scholarly journals Pneumococcal exposure routes for infants: a nested cross-sectional survey in Nha Trang, Vietnam

Author(s):  
George Qian ◽  
Michiko Toizumi ◽  
Samuel Clifford ◽  
Lien Thuy Le ◽  
Tasos Papastylianou ◽  
...  

Background: Infants are at highest risk of pneumococcal disease. Their added protection through herd effects is a key part in the considerations on optimal pneumococcal vaccination strategies. Yet, little is currently known about the main transmission pathways to this vulnerable age group. Methods and findings: We conducted a nested cross-sectional contact and nasopharyngeal swabbing survey in randomly selected infants across all 27 communes of Nha Trang, Vietnam. Bayesian logistic regression models were used to estimate age specific carriage prevalence in the population, a proxy for the probability that a contact of a given age could lead to pneumococcal exposure for the infant. We used another Bayesian logistic regression model to estimate the correlation between infant carriage and the probability that at least one of their reported contacts carried pneumococci, controlling for age and locality. In total 1583 infants between 4 and 13 months old participated, with 7428 contacts reported. Few infants (5%) attended day care and carriage prevalence was 22%. Most infants (61%) had less than a 25% probability to have had close contact with a pneumococcal carrier on the surveyed day. Pneumococcal infection risk and contact behaviour were highly correlated: if adjusted for age and locality the odds of an infant's carriage increased by 22% (95%CI:15-29) per 10 percentage points increase in the probability to have had close contact with at least one pneumococcal carrier. Two to six year old children contributed 51% (95%CI: 39-63) to the total pneumococcal exposure risks to infants in this setting. Conclusions: Cross-sectional contact and infection studies can help identify pneumococcal transmission routes. In Nha Trang, preschool age children are the largest reservoir for pneumococcal transmission to infants.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Harry Tattan-Birch ◽  
Jamie Brown ◽  
Lion Shahab ◽  
Sarah E. Jackson

AbstractThis study examined use trends of e-cigarette devices types, heated tobacco products (HTPs) and e-liquid nicotine concentrations in England from 2016 to 2020. Data were from a representative repeat cross-sectional survey of adults aged 16 or older. Bayesian logistic regression was used to estimate proportions and 95% credible intervals (CrIs). Of 75,355 participants, 5.3% (weighted = 5.5%) were currently using e-cigarettes or HTPs, with the majority (98.7%) using e-cigarettes. Among e-cigarette users, 53.7% (CrI 52.0–55.1%) used tank devices, 23.7% (22.4–25.1%) mods, 17.3% (16.1–18.4%) pods, and 5.4% (4.7–6.2%) disposables. Tanks were the most widely used device type throughout 2016–2020. Mods were second until 2020, when pods overtook them. Among all e-cigarette/HTP users, prevalence of HTP use remains rare (3.4% in 2016 versus 4.2% in 2020), whereas JUUL use has risen from 3.4% in 2018 to 11.8% in 2020. Across all years, nicotine concentrations of ≤ 6 mg/ml were most widely (41.0%; 39.4–42.4%) and ≥ 20 mg/ml least widely used (4.1%; 3.4–4.9%). Among e-cigarette/HTP users, ex-smokers were more likely than current smokers to use mod and tank e-cigarettes, but less likely to use pods, disposables, JUUL and HTPs. In conclusion, despite growing popularity of pods and HTPs worldwide, refillable tank e-cigarettes remain the most widely used device type in England.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037362
Author(s):  
Ben Wamamili ◽  
Mark Wallace-Bell ◽  
Ann Richardson ◽  
Randolph C Grace ◽  
Pat Coope

