Who is at risk of occupational Q fever: new insights from a multi-profession cross-sectional study

ObjectivesQ fever is a zoonosis caused by the bacteriumCoxiella burnetii. It is recognised as an occupational hazard for individuals who are in regular contact with animal birth products. Data from the literature are not comparable because different serological assays perform very differently in detecting past infections. It is therefore essential to choose the right assay for obtaining reliable data of seroprevalence. Obstetricians are another profession potentially at risk of Q fever. They can be infected from birth products of women with Q fever during pregnancy. There is little data, however, for Q fever in this occupational group. Our study therefore had two purposes. The first was to obtain reliable seroprevalence data for occupational groups in regular contact with animal birth products by using an assay with proven excellent sensitivity and specificity for detecting past infections. The second purpose was to obtain primary data for obstetricians.DesignWe carried out a cross-sectional study.SettingThe study included shepherds, cattle farmers, veterinarians and obstetricians from Thuringia.Participants77 shepherds, 74 veterinarians, 14 cattle farmers, 17 office employees and 68 obstetricians participated. The control group consisted of 92 blood donors.Primary outcome measureThe primary outcome measure wasC. burnetiiphase II specific IgG. The assay used was evaluated for this purpose in a previous study.ResultsOf the 250 blood samples we analysed, the very highest seroprevalences (64%–77%) occurred in individuals with frequent animal contact. There were no significant differences between shepherds, cattle farmers and veterinarians. The seroprevalence in people working in administration was lower but still significantly greater than the control. No obstetricians or midwives tested positive.ConclusionsShepherds, cattle farmers and veterinarians have a high risk ofC. burnetiiinfection. However, our study clearly proves that there was no increased risk for people working in an obstetric department.

Download Full-text

A Cross-Sectional Study on Subjective Fever Assessment in Children by Palpation: Are Fathers as Reliable as Mothers?

Emergency Medicine International ◽

10.1155/2020/3534267 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Ehud Rosenbloom ◽

Crysta Balis ◽

Dustin Jacobson ◽

Melanie Conway ◽

Ji Cheng ◽

...

Keyword(s):

Primary Outcome ◽

Pediatric Patients ◽

Cross Sectional Study ◽

Primary Outcome Measure ◽

Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Mothers And Fathers ◽

Significant Difference ◽

The Mean

Background. Fever is common in pediatric patients. Often, parents rely solely on palpation when assessing their child’s fever. The objective of the current study was to determine the accuracy of parents in detecting their child’s fever by palpation. Methods. A prospective cross-sectional study was conducted at the emergency department (ED) of a tertiary pediatric hospital. Infants and children, 0–4 years of age, presenting to the ED with both parents were included. Parents were separately asked if their child had a fever and, if so, were asked to assess the temperature by palpation. A nurse obtained the rectal temperature. The primary outcome measure was the accuracy of fathers and mothers in detecting fever. Results. A total of 170 children with their parents were enrolled. The mean ages of the children, mothers, and fathers were 18.9 (SD 0.8) months, 31.1 (SD 6.4) years, and 33.7 (SD 6.9) years, respectively. No statistically significant difference was found between mothers and fathers in the ability to assess fever by palpation (OR 0.65, 95% CI 0.39,−1.08). Sensitivities for detecting fever by palpation for mothers and father were 86.4% and 88.2%, respectively (specificity among mothers: 54.2% and specificity among fathers: 43.1%). The overall negative and positive predictive values were 65.9% (95% CI 55%–75.7%) and 75.7% (95% CI 69.9%–80.8%), respectively. Conclusions. Mothers and fathers do not differ in their ability to accurately assess their child’s fever by palpation. The low positive and negative predictive values indicate that if temperature was not measured, physicians cannot rely on parents’ reports.

Download Full-text

Burnout as a correlate of depression among medical students in Cameroon: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-027709 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027709 ◽

Cited By ~ 4

Author(s):

Tsi Njim ◽

Clarence Mvalo Mbanga ◽

Maxime Tindong ◽

Steve Fonkou ◽

Haman Makebe ◽

...

Keyword(s):

Medical Students ◽

Linear Regression ◽

Primary Outcome ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Primary Outcome Measure ◽

