Factors associated with the practice of minimal counseling by medical residents

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Smoking is a public health problem. Doctors have an important role in the fight against smoking, in particular through the minimum advice they can give. Purpose The aim of this work was to study the prevalence of the application of minimal advice by medical residents and to identify factors that may influence its practice. Methods We conducted a descriptive and analytical study with a prospective data collection that included 302 residents practicing in Tunisia and who agreed to respond to an online questionnaire submitted between February and March 2020. Results Residents mean age was of 28 ± 2 years and the gender ratio was 0.65. Sixty-four percent of residents were non-smokers. During their practice, 94% of residents systematically identified the patient"s smoking status and 61.9% were unfamiliar with the concept of minimal advice. The rate of application of the minimum advice by residents was 57.6%. In multivariate analysis, the factors influencing the application of minimum counseling were: gender (OR =0.321, p = 0.0001), knowledge of minimum counseling (OR = 2.808, p = 0.002) and having attended the minimum advice given by a senior (OR = 2.328, p = 0.0001). Conclusion The rate of application of the minimum advice remains low. Improving one"s theoretical and practical teaching during medical studies is essential.

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Rising patients" adherence to CVD preventive treatment via medical and psychological counseling using remote technologies

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.319 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

OV Kopylova ◽

NA Sirota ◽

VM Yaltonsky

Keyword(s):

Risk Factors ◽

Medical Treatment ◽

Healthy Lifestyle ◽

Preventive Treatment ◽

Control Group ◽

Psychological Counselling ◽

Funding Sources ◽

Item Questionnaire ◽

Experimental Group ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Low adherence to healthy lifestyle and CVD preventive medical treatment is a seriouse problem in lowering of CVD morbidity and mortality. Using modern medical, psychological and remote technologies may help to increase patients" adherence. Purpose To study the efficacy of medical and psychological counselling using remote technologies in rising patients" adherence to CVD preventive treatment. Methods The study included 140 patients with risk factors for cardiovascular disease (RF CVD), who were divided into two comparable groups: group of medical and psychological counselling with the use of remote technologies (n = 70) and group of control (n = 70). The study lastet 12 months. Level of adherence was measured via standard Morisky-Green"s 4-item questionnaire as well as via additional questionnaire developed by authors for this study. Results Comparative analysis of the level of adherence in the two groups did not reveal statistically significant differences at baseline. After 12 months, the experimental group showed a statistically significant increase in adherence to preventive treatment compared with the control group (р=0,001) Conclusion(s) Medical and psychological counselling using remote technologies is an effective method for rising patients" adherence to CVD preventive medical treatment

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The underrepresentation of female participants in studies assessing the impact of high-dose exercise on cardiovascular outcomes: a scoping review

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.367 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

S Pallikadavath ◽

R Patel ◽

CL Kemp ◽

M Hafejee ◽

N Peckham ◽

...

Keyword(s):

Scoping Review ◽

High Volume ◽

Cardiovascular Outcomes ◽

High Dose ◽

Funding Sources ◽

Review Protocol ◽

The Mean ◽

The Impact ◽

Over Time ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiovascular adaptations as a result of exercise conducted at high-intensity and high-volume are often termed the ‘Athlete’s heart’. Studies have shown that these cardiovascular adaptations vary between sexes. It is important that both sexes are well represented in this literature. However, many studies assessing the impact of high-dose exercise on cardiovascular outcomes under-recruit female participants. Purpose This scoping review aimed to evaluate the representation of females in studies assessing the impact of high-dose exercise on cardiovascular outcomes and demonstrate how this has changed over time. Methods The scoping review protocol as outlined by Arksey and O’Malley was used. OVID and EMBASE databases were searched and studies independently reviewed by two reviewers. Studies must have investigated the effects of high-dose exercise on cardiovascular outcomes. To assess how the recruitment of females has changed over time, two methods were used. One, the median study date was used to categorise studies into two groups. Two, studies were divided into deciles to form ten equal groups over the study period. Mean percentage of female recruitment and percentage of studies that failed to include females were calculated. Results Overall, 250 studies were included. Over half the studies (50.8%, n = 127) did not include female participants. Only 3.2% (n = 8) did not include male participants. Overall, mean percentage recruitment was 18.2%. The mean percentage of recruitment was 14.5% before 2011 and 21.8% after 2011. The most recent decile of studies demonstrated the highest mean percentage of female recruitment (29.3%) and lowest number of studies that did not include female participants (26.9%). Conclusion Female participants are significantly underrepresented in studies assessing cardiovascular outcomes caused by high-dose exercise. The most recent studies show that female recruitment may be improving, however, this still falls significantly short for equal representation. Risk factors, progression and management of cardiovascular diseases vary between sexes, hence, translating findings from male dominated data is not appropriate. Future investigators should aim to establish barriers and strategies to optimise fair recruitment. Mean percentage females recruited per study (%) Percentage studies that do not include women (%) Overall (n = 250) 18.2 50.8 (n = 127) Studies before 2011 (n = 121) 14.5 59.5 (n = 72) Studies after 2011 (n = 129) 21.8 42.6 (n = 55) Table 1: Female recruitment characteristics. The year 2011 (median study year) was chosen as this divides all included studies into two equal groups.

