scholarly journals Children and young people’s versus parents’ responses in an English national inpatient survey

2018 ◽  
Vol 103 (5) ◽  
pp. 486-491 ◽  
Author(s):  
Dougal S Hargreaves ◽  
Steve Sizmur ◽  
Jacqueline Pitchforth ◽  
Amy Tallett ◽  
Sara L Toomey ◽  
...  

ObjectiveDespite growing interest in children and young people’s (CYP) perspectives on healthcare, they continue to be excluded from many patient experience surveys. This study investigated the feasibility of, and additional information gained by, measuring CYP experiences of a recent hospital admission.DesignCross-sectional analysis of national survey data.SettingInpatients aged 8–15 years in eligible National Health Service hospitals, July–September 2014.Participants6204 parents/carers completed the parent section of the survey. The CYP section of the survey was completed by CYP themselves (n=3592), parents (n=849) or jointly (n=1763).Main outcome measuresPain relief, involvement, quality of staff communication, perceived safety, ward environment, overall experience.AnalysesSingle-measures intraclass correlations (ICCs) were used to assess the concordance between CYP and parent responses about the same inpatient episode. Multilevel logistic regression models, adjusted for individual characteristics, were used to compare the odds of positive responses when the CYP section of the survey was completed by parents, by CYP themselves or jointly.ResultsThe CYP section of the survey was completed independently by 57.8% of CYP. Agreement between CYP and parent responses was reasonably good for pain relief (ICC=0.61 (95% CI 0.58 to 0.63)) and overall experience (ICC=0.70 (95% CI 0.68 to 0.72)), but much lower for questions comparing professionals’ communication with CYP and with their parents (ICC range=0.28 (95% CI 0.24 to 0.32) to 0.51 (95% CI 0.47 to 0.54)). In the regression models, CYP were significantly less likely than parents to report feeling safe (adjusted OR (AOR)=0.54 (95% CI 0.38 to 0.76)), involvement in decisions (AOR=0.66 (95% CI 0.46 to 0.94)) or adequate privacy (AOR=0.68 (95% CI 0.52 to 0.89)).ConclusionsIncluding CYP (8–15 years) in patient experience surveys is feasible and enhances what is known from parents’ responses.

2016 ◽  
Vol 29 (1) ◽  
pp. 172-184 ◽  
Author(s):  
Kevin J. Contrera ◽  
Josh Betz ◽  
Jennifer Deal ◽  
Janet S. Choi ◽  
Hilsa N. Ayonayon ◽  
...  

Objective: The objective of the study is was investigate the association between hearing impairment and anxiety. Method: We conducted a cross-sectional analysis of 1,732 community-based adults aged 76 to 85 years who participated in the Health Aging and Body Composition (ABC) study. Logistic regression models were adjusted for demographic and cardiovascular risk factors. Hearing impairment was defined by the speech-frequency pure tone average. Anxiety was defined as reporting two symptoms of at least “a little” or one symptom “quite a bit” on the three-item Hopkins Symptom Checklist. Results: Compared with individuals with no hearing impairment, the odds of prevalent anxiety were higher among individuals with mild hearing impairment (odds ratio [OR] = 1.32, 95% confidence interval [CI] = [1.01, 1.73]) and moderate or greater hearing impairment (OR = 1.59, 95% CI = [1.14, 2.22]). Hearing aid use was not significantly associated with lower odds of anxiety. Discussion: Hearing impairment is independently associated with greater odds of anxiety symptoms in older adults.


2019 ◽  
Vol 189 (5) ◽  
pp. 375-383 ◽  
Author(s):  
Yan Zhang ◽  
Lin Ji ◽  
Yi Hu ◽  
Lap Ah Tse ◽  
Yiwen Wang ◽  
...  

