scholarly journals Determinants of inter-practice variation in childhood asthma and respiratory infections: cross-sectional study of a national sentinel network

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e024372
Author(s):  
Uy Hoang ◽  
Harshana Liyanage ◽  
Rachel Coyle ◽  
Charles Godden ◽  
Simon Jones ◽  
...  
Keyword(s):  
Childhood Asthma ◽  
Respiratory Infections ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Practice Level ◽  
Children With Asthma ◽  
The Mean ◽  
Tract Infections

ObjectivesRespiratory infections are associated with acute exacerbations of asthma and accompanying morbidity and mortality. In this study we explore inter-practice variations in respiratory infections in children with asthma and study the effect of practice-level factors on these variations.DesignCross-sectional study.SettingWe analysed data from 164 general practices in the Royal College of General PractitionersResearch and Surveillance Centresentinel network in England.ParticipantsChildren 5–12 years.InterventionsNone. In this observational study, we used regression analysis to explore the impact of practice-level determinants on the number of respiratory infections in children with asthma.Primary and secondary outcome measuresWe describe the distribution of childhood asthma and the determinants of upper/lower respiratory tract infections in these children.Results83.5% (137/164) practices were in urban locations; the mean number of general practitioners per practice was 7; and the mean duration since qualification 19.7 years. We found almost 10-fold difference in the rate of asthma (1.5–11.8 per 100 children) and 50-fold variation in respiratory infection rates between practices. Larger practices with larger lists of asthmatic children had greater rates of respiratory infections among these children.ConclusionWe showed that structural/environmental variables are consistent predictors of a range of respiratory infections among children with asthma. However, contradictory results between measures of practice clinical care show that a purely structural explanation for variability in respiratory infections is limited. Further research is needed to understand how the practice factors influence individual risk behaviours relevant to respiratory infections.

scholarly journals Assessment of the level of knowledge, awareness and management of hypertension and diabetes among adults in Imo and Kaduna states, Nigeria: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043951
Author(s):  
Jennifer Anyanti ◽  
Selema Margaret Akuiyibo ◽  
Oluwole Fajemisin ◽  
Omokhudu Idogho ◽  
Babatunde Amoo
Keyword(s):  
Outcome Measures ◽  
Cross Sectional Study ◽  
Good Knowledge ◽  
Secondary Outcome ◽  
Diabetes Knowledge ◽  
Sectional Study ◽  
Unhealthy Lifestyle ◽  
Cross Sectional ◽  
Level Of Knowledge ◽  
The Mean

ObjectivesThis study was designed to assess levels of awareness, knowledge, attitude and practices relating to hypertension and diabetes among adults aged 35 years resident in selected communities in Imo and Kaduna states, Nigeria.DesignA descriptive cross-sectional study.SettingSelected communities across 14 local government areas in Imo and Kaduna states were included.ParticipantsIn total, 824 adults, aged 35 years or older and resident in selected communities where the Access-N project was being implemented in Imo and Kaduna states participated in the study.Primary and secondary outcome measuresThe study assessed the level of hypertension and diabetes knowledge among the participants. Regular blood pressure (BP) and glucose screening practices were also examined as outcome measures.ResultsThe mean age of the respondents was 48.32 years. In total, 778 (94.4%) and 746 (90.5%) of the respondents were aware of hypertension and diabetes, respectively. The mean hypertension and diabetes knowledge scores (±SD) were 4.99 (±1.99) and 8.02 (±2.61), respectively. A total of 326 (41.9%) respondents aware of hypertension had a good knowledge of hypertension while 477 (63.9%) of those aware of diabetes had a good knowledge of diabetes. Levels of hypertension and diabetes knowledge were found to be associated with physical activity and the level of education of the respondents. About two-thirds (62.6%) and less than half (41.5%) of the respondents, respectively check their BP and blood glucose (BG) levels regularly (at least once yearly). Statistically significant associations were observed between age and regular BP and BG level checks.ConclusionsDespite the high awareness rate of hypertension and diabetes observed in this study and a relatively good knowledge about the two conditions, unhealthy lifestyle practices and non-regular routine screening abounds among the respondents. Thus, there is a need to improve access to quality information about hypertension and diabetes aimed at motivating adoption of healthy behaviours.

