Adult CHD: the ongoing need for physician counselling about heredity and contraceptive options

AbstractPurposeCurrent guidelines recommend that patients with CHD receive age-appropriate counselling on reproduction, pregnancy, and risk of heredity. Our aim was to examine patient knowledge of reproductive health and explore the association between patient knowledge of CHD transmission risk and earlier physician counselling in adults with CHD.MethodsWe performed a cross-sectional survey of patients with CHD aged 18 years and older in a paediatric hospital.ResultsOf the 100 patients who completed the questionnaire, most did not report counselling on heredity (66%) or contraception (71%). Of the 54 women, 25 (46%) identified their contraceptive options correctly; 42 (78%) women were classified as being at significantly increased risk for an adverse outcome during pregnancy, and of these 20 (48%) identified this risk correctly. Of all patients surveyed, 72% did not know that having CHD placed them at increased risk for having a child with CHD. On multivariate analysis, factors associated with correct knowledge about risk of recurrence were correct identification of CHD diagnosis (p=0.04) and patient-reported counselling (p=0.001).ConclusionsKnowledge about heredity, pregnancy risk, and contraceptive options is inadequate among adults with CHD followed-up in a paediatric subspecialty clinic. The majority of patients did not report a history of counselling about reproductive health. There is a strong correlation between history of counselling by the patient’s cardiologist and correct knowledge about recurrence risk, suggesting that effective reproductive counselling can positively impact this knowledge gap.

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Association and interaction of hemoglobin glycation index with hypertension risk: a community-based cross-sectional survey

10.21203/rs.3.rs-29532/v1 ◽

2020 ◽

Author(s):

Jing Mi ◽

Jian Song ◽

Yingying Zhao ◽

xue-sen wu

Keyword(s):

Family History ◽

Interactive Effect ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Hypertension Risk ◽

Increased Risk ◽

History Of ◽

Family History Of Hypertension ◽

Hemoglobin Glycation

Abstract BackgroundHemoglobin glycation index (HGI) is considered to be a convenient measurable indicator to assess the inter-individual variation of HbA1c. In the present study, we tested the relationship between HGI and risk of hypertension, and further explored the possible interacting influences of HGI with other such factors on hypertension risk among Chinese individuals.Methods The eligible subjects were chosen from a community-based cross-sectional survey in China. We collected relevant data and clinical indicators for each participant. HGI was calculated as “measured HbA1c-predicted HbA1c” and divided into four categories according to quartile. The following indicators were used to assess interactive effects：(1) relative excess risk due to interaction (RERI); (2) attributable proportion due to interaction (AP); and (3) synergy index (SI). Statistical analysis was performed using R software.ResultsSpecifically, 1777 eligible participants were selected in this cross-sectional survey. There were 433 subjects who were identified to have hypertension (24.4%). A significant increase in the prevalence of hypertension from Q1 to Q4 of HGI was observed (P<0.001). Multivariable logistic model demonstrated that subjects at the highest HGI group had a substantially increased risk of being hypertensive than subjects in the first quartile of HGI, as indicated by the OR value of 1.87(95%CI: 1.26-2.78). Moreover, a significant interaction between family history of hypertension and HGI on hypertension risk was detected (RERI:1.36,95%CI:0.11-2.63; AP: 0.43, 95%CI:0.17-0.69; and SI:2.68, 95% CI:1.10-6.48). The interactive effect between HGI and abdominal obesity was also found to be significant, as estimated by the value of RERI (1.04, 95%CI:0.24-1.85), AP (0.33, 95% CI: 0.11-0.56) and SI (1.96, 95%CI:1.01-3.79). However, in the analysis of the interaction between HGI and general obesity, only the AP value (0.28, 95%CI: 0.01-0.54) was observed to be significant.ConclusionHigh HGI was independently associated with the risk of hypertension. Moreover, HGI significantly shared interactions with obesity and family history of hypertension that influenced the risk of hypertension.

