scholarly journals Influence of agents and mechanisms of injury on anatomical burn locations in children <5 years old with a scald

2021 ◽  
pp. archdischild-2020-320710
Author(s):  
Assim Ali Javaid ◽  
Emma Johnson ◽  
Linda Hollén ◽  
Alison Mary Kemp
Keyword(s):  
Child Protection ◽  
Primary Outcome ◽  
Descriptive Analysis ◽  
Cross Sectional Study ◽  
Hot Water ◽  
Secondary Outcome ◽  
Anatomical Location ◽  
Cross Sectional ◽  
Causative Agents ◽  
Hands And Feet

ObjectiveTo demonstrate how the mechanism and agent of injury can influence the anatomical location of a scald.DesignProspective multicentre cross-sectional study.Setting20 hospital sites across England and Wales including emergency departments, minor injury units and regional burns units.PatientsChildren aged 5 years and younger who attended hospital with a scald.Main outcome measuresPrimary outcome: a descriptive analysis of the mechanism, agent and anatomical location of accidental scalds. Secondary outcome: a comparison of these factors between children with and without child protection (CP) referral.ResultsOf 1041 cases of accidental scalds, the most common narrative leading to this injury was a cup or mug of hot beverage being pulled down and scalding the head or trunk (132/1041; 32.9% of cases). Accidental scalds in baths/showers were rare (1.4% of cases). Accidental immersion injuries were mainly distributed on hands and feet (76.7%). There were differences in the presentation between children with accidental scalds and the 103 who were referred for CP assessment; children with scalds caused by hot water in baths/showers were more likely to get referred for CP assessment (p<0.0001), as were those with symmetrically distributed (p<0.0001) and unwitnessed (p=0.007) scalds.ConclusionsAn understanding of the distributions of scalds and its relationship to different mechanisms of injury and causative agents will help clinicians assess scalds in young children, particularly those new to the emergency department who may be unfamiliar with expected scald patterns or with the importance of using appropriate terminology when describing scalds.

scholarly journals Contact burns: the influence of agents and mechanisms of injury on anatomical burn locations in children <5 years old and associations with child protection referrals

2019 ◽  
Vol 105 (6) ◽  
pp. 580-586
Author(s):  
Assim Ali Javaid ◽  
Verity Bennett ◽  
Linda Hollén ◽  
Alison Mary Kemp
Keyword(s):  
Young Children ◽  
Outcome Measures ◽  
Child Protection ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Mechanism Of Injury ◽  
Sectional Study ◽  
Cross Sectional ◽  
Burn Units ◽  
Causative Agents

ObjectiveTo identify how causative agents and mechanisms of injury influence the location of an accidental contact burn in children and whether these factors differ in cases referred for child protection (CP) assessment.DesignProspective multicentre cross-sectional study.Setting20 hospital sites across England and Wales, including: emergency departments, minor injury units and regional burn units.PatientsChildren less than 5 years old who attended hospital for a contact burn (August 2015 to September 2018).Main outcome measuresLocation of burns with respect to agent and mechanism for accidental contact burns. Secondary outcome: mechanism, agent and location of burns referred for CP assessment.Results816 accidental burns and 92 referrals for CP assessment. The most common for accidental burns: mechanism was reaching while stationary (68%, 553/816), agent was oven (24.5%, 200/816) and site was the hand (69.2%, 565/816). Burns to head and trunk were rare at 3.7% (30/816). The data enabled a tabulation of the locations of burns as predicted by agent and mechanism of injury. The location of the burn was most strongly influenced by mechanism.Burns from irons (p<0.01), caused by mechanisms independent of the child (p=0.01), unwitnessed burns (p<0.001) and burns to the head and trunk (p<0.001) were significantly more common among the children referred for CP assessment.ConclusionsBy overlaying agent, mechanism and site it was possible to tabulate and quantify simple narratives of accidental contact burns in population of young children. These findings have the potential to aid clinicians in recognising accidental contact burns.