scholarly journals Patient and practice characteristics predicting attendance and completion at a specialist weight management service in the UK: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018286 ◽  
Author(s):  
David N Blane ◽  
Philip McLoone ◽  
David Morrison ◽  
Sara Macdonald ◽  
Catherine A O’Donnell
Keyword(s):  
Weight Management ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Management Service ◽  
Sectional Study ◽  
Cross Sectional ◽  
Practice Level ◽  
Practice Characteristics ◽  
Weight Management Service ◽  
Deprived Areas

ObjectiveTo determine the association between patient and referring practice characteristics and attendance and completion at a specialist health service weight management service (WMS).DesignCross-sectional study.SettingRegional specialist WMS located in the West of Scotland.Participants9677 adults with obesity referred between 2012 and 2014; 3250 attending service and 2252 completing.Primary and secondary outcome measuresPrimary outcome measure was attendance at the WMS; secondary outcome was completion, defined as attending four or more sessions.AnalysisMultilevel binary logistic regression models constructed to determine the association between patient and practice characteristics and attendance and completion.ResultsApproximately one-third of the 9677 obese adults referred attended at least one session (n=3250, 33.6%); only 2252 (23%) completed by attending four or more sessions. Practice referrals ranged from 1 to 257. Patient-level characteristics were strongest predictors of attendance; odds of attendance increased with age (OR 4.14, 95% CI 3.27 to 5.26 for adults aged 65+ compared with those aged 18–24), body mass index (BMI) category (OR 1.83, 95% CI 1.56 to 2.15 for BMI 45+ compared with BMI 30–35) and increasing affluence (OR 1.96, 95% CI 1.17 to 3.28). Practice-level characteristics most strongly associated with attendance were being a non-training practice, having a larger list size and not being located in the most deprived areas.ConclusionsThere was wide variation in referral rates across general practice, suggesting that there is still much to do to improve engagement with weight management by primary care practitioners. The high attrition rate from referral to attendance and from attendance to completion suggests ongoing barriers for patients, particularly those from the most socioeconomically deprived areas. Patient and practice-level characteristics can help us understand the observed variation in attendance at specialist WMS following general practitioner (GP) referral and the underlying explanations for these differences merit further investigation.

scholarly journals Frequency of Cystic Fibrosis in Children with Recurrent Respiratory Infections by Sweat Chloride Testing: A Hospital-Based Cross-sectional Study

2020 ◽  
Vol 24 (4) ◽  
pp. 302-305
Author(s):  
Nahdia Zaman ◽  
Anam Zafar ◽  
Maryam Amjad ◽  
Shahzadi Sumbal Ghazi ◽  
Uzma Abid ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Respiratory Infections ◽  
Cross Sectional Study ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sweat Chloride ◽  
Recurrent Respiratory Infections ◽  
Ethical Approval ◽  
Tract Infections

Objective: This study was designed to find out the frequency of cystic fibrosis in children with recurrent respiratory infections by performing a sweat chloride test.Material and Methods: This cross-sectional study was carried out from 1st September 2015 to 28th February 2016 in the department of Pediatric Medicine at the Children’s Hospital and the Institute of Child Health, Lahore after ethical approval. A total of 300 cases of recurrent respiratory tract infections were included. The sweat chloride test was done by using pilocarpine-induced iontophoresis and measuring chloride levels on the forearm or thigh by sweat analyzer at the time of induction. Cystic fibrosis was labeled if sweat chloride level ranges above 60 mEq/L. Data was collected on Performa and SPSS version 23 was used to analyze the data. Results: Mean age of patients was 6.24 ± 2.7 years with 52.7% males and 47.3% females. Most patients (86.3%) have more than 5 episodes of respiratory infection in a year. Cystic fibrosis was diagnosed in 19 (6.3%) patients. There was no relationship between the frequency of respiratory infections in a year and cystic fibrosis (p-value 0.78).Conclusion: This hospital-based study showed quite a high incidence of cystic fibrosis in our population. So facilities including neonatal screening along with sweat chloride testing and genetic analysis should be increased.

scholarly journals The Effect of Parental Smoking on the Severity of Asthma in Children: A Cross-Sectional Study

