4.2 ± 3.0 respectively. Total mean time spent on all passive activities (TV, computer, reading homework etc) per day was 9.8 ± 4.7 hours. In this study we have demonstrated that, adolescents do not have healthy eating patterns. Educational interventions should be planned to decrease the health risks attributable to their eating behaviors.

  9. Acute kidney injury in China: a cross-sectional survey.

    PubMed

    Yang, Li; Xing, Guolan; Wang, Li; Wu, Yonggui; Li, Suhua; Xu, Gang; He, Qiang; Chen, Jianghua; Chen, Menghua; Liu, Xiaohua; Zhu, Zaizhi; Yang, Lin; Lian, Xiyan; Ding, Feng; Li, Yun; Wang, Huamin; Wang, Jianqin; Wang, Rong; Mei, Changlin; Xu, Jixian; Li, Rongshan; Cao, Juan; Zhang, Liang; Wang, Yan; Xu, Jinhua; Bao, Beiyan; Liu, Bicheng; Chen, Hongyu; Li, Shaomei; Zha, Yan; Luo, Qiong; Chen, Dongcheng; Shen, Yulan; Liao, Yunhua; Zhang, Zhengrong; Wang, Xianqiu; Zhang, Kun; Liu, Luojin; Mao, Peiju; Guo, Chunxiang; Li, Jiangang; Wang, Zhenfu; Bai, Shoujun; Shi, Shuangjie; Wang, Yafang; Wang, Jinwei; Liu, Zhangsuo; Wang, Fang; Huang, Dandan; Wang, Shun; Ge, Shuwang; Shen, Quanquan; Zhang, Ping; Wu, Lihua; Pan, Miao; Zou, Xiting; Zhu, Ping; Zhao, Jintao; Zhou, Minjie; Yang, Lin; Hu, Wenping; Wang, Jing; Liu, Bing; Zhang, Tong; Han, Jianxin; Wen, Tao; Zhao, Minghui; Wang, Haiyan

    2015-10-10

    Acute kidney injury (AKI) has become a worldwide public health problem, but little information is available about the disease burden in China. We aimed to evaluate the burden of AKI and assess the availability of diagnosis and treatment in China. We launched a nationwide, cross-sectional survey of adult patients who were admitted to hospital in 2013 in academic or local hospitals from 22 provinces in mainland China. Patients with suspected AKI were screened out on the basis of changes in serum creatinine by the Laboratory Information System, and we reviewed medical records for 2 months (January and July) to confirm diagnoses. We assessed rates of AKI according to two identification criteria: the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) AKI definition and an increase or decrease in serum creatinine by 50% during hospital stay (expanded criteria). We estimated national rates with data from the 2013 report by the Chinese National Health and Family Planning Commission and National Bureau of Statistics. Of 2,223,230 patients admitted to the 44 hospitals screened in 2013, 154,950 (7·0%) were suspected of having AKI by electronic screening, of whom 26,086 patients (from 374,286 total admissions) were reviewed with medical records to confirm the diagnosis of AKI. The detection rate of AKI was 0·99% (3687 of 374,286) by KDIGO criteria and 2·03% (7604 of 374,286) by expanded criteria, from which we estimate that 1·4-2·9 million people with AKI were admitted to hospital in China in 2013. The non-recognition rate of AKI was 74·2% (5608 of 7555 with available data). Renal referral was done in 21·4% (1625 of 7604) of the AKI cases, and renal replacement therapy was done in 59·3% (531 of 896) of those who had the indications. Delayed AKI recognition was an independent risk factor for in-hospital mortality, and renal referral was an independent protective factor for AKI under-recognition and mortality AKI has become a huge medical burden in China, with

  10. Family Food Providers' Perceptions of the Causes of Obesity and Effectiveness of Weight Control Strategies in Five Countries in the Asia Pacific Region: A Cross-Sectional Survey.

    PubMed

    Worsley, Anthony; Wang, Wei; Sarmugam, Rani; Pham, Quynh; Februhartanty, Judhiastuty; Ridley, Stacey

    2017-01-18

    The rise of the middle classes in developing countries and the associated epidemiological transition raises the importance of assessing this population group's awareness of the causes of obesity and effective weight control strategies in order to develop effective health promotion strategies. The study aimed to examine the perceptions of the causes of obesity and weight control strategies held by middle class household food providers in Melbourne, Singapore, Shanghai, Indonesia and Vietnam. An online survey was conducted in late 2013, early 2014 among 3945 respondents. Information about body weight concerns, perceived causes of obesity, effectiveness of weight control methods, demographics, self-reported height and weight, and personal values was elicited. Confirmatory factor analyses (CFA) derived nine reliable factors which were used in structural equation modelling (SEM). Two thirds of respondents were trying to change their body weight, of them, 71% were trying to lose weight. The CFA and SEM showed that demographics, region of residence, personal values and perceptions of the causes of obesity (Unhealthy food behaviours, influences Beyond personal control and Environmental influences) had direct and indirect associations with three weight control methods factors, named: Healthy habits, Eat less, sit less, and Dieting. Middle class food providers in the study regions share public health views of obesity causation and personal weight control. These findings could inform public health and food policies, and the design of public health interventions and communications. Further research is required among lower socio economic status (SES) populations.

  11. Family Food Providers’ Perceptions of the Causes of Obesity and Effectiveness of Weight Control Strategies in Five Countries in the Asia Pacific Region: A Cross-Sectional Survey

    PubMed Central

    Worsley, Anthony; Wang, Wei; Sarmugam, Rani; Pham, Quynh; Februhartanty, Judhiastuty; Ridley, Stacey

    2017-01-01

    The rise of the middle classes in developing countries and the associated epidemiological transition raises the importance of assessing this population group’s awareness of the causes of obesity and effective weight control strategies in order to develop effective health promotion strategies. The study aimed to examine the perceptions of the causes of obesity and weight control strategies held by middle class household food providers in Melbourne, Singapore, Shanghai, Indonesia and Vietnam. An online survey was conducted in late 2013, early 2014 among 3945 respondents. Information about body weight concerns, perceived causes of obesity, effectiveness of weight control methods, demographics, self-reported height and weight, and personal values was elicited. Confirmatory factor analyses (CFA) derived nine reliable factors which were used in structural equation modelling (SEM). Two thirds of respondents were trying to change their body weight, of them, 71% were trying to lose weight. The CFA and SEM showed that demographics, region of residence, personal values and perceptions of the causes of obesity (Unhealthy food behaviours, influences Beyond personal control and Environmental influences) had direct and indirect associations with three weight control methods factors, named: Healthy habits, Eat less, sit less, and Dieting. Middle class food providers in the study regions share public health views of obesity causation and personal weight control. These findings could inform public health and food policies, and the design of public health interventions and communications. Further research is required among lower socio economic status (SES) populations. PMID:28106781

  12. Glycemic Control in Chinese Patients with Type 2 Diabetes Mellitus Receiving Oral Antihyperglycemic Medication-Only or Insulin-Only Treatment: A Cross-Sectional Survey.

    PubMed

    Chen, Yun; Liu, Li; Gu, Liqun; Babineaux, Steven; Colclough, Hayley; Curtis, Bradley

    2015-06-01

    The primary aim of this analysis was to explore whether glycemic control (glycated hemoglobin [HbA1c] <7%) and the incidence of hypoglycemia are different between Chinese patients with type 2 diabetes mellitus (T2DM) receiving oral antihyperglycemic medication (OAM)-only or insulin-only regimens. Physicians in nine Chinese cities completed surveys (Adelphi Real World Diabetes Disease Specific Programme) from October 2011 to March 2012. Key information collected included patients' demographic and clinical characteristics, HbA1c levels, and hypoglycemia incidence. Patients receiving OAM-only (n = 1077) or insulin-only (n = 292) regimens for ≥6 months who had most recent HbA1c results available and measured within 3 months of survey completion were included. The primary and secondary outcomes were glycemic control and the incidence of hypoglycemia. Primary (multivariate logistic regression analysis with adjustment for potential confounders) and sensitivity analyses (propensity score matching method) were performed. A higher proportion of patients in the insulin-only group achieved glycemic control than patients in the OAM-only group (41.8% vs 35.9%). Insulin-only treatment was associated with significantly (P = 0.013) better glycemic control than OAM-only treatment (odds ratio [95% confidence interval]: 1.48 [1.09, 2.01]). A higher proportion of patients in the insulin-only group experienced hypoglycemia (overall) than patients in the OAM-only group (33.3% vs 14.4%). Insulin-only treatment was associated with significantly (P < 0.001) increased overall hypoglycemia compared with OAM-only treatment (odds ratio [95% confidence interval]: 2.38 [1.72, 3.29]). Sensitivity analysis results were consistent with the primary analysis results. The results of this analysis provide important real-world information on glycemic control and hypoglycemia in Chinese patients with T2DM, which may be useful for guiding evidenced-based management. Notably, Chinese patients

  13. Anemia in pregnancy in Malaysia: a cross-sectional survey.

    PubMed

    Haniff, Jamaiyah; Das, Anita; Onn, Lim Teck; Sun, Chen Won; Nordin, Noraihan Mohd; Rampal, Sanjay; Bahrin, Safiah; Ganeslingam, Muralitharan; Kularatnam, Kumar Iswaran K; Zaher, Zaki Morad Mohamad

    2007-01-01

    Anemia is the most prevalent nutritional deficiency during pregnancy. Except for a study conducted 10 years ago in Kelantan, Malaysia's available statistics are based on isolated small urban maternity hospital studies from the 1980s. There was therefore, a need for a large study at national level to estimate the magnitude of the problem in the country as well as to understand its epidemiology. This multi-center, cross-sectional study was conducted from February to March 2005, to assess the prevalence of anemia. Multistage stratified random sampling technique was used and 59 Ministry of Health (MOH) primary health care clinics were selected. Our final dataset consisted of 1,072 antenatal mothers from 56 clinics. The overall prevalence of anemia in this population was 35 % (SE 0.02) if the cut off level is 11 g/dL and 11 % (SE 0.03) if the cut-off level is 10 g/dL. The majority was of the mild type. The prevalence was higher in the teenage group, Indians followed by Malays and Chinese being the least, grandmultiparas, the third trimester and from urban residence. After multiple linear regression analysis, only gestational age remained significant. These findings are useful for our Maternal Health program planners and implementers to target and evaluate interventions. Work is in progress for outcomes and cost-effectiveness studies to best tackle this problem. In conclusion, the prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.

  14. Risk factors, perceptions and practices associated with Taenia solium cysticercosis and its control in the smallholder pig production systems in Uganda: a cross-sectional survey.

    PubMed

    Kungu, Joseph M; Dione, Michel M; Ejobi, Francis; Ocaido, Michael; Grace, Delia

    2017-01-03

    Prevalence studies report Taenia solium cysticercosis in pig and human populations in Uganda. However, the factors influencing occurrence in smallholder pig production systems are not well documented and little is known about farmers' perceptions of T. solium cysticercosis or farmer practices that could reduce transmission. To determine the risk factors, perceptions and practices regarding T. solium cysticercosis, a household survey using a semi-structured questionnaire was conducted in 1185 households in the rural and urban pig production systems in Masaka, Mukono and Kamuli Districts. Logistic regression was used to measure associations of risk factors with infection. Performance scores were calculated to summarise perceptions and practices of farmers regarding taeniosis, human cysticercosis and porcine cysticercosis as well as farmer behavior related to control or breaking transmission. Pig breed type, farmers' knowledge about transmission, sources of water used, and pig keeping homes where family members were unable to use the latrine were all significantly associated with T. solium cysticercosis in pigs. Performance scores indicated that farmers were more aware of taeniosis (63.0%; 95% Confidence Interval 60.0-65.8) than human or porcine cysticercosis; only three farmers (0.3%, 95% CI = 0.1-0.8) had knowledge on all three conditions. More farmers reported that they dewormed pigs (94.1%) than reported deworming themselves and their family members (62.0%). Albendazole was the most commonly used drug for deworming both pigs and humans (85.0 and 81.5% respectively). Just over half (54.6%) of the farmers interviewed had clean water near the latrines for washing hands. Of these, only 41.9% used water with soap to wash hands after latrine use. Factors that significantly influenced occurrence of T. solium cysticercosis in pigs were identified. Farmers had some knowledge about the disease but did not link taeniosis, human cysticercosis, and porcine cysticercosis

  15. Healthcare Environments and Spatial Variability of Healthcare Associated Infection Risk: Cross-Sectional Surveys

    PubMed Central

    Gaudart, Jean; Cloutman-Green, Elaine; Guillas, Serge; D’Arcy, Nikki; Hartley, John C.; Gant, Vanya; Klein, Nigel

    2013-01-01

    Prevalence of healthcare associated infections remains high in patients in intensive care units (ICU), estimated at 23.4% in 2011. It is important to reduce the overall risk while minimizing the cost and disruption to service provision by targeted infection control interventions. The aim of this study was to develop a monitoring tool to analyze the spatial variability of bacteriological contamination within the healthcare environment to assist in the planning of interventions. Within three cross-sectional surveys, in two ICU wards, air and surface samples from different heights and locations were analyzed. Surface sampling was carried out with tryptic Soy Agar contact plates and Total Viable Counts (TVC) were calculated at 48hrs (incubation at 37°C). TVCs were analyzed using Poisson Generalized Additive Mixed Model for surface type analysis, and for spatial analysis. Through three cross-sectional survey, 370 samples were collected. Contamination varied from place-to-place, height-to-height, and by surface type. Hard-to-reach surfaces, such as bed wheels and floor area under beds, were generally more contaminated, but the height level at which maximal TVCs were found changed between cross-sectional surveys. Bedside locations and bed occupation were risk factors for contamination. Air sampling identified clusters of contamination around the nursing station and surface sampling identified contamination clusters at numerous bed locations. By investigating dynamic hospital wards, the methodology employed in this study will be useful to monitor contamination variability within the healthcare environment and should help to assist in the planning of interventions. PMID:24069459

  16. The status of diabetes control in Asia--a cross-sectional survey of 24 317 patients with diabetes mellitus in 1998.

    PubMed

    Chuang, L M; Tsai, S T; Huang, B Y; Tai, T Y

    2002-12-01

    To establish the status of diabetes control in Asia, the Diabcare-Asia 198 study collected data from 230 diabetes centres in Bangladesh, People's Republic of China, India, Indonesia, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan, Thailand and Vietnam from March to December 1998. Data were obtained either by patient interview during the enrolment visit or by reviewing medical records for the most recent laboratory assessment and clinical examinations. Blood samples were also collected during patients'. visits for central assessments of HbA1c (normal range 4.7-6.4%). The mean of centrally measured HbA1c was 8.6 +/- 2.0% for 18 211 patients (82% of the analysis population). Of the patients with central HbA1c measurements, the majority (55%) had values exceeding 8%, indicative of poor glycaemic control. The prevalence of retinopathy, microalbuminuria and neuropathy was also higher in the group of patients with higher HbA1c. Based on the findings from central HbA1c measurements and reported local HbA1c assessments, it also appears that more patients with poor glycaemic control did not have access to glycated haemoglobin measurements. Mean HbA1c of thediabetic populations in Bangladesh, Indonesia, Korea, Malaysia and Taiwan were significantly lower (all P = 0.0001, except P = 0.0007 for Malaysia), while that of China, India, Philippines and Vietnam was significantly higher (all P = 0.0001) than the grand mean. In our study population of the Asian diabetes patients treated at diabetes centres, more than half were not well controlled. The prevalence of diabetic microvascular complications was higher in the group of patients with higher HbA1c. Further therapeutic actions to improve glycaemic control are required to prevent chronic diabetic complications.

  17. Critical care transportation by paramedics: a cross-sectional survey.

    PubMed

    Raynovich, William; Hums, Jason; Stuhlmiller, David F; Bramble, James D; Kasha, Ted; Galt, Kim

    2013-01-01

    The purpose of this study was to gather data from paramedics practicing in the critical care transport setting to guide development of the education, training, and clinical practices for certification as a critical care paramedic. A paper survey of 1991 randomly selected nationally registered (NREMT) paramedics was conducted. Nine paramedics with residences in small US Pacific Island territories were not included in the survey. We received 610 responses (30.6%). Respondents that stated that they provided critical care transport services reported using pediatric skills and equipment the most and intracranial pressure monitoring the least. Paramedics served as the primary provider for pediatric patients (72.5%), 12-lead electrocardiogram (66.3%), intravenous infusion pump (76.7%), mechanical ventilator (66.9%), central line management (63.1%), and chest tube management (63.3%). Paramedics served in a team member capacity most often with neonatal isolette (71.8%), intra-aortic balloon pump (79.2%), and ICP monitoring (64.9%). The majority provided ground critical care transport (249) compared to 44 rotor-wing and 6 fixed-wing. Sixteen respondents reported serving as primary providers on combinations of ground, rotor-, and fixed-wing services. Paramedics reported being the primary provider on the critical care transport team and performing skills while using equipment and administering medications that exceeded their education and training as paramedic and, at times, without the benefit of any additional education or training. National appreciation of this reality should spur development of standardized education, licensing or certification, and continuing education to prepare paramedics for their role as critical care medical providers. Copyright © 2013 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

  18. Surveying Cross Sections of the Kootenai River Between Libby Dam, Montana, and Kootenay Lake, British Columbia, Canada

    USGS Publications Warehouse

    Barton, Gary J.; Moran, Edward H.; Berenbrock, Charles

    2004-01-01

    The declining population of Kootenai River white sturgeon, which was listed as an Endangered Species in 1994, has prompted a recovery team to assess the feasibility of various habitat enhancement scenarios to reestablish white sturgeon populations. As the first phase in this assessment, the U.S. Geological Survey collected stream channel cross-section and longitudinal data during 2002—03 at about 400 locations along the Kootenai River from Libby Dam near Libby, Montana, to where the river empties into Kootenay Lake near Creston, British Columbia, Canada. Survey control stations with a horizontal and vertical accuracy of less than 0.1 foot were established using a global positioning system (GPS) prior to collection of stream channel cross-section data along the Kootenai River. A total of 245 cross sections were surveyed. Six cross sections upstream from Kootenai Falls were surveyed using a total station where the river was too shallow or dangerous to navigate by vessel. The remaining 239 cross sections were surveyed by interfacing real-time GPS equipment with an echo sounder to obtain bathymetric data and with a laser range- finder to obtain streambank data. These data were merged, straightened, ordered, and reduced in size to be useful. Spacing between these cross sections ranged from about 600 feet in the valley flat near Deep Creek and Shorty Island and near bridges to as much as several miles in other areas. These stream channel cross sections will provide information that can be used to develop hydraulic flow models of the Kootenai River from Libby Dam, Montana, to Queens Bay on Kootenay Lake in British Columbia, Canada.

  19. Policy on Hazard Analysis and Critical Control Point (HACCP) and adherence to food preparation guidelines: a cross sectional survey of stakeholders in food service in Kumasi, Ghana

    PubMed Central

    2013-01-01

    Background Food borne diseases claim more lives and are growing public health concerns. Simple preventive techniques such as adoption and adherence to hazard analysis and critical control point (HACCP) policy can significantly reduce this disease burden. Though food screening and inspection are done, the ultimate regulation, Hazard Analysis and Critical Control Point, which is known and accepted worldwide, appears not to be popular among food operators in Ghana. This paper examines the level of awareness of the existence of policy on hazard analysis and critical control point (HACCP) and its adherence to food preparation guidelines among food service providers in Ghana. Results The results revealed the mean age of food providers as 33.1 years with a standard deviation of 7.5, range of 18–55 years, more females, in full time employment and with basic education. Of the fifty institutional managers, 42 (84%) were senior officers and had worked for more than five years. Education and type of food operator had strong statistically significant relationship with the implementation of HCCP policy and adherence with food preparation guidelines. The enforcement of HACCP policy and adherence with food safety guidelines was led by the Ghana Tourist Board, Public Health officers, and KMA, respectively. While a majority of food operators 373/450 (83.3%) did not know HACCP policy is part of food safety guidelines, staff of food safety law enforcement 44/50 (88%) confirmed knowing that food operators were not aware of the HACCP policy. Conclusion The study documents evidence on the practice of food safety principles or HACCP policy or adherence to food preparation guidelines. Existing food safety guidelines incorporate varying principles of HACCP, however, awareness is low among food operators. The implication is that food production is likely to fall short of acceptable standards and not be wholesome putting consumers at health risk. Repeating this study in rural and urban

  20. Policy on Hazard Analysis and Critical Control Point (HACCP) and adherence to food preparation guidelines: a cross sectional survey of stakeholders in food service in Kumasi, Ghana.

    PubMed

    Agyei-Baffour, Peter; Sekyere, Kofi Boateng; Addy, Ernestine Akosua

    2013-11-04

    Food borne diseases claim more lives and are growing public health concerns. Simple preventive techniques such as adoption and adherence to hazard analysis and critical control point (HACCP) policy can significantly reduce this disease burden. Though food screening and inspection are done, the ultimate regulation, Hazard Analysis and Critical Control Point, which is known and accepted worldwide, appears not to be popular among food operators in Ghana. This paper examines the level of awareness of the existence of policy on hazard analysis and critical control point (HACCP) and its adherence to food preparation guidelines among food service providers in Ghana. The results revealed the mean age of food providers as 33.1 years with a standard deviation of 7.5, range of 18-55 years, more females, in full time employment and with basic education. Of the fifty institutional managers, 42 (84%) were senior officers and had worked for more than five years. Education and type of food operator had strong statistically significant relationship with the implementation of HCCP policy and adherence with food preparation guidelines. The enforcement of HACCP policy and adherence with food safety guidelines was led by the Ghana Tourist Board, Public Health officers, and KMA, respectively. While a majority of food operators 373/450 (83.3%) did not know HACCP policy is part of food safety guidelines, staff of food safety law enforcement 44/50 (88%) confirmed knowing that food operators were not aware of the HACCP policy. The study documents evidence on the practice of food safety principles or HACCP policy or adherence to food preparation guidelines. Existing food safety guidelines incorporate varying principles of HACCP, however, awareness is low among food operators. The implication is that food production is likely to fall short of acceptable standards and not be wholesome putting consumers at health risk. Repeating this study in rural and urban areas in Ghana is necessary to

  1. Health literacy of Dutch adults: a cross sectional survey.

    PubMed

    van der Heide, Iris; Rademakers, Jany; Schipper, Maarten; Droomers, Mariël; Sørensen, Kristine; Uiters, Ellen

    2013-02-27

    Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify socio-economic disparities in health. This paper is part of the European Health Literacy Survey (HLS-EU). It aims to add to the body of theoretical knowledge about health literacy by measuring perceived difficulties with health information in various domains of health, looking at a number of competences. The definition and measure of health literacy is still topic of debate and hardly any instruments are available that are applicable for the general population. The objectives were to obtain an initial measure of health literacy in a sample of the general population in the Netherlands and to relate this measure to education, income, perceived social status, age, and sex. The HLS-EU questionnaire was administered face-to-face in a sample of 925 Dutch adults, during July 2011. Perceived difficulties with the health literacy competences for accessing, understanding, appraising and applying information were measured within the domains of healthcare, disease prevention and health promotion. Multiple linear regression analyses were applied to explore the associations between health literacy competences and education, income, perceived social status, age, and sex. Perceived difficulties with health information and their association with demographic and socio-economic variables vary according to the competence and health domain addressed. Having a low level of education or a low perceived social status or being male were consistently found to be significantly related to relatively low health literacy scores, mainly for accessing and understanding health information. Perceived difficulties with health information vary between competences and domains of health. Health literacy competences are

  2. Health literacy of Dutch adults: a cross sectional survey

    PubMed Central

    2013-01-01

    Background Relatively little knowledge is available to date about health literacy among the general population in Europe. It is important to gain insights into health literacy competences among the general population, as this might contribute to more effective health promotion and help clarify socio-economic disparities in health. This paper is part of the European Health Literacy Survey (HLS-EU). It aims to add to the body of theoretical knowledge about health literacy by measuring perceived difficulties with health information in various domains of health, looking at a number of competences. The definition and measure of health literacy is still topic of debate and hardly any instruments are available that are applicable for the general population. The objectives were to obtain an initial measure of health literacy in a sample of the general population in the Netherlands and to relate this measure to education, income, perceived social status, age, and sex. Methods The HLS-EU questionnaire was administered face-to-face in a sample of 925 Dutch adults, during July 2011. Perceived difficulties with the health literacy competences for accessing, understanding, appraising and applying information were measured within the domains of healthcare, disease prevention and health promotion. Multiple linear regression analyses were applied to explore the associations between health literacy competences and education, income, perceived social status, age, and sex. Results Perceived difficulties with health information and their association with demographic and socio-economic variables vary according to the competence and health domain addressed. Having a low level of education or a low perceived social status or being male were consistently found to be significantly related to relatively low health literacy scores, mainly for accessing and understanding health information. Conclusions Perceived difficulties with health information vary between competences and domains of

  3. Digital database of channel cross-section surveys, Mount St. Helens, Washington

    USGS Publications Warehouse

    Mosbrucker, Adam R.; Spicer, Kurt R.; Major, Jon J.; Saunders, Dennis R.; Christianson, Tami S.; Kingsbury, Cole G.

    2015-08-06

    Stream-channel cross-section survey data are a fundamental component to studies of fluvial geomorphology. Such data provide important parameters required by many open-channel flow models, sediment-transport equations, sediment-budget computations, and flood-hazard assessments. At Mount St. Helens, Washington, the long-term response of channels to the May 18, 1980, eruption, which dramatically altered the hydrogeomorphic regime of several drainages, is documented by an exceptional time series of repeat stream-channel cross-section surveys. More than 300 cross sections, most established shortly following the eruption, represent more than 100 kilometers of surveyed topography. Although selected cross sections have been published previously in print form, we present a comprehensive digital database that includes geospatial and tabular data. Furthermore, survey data are referenced to a common geographic projection and to common datums. Database design, maintenance, and data dissemination are accomplished through a geographic information system (GIS) platform, which integrates survey data acquired with theodolite, total station, and global navigation satellite system (GNSS) instrumentation. Users can interactively perform advanced queries and geospatial time-series analysis. An accuracy assessment provides users the ability to quantify uncertainty within these data. At the time of publication, this project is ongoing. Regular database updates are expected; users are advised to confirm they are using the latest version.

  4. A cross-sectional survey of experts’ opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence?

    PubMed Central

    2013-01-01

    Background There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. Methods A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. Results A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p’s < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. Conclusions Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based. PMID:24314097

  5. A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: what do we choose in the absence of evidence?

    PubMed

    Paul, Christine L; Turon, Heidi; Bonevski, Billie; Bryant, Jamie; McElduff, Patrick

    2013-12-08

    There is a clear disparity in smoking rates according to social disadvantage. In the absence of sufficiently robust data regarding effective strategies for reducing smoking prevalence in disadvantaged populations, understanding the views of tobacco control experts can assist with funding decisions and research agendas. A web-based cross-sectional survey was conducted with 192 respondents (response rate 65%) sampled from the Australian and New Zealand Tobacco Control Contacts list and a literature search. Respondents were asked to indicate whether a number of tobacco control strategies were perceived to be effective for each of: the general population; Aboriginal and Torres Strait Islander people; those with a low income; and people with a mental illness. A high proportion of respondents indicated that mass media and increased tobacco taxation (84% and 89% respectively) were effective for the general population. Significantly lower proportions reported these two strategies were effective for sub-populations, particularly Aboriginal and Torres Strait Islanders (58% and 63% respectively, p's < .0001). Subsidised medication was the only strategy associated with a greater proportion of respondents perceiving it to be effective in disadvantaged sub-populations compared to the general population. Tailored quit programs and culturally relevant programs were nominated as additional effective strategies for disadvantaged populations. Views about subsidised medications in particular, suggest the need for robust cost-effectiveness data relevant to disadvantaged groups to avoid wastage of scarce tobacco control resources. Strategies perceived to be effective for disadvantaged populations such as tailored or culturally relevant programs require rigorous evaluation so that potential adoption of these approaches is evidence-based.

  6. Low back pain status in elite and semi-elite Australian football codes: a cross-sectional survey of football (soccer), Australian rules, rugby league, rugby union and non-athletic controls.

    PubMed

    Hoskins, Wayne; Pollard, Henry; Daff, Chris; Odell, Andrew; Garbutt, Peter; McHardy, Andrew; Hardy, Kate; Dragasevic, George

    2009-04-17

    Our understanding of the effects of football code participation on low back pain (LBP) is limited. It is unclear whether LBP is more prevalent in athletic populations or differs between levels of competition. Thus it was the aim of this study to document and compare the prevalence, intensity, quality and frequency of LBP between elite and semi-elite male Australian football code participants and a non-athletic group. A cross-sectional survey of elite and semi-elite male Australian football code participants and a non-athletic group was performed. Participants completed a self-reported questionnaire incorporating the Quadruple Visual Analogue Scale (QVAS) and McGill Pain Questionnaire (short form) (MPQ-SF), along with additional questions adapted from an Australian epidemiological study. Respondents were 271 elite players (mean age 23.3, range 17-39), 360 semi-elite players (mean age 23.8, range 16-46) and 148 non-athletic controls (mean age 23.9, range 18-39). Groups were matched for age (p = 0.42) and experienced the same age of first onset LBP (p = 0.40). A significant linear increase in LBP from the non-athletic group, to the semi-elite and elite groups for the QVAS and the MPQ-SF was evident (p < 0.001). Elite subjects were more likely to experience more frequent (daily or weekly OR 1.77, 95% CI 1.29-2.42) and severe LBP (discomforting and greater OR 1.75, 95% CI 1.29-2.38). Foolers in Australia have significantly more severe and frequent LBP than a non-athletic group and this escalates with level of competition.

  7. Low back pain status in elite and semi-elite Australian football codes: a cross-sectional survey of football (soccer), Australian rules, rugby league, rugby union and non-athletic controls

    PubMed Central

    Hoskins, Wayne; Pollard, Henry; Daff, Chris; Odell, Andrew; Garbutt, Peter; McHardy, Andrew; Hardy, Kate; Dragasevic, George

    2009-01-01

    Background Our understanding of the effects of football code participation on low back pain (LBP) is limited. It is unclear whether LBP is more prevalent in athletic populations or differs between levels of competition. Thus it was the aim of this study to document and compare the prevalence, intensity, quality and frequency of LBP between elite and semi-elite male Australian football code participants and a non-athletic group. Methods A cross-sectional survey of elite and semi-elite male Australian football code participants and a non-athletic group was performed. Participants completed a self-reported questionnaire incorporating the Quadruple Visual Analogue Scale (QVAS) and McGill Pain Questionnaire (short form) (MPQ-SF), along with additional questions adapted from an Australian epidemiological study. Respondents were 271 elite players (mean age 23.3, range 17–39), 360 semi-elite players (mean age 23.8, range 16–46) and 148 non-athletic controls (mean age 23.9, range 18–39). Results Groups were matched for age (p = 0.42) and experienced the same age of first onset LBP (p = 0.40). A significant linear increase in LBP from the non-athletic group, to the semi-elite and elite groups for the QVAS and the MPQ-SF was evident (p < 0.001). Elite subjects were more likely to experience more frequent (daily or weekly OR 1.77, 95% CI 1.29–2.42) and severe LBP (discomforting and greater OR 1.75, 95% CI 1.29–2.38). Conclusion Foolers in Australia have significantly more severe and frequent LBP than a non-athletic group and this escalates with level of competition. PMID:19371446

  8. Oral health behavior patterns among Tanzanian university students: a repeat cross-sectional survey

    PubMed Central

    Åstrøm, Anne Nordrehaug; Masalu, Joyce Rose

    2001-01-01

    Purpose This study examines oral health behavioral trends and the development of sociodemographic differences in oral health behaviors among Tanzanian students between 1999 and 2000. Methods The population targeted was students attending the Muhimbili University College of Health Sciences (MUCHS) at the University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania. Cross-sectional surveys were conducted and a total of 635 and 981 students, respectively, completed questionnaires in 1999 and 2001. Results Cross-tabulation analyses revealed that in 1999, the rates of abstinence from tobacco use, and of soft drink consumption, regular dental checkups, and intake of chocolate/candy were 84%, 51%, 48%, and 12%, respectively, among students of urban origin and 83%, 29%, 37%, and 5% among their rural counterparts. The corresponding rates in 2001 were 87%, 56%, 50%, and 9% among urban students and 84%, 44%, 38%, and 4% among rural ones. Multiple logistic regression analyses controlling for sex, age, place of origin, educational level, year of survey, and their interaction terms revealed a significant increase in the rate of soft drink consumption, implementation of oral hygiene measures, and abstinence from tobacco use between 1999 and 2001. Social inequalities observed in 1999, with urban students being more likely than their rural counterparts to take soft drinks and go for regular dental checkups, had leveled off by 2001. Conclusion This study provides initial evidence of oral health behavioral trends, that may be utilized in the planning of preventive programs among university students in Tanzania. PMID:11782294

  9. Oral health behavior patterns among Tanzanian university students: a repeat cross-sectional survey.

    PubMed

    Åstrøm, Anne Nordrehaug; Masalu, Joyce Rose

    2001-01-01

    PURPOSE: This study examines oral health behavioral trends and the development of sociodemographic differences in oral health behaviors among Tanzanian students between 1999 and 2000. METHODS: The population targeted was students attending the Muhimbili University College of Health Sciences (MUCHS) at the University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania. Cross-sectional surveys were conducted and a total of 635 and 981 students, respectively, completed questionnaires in 1999 and 2001. RESULTS: Cross-tabulation analyses revealed that in 1999, the rates of abstinence from tobacco use, and of soft drink consumption, regular dental checkups, and intake of chocolate/candy were 84%, 51%, 48%, and 12%, respectively, among students of urban origin and 83%, 29%, 37%, and 5% among their rural counterparts. The corresponding rates in 2001 were 87%, 56%, 50%, and 9% among urban students and 84%, 44%, 38%, and 4% among rural ones. Multiple logistic regression analyses controlling for sex, age, place of origin, educational level, year of survey, and their interaction terms revealed a significant increase in the rate of soft drink consumption, implementation of oral hygiene measures, and abstinence from tobacco use between 1999 and 2001. Social inequalities observed in 1999, with urban students being more likely than their rural counterparts to take soft drinks and go for regular dental checkups, had leveled off by 2001. CONCLUSION: This study provides initial evidence of oral health behavioral trends, that may be utilized in the planning of preventive programs among university students in Tanzania.

  10. Chagas disease and housing improvement in northeastern Brazil: a cross-sectional survey.

    PubMed

    Lima, Marli M; Carvalho-Costa, Filipe A; Toma, Helena K; Borges-Pereira, José; de Oliveira, Tiago Guedes; Sarquis, Otília

    2015-05-01

    Chagas disease was investigated in two new settlements of landless rural workers inhabiting prefabricated, triatomine-proof houses and in four neighboring older communities where mud huts were still well suitable for vectors. Through a cross-sectional survey and entomological assessment, we surveyed 148 houses/families in the two new settlements and in 47 houses/families in the four older localities. We determined seroprevalence of Chagas disease through IFI and Elisa (eluates) assays and searched for vectors in the domestic and peridomestic environments. Seroprevalence reached 0.6% (3/466) in the new settlements and 0.8% (1/115) in the older communities. Triatomines were not found in the new settlements, while 7 Triatoma brasiliensis, 4 T. pseudomaculata, 1 Panstrongylus lutzi, and 145 Rhodnius nasutus were collected in the older localities. In addition, a colony of T. brasiliensis (n = 55) was encountered inside a school attended by children of the region. Parasite strains isolated from the insects were characterized as T. cruzi I. Despite the low prevalence of Chagas disease in both scenarios, entomological surveillance must be strengthened and housing improvement reinforced in order to control vector transmission. The risk of infection by the vectors was lower in the settlements of improved homes, where conditions for colonization of the peridomestic environment by transmitting insects were not observed.

  11. Rising risk of type 2 diabetes among inhabitants of Jamnagar, Gujarat: A cross-sectional survey

    PubMed Central

    Sharma, Rohit; Prajapati, Pradeep Kumar

    2015-01-01

    Introduction: Undoubtedly, diabetes is an incremental threat for the world health and substantial evidence now suggest that diabetes is strongly associated with patients’ unhealthy lifestyle, behavioral patterns, and socioeconomic changes. Treatment modalities, in particular to this disease differs from patient to patient. In Ayurveda, this individuality is decided on the basis of Prakriti, Vaya, Bala, Desha etc., and hence it is essential to know these factors for successful management of diseases. Aim: To assess the role of demographic profile, changes in life style habits, dietary patterns, occupational and social background in increasing prevalence of type 2 diabete mellitus (DM) at Jamnagar region. Materials and Methods: A cross-sectional survey study was conducted on randomly selected 350 diabetic patients of Jamnagar region. A survey proforma was prepared and detailed history of each patient fulfilling the diagnostic criteria was taken along with demographic profile. Observations and Conclusion: The obtained data reveals that, certain faulty dietary and life style regimes of this region are responsible in manifestation of DM. Its magnitude and low awareness warrants appropriate public health interventions for its effective control. PMID:26730132

  12. Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries.

    PubMed

    Chow, Clara K; Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

    2017-03-31

    This study examines in a cross-sectional study 'the tobacco control environment' including tobacco policy implementation and its association with quit ratio. 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Community audits and surveys of adults (35-70 years, n=12 953). Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly in LMICs. The gender-related differences in associations of policy, social unacceptability and

  13. Tobacco control environment: cross-sectional survey of policy implementation, social unacceptability, knowledge of tobacco health harms and relationship to quit ratio in 17 low-income, middle-income and high-income countries

    PubMed Central

    Corsi, Daniel J; Gilmore, Anna B; Kruger, Annamarie; Igumbor, Ehimario; Chifamba, Jephat; Yang, Wang; Wei, Li; Iqbal, Romaina; Mony, Prem; Gupta, Rajeev; Vijayakumar, Krishnapillai; Mohan, V; Kumar, Rajesh; Rahman, Omar; Yusoff, Khalid; Ismail, Noorhassim; Zatonska, Katarzyna; Altuntas, Yuksel; Rosengren, Annika; Bahonar, Ahmad; Yusufali, AfzalHussein; Dagenais, Gilles; Lear, Scott; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Rangarajan, Sumathy; Teo, Koon; McKee, Martin; Yusuf, Salim

    2017-01-01

    Objectives This study examines in a cross-sectional study ‘the tobacco control environment’ including tobacco policy implementation and its association with quit ratio. Setting 545 communities from 17 high-income, upper-middle, low-middle and low-income countries (HIC, UMIC, LMIC, LIC) involved in the Environmental Profile of a Community's Health (EPOCH) study from 2009 to 2014. Participants Community audits and surveys of adults (35–70 years, n=12 953). Primary and secondary outcome measures Summary scores of tobacco policy implementation (cost and availability of cigarettes, tobacco advertising, antismoking signage), social unacceptability and knowledge were associated with quit ratios (former vs ever smokers) using multilevel logistic regression models. Results Average tobacco control policy score was greater in communities from HIC. Overall 56.1% (306/545) of communities had >2 outlets selling cigarettes and in 28.6% (154/539) there was access to cheap cigarettes (<5cents/cigarette) (3.2% (3/93) in HIC, 0% UMIC, 52.6% (90/171) LMIC and 40.4% (61/151) in LIC). Effective bans (no tobacco advertisements) were in 63.0% (341/541) of communities (81.7% HIC, 52.8% UMIC, 65.1% LMIC and 57.6% LIC). In 70.4% (379/538) of communities, >80% of participants disapproved youth smoking (95.7% HIC, 57.6% UMIC, 76.3% LMIC and 58.9% LIC). The average knowledge score was >80% in 48.4% of communities (94.6% HIC, 53.6% UMIC, 31.8% LMIC and 35.1% LIC). Summary scores of policy implementation, social unacceptability and knowledge were positively and significantly associated with quit ratio and the associations varied by gender, for example, communities in the highest quintile of the combined scores had 5.0 times the quit ratio in men (Odds ratio (OR) 5·0, 95% CI 3.4 to 7.4) and 4.1 times the quit ratio in women (OR 4.1, 95% CI 2.4 to 7.1). Conclusions This study suggests that more focus is needed on ensuring the tobacco control policy is actually implemented, particularly

  14. A cross-sectional survey to investigate community understanding of medical research ethics committees.

    PubMed

    Fritschi, Lin; Kelsall, Helen L; Loff, Bebe; Slegers, Claudia; Zion, Deborah; Glass, Deborah C

    2015-07-01

    Study explanatory forms often state that an ethics committee has approved a research project. To determine whether the lay community understand the roles of ethics committees in research, we took a cross-sectional national sample from three sampling frames: the general population (n=1532); cohort study participants (n=397); and case-control study participants (n=151). About half (51.3%) of the participants had heard of ethics committees. Those who had were more likely to be those who had participated in previous surveys, older participants, those born in Australia and those with higher education. Almost all participants agreed that the roles of an ethics committee were to protect participants' privacy and ensure no harm came to study participants and most agreed that the committee's role was to ensure that the research was capable of providing answers. Case-control and cohort participants were more likely than the general population to consider that the role of an ethics committee was to design the research and obtain research funding. Overall, we found that about half of the population are aware of ethics committees and that most could correctly identify that ethics committees are there to protect the welfare and rights of research participants, although a substantial minority had some incorrect beliefs about the committees' roles. Increased education, particularly for migrants and older people, might improve understanding of the role of ethics committees in research.

  15. Cross-sectional prevalence survey of intimate partner violence perpetration and victimization in Canadian military personnel

    PubMed Central

    2013-01-01

    Background Intimate partner violence (IPV) is prevalent and is associated with a broad range of adverse consequences. In military organizations, IPV may have special implications, such as the potential of service-related mental disorders to trigger IPV. However, the Canadian Armed Forces (CAF) have limited data to guide their prevention and control efforts. Methods Self-reported IPV perpetration, victimization, and their correlates were assessed on a cross-sectional survey of a stratified random sample of currently-serving Canadian Regular Forces personnel (N = 2157). The four primary outcomes were perpetration or victimization of any physical and/or sexual or emotional and/or financial IPV over the lifespan of the current relationship. Results Among the 81% of the population in a current relationship, perpetration of any physical and/or sexual IPV was reported in 9%; victimization was reported in 15%. Any emotional and/or financial abuse was reported by 19% (perpetration) and 22% (victimization). Less physically injurious forms of abuse predominated. Logistic regression modelling showed that relationship dissatisfaction was independently associated with all four outcomes (OR range = 2.3 to 3.7). Probable depression was associated with all outcomes except physical and/or sexual IPV victimization (OR range = 2.5 – 2.7). PTSD symptoms were only associated with physical and/or sexual IPV perpetration (OR = 3.2, CI = 1.4 to 7.9). High-risk drinking was associated with emotional and/or financial abuse. Risk of IPV was lowest in those who had recent deployment experience; remote deployment experience (vs. never having deployed) was an independent risk factor for all IPV outcomes (OR range = 2.0 – 3.4). Conclusions IPV affects an important minority of military families; less severe cases predominate. Mental disorders, high-risk drinking, relationship dissatisfaction, and remote deployment were independently associated with abuse outcomes. The

  16. Quantifying consumer portion control practices. A cross-sectional study.

    PubMed

    Spence, M; Lähteenmäki, L; Stefan, V; Livingstone, M B E; Gibney, E R; Dean, M

    2015-09-01

    The use of portion control practices has rarely been quantified. The present study aimed to: (1) explore which portion control practices are actually used by the general population and their association with cognitive restraint, demographic background and general health interest (GHI), and (2) examine how the usage of portion control practices predicts the estimated consumption of an energy dense food (i.e. pizza). Twenty-two portion control practices were rated in terms of their frequency of use from 'never' to 'very often' by a representative sample of 1012 consumers from the island of Ireland. Three factors were extracted and named: measurement-strategy scale, eating-strategy scale, and purchasing-strategy scale. The eating-strategy scale score was the highest, while the measurement-strategy scale carried the lowest frequency score. For each strategy scale score, the strongest predictor was GHI, followed by gender. Having higher GHI and being female were independently associated with more frequent portion control. Both the eating-strategy scale score and the purchasing-strategy scale score were negatively associated with pizza portion size consumption estimates. In conclusion, while this study demonstrates that the reported use of portion control practices is low, the findings provide preliminary evidence for their validity. Further studies are needed to explore how portion control practices are used in different kinds of portion size decisions and what their contribution is to the intake of food over an extended period of time. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  17. Cigarette pack design and adolescent smoking susceptibility: a cross-sectional survey

    PubMed Central

    Ford, Allison; MacKintosh, Anne Marie; Moodie, Crawford; Richardson, Sol; Hastings, Gerard

    2013-01-01

    Objectives To compare adolescents’ responses to three different styles of cigarette packaging: novelty (branded packs designed with a distinctive shape, opening style or bright colour), regular (branded pack with no special design features) and plain (brown pack with a standard shape and opening and all branding removed, aside from brand name). Design Cross-sectional in-home survey. Setting UK. Participants Random location quota sample of 1025 never smokers aged 11–16 years. Main outcome measures Susceptibility to smoking and composite measures of pack appraisal and pack receptivity derived from 11 survey items. Results Mean responses to the three pack types were negative for all survey items. However, ‘novelty’ packs were rated significantly less negatively than the ‘regular’ pack on most items, and the novelty and regular packs were rated less negatively than the ‘plain’ pack. For the novelty packs, logistic regressions, controlling for factors known to influence youth smoking, showed that susceptibility was associated with positive appraisal and also receptivity. For example, those receptive to the innovative Silk Cut Superslims pack were more than four times as likely to be susceptible to smoking than those not receptive to this pack (AOR=4.42, 95% CI 2.50 to 7.81, p<0.001). For the regular pack, an association was found between positive appraisal and susceptibility but not with receptivity and susceptibility. There was no association with pack appraisal or receptivity for the plain pack. Conclusions Pack structure (shape and opening style) and colour are independently associated, not just with appreciation of and receptivity to the pack, but also with susceptibility to smoke. In other words, those who think most highly of novelty cigarette packaging are also the ones who indicate that they are most likely to go on to smoke. Plain packaging, in contrast, was found to directly reduce the appeal of smoking to adolescents. PMID:24056481

  18. The use of adherence aids by adults with diabetes: a cross-sectional survey.

    PubMed

    Littenberg, Benjamin; MacLean, Charles D; Hurowitz, Laurie

    2006-01-05

    Adherence with medication taking is a major barrier to physiologic control in diabetes and many strategies for improving adherence are in use. We sought to describe the use of mnemonic devices and other adherence aids by adults with diabetes and to investigate their association with control of hyperglycemia, hyperlipidemia and hypertension. Cross sectional survey of diabetic adults randomly selected from Primary Care practices in the Vermont Diabetes Information System. We used linear regression to examine the associations between the use of various aids and physiologic control among subjects who used oral agents for hyperglycemia, hypercholesterolemia, and hypertension. 289 subjects (mean age 65.4 years; 51% female) used medications for all three conditions. Adherence aids were reported by 80%. The most popular were day-of-the-week pill boxes (50%), putting the pills in a special place (41%), and associating pill taking with a daily event such as a meal, TV show, or bedtime (11%). After adjusting for age, sex, marital status, income, and education, those who used a special place had better glycemic control (A1C -0.36%; P = .04) and systolic blood pressure (-5.9 mm Hg; P = .05) than those who used no aids. Those who used a daily event had better A1C (-0.56%; P = .01) than patients who used no aids. Although adherence aids are in common use among adults with diabetes, there is little evidence that they are efficacious. In this study, we found a few statistically significant associations with adherence aids and better diabetes control. However, these findings could be attributed to multiple comparisons or unmeasured confounders. Until more rigorous evaluations are available, it seems reasonable to recommend keeping medicines in a special place for diabetic adults prescribed multiple medications.

  19. Selective reporting of antibiotic susceptibility test results in European countries: an ESCMID cross-sectional survey.

    PubMed

    Pulcini, Céline; Tebano, Gianpiero; Mutters, Nico T; Tacconelli, Evelina; Cambau, Emmanuelle; Kahlmeter, Gunnar; Jarlier, Vincent

    2017-02-01

    Selective reporting of antibiotic susceptibility test (AST) results is one possible laboratory-based antibiotic stewardship intervention. The primary aim of this study was to identify where and how selective reporting of AST results is implemented in Europe both in inpatient and in outpatient settings. An ESCMID cross-sectional, self-administered, internet-based survey was conducted among all EUCIC (European Committee on Infection Control) or EUCAST (European Committee on Antimicrobial Susceptibility Testing) national representatives in Europe and Israel. Of 38 countries, 36 chose to participate in the survey. Selective reporting of AST results was implemented in 11/36 countries (31%), was partially implemented in 4/36 (11%) and was limited to local initiatives or was not adopted in 21/36 (58%). It was endorsed as standard of care by health authorities in only three countries. The organisation of selective reporting was everywhere discretionally managed by each laboratory, with a pronounced intra- and inter-country variability. The most frequent application was in uncomplicated community-acquired infections, particularly urinary tract and skin and soft-tissue infections. The list of reported antibiotics ranged from a few first-line options, to longer reports where only last-resort antibiotics were hidden. Several barriers to implementation were reported, mainly lack of guidelines, poor system support, insufficient resources, and lack of professionals' capability. In conclusion, selective reporting of AST results is poorly implemented in Europe and is applied with a huge heterogeneity of practices. Development of an international framework, based on existing initiatives and identified barriers, could favour its dissemination as one important element of antibiotic stewardship programmes. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  20. Triatoma dimidiata Infestation in Chagas Disease Endemic Regions of Guatemala: Comparison of Random and Targeted Cross-Sectional Surveys

    PubMed Central

    King, Raymond J.; Cordon-Rosales, Celia; Cox, Jonathan; Kitron, Uriel D.

    2011-01-01

    Background Guatemala is presently engaged in the Central America Initiative to interrupt Chagas disease transmission by reducing intradomiciliary prevalence of Triatoma dimidiata, using targeted cross-sectional surveys to direct control measures to villages exceeding the 5% control threshold. The use of targeted surveys to guide disease control programs has not been evaluated. Here, we compare the findings from the targeted surveys to concurrent random cross-sectional surveys in two primary foci of Chagas disease transmission in central and southeastern Guatemala. Methodology/Principal Findings Survey prevalences of T. dimidiata intradomiciliary infestation by village and region were compared. Univariate logistic regression was used to assess the use of risk factors to target surveys and to evaluate indicators associated with village level intradomiciliary prevalences >5% by survey and region. Multivariate logistic regression models were developed to assess the ability of random and targeted surveys to target villages with intradomiciliary prevalence exceeding the control threshold within each region. Regional prevalences did not vary by survey; however, village prevalences were significantly greater in random surveys in central (13.0% versus 8.7%) and southeastern (22.7% versus 6.9%) Guatemala. The number of significant risk factors detected did not vary by survey in central Guatemala but differed considerably in the southeast with a greater number of significant risk factors in the random survey (e.g. land surface temperature, relative humidity, cropland, grassland, tile flooring, and stick and mud and palm and straw walls). Differences in the direction of risk factor associations were observed between regions in both survey types. The overall discriminative capacity was significantly greater in the random surveys in central and southeastern Guatemala, with an area under the receiver-operator curve (AUC) of 0.84 in the random surveys and approximately 0.64 in the

  1. Adherence to the oral contraceptive pill: a cross-sectional survey of modifiable behavioural determinants

    PubMed Central

    2012-01-01

    Background Poor adherence to the oral contraceptive pill (OCP) is reported as one of the main causes of unintended pregnancy in women that rely on this form of contraception. This study aims to estimate the associations between a range of well-established modifiable psychological factors and adherence to OCP. Method A cross-sectional survey of 130 female University students currently using OCP (Mean age: 20.46 SD: 3.01, range 17–36) was conducted. An OCP specific Medication Adherence Report Scale was used to assess non-adherence. Psychological predictor measures included necessity and concern beliefs about OCP, intentions, perceived behavioural control (pbc), anticipated regret and action and coping planning. Multiple linear regression was used to analyse the data. Results Fifty-two per cent of participants reported missing their OCP once or more per month and 14% twice or more per month. In bivariate analysis intentions (r = −0.25), perceived behavioural control (r= −0.66), anticipated regret (r=0.20), concerns about OCP (r =0.31), and action (r= −0.25) and coping (r= −0.28) planning were all significantly associated with adherence to OCP in the predicted direction. In a multivariate model almost half (48%) of the variation in OCP adherence could be explained. The strongest and only statistically significant predictors in this model were perceived behavioural control (β=−0.62, p<0.01) and coping planning (β =−0.23, p=0.03). A significant interaction between intentions and anticipated regret was also observed. Conclusion The present data point to a number of key modifiable psychological determinants of OCP use. Future work will establish whether changing these variables results in better adherence to the OCP. PMID:23031437

  2. Sample Size Methods for Estimating HIV Incidence from Cross-Sectional Surveys

    PubMed Central

    Brookmeyer, Ron

    2015-01-01

    Summary Understanding HIV incidence, the rate at which new infections occur in populations, is critical for tracking and surveillance of the epidemic. In this paper we derive methods for determining sample sizes for cross-sectional surveys to estimate incidence with sufficient precision. We further show how to specify sample sizes for two successive cross-sectional surveys to detect changes in incidence with adequate power. In these surveys biomarkers such as CD4 cell count, viral load, and recently developed serological assays are used to determine which individuals are in an early disease stage of infection. The total number of individuals in this stage, divided by the number of people who are uninfected, is used to approximate the incidence rate. Our methods account for uncertainty in the durations of time spent in the biomarker defined early disease stage. We find that failure to account for this uncertainty when designing surveys can lead to imprecise estimates of incidence and underpowered studies. We evaluated our sample size methods in simulations and found that they performed well in a variety of underlying epidemics. Code for implementing our methods in R is available with this paper at the Biometrics website on Wiley Online Library. PMID:26302040

  3. Sexual abuse in childhood and youth as psychopathologically relevant life occurrence: cross-sectional survey.

    PubMed

    Nickel, Marius K; Tritt, Karin; Mitterlehner, Ferdinand O; Leiberich, Peter; Nickel, Cerstin; Lahmann, Claas; Forthuber, Petra; Rother, Wolfhardt K; Loew, Thomas H

    2004-08-01

    To assess the perpetrators of sexual abuse in childhood, forms of simultaneous abuse, and characteristics of the families of origin, and the possible effects of abuse on health in adult life. A cross sectional study conducted between 1998 and 2002 included a random group of 936 inpatients (723 women) aged (mean+/-standard deviation) 41.0+/-2.5 years at the psychosomatic clinic in Simbach, Germany. The following questionnaires, previously validated in German, were used to assess the patients: Questionnaire for Life Story and Partnership, Scale for Survey of Quality of Life, Existential Orientation Scale, Leipzig Incidence and Psychological Stress Questionnaire, Questionnaire for Assessment of One's Own Body, Survey of Life Satisfaction, Frankfurt Physical Concept Scale, Giessen Complaint Survey, and the Survey for Collection of Health Behavior Data. We compared the inpatients who had been sexually abused in their childhood (n=250) with other psychiatric inpatients in the control group (n=486). Out of 250 sexually abused patients, 25.7% were victimized by fathers/stepfathers, 4% by mothers/stepmothers, 12.4% by aunts or uncles, 10% by brothers or sisters, 7.6% by grandmothers/grandfathers, 30.1% by family acquaintances, and 29.3% by strangers. Unlike the parents of patients in the control group, the parents of sexually abused patients had more conflicts, especially over alcohol consumption (p<0.001) and extramarital affairs (p<0.001), they divorced more frequently during the first seven years of the patient's life (p<0.001), and had more underlying emotional (p<0.001) and physical illnesses (p=0.006). Significantly more sexually abused patients reported having poor concentration (odds ratio [OR]=5.03; 95% confidence interval [CI]=1.98-9.70; p<0.001) and sexual handicaps (OR=5.16; 95% CI=1.81-11.39; p<0.001), tended to hide their body (OR=3.65; 95% CI=1.69-7.30; p<0.001), abused illicit drugs (OR=2.38; 95% CI=1.08-6.01; p<0.001), had borderline personality disorder

  4. Frequency and Perceptions of Herbal Medicine use Among Hmong Americans: a Cross Sectional Survey.

    PubMed

    Lor, Kajua B; Moua, Sakura; Ip, Eric J

    2016-04-01

    To determine the frequency and perceptions of herbal medicine use among Hmong Americans. Cross-sectional telephone survey. Sacramento, California Hmong community. Out of 118 subjects reached, 77 (65.3 %) reported lifetime use of herbal medicines. A majority of respondents agreed that herbal medicines were able to treat the body as a whole. Respondents felt that a leaflet of information indicating uses/side effects would be important to include for herbal medicines. Herbal medicine use was commonly reported among Hmong Americans. Thus, health care providers should be encouraged to discuss these alternative medicines with their Hmong American patients.

  5. Assessment of hospitalizations among HIV patients in the UK: a national cross-sectional survey.

    PubMed

    Rodger, A J; Curtis, H; Sabin, C; Johnson, M

    2010-11-01

    This 2007 cross-sectional survey is illustrative of UK HIV hospitalization patterns. Data were received for 255 inpatients of whom 43.9% had AIDS-defining illnesses (ADIs). A total of 56.3% had CD4 counts <200 mm(3) and 17% were diagnosed with HIV on their current admission. In those diagnosed for >3 months with CD4 < 200/mm(3) (90/188), 47% were not on combination antiretroviral therapy (cART). ADIs still make up a substantial proportion of inpatient work in the UK and late diagnosis and failure to benefit from cART remain too common.

  6. Clinical preventive services in Guatemala: a cross-sectional survey of internal medicine physicians.

    PubMed

    Corral, Juan E; Arnold, Lauren D; Argueta, Erwin E; Ganju, Akshay; Barnoya, Joaquín

    2012-01-01

    Guatemala is currently undergoing an epidemiologic transition. Preventive services are key to reducing the burden of non-communicable diseases, and smoking counseling and cessation are among the most cost-effective and wide-reaching strategies. Internal medicine physicians are fundamental to providing such services, and their knowledge is a cornerstone of non-communicable disease control. A national cross-sectional survey was conducted in 2011 to evaluate knowledge of clinical preventive services for non-communicable diseases. Interns, residents, and attending physicians of the internal medicine departments of all teaching hospitals in Guatemala completed a self-administered questionnaire. Participants' responses were contrasted with the Guatemalan Ministry of Health (MoH) prevention guidelines and the US Preventive Services Task Force (USPSTF) recommendations. Analysis compared knowledge of recommendations within and between hospitals. In response to simulated patient scenarios, all services were recommended by more than half of physicians regardless of MoH or USPSTF recommendations. Prioritization was adequate according to the MoH guidelines but not including other potentially effective services (e.g. colorectal cancer and lipid disorder screenings). With the exception of colorectal and prostate cancer screening, less frequently recommended by interns, there was no difference in recommendation rates by level. Guatemalan internal medicine physicians' knowledge on preventive services recommendations for non-communicable diseases is limited, and prioritization did not reflect cost-effectiveness. Based on these data we recommend that preventive medicine training be strengthened and development of evidence-based guidelines for low-middle income countries be a priority.

  7. Public support for tobacco control policy extensions in Western Australia: a cross-sectional study

    PubMed Central

    Rosenberg, Michael; Wood, Lisa; Ferguson, Renee; Houghton, Stephen

    2012-01-01

    Objectives Policy makers seeking to introduce new tobacco control measures need to anticipate community support to assist them in planning appropriate implementation strategies. This study assessed community support for plain packaging and smoking bans in outdoor locations in Australia. Design Analytical cross-sectional survey. Setting and participants 2005 Western Australian adults participated in a computer-assisted telephone interview. Random household telephone numbers were used to obtain a representative sample. Outcome measures Support for plain packaging of cigarettes and smoking bans at outdoor venues by demographic characteristics. Results Around half of the survey respondents supported plain packaging and almost a further quarter reported being neutral on the issue. Only one in three smokers disagreed with the introduction of a plain packaging policy. A majority of respondents supported smoking bans at five of the six nominated venues, with support being strongest among those with children under the age of 15 years. The venues with the highest levels of support were those where smoke-free policies had already been voluntarily introduced by the venue managers, where children were most likely to be in attendance, and that were more limited in size. Conclusions The study results demonstrate community support for new tobacco control policies. This evidence can be used by public policy makers in their deliberations relating to the introduction of more extensive tobacco control regulations. PMID:22382124

  8. Prevalence and treatment of cancer pain in Italian oncological wards centres: a cross-sectional survey.

    PubMed

    Mercadante, Sebastiano; Roila, Fausto; Berretto, Oscar; Labianca, Roberto; Casilini, Stefania

    2008-11-01

    The aim of this national cross-sectional survey was to draw information on pain prevalence and intensity from a large sample of patients who were admitted to oncologic centres for different reasons and to evaluate the pain treatment and possible influencing factors. A total of 2,655 patients completed the study. Nine hundred and one patients (34%) reported pain. Higher pain levels were observed in inpatients, in the presence of bone metastases, and with low levels of Eastern Cooperative Oncology Group status. The number of patients receiving strong opioids increased with the highest levels of pain. However, a significant part of patients with moderate-severe pain were not receiving appropriate medication, patients being predominantly administered non-opioid drugs. General practitioners' attitudes did not negatively influence the opioid prescription. The results of this survey indicate a need for continuing educational and informative program in pain management for oncologists and more generally for any physician dealing with cancer patients.

  9. A cross-sectional survey of cadmium biomarkers and cigarette smoking.

    PubMed

    Hecht, Eric M; Arheart, Kris; Lee, David J; Hennekens, Charles H; Hlaing, WayWay M

    2016-07-01

    Cadmium contamination of tobacco may contribute to the health hazards of cigarette smoking. The 2005-2012 United States National Health and Nutrition Examination Survey data provided a unique opportunity to conduct a cross-sectional survey of cadmium biomarkers and cigarette smoking. Among a sample of 6761 participants, we evaluated mean differences and correlations between cadmium biomarkers in the blood and urine and characteristics of never, former and current smokers. We found statistically significant differences in mean cadmium biomarker levels between never and former smokers as well as between never and current smokers. In current smokers, duration in years had a higher correlation coefficient with urinary than blood cadmium levels. In contrast, number of cigarettes smoked per day had a higher correlation coefficient with blood than urinary cadmium levels. These data suggest that blood and urine cadmium biomarker levels differ by duration and dose. These findings should be considered in evaluating any association between cadmium and smoking related diseases, especially cardiovascular disease.

  10. Military-related sexual assault in Canada: a cross-sectional survey

    PubMed Central

    Watkins, Kimberley; Bennett, Rachel; Zamorski, Mark A.; Richer, Isabelle

    2017-01-01

    Background: Most research on military-related sexual assault is based on the United States military and has important limitations, such as low response rates. We sought to estimate the lifetime prevalence of sexual assault, assess its relation to military service and identify the circumstances, correlates and associations with mental disorders of military-related sexual assault among Canadian military personnel. Methods: We used the 2013 Canadian Forces Mental Health Survey, a cross-sectional representative survey of Canadian Regular Force personnel (n = 6696). The sample was weighted to be representative of the entire Canadian Armed Forces Regular Force population in 2012 (n = 67 776), as per Statistics Canada requirements. We assessed lifetime trauma exposure and past-year mental disorders using the Composite International Diagnostic Interview. We defined lifetime military-related sexual assault as forced sexual activity or unwanted sexual touching that occurred on deployment or in another military workplace, or was perpetrated by Department of National Defence or Canadian Armed Forces personnel. We defined all other sexual assault as non-military-related sexual assault. Results: Self-reported sexual assault was more prevalent among women (non-military-related sexual assault 24.2%, military-related sexual assault 15.5%) than men (5.9% and 0.8%, respectively). About a quarter of women with military-related sexual assault reported experiencing at least 1 event on deployment. After covariates were controlled for, military-related sexual assault was independently associated with any lifetime and any past-year mental disorder (adjusted odds ratio 2.9 and 3.0, respectively) and lifetime and past-year posttraumatic stress disorder (adjusted odds ratio 4.3 and 4.1, respectively). Interpretation: Canadian military women are at increased risk for sexual assault and military-related sexual assault relative to their male counterparts. Deployment may be a period of elevated

  11. Hypertension in Sub-Saharan Africa: Cross-Sectional Surveys in Four Rural and Urban Communities

    PubMed Central

    Hendriks, Marleen E.; Wit, Ferdinand W. N. M.; Roos, Marijke T. L.; Brewster, Lizzy M.; Akande, Tanimola M.; de Beer, Ingrid H.; Mfinanga, Sayoki G.; Kahwa, Amos M.; Gatongi, Peter; Van Rooy, Gert; Janssens, Wendy; Lammers, Judith; Kramer, Berber; Bonfrer, Igna; Gaeb, Esegiel; van der Gaag, Jacques; Rinke de Wit, Tobias F.; Lange, Joep M. A.; Schultsz, Constance

    2012-01-01

    Background Cardiovascular disease (CVD) is the leading cause of adult mortality in low-income countries but data on the prevalence of cardiovascular risk factors such as hypertension are scarce, especially in sub-Saharan Africa (SSA). This study aims to assess the prevalence of hypertension and determinants of blood pressure in four SSA populations in rural Nigeria and Kenya, and urban Namibia and Tanzania. Methods and Findings We performed four cross-sectional household surveys in Kwara State, Nigeria; Nandi district, Kenya; Dar es Salaam, Tanzania and Greater Windhoek, Namibia, between 2009–2011. Representative population-based samples were drawn in Nigeria and Namibia. The Kenya and Tanzania study populations consisted of specific target groups. Within a final sample size of 5,500 households, 9,857 non-pregnant adults were eligible for analysis on hypertension. Of those, 7,568 respondents ≥18 years were included. The primary outcome measure was the prevalence of hypertension in each of the populations under study. The age-standardized prevalence of hypertension was 19.3% (95%CI:17.3–21.3) in rural Nigeria, 21.4% (19.8–23.0) in rural Kenya, 23.7% (21.3–26.2) in urban Tanzania, and 38.0% (35.9–40.1) in urban Namibia. In individuals with hypertension, the proportion of grade 2 (≥160/100 mmHg) or grade 3 hypertension (≥180/110 mmHg) ranged from 29.2% (Namibia) to 43.3% (Nigeria). Control of hypertension ranged from 2.6% in Kenya to 17.8% in Namibia. Obesity prevalence (BMI ≥30) ranged from 6.1% (Nigeria) to 17.4% (Tanzania) and together with age and gender, BMI independently predicted blood pressure level in all study populations. Diabetes prevalence ranged from 2.1% (Namibia) to 3.7% (Tanzania). Conclusion Hypertension was the most frequently observed risk factor for CVD in both urban and rural communities in SSA and will contribute to the growing burden of CVD in SSA. Low levels of control of hypertension are alarming. Strengthening of health

  12. Social Media and Evidence-Based Maternity Care: A Cross-Sectional Survey Study

    PubMed Central

    Dekker, Rebecca L.; King, Sarah; Lester, Kara

    2016-01-01

    ABSTRACT The purpose of this study was to describe how people use social media to find and disseminate information about evidence-based maternity care. We used a cross-sectional Internet-based survey design in which 1,661 participants were recruited from childbirth-related blogs. Participants answered questions about how they find, use, and share evidence-based maternity information using social media. Overall, women in this study were highly engaged in using social media to find and share maternity information. Most respondents were very interested in reading evidence-based maternity care articles online. Most intend to use this information that they found, despite the fact that a substantial percentage had no intentions of discussing this information with their childbirth educators or physician. PMID:27445448

  13. Cross-sectional survey on helminth infections of chickens in the Samsun region, Turkey.

    PubMed

    Kurt, M; Acici, M

    2008-06-01

    A cross-sectional survey was performed to determine the prevalence and intensity of helminth infections in 185 chickens from nine districts in the Samsun region, northern Turkey between July 1999 and June 2000. In total, 88% of 83 scavenging chickens and 4% of 52 layers from laying batteries were infected, but none of the 50 broilers harboured helminths in the alimentary tract or trachea. The difference in prevalence was statistically significant among broilers, layers from laying batteries and scavenging chickens. A total of 16 different species were detected. The helminth species found were: Davainea proglottina (23%), Raillietina echinobothrida (13%), Raillietina cesticillus (12%), Hymenolepis carioca (10%), Raillietina tetragona (6%), Choanotaenia. infundibulum (2%), Amoebotaenia cuneata (2%), Echinoparyhium recurvatum (1%), Echinostoma revolutum (1%), Heterakis gallinarum (29%), Ascaridia galli (16%), Capillaria caudinflata (12%), Capillaria retusa (6%), Capillaria bursata (4%), Capillaria annulata (1%) and Syngamus trachea (2%).

