scholarly journals Compliance with the 24-Hour Movement Behavior Guidelines and Associations with Adiposity in European Preschoolers: Results from the ToyBox-Study

2021 ◽  
Vol 18 (14) ◽  
pp. 7499
Author(s):  
Marga Decraene ◽  
Vera Verbestel ◽  
Greet Cardon ◽  
Violeta Iotova ◽  
Berthold Koletzko ◽  
...  
Keyword(s):  
Sleep Duration ◽  
Screen Time ◽  
Total Sample ◽  
Cross Sectional Study ◽  
World Health ◽  
Movement Behavior ◽  
Cross Sectional ◽  
Guideline Compliance ◽  
Z Scores ◽  
Health Organization

In 2019, the World Health Organization (WHO) published 24 h movement behavior guidelines for preschoolers with recommendations for physical activity (PA), screen time (ST), and sleep. The present study investigated the proportion of preschoolers complying with these guidelines (on a total week, weekdays and weekend days), and the associations with adiposity. This cross-sectional study included 2468 preschoolers (mean age: 4.75 years; 41.9% boys) from six European countries. The associations were investigated in the total sample and in girls and boys separately. PA was objectively assessed by step counts/day. Parent-reported questionnaires provided ST and sleep duration data. Generalized estimating equations were used to analyze the association between guideline compliance and adiposity indicators, i.e., body mass index (BMI) z-score and waist to height ratio (WHR). Only 10.1% of the preschoolers complied with the 24 h movement behavior guidelines, 69.2% with the sleep duration guideline, 39.8% with the ST guideline and 32.7% with the PA guideline. No association was found between guideline compliance with all three movement behaviors and adiposity. However, associations were found for isolated weekday screen time (BMI z-scores and WHR: p = 0.04) and weekend day sleep duration (BMI z-scores and WHR: p = 0.03) guideline compliance with both lower adiposity indicators. The latter association for sleep duration was also found in girls separately (BMI z-scores: p = 0.02; WHR: p = 0.03), but not in boys. Longitudinal studies, including intervention studies, are needed to increase preschoolers’ guideline compliance and to gain more insight into the manifestation of adiposity in children and its association with 24 h movement behaviors from a young age onwards.

scholarly journals PERBANDINGAN NILAI VOLUME EKSPIRASI PAKSA DETIK PERTAMA (VEP1) PEROKOK KONVENSIONAL DENGAN PEROKOK ELEKTRIK

2020 ◽  
Vol 8 (1) ◽  
pp. 27-31
Author(s):  
Ruth Tio Napitupulu ◽  
Bobby Singh ◽  
Mila Citrawati
Keyword(s):  
World Health Organization ◽  
Sampling Method ◽  
Total Sample ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Consecutive Sampling ◽  
The Difference ◽  
Health Organization ◽  
Statistic Result