2017 ◽  
Vol 10 (1) ◽  
pp. 140 ◽  
Author(s):  
Carla Irani ◽  
Jad Saliba
Keyword(s):  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Lower Respiratory Tract Infections ◽  
Cross Sectional ◽  
Asthma Exacerbations ◽  
Children With Asthma ◽  
Tract Infections

BACKGROUND: Several environmental factors trigger attacks of asthma by immunological and non-immunological mechanisms. Among these factors are cited the passive or second hand smoking (SHS) which has a deleterious effect on the prognosis of childhood asthma and induces a resistance to treatment by corticosteroids. The aim of the present study was to identify parents of children with asthma who are smokers and to explore the possible negative impact of SHS exposure on the disease of asthmatic children.MATERIALS & METHODS: A cross sectional study was conducted from February 2012 to February 2013.The study population consisted of children with asthma. The information concerning the patients was collected from their medical records filled out by the physician in a clinical setting in direct communication with the patients, or their parents when it is a little child. A group of 100 children age between 2 and 15 years, with asthma were recruited for the study. The study children were divided into two groups: cases with 28 children from smoking families, and controls with 73 children from non-smoking families. Analysis of the number of respiratory infections, asthma exacerbations per year, and the average number of hospitalization was done in both groups.RESULTS: Pearson chi2 test was adopted. We showed that smoking among the father was positively correlated with a higher number of hospitalizations for asthma, higher incidence of lower respiratory tract infections and asthma exacerbations. Similarly, the maternal smoking was positively correlated with a higher number of hospitalizations for asthma, lower respiratory tract infections and asthma exacerbations.CONCLUSION: Passive smoking causes respiratory illness, asthma, poor growth, neurological disorders in children. To avoid the risk of respiratory and allergic diseases by environmental tobacco smoke, absolute smoking cessation by parents is strongly recommended.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Trochlear Dysplasia ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

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 Prevalence of dysmenorrhoea, associated risk factors and its relationship with academic performance among graduating female university students in Ethiopia: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043814
Author(s):  
Mesfin Tadese ◽  
Andargachew Kassa ◽  
Abebaw Abeje Muluneh ◽  
Girma Altaye
Keyword(s):  
Risk Factors ◽  
Academic Performance ◽  
University Students ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Point ◽  
Significant Difference ◽  
Associated Risk Factors

ObjectivesThe study aimed to provide an association between dysmenorrhoea and academic performance among university students in Ethiopia. Further, the study attempts to determine the prevalence and associated risk factors of dysmenorrhoea.Design and methodInstitution-based cross-sectional study was conducted from 1 April to 28 April 2019. A semistructured and pretested self-administered questionnaire was used to collect data. Binary logistic regression analysis and one-way analysis of variance were performed to model dysmenorrhoea and academic performance, respectively.Setting and participantsEthiopia (2019: n=647 female university students).OutcomesThe primary outcome is dysmenorrhoea, which has been defined as painful menses that prevents normal activity and requires medication. The self-reported cumulative grade point average of students was used as a proxy measure of academic performance, which is the secondary outcome.ResultsThe prevalence of dysmenorrhoea was 317 (51.5%). The educational status of father (adjusted OR (AOR) (95% CI) 2.64 (1.04 to 6.66)), chocolate consumption (AOR (95% CI) 3.39 (95% 1.28 to 8.93)), daily breakfast intake (<5 days/week) (AOR (95% CI) 0.63 (0.42 to 0.95)), irregular menstrual cycle AOR (95% CI) 2.34 (1.55 to 3.54)) and positive family history of dysmenorrhoea AOR (95% CI) 3.29 (2.25 to 4.81)) had statistically significant association with dysmenorrhoea. There was no statistically significant difference in academic performance among students with and without dysmenorrhoea (F (3611)=1.276, p=0.28)).ConclusionsDysmenorrhoea was a common health problem among graduating University students. However, it has no statistically significant impact on academic performance. Reproductive health officers should educate and undermine the negative academic consequences of dysmenorrhoea to reduce the physical and psychological stress that happens to females and their families.

