A multicentre survey of pain management in cancer patients and physicians attending radiotherapy clinics in Shandong Province, China

Objective To obtain a better understanding of the prevalence and management of pain in patients undergoing radiotherapy for cancer in Shandong Province, China. Methods This cross-sectional study used a questionnaire during face-to-face interviews to collect data from physicians and patients regarding the recognition, prevalence and treatment of pain during the waiting period before commencement of radiotherapy and during the radiotherapy period. Physicians and patients were recruited from 10 tertiary Class A hospitals across Shandong Province, China. Results A total of 184 patients and 87 physicians were recruited to the study. During the waiting period, pain was reported by the physicians according to their experience to affect 26.0% of patients, which almost agreed with the patients’ data (36.5%; 160 of 438). During the radiotherapy period, there was a significant difference in the reported prevalence of pain during the radiotherapy period between the physicians’ data (23.0%) based on their experience and the patients’ data (84.1%; 169 of 201 patients). The majority of physicians (98.9%; 86 of 87) agreed to the use opioids for pain management and 90.8% (79 of 87) were satisfied with the analgesic effect, but more than half of the patients who received pain treatment reported inadequate analgesia. Conclusion There was a high incidence of cancer pain, but insufficient assessment, inadequate treatment and inadequate education about pain in both the waiting and radiotherapy periods.

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Acute and Chronic Pain Learning and Teaching in Medical School—An Observational Cross-Sectional Study Regarding Preparation and Self-Confidence of Clinical and Pre-Clinical Medical Students

Medicina ◽

10.3390/medicina55090533 ◽

2019 ◽

Vol 55 (9) ◽

pp. 533 ◽

Cited By ~ 2

Author(s):

Kacper Lechowicz ◽

Igor Karolak ◽

Sylwester Drożdżal ◽

Maciej Żukowski ◽

Aleksandra Szylińska ◽

...

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Medical Students ◽

Acute Pain ◽

Pain Treatment ◽

Cross Sectional Study ◽

Clinical Group ◽

Sectional Study ◽

Cross Sectional ◽

Actual Knowledge

Background and objectives: Adequate pain management is a major challenge of public health. The majority of students graduating from medical schools has insufficient education and experience with patients suffering pain. Not enough is being taught regarding pain in non-verbal patients (children, critically ill in the intensive care unit, demented). Chronic pain is the most difficult to optimize and requires appropriate preparation at the level of medical school. Our aim was to evaluate attitudes, expectations and the actual knowledge of medical students at different levels of their career path regarding the assessment and treatment of acute and chronic pain. Materials and Methods: We performed an observational cross-sectional study that was based on a survey distributed among medical students of pre-clinical and post-clinical years at the Pomeranian Medical University in Szczecin, Poland. The survey included: demographic data, number of hours of formal pain teaching, actual knowledge of pain assessment, and pain treatment options in adults and children. Results: We received responses from 77/364 (21.15%) students and 79.2% of them rated the need to obtain knowledge regarding pain as very important (10/10 points). Post-clinical group declared having on average 11.51 h of acute pain teaching as compared to the 7.4 h reported by the pre-clinical group (p = 0.012). Graduating students also reported having significantly more classes regarding the treatment of chronic pain (6.08 h vs. 3.79 h, p = 0.007). The average level of comfort in the post-clinical group regarding treatment of acute pain was higher than in the pre-clinical group (6.05 vs. 4.26, p = 0.006), similarly with chronic pain treatment in adults (4.33 vs. 2.97, p = 0.021) and with pain treatment in children (3.14 vs. 1.97, p = 0.026). Conclusions: This study shows that education about pain management is a priority to medical students. Despite this, there continues to be a discrepancy between students’ expectations and the actual teaching and knowledge regarding effective pain management, including the vulnerable groups: chronic pain patients, children, and critically ill people.

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Predictors and Prevalence of Pain and Its Management in Four Regional Cancer Hospitals in India

Journal of Global Oncology ◽

10.1200/jgo.2016.006783 ◽

2018 ◽

pp. 1-9

Author(s):

Katherine E. Doyle ◽

Shatha K. El Nakib ◽

M.R. Rajagopal ◽

Sunil Babu ◽

Geeta Joshi ◽

...