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Adherence to Primary Prevention and Skin Self-Examination Practices by Spanish Melanoma Patients

Dermatology ◽

10.1159/000512887 ◽

2021 ◽

pp. 1-7

Author(s):

Irene Torrecilla-Martínez ◽

Esperanza Manrique-Silva ◽

Victor Traves ◽

Celia Requena ◽

Eduardo Nagore

Keyword(s):

Primary Prevention ◽

Cutaneous Melanoma ◽

Public Health Problem ◽

Global Public Health ◽

Prevention Measures ◽

Online Questionnaire ◽

Cross Sectional ◽

History Of ◽

High Level ◽

Self Examination

Background: The incidence of cutaneous melanoma, an important global public health problem, has been increasing over the last several decades. Objectives: In order to decrease melanoma-related mortality, ways to communicate and implement the correct methods for conducting primary and secondary prevention measures (such as early detection via self-examination) should be investigated. Materials and Methods: An observational, cross-sectional, retrospective study consisting of 409 patients diagnosed with cutaneous melanoma was conducted. An online questionnaire was created to evaluate knowledge levels, attitudes, and adherence to primary preventive measures and to skin self-examination practices. Results: The results revealed that even when 43% of the patients perform cutaneous self-examinations, only half of them fully followed the recommendations. Patients aged <45 years, female, with a I–II phototype, with an intermediate/high level of education, and with a history of NMSC were more likely to have an adequate degree of knowledge. Moreover, patients aged <45 years and with an adequate degree of knowledge more frequently showed an adequate adherence to the primary prevention measures. Finally, patients aged 45–60 years and with an adequate degree of knowledge presented a good adherence to the self-skin examination measures. Limitations: Possible limitations of this study were memory bias through the influence of age within the study population, and bias due to a greater proportion of subjects with a high education level. Conclusion: Within the population of patients with melanoma, a high percentage of patients do not rigorously follow the recommended prevention measures. Our study highlights the need to implement awareness in this population to improve the prevention of cutaneous cancer.

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Prise En Charge Des Péritonites Aiguës Dans Un Hôpital De District En Afrique Sub-saharienne : Cas Du Bénin

European Scientific Journal ESJ ◽

10.19044/esj.2017.v13n36p388 ◽

2017 ◽

Vol 13 (36) ◽

pp. 388

Author(s):

Bio Tamou Sambo ◽

Salako Alexandre Allodé ◽

Didier Sewadé Wekpon ◽

Djifid Morel Séto ◽

Montcho Adrien Hodonou ◽

...

Keyword(s):

Mortality Rate ◽

District Hospital ◽

Public Health Problem ◽

Sub Saharan Africa ◽

Prise En Charge ◽

Prospective Data ◽

Acute Peritonitis ◽

Generalized Peritonitis ◽

Sub Saharan ◽

Surgery Department

Introduction: Peritonitis remains a public health problem in Africa. We aim to describe the epidemiological, etiological and therapeutic aspects of acute peritonitis in a district hospital in Sub Saharan Africa. Methods: This was a descriptive study with prospective data collection over a period of 15 months from May 1 st 2015 to July 31st 2016 in Bembereke district hospital. It has taken into account all the patients managed in the general surgery department for acute generalized peritonitis that has been confirmed at laparotomy. Results: Fifty-three patients, 38 men (71.7 %) and 15 women (28.3 %) had been registered. The average age of the patients was 19.8 ± 16.9 years. The main etiologies were: non-traumatic ileal perforation from typhoid infection 52.8%; perforated gastric or duodenal ulcer 17%; complicated appendicitis and abdominal traumas 11.3% each one. Twenty nine patients (54.7%) have been operated by a surgeon and the 24 remaining (45.3%) by a general practitioner with surgical skills. Twenty one patients (39.6%) had postoperative complications of which 11 cases of parietal suppurations (52.4%). The mortality rate was 11.3%. The mean hospital stay was 22.5 ± 4 days. Conclusion: In northern-Benin, peritonitis remains dominated by the complications of typhoid fever. The mortality rate remains high. Prevention requires good hygiene and awareness of early consultations.

