Use of prescribing indicators as a means of identifying variation in the prevalence of valproate prescribing between health communities: a cross-sectional study

ObjectiveTo determine the appropriateness of valproate prescribing indicators in England and Wales as a means of identifying variation in the prevalence of valproate use among women and girls of childbearing potential between health communities.Methods and analysisCross-sectional study using an ecological design using routinely published, publicly available valproate prescribing data for the period January to March 2019 and 2018 mid-year population estimates.ResultsIn England and Wales, 87.7 people in every 1000 people prescribed valproate were women or girls aged 14–45 years (range 60.4–133.2). The prevalence of valproate use among all women and girls of childbearing age was 1.49 cases per 1000 women and girls aged 14–45 years (range 0.47–3.13). Considerable variation in prevalence was observed depending on which of two measures was used. The relative risk of exposure between health communities increased from 2.2 to 6.6 depending on the measure used, leading to the identification of different health communities being a priority for action. Wide variation was observed in the prevalence of valproate use among individuals other than women and girls aged 14–45 years (mean prevalence 3.89 cases per 1000 population, range 2.42–7.78). The prevalence of valproate use in all Clinical Commissioning Groups and Local Health Boards was lower in the at-risk population than in the rest of the population (p=0.046) with a strong positive correlation observed between the prevalence of valproate use in these two groups (p<0.001).ConclusionCurrent indicators may lead to a failure to systematically review women and girls of childbearing age prescribed valproate. Urgent consideration should be given to changing the indicators used in England and Wales.

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Dietary Factors of blaNDM Carriage in Health Community Population: A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115959 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5959

Author(s):

Shuangfang Hu ◽

Ziquan Lv ◽

Qiumei Xiang ◽

Yang Wang ◽

Jianzhong Shen ◽

...

Keyword(s):

Risk Factors ◽

Antimicrobial Resistance ◽

Cross Sectional Study ◽

Dietary Factors ◽

Coarse Grain ◽

Sectional Study ◽

Cross Sectional ◽

Health Community ◽

Health Communities ◽

Tuber Crops

Aim: There is an ongoing debate as to what extent antimicrobial resistance (AMR) can be transmitted from dietary to humans via the consumption of food products. We investigated this association between dietary and global spreading carbapenem-resistant gene blaNDM Methods: We did a cross-sectional study to assess the risk factors for carrier of blaNDM in health community. Healthy adults were recruited from the residents attending Community Healthcare Service in Shenzhen City (Guangdong Province, China), through 1February 2018 to 31December 2019, and 718 pre-participants were included in this study. Questionnaire were obtained and the qualitative food frequency questionnaire (Q-FFQ) were used to assess dietary intake. qPCR was applied to confirm the carrier of blaNDM in participants’fecal samples. Multivariable logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (95% CI) of each outcome according to each dietary factor before and after prosperity score matching (PSM). Results: we showed that a high intake of coarse grain (OR 1.003; 95% CI 1.001–1.005, p < 0.01) and root and tuber crops (OR 1.003; 95% CI 1.001–1.004, p < 0.05) were independent risk factor for blaNDM carrier in health communities, suggesting a possible transfer of AMRbetweendietary andhumans. Surprisingly, we also showed an association between a higher intake of poultry as a protective, which may be explained by the beneficial effects on the gut microbiota. Conclusion: Dietary factors such as intake of coarse grain, root and tuber crops and poultry were associated with blaNDM carrier in health communities. The influence of dietary factorson blaNDM carrier in the present study provides insights for the tangible dietary advice with guidelines to the routine of people with the risk of blaNDM carrier. This demonstrates the role of dietary intake in the prevention of blaNDM carrier, since prevention is the best way to control modifiable risk factors. A lower carrier rate of blaNDM is helpful to reduce the possibility of transmission and pathogenicity. Further studies on food, microbiota and antimicrobial resistance are necessary to confirm this possible association and unravel underlying mechanisms.

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Wide variability in colorectal cancer screening uptake by general practitioner: Cross-sectional study

Journal of Medical Screening ◽

10.1177/09691413211035795 ◽

2021 ◽

pp. 096914132110357

Author(s):

Cecilia Acuti Martellucci ◽

Maria E Flacco ◽

Margherita Morettini ◽

Giusi Giacomini ◽

Matthew Palmer ◽

...