ObjectiveIn March 2011, New Zealand (NZ) launched an aspirational goal to reduce smoking prevalence to 5% or less by 2025 (Smokefree 2025 goal). Little is known about university students’ awareness of, support for and perceptions about this goal. We sought to narrow the knowledge gap.SettingUniversity students in NZ.MethodsWe analysed data from a 2018 cross-sectional survey of university students across NZ. Logistic regression analysis examined the associations between responses about the Smokefree goal with smoking and vaping, while controlling for age, sex and ethnicity. Confidence intervals (95% CI) were reported where appropriate.ParticipantsThe sample comprised 1476 students: 919 (62.3%) aged 18 to 20 and 557 (37.7%) aged 21 to 24 years; 569 (38.6%) male and 907 (61.4%) female; 117 (7.9%) Māori and 1359 (92.1%) non-Māori. Of these, 10.5% currently smoked (ie, smoked at least monthly) and 6.1% currently vaped (ie, used an e-cigarette or vaped at least once a month).ResultsOverall awareness of the Smokefree goal was 47.5% (95% CI: 44.9 to 50.1); support 96.9% (95% CI: 95.8 to 97.8); belief that it can be achieved 88.8% (95% CI: 86.8 to 90.7) and belief that e-cigarettes/vaping can help achieve it 88.1% (95% CI: 86.0 to 89.9).Dual users of tobacco cigarettes and e-cigarettes had greater odds of being aware of the Smokefree goal (OR=3.07, 95% CI: 1.19 to 7.92), current smokers had lower odds of supporting it (OR=0.13, 95% CI: 0.06 to 0.27) and of believing that it can be achieved (OR=0.15, 95% CI: 0.09 to 0.24) and current vapers had greater odds of believing that e-cigarettes/vaping can help to achieve it (OR=8.57, 95% CI: 1.18 to 62.52) compared with non-users.ConclusionsThe results suggest strong overall support for the Smokefree goal and belief that it can be achieved and that e-cigarettes/vaping can help achieve it. Smoking and vaping were associated with high awareness of the Smokefree goal, but lower support and optimism that it can be achieved.


Author(s):  
Danielle LoRe ◽  
Christopher Mattson ◽  
Dalia M. Feltman ◽  
Jessica T. Fry ◽  
Kathleen G. Brennan ◽  
...  

Objective The study aimed to explore physician views on whether extremely early newborns will have an acceptable quality of life (QOL), and if these views are associated with physician resuscitation preferences. Study Design We performed a cross-sectional survey of neonatologists and maternal fetal medicine (MFM) attendings, fellows, and residents at four U.S. medical centers exploring physician views on future QOL of extremely early newborns and physician resuscitation preferences. Mixed-effects logistic regression models examined association of perceived QOL and resuscitation preferences when adjusting for specialty, level of training, gender, and experience with ex-premature infants. Results A total of 254 of 544 (47%) physicians were responded. A minority of physicians had interacted with surviving extremely early newborns when they were ≥3 years old (23% of physicians in pediatrics/neonatology and 6% in obstetrics/MFM). The majority of physicians did not believe an extremely early newborn would have an acceptable QOL at the earliest gestational ages (11% at 22 and 23% at 23 weeks). The majority of physicians (73%) believed that having an extremely preterm infant would have negative effects on the family's QOL. Mixed-effects logistic regression models (odds ratio [OR], 95% confidence interval [CI]) revealed that physicians who believed infants would have an acceptable QOL were less likely to offer comfort care only at 22 (OR: 0.19, 95% CI: 0.05–0.65, p < 0.01) and 23 weeks (OR: 0.24, 95% CI: 0.07–0.78, p < 0.02). They were also more likely to offer active treatment only at 24 weeks (OR: 9.66, 95% CI: 2.56–38.87, p < 0.01) and 25 weeks (OR: 19.51, 95% CI: 3.33–126.72, p < 0.01). Conclusion Physician views of extremely early newborns' future QOL correlated with self-reported resuscitation preferences. Residents and obstetric physicians reported more pessimistic views on QOL. Key Points


2021 ◽  
Vol 12 (2) ◽  
pp. 4
Author(s):  
Olajide O. Fadare ◽  
Michael Andreski ◽  
Matthew J. Witry

