Understanding patient profiles and characteristics of current chiropractic practice: a cross-sectional Ontario Chiropractic Observation and Analysis STudy (O-COAST)

ObjectivesThere is no current detailed profile of people seeking chiropractic care in Canada. We describe the profiles of chiropractors’ practice and the reasons, nature of the care provided to their patients and extent of interprofessional collaborations in Ontario, Canada.DesignCross-sectional observational study.SettingPrimary care setting in Ontario, Canada.ParticipantsWe randomly recruited chiropractors from a list of registered chiropractors (n=3978) in active practice in 2015. Of the 135 randomly selected chiropractors, 120 were eligible, 43 participated and 42 completed the study.Outcome measuresEach chiropractor recorded information for up to 100 consecutive patient encounters, documenting patient health profiles, reasons for encounter, diagnoses and care provided. Descriptive statistics summarised chiropractor, patient and encounter characteristics, with analyses accounting for clustering and design effects.ResultsChiropractors provided data on 3523 chiropractor-patient encounters. More than 65% of participating chiropractors were male, mean age 44 years and had practised on average 15 years. The typical patient was female (59% of encounters), between 45 and 64 years (43%) and retired (21%) or employed in business and administration (13%). Most (39.4%) referrals were from other patients, with 6.8% from physicians. Approximately 68% of patients paid out of pocket or claimed extended health insurance for care. Most common diagnoses were back (49%, 95% CI 44 to 56) and neck (15%, 95% CI 13 to 18) problems, with few encounters related to maintenance/preventive care (0.86%, 95% CI 0.2 to 3.9) and non-musculoskeletal problems (1.3%, 95% CI 0.7 to 2.3). The most common treatments included spinal manipulation (72%), soft tissue therapy (70%) and mobilisation (35%).ConclusionsThis is the most comprehensive profile to date of chiropractic practice in Canada. People who present to Ontario chiropractors are mostly adults with a musculoskeletal condition. Our results can be used by stakeholders to make informed decisions about workforce development, education and healthcare policy related to chiropractic care.

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A cross-sectional examination of the profile of chiropractors recruited to the Australian Chiropractic Research Network (ACORN): a sustainable resource for future chiropractic research

BMJ Open ◽

10.1136/bmjopen-2017-015830 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015830 ◽

Cited By ~ 15

Author(s):

Jon Adams ◽

Wenbo Peng ◽

Amie Steel ◽

Romy Lauche ◽

Craig Moore ◽

...

Keyword(s):

Research Programme ◽

Research Capacity ◽

Chiropractic Care ◽

Research Network ◽

Cross Sectional ◽

Tissue Therapy ◽

Healthcare Profession ◽

Practice Based Research ◽

Nationally Representative ◽

Chiropractic Research

ObjectivesThe Australian Chiropractic Research Network (ACORN) practice-based research network (PBRN) cohort was established to provide sustainable infrastructure necessary to address lack of rigorous investigation and to bridge the research–practice gap focused on chiropractic care for future years. This paper presents the profile of chiropractors recruited to the ACORN PBRN, a nationally representative sample of chiropractors working in Australia.DesignCross-sectional analysis of baseline data from a cohort study of chiropractors in Australia.SettingAll registered chiropractors in Australia were invited to participate in the ACORN study and those who completed a practitioner questionnaire and consent form were included in the PBRN cohort.ParticipantsA total of 1680 chiropractors (36%) were recruited to the cohort database. The average age of the PBRN participants is 41.9 years and 63% are male. The vast majority of the PBRN participants hold a university degree.ResultsGeneral practitioners were identified as the most popular referral source for chiropractic care and low back pain and neck pain were the most common conditions ‘often’ treated by the PBRN chiropractors. The chiropractors in this PBRN cohort rated high velocity, low amplitude adjustment/manipulation/mobilisation as the most commonly used technique/method and soft tissue therapy as the most frequently employed musculoskeletal intervention in their patient management.ConclusionsThe ACORN PBRN cohort constitutes the largest coverage of any single healthcare profession via a national voluntary PBRN providing a sustainable resource for future follow-up. The ACORN cohort provides opportunities for further nested substudies related to chiropractic care, chiropractors, their patients and a vast range of broader healthcare issues with a view to helping build a diverse but coordinated research programme and further research capacity building around Australian chiropractic.