Keyword(s):

Colorectal Cancer ◽

Geographical Area ◽

Central Italy ◽

Cross Sectional Study ◽

Local Health ◽

Sectional Study ◽

Cross Sectional ◽

Crc Screening ◽

Screening Uptake

Objectives Despite several interventions, colorectal cancer (CRC) screening uptake remains below acceptable levels in Italy. Among the potential determinants of screening uptake, only a few studies analysed the role of general practitioners (GPs). The aim was to evaluate the variation in screening uptake of the clusters of subjects assisted by single GPs. Setting Ancona province, Central Italy. Methods Cross-sectional study, including all residents aged 50–69 years, who were offered the public screening programme with biannual faecal immunochemical tests. Demographic (of all GPs) and screening data (of all eligible residents) for years 2018–2019 were collected from the official electronic datasets of the Ancona Local Health Unit. The potential predictors of acceptable screening uptake, including GP's gender, age, and number of registered subjects, were evaluated using random-effect logistic regression, with geographical area as the cluster unit. Results The final sample consisted of 332 GP clusters, including 120,178 eligible subjects. The overall province uptake was 38.0% ± 10.7%. The uptake was lower than 30% in one-fifth of the GP clusters, and higher than 45% in another fifth. At multivariable analysis, the significant predictors of uptake were younger GP age ( p = 0.010) and lower number of registered subjects ( p < 0.001). None of the GP clusters with 500 subjects or more showed an uptake ≥45%. Conclusions The wide variation across GPs suggests they might substantially influence screening uptake, highlighting a potential need to increase their commitment to CRC screening. Further research is needed to confirm the role of the number of registered subjects.

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Protocol for the avatar acceptability study: a multiperspective cross-sectional study evaluating the acceptability of using patient-derived xenografts to guide personalised cancer care in Australia and New Zealand

BMJ Open ◽

10.1136/bmjopen-2018-024064 ◽

2018 ◽

Vol 8 (8) ◽

pp. e024064 ◽

Cited By ~ 1

Author(s):

Claire E Wakefield ◽

Emma L Doolan ◽

Joanna E Fardell ◽

Christina Signorelli ◽

Veronica F Quinn ◽

...

Keyword(s):

Cancer Survivors ◽

Cancer Care ◽

New Technologies ◽

Cross Sectional Study ◽

Decisional Balance ◽

Local Health ◽

Sectional Study ◽

Structured Interviews ◽

Cross Sectional ◽

Advantages And Disadvantages

IntroductionPatient-derived xenografts (PDXs) have the potential to transform personalised cancer care, however, little is known about the acceptability of using PDXs to guide treatment decision-making. Given that patient and community preferences can influence satisfaction with care as well as the success of new technologies, we will evaluate the acceptability of PDXs in individuals affected by cancer and community comparisons.Methods and analysisThis comparative cross-sectional study will recruit 323 individuals affected by cancer (cancer survivors (of childhood or adult cancer) and parents of childhood cancer survivors) and 323 community comparisons (adults and parents). We will collect data via structured interviews and questionnaires. To determine the acceptability of PDXs, we will assess five domains: willingness to use PDXs when/if diagnosed with cancer, perceived advantages and disadvantages of PDXs, maximum acceptable out-of-pocket costs per patient, maximum acceptable turnaround time to receive results and maximum acceptable number of mice sacrificed per patient. The primary endpoint will be participants’ decisional balance ratio (calculated as participants’ advantages ratings divided by perceived disadvantages ratings).Ethics and disseminationThe study protocol has been approved by the South Eastern Sydney Local Health District Human Research Ethics Committee (HREC:12/173) and UNSW Sydney (HC15773). The results will be disseminated in peer-reviewed journals and at scientific conferences. A lay summary will be published on the Behavioural Sciences Unit website.

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Investigating ethnic inequalities in hearing aid use in England and Wales: a cross-sectional study

International Journal of Audiology ◽

10.1080/14992027.2021.2009131 ◽

2021 ◽

pp. 1-11

Author(s):

Harry Taylor ◽

Piers Dawes ◽

Dharmi Kapadia ◽

Nick Shryane ◽

Paul Norman

Keyword(s):

Hearing Aid ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

England And Wales ◽

Ethnic Inequalities ◽

Hearing Aid Use

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Prescribing practices using WHO prescribing indicators and factors associated with antibiotic prescribing in six community pharmacies in Asmara, Eritrea: a cross-sectional study

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-019-0620-5 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 4

Author(s):

Nebyu Daniel Amaha ◽

Dawit G. Weldemariam ◽

Nuru Abdu ◽

Eyasu H. Tesfamariam

Keyword(s):