scholarly journals Misconceptions about COVID-19 among older Rohingya (forcefully displaced Myanmar nationals) adults in Bangladesh: findings from a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e050427
Author(s):  
Sabuj Kanti Mistry ◽  
A R M Mehrab Ali ◽  
Uday Narayan Yadav ◽  
Saruna Ghimire ◽  
Md. Belal Hossain ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Health Workers ◽  
Multiple Linear Regression Model ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
Factors Associated ◽  
Cumulative Score ◽  
Low Health Literacy ◽  
Communication Frequency

ObjectivesDue to low health literacy and adverse situation in the camps, there are possibilities of misconceptions related to COVID-19 among the older Rohingya (forcefully displaced Myanmar nationals or FDMNs) adults in Bangladesh. The present research aimed to assess the level of misconceptions and the factors associated with it among the older FDMNs in Bangladesh.DesignCross-sectional.SettingA selected Rohingya camp situated in Cox’s Bazar, a southeastern district of Bangladesh.ParticipantsInformation was collected from 416 conveniently selected FDMNs who were aged 60 years and above.Primary and secondary outcome measuresThe primary outcome was misconceptions related to the spread, prevention and treatment of COVID-19. Information on 14 different locally relevant misconceptions was gathered, each was scored as one, and obtained a cumulative score, ranging from 0 to 14, with a higher score indicating a higher level of misconceptions. A multiple linear regression model explored the factors associated with misconceptions.ResultsThe participants had an average of five misconceptions. The most prevalent misconceptions were: everyone should wear personal protective equipment when outside (84.6%) and its prevention by nutritious food (62.5%) and drinking water (59.3%). Other notable misconceptions included the spread of COVID-19 through mosquito bites (42%) and its transmissions only to the non/less religious person (31.4%). In regression analyses, memory or concentration problems, communication frequency with social networks, pre-existing conditions and receiving information from health workers were significantly associated with higher COVID-19 misconceptions. These misconceptions were less likely among those overwhelmed by COVID-19, having COVID-19 diagnosed friends or family members and receiving information from friends and family.ConclusionsOverall, we found that misconceptions were prevalent among the older FDMNs in Bangladesh. The associations have important implications for programmes to prevent and manage COVID-19 in these settings. Health workers need to be adequately trained to provide clear communication and counter misconceptions.

scholarly journals Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018739 ◽  
Author(s):  
Pontius Bayo ◽  
Imose Itua ◽  
Suzie Paul Francis ◽  
Kofi Boateng ◽  
Elijo Omoro Tahir ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Postpartum Haemorrhage ◽  
South Sudan ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Obstetric Complications ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional

ObjectiveTo determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication.DesignThis was a retrospective cross-sectional study.SettingFour primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan.ParticipantsAll admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications.Primary and secondary outcome measuresThe primary outcome was met need for EmOC, which was defined as the proportion of all women with direct major obstetric complications in 2015 treated in health facilities providing EmOC services. The frequency of each complication and the interventions for treatment were the secondary outcomes.ResultsTwo hundred and fifty four major obstetric complications were admitted in 2015 out of 390 expected from 2602 pregnancies, representing 65.13% met need. The met need was highest (88%) for Nyong Payam, an urban area, compared with the other two rural payams, and 98.8% of the complications were treated from the hospital, while no complications were treated from three PHCCs. The most common obstetric complications were abortions (45.7%), prolonged obstructed labour (23.2%) and haemorrhage (16.5%). Evacuation of the uterus for retained products (42.5%), caesarean sections (32.7%) and administration of oxytocin for treatment of postpartum haemorrhage (13.3%) were the most common interventions.ConclusionThe met need for EmOC in Torit County is low, with 35% of women with major obstetric complications not accessing care, and there is disparity with Nyong Payam having a higher met need. We suggest more support supervision to the PHCCs to increase access for the rural population.

scholarly journals Association between previous rheumatoid arthritis and COVID-19 and its severity: a nationwide cohort study in South Korea

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e054753
Author(s):  
Younghee Jung ◽  
Mihye Kwon ◽  
Hyo Geun Choi
Keyword(s):  
Rheumatoid Arthritis ◽  
Primary Outcome ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Diagnostic Code ◽  
Cross Sectional ◽  
International Classification Of Disease ◽  
Laboratory Confirmation ◽  
History Of ◽  
And Control