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Association of hemoglobin glycation index and its interaction with obesity/family history of hypertension on hypertension risk: a community-based cross-sectional survey

10.21203/rs.3.rs-29532/v3 ◽

2020 ◽

Author(s):

Jing Mi ◽

Jian Song ◽

Yingying Zhao ◽

xue-sen wu

Keyword(s):

Family History ◽

Interactive Effect ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Hypertension Risk ◽

Increased Risk ◽

History Of ◽

Family History Of Hypertension ◽

Hemoglobin Glycation

Abstract BackgroundHemoglobin glycation index (HGI) is considered to be a convenient measurable indicator to assess the inter-individual variation of HbA1c. In the present study, we tested the relationship between HGI and risk of hypertension, and further explored the possible interacting influences of HGI with other such factors on hypertension risk among Chinese individuals.Methods The eligible subjects were chosen from a community-based cross-sectional survey in China.We collected relevant data and clinical indicators for each participant. HGI was calculated as “measured HbA1c-predicted HbA1c” and divided into four categories according to quartile. The following indicators were used to assess interactive effects：(1) relative excess risk due to interaction (RERI); (2) attributable proportion due to interaction (AP); and (3) synergy index (SI). Statistical analysis was performed using R software.ResultsSpecifically, 1777 eligible participants were selected in this cross-sectional survey. There were 433 subjects who were identified to have hypertension (24.4%). A significant increase in the prevalence of hypertension from Q1 to Q4 of HGI was observed (P<0.001). Multivariable logistic model demonstrated that subjects at the highest HGI group had a substantially increased risk of being hypertensive than subjects in the first quartile of HGI, as indicated by the OR value of 1.87(95%CI: 1.26-2.78). Moreover, a significant interaction between family history of hypertension and HGI on hypertension risk was detected (RERI:1.36,95%CI:0.11-2.63; AP: 0.43, 95%CI:0.17-0.69; and SI:2.68, 95% CI:1.10-6.48). The interactive effect between HGI and abdominal obesity was also found to be significant, as estimated by the value of RERI (1.04, 95%CI:0.24-1.85), AP (0.33, 95% CI: 0.11-0.56) and SI (1.96, 95%CI:1.01-3.79). However, in the analysis of the interaction between HGI and general obesity, only the AP value (0.28, 95%CI: 0.01-0.54) was observed to be significant.ConclusionHigh HGI was independently associated with the risk of hypertension. Moreover, HGI significantly shared interactions with obesity and family history of hypertension that influenced the risk of hypertension.

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Association of hemoglobin glycation index and its interaction with obesity /family history of hypertension on hypertension risk: a community-based cross-sectional survey

10.21203/rs.3.rs-29532/v2 ◽

2020 ◽

Author(s):

Jing Mi ◽

Jian Song ◽

Yingying Zhao ◽

xue-sen wu

Keyword(s):

Family History ◽

Interactive Effect ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Hypertension Risk ◽

Increased Risk ◽

History Of ◽

Family History Of Hypertension ◽

Hemoglobin Glycation

Abstract Background: Hemoglobin glycation index (HGI) is considered to be a convenient measurable indicator to assess the inter-individual variation of HbA1c. In the present study, we tested the relationship between HGI and risk of hypertension, and further explored the possible interacting influences of HGI with other such factors on hypertension risk among Chinese individuals.Methods : The eligible subjects were chosen from a community-based cross-sectional survey in China. We collected relevant data and clinical indicators for each participant. HGI was calculated as “measured HbA1c-predicted HbA1c” and divided into four categories according to quartile. The following indicators were used to assess interactive effects：(1) relative excess risk due to interaction (RERI); (2) attributable proportion due to interaction (AP); and (3) synergy index (SI). Statistical analysis was performed using R software.Results: Specifically, 1777 eligible participants were selected in this cross-sectional survey. There were 433 subjects who were identified to have hypertension (24.4%). A significant increase in the prevalence of hypertension from Q1 to Q4 of HGI was observed (P<0.001). Multivariable logistic model demonstrated that subjects at the highest HGI group had a substantially increased risk of being hypertensive than subjects in the first quartile of HGI, as indicated by the OR value of 1.87(95%CI: 1.26-2.78). Moreover, a significant interaction between family history of hypertension and HGI on hypertension risk was detected (RERI:1.36,95%CI:0.11-2.63; AP: 0.43, 95%CI:0.17-0.69; and SI:2.68, 95% CI:1.10-6.48). The interactive effect between HGI and abdominal obesity was also found to be significant, as estimated by the value of RERI (1.04, 95%CI:0.24-1.85), AP (0.33, 95% CI: 0.11-0.56) and SI (1.96, 95%CI:1.01-3.79). However, in the analysis of the interaction between HGI and general obesity, only the AP value (0.28, 95%CI: 0.01-0.54) was observed to be significant.Conclusion: High HGI was independently associated with the risk of hypertension. Moreover, HGI significantly shared interactions with obesity and family history of hypertension that influenced the risk of hypertension.