ABSTRAK  Latar Belakang: VEP1 adalah volume udara yang dapat dikeluarkan dalam waktu satu detik pertama setelah inspirasi dan ekspirasi maksimal. Faktor yang dapat mempengaruhi nilai VEP1 di antaranya adalah penyakit, usia, paparan bahan iritan, jenis kelamin. Rokok adalah paparan bahan iritan yang dapat mempengaruhi nilai VEP1. Menurut World Health Organization prevalensi perokok di dunia pada tahun 2015 sebanyak 22.2% dan prevalensi di Indonesia sebanyak 33.5%. Rokok terdiri atas dua jenis yaitu rokok konvensional dan elektrik. Rokok konvensional adalah tembakau yang digunakan dengan cara dihisap sedangkan rokok elektrik adalah perangkat yang menggunakan tenaga baterai untuk menyalurkan uap. Penelitian ini dilakukan untuk mengetahui perbedaan nilai VEP1 pada perokok konvensional dan perokok elektrik.  Metode: Penelitian ini menggunakan desain penelitian cross sectional. Jumlah sampel penelitian sebanyak 81 orang, sebanyak 44 orang perokok konvensional dan 37 orang perokok elektrik yang diambil dengan consecutive sampling. Nilai VEP1 diukur pada orang yang menggunakan rokok selama ≥5 tahun.  Hasil: Berdasarkan penelitian ini didapatkan adanya penurunan VEP1 pada perokok konvensional dan perokok elektrik, namun penurunan pada perokok elektrik lebih rendah dibanding perokok konvensional. Hasil uji statistik menunjukkan terdapat perbedaan antara perokok konvensional dan perokok elektrik (p=0,00).  Kesimpulan: Hasil penelitian didapatkan bahwa rerata VEP1 perokok tembakau adalah 76,31±8,21% dan rerata VEP1 perokok elektrik adalah 83.94±6.95%.  Kata Kunci: Perokok elektrik, Perokok konvensional, VEP1  ABSTRACT  Background: FEV1 is the volume of air exhaled in first second after maximal level of inspiration and expiration. There are some factors which can affect FEV1 value for example obstruction, age, irritant exposure, and sex. Cigarette is an irritant substance that can influence FEV1 value. According to World Health Organization in 2015 world and Indonesian smokers’ prevalence was 22,2% and 33,5%. Cigarettes are divided into two kinds; conventional and electrical. Conventional cigarette is dried-tobacco usually rolled with a paper and commonly inhaled in the usage, while electric cigarette is a battery powered device that vaporize liquid into fumes. This research aimed to investigate the difference of FEV1’s value between conventional smoker and electric cigarette user. Method: Cross sectional study design was applied in this research. Total sample in this research was 81 participants consist of 44 conventional smokers and 37 electric cigarette users selected by using consecutive sampling method. The FEV1 value measured in people who had been smoking for at least 5 years.  Result: This research found that the FEV1 value was decreased in both smokers, but the electrical cigarette user having less decreasing of FEV1 value. The statistic result was revealed the differences between conventional smoker and electric cigarette user (p=0,00).  Conclusion: As the result, the average of conventional smoker’s FEV1 value is 76,31±8,21% and the average of electric cigarette user’s FEV1 value is 83.94±6.95%.  Keywords: Conventional smoker, Electric cigarette user, FEV1

scholarly journals Burden of undernutrition among children of 12-59 months living in a slum of Kolkata: a cross-sectional study

2021 ◽  
Vol 8 (8) ◽  
pp. 3927
Author(s):  
Aparajita Dasgupta ◽  
Nidhi Shree ◽  
Bobby Paul ◽  
Lina Bandyopadhyay ◽  
Soumit Roy ◽  
...  
Keyword(s):  
Dietary Diversity ◽  
Univariate Analysis ◽  
Composite Index ◽  
Good Health ◽  
Cross Sectional Study ◽  
World Health ◽  
Cross Sectional ◽  
Care Givers ◽  
Z Scores ◽  
Health Organization

Background: Children living in slums are often deprived of good health. Their predisposition to malnutrition, makes them vulnerable to various infections and deficiency disorders affecting their growth. The objective of the study was to assess the nutritional status of 12-59 months children using Composite Index of Anthropometric Failure, to find out their morbidity profile, dietary diversity scores and to determine factors associated with CIAF.Methods: Study was conducted among 115 children of 12-59 months age, living in Chetla slum, Kolkata, West Bengal from July to October 2019. A pre-designed, pre-tested schedule containing their sociodemographic characteristics, morbidity profile, dietary diversity and anthropometric measurements were used to collect the data. World Health Organization (WHO) Anthro. Ink 11 software was used to calculate the z scores Data was analysed in Microsoft Excel 2016 and Statistical package for social sciences (SPSS) version 16.Results: Mean age (SD) of study participants was 30.77 (7) months. 43.5% children had CIAF. Proportion of underweight, stunting, weight for height and mid upper arm circumference wise malnutrition were 16.5%, 27.8%, 14.8% and 43% respectively. Majority, 87.8% had low dietary diversity and 38% had morbidity.Conclusions: The proportion of CIAF was found high in the study. Low birth weight, single living child, absence of exclusive breastfeeding practice and dietary diversity were significantly associated in univariate analysis. CIAF gives a single convenient complete picture for malnutrition compared to other conventional interpretation methods, this it can be included in child health programmes. Enlightening the care givers of under-five by health education and health promotional programmes can prevent malnutrition from occurring. 

