scholarly journals Persistent Misperceptions about Nicotine among US Physicians: Results from a Randomized Survey Experiment

2021 ◽  
Vol 18 (14) ◽  
pp. 7713
Author(s):  
Michelle T. Bover Manderski ◽  
Michael B. Steinberg ◽  
Olivia A. Wackowski ◽  
Binu Singh ◽  
William J. Young ◽  
...  
Keyword(s):  
Health Effects ◽  
Birth Defects ◽  
Prevalence Ratio ◽  
Chronic Obstructive ◽  
Survey Experiment ◽  
Obstructive Pulmonary Disease ◽  
Question Wording ◽  
Demographic Correlates ◽  
Strongly Agree ◽  
To Receive

We conducted a survey experiment among US physicians to evaluate whether question wording impacted perceptions about the health effects of nicotine. 926 physicians were randomized to receive one of two versions of a question matrix that asked about the “extent to which they agree or disagree that ‘nicotine’ (Version 1) or ‘nicotine, on its own,’ (Version 2) directly contributes to” birth defects, cardiovascular disease (CVD), cancer, depression, and chronic obstructive pulmonary disease (COPD). We evaluated whether question condition predicted strong agreement and/or agreement with each statement, and assessed demographic correlates of each outcome while adjusting for question version. Physicians who received Version 2 were less likely to “strongly agree” that nicotine directly caused birth defects (Prevalence Ratio (PR) 0.84, 95% CI 0.72–0.98), CVD (PR 0.89, 95% CI 0.84–0.95), cancer (PR 0.81, 95% CI 0.75–0.87), and COPD (PR 0.78, 95% CI 0.72–0.84). Females were more likely to “strongly agree” that nicotine directly contributes to birth defects and cancer, and family physicians were most likely to “strongly agree” that nicotine directly contributes to CVD, cancer, and COPD. Question wording is important when measuring physicians’ beliefs about nicotine; however, even after accounting for question version, misperceptions about the direct health effects of nicotine were common and varied by sex and specialty.

scholarly journals Prevalence, pattern and determinants of chronic disease multimorbidity in Nepal: secondary analysis of a national survey

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047665
Author(s):  
Raja Ram Dhungana ◽  
Khem Bahadur Karki ◽  
Bihungum Bista ◽  
Achyut Raj Pandey ◽  
Meghnath Dhimal ◽  
...  
Keyword(s):  
Urban Areas ◽  
Formal Education ◽  
Secondary Analysis ◽  
Density Lipoprotein ◽  
Prevalence Ratio ◽  
Urban Setting ◽  
Chronic Obstructive ◽  
Cluster Sampling ◽  
Obstructive Pulmonary Disease ◽  
Nationally Representative

ObjectivesTo assess the prevalence, pattern and determinants of non-communicable diseases (NCDs) multimorbidity in Nepal.DesignSecondary analysis of the data from the NCD survey 2018, which was conducted between 2016 and 2018.SettingThe data belong to the nationally representative survey, that selected the study samples from throughout Nepal using multistage cluster sampling.Participants8931 participants aged 20 years and older were included in the study.Primary outcomesNCD multimorbidity (occurrence of two or more chronic conditions including hypertension, diabetes, chronic obstructive pulmonary disease, chronic kidney disease, coronary artery disease and cancer). Descriptive statistics, prevalence ratio and odds ratio were computed to assess pattern and determinants of multimorbidity.ResultsMean (SD) age was 46.7 years (14.9 years). The majority of the participants were women (57.8%), without formal education (53.4%) and from urban areas (51.5%). Multimorbidity was present in 13.96% (95% CI: 12.9% to 15.1%). Hypertension and diabetes coexisted in 5.7%. Age, alcohol consumption, body mass index, non-high-density lipoprotein (non-HDL) level and rural–urban setting were significantly associated with multimorbidity.ConclusionMultimorbidity was prevalent in particular groups or geographical areas in Nepal suggesting a need for coordinated and integrated NCD care approach for the management of multiplicative co-comorbid conditions.

scholarly journals Determinants of COVID-19 preventive behaviours among adults with chronic diseases in the USA: an analysis of the nationally representative COVID-19 impact survey