Objectives: This study aimed to 1) determine the validity of the Copenhagen Burnout Inventory (CBI) for use in the assessment of burnout in a sample of pharmacists using confirmatory factor analysis (CFA), and 2) use the CBI items and other measures of work-life to assess burnout in pharmacists employed in various types of practice. Methods: A cross-sectional survey was administered to a sample of 2,582 pharmacists in a single Midwestern US state. The survey included the three subscales of the CBI, each of which measures personal, work-related, and patient-related dimensions of burnout. Other items included demographics, practice type, workload, and work-life balance. CFA was used to measure fit, and Cronbach’s alpha was used to assess reliability. Correlation was used to assess criterion validity of the CBI. Logistic regression and bivariate analyses were used to assess pharmacist burnout based on demographics. Results: Following the removal of 2 items from the measurement model, a 17-item 3-factor CBI was found to possess satisfactory psychometric properties for use in pharmacists. The CBI correlated with measures of work-life demonstrating criterion validity. A logistic regression showed that younger pharmacists and community pharmacists experience higher burnout than older pharmacists and clinical pharmacists. Community pharmacists also more often reported high workloads and poorer work-life integration. Both community and clinic pharmacists desired more time providing patient care services and less time dispensing. Conclusion: The CBI is a psychometrically reliable and valid instrument for assessing burnout in pharmacists. Younger pharmacists and community pharmacists warrant attention due to their higher degree of burnout.


2018 ◽  
Vol 1 (1) ◽  
pp. 7-13
Author(s):  
Mohammed Al Saad ◽  
Saad Ahmed Ali Jadoo

Background: Cervical cancer (CC) ranks the eighth most frequent cancer among Syrian women with crude incidence rates 1.4 per 100, 000 populations per year. This study aimed to test the acceptance of the human papillomavirus (HPV) vaccine among mothers of schoolgirls in sixth-grade class. Methods: A cross-sectional survey was conducted through a structured and self-administrated questionnaire. A total of 400 Syrian mothers of schoolgirls were selected randomly by the cluster sampling method in Aleppo city, Syria, in 2011. Significant variables from univariate analysis were included in an enter technique multiple logistic regression analysis. Results: The response rate was 86%. If the vaccine was free, 282 (81.7%) mothers would accept the vaccine for themselves and 236 (68.4%) for their daughters, respectively. However, the acceptance rate grossly decreased to 24.6% and 15.1%, respectively, if the vaccine was not provided free. The high cost of the HPV vaccine and lack of knowledge were the significant barriers for mothers' acceptance of the HPV vaccine. Protection of daughters and the trust with health authority were the main encouraging reasons to accept the HPV vaccine. Findings from logistic regression analysis revealed that the employed mothers (odds ratio = 2.4; 95% CI: 1.3–4.4), with a positive history of gynecological examination (OR = 2.1; 95% CI: 1.6–2.9) and having sound knowledge (OR = 2.4; 95% CI: 1.0–5.7) are independent factors related to the acceptance of the HPV vaccine for their daughters. Conclusion: The results from this study suggest that mothers from different cultural backgrounds, including Syrian mothers, are holding different beliefs on privacy and health that may affect their willingness to accept the HPV vaccine.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1945 ◽  
Author(s):  
Bishwajit Ghose ◽  
Shangfeng Tang ◽  
Sanni Yaya ◽  
Zhanchun Feng

Background:Food insecurity and hidden hunger (micronutrient deficiency) affect about two billion people globally. Household food insecurity (HFI) has been shown to be associated with one or multiple micronutrient (MMN) deficiencies among women and children. Chronic food insecurity leads to various deficiency disorders, among which anemia stands out as the most prevalent one. As a high malnutrition prevalent country, Bangladesh has one of the highest rates of anemia among all Asian countries. In this study, we wanted to investigate for any association exists between HFI and anemia among women of reproductive age in Bangladesh.Methodology:Information about demographics, socioeconomic and anemia status on 5,666 married women ageing between 13 and 40 years were collected from a nationally representative cross-sectional survey Bangladesh Demographic and Health Survey (BDHS 2011). Food security was measured by the Household Food Insecurity Access Scale (HFIAS). Capillary hemoglobin concentration (Hb) measured by HemoCue® was used as the biomarker of anemia. Data were analysed using cross-tabulation, chi-square tests and multiple logistic regression methods.Results:Anemia prevalence was 41.7%. Logistic regression showed statistically significant association with anemia and type of residency (p = 0.459; OR = 0.953, 95%CI = 0.840–1.082), wealth status (Poorest: p < 0.001; OR = 1.369, 95%CI = 1.176–1.594; and average: p = 0.030; 95%CI = 1.017–1.398), educational attainment (p < 0.001; OR = 1.276, 95%CI = 1.132–1.439) and household food insecurity (p < 0.001; 95%CI = 1.348–1.830). Women who reported food insecurity were about 1.6 times more likely to suffer from anemia compared to their food secure counterparts.Conclusion:HFI is a significant predictor of anemia among women of reproductive age in Bangladesh. Programs targeting HFI could prove beneficial for anemia reduction strategies. Gender aspects of food and nutrition insecurity should be taken into consideration in designing national anemia prevention frameworks.