  14. Social Media and Evidence-Based Maternity Care: A Cross-Sectional Survey Study.

    PubMed

    Dekker, Rebecca L; King, Sarah; Lester, Kara

    2016-01-01

    The purpose of this study was to describe how people use social media to find and disseminate information about evidence-based maternity care. We used a cross-sectional Internet-based survey design in which 1,661 participants were recruited from childbirth-related blogs. Participants answered questions about how they find, use, and share evidence-based maternity information using social media. Overall, women in this study were highly engaged in using social media to find and share maternity information. Most respondents were very interested in reading evidence-based maternity care articles online. Most intend to use this information that they found, despite the fact that a substantial percentage had no intentions of discussing this information with their childbirth educators or physician.

  15. Compassion fatigue and satisfaction: a cross-sectional survey among US healthcare workers.

    PubMed

    Smart, Denise; English, Ashley; James, Jennifer; Wilson, Marian; Daratha, Kenn B; Childers, Belinda; Magera, Chris

    2014-03-01

    Professional quality of life among healthcare providers can impact the quality and safety of patient care. The purpose of this research was to investigate compassion satisfaction and compassion fatigue levels as measured by the Professional Quality of Life Scale self-report instrument in a community hospital in the United States. A cross-sectional survey study examined differences among 139 RNs, physicians, and nursing assistants. Relationships among individual and organizational variables were explored. Caregivers for critical patients scored significantly lower on the Professional Quality of Life subscale of burnout when compared with those working in a noncritical care unit. Linear regression results indicate that high sleep levels and employment in critical care areas are associated with less burnout. Identification of predictors can be used to design interventions that address modifiable risks.

  16. Job dissatisfaction and burnout of nurses in Hunan, China: A cross-sectional survey.

    PubMed

    Zhou, Wenjuan; He, Guoping; Wang, Honghong; He, Ying; Yuan, Qun; Liu, Dan

    2015-12-01

    In this study, we focused on measuring levels of nurse burnout and job dissatisfaction in the daily practice of nurses in Hunan province, China, analyzed factors related to nurse burnout and job dissatisfaction, and explored the relationship between them. Previous studies have shown a high level of burnout and job dissatisfaction among nurses worldwide. A cross-sectional survey of 1100 nurses was conducted. The nurses worked at 20 hospitals in 11 cities and counties throughout China's Hunan province. Nurse burnout was measured by the Maslach Burnout Inventory. Nurse-rated job dissatisfaction was described using a four point scale, and work environment was measured using the Nursing Work Index - Practice Environment Scale. The results showed that nurses had high burnout scores and were dissatisfied with their jobs. Staffing, work environment, and work hours were all significantly associated with nurse burnout and job dissatisfaction. Adequate staffing, improved work environment, and reasonable work hours are related to decreasing nurse burnout and job dissatisfaction.

  17. Predicting medical professionals' intention to allow family presence during resuscitation: A cross sectional survey.

    PubMed

    Lai, Meng-Kuan; Aritejo, Bayu Aji; Tang, Jing-Shia; Chen, Chien-Liang; Chuang, Chia-Chang

    2017-05-01

    Family presence during resuscitation is an emerging trend, yet it remains controversial, even in countries with relatively high acceptance of family presence during resuscitation among medical professionals. Family presence during resuscitation is not common in many countries, and medical professionals in these regions are unfamiliar with family presence during resuscitation. Therefore, this study predicted the medical professionals' intention to allow family presence during resuscitation by applying the theory of planned behaviour. A cross-sectional survey. A single medical centre in southern Taiwan. Medical staffs including physicians and nurses in a single medical centre (n=714). A questionnaire was constructed to measure the theory of planned behaviour constructs of attitudes, subjective norms, perceived behavioural control, and behavioural intentions as well as the awareness of family presence during resuscitation and demographics. In total, 950 questionnaires were distributed to doctors and nurses in a medical centre. Among the 714 valid questionnaires, only 11 participants were aware of any association in Taiwan that promotes family presence during resuscitation; 94.7% replied that they were unsure (30.4%) or that their unit did not have a family presence during resuscitation policy (74.8%). Regression analysis was performed to predict medical professionals' intention to allow family presence during resuscitation. The results indicated that only positive attitudes and subjective norms regarding family presence during resuscitation and clinical tenure could predict the intention to allow family presence during resuscitation. Because Family presence during resuscitation practice is not common in Taiwan and only 26.19% of the participants agreed to both items measuring the intention to allow family presence during resuscitation, we recommend the implementation of a family presence during resuscitation education program that will enhance the positive beliefs

  18. The epidemiology of chronic pain in Libya: a cross-sectional telephone survey.

    PubMed

    Elzahaf, Raga A; Johnson, Mark I; Tashani, Osama A

    2016-08-11

    Chronic pain is a public health problem although there is a paucity of prevalence data from countries in the Middle East and North Africa. The aim of this study was to estimate the prevalence of chronic pain and neuropathic pain in a sample of the general adult population in Libya. A cross-sectional telephone survey was conducted before the onset of the Libyan Civil War (February 2011) on a sample of self-declared Libyans who had a landline telephone and were at least 18 years of age. Random sampling of household telephone number dialling was undertaken in three major cities and interviews conducted using an Arabic version of the Structured Telephone Interviews Questionnaire on Chronic Pain previously used to collect data in Europe. In addition, an Arabic version of S-LANSS was used. 1212 individuals were interviewed (response rate = 95.1 %, mean age = 37.8 ± 13.9 years, female = 54.6 %). The prevalence of chronic pain ≥ 3 months was 19.6 % (95 % CI 14.6 % to 24.6 %) with a mean ± SD duration of pain of 6 · 5 ± 5 · 7 years and a higher prevalence for women. The prevalence of neuropathic pain in the respondents reporting chronic pain was 19 · 7 % (95 % CI 14 · 6-24 · 7), equivalent to 3 · 9 % (95 % CI 2 · 8 to 5 · 0 %) of the general adult population. Only, 71 (29 · 8 %) of respondents reported that their pain was being adequately controlled. The prevalence of chronic pain in the general adult population of Libya was approximately 20 % and comparable with Europe and North America. This suggests that chronic pain is a public health problem in Libya. Risk factors are being a woman, advanced age and unemployment. There is a need for improved health policies in Libya to ensure that patients with chronic pain receive effective management.

  19. Patterns and Controls of Cross-section Morphology for the Glaciated Bow River Valley, Canadian Rockies

    NASA Astrophysics Data System (ADS)

    Chapuis, A.; Martin, Y.; Sjogren, D.

    2006-12-01

    Glaciers are powerful agents of erosion that can broaden and deepen valley floors, steepen valley sides and enhance local relief. The objective of this research is to analyze downvalley patterns in valley cross-section profiles in the Canadian Rocky Mountains to infer information about controls on glacial valley genesis. This study focuses on the Bow River valley, located on the east side of the Great Divide in the Canadian Rockies. The valley is mainly situated parallel to overall geologic structure, with some valley locations oriented perpendicular to structure. The last glacial advance to affect the area was late-Pleistocene. Eleven valley cross-sections along the Bow River valley were extracted from a 30m DEM for analysis. Cross- sections were analysed using different mathematical models: (i) power law; (ii) quadratic; and (iii) variable width/depth ratio. As the shape of the valley in the present day is influenced by post-glacial filling, we also defined best-fit equations that estimate the erosional form, rather than the present day valley, by fitting equations for cross-sections to data points restricted to the valley sides. Equations were thus extrapolated below the surface deposits of the valley floor to estimate the depth of valley fill. No strong downvalley trend in steepness for the valley sidewalls is visible in the data, although two groups are evident; one group for cross-sections with steep valley walls and one for those with less steep valley walls. There is a possible decreasing trend in valley width in the downvalley direction, although the signal is weak. When cross-section data were analyzed in relation to geological structure, cross-sections oriented perpendicular to structure are found to be steeper and narrower than those which are not. This finding suggests a strong preconditioning on the cross-section form by geological structure. When the best-fit equations were extrapolated below the surface deposits to estimate the depth of valley fill

  20. Cross-Sectional Survey of Physicians on Providing Volunteer Care for In-Flight Medical Events.

    PubMed

    Chatfield, Eric; Bond, William F; McCay, Bradley; Thibeault, Claude; Alves, Paulo M; Squillante, Marc; Timpe, Joshua; Cook, Courtney J; Bertino, Raymond E

    2017-09-01

    Airline carriers have equipment, procedures, and protocols in place to handle in-flight medical events (IFMEs). Community physicians may be asked for aid during IFMEs. Cross-Sectional Survey of Physicians on Providing Volunteer Care for In-Flight Medical Events surveyed self-assessed awareness and knowledge, perceived barriers, and suggestions for improving responses to IFMEs. We composed a survey regarding clinicians' self-assessed understanding of in-flight resources, procedures, flight environmental issues, and Good Samaritan protections. The survey was distributed primarily via electronic mail to medical staff list serves to a total of approximately 1300 physicians representing 2 health networks that serve urban, suburban, and rural areas in both inpatient and outpatient settings. Total number of responses was 418. Physician response rate was 29.2% (379/1300). In 3% (39/1300), the responder either failed to indicate their background or was another type of health care professional (e.g., dentist, medical student, physician assistant). Of the physicians, 37.5% (142/379) were primary care and 42% (177/418) of responders reported at least one experience of being asked to volunteer. When asked how well they understand the protocols with which medical events are handled, 64% (262/412) responded "not at all" and 23% (94/412) reported "a little" knowledge. Only 56% (223/397) answered that 75% or more of U.S. flights have ground medical support available. There were 73% (298/411) who believed airlines were required to have medical supplies, but 54% (222/410) reported no knowledge of supplies available. A total of 69% (279/403) believed or were sure that the U.S. has a Good Samaritan law that applies to IFMEs. Many physicians lack basic knowledge about IFMEs. Responders may assist more effectively if better informed about protocols and the availability of ground medical support. Education and timely information support are recommended.Chatfield E, Bond WF, McCay B

  1. Personality disorder and self-rated health: a population-based cross-sectional survey.

    PubMed

    Fok, Marcella; Hotopf, Matthew; Stewart, Robert; Hatch, Stephani; Hayes, Richard; Moran, Paul

    2014-06-01

    Little is known about the impact of personality disorder (PD) on the health of people living in the community. The authors set out to examine the association between PD and general health, using a cross-sectional survey of a representative community sample in London, UK. A total of 1,698 adults aged 16 years or over from 1,075 randomly selected households were recruited and interviewed face-to-face by trained interviewers. Using multivariable logistic regression, the authors examined the cross-sectional association between PD screen status, as assessed by the Standardised Assessment of Personality-Abbreviated Scale (SAPAS), and self-rated health, adjusting for demographic and health covariates. Of the participants, 14.5% screened positively for PD. A greater proportion of those scoring positively for PD reported poor self-rated health, compared to screen negative participants (41.3% versus 15.0%). This association was reduced, but remained significant, after adjustment for potential confounders (unadjusted odds ratio (OR) = 3.99, 95% CI [2.93, 5.42]; fully adjusted OR = 1.53, 95% CI [1.02, 2.29]. Of note, subthreshold symptoms of PD were significantly associated with poor self-rated health (unadjusted OR per unit SAPAS score increment = 1.53, 95% CI [1.40, 1.67]; fully adjusted OR = 1.19, 95% CI [1.07, 1.33]. Furthermore, people screening positive for PD were more likely to report multiple (three or more) long-standing illnesses. The authors conclude that in the general population, individuals who are at high risk for PD are independently at increased risk of poor general health.

  2. Positive and negative reasons for sickness presenteeism in Norway and Sweden: a cross-sectional survey

    PubMed Central

    Johansen, Vegard; Aronsson, Gunnar; Marklund, Staffan

    2014-01-01

    Objectives This article investigates various reasons for sickness presenteeism (SP), that is, going to work despite illness. The research questions asked is: What are the main reported reasons for SP in Norway and Sweden? Design Cross-sectional survey in Norway and Sweden. Use of binomial logistic regression analysis. Participants A random sample of people aged between 20 and 60 years was obtained from complete and updated databases of the Norwegian and Swedish populations. A postal questionnaire was sent to the selected individuals, with response rate 33% (n=2843). 2533 workers responded to questions about SP during the last 12 months. Primary and secondary outcome measures The article informs about the distribution of reasons for SP in Norway and Sweden, selected by the respondents from a closed list. The article also examines which factors influence the most often reported reasons for SP. Results 56% of the Norwegian and Swedish respondents experienced SP in the previous year. The most frequently reported reasons for SP include not burden colleagues (43%), enjoy work (37%) and feeling indispensable (35%). A lower proportion of Norwegians state that they cannot afford taking sick leave adjusted OR (aOR 0.16 (95% CI 0.10 to 0.22)), while a higher proportion of Norwegians refer to that they enjoy their work (aOR=1.64 (95% CI 1.28 to 2.09)). Women and young workers more often report that they do not want to burden their colleagues. Managers (aOR=2.19 (95% CI 1.67 to 2.86)), highly educated persons and the self-employed more often report that they are indispensable. Conclusions Positive and negative reasons for SP are reported, and there are significant differences between respondents from the two countries. The response rate is low and results must be interpreted with caution. Study design Cross-sectional study. PMID:24523425

  3. Dietetic management of gestational diabetes in New Zealand: A cross-sectional survey.

    PubMed

    Lawrence, Robyn L; Wall, Clare R; Bloomfield, Frank H; Crowther, Caroline A

    2017-02-01

    The aim of this study was to evaluate dietetic practice in the management of gestational diabetes in New Zealand, compare this with evidence-based guidelines and determine the need for New Zealand-specific evidence-based nutrition practice guidelines for gestational diabetes. A 64-item cross-sectional online survey of New Zealand-registered dietitians providing care to women with gestational diabetes was undertaken. Participants were recruited through Dietitians New Zealand, District Health Boards and private practices across New Zealand. The survey examined dietetic service provision, management recommendations, guideline use, service evaluation, compliance with national and international guidelines and the perceived need for New Zealand-specific evidence-based guidelines for the nutritional management of gestational diabetes. Thirty-three (62%) eligible dietitians participated in the survey. There was significant variation in dietetic services and management recommendations. Nine (28%) dietitians felt the service within which they worked did not offer adequate dietetic services for women with gestational diabetes. Compliance with national and international evidence-based guidelines ranged from 28 to 100% depending on the recommendation. Twenty-five (76%) respondents felt there was a need for New Zealand-specific evidence-based nutrition practice guidelines for gestational diabetes. These results highlight differences in dietetic services and practice in New Zealand and variations in compliance with local and international evidence-based guidelines. The development of New Zealand-specific evidence-based nutrition practice guidelines for gestational diabetes is supported. © 2016 Dietitians Association of Australia.

  4. Professional satisfaction of family physicians in Pakistan--results of a cross-sectional postal survey.

    PubMed

    Ashraf, Hiba; Shah, Nasir; Anwer, Fahad; Akhtar, Hina; Abro, Mairaj Anwar; Khan, Asma

    2014-04-01

    To assess the level of professional satisfaction amongst family physicians of Pakistan and to identify the factors associated with professional dissatisfaction. The study was part of a larger national survey for "Status of PostgraduateTraining and Continuing Medical Education of Family Physicians in Pakistan" which was a cross-sectional, postal survey of family physicians conducted over 10 months between November 2009 and September 2010. The main outcome variables were professional satisfaction, as well as reasons for professional satisfaction and dissatisfaction. SPSS 17 was used for data analysis. Multivariable logistic regression was used to determine factors associated with professional dissatisfaction. Of the total 1200 survey forms distributed, 288 (24%) were received back. The mean age of the participants was 37 +/- 9 years with a range between 26 and 72 years. Of the total, 226 (78.5%) were males. Overall, 213 (74%) family physicians were satisfied with their profession. The factors significantly associated with professional dissatisfaction included the participants opinion that they were not respected by the public (OR: 11.6, C.I: 1.9-71.5); as well as regretting being a doctor (OR:62.9, C.I: 8.4-469.8). Most of the family physicians had professional satisfaction, but a minority had regrets about being a doctor and were dissatisfied over how their profession affected their family life. Further research may be needed to study work-life balance amongst family physicians of Pakistan.

  5. Bullying in the American Graduate Medical Education System: A National Cross-Sectional Survey.

    PubMed

    Chadaga, Amar R; Villines, Dana; Krikorian, Armand

    2016-01-01

    To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups. A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications. Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months. Almost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than < 5'8 and BMI ≥ 25 individuals. Many trainees report experiencing bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of healthcare.

  6. Bullying in the American Graduate Medical Education System: A National Cross-Sectional Survey

    PubMed Central

    2016-01-01

    Objectives To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups. Design/Setting/Participants A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications. Main Outcomes/Measures Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months. Results Almost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than < 5’8 and BMI ≥ 25 individuals. Conclusions/Relevance Many trainees report experiencing bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all

  7. The chiropractic scope of practice in the United States: a cross-sectional survey.

    PubMed

    Chang, Mabel

    2014-01-01

    The purpose of this study was to assess the current status of chiropractic practice laws in the United States. This survey is an update and expansion of 3 original surveys conducted in 1987, 1992, and 1998. A cross-sectional survey of licensure officials from the Federation of Chiropractic Licensing Boards e-mail list was conducted in 2011 requesting information about chiropractic practice laws and 97 diagnostic, evaluation, and management procedures. To evaluate content validity, the survey was distributed in draft form at the fall 2010 Federation of Chiropractic Licensing Boards regional meeting to regulatory board members and feedback was requested. Comments were reviewed and incorporated into the final survey. A duplicate question was imbedded in the survey to test reliability. Partial or complete responses were received from 96% (n = 51) of the jurisdictions in the United States. The states with the highest number of services that could be performed were Missouri (n = 92), New Mexico (n = 91), Kansas (n = 89), Utah (n = 89), Oklahoma (n = 88), Illinois (n = 87), and Alabama (n = 86). The states with the highest number of services that cannot be performed are New Hampshire (n = 49), Hawaii (n = 47), Michigan (n = 42), New Jersey (n = 39), Mississippi (n = 39), and Texas (n = 30). The scope of chiropractic practice in the United States has a high degree of variability. Scope of practice is dynamic, and gray areas are subject to interpretation by ever-changing board members. Although statutes may not address specific procedures, upon challenge, there may be a possibility of sanctions depending on interpretation. Copyright © 2014 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

  8. A cross-sectional internet-based patient survey of the management strategies for gout.

    PubMed

    Singh, Jasvinder A; Shah, Nipam; Edwards, N Lawrence

    2016-03-01

    Almost half of the patients with gout are not prescribed urate-lowering therapy (ULT) by their health care provider and >50 % use complementary and alternative therapies. Diet modification is popular among gout patients due to known associations of certain foods with gout flares. The interplay of the use of dietary supplements, diet modification, and ULT adherence in gout patients is not known. Despite the recent interest in diet and supplements, there are limited data on their use. Our objective was to assess ULT use and adherence and patient preference for non-pharmacological interventions by patients with gout, using a cross-sectional survey. People who self-reported physician-diagnosed gout during their visit to a gout website ( http://gouteducation.org ) were invited to participate in a brief anonymous cross-sectional Internet survey between 08/11/2014 to 04/14/2015 about the management of their gout. The survey queried ULT prescription, ULT adherence, the use of non-pharmacological interventions (cherry extract, diet modification) and the likelihood of making a lifelong diet modification for gout management. A total of 499 respondents with a mean age 56.3 years were included; 74% were males and 74% were White. Of these, 57% (285/499) participants were prescribed a ULT for gout, of whom 88% (251/285) were currently taking ULT. Of those using ULT, 78% (97/251) reported ULT adherence >80%. Gender, race, and age were not significantly associated with the likelihood of receiving a ULT prescription or ULT adherence >80%. Fifty-six percent of patients with gout preferred ULT as a lifelong treatment for gout, 24% preferred cherry extract and 16% preferred diet modification (4% preferred none). Men had significantly lower odds of preferring ULT as the lifelong treatment choice for gout vs. other choices (p = 0.03). We found that 38.3% participants were highly motivated to make a lifelong dietary modification to improve their gout (score of 9-10 on a 0

  9. Beliefs about bioidentical hormone therapy: a cross-sectional survey of pharmacists.

    PubMed

    Siyam, Tasneem; Yuksel, Nesé

    2013-02-01

    The aim of this study was to assess pharmacists' beliefs about bioidentical hormone therapy (BHT) and to identify factors influencing these beliefs. This was a cross-sectional survey of pharmacists. An email invitation to participate in the online survey was sent to a random sample of 2000 pharmacists in Alberta. The survey was accessible for a six-week period from May to July, 2011. A 54-item questionnaire was used to capture knowledge and beliefs about, and confidence in BHT. Summary statistics and multivariate regression were used for analyses. Overall, 401 pharmacists completed the survey (response rate 20%). Respondents were mainly female (64%), above 30 years of age (81%) and in practice for more than 10 years (63%). Only 35% of respondents correctly classified BHT as including both compounding and commercial products. In regards to beliefs, 68% of respondents agreed that BHT is as effective as non-bioidentical hormones for vasomotor symptoms, while 60% agreed BHT had equal risk. Beliefs on estriol, progesterone, and saliva testing however, were more diverse with many "do not know" responses (40%). In multivariate analysis, pharmacists who worked in pharmacies that compounded BHT were more likely to believe in BHT safety (p<0.001), and have greater confidence with BHT (p<0.001). Results from this survey indicated that pharmacists had varying beliefs on BHT. In addition, beliefs on the safety of BHT were associated with pharmacists' practice, specifically working in a pharmacy that compounds BHT. This study helps identify areas for targeted education. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  10. The use of herbal medicines by people with cancer: a cross-sectional survey

    PubMed Central

    Damery, S; Gratus, C; Grieve, R; Warmington, S; Jones, J; Routledge, P; Greenfield, S; Dowswell, G; Sherriff, J; Wilson, S

    2011-01-01

    Background: A large proportion of cancer patients are estimated to use herbal medicines, but data to substantiate this are lacking. This study aimed to investigate the prevalence of herbal medicine use among cancer patients in the West Midlands, and determine the characteristics predicting herbal medicine use. Methods: A cross-sectional survey of oncology patients (n=1498) being followed up at a hospital in Coventry was undertaken. Recipients were asked about herbal medicine use since their cancer diagnosis, and the association between sociodemographic and cancer-related characteristics and herbal medicine use was evaluated. Results: A total of 1134 responses were received (75.7%). The prevalence of herbal medicine use was 19.7% (95% CI: 17.4–22.1; n=223). Users were more likely to be affluent, female, and aged under 50 years. Usage increased with time since cancer diagnosis (X2 for trend=4.63; P=0.031). A validation data set, derived from a survey of oncology patients in Birmingham (n=541) with differing socioeconomic characteristics showed no significant difference in estimated prevalence (16.6% 95% CI: 11.9–22.2). Conclusion: A substantial number of people with cancer are likely to be taking herbal medicines. Understanding the self-medication behaviours of these individuals is essential if health-care professionals are to support treatment adherence and avoid unwanted pharmacological interactions. PMID:21364591

  11. Epidemiological Study of Sepsis in China: Protocol of a Cross-sectional Survey

    PubMed Central

    Yang, Yi; Xie, Jian-Feng; Yu, Kai-Jiang; Yao, Chen; Li, Jian-Guo; Guan, Xiang-Dong; Yan, Jing; Ma, Xiao-Chun; Kang, Yan; Yang, Cong-Shan; Yao, Xiao-Qing; Shang, Hong-Cai; Qiu, Hai-Bo

    2016-01-01

    Background: Sepsis is the leading cause of death among critically ill patients. Herein, we conducted a national survey to provide data on epidemiology and treatment of sepsis in the clinical practice in China, which has no detailed epidemiological data available on sepsis. Methods: This was a prospective cross-sectional survey from December 1, 2015 to January 31, 2016 in all provinces/municipalities of the mainland of China. The primary outcome of this study was the incidence of sepsis, and the secondary outcome was its etiology in China. Patients with sepsis admitted to the Intensive Care Units were included in this study. The demographic, physiological, bacteriological, and therapeutic data of these patients were recorded. The incidence of sepsis was estimated using the data from the sixth census in China, reported by the Chinese National Health and Family Planning Commission and the National Bureau of Statistics as the standard population. The independent risk factors for increased mortality from sepsis were calculated. Conclusions: This study indicated the incidence and outcome of sepsis in China. It also showed the most common etiology of different sites and types of infection, which could guide empiric antibiotic therapy. Moreover, it provided information on the independent risk factors for increased mortality due to sepsis. The findings provide evidence to guide clinical management and may help improve the outcome in septic patients. Trial Registration: ClinicalTrials.gov, NCT02448472; https://clinicaltrials.gov/show/NCT02448472. PMID:27958229

  12. Comparability of self rated health: cross sectional multi-country survey using anchoring vignettes

    PubMed Central

    Salomon, Joshua A; Tandon, Ajay; Murray, Christopher J L

    2004-01-01

    Objective To examine differences in expectations for health using anchoring vignettes, which describe fixed levels of health on dimensions such as mobility. Design Cross sectional survey of adults living in the community. Setting China, Myanmar, Sri Lanka, Pakistan, Turkey, and United Arab Emirates. Participants 3012 men and women aged 18 years and older (self ratings); subsample of 406 (vignette ratings). Main outcome measures Self rated mobility levels and ratings of hypothetical vignettes using the same questions and response categories. Results Consistent rankings of vignettes are evidence that vignettes are understood in similar ways in different settings, and internal consistency of orderings on two mobility questions indicates good comprehension. Variation in vignette ratings across age groups suggests that expectations for mobility decline with age. Comparison of responses to two different mobility questions supports the assumption that individual ratings of hypothetical vignettes relate to expectations for health in similar ways as self assessments. Conclusions Anchoring vignettes could provide a powerful tool for understanding and adjusting for the influence of different health expectations on self ratings of health. Incorporating anchoring vignettes in surveys can improve the comparability of self reported measures. PMID:14742348

  13. Perceived relevance of educative information on public (skin) health: a cross-sectional questionnaire survey.

    PubMed

    Haluza, Daniela; Cervinka, Renate

    2013-03-01

    Unprotected leisure time exposure to ultraviolet radiation from the sun or artificial tanning beds is the most important environmental risk factor for melanoma, a malignant skin cancer with increasing incidences over the past decades. The aim of the present study was to assess the impact of skin health information provided by several sources and different publishing issues on knowledge, risk perception, and sun protective behavior of sunbathers. A cross-sectional questionnaire survey was conducted among Austrian residents (n=563) spending leisure time outdoors in August 2010. Print media, television, and family were perceived as the most relevant sources of information on skin health, whereas the source physician was only ranked as fourth important source. Compared to other sources, information provided by doctors positively influenced participants' knowledge on skin risk and sun protective behavior resulting in higher scores in the knowledge test (p=0.009), higher risk perception (p<0.001), and more sun protection (p<0.001). Regarding gender differences, internet was more often used by males as health information source, whereas females were more familiar with printed information material in general. The results of this survey put emphasis on the demand for information provided by medical professionals in order to attain effective, long-lasting promotion of photoprotective habits.

  14. Cross-sectional survey of the seroprevalence of Puumala hantavirus in Austria.

    PubMed

    Poeppl, Wolfgang; Tobudic, Selma; Winkler, Heide-Maria; Faas, Angelus; Mooseder, Gerhard; Burgmann, Heinz

    2012-08-01

    The prevalence of Puumala hantavirus infections in Austria and the occupational exposure of military personnel to this virus were assessed in 2009 in an exploratory nationwide cross-sectional seroprevalence survey in 526 healthy individuals, of which 222 were soldiers and 304 were civilians. In addition, information on possible risk factors for hantavirus exposure, including previous foreign military assignments, residential area, occupational animal contact, and regular outdoor activities, was obtained. Immunoglobulin G antibodies against Puumala hantavirus were examined with a commercial enzyme-linked immunosorbent assay. Overall, 7 (1.3%) individuals, aged 19, 22, 24, 24, 26, 38, and 60 years, tested positive on serologic screening. There were no significant differences between the seroprevalence of the virus and any of the variables surveyed. Our data demonstrate serologic evidence of Puumala hantavirus infection among the Austrian population, with a stable prevalence in the past decade. When compared with the general population, no increased risk of exposure to Puumala hantavirus could be detected for military personnel.

  15. Pregnancy in patients with tuberculosis: a TBNET cross-sectional survey.

    PubMed

    Bothamley, Graham H; Ehlers, Cordula; Salonka, Irina; Skrahina, Alena; Orcau, Angels; Codecasa, Luigi R; Ferrarese, Maurizio; Pesut, Dragica; Solovic, Ivan; Dudnyk, Andrii; Anibarro, Luis; Denkinger, Claudia; Guglielmetti, Lorenzo; Muylle, Inge; Confalonieri, Marco

    2016-10-12

    Objectives: To determine whether the incidence of tuberculosis with pregnancy is more common than would be expected from the crude birth rate; to see whether there is significant delay in the diagnosis of tuberculosis during pregnancy. Design: A cross-sectional survey. 13 tuberculosis clinics within different European countries and the USA. All patients with tuberculosis seen at these clinics for a period > 1 year. Questionnaire survey based on continuous data collection. number and proportion of women with tuberculosis who were pregnant; timing of diagnosis in relation to pregnancy, including those who were pregnant or delivered in the 3 months prior to the diagnosis of TB and those who developed TB within 3 months after delivery. Pregnancy occurred in 224 (1.5 %) of 15,217 TB patients and followed the expected rate predicted from the crude birth rate for the clinic populations. TB was diagnosed more commonly in the 3 months after delivery (n = 103) than during pregnancy (n = 68; χ (2) = 25.1, P < 0.001). TB is diagnosed more frequently after delivery, despite variations in local TB incidence and healthcare systems.

  16. Blood pressure control in patients with chronic renal insufficiency in Spain: a cross-sectional study.

    PubMed

    Marín, Rafael; Fernández-Vega, Francisco; Gorostidi, Manuel; Ruilope, Luis M; Díez, Javier; Praga, Manuel; Herrero, Pablo; Alcázar, Jose M; Laviades, Concepción; Aranda, Pedro

    2006-02-01

    Despite therapeutic advances, strict control of hypertension remains elusive in patients with chronic renal insufficiency (CRI). The present study was designed for assessment of control rates of blood pressure in patients with CRI. Secondary objectives included evaluation of the control rates of proteinuria and cardiovascular comorbidities. A multicenter and cross-sectional survey of unselected patients with CRI attending outpatient nephrology clinics in Spain between April and September 2003 was performed. Fifty-two centers recruited 2501 patients with a mean age 64.8 years (65.7% men). The prevalence of previous cardiovascular disease was 55%. The two most prevalent renal diseases were vascular (38.9%) and diabetic nephropathy (20.1%). Blood pressure below 130/80 mmHg was observed in 435 patients (17.4%). A poor blood pressure control was associated with older age, greater proteinuria and higher low-density lipoprotein cholesterol levels. Proteinuria less than 0.5 g/day was observed in 1209 cases (48.3%). A total of 1899 patients (75.9%) were receiving drugs suppressing the activity of the renin-angiotensin system and 1048 patients (41.9%) were being treated with three or more antihypertensive drugs. Lipid-lowering agents and antiplatelet therapy were used in 49.3 and 38.1% of patients, respectively. The control rate of blood pressure in patients with CRI is inadequate despite frequent use of combination therapy that most commonly included an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Greater emphasis should be made to increase the number and dose of antihypertensive drugs and the need for using a statin as well as antiplatelet therapy in order to improve renal and cardiovascular outcomes.

  17. A cross-sectional survey of essential surgical capacity in Somalia

    PubMed Central

    Elkheir, Natalie; Sharma, Akshay; Cherian, Meena; Saleh, Omar Abdelrahman; Everard, Marthe; Popal, Ghulam Rabani; Ibrahim, Abdi Awad

    2014-01-01

    Objective To assess life-saving and disability-preventing surgical services (including emergency, trauma, obstetrics, anaesthesia) of health facilities in Somalia and to assist in the planning of strategies for strengthening surgical care systems. Design Cross-sectional survey. Setting Health facilities in all 3 administrative zones of Somalia; northwest Somalia (NWS), known as Somaliland; northeast Somalia (NES), known as Puntland; and south/central Somalia (SCS). Participants 14 health facilities. Measures The WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was employed to capture a health facility's capacity to deliver surgical and anaesthesia services by investigating four categories of data: infrastructure, human resources, interventions available and equipment. Results The 14 facilities surveyed in Somalia represent 10 of the 18 districts throughout the country. The facilities serve an average patient population of 331 250 people, and 12 of the 14 identify as hospitals. While major surgical procedures were provided at many facilities (caesarean section, laparotomy, appendicectomy, etc), only 22% had fully available oxygen access, 50% fully available electricity and less than 30% had any management guidelines for emergency and surgical care. Furthermore, only 36% were able to provide general anaesthesia inhalation due to lack of skills, supplies and equipment. Basic supplies for airway management and the prevention of infection transmission were severely lacking in most facilities. Conclusions According to the results of the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care survey, there exist significant gaps in the capacity of emergency and essential surgical services in Somalia including inadequacies in essential equipment, service provision and infrastructure. The information provided by the WHO tool can serve as a basis for evidence-based decisions on country-level policy regarding the

  18. Medical barriers to emergency contraception: a cross-sectional survey of doctors in North India

    PubMed Central

    Khan, M E; Dixit, Anvita; Bhatnagar, Isha; Brady, Martha

    2014-01-01

    Background: Some medical doctors in India have publicly expressed opposition to making emergency contraceptive pills (ECPs) easily accessible, even though ECPs are included in the method mix of the Ministry of Health and Family Welfare program and as an over-the-counter (OTC) product. Such opposition affects access to ECPs by influencing policy, procurement, and distribution, besides stigmatizing the ECP user. This study was conducted to assess ECP knowledge, attitudes, and practices of doctors in North India. Methods: A cross-sectional survey of 83 doctors who provide ECPs, randomly selected from 3 cities in the state of Uttar Pradesh, was conducted in 2011. The quantitative data were complemented by 19 in-depth interviews with purposively selected senior gynecologists and other opinion leaders. Results: All surveyed physicians cited the correct dose and regimen for ECPs. However, the large majority of those surveyed believed that ECPs work by preventing implantation. (The best evidence currently indicates that ECPs do not work by preventing implantation.) Most doctors also believed incorrectly that ECPs have several contraindications and side effects. They also had strong reservations against OTC provision of ECPs by pharmacists and community health workers (CHWs) and negative attitudes toward ECP users, which serve as serious medical barriers to mainstreaming use of ECPs. Conclusion: Physicians and their professional associations exert a strong influence on the operationalization of national contraceptive policies. Evidence-based advocacy and educational campaigns targeting doctors are needed to address and resolve their reservations about ECPs, particularly about its provision as an OTC product and its distribution by CHWs. Partnerships with medical associations can help reduce doctors' negative attitudes and create a conducive environment for influencing clinical practices. Such changes are needed to increase the availability and use of ECPs as part of a

  19. Patients' experiences and expectations of chiropractic care: a national cross-sectional survey.

    PubMed

    MacPherson, Hugh; Newbronner, Elizabeth; Chamberlain, Ruth; Hopton, Ann

    2015-01-01

    Not enough is understood about patients' views of chiropractic care. The aims of this research were to explore patients' experiences and expectations, their perceptions of benefits and risks, and the implications for chiropractors' continuing fitness to practise. Survey questions were formulated from existing literature, published guidance on good practice from the General Chiropractic Council, and from 28 telephone interviews and a small focus group with chiropractic patients using a semi-structured topic guide. In its final form, the survey elicited patients' ratings on expectations regarding 33 aspects of care. In a national cross-sectional survey, a number of sampling methods were required as a consequence of the low practitioner response rate. In total, 544 completed questionnaires were received from chiropractic patients, a lower response rate than expected (8%). The two main benefits that patients reported regarding their chiropractic care were reduced pain (92%) and increased mobility (80%). Of respondents, 20% reported unexpected or unpleasant reactions to their treatment, most commonly tiredness or fatigue (32%), and extra pain (36%). In most cases they expressed low levels of concern about these reactions. Patients' expectations were met for most aspects of care. The four aspects of practice where expectations were least well met comprised: having more information on the cost of the treatment plan at the first consultation (80%); the chiropractor contacting the patient's general practitioner if necessary (62%); having a discussion about a referral to another healthcare practitioner (62%); and providing a method for confidential feedback (66%). Overall, patients reported a high level of satisfaction with the benefits of their chiropractic care, although there is a likelihood of bias towards patients with a positive experience of chiropractic. There were no serious adverse reactions; however, patients reported concern about pain, tingling and numbness in

  20. Sharing of clinical trial data among trialists: a cross sectional survey

    PubMed Central

    Rathi, Vinay; Dzara, Kristina; Gross, Cary P; Hrynaszkiewicz, Iain; Joffe, Steven; Krumholz, Harlan M; Strait, Kelly M

    2012-01-01

    Objective To investigate clinical trialists’ opinions and experiences of sharing of clinical trial data with investigators who are not directly collaborating with the research team. Design and setting Cross sectional, web based survey. Participants Clinical trialists who were corresponding authors of clinical trials published in 2010 or 2011 in one of six general medical journals with the highest impact factor in 2011. Main outcome measures Support for and prevalence of data sharing through data repositories and in response to individual requests, concerns with data sharing through repositories, and reasons for granting or denying requests. Results Of 683 potential respondents, 317 completed the survey (response rate 46%). In principle, 236 (74%) thought that sharing de-identified data through data repositories should be required, and 229 (72%) thought that investigators should be required to share de-identified data in response to individual requests. In practice, only 56 (18%) indicated that they were required by the trial funder to deposit the trial data in a repository; of these 32 (57%) had done so. In all, 149 respondents (47%) had received an individual request to share their clinical trial data; of these, 115 (77%) had granted and 56 (38%) had denied at least one request. Respondents’ most common concerns about data sharing were related to appropriate data use, investigator or funder interests, and protection of research subjects. Conclusions We found strong support for sharing clinical trial data among corresponding authors of recently published trials in high impact general medical journals who responded to our survey, including a willingness to share data, although several practical concerns were identified. PMID:23169870

  1. A cross-sectional survey of essential surgical capacity in Somalia.

    PubMed

    Elkheir, Natalie; Sharma, Akshay; Cherian, Meena; Saleh, Omar Abdelrahman; Everard, Marthe; Popal, Ghulam Rabani; Ibrahim, Abdi Awad

    2014-05-07

    To assess life-saving and disability-preventing surgical services (including emergency, trauma, obstetrics, anaesthesia) of health facilities in Somalia and to assist in the planning of strategies for strengthening surgical care systems. Cross-sectional survey. Health facilities in all 3 administrative zones of Somalia; northwest Somalia (NWS), known as Somaliland; northeast Somalia (NES), known as Puntland; and south/central Somalia (SCS). 14 health facilities. The WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was employed to capture a health facility's capacity to deliver surgical and anaesthesia services by investigating four categories of data: infrastructure, human resources, interventions available and equipment. The 14 facilities surveyed in Somalia represent 10 of the 18 districts throughout the country. The facilities serve an average patient population of 331 250 people, and 12 of the 14 identify as hospitals. While major surgical procedures were provided at many facilities (caesarean section, laparotomy, appendicectomy, etc), only 22% had fully available oxygen access, 50% fully available electricity and less than 30% had any management guidelines for emergency and surgical care. Furthermore, only 36% were able to provide general anaesthesia inhalation due to lack of skills, supplies and equipment. Basic supplies for airway management and the prevention of infection transmission were severely lacking in most facilities. According to the results of the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care survey, there exist significant gaps in the capacity of emergency and essential surgical services in Somalia including inadequacies in essential equipment, service provision and infrastructure. The information provided by the WHO tool can serve as a basis for evidence-based decisions on country-level policy regarding the allocation of resources and provision of emergency and essential

  2. A national, cross-sectional survey of children's hospital-based safety resource centres.

    PubMed

    Kendi, Sadiqa; Zonfrillo, Mark R; Seaver Hill, Karen; Arbogast, Kristy B; Gittelman, Michael A

    2014-03-25

    To describe the location, staffing, clientele, safety product disbursement patterns, education provided and sustainability of safety resource centres (SRCs) in US children's hospitals. A cross-sectional survey was distributed to children's hospital-based SRC directors. Survey categories included: funding sources, customer base, items sold, items given free of charge, education provided and directors' needs. 32/38 (84.2%) SRC sites (affiliated with 30 hospitals) completed the survey. SRCs were in many hospital locations including lobby (28.1%), family resource centres (12.5%), gift shop/retail space (18.8%), mobile units (18.8%) and patient clinics (12.5%). 19% of respondents reported that their SRC was financially self-sustainable. Sales to patients predominated (mean of 44%); however, hospital employees made up a mean of 20% (range 0-60%) of sales. 78.1% of SRCs had products for children with special healthcare needs. Documentation kept at SRC sites included items purchased (96.9%), items given free of charge (65.6%) and customer demographics (50%). 56.3% of SRCs provided formal injury prevention education classes. The SRCs' directors' most important needs were finances (46.9%), staffing (50%) and space (46.9%). All of the directors were 'somewhat interested' or 'very interested' in each of the following: creation of a common SRC listserv, national SRC data bank and multisite SRC research platform. SRCs are located in many US children's hospitals, and can be characterised as heterogeneous in location, products sold, data kept and ability to be financially sustained. Further research is needed to determine best practices for SRCs to maximise their impact on injury prevention.

  3. The European Board of Interventional Radiology Examination: A Cross-Sectional Web-Based Survey.

    PubMed

    Tong, Emma; Spooner, Muirne; Van Delden, Otto; Uberoi, Raman; Sheehan, Mark; O'Neill, Damien C; Lee, Michael

    2017-08-15

    The Cardiovascular and Interventional Radiology Society of Europe established the European Board of Interventional Radiology (EBIR) as an international examination in Interventional Radiology (IR), in 2010. The main objective of this study was to examine candidates' variables which could influence examination success. The secondary objective was to evaluate candidate feedback. This study was a cross-sectional web-based survey incorporating 30 questions which reviewed candidates' demographics; use of English language; education; and radiology training. Free-text responses provided perspective on the examination process and any potential career implications. This survey was distributed via Surveygizmo(TM) and emailed to 227 candidates, and the results were then anonymised and analysed. A total of 115 candidates responded to the survey. 4.4% (N = 5/115) of candidates were women, and 38.3% (N = 44/115) of candidates were fluent in English. Over 45.2% (N = 52/115) of the respondents achieved a distinction, or >70% equivalent in their medical degree, and 60.8% (N = 70/115) achieved some form of higher degree after medical school. 54.8% (N = 63/115) spent time in other medical specialties, of which the majority (33.8%, N = 39/115) was in surgery. 67.5% (N = 77/114) completed a dedicated fellowship in IR. 61.9% (70/113) felt the EBIR qualification helped their career, for example with academic promotion or increased clinical privileges. EBIR applicants were predominantly male (>95%). Clinical training, prior to radiology training, was very common in this cohort. Overall, most candidates expressed satisfaction with the examination process, and many felt this qualification helped their career. The recent recognition by national accreditation bodies should hopefully improve the profile of the examination greatly.

  4. Nurses’ perceptions of medication adherence in schizophrenia: results of the ADHES cross-sectional questionnaire survey

    PubMed Central

    Emsley, Robin; Alptekin, Koksal; Azorin, Jean-Michel; Cañas, Fernando; Dubois, Vincent; Gorwood, Philip; Haddad, Peter M.; Naber, Dieter; Olivares, José Manuel; Papageorgiou, Georgios; Roca, Miguel; Thomas, Pierre; Hargarter, Ludger; Schreiner, Andreas

    2015-01-01

    Objectives: Poor adherence to antipsychotic treatment is a widespread problem within schizophrenia therapy with serious consequences including increased risks of relapse and rehospitalization. Mounting evidence supports the key roles that nurses play in monitoring patient progress and facilitating long-term treatment adherence. The Adherencia Terapéutica en la Esquizofrenia (ADHES) nurses’ survey was designed to assess the opinions of nurses on the causes and management of partial/nonadherence to antipsychotic medication. Methods: A questionnaire-based cross-sectional survey of 4120 nurses from Europe, the Middle East and Africa. Interpretation of results was based on a descriptive comparison of responses. Results: Nurses perceived 54% of patients seen in the preceding month to be partially/nonadherent to treatment. Most nurses (90%) reported some level of experience with administration of long-acting injectable (LAI) antipsychotics, with 24% of nurses administering >10 injections per month. The majority (85%) of nurses surveyed believed that improving adherence would improve patient outcomes. Nearly half (49%) reported that most of their patients depend on a family member or other nonprofessional carer to remind them to take their medication as prescribed. A similar proportion of nurses (43%) reported that most of their patients relied on a professional to remind them to take medication. Most nurses (92%) felt that ensuring continuous medication with LAI antipsychotics would yield long-term benefits for patients, but their opinion was that over a third of patients were unaware of LAI antipsychotic treatments. In a series of forced options, the strategy used most often by respondents (89%) to promote medication adherence was to build trusting relationships with patients while listening to and interpreting their needs and concerns. Respondents also rated this as the most effective strategy that they used (48%). Conclusion: Nurses are highly aware of adherence

  5. Nurses' perceptions of medication adherence in schizophrenia: results of the ADHES cross-sectional questionnaire survey.

    PubMed

    Emsley, Robin; Alptekin, Koksal; Azorin, Jean-Michel; Cañas, Fernando; Dubois, Vincent; Gorwood, Philip; Haddad, Peter M; Naber, Dieter; Olivares, José Manuel; Papageorgiou, Georgios; Roca, Miguel; Thomas, Pierre; Hargarter, Ludger; Schreiner, Andreas

    2015-12-01

    Poor adherence to antipsychotic treatment is a widespread problem within schizophrenia therapy with serious consequences including increased risks of relapse and rehospitalization. Mounting evidence supports the key roles that nurses play in monitoring patient progress and facilitating long-term treatment adherence. The Adherencia Terapéutica en la Esquizofrenia (ADHES) nurses' survey was designed to assess the opinions of nurses on the causes and management of partial/nonadherence to antipsychotic medication. A questionnaire-based cross-sectional survey of 4120 nurses from Europe, the Middle East and Africa. Interpretation of results was based on a descriptive comparison of responses. Nurses perceived 54% of patients seen in the preceding month to be partially/nonadherent to treatment. Most nurses (90%) reported some level of experience with administration of long-acting injectable (LAI) antipsychotics, with 24% of nurses administering >10 injections per month. The majority (85%) of nurses surveyed believed that improving adherence would improve patient outcomes. Nearly half (49%) reported that most of their patients depend on a family member or other nonprofessional carer to remind them to take their medication as prescribed. A similar proportion of nurses (43%) reported that most of their patients relied on a professional to remind them to take medication. Most nurses (92%) felt that ensuring continuous medication with LAI antipsychotics would yield long-term benefits for patients, but their opinion was that over a third of patients were unaware of LAI antipsychotic treatments. In a series of forced options, the strategy used most often by respondents (89%) to promote medication adherence was to build trusting relationships with patients while listening to and interpreting their needs and concerns. Respondents also rated this as the most effective strategy that they used (48%). Nurses are highly aware of adherence issues faced by their patients; further patient

  6. Cross Sectional Survey of Influenza Antibodies before and during the 2009 Pandemic in Shenzhen, China

    PubMed Central

    Lv, Xing; Chen, Ying; Kung, Hsiang-fu; Zee, Benny; Cheng, Xiao-wen; He, Ming-Liang

    2013-01-01

    Much information is available for the 2009 H1N1 influenza immunity response, but little is known about the antibody change in seasonal influenza before and during the novel influenza A pandemic. In this study, we conducted a cross-sectional serological survey of 4 types of major seasonal influenza in March and September 2009 on a full range of age groups, to investigate seasonal influenza immunity response before and during the outbreak of the sH1N1 influenza in Shenzhen – the largest migration city in China. We found that the 0–5 age group had an increased antibody level for all types of seasonal influenza during the pandemic compared to the pre-outbreak level, in contrast with almost all other age groups, in which the antibody level decreased. Also, distinct from the antibodies of A/H3N2, B/Yamagata and B/Victoria that decreased significantly during the 2009 H1N1 pandemic, the antibody of A/H1N1 showed no statistical difference from the pre-outbreak level. The results suggest that the antibodies against the 2009 sH1N1 cross-reacted with seasonal H1N1. Moreover, the 0–5 age group was under attack by both seasonal and 2009 H1N1 influenza during the pandemic, hence vaccination merely against a new strain of flu might not be enough to protect the youngest group. PMID:23382854

  7. Nurses' perceptions of pain assessment and management practices in neonates: a cross-sectional survey.

    PubMed

    Pölkki, Tarja; Korhonen, Anne; Laukkala, Helena

    2017-08-22

    This study aimed to describe pain assessment and management practices for neonates based on nurses' perceptions in neonatal intensive care units (NICUs). A descriptive cross-sectional survey was conducted in Finland. Of all nurses (N = 422) working in the NICUs in the country's five university hospitals, 294 responded to a questionnaire. The data were analysed by statistical methods. Nurses agreed that pain assessment is important, but over half of them reported being able to assess pain in a reliable way without using pain assessment scales. Physiological parameters and changes in neonate's behaviour were reported as routinely observed, but many specific facial expressions indicative of pain were less often observed. Only a few pain assessment scales were known, and they were not routinely used in clinical practice. Most nurses reported using physical methods and giving oral sucrose along with non-nutritive sucking. Counselling parents to continue breastfeeding or guiding them to use skin-to-skin care or music was rarely reported as used to alleviate infants' pain. Educational interventions for nurses are needed to improve pain assessment and management practices in the NICUs. In addition, there is a need for national guidelines in order to ensure the equal treatment to all neonates. © 2017 Nordic College of Caring Science.

  8. Laparoscopic simulation training in gynaecology: Current provision and staff attitudes - a cross-sectional survey.

    PubMed

    Burden, Christy; Fox, Robert; Hinshaw, Kim; Draycott, Timothy J; James, Mark

    2016-01-01

    The objectives of this study were to explore current provision of laparoscopic simulation training, and to determine attitudes of trainers and trainees to the role of simulators in surgical training across the UK. An anonymous cross-sectional survey with cluster sampling was developed and circulated. All Royal College of Obstetricians and Gynaecologists (RCOG) Training Programme Directors (TPD), College Tutors (RCT) and Trainee representatives (TR) across the UK were invited to participate. One hundred and ninety-six obstetricians and gynaecologists participated. Sixty-three percent of hospitals had at least one box trainer, and 14.6% had least one virtual-reality simulator. Only 9.3% and 3.6% stated that trainees used a structured curriculum on box and virtual-reality simulators, respectively. Respondents working in a Large/Teaching hospital (p = 0.008) were more likely to agree that simulators enhance surgical training. Eighty-nine percent agreed that simulators improve the quality of training, and should be mandatory or desirable for junior trainees. Consultants (p = 0.003) and respondents over 40 years (p = 0.011) were more likely to hold that a simulation test should be undertaken before live operation. Our data demonstrated, therefore, that availability of laparoscopic simulators is inconsistent, with limited use of mandatory structured curricula. In contrast, both trainers and trainees recognise a need for greater use of laparoscopic simulation for surgical training.

  9. Cross-sectional survey of the disaster preparedness of nurses across the Asia-Pacific region.

    PubMed

    Usher, Kim; Mills, Jane; West, Caryn; Casella, Evan; Dorji, Passang; Guo, Aimin; Koy, Virya; Pego, George; Phanpaseuth, Souksavanh; Phouthavong, Olaphim; Sayami, Jamuna; Lak, Muy Seang; Sio, Alison; Ullah, Mohammad Mofiz; Sheng, Yu; Zang, Yuli; Buettner, Petra; Woods, Cindy

    2015-12-01

    Healthcare workers who have received disaster preparedness education are more likely to report a greater understanding of disaster preparedness. However, research indicates that current nursing curricula do not adequately prepare nurses to respond to disasters. This is the first study to assess Asia-Pacific nurses' perceptions about their level of disaster knowledge, skills, and preparedness. A cross-sectional survey was conducted with 757 hospital and community nurses in seven Asia-Pacific countries. Data were collected using the modified Disaster Preparedness Evaluation Tool. Participants were found to have overall low-to-moderate levels of disaster knowledge, skills and preparedness, wherein important gaps were identified. A majority of the variance in disaster preparedness scores was located at the level of the individual respondent, not linked to countries or institutions. Multilevel random effects modelling identified disaster experience and education as significant factors of positive perceptions of disaster knowledge, skills, and management. The first step toward disaster preparedness is to ensure frontline health workers are able to respond effectively to disaster events. The outcomes of this study have important policy and education implications.

  10. Intimate partner violence and socioeconomic deprivation in England: findings from a national cross-sectional survey.

    PubMed

    Khalifeh, Hind; Hargreaves, James; Howard, Louise M; Birdthistle, Isolde

    2013-03-01

    We examined the prevalence of intimate partner violence (IPV) and its association with social deprivation in England. We used multivariable logistic regression to investigate IPV correlates among 21 226 men and women aged 16 to 59 years in the 2008 nationally representative cross-sectional British Crime Survey. Lifetime IPV was reported by 23.8% of women and 11.5% of men. Physical IPV was reported by 16.8% and 7.0%, respectively; emotional-only IPV was reported by 5.8% and 4.2%, respectively. After adjustment for demographic confounders, lifetime physical IPV experienced by women was associated with social housing tenure (odds ratio [OR] = 2.3; 95% confidence interval [CI] = 2.0, 2.7), low household income (OR = 2.2; 95% CI = 1.8, 2.7), poor educational attainment (OR = 1.2; 95% CI = 1.0, 1.5), low social class (OR = 1.5; 95% CI = 0.3, 1.7), and living in a multiply deprived area (OR = 1.4; 95% CI = 1.1, 1.7). Physical IPV experienced by men and emotional IPV experienced by either gender were generally not associated with deprivation factors. Physical and emotional IPV are very common among adults in England. Emotional IPV prevention policies may be appropriate across the social spectrum; those for physical IPV should be particularly accessible to disadvantaged women.

  11. Cross-sectional survey of Good Samaritan behaviour by physicians in North Carolina

    PubMed Central

    Garneau, William M; Harris, Dean M; Viera, Anthony J

    2016-01-01

    Objective To assess the responses of physicians to providing emergency medical assistance outside of routine clinical care. We assessed the percentage who reported previous Good Samaritan behaviour, their responses to hypothetical situations, their comfort providing specific interventions and the most likely reason they would not intervene. Setting Physicians residing in North Carolina. Participants Convenience sample of 1000 licensed physicians. Intervention Mailed survey. Design Cross-sectional study conducted May 2015 to September 2015. Main outcome and measures Willingness of physicians to act as Good Samaritans as determined by the last opportunity to intervene in an out-of-office emergency. Results The adjusted response rate was 26.1% (253/970 delivered). 4 out of 5 physicians reported previous opportunities to act as Good Samaritans. Approximately, 93% reported acting as a Good Samaritan during their last opportunity. There were no differences in this outcome between sexes, practice setting, specialty type or experience level. Doctors with greater perceived knowledge of Good Samaritan law were more likely to have intervened during a recent opportunity (p=0.02). The most commonly cited reason for potentially not intervening was that another health provider had taken charge. Conclusions We found the frequency of Good Samaritan behaviour among physicians to be much higher than reported in previous studies. Greater helping behaviour was exhibited by those who expressed more familiarity with Good Samaritan law. These findings suggest that physicians may respond to legal protections. PMID:26966061

  12. Cross-Sectional Survey on Quitting Attempts among Adolescent Smokers in Dharan, Eastern Nepal

    PubMed Central

    Marahatta, Kedar

    2016-01-01

    Background. Adolescents frequently attempt smoking cessation but are unable to maintain long term abstinence because they are dependent on nicotine and experience withdrawal symptoms. Objectives. This study aimed to explore the quitting attempts among adolescent smokers in Dharan Municipality of Eastern Nepal. Methods. A cross-sectional study was conducted using pretested self-administered questionnaire adapted from Global Youth Tobacco Survey to assess current smokers and quitting attempts among 1312 adolescent students in middle (14-15 years) and late adolescence (16–19 years). Chi square test was used for association of various factors with quitting attempts. Results. The prevalence of current smoking was 13.7%. Among the current smokers, 66.5% had attempted to quit in the past because they believed smoking was harmful to health (35.5%). The median duration of quitting was 150 days. Nearly 8% of the current smokers were unwilling to quit in the future because they thought it is already a habit (60%). Smokers who are willing to quit smoking in the future were more likely to have made quitting attempts (OR = 1.36, 95% CI = 0.40–4.45). Conclusion. Relapse often occurs even after multiple quitting attempts. Tobacco focused interventions to support abstinence are important during adolescence to prevent habituation. PMID:27747130

  13. Current dilemmas of nursing homes in Chengdu: a cross-sectional survey.

    PubMed

    Hao, Qiukui; Wu, Shiying; Ying, Li; Luo, Li; Dong, Dingwen; Dong, Birong

    2012-05-01

    Chengdu, China, is facing challenges from the growth of the elderly population. There are nursing homes in Chengdu, but there is no study on the current status of these nursing homes and their residents. The present study was conducted to investigate the current situation of nursing homes in Chengdu. This cross-sectional study randomly selected 10 nursing agencies from the 110 agencies in Chengdu (5 main zones and districts) using a cluster random sampling method. Descriptive statistics were used to analyze the data. Ten agencies (10%) were surveyed: 5 government-run social welfare, 2 collective run, and 3 private institutions. The basic service in the nursing home includes personal care, basic medical care, room cleaning, meals, and laundry. Standard setting, assessment, rehabilitation therapy, and some equipment and volunteer service monitoring are inadequate. Most care staff receive little training in elder care. Some have no qualified certification and they have low income, heavy work, and insufficient knowledge. The whole team has a high mobility. Nursing homes in Chengdu are at a lower level than those in developed countries. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

  14. Quantifying the utility of taking pills for preventing adverse health outcomes: a cross-sectional survey

    PubMed Central

    Hutchins, Robert; Pignone, Michael P; Sheridan, Stacey L; Viera, Anthony J

    2015-01-01

    Objectives The utility value attributed to taking pills for prevention can have a major effect on the cost-effectiveness of interventions, but few published studies have systematically quantified this value. We sought to quantify the utility value of taking pills used for prevention of cardiovascular disease (CVD). Design Cross-sectional survey. Setting Central North Carolina. Participants 708 healthcare employees aged 18 years and older. Primary and secondary outcomes Utility values for taking 1 pill/day, assessed using time trade-off, modified standard gamble and willingness-to-pay methods. Results Mean age of respondents was 43 years (19–74). The majority of the respondents were female (83%) and Caucasian (80%). Most (80%) took at least 2 pills/day. Mean utility values for taking 1 pill/day using the time trade-off method were: 0.9972 (95% CI 0.9962 to 0.9980). Values derived from the standard gamble and willingness-to-pay methods were 0.9967 (0.9954 to 0.9979) and 0.9989 (95% CI 0.9986 to 0.9991), respectively. Utility values varied little across characteristics such as age, sex, race, education level or number of pills taken per day. Conclusions The utility value of taking pills daily in order to prevent an adverse CVD health outcome is approximately 0.997. PMID:25967985

  15. Post-market clinical research conducted by medical device manufacturers: a cross-sectional survey

    PubMed Central

    Ross, Joseph S; Blount, Katrina L; Ritchie, Jessica D; Hodshon, Beth; Krumholz, Harlan M

    2015-01-01

    Background In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA) to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA’s pre-market approval (PMA) pathway. Methods and results We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%), nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Conclusion Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives. PMID:26060416

  16. German medical students' exposure and attitudes toward pharmaceutical promotion: a cross-sectional survey.

    PubMed

    Jahnke, Kristine; Kremer, Marcel Stephan; Schmidt, Carsten Oliver; Kochen, Michael M; Chenot, Jean-François

    2014-01-01

    Early contact of medical students with pharmaceutical promotion has been shown in many international studies. We assessed the frequency and places of contact of German medical students to pharmaceutical promotion and examined their attitudes toward pharmaceutical promotional activities. This cross-sectional survey was based on a self-developed questionnaire. It was distributed to all clinical students at the University of Goettingen Medical School in 2010. A 4-point rating scale was used to assess the attitudes toward different statements regarding pharmaceutical promotion. The overall response rate was 55% (702/1287). The proportion of students with direct contact to pharmaceutical sales representatives increased from 21% in the first clinical year up to 77% in the final year. 60% were contacted during their elective clerkship. 80% had accepted promotional gifts. 86% stated their prescribing behavior to be unsusceptible to the influence of accepting promotional gifts. However, 35% of the unsusceptible students assumed doctors to be susceptible. Almost all (90%) reported that dealing with pharmaceutical promotion was never addressed during lectures and 65% did not feel well prepared for interactions with the pharmaceutical industry. 19% agreed to prohibit contacts between medical students and the pharmaceutical industry. German medical students get in contact with pharmaceutical promotion early and frequently. There is limited awareness for associated conflicts of interests. Medical schools need to regulate contacts and incorporate the topic in their curriculum to prepare students for interactions with the pharmaceutical industry.

  17. A Cross-Sectional Survey on Older Adults' Community Mobility in an Indian Metropolis.

    PubMed

    Ramachandran, Meena; D'Souza, Sebestina A

    2016-03-01

    Community mobility supports occupational participation among older adults and promotes active ageing. This study aimed to explore community mobility of older adults within an urban Indian context in view of the limited available literature in this area. A cross-sectional survey was conducted on a convenience sample of 75 older adults residing in Chennai city using a questionnaire and a non-retrospective, open format, two-day time diary. Participants engaged in community mobility and activities outside home for 10% of time over two days. Activities and roles related to religious and spiritual activities and expression, social participation, leisure and informal personal education participation occupied most time and were engaged in most frequently. Walking was the most frequently used mode of transportation and participants reported numerous road-related hazards (lack of proper pavements, disobedience of traffic rules, difficulty crossing roads, crowded roads, and poor condition of roads). Participants used public transport less often. Public transport-related barriers (difficulty boarding and alighting buses/trains due to high steps/insufficient time, inadequate seat reservation for older adults, overcrowding and increased expense on auto rickshaws/taxis) were also expressed as concerns. Participants linked their ability to use public transport with independence and assigned relatively less value to driving. The findings emphasize the significance of community mobility to promote participation in older adults and recommend age-friendly environments in Indian cities.

  18. Understanding and predicting social media use among community health center patients: a cross-sectional survey.

    PubMed

    Hanson, Carl L; West, Josh; Thackeray, Rosemary; Barnes, Michael D; Downey, Jordan

    2014-11-26

    The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. The aim was to determine the use and factors predicting the use of social media for health care-related purposes among medically underserved primary care patients. A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Understanding use and factors predicting use can increase adoption and utilization of social media for health care-related purposes among underserved patients in community health centers.

  19. Physicians' knowledge about ionizing radiation and radiological imaging techniques: a cross-sectional survey.

    PubMed

    Yucel, Aylin; Alyesil, Cansu; Sim, Saadet

    2011-06-01

    Radiological examinations are critical for the evaluation of many disorders in daily practice. To determine the knowledge of ionizing radiation and radiological imaging techniques among physicians of various grades. A cross-sectional survey was carried out of 55 physicians with a mean age of 35.7 ± 6.0 years (age range 25-52 years) in a university hospital. A questionnaire which tested physicians' information about ionizing radiation and their risks was distributed by medical school students. Among the participants, 32 (58.2%) were consultants and 23 (41.8%) were residents. The mean score was 68.2 ± 11.1 (range 37.8-91.8) out of 100. Consultants' points were lower than residents (p = 0.040). Consultants had significantly higher frequency of incorrect answer than residents in the question about 'whether CT scan increases lifetime cancer risk' (p = 0.036). Medical practices in years do not enhance the level of the awareness regarding the ionizing radiation.

  20. Attitudes toward organ donation among waitlisted transplant patients: results of a cross-sectional survey.

    PubMed

    Merola, Jonathan; Pei, Kevin Y; Rodriguez-Davalos, Manuel I; Gan, Geliang; Deng, Yanhong; Mulligan, David C; Davis, Kimberly A

    2016-11-01

    Organ shortage remains a major barrier to transplantation. While many efforts have focused on educating the general population regarding donation, few studies have examined knowledge regarding donation and donor registration rates among waitlisted candidates. We aimed to determine waitlisted patients' willingness to donate, elucidate attitudes surrounding organ allocation, and identify barriers to donation. A cross-sectional survey was distributed to assess demographics, knowledge regarding organ donation, and attitudes regarding the allocation process. Responses from 225 of 579 (39%) waitlisted patients were collected. Seventy-one respondents (32%) were registered donors, while 64 patients (28%) noted no interest in participating in donation. A total of 19% of respondents felt their medical treatment would change by being a donor, while 86 patients (38%) felt their condition precluded them from donation. Forty patients (18%) felt they should be prioritized on the waitlist if they agreed to donate. A minority of patients (28%) reported discussion of organ donation with their physician. Waitlisted candidates constitute a population of willing, although often unregistered, organ donors. Moreover, many endorse misconceptions regarding the allocation process and their donation eligibility. In a population for which transplantation is not always possible, education is needed regarding organ donation among waitlisted patients, as this may enhance donation rates.

  1. A cross-sectional survey on consequences of nurses' burnout: moderating role of organizational politics.

    PubMed

    Basar, Ufuk; Basim, Nejat

    2016-08-01

    The aim of the study was to assess whether perceptions of organizational politics (defined as self-serving behaviours at the expense of others) influence the prospective associations between nurses' burnout and its consequences, namely, intention to quit and neglect of work. Researchers have previously investigated relationships between nurses' burnout, intention to quit, neglect of work and perceptions of organizational politics in different research models and from different perspectives. As far as we know, no studies have considered whether nurses' perceptions of organizational politics moderate the influence of burnout. A cross-sectional survey using self-report questionnaires. Data were collected by questionnaire from a sample of 456 nurses from six private hospitals in Ankara, Turkey in March 2015. Four different previously designed scales were used to measure research variables (burnout, intention to quit, neglect of work and perceptions of organizational politics). Following confirmatory validity and reliability analyses of data collection instruments, descriptive statistics for each research variable were analysed. Structural regression models were created to assess relationships among variables. Burnout resulted in intention to quit and neglect. Intention to quit partially mediated the association between burnout and neglect. Burnout gave rise to intention to quit slightly more strongly in nurses who had greater perceptions of organizational politics. This study uncovers and emphasizes the moderating role of perceptions of organizational politics in consequences of burnout. This may help hospital managers and nurses to improve costs, efficiency, satisfaction and productivity. © 2016 John Wiley & Sons Ltd.

  2. Orthopaedic nurses' attitudes towards clinical nursing research - A cross-sectional survey.

    PubMed

    Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

    2015-05-01

    The call for evidence-based knowledge in clinical nursing practice has increased during recent decades and research in orthopaedic nursing is needed to improve patients' conditions, care and treatment. A descriptive cross-sectional survey was conducted to determine the self-perceived theoretical knowledge and practical research competencies among orthopaedic nurses and their interest and motivation to increase these in everyday practice. A newly developed questionnaire was given to a convenience sample of 87 orthopaedic nurses. Forty three orthopaedic nurses (49.4%) completed the questionnaire. The results indicated that despite the majority of orthopaedic nurses having low self-perceived theoretical knowledge and practical research competencies, their interest and motivation to improve these were high, especially their inner motivation. However, the nurses' inner motivation was inhibited by a lack of acceptance from colleagues and section head nurses and a shortage of time. This study forms a baseline as a part of a larger study and contributes knowledge useful to other orthopaedic departments with an interest in optimizing nursing research to improve orthopaedic nursing care quality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Tobacco marketing and susceptibility to smoking: cross-sectional survey of Polish children.

    PubMed

    Maruska, Karin; Isensee, Barbara; Florek, Ewa; Hanewinkel, Reiner

    2012-01-01

    Susceptibility to smoking has been identified as predictor of smoking onset in adolescence. Aim of the study was to investigate whether receptivity to tobacco marketing, for which a link to adolescent smoking already could be shownin the past, was also associated with susceptibility to smoking. A cross-sectional survey of 1,478 Polish students who reported having never smoked wasconducted. Mean age was 10.1 years and about 53.3% were female. Overall, 84 (5.7%) students were classifiedas susceptible to smoking, and 33 (2.3%) were considered as receptiveto tobacco marketing, operationalised by asking students to name a brand of their favourite cigarette advertisement. Crude logistic regression analyses as well as logistic regression analyses adjusting for socio-demographic characteristics, personality characteristics, factors of social influence and smoking-related cognitions revealed a positive association between receptivity to tobacco marketing and susceptibility to smoking (adjusted odds ratio=3.49 [95% confidence interval: 1.28-9.46], p=0.014). In conclusion, this study revealed that receptivityto tobacco marketing increases susceptibility to smoking. Results providesupport for the almost comprehensive ban of tobacco marketing as existing in Poland and recommend its further expansion towards a total ban including e.g. ban of promotion at point of sale.