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Patients who complain of autonomic dysregulation: A cross-sectional study of patients with somatic symptom disorder

International Journal of Social Psychiatry ◽

10.1177/00207640211025549 ◽

2021 ◽

pp. 002076402110255

Author(s):

Chao-Ying Tu ◽

Wei-Shih Liu ◽

Yen-Fu Chen ◽

Wei-Lieh Huang

Keyword(s):

Help Seeking ◽

Somatic Symptom ◽

Health Anxiety ◽

Cross Sectional Study ◽

Psychiatric Diagnoses ◽

Somatic Symptom Disorder ◽

Autonomic Dysregulation ◽

Cross Sectional ◽

Significant Difference ◽

Patient Health

Background: Somatic symptom disorder (SSD) is common in medical settings but has been underdiagnosed. Stigma related to psychiatric illness was one of the barriers to making the diagnosis. More and more SSD patients who visited psychiatric clinics with physical complaints identify themselves as having ‘autonomic dysregulation’ in Taiwan. Aims: This study aimed to investigate the characteristics of patients with a subjective diagnosis of ‘autonomic dysregulation’. Method: We assessed the sociodemographic profile, medical/psychiatric diagnoses, subjective psychiatric diagnoses, perceived psychiatric stigma, help-seeking attitude, and healthcare utilization of 122 participants with SSD. Participants who identified themselves as having ‘autonomic dysregulation’ ( n = 84) were compared to those who did not (n=38). Results: Participants with a subjective diagnosis of ‘autonomic dysregulation’ were younger and had a higher education level than those who did not have such a subjective diagnosis. They also had higher scores on the Patient Health Questionnaire-15 (PHQ-15) and Health Anxiety Questionnaire (HAQ), whereas comorbid psychiatric diagnoses were similar in the two groups. Participants with and without a subjective diagnosis of ‘autonomic dysregulation’ did not have a significant difference in perceived psychiatric stigma and help-seeking attitude/behaviors. In a multiple logistic regression model, only age was associated with having a subjective diagnosis of ‘autonomic dysregulation’. Conclusion: Among SSD patients, those who identify themselves as having ‘autonomic dysregulation’ tend to have higher somatic distress and health anxiety than those who do not. ‘Autonomic dysregulation’ is not associated with perceived psychiatric stigma.

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Psychological Effects of the COVID-19 Pandemic on Hungarian Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249565 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9565

Author(s):

Csanád Szabó ◽

Judit Pukánszky ◽

Lajos Kemény

Keyword(s):

Perceived Stress ◽

Psychological Effects ◽

Measuring Instruments ◽

Online Questionnaire ◽

Cross Sectional ◽

Psychological Variables ◽

Ways Of Coping ◽

General Anxiety Disorder ◽

General Anxiety ◽

Patient Health

We aimed to explore psychological effects of the coronavirus pandemic on Hungarian adults in the time of the national quarantine situation in May 2020.We conducted a cross-sectional observational study with the use of an anonymous online questionnaire that consisted of 65 items. The following measuring instruments were used: Perceived Stress Scale (PSS-10); The General Anxiety Disorder Assessment (GAD)-2; The Patient Health Questionnaire (PHQ)-2; European Quality of Life Visual Analogue Scale (EQ-VAS); Self-administered inventory of complaints (Hungarian questionnaire); Shortened (Hungarian) version of the Ways of Coping Questionnaire; 2 open-ended questions to examine the participants’ mood and ways of coping during the pandemic. The data of 431 participants were analyzed, their average age was 47.53 ± 11.66 years, and the percentage of females was 90%. The mean of participants’ scores were the following: 19.34 ± 7.97 for perceived stress, 73.05 ± 21.73 for health status, and 8.68 ± 4.65 for neurotic complaints. Thirty-four and one-tenth percent of participants were depressed, 36.2% were anxious, and they tended to use problem-focused coping strategies more frequently than emotion-focused ones. We found significant correlations between all of the seven examined psychological variables. Our results highlight the importance of stress management in the psychological support of healthy adults in quarantine situation caused by the coronavirus pandemic.

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Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians

npj Digital Medicine ◽

10.1038/s41746-021-00400-z ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Yu Fang ◽

Daniel B. Forger ◽

Elena Frank ◽

Srijan Sen ◽

Cathy Goldstein

Keyword(s):