scholarly journals KADAR HEMOGLOBIN (Hb) IBU HAMIL DI PUSKESMAS BAHU MANADO

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Aprilia Fransiska Lantu ◽  
Hermie M. M. Tendean ◽  
Eddy Suparman
Keyword(s):  
Pregnant Women ◽  
World Health Organization ◽  
Medical Condition ◽  
Total Sample ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Hemoglobin Level ◽  
World Health ◽  
Cross Sectional ◽  
Health Organization

Abstract: Hemoglobin is a parameter used broadly to stipulate the anemia prevalence. Anemia is a medical condition where the amount of hemoglobin is abnormal. In pregnancy, if the level of hemoglobin (Hb <11 g/dL, then it is categorized as anemia. World health organization predicts that 35-75% of pregnant women in developing countries and 18% in developed countries are in anemia condition. According to WHO, the anemia prevalence globally on pregnant women is about 41,8%. This research is intended to know the level of hemoglobin (Hb) on pregnant women in Puskesmas Bahu Manado. This type of research is descriptive and prospective, observational study with cross sectional study design. Forty subjects participated in this research. After hemoglobin level checking, 13 people (32,5%) with hemoglobin level (Hb) <11 g/dL, and 27 people (67,5%) with hemoglobin level (Hb) ≥11 g/dL. This study cocludes that: there are more pregnant women with normal level of Hb ( ≥11 g/dL) in Puskesmas Bahu than the ones with lower level of Hb ( <11 g/dL). The number of pregnant women in Puskesmas Bahu with normal Hb level is 27 people (67,5%) of the total sample while there are 13 people with lower level of Hb (32,5%) of total sample.Keywords: hemoglobin level, anemia, pregnant level Abstrak: Hemoglobin merupakan parameter yang digunakan secara luas untuk menetapkan prevalensi anemia. Anemia ialah suatu kondisi medis dimana jumlah sel darah merah atau hemoglobin (Hb) kurang dari normal. Pada ibu hamil dikatakan anemia jika kadar hemoglobin (Hb) <11 g/dL. World Health Organization (WHO) memperkirakan bahwa 35-75 % ibu hamil di negara berkembang dan 18 % ibu hamil di negara maju mengalami anemia. Menurut data WHO, secara global prevalensi anemia pada ibu hamil di seluruh dunia adalah sebesar 41,8 %. Penelitian ini bertujuan untuk mengetahui kadar hemoglobin (Hb) ibu hamil di Puskesmas Bahu Manado. Jenis penelitian yang digunakan adalah penelitian observasional bersifat deskriptif prospektif dengan rancangan penelitian cross sectional (potong lintang). Empat puluh subjek berpartisipasi dalam penelitian ini. Setelah dilakukan pemeriksaan kadar hemoglobin (Hb) didapatkan 13 orang (32,5%) dengan kadar hemoglobin (Hb) <11 g/dL, dan 27 orang (67,5%) dengan kadar hemoglobin (Hb) ≥11 g/dL. Berdasarkan hasil penelitian dapat disimpulkan bahwa: ibu hamil yang memiliki gambaran kadar Hb normal ( ≥11 g/dL) di Puskesmas Bahu ditemukan lebih banyak daripada ibu hamil yang memilliki kadar Hb rendah ( <11 g/dL). Jumlah ibu hamil di Puskesmas Bahu yang memiliki kadar Hb normal adalah 27 orang (67,5%) dari total sampel. Sedangkan ibu hamil di Puskesmas bahu yang memiliki kadar Hb rendah adalah 13 orang (32,5%) dari total sampel.Kata kunci: kadar hemoglobin, anemia, ibu hamil

Evaluation of Drug Use Based on WHO Prescribing Indicator in Mizan- Tepi University Teaching Hospital, south Western Ethiopia: A Cross Sectional Study

2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam
Keyword(s):  
Drug Use ◽  
World Health Organization ◽  
Teaching Hospital ◽  
Cross Sectional Study ◽  
University Teaching ◽  
World Health ◽  
Sectional Study ◽  
Hospital Data ◽  
Cross Sectional ◽  
Health Organization

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.

scholarly journals The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
World Health ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Maternity Services ◽  
Community Needs ◽  
Care Services ◽  
Skin Contact ◽  
Health Organization ◽  
The Impact

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

scholarly journals The Utilization of Protective Face Masks among Polish Healthcare Workers during COVID-19 Pandemic: Do We Pass the Exam?