ObjectivesThe prevalence of rheumatoid arthritis (RA) among patients with COVID-19 and the association between RA and the outcome of COVID-19 remain unclear. We aimed to compare the prevalence of RA between participants with and without COVID-19; we then analysed the association between the presence of RA and the severity of COVID-19.DesignA cross-sectional study.SettingData from a nationwide COVID-19 cohort database by the Korea National Health Insurance Corporation were used.Participants and interventionsA total of 8070 patients with COVID-19 (1 January 2020 through 4 June 2020) were matched with 32 280 control participants with regard to age, sex and income. Patients with COVID-19 were confirmed by SARS-CoV-2 PCR and controls were collected from the database. RA was confirmed using the diagnostic code (International Classification of Disease, Tenth Revision) and medication claim codes. Conditional/unconditional logistic regression was applied to analyse the association between RA and COVID-19.Primary outcome and secondary outcomeLaboratory confirmation of SARS-CoV-2 infection was defined as the primary outcome. The secondary outcome was severe COVID-19 defined as a history of intensive care unit admission, invasive ventilation or death.ResultsThe prevalence of RA in the COVID-19 (0.4%, 35/8070) and control (0.4%, 121/32,280) groups did not differ (p=0.446). After adjusting for underlying diseases, no association between RA and COVID-19 was observed (adjusted OR=1.14, 95% CI: 0.78 to 1.67) and COVID-19 severity was not associated with RA (adjusted OR=0.62, 95% CI: 0.14 to 7.29). The overall mortality rate was 2.9% (237/8070) and RA was not significantly associated with mortality (adjusted OR=1.64, 95% CI: 0.33 to 8.15).ConclusionWe did not find an association between the presence of RA and COVID-19. In addition, RA was not associated with the severity of COVID-19.

scholarly journals Cross-sectional study of nutritional intake among patients undergoing tuberculosis treatment along the Myanmar–Thailand border

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e052981
Author(s):  
Karim Damji ◽  
Ahmar H Hashmi ◽  
Lin Lin Kyi ◽  
Michele Vincenti-Delmas ◽  
Win Pa Pa Htun ◽  
...  
Keyword(s):  
Weight Gain ◽  
Primary Outcome ◽  
Cross Sectional Study ◽  
Nutritional Intake ◽  
Secondary Outcome ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Tb Treatment ◽  
Micronutrient Intake ◽  
Caloric Requirements

ObjectiveThis study summarises nutritional intake among patients with tuberculosis (TB) along the Myanmar–Thailand border according to the local diet.SettingTB clinic along the Myanmar–Thailand border.ParticipantsCross-sectional surveys of 24-hour food recall were conducted with participants receiving anti-TB treatment. Participants were purposively selected to reflect proportion of age, sex and HIV co-infection based on historical patient records. Out of a total of 28 participants, 20 (71.4%) were men and 5 (17.9%) were co-infected with HIV.Primary and secondary outcome measuresThe primary outcome compared actual recorded intake to recommended intake. Secondary outcomes compared weight gain and body mass index (BMI) from diagnosis to time of survey.ResultsThere were no significant differences in macronutrient or micronutrient intake by sex or for patients supplementing their rations. Mean treatment length at time of survey was 20.7 weeks (95% CI: 16.5 to 24.8). A significantly higher proportion of women (8/8, 100%) met caloric requirements compared with men (9/20, 45.0%, p=0.010), but few participants met other macronutrient or micronutrient requirements, with no significant differences by sex or for patients supplementing their rations. From diagnosis to the time of the survey, participants averaged significant weight gain of 6.48 kg (95% CI: 3.87 to 9.10) and increased BMI of 2.47 kg/m2 (95% CI: 1.45 to 3.49; p=0.0001 for both). However, 50% (14/28) still had mild or more severe forms of malnutrition.ConclusionsThis cross-sectional survey of nutritional intake in patients undergoing TB treatment in a sanatorium setting demonstrates the difficulty in sufficiently meeting nutritional demands, even when providing nutritional support.