Mental Health ◽

Smartphone Application ◽

Sleep Time ◽

Self Report ◽

First Year ◽

Cross Sectional ◽

Wake Time ◽

Mood Variability ◽

Patient Health ◽

Sleep Parameters

AbstractWhile 24-h total sleep time (TST) is established as a critical driver of major depression, the relationships between sleep timing and regularity and mental health remain poorly characterized because most studies have relied on either self-report assessments or traditional objective sleep measurements restricted to cross-sectional time frames and small cohorts. To address this gap, we assessed sleep with a wearable device, daily mood with a smartphone application and depression through the 9-item Patient Health Questionnaire (PHQ-9) over the demanding first year of physician training (internship). In 2115 interns, reduced TST (b = −0.11, p < 0.001), later bedtime (b = 0.068, p = 0.015), along with increased variability in TST (b = 0.4, p = 0.0012) and in wake time (b = 0.081, p = 0.005) were associated with more depressive symptoms. Overall, the aggregated impact of sleep variability parameters and of mean sleep parameters on PHQ-9 were similar in magnitude (both r2 = 0.01). Within individuals, increased TST (b = 0.06, p < 0.001), later wake time (b = 0.09, p < 0.001), earlier bedtime (b = − 0.07, p < 0.001), as well as lower day-to-day shifts in TST (b = −0.011, p < 0.001) and in wake time (b = −0.004, p < 0.001) were associated with improved next-day mood. Variability in sleep parameters substantially impacted mood and depression, similar in magnitude to the mean levels of sleep parameters. Interventions that target sleep consistency, along with sleep duration, hold promise to improve mental health.

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Depression and its associated factors among pregnant women in central Vietnam

Health Psychology Open ◽

10.1177/2055102920988445 ◽

2021 ◽

Vol 8 (1) ◽

pp. 205510292098844

Author(s):

Bao-Yen Luong-Thanh ◽

Lan Hoang Nguyen ◽

Linda Murray ◽

Manuel Eisner ◽

Sara Valdebenito ◽

...

Keyword(s):

Pregnant Women ◽

Associated Factors ◽

Mental Health Problems ◽

Cross Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Prevalence Of Depression ◽

Patient Health ◽

Quota Sampling

To date, little attention has been given to prenatal depression, especially in low and middle-income countries. The aim of this research was to assess the prevalence of depression and its associated factors amongst pregnant women in a central Vietnamese city. This cross-sectional study included 150 pregnant women from 29 to 40 weeks of gestation, from eight wards of Hue city, via quota sampling from February to May 2019. We employed the Patient Health Questionnaire (PHQ-9) to assess depression. Findings suggest the need to provide routine screening of pregnant women in primary care for depressive symptoms and other mental health problems.

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Public Concerns during the COVID-19 Lockdown: A Multicultural Cross-Sectional Study among Internet Survey Respondents in Three Countries

Journal of Clinical Medicine ◽

10.3390/jcm10081577 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1577

Author(s):

Alona Emodi-Perlman ◽

Ilana Eli ◽

Nir Uziel ◽

Joanna Smardz ◽

Anahat Khehra ◽

...

Keyword(s):

Mental Health ◽

Online Survey ◽

Middle Eastern ◽

Well Being ◽

Cross Sectional Study ◽

Internet Survey ◽

Physical And Mental Health ◽

Cross Sectional ◽

Culturally Different ◽

Patient Health

(1) Background: this study aimed to evaluate the worries, anxiety, and depression in the public during the initial coronavirus disease 2019 (COVID-19) pandemic lockdown in three culturally different groups of internet survey respondents: Middle Eastern (Israel), European (Poland), and North American (Canada). (2) Methods: a cross-sectional online survey was conducted in the mentioned countries during the lockdown periods. The survey included a demographic questionnaire, a questionnaire on personal concerns, and the Patient Health Questionnaire-4 (PHQ-4). A total of 2207 people successfully completed the survey. (3) Results: Polish respondents were the most concerned about being infected. Canadian respondents worried the most about their finances, relations with relatives and friends, and both physical and mental health. Polish respondents worried the least about their physical health, and Israeli respondents worried the least about their mental health and relations with relatives and friends. Canadian respondents obtained the highest score in the PHQ-4, while the scores of Israeli respondents were the lowest. (4) Conclusions: various factors should be considered while formulating appropriate solutions in emergency circumstances such as a pandemic. Understanding these factors will aid in the development of strategies to mitigate the adverse effects of stress, social isolation, and uncertainty on the well-being and mental health of culturally different societies.