Burnout Syndrome ◽

Sectional Study ◽

Cross Sectional ◽

Prevalence Of Depression

ObjectiveBurnout syndrome has been shown to mediate the pathway between job stress and depression. This study aims to assess the relationship between the various components of burnout syndrome and depression; and to determine the contribution of other sociodemographic variables to depression among medical students in Cameroon.DesignA cross-sectional study.SettingThree of the five medical schools in Cameroon with students in both preclinical and clinical levels of studies.ParticipantsThe study included 413 consenting medical students.Primary outcome measureData were collected via a printed self-administered questionnaire. The primary outcome—depression was assessed using the Patient Health Questionnaire–9 (PHQ-9). Burnout was assessed using the Oldenburg Burnout Inventory. Multivariable linear regression was used to identify independent correlates of depression.ResultsThe overall prevalence of depression (PHQ-9 >4) and major depressive disorder (PHQ-9 >9) in these students was 66.34% and 23.00%, respectively. After multivariable linear regression analysis, four variables—total OLBI (beta=0.32; 95% CI 0.22 to 0.42; p<0.001); number of children (beta=−2.26; 95% CI −3.70 to –0.81; p=0.002); occurrence of a life-changing crises (beta=1.29; 95% CI 0.13 to 2.45; p=0.029) and presence of a chronic illness (beta=3.19; 95% CI 0.96 to 5.42; p=0.005) significantly predicted depression in these students and explained 32.4% of the variance (R2=32.4, F[14, 204]=6.98, p<0.001). The emotional exhaustion component (R2=17.4, F[1, 411]=86.39, p<0.001) explained more of the variance in depression than the disengagement component (R2=6.1, F[1, 411]=26.76, p<0.001) of burnout syndrome.ConclusionThe prevalence of depression among medical students in Cameroon is high. It is important that correlates of depression are identified early in medical students to limit progress to depression.

Download Full-text

Comparative Study of Chemosensory Dysfunction in COVID-19 in 2 Geographically Distinct Regions

Ear Nose & Throat Journal ◽

10.1177/01455613211000170 ◽

2021 ◽

pp. 014556132110001

Author(s):

Daniel J. Lee ◽

Daniella Daliyot ◽

Ri Wang ◽

Joel Lockwood ◽

Paul Das ◽

...

Keyword(s):

Comparative Study ◽

Symptom Onset ◽

Subgroup Analysis ◽

Primary Outcome ◽

Cross Sectional Study ◽

The Self ◽

Sectional Study ◽

Cross Sectional ◽

Specific Data ◽

Geographical Regions

Objective: To directly compare the prevalence of chemosensory dysfunction (smell and taste) in geographically distinct regions with the same questionnaires. Methods: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (older than 18 years) who underwent COVID-19 testing at an ambulatory assessment center in Canada and at a hospital in Israel between March 16, 2020, and August 19, 2020. The primary outcome was the prevalence of self-reported chemosensory dysfunction (anosmia/hypomsia and dysgeusia/ageusia). Subgroup analysis was performed to evaluate the prevalence of chemosensory deficits among the outpatients. Results: We identified a total of 350 COVID-19–positive patients (138 Canadians and 212 Israelis). The overall prevalence of chemosensory dysfunction was 47.1%. There was a higher proportion of chemosensory deficits among Canadians compared to Israelis (66.7% vs 34.4%, P < .01). A subgroup analysis for outpatients (never hospitalized) still identified a higher prevalence of chemosensory dysfunction among Canadians compared to Israelis (68.2% vs 36.1%, P < 0.01). A majority of patients recovered their sense of smell after 4 weeks of symptom onset. Conclusion: Although the prevalence of chemosensory deficit in COVID-19 was found to be similar to previously published reports, the prevalence can vary significantly across different geographical regions. Therefore, it is important to obtain regionally specific data so that the symptom of anosmia/dysgeusia can be used as a guide for screening for the clinical diagnosis of COVID-19.

Download Full-text

Are local offices of emergency management prepared for people with disabilities? Results from the FEMA Region 9 Survey

Journal of Emergency Management ◽

10.5055/jem.0506 ◽

2021 ◽

Vol 19 (1) ◽

pp. 7-20

Author(s):

Robyn R. Gershon, MHS, DrPH ◽

Michelle A. Muska, EMT, MPH ◽

Qi Zhi, MPH ◽

Lewis E. Kraus, MPH, MCP

Keyword(s):

Emergency Management ◽

Primary Outcome ◽

People With Disabilities ◽

Cross Sectional Study ◽

Sectional Study ◽

Department Of Justice ◽

Cross Sectional ◽

Sign Language Interpreters ◽

Personal Assistants ◽

Management Recommendations

Objective: To assess disaster planning of local Offices of Emergency Management (OEM) with respect to people with disabilities (PWD).Design: A cross-sectional study of local OEM from Federal Emergency Management Agency (FEMA) Region 9 (N = 61) was conducted using an internet-based survey. The primary outcome was the adoption of emergency management recommendations by the Department of Justice (DOJ) and FEMA in applying Title II of the Americans with Disabilities Act (ADA). Results: OEM implementation of ADA requirements was generally suboptimal. While 63 percent reported that plans addressed the needs of PWD, only 41 percent reported detailed operating procedures for PWD. Training of staff to ensure that they were knowledgeable on the ADA requirements for inclusivity was rarely conducted. While accessible shelters and transportation were often identified, accessible communication strategies, including emergency notifications, were often lacking; only 28 percent of OEMs reported availability of sign language interpreters at shelters. Shelters often allowed service animal access (62 percent), but fewer allowed access to personal assistants (39 percent). Engagement of the disability community, from plan development to community drills, was uncommon. While more than half (59 percent) of OEM felt clear about their responsibilities in providing equal access to PWD, only 23 percent reported having qualified staff and other resources necessary in order to meet those responsibilities. Participants cited the need for more training on the ADA requirements in order to better meet the needs of PWD. Conclusion: Strategies for improvement to assure inclusiveness of PWD in all phases of emergency management are needed.