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044600
Author(s):  
Jessica Y. Islam ◽  
Denise C. Vidot ◽  
Marlene Camacho-Rivera
Keyword(s):  
Chronic Diseases ◽  
Rural Areas ◽  
Prevalence Ratio ◽  
Face Mask ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
High School Degree ◽  
The Usa ◽  
Nationally Representative

BackgroundPreventive behaviours have been recommended to control the spread of SARS-CoV-2. Adults with chronic diseases (CDs) are at higher risk of COVID-19-related mortality compared to the general population. Our objective was to evaluate adherence to COVID-19 preventive behaviours among adults without CDs compared with those with CDs and identify determinants of non-adherence to COVID-19 preventive behaviours.Study designCross-sectional.Setting and participantsWe used data from the nationally representative COVID-19 Impact Survey (n=10 760) conducted in the USA.Primary measuresAdults with CDs were categorised based on a self-reported diagnosis of diabetes, high blood pressure, heart disease/heart attack/stroke, asthma, chronic obstructive pulmonary disease (COPD), bronchitis or emphysema, cystic fibrosis, liver disease, compromised immune system, or cancer (54%).ResultsCompared with adults without CDs, adults with CDs were more likely to adhere to preventive behaviours including wearing a face mask (χ2-p<0.001), social distancing (χ2-p<0.001), washing or sanitising hands (χ2-p<0.001), and avoiding some or all restaurants (χ2-p=0.002) and public or crowded places (χ2-p=0.001). Adults with a high school degree or below [Adjusted prevalence ratio (aPR):1.82, 95% Confidence interval (CI)1.04 to 3.17], household income <US$50 000 (aPR:2.03, 95% CI 1.34 to 2.72), uninsured (aPR:1.65, 95% CI1.09 to 2.52), employed (aPR:1.48, 95% CI 1.02 to 2.17), residing in rural areas (aPR:1.70, 95% CI 1.01 to 2.85) and without any CD (aPR:1.78, 95% CI 1.24 to 2.55) were more likely to not adhere to COVID-19 preventive behaviours.ConclusionAdults with CDs are more likely to adhere to recommended COVID-19 preventive behaviours. Public health messaging targeting specific demographic groups and geographic areas, such as adults without CD or adults living in rural areas, should be prioritised.

scholarly journals Understanding racial differences of COPD patients with an ecological model: two large cohort studies in the US and Korea

2021 ◽  
Vol 12 ◽  
pp. 204062232098245
Author(s):  
Hye Yun Park ◽  
Hyun Lee ◽  
Danbee Kang ◽  
Hye Sook Choi ◽  
Yeong Ha Ryu ◽  
...  
Keyword(s):  
Racial Differences ◽  
Large Scale ◽  
Ecological Model ◽  
Prevalence Ratio ◽  
Poor Quality ◽  
Smoking History ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
The Us

Background: There are limited data about the racial difference in the characteristics of chronic obstructive pulmonary disease (COPD) patients who are treated at clinics. We aimed to compare sociodemographic and clinical characteristics between US and Korean COPD patients using large-scale nationwide COPD cohorts. Methods: We used the baseline demographic and clinical data of COPD patients aged 45 years or older with at least a 10 pack-per year smoking history from the Korean COPD Subtype Study (KOCOSS, n = 1686) cohort (2012–2018) and phase I (2008–2011) of the US Genetic Epidemiology of COPD (COPDGene) study ( n = 4477, 3461 were non-Hispanic whites [NHW], and 1016 were African Americans [AA]). Results: Compared to NHW, AA had a significantly lower adjusted prevalence ratio (aPR) of cough >3 months (aPR: 0.67; 95% CI [confidence interval]: 0.60–0.75) and phlegm >3 months (aPR: 0.78, 95% CI: 0.70–0.86), but higher aPR of dyspnea (modified Medical Round Council scale ⩾2) (aPR: 1.22; 95% CI: 1.15–1.29), short six-minute walk distance (<350 m) (aPR: 1.98; 95% CI: 1.81–2.14), and poor quality of life (aPR: 1.10; 95% CI: 1.05–1.15). Compared to NHW, Koreans had a significantly lower aPR of cough >3 months (aPR: 0.53; 95% CI: 0.47–0.59), phlegm >3 months (aPR: 0.75; 95% CI: 0.67–0.82), dyspnea (aPR: 0.72; 95% CI: 0.66–0.79), and moderate-to-severe acute exacerbation in the previous year (aPR: 0.73; 95% CI: 0.65–0.82). NHW had the highest burden related to chronic bronchitis symptoms and cardiovascular diseases related to comorbidities. Conclusion: There are substantial differences in sociodemographic characteristics, clinical presentation, and comorbidities between COPD patients from the KOCOSS and COPDGene, which might be caused by interactions between various intrapersonal, interpersonal, and environmental factors of the ecological model. Thus, a broader and more comprehensive approach would be necessary to understand the racial differences of COPD patients.