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Psychopathology and Somatic Complaints: A Cross-Sectional Study with Portuguese Adults

Healthcare ◽

10.3390/healthcare9040478 ◽

2021 ◽

Vol 9 (4) ◽

pp. 478

Author(s):

Joana Proença Becker ◽

Rui Paixão ◽

Manuel João Quartilho

Keyword(s):

Early Detection ◽

Short Form ◽

Female Gender ◽

Cross Sectional Study ◽

Physical Symptoms ◽

Brief Symptom Inventory ◽

Cross Sectional ◽

Psychopathological Symptoms ◽

Patient Health ◽

The Impact

(1) Background: Functional somatic symptoms (FSS) are physical symptoms that cannot be fully explained by medical diagnosis, injuries, and medication intake. More than the presence of unexplained symptoms, this condition is associated with functional disabilities, psychological distress, increased use of health services, and it has been linked to depressive and anxiety disorders. Recognizing the difficulty of diagnosing individuals with FSS and the impact on public health systems, this study aimed to verify the concomitant incidence of psychopathological symptoms and FSS in Portugal. (2) Methods: For this purpose, 93 psychosomatic outpatients (91.4% women with a mean age of 53.9 years old) and 101 subjects from the general population (74.3% women with 37.8 years old) were evaluated. The survey questionnaire included the 15-item Patient Health Questionnaire, the 20-Item Short Form Survey, the Brief Symptom Inventory, the Depression, Anxiety and Stress Scale, and questions on sociodemographic and clinical characteristics. (3) Results: Increases in FSS severity were correlated with higher rates of depression, anxiety, and stress symptoms. The findings also suggest that increased rates of FSS are associated with lower educational level and female gender. (4) Conclusion: Being aware of the relationship between FSS and psychopathological symptoms and the need to explore psychosocial issues during clinical interviews may favor early detection of these cases. The early detection of mental disorders is essential for individuals’ adherence to treatments, reflecting on healthcare costs.

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Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.620 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Graffigna ◽

S Barello ◽

L Palamenghi ◽

M Savarese ◽

G Castellini

Keyword(s):

Healthcare Services ◽

Cross Sectional Study ◽

Health Prevention ◽

Prevention Measures ◽

Cross Sectional ◽

Health Authorities ◽

Patient Health ◽

Public Health Authorities ◽

High Level ◽

Restrictive Measures

Abstract Background At the end of February 2020 a new case was diagnosed with COVID-19 in north Italy, suddenly followed by new cases. Italian health authorities decided to enforce restrictive measures. Northern areas of Italy were identified as “red areas” to slow down the epidemic and its impact on the healthcare system. From this perspective, the COVID-19 epidemic in Italy constitutes a testing ground for the assessment of the ability of consumers to cope with this health risk. Methods A cross-sectional study on a representative sample of 1000 Italian citizens was conducted over the period 27 February- 5 March exploring the following hypotheses: 1) less engaged individuals are more concerned for the health emergency and feel more vulnerable; 2) less engaged have higher probability to develop negative attitudes and dysfunctional behaviors. Results only the 16% the interviewees presented a high level of engagement. Lower levels of engagement were measured in the southern parts of Italy (not yet touched by the epidemics at the time of data collection). People with lowers levels of engagement reported higher fears for the contagion and sense of vulnerability. Furthermore, they showed the lower levels of trust in the Public Health Authorities, in medical research and in vaccines. Finally, they appeared more dismissive in their preventive behaviors and more disorganized in the fruition of the healthcare services. Conclusions A psychological analysis of processes of attitudinal and role change in the direction of becoming more engaged in health prevention is worthy in order to forecast potential dysfunctional reactions to restrictive health prevention measures and to orient personalized education initiatives to consumers with different level of engagement. Key messages Profiling based on the levels of health engagement is important in order to plan more effective healthcare measures during epidemics. Targeted educational initiatives should take into account citizens' engagement profiles.

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AB1192 THE UNDERWORLD OF DEPRESSIVE SYMPTOMS IN RHEUMATIC DISEASES: OVERLOOKED, UNRECOGNIZED OR UNPERCEIVED?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1998 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1886.2-1887

Author(s):

F. Ingegnoli ◽

T. Schioppo ◽

T. Ubiali ◽

V. Bollati ◽

S. Ostuzzi ◽

...

Keyword(s):

