scholarly journals 1670. Access to Antibiotics Without Prescription for Travelers and Colombian Citizens at Community Pharmacies in Bogotá, Colombia: A Cross-Sectional Study

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S611-S611
Author(s):  
Marie Kasbaum ◽  
Catalina V Lizarraga ◽  
Alejandro De la Hoz ◽  
Jinnethe Reyes ◽  
Cesar A Arias
Keyword(s):  
The United States ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Community Pharmacies ◽  
Prescription Data ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us ◽  
Rapid Dissemination ◽  
International Visitors

Abstract Background Antimicrobial-resistant pathogens often emerge in communities where antibiotics are frequently sold without prescriptions. In Colombia, nonprescription sale of antibiotics still occurs despite national regulations. Use of antimicrobials in international travelers has been linked to the rapid dissemination of multidrug-resistant pathogens around the globe. Despite the exponential increase of international visitors to Colombia recently, there is a notable lack of studies investigating the accessibility of antibiotics to foreign travelers without prescriptions in Colombian pharmacies. Methods This cross-sectional study compares the access to antibiotics without prescription in community pharmacies between travelers from the United States and local Colombian citizens in Bogotá. Both groups visited 91 pharmacies and conducted trials as covert simulated clients (SCs). The SCs followed a standardized script when interacting with pharmacy personnel, acting as though they were seeking antibiotics for moderate Traveler’s Diarrhea (TD), without a prescription. Data were gathered on the employees’ responses, including the level of “prompting” needed for an employee to offer antibiotics, reasons given to the SCs for refusing to sell antibiotics if no sale was offered, and generic brand of compounds offered. Results Antibiotics were offered to the US travelers in 62 (68.13%) pharmacies, and to the Colombian group in 57 (62.64%) pharmacies. The traveler group was significantly more likely than the comparator group to be offered antibiotics without any prompting (P = 0.003). When pharmacy employees refused to sell antibiotics during trials, the traveler group was significantly more likely to be given a clinical reason not to receive antibiotics. Refusal to Colombian citizens was more frequently due legal reasons (P < 0.001). Conclusion Antibiotics were accessible without prescriptions at similarly high frequencies, regardless of the customers’ nationality. The US travelers were more likely than the Colombian group to be offered antibiotics without needing to prompt the pharmacist. Additionally, pharmacists were much more likely to deny antibiotics to the Colombian group due to legal reasons, as opposed to clinical reasons for US travelers. Disclosures All authors: No reported disclosures.

scholarly journals 218. Changes in Dental Antibiotic Prescribing in the United States, 2012–2017

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S111-S111
Author(s):  
Swetha Ramanathan ◽  
Connie H Yan ◽  
Colin Hubbard ◽  
Gregory Calip ◽  
Lisa K Sharp ◽  
...  
Keyword(s):  
The United States ◽  
Cross Sectional Study ◽  
Antibiotic Prescribing ◽  
Prescription Data ◽  
Oral Antibiotic ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prescribing Trends ◽  
Adults And Children ◽  
Linear Regressions

Abstract Background Data suggest dental antibiotic prescribing is increasing with relatively less documented about prescribing trends in adults and children. Therefore, the aim was to evaluate trends in antibiotic prescribing by US dentists from 2012–2017. Methods This was a cross-sectional study of US dental prescribing using IQVIA Longitudinal Prescription Data from 2012 to 2017. Prescribing rates (prescriptions [Rx] per 100,000 dentists), mean days’ supply, and mean quantity dispensed were calculated monthly across eight oral antibiotic groups: amoxicillin, clindamycin, cephalexin, azithromycin, penicillin, doxycycline, fluoroquinolone, and other antibiotics. Descriptive frequencies and multiple linear regressions were performed to obtain trends overall and stratified by adults (≥ 18) and children (&lt; 18). Results 220, 325 dentists prescribed 135 million Rx (94.0% in adults). 61.0% were amoxicillin, 14.4% clindamycin, 11.7% penicillin, 4.4% azithromycin, 4.3% cephalexin, 2.0% other antibiotics, 1.4% doxycycline, and 0.7% fluoroquinolones. Prescribing increased by 33 Rx/100,000 dentists (p&lt; 0.0001) each month for all antibiotics. Amoxicillin (p&lt; 0.0001) and clindamycin (p=0.02) prescribing rate increased by 73 and 5 Rx/100,000 dentists, respectively. Prescribing decreased by 8, 12, and 2 Rx/100,000 dentists for cephalexin (p&lt; 0.0001), doxycycline (p&lt; 0.0001), and fluoroquinolones (p=0.008), respectively. Mean days’ supply increased for amoxicillin, penicillin, and clindamycin (p&lt; 0.0001), and decreased for cephalexin (p&lt; 0.0001).Mean quantity dispensed decreased (p&lt; 0.0001) for all groups except azithromycin and doxycycline. Among adults, cephalexin prescribing rates (7 Rx/100,000 dentist; p&lt; 0.0001) and other antibiotics days’ supply (p&lt; 0.0001) decreased. Among children, azithromycin prescribing rates (1 Rx/100,000 dentists, p=0.02), and fluoroquinolone and other antibiotics days’ supply (p&lt; 0.0001) decreased. Conclusion These findings support dental antibiotic prescribing is increasing, specifically for amoxicillin and clindamycin. Further, trends differed between adults and children. Understanding what is driving these trends is important to target dental antibiotic stewardship efforts. Disclosures All Authors: No reported disclosures