  4. Optimal communication from occupational physicians to GPs: a cross-sectional survey.

    PubMed

    Stern, Anna F; Madan, Ira

    2012-12-01

    Correspondence from occupational physicians to GPs is infrequent, despite evidence that good communication leads to earlier return to work of sick-listed patients and is cost effective. To explore the circumstances, content, and preferred method of communication GPs would value from an occupational physician, following an occupational health consultation with one of their patients. A cross-sectional survey in the UK. A questionnaire was developed de novo, piloted, and sent to 600 GPs of consecutive employees undergoing occupational physician assessments. Descriptive data were generated using Excel. The response rate was 374/600 (62%). Demographic features of GP responders reflected national figures. A total of 372 (99.5%) GPs wanted information from occupational physicians. Most wanted information on diagnosis (303, 81%), clinical assessment (275, 74%), functional assessment (295, 79%), or advice on the timing (308, 82%) and adjustments 290 (78%) of any return-to-work plan. Over 80% wanted information following every occupational physician consultation, and over 90% wanted information on the timing of a return to work, adjustments suggested, or if different medical diagnosis or management was suggested. The preferred method of communication was letter by post 341/374 (92%). Brief, relevant information was valued and considered useful for completing 'fit notes'. Occupational physicians should send formal letters, by post, to the patient's GP following occupational health assessments. This would assist the GP in completing the patient's 'fit note' and ultimately increase the chances of their patient being rehabilitated back to work.

  5. West Nile Virus Seroprevalence in the Greek Population in 2013: A Nationwide Cross-Sectional Survey

    PubMed Central

    Hadjichristodoulou, Christos; Pournaras, Spyros; Mavrouli, Maria; Marka, Andriani; Tserkezou, Persefoni; Baka, Agoritsa; Billinis, Charalambos; Katsioulis, Antonios; Psaroulaki, Anna; Papa, Anna; Papadopoulos, Nikos; Mamuris, Zissis; Tsakris, Athanasios; Kremastinou, Jenny

    2015-01-01

    Cases of West Nile Virus (WNV) disease were recorded for three consecutive years in Greece following the year 2010 outbreak. A cross-sectional serologic survey was conducted to estimate the WNV seroprevalence and assess the ratio of infection to neuroinvasive disease. A stratified left-over sampling methodology was used including age and residence strata. A total of 3,962 serum samples was collected and tested for WNV Immunoglobulin G (IgG) antibodies by Enzyme–Linked Immunosorbent Assay (ELISA). All positive samples were further tested by Plaque Reduction Neutralization Test (PRNT) and WNV Immunoglobulin M (IgM) antibodies. WNV IgG antibodies were detected in 82 samples and 61 were also positive in PRNT representing a weighted seroprevalence of 2.1% (95% C.I.: 1.7–2.6) and 1.5% (95% C.I.: 1.2–2.0), respectively. Multivariable analysis showed that seroprevalence was associated with age and residence. The overall ratio of neuroinvasive disease to infected persons was estimated at 1:376 (95% C.I.: 1:421–1:338), while the elderly people had the highest ratio. This nationwide study provided valuable data regarding the epidemiology of WNV in Greece based on the fact that elderly people have higher risk of being both infected and having severe disease. PMID:26605539

  6. Determinants of sleep quality among pregnant women in China: a cross-sectional survey.

    PubMed

    Yang, Ying; Mao, Jing; Ye, Zhiying; Zeng, Xiaoli; Zhao, Huimin; Liu, Yueting; Li, Jie

    2017-08-03

    Sleep disturbances are common during pregnancy, yet few studies are currently available regarding the determinants of sleep quality among pregnant women in China. This study aimed to: (a) calculate the prevalence of sleep disorder during pregnancy, (b) examine the difference in sleep quality among three trimesters, and (c) identify determinants of sleep quality in pregnant women. This study was designed as a cross-sectional survey. Five hundred pregnant women were recruited at the outpatient department of obstetrics and gynecology of two teaching hospitals in central China. Five selfreport questionnaires were used for gathering data, including information of sample characteristics, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), prenatal depression (the Edinburgh Postnatal Depression Scale (EPDS)), perceived stress (Perceived Stress Scale (PSS)), and perceived social support (Multidimensional Scale of Perceived Social Support (MSPSS)). A total of 454 pregnant women participated in the study between September 2016 and April 2017. Eighty-seven percent pregnant women experienced sleep disorder (PSQI score >5). Poorer global sleep quality, subjective sleep quality, lower sleep efficiency and sleep disturbances were most prevalent during third trimester. The significant contributors to sleep quality for pregnant women were prenatal depression, maternal age, and gestational age. Sleep disorder is very common in pregnant women from China. Depressive symptoms, increased maternal age, and gestational age are determinants of sleep quality. These determinants can assist healthcare professionals in preventative intervention.

  7. Stress and psychosomatic symptoms in Chinese school children: cross-sectional survey.

    PubMed

    Hesketh, Therese; Zhen, Yan; Lu, Li; Dong, Zhou Xu; Jun, Ye Xu; Xing, Zhu Wei

    2010-02-01

    The Chinese educational system is highly competitive from the start of primary school with great emphasis on academic performance and intolerance of failure. This study aimed to explore the pressures on primary schoolchildren, and to determine the relationship between these pressures and psychosomatic symptoms: abdominal pain and headache. Cross-sectional survey using self-completion questionnaires. 9- to 12-year-olds in primary schools in urban and rural areas of Zhejiang Province, eastern China. Proportion of children with defined school-related stressors and frequency of psychosomatic illness. Completed questionnaires were obtained from 2191 children. All stressors were common in boys and girls and in urban and rural schools. Eighty-one per cent worry 'a lot' about exams, 63% are afraid of the punishment of teachers, 44% had been physically bullied at least sometimes, with boys more often victims of bullying, and 73% of children are physically punished by parents. Over one-third of children reported psychosomatic symptoms at least once per week, 37% headache and 36% abdominal pain. All individual stressors were highly significantly associated with psychosomatic symptoms. Children identified as highly stressed (in the highest quartile of the stress score) were four times as likely to have psychosomatic symptoms. The competitive and punitive educational environment leads to high levels of stress and psychosomatic symptoms in Chinese primary schoolchildren. Measures to reduce unnecessary stress on children in schools should be introduced urgently.

  8. Cross-Sectional Survey on Newborn Screening in Wisconsin Amish and Mennonite Communities

    PubMed Central

    Sieren, Shelby; Grow, Meghan; GoodSmith, Matthew; Spicer, Gretchen; Deline, James; Zhao, Qianqian; Lindstrom, Mary J.; Harris, Anne Bradford; Rohan, Angela M.; Seroogy, Christine M.

    2015-01-01

    Old order Amish and Mennonites, or Plain populations, are a growing minority in North America with unique health care delivery and access challenges coupled with higher frequencies of genetic disorders. The objective of this study was to determine newborn screening use and attitudes from western Wisconsin Plain communities. A cross-sectional survey, with an overall response rate of 25%, provided data representing 2,010 children. In households with children (n=297), the rate of newborn screening was 74% and all children were screened in 40% of these households. Lack of access to testing was the most common reason for not screening all children and parental age was inversely associated with testing. The majority of respondents reported some or more knowledge of screening, viewed screening as important, and had access to screening in their communities. Households with children who had never received newborn screening (26%) reported lower frequencies of favorable responses in all categories compared to households that had at least one child screened. The difference in access to newborn screening was less marked between the groups compared to differences on knowledge and consideration of its importance. Moreover, 55% of households who had never screened any of their children reported being unlikely or unsure of screening any future children. A focus on improving access to newborn screening alongside establishing approaches to change parental perceptions on the importance of newborn screening is necessary for increasing newborn screening in these Plain communities. PMID:26433724

  9. Cross-Sectional Survey on Newborn Screening in Wisconsin Amish and Mennonite Communities.

    PubMed

    Sieren, Shelby; Grow, Meghan; GoodSmith, Matthew; Spicer, Gretchen; Deline, James; Zhao, Qianqian; Lindstrom, Mary J; Harris, Anne Bradford; Rohan, Angela M; Seroogy, Christine M

    2016-04-01

    Old Order Amish and Mennonites, or Plain populations, are a growing minority in North America with unique health care delivery and access challenges coupled with higher frequencies of genetic disorders. The objective of this study was to determine newborn screening use and attitudes from western Wisconsin Plain communities. A cross-sectional survey, with an overall response rate of 25 %, provided data representing 2010 children. In households with children (n = 297), the rate of newborn screening was 74 % and all children were screened in 40 % of these households. Lack of access to testing was the most common reason for not screening all children and parental age was inversely associated with testing. The majority of respondents reported some or more knowledge of screening, viewed screening as important, and had access to screening in their communities. Households with children who had never received newborn screening (26 %) reported lower frequencies of favorable responses in all categories compared to households that had at least one child screened. The difference in access to newborn screening was less marked between the groups compared to differences on knowledge and consideration of its importance. Moreover, 55 % of households who had never screened any of their children reported being unlikely or unsure of screening any future children. A focus on improving access to newborn screening alongside establishing approaches to change parental perceptions on the importance of newborn screening is necessary for increasing newborn screening in these Plain communities.

  10. Socioeconomic Status and Health Communication Inequalities in Japan: A Nationwide Cross-Sectional Survey

    PubMed Central

    Ishikawa, Yoshiki; Nishiuchi, Hiromu; Hayashi, Hana; Viswanath, Kasisomayajula

    2012-01-01

    Background Considerable evidence suggests that communication inequality is one potential mechanism linking social determinants, particularly socioeconomic status, and health inequalities. This study aimed to examine how dimensions of health communication outcomes (health information seeking, self-efficacy, exposure, and trust) are patterned by socioeconomic status in Japan. Methods Data of a nationally representative cross-sectional survey of 2,455 people aged 15–75 years in Japan were used for secondary analysis. Measures included socio-demographic characteristics, subjective health, recent health information seeking, self-efficacy in seeking health information, and exposure to and trust in health information from different media. Results A total of 1,311 participants completed the questionnaire, giving a response rate of 53.6%. Multivariate logistic regression revealed that education and household income, but not employment, were significantly associated with health information seeking and self-efficacy. Socioeconomic status was not associated with exposure to and trust in health information from mass media, but was significantly associated with health information from healthcare providers and the Internet. Conclusion Health communication outcomes were patterned by socioeconomic status in Japan thus demonstrating the prevalence of health communication inequalities. Providing customized exposure to and enhancing the quality of health information by considering social determinants may contribute to addressing social disparities in health in Japan. PMID:22808229

  11. Social capital and antenatal depression among Chinese primiparas: A cross-sectional survey.

    PubMed

    Zhou, Chi; Ogihara, Atsushi; Chen, Hao; Wang, Weijue; Huang, Liu; Zhang, Baodan; Zhang, Xueni; Xu, Liangwen; Yang, Lei

    2017-08-24

    The aim of this study is to investigate the associations between social capital and antenatal depression among Chinese primiparas. A cross-sectional design was used and a questionnaire survey was conducted with 1471 participants using the intercept method at the provincial hospital in Zhejiang in 2016. Antenatal depression was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) and social capital was assessed by the Chinese version of Social Capital Assessment Questionnaire (C-SCAQ). The prevalence of antenatal depression was assessed among Chinese primiparas in their third trimesters. The antenatal depression prevalence among sub-groups with lower social trust (ST), social reciprocity (SR), social network (SN), and social participation (SP) were significantly higher than those among higher score sub-groups. In the fully adjusted model, primiparas' antenatal depression was significantly associated with ST, SR, SN, and SP. Compared to the structural social capital, the cognitive social capital was a more crucial dimension to the prevalence of antenatal depression. For future community pregnancy health care management programs in China, it might be beneficial to add more social capital related intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Attitudes of Mexican anesthesiologists to indicate preoperative fasting periods: A cross-sectional survey

    PubMed Central

    Ramírez-Mora, Juan Carlos; Moyao-García, Diana; Nava-Ocampo, Alejandro A

    2002-01-01

    Background In Mexico, guidelines for fasting periods, or any audits on this topic are unavailable, and therefore the attitudes of anesthesiologists for recommending preoperative fasting periods are unknown. Material and methods The study was a cross-sectional survey of anesthesiologists subscribed to the Annual Updated Course, organized by the Sociedad Mexicana de Anestesiologia in 2000. The response rate was 31.4%. Results Most respondents were general anesthesiologists, with 5 or more years experience in a clinical post, were working in both public and private hospitals, and were performing anesthetic procedures on both pediatric and adult patients and in both ambulatory and hospitalized patients. Approximately 23% of the respondents considered natural fruit juices to be clear liquids. For a pediatric patient ingesting breast milk 1 h before undergoing a surgical procedure, 45% thought that surgery should be delayed for 3h, followed by those delaying the surgical procedure for 6 to 8 h. Our results show that more than 50% of the anesthesiologists had better defined attitudes for fasting milk and clear liquids in patients of 6 month or under than for older children and adults. However, due to the poor definition or pre-operative fasting, using clear liquids, in all other patient groups, several patients are allowed to go without oral clear liquids administration for prolonged periods. Conclusion Preoperative fasting periods recommended by Mexican anesthesiologists differ from international guidelines. PMID:12019024

  13. Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey.

    PubMed

    Keyvanara, Mahmoud; Sajadi, Haniye Sadat

    2015-02-12

    Changes in modern societies develop the perception that the external environment is essential in organization's practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. The mean score of hospitals' social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals' ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals' social responsibility level, especially through concentrating on their staff's working environment. © 2015 by Kerman University of Medical Sciences.

  14. Post-market clinical research conducted by medical device manufacturers: a cross-sectional survey.

    PubMed

    Ross, Joseph S; Blount, Katrina L; Ritchie, Jessica D; Hodshon, Beth; Krumholz, Harlan M

    2015-01-01

    In the US, once a medical device is made available for use, several requirements have been established by the US Food and Drug Administration (FDA) to ensure ongoing post-market surveillance of device safety and effectiveness. Our objective was to determine how commonly medical device manufacturers initiate post-market clinical studies or augment FDA post-market surveillance requirements for higher-risk devices that are most often approved via the FDA's pre-market approval (PMA) pathway. We conducted a cross-sectional survey of 47 manufacturers with operations in California, Minnesota, and Massachusetts who market devices approved via the PMA pathway. Among 22 respondents (response rate =47%), nearly all self-reported conducting post-market clinical research studies, commonly between 1 and 5; only 1 respondent reported never conducting post-market clinical research studies. While manufacturers most often engaged in these studies to satisfy FDA requirements, other reasons were reported, including performance monitoring and surveillance and market acceptance initiatives. Risks of conducting and not conducting post-market clinical research studies were described through open-ended response to questions. Medical device manufacturers commonly initiate post-market clinical studies at the request of the FDA. Clinical data from these studies should be integrated into national post-market surveillance initiatives.

  15. Child obesity service provision: a cross-sectional survey of physiotherapy practice trends and professional needs.

    PubMed

    Milne, Nikki; Choy, Nancy Low; Leong, Gary M; Hughes, Roger; Hing, Wayne

    2016-01-01

    This study explored current physiotherapy practice trends for management of children who are overweight or obese. The professional needs of physiotherapists working with this population were also assessed, including the perceived need for physiotherapy clinical guidelines for prevention and management of children with obesity. A cross-sectional survey design was used, with questionnaires purposefully distributed through 13 key physiotherapy services throughout Australia. Snowball sampling resulted in completed questionnaires from 64 physiotherapists who provided services to children. Half (n=33, 52%) of respondents provided services specifically to overweight or obese children. Of those providing services, one-quarter had prior training specific to working with this population. Most used multi-disciplinary models (n=16, 76%) and provided under 5h of obesity-related services each week (n=29, 88%). Half (n=16, 49%) used body mass index as an outcome measure but more (n=25, 76%) used bodyweight. Only 14 (42%) assessed motor skills. The majority of respondents (n=57, 89%) indicated a need for physiotherapy guidelines to best manage overweight and obese children. Professional development priorities included: 'Educating children and families', 'Assessment methods' and 'Exercise prescription' for overweight and obese children. This data provides workforce intelligence to guide future professional training and inform development of clinical guidelines for physiotherapists in prevention and management of children with obesity and related chronic disease.

  16. Attitudes of Mexican anesthesiologists to indicate preoperative fasting periods: A cross-sectional survey.

    PubMed

    Ramírez-Mora, Juan; Moyao-García, Diana; Nava-Ocampo, Alejandro A

    2002-05-17

    BACKGROUND: In Mexico, guidelines for fasting periods, or any audits on this topic are unavailable, and therefore the attitudes of anesthesiologists for recommending preoperative fasting periods are unknown. MATERIAL AND METHODS: The study was a cross-sectional survey of anesthesiologists subscribed to the Annual Updated Course, organized by the Sociedad Mexicana de Anestesiologia in 2000. The response rate was 31.4%. RESULTS: Most respondents were general anesthesiologists, with 5 or more years experience in a clinical post, were working in both public and private hospitals, and were performing anesthetic procedures on both pediatric and adult patients and in both ambulatory and hospitalized patients. Approximately 23% of the respondents considered natural fruit juices to be clear liquids. For a pediatric patient ingesting breast milk 1 h before undergoing a surgical procedure, 45% thought that surgery should be delayed for 3h, followed by those delaying the surgical procedure for 6 to 8 h. Our results show that more than 50% of the anesthesiologists had better defined attitudes for fasting milk and clear liquids in patients of 6 month or under than for older children and adults. However, due to the poor definition or pre-operative fasting, using clear liquids, in all other patient groups, several patients are allowed to go without oral clear liquids administration for prolonged periods. CONCLUSION: Preoperative fasting periods recommended by Mexican anesthesiologists differ from international guidelines.

  17. [A Cross-sectional Study of School dropout in adolescents: National Mental Health Survey Colombia 2015].

    PubMed

    Gómez-Restrepo, Carlos; Padilla Muñoz, Andrea; Rincón, Carlos Javier

    2016-12-01

    School dropout in adolescents can have negative consequences, not only for the individual and the family, but also for the society. To identify the characteristics associated with the occurrence of this event might contribute to the planning of a prevention strategy. To evaluate the relationship between the individual and home characteristics and school dropout in adolescents from 12 to 17 years old in Colombia. A cross sectional study was conducted from information taken from the results obtained in the 2015 National Mental Health Survey. A study was made of the relationship between the individual and home characteristics and school dropout in adolescents from 12 to 17 years old RESULTS: A higher percentage of school dropouts was found in the older adolescents, females, and those who have children. Among the home characteristics, it was observed that those homes with more than two people, located in rural area, or that are classified as poor, have an increased percentage of school dropout adolescents. Strategies for which the main goal is to prevent school dropout should consider populations with higher prevalence of out-of-school adolescents (female, homes in rural area, or household poverty). Preventive actions of adolescent pregnancy might contribute to reduce the school dropout rate. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Critical care resources in the Solomon Islands: a cross-sectional survey.

    PubMed

    Westcott, Mia; Martiniuk, Alexandra Lc; Fowler, Robert A; Adhikari, Neill Kj; Dalipanda, Tenneth

    2012-03-01

    There are minimal data available on critical care case-mix, care processes and outcomes in lower and middle income countries (LMICs). The objectives of this paper were to gather data in the Solomon Islands in order to gain a better understanding of common presentations of critical illness, available hospital resources, and what resources would be helpful in improving the care of these patients in the future. This study used a mixed methods approach, including a cross sectional survey of respondents' opinions regarding critical care needs, ethnographic information and qualitative data. The four most common conditions leading to critical illness in the Solomon Islands are malaria, diseases of the respiratory system including pneumonia and influenza, diabetes mellitus and tuberculosis. Complications of surgery and trauma less frequently result in critical illness. Respondents emphasised the need for basic critical care resources in LMICs, including equipment such as oximeters and oxygen concentrators; greater access to medications and blood products; laboratory services; staff education; and the need for at least one national critical care facility. A large degree of critical illness in LMICs is likely due to inadequate resources for primary prevention and healthcare; however, for patients who fall through the net of prevention, there may be simple therapies and context-appropriate resources to mitigate the high burden of morbidity and mortality. Emphasis should be on the development and acquisition of simple and inexpensive tools rather than complicated equipment, to prevent critical care from unduly diverting resources away from other important parts of the health system.

  19. Cross sectional survey of perpetrators, victims, and witnesses of violence in Bogotá, Colombia

    PubMed Central

    Duque, L; Klevens, J; Ramirez, C

    2003-01-01

    Objectives: To establish the prevalence and distribution of witnesses, victims, and perpetrators of different types of violence in the general population and the proportion of victims consulting health services or reporting the incident to authorities. Methods: Cross sectional survey of a random sample of 3007 inhabitants between the ages of 15 and 60 in the city of Bogotá, Colombia, in 1997, based on a face to face interview. Results: Age adjusted past year prevalence of witnesses, victims, and perpetrators of physical aggression was 61%, 27%, and 27%, respectively, while lifetime prevalence of witnesses, victims, and perpetrators of assault with a weapon in this population reached 70%, 55%, and 5.8%. Between 11% and 67% of the victims consulted a health service and less than 32% reported the incident to an authority. Those involved in most types of physical violence tended to be young, male, from lower middle social classes, with some degree of secondary education, and single or divorced. Conclusions: Prevalence of witnesses and victims of violence in this sample appears to be high, while perpetrators constitute a small proportion. Violence is not equally distributed throughout the population suggesting the possibility of identifying a population at higher risk for the development of intervention programmes. PMID:12700220

  20. Cross sectional survey of perpetrators, victims, and witnesses of violence in Bogotá, Colombia.

    PubMed

    Duque, L F; Klevens, J; Ramirez, C

    2003-05-01

    To establish the prevalence and distribution of witnesses, victims, and perpetrators of different types of violence in the general population and the proportion of victims consulting health services or reporting the incident to authorities. Cross sectional survey of a random sample of 3007 inhabitants between the ages of 15 and 60 in the city of Bogotá, Colombia, in 1997, based on a face to face interview. Age adjusted past year prevalence of witnesses, victims, and perpetrators of physical aggression was 61%, 27%, and 27%, respectively, while lifetime prevalence of witnesses, victims, and perpetrators of assault with a weapon in this population reached 70%, 55%, and 5.8%. Between 11% and 67% of the victims consulted a health service and less than 32% reported the incident to an authority. Those involved in most types of physical violence tended to be young, male, from lower middle social classes, with some degree of secondary education, and single or divorced. Prevalence of witnesses and victims of violence in this sample appears to be high, while perpetrators constitute a small proportion. Violence is not equally distributed throughout the population suggesting the possibility of identifying a population at higher risk for the development of intervention programmes.

  1. The health of children in refuges for women victims of domestic violence: cross sectional descriptive survey.

    PubMed

    Webb, E; Shankleman, J; Evans, M R; Brooks, R

    2001-07-28

    To describe the health and developmental status of children living in refugees for women victims of domestic violence and to investigate their access to primary healthcare services. Cross sectional survey. Women's refugees in Cardiff. 148 resident children aged under 16 years and their mothers. Completeness of records on the child health system (register of all children that includes data on the child's health) for named health visitor, named general practitioner, and immunisation uptake; satisfactory completion of child health surveillance; Denver test results for developmental status; Rutter test scores for behavioural and emotional problems; reports of maternal concerns. 148/257 (58%) children living in refugee between April 1999 and January 2000 were assessed. Child health system data were incorrect (general practitioner and/or address) or unavailable for 85/148 (57%) children. Uptake of all assessments and immunisations was low. 13/68 (19%) children aged <5 years had delayed or questionable development on the Denver test, and 49/101 (49%) children aged 3-15 years had a Rutter score of >10 (indicating probable mental health problems). Concerns were expressed by mothers of 113/148 (76%) children. After leaving the refuge, 22 children were untraceable and 36 returned home to the perpetrator from whom the families had fled. The children had a high level of need, as well as poor access to services. Time spent in a refuge provides a window of opportunity to review health and developmental status. Specialist health visitors could facilitate and provide support, liaison, and follow up.

  2. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey.

    PubMed

    Thornicroft, Graham; Brohan, Elaine; Rose, Diana; Sartorius, Norman; Leese, Morven

    2009-01-31

    Many people with schizophrenia experience stigma caused by other people's knowledge, attitudes, and behaviour; this can lead to impoverishment, social marginalisation, and low quality of life. We aimed to describe the nature, direction, and severity of anticipated and experienced discrimination reported by people with schizophrenia. We did a cross-sectional survey in 27 countries, in centres affiliated to the INDIGO Research Network, by use of face-to-face interviews with 732 participants with schizophrenia. Discrimination was measured with the newly validated discrimination and stigma scale (DISC), which produces three subscores: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination. Negative discrimination was experienced by 344 (47%) of 729 participants in making or keeping friends, by 315 (43%) of 728 from family members, by 209 (29%) of 724 in finding a job, 215 (29%) of 730 in keeping a job, and by 196 (27%) of 724 in intimate or sexual relationships. Positive experienced discrimination was rare. Anticipated discrimination affected 469 (64%) in applying for work, training, or education and 402 (55%) looking for a close relationship; 526 (72%) felt the need to conceal their diagnosis. Over a third of participants anticipated discrimination for job seeking and close personal relationships when no discrimination was experienced. Rates of both anticipated and experienced discrimination are consistently high across countries among people with mental illness. Measures such as disability discrimination laws might, therefore, not be effective without interventions to improve self-esteem of people with mental illness.

  3. Temporomandibular Disorders and Related Factors in a Group of Iranian Adolescents: A Cross-sectional Survey

    PubMed Central

    Ebrahimi, Masoumeh; Dashti, Hossein; Mehrabkhani, Maryam; Arghavani, Mohammad; Daneshvar-Mozafari, Avideh

    2011-01-01

    Background and aims Temporomandibular disorders (TMDs) are the most common condition affecting the tem-poromandibular joint and associated structures. The aim of this study was the epidemiologic evaluation of TMDs and re-lated factors in a group of Iranian adolescents. Materials and methods This descriptive cross-sectional survey included a sample of800 high school students (400 girls and 400 boys) aged 14 to18 years, in Mashhad, Iran, selected using cluster sampling. Examiners completed question-naires and performed the clinical examinations. Data were analyzed with the Chi-square and Fisher exact tests. Results The prevalence of TMDs in the studied sample was 34.7%. The most common signs of TMDs were clicking, muscle tenderness and TMJ tenderness. The most prevalent predisposing factors of TMDs were clenching, premature con-tact in protrusive movement and bruxism. A clear predominance was seen in girls (40.5%) compared with boys (29%) (P = 0.001). Conclusion Signs and symptoms of TMDs were prevalent in Iranian adolescents with a clear female predominance. PMID:22991620

  4. Risk factors for trachomatous trichiasis in children: cross-sectional household surveys in Southern Sudan.

    PubMed

    Ngondi, Jeremiah; Reacher, Mark H; Matthews, Fiona E; Brayne, Carol; Gatpan, Gideon; Becknell, Steven; Kur, Lucia; King, Jonathan; Callahan, Kelly; Emerson, Paul M

    2009-03-01

    We have previously documented blinding trachoma to be a serious public health problem in Southern Sudan, with an unusually high prevalence of trachomatous trichiasis (TT) among children. We aimed to investigate risk factors for TT in children in Southern Sudan. Cross-sectional surveys were undertaken in 11 districts between 2001 and 2006, and eligible participants were examined for trachoma signs. Risk factors were assessed through interviews and observations. Using logistic regression, associations between TT in children and potential risk factors were investigated. In total, 11155 children aged 1-14 years from 3950 households were included in the analysis. Overall prevalence of TT was 1.5% (95% CI 1.1-2.1). Factors independently associated with increased odds of TT in children aged 1-14 years were: increasing age (P(trend)<0.001); female gender (odds ratio=1.5; 95% CI 1.1-2.1); increasing proportion of children in the household with trachomatous inflammation-intense (TI) (P(trend)=0.002); and increasing number of adults in the household with TT (P(trend)<0.001). Our study revealed risk factors for TT in children consistent with those previously reported for TT in adults. While the associations of TT in children with TI in siblings and TT in adult relatives merit further investigation, there is an urgent need for trachoma prevention interventions and trichiasis surgery services that are tailored to cater for young children in Southern Sudan.

  5. Enhancing the role of nutrition professionals in weight management: A cross-sectional survey.

    PubMed

    Bleich, Sara N; Bandara, Sachini; Bennett, Wendy; Cooper, Lisa A; Gudzune, Kimberly A

    2015-02-01

    (1) To determine the nonphysician health profession perceived as best qualified to provide weight management. (2) To examine nutrition professionals' current practice characteristics and perceived challenges and solutions for obesity care. (3) To examine the association between nutrition professionals' quality of training and self-efficacy in weight management. A 2014 national cross-sectional online survey of 500 U.S. nonphysician health professionals (100 from each: nutrition, nursing, behavioral/mental health, exercise, pharmacy) was analyzed. Nutrition professionals most commonly self-identified as the most qualified group to help patients lose weight (92%), sentiments supported by other health professionals (57%). The most often cited challenge was lack of patient adherence (87%). Among nutrition professionals, 77% reported receiving high-quality training in weight loss counseling. Nutrition professionals who reported high-quality training were significantly more likely to report confidence (95% vs. 48%) and success (74 vs. 50%) in helping obese patients lose weight (P<0.05) than those reporting lower-quality training. Across all nonphysician health professionals, nutrition professionals were identified as best suited to provide routine weight management counseling to obese patients. Yet nutrition professionals' receipt of high-quality weight management training appears critical to their success in helping patients lose weight. © 2014 The Obesity Society.

  6. Factors influencing trainers’ feedback-giving behavior: a cross-sectional survey

    PubMed Central

    2014-01-01

    Background The literature provides some insight into the role of feedback givers, but little information about within-trainer factors influencing ‘feedback-giving behaviours’. We looked for relationships between characteristics of feedback givers (self-efficacy, task perception, neuroticism, extraversion, agreeableness and conscientiousness) and elements of observation and feedback (frequency, quality of content and consequential impact). Methods We developed and tested several hypotheses regarding the characteristics and elements in a cross-sectional digital survey among GP trainers and their trainees in 2011 and 2012. We conducted bivariate analysis using Pearson correlations and performed multiple regression analysis. Results Sixty-two trainer-trainee couples from three Dutch institutions for postgraduate GP training participated in the study. Trainer scores on ‘task perception’ and on a scale of the trait ‘neuroticism’ correlated positively with frequency of feedback and quality of feedback content. Multiple regression analysis supported positive correlations between task perception and frequency of feedback and between neuroticism and quality of feedback content. No other correlations were found. Conclusion This study contributes to the literature on feedback giving by revealing factors that influence feedback-giving behaviour, namely neuroticism and task perception. Trainers whose task perception included facilitation of observation and feedback (task perception) and trainers who were concerned about the safety of their patients during consultations with trainees (neuroticism) engaged more frequently in observation and feedback and gave feedback of higher quality. PMID:24690387

  7. Small cross-sectional survey of composite restoration attributes associated with choices for replacement.

    PubMed

    Parpaiola, Alessandra Ramos; Guimarães, Priscilla Santos; França, Fabiana Mantovani Gomes; Basting, Roberta Tarkany

    2009-01-01

    The aim of this work was to present a small cross-sectional survey of composite restoration clinical attributes associated with choices for replacement. Ninety-four composite fillings selected to be replaced were included in this study. A questionnaire was filled out after each procedure in order to assess the clinical conditions that indicated the restoration replacement (marginal staining, unsatisfactory restoration anatomy, marginal fracture, fractured restoration body, painful symptoms, dental fracture, composite discoloration and/or restoration displacement). These conditions could be combined. The chi-square and Exact Fisher tests were performed to analyze the different variables (p < 0.05). The results showed that composite shade discoloration was the main cause of restoration replacement (63.8%). Marginal staining (50%), unsatisfactory restoration anatomy (50%), marginal fracture (14.9%), painful symptoms (8.5%), fractured restoration body (4.3%), dental fracture (1.1%) and total displacement of the restoration (1.1%) were conditions that could be associated. The main cause of dental composite restoration replacement was material shade mismatch with the dental structure (anterior teeth) or marginal staining and unsatisfactory restoration shape (posterior teeth). Marginal staining and composite shade discoloration contrasting with dental structure were related to the presence of caries.

  8. A survey on clinical governance awareness among clinical staff: a cross-sectional study.

    PubMed

    Ravaghi, Hamid; Zarnaq, Rahim Khodayari; Adel, Amin; Badpa, Mahnaz; Adel, Moein; Abolhassani, Nazanin

    2014-06-25

    Clinical Governance (CG) program has been raised in Iran in order to improve the quality of clinical care. The purpose of this study is to investigate the awareness of clinical governance program among clinical staff working in selected teaching hospitals in Tehran, Iran. To investigate the CG awareness, a cross-sectional survey was conducted among 345 clinical staff working in 20 selected public hospitals in Tehran. Data were gathered using the standardized clinical governance awareness questionnaire. Descriptive statistics were used to analyze the data. The results showed that the level of staff awareness about the concept of CG was low. They perceived continuous quality improvement, responsibility, medical errors reduction and patient safety as the main concepts of the CG framework. Reaching agreement of standards concepts among staff and positive changes in attitudes were considered as two most observed changes. The main perceived barriers to the implementation of clinical governance included lack of proper management and leadership, lack of full support, inappropriate organizational culture, lack of knowledge, poor communication system and insufficient training. The concepts and goals of clinical governance have not been effectively conveyed to the staff and despite its implementation in the hospitals, there has been low clinical governance awareness among the staff. Clinical Governance must be implemented through comprehensive management support and participation of all staff and health professionals at both hospital and policy making level.

  9. German medical students´ exposure and attitudes toward pharmaceutical promotion: A cross-sectional survey

    PubMed Central

    Jahnke, Kristine; Kremer, Marcel Stephan; Schmidt, Carsten Oliver; Kochen, Michael M.; Chenot, Jean-François

    2014-01-01

    Objective: Early contact of medical students with pharmaceutical promotion has been shown in many international studies. We assessed the frequency and places of contact of German medical students to pharmaceutical promotion and examined their attitudes toward pharmaceutical promotional activities. Methods: This cross-sectional survey was based on a self-developed questionnaire. It was distributed to all clinical students at the University of Goettingen Medical School in 2010. A 4-point rating scale was used to assess the attitudes toward different statements regarding pharmaceutical promotion. Results: The overall response rate was 55% (702/1287). The proportion of students with direct contact to pharmaceutical sales representatives increased from 21% in the first clinical year up to 77% in the final year. 60% were contacted during their elective clerkship. 80% had accepted promotional gifts. 86% stated their prescribing behavior to be unsusceptible to the influence of accepting promotional gifts. However, 35% of the unsusceptible students assumed doctors to be susceptible. Almost all (90%) reported that dealing with pharmaceutical promotion was never addressed during lectures and 65% did not feel well prepared for interactions with the pharmaceutical industry. 19% agreed to prohibit contacts between medical students and the pharmaceutical industry. Conclusions: German medical students get in contact with pharmaceutical promotion early and frequently. There is limited awareness for associated conflicts of interests. Medical schools need to regulate contacts and incorporate the topic in their curriculum to prepare students for interactions with the pharmaceutical industry. PMID:25228934

  10. Understanding and Predicting Social Media Use Among Community Health Center Patients: A Cross-Sectional Survey

    PubMed Central

    2014-01-01

    Background The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. Objective The aim was to determine the use and factors predicting the use of social media for health care–related purposes among medically underserved primary care patients. Methods A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Results Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Conclusions Understanding use and factors predicting use can increase adoption and utilization of social media for health care–related purposes among underserved patients in community health centers. PMID:25427823

  11. Enhancing the role of nutrition professionals in weight management: A cross sectional survey

    PubMed Central

    Bleich, Sara N.; Bandara, Sachini; Bennett, Wendy; Cooper, Lisa A.; Gudzune, Kimberly A.

    2014-01-01

    Objective 1) To determine the non-physician health profession perceived as best qualified to provide weight management; 2) To examine nutrition professionals’ current practice characteristics and perceived challenges and solutions for obesity care; and 3) To examine the association between nutrition professionals’ quality of training and self-efficacy in weight management. Design and methods We analyzed a 2014 national cross-sectional online survey of 500 U.S. non-physician health professionals (100 from each: nutrition, nursing, behavioral/mental health, exercise, pharmacy). Results Nutrition professionals most commonly self-identified as the most qualified group to help patients lose weight (92%), sentiments supported by other health professionals (57%). The most often cited challenge was lack of patient adherence (87%). Among nutrition professionals, 77% reported receiving high quality training in weight loss counseling. Nutrition professionals who reported high quality training were significantly more likely to report confidence (95% vs. 48%) and success (74% vs. 50%) in helping obese patients lose weight (p<0.05) than those reporting lower quality training. Conclusion Across all non-physician health professionals, nutrition professionals were identified as best suited to provide routine weight management counseling to obese patients. Yet, nutrition professionals’ receipt of high quality weight management training appears critical to their success in helping patients lose weight. PMID:25445319

  12. Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey

    PubMed Central

    Keyvanara, Mahmoud; Sajadi, Haniye Sadat

    2015-01-01

    Background: Changes in modern societies develop the perception that the external environment is essential in organization’s practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. Methods: A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. Results: The mean score of hospitals’ social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals’ ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. Conclusion: It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals’ social responsibility level, especially through concentrating on their staff’s working environment. PMID:26340391

  13. Prevalence and Correlates of Binge Drinking among Young Adults Using Alcohol: A Cross-Sectional Survey

    PubMed Central

    Carrà, Giuseppe

    2014-01-01

    Background. Although binge drinking prevalence and correlates among young people have been extensively studied in the USA and Northern Europe, less is known for Southern Europe countries with relatively healthier drinking cultures. Objective. We aimed at analyzing prevalence and correlates of binge drinking in a representative sample of young adults in Italy. Methods. We conducted a cross-sectional survey among alcohol-consuming young adults. We carried out univariate and multivariate analyses to assess associations between recent binge drinking and candidate variables. Results. We selected 654 subjects, with 590 (mean age: 20.65 ± 1.90) meeting inclusion criteria. Prevalence for recent binge drinking was 38.0%, significantly higher for females than males. Multivariate analysis showed that high alcohol expectancies, large amount of money available during the weekend, interest for parties and discos, female gender, cannabis use, influence by peers, and electronic cigarettes smoking all were significantly associated with recent binge drinking, whereas living with parents appeared a significant protective factor. Conclusions. More than a third of young adults using alcohol are binge drinkers, and, in contrast with findings from Anglo-Saxon countries, females show higher risk as compared with males. These data suggest the increasing importance of primary and secondary prevention programmes for binge drinking. PMID:25101300

  14. Basic Competence of Intensive Care Unit Nurses: Cross-Sectional Survey Study

    PubMed Central

    Lakanmaa, Riitta-Liisa; Suominen, Tarja; Ritmala-Castrén, Marita; Vahlberg, Tero; Leino-Kilpi, Helena

    2015-01-01

    Critical care patients benefit from the attention of nursing personnel with a high competence level. The aim of the study was to describe and evaluate the self-assessed basic competence of intensive care unit nurses and related factors. A cross-sectional survey design was used. A basic competence scale (Intensive and Critical Care Nursing Competence Scale version 1, Likert scale 1–5, 1 = poor and 5 = excellent) was employed among Finnish intensive care unit nurses (n = 431). Intensive care unit nurses' self-assessed basic competence was good (mean 4.19, SD 0.40). The attitude and value base of basic competence was excellent whereas experience base was the poorest compared to the knowledge base and skill base of intensive and critical care nursing. The strongest factor explaining nurses' basic competence was their experience of autonomy in nursing care (F value 60.85, β 0.11, SE 0.01, and P ≤ 0.0001). Clinical competence was self-rated as good. Nurses gave their highest competence self-ratings for ICU patient care according to the principles of nursing care. The ICU nurses also self-rated their professional competence as good. Collaboration was self-rated as the best competence. In basic and continuing education and professional self-development discussions it is meaningful to consider and find solutions for how to improve nurses' experienced autonomy in nursing. PMID:26557676

  15. Determinants of smoking initiation among women in five European countries: a cross-sectional survey

    PubMed Central

    2010-01-01

    Background The rate of smoking and lung cancer among women is rising in Europe. The primary aim of this study was to determine why women begin smoking in five different European countries at different stages of the tobacco epidemic and to determine if smoking is associated with certain characteristics and/or beliefs about smoking. Methods A cross-sectional telephone survey on knowledge and beliefs about tobacco was conducted as part of the Women in Europe Against Lung Cancer and Smoking (WELAS) Project. A total of 5 000 adult women from France, Ireland, Italy, Czech Republic, and Sweden were interviewed, with 1 000 from each participating country. All participants were asked questions about demographics, knowledge and beliefs about smoking, and their tobacco use background. Current and former smokers also were asked questions about smoking initiation. Basic statistics on the cross-sectional data was reported with chi-squared and ANOVA p-values. Logistic regression was used to analyze ever versus never smokers. Linear regression analyses were used to analyze age of smoking initiation. Results Being older, being divorced, having friends/family who smoke, and having parents who smoke were all significantly associated with ever smoking, though the strength of the associations varied by country. The most frequently reported reason for initiation smoking was friend smoking, with 62.3% of ever smokers reporting friends as one of the reasons why they began smoking. Mean age of smoking initiation was 18.2 years and over 80% of participants started smoking by the age of 20. The highest levels of young initiators were in Sweden with 29.3% of women initiating smoking at age 14-15 and 12.0% initiating smoking younger than age 14. The lowest level of young initiators was in the Czech Republic with 13.7% of women initiating smoking at age 14-15 and 1.4% of women initiating smoking younger than age 14. Women who started smoking because their friends smoked or to look 'cool' were

  16. Prevalence of Developmental Dysplasia of the Hip in Chinese Adults: A Cross-sectional Survey

    PubMed Central

    Tian, Feng-De; Zhao, De-Wei; Wang, Wei; Guo, Lin; Tian, Si-Miao; Feng, Ao; Yang, Fan; Li, Dong-Yi

    2017-01-01

    Background: The prevalence of developmental dysplasia of the hip (DDH) is unknown in China. We aimed to determine the prevalence of DDH in Chinese adults. Methods: In this study, we performed a cross-sectional survey of a nationally representative sample of Chinese adults. All participants underwent questionnaire investigation, physical examination, and X-ray examination. Factors associated with DDH were analyzed with logistic regression. Results: We invited 29,180 individuals aged 18 years and over to participate, randomly selected from 18 primary sampling units (street districts in urban areas and townships in rural areas). The survey and examination were completed in 25,767 people (10,296 men and 15,471 women). DDH was diagnosed in 391 people, yielding an overall DDH prevalence of 1.52%. Based on this information, we estimate the number of individuals with DDH in China to be approximately 16.05 million. DDH prevalence increased with age (odds ratio = 1.53 [1.03–2.27], P = 0.036), was significantly higher among women than men (2.07% vs. 0.75%, P < 0.001), and was higher among rural residents than urban residents (1.75% vs. 1.29%, P < 0.001). Economic development was independently associated with the presence of DDH. There was no evidence of an association between body mass index alone, education, or current smoking or drinking and risk of DDH (P > 0.05). Conclusions: DDH has become an important public health problem. Special attention should be paid to residents with DDH. Screening for DDH should be performed in China. PMID:28524823

  17. Prevalence of Developmental Dysplasia of the Hip in Chinese Adults: A Cross-sectional Survey.

    PubMed

    Tian, Feng-De; Zhao, De-Wei; Wang, Wei; Guo, Lin; Tian, Si-Miao; Feng, Ao; Yang, Fan; Li, Dong-Yi

    2017-06-05

    The prevalence of developmental dysplasia of the hip (DDH) is unknown in China. We aimed to determine the prevalence of DDH in Chinese adults. In this study, we performed a cross-sectional survey of a nationally representative sample of Chinese adults. All participants underwent questionnaire investigation, physical examination, and X-ray examination. Factors associated with DDH were analyzed with logistic regression. We invited 29,180 individuals aged 18 years and over to participate, randomly selected from 18 primary sampling units (street districts in urban areas and townships in rural areas). The survey and examination were completed in 25,767 people (10,296 men and 15,471 women). DDH was diagnosed in 391 people, yielding an overall DDH prevalence of 1.52%. Based on this information, we estimate the number of individuals with DDH in China to be approximately 16.05 million. DDH prevalence increased with age (odds ratio = 1.53 [1.03-2.27], P = 0.036), was significantly higher among women than men (2.07% vs. 0.75%, P< 0.001), and was higher among rural residents than urban residents (1.75% vs. 1.29%, P< 0.001). Economic development was independently associated with the presence of DDH. There was no evidence of an association between body mass index alone, education, or current smoking or drinking and risk of DDH (P > 0.05). DDH has become an important public health problem. Special attention should be paid to residents with DDH. Screening for DDH should be performed in China.

  18. Cumulative risks and cessation of exclusive breast feeding: Australian cross-sectional survey.

    PubMed

    Ayton, Jennifer; van der Mei, Ingrid; Wills, Karen; Hansen, Emily; Nelson, Mark

    2015-09-01

    To estimate the prevalence of cessation of exclusive breast feeding at each month up to 6 months and document key factors and cumulative risks associated with exclusive breastfeeding cessation for children aged from 0 to 6 months. Secondary analysis using a national representative sample of 22 202 mother and infant pairs derived from the 2010 Australian Institute of Health and Welfare cross-sectional survey, the Australian Infant Feeding Survey. Among breastfed infants, 49% had ceased exclusive breast feeding before they had reached 2 months of age. In the final Cox proportional hazards model, cessation of exclusive breast feeding was most strongly associated with partners preferring bottle feeding (HR 1.86, 95% CI 1.69 to 20.6) or having no preference (HR 1.37, 95% CI 1.33 to 1.42), regular dummy use (HR 1.35, 95% CI 1.31 to 1.39) and maternal obesity (HR 1.29, 95% CI 1.24 to 1.35). Living within the most disadvantaged areas of Australia (quintile 1) was not strongly associated with cessation (HR 1.08, 95% CI 1.02 to 1.14) compared with least disadvantaged areas. Having three risk factors significantly increased the risk of cessation by 31% (HR 1.31, 95% CI 1.07 to 1.6). The prevalence of early cessation of exclusive breast feeding is alarmingly high with 50% of infants no longer exclusively breast fed by age 2 months. Given that not one factor is associated with cessation of exclusive breast feeding, the greatest public health impact is likely to be achieved when multiple risk factors are modified or prevented. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  19. A cross-sectional survey of urinary iodine status in Latvia.

    PubMed

    Konrade, Ilze; Neimane, Lolita; Makrecka, Marina; Strele, Ieva; Liepinsh, Edgars; Lejnieks, Aivars; Vevere, Parsla; Gruntmanis, Ugis; Pīrāgs, Valdis; Dambrova, Maija

    2014-01-01

    A nationwide survey of schoolchildren was conducted to detect regional differences in urinary iodine excretion in Latvia and to compare the results with data from the newborn thyroid-stimulating hormone (TSH) screening database as well with the results of a similar study performed in Latvia 10 years ago. We conducted a cross-sectional school-based cluster survey of 915 children aged 9-12 years in 46 randomly selected schools in all regions of Latvia. Urine samples, questionnaires on the consumption of iodized salt and information on socioeconomic status were collected. TSH levels in newborns were also measured. The median creatinine-standardized urinary iodine concentration (UIC) in our study was 107.3μg/g Cr. UIC measurements indicative of mild iodine deficiency were present in 31.6%, moderate deficiency in 11.9% and severe deficiency in 2.8% of the participants. The prevalence of iodine deficiency was the highest in the southeastern region of Latgale and the northeastern region of Vidzeme. The prevalence of TSH values >5mIU/L followed a similar pattern. The self-reported prevalence of regular iodized salt consumption was 10.2%. Children from urban schools had a significantly lower UIC than children from rural schools. Our findings suggest that although the overall median UIC in Latvian schoolchildren falls within the lower normal range, almost 50% of the schoolchildren are iodine deficient, especially in urban schools and in the eastern part of Latvia. The absence of a mandatory salt iodization program puts a significant number of children and pregnant women at risk. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  20. Awareness and analysis of a significant event by general practitioners: a cross sectional survey.

    PubMed

    Bowie, P; McKay, J; Norrie, J; Lough, M

    2004-04-01

    To determine the extent to which general practitioners (GPs) were aware of a recent significant event and whether a structured analysis of this event was undertaken to minimise the perceived risk of recurrence. Cross sectional survey using a postal questionnaire. Greater Glasgow primary care trust. 466 principals in general practice from 188 surgeries. GPs' self-reported personal and practice characteristics, awareness of a recent significant event, participation in the structured analysis of the identified significant event, perceived chance of recurrence, forums for discussing and analysing significant events, and levels of primary care team involvement. Four hundred and sixty six GPs (76%) responded to the survey. GPs from single handed practices were less likely to respond than those in multi-partner training and non-training practices. 401 (86%) reported being aware of a recent significant event; lack of awareness was clearly associated with GPs from non-training practices. 219 (55%) had performed all the necessary stages of a structured analysis (as determined by the authors) of the significant event. GPs from training practices were more likely to report participation in the structured analysis of the recent event, to perceive the chance of this event recurring as "nil" or "very low", and to report significant event discussions taking place. Most GPs were aware of a recent significant event and participated in the structured analysis of this event. The wider primary care team participated in the analysis process where GPs considered this involvement relevant. There is variation in the depth of and approach to significant event analysis within general practice, which may have implications for the application of the technique as part of the NHS quality agenda.

  1. Career Satisfaction Among Dental Public Health Specialists in India – A Cross-sectional Survey

    PubMed Central

    Joseph, Joe; Antony, Bobby

    2017-01-01

    Introduction The satisfaction in career is an important indicator for the growth of the discipline and the profession. An empirical investigation of satisfaction in career and amendments needed in course and profession may help in growth of discipline. Aim To assess career satisfaction among Dental Public Health (DPH) specialists working in India and analyze their perspective on changes required in the profession. Materials and Methods Questionnaire for this cross-sectional survey was adapted from Minnesota Job Satisfaction Survey which included 40 enquiries to understand the reasons for choosing public health dentistry as career, competencies of public health dentists, satisfaction as a public health dentist and changes required in the profession. The questions were both open and closed end type. Updated electronic mail details of all registered public health dentists were collected from the head office of Indian Association of Public Health Dentistry. Each participant was contacted by electronic mail and consent to participate were sought. Reminders were e-mailed thrice during three months. A total of 580 participants were contacted. A total of 183 responses were received, among which 179 consented. Results Nearly half of the respondents felt they are yet to achieve the accomplishment from the present career as public health dentist. Only 46.9% felt that there is advancement in the profession as career. Nearly three-fourth of respondents could not attain recognition as a public health dentist. A 45.8% of respondents were of the opinion that career in public health dentistry would provide them a steady employment and 53.1% of public health dentists would envision as satisfied in their career in next 10 years. Nearly 85% felt public health dentistry training needs a major course correction. Conclusion There has been some reservation or skepticism about the future of the specialty as the jobs are in declining stage. This information provides insight about success

  2. Factors relating to adolescent suicidal behavior: a cross-sectional Malaysian school survey.

    PubMed

    Chen, Paul C Y; Lee, Lai Kah; Wong, Kam Cheong; Kaur, Jagmohni

    2005-10-01

    This study was undertaken to examine factors relating to adolescent suicide behavior. This was a cross-sectional school survey of 4,500 adolescent students based on a structured questionnaire. Data were collected using the supervised self-administered questionnaire (modified version of the Youth Risk Behavior Surveillance in the Malaysian National Language, Bahasa Malaysia). Seven percent (312 of 4,454) of the adolescent students had seriously considered attempting suicide. Among the adolescents, 4.6% had attempted suicide at least once during the 12 months preceding the survey. Female adolescents were more likely to put their suicidal thoughts into suicidal action than were male adolescents. Malay and Indian people are more likely than the Chinese to respond, "Felt sad and hopeless." However, Malay adolescents had the lowest rate of attempted suicide. Based on multiple logistic regression, factors significantly related to urban adolescents' suicide behavior are "Felt sad or hopeless," "Number of days felt unsafe to go to school," "Riding with a driver who had been drinking alcohol," "Physical fight," and "Number of days absent from school." In comparison, factors relating to rural adolescents' suicide behavior are "Felt sad or hopeless," "Physical fight," "Physical fight resulting in injury," and "Drive a vehicle after drinking alcohol." Adolescent suicide behavior should be viewed as a serious problem. Measures can be taken to prevent suicide by looking at the factors significantly linked to suicidal behavior among adolescents. Steps can then be taken to identify adolescents who have serious suicidal ideation so that intervention can be taken to reduce the suicidal rate.

  3. Factors influencing medical students in pursuing a career in surgery: a cross-sectional survey.

    PubMed

    Scott, A J; Kahn, D

    2017-06-01

    Many factors play a role in the decision of a medical student to pursue a career in surgery. With a decline in numbers of applications into surgical programmes seen globally, the aim of this study was to determine the factors that influence medical students in pursuing a career in surgery. A descriptive, cross-sectional survey was distributed online to all medical students studying at a tertiary, academic institution. Survey items obtained data on demographics, surgical interest and training, as well as factors affecting a surgical career. A total of 245 medical students responded, of which 56% were female. The majority (69%) stated they were interested in pursuing a career in surgery. Despite 75% of respondents stating South Africa was a good place for surgical training, females reported significantly higher levels of agreement that surgical training would be better overseas when compared to males (p = 0.027). Overall, 20% were undecided on what surgical specialty they would pursue. The largest proportion of respondents (33%) stated that 'Length of training' was the main barrier to pursuing a career in surgery. Thirtythree (13.5%) respondents reported 'Female-unfriendly' as a barrier, of whom all were female. The greatest motivator to pursuing a career in surgery was 'Hands-on work', stated by 36% of respondents. Though length of surgical training was deemed the principal barrier, the majority of students indicated they would pursue a career in surgery. Despite continued perceptions that surgery poses a female-unfriendly environment as a career, respondents held South African surgical training in high esteem, and were motivated by a clinically hands-on approach. These factors may play an important role in determining methods of improving numbers of surgical applications worldwide.

  4. Premarital sexual intercourse among adolescents in Malaysia: a cross-sectional Malaysian school survey.

    PubMed

    Lee, L K; Chen, P C Y; Lee, K K; Kaur, J

    2006-06-01

    Sexual intercourse among Malaysian adolescents is a major concern, especially with the worry of HIV/AIDS. This study was done to determine the prevalence of sexual intercourse among secondary school students aged 12 to 19 years in Negeri Sembilan, Malaysia. This is a cross-sectional school survey conducted on 4,500 adolescent students based on a structured questionnaire. Data were collected using the self-administered questionnaire (translated version of the Youth Risk Behaviour Surveillance in Bahasa Malaysia). The study showed that 5.4 percent of the total sample were reported to have had sexual intercourse. The proportion among male students who had had sex was higher (8.3 percent) compared with female students (2.9 percent). The mean age at first sexual intercourse was 15 years. One percent of students reported that they had been pregnant or had made someone else pregnant. Adolescent sexual intercourse was significantly associated with (1) socio-demographical factors (age, gender); (2) environmental factors (staying with parents); and (3) substance use (alcohol use, cigarette smoking, drug use), even after adjustment for demographical factors. The survey showed that 20.8 percent of respondents had taken alcohol, 14.0 percent had smoked cigarettes, 2.5 percent had tried marijuana, 1.2 percent had tried ecstasy pills, 2.6 percent had tried glue sniffing, 0.7 percent had tried heroin, and 0.7 percent had intravenous drugs. Prevalence of sexual intercourse among Malaysian adolescents was relatively low compared to developed countries. However, certain groups of adolescents tend to be at higher risk of engaging in sexual intercourse. This problem should be addressed early by targeting these groups of high-risk adolescents.

  5. Exercise training characteristics in cardiac rehabilitation programmes: a cross-sectional survey of Australian practice

    PubMed Central

    Abell, Bridget; Glasziou, Paul; Briffa, Tom; Hoffmann, Tammy

    2016-01-01

    Introduction Exercise training is a core component of cardiac rehabilitation (CR), however, little information exists regarding the specific exercise interventions currently provided for coronary heart disease in Australian practice. We aimed to analyse the current status of exercise-based CR services across Australia. Design Cross-sectional survey. Methods Australian sites offering exercise-based CR were identified from publically available directories. All sites were invited by email to participate in an online Survey Monkey questionnaire between October 2014 and March 2015, with reminders via email and phone follow-up. Questions investigated the demographics and format of individual programmes, as well as specific exercise training characteristics. Results 297 eligible programmes were identified, with an 82% response rate. Most sites (82%) were based at hospital or outpatient centres, with home (15%), community (18%) or gym-based options (5%) less common. While CR was most often offered in a comprehensive format (72% of sites), the level of exercise intervention varied greatly among programmes. Most frequently, exercise was prescribed 1–2 times per week for 60 min over 7 weeks. Almost one-quarter (24%) had a sole practitioner supervising exercise, although the majority used a nurse/physiotherapist combination. Low to moderate exercise intensities were used in 60% of programmes, however, higher intensity prescriptions were not uncommon. Few sites (<6%) made use of technology, such as mobile phones or the internet, to deliver or support exercise training. Conclusions While advances have been made towards providing flexible and accessible exercise-based CR, much of Australia's service remains within traditional models of care. A continuing focus on service improvement and evidence-based care should, therefore, be considered a core aim of those providing exercise for CR in order to improve health service delivery and optimise outcomes for patients. PMID

  6. Burnout among anaesthetists in Chinese hospitals: a multicentre, cross-sectional survey in 6 provinces.

    PubMed

    Rui, Min; Ting, Chen; Pengqian, Fang; Xinqiao, Fu

    2016-06-01

    Anesthesiology has reached a new stage which anaesthesia safety is significantly affected by human factors. The number of Chinese anaesthetists has increased to nearly twice as many as that in 2005. Attributed to traditional concepts, many problems in anesthesiology persist in Chinese hospitals. This study aims to determine the current status of anaesthesia job burnout, including problems related to burnout, as well as the conditions of anaesthesia human resources in Chinese hospitals. A multi-center, cross-sectional survey of 395 anaesthetists from 60 hospitals in 6 provinces was conducted to collect data on the work conditions of anesthesiologists by using questionnaires. The Maslach Burnout Inventory (MBI) was used to measure burnout. Different statistical models were also used to evaluate the data. The number of Chinese anaesthetists has increased to nearly twice as many as that in 2005. According to our field survey of burnout among anaesthetists, only 17 (4.30%) respondents exhibited high levels of burnout. The average scores corresponding to the dimensions of burnout are 14.64 ± 11.40 (emotional exhaustion, EE), 4.22 ± 5.74 (depersonalization, DP), and 33.41 ± 10.05 (personal accomplishment, PA), as determined by MBI. These results indicate the differences in the spatial distribution of anaesthetists. Moreover, 15.3% of the anaesthetists showed high EE, 8.1% exhibited high DP, and 33.6% had low PA. Anxiety and undesirable conditions experienced by professional groups in anaesthesiology need to be addressed. Educational level, an important factor in anaesthesia care, influences not only psychological health of practitioners but patient safety as well. Thus, personnel structure must be optimized to relieve tension in the practice of the profession and reduce burnout among anaesthetists in hospitals in China. Meanwhile, the management must increase its effort toward improving the mental health of practitioners and patient safety in anaesthesia care. © 2016

  7. Prevalence and characteristics of tremor in the NARCOMS multiple sclerosis registry: a cross-sectional survey

    PubMed Central

    Rinker, John R; Salter, Amber R; Walker, Harrison; Amara, Amy; Meador, William; Cutter, Gary R

    2015-01-01

    Objectives (1)To describe the prevalence and severity of tremor in patients with multiple sclerosis (MS) registered within a large North American MS registry; (2) to provide detailed descriptions on the characteristics and severity of tremor in a subset of registrants and (3) to compare several measures of tremor severity for strength of agreement. Setting The North American Research Committee on MS (NARCOMS) registry. Participants Registrants of NARCOMS reporting mild or greater tremor severity. Outcome measures We determined the cross-sectional prevalence of tremor in the NARCOMS registry over three semiannual updates between fall 2010 and fall 2011. A subset of registrants (n=552) completed a supplemental survey providing detailed descriptions of their tremor. Outcomes included descriptive characteristics of their tremors and correlations between outcome measures to determine the strength of agreement in assessing tremor severity. Results The estimated prevalence of tremor in NARCOMS ranged from 45% to 46.8%, with severe tremor affecting 5.5–5.9% of respondents. In the subset completing the supplemental survey, mild tremor severity was associated with younger age of MS diagnosis and tremor onset than those with moderate or severe tremor. However, tremor severity did not differ by duration of disease or tremor. Respondents provided descriptions of tremor symptoms on the Clinical Ataxia Rating Scale, which had a moderate to good (ρ=0.595) correlation with the Tremor Related Activities of Daily Living (TRADL) scale. Objectively scored Archimedes’ spirals had a weaker (ρ=0.358) correlation with the TRADL. Rates of unemployment, disability and symptomatic medication use increased with tremor severity, but were high even among those with mild tremor. Conclusions Tremor is common among NARCOMS registrants and severely disabling for some. Both ADL-based and symptom-descriptive measures of tremor severity can be used to stratify patients. PMID:25573524

  8. Error, stress, and teamwork in medicine and aviation: cross sectional surveys

    NASA Technical Reports Server (NTRS)

    Sexton, J. B.; Thomas, E. J.; Helmreich, R. L.

    2000-01-01

    OBJECTIVES: To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. DESIGN:: Cross sectional surveys. SETTING:: Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. PARTICIPANTS:: 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). MAIN OUTCOME MEASURES:: Perceptions of error, stress, and teamwork. RESULTS:: Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. CONCLUSIONS: Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members.

  9. Paediatric surgery and anaesthesia in south-western Uganda: a cross-sectional survey

    PubMed Central

    Obua, Apunyo D; Mouton, Falan; Ttendo, Steven; Wilson, Iain H

    2010-01-01

    Abstract Objective To study paediatric surgery rates in south-western Uganda, compare them to rates in England, and determine if existing surgical facilities and workforce meet World Health Organization (WHO) standards. Methods To obtain information on surgical facilities and workforce, we conducted a cross-sectional survey of all hospitals performing major surgery in 14 districts of south-western Uganda in 2007–2008. Using theatre logbook data, we determined the surgical rates, types of surgery performed and in-theatre surgical outcomes. Findings Of 72 hospitals surveyed, 29 were performing major surgery. None met WHO standards for essential surgery. There were 0.7 accredited surgeons per 100 000 population and no paediatric surgeons. Most anaesthetists were not physicians (accredited anaesthetist per 100 000 population: 1.1). The annual surgical rate for children aged ≤ 14 years was 180 operations per 100 000 population; most were emergency procedures. The annual surgical rate for patients of all ages was 652 operations per 100 000 population, with a median of 422 per operating theatre (range: 60–3497) and of 226 per surgeon (range: 60–1748). Mission or nongovernmental organization (NGO) hospitals, which had 44% of the hospital beds in the region, performed 3039 (55%) of the paediatric operations. Externally funded surgeons performed 80% of the 140 cleft lip and palate operations. Four in-theatre deaths occurred in children ≤ 14 years old (in-theatre mortality: 7.7 deaths per 10 000 operations). Conclusion Access to all surgery, including paediatric surgery, is poor in south-western Uganda and investment in basic health-care facilities and surgical workforce and training is urgently needed. Mission and NGO hospitals make a valuable contribution to elective surgery, and externally funded surgeons make an important contribution to specialist surgery. In-theatre mortality was lower than reported for similar settings. PMID:21124714

  10. Error, stress, and teamwork in medicine and aviation: cross sectional surveys

    PubMed Central

    Sexton, J Bryan; Thomas, Eric J; Helmreich, Robert L

    2000-01-01

    Objectives: To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. Design: Cross sectional surveys. Setting: Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. Participants: 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). Main outcome measures: Perceptions of error, stress, and teamwork. Results: Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. Conclusions: Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members. PMID:10720356

  11. Examining missed care in community nursing: A cross section survey design.

    PubMed

    Phelan, Amanda; Mccarthy, Sandra; Adams, Elizabeth

    2017-09-27

    To examine the prevalence of missed care in the community nursing. Previous studies have used a missed care framework to identify challenges routine nursing care in acute care environments. Several issues related to quality of care, safe staffing, job satisfaction and poor teamwork. However, this concept has not been examined in the community nursing context. A cross-sectional survey design was used to explore the concept of missed care in community nursing using demographical information, community nursing roles and reasons for missed care. Online questionnaires were completed by 458 community nurses in the Republic of Ireland to determine the prevalence of and reasons for missed care (31 July -25 September 2015). With a response rate of 29%, findings were above 70 percent in several routine care responsibilities. Other findings point to a higher level of missed care in nurses who had less than five years' experience and other variables such as age, those who worked additional unpaid hours and there were some regional variations. The results of the study indicate a high prevalence of missed care in the community nurses surveyed and that preventative care was the type of care most likely to be missed. This has serious implications for a nursing service that is preventative in nature and suggests that the missed care framework could benefit workforce planning for community nursing services both in Ireland and elsewhere. Accordingly, policy, practice and educational reforms are fundamental to meet current and future population needs. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents.

    PubMed

    Daniels, Michael N; Maynard, Sharon; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

    2017-01-01

    Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents' interest in nephrology careers. Residents endorsed several negative

  13. Factors associated with domestic violence: a cross-sectional survey among women in Jeddah, Saudi Arabia

    PubMed Central

    Fageeh, Wafa M K

    2014-01-01

    Objective This study aims to identify the factors associated with domestic violence (DV) among women in Jeddah. Design Cross-sectional survey. Setting Outpatient departments of three tertiary hospitals in Jeddah. Participants Convenience sample of women, aged 15–70 years, at the outpatient and inpatient clinics. Interventions Between 15 December 2011 and 30 May 2012, a psychologist and a professional health assistant explained the purpose of the research to participants, who were then asked to fill a 50-item questionnaire. The questionnaire was created based on questions from three questionnaires: the NorVold Domestic Abuse Questionnaire, the Pregnancy Risk Assessment Monitoring System and the Kansas Marital Satisfaction Scale. The questionnaire was used to assess the association between DV and family status, male partner attitudes, age, educational attainment, employment, financial and socioeconomic status. Results A total of 2301 women participated in the survey (81% response rate). The mean±SD age of the participants was 34.4±10.9 years. The lifetime prevalence of DV was 34%. Abused women had more children than non-abused women (p=0.001), and their spouses were significantly older than those of non-abused women (p<0.0001). Financially dependent women and those with a high educational status were significantly more likely to report abuse (p=0.003 and p<0.001, respectively). Abused women were also likely to report that their spouse was a smoker (p<0.0001) and had completed at least primary or secondary education (p<0.0001). A significantly lower proportion of abused women reported that their male partners were alcohol users (p=0.001). The results of logistic regression showed that women who were financially dependent had about 1.5-fold odds of being physically abused by a spouse. Conclusions Many factors are associated with DV against women, thereby highlighting the need to design effective DV prevention programmes. PMID:24531451

  14. Cross-sectional survey of attitudes and beliefs about back pain in New Zealand

    PubMed Central

    Darlow, Ben; Perry, Meredith; Stanley, James; Mathieson, Fiona; Melloh, Markus; Baxter, G David; Dowell, Anthony

    2014-01-01

    Objectives To explore the prevalence of attitudes and beliefs about back pain in New Zealand and compare certain beliefs based on back pain history or health professional exposure. Design Population-based cross-sectional survey. Setting Postal survey. Participants New Zealand residents and citizens aged 18 years and above. 1000 participants were randomly selected from the New Zealand Electoral Roll. Participants listed on the Electoral Roll with an overseas postal address were excluded. 602 valid responses were received. Measures Attitudes and beliefs about back pain were measured with the Back Pain Attitudes Questionnaire (Back-PAQ). The interaction between attitudes and beliefs and (1) back pain experience and (2) health professional exposure was investigated. Results The lifetime prevalence of back pain was reported as 87% (95% CI 84% to 90%), and the point prevalence as 27% (95% CI 24% to 31%). Negative views about the back and back pain were prevalent, in particular the need to protect the back to prevent injury. People with current back pain had more negative overall scores, particularly related to back pain prognosis. There was uncertainty about links between pain and injury and appropriate physical activity levels during an episode of back pain. Respondents had more positive views about activity if they had consulted a health professional about back pain. The beliefs of New Zealanders appeared to be broadly similar to those of other Western populations. Conclusions A large proportion of respondents believed that they needed to protect their back to prevent injury; we theorise that this belief may result in reduced confidence to use the back and contribute to fear avoidance. Uncertainty regarding what is a safe level of activity during an episode of back pain may limit participation. People experiencing back pain may benefit from more targeted information about the positive prognosis. The provision of clear guidance about levels of activity may enable

  15. GPs' mental wellbeing and psychological resources: a cross-sectional survey.

    PubMed

    Murray, Marylou Anna; Cardwell, Chris; Donnelly, Michael

    2017-08-01

    The negative impact of work has been the traditional focus of GP surveys. We know little about GP positive mental health and psychological resources. To profile and contextualise GP positive mental health and personal psychological resources. Cross-sectional survey of GPs working in Northern Ireland (NI). A questionnaire comprising the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and measures of resilience, optimism, self-efficacy, and hope, and sociodemographic information was posted to 400 GPs randomly selected from a publicly available GP register. The response rate was 55% (n = 221 out of 400). Mean value for GP wellbeing (WEMWBS) was 50.2 (standard deviation [SD] 8) compared to UK vets 48.8 (SD 9), UK teachers 47.2 (SD 9), and the population of NI 50.8 (SD 9). After adjustment for confounding, mean WEMWBS was 2.4 units (95% CI = 0.02 to 4.7) higher in female GPs than males (P = 0.05), and 4.0 units (95% CI = 0.8 to 7.3) higher in GPs ≥55 years than GPs ≤44 years (P = 0.02). Optimism was 1.1 units higher in female GPs than male GPs (95% CI = 0.1 to 2.0), and 1.56 units higher in GPs ≥55 years (95% CI = 0.2 to 2.9) than in those ≤44 years. Hope was 3 units higher in GPs ≥55 years (95% CI = 0.4 to 5.7) than in those aged 45-54 years. Correlation between WEMWBS and psychological resources was highest with hope (r = 0.65, P < 0.001). GPs have levels of positive mental health that are comparable to the local population and better than other occupational groups, such as vets and teachers. Male and younger GPs may have most to gain from wellbeing interventions. © British Journal of General Practice 2017.