Download Full-text

Screening children at risk for developmental disabilities based on face landmark from video data of mobile-based application: Preliminary Cross-Sectional Study (Preprint)

JMIR Pediatrics and Parenting ◽

10.2196/29908 ◽

2021 ◽

Author(s):

Yu Rang Park ◽

Sang Ho Hwang ◽

Yeonsoo Yu ◽

Jichul Kim ◽

Taeyeop Lee ◽

...

Keyword(s):

At Risk ◽

Developmental Disabilities ◽

Cross Sectional Study ◽

Video Data ◽

Sectional Study ◽

Children At Risk ◽

Cross Sectional

Download Full-text

Pediatric neurodevelopment by prenatal Zika virus exposure: A cross-sectional study of the Microcephaly Epidemic Research Group Cohort

10.21203/rs.3.rs-24132/v2 ◽

2020 ◽

Author(s):

paula sobral Silva ◽

Sophie Helena Eickmann ◽

Ricardo Arraes de Alencar Ximenes ◽

Ulisses Ramos Montarroyos ◽

Marília de Carvalho Lima ◽

...

Keyword(s):

At Risk ◽

Zika Virus ◽

Cross Sectional Study ◽

Sectional Study ◽

Early Assessment ◽

Cross Sectional ◽

Group 4 ◽

Neurological Abnormalities ◽

Development Delay ◽

And Behavior

Abstract Background: The implications of congenital Zika Virus (ZIKV) infections for pediatric neurodevelopment and behavior remain inadequately studied. The aim of this study is to investigate patterns of neurodevelopment and behavior in children with different levels of ZIKV-related microcephaly or with prenatal ZIKV exposure in the absence of microcephaly. Methods: We conducted a cross-sectional study, nested in a cohort, of 274 children (aged 10-45 months) who were born during the peak and decline of the microcephaly epidemic in Northeast Brazil. Participants were evaluated between February 2017 and August 2019 at two tertiary care hospitals in Recife, Brazil. We analyzed the children in four groups assigned based on clinical and laboratory criteria: Group 1 had severe microcephaly; Group 2 had moderate microcephaly; Group 3 had prenatal ZIKVxposure confirmed by maternal RT-PCR testing and no microcephaly; and Group 4 was a neurotypical control group. Groups were evaluated clinically for neurological abnormalities and compared using the Survey of Wellbeing of Young Children (SWYC), a neurodevelopment and behavior screening instrument, and a SWYC adapted form to compare severe cases. Results: Based on the SWYC screening, we observed differences between the groups for developmental milestones but not behavior. Among children with severe microcephaly of whom 98.2% presented with neurological abnormalities, 99.1% were at risk of development delay, and presented similar performance whether evaluated under or over 24 months of age. Among children with moderate microcephaly of whom 60% presented with neurological abnormalities, 65% were at risk of development delay. For children without microcephaly, the percentages found to be at risk of developmental delays were markedly lower and did not differ by prenatal ZIKV exposure status: Groups 3, 13.8%; Group 4, 21.7%. Conclusions: Among groups of children with prenatal ZIKV exposure, we found a gradient of risk of development delay. Children with severe microcephaly were at highest risk, while normocephalic ZIKV-exposed children had similar risks to unexposed control children. We propose that ZIKV-exposed children should undergo first-line screening for neurodevelopment and behavior using the SWYC. Early assessment and follow-up will enable at-risk children to be referred to a more comprehensive developmental evaluation and to multidisciplinary care management.