Sampling Technique ◽

Cross Sectional Study ◽

Essential Medicines ◽

Community Pharmacies ◽

Antibiotic Prescribing ◽

Sectional Study ◽

Prescribing Practices ◽

Cross Sectional ◽

Prescribing Indicators ◽

Factors Affecting

Abstract Background Antibiotics require more prudent prescribing, dispensing and administration than other medicines because these medicines are at a greater risk of antimicrobial resistance (AMR). Studying the current medicine use practices and factors affecting the prescribing of an antibiotic would help decision makers to draft policies that would enable a more rational use of medicines. Methods A prospective, descriptive, and cross-sectional study was conducted to assess the current prescribing practices including antibiotics use in six community pharmacies in Asmara. A total of 600 encounters were reviewed using the WHO core prescribing indicators between May 5 and May 12, 2019 using stratified random sampling technique. Descriptive statistics and logistic regression were employed using IBM SPSS® (version 22). Results The average number of medicines per prescription was 1.76 and 83.14% of the medicines were prescribed using generic names while 98.39% of the medicines were from the National Essential Medicines List (NEML). The percentage of prescriptions containing antibiotics was 53%. The number of encounters containing injections was 7.8%. Patient age, gender and number of medicines prescribed were significantly associated with antibiotic prescribing at bivariate and multivariable models. Subjects under the age of 15 were approximately three times more likely to be prescribed antibiotic compared to subjects whose age is 65 and above (Adjusted Odds Ratio (AOR): 2.93, 95%CI: 1.71–5). Similarly, males were more likely to be prescribed antibiotic than females (AOR: 1.57, 95%CI: 1.10–2.24). Subjects to whom three to four medicines prescribed were two times more likely to be prescribed an antibiotic compared to those who were to be prescribed one to two medicines per encounter (AOR: 2.17, 95%CI: 1.35–3.5). A one-unit increase in the number of medicines increased the odds of antibiotic prescribing increased by 2.02 units (COR: 2.02; 95%CI: 1.62–2.52). Conclusions This study found that the percentage of antibiotics being prescribed at the community pharmacies in Asmara was 53% which deviated significantly from the WHO recommended values (20–26.8%). Furthermore, the percentage of encounters with an injection was 7.8% lower than the WHO value of 13.4–24.0%. Patients’ age, gender and number of medicines were significantly associated with antibiotic prescribing.

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Pregnancy protection and pregnancies in women prescribed ACE inhibitors or ARBs: a cross-sectional study in primary care

British Journal of General Practice ◽

10.3399/bjgp20x712997 ◽

2020 ◽

Vol 70 (700) ◽

pp. e778-e784

Author(s):

Elizabeth Lovegrove ◽

John Robson ◽

Patricia McGettigan

Keyword(s):

Primary Care ◽

Ace Inhibitors ◽

Ace Inhibitor ◽

Angiotensin Receptor Blockers ◽

Age Groups ◽

Cross Sectional Study ◽

Women Of Childbearing Age ◽

Sectional Study ◽

Childbearing Age ◽

Cross Sectional

BackgroundThe teratogenic risks of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are well documented, but prescribing these in younger women in primary care is becoming increasingly frequent.AimTo record how frequently women of childbearing age, who are prescribed an ACE inhibitor or ARB, receive preconception advice and/or are prescribed contraception, and how many pregnancies, terminations, and miscarriages occur in this population. Additionally, to ascertain whether patterns in the above differ across age groups.Design and settingCross-sectional study conducted among patients from 141 general practices in East London.MethodWomen aged 15–45 years who were issued a prescription for an ACE inhibitor or ARB between 1 October 2018 and 1 January 2019 inclusive were included. An electronic search strategy was designed to extract pseudonymised data concerning preconception and contraception advice, contraception, and pregnancies from the electronic clinical system; this was applied to the selected cohort on 1 January 2019. Data were analysed in 5-year age groups.ResultsOf 302 939 women aged 15–45 years, 2651 (0.9%) were prescribed an ACE inhibitor or an ARB in a 3-month period. Of these, 2159 (81.4%) had no advice and no contraception prescription recorded, 35 (1.3%) had preconception advice recorded, and 230 (8.7%) had contraception advice recorded. A total of 100 pregnancies and 21 terminations/miscarriages were recorded in the 12 months preceding the index date (1 January 2019).ConclusionThis study found that the recording of pre-pregnancy advice and contraception in women of childbearing age who were prescribed an ACE inhibitor or an ARB was suboptimal; this may place women and their babies at risk of exposure to teratogens during pregnancy. The findings indicate that there is a need for improved safety strategies based in primary care.