scholarly journals Income-based inequalities in self-reported moderate-to-vigorous physical activity among adolescents in England and the United States: a cross-sectional study

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Jennifer S Mindell
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
The United States ◽  
Cross Sectional Study ◽  
High Income ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us ◽  
Low Income Households

Objective: Quantify inequalities in self-reported moderate-to-vigorous physical activity (MVPA) in England and the United States (US). Design: Population-based cross-sectional study. Participants: 4019 adolescents aged 11-15 years in England (Health Survey for England 2008, 2012, 2015) and 4312 aged 12-17 years in the US (National Health and Nutrition Examination Survey 2007-16). Main outcome measures: Three aspects of MVPA: (1) doing any, (2) average min/day (MVPA: including those who did none), and (3) average min/day conditional on participation (MVPA-active). Using hurdle models, we quantified inequalities (average marginal effects: AMEs) using the absolute difference in marginal means. Results: In England, adolescents in high-income households were more likely than those in low-income households to have done any formal sports/exercise in the last seven days (boys: 11%; 95% CI: 4% to 17%; girls: 13%; 95% CI: 6% to 20%); girls in high-income households did more than their low-income counterparts (MVPA: 6 min/day, 95% CI: 2 to 9). Girls in low-income households spent more time in informal activities than girls in high-income households (MVPA: 21 min/day; 95% CI: 10 to 33), whilst boys in low-income versus high-income households spent longer in active travel (MVPA: 21 min/week; 95% CI: 8 to 34). In the US, in a typical week, recreational activity was greater among high-income versus low-income households (boys: 15 min/day; 95% CI: 6 to 24 min/day; girls: 19 min/day; 95% CI: 12 to 27). In contrast, adolescents in low-income versus high-income households were more likely to travel actively (boys: 11%; 95% CI: 3% to 19%; girls: 10%; 95% CI: 3% to 17%) and do more. Conclusions: Policy actions and interventions are required to increase MVPA across all income groups in England and the US. Differences in formal sports/exercise (England) and recreational (US) activities suggest that additional efforts are required to reduce inequalities.

scholarly journals Financial ties between leaders of influential US professional medical associations and industry: cross sectional study

BMJ ◽  
2020 ◽  
pp. m1505 ◽  
Author(s):  
Ray Moynihan ◽  
Loai Albarqouni ◽  
Conrad Nangla ◽  
Adam G Dunn ◽  
Joel Lexchin ◽  
...  
Keyword(s):  
Clinical Oncology ◽  
American Psychiatric Association ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical Associations ◽  
The Us ◽  
American Society ◽  
Financial Relationships

AbstractObjectiveTo investigate the nature and extent of financial relationships between leaders of influential professional medical associations in the United States and pharmaceutical and device companies.DesignCross sectional study.SettingProfessional associations for the 10 costliest disease areas in the US according to the US Agency for Healthcare Research and Quality. Financial data for association leadership, 2017-19, were obtained from the Open Payments database.Population328 leaders, such as board members, of 10 professional medical associations: American College of Cardiology, Orthopaedic Trauma Association, American Psychiatric Association, Endocrine Society, American College of Rheumatology, American Society of Clinical Oncology, American Thoracic Society, North American Spine Society, Infectious Diseases Society of America, and American College of Physicians.Main outcome measuresProportion of leaders with financial ties to industry in the year of leadership, the four years before and the year after board membership, and the nature and extent of these financial relationships.Results235 of 328 leaders (72%) had financial ties to industry. Among 293 leaders who were medical doctors or doctors of osteopathy, 235 (80%) had ties. Total payments for 2017-19 leadership were almost $130m (£103m; €119m), with a median amount for each leader of $31 805 (interquartile range $1157 to $254 272). General payments, including those for consultancy and hospitality, were $24.8m and research payments were $104.6m—predominantly payments to academic institutions with association leaders named as principle investigators. Variation was great among the associations: median amounts varied from $212 for the American Psychiatric Association leaders to $518 000 for the American Society of Clinical Oncology.ConclusionsFinancial relationships between the leaders of influential US professional medical associations and industry are extensive, although with variation among the associations. The quantum of payments raises questions about independence and integrity, adding weight to calls for policy reform.