  16. Error, stress, and teamwork in medicine and aviation: cross sectional surveys

    NASA Technical Reports Server (NTRS)

    Sexton, J. B.; Thomas, E. J.; Helmreich, R. L.

    2000-01-01

    OBJECTIVES: To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. DESIGN:: Cross sectional surveys. SETTING:: Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. PARTICIPANTS:: 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). MAIN OUTCOME MEASURES:: Perceptions of error, stress, and teamwork. RESULTS:: Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. CONCLUSIONS: Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members.

  17. Error, stress, and teamwork in medicine and aviation: cross sectional surveys.

    PubMed

    Sexton, J B; Thomas, E J; Helmreich, R L

    2000-03-18

    To survey operating theatre and intensive care unit staff about attitudes concerning error, stress, and teamwork and to compare these attitudes with those of airline cockpit crew. : Cross sectional surveys. : Urban teaching and non-teaching hospitals in the United States, Israel, Germany, Switzerland, and Italy. Major airlines around the world. : 1033 doctors, nurses, fellows, and residents working in operating theatres and intensive care units and over 30 000 cockpit crew members (captains, first officers, and second officers). : Perceptions of error, stress, and teamwork. : Pilots were least likely to deny the effects of fatigue on performance (26% v 70% of consultant surgeons and 47% of consultant anaesthetists). Most pilots (97%) and intensive care staff (94%) rejected steep hierarchies (in which senior team members are not open to input from junior members), but only 55% of consultant surgeons rejected such hierarchies. High levels of teamwork with consultant surgeons were reported by 73% of surgical residents, 64% of consultant surgeons, 39% of anaesthesia consultants, 28% of surgical nurses, 25% of anaesthetic nurses, and 10% of anaesthetic residents. Only a third of staff reported that errors are handled appropriately at their hospital. A third of intensive care staff did not acknowledge that they make errors. Over half of intensive care staff reported that they find it difficult to discuss mistakes. Medical staff reported that error is important but difficult to discuss and not handled well in their hospital. Barriers to discussing error are more important since medical staff seem to deny the effect of stress and fatigue on performance. Further problems include differing perceptions of teamwork among team members and reluctance of senior theatre staff to accept input from junior members.

  18. Korean public opinion on alcohol control policy: a cross-sectional International Alcohol Control study.

    PubMed

    Seo, Seonwha; Chun, Sungsoo; Newell, Maxine; Yun, Mieun

    2015-01-01

    To examine Korean public opinions toward alcohol control measures on availability, advertisement, drink-driving and pricing policy, and how the views on alcohol control policy vary by demographics, drinking patterns and attitude to drinking environments. The study used national-based, cross-sectional data collected in 2012 as part of the International Alcohol Control study. 2510 people (M: 1163, F: 1261) aged 15-65 and living in geographically diverse regions of Korea completed the questionnaire asking the support of 12 alcohol control measures. Generally, targeted measures (purchase age of 20 and drink-driving) were more popular than universal (availability, advertisement and price) among Koreans. Gender, age, marital status, drinking patterns and attitude to drinking environments related to alcohol use of young and heavy drinkers were strong predictors of the opinions on most of the alcohol control measures. It was daily/weekly drinkers who opposed most restrictions on alcohol availability and price and the support from individuals who are more aware of problems with drinking in public place was outstanding in every control measure. These findings should be taken into account by Korean policy-makers as they formulate an alcohol policy for the country. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Factors associated with herbal use among urban multiethnic primary care patients: a cross-sectional survey

    PubMed Central

    Kuo, Grace M; Hawley, Sarah T; Weiss, L Todd; Balkrishnan, Rajesh; Volk, Robert J

    2004-01-01

    Background The use of herbal supplements in the United States has become increasingly popular. The prevalence of herbal use among primary care patients varies in previous studies; the pattern of herbal use among urban racially/ethnically diverse primary care patients has not been widely studied. The primary objectives of this study were to describe the use of herbs by ethnically diverse primary care patients in a large metropolitan area and to examine factors associated with such use. The secondary objective was to investigate perceptions about and patterns of herbal use. Methods Data for a cross-sectional survey were collected at primary care practices affiliated with the Southern Primary-care Urban Research Network (SPUR-Net) in Houston, Texas, from September 2002 to March 2003. To participate in the study, patients had to be at least 18 years of age and visiting one of the SPUR-Net clinics for routine, nonacute care. Survey questions were available in both English and Spanish. Results A total of 322 patients who had complete information on race/ethnicity were included in the analysis. Overall, 36% of the surveyed patients (n = 322) indicated use of herbs, with wide variability among ethnic groups: 50% of Hispanics, 50% of Asians, 41% of Whites, and 22% of African-Americans. Significant factors associated with an individual's herbal use were ethnicity other than African-American, having an immigrant family history, and reporting herbal use by other family members. About 40% of survey respondents believed that taking prescription medications and herbal medicines together was more effective than taking either alone. One-third of herbal users reported using herbs on a daily basis. More Whites (67%) disclosed their herbal use to their health-care providers than did African-Americans (45%), Hispanics (31%), or Asians (31%). Conclusions Racial/ethnic differences in herbal use were apparent among this sample of urban multiethnic adult primary care patients. Associated

  20. Nursing and midwifery practice for maintenance of vascular access device patency. A cross-sectional survey.

    PubMed

    Keogh, Samantha; Flynn, Julie; Marsh, Nicole; Higgins, Niall; Davies, Karen; Rickard, Claire M

    2015-11-01

    Up to 85% of hospital in-patients will require some form of vascular access device to deliver essential fluids, drug therapy, nutrition and blood products, or facilitate sampling. The failure rate of these devices is unacceptably high, with 20-69% of peripheral intravenous catheters and 15-66% of central venous catheters failing due to occlusion, depending on the device, setting and population. A range of strategies have been developed to maintain device patency, including intermittent flushing. However, there is limited evidence informing flushing practice and little is known about the current flushing practices. The aim of the study was to improve our understanding of current flushing practices for vascular access devices through a survey of practice. A cross-sectional survey of nurses and midwives working in the State of Queensland, Australia was conducted using a 25-item electronic survey that was distributed via the local union membership database. A total of 1178 surveys were completed and analysed, with n=1068 reporting peripheral device flushing and n=584 reporting central device flushing. The majority of respondents were registered nurses (55%) caring for adult patients (63%). A large proportion of respondents (72% for peripheral, 742/1028; 80% for central, 451/566) were aware of their facility's policy for vascular access device flushing. Most nurses reported using sodium chloride 0.9% for flushing both peripheral (96%, 987/1028) and central devices (75%, 423/566). Some concentration of heparin saline was used by 25% of those flushing central devices. A 10-mL syringe was used by most respondents for flushing; however, 24% of respondents used smaller syringes in the peripheral device group. Use of prefilled syringes (either commercially prepared sterile or prefilled in the workplace) was limited to 10% and 11% respectively for each group. The frequency of flushing varied widely, with the most common response being pro re nata (23% peripheral and 21

  1. Lower Urinary Tract Dysfunction in Elementary School Children: Results of a Cross-Sectional Teacher Survey

    PubMed Central

    Ko, Lauren N.; Chuang, Kai-wen; Champeau, Angelique; Allen, I. Elaine; Copp, Hillary L.

    2016-01-01

    Purpose Lower urinary tract dysfunction in school-aged children is common and yet data are lacking on current teacher practice regarding bathroom use and daytime incontinence during classroom hours. We determined the prevalence of elementary school teachers who promote lower urinary tract health and identified predictors for and against such behavioral promotion. Materials and Methods We performed an electronic cross-sectional survey among self-identified teachers using targeted social media advertisement during a 1-week period in July 2014. The empirical survey tool consisted of 27 questions and collected data on 5 principal domains, including 1) teacher demographics, 2) rules and regulations on water intake and bathroom use during classroom hours, 3) characteristics of school bathrooms in terms of safety, supervision and suitability for use, 4) experience with and management of students with daytime incontinence and 5) training on the topic of lower urinary tract health. Predictors for promoting lower urinary tract health were identified by multivariable logistic regression. Results Of the 4,166 teachers who completed the survey 88% indicated that they encourage students to hold urine. Despite strict bathroom protocols 81% of teachers allowed children unlimited access to water. Of the teachers 82% reported never having undergone any professional development on bathroom regulations for children. Overall only 24% of surveyed teachers met criteria for promoting lower urinary tract health. The odds of promoting lower urinary tract health decreased with ascending grade level (OR 0.80, 95% CI 0.76–0.84). Conversely it increased if teaching experience was greater than 5 years (OR 1.66, 95% CI 1.39–1.98) or professional development on the subject had been received (OR 1.42, 95% CI 1.18–1.70). Conclusions Of elementary school teachers 76% are not promoting lower urinary tract health in school-aged children. Professional development training on the topics of lower

  2. Lower Urinary Tract Dysfunction in Elementary School Children: Results of a Cross-Sectional Teacher Survey.

    PubMed

    Ko, Lauren N; Chuang, Kai-wen; Champeau, Angelique; Allen, I Elaine; Copp, Hillary L

    2016-04-01

    Lower urinary tract dysfunction in school-aged children is common and yet data are lacking on current teacher practice regarding bathroom use and daytime incontinence during classroom hours. We determined the prevalence of elementary school teachers who promote lower urinary tract health and identified predictors for and against such behavioral promotion. We performed an electronic cross-sectional survey among self-identified teachers using targeted social media advertisement during a 1-week period in July 2014. The empirical survey tool consisted of 27 questions and collected data on 5 principal domains, including 1) teacher demographics, 2) rules and regulations on water intake and bathroom use during classroom hours, 3) characteristics of school bathrooms in terms of safety, supervision and suitability for use, 4) experience with and management of students with daytime incontinence and 5) training on the topic of lower urinary tract health. Predictors for promoting lower urinary tract health were identified by multivariable logistic regression. Of the 4,166 teachers who completed the survey 88% indicated that they encourage students to hold urine. Despite strict bathroom protocols 81% of teachers allowed children unlimited access to water. Of the teachers 82% reported never having undergone any professional development on bathroom regulations for children. Overall only 24% of surveyed teachers met criteria for promoting lower urinary tract health. The odds of promoting lower urinary tract health decreased with ascending grade level (OR 0.80, 95% CI 0.76-0.84). Conversely it increased if teaching experience was greater than 5 years (OR 1.66, 95% CI 1.39-1.98) or professional development on the subject had been received (OR 1.42, 95% CI 1.18-1.70). Of elementary school teachers 76% are not promoting lower urinary tract health in school-aged children. Professional development training on the topics of lower urinary tract dysfunction and/or lower urinary tract

  3. Deliberate Self-Harm in Adolescents Aged 12-18: A Cross-Sectional Survey of 18,104 Students

    ERIC Educational Resources Information Center

    Watanabe, Norio; Nishida, Atsushi; Shimodera, Shinji; Inoue, Ken; Oshima, Norihito; Sasaki, Tsukasa; Inoue, Shimpei; Akechi, Tatsuo; Furukawa, Toshi A.; Okazaki, Yuji

    2012-01-01

    Little is known about accurate prevalence and associated factors of deliberate self-harm (DSH) among adolescents in Asian countries. In this study, the prevalence and associated factors of DSH among adolescents in Japan were examined. Data were derived from a cross-sectional survey using an anonymous self-report questionnaire and enrolling 8,620…

  4. Deliberate Self-Harm in Adolescents Aged 12-18: A Cross-Sectional Survey of 18,104 Students

    ERIC Educational Resources Information Center

    Watanabe, Norio; Nishida, Atsushi; Shimodera, Shinji; Inoue, Ken; Oshima, Norihito; Sasaki, Tsukasa; Inoue, Shimpei; Akechi, Tatsuo; Furukawa, Toshi A.; Okazaki, Yuji

    2012-01-01

    Little is known about accurate prevalence and associated factors of deliberate self-harm (DSH) among adolescents in Asian countries. In this study, the prevalence and associated factors of DSH among adolescents in Japan were examined. Data were derived from a cross-sectional survey using an anonymous self-report questionnaire and enrolling 8,620…

  5. The Commissioning and Provision of Advocacy for Problem Drug Users in English DATS: A Cross-Sectional Survey

    ERIC Educational Resources Information Center

    Cargill, Tamsin; Weaver, Tim D.; Patterson, Sue

    2012-01-01

    Aims: This study investigated the commissioning and delivery of advocacy for problem drug users. We aimed to quantify provision, describe the commissioning of advocacy services in Drug Action Teams (DATs) and to identify factors influencing advocacy provision. Methods: A cross-sectional survey of a randomly selected sample of 50 English DATs. The…

  6. The Commissioning and Provision of Advocacy for Problem Drug Users in English DATS: A Cross-Sectional Survey

    ERIC Educational Resources Information Center

    Cargill, Tamsin; Weaver, Tim D.; Patterson, Sue

    2012-01-01

    Aims: This study investigated the commissioning and delivery of advocacy for problem drug users. We aimed to quantify provision, describe the commissioning of advocacy services in Drug Action Teams (DATs) and to identify factors influencing advocacy provision. Methods: A cross-sectional survey of a randomly selected sample of 50 English DATs. The…

  7. The National Survey of Student Engagement as a Predictor of Undergraduate GPA: A Cross-Sectional and Longitudinal Examination

    ERIC Educational Resources Information Center

    Fuller, M. B.; Wilson, M. A.; Tobin, R. M.

    2011-01-01

    Data from the National Survey of Student Engagement (NSSE) collected across seven years were used to predict final, cumulative grade point averages (GPA). Cross-product regression was used to explore the predictive abilities of the NSSE benchmark scores for freshmen (n = 2578) and seniors (n = 2293) collected in cross-sectional cohorts.…

  8. Cross-sectional survey of Good Samaritan behaviour by physicians in North Carolina.

    PubMed

    Garneau, William M; Harris, Dean M; Viera, Anthony J

    2016-03-10

    To assess the responses of physicians to providing emergency medical assistance outside of routine clinical care. We assessed the percentage who reported previous Good Samaritan behaviour, their responses to hypothetical situations, their comfort providing specific interventions and the most likely reason they would not intervene. Physicians residing in North Carolina. Convenience sample of 1000 licensed physicians. Mailed survey. Cross-sectional study conducted May 2015 to September 2015. Willingness of physicians to act as Good Samaritans as determined by the last opportunity to intervene in an out-of-office emergency. The adjusted response rate was 26.1% (253/970 delivered). 4 out of 5 physicians reported previous opportunities to act as Good Samaritans. Approximately, 93% reported acting as a Good Samaritan during their last opportunity. There were no differences in this outcome between sexes, practice setting, specialty type or experience level. Doctors with greater perceived knowledge of Good Samaritan law were more likely to have intervened during a recent opportunity (p=0.02). The most commonly cited reason for potentially not intervening was that another health provider had taken charge. We found the frequency of Good Samaritan behaviour among physicians to be much higher than reported in previous studies. Greater helping behaviour was exhibited by those who expressed more familiarity with Good Samaritan law. These findings suggest that physicians may respond to legal protections. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Predictors of breast feeding self-efficacy among Chinese mothers: a cross-sectional questionnaire survey.

    PubMed

    Zhu, Jiemin; Chan, Wai Chi Sally; Zhou, Xiuzhu; Ye, Benlan; He, Hong-Gu

    2014-06-01

    to examine breast feeding self-efficacy and identify its predictors among expectant Chinese mothers in the antenatal period. a cross-sectional descriptive questionnaire survey was conducted in the antenatal clinics of three university hospitals in China between September and December 2011. expectant mothers planning to breast feed, and who were at least 18 years of age, expecting a single, healthy, full-term baby, and competent in Mandarin (n=201). a socio-demographic data sheet, the Chinese version of the Breastfeeding Self-Efficacy Scale, and the Perceived Social Support Scale. the expectant Chinese mothers reported moderate levels of breast feeding self-efficacy. Expectant mothers who had had previous experience in breast feeding, who had watched other mothers breast feed their infants, or who had made the decision to breast feed earlier reported higher breast feeding self-efficacy. Expectant mothers' perceived social support, perceived attitude of significant others, including husband, mothers, and friends, towards breast feeding are correlated with breast feeding self-efficacy. The best-fit regression analysis revealed five variables that explained 34% of the variance in breast feeding self-efficacy in the antenatal period: perceived social support, previous experience of breast feeding, previous experience of watching others breast feed, timing of maternal decision to breast feed, and perceived husband's attitude towards breast feeding. this study highlighted the importance of improving Chinese mothers' breast feeding self-efficacy by considering the main predictors found in this study. health care professionals could develop strategies to promote breast feeding self-efficacy, such as providing opportunities for expectant mothers to learn from others' successful experience, adopt a family-centred approach in the provision of breast feeding education, provide breast feeding education at the beginning of pregnancy or even earlier, and rally comprehensive social

  10. Workplace bullying among nurses and their related factors in Japan: a cross-sectional survey.

    PubMed

    Yokoyama, Mami; Suzuki, Miho; Takai, Yukari; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Yamamoto-Mitani, Noriko

    2016-09-01

    To explore the association between workplace bullying and workplace environment factors among nurses in Japan. Workplace bullying among nurses is increasing globally and occurs more frequently than among other professions. However, there is little information on the impact of workplace environment factors on nurse bullying in Japan. A cross-sectional survey using a self-administered questionnaire. Participants were 1152 nurses recruited at seminars or training courses outside of their workplaces in Tokyo. Workplace bullying was measured using the Negative Acts Questionnaire-Revised. Participants were considered to have been 'bullied' if they reported experiencing at least one negative act on a daily or weekly basis. Workplace environment factors were measured using the Practice Environment Scale of the Nursing Work Index, which comprises five domains: nurse participation in hospital affairs; nursing foundations for quality of care; nurse manager ability, leadership and support of nurses; staffing and resource adequacy; and collegial nurse-physician relationships. A total of 898 (78·0%) questionnaires were returned, of which 825 (71·6%) were analysed. Altogether, 153 (18·5%) nurses were considered 'bullied.' The three most frequent negative acts reported as occurring on a weekly or daily basis were 'someone withholding information which affects your performance' (6·7%), 'being exposed to an unmanageable workload' (4·4%) and 'being shouted at or being the target of spontaneous anger (or rage)' (3·6%). Logistic regression analysis indicated that 'bullied' were associated with low scores on two work environment domains: nurse manager ability, leadership and support of nurses and staffing and resource adequacy. Effective nurse manager leadership and support as well as appropriate staffing management may positively influence workplace bullying among nurses in Japan. Authentic leadership styles and allowing nurses to easily request days off might also be important

  11. Recent employment trend of childhood cancer survivors in Japan: a cross-sectional survey.

    PubMed

    Ishida, Yasushi; Hayashi, Mitsue; Inoue, Fumiko; Ozawa, Miwa

    2014-12-01

    Previous research has shown that some adult childhood cancer survivors (CCSs) have experienced employment difficulties. However, the actual employment status of CCSs in Japan has not been studied. The participants were selected from the membership directory of Heart Link mutual-aid health insurance and recruited by the Childhood Cancer Patients' Network. We conducted a cross-sectional survey (a self-rated questionnaire on employment) via postal mail or an email communication with a link to an Internet website. We explored the association between the characteristics of CCSs who require disability qualification and having experienced unemployment. The adjusted odds ratios (ORs) for the factors with an outcome of interest were estimated with logistic regression analysis. In total, 44 CCSs indicated that they had a disability qualification. The significant independent factors related to needing a disability qualification were late effects [OR 12.3; 95 % confidence interval (CI) 3.37-45.2], brain tumors (OR 9.55; 95 % CI 1.90-48.0), and being a high school graduate (OR 9.86; CI 2.67-36.4). The unemployment rate was 15.9 % among CCSs, excluding homemakers and students. Approximately 70 % of unemployed CCSs had some late effects; independent factors related to unemployment were late effects (OR 6.22; 95 % CI 1.80-21.40), dropping out of school (OR 8.46; 95 % CI 1.66-43.10), and brain tumors (OR 2.73; 95 % CI 0.83-8.96). Most unemployed CCSs were likely to seek work, despite their health problems. The unemployment rate is not high in Japan, but some CCSs need extended disability qualification. The independent factors related to unemployment were late effects and dropping out of school.

  12. Health IT acceptance factors in long-term care facilities: a cross-sectional survey.

    PubMed

    Yu, Ping; Li, Haocheng; Gagnon, Marie-Pierre

    2009-04-01

    This study applied a modified version of the extended technology acceptance model (TAM2) to examine the factors determining the acceptance of health IT applications by caregivers in long-term care facilities. The antecedent variables, including social influence factors such as subjective norm and image were examined together with demographic variables including age, job level, long-term care work experience and computer skills in regard to their impact on caregivers' acceptance of health IT applications. A self-administered questionnaire was developed based on the validated items from TAM2. The data was collected in a cross-sectional survey using convenience sample. Confirmatory factor analysis and structural equation modelling techniques were used to validate our causal model. Perceived usefulness, perceived ease of use and computer skills had significant positive impact, whereas image had significant negative impact on caregivers' intention to use health IT applications. Image, subjective norm and computer skills also indirectly impacted on intention through the mediating factor of ease of use. Ease of use, subjective norm and job level also determined perceived usefulness. The other demographic factors (including age and long-term care work experience) did not have any significant effect on caregivers' acceptance of a health IT application. Our model explains 34% of caregivers' intention to use an introduced IT application before any hands-on experience with the system established. The planners and managers should ensure that a health IT application to be introduced into a long-term care facility is useful and easy to use. Effort should be focused on forming a positive social norm for the introduction of the new innovation and improving caregivers' computer skills. Securing the managers' and senior nurses' support for the innovation at the onset of the project is critical for success. Finally the caregivers appear to dislike the idea of increased IT ability will

  13. Administration options for pegfilgrastim prophylaxis: patient and physician preferences from a cross-sectional survey.

    PubMed

    Brett Hauber, A; Mange, Brennan; Price, Mark A; Wolin, Daniel; Bensink, Mark; Kaye, James A; Chandler, David

    2017-08-07

    Although clinical guidelines recommend administration of pegfilgrastim 1-4 days after a myelosuppressive chemotherapy cycle to decrease the incidence of febrile neutropenia (FN), some physicians administer pegfilgrastim on the same day as chemotherapy administration. A novel on-body injector (OBI) that automatically delivers pegfilgrastim the day after chemotherapy is also available. Our objective was to estimate patient and physician preferences among the pegfilgrastim administration options. We conducted a cross-sectional survey of patients receiving pegfilgrastim and physicians prescribing pegfilgrastim. Respondents' preferences for pegfilgrastim administration options were elicited using direct elicitation; the relative importance of features associated with the options was estimated in a point-allocation exercise. Physicians considered two hypothetical patient profiles when completing the exercises. The samples included 200 patients and 200 physicians. Patients generally preferred the administration option with which they had experience. Among patients, 48.5% with previous in-clinic injections 24 hours after chemotherapy preferred this option; 56.8% with previous OBI administration preferred this option. For a clinically compromised patient, 37.5% of physicians preferred an in-clinic injection option; 49.5% preferred the OBI. For a less compromised patient, 55.5% preferred an in-clinic injection option; 28.0% preferred the OBI. Avoiding the need to return to the clinic was chosen most often as the most important treatment feature for patients and physicians. Patients and physicians identified that returning clinic visits for pegfilgrastim administration may be burdensome. A potential solution to mitigate this burden is the OBI, which allows adherence to the labeled use of pegfilgrastim without return visits to the clinic.

  14. Intimate Partner Violence and Socioeconomic Deprivation in England: Findings From a National Cross-Sectional Survey

    PubMed Central

    Hargreaves, James; Howard, Louise M.; Birdthistle, Isolde

    2013-01-01

    Objectives. We examined the prevalence of intimate partner violence (IPV) and its association with social deprivation in England. Methods. We used multivariable logistic regression to investigate IPV correlates among 21 226 men and women aged 16 to 59 years in the 2008 nationally representative cross-sectional British Crime Survey. Results. Lifetime IPV was reported by 23.8% of women and 11.5% of men. Physical IPV was reported by 16.8% and 7.0%, respectively; emotional-only IPV was reported by 5.8% and 4.2%, respectively. After adjustment for demographic confounders, lifetime physical IPV experienced by women was associated with social housing tenure (odds ratio [OR] = 2.3; 95% confidence interval [CI] = 2.0, 2.7), low household income (OR = 2.2; 95% CI = 1.8, 2.7), poor educational attainment (OR = 1.2; 95% CI = 1.0, 1.5), low social class (OR = 1.5; 95% CI = 0.3, 1.7), and living in a multiply deprived area (OR = 1.4; 95% CI = 1.1, 1.7). Physical IPV experienced by men and emotional IPV experienced by either gender were generally not associated with deprivation factors. Conclusions. Physical and emotional IPV are very common among adults in England. Emotional IPV prevention policies may be appropriate across the social spectrum; those for physical IPV should be particularly accessible to disadvantaged women. PMID:22897532

  15. Self-Efficacy Beliefs Are Associated with Visual Height Intolerance: A Cross-Sectional Survey

    PubMed Central

    Grill, Eva; Schäffler, Florian; Huppert, Doreen; Müller, Martin; Kapfhammer, Hans-Peter; Brandt, Thomas

    2014-01-01

    Background Responses to height may range from indifference to minor distress to severe symptoms of fear of heights (acrophobia); visual height intolerance (vHI) denotes the whole spectrum of symptoms. Although there are options to manage vHI, only a small part of persons affected by vHI are willing to seek professional help or confront their problem. Purpose of this study was to determine if persons with vHI, specifically those who show avoidant behavior towards heights (avoiders), score lower in their general self-efficacy (GSE) than those who confront vHI (confronters). Method Cross-sectional survey in 607 individuals living in the urban region of Munich, Germany, using a mailed questionnaire on presence or absence of vHI, confronting or avoiding behaviour, and GSE. Results Of all participants (mean age 53.9, 50.3% female), 407 reported life-time presence of vHI. Participants with vHI had a mean GSE score of 31.8 (SD 4.3) points (participants without vHI: 32.5, SD 4.3, p  = 0.008 for difference). Among individuals with vHI, 23% reported confronting behavior. Confronters were significantly younger (p<.0001, 50.2 vs. 55.7 years), more likely to be female (p  = 0.0039, 64.3% female), and had a higher GSE score (p  = 0.0049, 32.5 vs. 31.1). Associations remained significant after multiple adjustment. Conclusions Our study provides evidence for the association of GSE and vHI. These findings may have consequences for strategies of alleviation and therapy of vHI. PMID:25548910

  16. Food consumption patterns in the Waterloo Region, Ontario, Canada: a cross-sectional telephone survey

    PubMed Central

    Nesbitt, Andrea; Majowicz, Shannon; Finley, Rita; Pollari, Frank; Pintar, Katarina; Marshall, Barbara; Cook, Angela; Sargeant, Jan; Wilson, Jeff; Ribble, Carl; Knowles, Lewinda

    2008-01-01

    Background The demographics and lifestyles of Canadians are changing, thereby influencing food choices and food preparation in the home. Although different dietary practices are associated with increased risk of foodborne illness, our ability to evaluate food consumption trends and assess risks associated with foodborne illness is limited by lack of data on current eating habits and consumer food safety practices. The objective of this study was to describe, for the first time, the food consumption patterns in a Canadian-based population from a food safety perspective, in order to establish baseline data on actual food intake of individuals. Method A cross-sectional telephone survey of 2,332 randomly selected residents of Waterloo Region, Ontario, Canada (C-EnterNet pilot site) was conducted between November 2005 and March 2006. Food intake was assessed using a 7-day dietary recall method. Results Certain food items were consumed more than others among the same food groups, and consumption of many food items varied by gender and age. Specific foods considered high-risk for the transmission of certain enteric pathogens were significantly more likely to be consumed by males (i.e. unpasteurized juice, bean sprouts, and undercooked meat) and elderly individuals (i.e. undercooked eggs). The majority of households prepared and consumed most meals at home, allocating an average of 44 minutes to prepare a meal. Conclusion Baseline data on actual food intake is useful to public health professionals and food safety risk assessors for developing communication messages to consumers and in foodborne outbreak investigations. PMID:18950509

  17. Pregnant women's awareness, knowledge and beliefs about pelvic floor muscles: a cross-sectional survey.

    PubMed

    Hill, Anne-Marie; McPhail, Steven M; Wilson, Judith M; Berlach, Richard G

    2017-03-14

    Pregnant women benefit from completing pelvic floor muscle exercises (PFMEs). The aims of the study were to evaluate pregnant women's levels of awareness, knowledge, and beliefs about the pelvic floor muscles (PFMs) and PFMEs. A cross-sectional survey was conducted. Respondents were pregnant women over the age of 18 years who attended antenatal clinics in Western Australia (WA). Questionnaire items measured awareness and knowledge about PFMs, confidence and beliefs about engaging in PFMEs, and attendance at antenatal education (ANE) classes. Chi-squared tests examined potential associations between questionnaire items and respondent characteristics. Mean gestation of respondents (n = 633 out of 850; 74% response rate) was 28.7 (+7.8) weeks and 50% were giving birth for the first time. Although 76% of respondents knew that PFMs can prevent urinary incontinence, only 27% knew that they prevented faecal incontinence and 41% thought it was normal to leak urine when pregnant. Only n = 72 (11%) were practicing PFMEs. Respondents who had attended ANE (28%) were significantly more knowledgeable about pelvic floor function (p < .001) and significantly less likely to believe that leaking urine during pregnancy was normal (p = 0.02), compared with those who had not attended ANE. Respondents who did not speak English at home (18%) were significantly less knowledgeable about PFMs and PFMEs, and significantly less likely to have attended, or planned to attend, ANE classes. Pregnant women require more health education regarding PFMs. Education should be provided using diverse modes, especially for women from migrant backgrounds and women who do not plan to attend formal ANE classes.

  18. Discussing prognosis with patients with osteoarthritis: a cross-sectional survey in general practice.

    PubMed

    Clarson, L E; Nicholl, B I; Bishop, A; Daniel, R; Mallen, C D

    2016-04-01

    Osteoarthritis is a leading cause of chronic pain and disability and one of the most common conditions diagnosed and managed in primary care. Despite the evidence that patients would value discussions about the course of osteoarthritis to help them make informed treatment decisions and plan for the future, little is known of GPs' practice of, or views regarding, discussing prognosis with these patients. A cross-sectional postal survey asked 2500 randomly selected UK GPs their views on discussing prognosis with patients with osteoarthritis and potential barriers or facilitators to such discussions. They were also asked if prognostic discussions were part of their current practice and what indicators they considered important in assessing the prognosis associated with osteoarthritis. Of 768 respondents (response rate 30.7 %), the majority felt it necessary to discuss prognosis with osteoarthritis patients (n = 738, 96.1 %), but only two thirds reported that it was part of their routine practice (n = 498, 64.8 %). Most respondents found predicting the course of osteoarthritis (n = 703, 91.8 %) and determining the prognosis of patients difficult (n = 589, 76.7 %). Obesity, level of physical disability and pain severity were considered the most important prognostic indicators in osteoarthritis. Although GPs consider prognostic discussions necessary for patients with osteoarthritis, few prioritise these discussions. Lack of time and perceived difficulties in predicting the disease course and determining prognosis for patients with osteoarthritis may be barriers to engaging in prognostic discussions. Further research is required to identify ways to assist GPs making prognostic predictions for patients with osteoarthritis and facilitate engagement in these discussions.

  19. Road traffic injuries to children during the school commute in Hyderabad, India: cross-sectional survey

    PubMed Central

    Tetali, Shailaja; Murthy, G V S; Roberts, I

    2016-01-01

    Background India is motorising rapidly. With increasing motorisation, road traffic injuries are predicted to increase. A third of a billion children travel to school every day in India, but little is known about children's safety during the school commute. We investigated road traffic injury to children during school journeys. Methods We conducted a cross-sectional survey in Hyderabad using a two-stage stratified cluster sampling design. We used school travel questionnaires to record any road injury in the past 12 months that resulted in at least 1 day of school missed or required treatment by a doctor or nurse. We estimated the prevalence of road injury by usual mode of travel and distance to school. Results The total sample was 5842 children, of whom 5789 (99.1%) children answered the question on road injury. The overall prevalence of self-reported road injury in the last 12 months during school journeys was 17% (95% CI 12.9% to 21.7%). A higher proportion of boys (25%) reported a road injury than girls (11%). There was a strong association between road injury, travel mode and distance to school. Children who cycled to school were more likely to be injured compared with children who walked (OR 1.5; 95% CI 1.2 to 2.0). Travel by school bus was safer than walking (OR 0.5; 95% CI 0.3 to 0.9). Conclusions A sixth of the children reported a road traffic injury in the past 12 months during school journeys in Hyderabad. Injury prevention interventions should focus on making walking and cycling safer for children. PMID:26701985

  20. Social relationships and HRQL: a cross-sectional survey among older Italian adults.

    PubMed

    de Belvis, Antonio Giulio; Avolio, Maria; Sicuro, Lorella; Rosano, Aldo; Latini, Elide; Damiani, Gianfranco; Ricciardi, Walter

    2008-10-03

    The aim of this study is to investigate the association between social relationships and Health Related Quality of Life (HRQL) among the elderly in Italy. A sample of 33,744 Italian residents, representing the non-institutionalised population aged 60 years and over was extracted from the national ISTAT cross-sectional survey during 1999-2000. HRQL was measured with the SF-12, from which the Physical Component Score (PCS) and Mental Component Score (MCS) were obtained. Data were subjected to descriptive analysis and multiple logistic regression models with adjustment for the main confounders. Our analysis shows a gradient in PCS and MCS among the terziles in seeing/meeting "friends" and "family" and, for PCS, a North-South gradient among the Italian regions. Females, the elderly who reported a lower household income, those who spent less time in recreational and religious activities, who lived too far from their relatives and had few relationships with friends and relatives, were significantly less likely to have an MCS above the median value. For PCS, an increase in HRQL was likely to be associated with a higher educational level, while lower PCS scores were associated with: age 75+, inadequate household income, unmarried status, infrequency of seeing/meeting friends, too high a mean distance from own home to relatives' homes, lack of leisure time spent in recreational activities, living in the Centre-South of Italy, chronic diseases, reduced autonomy, and use of drugs during the previous two days. Significant interactions between suffering from one chronic disease and the use of drugs were also found for both MCS and PCS. Some dimensions of social relationships were significantly associated with HRQL. These findings are crucial for devising welfare strategies at both the regional and the European level, i.e. in countries such as Italy where the primacy of family support of the elderly has declined in recent years.

  1. Health effects of family size: cross sectional survey in Chinese adolescents

    PubMed Central

    Hesketh, T; Qu, J; Tomkins, A

    2003-01-01

    Aims: To determine whether only children differ in terms of morbidity, nutritional status, risk behaviours, and utilisation of health services from children with siblings, in China. Methods: A cross sectional survey was carried out using self completion questionnaires, anthropometry, and haemoglobin measurement in middle schools (predominant age 12–16 years) in three distinct socioeconomic areas of Zhejiang province, eastern China. Results: Data were obtained for 4197 participants. No significant differences were found between only children and those with siblings for some key indicators: underweight 19% v 18%, suicide ideation 14% v 14%, and ever smoking 17% v 15%. Only children were more likely to be overweight (4.8% v 1.5%), and to have attended a doctor (71% v 63%) or dentist (17% v 10%) in the past year. Sibling children are significantly more likely to be anaemic (42% v 32%) and to admit to depression (41% v 21%) or anxiety (45% v 37%). However, after adjusting for area, sex, and parental education levels only two differences remained: sibling children are more likely to be bullied (OR 1.5, 1.1–2.0; p = 0.006) and are less likely to confide in parents (OR 0.6, 0.3–0.8, p = 0.009). There were no significant differences in the key parameters between first and second born children. Conclusions: We found no detrimental effects of being an only child using the indicators measured. Being an only child may confer some benefits, particularly in terms of socialisation. PMID:12765907

  2. Mental health associations with eczema, asthma and hay fever in children: a cross-sectional survey

    PubMed Central

    Hammer-Helmich, Lene; Linneberg, Allan; Obel, Carsten; Thomsen, Simon Francis; Tang Møllehave, Line; Glümer, Charlotte

    2016-01-01

    Objective This study aimed to examine the association of eczema, asthma and hay fever with mental health in a general child population and to assess the influence of parental socioeconomic position on these associations. Methods We conducted a cross-sectional health survey of children aged 3, 6, 11 and 15 years in the City of Copenhagen, Denmark. Individual questionnaire data on eczema, asthma, and hay fever and mental health problems assessed using the Strengths and Difficulties Questionnaire (SDQ) was linked to register data on demographics and parental socioeconomic position. 9215 (47.9%) children were included in the analyses. Results Linear regression analyses showed that children with current eczema symptoms had higher SDQ scores (mean difference, 95% CI) of emotional problems (0.26, 0.12 to 0.39), conduct problems (0.19, 0.09 to 0.29) and hyperactivity problems (0.32, 0.16 to 0.48); children with current asthma symptoms had higher SDQ scores of emotional problems (0.45, 0.32 to 0.58), conduct problems (0.28, 0.18 to 0.38) and hyperactivity problems (0.52, 0.35 to 0.69); and children with current hay fever symptoms had higher SDQ scores of emotional problems (0.57, 0.42 to 0.72), conduct problems (0.22, 0.11 to 0.33), hyperactivity problems (0.44, 0.26 to 0.61) and peer problems (0.14, 0.01 to 0.26), compared with children without current symptoms of the relevant disease. For most associations, parental socioeconomic position did not modify the effect. Conclusions Children with eczema, asthma or hay fever had more emotional, conduct and hyperactivity problems, but not peer problems, compared with children without these diseases. Atopic diseases added equally to the burden of mental health problems independent of socioeconomic position. PMID:27742629

  3. Relationship between commuting and health outcomes in a cross-sectional population survey in southern Sweden

    PubMed Central

    2011-01-01

    Background The need for a mobile workforce inevitably means that the length of the total work day (working and traveling time) will increase, but the health effects of commuting have been surprisingly little studied apart from perceived stress and the benefits of physically active commuting. Methods We used data from two cross-sectional population-based public health surveys performed in 2004 and 2008 in Scania, Sweden (56% response rate). The final study population was 21, 088 persons aged 18-65, working > 30 h/week. Duration (one-way) and mode of commuting were reported. The outcomes studied were perceived poor sleep quality, everyday stress, low vitality, mental health, self-reported health, and absence from work due to sickness during the past 12 months. Covariates indicating socioeconomic status and family situation, overtime, job strain and urban/rural residency were included in multivariate analyses. Subjects walking or cycling to work < 30 min were used as a reference category. Results Monotonous relations were found between duration of public transport commuting and the health outcomes. For the category commuting > 60 min odds ratios (ORs) ranged from 1.2 - 1.6 for the different outcomes. For car commuting, the relationships were concave downward or flat, with increasing subjective health complaints up to 30-60 min (ORs ranging from 1.2 - 1.4), and lower ORs in the > 60 min category. A similar concave downward relationship was observed for sickness absence, regardless of mode of transport. Conclusions The results of this study are concordant with the few earlier studies in the field, in that associations were found between commutation and negative health outcomes. This further demonstrates the need to consider the negative side-effects of commuting when discussing policies aimed at increasing the mobility of the workforce. Studies identifying population groups with increased susceptibility are warranted. PMID:22039952

  4. Participation of ICUs in critical care pandemic research: a province wide, cross-sectional survey.

    PubMed

    Burns, Karen E A; Rizvi, Leena; Tan, Wylie; Marshall, John C; Pope, Karen

    2013-04-01

    Little information exists to identify barriers to participation in pandemic research involving critically ill patients. We sought to characterize clinical research activity during the recent influenza A pandemic and to understand the experiences, beliefs, and practices of key stakeholders involved in pandemic research implementation. Cross-sectional, provincial postal questionnaire. Level III ICUs. ICU administrators and research coordinators. We used rigorous survey methodology to identify potential respondents and to develop, test, and administer two-related questionnaires. We analyzed responses from 39 research coordinators and 139 administrators (response rates: 70.9% and 73.2%, respectively). Compared with non-influenza A studies, influenza A studies were less likely to be randomized trials and most often investigator-initiated and peer-review funded. Whereas both respondent groups felt that pandemic research would be helpful in providing care during future pandemics, research coordinators placed significantly greater importance on their ICU's participation in pandemic research. Both respondent groups expressed a need for rapid approval processes, designated funding for research personnel, adequate funding for start-up and patient screening, preapproved template protocols and consent forms, and clearer guidance regarding co-enrollment. Research coordinators acknowledged a need for alternative consent models to increase their capacity to participate in future pandemic research. More administrators expressed willingness to participate in the next pandemic if the required research resources were made available to them. Whereas research personnel and administrators support participation in pandemic ICU research, several modifiable barriers to participation exist. Pandemic research preparedness planning with regulatory bodies and dedicated funding to support research infrastructure, especially in community settings, are required to optimize future pandemic research

  5. The information and consent process in patients undergoing elective ENT surgery: A cross-sectional survey.

    PubMed

    Georgalas, Christos; Ganesh, Kulandaivelu; Papesch, Eva

    2008-09-17

    To assess the importance of different information pathways for patients undergoing elective ENT surgery (General Practitioner, Specialist consultation, pre assessment clinic and consent process as well as printed information material and non medical sources) and to correlate their relative importance with patient and doctor factors METHODS - PATIENTS: Cross - sectional questionnaire survey226 consecutive patients undergoing elective non-oncological otolaryngology procedures at a District General Hospital between May and August 2004 Overall patients were moderately satisfied with the information they received prior to surgery (score 63/100). Although they were generally satisfied with the quality of information they received at their outpatient consultation and at the preadmission clinic, they were less satisfied with the quality of information provided by their GPs and by the quality of self - obtained information. Most importantly, linear regression modeling showed that the overall level of information could be predicted by three factors: The quality of written information received at the hospital, the quality of self-obtained information and the information provided by the specialist at the time of listing for surgery. While patient's education level was correlated with the information process, the age and gender of the patient as well as the grade of the doctor at the outpatients were not associated with his overall levels of satisfaction. Although the impact of the initial outpatient consultation for patients undergoing elective surgery can not be over emphasized, written information provided at the hospital as well as patient - initiated, parallel information pathways are at least as important: It is our duty to recognize them and use them for the patient's advantage.

  6. Total fluid intake of children and adolescents: cross-sectional surveys in 13 countries worldwide.

    PubMed

    Iglesia, Iris; Guelinckx, Isabelle; De Miguel-Etayo, Pilar M; González-Gil, Esther M; Salas-Salvadó, Jordi; Kavouras, Stavros A; Gandy, Joan; Martínez, Homero; Bardosono, Saptawati; Abdollahi, Morteza; Nasseri, Esmat; Jarosz, Agnieszka; Ma, Guansheng; Carmuega, Esteban; Thiébaut, Isabelle; Moreno, Luis A

    2015-06-01

    To describe total fluid intake (TFI) according to socio-demographic characteristics in children and adolescents worldwide. Data of 3611 children (4-9 years) and 8109 adolescents (10-18 years) were retrieved from 13 cross-sectional surveys (47 % males). In three countries, school classes were randomly recruited with stratified cluster sampling design. In the other countries, participants were randomly recruited based on a quota method. TFI (drinking water and beverages of all kinds) was obtained with a fluid-specific record over 7 consecutive days. Adequacy was assessed by comparing TFI to 80 % of adequate intake (AI) for total water intake set by European Food Safety Authority. Data on height, weight and socio-economic level were collected in most countries. The mean (SD) TFI ranged from [1.32 (0.68)] to [1.35 (0.71)] L/day. Non-adherence to AIs for fluids ranged from 10 % (Uruguay) to >90 % (Belgium). Females were more likely to meet the AIs for fluids than males (4-9 years: 28 %, OR 0.72, p = 0.002; 10-18 years: 20 %, OR 0.80, p = 0.001), while adolescents were less likely to meet the AI than children (OR 1.645, p < 0.001 in males and OR 1.625, p < 0.001 in females). A high proportion of children and adolescents are at risk of an inadequate fluid intake. This risk is especially high in males and adolescents when compared with females or children categories. This highlights water intake among young populations as an issue of global concern.

  7. Optimal communication from occupational physicians to GPs: a cross-sectional survey

    PubMed Central

    Stern, Anna F; Madan, Ira

    2012-01-01

    Background Correspondence from occupational physicians to GPs is infrequent, despite evidence that good communication leads to earlier return to work of sick-listed patients and is cost effective. Aim To explore the circumstances, content, and preferred method of communication GPs would value from an occupational physician, following an occupational health consultation with one of their patients. Design and setting A cross-sectional survey in the UK. Method A questionnaire was developed de novo, piloted, and sent to 600 GPs of consecutive employees undergoing occupational physician assessments. Descriptive data were generated using Excel®. Results The response rate was 374/600 (62%). Demographic features of GP responders reflected national figures. A total of 372 (99.5%) GPs wanted information from occupational physicians. Most wanted information on diagnosis (303, 81%), clinical assessment (275, 74%), functional assessment (295, 79%), or advice on the timing (308, 82%) and adjustments 290 (78%) of any return-to-work plan. Over 80% wanted information following every occupational physician consultation, and over 90% wanted information on the timing of a return to work, adjustments suggested, or if different medical diagnosis or management was suggested. The preferred method of communication was letter by post 341/374 (92%). Brief, relevant information was valued and considered useful for completing ‘fit notes’. Conclusion Occupational physicians should send formal letters, by post, to the patient’s GP following occupational health assessments. This would assist the GP in completing the patient’s ‘fit note’ and ultimately increase the chances of their patient being rehabilitated back to work. PMID:23211264

  8. Implantable cardioverter defibrillator knowledge and end-of-life device deactivation: A cross-sectional survey.

    PubMed

    McEvedy, Samantha M; Cameron, Jan; Lugg, Eugene; Miller, Jennifer; Haedtke, Chris; Hammash, Muna; Biddle, Martha J; Lee, Kyoung Suk; Mariani, Justin A; Ski, Chantal F; Thompson, David R; Chung, Misook Lee; Moser, Debra K

    2017-06-01

    End-of-life implantable cardioverter defibrillator deactivation discussions should commence before device implantation and be ongoing, yet many implantable cardioverter defibrillators remain active in patients' last days. To examine associations among implantable cardioverter defibrillator knowledge, patient characteristics and attitudes to implantable cardioverter defibrillator deactivation. Cross-sectional survey using the Experiences, Attitudes and Knowledge of End-of-Life Issues in Implantable Cardioverter Defibrillator Patients Questionnaire. Participants were classified as insufficient or sufficient implantable cardioverter defibrillator knowledge and the two groups were compared. Implantable cardioverter defibrillator recipients ( n = 270, mean age 61 ± 14 years; 73% male) were recruited from cardiology and implantable cardioverter defibrillator clinics attached to two tertiary hospitals in Melbourne, Australia, and two in Kentucky, the United States. Participants with insufficient implantable cardioverter defibrillator knowledge ( n = 77, 29%) were significantly older (mean age 66 vs 60 years, p = 0.001), less likely to be Caucasian (77% vs 87%, p  = 0.047), less likely to have received implantable cardioverter defibrillator shocks (26% vs 40%, p = 0.031), and more likely to have indications of mild cognitive impairment (Montreal Cognitive Assessment score <24: 44% vs 16%, p < 0.001). Insufficient implantable cardioverter defibrillator knowledge was associated with attitudes suggesting unwillingness to discuss implantable cardioverter defibrillator deactivation, even during the last days towards end of life ( p < 0.05). Implantable cardioverter defibrillator recipients, especially those who are older or have mild cognitive impairment, often have limited knowledge about implantable cardioverter defibrillator deactivation. This study identified several potential teachable moments throughout the patients' treatment trajectory

  9. Employers' and employees' views on responsibilities for career management in nursing: a cross-sectional survey.

    PubMed

    Philippou, Julia

    2015-01-01

    To examine nurse employees' and employers' views about responsibilities for managing nurses' careers. Career management policies are associated with cost savings, in terms of workforce recruitment and retention and an increase in job and career satisfaction. In nursing, responsibility for career management remains relatively unexplored. A multicenter, cross-sectional questionnaire survey. Data were collected from 871 nurse employees and employers in the British National Health Service. The study was conducted in 2008, a period when policy reforms aimed at modernizing the healthcare workforce in England. In the current discussions in Europe and the USA about the future of nursing, these data reveal insights not previously reported. Exploratory analyses were undertaken using descriptive and inferential statistics. The analysis indicated a temporal dimension to career management responsibilities. Short-term responsibilities for securing funding and time for development lay more with employers. Medium-term responsibilities for assessing nurses' strengths and weakness, determining job-related knowledge and skills and identifying education and training needs appeared to be shared. Long-term responsibilities for developing individual careers and future development plans lay primarily with employees. New ways of managing nurses' career development that lead to greater independence for employees and greater flexibility for employers, while retaining a high-calibre and competent workforce, are needed. Ultimately, career management responsibilities should not tilt to either side but rather be shared to benefit both parties. Clarifying employers' and employees' responsibilities for career management may help both parties to develop a common understanding of each other's role and to meet their obligations in a constructive dialogue. © 2014 John Wiley & Sons Ltd.

  10. Predictors of childbirth fear among pregnant Chinese women: A cross-sectional questionnaire survey.

    PubMed

    Gao, Ling-Ling; Liu, Xiao Jun; Fu, Bai Ling; Xie, Wen

    2015-09-01

    to examine childbirth fear and identify its predictors among pregnant Chinese women. a cross-sectional descriptive questionnaire survey was conducted in a regional teaching hospital in Guangzhou, China, between October and November 2013. 353 pregnant Chinese women who were at least 18 years old, with a singleton fetus, in the third trimester of pregnancy, not at high risk for complications of pregnancy, and not having had a previous caesarean section. a social-demographic data sheet; the Chinese version of the Childbirth Attitude Questionnaire and the Spielberger׳s State-Trait Anxiety Inventory; and the short form of 32-item Chinese Childbirth Self-Efficacy Inventory. the pregnant Chinese women reported moderate levels of childbirth fear. The pregnant Chinese women who were younger, with lower educational level, not satisfied with their husbands׳ support, and with previous experience of miscarriage reported higher level of childbirth fear. Pregnant women׳s childbirth self-efficacy, state anxiety and trait anxiety were correlated with childbirth fear. The best-fit regression analysis revealed four variables that explained 28% of variance in childbirth fear: trait anxiety, state anxiety, age and previous experience of miscarriage. this study highlighted the connection between childbirth fear, state and trait anxiety, childbirth self-efficacy, age, education and previous miscarriage among pregnant Chinese women. the CAQ was an appropriate method to measure childbirth fear in pregnant Chinese women. The health-care professionals should be sensitive toward issues that could affect levels of childbirth fear in pregnant Chinese women, including age, education and previous miscarriage. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Melanoma awareness and prevalence of dermoscopic examination among internet users: a cross-sectional survey

    PubMed Central

    Wydmanski, Jerzy; Gajda, Maksymilian; Tukiendorf, Andrzej

    2016-01-01

    Introduction Melanoma presents the greater threat to health the later the disease is detected and treated, although treatment results can be improved by the widespread use of dermoscopy. However, scarce data are available concerning the awareness of dermoscopy and the frequency of its performance in the non-patient population. Aim To assess the awareness of melanoma detection by dermoscopic examination among the audience of a scientific website. Material and methods Respondents were invited to participate in an online cross-sectional survey. They were asked to complete an online questionnaire designed by the authors. The preliminary analysis of 5,154 collected forms and the exclusion of incomplete forms yielded 4,919 fully completed questionnaires; the resulting database was analyzed statistically using logistic regression with the R software program (95% CI). Results Less than two-fifths (39.2%) of respondents reported ever having sought the advice of a medical professional (dermatologist or other specialist), and 25.4% of the respondents had undergone dermoscopy at least once in their life. Furthermore, approximately one-tenth of respondents (10.7%) were not aware of this detection tool. The study respondents gained knowledge about dermoscopic examination from television and magazines. The performance of dermoscopy was more increasingly associated with inhabitants of larger locales, the use of higher-SPF sunscreens, and greater awareness of the relationship between the risk of melanoma and sunburn. Conclusions Awareness of melanoma and sun care varied within the analyzed population. A subset of individuals at high risk of melanoma was identified. This group included those who engaged in risky sun exposure behaviors and who had never been examined by dermoscopy. PMID:28035218

  12. Menstrual patterns and disorders among secondary school adolescents in Egypt. A cross-sectional survey.

    PubMed

    Abdelmoty, Hatem I; Youssef, M A; Abdallah, Shimaa; Abdel-Malak, Khaled; Hashish, Nawara M; Samir, Dalia; Abdelbar, Moutafa; Hosni, Ahmed Naguib; Abd-El Ghafar, Mohamed; Khamis, Yasser; Seleem, Mostafa

    2015-09-04

    To our knowledge, no large population - based studies have been performed on the topic of menstrual patterns among Egyptian adolescent in recent years. The aims of this study were to identify menstrual patterns and associated disorders as well as the sources of menstrual health knowledge among Egyptian adolescents. A cross-sectional survey. A total of 800 questionnaires were administered to post-menarcheal Egyptian adolescents attending secondary schools in Giza, Egypt, from September 1, 2012, to December 1, 2013. Participants were asked to respond to a semi-structured questionnaire on menstrual health awareness. The questionnaire included items on girl's socio-demographic and menstrual pattern characteristics, concerning their age at menarche, menstrual cycle length and regularity, duration and amount of flow, type and severity of pain related to menstruation, need for analgesia; and symptoms suggestive of premenstrual syndrome (PMS) Main Outcome Measure: description of menstrual patterns, disorders and source of knowledge. Four hundred twelve (51.5 %) out of 800 adolescents completed the questionnaire. The mean age of the girls was 14.67 ± 1.7 years. Mean age at menarche was 12.49 ± 1.20 years. 382 respondents reported various menstrual disorders, giving a prevalence rate of 95 %. Dysmenorrhea was the most prevalent (93 %) menstrual disorder in our sample, followed by PMS (65 %), and abnormal cycle lengths (43 %). Menstrual disorders interfered with social and academic life of 33 and 7.7 % of respondents respectively. Most participants lacked menstrual health knowledge and only 8.9 % of girls reported consulting a physician. To the best of our knowledge, this is one of the largest studies on menstrual pattern and disorders among Egyptian adolescent girls. Our Findings of the present study are consistent with other studies and reported higher than expected prevalence of menstrual disorders.

  13. Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey.

    PubMed Central

    Biddle, Lucy; Gunnell, David; Sharp, Debbie; Donovan, Jenny L

    2004-01-01

    BACKGROUND: Young adults, especially men, are among those least likely to consult healthcare professionals when mentally distressed or suicidal. AIMS: To investigate the help-seeking behaviours of mentally distressed young adults. Design of study: Cross-sectional survey. SETTING: Bristol and surrounding areas, including inner-city, suburban and urban locations. METHOD: A questionnaire was sent to a sample of 3004 young adults aged 16-24 years. This assessed probable mental disorder (using the 12-item general health questionnaire [GHQ-12]), suicidal thoughts (GHQ-28 suicide subscale), and help-seeking behaviours. RESULTS: Most responders who were assessed as having probable mental disorders (GHQ "cases") had not sought help. Help seeking was more common in female GHQ cases than male cases (34.8% and 21.8%,respectively; P = 0.003) and women with suicidal thoughts more commonly sought help than men with suicidal thoughts (41.6% and 30.9%, respectively; P = 0.15). Small proportions of male and female GHQ cases (7.5% and 8.9%, respectively; P = 0.6), and less than one in five responders with suicidal thoughts, had consulted a general practitioner. In more female than male cases, help was sought from family and friends (30.7% and 18.4%, respectively; P = 0.004). GHQ score was the strongest predictor of help seeking. Men had a higher threshold of severity at which they would seek help than women. Recent experience of suicidal thoughts appeared to be a stronger predictor of formal help seeking in mentally distressed women than mentally distressed men. CONCLUSION: Distressed young adults are reluctant to seek help. Men are particularly unlikely to do so unless severely distressed and tend not to seek lay support. Sex differences in help seeking may be important in understanding the high suicide rate for men. PMID:15113490

  14. Sexual health problems managed in Australian general practice: a national, cross sectional survey

    PubMed Central

    Freedman, E; Britt, H; Harrison, C M; Mindel, A

    2006-01-01

    Objectives To ascertain how frequently Australian general practitioners (GPs) identify sexual health (SH) problems, to gain understanding of how SH problems are managed in general practice and to determine the characteristics of GPs who manage them. Methods A secondary analysis of data from the BEACH programme April 2000–March 2003. BEACH is a cross sectional national survey of GP activity: approximately 1000 GPs per year, each records details of 100 consecutive patient encounters. Initially, patient reasons for encounter (RFE), suggestive of a SH problem, were used to derive a list of SH problems (that is, doctor's diagnosis/problem label). Management of these problems was then investigated for all encounters with patients aged 12–49 years. The frequency of SH problems, their management and the characteristics of GPs managing them, were analysed using SAS. Results During 299 000 encounters with 2990 GPs, 3499 (1.17 per 100 encounters) STI/SH problems were managed, the majority (81.1%) in females. The most common in women were genital candidiasis, vaginal symptoms, urinary symptoms, and intermenstrual bleeding, and in men were testicular symptoms, genital warts, and urethritis. Tests to exclude specific STIs were seldom taken and symptomatic management was common. GPs managing SH problems were younger, more likely to be female, have fewer years in practice, work in larger practices; hold FRACGP status (all p = <0.001) than those GPs who managed none. Conclusion Patients seeking medical attention for SH problems are often managed by GPs. Tests to diagnose or exclude specific sexually transmitted infections are seldom ordered and symptomatic management is common. Strategies to improve management of SH problems in general practice need to be developed and evaluated. PMID:16461607

  15. Community preparedness for emergency: a cross-sectional survey of residents in Heilongjiang of China

    PubMed Central

    Xu, Weilan; Hao, Yanhua; Wu, Qunhong; Ning, Ning; You, Jia; Liu, Chaojie; Jiao, Mingli; Gao, Lijun; Kang, Zheng; Liang, Libo; Sun, Hong; Cui, Yu; Li, Ye; Han, Xiaonan; Fang, Xin; Zhao, Xiyan; Hu, Man; Ding, Ding; Gao, Hao; Lu, Jun

    2015-01-01

    Objective This article aims to identify factors that shape the knowledge, attitudes and behaviours of community residents in China's Heilongjiang province towards emergency preparedness. Findings of such a study may provide evidence to support the development of effective public risk communication strategies and education campaigns. Design A cross-sectional household questionnaire survey was conducted in Heilongjiang province in 2014. A stratified cluster sampling strategy was employed to select study participants. The questionnaires were administered using face-to-face interviews. 2800 questionnaires were completed, among which 2686 (95.9%) were considered valid for data analyses. A multivariate logistic regression model was adopted to identify the extent to which the independent variables were associated with emergency preparedness. Results Fewer than 5% respondents were well prepared for emergency. Over half (52%) of poorly prepared respondents did not know what to do in emergency; women (OR=1.691), higher household income (OR ranging from 1.666 to 2.117), previous experience with emergency (OR=1.552), higher levels of knowledge about emergency (OR=2.192), risk awareness (OR=1.531), self-efficacy (OR=1.796), as well as positive attitudes towards emergency preparedness (OR=2.265) were significant predictors for emergency preparedness. Neither educational attainment nor exposure to awareness-raising entered into the logic regression model as a significant predictor for emergency preparedness. Conclusions The level of emergency preparedness in Heilongjiang residents is very low, which is linked with poor knowledge and attitudes of the residents towards emergency preparedness. Future emergency awareness campaigns should be more focused and tailored to the needs of intended audience, taking into consideration of their usual source of information and knowledge in relation to emergency. PMID:26553829

  16. Factors influencing blood donation: a cross-sectional survey in Guangzhou, China.

    PubMed

    Ou-Yang, J; Bei, C-H; He, B; Rong, X

    2017-08-01

    The present study aimed to determine major factors that influence blood donation in China. Factors affecting blood donation often vary in various populations. This cross-sectional study used self-administered, standardised, structured questionnaires to survey selected donors and non-donors in Guangzhou, China between 10 December 2013 and 25 June 2014. Among the 1080 questionnaires collected, 1034 (95·7%) questionnaires were valid for this analysis, including 602 donors and 432 non-donors. Results revealed that helping patients (n = 405, 68·2%) was the main objective of blood donation, and self-perception of poor health (n = 138, 33·1%) was the main reason for not donating. Responses to questions raised by donors and inquiring about a donor's physical condition were thought to be the most important blood donation routines (n = 302, 65·5%). For non-donors, 90·3% (n = 390) expressed their intention to donate blood in the future, and usage of blood (n = 182, 46·7%) was the most asked question. Prepaid cellular phone cards were the most popular incentives. Raising the awareness of blood donation was the most effective way of enhancing blood donation programmes, and television ads and the internet were the most effective means. Helping patients was the main objective of blood donation in China. However, self-perception of poor health was a major barrier to donating blood. Raising the awareness of blood donation in combination with multiple aspects of campaigns that target different populations with potential blood donors is critical. Television and the internet are the most effective tools for promotion of and recruitment for blood donation. © 2017 British Blood Transfusion Society.

  17. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey

    PubMed Central

    Xing, Kai; Jiao, Mingli; Ma, Hongkun; Qiao, Hong; Hao, Yanhua; Li, Ye; Gao, Lijun; Sun, Hong; Kang, Zheng; Liang, Libo; Wu, Qunhong

    2015-01-01

    Purpose The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals. Methods A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%). Results A total of 106 of the 840 (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients’ relatives (62.3%), followed by the patient (22.6%); 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60) resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%). Most respondents (62.8%) did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats) was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc.). Conclusions Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue. PMID:26571388

  18. Public stigma associated with mental illnesses in Pakistani university students: a cross sectional survey

    PubMed Central

    Zubair, Muhammad; Ghulam, Hamzah; Wajih Ullah, Muhammad; Zubair Tariq, Muhammad

    2014-01-01

    Background. The objectives of the study were to explore the knowledge and attitudes of Pakistani university students toward mental illnesses. People with mental illnesses are challenged not only by their symptoms but also by the prejudices associated with their illness. Acknowledging the stigma of mental illness should be the first essential step toward devising an appropriate treatment plan. Methods. A cross-sectional survey was conducted at the University of Punjab, Lahore, CMH Lahore Medical and Dental College, Lahore, and University of Sargodha, Sub-campus Lahore, from February to May 2014. The self-administered questionnaire consisted of three sections: demographics, general knowledge of psychiatric illnesses, and Community Attitudes towards Mental Illnesses (CAMI) Scale. The questionnaire was distributed to 650 participants enrolled in different disciplines (Social Sciences, Medicine and Formal Sciences). Results. Response rate was 81% (527/650 respondents). Mean age was 20.98 years. Most of the students (331, 62.8%) had an urban background and studied Social Sciences (238, 45.2%). Four hundred and eighteen respondents (79.3%) considered religion very important and most respondents considered psychiatrists (334, 63.4%) and spiritual leaders (72, 13.7%) to be best able to treat mental illnesses. One hundred and sixty nine respondents (32.1%) considered black magic to be a cause of mental illness. Only 215 (41%) respondents had ever read an article on mental illnesses. Multiple regression analysis revealed study discipline, exposure, perceived causes of mental illnesses and superstitions to be significantly associated with attitudes towards mental illnesses (p < .05). Conclusion. Although low awareness and exposure were found in this sample of Pakistani university students, their attitude towards mental illnesses was generally positive. Most respondents gave supernatural explanations for mental illnesses but only a few believed that spiritual leaders can play a

  19. Attitudes towards mental illness in Malawi: a cross-sectional survey

    PubMed Central

    2012-01-01

    Background Stigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi. Methods A cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”. Results 210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample. Conclusions Our study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue. PMID:22823941

  20. Attitudes Toward Risk and Informed Consent for Research on Medical Practices: A Cross-sectional Survey.

    PubMed

    Cho, Mildred K; Magnus, David; Constantine, Melissa; Lee, Sandra Soo-Jin; Kelley, Maureen; Alessi, Stephanie; Korngiebel, Diane; James, Cyan; Kuwana, Ellen; Gallagher, Thomas H; Diekema, Douglas; Capron, Alexander M; Joffe, Steven; Wilfond, Benjamin S

    2015-05-19

    The U.S. Office for Human Research Protections has proposed that end points of randomized trials comparing the effectiveness of standard medical practices are risks of research that would require disclosure and written informed consent, but data are lacking on the views of potential participants. To assess attitudes of U.S. adults about risks and preferences for notification and consent for research on medical practices. Cross-sectional survey conducted in August 2014. Web-based questionnaire. 1095 U.S. adults sampled from an online panel (n = 805) and an online convenience river sample (n = 290). Attitudes toward risk, informed consent, and willingness to participate in 3 research scenarios involving medical record review and randomization of usual medical practices. 97% of respondents agreed that health systems should evaluate standard treatments. Most wanted to be asked for permission to participate in each of 3 scenarios (range, 75.2% to 80.4%), even if it involved only medical record review, but most would accept nonwritten (oral) permission or general notification if obtaining written permission would make the research too difficult to conduct (range, 70.2% to 82.7%). Most perceived additional risk from each scenario (range, 64.0% to 81.6%). Use of hypothetical scenarios and a nonprobability sample that was not fully representative of the U.S. population. Most respondents preferred to be asked for permission to participate in observational and randomized research evaluating usual medical practices, but they are willing to accept less elaborate approaches than written consent if research would otherwise be impracticable. These attitudes are not aligned with proposed regulatory guidance. National Center for Advancing Translational Sciences at the National Institutes of Health.

  1. Orientation of Dental Professionals in India towards Integrative Medicine: A Cross-Sectional Survey

    PubMed Central

    Gayathri, Haritheertham; Garhnayak, Mirna; Naik, Eslavath Seena

    2016-01-01

    Introduction There is a growing demand on our health care system, including Dentistry, to shift from a bio-medical approach to Integrative model of care. The attitudes of health professionals towards Integrative Medicine (IM) are an important factor that influences this transition. Aim The aim of this study was to evaluate and compare the orientation of the dental professionals in India towards the principles and practice of Integrative Medicine. Materials and Methods A cross-sectional survey was conducted on 286 dental faculty and postgraduate students from three dental schools in India. The participants voluntarily and anonymously completed the “Integrative Medicine-30’ questionnaire, a 30 item self-report instrument that measures the health care provider’s orientation towards Integrative Medicine in five subscales. Data analysis included summary statistics and intergroup comparisons by gender and professional status with independent samples Mann-Whitney U test. Results The overall orientation of the dental professionals towards IM was almost neutral. While the use of learning resources on Complementary and Alternative Medicine was lower, they showed a more positive orientation towards patient-centred care. Compared to postgraduate students of Dentistry, the dental faculty were more oriented towards IM (median score of 82 vs. 79.5, p<0.01), especially in terms of learning from alternate paradigms (14 vs. 12, p<0.01) and safety of Complementary and Alternative Medicine (13 vs. 12, p<0.01). Females scored better than males both in terms of overall orientation (82 vs. 78, p<0.01) and towards patient-centred care (12 vs. 11, p<0.001). Conclusion The results highlight the impending need to improve the orientation of dental professionals in India towards the principles and practice of IM. PMID:27042588

  2. What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey

    PubMed Central

    Bradbury, Andrew; Evans, Christine; Allan, Paul; Lee, Amanda; Ruckley, C Vaughan; Fowkes, F G R

    1999-01-01

    Objective To define the relations between age, sex, lower limb symptoms, and the presence of trunk varicose veins on clinical examination. Design Cross sectional population study. Setting 12 general practices with catchment areas geographically and socioeconomically distributed throughout Edinburgh. Participants An age stratified random sample of 1566 people (699 men and 867 women) aged 18-64 selected from the computerised age-sex registers of participating practices. Main outcome measures Self administered questionnaire on the presence of lower limb symptoms and physical examination to determine the presence and severity of varicose veins. Results Women were significantly more likely than men to report lower limb symptoms such as heaviness or tension, swelling, aching, restless legs, cramps, and itching. The prevalence of symptoms tended to increase with age in both sexes. In men, only itching was significantly related to the presence and severity of trunk varices (linear test for trend, P=0.011). In women there was a significant relation between trunk varices and the symptoms of heaviness or tension (P⩽0.001), aching (P⩽0.001), and itching (P⩽0.005). However, the level of agreement between the presence of symptoms and trunk varices was too low to be of clinical value, especially in men. Conclusions Even in the presence of trunk varices, most lower limb symptoms probably have a non-venous cause. Surgical extirpation of trunk varices is unlikely to ameliorate such symptoms in most patients. Key messagesIn this population survey women were more likely than men to report a wide range of lower limb symptomsIn men, only itching was significantly related to the presence of trunk varicesIn women there was a significant relation between trunk varices and heaviness or tension, aching, and itchingThe level of agreement between the presence of symptoms and trunk varices is probably too low to be clinically usefulA thorough clinical history and examination should be

  3. Adenine phosphoribosyltransferase deficiency in the United Kingdom: two novel mutations and a cross-sectional survey

    PubMed Central

    Arenas-Hernandez, Monica; Escuredo, Emilia; Fairbanks, Lynette; Marinaki, Tony; Mapplebeck, Sarah; Sheaff, Michael; Almond, Michael K.