scholarly journals A cross-sectional study to identify the determinants of non-communicable diseases among fishermen in Southern India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Akhila Doddamani ◽  
A. B. Kirthinath Ballala ◽  
Sharath P. Madhyastha ◽  
Asha Kamath ◽  
Muralidhar M. Kulkarni
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Waist Circumference ◽  
Cross Sectional Study ◽  
Modifiable Risk Factors ◽  
Sectional Study ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Dietary Practice ◽  
The Mean

Abstract Background India is currently facing a rising epidemic of Non-Communicable Diseases (NCDs). Identification of modifiable risk factors is of paramount importance to curb this menace. Fishermen are one of the most vulnerable occupational groups with unique characteristics that make them prone to acquire NCDs, as a significant share of their life is spent at sea. Hence, this study was planned to ascertain the burden of NCDs, determine various risk factors of NCDs, and measure the association between risk factors and NCDs among fishermen of Coastal Karnataka in South India. Methods A cross-sectional study was conducted among 681 fishermen aged 18 years and above as per the semi-structured interview schedule for two years (2017–2019). A convenience sampling strategy was adopted. The data was entered and analyzed using SPSS v.15.0. The results were described in terms of proportions and their 95% confidence intervals. Continuous data were summarized using the mean and standard deviation or median and interquartile range depending on the skewness of data. Chi-square test was used to study the association between NCDs and modifiable risk factors. Multiple logistic regression was used to identify risk factors of NCDs. Results The mean (SD) age of the population was 42.5 (SD 12.5) years. The mean years involved in fishing was 19.8 years (SD 10.9). More than half (59.5%) of the study participants had severe stress and most (80.3%) were ever substance users. Advancing age, not being able to contact family while at sea, poor dietary practice, ever substance use, increasing waist circumference were significant correlates of NCDs. Conclusions The commonly prevalent risk factors of NCDs among fishermen included poor dietary practice, higher stress levels, substance use, increasing waist circumference, and inability to contact with family while at sea. Hypertension and Diabetes were the two common NCDs in the study population. There is a need for immediate attention in managing NCDs’ risk factors by promoting a healthy lifestyle by primary health care providers through a sustainable community awareness program targeting fishermen at a convenient time and location, either at the sea-port or meeting places. Harmful effects of substance use, healthy dietary practices, and the importance of physical activity outside their job need emphasis. In addition, screening programs should be organized with the help of boat owners and fishing associations at-least once a year to pick up NCDs at an early stage.

A cross sectional study: The association between sleeping quality and stress among second and third medical students at the University of Jordan

2021 ◽  
pp. 009121742110112
Author(s):  
AA Toubasi ◽  
BR Khraisat ◽  
RB AbuAnzeh ◽  
HM Kalbouneh
Keyword(s):  
Logistic Regression ◽  
Medical Students ◽  
Cross Sectional Study ◽  
Regular Exercise ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
The Mean ◽  
University Of Jordan ◽  
The University

Objective Medicine is considered one if not the most stressful educational field. Thus, the aim of this study is to investigate the prevalence of stress and poor sleeping quality among medical students and the association between them. Method This cross-sectional study was conducted at the University of Jordan on second- and third-year medical students. The questionnaire consisted of: 1) Demographics; 2) The assessment tools which were Pittsburgh Quality of Sleep Index (PSQI) and Kessler Psychological Distress Status (K10). Binary logistic regression, chi-square and linear regression were used to investigate the association between PSQI, K10, and their determinants. Results The mean for PSQI score was 6.76 ± 3.32. PSQI scores interpretation revealed that 61.7% of the 282 participants of this study were poor sleepers. Logistic regression results showed that only the category of not napping at all from the napping hours variable was significantly associated with sleeping quality. Furthermore, the mean of K10 scores was 24.5 ± 8.5. K10 scores revealed that 66.3% of the participants were stressed. Logistic regression results showed that gender and regular exercise were significantly associated with psychological distress. Additionally, chi-square test, logistic regression and linear regression showed that PSQI was significantly associated with K10 (P <0.01). Conclusions Stress and poor sleeping quality in medical students at the University of Jordan were highly prevalent and strongly associated. What determined PSQI was daytime napping, and for K10 were regular exercise and gender. Further investigations into stress and sleep quality in the Arabian region are needed.

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