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Epilepsy in context of acquired brain injury (ABI) in a tertiary neuropsychiatric setting

European Psychiatry ◽

10.1016/s0924-9338(11)72590-1 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 885-885

Author(s):

A. Tajer ◽

R.A. Faruqui ◽

S. Bonthala ◽

K. El-Kadi ◽

R. Shah

Keyword(s):

Brain Injury ◽

Acquired Brain Injury ◽

Challenging Behaviour ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk ◽

History Of ◽

Active Epilepsy ◽

Early Seizures

IntroductionEach year around 1/10,000 of general population sustain a traumatic brain injury (7,000 individual in UK) and as a result have an increased risk of epilepsy in the long term.To the best of our knowledge there is not much literature available on incidence and prevalence of epilepsy following ABI in the group of patients who develop psychiatric presentation as a result.AimsTo ascertain the prevalence of epilepsy in a group of in-patients with neuropsychiatric presentation admitted in a tertiary Brain Injury Neuropsychiatry Centre.MethodsA cross sectional survey of healthcare records of 125 in-patients was carried out to ascertain the diagnosis of epilepsy. The current diagnosis of epilepsy and frequency of these patients’ seizures as well as history of early seizures following ABI were noted.ResultsOut of 125 patients studied, 40 (32%) were diagnosed with epilepsy at some point following their brain injury or at the time of survey. Out of these, 35 patients had active epilepsy at the time of the survey with definite seizures witnessed and documented in the in-patients notes. Fifteen patients had had seizures in early phase following their ABI and no seizures reported since.ConclusionsPatients who present with either cognitive impairment, challenging behaviour or and psychiatric illness are at a higher risk of epilepsy compared to those reported in general Brain Injury Neuro-rehabilitation setting. This could be explained by severity of ABI or the areas of brain damaged which may be involved in neuro-psychiatric presentation also causing epilepsy.

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Impact of Adherence, Knowledge, and Quality of Life on Anticoagulation Control

Annals of Pharmacotherapy ◽

10.1345/aph.1e464 ◽

2005 ◽

Vol 39 (4) ◽

pp. 632-636 ◽

Cited By ~ 97

Author(s):

Nichola J Davis ◽

Henny H Billett ◽

Hillel W Cohen ◽

Julia H Arnsten

Keyword(s):

Quality Of Life ◽

New York ◽

Warfarin Therapy ◽

Patient Knowledge ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk ◽

Perceived Impact ◽

Anticoagulation Control

BACKGROUND: Patients receiving chronic warfarin therapy who have poor anticoagulation control are at increased risk for adverse events. However, it is unknown how adherence to warfarin, patient demographics, patient knowledge about therapy, and perceived impact of warfarin therapy on quality of life are associated with anticoagulation control. OBJECTIVE: To determine the association between these patient factors and anticoagulation control in patients attending 2 anticoagulation clinics in the Bronx, New York City. METHODS: A cross-sectional survey of 52 patients was conducted. The 4-item Morisky survey was used to assess self-reported adherence. Patient knowledge about warfarin therapy and the perceived impact of warfarin therapy on quality of life were determined by self-administered questionnaires. Associations between adherence, patient knowledge, impact of warfarin therapy on quality of life, and anticoagulation control were determined with t-tests, χ2 analysis, and logistic regression. RESULTS: Only 14% of patients had good anticoagulation control. Adequate adherence was reported by 50% of patients and was significantly associated with good anticoagulation control (p = 0.01). Thirty-seven percent of participants had good knowledge of anticoagulation, and 19% of participants reported that warfarin negatively impacted their quality of life. Knowledge about warfarin therapy and impact of warfarin on quality of life were not significantly associated with anticoagulation control. CONCLUSIONS: Adherence is one of many factors that contribute to anticoagulation control. Adequate adherence, as determined by the Morisky survey, was significantly associated with anticoagulation control. Patient demographic characteristics, knowledge about warfarin therapy, and perceived impact of warfarin on quality of life were not associated with anticoagulation control.