Download Full-text

Seroprevalence of Coxiella burnetii in sheep flocks in Kaduna State, Northwestern Nigeria

Acta Veterinaria Hungarica ◽

10.1556/004.2021.00034 ◽

2021 ◽

Author(s):

Shuaibu Gidado Adamu ◽

Junaidu Kabir ◽

Jarlath Udo Umoh ◽

Mashood Abiola Raji

Keyword(s):

Risk Factors ◽

Coxiella Burnetii ◽

Q Fever ◽

Jugular Vein ◽

Cross Sectional Study ◽

Enzyme Linked Immunosorbent Assay ◽

Sectional Study ◽

High Seroprevalence ◽

Cross Sectional ◽

Significant Difference

Abstract A cross-sectional study was carried out to determine the seroprevalence and risk factors of Q fever in sheep in the northern part of Kaduna State, Nigeria. This study aimed to determine Coxiella burnetii infection and its risk factors in sheep in Kaduna State. A total of 400 blood samples consisting of 259 samples from females and 141 from males were aseptically collected from the jugular vein of sheep from flocks in Kaduna State. The sera obtained were screened for Q fever using an indirect enzyme-linked immunosorbent assay (iELISA). The obtained data were analysed to determine whether there is a relationship between sex, age, and the animals tested. The analysis revealed that 8.0% of the sera was seropositive by iELISA. There was no significant difference in Q fever seropositivity in the study area according to the sex of sheep (P > 0.05). There was a statistically significant difference (P < 0.05) in Q fever seropositivity according to the age of sheep. This study indicated a high seroprevalence of Q fever mainly among female animals and older sheep. Further studies are required to determine the epizootiology of Q fever in the study area more precisely.

Download Full-text

The Association Between Hands-On Instruction and Proper Child Safety Seat Installation

PEDIATRICS ◽

10.1542/peds.106.s3.924 ◽

2000 ◽

Vol 106 (Supplement_3) ◽

pp. 924-929

Author(s):

Wendy G. Lane ◽

Gilbert C. Liu ◽

Elizabeth Newlin

Keyword(s):

Primary Care ◽

Outcome Measure ◽

Private Insurance ◽

Cross Sectional Study ◽

Child Safety ◽

Sectional Study ◽

Cross Sectional ◽

Main Outcome Measure ◽

Hands On ◽

Safety Seat

Objective. To determine if hands-on instruction in child safety seat (CSS) installation decreases the number of errors in installation. Design. Cross-sectional study. Setting. Primary care offices, emergency department, CSS checkpoint. Participants. Parents of children <2 years old receiving medical care or attending a CSS check. Main Outcome Measure. Errors in CSS use. Results. Only 6.4% of parents had a correctly installed CSS. Hands-on instruction was associated with fewer errors in seat installation. Increased parent age, completion of college, and having private insurance were also associated with fewer errors in CSS placement. The majority of parents learned to install seats from reading the manual, from friends and relatives, and from figuring it out on their own. Conclusions. Errors in CSS installation are a significant problem. Hands-on instruction decreases the numbers of errors in CSS installation. However, few parents receive hands-on instruction from experts in CSS installation. Increases in correct CSS use could result from hands-on education by trained professionals.

Download Full-text

Hawaii's Healthy Start Program of Home Visiting for At-Risk Families: Evaluation of Family Identification, Family Engagement, and Service Delivery

PEDIATRICS ◽

10.1542/peds.105.s2.250 ◽

2000 ◽

Vol 105 (Supplement_2) ◽

pp. 250-259 ◽

Cited By ~ 1

Author(s):

Anne Duggan ◽

Amy Windham ◽

Elizabeth McFarlane ◽

Loretta Fuddy ◽

LCSW, MPH ◽

...

Keyword(s):

Risk Factors ◽

At Risk ◽

Early Identification ◽

Home Visiting ◽

Family Engagement ◽

Cross Sectional Study ◽

Family Characteristics ◽

Sectional Study ◽

Cross Sectional ◽

Healthy Start Program

Objective. To describe family identification, family engagement, and service delivery in a statewide home visiting program for at-risk families of newborns. Setting. Six target communities of Hawaii's Healthy Start Program (HSP), which incorporates 1) early identification of at-risk families of newborns via population-based screening and assessment, and 2) paraprofessionalhome visiting to improve family functioning, promote child health and development, and prevent child maltreatment. Design. Cross-sectional study: describes early identification process and family characteristics associated with initial enrollment. Longitudinal study: describes home visiting process and characteristics associated with continued participation. Subjects. Cross-sectional study: civilian births in 6 communities (n = 6553). Longitudinal study: at-risk families in the intervention group of a randomized trial of the HSP (n = 373). Measures. Process: completeness and timeliness of early identification and home visiting activities; family characteristics: sociodemographics, child abuse risk factors, infant biologic risk. Results. Early identification staff determined risk status for 84% of target families. Families with higher risk scores, young mothers with limited schooling, and families with infants at biologic risk were more likely to enroll in home visiting. Half of those who enrolled were active at 1 year with an average of 22 visits. Families where the father had multiple risk factors and where the mother was substance abusing were more likely to have ≥12 visits; mothers who were unilaterally violent toward the father were less likely. Most families were linked with a medical home; linkage rates for other community resources varied widely by type of service. Half of families overall, but ≥80% of those active at 1 year, received core home visiting services. Performance varied by program site. Conclusions. It is challenging to engage and retain at-risk families in home visiting. Service monitoring must be an integral part of operations.

Download Full-text