Depressive Symptoms ◽

Rheumatic Diseases ◽

Real Life ◽

Severe Depression ◽

Mild Depression ◽

Cross Sectional ◽

Online Study ◽

Social Burden ◽

Patient Health ◽

The University

Background:The concomitant presence of depressive symptoms and rheumatic diseases (RDs) impose a considerable economic and social burden on the communities as they are associated with numerous deleterious outcomes such as increased mortality, work disability, higher disease activity and worsening physical function, higher pain levels and fatigue. Despite growing interest on depressive symptoms burden in RDs, current patient perception on this topic is unknown.Objectives:Italian patients with RDs were invited to participate in an online study gauging the presence and the perception of depressive symptoms using the Patient Health Questionnaire (PHQ-9).Methods:This was a cross-sectional no-profit online study to screen the presence and the perception of depressive symptoms in RDs patients. All participants gave their consent to complete the PHQ-9 and they were not remunerated. Completion was voluntary and anonymous. The PHQ-9 rates the frequency of symptoms over the past 2 weeks on a 0-3 Likert-type scale. It contains the following items: anhedonia, depressed mood, trouble sleeping, feeling tired, change inappetite, guilt or worthlessness, trouble concentrating, feeling slowed down or restless, and suicidal thoughts. Patients were stratified as: <4 not depressed, 5-9 sub-clinical or mild depression, 10-14 moderate depression, 15-19 moderately severe depression and 20-27 severe depression. The survey was disseminated by ALOMAR (Lombard Association for Rheumatic Diseases) between June and October 2019.Results:192 patients took part in the study: 170 female with median age 50 years. Among respondents only 35 (18.2%) were not depressed. Depression was sub-clinical or mild in 68 (35.4%), moderate in 42 (21.9%), moderately severe in 30 (15.6%), and severe in 17 (8.9%). 16 (8.3%) of respondents declared to have depressive symptoms and 7 of 16 were under psychiatric therapy.Moreover, patients were grouped according to diagnosis.124 respondents had inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis). 23 (18.5%) were not depressed. Depression was sub-clinical or mild in 41 (33%), moderate in 26 (21%), moderately severe in 21 (17%), and severe in 13 (10.5%). Among them, 8 (6.5%) declared to have depressive symptoms depressed and 3 of 8 were under psychiatric therapy.49 respondents had a connective tissue disease or vasculitis. 11 (22.5%) were not depressed. Depression was sub-clinical or mild in 19 (38.8%), moderate in 13 (26.5%), moderately severe in 2 (4%), and severe in 4 (8.2%). Among them, 3 (6%) declared to have depressive symptoms and 1 of 6 were under psychiatric therapy.19 respondents had other rheumatic diseases. 1 (5.3%) was not depressed. Depression was sub-clinical or mild in 8 (42.1%), moderate in 3 (15.8%), moderately severe in 7 (36.8%). Among them, 5 (26.3%) declared to be depressed and 3 of 5 were under psychiatric therapy.Conclusion:Our study confirmed that the overall real-life burden of depressive symptoms is relevant in all RDs. At the same time, these results highlighted that depressive symptoms are overlook by physicians and unperceived by patients since fewer that half of respondents (46.4%) had a clinical depression (PHQ-9>10). These results suggested that screening for depression should form part of the routine clinical assessment of RD patients.Acknowledgments:We thank the Lombard Association of Rheumatic Diseases (ALOMAR) for its contribution to design and disseminate the survey, the group that sustain systemic sclerosis (GILS), and the IT service of the University of Milan.Disclosure of Interests:Francesca Ingegnoli: None declared, Tommaso Schioppo: None declared, Tania Ubiali: None declared, Valentina Bollati: None declared, Silvia Ostuzzi: None declared, Massimiliano Buoli: None declared, Roberto Caporali Consultant of: AbbVie; Gilead Sciences, Inc.; Lilly; Merck Sharp & Dohme; Celgene; Bristol-Myers Squibb; Pfizer; UCB, Speakers bureau: Abbvie; Bristol-Myers Squibb; Celgene; Lilly; Gilead Sciences, Inc; MSD; Pfizer; Roche; UCB

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PREVALENCE OF NECK PAIN AMONG TAILORS IN NORTH GUJARAT - A CROSS SECTIONAL STUDY

10.36106/ijsr/8324703 ◽

2021 ◽

pp. 49-51

Author(s):

Nipa V. Patel ◽

Roshani A. Patel

Keyword(s):

Neck Pain ◽

Functional Disability ◽

Cross Sectional Study ◽

Use Of Self ◽

Sectional Study ◽

Cross Sectional ◽

Musculoskeletal Problems ◽

The Common ◽

North Gujarat ◽

Awkward Posture

Background: - Neck pain is one of the common musculoskeletal problems faced by tailors due to constant work on the sewing machine with the awkward posture. Aim:-The aim of study is to nd out the prevalence of neck pain among Tailors. Objective:-To nd out the prevalence of neck pain among Tailors use of self questionnaire. Materials And Methodology:-Across sectional study was performed among 100 tailors working in North Gujarat to determine the prevalence of neck pain in them. Aself – questionnaire was used. Result: - 91% prevalence of neck pain was found among the tailors in North Gujarat. Also 67% tailors have activity limitation. Conclusion: -The prevalence of neck pain among Tailors in North Gujarat is found to be highest (91%). Neck pain is one of the common condition contributing to the increase in functional disability

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