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Association of hemoglobin glycation index and its interaction with obesity/family history of hypertension on hypertension risk: a community-based cross-sectional survey

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01762-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Jing Mi ◽

Jian Song ◽

Yingying Zhao ◽

Xuesen Wu

Keyword(s):

Family History ◽

Interactive Effect ◽

Cross Sectional Survey ◽

Community Based ◽

Cross Sectional ◽

Hypertension Risk ◽

Increased Risk ◽

History Of ◽

Family History Of Hypertension ◽

Hemoglobin Glycation

Abstract Background Hemoglobin glycation index (HGI) is considered to be a convenient measurable indicator to assess the inter-individual variation of HbA1c. In the present study, we tested the relationship between HGI and risk of hypertension, and further explored the possible interacting influences of HGI with other such factors on hypertension risk among Chinese individuals. Methods The eligible subjects were chosen from a community-based cross-sectional survey in China. We collected relevant data and clinical indicators for each participant. HGI was calculated as “measured HbA1c-predicted HbA1c” and divided into four categories according to quartile. The following indicators were used to assess interactive effects: (1) relative excess risk due to interaction (RERI); (2) attributable proportion due to interaction (AP); and (3) synergy index (SI). Statistical analysis was performed using R software. Results Specifically, 1777 eligible participants were selected in this cross-sectional survey. There were 433 subjects who were identified to have hypertension (24.4%). A significant increase in the prevalence of hypertension from Q1 to Q4 of HGI was observed (p < 0.001). Multivariable logistic model demonstrated that subjects at the highest HGI group had a substantially increased risk of being hypertensive than subjects in the first quartile of HGI, as indicated by the OR value of 1.87 (95% CI 1.26–2.78). Moreover, a significant interaction between family history of hypertension and HGI on hypertension risk was detected (RERI: 1.36, 95% CI 0.11–2.63; AP: 0.43, 95% CI 0.17–0.69; and SI:2.68, 95% CI 1.10–6.48). The interactive effect between HGI and abdominal obesity was also found to be significant, as estimated by the value of RERI (1.04, 95% CI 0.24–1.85), AP (0.33, 95% CI 0.11–0.56) and SI (1.96, 95% CI 1.01–3.79). However, in the analysis of the interaction between HGI and general obesity, only the AP value (0.28, 95% CI 0.01–0.54) was observed to be significant. Conclusion High HGI was independently associated with the risk of hypertension. Moreover, HGI significantly shared interactions with obesity and family history of hypertension that influenced the risk of hypertension.

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Leg length, skull circumference, and the prevalence of dementia in low and middle income countries: a 10/66 population-based cross sectional survey

International Psychogeriatrics ◽

10.1017/s1041610210001274 ◽

2010 ◽

Vol 23 (2) ◽

pp. 202-213 ◽

Cited By ~ 8

Author(s):

Martin Prince ◽

Daisy Acosta ◽

Alan D Dangour ◽

Ricardo Uauy ◽

Mariella Guerra ◽

...

Keyword(s):

Family History ◽

Sampling Error ◽

Leg Length ◽

Reverse Causality ◽

Cross Sectional Survey ◽

Anthropometric Measures ◽

Cross Sectional ◽

Increased Risk ◽

Catchment Areas ◽

History Of

ABSTRACTBackground: Adult leg length is influenced by nutrition in the first few years of life. Adult head circumference is an indicator of brain growth. There is a limited literature linking short legs and small skulls to an increased risk for cognitive impairment and dementia in late life.Methods: One phase cross-sectional surveys were carried out of all residents aged over 65 years in 11 catchment areas in China, India, Cuba, Dominican Republic, Venezuela, Mexico and Peru (n = 14,960). The cross-culturally validated 10/66 dementia diagnosis, and a sociodemographic and risk factor questionnaire were administered to all participants, and anthropometric measures taken. Poisson regression was used to calculate prevalence ratios for the effect of leg length and skull circumference upon 10/66 dementia, controlling for age, gender, education and family history of dementia.Results: The pooled meta-analyzed fixed effect for leg length (highest vs. lowest quarter) was 0.82 (95% CI, 0.68–0.98) and for skull circumference 0.75 (95% CI, 0.63–0.89). While point estimates varied between sites, the proportion of the variability attributable to heterogeneity between studies as opposed to sampling error (I2) was 0% for leg length and 22% for skull circumference. The effects were independent and not mediated by family history of dementia. The effect of skull circumference was not modified by educational level or gender, and the effect of leg length was not modified by gender.Conclusions: Since leg length and skull circumference are said to remain stable throughout adulthood into old age, reverse causality is an unlikely explanation for the findings. Early life nutritional programming, as well as neurodevelopment may protect against neurodegeneration.