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Impact of the COVID-19 pandemic on electrophysiological procedures at a national referral center

EP Europace ◽

10.1093/europace/euab116.042 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

A Cueva-Parra ◽

G Munoz-Benavides ◽

W Ortiz-Solis ◽

J Gomez-Flores ◽

MF Marquez ◽

...

Keyword(s):

Electronic Devices ◽

Referral Center ◽

Funding Sources ◽

Cardiac Implantable Electronic Devices ◽

Electrophysiological Studies ◽

Electrophysiological Procedures ◽

The Impact ◽

Large Groups ◽

Made In ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background - Introduction: The COVID-19 pandemic has generated serious repercussions on the health system, reducing the number of all cardiology procedures worldwide. Objectives Describe the impact of the COVID-19 pandemic on the procedures performed by the electrophysiology department in a national referral center. Methods We made a retrospective review of our data base and we compared procedures made in the last 3 years since 2017 to 2019 with the procedures made in the 2020. We divide the procedures into two large groups: Cardiac Implantable Electronic Devices (CIED) related procedures (which included implants, revisions, changes, upgrades and extractions) and electrophysiological studies and ablations (which included conventional and complex procedures). Other types of procedures were no included. Results There was a significant reduction in all procedures, the average of procedures performed in the last 3 previous years was 467 (there were 479 in 2017, 411 in 2018 and 511 in 2019), while in 2020 we performed only 319 (p = 0.01); this represents a reduction of 33.4% in the total number of procedures performed in our center. There was no statistical difference regarding the CIED related procedures, the average of procedures of the last 3 previous years was 174 (there were 186 in 2017, 148 in 2018 and 188 in 2019), and in 2020 we performed 189 procedures, this value is near to the average of the last 3 previous years and very close to the value of the 2019 (p = 0.46). Regarding the electrophysiological studies and ablations, the average of procedures of the last 3 previous years was 293 (there were 293 in 2017, 263 in 2018 and 323 in 2019), while in 2020 we performed only 129 procedures, considerably decreasing compared to the previous years (p < 0.01). The reduction in the electrophysiological studies and ablations was 55.97%. The most affected months were April, May and June. Conclusions The COVID-19 pandemic considerably affected the number of electrophysiological procedures in our center, reducing it by 33.4% compared to the previous years. The reduction of procedures fundamentally affected the electrophysiological studies and ablations, reducing them by 55.97%. The number of CIED related procedures were no affected. Electrophysiological procedures Procedures2017201820192017-2019 average2020CIED related procedures186148188174189Electrophysiological studies and ablations293263323293129Total479411511467319Comparative table of the electrophysiological procedures performed in our center in recent years.Abstract Figure. Comparison of the procedures.

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Awareness, attitude and practice of COVID-19 and its vaccination in J&K, India

Indian Journal of Forensic and Community Medicine ◽

10.18231/j.ijfcm.2021.045 ◽

2021 ◽

Vol 8 (4) ◽

pp. 220-226

Author(s):

Abdul Rouf ◽

Fouzia Nazir ◽

Muneer Ahmad Masoodi

Keyword(s):