scholarly journals Primary outcome switching among drug trials with and without principal investigator financial ties to industry: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019831 ◽  
Author(s):  
Christopher W Jones ◽  
Benjamin S Misemer ◽  
Timothy F Platts-Mills ◽  
Rosa Ahn ◽  
Alexandra Woodbridge ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
Study Endpoint ◽  
Secondary Outcome ◽  
Primary Study ◽  
Drug Trials ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

ObjectivesTo determine the relationship between manufacturer-related financial ties among investigators of published drug trials and rates of discrepant registered and published primary trial outcomes.DesignCross-sectional study.SettingHuman subjects drug trials published in ‘core clinical’ MEDLINE journals in 2013.Primary and secondary outcome measuresThe primary study endpoint was the presence of a prospectively registered, clearly defined primary outcome that matched the published primary outcome for each included trial. Secondary outcomes included assessments of registration timing and quality, and the impact of outcome discrepancies between registration and publication on the statistical significance of the included trials.ResultsOf 192 included trials, 134 (70%) were positive and 58 (30%) were negative. Financial ties were present between first or last authors and drug manufacturers for 130 trials (68%), of which 78% were positive, versus 53% of trials with no financial ties that were positive. Clearly defined, prospectively registered outcomes that matched the published outcomes were present in just 76 of the 192 trials (40%). After adjusting for study start date and sample size, the observed relationship between investigator financial ties and the presence of a match between prospectively registered and published primary outcomes was of borderline statistical significance (OR 2.12, 95% CI 0.998 to 4.50). Studies with financial ties present were more likely than studies without ties to have been prospectively registered (78%vs48%, P<0.001) and were more likely to have prospectively registered a clearly defined primary outcome(62%vs35%, P<0.001).ConclusionsLess than half of the trials in this cohort were prospectively registered with a clear primary outcome that was consistent with the primary outcome reported in the published manuscript. The presence of investigator financial ties was associated with higher quality registration practices, though this association diminished after adjusting for factors that impact registration quality.

Patient Tolerability of Bowel Preparation is Associated with Polyp Detection Rate During Colonoscopy

2014 ◽  
Vol 23 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Edward W. Holt ◽  
Kidist K. Yimam ◽  
Hanley Ma ◽  
Richard E. Shaw ◽  
Richard A. Sundberg ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Polyp Detection ◽  
Cross Sectional ◽  
Quality Outcomes ◽  
Negative Experience ◽  
Polyp Detection Rate ◽  
Patient Reported ◽  
Bowel Prep

Background & Aims: A number of factors have been identified that influence the yield of screeningcolonoscopy. The perceived tolerability of bowel preparation has not been studied as a predictor of quality outcomes in colonoscopy. We aimed to characterize the association between patient-perceived tolerability of bowel preparation and polyp detection during colonoscopy.Methods: We performed a cross-sectional cohort study of 413 consecutive adult patients presenting foroutpatient colonoscopy at two outpatient endoscopy centers at our institution. We developed a standardized questionnaire to assess the patient's experience with bowel preparation. Bowel preparation quality was measured using the validated Ottawa scale and colonoscopic findings were recorded for each patient. The primary outcome was polyp detection and the secondary outcome was the quality of bowel preparation.Results: Patient-reported clarity of effluent during bowel preparation correlated poorly with Ottawa score during colonoscopy, k=0.15. Female gender was an independent risk factor for a poorly tolerated bowel prep (OR 3.93, 95% CI 2.30 - 6.72, p<0.001). Report of a poorly tolerated bowel prep was independently associated with the primary outcome, polyp detection (OR 0.39, 95% CI 0.18 - 0.84, p=0.02) and also with the secondary outcome, lower quality bowel preparation (OR 2.39, 95% CI 1.17 - 4.9, p=0.02).Conclusions: A patient-perceived negative experience with bowel preparation independently predicted both a lower quality bowel preparation and a lower rate of polyp of detection. Assessment of the tolerability of bowel preparation before colonoscopy may be a clinically useful predictor of quality outcomes during colonoscopy.