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Recent trends in seroprevalence of rubella in Korean women of childbearing age: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-030873 ◽

2020 ◽

Vol 10 (1) ◽

pp. e030873 ◽

Cited By ~ 1

Author(s):

Rihwa Choi ◽

Yejin Oh ◽

Youngju Oh ◽

Sung Ho Kim ◽

Sang Gon Lee ◽

...

Keyword(s):

Cross Sectional Study ◽

Korean Women ◽

Test Results ◽

Women Of Childbearing Age ◽

Sectional Study ◽

Childbearing Age ◽

Igg Antibody ◽

Cross Sectional ◽

Specific Igg ◽

Catch Up

ObjectivesThe aim of this study was to investigate the immunity against rubella using the serological status of rubella-specific IgG antibodies (antirubella IgG) in Korean women of childbearing age (15–49 years).DesignRetrospective cross-sectional study.SettingPopulation-based cross-sectional study in South Korea.ParticipantsBetween January 2010 and December 2017, test results from Korean women aged 15–49 years who had visited an obstetric private clinic (nationwide institutions) and had requested rubella-specific IgG antibody tests from Green Cross Laboratories were obtained from the laboratory information system.ResultsBetween 2010 and 2017, antirubella IgG test results from 328 426 Korean women aged 15–49 years who had visited private obstetric clinics (1438 institutions nationwide) were retrospectively analysed by tested year, age, cohort and geographic regions. Over the 8-year study period, the rate of unimmunised women ranged from 7.8% to 9.7%. Multivariable-adjusted logistic regression models showed that the odds of being immune to rubella (positive and equivocal results of antirubella IgG test) were lower in 2017 compared with 2010, in women in their 40s, in a pre-catch-up cohort and in women living in Incheon, Busan, South Gyeongsang, North and South Jeolla and Jeju provinces (p<0.0001).ConclusionsIn consideration of the factors associated with prevalence of women unimmunised to rubella, future public health efforts should be focused on catch-up activities. The results of this study could be used to strengthen disease control and prevent rubella, including a nationwide immunisation programme.

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Food Safety Practice and Associated Factors among Meat Handlers in Gondar Town: A Cross-Sectional Study

Journal of Environmental and Public Health ◽

10.1155/2020/7421745 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Dawit Getachew Yenealem ◽

Walelegn Worku Yallew ◽

Shafi Abdulmajid

Keyword(s):

Associated Factors ◽

Cross Sectional Study ◽

Outcome Variable ◽

Local Health ◽

Sectional Study ◽

Food Handling ◽

Cross Sectional ◽

Good Level ◽

Gondar Town ◽

Butcher Shops

Introduction. Animal sources of foods (ASF), including meat, are a source of high-quality nutrients. However, meat composition makes it an ideal medium for the growth of a good number of microorganisms. Around 600 million foodborne illnesses and 420000 deaths occur each year due to poor food handling practice. Thus, probing into meat handling practice will be an insatiable input for the intervention. This study aims to investigate the level of meat handling practice and associated factors among meat handlers in butcheries in Gondar town, Ethiopia. Method. The study was a community-based cross-sectional study among butcher shops in Gondar town from April 20 to 30, 2019. Data were collected using a pretested structured questionnaire by trained data collectors among 214 meat handlers from butcher shops. Multivariable logistic regression analysis with a 95% confidence interval (CI) was used to identify the factors significantly associated with a good level of meat handling practice. Result. More than half of the meat handlers 66.4% (95% CI: (59.8, 72.4)) in butcher shops had a good level of meat handling practice. Level of attitude (AOR = 4.45; 95% CI, 2.09–9.43) and knowledge (AOR = 2.04; 95% CI, 1.09–3.82) were significantly associated with a good level of meat handling practice. The majority of respondents wash their hands after disposing garbage (91.6%) with less vigilance after smoking, sneezing, or coughing (64.0%). Conclusion. The study revealed that the level of food handling practice was unsatisfactory among meat handlers. This result is a testimony to the prevailing potential risk faced by consumers due to the disregarding of hygienic behaviors by food handlers. Considering attitude and knowledge are associated with the outcome variable, investing time on behavioral change activities that will contribute to the improvement of meat handler’s attitude & practice, primarily focusing on reducing working while ill is essential. Therefore, much supervisory and coaching work will be expected from local health departments & regulatory bodies.

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