Social Media ◽

Positive Attitude ◽

Care Delivery ◽

Good Practice ◽

Public Health Problem ◽

Social Progress ◽

Vaccine Hesitancy ◽

Online Questionnaire ◽

Jammu And Kashmir ◽

Attitude And Practice

COVID-19 Pandemic has severely affected the health care delivery system, economic and social progress since its inception. Although COVID-19 vaccines have given, a new hope but Vaccine hesitancy has been recognized as a serious public health problem that needs extensive research among different population groups. This study was aimed to assess awareness, attitude and practice towards COVID-19 vaccination and its association with Sociodemographicvariables among social media users in Jammu and Kashmir, India.The Department of Community Medicine, Government Medical College, Anantnag conducted this cross-sectional study in June 2021, among social media users, 18 and above years of age, using online questionnaire through Google Forms. The questionnaire comprised of four segments, sociodemographic details, awareness, attitude, and practice regarding COVID-19 vaccination, ten questions from each segment.In this study, although the calculated sample size was 423, a total of 425 respondents were included. The mean scores of awareness, regarding COVID-19 disease and its vaccination, was 3.68 ± 0.44, with overall awareness was 73.6%, positive attitude 3.53 ± 0.41, with an overall positive attitude of 70.6%, and good practice towards adopting COVID-19 appropriate behaviour and vaccination was 3.43 + 0.71 with an overall good practice of 68.6% respectively. Participants with higher awareness regarding COVID-19 disease and its vaccination were 9.1 times (95% C.I = 5.16-14.32) more likely to have a positive attitude towards using COVID-19 appropriate behaviour and its vaccination and 7.8 times (95% C.I = 4.62-13.83) adopting good practice than with the low level of awareness.In Jammu and Kashmir, social media users are having good awareness toward COVID-19 disease and its vaccination. Awareness generation seems to be a good tool for bringing behavioural changes and this platform should be used to disseminate information regarding COVID-19 appropriate behaviour and its vaccination.

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Electrocardiographic characteristics of patients with coronavirus disease 2019 (COVID-2019) related pneumonia at first presentation

EP Europace ◽

10.1093/europace/euab116.023 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

U Nguyen ◽

M Strik ◽

S Abu-Arib ◽

A Bruekers ◽

T Nguyen ◽

...

Keyword(s):

Clinical Presentation ◽

Negative Group ◽

Male Mortality ◽

Funding Sources ◽

Atrial Enlargement ◽

Study Population ◽

Polymerase Chain ◽

Repolarization Abnormalities ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Purpose To evaluate electrocardiographic (ECG) characteristics at first presentation in patients with possible coronavirus disease (COVID-19) pneumonia. Methods and results 356 patients presenting at the emergency room with possible COVID-19 pneumonia based on clinical presentation and computed tomography findings were included and subdivided into a COVID-19 positive group ([COVID-19-positive], n = 231, 65%) and a COVID-19 negative group ([COVID-19-negative], n = 125, 35%) based on polymerase chain reaction tests. The study population was predominantly middle aged-elderly (67 ± 14 year; n = 235, 66% male). Mortality rate was 24% after 1-month follow-up. There were no significant (NS) differences in sex, age, and mortality between the COVID-19-positive and COVID-19-negative group. Atrial fibrillation (AF) was common (9%), though its prevalence was NS (regression analyses adjusted for age and sex) different in the COVID-19-positive vs. the COVID-19-negative group. ECG characteristics reflecting atrial enlargement and repolarization abnormalities were frequently present (<38% and 14% respectively). No significant differences were found between the COVID-19-positive vs. the COVID-19-negative group for the majority of morphological ECG characteristics (Figure 1 for more detailed data). Conclusion AF and ECG characteristics reflecting atrial enlargement and repolarization abnormalities are commonly present in COVID-19 patients. The prevalence of these ECG characteristics however do NS differ from their COVID-19-negative counterparts. Abstract Figure.

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Impact of air pollution on mortality due to cerebrovascular diseases

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.177 ◽

2021 ◽

Vol 28 (Supplement_1) ◽

Author(s):

L Kuzma ◽

EJ Dabrowski ◽

A Kurasz ◽

M Swieczkowski ◽

H Bachorzewska-Gajewska ◽

...

Keyword(s):

Air Pollution ◽

Cold Season ◽

Cerebrovascular Diseases ◽

Term Effect ◽

Short Term ◽

Short Term Effect ◽

Funding Sources ◽

Specific Mortality ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background The short-term effect of air pollution on cardiovascular mortality is well-documented but a scarce number of studies focus on cause-specific mortality in low-polluted areas. Purpose We decided to distinguish deaths due to cerebrovascular disease (CbVD) from a region widely known as the Green Lungs of Poland to assess the short-term effect of air pollution on CbVD mortality. Methods The analysis with almost 4,500,000 person-years of follow-up with a time-stratified case-crossover design was performed. Results are reported as odds ratio (OR) associated with an increase in interquartile range (IQR) of air pollution. Results In the overall analysis of the studied region PM2.5 had an impact on increased CbVD mortality at LAG 0 (OR 1.046, 95% CI 1.013 – 1.080, P = 0.006), LAG 0-1 (1.048, 1.002-1.082, P = 0.040), and LAG 0-3 (1.052, 1.015-1.090, P = 0.006). The influence of PM10 was noted at LAG 0 (1.041, 1.002-1.082, P = 0.040). CbVD mortality in Bialystok was increased by exposure to PM10 at LAG 0 (1.05, 1.00-1.09, P = 0.048) and CO at LAG 1 (1.07, 1.00-1.14, P = 0.04). Additionally, an effect of CO was observed in cold season at LAG 1 (1.09, 1.02-1.17, P = 0.02), LAG 0-1 (1.08, 1.00-1.016, P = 0.04), and LAG 0-3 (1.09, 1.01-1.18, P = 0.04). In Suwalki, an impact of PM2.5 was also observed. Conclusions A short-term increase in air pollutants concentrations, especially in PM2.5 and CO, had an influence on CbVD mortality. Mortality rates were significantly increased in cold season. We also found heterogeneity in the influence of major contributors on mortality between analyzed cities.