Keyword(s):

Pain Management ◽

Cancer Pain ◽

Brief Pain Inventory ◽

Cross Sectional Study ◽

Cross Sectional ◽

Survey Tool ◽

Patients With Cancer ◽

Pain Management Index ◽

Indian Patients ◽

Prevalence Of Pain

Purpose More than 1 million new occurrences of cancer are diagnosed in India annually. Among patients with cancer, pain is a common and persistent symptom of the disease and its treatment. However, few studies to date have evaluated the prevalence of pain and the adequacy of pain management in Indian hospitals. This cross-sectional study aimed to assess the prevalence and sociodemographic patterns of cancer pain and pain management among a sample of inpatients and newly registered outpatients at four large regional cancer centers in India. Methods A sample of 1,600 patients with cancer who were current inpatients or newly registered outpatients were recruited and administered a questionnaire that was based on the Brief Pain Inventory. The survey tool included questions on demographics, medical history, and extent of clinical pain experienced. In addition, a pain management index score was created to link the severity of cancer pain with medication prescribed to treat it. Results A total of 88% of patients reported pain in the past 7 days, and approximately 60% reported that their worst pain was severe. Several demographic and medical characteristics of the study population predicted severe pain, including the following: lower educational level, outpatient status, and debt incurred as a result of illness. A total of 67% of patients were inadequately treated with analgesics. Inadequate pain management was associated with both treatment hospital and patient type, and patients who reported debt as a result of their illness were more likely to have inadequate pain management. Conclusion A majority of Indian patients with cancer experience significant pain and receive inadequate pain management. Improvement of pain management for Indian patients with cancer is needed urgently.

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Self-Reported Morbidities, Nutritional Characteristics, and Associated Factors in Institutionalized and Non-Institutionalized Elderly

10.21203/rs.3.rs-38969/v1 ◽

2020 ◽

Author(s):

BENKSIM ABDELHAFID ◽

Ait Addi Rachid ◽

khalloufi elhassania ◽

Habibi Aziz ◽

Cherkaoui Mohammed

Keyword(s):

Health Insurance ◽

Statistical Significance ◽

The Elderly ◽

Cross Sectional Study ◽

Cross Sectional ◽

Face To Face ◽

Number Of Children ◽

Preventive Actions ◽

Significant Difference ◽

Nutritional Characteristics

Abstract Background: Older people make up a large part of the world's population and their numbers are expected to increase significantly by 2030. The objective of this study is to determine socio-economic, health and nutritional characteristics of institutionalized and non-institutionalized elders in the province of Marrakech.Methods: This cross-sectional study was conducted among 368 participants in Marrakech province between March 2017 and June 2019 through a face-to-face interview. Of all participants, 180 elders are residing in public institutions and 188 at home. Face-to-face interviews provided information on socioeconomic and health characteristics. Results: Institutionalized elders were illiterate (80.0%), had low incomes (95.5%), and unmarried (73.3%).They reported less children (1.52±2.35) and no health insurance (98.9%). Institutional residents suffered from malnutrition (22.2%), hearing impairments (35.6%) and severe edentulism (43.3%). There was no significant difference between both groups on daily activities and depression. A multivariate analysis identified a model with three significant variables associated with non-institutionalized elders: health insurance (P=0.001; OR=107.49), number of children (P=0.001; OR=1.74) and nutritional status (p=0.001; OR=3853). The data were analyzed by using SPSS version 16.0. Statistical significance was set at p<0.05.Conclusions: This study shows that the institutionalization of the elderly is considerably induced by various factors such as nutritional problems, lack of health insurance and family structure. To mitigate the effects of this phenomenon, home care strategies and preventive actions should be carried out to delay the referral of the elderly to institutions and to keep them socially active

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Students’ and lecturers’ perspective on the implementation of online learning in dental education due to SARS-CoV-2 (COVID-19): a cross-sectional study

BMC Medical Education ◽

10.1186/s12909-020-02266-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Maximiliane Amelie Schlenz ◽

Alexander Schmidt ◽

Bernd Wöstmann ◽

Nobert Krämer ◽

Nelly Schulz-Weidner

Keyword(s):