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Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

British Journal of General Practice ◽

10.3399/bjgp18x697349 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697349

Author(s):

Anna Lalonde ◽

Emma Teasdale ◽

Ingrid Muller ◽

Joanne Chalmers ◽

Peter Smart ◽

...

Keyword(s):

Mixed Methods ◽

Information Needs ◽

Qualitative Data ◽

Information Provision ◽

Mixed Methods Study ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Face To Face ◽

Patient Information Needs ◽

History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

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Evaluating the readiness of mobile technology in Saudi Arabia: An Integrative Perspective with respect to e-health (Preprint)

10.2196/preprints.22896 ◽

2020 ◽

Author(s):

Fahad Alanezi

Keyword(s):

Saudi Arabia ◽

Health System ◽

Mobile Phones ◽

Personal Data ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Health Apps ◽

History Of ◽

Vision 2030 ◽

Awareness Programs

UNSTRUCTURED E-health system is emerging and providing health services and solutions through different electronic gadgets. Saudi Arabia has launched a program called Saudi Arabia vision 2030, in which providing state-of-the-art health facilities to their citizen is of topmost priority. After all the efforts, the residents of Saudi Arabia are still reluctant for the adaptation of e-health system. The current study was conducted to evaluate the obstacle in adoption of the e-health system through the mobile phones. The current study was cross-sectional survey and was conducted by developing a self-administered structured questionnaire asking the utilization of mobile phone in state of health emergency prior to ask any medical history. Majority of the participants was married and doing jobs in different firms and have their personal mobile phones (p = 0.100, > 0.05) which indicates easily access to the e-health apps. The majority of the participants suffers from either obesity or high blood pressure (p = 0.018, < 0.05) regardless of either history of mental disorder or other family history of mental diseases. The pattern of diseases with mental disorders correlate well with adoption of e-health in government policies. The obstacles in adopting e-health includes fear of the loss of personal data and information (p = 0.0401, < 0.05). Moreover, they did not trust on online medications as the doctor cannot prescribe medicines without seeing physical health of the patient. The current study concluded that by making improvement in policies and proper commercializing the e-health apps together with awareness programs can boast the adoption of e-health in Saudi Arabia.

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Brain smart – Let's play safely: Evaluation of a concussion education program in schools

Journal of Concussion ◽

10.1177/20597002211024447 ◽

2021 ◽

Vol 5 ◽

pp. 205970022110244

Author(s):

Katie Alison Falla ◽

Sarah Randall ◽

Carol DeMatteo

Keyword(s):

School Board ◽

Education Program ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Concussion Management ◽

Chi Squared ◽

Post Test ◽

History Of ◽

Concussion Knowledge ◽

Concussion Education

Objectives There are two objectives for this paper. First, to determine effects of a concussion education program in a local school board in terms of concussion-specific knowledge in children and confidence in identifying and managing concussion in adults. Second, to identify differences and similarities in concussion knowledge between children who participate in sports and those who do not and between children with a history of one or more concussions and those without. Design A cross sectional survey regarding concussion knowledge was distributed randomly to students and adults at both pre- and posteducation timepoints. A concussion education program was disseminated across the school board for students between the distribution survey timepoints. Following the education program, adults and students completed their respective post-test surveys. Chi-squared tests in SPSS determined the significance of between-group differences. Results All 17 adults (100.0%) who had received concussion education recently reported confidence in their knowledge of concussion management, compared to 35.7% adults who had not received education for over a year (p = 0.020). For students, all of whom completed the concussion education training between the pre- and post-tests, there were no significant differences in concussion knowledge scores between athletes and non-athletes (either in or outside of school) or between those with a history of concussion and those without. There were no significant changes in concussion knowledge between the pre- and post-tests, except for one question. Conclusion Concussion education programs increase confidence of concussion management protocols in adults involved in sport, but they require improvements to better support knowledge amelioration, particularly for target groups that are at high risk of sustaining another injury.

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