    2016-01-01

    Background Adenine phosphoribosyltransferase deficiency is an inborn error of metabolism that can cause kidney disease from crystalline nephropathy or kidney stones. Methods We present three cases from a single centre with varied presentations to illustrate how increasing awareness led to better patient identification. We then undertook a cross-sectional survey of all the patients identified from the Purine Research Laboratory in the UK since 1974. Results Our index case presented with recurrent nephrolithiasis and was diagnosed on stone analysis, the second case presented with acute kidney injury and the third case was identified from a biopsy undertaken for acute on chronic kidney injury. Genetic studies identified two novel mutations. Twenty patients were retrospectively identified. The mean age at diagnosis was 25 years (range 2–70); eight were <20 years, seven were 20–40 years and five were >40 years. Five of the 20 patients were deceased, 3 after end-stage renal disease (ESRD). Twelve have normal renal function, one had CKD stage 3, one had severe kidney disease and one was on dialysis. Conclusions Adenine phosphoribosyltransferase deficiency presents in a wide spectrum in all age groups. Patients can be completely asymptomatic and kidney disease may be incorrectly attributed to other conditions. Outcome is poor in late diagnosis and there is a high prevalence of ESRD. Patients with unexplained renal stone disease or deterioration in kidney function should be considered for screening. Identification and surveillance of patients in the UK can improve. There is now a rare disease registry with meetings organized that include patients, families and health care providers to improve awareness. PMID:27994857

  4. Health provider experiences with galactagogues to support breastfeeding: a cross-sectional survey

    PubMed Central

    Bazzano, Alessandra N; Littrell, Lisa; Brandt, Amelia; Thibeau, Shelley; Thriemer, Kamala; Theall, Katherine P

    2016-01-01

    Background Exclusive breastfeeding for infants up to 6 months is widely recommended, yet breastfeeding rates are relatively low in the US. The most common reason women stop breastfeeding early is a perceived insufficiency of milk. Galactagogues are herbal and pharmaceutical products that can help increase milk supply; however, data on their efficacy and safety is limited. Lactation consultants, obstetricians, and other health providers are an important point of contact for breastfeeding women experiencing challenges with lactation. This study explored providers’ perceptions, experiences, and practices in relation to galactagogue recommendation. Method A cross-sectional survey was conducted among a convenience sample of English-speaking health providers in the US who counsel breastfeeding women and their infants. Results More than 70% of respondents reported to recommend galactagogues. The most frequently recommended galactagogue was fenugreek with respondents indicating that they recommend it either ‘always’ (8.5%) or ‘most of the time’ (14.9%) and ‘sometimes’ (46.8%). More than 80% of the respondents indicated that galactagogues were useful for their clients and only one-third reported side effects. Reasons for refraining from recommending galactagogues were insufficient evidence of its efficacy and safety. Respondents reported a wide variety of sources of information used for their own education about galactagogues. Discussion Despite little evidence regarding safety and efficacy, some galactagogues are widely recommended and often perceived to be useful. However, concerns about their efficacy and safety remain. In order to assure both providers and users about safety and efficacy, more robust studies as well as better pharmacovigilance systems are needed. PMID:27895489

  5. Role of ethnicity in social anxiety disorder: A cross-sectional survey among health science students

    PubMed Central

    Jager, Philip De; Suliman, Sharain; Seedat, Soraya

    2014-01-01

    AIM: To investigate the influence of ethnicity in social anxiety disorder (SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students . METHODS: This was a cross-sectional survey of 112 1st, 2nd and 3rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory (SPIN) was adapted to a version called the E-SPIN (Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol Use Disorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale. RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4% (n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder. CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse. PMID:25032201

  6. Specialty choice in times of economic crisis: a cross-sectional survey of Spanish medical students

    PubMed Central

    Harris, Jeffrey E; González López-Valcárcel, Beatriz; Ortún, Vicente; Barber, Patricia

    2013-01-01

    Objective To investigate the determinants of specialty choice among graduating medical students in Spain, a country that entered into a severe, ongoing economic crisis in 2008. Setting Since 2008, the percentage of Spanish medical school graduates electing Family and Community Medicine (FCM) has experienced a reversal after more than a decade of decline. Design A nationwide cross-sectional survey conducted online in April 2011. Participants We invited all students in their final year before graduation from each of Spain's 27 public and private medical schools to participate. Main outcome measures Respondents’ preferred specialty in relation to their perceptions of: (1) the probability of obtaining employment; (2) lifestyle and work hours; (3) recognition by patients; (4) prestige among colleagues; (5) opportunity for professional development; (6) annual remuneration and (7) the proportion of the physician's compensation from private practice. Results 978 medical students (25% of the nationwide population of students in their final year) participated. Perceived job availability had the largest impact on specialty preference. Each 10% increment in the probability of obtaining employment increased the odds of preferring a specialty by 33.7% (95% CI 27.2% to 40.5%). Job availability was four times as important as compensation from private practice in determining specialty choice (95% CI 1.7 to 6.8). We observed considerable heterogeneity in the influence of lifestyle and work hours, with students who preferred such specialties as Cardiovascular Surgery and Obstetrics and Gynaecology valuing longer rather than shorter workdays. Conclusions In the midst of an ongoing economic crisis, job availability has assumed critical importance as a determinant of specialty preference among Spanish medical students. In view of the shortage of practitioners of FCM, public policies that take advantage of the enhanced perceived job availability of FCM may help steer medical school

  7. Self-efficacy beliefs are associated with visual height intolerance: a cross-sectional survey.

    PubMed

    Grill, Eva; Schäffler, Florian; Huppert, Doreen; Müller, Martin; Kapfhammer, Hans-Peter; Brandt, Thomas

    2014-01-01

    Responses to height may range from indifference to minor distress to severe symptoms of fear of heights (acrophobia); visual height intolerance (vHI) denotes the whole spectrum of symptoms. Although there are options to manage vHI, only a small part of persons affected by vHI are willing to seek professional help or confront their problem. Purpose of this study was to determine if persons with vHI, specifically those who show avoidant behavior towards heights (avoiders), score lower in their general self-efficacy (GSE) than those who confront vHI (confronters). Cross-sectional survey in 607 individuals living in the urban region of Munich, Germany, using a mailed questionnaire on presence or absence of vHI, confronting or avoiding behaviour, and GSE. Of all participants (mean age 53.9, 50.3% female), 407 reported life-time presence of vHI. Participants with vHI had a mean GSE score of 31.8 (SD 4.3) points (participants without vHI: 32.5, SD 4.3, p = 0.008 for difference). Among individuals with vHI, 23% reported confronting behavior. Confronters were significantly younger (p<.0001, 50.2 vs. 55.7 years), more likely to be female (p = 0.0039, 64.3% female), and had a higher GSE score (p = 0.0049, 32.5 vs. 31.1). Associations remained significant after multiple adjustment. Our study provides evidence for the association of GSE and vHI. These findings may have consequences for strategies of alleviation and therapy of vHI.

  8. Workplace violence against physicians in Turkey's emergency departments: a cross-sectional survey.

    PubMed

    Bayram, Başak; Çetin, Murat; Çolak Oray, Neşe; Can, İsmail Özgür

    2017-06-29

    We aimed to determine the prevalence of violence directed at emergency department (ED) physicians in Turkey and confirm the factors influencing such violence. Cross-sectional survey study. Country of Turkey. Physicians currently practising in EDs in Turkey. The prevalence of violence directed at physicians and factors that may influence it, such as physicians' personal characteristics, ED characteristics and physicians' opinions regarding the causes of and suggested methods of preventing violence. A total of 713 physicians participated. Of these, 78.1% reported being subjected to violence in the past year and 65.9% reported more than one such incident. Being subjected to violence was related to age (p=0.008), working in an ED with a high patient admission rate (p=0.018), current position (p<0.001), working outside regular work hours (p<0.001), working in a state hospital (p<0.001) and level of experience (p<0.001). Gender, type of patient typically seen, region and patient waiting period did not influence subjection to violence. The present safety precautions against violence do not appear to influence the prevalence of violence. Our results indicated that ED physicians' experience of violence is related to personal characteristics such as age and level of expertise, and hospital and ED characteristics such as high patient admission rates. Presently, no measures taken to reduce this violence have been proven effective. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Health literacy among different age groups in Germany: results of a cross-sectional survey.

    PubMed

    Berens, Eva-Maria; Vogt, Dominique; Messer, Melanie; Hurrelmann, Klaus; Schaeffer, Doris

    2016-11-09

    Health literacy is of increasing importance in public health research. It is a necessary pre-condition for the involvement in decisions about health and health care and related to health outcomes. Knowledge about limited health literacy in different age groups is crucial to better target public health interventions for subgroups of the population. However, little is known about health literacy in Germany. The study therefore assesses the prevalence of limited health literacy and associated factors among different age groups. The Health Literacy Survey Germany is a cross-sectional study with 2,000 participants aged 15 years or older in private households. Perceived health literacy was assessed via computer-assisted personal interviews using the HLS-EU-Q-47 questionnaire. Descriptive analyses, chi-square tests and odds ratios were performed stratified for different age groups. The population affected by limited perceived health literacy increases by age. Of the respondents aged 15-29 years, 47.3 % had limited perceived health literacy and 47.2 % of those aged 30-45 years, whereas 55.2 % of the respondents aged 46-64 years and 66.4 % aged 65 years and older showed limited perceived health literacy. In all age groups, limited perceived health literacy was associated with limited functional health literacy, low social status, and a high frequency of doctor visits. The results suggest a need to further investigate perceived health literacy in all phases of the life-course. Particular attention should be devoted to persons with lower social status, limited functional health literacy and/or a high number of doctor visits in all age groups.

  10. Malawi women's knowledge and use of labour and birthing positions: A cross-sectional descriptive survey.

    PubMed

    Zileni, Barbara Debra; Glover, Pauline; Jones, Meril; Teoh, Kung-Keat; Zileni, Chisomo WaaZileni; Muller, Amanda

    2017-02-01

    Despite research evidence supporting use of upright birthing positions, most women give birth in supine position. Little is known about women's knowledge and use of labour and birthing positions. Specifically, there is a lack of evidence on Malawi women's knowledge and use of birthing positions, and this limits the possibility of improvement in childbirth practices. To assess women's knowledge and use of different positions during labour and birthing. The study used a cross-sectional descriptive survey in a Malawi maternity unit where 373 low-risk postnatal women participated in face-to-face exit interviews, using a structured questionnaire. A descriptive analysis of the categorical variables was conducted to examine frequencies and percentages. The majority of women knew about walking (66.4%) and lateral (60.6%) as labour positions, whereas 99.2% knew about the supine as a birthing position. Half of the women (50%) walked during labour and the majority (91.4%) gave birth whilst in supine position. Midwives were the main source of information on positions used during childbirth. Education about different birthing positions is needed for women who deliver at the maternity unit so that they can make informed decisions on their own options for childbirth. However, midwives must have the competence to encourage and assist women give birth in different positions, so professional development of midwives in childbirth positions is a priority. Childbirth education should include information on the various labour and birthing positions. Midwives should be equipped with appropriate skills to help women use different positions during childbirth. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  11. Most Common Barriers to Glaucoma Medication Adherence: A Cross-Sectional Survey

    PubMed Central

    Newman-Casey, Paula Anne; Robin, Alan L.; Blachley, Taylor; Farris, Karen; Heisler, Michele; Resnicow, Ken; Lee, Paul P.

    2015-01-01

    Purpose To both evaluate the frequency of eleven commonly cited barriers to optimal glaucoma medication adherence among glaucoma patients and identify barriers contributing to poor adherence. Design Prospective, cross-sectional survey. Participants 190 adults with glaucoma taking ≥1 glaucoma medication who received care in glaucoma clinics in Ann Arbor, MI and Baltimore, MD. Methods Participants completed a survey on demographic and disease characteristics, barriers to optimal glaucoma medication adherence, interest in an eye drop aid, and self-reported adherence (measured by the Morisky Adherence Scale). Descriptive statistics and logistic regression analyses were performed. Main Outcome Measures Frequency and number of barriers to adherence among both adherent and non-adherent patients. Odds ratios with 95% confidence intervals identifying barriers associated with poor adherence. Results 27% of the sample reported poor adherence. 61% of all participants cited multiple barriers and 10% cited a single barrier as impediments to optimal adherence. 29% of subjects cited no barriers, though only 13% of patients who cited no barriers were non-adherent. Among non-adherent patients, ≥31% cited each of the eleven barriers as important. Logistic regression analysis, adjusted for age, revealed that the following barriers were associated with higher odds of non-adherence: decreased self-efficacy, OR = 4.7 [95% CI 2.2–9.7, p= < 0.0001]; difficulty instilling drops, OR = 2.3 [95% CI 1.1–4.9, p= 0.03]; forgetfulness, OR = 5.6 [95% CI 2.6–12.1, p= < 0.0001]; and difficulties with the medication schedule, OR = 2.9 [1.4–6.0, p= 0.006]. For each additional barrier cited as important, there was a 10% increased odds of being non-adherent, OR = 1.1 [95% CI 1.0–1.2, p= 0.01]. Conclusion Each of the eleven barriers was important to at least 30% of surveyed patients with poor adherence, with the majority identifying multiple barriers to adherence. Low self

  12. The mental health of nurses in acute teaching hospital settings: a cross-sectional survey.

    PubMed

    Perry, Lin; Lamont, Scott; Brunero, Scott; Gallagher, Robyn; Duffield, Christine

    2015-01-01

    Nursing is an emotionally demanding profession and deficiencies in nurses' mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses' health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. A cross sectional survey design was used. The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected. A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month. Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating. Nurses and their managers should strive to create workplaces where working practices promote nurses' health

  13. Guideline use behaviours and needs of primary care practitioners in China: a cross-sectional survey.

    PubMed

    Zeng, Linan; Li, Youping; Zhang, Lingli; Liu, Guanjian; Zhang, Yang; Zhen, Shangwei; Li, Honghao; Song, Xue; Duan, Yanjun; Yu, Jiajie; Wang, Xiaodong

    2017-09-03

    Clinical guidelines have been recognised as an effective way to improve healthcare performance. However, little is known about the uptake and implementation of guidelines by general practitioners in China. The aim of this study was to investigate the guideline use behaviours and needs of practitioners in primary care settings in China. We conducted a cross-sectional survey from December 2015 to May 2016 that included practitioners at 268 institutions in 15 provinces in China. Questionnaire development was informed by the execution of a literature review and consultation of experts. On-site surveys were implemented using a paper questionnaire to minimise missing responses. A multivariate logistic regression analysis was performed to identify factors associated with provider knowledge of and attitudes towards clinical guidelines. Of the respondents, 91.7% (1568/1708) were aware of clinical guidelines, but only 11.3% (177/1568) frequently used them. The main mechanism by which primary care practitioners accessed guidelines was public search engines (63.4%; 911/1438), and practitioners seldom reported using biomedical databases. The most frequently identified barriers to guideline use were lack of training (49.9%; 778/1560), lack of access (44.6%; 696/1560) and lack of awareness (38.0%; 592/1560). Less than one-quarter of respondents considered current guidelines 'entirely appropriate' for use in primary care (23.5%; 339/1442). Most participants (96.2%; 1509/1568) believed it was necessary to develop primary care guidelines. Provider attitudes towards current guidelines were associated with the location and level of the institution and professional title of the practitioner (p<0.05). Our survey revealed poor knowledge and uptake of clinical guidelines in primary care, and we identified a gap between the needs of practitioners and availability of clinical guidelines for use in primary care in China. In addition, lacking access to and training in guidelines also

  14. Hypertension among adults in Bangladesh: evidence from a national cross-sectional survey.

    PubMed

    Chowdhury, Muhammad Abdul Baker; Uddin, Md Jamal; Haque, Md Rabiul; Ibrahimou, Boubakari

    2016-01-25

    Hypertension is an increasing problem in Southeast Asia, particularly in Bangladesh. Although some epidemiological studies on hypertension have been conducted in Bangladesh, the factors associated with hypertension in this nation remain unclear. We aimed to determine the factors associated with hypertension among the adults in Bangladesh. We conducted a cross-sectional study using data from the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS). A total of 7,839 (3,964 women and 3,875 men) adults aged 35 years and older who participated in the survey was included. Hypertension was defined by a systolic blood pressure ≥ 140 mmHg and/or, diastolic blood pressure ≥ 90 mmHg and/or, receipt of an anti-hypertensive medication at time of the survey. The degree of association between the risk factors and the outcome was assessed by the odd ratio (OR) obtained from the bivariate and multivariable logistic regression models. The overall prevalence of hypertension was 26.4 %, and the prevalence was higher in women (32.4%) than men (20.3%). Study participants with the age group of 60-69 years had higher odds of having hypertension (AOR: 3.77, 95% CI: 3.01-4.72) than the age group 35-39 years. Moreover, individuals who had higher educational attainment (AOR: 1.63, 95% C.I: 1.25-2.14) and higher wealth status (AOR = 1.91, 95% CI: 1.54-2.38) had higher odds of having hypertension than the individuals with no education and lower social status, respectively. The analysis also showed that high BMI (AOR: 2.19, 95% C.I: 1.87-2.57) and having diabetes (AOR: 1.54, 95% C.I: 1.31-1.83) were associated with the increasing risk of hypertension. Our study shows that the risk of hypertension was significantly associated with older age, sex, education, place of residence, working status, wealth index, BMI, and diabetes. Moreover, hypertension is largely untreated, especially in rural settings. The health system needs to develop appropriate strategies

  15. Integrated surgical academic training in the UK: a cross-sectional survey.

    PubMed

    Blencowe, Natalie S; Glasbey, James C; McElnay, Philip J; Bhangu, Aneel; Gokani, Vimal J; Harries, Rhiannon L

    2017-10-01

    This study aimed to explore variations in the provision of integrated academic surgical training across the UK. This is an online cross-sectional survey (consisting of 44 items with a range of free-text, binomial and 5-point Likert scale responses) developed by the Association of Surgeons in Training. A self-reported survey instrument was distributed to academic surgical trainees across the UK (n=276). 143 (51.9%) responses were received (81% male, median age: 34 years), spanning all UK regions and surgical specialties. Of the 143 trainees, 29 were core trainees (20.3%), 99 were specialty trainees (69.2%) and 15 (10.5%) described themselves as research fellows. The structure of academic training varied considerably, with under a third of trainees receiving guaranteed protected time for research. Despite this, however, 53.1% of the respondents reported to be satisfied with how their academic training was organised. Covering clinical duties during academic time occurred commonly (72.7%). Although most trainees (n=88, 61.5%) met with their academic supervisor at least once a month, six (4.2%) never had an academic supervisory meeting. Most trainees (n=90, 62.9%) occupied a full-time rota slot and only 9.1% (n=13) described their role as 'supernumerary'. Although 58.7% (n=84) of the trainees were satisfied with their clinical competence, 37.8% (n=54) felt that clinical time focused more on service provision than the acquisition of technical skills. 58 (40.6%) had experienced some form of negative sentiment relating to their status as an academic trainee. Integrated academic training presents unique challenges and opportunities within surgery. This survey has identified variation in the quality of current programmes, meaning that the future provision of integrated surgical academic training should be carefully considered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

  16. Australian general practice nurse's knowledge, attitudes and practices regarding influenza vaccination: a cross-sectional survey.

    PubMed

    Smith, Sarah; Sim, Jenny; Halcomb, Elizabeth

    2016-09-01

    The aim of this study was to examine the knowledge, attitudes and practices of Australian general practice nurses (GPNs) regarding influenza vaccination. Despite the evidence for the benefits of influenza vaccination, vaccination rates remain sub-optimal. The knowledge, attitudes and practices of nurses both affects vaccination rates and the advice given to consumers. Given their significant role in opportunistic and planned vaccinations, GPNs are in an optimal position to positively influence vaccination rates. A descriptive cross-sectional survey was used. GPNs were recruited by email to complete an online survey. The survey tool comprised the King's College Nurses' Influenza Vaccination Questionnaire and adapted demographic items. Data analysis used descriptive and inferential statistics. Open-ended questions were analysed using thematic analysis. Most of the 85 respondents had received the seasonal influenza vaccination in the last year (n = 67; 78·8%); fewer received the H1N1 vaccination (n = 54; 63·5%). Intention to receive vaccination was affected by previous vaccination. Those who had received the seasonal influenza vaccine in the last year had a higher total knowledge score. The seasonal and total influenza knowledge score was high, with lower scores on the H1N1 sub-scale. A positive correlation was identified between influenza knowledge and risk perception. This study highlighted the high level of knowledge amongst GPNs related to seasonal influenza, whilst identifying a knowledge deficit around the H1N1 items. It demonstrated that GPN's knowledge of seasonal influenza was related to vaccination status and risk perception. Further research is required to explore how this translates into the advice GPNs give to consumers. Influenza vaccination should be considered as a key topic for GPNs ongoing professional development. The evidence for links between education and vaccination uptake should encourage employers to facilitate opportunities for this

  17. Comorbidity of headache and functional constipation in children: a cross-sectional survey.

    PubMed

    Inaloo, Soror; Dehghani, Seyyed Mohsen; Hashemi, Seyyed Mohammad; Heydari, Mojtaba; Heydari, Seyyed Taghi

    2014-10-01

    Constipation and headache are prevalent conditions among children worldwide. Previous studies have shown the relationship between upper gastrointestinal complaints and headache in children. However, the association with lower gastrointestinal complaints such as constipation has not been investigated until present. The aim of this study is to evaluate the relationship between headache and chronic functional constipation in children aged 4-12 years old. This cross-sectional study has evaluated the prevalence of headache in 326 children in Shiraz, Iran 2012. All the subjects and their parents were interviewed based on a structured questionnaire for the diagnosis of constipation and headache. Children with constipation were selected from the Pediatric Gastroenterology Clinic Affiliated to the Shiraz University of Medical Sciences. The control group was selected from healthy children attending Shiraz schools. Diagnosis of headache and constipation were made based on the second Edition of The International Headache Classification (ICHD-2) and ROME III criteria, respectively. Headache prevalence among children with constipation was significantly higher (19.8%) than that of the control group (5.6%) [Odds ratio (OR) 4.192, p<0.001], which was significant only in the non-migraine headache subtypes (15.1% vs 2.8%, OR 25, p<0.002). Among the headache subtypes of different severity (mild, moderate, severe), only mild headache was significantly more prevalent in constipated children (14.9% vs. 1.4%, in the control group, respectively, p<0.001). This study revealed a strong correlation between headache and chronic functional constipation, which can result from the effect of these comorbid conditions with emotional stress, depression, and anxiety.

  18. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study.

    PubMed

    Joffres, Michel; Falaschetti, Emanuela; Gillespie, Cathleen; Robitaille, Cynthia; Loustalot, Fleetwood; Poulter, Neil; McAlister, Finlay A; Johansen, Helen; Baclic, Oliver; Campbell, Norm

    2013-08-30

    Comparison of recent national survey data on prevalence, awareness, treatment and control of hypertension in England, the USA and Canada, and correlation of these parameters with each country stroke and ischaemic heart disease (IHD) mortality. Non-institutionalised population surveys. England (2006 n=6873), the USA (2007-2010 n=10 003) and Canada (2007-2009 n=3485) aged 20-79 years. Stroke and IHD mortality rates were plotted against countries' specific prevalence data. Mean systolic blood pressure (SBP) was higher in England than in the USA and Canada in all age-gender groups. Mean diastolic blood pressure (DBP) was similar in the three countries before age 50 and then fell more rapidly in the USA, being the lowest in the USA. Only 34% had a BP under 140/90 mm Hg in England, compared with 50% in the USA and 66% in Canada. Prehypertension and stages 1 and 2 hypertension prevalence figures were the highest in England. Hypertension prevalence (≥140 mm Hg SBP and/or ≥90 mm Hg DBP) was lower in Canada (19·5%) than in the USA (29%) and England (30%). Hypertension awareness was higher in the USA (81%) and Canada (83%) than in England (65%). England also had lower levels of hypertension treatment (51%; USA 74%; Canada 80%) and control (<140/90 mm Hg; 27%; the USA 53%; Canada 66%). Canada had the lowest stroke and IHD mortality rates, England the highest and the rates were inversely related to the mean SBP in each country and strongly related to the blood pressure indicators, the strongest relationship being between low hypertension awareness and stroke mortality. While the current prevention efforts in England should result in future-improved figures, especially at younger ages, these data still show important gaps in the management of hypertension in these countries, with consequences on stroke and IHD mortality.

  19. Schizophrenia through the carers' eyes: results of a European cross-sectional survey.

    PubMed

    Svettini, A; Johnson, B; Magro, C; Saunders, J; Jones, K; Silk, S; Hargarter, L; Schreiner, A

    2015-09-01

    adherence to medication. A questionnaire-based cross-sectional survey of 138 carers across 16 European countries. Interpretation of results was based on a descriptive comparison of responses. Carers recognized the importance of medication to help patients get better (76%) and improve their quality of life (76%) and relationships (74%). Sixty-seven per cent believed medication damages general health. Sixty-five per cent reported that treatment adherence was a burden for patients. Thirty-eight per cent indicated that it was a daily struggle to get patients to take their medication. Fifty per cent perceived that medication administered every few weeks rather than daily was quite/very important. Ninety-three per cent agreed on the importance of family support to boost adherence, with education and information deemed important for families and patients. Carers rely less on the patient themselves when assessing adherence than psychiatrists. The burden faced by carers and patients in taking medication provides an opportunity for healthcare professionals to provide support in a multidisciplinary 'team' involving psychiatrists, nurses and carers. © 2015 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.

  20. Aggression and violence against health care workers in Germany - a cross sectional retrospective survey

    PubMed Central

    2010-01-01

    Background Although international scientific research on health issues has been dealing with the problem of aggression and violence towards those employed in health care, research activities in Germany are still at an early stage. In view of this, the aim of this study was to examine the frequency and consequences of aggressive behaviour towards nurses and health care workers in different health sectors in Germany and to assess the need for preventive measures. Methods We conducted a cross-sectional retrospective survey. Nurses and health care workers from two nursing homes, a psychiatric clinic and a workshop for people with disabilities were interviewed using a standardised questionnaire. The sample covered 123 individuals (response rate 38.8%). The survey assessed the frequency, the type and the consequences of aggressive behaviour, and social support in connection with coping with aggression in the workplace. Odds ratios (OR) and 95% confidence intervals (CI) for putative risk factors which may influence the stress induced by aggression at the workplace were calculated using conditional logistic regression. Results During the previous twelve months 70.7% of the respondents experienced physical and 89.4% verbal aggression. Physical aggression more frequently occurred in nursing homes (83.9% of the employees) and verbal aggression was more common in the psychiatric clinic (96.7% of the employees). The proportion of the individuals affected in the workshop for people with disabilities was lower (41.9% and 77.4% respectively). The incidents impaired the physical (55%) and emotional well-being (77.2%) of the employees. The frequency of incidents (weekly: OR 2.7; 95% CI 1.1-6.4) combined with the lack of social support (OR 2.8; 95% CI 1.2-6.6) increased the probability of higher stress due to aggression. Conclusions This study corroborates previous reports of frequent physical and verbal aggression towards care workers in the various areas of health care. The present

  1. No global consensus: a cross-sectional survey of maternal weight policies

    PubMed Central

    2014-01-01

    Background Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. Methods This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. Results Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that

  2. Nursing home administrators' perspectives on a study feedback report: a cross sectional survey.

    PubMed

    Boström, Anne-Marie; Cranley, Lisa A; Hutchinson, Alison M; Cummings, Greta G; Norton, Peter G; Estabrooks, Carole A

    2012-09-13

    This project is part of the Translating Research in Elder Care (TREC) program of research, a multi-level and longitudinal research program being conducted in 36 nursing homes in three Canadian Prairie Provinces. The overall goal of TREC is to improve the quality of care for older persons living in nursing homes and the quality of work life for care providers. The purpose of this paper is to report on development and evaluation of facility annual reports (FARs) from facility administrators' perspectives on the usefulness, meaningfulness, and understandability of selected data from the TREC survey. A cross sectional survey design was used in this study. The feedback reports were developed in collaboration with participating facility administrators. FARs presented results in four contextual areas: workplace culture, feedback processes, job satisfaction, and staff burnout. Six weeks after FARs were mailed to each administrator, we conducted structured telephone interviews with administrators to elicit their evaluation of the FARs. Administrators were also asked if they had taken any actions as a result of the FAR. Descriptive and inferential statistics, as well as content analysis for open-ended questions, were used to summarize findings. Thirty-one facility administrators (representing thirty-two facilities) participated in the interviews. Six administrators had taken action and 18 were planning on taking action as a result of FARs. The majority found the four contextual areas addressed in FAR to be useful, meaningful, and understandable. They liked the comparisons made between data from years one and two and between their facility and other TREC study sites in their province. Twenty-two indicated that they would like to receive information on additional areas such as aggressive behaviours of residents and information sharing. Twenty-four administrators indicated that FARs contained enough information, while eight found FARs 'too short'. Administrators who reported

  3. Management of Patient-Reported Outcome (PRO) Alerts in Clinical Trials: A Cross Sectional Survey.

    PubMed

    Kyte, Derek; Ives, Jonathan; Draper, Heather; Calvert, Melanie

    2016-01-01

    Assessment of patient-reported outcomes (PROs) provides valuable information to inform patient-centered care, but may also reveal 'PRO alerts': psychological distress or physical symptoms that may require an immediate response. Ad-hoc management of PRO alerts in clinical trials may result in suboptimal patient care or potentially bias trial results. To gain greater understanding of current practice in PRO alert management we conducted a national survey of personnel involved in clinical trials with a PRO endpoint. We conducted a national cross-sectional survey of 767 UK-based research nurses, data managers/coordinators, trial managers and chief/principal investigators involved in clinical trials using PROs. Respondents were self-selected volunteers from a non-randomised sample of eligible individuals recruited via 55 UK Clinical Research Collaboration Registered Clinical Trials Units and 19 Comprehensive Local Research Networks. Questions centred on the proportion of trial personnel encountering alerts, how staff responded to PRO alerts and whether current guidance was deemed sufficient to support research personnel. We undertook descriptive analyses of the quantitative data and directed thematic analysis of free-text comments. 20% of research nurses did not view completed PRO questionnaires and were not in a position to discover alerts, 39-50% of the remaining respondent group participants reported encountering PRO alerts. Of these, 83% of research nurses and 54% of data managers/trial coordinators reported taking action to assist the trial participant, but less than half were able to record the intervention in the trial documentation. Research personnel reported current PRO alert guidance/training was insufficient. Research personnel are intermittently exposed to PRO alerts. Some intervene to help trial participants, but are not able to record this intervention in the trial documentation, risking co-intervention bias. Other staff do not check PRO information

  4. Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents

    PubMed Central

    Daniels, Michael N.; Porter, Ivan; Kincaid, Hope; Jain, Deepika; Aslam, Nabeel

    2017-01-01

    Background Interest in nephrology careers among internal medicine residents in the United States is declining. Our objective was to assess the impact of the presence of a nephrology fellowship training program on perceptions and career interest in nephrology among internal medicine residents. A secondary objective was to identify commonly endorsed negative perceptions of nephrology among internal medicine residents. Methods This was a repeated cross-sectional survey of internal medicine residents before (Group 1) and 3 years after (Group 2) the establishment of nephrology fellowship programs at two institutions. The primary outcome was the percentage of residents indicating nephrology as a career interest in Group 1 vs. Group 2. Secondary outcomes included the frequency that residents agreed with negative statements about nephrology. Results 131 (80.9%) of 162 residents completed the survey. 19 (14.8%) residents indicated interest in a nephrology career, with 8 (6.3%) indicating nephrology as their first choice. There was no difference in career interest in nephrology between residents who were exposed to nephrology fellows during residency training (Group 2) and residents who were not (Group 1). The most commonly endorsed negative perceptions of nephrology were: nephrology fellows have long hours/burdensome call (36 [28.1%] of residents agreed or strongly agreed), practicing nephrologists must take frequent/difficult call (35 [27.6%] agreed or strongly agreed), and nephrology has few opportunities for procedures (35 [27.3%] agreed or strongly agreed). More residents in Group 2 agreed that nephrology is poorly paid (8.9% in Group 1 vs. 20.8% in Group 2, P = 0.04), whereas more residents in Group 1 agreed that nephrologists must take frequent/difficult call (40.0% in Group 1 vs. 18.1% in Group 2, P = 0.02). Conclusions The initiation of a nephrology fellowship program was not associated with an increase in internal medicine residents’ interest in nephrology

  5. Storage and wastage of drug products in Jordanian households: a cross-sectional survey.

    PubMed

    Abushanab, Amani S; Sweileh, Waleed M; Wazaify, Mayyada

    2013-06-01

    Appropriate household storage and use of drug products can reduce drug wastage and unnecessary hazards. We aimed to quantify the amounts and types of medications that were stored in Jordanian households and the extent of drug wastage in terms of the amount and cost of these medications. The setting was households in Amman, Jordan. This was a cross-sectional survey study using a pre-piloted questionnaire. Family members were interviewed in person about use of drug products, and where drug products were stored. The main outcomes were types, storage methods, cost and quantities of drug products in every household. Two hundred and forty-three households were approached, out of which 219 agreed to participate. A total of 2393 (mean 10.9, SD 5.2) drug products were recorded from the 219 households surveyed. A significant positive correlation was noted between the number of drug products in a household and family size (r = 0.19, P < 0.01), the level of the mother's education (r = 0.24, P < 0.01), the level of the father's education (r = 0.28, P < 0.01) and income (r = 0.14, P = 0.034). Eighty nine (40.6%) households had at least one child younger than 6 years of age, and 1122 (46.9%) drug products were stored in unsafe places in the houses, within the reach of children. More than a quarter of drug products (1509, 27.2%) were not in their original containers, 360 (15%) were unused since dispensing, 261 (10.9%) had expired and 44 (1.8%) had no clear expiry date. We estimated that the cost of drug wastage in the 219 households was US$5414. Paracetamol (202, 8.4%), diclofenac (98, 4.1%) and amoxicillin (79, 3.3%) were the most commonly reportedly stored individual drugs. Drug products are stored in large quantities in Jordanian households. Unsafe storage practices have the potential to pose safety hazards, especially to children. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  6. Acne, anxiety, depression and suicide in teenagers: a cross-sectional survey of New Zealand secondary school students.

    PubMed

    Purvis, Diana; Robinson, Elizabeth; Merry, Sally; Watson, Peter

    2006-12-01

    To examine the associations between acne and depressive symptoms, anxiety and suicidal behaviours. This was a secondary analysis of a cross-sectional survey -'Youth2000' (New Zealand national survey of youth health). A total of 9567 secondary school students aged 12-18 years participated in the survey. The main outcome measures were self-reported acne, depressive symptoms (Reynolds Adolescent Depression Scale > 77), anxiety (Anxiety Disorder Index from Multidimensional Anxiety Scale for Children) and self-reported suicide attempts. 'Problem acne' was associated with an increased probability of depressive symptoms, odds ratio 2.04 (95% confidence interval 1.70-2.45); anxiety, odds ratio 2.3 (1.74-3.00); and suicide attempts, odds ratio 1.83 (1.51-2.22) in a logistic model that included age, gender, ethnicity, school decile and socio-economic status. The association of acne with suicide attempts remained after controlling for depressive symptoms and anxiety, odds ratio 1.50 (1.21-1.86). Young people presenting with acne are at increased risk of depression, anxiety and suicide attempts. Attention should be paid to their mental health, and the importance of asking directly regarding suicide is emphasised.

  7. How do people respond to self-test results? A cross-sectional survey

    PubMed Central

    2010-01-01

    Background Self-tests, tests on medical conditions that can be performed by consumers without consulting a doctor first, are frequently used. Nevertheless, there are concerns about the safety of self-testing, as it may delay diagnosis and appropriate treatment in the case of inappropriate use of the test, or false-negative results. It is unclear whether self-tests stimulate appropriate follow-up behaviour. Our aim was to examine the frequency of self-test use, consumers' response to self-test results in terms of their confidence in the result, reassurance by the test result, and follow-up behaviour. Methods A two step cross-sectional survey was designed. A random sample of 6700 Internet users in an existing Internet panel received an online questionnaire on the use of self-tests. Self-tests were defined as tests on body materials, initiated by consumers with the aim to diagnose a disease or risk factor. A second questionnaire on consumers' response to self-test results was sent to the respondents that were identified as a self-tester in the first questionnaire (n = 703). Results 18.1% (799/4416) of the respondents had ever performed a self-test, the most frequently used tests being those for diabetes (5.3%), kidney disease (4.9%), cholesterol (4.5%), urinary tract infection (1.9%) and HIV/AIDS and Chlamydia (both 1.6%). A total of 78.1% of the testers with a normal test result and 81.4% of those with an abnormal result reported confidence in this result. Almost all (95.6%) of the testers with a normal result felt reassured. After a normal result, 78.1% did not take any further action and 5.8% consulted a doctor. The corresponding figures after an abnormal test result were 9.3% and 72.2%, respectively. Conclusions Respondents who had performed a self-test seemed to base their follow-up behaviour on the result of the test. They had confidence in the test result, and were often reassured by a normal result. After an abnormal result, most self-testers sought medical

  8. A Competency Model for Clinical Physicians in China: A Cross-Sectional Survey

    PubMed Central

    Liu, Zhuang; Tian, Lei; Chang, Qing; Sun, Baozhi; Zhao, Yuhong

    2016-01-01

    Background Around the world, regulatory bodies have taken the lead in determining the competencies required to become a physician. As a first step in addressing this project, it was decided to develop a set of core competencies that were unique to China and that might serve as a basis for medical education. The purpose of this paper was to construct a competency model for clinical physicians in China. Methods Data was collected using a cross-sectional survey of 6247 clinicians from seven administrative regions (31 provinces, autonomous regions and municipalities directly under the central government) in China. The total sample was randomly divided into two sub-samples, an initial sample (Sample 1) and a replication sample (Sample 2). Independent exploratory factor analysis was conducted in each sample and the results were compared to determine the stability. After that the confirmatory factor analysis was used to ascertain the competency model for physicians. The reliability, convergent and discriminant validity of competency-based instrument were also examined. Results 76 items with 8 dimensions were identified, accounting for 68.41% of the construct’s total variance in the initial sample and 67.47% in the replication sample. For the two samples, the overall scale reliability (Cronbach’s alpha) was both 0.985 with dimensions from 0.905 to 0.954 for the initial sample and from 0.902 to 0.955 for the replication sample after deleting the items. In confirmatory factor analysis, the result showed that all items had acceptable goodness of fit index. RMSEA and SRMR were less than 0.08 (RMSEA = 0.046, SRMR = 0.040), while GFI, NFI, IFI, and CFI were higher than 0.9 (GFI = 0.905, NFI = 0.903, IFI = 0.909, CFI = 0.909), leading to acceptable construct validity. All construct reliability values of the factors were higher than 0.70, and all average variance extracted values exceeded 0.50. Thus, we considered the reliability and validity of the 8 dimensions were

  9. Why medical students choose psychiatry - a 20 country cross-sectional survey

    PubMed Central

    2014-01-01

    Background Recruitment to psychiatry is insufficient to meet projected mental health service needs world-wide. We report on the career plans of final year medical students from 20 countries, investigating factors identified from the literature which influence psychiatric career choice. Methods Cross sectional electronic or paper survey. Subjects were final year medical students at 46 medical schools in participating countries. We assessed students’ career intentions, motivations, medical school teaching and exposure to psychiatry. We assessed students’ attitudes and personality factors. The main outcome measure was likelihood of specializing in psychiatry. Multilevel logistic regression was used to examine the joint effect of factors upon the main outcome. Results 2198 of 9135 (24%) of students responded (range 4 to 91%) across the countries. Internationally 4.5% of students definitely considered psychiatry as a career (range 1 to 12%). 19% of students (range 0 to 33%) were “quite likely”, and 25% were “definitely not” considering psychiatry. Female gender, experience of mental/physical illness, media portrayal of doctors, and positive attitudes to psychiatry, but not personality factors, were associated with choosing psychiatry. Quality of psychiatric placement (correlation coefficient = 0.22, p < 0.001) and number of placements (correlation coefficient =0.21, p < 0.001) were associated with higher ATP scores. During medical school, experience of psychiatric enrichment activities (special studies modules and university psychiatry clubs), experience of acutely unwell patients and perceived clinical responsibility were all associated with choice of psychiatry. Multilevel logistic regression revealed six factors associated with students choosing psychiatry: importance of own vocation, odds ratio (OR) 3.01, 95% CI 1.61 to 5.91, p < 0.001); interest in psychiatry before medical school, OR 10.8 (5.38 to 21.8, p < 0.001); undertaking a

  10. Prevalence and Perceptions of Musculoskeletal Disorders Among Hospital Nurses in Pakistan: A Cross-sectional Survey

    PubMed Central

    Attique, Rayan; Asmaa, Yumna

    2017-01-01

    Introduction Nursing is a professionally demanding job, and nurses are prone to develop musculoskeletal disorders. However, no data is available regarding its prevalence among Pakistani nurses. This study was conducted to document the pattern of work-related musculoskeletal disorders (WRMDs) in Pakistani nurses and their perceptions about contributing factors and management of WRMDs. Methods A questionnaire-based, cross-sectional survey was conducted in six hospitals in Lahore and Rawalpindi, which were selected using a convenient sampling technique. A four-part questionnaire comprised of demographic data, experience of musculoskeletal disorders, and perception of management and contributing factors of WRMDs was distributed among 150 nurses. One hundred and seventeen nurses returned completed forms. Data was analyzed using SPSS Statistics v20 (IBM, Armonk, New York, USA). Ethics review committee approval was obtained by CMH Lahore Medical College and the Institute of Dentistry, and informed consent was obtained. Results The prevalence of musculoskeletal disorders over a 12-month period was 31.6%, with the most common site being the low back (32%) followed by the shoulder (20%), upper back, and knees (10%). Among those affected, 60.6% sought professional help. Married nurses were more prone to WRMDs (p=0.0001). Regarding management, most (94%) agreed that rest is required to get better, neglecting problems of this kind can cause permanent health problems (89.7%), and physical activity should be avoided (38.7%). Working in the same positions for long periods (93.1%), attending an excessive number of patients in one day (81.2%), and working in awkward and cramped positions (78.6%) were the most commonly perceived risk factors for WRMDs. Conclusion About one-third of Pakistani nurses in this cohort reported work-related musculoskeletal disorders with the low back most commonly affected. There is a need to increase awareness regarding ergonomics and posture

  11. Lifetime prevalence, characteristics, and associated problems of non-consensual sex in men: cross sectional survey

    PubMed Central

    Coxell, Adrian; King, Michael; Mezey, Gillian; Gordon, Dawn

    1999-01-01

    Objective To identify the lifetime prevalence of non-consensual sexual experiences in men, the relationship between such experiences as a child and as an adult, associated psychological and behavioural problems, and help received. Design Cross sectional survey. Setting England. Subjects 2474 men (mean age 46 years) attending one of 18 general practices. Main outcome measures Experiences of non-consensual and consensual sex before and after the age of 16 years—that is, as a child and adult respectively—psychological problems experienced for more than 2 weeks at any one time, use of alcohol (CAGE questionnaire), self harm, and help received. Results 2474 of 3142 men (79%) agreed to participate; 71/2468 (standardised rate 2.89%, 95% confidence interval 2.21% to 3.56%) reported non-consensual sexual experiences as adults, 128/2423 (5.35%, 4.39% to 6.31%) reported non-consensual sexual experiences as children, and 185/2406 (7.66%, 6.54% to 8.77%) reported consensual sexual experiences as children that are illegal under English law. Independent predictors of non-consensual sex as adults were reporting male sexual partners (odds ratio 6.0, 2.6 to 13.5), non-consensual sex in childhood (4.2, 2.1 to 8.6), age (0.98, 0.96 to 0.99), and sex of interviewer (2.0, 1.2 to 3.5). Non-consensual sexual experiences were associated with a greater prevalence of psychological problems, alcohol misuse, and self harm. These sexual experiences were also significant predictors of help received from mental health professionals. Conclusion Almost 3% of men in England report non-consensual sexual experiences as adults. Medical professionals need to be aware of the range of psychological difficulties in men who have had such experiences. They also need to be aware of the relationship between sexual experiences in childhood and adulthood in men. Key messagesAlmost 3% of men report non-consensual sexual experiences as adultsOver 5% of men report sexual abuse as childrenNon-consensual sexual

  12. Self medication with antibiotics in Yogyakarta City Indonesia: a cross sectional population-based survey

    PubMed Central

    2011-01-01

    Background Self medication with antibiotics has become an important factor driving antibiotic resistance. This study investigated the period prevalence, patterns of use, and socio-demographic factors associated with self medication with antibiotics in Yogyakarta City Indonesia. This cross-sectional population-based survey used a pre-tested questionnaire which was self-administered to randomly selected respondents (over 18 years old) in Yogyakarta City Indonesia in 2010 (N = 625). Descriptive statistics, chi-square and logistic regression were applied. Results A total of 559 questionnaires were analyzed (response rate = 90%). The period prevalence of self medication with antibiotics during the month prior to the study was 7.3%. Amoxicillin was the most popular (77%) antibiotic for self medication besides ampicilline, fradiomisin-gramisidin, tetracycline, and ciprofloxacin to treat the following symptoms: the common-cold including cough and sore throat, headache, and other minor symptoms; with the length of use was mostly less than five days. Doctors or pharmacists were the most common source of information about antibiotics for self medication (52%). Antibiotics were usually purchased without prescription in pharmacies (64%) and the cost of the purchases was commonly less than US $1 (30%). Previous experience was reported to be the main reason for using non-prescribed antibiotics (54%). There were no socio-demographic variables significantly associated with the actual practice of using non-prescribed antibiotics. However, gender, health insurance, and marital status were significantly associated with the intent to self medicate with antibiotics (P < 0.05). Being male (Odds Ratio = 1.7 (1.2 - 2.6)) and having no health insurance (Odds Ratio = 1.5 (1.0 -2.3)) is associated with the intent to self medicate with antibiotics. Conclusions This study is the first population-based study of self-medication with antibiotics among the Indonesian population. Usage of non

  13. Climate change and health in Bangladesh: a baseline cross-sectional survey.

    PubMed

    Kabir, Md Iqbal; Rahman, Md Bayzidur; Smith, Wayne; Lusha, Mirza Afreen Fatima; Milton, Abul Hasnat

    2016-01-01

    Background Bangladesh is facing the unavoidable challenge of adaptation to climate change. However, very little is known in relation to climate change and health. This article provides information on potential climate change impact on health, magnitude of climate-sensitive diseases, and baseline scenarios of health systems to climate variability and change. Design A cross-sectional study using multistage cluster sampling framework was conducted in 2012 among 6,720 households of 224 rural villages in seven vulnerable districts of Bangladesh. Information was obtained from head of the households using a pretested, interviewer-administered, structured questionnaire. A total of 6,720 individuals participated in the study with written, informed consent. Results The majority of the respondents were from the low-income vulnerable group (60% farmers or day labourers) with an average of 30 years' stay in their locality. Most of them (96%) had faced extreme weather events, 45% of people had become homeless and displaced for a mean duration of 38 days in the past 10 years. Almost all of the respondents (97.8%) believe that health care expenditure increased after the extreme weather events. Mean annual total health care expenditure was 6,555 Bangladeshi Taka (BDT) (1 USD=77 BDT in 2015) and exclusively out of pocket of the respondents. Incidence of dengue was 1.29 (95% CI 0.65-2.56) and malaria 13.86 (95% CI 6.00-32.01) per 1,000 adult population for 12 months preceding the data collection. Incidence of diarrhoea and pneumonia among under-five children of the households for the preceding month was 10.3% (95% CI 9.16-11.66) and 7.3% (95% CI 6.35-8.46), respectively. Conclusions The findings of this survey indicate that climate change has a potential adverse impact on human health in Bangladesh. The magnitude of malaria, dengue, childhood diarrhoea, and pneumonia was high among the vulnerable communities. Community-based adaptation strategy for health could be beneficial to

  14. Prevalence and Perceptions of Musculoskeletal Disorders Among Hospital Nurses in Pakistan: A Cross-sectional Survey.

    PubMed

    Rathore, Farooq A; Attique, Rayan; Asmaa, Yumna

    2017-01-26

    Nursing is a professionally demanding job, and nurses are prone to develop musculoskeletal disorders. However, no data is available regarding its prevalence among Pakistani nurses. This study was conducted to document the pattern of work-related musculoskeletal disorders (WRMDs) in Pakistani nurses and their perceptions about contributing factors and management of WRMDs. A questionnaire-based, cross-sectional survey was conducted in six hospitals in Lahore and Rawalpindi, which were selected using a convenient sampling technique. A four-part questionnaire comprised of demographic data, experience of musculoskeletal disorders, and perception of management and contributing factors of WRMDs was distributed among 150 nurses. One hundred and seventeen nurses returned completed forms. Data was analyzed using SPSS Statistics v20 (IBM, Armonk, New York, USA). Ethics review committee approval was obtained by CMH Lahore Medical College and the Institute of Dentistry, and informed consent was obtained. The prevalence of musculoskeletal disorders over a 12-month period was 31.6%, with the most common site being the low back (32%) followed by the shoulder (20%), upper back, and knees (10%). Among those affected, 60.6% sought professional help. Married nurses were more prone to WRMDs (p=0.0001). Regarding management, most (94%) agreed that rest is required to get better, neglecting problems of this kind can cause permanent health problems (89.7%), and physical activity should be avoided (38.7%). Working in the same positions for long periods (93.1%), attending an excessive number of patients in one day (81.2%), and working in awkward and cramped positions (78.6%) were the most commonly perceived risk factors for WRMDs. About one-third of Pakistani nurses in this cohort reported work-related musculoskeletal disorders with the low back most commonly affected. There is a need to increase awareness regarding ergonomics and posture maintenance to reduce WRMDs and improve patient

  15. Why medical students choose psychiatry - a 20 country cross-sectional survey.

    PubMed

    Farooq, Kitty; Lydall, Gregory J; Malik, Amit; Ndetei, David M; Bhugra, Dinesh

    2014-01-15

    Recruitment to psychiatry is insufficient to meet projected mental health service needs world-wide. We report on the career plans of final year medical students from 20 countries, investigating factors identified from the literature which influence psychiatric career choice. Cross sectional electronic or paper survey. Subjects were final year medical students at 46 medical schools in participating countries. We assessed students' career intentions, motivations, medical school teaching and exposure to psychiatry. We assessed students' attitudes and personality factors. The main outcome measure was likelihood of specializing in psychiatry. Multilevel logistic regression was used to examine the joint effect of factors upon the main outcome. 2198 of 9135 (24%) of students responded (range 4 to 91%) across the countries. Internationally 4.5% of students definitely considered psychiatry as a career (range 1 to 12%). 19% of students (range 0 to 33%) were "quite likely", and 25% were "definitely not" considering psychiatry. Female gender, experience of mental/physical illness, media portrayal of doctors, and positive attitudes to psychiatry, but not personality factors, were associated with choosing psychiatry. Quality of psychiatric placement (correlation coefficient = 0.22, p < 0.001) and number of placements (correlation coefficient =0.21, p < 0.001) were associated with higher ATP scores. During medical school, experience of psychiatric enrichment activities (special studies modules and university psychiatry clubs), experience of acutely unwell patients and perceived clinical responsibility were all associated with choice of psychiatry.Multilevel logistic regression revealed six factors associated with students choosing psychiatry: importance of own vocation, odds ratio (OR) 3.01, 95% CI 1.61 to 5.91, p < 0.001); interest in psychiatry before medical school, OR 10.8 (5.38 to 21.8, p < 0.001); undertaking a psychiatry special study module, OR 1.45 (1.05 to 2.01, p = 0

  16. Prescription antibiotics for outpatients in Bangladesh: a cross-sectional health survey conducted in three cities.

    PubMed

    Biswas, Mohitosh; Roy, Debendra Nath; Tajmim, Afsana; Rajib, Sheikh Shahriar; Hossain, Mosharraf; Farzana, Fahamida; Yasmen, Nelufar

    2014-04-22

    Antibiotics prescribing by physicians have gained due importance across the globe, mainly because of an increase in antibiotic usage, prevalence of infections and drug resistances. The present study is aimed to evaluate the physicians prescribing pattern of antibiotics, their usages by outpatients and disease conditions for which the antibiotics are prescribed in three cities of Bangladesh. This cross sectional health survey was carried out with a self designed standard questionnaire by manual data collection over a three months period (20.03.2013 to 20.06.2013) at three adjacent cities Jessore Sadar, Monirampur and Keshabpur upazila respectively. The data were collected from the patient's prescription and by directly interviewing the patients who were prescribed at least one antibiotic during the study period. WHO Anatomical Therapeutic Chemical (ATC) classifications for antibiotics was used and descriptive statistics were applied to the collected data and analyzed using Microsoft Excel software. Modified Wald method was applied to calculate 95% CI. A total of 900 prescriptions were analyzed during the study period. It was found that the prescriber prescribed antibiotics to the patients who were suffering mainly from cold and fever, infections, diarrhea and gonorrhea. The highest prescribed antibiotic groups were cephalosporins (31.78%), macrolides (27.33%), quinolones (16.33%), penicillins (7.11%), and metronidazoles (6.78%) respectively. Two or more antibiotics were prescribed in 25.44% of prescriptions. A total of 66.89% prescriptions had complete information on dosage form, 57% had complete direction for antibiotics use and 64.22% patients completed full course of antibiotics. Although 83% prescriptions have no clinical test for using antibiotics, even though the percentages of patients' disease recovery were 61.78% and in compliance were 38.22%. From this research, it is observed that physicians prescribed antibiotics rationally in some cases but needs to

  17. Resilience of health-care workers in the UK; a cross-sectional survey.

    PubMed

    Sull, Andeep; Harland, Nicholas; Moore, Andrew

    2015-01-01

    Working for the UK National Health Service (NHS) requires working for organisations under financial pressures and frequent restructures, which can lead to anxiety over continuing employment and income. There are currently no studies to date that have examined the influence of personal resilience across all professions and demographics in the NHS. This study aims to quantify resilience within an NHS trust and explore the contribution of demographic variables of gender, age, years of service, pay grade, hours worked, job role, and division worked to the resilience response of employees. The study also explores the relationship between resilience levels and absence rates, as a marker for health and well-being amongst NHS staff. This study consists of a cross-sectional on-line survey of staff employed in an NHS Trust. All trust employees were asked to complete a Resilience Scale (RS-25), and demographic questions including age, sex, length of service, NHS pay grade (banding), division, job role and number of hours worked per week. Trust level sickness absence rates were also collected during this period. Results were analysed using descriptive statistics, bivariate comparisons and chi-squared tests. Data was gained from 845 employees; a significant association between gender and resilience found females scoring higher on the resilience scale; x (2)(5) =18.30, p < 0.05. A weak positive correlation between age and resilience found older employees displaying a higher level of resilience; r = 0.11, p <0.05. Results also suggest employees working between 18.75-37.5 hours a week have higher levels of resilience. Ancillary staff scored low on resilience compared to all other staff groups which showed moderate resilience. Clinical staff scored lower on resilience compared to both administrative staff and clinical staff with line management responsibilities. No correlations were found between absence rates and resilience. This study gives a snapshot of the resilience of

  18. Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey

    PubMed Central

    Knight, Louise; Child, Jennifer C; Kyegombe, Nambusi; Hossain, Mazeda; Lees, Shelley; Watts, Charlotte; Naker, Dipak

    2017-01-01

    Objectives Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home. Design A representative cross-sectional survey of primary schools. Participants 3427 non-boarding primary school students, aged about 11–14 years. Setting Luwero District, Uganda, 2012. Measures Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV. Results 26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves. Conclusions In this sample, witnessing IPV almost never occurred in isolation—almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child

  19. Mental health literacy in korean older adults: A cross-sectional survey.

    PubMed

    Kim, Y S; Lee, H Y; Lee, M H; Simms, T; Park, B H

    2017-09-01

    WHAT IS KNOWN ON THE SUBJECT?: Mental health literacy is a fairly new concept, first introduced in 1997. It refers to what people know and believe about mental health disorders. People's knowledge and beliefs help them to recognize, manage and prevent mental disorders. Generally, older adults have lower health literacy compared to young and middle-aged adults. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE?: This is the first study on the mental health literacy of Korean older adults. This study looks beyond peoples' ability to recognize mental health disorders and their opinions about them. It identifies factors that are associated with mental health literacy (level of education and social support, the number of people in one's social circles and how individuals rate their health). WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Older adults might get more out of mental health literacy programmes in group or social settings. Programmes that use older adult peer educators/supporters, such as the "older people's champions" of the Healthy Passport programme in England, might make the programmes more effective. Mental health campaigns, such as Australia's beyondblue, might increase mental health literacy of older adults. Introduction Korea is experiencing rapid population ageing, spurring an increased need for mental health services for the elderly. Approximately one-third of Korean older adults experience depressive symptoms, and Korea has the highest elder suicide rate among 34 developed nations. Mental health literacy is an important component of promoting mental health, yet studies on the concept have been conducted in few countries. Aim This study examines the level of mental health literacy among Korean older adults and identifies factors associated with their mental health literacy. Method A cross-sectional survey was conducted with 596 community-dwelling Korean adults aged 65 and older. Andersen's Behavioral Model of Health Services Use framed the study. Results Overall

  20. Responsibility for managing musculoskeletal disorders--a cross-sectional postal survey of attitudes.

    PubMed

    Larsson, Maria E H; Nordholm, Lena A

    2008-08-05

    Musculoskeletal disorders are a major burden on individuals, health systems and social care systems and rehabilitation efforts in these disorders are considerable. Self-care is often considered a cost effective treatment alternative owing to limited health care resources. But what are the expectations and attitudes in this question in the general population? The purpose of this study was to describe general attitudes to responsibility for the management of musculoskeletal disorders and to explore associations between attitudes and background variables. A cross-sectional, postal questionnaire survey was carried out with a random sample of a general adult Swedish population of 1770 persons. Sixty-one percent (n = 1082) responded to the questionnaire and was included for the description of general attitudes towards responsibility for the management of musculoskeletal disorders. For the further analyses of associations to background variables 683-693 individuals could be included. Attitudes were measured by the "Attitudes regarding Responsibility for Musculoskeletal disorders" (ARM) instrument, where responsibility is attributed on four dimensions; to myself, as being out of my hands, to employers or to (medical) professionals. Multiple logistic regression was used to explore associations between attitudes to musculoskeletal disorders and the background variables age, sex, education, physical activity, presence of musculoskeletal disorders, sick leave and whether the person had visited a care provider. A majority of participants had internal views, i.e. showed an attitude of taking personal responsibility for musculoskeletal disorders, and did not place responsibility for the management out of their own hands or to employers. However, attributing shared responsibility between self and medical professionals was also found. The main associations found between attitude towards responsibility for musculoskeletal disorders and investigated background variables were that

  1. Doctors' use of electronic medical records systems in hospitals: cross sectional survey

    PubMed Central

    Lærum, Hallvard; Ellingsen, Gunnar; Faxvaag, Arild

    2001-01-01

    Objectives To compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks. Design Cross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems. Setting 32 hospital units in 19 Norwegian hospitals with electronic medical records systems. Participants 227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems. Main outcome measures Proportion of respondents who used the electronic system, calculated for each of 23 tasks; difference in proportions of users of different systems when functionality of systems was similar. Results Most tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems. Conclusions Doctors used electronic medical records systems for far fewer tasks than the systems supported. What is already known on this topicElectronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been madeGiven the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasksWhat this study addsDoctors in Norwegian hospitals reported a low level of use of all electronic medical records systems

  2. Witnessing intimate partner violence and child maltreatment in Ugandan children: a cross-sectional survey.

    PubMed

    Devries, Karen M; Knight, Louise; Child, Jennifer C; Kyegombe, Nambusi; Hossain, Mazeda; Lees, Shelley; Watts, Charlotte; Naker, Dipak

    2017-02-28

    Existing evidence, mainly from high-income countries, shows children who witness intimate partner violence (IPV) at home are more likely to experience other forms of violence, but very little evidence is available from lower income countries. In this paper we aim to explore whether Ugandan children who witness IPV at home are also more likely to experience other forms of maltreatment, factors associated with witnessing and experiencing violence, and whether any increased risk comes from parents, or others outside the home. A representative cross-sectional survey of primary schools. 3427 non-boarding primary school students, aged about 11-14 years. Luwero District, Uganda, 2012. Exposure to child maltreatment was measured using the International Society for the Prevention of Child Abuse and Neglect Child Abuse Screening Tool-Child Institutional, and 2 questions measured witnessing IPV. 26% of children reported witnessing IPV, but nearly all of these children had also experienced violence themselves. Only 0.6% of boys and 1.6% of girls had witnessed partner violence and not experienced violence. Increased risk of violence was from parents and also from other perpetrators besides parents. Both girls and boys who witnessed and experienced violence had between 1.66 (95% CI 0.96 to 2.87) and 4.50 (95% CI 1.78 to 11.33) times the odds of reporting mental health difficulties, and 3.23 (95% CI 1.99 to 5.24) and 8.12 (95% CI 5.15 to 12.80) times the odds of using physical or sexual violence themselves. In this sample, witnessing IPV almost never occurred in isolation-almost all children who witnessed partner violence also experienced violence themselves. Our results imply that children in Uganda who are exposed to multiple forms of violence may benefit from intervention to mitigate mental health consequences and reduce use of violence. IPV prevention interventions should be considered to reduce child maltreatment. Large numbers of children also experience maltreatment in

  3. Climate change and health in Bangladesh: a baseline cross-sectional survey.

    PubMed

    Kabir, Md Iqbal; Rahman, Md Bayzidur; Smith, Wayne; Lusha, Mirza Afreen Fatima; Milton, Abul Hasnat

    2016-01-01

    Bangladesh is facing the unavoidable challenge of adaptation to climate change. However, very little is known in relation to climate change and health. This article provides information on potential climate change impact on health, magnitude of climate-sensitive diseases, and baseline scenarios of health systems to climate variability and change. A cross-sectional study using multistage cluster sampling framework was conducted in 2012 among 6,720 households of 224 rural villages in seven vulnerable districts of Bangladesh. Information was obtained from head of the households using a pretested, interviewer-administered, structured questionnaire. A total of 6,720 individuals participated in the study with written, informed consent. The majority of the respondents were from the low-income vulnerable group (60% farmers or day labourers) with an average of 30 years' stay in their locality. Most of them (96%) had faced extreme weather events, 45% of people had become homeless and displaced for a mean duration of 38 days in the past 10 years. Almost all of the respondents (97.8%) believe that health care expenditure increased after the extreme weather events. Mean annual total health care expenditure was 6,555 Bangladeshi Taka (BDT) (1 USD=77 BDT in 2015) and exclusively out of pocket of the respondents. Incidence of dengue was 1.29 (95% CI 0.65-2.56) and malaria 13.86 (95% CI 6.00-32.01) per 1,000 adult population for 12 months preceding the data collection. Incidence of diarrhoea and pneumonia among under-five children of the households for the preceding month was 10.3% (95% CI 9.16-11.66) and 7.3% (95% CI 6.35-8.46), respectively. The findings of this survey indicate that climate change has a potential adverse impact on human health in Bangladesh. The magnitude of malaria, dengue, childhood diarrhoea, and pneumonia was high among the vulnerable communities. Community-based adaptation strategy for health could be beneficial to minimise climate change attributed health

  4. Sexual behaviour of adolescents in Nigeria: cross sectional survey of secondary school students.

    PubMed

    Slap, Gail B; Lot, Lucy; Huang, Bin; Daniyam, Comfort A; Zink, Therese M; Succop, Paul A

    2003-01-04

    To determine whether family structure (polygamous or monogamous) is associated with sexual activity among school students in Nigeria. Cross sectional school survey with a two stage, clustered sampling design. 4218 students aged 12-21 years attending 39 schools in Plateau state, Nigeria. Responses from 2705 students were included in the analysis. Report of ever having had sexual intercourse. Variables of interest included sexual history, age, sex, religion, family polygamy, educational level of parents, having a dead parent, and sense of connectedness to parents and school. Overall 909 students (34%) reported ever having had sexual intercourse, and 1119 (41%) reported a polygamous family structure. Sexual activity was more common among students from polygamous families (42% of students) than monogamous families (28%) (chi2=64.23; P<0.0001). Variables independently associated with sexual activity were male sex (adjusted odds ratio 2.52 (95% confidence interval 2.05 to 3.12)), older age (1.62 (1.24 to 2.14)), lower sense of connectedness with parents (1.87 (1.48 to 2.38)), having a dead parent (1.59 (1.27 to 2.00)), family polygamy (1.58 (1.29 to 1.92)), lower sense of connectedness with school (1.25 (1.09 to 1.44)), and lower educational level of parents (1.14 (1.05 to 1.24)). Multistep logistic regression analysis showed that the effect of polygamy on sexual activity was reduced by 27% by whether students were married and 22% by a history of forced sex. Secondary school students in Nigeria from a polygamous family structure are more likely to have engaged in sexual activity than students from a monogamous family structure. This effect is partly explained by a higher likelihood of marriage during adolescence and forced sex. Students' sense of connectedness to their parents and school, regardless of family structure, decreases the likelihood of sexual activity, and fostering this sense may help reduce risky sexual behaviour among Nigerian youth.