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Long term stability of the subcutaneous cardioverter defibrillator implanted by means of the intermuscular two incision technique

EP Europace ◽

10.1093/europace/euab116.403 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

G Bisignani ◽

A Bisignani ◽

AL Cavaliere ◽

M Lovecchio ◽

S Valsecchi ◽

...

Keyword(s):

Thoracic Wall ◽

Fat Tissue ◽

Cardioverter Defibrillator ◽

Long Term Stability ◽

Funding Sources ◽

Incision Technique ◽

Post Implantation ◽

Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Background To ensure effective defibrillation with the subcutaneous implantable cardioverter defibrillator (S-ICD), both the lead and the generator must be adequately positioned extrathoracically. We assessed the long-term adequacy of the S-ICD system position and its stability in a group of patients who received the S-ICD by means of the two-incision intermuscular technique. Methods The PRAETORIAN score uses chest radiography to provide feedback on S-ICD positioning, and identifies patients with high defibrillation thresholds. We compared radiographs taken immediately after implantation and on 12-month follow-up examination. Results We analyzed data from 38 patients with the S-ICD generator positioned in an intermuscular pocket. The median PRAETORIAN score was 38 [25th to 75th percentile: 30 to 60]. Two (5%) patients had a score of 90 (intermediate risk of conversion failure). The thickness of the adipose tissue between the coil and the sternum was ≤1 coil width in 72% of patients, the generator was on, or posterior to, the midline in 94% of patients, and the amount of fat tissue between the generator and the thoracic wall was less than the generator width in 78% of patients. No generator or electrode dislodgments were detected on analyzing radiographs collected at the 12-month visit. In all patients, assessment of the PRAETORIAN score confirmed the values calculated on post-implantation analysis. During follow-up, no ineffective therapies, sudden cardiac or device-related deaths occurred. Conclusions The position of the S-ICD system implanted using the two-incision intermuscular technique was adequate at the time of implantation and remained stable after 12 months.

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Second-Hand Smoking among Intermediate and Secondary School Students in Madinah, Saudi Arabia

BioMed Research International ◽

10.1155/2015/672393 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 9

Author(s):

Abdulmohsen H. Al-Zalabani ◽

Soliman M. Amer ◽

Khaled A. Kasim ◽

Reem I. Alqabshawi ◽

Ayat R. Abdallah

Keyword(s):

Saudi Arabia ◽

Secondary School ◽

Secondary School Students ◽

Smoking Status ◽

Public Health Problem ◽

Parental Smoking ◽

Second Hand Smoke ◽

School Students ◽

Related Factors ◽

Shs Exposure

Background and objectives. Second-hand smoke (SHS) is an important public health problem worldwide. The study aimed to estimate the prevalence of SHS exposure and its associated risk factors among intermediate and secondary school students.Methods. A cross-sectional study was conducted in 2013 among 3400 students from 34 intermediate and secondary schools in Madinah City, Saudi Arabia. Data about sociodemographic and smoking-related factors and SHS exposure were collected using a self-administered questionnaire.Results. Of the 3210 students analyzed, the prevalence of SHS exposure was 32.7% 49.3%, and 25% inside, outside, and both inside and outside the home, respectively. The highest risk of SHS exposure was associated with the adolescent’s smoking status, parental smoking, close friends smoking, and family structure. The risk was markedly increased in association with parental smoking for exposure inside the home (OR = 6.49; 95% CI = 5.44–7.73) and with close friends smoking for exposure outside the home (OR = 4.16; 95% CI = 3.54–4.77). The risk of SHS, however, was lower among adolescents having knowledge about smoking and highly educated parents.Conclusion. The study revealed a considerably high prevalence of SHS both inside and outside the home among adolescents. Knowledge and beliefs about SHS exposure are the main preventable approach.

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