2021 ◽  
Vol 18 (2) ◽  
pp. 841
Author(s):  
Radomir Reszke ◽  
Łukasz Matusiak ◽  
Piotr K. Krajewski ◽  
Marta Szepietowska ◽  
Rafał Białynicki-Birula ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Medical Profession ◽  
Cross Sectional Study ◽  
Internet Survey ◽  
World Health ◽  
Cross Sectional ◽  
Protective Measures ◽  
Who Criteria ◽  
The Face ◽  
Health Organization

Relevant personal protective measures during the COVID-19 pandemic include face masks, possibly decreasing the risk of infection among the general population and healthcare workers (HCW) if utilized properly. The aim of the study was to assess whether different Polish HCW utilize face masks according to the 2020 World Health Organization guidance (WHO) criteria. This cross-sectional study included 1156 respondents who participated in an internet survey evaluating mask-related behaviors. All the WHO criteria were complied with by 1.4% of participants, regardless of medical profession, specialty or place of employment. HCW mostly adhered to criterion 1 (C1; strict covering of the face and mouth with the mask; 90.8%), C4 (washing/disinfecting the hands after touching/taking off the mask; 49%) and C3 (taking off the mask properly without touching the anterior surface; 43.4%), whereas C2 (avoidance of touching the mask with hands) was complied with least commonly (6.8%). HCW with mask-induced itch (31.6%) complied to C2 less often (odds ratio 0.53; p = 0.01). The study reveals that Polish HCW rarely adhere to all the 2020 WHO guidance criteria on the use of masks, whereas the adherence to particular criteria is variable and may be associated with the presence of skin-related conditions and other factors. Better compliance with the recommendations in the future is necessary to increase personal safety of HCW and prevent the transmission of SARS-CoV-2.

scholarly journals Managing the Return to Football During the COVID-19 Pandemic: A Survey of the Head Team Physicians of the Football Bowl Subdivision Programs

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712199204
Author(s):  
Alexander D. Slabaugh ◽  
John W. Belk ◽  
Jonathan C. Jackson ◽  
Richard J. Robins ◽  
Eric C. McCarty ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
National Collegiate Athletic Association ◽  
College Football ◽  
Cross Sectional Study ◽  
Return To Play ◽  
World Health ◽  
Cross Sectional ◽  
Football Bowl Subdivision ◽  
Health Organization

Background: COVID-19 is a severe respiratory virus that spreads via person-to-person contact through respiratory droplets. Since being declared a pandemic in early March 2020, the World Health Organization had yet to release guidelines regarding the return of college or professional sports for the 2020-2021 season. Purpose: To survey the head orthopedic surgeons and primary care team physicians for the National Collegiate Athletic Association (NCAA) Football Bowl Subdivision (FBS) football teams so as to gauge the management of common COVID-19 issues for the fall 2020 college football season. Study Design: Cross-sectional study. Methods: The head team orthopaedic surgeons and primary care physicians for all 130 FBS football teams were surveyed regarding their opinions on the management of college football during the COVID-19 pandemic. A total of 30 questions regarding testing, return-to-play protocol, isolating athletes, and other management issues were posed via email survey sent on June 5, 2020. Results: Of the 210 team physicians surveyed, 103 (49%) completed the questionnaire. Overall, 36.9% of respondents felt that it was unsafe for college athletes to return to playing football during fall 2020. While the majority of football programs (96.1%) were testing athletes for COVID-19 as they returned to campus, only 78.6% of programs required athletes to undergo a mandatory quarantine period before resuming involvement in athletic department activities. Of the programs that were quarantining their players upon return to campus, 20% did so for 1 week, 20% for 2 weeks, and 32.9% quarantined their athletes until they had a negative COVID-19 test. Conclusion: While US Centers for Disease Control and Prevention guidelines evolve and geographic regions experience a range of COVID-19 infections, determining a universal strategy for return to socialization and participation in sports remains a challenge. The current study highlighted areas of consensus and strong agreement, but the results also demonstrated a need for clarity and consistency in operations, leadership, and guidance for medical professionals in multiple areas as they attempt to safely mitigate risk for college football players amid the COVID-19 pandemic.