Online Learning ◽

Online Teaching ◽

Cross Sectional Study ◽

Knowledge Gain ◽

Online Questionnaire ◽

Cross Sectional ◽

Face To Face ◽

Significant Difference ◽

The Future ◽

Face To Face Learning

Abstract Background On account of physical distancing measures, universities worldwide are strongly affected by SARS-CoV-2 (COVID-19). Thus, the dental school of Justus-Liebig-University Giessen (Germany) transferred the established “face-to-face” learning to online learning in the spring term 2020. The aim of this study was to assess the students’ and lecturers’ perspectives on the implementation of online learning due to COVID-19, using a questionnaire survey. Methods After the online period, all students and lecturers were asked to fill out an online questionnaire containing evaluative statements regarding handling, didactic benefit, motivation, and overall assessment. Furthermore, the questionnaire for lecturers contained additional aspects regarding knowledge gain in terms of providing online learning. Besides that, students and lecturers were asked for the amount of online learning in the future curriculum (independent of COVID-19). Data were subjected to regression analysis and T-test (p < .05). Results 36.8% of students preferred “face-to-face” learning instead of sole online learning. An increase of know how concerning online teaching was observable for lecturers. Both, students and lecturers, want to keep up with online courses in the future curriculum. However, in terms of the optimal amount of online learning a significant difference between students’ and lecturers’ perspective was observed. While students suggested 53.2% (24.9) (mean (standard deviation)) lecturers only stated 38.6% (21.5). Conclusions Within the limitation of this study, students’ and lecturers’ showed a predominantly positive perspective on the implementation of online learning, providing the chance to use online learning even beyond COVID-19 in the future curriculum.

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The Changes in Fear of Childbirth in Pregnancy During and Before the COVID-19 Pandemic

10.21203/rs.3.rs-628149/v1 ◽

2021 ◽

Author(s):

Cenk Soysal ◽

Özlem Erten ◽

Mehmet Murat Işıkalan ◽

İsmail Bıyık ◽

Yasemin Taşçı ◽

...

Keyword(s):

Pregnant Women ◽

Cross Sectional Study ◽

Study Data ◽

Education Level ◽

Fear Of Childbirth ◽

Cross Sectional ◽

Face To Face ◽

Significant Difference ◽

Education Levels ◽

Training And Research

Abstract Background: We aimed to compare the changes experienced by pregnant women before and during the pandemic regarding fear of childbirth andhow much they were affected by factors such as age, education level, and planned delivery type.Materials and Methods: This cross-sectional study comparedthe pre-pandemic pregnant group (July 2019 and December 2019) and the pandemic group (November 2020 and May 2021) of patients atKütahya Health Sciences University Evliya Çelebi Training and Research Hospital. A total of 696 pregnant womenin their second trimesterwere included in the study. All of them were literate andvoluntarily agreed to participate in the study. Data were collected with the Wijma Delivery Expectancy/Experience Questionnaire (WDEQ-A), and the outpatient doctor asked the questions face-to-face.Results: The mean age of the pregnant women participating in the study was 31.6±6.8 years. While the total Wijma score was 62.1±25.1 in the pre-pandemic group, it was 61.3±26.4 in the pandemic group, and there was no significant difference between the two groups (p=0.738).While 25.7% (n=179) of all participants had a normal fear of childbirth, 22% (n=153) had a mild fear of childbirth, 27% (n=188) had a moderate fear of childbirth, and 25.3% (n=176) had a severe fear of childbirth (Wijma score of 85 and above). When the pre-pandemic and the pandemic period were compared, the fear of childbirth wasunchanged in pregnant women at all education levels (p=0.079, p=0.957, p=0.626, p=0.539, p=0.202).Conclusion: When the pre-pandemic and pandemic periods are compared, it is seen that the fear of childbirth didnot change within each education level. Informing pregnant women about the effects of COVID-19 during the pandemic period may be effective in reducing fear of childbirth and reducing the numberof cesarean sections due to fear of birth.

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Case finding in dementia: comparative utility of three brief instruments in the memory clinic setting

International Psychogeriatrics ◽

10.1017/s1041610210002292 ◽

2011 ◽

Vol 23 (5) ◽

pp. 788-796 ◽

Cited By ~ 15

Author(s):

Daniela C. Gonçalves ◽

Elizabeth Arnold ◽

Kana Appadurai ◽

Gerard J. Byrne

Keyword(s):