scholarly journals Professional Life Satisfaction Based on Dimensions of Well-being among Firefighters in South Korea and the United States: A Cross-Sectional Study

2021 ◽  
Author(s):  
Dongwoo Song ◽  
Haejun Park ◽  
Changhoon Bang ◽  
Sohee Kim ◽  
Jaehong Kim
Keyword(s):  
Life Satisfaction ◽  
South Korea ◽  
Working Hours ◽  
Well Being ◽  
The United States ◽  
Cross Sectional Study ◽  
Job Skills ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us

Upgrading firefighters’ life satisfaction can enhance their job skills, and contribute to their safety and that of the public. This study’s purpose was to identify general life satisfaction levels and national characteristics, including firefighters’ occupational issues in Korea and the US. The final sample sizes in this cross-sectional study were 1,523 for South Korea and 229 for the US. The findings were based on firefighters’ physical/mental health and satisfaction with occupational problems. To measure their life satisfaction, six dimensions were examined: social, spiritual, intellectual, emotional, physical, and occupational. The average satisfaction score of firefighters was 3.50 in Korea and 4.00 in the US. The US showed high satisfaction in most subitems. However, US firefighters showed low satisfaction in the physical context and Korean firefighters in the occupational context. Multiple regression analysis of the variables affecting firefighters’ life satisfaction showed that the occupational dimension was significant in both Korea and the US, and a similar analysis of demographic characteristics as independent variables showed that differences in satisfaction by gender were important in both countries. For Korea, the key variables were in the working hours section; for the US, in the specialty section. The results of this study should make it easier to identify and focus on the relevant areas of firefighters’ working lives in Korea and the US, thereby improving their life satisfaction.

scholarly journals Professional Life Satisfaction Based on Dimensions of Well-being among Firefighters in South Korea and the United States: A Cross-Sectional Study

2021 ◽  
Author(s):  
Dongwoo Song ◽  
Haejun Park ◽  
Changhoon Bang ◽  
Sohee Kim ◽  
Jaehong Kim
Keyword(s):  
Life Satisfaction ◽  
South Korea ◽  
Working Hours ◽  
Well Being ◽  
The United States ◽  
Cross Sectional Study ◽  
Job Skills ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us

Upgrading firefighters’ life satisfaction can enhance their job skills, and contribute to their safety and that of the public. This study’s purpose was to identify general life satisfaction levels and national characteristics, including firefighters’ occupational issues in Korea and the US. The final sample sizes in this cross-sectional study were 1,523 for South Korea and 229 for the US. The findings were based on firefighters’ physical/mental health and satisfaction with occupational problems. To measure their life satisfaction, six dimensions were examined: social, spiritual, intellectual, emotional, physical, and occupational. The average satisfaction score of firefighters was 3.50 in Korea and 4.00 in the US. The US showed high satisfaction in most subitems. However, US firefighters showed low satisfaction in the physical context and Korean firefighters in the occupational context. Multiple regression analysis of the variables affecting firefighters’ life satisfaction showed that the occupational dimension was significant in both Korea and the US, and a similar analysis of demographic characteristics as independent variables showed that differences in satisfaction by gender were important in both countries. For Korea, the key variables were in the working hours section; for the US, in the specialty section. The results of this study should make it easier to identify and focus on the relevant areas of firefighters’ working lives in Korea and the US, thereby improving their life satisfaction.