Abstract Organophosphates (OPs) are the most heavily used pesticides in China. The Chinese population, including preconceptional women, is highly exposed, yet little is known regarding the associations between OP exposure and menstruation in humans. We conducted a cross-sectional analysis in women preparing for pregnancy to investigate the relationship between biomarkers of OP exposure and menstrual cycle characteristics. From 2013 to 2015, 627 women visiting free preconception-care clinics at 2 maternity hospitals in Shanghai, China, were included. Information on menstrual cycle characteristics was obtained through questionnaires. OP exposure was assessed by measuring urine concentrations of 6 dialkylphosphate metabolites (dimethylphosphate, dimethylthiophosphate, dimethyldithiophosphate, diethylphosphate, diethylthiophosphate, and diethyldithiophosphate). The relationship between concentrations of dialkylphosphate metabolites and menstrual cycle characteristics was analyzed using multiple linear regression models and logistic regression models. Log-transformed levels of diethyl phosphate metabolites (the sum of diethylphosphate and diethylthiophosphate levels) were related to a higher risk of irregularity of menstrual cycles (adjusted odds ratio = 2.36, 95% confidence interval: 1.28, 4.34). Subjects with a higher concentration of diethyl phosphate metabolites (log-transformed) had a shorter duration of menstrual bleeding (adjusted β = −0.33, 95% confidence interval: −0.64, −0.02). The findings suggest that OP exposure may be associated with alterations in menstrual function in preconceptional women.


Author(s):  
Sandie Ha ◽  
Valerie Martinez

We aim to evaluate the association between self-reported disabilities and infertility and whether disabilities are associated with decreased likelihood of seeking infertility-related care. This US nationally representative cross-sectional analysis includes 3789 non-pregnant women aged 18–49 years without history of hysterectomy or oophorectomy (NHANES, 2013–2018). Disabilities and infertility were both self-reported in personal interviews with trained interviewers. Logistic regression models estimated the adjusted odds ratio (aOR) and 95% confidence intervals for the association between disabilities and infertility and related care seeking. Models adjusted for potential confounders and complex probability sampling. Compared to women without disabilities, women with disabilities (WWD) had higher odds of infertility (aOR: 1.78 (1.31–2.40)). Similar findings were observed for sensory (2.32 (1.52–3.52)) and cognitive disabilities (1.77 (1.28–2.44)). Among women with infertility, WWD were less likely to seek infertility-related care (0.68 (0.32–1.44)) but these estimates were not statistically significant. WWD have increased odds of reporting infertility, and if affected, are less likely to visit a health care provider for this condition. While more research is needed to understand reproductive health issues and needs among WWD, it is important to push for more equitable policies and practices to address the health needs of this underserved population.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melissa Macalli ◽  
Nathalie Texier ◽  
Stéphane Schück ◽  
Sylvana M. Côté ◽  
Christophe Tzourio

AbstractPrevious studies have shown the negative impact of the COVID-19 epidemic on students’ mental health. It is, however, uncertain whether students are really at higher risk of mental health disturbances than non-students and if they are differentially impacted by lockdown periods over time. The objective of our study was to compare the frequency of depressive symptoms, anxiety, and suicidal thoughts in students and non-students enrolled in the same study in France and during the same key periods of the COVID-19 epidemic. Using a repeated cross-sectional design, we collected data from a sample of 3783 participants in the CONFINS study during three recruitment waves between March 2020 and January 2021. Multivariate logistic regression models, adjusted for potential confounding factors, showed that students were more likely to have high scores of depressive symptoms and anxiety more frequently than non-students. These differences were particularly strong during the first (depressive symptoms: adjusted odds ratio aOR 1.59, 95% CI 1.22–2.08; anxiety: aOR 1.63, 95% CI 1.22–2.18) and second lockdowns (depressive symptoms: aOR 1.80, 95% CI 1.04–3.12; anxiety: aOR 2.25, 95% CI 1.24–4.10). These findings suggest that the restrictive measures—lockdown and curfew—have an alarmingly stronger negative impact on students than on non-students and underline the frailty of students’ mental health and the need to pay greater attention to this population in this epidemic-related context.


2020 ◽  
Vol 34 (5) ◽  
pp. 559-562
Author(s):  
Kristi Rahrig Jenkins ◽  
Bruce W. Sherman

Purpose: This study examines the association between nonparticipation in wellness activities and employee turnover risk. Design: Retrospective, cross-sectional analysis. Setting: Large university in the Midwestern United States. Participants: Employees with continuous employment during 2016 and complete human resources and wellness program data (n = 34 405). Methods: Demographic, health risk assessment (HRA), and wellness program participation data were collected in 2016 and paired with administratively recorded turnover status from 2017. For the multivariate analyses, logistic regression models were used. Results: There were statistically significant associations between various socioeconomic and demographic characteristics (gender, age, race, wage, union and faculty status, and health score) with turnover status. Also, all 3 participation levels (participated in the HRA only, participated in the HRA and wellness programming, and participated in wellness programming only) had lower odds of experiencing turnover compared to nonparticipants (participated in the HRA only [adjusted odds ratio, AOR: 0.89; confidence interval, CI: 0.80-0.99], participated in wellness program(s) only [AOR: 0.77; CI: 0.62-0.95] and participated in both the HRA and program(s) [AOR: 0.82; CI: 0.74-0.91], respectively). Conclusion: Employee participation in wellness program activities appears to represent a measure of engagement with work. Nonparticipation in these programs is associated with increased risk of employment turnover in the subsequent year.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li Ran ◽  
Qi Chen ◽  
Jingyi Zhang ◽  
Xinlong Tu ◽  
Xiaodong Tan ◽  
...  