  5. The health of children in refuges for women victims of domestic violence: cross sectional descriptive survey

    PubMed Central

    Webb, Elspeth; Shankleman, Judith; Evans, Meirion R; Brooks, Rachel

    2001-01-01

    Objectives To describe the health and developmental status of children living in refuges for women victims of domestic violence and to investigate their access to primary healthcare services. Design Cross sectional survey. Setting Women's refuges in Cardiff. Participants 148 resident children aged under 16 years and their mothers. Main outcome measures Completeness of records on the child health system (register of all children that includes data on the child's health) for named health visitor, named general practitioner, and immunisation uptake; satisfactory completion of child health surveillance; Denver test results for developmental status; Rutter test scores for behavioural and emotional problems; reports of maternal concerns. Results 148/257 (58%) children living in refuges between April 1999 and January 2000 were assessed. Child health system data were incorrect (general practitioner and/or address) or unavailable for 85/148 (57%) children. Uptake of all assessments and immunisations was low. 13/68 (19%) children aged <5 years had delayed or questionable development on the Denver test, and 49/101 (49%) children aged 3-15 years had a Rutter score of >10 (indicating probable mental health problems). Concerns were expressed by mothers of 113/148 (76%) children. After leaving the refuge, 22 children were untraceable and 36 returned home to the perpetrator from whom the families had fled. Conclusions The children had a high level of need, as well as poor access to services. Time spent in a refuge provides a window of opportunity to review health and developmental status. Specialist health visitors could facilitate and provide support, liaison, and follow up. What is already known on this topicA pilot study showed poor uptake of immunisations and surveillance among children who live in refuges for women victims of domestic violenceQualitative studies suggest that these children are at risk of psychological ill healthWhat this study addsBaseline health and

  6. Experience of Lyme disease and preferences for precautions: a cross-sectional survey of UK patients

    PubMed Central

    2013-01-01

    Background Lyme disease (LD) is a tick-borne zoonosis currently affecting approximately 1000 people annually in the UK (confirmed through serological diagnosis) although it is estimated that the real figures may be as high as 3000 cases. It is important to know what factors may predict correct appraisal of LD symptoms and how the experience of LD might predict preferences for future precautionary actions. Methods A cross-sectional survey was conducted with early LD patients via the Lyme Borreliosis Unit at the Health Protection Agency. One hundred and thirty participants completed measures of awareness of having been bitten by ticks, knowledge of ticks and LD, interpretation of LD symptoms, suspicions of having LD prior to seeing the General Practitioner (GP), and preferences for precautionary actions during future countryside visits. Chi-square tests and logistic regression were used to identify key predictors of awareness of having been bitten by ticks and of having LD. t-tests assessed differences between groups of participants on suspicions of having LD and preferences for future precautions. Pearson correlations examined relationships between measures of preferences for precautions and frequency of countryside use, knowledge of ticks and LD, and intentions to avoid the countryside in the future. Results 73.8% of participants (n = 96) reported a skin rash as the reason for seeking medical help, and 44.1% (n = 64) suspected they had LD before seeing the GP. Participants reporting a direct event in realizing they had been bitten by ticks (seeing a tick on skin or seeing a skin rash and linking it to tick bites) were more likely to suspect they had LD before seeing the doctor. Participants distinguished between taking precautions against tick bites during vs. after countryside visits, largely preferring the latter. Also, the more frequently participants visited the countryside, the less likely they were to endorse during-visit precautions. Conclusions The

  7. A cross-sectional seroepidemiological survey of typhoid fever in Fiji.

    PubMed

    Watson, Conall H; Baker, Stephen; Lau, Colleen L; Rawalai, Kitione; Taufa, Mere; Coriakula, Jerimaia; Thieu, Nga Tran Vu; Van, Tan Trinh; Ngoc, Dung Tran Thi; Hens, Niel; Lowry, John H; de Alwis, Ruklanthi; Cano, Jorge; Jenkins, Kylie; Mulholland, E Kim; Nilles, Eric J; Kama, Mike; Edmunds, W John

    2017-07-01

    Fiji, an upper-middle income state in the Pacific Ocean, has experienced an increase in confirmed case notifications of enteric fever caused by Salmonella enterica serovar Typhi (S. Typhi). To characterize the epidemiology of typhoid exposure, we conducted a cross-sectional sero-epidemiological survey measuring IgG against the Vi antigen of S. Typhi to estimate the effect of age, ethnicity, and other variables on seroprevalence. Epidemiologically relevant cut-off titres were established using a mixed model analysis of data from recovering culture-confirmed typhoid cases. We enrolled and assayed plasma of 1787 participants for anti-Vi IgG; 1,531 of these were resident in mainland areas that had not been previously vaccinated against S. Typhi (seropositivity 32.3% (95%CI 28.2 to 36.3%)), 256 were resident on Taveuni island, which had been previously vaccinated (seropositivity 71.5% (95%CI 62.1 to 80.9%)). The seroprevalence on the Fijian mainland is one to two orders of magnitude higher than expected from confirmed case surveillance incidence, suggesting substantial subclinical or otherwise unreported typhoid. We found no significant differences in seropositivity prevalences by ethnicity, which is in contrast to disease surveillance data in which the indigenous iTaukei Fijian population are disproportionately affected. Using multivariable logistic regression, seropositivity was associated with increased age (odds ratio 1.3 (95% CI 1.2 to 1.4) per 10 years), the presence of a pit latrine (OR 1.6, 95%CI 1.1 to 2.3) as opposed to a septic tank or piped sewer, and residence in settlements rather than residential housing or villages (OR 1.6, 95% CI 1.0 to 2.7). Increasing seropositivity with age is suggestive of low-level endemic transmission in Fiji. Improved sanitation where pit latrines are used and addressing potential transmission routes in settlements may reduce exposure to S. Typhi. Widespread unreported infection suggests there may be a role for typhoid

  8. Building hospital pharmacy practice research capacity in Qatar: a cross-sectional survey of hospital pharmacists.

    PubMed

    Stewart, Derek; Al Hail, Moza; Abdul Rouf, P V; El Kassem, Wessam; Diack, Lesley; Thomas, Binny; Awaisu, Ahmed

    2015-06-01

    There is a need to systematically develop research capacity within pharmacy practice. Hamad Medical Corporation (HMC) is the principal non-profit health care provider in Qatar. Traditionally, pharmacists in Qatar have limited training related to research and lack direct experience of research processes. To determine the interests, experience and confidence of hospital pharmacists employed by HMC, Qatar in relation to research, attitudes towards research, and facilitators and barriers. Hospital pharmacy, Qatar. A cross-sectional survey of all pharmacists (n = 401). Responses were analysed using descriptive and inferential statistics, and principal component analysis (PCA). Interests, experience and confidence in research; attitudes towards research; and facilitators and barriers to participation in research. The response rate was 53.1 % (n = 213). High levels of interest were expressed for all aspects of research, with respondents less experienced and less confident. Summary scores for items of interest were significantly higher than experience and confidence (p < 0.001). PCA identified four components: general attitudes towards research; confidence, motivation and resources; research culture; and support. While respondents were generally positive in response to all items, they were less sure of resources to conduct research, access to training and statistical support. They were also generally unsure of many aspects relating to research culture. Half (50.7 %, n = 108) had either never thought about being involved in research or taken no action. In multivariate binary logistic regression analysis, the significant factors were possessing postgraduate qualifications [odds ratio (OR) 3.48 (95 % CI 1.73-6.99), p < 0.001] and having more positive general attitudes to research [OR 3.24 (95 % CI 1.62-4.67), p = 0.001]. Almost all (89.7 %, n = 172) expressed interest in being involved in research training. HMC pharmacists expressed significantly higher levels of interest in

  9. Prescription antibiotics for outpatients in Bangladesh: a cross-sectional health survey conducted in three cities

    PubMed Central

    2014-01-01

    Background Antibiotics prescribing by physicians have gained due importance across the globe, mainly because of an increase in antibiotic usage, prevalence of infections and drug resistances. The present study is aimed to evaluate the physicians prescribing pattern of antibiotics, their usages by outpatients and disease conditions for which the antibiotics are prescribed in three cities of Bangladesh. Methods This cross sectional health survey was carried out with a self designed standard questionnaire by manual data collection over a three months period (20.03.2013 to 20.06.2013) at three adjacent cities Jessore Sadar, Monirampur and Keshabpur upazila respectively. The data were collected from the patient’s prescription and by directly interviewing the patients who were prescribed at least one antibiotic during the study period. WHO Anatomical Therapeutic Chemical (ATC) classifications for antibiotics was used and descriptive statistics were applied to the collected data and analyzed using Microsoft Excel software. Modified Wald method was applied to calculate 95% CI. Results A total of 900 prescriptions were analyzed during the study period. It was found that the prescriber prescribed antibiotics to the patients who were suffering mainly from cold and fever, infections, diarrhea and gonorrhea. The highest prescribed antibiotic groups were cephalosporins (31.78%), macrolides (27.33%), quinolones (16.33%), penicillins (7.11%), and metronidazoles (6.78%) respectively. Two or more antibiotics were prescribed in 25.44% of prescriptions. A total of 66.89% prescriptions had complete information on dosage form, 57% had complete direction for antibiotics use and 64.22% patients completed full course of antibiotics. Although 83% prescriptions have no clinical test for using antibiotics, even though the percentages of patients’ disease recovery were 61.78% and incompliance were 38.22%. Conclusion From this research, it is observed that physicians prescribed antibiotics

  10. Climate change and health in Bangladesh: a baseline cross-sectional survey

    PubMed Central

    Kabir, Md Iqbal; Rahman, Md Bayzidur; Smith, Wayne; Lusha, Mirza Afreen Fatima; Milton, Abul Hasnat

    2016-01-01

    Background Bangladesh is facing the unavoidable challenge of adaptation to climate change. However, very little is known in relation to climate change and health. This article provides information on potential climate change impact on health, magnitude of climate-sensitive diseases, and baseline scenarios of health systems to climate variability and change. Design A cross-sectional study using multistage cluster sampling framework was conducted in 2012 among 6,720 households of 224 rural villages in seven vulnerable districts of Bangladesh. Information was obtained from head of the households using a pretested, interviewer-administered, structured questionnaire. A total of 6,720 individuals participated in the study with written, informed consent. Results The majority of the respondents were from the low-income vulnerable group (60% farmers or day labourers) with an average of 30 years’ stay in their locality. Most of them (96%) had faced extreme weather events, 45% of people had become homeless and displaced for a mean duration of 38 days in the past 10 years. Almost all of the respondents (97.8%) believe that health care expenditure increased after the extreme weather events. Mean annual total health care expenditure was 6,555 Bangladeshi Taka (BDT) (1 USD=77 BDT in 2015) and exclusively out of pocket of the respondents. Incidence of dengue was 1.29 (95% CI 0.65–2.56) and malaria 13.86 (95% CI 6.00–32.01) per 1,000 adult population for 12 months preceding the data collection. Incidence of diarrhoea and pneumonia among under-five children of the households for the preceding month was 10.3% (95% CI 9.16–11.66) and 7.3% (95% CI 6.35–8.46), respectively. Conclusions The findings of this survey indicate that climate change has a potential adverse impact on human health in Bangladesh. The magnitude of malaria, dengue, childhood diarrhoea, and pneumonia was high among the vulnerable communities. Community-based adaptation strategy for health could be

  11. Adaptive geostatistical sampling enables efficient identification of malaria hotspots in repeated cross-sectional surveys in rural Malawi

    PubMed Central

    Chipeta, Michael G.; McCann, Robert S.; Phiri, Kamija S.; van Vugt, Michèle; Takken, Willem; Diggle, Peter; Terlouw, Anja D.

    2017-01-01

    Introduction In the context of malaria elimination, interventions will need to target high burden areas to further reduce transmission. Current tools to monitor and report disease burden lack the capacity to continuously detect fine-scale spatial and temporal variations of disease distribution exhibited by malaria. These tools use random sampling techniques that are inefficient for capturing underlying heterogeneity while health facility data in resource-limited settings are inaccurate. Continuous community surveys of malaria burden provide real-time results of local spatio-temporal variation. Adaptive geostatistical design (AGD) improves prediction of outcome of interest compared to current random sampling techniques. We present findings of continuous malaria prevalence surveys using an adaptive sampling design. Methods We conducted repeated cross sectional surveys guided by an adaptive sampling design to monitor the prevalence of malaria parasitaemia and anaemia in children below five years old in the communities living around Majete Wildlife Reserve in Chikwawa district, Southern Malawi. AGD sampling uses previously collected data to sample new locations of high prediction variance or, where prediction exceeds a set threshold. We fitted a geostatistical model to predict malaria prevalence in the area. Findings We conducted five rounds of sampling, and tested 876 children aged 6–59 months from 1377 households over a 12-month period. Malaria prevalence prediction maps showed spatial heterogeneity and presence of hotspots—where predicted malaria prevalence was above 30%; predictors of malaria included age, socio-economic status and ownership of insecticide-treated mosquito nets. Conclusions Continuous malaria prevalence surveys using adaptive sampling increased malaria prevalence prediction accuracy. Results from the surveys were readily available after data collection. The tool can assist local managers to target malaria control interventions in areas with the

  12. Adaptive geostatistical sampling enables efficient identification of malaria hotspots in repeated cross-sectional surveys in rural Malawi.

    PubMed

    Kabaghe, Alinune N; Chipeta, Michael G; McCann, Robert S; Phiri, Kamija S; van Vugt, Michèle; Takken, Willem; Diggle, Peter; Terlouw, Anja D

    2017-01-01

    In the context of malaria elimination, interventions will need to target high burden areas to further reduce transmission. Current tools to monitor and report disease burden lack the capacity to continuously detect fine-scale spatial and temporal variations of disease distribution exhibited by malaria. These tools use random sampling techniques that are inefficient for capturing underlying heterogeneity while health facility data in resource-limited settings are inaccurate. Continuous community surveys of malaria burden provide real-time results of local spatio-temporal variation. Adaptive geostatistical design (AGD) improves prediction of outcome of interest compared to current random sampling techniques. We present findings of continuous malaria prevalence surveys using an adaptive sampling design. We conducted repeated cross sectional surveys guided by an adaptive sampling design to monitor the prevalence of malaria parasitaemia and anaemia in children below five years old in the communities living around Majete Wildlife Reserve in Chikwawa district, Southern Malawi. AGD sampling uses previously collected data to sample new locations of high prediction variance or, where prediction exceeds a set threshold. We fitted a geostatistical model to predict malaria prevalence in the area. We conducted five rounds of sampling, and tested 876 children aged 6-59 months from 1377 households over a 12-month period. Malaria prevalence prediction maps showed spatial heterogeneity and presence of hotspots-where predicted malaria prevalence was above 30%; predictors of malaria included age, socio-economic status and ownership of insecticide-treated mosquito nets. Continuous malaria prevalence surveys using adaptive sampling increased malaria prevalence prediction accuracy. Results from the surveys were readily available after data collection. The tool can assist local managers to target malaria control interventions in areas with the greatest health impact and is ready for

  13. [A cross-sectional survey on the patterns of primary teeth eruption in 2 581 children].

    PubMed

    Li, R X; Hu, Y

    2017-01-02

    Objective: To investigate the patterns of primary teeth eruption by a cross-sectional survey in 0-40 months old children in Chongqing and to provide normal timetables of tooth eruption that are practical in general physical growth assessment. Method: Data of 2 581 0-40 months old healthy children were collected from January 2014 to January 2016 at Children's Hospital of Chongqing Medical University. General information was recorded by primary child health care doctors, including age, gender, gestation age, birth weight, time and sequence of first primary tooth eruption, number of teeth and age of totally primary teeth emergence. Median and constituent ratio were used in describing the age of tooth eruption and eruption characteristics at different age. Moreover, independent-sample t test, variance analysis, Pearson product-moment correlation and Logistic regression were also involved in data analysis. Result: Totally 2 581 children were involved in this survey, including 506 infants of 0-6 months old, 600 infants of 7-12 months old, 730 toddlers of 13-24 months old and 745 children of 25-40 months old. There were 1 473 boys and 1 108 girls, 89 preterm babies and 2 492 full term babies, 1 829 children with tooth erupted and 626 children with all primary teeth erupted.The age of the first primary tooth eruption was between 2-15 months old ( median age: 8 months old, 95%CI: 2.7-12.7)and for the last primary tooth emergence was between 23-35 months of age (median age: 31 months, 95%CI: 24.7-36.7). The time of first tooth eruption was positively correlated with that of total teeth emergence (r=0.879, P<0.05). Dental charts (number of tooth for age) of different gender were drawn according to teeth eruption information. The first primary tooth eruption was the incisor of mandible in 95.3% (1 743/1 829)infants and was the incisor of maxilla in 4.6% (84/1 829)infants. During the period of tooth emerging actively (number of teeth ≤16), the number of primary teeth might be

  14. Codeine use, dependence and help-seeking behaviour in the UK and Ireland: an online cross-sectional survey.

    PubMed

    Kimergård, A; Foley, M; Davey, Z; Dunne, J; Drummond, C; Deluca, P

    2017-09-01

    Codeine misuse and dependence poses a clinical and public health challenge. However, little is known about dependence and treatment needs in the UK and Ireland. To characterize codeine use, dependence and help-seeking behaviour. An online cross-sectional survey advertised on Facebook, Twitter, health and drug websites and e-mail circulars. The survey collected data on demographics and codeine use amongst adults from the UK and Ireland. The Severity of Dependence Scale measured the level of codeine dependence. The sample of 316 respondents had a mean age of 35.3 years (SD = 12.3) and 67% were women. Of the 316 respondents, 54 scored ≥5 on the Severity of Dependence Scale indicating codeine dependence (17.1%). Our study found that codeine dependence is a problem with both prescribed and 'over-the-counter' codeine. Codeine dependence was associated with daily use of codeine, faking or exaggerating symptoms to get a prescription for codeine and 'pharmacy shopping' ( P < 0.01). A higher number of respondents had sought advice on the Internet (12%) rather than from their general medical practitioner (GP) (5.4%). Less than 1% of respondents had sought advice from a pharmacist. Codeine dependent users were more likely to seek help on the Internet to control their use of codeine than from a GP, which may indicate a potential for greater specialized addiction treatment demand through increased identification and referrals in primary care.

  15. Amantadine use associated with impulse control disorders in Parkinson disease in cross-sectional study.

    PubMed

    Weintraub, Daniel; Sohr, Mandy; Potenza, Marc N; Siderowf, Andrew D; Stacy, Mark; Voon, Valerie; Whetteckey, Jacqueline; Wunderlich, Glen R; Lang, Anthony E

    2010-12-01

    A recent controlled clinical trial suggested a role for amantadine as a treatment for pathological gambling in patients with Parkinson disease (PD). Analyzing data from a large cross-sectional study of impulse control disorders (ICDs) in PD, amantadine use (n = 728), vs no amantadine use (n = 2,357), was positively associated with a diagnosis of any ICD (17.6% vs 12.4%, p < 0.001) and compulsive gambling specifically (7.4% vs 4.2%, p < 0.001). This amantadine association remained after controlling for covariates of amantadine use, including both dopamine agonist use and levodopa dosage. Further research, including larger clinical trials, is needed to assess the role of amantadine in the development and treatment of ICDs in PD.

  16. High Prevalence of Restless Legs Syndrome among Patients with Fibromyalgia: A Controlled Cross-Sectional Study

    PubMed Central

    Viola-Saltzman, Mari; Watson, Nathaniel F.; Bogart, Andy; Goldberg, Jack; Buchwald, Dedra

    2010-01-01

    Study Objectives: To investigate the prevalence of restless legs syndrome (RLS) in fibromyalgia (FM) and determine the presence and amount of sleep disruption in FM patients with RLS. RLS and FM have been associated in uncontrolled studies using a variety of RLS definitions. We explored this relationship using a cross-sectional study design. Methods: FM cases that met the American College of Rheumatology diagnostic criteria were recruited through an academic referral clinic and advertising. Pain- and fatigue-free controls were recruited from the Seattle metropolitan area. We enrolled 172 FM patients (mean age 50 years, 93% female) and 63 pain- and fatigue-free controls (mean age 41 years, 56% female). RLS was ascertained by a self-administered validated diagnostic interview. Results: The age- and gender-adjusted prevalence of RLS was higher in the FM group than the control group (33.0%; 95% CI: 25.9, 40.1 vs. 3.1%; 95% CI: 0.0, 7.4; p = 0.001). Likewise, the FM group was more likely to report RLS (OR = 11.7; 95% CI: 2.6, 53.0), even after adjusting for age and gender. The mean Pittsburgh Sleep Quality Index score was higher among FM patients with RLS than those without (11.8 vs. 9.9; p = 0.01) but subjective limb pain measures did not differ between these 2 groups. Conclusions: There is a higher prevalence and odds of RLS in those with FM compared to controls. Clinicians should routinely query FM patients regarding RLS symptoms because treatment of RLS can potentially improve sleep and quality of life in these patients. Citation: Viola-Saltzman M; Watson NF; Bogart A; Goldberg J; Buchwald D. High prevalence of restless legs syndrome among patients with fibromyalgia: a controlled cross-sectional study. J Clin Sleep Med 2010;6(5):423-427. PMID:20957840

  17. Mobile Phone Use Among Medical Residents: A Cross-Sectional Multicenter Survey in Saudi Arabia

    PubMed Central

    Temsah, Mohamad-Hani; Khan, Samina A; Al-Eyadhy, Ayman; Chiang, Michael F

    2016-01-01

    Background Mobile phones have great potential for medical education, as they allow health care providers and students to access resources efficiently at the precise time at the point-of-care to help in informed decision making. Objective The objective of the study was to evaluate the prevalence of mobile phone usage among medical residents and to explore their attitudes, perceptions, and the challenges they experience when using mobile phones in academic and clinical practice. Methods A cross-sectional survey was conducted on all 133 residents in 17 different specialties across two large academic hospitals in Riyadh, Saudi Arabia. The Web-based validated questionnaire measured mobile phone platform preferences, and their uses in general and medical practice. The perception of confidentiality and safety impact of using mobile phones for communication and accessing patient’s data was also explored, alongside challenges of use and how residents learn to use their mobile phone. Results With a response rate of 101/133 (75.9%) and mean age of 27.8 (SD 3.0) years, we found that 100/101 (99.0%) of participants were mobile phone users with mean duration of use of 5.12 (SD 2.4) years, and a range from 1 to 12 years. There was no significant difference in use between male and female respondents. A negative linear correlation was found between age and use duration (P=.004). The most common operating system used by participants was the iOS platform (55/101, 54.5%), with English the most commonly used language to operate residents’ mobile phones (96/100, 96.0%) despite their native language being Arabic. For communication outside medical practice, chatting applications such as WhatsApp matched phone calls as most commonly used tools (each 88/101, 87.1%). These were also the primary tools for medical communication, but used at a lower rate (each 65/101, 64.4%). In medical practice, drug (83/101, 82.2%) and medical (80/101, 79.2%) references and medical calculation

  18. Mobile Phone Use Among Medical Residents: A Cross-Sectional Multicenter Survey in Saudi Arabia.

    PubMed

    Jamal, Amr; Temsah, Mohamad-Hani; Khan, Samina A; Al-Eyadhy, Ayman; Koppel, Cristina; Chiang, Michael F

    2016-05-19

    Mobile phones have great potential for medical education, as they allow health care providers and students to access resources efficiently at the precise time at the point-of-care to help in informed decision making. The objective of the study was to evaluate the prevalence of mobile phone usage among medical residents and to explore their attitudes, perceptions, and the challenges they experience when using mobile phones in academic and clinical practice. A cross-sectional survey was conducted on all 133 residents in 17 different specialties across two large academic hospitals in Riyadh, Saudi Arabia. The Web-based validated questionnaire measured mobile phone platform preferences, and their uses in general and medical practice. The perception of confidentiality and safety impact of using mobile phones for communication and accessing patient's data was also explored, alongside challenges of use and how residents learn to use their mobile phone. With a response rate of 101/133 (75.9%) and mean age of 27.8 (SD 3.0) years, we found that 100/101 (99.0%) of participants were mobile phone users with mean duration of use of 5.12 (SD 2.4) years, and a range from 1 to 12 years. There was no significant difference in use between male and female respondents. A negative linear correlation was found between age and use duration (P=.004). The most common operating system used by participants was the iOS platform (55/101, 54.5%), with English the most commonly used language to operate residents' mobile phones (96/100, 96.0%) despite their native language being Arabic. For communication outside medical practice, chatting applications such as WhatsApp matched phone calls as most commonly used tools (each 88/101, 87.1%). These were also the primary tools for medical communication, but used at a lower rate (each 65/101, 64.4%). In medical practice, drug (83/101, 82.2%) and medical (80/101, 79.2%) references and medical calculation applications (61/101, 60.4%) were the most commonly

  19. Heart Failure Telemonitoring in Japan and Sweden: A Cross-Sectional Survey

    PubMed Central

    Johansson, Peter; Okada, Ikuko; de Vries, Arjen E; Kinugawa, Koichiro; Strömberg, Anna; Jaarsma, Tiny

    2015-01-01

    Background Telemonitoring of heart failure (HF) patients is increasingly discussed at conferences and addressed in research. However, little is known about actual use in specific countries. Objective We aimed to (1) describe the use of non-invasive HF telemonitoring, (2) clarify expectations of telemonitoring among cardiologists and nurses, and (3) describe barriers to the implementation of telemonitoring in Japan and Sweden. Methods This study used a cross-sectional survey of non-invasive HF telemonitoring. A total of 378 Japanese (120 cardiologists, 258 nurses) and 120 Swedish (39 cardiologists, 81 nurses) health care professionals from 165 Japanese and 61 Swedish hospitals/clinics nationwide participated in the study (210 in Japan and 98 in Sweden were approached). Data were collected between November 2013 and May 2014 with a questionnaire that was adapted from a previous Dutch study on telemonitoring. Results The mean age of the cardiologists and nurses was 47 years and 41 years, respectively. Experience at the current position caring for HF patients was 19 years among the physicians and 15 years among the nurses. In total, 7 Japanese (4.2%) and none of the Swedish health care institutions used telemonitoring. One fourth (24.0%, 118/498) of the health care professionals were familiar with the technology (in Japan: 21.6%, 82/378; in Sweden: 30.0%, 36/120). The highest expectations of telemonitoring (rated on a scale from 0-10) were reduced hospitalizations (8.3 in Japan and 7.5 in Sweden), increased patient self-care (7.8 and 7.4), and offering high-quality care (7.8 and 7.0). The major goal for introducing telemonitoring was to monitor physical condition and recognize signs of worsening HF in Japan (94.1%, 352/374) and Sweden (88.7%, 102/115). The following reasons were also high in Sweden: to monitor effects of treatment and adjust it remotely (86.9%, 100/115) and to do remote drug titration (79.1%, 91/115). Just under a quarter of Japanese (22.4%, 85/378) and

  20. A cross-sectional investigation of acceptance of health information technology: A nationwide survey of community pharmacists in Turkey.

    PubMed

    Sezgin, Emre; Özkan-Yıldırım, Sevgi

    Health information technologies have become vital to health care services. In that regard, successful use of information technologies in pharmaceutical services is important to manage, control and maintain pharmaceutical transactions, which increase the quality of health care delivery. This study aimed to identify influencing factors on pharmacists' acceptance of pharmaceutical service systems. A cross-sectional study was conducted employing a research model based on technology acceptance theories. A parsimonious model was developed, and a self-reported questionnaire was distributed online. Community pharmacists participated voluntarily via the website of Turkish Pharmacists' Association. The data was analyzed employing Structural Equation Modeling. From 77 out of 81 cities of Turkey, 2169 community pharmacists participated to the survey with 43% response rate. Perceived usefulness, perceived ease of use, system factors and perceived behavioral control explained 47% of total variance in pharmacists' intention to use the pharmaceutical technology. The findings of the research provided insight about relations of influencing factors and practical implications regarding perceived behaviors and system use. Future researchers would benefit from the study design and findings. The study is also valuable for being the first nationwide study conducted on pharmacists about user attitudes toward a technology. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Taylor-Couette flow control by amplitude variation of the inner cylinder cross-section oscillation

    NASA Astrophysics Data System (ADS)

    Oualli, Hamid; Mekadem, Mahmoud; Lebbi, Mohamed; Bouabdallah, Ahcene

    2015-07-01

    The hydrodynamic stability of a viscous fluid flow evolving in an annular space between a rotating inner cylinder with a periodically variable radius and an outer fixed cylinder is considered. The basic flow is axis-symmetric with two counter-rotating vortices each wavelength along the whole filled system length. The numerical simulations are implemented on the commercial Fluent software package, a finite-volume CFD code. It is aimed to make investigation of the early flow transition with assessment of the flow response to radial pulsatile motion superimposed to the inner cylinder cross-section as an extension of a previous developed work in Oualli et al. [H. Oualli, A. Lalaoua, S. Hanchi, A. Bouabdallah, Eur. Phys. J. Appl. Phys. 61, 11102 (2013)] where a comparative controlling strategy is applied to the outer cylinder. The same basic system is considered with similar calculating parameters and procedure. In Oualli et al. [H. Oualli, A. Lalaoua, S. Hanchi, A. Bouabdallah, Eur. Phys. J. Appl. Phys. 61, 11102 (2013)], it is concluded that for the actuated outer cylinder and relatively to the non-controlled case, the critical Taylor number, Tac1, characterizing the first instability onset illustrated by the piled Taylor vortices along the gap, increases substantially to reach a growing rate of 70% when the deforming amplitude is ɛ = 15%. Interestingly, when this controlling strategy is applied to the inner cylinder cross-section with a slight modification of the actuating law, this tendency completely inverts and the critical Taylor number decreases sharply from Tac1 = 41.33 to Tac1 = 17.66 for ɛ = 5%, corresponding to a reduction rate of 57%. Fundamentally, this result is interesting and can be interpreted by prematurely triggering instabilities resulting in rapid development of flow turbulence. Practically, important applicative aspects can be met in several industry areas where substantial intensification of transport phenomena (mass, momentum and heat) is

  2. Knowledge, attitude and practice among Chinese acupuncturists receiving sham and/or placebo acupuncture: a cross-sectional survey.

    PubMed

    Jin, Chunlan; Zhou, Xinyao; Pang, Ran

    2015-06-01

    Placebo and sham acupuncture are common control strategies in acupuncture studies. However, the perception and practice of these approaches in acupuncturists are poorly documented. To investigate knowledge of, attitude towards and practice of sham and/or placebo acupuncture among Chinese acupuncturists. A cross-sectional survey conducted in six different tertiary care hospitals of traditional Chinese medicine in Beijing, China. A total of 92 licensed acupuncturists were asked to complete a predesigned and structured questionnaire on-site. A response rate of 92.4% (n=85) was achieved. Almost all participants (99%, n=84) had moderate knowledge about sham and/or placebo acupuncture, but only a minority (27%, n=23) reported an excellent understanding. The general attitude towards sham and/or placebo acupuncture was positive. Most respondents (99%, n=84) thought such controls were necessary and the majority (81%, n=69) believed they were feasible in acupuncture research. More than two-thirds of participants (71%, n=60) had applied sham and/or placebo acupuncture, but only a few (8%, 5/60) used it as the most common control strategy in clinical trials. The result of our survey suggests that Chinese acupuncturists have a moderate knowledge of, and a positive attitude towards, sham and/or placebo acupuncture. Research into sham and/or placebo acupuncture is limited in comparison with other control strategies. Therefore, an in-service education programme for acupuncturists and standardisation of sham and/or placebo acupuncture need to be developed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  3. Social disparities in children’s exposure to second hand smoke at home: a repeated cross-sectional survey

    PubMed Central

    2012-01-01

    Background Exposure to second hand smoke (SHS) is an important preventable cause of morbidity and mortality in children. We hypothesised that there has been a growth in social inequality in children’s exposure to SHS at home over time. The purpose of this study was to investigate temporal change in smoking in homes including children, focusing on the socioeconomic differences. Methods Data is from a repeated cross-sectional survey, ‘Health Profiles of the Capital Region of Denmark’ conducted in 2007 and 2010, in 29 municipalities. The response rate was 52.3%, in both surveys. Our study included persons aged 25 to 64, living with children ≤15 years of age; N=9,289 in 2007 and 12,696 in 2010. Analyses were weighted for size of municipality and for non-response, which was higher among men and among persons who were younger, had a lower income, were living alone, were unemployed, and/or were of an ethnicity other than Danish. Regression analyses were used to investigate smoking in homes including children across parent/adult education levels, focusing on temporal changes. Results There were significant large socioeconomic differences in both 2007 and 2010. In 2010 it was more than 11 times more likely for a child to be exposed to SHS at home if the parent had very low education than if they were highly educated (p<0.001). Smoking in a home with children decreased from 16.2% in 2007 to 10.9% in 2010. The odds of a temporal decrease in domestic smoking did not differ significantly across parent education levels (p=0.40). Conclusions Marked social inequalities in children’s exposure to SHS and a significant temporal decrease in exposure, independent of the education level of the parent/adult, were found in repeated large cross-sectional population-based studies. Social disparities have persisted over time, but not increased. Both clinical and population policy interventions will be needed in order to control child SHS exposure. We call for legislative protection

  4. Association between Allergic Rhinitis and Asthma Control in Peruvian School Children: A Cross-Sectional Study

    PubMed Central

    Uceda, Mónica; Ziegler, Otto; Lindo, Felipe; Herrera-Pérez, Eder

    2013-01-01

    Background. Asthma and allergic rhinitis are highly prevalent conditions that cause major illness worldwide. This study aimed to assess the association between allergic rhinitis and asthma control in Peruvian school children. Methods. A cross-sectional study was conducted among 256 children with asthma recruited in 5 schools from Lima and Callao cities. The outcome was asthma control assessed by the asthma control test. A score test for trend of odds was used to evaluate the association between allergic rhinitis severity and the prevalence of inadequate asthma control. A generalized linear regression model was used to estimate the adjusted prevalence ratios of inadequate asthma control. Results. Allergic rhinitis was present in 66.4% of the population with asthma. The trend analysis showed a positive association between allergic rhinitis and the probability of inadequate asthma control (P < 0.001). It was associated with an increased prevalence of inadequate asthma control, with adjusted prevalence ratios of 1.53 (95% confidence interval: 1.19−1.98). Conclusion. This study indicates that allergic rhinitis is associated with an inadequate level of asthma control, giving support to the recommendation of evaluating rhinitis to improve asthma control in children. PMID:23984414

  5. Financial protection of rural health insurance for patients with hypertension and diabetes: repeated cross-sectional surveys in rural China.

    PubMed

    Liu, Xiaoyun; Sun, Xiaojie; Zhao, Yang; Meng, Qingyue

    2016-09-08

    The New Cooperative Medical Scheme (NCMS) in rural China has been expanding in both population coverage and benefit package. China has also established an essential medicine policy in recent years to further reduce patients' medical expenditures and financial burden. This study aims to evaluate the impact of these policies on reducing medical expenditures and financial burden of patients diagnosed with hypertension and diabetes. This study used repeated cross-sectional surveys in 2011 and 2012 in three counties of Shandong Province. Outpatient and inpatient service expenditures and catastrophic health expenditures (CHE) were measured and analyzed. Medical expenditures for outpatient services significantly increased for hypertensive and diabetic patients within a 1 year period, while inpatient service expenditures remained unchanged. Although NCMS increased its reimbursement rate, hypertensive and diabetic patients still heavily suffered CHE from both outpatient and inpatient services. Outpatient services were more important factors than inpatient services contributing to non-communicable chronic diseases (NCD) patients' financial burden. The effects of NCMS expansion have been offset by the rapid escalation of medical expenditures. More attention should be paid to the design of NCMS benefit package to cover NCD outpatient services. There is also an urgent need to reform the current Fee for Service to other provider payment methods in order to control the escalating NCD medical expenditures.

  6. Public awareness and misunderstanding about DrinkWise Australia: a cross-sectional survey of Australian adults.

    PubMed

    Brennan, Emily; Wakefield, Melanie A; Durkin, Sarah J; Jernigan, David H; Dixon, Helen G; Pettigrew, Simone

    2017-08-01

    DrinkWise Australia is an alcohol industry Social Aspects/Public Relations Organisation (SAPRO). We assessed the Australian public's awareness of DrinkWise, beliefs about its funding source, and associations between funding beliefs and perceptions of DrinkWise. A total of 467 adult weekly drinkers completed an online cross-sectional survey in February 2016. Half the sample had heard of DrinkWise (48.6%); of these, the proportion aware that DrinkWise is industry funded (37.0%) was much smaller than the proportion believing it receives government funding (84.1%). Respondents who incorrectly believed DrinkWise receives government funding were more likely to hold a favourable perception of the organisation's credibility, trustworthiness and respectability than those who did not believe it receives government funding (75.9% vs. 58.3%; p=0.032). The drinking population is vulnerable to believing that alcohol industry public relations organisations such as DrinkWise are government funded, which in turn is associated with more favourable perceptions of the organisation's credibility, trustworthiness, and respectability. Implications for public health: Favourable perceptions of DrinkWise may enhance the industry's ability to delay or dilute potentially effective alcohol control policies. Future research should investigate whether educating the public about DrinkWise's alcohol industry funding alters the public's perception of how credible, trustworthy and respectable the organisation is. © 2017 The Authors.

  7. Determinants of caregivers’ vaccination intention with respect to child age group: a cross-sectional survey in South Korea

    PubMed Central

    Paek, Hye-Jin; Shin, Kyung-Ah; Park, Kisoo

    2015-01-01

    Objective This study examined how knowledge, risk perception, health beliefs and multidimensional health locus of control (HLC) were associated with caregivers’ intention to vaccinate their child, and how these associations varied across child age groups. Setting South Korea. Methods The cross-sectional survey was conducted via a face-to-face interview among 1017 nationally representative caregivers who had children aged 12 or younger. The outcome variable was caregivers’ intention to vaccinate their children. Results Hierarchical regression analysis indicated that risk perception was negatively associated with vaccination intention only among the age group 4–6 (β=−0.127, p<0.05). Perceived benefit was the only significant predictor of the outcome variables for all three age groups. In contrast, perceived barrier was negatively related to vaccination intention only among the age group 7–12 (β=−0.104, p<0.05). Internal HLC was positively related to vaccination intention only among the age group 7–12 (β=0.151, p<0.001), while chance HLC was negatively related to vaccination intention only among the age group 0–3 (β=−0.121, p<0.05). Conclusions This study identifies key vaccination intention determinants that are differentially associated with caregivers’ children's age groups. To improve vaccination rates, it suggests the need for strategies tailored to children's age. PMID:26408283

  8. Determinants of caregivers' vaccination intention with respect to child age group: a cross-sectional survey in South Korea.

    PubMed

    Paek, Hye-Jin; Shin, Kyung-Ah; Park, Kisoo

    2015-09-24

    This study examined how knowledge, risk perception, health beliefs and multidimensional health locus of control (HLC) were associated with caregivers' intention to vaccinate their child, and how these associations varied across child age groups. South Korea. The cross-sectional survey was conducted via a face-to-face interview among 1017 nationally representative caregivers who had children aged 12 or younger. The outcome variable was caregivers' intention to vaccinate their children. Hierarchical regression analysis indicated that risk perception was negatively associated with vaccination intention only among the age group 4-6 (β=-0.127, p<0.05). Perceived benefit was the only significant predictor of the outcome variables for all three age groups. In contrast, perceived barrier was negatively related to vaccination intention only among the age group 7-12 (β=-0.104, p<0.05). Internal HLC was positively related to vaccination intention only among the age group 7-12 (β=0.151, p<0.001), while chance HLC was negatively related to vaccination intention only among the age group 0-3 (β=-0.121, p<0.05). This study identifies key vaccination intention determinants that are differentially associated with caregivers' children's age groups. To improve vaccination rates, it suggests the need for strategies tailored to children's age. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey

    PubMed Central

    Rani, M; Bonu, S; Jha, P; Nguyen, S; Jamjoum, L

    2003-01-01

    Objective: To estimate the prevalence and the socioeconomic and demographic correlates of tobacco consumption in India. Design: Cross sectional, nationally representative population based household survey. Subjects: 315 598 individuals 15 years or older from 91 196 households were sampled in National Family Health Survey-2 (1998–99). Data on tobacco consumption were elicited from household informants. Measures and methods: Prevalence of current smoking and current chewing of tobacco were used as outcome measures. Simple and two way cross tabulations and multivariate logistic regression analysis were the main analytical methods. Results: Thirty per cent of the population 15 years or older—47% men and 14% of women—either smoked or chewed tobacco, which translates to almost 195 million people—154 million men and 41million women in India. However, the prevalence may be underestimated by almost 11% and 1.5% for chewing tobacco among men and women, respectively, and by 5% and 0.5% for smoking among men and women, respectively, because of use of household informants. Tobacco consumption was significantly higher in poor, less educated, scheduled castes and scheduled tribe populations. The prevalence of tobacco consumption increased up to the age of 50 years and then levelled or declined. The prevalence of smoking and chewing also varied widely between different states and had a strong association with individual's sociocultural characteristics. Conclusion: The findings of the study highlight that an agenda to improve health outcomes among the poor in India must include effective interventions to control tobacco use. Failure to do so would most likely result in doubling the burden of diseases—both communicable and non-communicable—among India's teeming poor. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed. The study also suggests a need to adjust the

  10. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey.

    PubMed

    Rani, M; Bonu, S; Jha, P; Nguyen, S N; Jamjoum, L

    2003-12-01

    To estimate the prevalence and the socioeconomic and demographic correlates of tobacco consumption in India. Cross sectional, nationally representative population based household survey. 315 598 individuals 15 years or older from 91 196 households were sampled in National Family Health Survey-2 (1998-99). Data on tobacco consumption were elicited from household informants. Measures and methods: Prevalence of current smoking and current chewing of tobacco were used as outcome measures. Simple and two way cross tabulations and multivariate logistic regression analysis were the main analytical methods. Thirty per cent of the population 15 years or older-47% men and 14% of women-either smoked or chewed tobacco, which translates to almost 195 million people-154 million men and 41 million women in India. However, the prevalence may be underestimated by almost 11% and 1.5% for chewing tobacco among men and women, respectively, and by 5% and 0.5% for smoking among men and women, respectively, because of use of household informants. Tobacco consumption was significantly higher in poor, less educated, scheduled castes and scheduled tribe populations. The prevalence of tobacco consumption increased up to the age of 50 years and then levelled or declined. The prevalence of smoking and chewing also varied widely between different states and had a strong association with individual's sociocultural characteristics. The findings of the study highlight that an agenda to improve health outcomes among the poor in India must include effective interventions to control tobacco use. Failure to do so would most likely result in doubling the burden of diseases-both communicable and non-communicable-among India's teeming poor. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed. The study also suggests a need to adjust the prevalence estimates based on household informants.

  11. Factors associated with Leishmania asymptomatic infection: results from a cross-sectional survey in highland northern Ethiopia.

    PubMed

    Custodio, Estefanía; Gadisa, Endalamaw; Sordo, Luis; Cruz, Israel; Moreno, Javier; Nieto, Javier; Chicharro, Carmen; Aseffa, Abraham; Abraham, Zelalem; Hailu, Tsegaye; Cañavate, Carmen

    2012-01-01

    In northern Ethiopia the prevalence of visceral leishmaniasis is steadily rising posing an increasing public health concern. In order to develop effective control strategies on the transmission of the disease it is important to generate knowledge on the epidemiological determinants of the infection. We conducted a cross-sectional survey on children 4-15 years of age using a multi staged stratified cluster sampling on high incidence sub-districts of Amhara regional state, Ethiopia. The survey included a socio-demographic, health and dietary questionnaire, and anthropometric measurements. We performed rK39-ICT and DAT serological tests in order to detect anti-Leishmania antibodies and carried out Leishmanin Skin Test (LST) using L.major antigen. Logistic regression models were used. Of the 565 children surveyed 56 children were positive to infection (9.9%). The individual variables that showed a positive association with infection were increasing age, being male and sleeping outside [adjusted odds ratios (95% CI): 1.15 (1.03, 1.29), 2.56 (1.19, 5.48) and 2.21 (1.03, 4.71) respectively] and in relation to the household: past history of VL in the family, living in a straw roofed house and if the family owned sheep [adjusted OR (95% CI): 2.92 (1.25, 6.81), 2.71 (1.21, 6.07) and 4.16 (1.41, 12.31) respectively]. A behavioural pattern like sleeping outside is determinant in the transmission of the infection in this area. Protective measures should be implemented against this identified risk activity. Results also suggest a geographical clustering and a household focalization of the infection. The behaviour of the vector in the area needs to be clarified in order to establish the role of domestic animals and house materials in the transmission of the infection.

  12. Factors Associated with Leishmania Asymptomatic Infection: Results from a Cross-Sectional Survey in Highland Northern Ethiopia

    PubMed Central

    Custodio, Estefanía; Gadisa, Endalamaw; Sordo, Luis; Cruz, Israel; Moreno, Javier; Nieto, Javier; Chicharro, Carmen; Aseffa, Abraham; Abraham, Zelalem; Hailu, Tsegaye; Cañavate, Carmen

    2012-01-01

    Background In northern Ethiopia the prevalence of visceral leishmaniasis is steadily rising posing an increasing public health concern. In order to develop effective control strategies on the transmission of the disease it is important to generate knowledge on the epidemiological determinants of the infection. Methodology/Principal Findings We conducted a cross-sectional survey on children 4–15 years of age using a multi staged stratified cluster sampling on high incidence sub-districts of Amhara regional state, Ethiopia. The survey included a socio-demographic, health and dietary questionnaire, and anthropometric measurements. We performed rK39-ICT and DAT serological tests in order to detect anti-Leishmania antibodies and carried out Leishmanin Skin Test (LST) using L.major antigen. Logistic regression models were used. Of the 565 children surveyed 56 children were positive to infection (9.9%). The individual variables that showed a positive association with infection were increasing age, being male and sleeping outside [adjusted odds ratios (95% CI): 1.15 (1.03, 1.29), 2.56 (1.19, 5.48) and 2.21 (1.03, 4.71) respectively] and in relation to the household: past history of VL in the family, living in a straw roofed house and if the family owned sheep [adjusted OR (95% CI): 2.92 (1.25, 6.81), 2.71 (1.21, 6.07) and 4.16 (1.41, 12.31) respectively]. Conclusions/Significance A behavioural pattern like sleeping outside is determinant in the transmission of the infection in this area. Protective measures should be implemented against this identified risk activity. Results also suggest a geographical clustering and a household focalization of the infection. The behaviour of the vector in the area needs to be clarified in order to establish the role of domestic animals and house materials in the transmission of the infection. PMID:23029576

  13. Boat-based water-surface cross sectional elevation surveys along the upper Willamette River, Oregon, in Spring, 2015

    USGS Publications Warehouse

    Lind, Greg D.; Wellman, Roy; Mangano, Joseph F.

    2016-01-01

    Water-surface elevation measurements were collected in Spring, 2015 along the upper Willamette River, Oregon, between Harrisburg and Corvallis. These surveys were collected over a small range of discharges, from 6,900 cubic feet per second to 8,300 cubic feet per second, using a real-time kinematic global positioning system (RTK-GPS) on a motorboat at various cross sections along the river. These datasets were collected for equipment calibration and validation for the National Aeronautics and Space Administration’s (NASA) Surface Water and Ocean Topography (SWOT) satellite mission. This is one of multiple survey datasets that will be released for this effort.

  14. Is tuberculosis health education reaching the public in China? A cross-sectional survey in Guizhou Province

    PubMed Central

    Chen, Wei; Li, Yang; Yang, Haiqin; Ehiri, John; Chen, Zaiping; Liu, Ying; Wang, Mei; Liu, Shili; Tang, He; Li, Ying

    2016-01-01

    Background Knowledge about tuberculosis (TB) is important for TB control, and China's national TB control guidelines emphasise TB health promotion. A 2010 national TB epidemiology survey showed that the general public had limited knowledge and awareness of TB. Objective To assess the level of TB knowledge after 5 years of TB health promotion in Guizhou Province, one of the regions with the highest TB burden in China. Design and setting A community-based, cross-sectional survey of 10 237 residents of Guizhou Province from June to August 2015. Multiple logistic regression models were used to examine factors associated with core TB knowledge and TB health education among respondents. Results Overall, residents of Guizhou Province had inadequate knowledge of TB. The overall awareness of TB was 41.5%. Less than 30% of respondents were familiar with China's policy of free treatment for TB or knew that the disease could be cured. Factors associated with core TB knowledge included gender, age, ethnicity, education, occupation, region, and having received TB health education. Women, older adults, people employed in non-government institutions, and those living in counties with low TB burdens had little access to TB health education, whereas people with higher education levels had greater access. Respondents' sources of TB knowledge did not necessarily match their preferred channels for delivery of TB health education. Conclusions Our findings indicate that TB health education should be further strengthened in China and other countries with a high TB burden. TB health education programmes require further formative and implementation research in order to improve programme effectiveness. PMID:27670524

  15. Cross-sectional study of glycemic control among adults with type 2 diabetes.

    PubMed

    Amarasekara, Amarasekara Appuhamillage Thamara Dilhani; Fongkaew, Warunee; Wimalasekera, Savithri Wasundara; Turale, Sue; Chanprasit, Chawapornpan

    2015-06-01

    Type 2 diabetes mellitus is a chronic condition, a global concern, and a serious issue in Sri Lanka, where there is little data regarding the influence of dietary control, exercise, and adherence to medication behaviors among adults diabetes. In this cross-sectional, descriptive study, we identified current factors influencing glycemic control and glycemic control behavior among adults with diabetes. A total of 230 people attending diabetes clinics in a tertiary hospital and a primary care institute were administered the self-report Diabetes Information Form, assessing their socioeconomic and medical information and glycemic control behaviors. Data were analyzed by frequency distribution, percentages, mean scores, and standard deviation. The results indicated that most participants had not achieved the recommended fasting blood glucose level (< 126 mg/dL). Although dietary control was practised by 72%, regular exercise was not practised by 85%, and while 77% reported adhering to regular medication, they still had poor glycemic control. The findings highlight the need for health professionals to adopt new strategies for diabetes education to overcome issues related to misconceptions and barriers in providing diabetes care in Sri Lanka.

  16. Anxiety, stress, and quality of life among Iraqi refugees in Jordan: A cross sectional survey.

    PubMed

    Al-Smadi, Ahmed Mohammad; Tawalbeh, Loai Issa; Gammoh, Omar Salem; Ashour, Ala Fawzi; Alshraifeen, Ali; Gougazeh, Yazeed Mohammed

    2017-03-01

    This study was conducted to identify the predictors, levels, and prevalence of anxiety and stress and to assess the relationship between these factors and quality of life in recently displaced Iraqis. A cross-sectional design was used. A convenience sample of 171 Iraqi refugees was recruited. The results indicated that more than half of the sample suffered from high anxiety levels, while 42.8% reported high stress. The regression model explained 46.3% of the variance in levels of quality of life. Unemployment, fewer than three family members, and high anxiety significantly predicted low-level quality of life. These three predictors need to be taken into consideration when developing health-related interventions to improve the quality of life of Iraqi refugees.

  17. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study

    PubMed Central

    Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    Aim The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Methods Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. Results 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30–0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26–0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Conclusions Meeting with friends occasionally is associated with better glycemic control among older people. PMID:28060887

  18. General Practitioners’ Attitudes towards Essential Competencies in End-of-Life Care: A Cross-Sectional Survey

    PubMed Central

    Giezendanner, Stéphanie; Jung, Corinna; Banderet, Hans-Ruedi; Otte, Ina Carola; Gudat, Heike; Haller, Dagmar M.; Elger, Bernice S.; Zemp, Elisabeth; Bally, Klaus

    2017-01-01

    Background Identifying essential competencies in end-of-life care, as well as general practitioners’ (GPs) confidence in these competencies, is essential to guide training and quality improvement efforts in this domain. Aim To determine which competencies in end-of-life care are considered important by GPs, to assess GPs’ confidence in these competencies in a European context and their reasons to refer terminally ill patients to a specialist. Design and Setting Cross-sectional postal survey involving a stratified random sample of 2000 GPs in Switzerland in 2014. Method Survey development was informed by a previous qualitative exploration of relevant end-of-life GP competencies. Main outcome measures were GPs’ assessment of the importance of and confidence in 18 attributes of end-of-life care competencies, and reasons for transferring care of terminally-ill patients to a specialist. GP characteristics associated with main outcome measures were tested using multivariate regression models. Results The response rate was 31%. Ninety-nine percent of GPs considered the recognition and treatment of pain as important, 86% felt confident about it. Few GPs felt confident in cultural (16%), spiritual (38%) and legal end-of-life competencies such as responding to patients seeking assisted suicide (35%) although more than half of the respondents regarded these competencies as important. Most frequent reasons to refer terminally ill patients to a specialist were lack of time (30%), better training of specialists (23%) and end-of-life care being incompatible with other duties (19%). In multiple regression analyses, confidence in end-of-life care was positively associated with GPs’ age, practice size, home visits and palliative training. Conclusions GPs considered non-somatic competencies (such as spiritual, cultural, ethical and legal aspects) nearly as important as pain and symptom control. Yet, few GPs felt confident in these non-somatic competencies. These findings

  19. Consumer satisfaction with practice nursing: a cross-sectional survey in New Zealand general practice.

    PubMed

    Halcomb, Elizabeth; Davies, Deborah; Salamonson, Yenna

    2015-01-01

    An important consideration in health service delivery is ensuring that services meet consumer needs. Whilst nursing services in primary care have grown internationally, there has been limited exploration of consumer satisfaction with these services. This paper reports a descriptive survey that sought to evaluate consumers' perceptions of New Zealand practice nurses (PNs). One thousand, five hundred and five patients who received nursing services at one of 20 participating New Zealand general practices completed a survey tool between December 2010 and December 2011. The 64-item self- report survey tool contained the 21-item General Practice Nurse Satisfaction (GPNS) scale. Data were analysed using both descriptive and inferential statistics. Internal consistency of the GPNS scale was high (Cronbach's α 0.97). Participants aged over 60 years and those of European descent were significantly less satisfied with the PN (P = 0.001). Controlling for these characteristics, participants who had visited the PN more than four times previously were 1.34 times (adjusted odds ratio 1.34 (95% CI: 1.06-1.70) more satisfied than the comparison group (up to 4 previous visits to PN). In addition to the further validation of the psychometric properties of the GPNS scale in a different setting, the study also revealed a high level of satisfaction with PNs, with increased satisfaction with an increased number of visits. Nevertheless, the lower levels of satisfaction with PNs in the older age group as well as those of European descent, warrants further examination. The study also highlights the need for PNs and consumers to discuss consumer's expectations of services and create a shared understanding of treatment goals.

  20. Attitude and Intention Regarding Pain Management among Chinese Nursing Students: A Cross-Sectional Questionnaire Survey.

    PubMed

    Fang, Liang-Yu; Xu, Yin-Chuan; Lin, Dan-Ni; Jin, Jing-Feng; Yan, Min

    2017-08-01

    Optimal pain management is a priority in effective nursing care. Lack of sufficient pain knowledge associated with inadequate pain management has been proved. However, the intention, defined as the predictor of behavior, regarding pain management remains unknown. Therefore, the study was to determine the attitude and intention regarding pain management among Chinese nursing students and investigate the underlying determinants and their interactions in terms of intention toward pain management. The Pain Management Survey Questionnaire, comprising the key determinants of the theory of planned behavior-that is, direct attitude, belief-based intention, subjective norm, direct control, and indirect control-was used to collect data from 512 nursing students who undertook clinical rotation in an affiliated hospital of a medical college in China. Data were analyzed using descriptive statistics, independent sample t test, Pearson correlation analysis, or structural equation modeling analysis. Chinese nursing students reported negative attitudes and behavioral intentions toward pain management. Direct control, subjective norm, belief-based attitude, and indirect control independently predicted nursing students' intention to treat patients with pain. Direct control was the strongest predictor. Structural equation modeling analysis further revealed 39.84% of the variance associated with intention that could be explained by determinants of the theory of planned behavior. Additionally, educational school level and previous pain management training had great effects on pain management intention. Overall, this study identified intention as an important factor in effective pain treatment. Chinese nursing students have negative attitudes and insufficient intention to pain management. Therefore, hospitals and universities in China should manage these factors to improve nursing students' practice regarding pain management. Copyright © 2017 American Society for Pain Management Nursing

  1. Falls and fear of falling in vertigo and balance disorders: A controlled cross-sectional study.

    PubMed

    Schlick, Cornelia; Schniepp, Roman; Loidl, Verena; Wuehr, Max; Hesselbarth, Kristin; Jahn, Klaus

    2016-01-01

    Vertigo and dizziness are among the most prevalent symptoms in neurologic disorders. Although many of these patients suffer from postural instability and gait disturbances, there is only limited data on their risk of falling. We conducted a controlled cross-sectional study at the tertiary care outpatient clinic of the German Center for Vertigo and Balance Disorders using a self-administered questionnaire to assess falls, fall-related injuries, and fear of falling. The recruitment period was 6 months. A total of 569 patients (mean age 59.6 ± 17.1 years, 55% females) and 100 healthy participants were included (response rate > 90%). Dizzy patients with central balance disorders (Parkinsonian, cerebellar, and brainstem oculomotor syndromes) had the highest fall rates (> 50% recurrent fallers, odds ratio > 10). The rate of recurrent fallers was 30% in bilateral vestibular failure and peripheral neuropathy (odds ratio > 5). Patients with functional dizziness (somatoform or phobic vertigo) were concerned about falling but did not fall more often than healthy controls (odds ratio 0.87). Falls are common in patients presenting to a dizziness unit. Those with central syndromes are at risk of recurrent and injurious falling. Fall rates and fear of falling should be assessed in balance disorders and used to guide the regimen of rehabilitation therapy. The identification of risk factors would help provide protective measures to these groups of patients.

  2. Increased coronary intervention rate among diabetic patients with poor glycaemic control: A cross-sectional study

    PubMed Central

    Çetin, Süha; Öztürk, Mehmet Akif; Barındık, Nadir; İmren, Ersin; Peker, Yüksel

    2014-01-01

    The relationship between glycaemic control and coronary artery disease (CAD) in type 2 diabetes mellitus (T2DM) is controversial. In the current cross-sectional study, we addressed the relationship between Hemoglobin A1c (HbA1c) values and the need for revascularization among diabetic patients undergoing coronary angiography. A total of 301 consecutive patients with known T2DM (age 61.8±10.1 years, 46.2% women) requiring coronary angiography due to CAD symptoms were included. T2DM patients were categorized into two groups based on their HbA1c values 93 (30.9%) diabetics with good glycaemic control (HbA1c≤7%), and 208 (69.1%) diabetics with poor glycaemic control (HbA1c>7%). A total of 123 patients (40.9%) required revascularization. The revascularization rate was 28.0% among T2DM patients with good glycaemic control and 46.6% among T2DM patients with poor glycaemic control, respectively (p=0.002). In a logistic regression analysis, the need for revascularization was predicted by poor glycaemic control (Odds Ratio [OR] 2.26, 95% Confidence Interval [CI] 1.32-3.82; p=0.003) adjusted for age, gender, Body-Mass-Index and diabetes duration. Moreover, there was a linear relationship between HbA1c values and number of affected coronary arteries (r= 0.169; p=0.003). Our data suggest that there is a close association between poor glycaemic control and increased revascularization rate in T2DM, which should be considered in primary and secondary prevention models. PMID:24579965

  3. Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey.

    PubMed

    Sun, Peihang; Zhang, Xue; Sun, Yihua; Ma, Hongkun; Jiao, Mingli; Xing, Kai; Kang, Zheng; Ning, Ning; Fu, Yapeng; Wu, Qunhong; Yin, Mei

    2017-01-19

    This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence (p < 0.05 for all correlations). Additionally, age, professional title, and occupation were correlated with non-physical violence, which critically affected doctors. Thus, gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals.

  4. Obesity and health behaviours of British adults with self-reported intellectual impairments: cross sectional survey

    PubMed Central

    2014-01-01

    Background People with intellectual disability have significantly higher age-adjusted rates of mortality and morbidity (including obesity) than their non-disabled peers. They are also significantly less likely to be physically active. Methods Secondary analysis of de-identified cross-sectional data from the first two waves of Understanding Society, a new longitudinal study focusing on the life experiences of UK citizens. Interviews were undertaken with 50,994 individuals aged 16 and over in Wave 1 and 54,585 in Wave 2. Of these, 520 participants age 16–49 (1.8% of the unweighted age-restricted sample) were identified at either Wave 1 or Wave 2 as having self-reported intellectual impairments. Results British adults with self-reported intellectual impairments have higher rates of obesity, inactivity, tobacco and alcohol use and poorer nutrition than their non-disabled peers. Adjusting risk estimates for between group differences in age, gender and exposure to material hardship indicated that a significant proportion of their increased risk of obesity, tobacco use and poorer nutrition may be attributable to their poorer living conditions (rather than their self-reported intellectual impairments per se). Conclusions People with intellectual disabilities should begin to be regarded as a ‘vulnerable’ group in the context of public health policy and practice. PMID:24588837

  5. Knowledge, attitudes, and breast feeding practices of postnatal mothers: A cross sectional survey

    PubMed Central

    Vijayalakshmi, Poreddi; Susheela, T; Mythili, D

    2015-01-01

    Background Breast feeding has several benefits for both the infants and mothers. However, despite strong evidences in support of breast feeding its prevalence has remained low worldwide. The objective of the present study was to examine the knowledge and attitude towards breast feeding and infant feeding practices among Indian postnatal mothers. Methodology A cross sectional descriptive study was carried out among randomly selected postnatal mothers at Pediatric outpatient department at a tertiary care center. Data was collected through face-to-face interview using a structured questionnaire. Results Our findings revealed that a majority (88.5%) of the mothers were breast feeders. However, merely 27% of the mothers were exclusive breast feeders and only 36.9% initiated breast feeding within an hour. While mothers have good knowledge on breast feeding (12.05±1.74, M±SD), the average score of the Iowa Infant Feeding Scale (IIFAS) (58.77±4.74, M ±SD) indicate neutral attitudes toward breast feeding. Mothers those who were currently breast feeding (58.83 ± 4.74) had more positive attitudes than non- breastfeed mothers (45.21±5.22). Conclusion Our findings also show that the level of exclusive breast-feeding was low. Thus, it is important to provide prenatal education to mothers and fathers on breast-feeding. We also recommend strengthening the public health education campaigns to promote breast-feeding. PMID:26715916

  6. Remission of rheumatoid arthritis and potential determinants: a national multi-center cross-sectional survey.

    PubMed

    Wang, Guan-Ying; Zhang, Sa-Li; Wang, Xiu-Ru; Feng, Min; Li, Chun; An, Yuan; Li, Xiao-Feng; Wang, Li-Zhi; Wang, Cai-Hong; Wang, Yong-Fu; Yang, Rong; Yan, Hui-Ming; Wang, Guo-Chun; Lu, Xin; Liu, Xia; Zhu, Ping; Chen, Li-Na; Jin, Hong-Tao; Liu, Jin-Ting; Guo, Hui-Fang; Chen, Hai-Ying; Xie, Jian-Li; Wei, Ping; Wang, Jun-Xiang; Liu, Xiang-Yuan; Sun, Lin; Cui, Liu-Fu; Shu, Rong; Liu, Bai-Lu; Yu, Ping; Zhang, Zhuo-Li; Li, Guang-Tao; Li, Zhen-Bin; Yang, Jing; Li, Jun-Fang; Jia, Bin; Zhang, Feng-Xiao; Tao, Jie-Mei; Lin, Jin-Ying; Wei, Mei-Qiu; Liu, Xiao-Min; Ke, Dan; Hu, Shao-Xian; Ye, Cong; Han, Shu-Ling; Yang, Xiu-Yan; Li, Hao; Huang, Ci-Bo; Gao, Ming; Lai, Bei; Cheng, Yong-Jing; Li, Xing-Fu; Song, Li-Jun; Yu, Xiao-Xia; Wang, Ai-Xue; Wu, Li-Jun; Wang, Yan-Hua; He, Lan; Sun, Wen-Wen; Gong, Lu; Wang, Xiao-Yuan; Wang, Yi; Zhao, Yi; Li, Xiao-Xia; Wang, Yan; Zhang, Yan; Su, Yin; Zhang, Chun-Fang; Mu, Rong; Li, Zhan-Guo

    2015-02-01

    The aim of this study is to investigate the remission rate of rheumatoid arthritis (RA) in China and identify its potential determinants. A multi-center cross-sectional study was conducted from July 2009 to January 2012. Data were collected by face-to-face interviews of the rheumatology outpatients in 28 tertiary hospitals in China. The remission rates were calculated in 486 RA patients according to different definitions of remission: the Disease Activity Score in 28 joints (DAS28), the Simplified Disease Activity Index (SDAI), the Clinical Disease Activity Index (CDAI), and the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Boolean definition. Potential determinants of RA remission were assessed by univariate and multivariate analyses. The remission rates of RA from this multi-center cohort were 8.6% (DAS28), 8.4% (SDAI), 8.2% (CDAI), and 6.8% (Boolean), respectively. Favorable factors associated with remission were: low Health Assessment Questionnaire (HAQ) score, absence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP), and treatment of methotrexate (MTX) and hydroxychloroquine (HCQ). Younger age was also predictive for the DAS28 and the Boolean remission. Multivariate analyses revealed a low HAQ score, the absence of anti-CCP, and the treatment with HCQ as independent determinants of remission. The clinical remission rate of RA patients was low in China. A low HAQ score, the absence of anti-CCP, and HCQ were significant independent determinants for RA remission.

  7. Violence against children perpetrated by peers: A cross-sectional school-based survey in Uganda.

    PubMed

    Wandera, Stephen Ojiambo; Clarke, Kelly; Knight, Louise; Allen, Elizabeth; Walakira, Eddy; Namy, Sophie; Naker, Dipak; Devries, Karen

    2017-06-01

    Violence against children by peers is a global public health problem. We aimed to assess factors associated with peer violence victimization among primary school children in Uganda. We conducted multilevel multivariable logistic regression analyses of cross-sectional data from 3706 primary students in 42 Ugandan primary schools. Among primary school students, 29% and 34% had ever experienced physical and emotional violence perpetrated by their peers, respectively. Factors strongly associated with both physical and emotional violence were similar and overlapping, and included exposure to interparental violence, having an attitude supportive of violence against children from school staff, not living with biological parents, working for payment, and higher SDQ score. However, we found that younger age, sharing sleeping area with an adult and achieving a higher educational performance score, were specifically associated with physical violence. On the other hand, being female, walking to school, reporting disability and eating one meal on the previous day, were particularly associated with emotional violence. Interventions to reduce peer violence should focus on family contexts, school environments and those with poor socio-economic status may need extra support. Copyright © 2017. Published by Elsevier Ltd.

  8. Undergraduate medical students' attitudes towards psychiatry: an international cross-sectional survey between India and Japan.

    PubMed

    Kato, Takahiro A; Balhara, Yatan Pal Singh; Chawla, Jatinder Mohan; Tateno, Masaru; Kanba, Shigenobu

    2013-08-01

    Undergraduate psychiatric education has an important role in developing psychiatric knowledge, decreasing stigma towards mental illness, and promoting psychiatry as a career choice. The attitudes and beliefs of medical students towards psychiatry have not been well understood, especially in non-western countries. To clarify this aspect, we have conducted a cross-sectional study between India and Japan. This study, conducted at two centres, one each in India and Japan, used a semi-structured questionnaire to evaluate the attitudes and beliefs of third-year medical students towards mental illness and psychiatry; such as emotions experienced dealing with psychiatric patients, aetiology and treatment of psychiatric disorders, and psychiatry as a career choice. A total of 79 medical students from India and 77 from Japan participated in the present study. Significant differences were observed in the emotions experienced by the medical students while dealing with psychiatric patients. Most medical students (> 90%) from both study sites favoured psychiatrists for treatment of psychiatric illness. Psychiatry as a carrier choice was significantly related to the nationality of the medical students. The findings of the current study provide insight in to the attitudes of third-year medical students from India and Japan towards psychiatric patients.

  9. Health promotion behavior in middle-aged Koreans: a cross sectional survey.

    PubMed

    Yeun, Eun Ja; Baek, Sunsook; Kim, Heejeong

    2013-12-01

    This cross-sectional study was conducted to verify self-efficacy, self-esteem, and social support as characteristics of health promotion behavior in middle-aged Koreans, and the influence of social support on self-efficacy and self-esteem with respect to health promotion behavior. Data were collected from 310 subjects in South Korea using a self-administered questionnaire. We found a significant finding that self-efficacy positively influences health promotion behavior, focusing on the moderating effect of social support. Self-efficacy affected health promotion behavior (P < 0.01) as did social support. Mean self-efficacy, self-esteem, health promotion behavior, and social support scores were 50.27, 29.35, 124.39, and 76.51, respectively. This finding provides strong evidence that social support can be used as a model to understand health promotion behavior. Individualized nursing interventions based on social support and self-efficacy theory should be utilized in high-risk middle-aged patients so as to assist and improve health promotion behavior. Also, in community practice settings, nurses should consider that increased social support and self-efficacy are required to improve health promotion behaviors.

  10. Illness behaviour of general practitioners—a cross-sectional survey

    PubMed Central

    Einsle, F.; Schneider, N.; Wensing, M.; Gensichen, J.