Firearm Access and Suicidal Crises Among Young Adults Experiencing Homelessness in the United States

Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Anthony Fulginiti ◽  
Hsun-Ta Hsu ◽  
Jarrod Call ◽  
Robin Petering ◽  
Diane Santa Maria ◽  
...  
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Risk Of Death ◽  
The Us ◽  
Innovative Solutions ◽  
Us Cities

Abstract. Background: Young adults experiencing homelessness (YAEH) report high rates of suicidal crises. Having access to firearms during suicidal crises elevates risk of death by suicide. Yet, no known information exists about firearm access among YAEH. Aims: We aimed to examine the proportion of participants who had firearm access, as well as the association between past-year suicidal crises and firearm access among participants. Method: We recruited 1,426 YAEH (18–26 years old) from homelessness service settings in seven US cities. Logistic regression analyses were used to examine the association between past-year suicidal crises and firearm access. Results: One third of the sample reported having easy firearm access. YAEH who experienced suicidal ideation and suicide attempts were more likely to report firearm access. Limitations: Results from this cross-sectional study cannot be causally interpreted nor generalized to all YAEH. Conclusion: A substantial segment of YAEH had easy firearm access and it was more common for YAEH with suicidal crises to have firearm access. Reducing firearm access should be part of suicide prevention planning for YAEH in the US but requires comprehensive and innovative solutions.

Does a Graduate Course in Fluency Disorders Make a Difference?

2010 ◽  
Vol 20 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Evelyn R. Klein ◽  
Barbara J. Amster
Keyword(s):  
Undergraduate Students ◽  
Graduate Programs ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Graduate Course ◽  
Cross Sectional ◽  
Fluency Disorders ◽  
Introductory Course ◽  
Communicative Disorders

Abstract A study by Yaruss and Quesal (2002), based on responses from 134 of 239 ASHA accredited graduate programs, indicated that approximately 25% of graduate programs in the United States allow students to earn their degree without having coursework in fluency disorders and 66% of programs allow students to graduate without clinical experience treating people who stutter (PWS). It is not surprising that many clinicians report discomfort in treating PWS. This cross-sectional study compares differences in beliefs about the cause of stuttering between freshman undergraduate students enrolled in an introductory course in communicative disorders and graduate students enrolled and in the final weeks of a graduate course in fluency disorders.

scholarly journals The potential role of local pharmacies to assess asthma control: an Italian cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
M. Caminati ◽  
L. Cegolon ◽  
M. Bacchini ◽  
N. Segala ◽  
A. Dama ◽  
...  
Keyword(s):  
Asthma Control ◽  
Multinomial Logistic Regression ◽  
Asthma Severity ◽  
Cross Sectional Study ◽  
Disease Assessment ◽  
Community Pharmacies ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Services ◽  
Disease Community

Abstract Background Asthma control and monitoring still represents a challenge worldwide. Although the international guidelines suggest the interplay between secondary and primary care services as an effective strategy to control the disease, community pharmacies’ are seldom involved in asthma control assessment. The present cross-sectional study aimed at providing a picture of the relationship between asthma severity and control in community pharmacies within the health district of the city of Verona (Veneto Region, North-Eastern Italy). Methods A call for participation was launched through the Pharmacists’ Association of Verona. Patients referring to the participating pharmacies with an anti-asthmatic drug medical prescription and an asthma exemption code were asked to complete the Asthma Control Test (ACT) and a brief questionnaire collecting information on their age, sex, smoking status, aerobic physical exercise and usual asthma therapy, which also defined asthma severity. A multinomial logistic regression model was fitted to investigate the risk of uncontrolled as well as poorly controlled vs. controlled asthma (base). Results were expressed as relative risk ratios (RRR) with 95% confidence interval (95%CI). Results Fifty-seven community pharmacies accepted to participate and 584 asthmatic patients (54% females; mean-age: 51 ± 19 years) were consecutively recruited from 1st January to 30th June 2018 (6 months). Based upon ACT score 50.5% patients had a controlled asthma, 22.3% a poorly controlled and 27.2% uncontrolled. A variable proportion of patients with uncontrolled asthma were observed for every level of severity, although more frequently with mild persistent form of asthma. Most patients (92%) self-reported regular compliance with therapy. At multinomial regression analysis, patients under regular asthma treatment course (RRR = 0.33; 95%CI: 0.15; 0.77) were less likely to have an ACT< 16 compared to those not taking medications regularly. Conclusions Overall, our findings highlighted an unsatisfactory asthma control in the general population, independently of the severity level of the disease. Community pharmacies could be a useful frontline interface between patients and the health care services, supporting an effective asthma management plan, from disease assessment and monitoring treatment compliance to referral of patients to specialist medical consultancies.

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