AbstractHypertension (HTN) and osteoarthritis (OA) are frequent in middle-aged and elderly people, and the co-occurrence of these two diseases is common. However, the pathogenesis of the multimorbidity of both diseases and the relation with sleep quality, hyperlipemia, and hyperglycemia is unclear. We conducted a cross-sectional study to make sense of the multimorbidity of HTN and OA and the relation with sleep quality, hyperlipemia, and hyperglycemia. The relation between sleep quality and OA and its joint effect with hyperlipemia or hyperglycemia was evaluated with logistic regression models. The additive interaction was assessed with the relative excess risk due to interaction (REEI), the attributable proportion (AP), and the synergy index (S). According to this research in a remote rural area, approximately 34.2% of HTN patients are accompanied with OA and 49.1% are suffering poor sleep. Both hyperlipemia/hyperglycemia and sleep quality were related to OA prevalence with crude ORs of 1.43 (95% CI 1.014–2.029) and 1.89 (95% CI 1.411–2.519, P < 0.001) respectively. An observed additive effect was found greater than the sum of the effects of sleep quality and hyperlipemia/hyperglycemia posed on OA prevalence alone. This additive interaction was observed in females (OR = 3.19, 95% CI 1.945–5.237) as well as males ≥ 65 years old (OR = 2.78, 95% CI 1.693–4.557), with RERI, AP, and S significant. Therefore, poor sleep and hyperlipemia/hyperglycemia are associated with OA, and further studies on the additive interaction among females and males ≥ 65 are warranted.


2017 ◽  
Vol 17 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Rana A. Qadeer ◽  
Lilly Shanahan ◽  
Mark A. Ferro

AbstractBackground and aimsThere has been a growth in the proportion of emerging adults vulnerable to pain-related sequelae of chronic health conditions (CHCs). Given the paucity of research during this important developmental period, this study investigated the association between CHCs and chronic disruptive pain among emerging adults and the extent to which psychiatric disorders moderate this association.MethodsData come from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH). This cross-sectional survey included 5987 participants that were 15-30 years of age and self-reported their CHCs (n = 2460,41%) and the extent to which pain impacted daily functioning using items from the Health Utilities Index Mark 3 (HUI 3). Group comparisons between respondents with CHCs and healthy controls were made using chi-square tests. Odds ratios (OR) and 95% confidence intervals (CI) were computed from ordinal logistic regression models adjusting for sociodemographic covariates. Product-term interactions between CHCs and psychiatric disorders were included in the models to explore moderating effects. All analyses were weighted to maintain representativeness of the study sample to the Canadian population.ResultsThe mean age of participants was 23.5 (SE 0.1) years and 48% were female. Compared to healthy controls, a greater proportion of participants with CHCs reported having chronic pain (20.3% vs. 4.5%, p < 0.001). Among those with chronic pain, respondents with CHCs reported a greater number of activities prevented because of chronic disruptive pain (χ2 = 222.28, p< 0.001). Similarly, in logistic regression models, participants with CHCs had greater odds of reporting chronic disruptive pain (OR = 4.94, 95% CI = 4.08-5.99). Alcohol (β = –0.66; p = 0.025) and drug abuse/dependence disorders (β = –1.24; p = 0.012) were found to moderate the association between CHCs and chronic disruptive pain. Specifically, the probability of chronic disruptive pain was higher for emerging adults without CHCs and with alcohol or drug disorders; however, among participants with CHCs, probability was higher for those without these disorders.ConclusionsThere is a robust association between CHCs and chronic disruptive pain. The moderating effects suggest that alcohol or drug disorders are especially harmful for emerging adults without CHCs and contribute to higher levels of chronic disruptive pain; however, among those with CHCs, alcohol and illicit drugs may be used as a numbing agent to blunt chronic disruptive pain.ImplicationsFindings from this study have implications for the integration and coordination of services to design strategies aimed at managing chronic disruptive pain and preventing pain-related disabilities later in life. Within the health system, healthcare providers should engage in dialogues about mental health and substance use regularly with emerging adults, be proactive in screening for psychiatric disorders, and continue to monitor the impact of pain on daily functioning. Given the age range of emerging adults, there is tremendous opportunity for clinicians to work cooperatively with colleagues in the education system to support emerging adults with and without CHCs. Overall, clinicians, researchers, educators, and those in social services should continue to be mindful of the complex interrelationships between physical and mental health and chronic disruptive pain and work cooperatively to optimize health outcomes and prevent pain-related disabilities among emerging adults.