    2017-01-01

    Background International guidelines recommend that physicians should be registered with a general practitioner (GP) and should avoid self-treatment. Adherence to these recommendations is mixed. Aims To describe illness behaviour and chronic medical conditions of GPs in Germany. Methods Cross-sectional, observational questionnaire study. We contacted 1000 GPs by mail in April 2014. We asked about registration with a GP, chronic conditions and self-treatment. We undertook descriptive statistical analysis and analysed associations using t-tests and chi-square test. Results Two hundred and eighty-five responses (29%) were eligible for analysis. Nineteen per cent of GPs were registered as patients of a GP, 58% reported at least one chronic condition, 68% disclosed self-diagnosis and 60% self-treatment. Self-therapy for chronic conditions was inversely correlated with subjective severity of the disease (r = −0.159; P < 0.05). Conclusions The high rates of self-treatment and the low rate of registration with a GP of German GPs are in contrast to international guideline recommendations. Further research is needed to analyse specific reasons. PMID:27697967

  11. Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey

    PubMed Central

    Sun, Peihang; Zhang, Xue; Sun, Yihua; Ma, Hongkun; Jiao, Mingli; Xing, Kai; Kang, Zheng; Ning, Ning; Fu, Yapeng; Wu, Qunhong; Yin, Mei

    2017-01-01

    This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence (p < 0.05 for all correlations). Additionally, age, professional title, and occupation were correlated with non-physical violence, which critically affected doctors. Thus, gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals. PMID:28106851

  12. Prevalence of intimate partner violence in Spain: A national cross-sectional survey in primary care.

    PubMed

    Ruiz-Pérez, Isabel; Escribà-Agüir, Vicenta; Montero-Piñar, Isabel; Vives-Cases, Carmen; Rodríguez-Barranco, Miguel

    2017-02-01

    (1) To analyze the prevalence of Intimate Partner Violence by types. (2) To examine the relationship between sociodemographic characteristics and Intimate Partner Violence. Cross-sectional study using a self-administered questionnaire. Primary Healthcare centers in Spain. 10,322 women (18-70 years) attending Primary Healthcare centers. A compound index was calculated based on frequency, types, and duration of Intimate Partner Violence. Multivariable adjusted logistic regression models were used to identify the sociodemographic factors, which were independently associated with each Intimate Partner Violence category. The prevalence of Intimate Partner Violence was 24.8%. For the physical only category, no differences were observed regarding education or employment status, and women with the highest income have less risk. For the psychological only category, no differences were observed according to the income level. The risk increases as the education level decreases, and the greatest frequency of only psychological Intimate Partner Violence was observed in women who were unemployed or students. For both the physical and psychological category of Intimate Partner Violence, a clear risk increase is observed as income and education levels decrease. Retired women showed the highest frequency of this violence category. The results show that Intimate Partner Violence affects women of all social strata, but the frequency and Intimate Partner Violence category will vary according to the socio-economic. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. Turkish parents' management of childhood fever: a cross-sectional survey using the PFMS-TR.

    PubMed

    Cinar, Nursan D; Altun, Insaf; Altınkaynak, Sevin; Walsh, Anne

    2014-02-01

    To explore Turkish parents' practices in childhood fever management. A cross-sectional study with 205 randomly selected Turkish parents of febrile children 6-months to 5-years from the paediatric hospital and two family health centres in Sakarya, Turkey in 2009. Data explored general fever management practices on the 8-item Parents' Fever Management Scale - Turkish version (5-point Liket scale; 1=never to 5=always) and socio-demographics. Parents wanted to know their child's temperature (61.5%), took temperatures (60%), slept in the same room (58.5%) and sought medical advice (53.7%). Non-evidence-based-practices included over-the-counter medications (42.4%); waking children during the night for fever reducing medication (33.2%). Evidence-based-practice ensured febrile children had plenty to drink (30.2%) and febrile children were checked during the night (59%). Parents' reports indicate high levels of concern about fever, overuse of over-the-counter medications and health services. Practices increase parents' burden of care, are disruptive of family life and lead to parental fatigue. The study confirms the appropriateness and applicability of the fever management instrument, a simple tool to incorporate into assessment of febrile children, in identifying Turkish parents' fever management practice. Copyright © 2013 College of Emergency Nursing Australasia Ltd. Published by Elsevier Ltd. All rights reserved.

  14. Helicopter emergency medical services in major incident management: A national Norwegian cross-sectional survey

    PubMed Central

    Johnsen, Anne Siri; Sollid, Stephen J. M.; Vigerust, Trond; Jystad, Morten; Rehn, Marius

    2017-01-01

    Objective Helicopter Emergency Medical Services (HEMS) aim to bring a highly specialised crew to the scene of major incidents for triage, treatment and transport. We aim to describe experiences made by HEMS in Norway in the management of major incidents. Design Doctors, rescue paramedics and pilots working in Norwegian HEMS and Search and Rescue Helicopters (SAR) January 1st 2015 were invited to a cross-sectional study on experiences, preparedness and training in major incident management. Results We identified a total of 329 Norwegian crewmembers of which 229 (70%) responded; doctors 101/150, (67%), rescue paramedics 64/78 (82%), pilots 64/101, (63%). HEMS and SAR crewmembers had experience from a median of 2 (interquartile range 0–6) major incidents. Road traffic incidents were the most frequent mechanism and blunt trauma the dominating injury. HEMS mainly contributed with triage, treatment and transport. Communication with other emergency services prior to arrival was described as bad, but good to excellent when cooperating on scene. The respondents called for more interdisciplinary exercises. Conclusion HEMS and SAR crewmembers have limited exposure to major incident management. Interdisciplinary training on frequent scenarios with focus on cooperation and communication is called for. PMID:28192440

  15. Helicopter emergency medical services in major incident management: A national Norwegian cross-sectional survey.

    PubMed

    Johnsen, Anne Siri; Sollid, Stephen J M; Vigerust, Trond; Jystad, Morten; Rehn, Marius

    2017-01-01

    Helicopter Emergency Medical Services (HEMS) aim to bring a highly specialised crew to the scene of major incidents for triage, treatment and transport. We aim to describe experiences made by HEMS in Norway in the management of major incidents. Doctors, rescue paramedics and pilots working in Norwegian HEMS and Search and Rescue Helicopters (SAR) January 1st 2015 were invited to a cross-sectional study on experiences, preparedness and training in major incident management. We identified a total of 329 Norwegian crewmembers of which 229 (70%) responded; doctors 101/150, (67%), rescue paramedics 64/78 (82%), pilots 64/101, (63%). HEMS and SAR crewmembers had experience from a median of 2 (interquartile range 0-6) major incidents. Road traffic incidents were the most frequent mechanism and blunt trauma the dominating injury. HEMS mainly contributed with triage, treatment and transport. Communication with other emergency services prior to arrival was described as bad, but good to excellent when cooperating on scene. The respondents called for more interdisciplinary exercises. HEMS and SAR crewmembers have limited exposure to major incident management. Interdisciplinary training on frequent scenarios with focus on cooperation and communication is called for.

  16. Dynamics of study strategies and teacher regulation in virtual patient learning activities: a cross sectional survey.

    PubMed

    Edelbring, Samuel; Wahlström, Rolf

    2016-04-23

    Students' self-regulated learning becomes essential with increased use of exploratory web-based activities such as virtual patients (VPs). The purpose was to investigate the interplay between students' self-regulated learning strategies and perceived benefit in VP learning activities. A cross-sectional study (n = 150) comparing students' study strategies and perceived benefit of a virtual patient learning activity in a clinical clerkship preparatory course. Teacher regulation varied among three settings and was classified from shared to strong. These settings were compared regarding their respective relations between regulation strategies and perceived benefit of the virtual patient activity. Self-regulation learning strategy was generally associated with perceived benefit of the VP activities (rho 0.27, p < 0.001), but was not true in all settings. The association was higher in the two strongly regulated settings. The external regulation strategy did generally associate weakly with perceived benefit (rho 0.17, p < 0.05) with large variations between settings. The flexible student-autonomous appeal of virtual patients should not lead to the dismissal of guidance and related course activities. External teacher and peer regulation seem to be productive for increasing learners' perceived benefit. Awareness of the interplay among teacher regulation (external) and various study strategies can increase the value of flexible web-based learning resources to students.

  17. Knowledge, attitudes, and breast feeding practices of postnatal mothers: A cross sectional survey.

    PubMed

    Vijayalakshmi, Poreddi; Susheela, T; Mythili, D

    2015-10-01

    Breast feeding has several benefits for both the infants and mothers. However, despite strong evidences in support of breast feeding its prevalence has remained low worldwide. The objective of the present study was to examine the knowledge and attitude towards breast feeding and infant feeding practices among Indian postnatal mothers. A cross sectional descriptive study was carried out among randomly selected postnatal mothers at Pediatric outpatient department at a tertiary care center. Data was collected through face-to-face interview using a structured questionnaire. Our findings revealed that a majority (88.5%) of the mothers were breast feeders. However, merely 27% of the mothers were exclusive breast feeders and only 36.9% initiated breast feeding within an hour. While mothers have good knowledge on breast feeding (12.05±1.74, M±SD), the average score of the Iowa Infant Feeding Scale (IIFAS) (58.77±4.74, M ±SD) indicate neutral attitudes toward breast feeding. Mothers those who were currently breast feeding (58.83 ± 4.74) had more positive attitudes than non- breastfeed mothers (45.21±5.22). Our findings also show that the level of exclusive breast-feeding was low. Thus, it is important to provide prenatal education to mothers and fathers on breast-feeding. We also recommend strengthening the public health education campaigns to promote breast-feeding.

  18. The multi-dimensional neighbourhood and health: a cross-sectional analysis of the Scottish Household Survey, 2001.

    PubMed

    Parkes, Alison; Kearns, Ade

    2006-03-01

    Neighbourhoods may influence the health of individual residents in different ways: via the social and physical environment, as well as through facilities and services. Not all factors may be equally important for all population subgroups. A cross-sectional analysis of the Scottish Household Survey 2001 examined a range of neighbourhood factors for links with three health outcomes and two health-related behaviours. The results support the hypothesis that the neighbourhood has a multi-dimensional impact on health. There was also some evidence that the relationship between neighbourhood factors and health varied according to the population subgroup, although not in a consistent manner.

  19. Exhaled breath temperature measurement and asthma control in children prescribed inhaled corticosteroids: A cross sectional study.

    PubMed

    Hamill, Laura; Ferris, Kathryn; Kapande, Kirsty; McConaghy, Laura; Douglas, Isobel; McGovern, Vincent; Shields, Michael D

    2016-01-01

    Exhaled breath temperature (EBT) reflects airways (both eosinophilic and neutrophilic) inflammation in asthma and thus may aid the management of children with asthma that are treated with anti-inflammatory drugs. A new EBT monitor has become available that is cheap and easy to use and may be a suitable monitoring device for airways inflammation. Little is known about how EBT relates to asthma treatment decisions, disease control, lung function, or other non-invasive measures of airways inflammation, such as exhaled nitric oxide (ENO). To determine the relationships between EBT and asthma treatment decision, current control, pulmonary function, and ENO. Cross-sectional prospective study on 159 children aged 5-16 years attending a pediatric respiratory clinic. EBT was compared with the clinician's decision regarding treatment (decrease, no change, increase), asthma control assessment (controlled, partial, uncontrolled), level of current treatment (according to British Thoracic Society guideline, BTS step), ENO, and spirometry. EBT measurement was feasible in the majority of children (25 of 159 could not perform the test) and correlated weakly with age (R = 0.33, P = <0.01). EBT did not differ significantly between the three clinician decision groups (P = 0.42), the three asthma control assessment groups (P = 0.9), or the current asthma treatment BTS step (P = 0.57). EBT measurement was not related to measures of asthma control determined at the clinic. The routine intermittent monitoring of EBT in children prescribed inhaled corticosteroids who attend asthma clinics cannot be recommended for adjusting anti-inflammatory asthma therapy. © 2015 Wiley Periodicals, Inc.

  20. Satisfaction with botulinum toxin treatment in post-stroke spasticity: results from two cross-sectional surveys (patients and physicians).

    PubMed

    Bensmail, Djamel; Hanschmann, Angelika; Wissel, Jörg

    2014-09-01

    To characterize patient and physician satisfaction with current standard-of-care botulinum toxin treatment regimens for symptom control in patients with post-stroke spasticity using structured interviews with patients and physicians. Two cross-sectional surveys were conducted in Canada, France, Germany, and the US. The patient survey included patients with post-stroke spasticity who had undergone at least two botulinum toxin A injection cycles. Information on patients' current and prior botulinum toxin treatment cycles and quality of life was collected. The physician survey included physicians treating post-stroke spasticity with botulinum toxins and collected information regarding physician satisfaction with botulinum toxin treatment for post-stroke spasticity. Of 79 participating patients with post-stroke spasticity, 61 (77%) received treatment with onabotulinumtoxinA, 15 (19%) with abobotulinumtoxinA, and three (4%) with incobotulinumtoxinA. Overall, 40.5% of patients were very satisfied, 48.1% were somewhat satisfied, and 11.4% were not at all satisfied with botulinum toxin treatment. Patient satisfaction was lowest just before injection and highest at the time of peak effect. The mean injection interval was 13.7 (SD = 3.5) weeks; however, 43.4% of patients expressed a preference for intervals of ≤ 10 weeks. Most of the 105 participating physicians' were moderately (57.7%) or very (36.5%) satisfied with botulinum toxin treatment. However, physicians estimated that 16.2% of their patients with post-stroke spasticity could benefit from shorter injection intervals, and that 24.6% of patients could benefit from higher doses than those permitted by current country directives. Patients' responses were based on subjective recollections and physicians' responses were based on general impressions. These surveys indicate that patients' and physicians' satisfaction with botulinum toxin therapy for post-stroke spasticity is overall very good. However, patients

  1. Health and happiness: cross-sectional household surveys in Finland, Poland and Spain.

    PubMed

    Miret, Marta; Caballero, Francisco Félix; Chatterji, Somnath; Olaya, Beatriz; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Leonardi, Matilde; Haro, Josep Maria; Ayuso-Mateos, José Luis

    2014-10-01

    To explore the associations between health and how people evaluate and experience their lives. We analysed data from nationally-representative household surveys originally conducted in 2011-2012 in Finland, Poland and Spain. These surveys provided information on 10 800 adults, for whom experienced well-being was measured using the Day Reconstruction Method and evaluative well-being was measured with the Cantril Self-Anchoring Striving Scale. Health status was assessed by questions in eight domains including mobility and self-care. We used multiple linear regression, structural equation models and multiple indicators/multiple causes models to explore factors associated with experienced and evaluative well-being. The multiple indicator/multiple causes model conducted over the pooled sample showed that respondents with younger age (effect size, β = 0.19), with higher levels of education (β = -0.12), a history of depression (β = -0.17), poor health status (β = 0.29) or poor cognitive functioning (β = 0.09) reported worse experienced well-being. Additional factors associated with worse evaluative well-being were male sex (β = -0.03), not living with a partner (β = 0.07), and lower occupational (β = -0.07) or income levels (β = 0.08). Health status was the factor most strongly correlated with both experienced and evaluative well-being, even after controlling for a history of depression, age, income and other sociodemographic variables. Health status is an important correlate of well-being. Therefore, strategies to improve population health would also improve people's well-being.

  2. Health and happiness: cross-sectional household surveys in Finland, Poland and Spain

    PubMed Central

    Miret, Marta; Caballero, Francisco Félix; Chatterji, Somnath; Olaya, Beatriz; Tobiasz-Adamczyk, Beata; Koskinen, Seppo; Leonardi, Matilde; Haro, Josep Maria

    2014-01-01

    Abstract Objective To explore the associations between health and how people evaluate and experience their lives. Methods We analysed data from nationally-representative household surveys originally conducted in 2011–2012 in Finland, Poland and Spain. These surveys provided information on 10 800 adults, for whom experienced well-being was measured using the Day Reconstruction Method and evaluative well-being was measured with the Cantril Self-Anchoring Striving Scale. Health status was assessed by questions in eight domains including mobility and self-care. We used multiple linear regression, structural equation models and multiple indicators/multiple causes models to explore factors associated with experienced and evaluative well-being. Findings The multiple indicator/multiple causes model conducted over the pooled sample showed that respondents with younger age (effect size, β = 0.19), with higher levels of education (β = −0.12), a history of depression (β = −0.17), poor health status (β = 0.29) or poor cognitive functioning (β = 0.09) reported worse experienced well-being. Additional factors associated with worse evaluative well-being were male sex (β = −0.03), not living with a partner (β = 0.07), and lower occupational (β = −0.07) or income levels (β = 0.08). Health status was the factor most strongly correlated with both experienced and evaluative well-being, even after controlling for a history of depression, age, income and other sociodemographic variables. Conclusion Health status is an important correlate of well-being. Therefore, strategies to improve population health would also improve people’s well-being. PMID:25378725

  3. Phonatory Symptoms and Acoustic Findings in Patients with Asthma: A Cross-Sectional Controlled Study.

    PubMed

    Hamdan, Abdul Latif; Ziade, Georges; Kasti, Maher; Akl, Leslie; Bawab, Ibrahim; Kanj, Nadim

    2017-03-01

    To investigate the prevalence of phonatory symptoms, perceptual, acoustic and aerodynamic findings in patients with asthma compared to a control group. This study is a cross-sectional study. A total of 50 subjects, 31 asthmatic and 19 control subjects matched according to age and gender were enrolled in this study. All subjects were asked about the presence or absence of dysphonia, vocal fatigue, phonatory effort, cough, dyspnea, and respiratory failure. Perceptual evaluation, acoustic analysis and aerodynamic measurements were also performed. Patient's self assessment using the Voice Handicap Index 10 was reported. The mean age of patients was 43.5 years with a female to male ratio of 2:1. There was a statistically significant difference in the prevalence of dysphonia between the two groups (32.3 vs. 5.3%, p value 0.025) with a non-significant higher prevalence of vocal fatigue and phonatory effort. The overall grade of dysphonia was significantly higher in asthmatics compared to controls (p value 0.002). Patients with asthma had also significantly higher degree of asthenia and straining (p value of 0.04 and 0.008, respectively) with borderline significant difference with respect to roughness. There was no significant difference in the means of any of the acoustic parameters between patients and controls except for Shimmer, which was higher in the asthmatic group (p value of 0.037). There was also no significant difference in the Maximum phonation time between the two groups. Dysphonia is significantly more prevalent in patients with asthma compared to controls.

  4. Pain in Parkinson disease: a cross-sectional survey of its prevalence, specifics, and therapy.

    PubMed

    Buhmann, Carsten; Wrobel, Nathalie; Grashorn, Wiebke; Fruendt, Odette; Wesemann, Katharina; Diedrich, Sabrina; Bingel, Ulrike

    2017-04-01

    We aimed to evaluate prevalence, phenotype, and therapeutic realities of pain in patients with Parkinson disease (PD). Therefore, we assessed 181 outpatients with PD using a cross-sectional approach applying the German Pain Questionaire (DSF), the PainDetect, and a self-developed Parkinson Disease Pain Questionaire (UPDPQ) covering detailed therapeutic aspects. Furthermore, we investigated the association between pain and PD-disease characteristics, quality of life (PDQ-39), depression, and anxiety (HADS-D, HADS-A). Overall, prevalence of pain was high (95.4%); 91.1% suffered from chronic pain, but in only 22.3% of them, pain disorder was diagnosed. Pain impaired everyday-life moderately to very severely in 48.4% of patients and was the most distressing symptom in 10.2% of all patients. Pain was localized mainly in the back (71.4%) or joints (52.4%), frequently occurred as pain attacks (79%) but appeared with neuropathic character in only 15.3% of patients. Most patients (74.2%) received some kind of pain treatment, mainly provided by orthopedists (62.0%) or general practitioners (50.0%). Physiotherapy (61.3%), pain killers (54.4%), or massage (35.5%) were the most frequent therapeutic measures. Rehabilitative therapy (96.3%) and physiotherapy (89.5%) were rated as most effective, but with vastly temporary effects. 53.3% of patients attributed PD as the main cause for their pain, but only 33.6% found relief from anti-parkinsonian drugs. High levels of pain were associated with higher scores of depression and anxiety, and lower quality of life. Results suggest that pain in PD is frequent, complex, and quality-of-life-impairing but under-diagnosed and unsystematically treated and indicate need to systematically investigate pathophysiology-based treatment strategies.

  5. Risk of child obesity from parental obesity: analysis of repeat national cross-sectional surveys.

    PubMed

    McLoone, Philip; Morrison, David S

    2014-04-01

    To estimate the potential to reduce childhood obesity through targeted interventions of overweight households. Cross-sectional nationally representative samples of the Scottish population. Households in Scotland during 2008 and 2009. A total of 1651 households with parents and children aged 2-15 years. The WHO cut-off points for adult body mass index (BMI): overweight (25 to <30 kg/m2) and obese (≥30 kg/m2). Overweight and obesity in childhood respectively defined as a BMI 85th to <95th percentile and ≥95th percentile based on 1990 reference centiles. Thirty-two percent (600/1849) of children and 75% (966/1290) of adults were overweight or obese. Seventy-five percent (1606/2128) of all children lived with a parent who was overweight or obese. Among obese children, 58% (185/318) lived with an obese parent. The population attributable risk percentage of child obesity associated with parental obesity was 32.5%. Targeting obese households would require substantial falls in adult weight and need to reach 38% of all children; it might achieve a reduction in the prevalence of childhood obesity of 14% in these households (from 26% to 12%). Targeting parents with BMI ≥ 40 might reduce the overall prevalence of child obesity by 9%. Such an intervention would require large weight loss, consistent with approaches used for morbidly obese adults; it would involve 4% of all children and lead to a reduction in the prevalence of obesity in these households from 57% to 16%. Family-based interventions for obesity would be most efficiently targeted at obese children whose parents are morbidly obese.

  6. Evaluating Scientific Research Knowledge and Attitude among Medical Representative in Jordan: A Cross-sectional Survey.

    PubMed

    Mukattash, Tareq; Alattar, Meys; Farha, Rana Abu; Alsous, Mervat; Jarab, Anan; El-Hajii, Feras; Mukattash, Ibrahim L

    2017-08-28

    Pharmaceutical companies provide a broad range of different mandatory trainings to their medical representatives to keep the business running, however research related training has often been neglected by these companies. Thus, this study was developed to assess the amount of scientific research knowledge and interest among pharmacy medical representatives in Jordan. A cross sectional study was conducted in Jordan in 2016. During the study period, a questionnaire was administered to 250 medical representatives working in pharmaceutical companies to evaluate their scientific research knowledge and attitudes. The majority of medical representatives had positive attitudes towards clinical trials and research communication and believe that it will increase the value of their work, but a considerable number of medical representatives did not detail clinical trials on every visit and found difficulty in answering clinical trials and research related questions asked by health care professionals. Most of the medical representatives did not have a complete understanding of some basic research terminologies. Medical representatives working in multinational companies seemed to have a significantly better understanding of research and terminologies compared to local companies (P-value= 0.000). Also Medical representatives with higher educational degrees seemed to have significantly better understanding of basic research terminologies (P-value= 0.023). The majority of medical representatives had positive attitudes towards clinical trials and research communication and found that it will increase the value of their work, but still there is a gap in their frequency of detailing. Thus, local pharmaceutical companies need to invest more in research and clinical trials knowledge kind of training. Also, universities need to include research related courses and subject in their bachelors' program curriculum in order to make pharmacists equipped in terms of research knowledge

  7. A study of nurses' spiritual intelligence: a cross-sectional questionnaire survey.

    PubMed

    Yang, Ke-Ping; Mao, Xiu-Ying

    2007-08-01

    Nurse's spiritual well-being may assure a positive attitude toward spiritual care, and assist patients in overcoming spiritual distress. Spirituality is often related to one's belief system. Spirituality on the part of nurses is yet largely unheard of in a society with materialism which is one of the most destructive belief systems on the world. The objective of the study was to explore the profile of spiritual intelligence among nurses, and to examine the effect of religions on nurses' spiritual intelligence in China. This is a cross-sectional descriptive and inferential designed study. The study was carried out in a medical center in China. Subjects were widely distributed, throughout seven provinces, with 16 hospital settings. A total of 130 registered hospital nurses, who were taking part in a 3-day, national nursing quality conference held by the target medical center in China, were recruited by convenience sampling. Wolman's (2001) four-point Likert-type Psycho-Matrix Spirituality Inventroy (PSI) was distributed collaboratively during the period of the conference. Upon receiving oral approval from nursing administrators, the author ensured that subjects' responses would remain confidential and that filling out the questionnaire was to be construed as willingness to participate in this study. 1. The majority of nurses (90%) tended to experience numerous instances of physical emotional pain and suffering throughout life. 2. Among the 130 subjects, only seven nurses clearly specified their religions, and religious beliefs accounted for most of the variance in the criterion variable in the study. Exploring nurses' spiritual profiles, especially for those who seem to be unfamiliar with spiritual matters, is a starting point on the journey to delivering spiritual care. Chinese nurses' spiritual intelligence is only to be excavated. The study draws attention to the diverse culture of the nurses' concepts of spirituality, which is fundamental to the delivery of truly

  8. An epidemiological survey in hospital setup in Lucknow district: A cross-sectional study

    PubMed Central

    Pal, Uma Shanker; Singh, Mayank; Kumar, Lakshya; Verma, Pankaj; Singh, R. K.; Kumar, Shailendra; Agarwal, G. G.; Asthana, Akash

    2016-01-01

    Introduction: Oral cancer is the sixth most common form of cancer reported globally which includes lip, tongue, mouth, and throat. Developing countries face several challenges to identify and remove potential risk factors. Chewing tobacco/pan masala is considered to be the most potential risk factor for oral precancerous lesions and oral cancer. Objective: To study the clinical-epidemiological profile of oral cancer cases and potential risk factor associated with it. Materials and Methods: This is cross-sectional study which includes all major tertiary hospital in Lucknow district. Five hundred and eight cases of oral cancer reported in all major tertiary hospitals in Lucknow district during 2013–2016. Study Variable: Clinicoepidemiological characteristics of oral cancer cases. Statistical Analysis: percentages, proportions. Results: Out of 508 cases, majority of the subjects included in the study belonged to 18–75 years age group. Reported cases of oral cancer in males were higher as compared to females. Most of the subjects belonged to lower middle and upper lower socioeconomic group. It was found that 199 (39.2%) subjects consumed smokeless tobacco. Buccal mucosa was the common site of oral cancer being present in 50.4% of the subjects. Histopathologically, 256 cases of buccal mucosa, 17 cases of lip, 33 cases of alveolar region, 16 cases of mandible region, 156 cases of tongue region, 7 cases of gingival buccal sulcus region, and 23 cases of palate were diagnosed as oral squamous cell carcinoma. Conclusion: In the present study, the most affected site was buccal mucosa (50.4%), tongue (30.7%), and other diagnosis was <10%. PMID:28356689

  9. Vitamin D levels and allergic diseases. An italian cross-sectional multicenter survey.

    PubMed

    Lombardi, C; Passalacqua, G

    2017-03-01

    Background. During the two last decades, the interest in the role of Vitamin D (VD) in allergic disease has increased. Apart from the well-known actions of VD in bone metabolism, recent studies suggested its possible role as an immune-modulator in allergy. Objective. This study, conducted over the Italian territory, evaluated the possible correlations between VD serum level and diagnosed allergic diseases (rhinitis / asthma, food allergy, atopic dermatitis). Thus, VD was assessed in patients with physician-diagnosed allergic diseases. Methods. The study was carried out in hospital- and private practice-based setting between October 2012 and March 2013, and 18 Centers participated. Only adult patients, with at least one positive skin prick test were included. The diagnostic procedures and the data collection were standardized among the centers. VD levels were assayed by the same laboratory test. Results. Three hundred and nine patients were enrolled (132 male, mean age 37.5 ± 17 years). Of them, 40% reported a positive family history for allergies (asthma / rhinitis). Rhinitis plus asthma was present in 47% of patients, atopic dermatitis in 15%, and a consistent clinical history of food allergy associated with positive skin tests was present in 25% of subjects. There was no significant association between VD level and age, sex, family history, rhinitis, or food allergy. VD levels were overall lower in patients with asthma and rhinitis, but without statistical significance. A significant difference in VD levels was detected between patient with or without atopic dermatitis. VD was not related to seasonal allergens, whereas a significant negative correlation was seen for house dust mite and dog dander. Conclusion. Our data, derived from a cross-sectional study involving only allergic patients, agree partially with the current literature. Nonetheless, the association between VD levels and allergies appeared weak. Studies involving larger samples would be required to

  10. Organisational and individual support for nurses' ethical competence: A cross-sectional survey.

    PubMed

    Poikkeus, Tarja; Suhonen, Riitta; Katajisto, Jouko; Leino-Kilpi, Helena

    2016-05-10

    Nurses' ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses' ethical competence is needed. This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses' and nurse leaders' ethical competence, perceptions of support for nurses' ethical competence at the organisational and individual levels and background factors associated with this support. A descriptive, cross-sectional study design was employed. The Ethical Competence and Ethical Competence Support questionnaires were used to measure the main components. Descriptive statistics and multifactor analysis of variance were used for data analysis. The participants were 298 nurses and 193 nurse leaders working in specialised (48%/52%), primary (43%/36%) or private healthcare (5%/7%) in Finland. Ethical approval was obtained from the university ethics committee. Nurses estimated their own ethical competence to be at an average level, whereas nurse leaders estimated their own competence at a high level. Nurses' and nurse leaders' perceptions of provided support for nurses' ethical competence was not at a high level. The positive agreement percentage related to organisational support was 44% among nurses and 51% among nurse leaders. The positive agreement percentage related to individual support was lower, that is, 38% among nurses and 61% among nurse leaders. University education had a positive association with some items of individual support. Despite the findings that ethical competence was estimated at a high level among nurse leaders, perceptions of support for nurses' ethical competence were not at a satisfactory level. At the organisational level, nurse leaders need to inform of ethical procedures and practices in orientation; encourage multidisciplinary ethics discussions and collaboration; and support nurses at an individual level

  11. Exploring the missing link – Empathy among dental students: An institutional cross-sectional survey

    PubMed Central

    Aggarwal, Vikram Pal; Garg, Robin; Goyal, Nikita; Kaur, Puneet; Singhal, Sakshi; Singla, Nancy; Gijwani, Deeksha; Sharma, Aditi

    2016-01-01

    Background: Empathy plays an important role in healthy dentist and patient relationship. Hence, the aim of the study is to (a) to measure the self-reported empathy levels among dental undergraduate and postgraduate students. (b) To review the trend of changes in empathy level with experience, age, and gender among dental undergraduate and postgraduate students. Materials and Methods: This cross-sectional, questionnaire-based study was carried out in two private dental institutions situated in Sri Ganganagar, India, with a sample size of 978. Data were obtained from the 1st to final year (BDS), interns, and postgraduate students from January to March 2015. An empathy level of students was assessed by the Jefferson Scale of Physician Empathy – Health Profession Students Version Questionnaire. An exploratory factor analysis using Kaiser's criteria was undertaken to appraise the construct validity and dimensionality. Based on the results of the factor analysis, three factors were selected; labeled as perspective taking, compassionate care, and standing in patient's shoes. Results: The majority of the students was female in a equivalent  ratio of 1338:618. There were significant differences in empathy scores by gender and age (P < 0.01). The lowest and highest mean empathy scores were found in postgraduate (mean = 108.77, standard deviation [SD] =9.12) and 1st year (mean = 117.23, SD = 14.19) dental students, respectively. Conclusion: Dental educators should consider the likely decline in empathy among students as early as possible and adopt communication teaching strategies to promote the development of empathy and reduce the risk of further decline. PMID:27857767

  12. Women's and men's negative experience of child birth-A cross-sectional survey.

    PubMed

    Nystedt, Astrid; Hildingsson, Ingegerd

    2017-08-05

    A negative birth experience may influence both women and men and can limit their process of becoming a parent. This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth. A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n=928) and men (n=818) completed the same questionnaire that investigated new parents' birth experiences in relation to socio-demographic background and birth related variables. Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0-10.8) and men (OR 4.5, Cl 95% 1.4-17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; 'It was a pain to give birth' were a strong contributing factor for both women and men. A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  13. Medical Students' Opinions About the Commercialization of Healthcare: A Cross-Sectional Survey.

    PubMed

    Civaner, M Murat; Balcioglu, Harun; Vatansever, Kevser

    2016-06-01

    There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients' best interests in the face of market demands.

  14. Road traffic crashes among farm vehicle drivers in southern China: A cross-sectional survey.

    PubMed

    Zhang, Xujun; Yang, Yaming; Chen, Yu; Yao, Hongyan; Wu, Ming; Cui, Mengjing; Li, Yang; Hu, Jie; Zhang, Cong; Li, Zhen; Stallones, Lorann; Xiang, Huiyun

    2017-01-02

    The objective of this study was to identify the prevalence and potential risk factors of farm vehicle-related road traffic crashes among farm vehicle drivers in southern China. A cross-sectional study was used to interview 1,422 farm vehicle drivers in southern China. Farm vehicle-related road traffic crashes that occurred from December 2013 to November 2014 were investigated. Data on farm vehicle-related road traffic crashes and related factors were collected by face-to-face interviews. The prevalence of farm vehicle-related road traffic crashes among the investigated drivers was 7.2%. Farm vehicle-related road traffic crashes were significantly associated with self-reported vision problem (adjusted odds ratio [AOR] = 6.48, 95% confidence interval [CI], 3.86-10.87), self-reported sleep disorders (AOR = 10.03, 95% CI, 6.28-15.99), self-reported stress (AOR = 20.47, 95% CI, 9.96-42.08), reported history of crashes (AOR = 5.40, 95% CI, 3.47-8.42), reported history of drunk driving (AOR = 5.07, 95% CI, 2.97-8.65), and reported history of fatigued driving (AOR = 5.72, 95% CI, 3.73-8.78). The number of road traffic crashes was highest in the daytime and during harvest season. In over 96% of farm vehicle-related road traffic crashes, drivers were believed to be responsible for the crash. Major crash-causing factors included improper driving, careless driving, violating of traffic signals or signs, and being in the wrong lane. Findings of this study suggest that farm vehicle-related road traffic crashes have become a burgeoning public health problem in China. Programs need to be developed to prevent farm vehicle-related road traffic crashes in this emerging country.

  15. Educational and economic determinants of food intake in Portuguese adults: a cross-sectional survey

    PubMed Central

    Moreira, Pedro A; Padrão, Patricia D

    2004-01-01

    Background Understanding the influences of educational and economic variables on food consumption may be useful to explain food behaviour and nutrition policymaking. The aim of this study was to evaluate the importance of educational and economic factors in determining food pattern in Portuguese adults. Methods A cross-sectional study in a representative sample of Portuguese adults (20977 women and 18663 men). Participants were distributed in four categories according to years of education (≤4, 5–9, 10–12, and >12) and income (≤314 euros, 315–547 euros, 548–815 euros, and >815 euros). Logistic regression models were fitted to estimate the magnitude of the association between food groups and education/income, adjusting for confounders. Results In both genders, the odds favouring milk, vegetable soup, vegetables, fruit, and fish consumption, increased significantly with education, for those having >12 years of education compared to those with ≤4 years; the odds favouring wine, and spirits consumption decreased significantly with education, for those having >12 years of education compared to those with ≤4 years. In males, the odds favouring starchy foods and meat consumption decreased significantly with income, while for milk, the odds increased with higher income (those having >815 euros compared to those with ≤314 euros). Conclusions The low and high income groups are or tend to be similar in regard to several food groups consumption, and access to education/information appears to be the key element to a better food pattern as indicated by higher frequency of milk, vegetable soup, vegetables, fruit, and fish consumption. PMID:15575953

  16. Association between Menopausal Symptoms and Overactive Bladder: A Cross-Sectional Questionnaire Survey in China

    PubMed Central

    Zhu, Lingping; Cheng, Xiaoxia; Sun, Jiaxin; Lv, Shiyi; Mei, Suzhen; Chen, Xing; Xi, Sisi; Zhang, Jin; Yang, Mukun; Bai, Wenpei; Yan, Xiaoyan

    2015-01-01

    Purpose The association between menopause and overactive bladder is controversial. The purpose of this study was to determine the association between menopausal symptoms and overactive bladder, and identify the risk factors for overactive bladder. Methods A cross-sectional study was performed. The study included 403 women aged 36–76 years who visited the menopause clinic at Peking University First Hospital between September 2012 and December 2013. The overactive bladder symptom score and modified Kupperman index questionnaires were used. Differences were assessed using descriptive statistics to determine any association between the overactive bladder symptom score and modified Kupperman index score, and to evaluate the risk factors for overactive bladder. Results A total of 304 women were finally enrolled. The prevalence of overactive bladder was 9.43%, and the modified Kupperman index score; number of sexual problems; and frequency of urinary tract infections, vertigo, melancholia, and mood swings were significantly higher in patients with overactive bladder than in the patients without overactive bladder (p < 0.05). Menopausal symptoms (modified Kupperman index score ≥ 15) (odds ratio: 1.049, 95% confidence interval: 1.006–1.095, p = 0.025) and a low frequency of sexual intercourse in the last 6 months (odds ratio: 2.580, 95% confidence interval: 1.228–5.422, p = 0.012) were identified as independent risk factors for overactive bladder. The frequency of sexual intercourse was found to decrease with an increase in the severity of overactive bladder (p = 0.004, linear-by-linear association = 0.001). Conclusion Menopausal symptoms may be closely associated with overactive bladder, and sexual activity may be associated with the severity of overactive bladder. Moreover, sexual problems, urinary tract infections, vertigo, melancholia, and mood swings may be associated with overactive bladder. PMID:26448626

  17. Infertility as a proxy of general male health: results of a cross-sectional survey.

    PubMed

    Ventimiglia, Eugenio; Capogrosso, Paolo; Boeri, Luca; Serino, Alessandro; Colicchia, Michele; Ippolito, Silvia; Scano, Roberta; Papaleo, Enrico; Damiano, Rocco; Montorsi, Francesco; Salonia, Andrea

    2015-07-01

    To evaluate the prevalence, and clinical and seminal impact of comorbidities in white European men presenting for couple infertility. Cross-sectional study. Academic reproductive medicine outpatient clinic. Cohort of 2,100 consecutive infertile men (noninterracial infertile couples). Obtaining complete demographic, clinical, and laboratory data from 2,100 consecutive infertile men with health-significant comorbidities scored via the Charlson comorbidity index (CCI; categorized 0 vs. 1 vs. ≥2) and semen analysis values assessed based on 2010 World Health Organization reference criteria. Assessment of the rate of comorbidities by means of CCI scores and possible associations between CCI, semen and hormonal parameters. Descriptive statistics and regression models tested the associations among semen parameters, clinical characteristics, and CCI. When assessing general comorbidity prevalence, CCI 0, CCI 1, and CCI ≥2 was found in 1,921 (91.5%), 102 (4.9%), and 77 (3.6%) patients, respectively. Patient age and follicle-stimulating hormone levels increased as the general health status decreased. Conversely, the total testosterone levels and sperm concentration decreased as CCI scores increased. A higher rate of oligozoospermia and nonobstructive azoospermia was observed in patients with CCI ≥1. No differences were observed among the considered comorbidity groups in terms of testicular volume or further hormonal or seminal parameters. Both continuously coded and categorized sperm concentrations were independent predictors of CCI ≥1. Patients with sperm concentration <45.6 million/mL (most informative cutoff value) had a 2.74-fold increased risk of having a CCI ≥1. Decreased general health status appears to be associated with impaired male reproductive health, including lower sperm concentration, lower total testosterone levels, and higher follicle-stimulating hormone values. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc

  18. [A cross-sectional survey on the efficacy of 'China Healthy Lifestyle for All' in 2012].

    PubMed

    Li, Yuan; Zhang, Juan; Shi, Xiao-ming; Liang, Xiao-feng

    2013-09-01

    To study the efficacy of 'China Healthy Lifestyle for All' (CHLA). Under similar GDP status, two counties(one with CHLA and one without)were randomly selected from each province of China. Cluster randomized sampling method was performed to select 500 over 18-year-olds from each county. Face-to-face questionnaire interview was used to collect data related to knowledge, awareness and behavior on healthy lifestyle. Generalized Estimated Equation was fitted for the multi-factor analysis. A total of 31 396 subjects were surveyed, with 11 871 urban and 6312 rural residents from counties that had under gone the CHLA. Another 3934 urban and 9279 rural subjects were from those counties that had not carried out the CHLA(as control group). In both urban and rural areas, the CHLA group seemed more likely to be aware of the Campaign itself and the knowledge on healthy lifestyle, than the control group as well as consciously limiting the salt and oil intake, after adjusting other factors such as county, gender, age and education. In the urban area, rates of awareness on the Campaign in both the CHLA and control groups were 57.1% and 31.7% (OR = 3.33, 95% CI:1.63-6.80, P = 0.001)respectively. And in the rural area, the rates of consciously limiting the salt intake in the CHLA group and in the control group were 51.5% and 38.8% (OR = 1.70, 95% CI:1.13-2.56, P = 0.011)respectively. In the urban area, subjects from the CHLA group were more likely to use the healthy supportive tools than the control group. Rates of using salt measuring spoons in both the CHLA group and control groups were 49.2% and 29.5% (OR = 2.46, 95% CI:1.45-4.17, P = 0.001) respectively. In the rural area, statistically significant difference was only found in the rate of using scaled oil pots(OR = 2.11, 95% CI:1.09-4.09, P = 0.028)between the CHLA group and the control group. In the rural area, the CHLA group was more likely to engage in more physical activities than the control group. No differences on the

  19. Development of a Questionnaire and Cross-Sectional Survey of Patient eHealth Readiness and eHealth Inequalities.

    PubMed

    Jones, Ray

    2013-01-01

    Many speak of the digital divide, but variation in the opportunity of patients to use the Internet for health (patient eHealth readiness) is not a binary difference, rather a distribution influenced by personal capability, provision of services, support, and cost. Digital divisions in health have been addressed by various initiatives, but there was no comprehensive validated measure to know if they are effective that could be used in randomized controlled trials (RCTs) covering both non-Internet-users and the range of Internet-users. The aim of this study was to develop and validate a self-completed questionnaire and scoring system to assess patient eHealth readiness by examining the spread of scores and eHealth inequalities. The intended use of this questionnaire and scores is in RCTs of interventions aiming to improve patient eHealth readiness and reduce eHealth inequalities. Based on four factors identified from the literature, a self-completed questionnaire, using a pragmatic combination of factual and attitude questions, was drafted and piloted in three stages. This was followed by a final population-based, cross-sectional household survey of 344 people used to refine the scoring system. the patient ehealth readiness questionnaire (perq) includes questions used to calculate four subscores: patients' perception of (1) provision, (2) their personal ability and confidence, (3) their interpersonal support, and (4) relative costs in using the Internet for health. These were combined into an overall PERQ score (0-9) which could be used in intervention studies. Reduction in standard deviation of the scores represents reduction in eHealth inequalities. PERQ appears acceptable for participants in British studies. The scores produced appear valid and will enable assessment of the effectiveness of interventions to improve patient eHealth readiness and reduce eHealth inequalities. Such methods need continued evolution and redevelopment for other environments. Full

  20. Spread of artemisinin-resistant Plasmodium falciparum in Myanmar: a cross-sectional survey of the K13 molecular marker

    PubMed Central

    Tun, Kyaw M; Imwong, Mallika; Lwin, Khin M; Win, Aye A; Hlaing, Tin M; Hlaing, Thaung; Lin, Khin; Kyaw, Myat P; Plewes, Katherine; Faiz, M Abul; Dhorda, Mehul; Cheah, Phaik Yeong; Pukrittayakamee, Sasithon; Ashley, Elizabeth A; Anderson, Tim J C; Nair, Shalini; McDew-White, Marina; Flegg, Jennifer A; Grist, Eric P M; Guerin, Philippe; Maude, Richard J; Smithuis, Frank; Dondorp, Arjen M; Day, Nicholas P J; Nosten, François; White, Nicholas J; Woodrow, Charles J

    2015-01-01

    Summary Background Emergence of artemisinin resistance in southeast Asia poses a serious threat to the global control of Plasmodium falciparum malaria. Discovery of the K13 marker has transformed approaches to the monitoring of artemisinin resistance, allowing introduction of molecular surveillance in remote areas through analysis of DNA. We aimed to assess the spread of artemisinin-resistant P falciparum in Myanmar by determining the relative prevalence of P falciparum parasites carrying K13-propeller mutations. Methods We did this cross-sectional survey at malaria treatment centres at 55 sites in ten administrative regions in Myanmar, and in relevant border regions in Thailand and Bangladesh, between January, 2013, and September, 2014. K13 sequences from P falciparum infections were obtained mainly by passive case detection. We entered data into two geostatistical models to produce predictive maps of the estimated prevalence of mutations of the K13 propeller region across Myanmar. Findings Overall, 371 (39%) of 940 samples carried a K13-propeller mutation. We recorded 26 different mutations, including nine mutations not described previously in southeast Asia. In seven (70%) of the ten administrative regions of Myanmar, the combined K13-mutation prevalence was more than 20%. Geospatial mapping showed that the overall prevalence of K13 mutations exceeded 10% in much of the east and north of the country. In Homalin, Sagaing Region, 25 km from the Indian border, 21 (47%) of 45 parasite samples carried K13-propeller mutations. Interpretation Artemisinin resistance extends across much of Myanmar. We recorded P falciparum parasites carrying K13-propeller mutations at high prevalence next to the northwestern border with India. Appropriate therapeutic regimens should be tested urgently and implemented comprehensively if spread of artemisinin resistance to other regions is to be avoided. Funding Wellcome Trust–Mahidol University–Oxford Tropical Medicine Research

  1. The traditional Chinese medicine prescription pattern of patients with primary dysmenorrhea in Taiwan: a large-scale cross sectional survey.

    PubMed

    Pan, Jung-Chuan; Tsai, Yueh-Ting; Lai, Jung-Nien; Fang, Ruei-Chi; Yeh, Chia-Hao

    2014-03-14

    Traditional Chinese medicine (TCM), when given for symptom relief, has gained widespread popularity among women with primary dysmenorrhea (PD). The aim of this study was to analyze the utilization of TCM among PD women in Taiwan. The use, service frequency and Chinese herbal products prescribed for PD women were evaluated using a cross sectional survey of 23,118 beneficiaries who were recruited from the National Health Insurance Research Database. The logistic regression method was employed to estimate the odds ratios (ORs) for utilization of TCM. Overall, 53.4% (N=12,349) of PD women utilized TCM and 92.2% of them sought TCM with the intention of treating their menstruation-related pain symptoms. PD women who do not take prescription painkillers (aOR=35.75, 95% CI:33.20-38.49) were more likely to seek TCM treatment than those who took pain medication (aOR=1.00). There were a total of 213,249 TCM visits due to PD, of which more than 99% were treated with Chinese herbal products (CHPs). Dang-gui-shao-yao-san (Tangkuei and Peony Powder) was the most frequently prescribed formula for treating PD. Primary dysmenorrhea women tended to use Chinese herbal products to deal with pain-related symptoms, rather than use acupuncture. Dang-gui-shao-yao-san, which containing both sedative and anti-inflammatory agents, is the most commonly prescribed Chinese herbal formula for the treatment of PD. A well designed, double-blind, randomized, placebo-controlled study to further evaluate the efficacy of Dang-gui-shao-yao-san as a treatment women with primary dysmenorrhea is warranted. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. Macrosomia in 23 developing countries: an analysis of a multicountry, facility-based, cross-sectional survey.

    PubMed

    Koyanagi, Ai; Zhang, Jun; Dagvadorj, Amarjargal; Hirayama, Fumi; Shibuya, Kenji; Souza, João Paulo; Gülmezoglu, Ahmet Metin

    2013-02-09

    Macrosomia is a risk factor for adverse delivery outcomes. We investigated the prevalence, risk factors, and delivery outcomes of babies with macrosomia in 23 developing countries in Africa, Asia, and Latin America. We analysed data from WHO's Global Survey on Maternal and Perinatal Health, which was a facility-based cross-sectional study that obtained data for women giving birth in 373 health facilities in 24 countries in Africa and Latin America in 2004-05, and in Asia in 2007-08. Facilities were selected by stratified multistage cluster sampling and women were recruited at admission for delivery. We extracted data from the medical records with a standardised questionnaire. We used logistic regression with random effects to assess the risk factors for macrosomia and the risks for caesarean section and adverse maternal and perinatal outcomes (assessed by a composite score) in babies with the disorder. Of 290,610 deliveries, we analysed data for 276,436 singleton livebirths or fresh stillbirths. Higher maternal age (20-34 years), height, parity, body-mass index, and presence of diabetes, post-term pregnancy, and male fetal sex were associated with a significantly increased risk of macrosomia. Macrosomia was associated with an increased risk of caesarean section because of obstructed labour and post-term pregnancy in all regions. Additionally, macrosomia was associated with an increased risk of adverse maternal birth outcomes in all regions, and of adverse perinatal outcomes only in Africa. Increasing prevalence of diabetes and obesity in women of reproductive age in developing countries could be associated with a parallel increase in macrosomic births. The effect and feasibility of control of diabetes and preconception weight on macrosomia should be investigated in these settings. Furthermore, increased institutional delivery in countries where rates are low could be crucial to reduce macrosomia-associated morbidity and mortality. None. Copyright © 2013 Elsevier

  3. Screening for Glucose-6-Phosphate Dehydrogenase Deficiency Using Three Detection Methods: A Cross-Sectional Survey in Southwestern Uganda.

    PubMed

    Roh, Michelle E; Oyet, Caesar; Orikiriza, Patrick; Wade, Martina; Mwanga-Amumpaire, Juliet; Boum, Yap; Kiwanuka, Gertrude N; Parikh, Sunil

    2016-11-02

    Despite the potential benefit of primaquine in reducing Plasmodium falciparum transmission and radical cure of Plasmodium vivax and Plasmodium ovale infections, concerns over risk of hemolytic toxicity in individuals with glucose-6-phosphate dehydrogenase deficiency (G6PDd) have hampered its deployment. A cross-sectional survey was conducted in 2014 to assess the G6PDd prevalence among 631 children between 6 and 59 months of age in southwestern Uganda, an area where primaquine may be a promising control measure. G6PDd prevalence was determined using three detection methods: a quantitative G6PD enzyme activity assay (Trinity Biotech(®) G-6-PDH kit), a qualitative point-of-care test (CareStart(™) G6PD rapid diagnostic test [RDT]), and molecular detection of the G6PD A- G202A allele. Qualitative tests were compared with the gold standard quantitative assay. G6PDd prevalence was higher by RDT (8.6%) than by quantitative assay (6.8%), using a < 60% activity threshold. The RDT performed optimally at a < 60% threshold and demonstrated high sensitivity (≥ 90%) and negative predictive values (100%) across three activity thresholds (below 60%, 30%, and 40%). G202A allele frequency was 6.4%, 7.9%, and 6.8% among females, males, and overall, respectively. Notably, over half of the G202A homo-/hemizygous children expressed ≥ 60% enzyme activity. Overall, the CareStart(™) G6PD RDT appears to be a viable screening test to accurately identify individuals with enzyme activities below 60%. The low prevalence of G6PDd across all three diagnostic modalities and absence of severe deficiency in our study suggests that there is little barrier to the use of single-dose primaquine in this region.

  4. A cross-sectional survey of depression, anxiety, and cognitive function in patients with type 2 diabetes.

    PubMed

    Trento, M; Raballo, M; Trevisan, M; Sicuro, J; Passera, P; Cirio, L; Charrier, L; Cavallo, F; Porta, M

    2012-06-01

    To evaluate the prevalence of depression in outpatients with type 2 diabetes and its possible correlation with anxiety, cognitive function, and clinical variables. The Zung Self-Rating Depression and Anxiety Scales and the Mini-Mental-State Examination were administered to 249 non-insulin-treated (NIT) and 249 insulin-treated (IT) outpatients with type 2 diabetes, aged 40-80, in a cross-sectional survey. Compared with a reported prevalence of 6-13% in the general population, 104 (20.9%) patients had either a score indicative of depression or were on anti-depressant medication. Assuming that medication might modify the responses to questionnaires, the latter patients were excluded from further analysis. IT patients had higher age, known duration of diabetes, HbA1c, more foot ulcers, retinopathy, microalbuminuria and practised more self-monitoring of blood glucose (P < 0.01 all) but a slightly lower mean depression score (P = 0.004) and similar anxiety or cognitive function. At multivariate analysis, depression was associated with anxiety (P < 0.001), age (P < 0.001), gender (men having lower scores than women, P = 0.042), and insulin treatment, IT patients being less depressed than NIT (P < 0.001), but none of the clinical variables. Anxiety correlated with age (P < 0.001). The association between depression and anxiety became progressively weaker with increasing age. These data confirm increased prevalence of depression in a population of patients with type 2 diabetes who did not show impaired cognitive function. The lack of correlation with disease duration, metabolic control, and complications suggests that depression may not appear/worsen with diabetes and/or its complications but rather supports suggestions that it might predate both.

  5. Determinants of Salivary Cotinine among Smokeless Tobacco Users: A Cross-Sectional Survey in Bangladesh

    PubMed Central

    Huque, Rumana; Shah, Sarwat; Mushtaq, Nasir; Siddiqi, Kamran

    2016-01-01

    Introduction More than 80% of all smokeless tobacco (ST) products in the world are consumed in South Asia; yet little is known about their consumption behaviour, addictiveness, and toxic properties. This paper, for the first time, describes associations between salivary cotinine concentrations among ST users in Bangladesh and their socio-demographic characteristics and tobacco use behaviours. Methods In a survey of ST users in Dhaka, Bangladesh, we purposively recruited 200 adults who were non-smokers but consumed ST on a regular basis. In-person interviews were conducted to obtain information about socio-demographic and ST use behaviours, and saliva samples were collected to measure cotinine concentration. Simple and multiple linear regression analyses were conducted to test associations between the log transformed salivary cotinine concentration and other study variables. Results The geometric mean of cotinine concentration among ST users was 380ng/ml (GSD:2). Total duration of daily ST use in months had a statistically significant association with cotinine concentration. Other ST use characteristics including type and quantity of ST use, swallowing of tobacco juice, urges and strength of urges and attempts to cut down on tobacco use were not found to be associated with cotinine concentration in a multivariable model. Conclusion This is the first report from Bangladesh studying cotinine concentration among ST users and it points towards high levels of addiction. This warrants effective tobacco control policies to help ST cessation and prevention. PMID:27504912

  6. Correlates of sunscreen use among high school students: a cross-sectional survey

    PubMed Central

    2011-01-01

    Background Adolescents put themselves at risk of later skin cancer development and accelerated photo-aging due to their high rates of ultraviolet radiation exposure and low rates of skin protection. The purpose of the current study was to determine which of the Integrative Model constructs are most closely associated with sunscreen use among high school students. Methods The current study of 242 high school students involved a survey based on the Integrative Model including demographic and individual difference factors, skin protection-related beliefs and outcome evaluations, normative beliefs, self-efficacy, sunscreen cues and availability, intentions, and sunscreen use. Our analyses included multiple linear regressions and bootstrapping to test for mediation effects. Results Sunscreen use was significantly associated with female gender, greater skin sensitivity, higher perceived sunscreen benefits, higher skin protection importance, more favorable sunscreen user prototype, stronger skin protection norms, greater perceived skin protection behavioral control, and higher sunscreen self-efficacy. Intentions to use sunscreen mediated the relationships between most skin protection-related beliefs and sunscreen use. Conclusions The current study identified specific variables that can be targeted in interventions designed to increase sunscreen use among adolescents. PMID:21884577

  7. Correlates of sunscreen use among high school students: a cross-sectional survey.

    PubMed

    Heckman, Carolyn J; Coups, Elliot J

    2011-08-31

    Adolescents put themselves at risk of later skin cancer development and accelerated photo-aging due to their high rates of ultraviolet radiation exposure and low rates of skin protection. The purpose of the current study was to determine which of the Integrative Model constructs are most closely associated with sunscreen use among high school students. The current study of 242 high school students involved a survey based on the Integrative Model including demographic and individual difference factors, skin protection-related beliefs and outcome evaluations, normative beliefs, self-efficacy, sunscreen cues and availability, intentions, and sunscreen use. Our analyses included multiple linear regressions and bootstrapping to test for mediation effects. Sunscreen use was significantly associated with female gender, greater skin sensitivity, higher perceived sunscreen benefits, higher skin protection importance, more favorable sunscreen user prototype, stronger skin protection norms, greater perceived skin protection behavioral control, and higher sunscreen self-efficacy. Intentions to use sunscreen mediated the relationships between most skin protection-related beliefs and sunscreen use. The current study identified specific variables that can be targeted in interventions designed to increase sunscreen use among adolescents.

  8. Evidence for a general stiffening motor control pattern in neck pain: a cross sectional study.

    PubMed

    Meisingset, Ingebrigt; Woodhouse, Astrid; Stensdotter, Ann-Katrin; Stavdahl, Øyvind; Lorås, Håvard; Gismervik, Sigmund; Andresen, Hege; Austreim, Kristian; Vasseljen, Ottar

    2015-03-17

    Neck pain is associated with several alterations in neck motion and motor control. Previous studies have investigated single constructs of neck motor control, while few have applied a comprehensive set of tests to investigate cervical motor control. This comparative cross- sectional study aimed to investigate different motor control constructs in neck pain patients and healthy controls. A total of 166 subjects participated in the study, 91 healthy controls (HC) and 75 neck pain patients (NP) with long-lasting moderate to severe neck pain. Neck flexibility, proprioception, head steadiness, trajectory movement control, and postural sway were assessed using a 3D motion tracking system (Liberty). The different constructs of neck motion and motor control were based on tests used in previous studies. Neck flexibility was lower in NP compared to HC, indicated by reduced cervical ROM and conjunct motion. Movement velocity was slower in NP compared to HC. Tests of head steadiness showed a stiffer movement pattern in NP compared to HC, indicated by lower head angular velocity. NP patients departed less from a predictable trajectory movement pattern (figure of eight) compared to healthy controls, but there was no difference for unpredictable movement patterns (the Fly test). No differences were found for postural sway in standing with eyes open and eyes closed. However, NP patients had significantly larger postural sway when standing on a balance pad. Proprioception did not differ between the groups. Largest effect sizes (ES) were found for neck flexibility (ES range: 0.2-0.8) and head steadiness (ES range: 1.3-2.0). Neck flexibility was the only construct that showed a significant association with current neck pain, while peak velocity was the only variable that showed a significant association with kinesiophobia. NP patients showed an overall stiffer and more rigid neck motor control pattern compared to HC, indicated by lower neck flexibility, slower movement velocity

  9. Use of complementary and alternative medicine by older adults – a cross-sectional survey

    PubMed Central

    2014-01-01

    Background Very little is known about complementary and alternative medicine (CAM) use by older adults in Germany. The aim of this study was to investigate the use of CAM and other health promoting substances (e.g., herbal teas) by older adults of at least 70 years of age. Methods A cross-sectional questionnaire study was conducted among persons of ≥70 years from metropolitan Berlin and rural parts of Brandenburg, Germany. Recorded were: demographics, current use of CAM, medical diagnoses, users’ opinions and preferences. Results A total of 400 older adults, living as ‘self-reliant’ (n = 154), ‘home care service user’ (n = 97), or ‘in nursing home’ (n = 149), and with the legal status ‘without guardian’ (n = 355) or ‘with guardian’ (n = 45) were included (mean age 81.8 ± 7.4 years, 78.5% female). Any type of CAM used 61.3% of respondents (dietary supplements 35.5%, herbal medicines 33.3%, and external preparations 26.8%); 3.0% used drug-interaction causing preparations. Usage was based on recommendations (total 30.3%; in 20.0% by friends or family and 10.4% by pharmacists), own initiative (27.3%), and doctors’ prescription (25.8%). Participants with legal guardian took almost solely prescribed dietary supplements. Of the others, only half (58.7%) informed their general practitioner (GP) of their CAM use. Participants expected significant (44.9%) or moderate (37.1%) improvement; half of them perceived a good effect (58.7%) and two-thirds (64.9%) generally preferred a combination of CAM and conventional medicine. More than half (57.9%) stated that they could neither assess whether their CAM preparations have side effects, nor assess what the side effects might be. Strongest predictors for CAM use were two treatment preferences (vs. ‘conventional only’: ‘CAM only’, OR = 3.98, p = 0.0042 and ‘CAM + conventional’, 3.02, 0.0028) and the type of health insurance (‘statutory’ vs. ‘private’, 3.57, 0.0356); against CAM use two

  10. Antecedents of hospital nurses' intention to leave the organization: A cross sectional survey.

    PubMed

    Bobbio, Andrea; Manganelli, Anna Maria

    2015-07-01

    Leadership and perceived organizational support inspire trust in the leader and in the organization. Consequently, these aspects may contribute to a reduction in job burnout among nurses and, in the end, of the intention on their part to leave the hospital. It is crucial to develop models in order to simultaneously test the correlations between these relevant psychosocial variables, so that complexity of the nursing work environment may be better understood. We expected to give support to and to further corroborate results in the literature linking perceived leadership style – and particularly servant leadership – perceived organizational support, trust in the leader and in the organization, job burnout among nurses and their subsequent intention to leave the hospital. Cross-sectional study. Two Italian large size public hospitals. Two samples including both graduates and non-graduates members of the nursing staff. Overall mean age was equal to 42.06 years while the general mean for tenure was 12.99 years. Data were collected in 2012. A regression model with latent variables was tested via structural equation modeling using LISREL. The multi-sample procedure was also applied in order to test invariance of results between the two samples. Servant leadership was positively associated with trust in the leader and perceived organizational support was positively associated with trust in the organization. Trust in the leader and trust in the organization displayed a negative correlation with the emotional exhaustion and cynicism factors of job burnout, and a positive correlation with the professional efficacy factor. Furthermore, trust scores mediated the effects of servant leadership and perceived organizational support on job burnout factors. The cynicism factor was negatively associated with intention to leave the organization and it also mediated the effects of both trust in the leader and servant leadership on intention to leave. On the other hand, trust in the

  11. Education and severe maternal outcomes in developing countries: a multicountry cross-sectional survey.

    PubMed

    Tunçalp, Ö; Souza, J P; Hindin, M J; Santos, C A; Oliveira, T H; Vogel, J P; Togoobaatar, G; Ha, D Q; Say, L; Gülmezoglu, A M

    2014-03-01

    To assess the relationship between education and severe maternal outcomes among women delivering in healthcare facilities. Cross-sectional study. Twenty-nine countries in Africa, Asia, Latin America, and the Middle East. Pregnant women admitted to 359 facilities during a period of 2-4 months of data collection between 2010 and 2011. Data were obtained from hospital records. Stratification was based on the Human Development Index (HDI) values of the participating countries. Multivariable logistic regression analyses were conducted to assess the association between maternal morbidity and education, categorised in quartiles based on the years of formal education by country. Coverage of key interventions was assessed. Severe maternal outcomes (near misses and death). A significant association between low education and severe maternal outcomes (adjusted odds ratio, aOR, 2.07; 95% confidence interval, 95% CI, 1.46-2.95), maternal near miss (aOR 1.80; 95% CI 1.25-2.57), and maternal death (aOR 5.62; 95% CI 3.45-9.16) was observed. This relationship persisted in countries with medium HDIs (aOR 2.36; 95% CI 1.33-4.17) and low HDIs (aOR 2.65; 95% CI 1.54-2.57). Less educated women also had increased odds of presenting to the hospital in a severe condition (i.e. with organ dysfunction on arrival or within 24 hours: aOR 2.06; 95% CI 1.36-3.10). The probability that a woman received magnesium sulphate for eclampsia or had a caesarean section significantly increased as education level increased (P < 0.05). Women with lower levels of education are at greater risk for severe maternal outcomes, even after adjustment for key confounding factors. This is particularly true for women in countries that have poorer markers of social and economic development. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

  12. A cross-sectional survey of supports for evidence-informed decision-making in healthcare organisations: a research protocol.

    PubMed

    Ouimet, Mathieu; Lavis, John N; Léon, Grégory; Ellen, Moriah E; Bédard, Pierre-Olivier; Grimshaw, Jeremy M; Gagnon, Marie-Pierre

    2014-10-09

    This protocol builds on the development of a) a framework that identified the various supports (i.e. positions, activities, interventions) that a healthcare organisation or health system can implement for evidence-informed decision-making (EIDM) and b) a qualitative study that showed the current mix of supports that some Canadian healthcare organisations have in place and the ones that are perceived to facilitate the use of research evidence in decision-making. Based on these findings, we developed a web survey to collect cross-sectional data about the specific supports that regional health authorities and hospitals in two Canadian provinces (Ontario and Quebec) have in place to facilitate EIDM. This paper describes the methods for a cross-sectional web survey among 32 regional health authorities and 253 hospitals in the provinces of Quebec and Ontario (Canada) to collect data on the current mix of organisational supports that these organisations have in place to facilitate evidence-informed decision-making. The data will be obtained through a two-step survey design: a 10-min survey among CEOs to identify key units and individuals in regard to our objectives (step 1) and a 20-min survey among managers of the key units identified in step 1 to collect information about the activities performed by their unit regarding the acquisition, assessment, adaptation and/or dissemination of research evidence in decision-making (step 2). The study will target three types of informants: CEOs, library/documentation centre managers and all other key managers whose unit is involved in the acquisition, assessment, adaptation/packaging and/or dissemination of research evidence in decision-making. We developed an innovative data collection system to increase the likelihood that only the best-informed respondent available answers each survey question. The reporting of the results will be done using descriptive statistics of supports by organisation type and by province. This study will

  13. Drug resistance of Mycobacterium tuberculosis in Malawi: a cross-sectional survey.

    PubMed

    Abouyannis, Michael; Dacombe, Russell; Dambe, Isaias; Mpunga, James; Faragher, Brian; Gausi, Francis; Ndhlovu, Henry; Kachiza, Chifundo; Suarez, Pedro; Mundy, Catherine; Banda, Hastings T; Nyasulu, Ishmael; Squire, S Bertel

    2014-11-01

    To document the prevalence of multidrug resistance among people newly diagnosed with - and those retreated for - tuberculosis in Malawi. We conducted a nationally representative survey of people with sputum-smear-positive tuberculosis between 2010 and 2011. For all consenting participants, we collected demographic and clinical data, two sputum samples and tested for human immunodeficiency virus (HIV).The samples underwent resistance testing at the Central Reference Laboratory in Lilongwe, Malawi. All Mycobacterium tuberculosis isolates found to be multidrug-resistant were retested for resistance to first-line drugs - and tested for resistance to second-line drugs - at a Supranational Tuberculosis Reference Laboratory in South Africa. Overall, M. tuberculosis was isolated from 1777 (83.8%) of the 2120 smear-positive tuberculosis patients. Multidrug resistance was identified in five (0.4%) of 1196 isolates from new cases and 28 (4.8%) of 581 isolates from people undergoing retreatment. Of the 31 isolates from retreatment cases who had previously failed treatment, nine (29.0%) showed multidrug resistance. Although resistance to second-line drugs was found, no cases of extensive drug-resistant tuberculosis were detected. HIV testing of people from whom M. tuberculosis isolates were obtained showed that 577 (48.2%) of people newly diagnosed and 386 (66.4%) of people undergoing retreatment were positive. The prevalence of multidrug resistance among people with smear-positive tuberculosis was low for sub-Saharan Africa - probably reflecting the strength of Malawi's tuberculosis control programme. The relatively high prevalence of such resistance observed among those with previous treatment failure may highlight a need for a change in the national policy for retreating this subgroup of people with tuberculosis.