Frequency of Neck and Upper Extremity Musculoskeletal Disorders in Dentists

2020 ◽  
Vol 9 (3) ◽  
pp. 207-211
Author(s):  
Sidra Sarwar ◽  
Sara Khalid ◽  
Tahir Mahmood ◽  
Hadeeqa Jabeen ◽  
Shahid Imran
Keyword(s):  
Upper Extremity ◽  
Musculoskeletal Disorders ◽  
Health Care Professionals ◽  
Descriptive Analysis ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Dental Hospital ◽  
Upper Extremity Musculoskeletal Disorders ◽  
And Performance

Background: Musculoskeletal disorders are not only becoming prevalent among health care professionals in our country but are affecting their health and performance adversely. They are caused by poor ergonomics and awkward posture during work activities. The purpose of this study was to determine the frequency of neck and upper limb musculoskeletal disorders in dentists of Lahore, Pakistan. Material and Methods: This cross-sectional study was conducted during October 2017 to March 2018. The data was collected using convenient sampling technique from 162 Dentists including 52 males and 110 females of Children hospital Lahore, Punjab Dental hospital and Fatima Memorial Hospital, Lahore. Data was collected by using Mangalore Questionnaire for identification of musculoskeletal disorders. Descriptive analysis of the data was done using SPSS version 22.0. Results: Of 162 dentists, 115 (71%) suffered from musculoskeletal disorders. Shoulder was the most commonly affected region (30.9%) followed by neck (25.9%), arm (6.2%), wrist (4.3%), elbow (3.1%) and forearm (0.6%). Pain (45.7%) was found to be the most common complaint followed by muscle weakness (20.4%), paraesthesia (3.7%) and swelling (1.2%). Conclusions: It was concluded that majority of the dentists were suffering from musculoskeletal disorders with shoulder as the most affected region and pain as the most frequent complaint. Key words: Dentists, Musculoskeletal disorders, Neck pain, Upper extremity

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals How do delirium motor subtypes differ in phenomenology and contributory aetiology? a cross-sectional, multisite study of liaison psychiatry and palliative care patients

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041214
Author(s):  
Kevin Glynn ◽  
Frank McKenna ◽  
Kevin Lally ◽  
Muireann O’Donnell ◽  
Sandeep Grover ◽  
...  
Keyword(s):  
Palliative Care ◽  
Rating Scale ◽  
Symptom Burden ◽  
Systemic Infection ◽  
International Study ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Liaison Psychiatry ◽  
Cross Sectional ◽  
Hypoactive Delirium

ObjectivesTo investigate whether delirium motor subtypes differ in terms of phenomenology and contributory aetiology.DesignCross-sectional study.SettingInternational study incorporating data from Ireland and India across palliative care, old age liaison psychiatry and general adult liaison psychiatry settings.Participants1757 patients diagnosed with delirium using criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition (DSM IV).Primary and secondary outcome measuresHyperactive, mixed and hypoactive delirium subtypes were identified using the abbreviated version of the Delirium Motor Subtype Scale. Phenomenology was assessed using the Delirium Rating Scale Revised. Contributory aetiologies were assessed using the Delirium Aetiology Checklist (DEC), with a score >2 indicating that the aetiology was likely or definitely contributory.ResultsHypoactive delirium was associated with dementia, cerebrovascular and systemic infection aetiologies (p<0.001) and had a lower overall burden of delirium symptoms than the other motor subtypes. Hyperactive delirium was associated with younger age, drug withdrawal and the DEC category other systemic aetiologies (p<0.001). Mixed delirium showed the greatest symptom burden and was more often associated with drug intoxication and metabolic disturbance (p<0.001). All three delirium motor subtypes had similar levels of impairment in attention and visuospatial functioning but differed significantly when compared with no subtype (p<0.001).ConclusionsThis study indicates a pattern of aetiology and symptomatology of delirium motor subtypes across a large international sample that had previously been lacking. It serves to improve our understanding of this complex condition and has implications in terms of early detection and management of delirium.

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