Diagnostic Accuracy ◽

High Specificity ◽

The Elderly ◽

Cross Sectional Study ◽

Study Data ◽

Memory Clinic ◽

Cross Sectional ◽

Face To Face ◽

Significant Difference ◽

Proxy Measure

ABSTRACTBackground:The principal goal of this study was to compare the diagnostic accuracy of three brief instruments in memory clinic attendees. Two of the instruments were based on face-to-face clinical assessment (Standardized Mini-mental State Examination and Rowland Universal Dementia Assessment Scale), whereas the third group used proxy information from an informant (Informant Questionnaire on Cognitive Decline in the Elderly). Dementia diagnosis as provided by a specialist physician (geriatrician, psychiatrist or neurologist) was used as the reference standard.Methods:This was a cross-sectional study. Data were collected from 204 consecutive memory clinic attendees (M = 76.90, 56% female) and their family caregivers. Comparative utility was assessed through receiver operating characteristic (ROC) analyses.Results:One hundred and fifty-two patients (75%) were diagnosed as having dementia. Diagnostic accuracy, as indicated by the area under the ROC curve (AUC), was similar for the three instruments as follows: SMMSE (AUC = 0.82, 95% CI = 0.76, 0.87,p< 0.0001) and RUDAS (AUC = 0.83, 95% CI = 0.77, 0.88,p< 0.0001), and slightly lower for IQCODE (AUC = 0.77, 95% CI = 0.71, 0.83,p< 0.0001). There was no significant difference between the areas under the curve (χ2= 2.57, df = 2,p= 0.28).Conclusions:Diagnostic accuracy was similar for the three instruments, which all proved to be moderately useful tools for initial screening for cognitive impairment in the memory clinic environment. Being a proxy measure, the IQCODE had specific practical use in this context, where the patient might not be able to provide information. The RUDAS exhibited high specificity and proved to be less dependent upon cultural factors than the SMMSE, making it particularly valuable in a multicultural setting.

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Personal Audio System: Hearing Symptoms, Habits, and Sound Pressure Levels Measured in Real Ear and a Manikin

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-19-00053 ◽

2020 ◽

Vol 63 (6) ◽

pp. 2016-2026

Author(s):

Tamara R. Almeida ◽

Clayton H. Rocha ◽

Camila M. Rabelo ◽

Raquel F. Gomes ◽

Ivone F. Neves-Lobo ◽

...

Keyword(s):

Sound Pressure ◽

Daily Basis ◽

Cross Sectional Study ◽

Normal Hearing ◽

Chi Square ◽

Cross Sectional ◽

The Real ◽

Significant Difference ◽

Sound Pressure Levels ◽

Audio System

Purpose The aims of this study were to characterize hearing symptoms, habits, and sound pressure levels (SPLs) of personal audio system (PAS) used by young adults; estimate the risk of developing hearing loss and assess whether instructions given to users led to behavioral changes; and propose recommendations for PAS users. Method A cross-sectional study was performed in 50 subjects with normal hearing. Procedures included questionnaire and measurement of PAS SPLs (real ear and manikin) through the users' own headphones and devices while they listened to four songs. After 1 year, 30 subjects answered questions about their usage habits. For the statistical analysis, one-way analysis of variance, Tukey's post hoc test, Lin and Spearman coefficients, the chi-square test, and logistic regression were used. Results Most subjects listened to music every day, usually in noisy environments. Sixty percent of the subjects reported hearing symptoms after using a PAS. Substantial variability in the equivalent music listening level (Leq) was noted ( M = 84.7 dBA; min = 65.1 dBA, max = 97.5 dBA). A significant difference was found only in the 4-kHz band when comparing the real-ear and manikin techniques. Based on the Leq, 38% of the individuals exceeded the maximum daily time allowance. Comparison of the subjects according to the maximum allowed daily exposure time revealed a higher number of hearing complaints from people with greater exposure. After 1 year, 43% of the subjects reduced their usage time, and 70% reduced the volume. A volume not exceeding 80% was recommended, and at this volume, the maximum usage time should be 160 min. Conclusions The habit of listening to music at high intensities on a daily basis seems to cause hearing symptoms, even in individuals with normal hearing. The real-ear and manikin techniques produced similar results. Providing instructions on this topic combined with measuring PAS SPLs may be an appropriate strategy for raising the awareness of people who are at risk. Supplemental Material https://doi.org/10.23641/asha.12431435

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Estimation of Trace Elements in Gingival Crevicular Fluid and Serum-Comparative Study in Healthy and Periodontitis

International Journal of Pharmaceutical and Clinical Research ◽

10.25258/ijpcr.v9i5.8599 ◽

2017 ◽

Vol 9 (5) ◽

Author(s):

Bhagavathami Meenaksh ◽

Chitraa R. Chandran ◽

Aravindhan Thathchari Ranganathan ◽

Kavindapadi Venkateswaran Rama ◽

Valarmathy Srinivasan

Keyword(s):