2010 ◽  
Vol 17 (4) ◽  
pp. 183-189 ◽  
Author(s):  
Vanessa Torres-Llenza ◽  
Sanjit Bhogal ◽  
Michael Davis ◽  
Francine M Ducharme

BACKGROUND: Because of the potential risk of interaction with, and underuse of, conventional medications, it is important to document the prevalence of the use of complementary and alternative medicines (CAMs) in asthmatic children.OBJECTIVE: To ascertain the prevalence and type of CAMs, and to identify factors associated with their use.METHODS: A cross-sectional survey of children who presented to the Asthma Centre of The Montreal Children’s Hospital (Montreal, Quebec) between 1999 and 2007 was conducted. At the initial consultation, parents completed a questionnaire inquiring, in part, about CAM use. Computerized health records provided information regarding patient characteristics and their condition.RESULTS: The median age of the 2027 children surveyed was 6.1 years (interquartile range 3.3 to 10.5 years); 58% were male and 59% of children had persistent asthma. The prevalence of CAM use was 13% (95% CI 12% to 15%). Supplemental vitamins (24%), homeopathy (18%) and acupuncture (11%) were the most commonly reported CAMs. Multivariable logistic regression analysis confirmed the association of CAM use with age younger than six years (OR 1.86; 95% CI 1.20 to 2.96), Asian ethnicity (OR 1.89; 95% CI 1.01 to 3.52), episodic asthma (OR 1.88; 95% CI 1.08 to 3.28) and poor asthma control (OR 1.98; 95% CI 1.80 to 3.31).CONCLUSION: The prevalence of reported CAM use among Quebec children with asthma remained modest (13%), with vitamins, homeopathy and acupuncture being the most popular modalities. CAM use was associated with preschool age, Asian ethnicity, episodic asthma and poor asthma control.


2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 198-198
Author(s):  
Michael Joseph Herriges ◽  
Ruben Pinkhasov ◽  
Keren Lehavot ◽  
Oleg Shapiro ◽  
Joseph M Jacob ◽  
...  

198 Background: Data on heterogeneity in cancer screening and diagnosis rates among sexual minorities (SMs) is lacking. Recent studies have shown SMs are more likely to engage in risky health behavior and have decreased healthcare utilization. However, few studies have examined how sexual orientation impacts cancer screening and prevalence. We therefore investigated whether sexual orientation affects prevalent gender-specific cancer including prostate (PCa), breast (BC), and cervical cancer (CC). Methods: This was a cross-sectional survey-based US study, including men and women aged 18+ from the Health Information National Trends Survey (HINTS) database (part of the National Cancer Institute’s division of cancer control and population sciences) between 2017-2019. The primary endpoint was individual-reported PCa, BC, and CC screening and prevalence rates among heterosexuals and homosexuals/bisexuals. Multivariable logistic regression analyses assessed association of various covariates with undergoing screening and diagnosis of these cancers. Results: Overall, 4,441 and 6,333 heterosexual men and women, respectively, were compared to 225 and 213 homosexual/bisexual men and women, respectively. Homosexuals/bisexuals were younger and less likely to be screened for PCa (34.7% vs 41.3%, p=0.013), BC (54.5% vs 80.7%, p=<0.001), and CC (88.3% vs 95.4%, p=<0.001). While rates of PCa and BC diagnosis were similar, more than twice as many homosexual/bisexual women were diagnosed with CC (4.2% vs 1.9%, p=0.023). Multivariable logistic regression models (Table) showed homosexuals/bisexuals were less likely to be screened for cancer with ORs of 0.61 (95% CI 0.39-0.95) for PCa, 0.52 (95% CI 0.30-0.92) for BC, and 0.21 (95% CI 0.09-0.46) for CC. Homosexuals/bisexuals were more likely to be diagnosed with any cancer with ORs of 1.64 (95% CI 1.06-2.54) in women only and 1.50 (95% CI 1.11-2.03) in men and women combined. Conclusions: Homosexuals/bisexuals in the US may be less likely to undergo screening of gender-specific prevalent malignancies, including PCa, BC, and CC. The implementation of cancer screening among SMs should be improved. [Table: see text]