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


Medicina ◽  
2018 ◽  
Vol 54 (6) ◽  
pp. 100
Author(s):  
Pietro Ferrara ◽  
Lucia Stromillo ◽  
Luciana Albano

Background and objectives: Vaccination against bacterial pathogens is decisive for preventing invasive meningococcal disease and pediatricians play a pivotal role in vaccination compliance and coverage. The aim of this study was to investigate awareness, attitude, and practices toward the vaccine against Meningococcal B serogroup (4CMenB) among a sample of Italian pediatricians. Materials and Methods: A cross-sectional study was carried out using an online questionnaire from March to May 2015. Three multivariate logistic regression models were built to identify factors associated with the outcomes of interest. Results: The data showed that 95.5% of the interviewees correctly responded about the availability of 4CMenB vaccine in Italy, while only 28.0% knew the vaccination schedule for children aged two years or under. This knowledge was significantly higher in younger pediatricians and in those who worked a higher number of hours per week. Pediatricians self-reported a positive attitude toward the utility and safety of 4CMenB vaccine. Those pediatricians with a strong positive attitude toward the utility of the vaccine, who knew the vaccination schedules for children of two years or under, and who declared a satisfactory or good knowledge about the vaccine were more likely to inform parents about its availability in Italy, recommend the vaccination, and verify patients’ vaccination status, in their daily practice. Conclusions: The study highlights factors that currently influence pediatricians’ practices regarding the 4CMenB vaccine. The results showed the possible actions recommended to improve physicians’ awareness and behaviors in order to improve the vaccination compliance and invasive meningococcal diseases prevention.


2021 ◽  
Author(s):  
Haonan Shi ◽  
Jing Fu ◽  
Xiaojing Liu ◽  
Yingxia Wang ◽  
Xianting Yong ◽  
...  

Abstract Background: To evaluate the prevalence of myopia in school students in Urumqi, China, and explore the influence of the interaction between parental myopia and poor reading and writing habits on myopia to identify the at-risk population and provide evidence to help school students avoid developing myopia.Methods: A cross-sectional survey was conducted with 6,883 school students aged 7–20 years in Urumqi in December 2019. The Standard Eye Chart and mydriatic optometry were used to determine whether students had myopia. Falconer’s method was used to calculate the heritability of parental myopia. Multivariate unconditional logistic regression models were used to analyze the risk factors for myopia and the additive and multiplicative interaction of parental myopia and poor reading and writing habits.Results After standardizing the age of the 6,883 students, the overall prevalence rate of myopia was 47.50%. The heritability of parental myopia was 66.57% for boys, 67.82% for girls, 65.02% for the Han group, and 52.71% for other ethnicities. There were additive interactions between parental myopia and poor reading and writing habits; among them, parental myopia and poor reading and writing habits (1) (the distance between the eyes and book is less than 30 cm when reading and writing, fingers block the sight of one eye while holding the pen, and leaning one’s body when reading and writing) increased the risk of myopia by 10.99 times (odds ratio [OR]=10.99, 95% confidence interval [CI]=8.33–14.68), parental myopia and poor reading and writing habits (2) (reading while lying down, walking, or in the car) increased the risk of myopia by 5.92 times (OR=5.92, 95% CI=4.84–7.27). There was no multiplicative interaction between parental myopia and poor reading and writing habits (1) or (2) (OR=0.69, 95% CI=0.44–1.08; OR=0.89, 95% CI=0.66–1.21, respectively).Conclusion The prevalence of myopia among students in Urumqi, Xinjiang is relatively high. The risk of developing myopia is affected by parental myopia and poor reading and writing habits. In addition, parental myopia amplifies the harm caused by poor reading and writing habits, thereby increasing the risk of myopia. Students with parents who have myopia should be targeted during myopia prevention efforts.


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