Trace Elements ◽

Inductively Coupled Plasma ◽

Gingival Crevicular Fluid ◽

Serum Zinc ◽

Cross Sectional Study ◽

Serum Copper ◽

Cross Sectional ◽

Inductively Coupled ◽

Significant Difference ◽

Copper Zinc

Background: This study aims to determine and compare the levels of trace elements copper, zinc, selenium and chromium in GCF and serum of patients with periodontitis and healthy individuals. Methods: This cross sectional study includes 24 study subjects recruited from the patients reporting to the Department of Periodontics , Tagore Dental College Chennai. All the selected patients were subjected to a clinical examination done by a single examiner. The estimation of trace elements Copper, Zinc, Selenium and Chromium in GCF and serum is performed using Perkin Elmer optima 5300 Inductively Coupled Plasma Emission Spectrometer (ICPOES). Results: GCF and serum copper levels showed no significant difference in both periodontitis and healthy groups . Selenium levels tend to be the same in both groups. Serum zinc levels are more in periodontitis patients than healthy subjects (p less than 0.01). GCF chromium levels are found to be more in patients with periodontitis than healthy. Conclusions : More research is therefore needed to monitor the role of these trace elements C with an increased sample size to ascertain whether they are associated with a reduced risk of periodontitis.

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Individual differences related to present and future mental orientation predict the sense of time

10.31234/osf.io/ezmhp ◽

2017 ◽

Cited By ~ 3

Author(s):

Marc Wittmann ◽

Henrike Fiedler ◽

Wilhelm Gros ◽

Julia Mossbridge ◽

Cintia Retz Lucci

Keyword(s):

Individual Differences ◽

Time Perspective ◽

Cross Sectional Study ◽

Self Report ◽

Reproduction Task ◽

Cross Sectional ◽

Waiting Period ◽

Frequency Scale ◽

Temporal Intervals ◽

Sense Of Time

With this cross-sectional study we investigated how individual differences regarding present- and future-oriented mental processes are related to the experience of time in the seconds and minutes range. A sample of students (N = 100) filled out self-report measures of time perspective (ZTPI), mindfulness (FMI), impulsiveness (BIS), and the daydreaming frequency scale (DDFS). Furthermore they were asked to (a) retrospectively judge the duration of a waiting period of five minutes, and (b) to prospectively perform an visual duration reproduction task with intervals of 3, 6, and 9 seconds. Regression models show that (a) being more present fatalistic (ZTPI) and more impulsive are related to longer duration estimates of the waiting period, and (b) having a stronger propensity to daydream leads to a stronger under-reproduction of temporal intervals. These findings show how personality traits related to present orientation are associated with the state-like perception of duration.

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Postpartum Depression and Its Associated Factors among Women in Bandar Abbas City

International Electronic Journal of Medicine ◽

10.31661/iejm621 ◽

2018 ◽

Vol 7 ◽

Author(s):

Arefeh Shahi

Keyword(s):

Postpartum Depression ◽

Associated Factors ◽

Parental Education ◽

Unwanted Pregnancy ◽

Routine Care ◽

Cross Sectional Study ◽

Vulnerable Groups ◽

Cross Sectional ◽

Significant Difference ◽

Bandar Abbas

Background: Postpartum depression with a different incidence of 40- 45% in different societies, which it has adverse effects on the health of mothers and their child, given the negative effects of maternal depression and its harmful effects on the baby and the quality of family life. So, this study was performed with the aim to determine postpartum depression and its associated factors in Bandar Abbas city. Materials and Methods: A descriptive cross-sectional study was conducted in 2015 after obtaining consent from mothers by the census. A total of 343 mothers was examined for depression who referred to Bandar Abbas health centers in the 2nd and 4th months after childbirth. The data collection tools included demographic information and Postpartum Depression Edinburgh questionnaires. Finally, the statistical analyses were performed using SPSS (version 22.0) software and data were analyzed using the Independent t-test, Mann Whitney, Chi-square, and Fisher exact tests.Result: Totally, 68 (19.8%) of samples were in the second month and 54 (15.7%) in the fourth month after delivery had postpartum depression. The incidence of depression in the four months was 6.6%. There was a significant difference between depression and income, parental education, father’s use of cigarette and abnormalities of the infant (P <0.001). There was no significant difference between other factors such as gestational age, infant sex, birth weight, unwanted pregnancy, and type of delivery. Conclusion: Regarding the prevalence of this disorder, it seems that postpartum depression screening planning should be considered during child routine care as an essential component, especially for vulnerable groups.

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