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036931
Author(s):  
Maaike Seekles ◽  
Paula Ormandy ◽  
Daiga Kamerāde

ObjectiveTo examine in-centre haemodialysis patients’ emotional distress and need for support across UK renal units with varying models of psychosocial service provision.DesignThe study used a cross-sectional survey design. Logistic regression analysis was used to examine patient distress, as captured by the Distress Thermometer, and need for support, across different renal units.SettingSeven renal units across England, Wales and Scotland. The units were purposively selected so that varying workforce models of renal psychosocial services were represented.ParticipantsIn total, 752 patients were on dialysis in the participating centres on the days of data collection. All adult patients, who could understand English, and with capacity (as determined by the nurse in charge), were eligible to participate in the study. The questionnaire was completed by 509 patients, resulting in an overall response rate of 67.7%.Outcome measuresThe prevalence of distress and patient-reported need for support.ResultsThe results showed that 48.9% (95% CI 44.5 to 53.4) of respondents experienced distress. A significant association between distress and models of renal psychosocial service provision was found (χ2(6)=15.05, p=0.019). Multivariable logistic regression showed that patients in units with higher total psychosocial staffing ratios (OR 0.65 (95% CI 0.47 to 0.89); p=0.008) and specifically higher social work ratios (OR 0.49 (95% CI 0.33 to 0.74); p=0.001) were less likely to experience distress, even after controlling for demographic variables. In addition, a higher patient-reported unmet need for support was found in units where psychosocial staffing numbers are low or non-existent (χ2(6)=37.80, p<0.001).ConclusionsThe novel findings emphasise a need for increased incorporation of dedicated renal psychosocial staff into the renal care pathway. Importantly, these members of staff should be able to offer support for psychological as well as practical and social care-related issues.


Author(s):  
Xue Yang ◽  
Xuewen Jiang ◽  
Phoenix Kit-han Mo ◽  
Yong Cai ◽  
Le Ma ◽  
...  

This study investigated the prevalence and interpersonal correlates of Internet gaming disorders (IGD) among Chinese adolescents. A cross-sectional survey was conducted in two cities (Shanghai and Xi’an) in China. A total of 2666 (Meanage = 12.77 ± 0.75) year-one students from eight middle schools completed a self-reported questionnaire. It tested their levels of IGD, parental psychological control, negative interpersonal events (physical/verbal abuse by parents, verbal abuse by teachers, peer/online bullying), social support from parents/peers, and positive relationships with parents/peers. Results showed that 346 participants (13.0%) were classified as having IGD. Gender, city, single-parent family, family socio-economic status, and mother’s education level were significantly associated with the risk of IGD. Logistic regression analyses with and without controlling for the significant background variables showed that the studied interpersonal variables were significantly associated with IGD, respectively. Forward stepwise logistic regression showed that the significant correlates of IGD included parental psychological control, physical/verbal abuse by parents, verbal abuse by teachers, and peer/online bullying. Results highlight the importance of addressing interpersonal risk factors to reduce adolescent IGD. Limitations and implications of this study are discussed.


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