scholarly journals An analysis of heavy metals contamination and estimating the daily intakes of vegetables from Uganda

2021 ◽  
Vol 5 ◽  
pp. 239784732098525
Author(s):  
Keneth Iceland Kasozi ◽  
Eric Oloya Otim ◽  
Herbert Izo Ninsiima ◽  
Gerald Zirintunda ◽  
Andrew Tamale ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Daily Intake ◽  
Principal Component ◽  
Absorption Spectrometry ◽  
Cross Sectional Study ◽  
Essential Elements ◽  
World Health ◽  
Cross Sectional ◽  
Health Organization ◽  
Daily Intakes

Background: Environmental contamination with elevated levels of copper (Cu), cobalt (Co), iron (Fe), zinc (Zn), lead (Pb), chromium (Cr6+), cadmium (Cd), and nickel (Ni)—all states of which are found in Uganda—raises health risk to the public. Pb, Cr6+, Cd, and Ni for instance are generally considered nonessential to cellular functions, notwithstanding the importance of the oxidative state of the metals in bioavailability. As such, we aimed in this study (i) to evaluate heavy metal concentrations in four vegetables from a typical open-air market in Uganda, (ii) to assess the safety of consuming these vegetables against the World Health Organization (WHO) recommended limits of heavy metals consumption, and (iii) to formulate a model of estimated daily intake (EDI) among consumers in the country. Methods: This was a cross-sectional study conducted in five georeferenced markets of Bushenyi district in January 2020. Amaranthus, cabbages, scarlet eggplants, and tomatoes were collected from open markets, processed, and analyzed by atomic absorption spectrometry. Modeled EDI, principal component (PCA) and cluster analysis (CA) were conducted to identify relationships in the samples. Results: The levels of essential elements in the four vegetables were found to fall from Co > Cu > Fe > Zn. Those of non-essential metals were significantly higher and followed the pattern Cd > Cr > Pb > Ni. The highest EDI values were those of Cu in scarlet eggplants, Zn in amaranthus, Fe in amaranthus, Co in amaranthus, Pb in cabbages, total Cr in scarlet eggplant, Cd in cabbages and tomatoes, and Ni in cabbages. In comparison to international limits, EDIs for Zn, Cu, Co and Fe were low while Ni in cabbages were high. PCA showed high variations in scarlet eggplant and amaranthus. The study vegetables were found to be related with each other, not according to the location of the markets from where they were obtained, but according to their species by CA. Conclusion: The presence of non-essential elements above WHO limits raises policy challenges for the consumption and marketing of vegetables in the study area. Furthermore, low EDIs of essential elements in the vegetables create demand for nutritious foods to promote healthy communities.

scholarly journals Regional differences in general practitioners’ behaviours regarding influenza vaccination: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jonathan Arlt ◽  
Kristina Flaegel ◽  
Katja Goetz ◽  
Jost Steinhaeuser
Keyword(s):  
Influenza Vaccination ◽  
General Practitioners ◽  
Personal Characteristics ◽  
Cross Sectional Study ◽  
Central Research Institute ◽  
World Health ◽  
Central Research ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Health Organization