  14. Drug resistance of Mycobacterium tuberculosis in Malawi: a cross-sectional survey

    PubMed Central

    Abouyannis, Michael; Dacombe, Russell; Dambe, Isaias; Mpunga, James; Faragher, Brian; Gausi, Francis; Ndhlovu, Henry; Kachiza, Chifundo; Suarez, Pedro; Mundy, Catherine; Banda, Hastings T; Nyasulu, Ishmael

    2014-01-01

    Abstract Objective To document the prevalence of multidrug resistance among people newly diagnosed with – and those retreated for – tuberculosis in Malawi. Methods We conducted a nationally representative survey of people with sputum-smear-positive tuberculosis between 2010 and 2011. For all consenting participants, we collected demographic and clinical data, two sputum samples and tested for human immunodeficiency virus (HIV).The samples underwent resistance testing at the Central Reference Laboratory in Lilongwe, Malawi. All Mycobacterium tuberculosis isolates found to be multidrug-resistant were retested for resistance to first-line drugs – and tested for resistance to second-line drugs – at a Supranational Tuberculosis Reference Laboratory in South Africa. Findings Overall, M. tuberculosis was isolated from 1777 (83.8%) of the 2120 smear-positive tuberculosis patients. Multidrug resistance was identified in five (0.4%) of 1196 isolates from new cases and 28 (4.8%) of 581 isolates from people undergoing retreatment. Of the 31 isolates from retreatment cases who had previously failed treatment, nine (29.0%) showed multidrug resistance. Although resistance to second-line drugs was found, no cases of extensive drug-resistant tuberculosis were detected. HIV testing of people from whom M. tuberculosis isolates were obtained showed that 577 (48.2%) of people newly diagnosed and 386 (66.4%) of people undergoing retreatment were positive. Conclusion The prevalence of multidrug resistance among people with smear-positive tuberculosis was low for sub-Saharan Africa – probably reflecting the strength of Malawi’s tuberculosis control programme. The relatively high prevalence of such resistance observed among those with previous treatment failure may highlight a need for a change in the national policy for retreating this subgroup of people with tuberculosis. PMID:25378741

  15. The interaction effects of risk factors for hypertension in adults: a cross-sectional survey in Guilin, China.

    PubMed

    Yu, Jian; Zou, Di-Sha; Xie, Meng-Ting; Ye, Yao; Zheng, Tian-Peng; Zhou, Su-Xian; Huang, Li-Li; Liu, Xiao-Ling; Xun, Jing-Qiong; Zhou, Yan

    2016-09-23

    The prevalence of hypertension in adults is increasing each year and has become a main public health issue worldwide. We must consider the impact of both individual factors and interactions among these factors on hypertension in adults. This study was designed to elucidate the clinical and metabolic characteristics of the prevalence of hypertension in adults and to explore the risk factors and interactions among these factors in adults with hypertension. We used overall random sampling to conduct a cross-sectional survey of 6660 individuals undergoing a health check from July to November 2012, the subjects were aged 20 to 89 years, including 3480 men and 3180 women. The survey content included a questionnaire, anthropometry, laboratory measurements, and liver Doppler ultrasonography. The clinical and metabolic characteristics were compared between the cases (adult hypertensive patients) and the controls (normotensives). The classification tree model and the non-conditional logistic regression were used to analyze the interactions of risk factors for hypertension in adults. In total, 1623 adult hypertensive patients (940 men and 683 women) were detected. The results showed that adult hypertensive patients were older and had higher levels of systolic blood pressure, diastolic blood pressure, body mass index, fasting plasma glucose, uric acid, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and prevalence of non-alcoholic fatty liver disease (P < 0.001). The classification tree model comprising 5 layers, 39 nodes, and 20 terminal nodes showed that two variables, age and BMI, were closely related to hypertension in adults. The area under the receiver operating characteristic curve for classification tree model was 81.6 % (95 % CI: 80.6 % ~ 82.5 %). Both univariate and multivariate logistic regression analyses revealed that advanced age and high BMI had a significant positive interaction in terms of hypertension in adults. After

  16. Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey

    PubMed Central

    2010-01-01

    Background Complementary and alternative medicine (CAM) is growing in popularity, especially within the pediatric population. Research on CAM practitioners and their specialties, such as pediatrics, is lacking. Within the chiropractic profession, pediatrics is one of the most recently established post-graduate specialty programs. This paper describes the demographic and practice characteristics of doctors of chiropractic with a pediatric diplomate. Methods 218 chiropractors with a pediatric diplomate were invited to complete our survey using either web-based or mailed paper survey methods. Practitioner demographics, practice characteristics, treatment procedures, referral patterns, and patient characteristics were queried with a survey created with the online survey tool, SurveyMonkey©®. Results A total of 135 chiropractors responded (62.2% response rate); they were predominantly female (74%) and white (93%). Techniques most commonly used were Diversified, Activator ®, and Thompson with the addition of cranial and extremity manipulation to their chiropractic treatments. Adjunctive therapies commonly provided to patients included recommendations for activities of daily living, corrective or therapeutic exercise, ice pack\\cryotherapy, and nutritional counseling. Thirty eight percent of respondents' patients were private pay and 23% had private insurance that was not managed care. Pediatrics represented 31% of the survey respondents' patients. Chiropractors also reported 63% of their work time devoted to direct patient care. Health conditions reportedly treated within the pediatric population included back or neck pain, asthma, birth trauma, colic, constipation, ear infection, head or chest cold, and upper respiratory infections. Referrals made to or from these chiropractors were uncommon. Conclusions This mixed mode survey identified similarities and differences between doctors of chiropractic with a pediatric diplomate to other surveys of doctors of chiropractic

  17. Practice patterns of doctors of chiropractic with a pediatric diplomate: a cross-sectional survey.

    PubMed

    Pohlman, Katherine A; Hondras, Maria A; Long, Cynthia R; Haan, Andrea G

    2010-06-14

    Complementary and alternative medicine (CAM) is growing in popularity, especially within the pediatric population. Research on CAM practitioners and their specialties, such as pediatrics, is lacking. Within the chiropractic profession, pediatrics is one of the most recently established post-graduate specialty programs. This paper describes the demographic and practice characteristics of doctors of chiropractic with a pediatric diplomate. 218 chiropractors with a pediatric diplomate were invited to complete our survey using either web-based or mailed paper survey methods. Practitioner demographics, practice characteristics, treatment procedures, referral patterns, and patient characteristics were queried with a survey created with the online survey tool, SurveyMonkey. A total of 135 chiropractors responded (62.2% response rate); they were predominantly female (74%) and white (93%). Techniques most commonly used were Diversified, Activator, and Thompson with the addition of cranial and extremity manipulation to their chiropractic treatments. Adjunctive therapies commonly provided to patients included recommendations for activities of daily living, corrective or therapeutic exercise, ice pack\\cryotherapy, and nutritional counseling. Thirty eight percent of respondents' patients were private pay and 23% had private insurance that was not managed care. Pediatrics represented 31% of the survey respondents' patients. Chiropractors also reported 63% of their work time devoted to direct patient care. Health conditions reportedly treated within the pediatric population included back or neck pain, asthma, birth trauma, colic, constipation, ear infection, head or chest cold, and upper respiratory infections. Referrals made to or from these chiropractors were uncommon. This mixed mode survey identified similarities and differences between doctors of chiropractic with a pediatric diplomate to other surveys of doctors of chiropractic, CAM professionals, and pediatric healthcare

  18. [A cross-sectional population survey of knee osteoarthritis in Taiyuan region].

    PubMed

    Zang, Chang-hai; Zeng, Qing-yu; Li, Xiao-feng; Dong, Hai-yuan; Zhang, Ai-lian; Zhao, Qi

    2006-07-01

    Osteoarthritis (OA) of the knee is found to be one of the commonest rheumatic disorders. For prevention of knee OA, the risk factors for this condition should first be identified. A population sample of 2188 adults aged 35 - 64 years, living in 6-story buildings without elevators, was surveyed from April to August 2005 in the urban of Taiyuan region, north China. Protocol of APLAR-COPCORD Core Questionnaire for identification of risk factors for knee OA was implemented. The positive respondents were examined simultaneously by rheumatologists. Lateral and anterior-posterior non-weight-bearing knee radiographs were arranged. Variables such as sex, age, body mass index (BMI), waist circumference, education level, and smoking et al, were included in binary logistic regression model for further analysis. Prevalence rate of knee pain and knee OA was 13.6% and 10.9% respectively, significantly higher than that in Shantou--in south of China and similar with Beijing--in north of China. Both of these prevalence was significantly higher in women than that in men (18.3% vs. 8.7% and 15.1% vs. 6.3%), and with a tendency of being increased with age. The prevalence rate of knee OA was increased more obviously in people after 40 years old in women and after 45 years old in men. BMI in knee OA group was significantly higher than that in non-knee OA group. Binary logistic regression revealed that age, sex, and BMI were significantly associated with knee OA. Whereas there were no significant association between the other factors such as climbing stairs, waist circumference, time length of occupation service, education level, smoking, as well as religious belief and knee OA. Geography, aging (aged > 40 years in woman and > 45 years in man, respectively), female, and overweight (BMI > or = 24 kg/m(2)) might be the associated risk factors of knee OA. No association between climbing stairs and knee OA was found. Prevention of knee OA should be initiated before the middle-aged, especially

  19. Older Patients’ Enthusiasm to Use Electronic Mail to Communicate With Their Physicians: Cross-Sectional Survey

    PubMed Central

    Fox, Sarah A; Petersen, Nancy J; Shethia, Anila; Street, Richard L

    2009-01-01

    Background Recent evidence indicates increased access to and use of Internet and non-healthcare-related email by older patients. Because email adoption could potentially reduce some of the disparities faced by this age group, there is a need to understand factors determining older patients’ enthusiasm to use email to communicate with their physicians. Electronic mail (email) represents a means of communication that, coupled with face-to-face communication, could enhance quality of care for older patients. Objective Test a model to determine factors associated with older patients’ enthusiasm to use email to communicate with their physicians. Methods We conducted a secondary data analysis of survey data collected in 2003 for two large, longitudinal, randomized controlled trials. Logistic-regression models were used to model the dichotomous outcome of patient enthusiasm for using email to communicate with their physicians. Explanatory variables included demographic characteristics, health status, use of email with people other than their physician, characteristics of the physician-patient relationship, and physician enthusiasm to use email with patients. Results Participants included a pooled sample of 4059 patients over 65 years of age and their respective physicians (n = 181) from community-based practices in Southern California. Although only 52 (1.3%) patient respondents reported that they communicated with their physician by email, about half (49.3%) expressed enthusiasm about the possibility of using it. Odds of being enthusiastic decreased with increased age (by 0.97 for each year over 66) but were significantly higher in African Americans (OR = 2.1, CI = 1.42 - 3.06), Hispanics (OR = 1.6, CI = 1.26 - 2.14) and men (OR = 1.3, CI = 1.1 - 1.5). A perception of better communication skills of their physician, lower quality of interaction with physician in traditional face-to-face encounters, and physician enthusiasm to use email with patients were significantly

  20. Older patients' enthusiasm to use electronic mail to communicate with their physicians: cross-sectional survey.

    PubMed

    Singh, Hardeep; Fox, Sarah A; Petersen, Nancy J; Shethia, Anila; Street, Richard L

    2009-06-16

    Recent evidence indicates increased access to and use of Internet and non-healthcare-related email by older patients. Because email adoption could potentially reduce some of the disparities faced by this age group, there is a need to understand factors determining older patients' enthusiasm to use email to communicate with their physicians. Electronic mail (email) represents a means of communication that, coupled with face-to-face communication, could enhance quality of care for older patients. Test a model to determine factors associated with older patients' enthusiasm to use email to communicate with their physicians. We conducted a secondary data analysis of survey data collected in 2003 for two large, longitudinal, randomized controlled trials. Logistic-regression models were used to model the dichotomous outcome of patient enthusiasm for using email to communicate with their physicians. Explanatory variables included demographic characteristics, health status, use of email with people other than their physician, characteristics of the physician-patient relationship, and physician enthusiasm to use email with patients. Participants included a pooled sample of 4059 patients over 65 years of age and their respective physicians (n = 181) from community-based practices in Southern California. Although only 52 (1.3%) patient respondents reported that they communicated with their physician by email, about half (49.3%) expressed enthusiasm about the possibility of using it. Odds of being enthusiastic decreased with increased age (by 0.97 for each year over 66) but were significantly higher in African Americans (OR = 2.1, CI = 1.42 - 3.06), Hispanics (OR = 1.6, CI = 1.26 - 2.14) and men (OR = 1.3, CI = 1.1 - 1.5). A perception of better communication skills of their physician, lower quality of interaction with physician in traditional face-to-face encounters, and physician enthusiasm to use email with patients were significantly associated with an enthusiasm to use

  1. Attitudes toward vaccination: A cross-sectional survey of students at the Canadian Memorial Chiropractic College.

    PubMed

    Lameris, Marlee; Schmidt, Catherine; Gleberzon, Brian; Ogrady, Jillian

    2013-09-01

    The purpose of this study was to conduct an online survey of chiropractic students in the 2011/12 academic year at CMCC in order to determine their attitudes toward vaccination, their history of vaccination and their opinions towards their level of preparedness and confidence to discuss vaccination with patients. All students enrolled in the program at CMCC were eligible to participate in this anonymous survey modeled after a similar survey administered in 1999/2000. The response rate was 43%. Over 90% of all students reported they had been vaccinated. Roughly half of students felt they were well prepared to discuss vaccination with their patients and two-thirds felt they were confident to do so. Between 83.9% and 90% of students in various years of the program expressed a positive attitude toward vaccination. Separate Welsh t-test for each year of study indicated statistically significant differences between our survey and the survey published in 1999/2000, with students in our study expressing a more positive attitude toward vaccination. Students enrolled in the chiropractic program at CMCC in the 2011/12 expressed a positive attitude toward vaccination.

  2. Attitudes toward vaccination: A cross-sectional survey of students at the Canadian Memorial Chiropractic College

    PubMed Central

    Lameris, Marlee; Schmidt, Catherine; Gleberzon, Brian; Ogrady, Jillian

    2013-01-01

    Introduction: The purpose of this study was to conduct an online survey of chiropractic students in the 2011/12 academic year at CMCC in order to determine their attitudes toward vaccination, their history of vaccination and their opinions towards their level of preparedness and confidence to discuss vaccination with patients. Method: All students enrolled in the program at CMCC were eligible to participate in this anonymous survey modeled after a similar survey administered in 1999/2000. Results: The response rate was 43%. Over 90% of all students reported they had been vaccinated. Roughly half of students felt they were well prepared to discuss vaccination with their patients and two-thirds felt they were confident to do so. Between 83.9% and 90% of students in various years of the program expressed a positive attitude toward vaccination. Discussion: Separate Welsh t-test for each year of study indicated statistically significant differences between our survey and the survey published in 1999/2000, with students in our study expressing a more positive attitude toward vaccination. Conclusion: Students enrolled in the chiropractic program at CMCC in the 2011/12 expressed a positive attitude toward vaccination. PMID:23997247

  3. AN INCREASE IN RISK FACTORS FOR CARDIOVASCULAR DISEASE IN YOGYAKARTA, INDONESIA: A COMPARISON OF TWO CROSS-SECTIONAL SURVEYS.

    PubMed

    Dewi, F S T; Stenlund, H; Hakimi, M; Weinehall, L

    2015-07-01

    This paper aims to describe changes in risk factors for cardiovascular disease (CVD) over a five year period in urban Indonesia. In 2004 (n = 3,205) and 2009 (n = 2,467) we conducted cross-sectional surveys of residents in Yogjakarta City, Indonesia evaluating risk factors for CVD. Smoking habits, fruit and vegetable intake, physical activity, blood pressure, weight, and height were recorded. The results of these 2 surveys conducted 5 years apart were then compared. The risk for having a CVD event was also calculated. Behavioral CVD risk factors were more common among men. The predicted risk of having a CVD event increased from 8.4% to 11.3% among men between 2004 and 2009. Effective measures need to be taken to change these behaviors among men in Yogyakarta, Indonesia.

  4. Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross sectional surveys.

    PubMed Central

    Magnus, P.; Jaakkola, J. J.

    1997-01-01

    OBJECTIVES: To review repeated surveys of the rising prevalence of obstructive lung disease among children and young adults and determine whether systematic biases may explain the observed trends. DESIGN: Review of published reports of repeated cross sectional surveys of asthma and wheezing among children and young adults. The repeated surveys used the same sampling frame, the same definition of outcome variables, and equivalent data collection methods. SETTING: Repeated surveys conducted anywhere in the world. SUBJECTS: All repeated surveys whose last set of results were published in 1983 or later. MAIN OUTCOME MEASURES: Lifetime and current prevalences of asthma and current prevalence of wheezing. The absolute increase (yearly percentage) in the prevalences of asthma and wheezing was calculated and compared between studies. RESULTS: 16 repeated surveys fulfilled the inclusion criteria. 12 reported increases in the current prevalence of asthma (from 0.09% to 0.97% a year) and eight reported increases in the current prevalence of wheezing (from 0.14% to 1.24% a year). Changes in labelling are likely to have occurred for the reporting of asthma, and information biases may have occurred for the reporting of wheezing. Only one study reported an increase in an objective measurement. CONCLUSIONS: The evidence for increased prevalences of asthma and wheezing is weak because the measures used are susceptible to systematic errors. Until repeated surveys incorporating more objective data are available no firm conclusions about increases in obstructive lung disease among children and young adults can be drawn. PMID:9224081

  5. Influence of internal migration on reproductive health in Myanmar: results from a recent cross-sectional survey.

    PubMed

    Sudhinaraset, May; Diamond-Smith, Nadia; Thet, May Me; Aung, Tin

    2016-03-09

    Maternal and reproductive health remains a significant public health issue in Myanmar. Little data exists on women's health issues, including social and demographic influences. While past studies have demonstrated rural/urban health disparities, an increasingly important population resulting from urban growth in Myanmar is the internal migrant population, individuals moving within the country for better job or educational opportunities. Past studies suggest that women make up more than half of internal migrants, yet there is a dearth of information on this new wave of migration, particularly on women's reproductive health issues. The objective of this study is to assess the influence of women's migration in Myanmar on reproductive health outcomes, including delivering in a facility, using a skilled birth attendant, and using a modern method of family planning. Data from a cross-sectional household survey using multistage cluster sampling design conducted between September to October 2014 was used to assess the accessibility and the use of maternal and child health products and services. A total of 1800 currently married women of reproductive age, including 348 from urban and 1452 from rural areas, were recruited to complete surveys. A set of multivariable regressions was performed to assess reproductive health outcomes and predictors. Across health indicators, female migrants had better health outcomes compared to non-migrants. Controlling for demographic characteristics, migrants were 1.60 times more likely to use a modern form of family planning compared to non-migrants (p < 0.01) and use antenatal care during pregnancy (p < 0.05). While not statistically significant, migrants were 1.29 times more likely to deliver with a skilled attendant and 1.08 times more likely to deliver in a facility. This study found that female migrants in Myanmar reported better health outcomes compared to non-migrant women in regards to family planning and maternal health

  6. The State of Addictions Education Programs: Results of a National Cross-Sectional Survey.

    ERIC Educational Resources Information Center

    Taleff, Michael J.

    2003-01-01

    Presents the results of an exploratory survey on collegiate addictions studies programs offered in the United States. Eighteen percent of these programs are at the graduate level, 13% at the bachelor's level, and 69% at the associate's level. Counseling courses by far were the most cited addiction studies offered at all academic levels with…

  7. Household food insecurity and diet diversity after the major 2010 landslide disaster in Eastern Uganda: a cross-sectional survey.

    PubMed

    Rukundo, Peter M; Andreassen, Bård A; Kikafunda, Joyce; Rukooko, Byaruhanga; Oshaug, Arne; Iversen, Per Ole

    2016-02-28

    In 2010, a landslide in Bududa, Eastern Uganda, killed about 350 people and nearly 1000 affected households were resettled in Kiryandongo, Western Uganda. A cross-sectional survey assessed household food insecurity and diet diversity among 1078 affected and controls. In Bududa, the affected had a lower adjusted mean score of food insecurity than controls - 9·2 (se 0·4) v. 12·3 (se 0·4) (P<0·01)--but higher diet diversity score (DDS) - 7·1 (se 0·1) v. 5·9 (se 0·1) (P<0·01). On controlling for disaster and covariates, recipients of relief food had higher food insecurity - 12·0 (se 0·6) v. 10·4 (se 0·3) (P=0·02)--whereas farmers had higher DDS - 6·6 (se 0·2) v. 5·6 (se 0·3) (P<0·01). Household size increased the likelihood of food insecurity (OR 1·15; 95% CI 1·00, 1·32; P<0·05) but reduced DDS (OR 0·93; 95% CI 0·87, <1·00; P=0·04). Low DDS was more likely in disaster affected (OR 4·22; 95% CI 2·65, 6·72; P<0·01) and farmers (OR 2·52; 95% CI 1·37, 4·64; P<0·01). In Kiryandongo, affected households had higher food insecurity - 12·3 (se 0·8) v. 2·6 (se 0·8) (P<0·01)--but lower DDS - 5·8 (se 0·3) v. 7·0 (se 0·3) (P=0·02). The latter reduced with increased age (OR 0·99; 95% CI 0·97, 1·00; P<0·05), lowest education (OR 0·54; 95% CI 0·31, 0·93; P=0·03), farmers (OR 0·59; 95 % CI 0·35, 0·98; P=0·04) and asset ownership (OR 0·56; 95% CI 0·39, 0·81; P<0·01). Addressing social protection could mitigate food insecurity.

  8. [Cross-sectional survey of smoking and smoking cessation behaviors in adults in Jiangxi province, 2013].

    PubMed

    Chen, Y Y; Zhu, L P; Yan, W; Liu, J; Ji, L; Xu, Y

    2017-05-10

    Objective: To describe the prevalence of smoking and smoking cessation in adults of Jiangxi province in 2013. Methods: Multi-stage stratified cluster random sampling method was used to select 6 000 individuals aged ≥18 years from 10 chronic and non-communicable disease and risk factor surveillance points of Jiangxi province in 2013. A face-to-face questionnaire survey was carried out to collect information about the risk factors for chronic and non-communicable diseases and 5 997 records were used in final analysis of smoking and smoking cessation. Sample was weighted to represent the adult population of Jiangxi province. The prevalence of different groups were analyzed. Results: The prevalence of current smoking of the sample was 21.53% (1 291/5 997). After complex weighting, the prevalence of smoking was 26.07% in adults in Jiangxi (95%CI:23.48%-28.66%), and it was much higher in men (50.62%, 95%CI: 46.31%-54.94%) than in women(1.46%, 95%CI: 0.57%-2.35%), the difference was statistically significant (P<0.05). The differences in smoking prevalence were significant among different age groups (P=0.029), and the smoking prevalence increased with educational level, but decreased with the worse of self-reported health condition. Most current smokers smoked every day (87.16%, 95%CI: 83.29%-91.03%) and averagely 19.27 (95%CI: 17.69-20.85) cigarettes were smoked daily. The proportion of smokers with average daily consumption ≥20 cigarettes was 64.74% (95%CI: 55.79%-73.70%). The smokers'average age of starting daily smoking was 20.28 (95%CI: 19.74-20.82) years old, which was lower in men [20.11(95%CI: 19.61-20.61) years old] than in women [26.88(95%CI: 24.73-29.03) years old], the difference was statistically significant (P<0.05). Among the male smokers, 27.04%(95%CI:18.91%-35.16%) of male smokers was less than 18 years old when they started daily smoking, and the proportion was 17.46%(95%CI: 0%-37.71%) in female smokers. The smoking cessation rate was 14.80% (95%CI

  9. Attitudes, beliefs and behaviours of Australia dietitians regarding dietary supplements: A cross-sectional survey.

    PubMed

    Marx, Wolfgang; Kiss, Nicole; McKavanagh, Daniel; Isenring, Elisabeth

    2016-11-01

    The aim of this study was to investigate the attitudes, beliefs and behaviors of Australian dietitians regarding dietary supplements. An online survey was disseminated through the mailing lists of multiple healthcare organizations. There were 231 Australian dietitians that replied to the online survey. The results indicate that Australian dietitians are interested in dietary supplements (65%); however, the results also indicate that Australian dietitians are tentative about integrating dietary supplements into their dietetic practice. Concerns regarding potential drug-nutrient/herbal interactions were reported as the primary barrier (67%) to utilizing dietary supplements as part of clinical practice. In addition, there was a strong interest in additional training in dietary supplements (79%). In summary, Australian dietitians are interested in the use of dietary supplements; however, due to current barriers, few dietitians utilize dietary supplements as part of dietetic practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. A cross-sectional survey on wounds in horses in New Zealand.

    PubMed

    Theoret, C L; Bolwell, C F; Riley, C B

    2016-03-01

    To determine the frequency and type of skin wounds encountered by New Zealand veterinarians in their equine patients, the duration and estimated costs of treatment as well as the expected outcomes for these wounds. An online survey was sent to all veterinarians registered with the New Zealand Equine Veterinary Association. The survey comprised questions on the location and experience of respondents, the number of wound-related cases in relation to the total equine caseload, the type and anatomical location of wounds treated, the frequency, duration and costs of treatments, the outcome of wound treatment and an estimate of the most common causes of death or euthanasia in their equine patients. The survey response rate was 110/262 (41.9%). The median number of equine cases seen by respondents was 20 (interquartile range (IQR) 6-60) per month; of these, five (IQR 2-10) were wound related. Wounds ranked third after lameness and respiratory disease for the relative frequency with which respondents encountered them. Of 102 respondents 59 (58%) reported that their clients frequently treated wounds incurred by their horse without consulting a veterinarian. Wounds on the distal limb, whether involving only the skin or also deeper structures, were reported by 86/101 (85%) respondents as the most frequently encountered. Wounds in this location also incurred the longest treatment period and were the most prone to develop complications. Finally, wounds ranked second, after colic, as the most common cause of death/euthanasia in the veterinary respondents' equine patients. The data obtained via the survey indicate that skin wounds, particularly on the distal limb, are a common occurrence in horses in New Zealand and, when they involve structures underlying the skin, are costly and time-consuming to manage and may lead to decreased performance, retirement or euthanasia. Consequently, we recommend that more effort be devoted to the education of equine veterinarians and owners, and

  11. Perceptions of Intimate Partner Violence: a cross sectional survey of surgical residents and medical students

    PubMed Central

    Sprague, Sheila; Kaloty, Roopinder; Madden, Kim; Dosanjh, Sonia; Mathews, Dave J.; Bhandari, Mohit

    2013-01-01

    Abstract: Background: Intimate partner violence (IPV) is an important health issue. Many medical students and residents have received training relating to IPV, but previous studies show that many students feel that their training has been inadequate. Our objective was to assess the knowledge, attitudes and perceptions about IPV among university medical students and surgical residents. Methods: We administered an online survey to a sample of Ontario medical students and surgical residents. The survey instrument was a modified version of the Provider Survey. Results: Two hundred medical students and surgical residents participated in the survey (response rate: 29%). Misperceptions about IPV among respondents included the following: 1) victims must get something from the abusive relationships (18.2%), 2) physicians should not interfere with a couple’s conflicts (21%), 3) asking about IPV risks offending patients (45%), 4) Victims choose to be victims (11.1%), 5) it usually takes ‘two to tango’ (18.3%), and 6) some patients’ personalities cause them to be abused (41.1%). The majority of respondents (75.0%) believed identifying IPV was very relevant to clinical practice. The majority of medical students (91.2%) and surgical residents (96.9%) estimated the IPV prevalence in their intended practice to be 10% or less. Most of the medical students (84%) and surgical residents (60%) felt that their level of training on IPV was inadequate and over three quarters of respondents (77.2%) expressed a desire to receive additional education and training on IPV. Conclusions: There are misconceptions among Canadian medical students and surgical residents about intimate partner violence. These misconceptions may stem from lack of education and personal discomfort with the issue or from other factors such as gender. Curricula in medical schools and surgical training programs should appropriately emphasize educational opportunities in the area of IPV. PMID:21926470

  12. Cross-Sectional and Panel Data Analyses of an Incompletely Observed Variable Derived from the Nonrandomized Method for Surveying Sensitive Questions

    ERIC Educational Resources Information Center

    Yamaguchi, Kazuo

    2016-01-01

    This article describes (1) the survey methodological and statistical characteristics of the nonrandomized method for surveying sensitive questions for both cross-sectional and panel survey data and (2) the way to use the incompletely observed variable obtained from this survey method in logistic regression and in loglinear and log-multiplicative…

  13. Impulse control disorders in Parkinson disease: a cross-sectional study of 3090 patients.

    PubMed

    Weintraub, Daniel; Koester, Juergen; Potenza, Marc N; Siderowf, Andrew D; Stacy, Mark; Voon, Valerie; Whetteckey, Jacqueline; Wunderlich, Glen R; Lang, Anthony E

    2010-05-01

    An association between dopamine-replacement therapies and impulse control disorders (ICDs) in Parkinson disease (PD) has been suggested in preliminary studies. To ascertain point prevalence estimates of 4 ICDs in PD and examine their associations with dopamine-replacement therapies and other clinical characteristics. Cross-sectional study using an a priori established sampling procedure for subject recruitment and raters blinded to PD medication status. Three thousand ninety patients with treated idiopathic PD receiving routine clinical care at 46 movement disorder centers in the United States and Canada. The Massachusetts Gambling Screen score for current problem/pathological gambling, the Minnesota Impulsive Disorders Interview score for compulsive sexual behavior and buying, and Diagnostic and Statistical Manual of Mental Disorders research criteria for binge-eating disorder. An ICD was identified in 13.6% of patients (gambling in 5.0%, compulsive sexual behavior in 3.5%, compulsive buying in 5.7%, and binge-eating disorder in 4.3%), and 3.9% had 2 or more ICDs. Impulse control disorders were more common in patients treated with a dopamine agonist than in patients not taking a dopamine agonist (17.1% vs 6.9%; odds ratio [OR], 2.72; 95% confidence interval [CI], 2.08-3.54; P < .001). Impulse control disorder frequency was similar for pramipexole and ropinirole (17.7% vs 15.5%; OR, 1.22; 95% CI, 0.94-1.57; P = .14). Additional variables independently associated with ICDs were levodopa use, living in the United States, younger age, being unmarried, current cigarette smoking, and a family history of gambling problems. Dopamine agonist treatment in PD is associated with 2- to 3.5-fold increased odds of having an ICD. This association represents a drug class relationship across ICDs. The association of other demographic and clinical variables with ICDs suggests a complex relationship that requires additional investigation to optimize prevention and treatment

  14. Associations Between Sleep Quality and Migraine Frequency: A Cross-Sectional Case-Control Study.

    PubMed

    Lin, Yu-Kai; Lin, Guan-Yu; Lee, Jiunn-Tay; Lee, Meei-Shyuan; Tsai, Chia-Kuang; Hsu, Yu-Wei; Lin, Yu-Zhen; Tsai, Yi-Chien; Yang, Fu-Chi

    2016-04-01

    Migraine has been associated with sleep disturbances. Relationship between sleep quality and migraine frequency is yet to be determined. The present study aimed to investigate sleep disturbances among low-frequency, moderate-frequency, high-frequency, and chronic migraineurs, with and without auras, with well-controlled confounding variables.This cross-sectional controlled study included 357 subjects from an outpatient headache clinic in Taiwan. Standardized questionnaires were utilized to collect demographic, migraine, sleep, depression, anxiety, and restless leg syndrome characteristics in all participants. According to frequency of migraine attacks, patients were divided into 4 groups: with 1 to 4 migraine days per month, 5 to 8 migraine days in a month, 9 to 14 migraine days in a month, and >14 migraine days per month. The Pittsburgh Sleep Quality Index (PSQI) and subgroup items were used to evaluate sleep quality. The association between migraine frequency and sleep quality was investigated using multivariable linear regression and logistic regression.The PSQI total score was highest in patients with high frequent migraine (10.0 ± 3.4) and lowest in controls (7.0 ± 3.4) with a significant trend analysis (P for trend = 0.006). Migraine frequency had an independent effect on the items "Cannot get to sleep within 30 minutes" (P < 0.001), "Wake up in the middle of the night or early morning" (P < 0.001), "Bad dreams" (P = 0.001), "Pain" (P = 0.004), and "Quality of sleep" (P < 0.001). The result showed the effect of migraine frequency in both the aura-present (P for trend = 0.008) and the aura-absent subgroups (P for trend = 0.011).High migraine frequency correlates with poor sleep quality and a higher prevalence of poor sleepers. These associations occur in migraine with aura and without aura.

  15. Food responsiveness, parental food control and anthropometric outcomes among young American Indian children: cross-sectional and prospective findings.

    PubMed

    Fulkerson, Jayne A; Hannan, Peter; Rock, Bonnie Holy; Smyth, Mary; Himes, John H; Story, Mary

    2013-01-01

    Assess cross-sectional and prospective associations between food responsiveness and parental food control and anthropometric outcomes among American Indian children. Parents/caregivers completed psychosocial surveys and trained staff measured children's anthropometry at baseline (kindergarten) and at follow-up (1st grade) as part of a school-based obesity prevention trial (Bright Start). On/near the Pine Ridge Indian reservation. 422 child (51% female, mean age=5.8 years, 30% overweight/obese) and parent/caregiver (89% mothers) dyads. Two independent variables (child's Food Responsiveness and Parental Control scales) and six child anthropometric dependent variables (overweight status, body mass index z-score, % body fat, waist circumference, triceps skinfold, subscapular skinfold). Linear regression analyses, stratified by sex and adjusted for age and treatment condition. Baseline Food Responsiveness scale scores were positively associated with all six baseline anthropometric outcomes among boys (P's all <.01), but not girls. Parental Control scale scores were not significantly associated with outcomes and no prospective associations were statistically significant. Responsiveness to food may be associated with excess adiposity in young American Indian boys, however, the effects are not detectable over time. Obesity prevention programs for American Indian children may benefit by addressing eating without hunger among boys.

  16. Effectiveness of tobacco control television advertising in changing tobacco use in England: a population-based cross-sectional study.

    PubMed

    Sims, Michelle; Salway, Ruth; Langley, Tessa; Lewis, Sarah; McNeill, Ann; Szatkowski, Lisa; Gilmore, Anna B

    2014-06-01

    To examine whether government-funded tobacco control television advertising shown in England between 2002 and 2010 reduced adult smoking prevalence and cigarette consumption. Analysis of monthly cross-sectional surveys using generalised additive models. England. More than 80 000 adults aged 18 years or over living in England and interviewed in the Opinions and Lifestyle Survey. Current smoking status, smokers' daily cigarette consumption, tobacco control gross rating points (GRPs-a measure of per capita advertising exposure combining reach and frequency), cigarette costliness, tobacco control activity, socio-demographic variables. After adjusting for other tobacco control policies, cigarette costliness and individual characteristics, we found that a 400-point increase in tobacco control GRPs per month, equivalent to all adults in the population seeing four advertisements per month (although actual individual-level exposure varies according to TV exposure), was associated with 3% lower odds of smoking 2 months later [odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.95, 0.999] and accounted for 13.5% of the decline in smoking prevalence seen over this period. In smokers, a 400-point increase in GRPs was associated with a 1.80% (95%CI = 0.47, 3.11) reduction in average cigarette consumption in the following month and accounted for 11.2% of the total decline in consumption over the period 2002-09. Government-funded tobacco control television advertising shown in England between 2002 and 2010 was associated with reductions in smoking prevalence and smokers' cigarette consumption. © 2014 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  17. THE ASSOCIATION BETWEEN MENSTRUAL CYCLE CHARACTERISTICS AND PERCEIVED BODY IMAGE: A CROSS-SECTIONAL SURVEY OF POLISH FEMALE ADOLESCENTS.

    PubMed

    Kaczmarek, Maria; Trambacz-Oleszak, Sylwia

    2016-05-01

    The increasing prevalence of negative body perceptions among adolescent girls and the tendency towards wishing to be thinner have become a cultural norm in Western culture. Adolescent girls are particularly vulnerable to developing a negative body image due to physical and sexual changes occurring during puberty. This study aimed to evaluate the association between different measures of body image perceptions and different phases of the menstrual cycle after controlling for weight status and other potential confounders in Polish adolescent girls aged 12-18 years. Three-hundred and thirty participants of a cross-sectional survey conducted in 2009, normally cycling and with no eating disorders, completed a background questionnaire and the Stunkard Figure Rating Scale, and their anthropometric measurements were collected. The dependent outcome variables were measures of body image (actual body image, ideal body image and ideal-self discrepancy) and dichotomous body image perception (satisfied versus dissatisfied) adjusted for other predictor factors: socio-demographic variables, menstrual history and cycle phases, and weight status. One-way ANOVA indicated that weight status, age at menarche and menstrual cycle phase were associated with actual body image and rate of ideal-self discrepancy. Ideal body image was associated with weight status and menstrual cycle phase. General logistic regression models were constructed to evaluate associations of body dissatisfaction and all potential predictor variables. The final selected model of the multiple logistic regression analysis using the backward elimination procedure revealed that adjusted for other factors, negative body image was significantly associated with different phases of the menstrual cycle (p trend=0.033) and increasing body weight status (p trend=0.0007). The likelihood of body dissatisfaction was greatest during the premenstrual phase of the menstrual cycle (OR=2.38; 95% CI 1.06, 5.32) and among girls in

  18. Rotating resident didactics in the emergency department: a cross-sectional survey on current curricular practices.

    PubMed

    Branzetti, Jeremy B; Aldeen, Amer Z; Mark Courtney, D

    2010-10-01

    Rotating (non-emergency medicine [EM]) residents perform clinical rotations in many academic emergency departments (EDs). The primary objective of this work was to quantify characteristics of rotating residents and the didactic curricula offered to them during their EM rotations. Secondary objectives were to identify barriers to instituting such didactics and to establish ideal curricular contents. A Web-based survey was administered by e-mail to residency directors of all U.S. allopathic EM residency programs. Consent was obtained in the first part of the survey, and the study was deemed exempt from full review by the institutional review board. Questions solicited information regarding type and quantity of rotating residents in their main EDs, the "didactic educational format" available to rotating residents, and ideal and actual didactic curricular contents. Statistics were reported as proportions and means with 95% confidence intervals (CIs) and medians with interquartile ranges (IQRs). Surveys were sent to 143 programs, and the response rate was 71%. Ninety-nine percent of respondents had rotating residents in their EDs, and the median number per month was 4 (IQR = 3-6). Five percent of respondents had established didactic curricula specifically for rotating residents, and 64% sent them to either EM resident or medical student lectures. Thirty-one percent of programs reported no didactics, and 65% of these felt there was no need for such education. Resuscitation, trauma, and toxicology were cited as the most important subjects for actual and ideal curricula. Most academic EDs have rotating residents, but very few provide didactic education specific to their learning needs and almost a third provide no didactics. © 2010 by the Society for Academic Emergency Medicine.

  19. Reconstructing the PMTCT cascade using cross-sectional household survey data: The PEARL Study

    PubMed Central

    CHI, Benjamin H.; TIH, Pius M.; ZANOLINI, Arianna; STINSON, Kathryn; EKOUEVI, Didier K.; COETZEE, David; WELTY, Thomas K.; BWEUPE, Maximillian; SHAFFER, Nathan; DABIS, Francois; STRINGER, Elizabeth M.; STRINGER, Jeffrey S A

    2016-01-01

    Background Given the ambitious targets to reduce pediatric AIDS worldwide, ongoing assessment of programs to prevent mother-to-child HIV transmission (PMTCT) is critical. The concept of a “PMTCT cascade” has been used widely to identify bottlenecks in program implementation; however, most efforts to reconstruct the cascade have relied on facility-based approaches that may limit external validity. Methods We analyzed data from the PEARL household survey, which measured PMTCT effectiveness in 26 communities across Zambia, South Africa, Cote d’Ivoire, and Cameroon. We recruited women who reported a delivery in the past two years. Among mothers confirmed to be HIV-infected at the time of survey, we reconstructed the PMTCT cascade with self-reported participant information. We also analyzed data about the child’s vital status; for those still alive, HIV testing was performed via DNA PCR. Results Of the 976 eligible women, only 355 (36%) completed every step of the PMTCT cascade. Among the 621 mother-child pairs who did not, 22 (4%) reported never seeking antenatal care, 103 (17%) were not tested for HIV during pregnancy, 395 (64%) reported testing but never received their HIV-positive result, 48 (8%) did not receive maternal antiretroviral prophylaxis, and 53 (9%) did not receive infant antiretroviral prophylaxis. The lowest prevalence of infant HIV infection or death was observed in those completing the cascade (10%, 95%CI: 7%–12%). Conclusions Future efforts to measure population PMTCT impact should incorporate dimensions explored in the PEARL Study – including HIV testing of HIV-exposed children in household surveys – to better understand program effectiveness. PMID:26068722

  20. To Morcellate or Not to Morcellate: A Cross-Sectional Survey Of Gynecologic Surgeons

    PubMed Central

    Apostol, Radu; Greene, Alexis D.; Pilkinton, Marjorie L.

    2017-01-01

    Background and Objectives: The inadvertent dissemination of uterine cancer cells with the power morcellator has received much attention in the press and a warning from the U.S. Food and Drug Administration. Many hospitals prohibit the use of the morcellator in gynecologic surgery. We conducted a survey in an attempt to assess gynecologic surgeons' beliefs regarding the intracorporeal power morcellation of fibroids in light of the risk of dissemination of malignancy in patients in whom the presence of cancer is unknown before surgery. Methods: We conducted an Internet-based survey of 3505 members of the Society of Laparoendoscopic Surgeons (SLS) to assess demographics, current use of the intracorporeal power morcellator, and whether the recent negative press has affected gynecologic surgeons' use of the morcellator. Results: Of the 3505 SLS members surveyed, 518 responded (response rate, 14.77%). Three hundred thirteen (61%) of the respondents were not using the intracorporeal power morcellator. Of those, 48% reported the reason was a hospital-wide ban, and an additional 17% reported lack of availability (not in stock). Senior attendings with >20 years of experience used the morcellator more often than junior attendings and fellows (P = .007). Furthermore, the morcellator was used significantly less among those with the belief that morcellation of occult malignancy affects survival (P = .013). Three hundred sixty-one (76%) of the participants currently perform laparotomy in fewer than a quarter of their cases; most those cases are still performed using laparoscopic and robot-assisted techniques. Conclusion: The recent negative press suggesting that intracorporeal power morcellation can disseminate occult malignancy and affect survival has decreased the use of the morcellator. Despite the declining use of power morcellation, most practicing gynecologic surgeons have not converted their procedures to laparotomy. PMID:28144125

  1. Reducing corruption in a Mexican medical school: impact assessment across two cross-sectional surveys.

    PubMed

    Paredes-Solís, Sergio; Villegas-Arrizón, Ascensio; Ledogar, Robert J; Delabra-Jardón, Verónica; Alvarez-Chávez, José; Legorreta-Soberanis, José; Nava-Aguilera, Elizabeth; Cockcroft, Anne; Andersson, Neil

    2011-12-21

    Corruption pervades educational and other institutions worldwide and medical schools are not exempt. Empirical evidence about levels and types of corruption in medical schools is sparse. We conducted surveys in 2000 and 2007 in the medical school of the Autonomous University of Guerrero in Mexico to document student perceptions and experience of corruption and to support the medical school to take actions to tackle corruption. In both 2000 and 2007 medical students completed a self-administered questionnaire in the classroom without the teacher present. The questionnaire asked about unofficial payments for admission to medical school, for passing an examination and for administrative procedures. We examined factors related to the experience of corruption in multivariate analysis. Focus groups of students discussed the quantitative findings. In 2000, 6% of 725 responding students had paid unofficially to obtain entry into the medical school; this proportion fell to 1.6% of the 436 respondents in 2007. In 2000, 15% of students reported having paid a bribe to pass an examination, not significantly different from the 18% who reported this in 2007. In 2007, students were significantly more likely to have bribed a teacher to pass an examination if they were in the fourth year, if they had been subjected to sexual harassment or political pressure, and if they had been in the university for five years or more. Students resented the need to make unofficial payments and suggested tackling the problem by disciplining corrupt teachers. The university administration made several changes to the system of admissions and examinations in the medical school, based on the findings of the 2000 survey. The fall in the rate of bribery to enter the medical school was probably the result of the new admissions system instituted after the first survey. Further actions will be necessary to tackle the continuing presence of bribery to pass examinations and for administrative procedures. The

  2. Variability in orthopedic surgeon treatment preferences for nondisplaced scaphoid fractures: A cross-sectional survey.

    PubMed

    Paulus, Megan Carroll; Braunstein, Jake; Merenstein, Daniel; Neufeld, Steven; Narvaez, Michael; Friedland, Robert; Bruce, Katherine; Pfaff, Ashley

    2016-12-01

    The absence of a best practice treatment standard contributes to clinical variation in medicine. Often in the absence of evidence, a standard of care is developed and treatment protocols are implemented. The purpose of this study was to examine whether the standard of care for the treatment of nondisplaced scaphoid fractures is uniform among orthopedic surgeons. A survey of orthopedic surgeons actively practicing in the US or abroad was conducted to elicit preferred treatment strategies for nondisplaced scaphoid fractures. The surgeons were recruited at orthopedic conferences, clinical visits, and via email. The survey included demographic questions along with a short clinical vignette. The option for fracture management included surgical versus nonsurgical treatment. For those who chose nonsurgical treatment, type/duration of immobilization was recorded. Cost analysis was performed to estimate direct and indirect costs of various treatment options. A total of 494 orthopedic surgeons completed the survey. The preference for surgical treatment was preferred in 13% of respondents. Hand/upper extremity specialists were significantly more likely to operate compared with generalists (p = 0.0002). Surgeons younger than forty-five were nearly twice as likely to choose surgery (p = 0.01). There was no clear consensus on duration of immobilization as 30% of surgeons chose 6 weeks, 33% selected 8 weeks, and 27% opted for 12 weeks. Total cost of surgery was 49% greater than that of nonoperative treatment. With each additional week of immobilization for nonoperative treatment, the total costs of surgical treatment near that of nonoperative treatment. There exist clear trends in how specific demographic groups choose to treat the nondisplaced scaphoid fracture. Whether these trends are the result of generational gaps or additional subspecialty training remains difficult to determine, but there is need to pursue a more consistent approach that benefits the patients and the

  3. Knowledge of binge eating disorder: a cross-sectional survey of physicians in the United States.

    PubMed

    Supina, Dylan; Herman, Barry K; Frye, Carla B; Shillington, Alicia C

    2016-01-01

    Binge eating disorder (BED)--now a designated disorder in the DSM-5--is the most prevalent eating disorder (ED), affecting 2-3% of the US population. This survey of US physicians assesses how BED is diagnosed, treated and referred. Internists, family practitioners, obstetrics/gynecologist (OB/GYNs) and psychiatrists were randomly selected from a nationally-representative panel. Participants completed an online survey and reviewed case vignettes consistent with DSM-5-defined BED, then answered questions to elicit whether they would assess for psychiatric conditions including EDs. Those reporting they would screen and who correctly identified BED in vignettes received additional questions about BED diagnosis, treatment, and referral patterns. Of 278 physicians surveyed, 96% were board-certified and 87% had practiced >10 years. 23% were psychiatrists, 27% family practitioners, 31% internists and 19% OB/GYNs. 92% were 'somewhat likely' to screen for ED after reviewing DSM-5-consistent vignettes. 206 (74%) correctly identified BED. Of these, 33% and 68% reported they proactively screen eating habits for all patients and obese patients, respectively. 10% reported not screening eating habits even in the presence of ED symptoms. Fewer than half reported using DSM criteria in Diagnosing BED, and 56 (27%) did not recognize BED to be a discreet ED. Although ED awareness is improving, understanding BED as a distinct ED is lacking, which may result in low rates of screening and diagnosis. This study illustrates how taking a complete patient history (including probing BED characteristics) may be an effective first-line strategy for clinicians to facilitate optimal care for these patients.

  4. To Morcellate or Not to Morcellate: A Cross-Sectional Survey Of Gynecologic Surgeons.

    PubMed

    Nezhat, Farr; Apostol, Radu; Greene, Alexis D; Pilkinton, Marjorie L

    2017-01-01

    The inadvertent dissemination of uterine cancer cells with the power morcellator has received much attention in the press and a warning from the U.S. Food and Drug Administration. Many hospitals prohibit the use of the morcellator in gynecologic surgery. We conducted a survey in an attempt to assess gynecologic surgeons' beliefs regarding the intracorporeal power morcellation of fibroids in light of the risk of dissemination of malignancy in patients in whom the presence of cancer is unknown before surgery. We conducted an Internet-based survey of 3505 members of the Society of Laparoendoscopic Surgeons (SLS) to assess demographics, current use of the intracorporeal power morcellator, and whether the recent negative press has affected gynecologic surgeons' use of the morcellator. Of the 3505 SLS members surveyed, 518 responded (response rate, 14.77%). Three hundred thirteen (61%) of the respondents were not using the intracorporeal power morcellator. Of those, 48% reported the reason was a hospital-wide ban, and an additional 17% reported lack of availability (not in stock). Senior attendings with >20 years of experience used the morcellator more often than junior attendings and fellows (P = .007). Furthermore, the morcellator was used significantly less among those with the belief that morcellation of occult malignancy affects survival (P = .013). Three hundred sixty-one (76%) of the participants currently perform laparotomy in fewer than a quarter of their cases; most those cases are still performed using laparoscopic and robot-assisted techniques. The recent negative press suggesting that intracorporeal power morcellation can disseminate occult malignancy and affect survival has decreased the use of the morcellator. Despite the declining use of power morcellation, most practicing gynecologic surgeons have not converted their procedures to laparotomy.

  5. Clinical experience and perception of abortion: A cross-sectional survey of gynecologists in Japan.

    PubMed

    Mizuno, Maki

    2015-12-01

    This study describes aspects of early induced abortion from the experience and perspectives of a sample of gynecologists in Japan. The survey questionnaire data were collected from 343 gynecologists from September to October 2010. Approximately 83% of participants preferred using only dilation and curettage (D&C), and 10.4% used electric vacuum aspiration (EVA). The cost of surgical abortion was not covered by insurance. Most gynecologists used intravenous pain management during abortion. Approximately 50% of the gynecologists were opposed to introducing medical abortion in Japan. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Financial ties of principal investigators and randomized controlled trial outcomes: cross sectional study.

    PubMed

    Ahn, Rosa; Woodbridge, Alexandra; Abraham, Ann; Saba, Susan; Korenstein, Deborah; Madden, Erin; Boscardin, W John; Keyhani, Salomeh

    2017-01-17

     To examine the association between the presence of individual principal investigators' financial ties to the manufacturer of the study drug and the trial's outcomes after accounting for source of research funding.  Cross sectional study of randomized controlled trials (RCTs).  Studies published in "core clinical" journals, as identified by Medline, between 1 January 2013 and 31 December 2013.  Random sample of RCTs focused on drug efficacy.  Association between financial ties of principal investigators and study outcome.  A total of 190 papers describing 195 studies met inclusion criteria. Financial ties between principal investigators and the pharmaceutical industry were present in 132 (67.7%) studies. Of 397 principal investigators, 231 (58%) had financial ties and 166 (42%) did not. Of all principal investigators, 156 (39%) reported advisor/consultancy payments, 81 (20%) reported speakers' fees, 81 (20%) reported unspecified financial ties, 52 (13%) reported honorariums, 52 (13%) reported employee relationships, 52 (13%) reported travel fees, 41 (10%) reported stock ownership, and 20 (5%) reported having a patent related to the study drug. The prevalence of financial ties of principal investigators was 76% (103/136) among positive studies and 49% (29/59) among negative studies. In unadjusted analyses, the presence of a financial tie was associated with a positive study outcome (odds ratio 3.23, 95% confidence interval 1.7 to 6.1). In the primary multivariate analysis, a financial tie was significantly associated with positive RCT outcome after adjustment for the study funding source (odds ratio 3.57 (1.7 to 7.7). The secondary analysis controlled for additional RCT characteristics such as study phase, sample size, country of first authors, specialty, trial registration, study design, type of analysis, comparator, and outcome measure. These characteristics did not appreciably affect the relation between financial ties and study outcomes (odds ratio 3.37, 1

  7. Autonomic control of cardiovascular system in pre- and postmenopausal women: a cross-sectional study

    PubMed Central

    Neufeld, Irina W.; Kiselev, Anton R.; Karavaev, Antoly S.; Prokhorov, Mikhail D.; Gridnev, Vladimir I.; Ponomarenko, Vladimir I.; Bezruchko, Boris P.

    2015-01-01

    Objective The aim of this cross-sectional study was to assess the features of autonomic control of the cardiovascular system in pre- and postmenopausal women. Material and Methods We studied 185 postmenopausal women aged 59.3±8.5 years (mean±SD) and 104 premenopausal women aged 45.1±5.8 years. Standard indices of heart rate variability (HRV) (mean heart rate, coefficient of variation, standard deviation of the NN interval (the time elapsing between two consecutive R waves in the electrocardiogram with normal sinus rhythm) (SDNN), square root of the mean squared differences of successive NN intervals (RMSSD), proportion derived by dividing RR50, the number of interval differences of successive NN intervals greater than 50 ms, by the total number of NN intervals (PNN50), and power of low frequency (LF) and high frequency (HF) bands in absolute values and percentages of total spectral power) and index S of synchronization between the 0.1-Hz rhythms in heart rate and photoplethysmogram were compared between these two groups at rest. We assessed the following sex hormones: estradiol, follicle stimulating hormone, dehydroepiandrosterone sulfate, and testosterone. Results Mean heart rate and power of LF and HF bands were significantly different (p<0.05) in pre- and postmenopausal women. The autonomic indices were similar in women with natural and surgical menopause. Some indices (coefficient of variation, SDNN, RMSSD, PNN50, and power of LF and HF bands) showed weak correlation with menopause time in women with natural menopause. In women with surgical menopause, a moderate statistically significant correlation was observed only between menopause time and S index (r=−0.41, p=0.039). In premenopausal women, only testosterone correlated weakly with coefficient of variation, SDNN, PNN50, RMSSD, and power of HF band. In postmenopausal women, no correlations were found. We did not find any significant relationship between autonomic indices and hot flashes, assessed by hot

  8. Quantifying the pediatric surgical need in Uganda: results of a nationwide cross-sectional, household survey.

    PubMed

    Butler, Elissa K; Tran, Tu M; Fuller, Anthony T; Brammell, Alexa; Vissoci, Joao Ricardo; de Andrade, Luciano; Makumbi, Fredrick; Luboga, Samuel; Muhumuza, Christine; Ssennono, Vincent F; Chipman, Jeffrey G; Galukande, Moses; Haglund, Michael M; Smith, Emily R

    2016-11-01

    Little is known about the prevalence of pediatric surgical conditions in low- and middle-income countries. Many children never seek medical care, thus the true prevalence of surgical conditions in children in Uganda is unknown. The objective of this study was to determine the prevalence of surgical conditions in children in Uganda. Using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey, we enumerated 4248 individuals in 2315 households in 105 randomly selected clusters throughout Uganda. Children aged 0-18 were included if randomly selected from the household; for those who could not answer for themselves, parents served as surrogates. Of 2176 children surveyed, 160 (7.4 %) reported a currently untreated surgical condition. Lifetime prevalence of surgical conditions was 14.0 % (305/2176). The predominant cause of surgical conditions was trauma (48.4 %), followed by wounds (19.7 %), acquired deformities (16.2 %), and burns (12.5 %). Of 90 pediatric household deaths, 31.1 % were associated with a surgically treatable proximate cause of death (28/90 deaths). Although some trauma-related surgical burden among children can be adequately addressed at district hospitals, the need for diagnostics, human resources, and curative services for more severe trauma cases, congenital deformities, and masses outweighs the current capacity of hospitals and trained pediatric surgeons in Uganda.

  9. Quality of surgical care in hospitals providing internship training in Kenya: a cross sectional survey.

    PubMed

    Mwinga, Stephen; Kulohoma, Colette; Mwaniki, Paul; Idowu, Rachel; Masasabi, John; English, Mike

    2015-02-01

    To evaluate services in hospitals providing internship training to graduate doctors in Kenya. A survey of 22 internship training hospitals was conducted. Availability of key resources spanning infrastructure, personnel, equipment and drugs was assessed by observation. Outcomes and process of care for pre-specified priority conditions (head injury, chest injury, fractures, burns and acute abdomen) were evaluated by auditing case records. Each hospital had at least one consultant surgeon. Scheduled surgical outpatient clinics, major ward rounds and elective (half day) theatre lists were provided once per week in 91%, 55% and 9%, respectively. In all other hospitals, these were conducted twice weekly. Basic drugs were not always available (e.g. gentamicin, morphine and pethidine in 50%, injectable antistaphylococcal penicillins in 5% hospitals). Fewer than half of hospitals had all resources needed to provide oxygen. One hundred and forty-five of 956 cases evaluated underwent operations under general or spinal anaesthesia. We found operation notes for 99% and anaesthetic records for 72%. Pre-operatively measured vital signs were recorded in 80% of cases, and evidence of consent to operation was found in 78%. Blood loss was documented in only one case and sponge and instrument counts in 7%. Evaluation of surgical services would be improved by development and dissemination of clear standards of care. This survey suggests that internship hospitals may be poorly equipped and documented care suggests inadequacies in quality and training. © 2014 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  10. General Population Knowledge about Extreme Heat: A Cross-Sectional Survey in Lisbon and Madrid.

    PubMed

    Gil Cuesta, Julita; van Loenhout, Joris Adriaan Frank; Colaço, Maria da Conceição; Guha-Sapir, Debarati

    2017-01-28

    Extreme heat is associated with an increased mortality and morbidity. National heat plans have been implemented to minimize the effect of extreme heat. The population's awareness and knowledge of national heat plans and extreme heat is essential to improve the community's behavior and adaptation. A general population survey was conducted in Lisbon and in Madrid to assess this knowledge. We used a questionnaire to interview passers-by. Results were compared between Lisbon and Madrid and between locals and foreigners, using Pearson Chi-square tests and Fisher's exact test. We conducted 260 interviews in six locations of different socio-economic backgrounds in each city. The most frequently mentioned extreme heat-related risk groups were the elderly (79.2%), children (49.6%) and babies (21.5%). The most frequently reported protective measures were increased fluid intake (73.1%) and avoiding exposure to the sun (50.8%). Knowledge about the heat plan was higher in Lisbon (37.2%) than in Madrid (25.2%) (p-value = 0.03). Foreigners had less knowledge of risk groups compared to locals. Heat plans were not widely known in Madrid and Lisbon. Nonetheless, knowledge of practical concepts to face extreme heat, such as certain risk groups and protective measures, was found. Our results were similar to comparable surveys where specific respondents' groups were identified as less knowledgeable. This highlighted the importance of addressing these groups when communicating public health messages on heat. Foreigners should be specifically targeted to increase their awareness.

  11. Goals of care conversation teaching in residency - a cross-sectional survey of postgraduate program directors.

    PubMed

    Roze des Ordons, Amanda; Kassam, Aliya; Simon, Jessica

    2017-01-06

    Residents are commonly involved in establishing goals of care for hospitalized patients. While education can improve the quality of these conversations, whether and how postgraduate training programs integrate such teaching into their curricula is not well established. The objective of this study was to characterize perceptions of current teaching and assessment of goals of care conversations, and program director interest in associated curricular integration. An electronic survey was sent to all postgraduate program directors at the University of Calgary. Quantitative data was analyzed using descriptive statistics and qualitative comments were analyzed using thematic analysis. The survey response rate was 34% (22/64). Formal goals of care conversation teaching is incorporated into 63% of responding programs, and most commonly involves lectures. Informal teaching occurs in 86% of programs, involving discussion, direct observation and role modeling in the clinical setting. Seventy-three percent of programs assess goals of care conversation skills, mostly in the clinical setting through feedback. Program directors believe that over two-thirds of clinical faculty are prepared to teach goals of care conversations, and are interested in resources to teach and assess goals of care conversations. Themes that emerged include 1) general perceptions, 2) need for teaching, 3) ideas for teaching, and 4) assessment of goals of care conversations. The majority of residency training programs at the University of Calgary incorporate some goals of care conversation teaching and assessment into their curricula. Program directors are interested in resources to improve teaching and assessment of goals of care conversations.

  12. Photoionization of Synchrotron-Radiation-Excited Atoms: Separating Partial Cross Sections by Full Polarization Control

    SciTech Connect

    Aloiese, S.; Meyer, M.; Cubaynes, D.; Grum-Grzhimailo, A. N.

    2005-06-10

    Resonant atomic excitation by synchrotron radiation and subsequent ionization by a tunable dye laser is used to study the photoionization of short-lived Rydberg states in Xe. By combining circular and linear polarization of the synchrotron as well as of the laser photons the partial photoionization cross sections were separated in the region of overlapping autoionizing resonances of different symmetry and the parameters of the resonances were extracted.

  13. Factors associated with blood pressure control amongst adults with hypertension in Yaounde, Cameroon: a cross-sectional study

    PubMed Central

    Menanga, Alain; Edie, Sandrine; Boombhi, Jérôme; Musa, Ahmadou Jingi; Mfeukeu, Liliane Kuate; Kingue, Samuel

    2016-01-01

    Background Hypertension is associated with considerable morbidity and mortality. Improvement of its management to reduce adverse cardiovascular outcomes will require an understanding of the patient characteristics and treatment factors associated with uncontrolled blood pressure. Factors that affect blood pressure control have not been sufficiently described in Cameroon. The main goal of our study was to determine the predictors of blood pressure control in patients with hypertension in an urban city in Cameroon. Methods This was descriptive cross-sectional study from five outpatient hypertension consultation units in Hospitals in Yaoundé. Controlled hypertension was defined as blood pressure ≤140/90 mmHg. Logistic regression was used to determine factors associated with blood pressure control. Results Among the 440 patients enrolled in the survey, 280 (63.6%) were females. The mean age was 61 (SD ±11) years. Mean systolic blood pressure (SBP) was 147 mmHg and mean diastolic blood pressure (DBP) was 88 mmHg. Only 36.8% of patients had their mean blood pressure controlled (BP ≤140/90 mmHg). Multivariable logistic regression analysis revealed good adherence to anti-hypertensive medications (OR= 3.99; 95% CI: 2.20–7.23; P<0.000) and dietary lifestyle changes (OR =1.5; 95% CI: 0.53–2.49; P=0.031) to be factors independently associated with controlled hypertension. Conclusions Only one out of three patients has their blood pressure controlled. The results of our study suggest that good adherence to treatment are important factors for tight blood pressure control in primary care. Further identification of patients at risk of non-adherence to treatment and poor blood pressure control can lead to targeted interventions to reduce hypertension related morbidity and mortality in this setting. PMID:27747167

  14. A community-based cross-sectional immunisation survey in parents of primary school students

    PubMed Central

    Hon, Kam Lun; Tsang, Yin Ching K; Chan, Lawrence C N; Ng, Daniel K K; Miu, Ting Yat; Chan, Johnny Y; Lee, Albert; Leung, Ting Fan

    2016-01-01

    Immunisation is a very important aspect of child health. Invasive pneumococcal and influenza diseases have been major vaccine-available communicable diseases. We surveyed demographics and attitudes of parents of primary school students who received pneumococcal conjugate vaccination (PCV) and compared them with those who did not receive pneumococcal vaccination. The survey was carried out in randomly selected primary schools in Hong Kong. Questionnaires were sent to nine primary schools between June and September 2014. Parents of 3,485 children were surveyed, and 3,479 (1,452 PCV immunised, 2,027 un-immunised) valid questionnaires were obtained. Demographic data were generally different between the two groups. PCV-immunised children were more likely to be female (57.0 vs. 52.2%, P=0.005), born in Hong Kong (94.2 vs. 92.3%, P=0.031), have a parent with tertiary education (49.2 vs. 31.8, P<0.0005), from the higher-income group (P=0.005), have suffered upper respiratory infections, pneumonia, otitis media or sinusitis (P=0.019), and have doctor visits in preceding 12 months (P=0.009). They were more likely to have received additional immunisations outside the Hong Kong Childhood Immunization Programme (64.0 vs. 30.6%, P<0.0005) at private practitioner clinics (91.1 vs. 83.5%, P<0.0005). Un-immunised children were more likely to live with senior relatives who had not received PCV. Their parents were less likely to be aware of public education programme on PCV and influenza immunisation, and children were less likely to have received influenza vaccination. The major reasons for PCV immunisations were parent awareness that pneumococcal disease could be severe and vaccines were efficacious in prevention. The major reasons for children not being immunised with PCV were concerns about vaccine side effects, cost, vaccine not efficacious or no recommendation by family doctor or government. In conclusion, PCV unimmunized children were prevalent during the study period

  15. Untreated surgical conditions in Sierra Leone: a cluster randomised, cross-sectional, countrywide survey.

    PubMed

    Groen, Reinou S; Samai, Mohamed; Stewart, Kerry-Ann; Cassidy, Laura D; Kamara, Thaim B; Yambasu, Sahr E; Kingham, T Peter; Kushner, Adam L

    2012-09-22

    Surgical care is increasingly recognised as an important part of global health yet data for the burden of surgical disease are scarce. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) was developed to measure the prevalence of surgical conditions and surgically treatable deaths in low-income and middle-income countries. We administered this survey countrywide in Sierra Leone, which ranks 180 of the 187 nations on the UN Development Index. The study was done between Jan 9 and Feb 3, 2012. 75 of 9671 enumeration areas, the smallest administrative units in Sierra Leone, were randomly selected for the study clusters, with a probability proportional to the population size. In each cluster 25 households were randomly selected to take part in the survey. Data were collected via handheld tablets by trained local medical and nursing students. A household representative was interviewed to establish the number of household members (defined as those who ate from the same pot and slept in the same structure the night before the interview), identify deaths in the household during the previous year, and establish whether any of the deceased household members had a condition needing surgery in the week before death. Two randomly selected household members underwent a head-to-toe verbal examination and need for surgical care was recorded on the basis of the response to whether they had a condition that they believed needed surgical assessment or care. Of the 1875 targeted households, data were analysed for 1843 (98%). 896 of 3645 (25%; 95% CI 22·9-26·2) respondents reported a surgical condition needing attention and 179 of 709 (25%; 95% CI 22·5-27·9) deaths of household members in the previous year might have been averted by timely surgical care. Our results show a large unmet need for surgical consultations in Sierra Leone and provide a baseline against which future surgical programmes can be measured. Additional surveys in other low-income and middle-income countries

  16. Reducing corruption in a Mexican medical school: impact assessment across two cross-sectional surveys

    PubMed Central

    2011-01-01

    Background Corruption pervades educational and other institutions worldwide and medical schools are not exempt. Empirical evidence about levels and types of corruption in medical schools is sparse. We conducted surveys in 2000 and 2007 in the medical school of the Autonomous University of Guerrero in Mexico to document student perceptions and experience of corruption and to support the medical school to take actions to tackle corruption. Methods In both 2000 and 2007 medical students completed a self-administered questionnaire in the classroom without the teacher present. The questionnaire asked about unofficial payments for admission to medical school, for passing an examination and for administrative procedures. We examined factors related to the experience of corruption in multivariate analysis. Focus groups of students discussed the quantitative findings. Results In 2000, 6% of 725 responding students had paid unofficially to obtain entry into the medical school; this proportion fell to 1.6% of the 436 respondents in 2007. In 2000, 15% of students reported having paid a bribe to pass an examination, not significantly different from the 18% who reported this in 2007. In 2007, students were significantly more likely to have bribed a teacher to pass an examination if they were in the fourth year, if they had been subjected to sexual harassment or political pressure, and if they had been in the university for five years or more. Students resented the need to make unofficial payments and suggested tackling the problem by disciplining corrupt teachers. The university administration made several changes to the system of admissions and examinations in the medical school, based on the findings of the 2000 survey. Conclusion The fall in the rate of bribery to enter the medical school was probably the result of the new admissions system instituted after the first survey. Further actions will be necessary to tackle the continuing presence of bribery to pass examinations

  17. Iodine deficiency during pregnancy: a national cross-sectional survey in Latvia.

    PubMed

    Konrade, Ilze; Kalere, Ieva; Strele, Ieva; Makrecka-Kuka, Marina; Jekabsone, Anna; Tetere, Elina; Veisa, Vija; Gavars, Didzis; Rezeberga, Dace; Pīrāgs, Valdis; Lejnieks, Aivars; Dambrova, Maija

    2015-11-01

    Low iodine intake during pregnancy may cause thyroid dysfunction, which results in inadequate fetal brain development. In the absence of a universal salt iodization programme, we conducted a nationwide survey of iodine deficiency in pregnant women in Latvia. A countrywide twenty-cluster survey, with at least twenty women per cluster. Participants completed a questionnaire on dietary habits concerning iodine intake (n 739). Thyroid function (thyroid-stimulating hormone, free thyroxine and thyroperoxidase antibodies) was measured (n 550). Urinary iodine was measured using the ammonium persulfate method (n 696). The survey was performed in all regions of Latvia during the spring and autumn seasons in 2013. Pregnant women (n 829). The median creatinine (Cr)-standardized urinary iodine concentration (UIC) was 80·8 (interquartile range (IQR) 46·1-130·6) µg/g Cr or 69·4 (IQR 53·9-92·6) µg/l during pregnancy, and 81% of pregnant women had UIC levels below the WHO recommended range of 150-250 µg/g Cr. The UIC was lowest during the first trimester of pregnancy, 56·0 (IQR 36·4-100·6) µg/g Cr, reaching higher concentrations of 87·5 (IQR 46·4-141·7) µg/g Cr and 86·9 (IQR 53·8-140·6) µg/g Cr in the second and third trimesters, respectively. Women taking supplements containing ≥150 µg iodine (6·8% of respondents) had non-significantly higher UIC than did women without supplementation (96·2 v. 80·3 µg/g Cr, respectively, P=NS). Thyroperoxidase antibody concentration did not correlate significantly with UIC: Spearman's ρ=-0·012, P=0·78. The median UIC indicates iodine deficiency in pregnant women in Latvia. Iodine supplementation (150 µg daily) and regular UIC monitoring should be suggested to overcome iodine deficiency and to reach the recommended levels without inducing autoimmune processes.

  18. A cross sectional survey of urban Canadian family physicians' provision of minor office procedures.

    PubMed

    Sempowski, Ian P; Rungi, Arne A; Seguin, Rachelle

    2006-03-19

    A discordance exists between the proportion of Canadian family physicians that we expect should be able to perform minor office procedures and the actual provision of care. This pattern has not been extensively studied. The objective of this study was to determine the current patterns and obstacles relating to the provision of four minor office procedures by GP/FPs in a small city in Ontario, Canada. An additional goal was to determine the impact of the remuneration method on the provision of such services. A survey was mailed to all GP/FPs practising in Kingston, Ontario. The main outcomes measured in the study were work setting and remuneration method, current procedural practices with respect to four procedures, reasons for not performing procedures, current skill levels, and desire to upgrade. Surveys were mailed to all 108 GP/FPs in the City of Kingston. Completed surveys were collected for 82 percent (89/108) and 10 were excluded leaving 79 eligible participants. The percentages of GP/FPs who reported performing the procedure were as follows: dermatological excision (63.3%), endometrial biopsy (35.4%), shoulder injection (31.6%), and knee injection (43.0%). The majority of GP/FPs who would not do the