Abstract Background The World Health Organization recommends vaccination rates of 75% against seasonal influenza for patients over 65 years old. In the 2013/2014 season, the German vaccination rates ranged between 14 and 65%. This study aimed to compare the attitudes, personal characteristics and vaccination behaviours of general practitioners (GPs) in regions with high and low vaccination rates in Germany. Methods In May 2016, a questionnaire was sent to 1594 GPs practising in 16 districts with the highest and the lowest vaccination rates in Western and Eastern Germany as described by the Central Research Institute of Ambulatory Health Care in Germany for the 2013/2014 season. Descriptive statistics and multiple regression analyses were computed to identify potential factors associated with high vaccination rates. Results A total response rate of 32% (515/1594 participants) was observed in the study. GPs reported their attitudes towards vaccination in general and vaccination against influenza as mostly ‘very positive’ (80%, n = 352 and 65%, n = 288, respectively). GPs practising in regions with low vaccination rates reported their attitudes towards vaccinations in general (p = 0.004) and towards influenza vaccination (p = 0.001) more negatively than their colleagues from regions with high vaccination rates. Multiple logistic regression identified an increasing influence of year-dependent changing efficiency on GPs’ influenza rates as the strongest factor for predicting GPs from highly vaccinating regions (OR = 4.31 [1.12–16.60]), followed by the patient’s vaccination refusal despite GP advice due to already receiving a vaccination from another physician (OR = 3.20 [1.89–5.43]) and vaccination information gathering through medical colleagues (OR = 2.26 [1.19–4.29]). Conclusions The results of this study suggest a correlation between GPs’ attitudes and regional vaccination rates. Beneath GPs’ individual attitudes, the regional attitude patterns of patients, colleagues and medical assistants surrounding those GPs seem decisive and should be integrated into future campaigns to increase vaccination rates at a regional level.

scholarly journals Diagnostic accuracy of symptoms as a diagnostic tool for SARS-CoV 2 infection: a cross-sectional study in a cohort of 2,173 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carlos Alfonso Romero-Gameros ◽  
Tania Colin-Martínez ◽  
Salomón Waizel-Haiat ◽  
Guadalupe Vargas-Ortega ◽  
Eduardo Ferat-Osorio ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Tool ◽  
Clinical Decision Making ◽  
Multivariate Logistic Regression Analysis ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
World Health ◽  
Likelihood Ratios ◽  
Cross Sectional ◽  
Health Organization

Abstract Background The SARS-CoV-2 pandemic continues to be a priority health problem; According to the World Health Organization data from October 13, 2020, 37,704,153 confirmed COVID-19 cases have been reported, including 1,079,029 deaths, since the outbreak. The identification of potential symptoms has been reported to be a useful tool for clinical decision-making in emergency departments to avoid overload and improve the quality of care. The aim of this study was to evaluate the performances of symptoms as a diagnostic tool for SARS -CoV-2 infection. Methods An observational, cross-sectional, prospective and analytical study was carried out, during the period of time from April 14 to July 21, 2020. Data (demographic variables, medical history, respiratory and non-respiratory symptoms) were collected by emergency physicians. The diagnosis of COVID-19 was made using SARS-CoV-2 RT-PCR. The diagnostic accuracy of these characteristics for COVID-19 was evaluated by calculating the positive and negative likelihood ratios. A Mantel-Haenszel and multivariate logistic regression analysis was performed to assess the association of symptoms with COVID-19. Results A prevalence of 53.72% of SARS-CoV-2 infection was observed. The symptom with the highest sensitivity was cough 71%, and a specificity of 52.68%. The symptomatological scale, constructed from 6 symptoms, obtained a sensitivity of 83.45% and a specificity of 32.86%, taking ≥2 symptoms as a cut-off point. The symptoms with the greatest association with SARS-CoV-2 were: anosmia odds ratio (OR) 3.2 (95% CI; 2.52–4.17), fever OR 2.98 (95% CI; 2.47–3.58), dyspnea OR 2.9 (95% CI; 2.39–3.51]) and cough OR 2.73 (95% CI: 2.27–3.28). Conclusion The combination of ≥2 symptoms / signs (fever, cough, anosmia, dyspnea and oxygen saturation < 93%, and headache) results in a highly sensitivity model for a quick and accurate diagnosis of COVID-19, and should be used in the absence of ancillary diagnostic studies. Symptomatology, alone and in combination, may be an appropriate strategy to use in the emergency department to guide the behaviors to respond to the disease. Trial registration Institutional registration R-2020-3601-145, Federal Commission for the Protection against Sanitary Risks 17 CI-09-015-034, National Bioethics Commission: 09 CEI-023-2017082.

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