scholarly journals Effects of PACK guide training on the management of asthma and chronic obstructive pulmonary disease by primary care clinicians: a pragmatic cluster randomised controlled trial in Florianópolis, Brazil

2019 ◽  
Vol 4 (6) ◽  
pp. e001921
Author(s):  
Max Oscar Bachmann ◽  
Eric D Bateman ◽  
Rafael Stelmach ◽  
Alvaro A Cruz ◽  
Matheus Pacheco de Andrade ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Link Type ◽  
To Receive

IntroductionThe Practical Approach to Care Kit (PACK) guide was localised for Brazil, where primary care doctors and nurses were trained to use it.MethodsTwenty-four municipal clinics in Florianópolis were randomly allocated to receive outreach training and the guide, and 24 were allocated to receive only the guide. 6666 adult patients with asthma or chronic obstructive pulmonary disease (COPD) were enrolled, and trial outcomes were measured over 12 months, using electronic medical records. The primary outcomes were composite scores of treatment changes and spirometry, and new asthma and COPD diagnosis rates.ResultsAsthma scores in 2437 intervention group participants were higher (74.8%, 20.4% and 4.8% with scores of 0, 1 and 2, respectively) than in 2633 control group participants (80.0%, 16.8% and 3.2%) (OR for higher score 1.32, 95% CI 1.08 to 1.61, p=0.006). Adjusted for asthma scores recorded in each clinic before training started, the OR was 1.24 (95% CI 1.03 to 1.50, p=0.022). COPD scores in 1371 intervention group participants (77.7%, 17.9% and 4.3% with scores of 0, 1 and 2) did not differ from those in 1181 control group participants (80.5%, 15.8% and 3.7%) (OR 1.21, 95% CI 0.94 to 1.55, p=0.142). Rates of new asthma and COPD diagnoses, and hospital admission, and indicators of investigation, diagnosis and treatment of comorbid cardiovascular disease, diabetes and depression, and tobacco cessation did not differ between trial arms.ConclusionPACK training increased guideline-based treatment and spirometry for asthma but did not affect COPD or comorbid conditions, or diagnosis rates.Trial registrationNCT02786030 (https://clinicaltrials.gov/).

scholarly journals Source contributions and potential reductions to health effects of particulate matter in India

2018 ◽  
Vol 18 (20) ◽  
pp. 15219-15229 ◽  
Author(s):  
Hao Guo ◽  
Sri Harsha Kota ◽  
Kaiyu Chen ◽  
Shovan Kumar Sahu ◽  
Jianlin Hu ◽  
...  
Keyword(s):  
Particulate Matter ◽  
Health Effects ◽  
Fine Particulate Matter ◽  
Uttar Pradesh ◽  
Premature Mortality ◽  
Chronic Obstructive ◽  
Years Of Life Lost ◽  
Obstructive Pulmonary Disease ◽  
Multi Scale ◽  
Source Contributions

Abstract. Health effects of exposure to fine particulate matter (PM2.5) in India were estimated in this study based on a source-oriented version of the Community Multi-scale Air Quality (CMAQ) model. Contributions of different sources to premature mortality and years of life lost (YLL) were quantified in 2015. Premature mortality due to cerebrovascular disease (CEVD) was the highest in India (0.44 million), followed by ischaemic heart disease (IHD, 0.40 million), chronic obstructive pulmonary disease (COPD, 0.18 million), and lung cancer (LC, 0.01 million), with a total of 1.04 million deaths. The states with highest premature mortality were Uttar Pradesh (0.23 million), Bihar (0.12 million), and West Bengal (0.10 million). The highest total YLL was 2 years in Delhi, and the Indo-Gangetic plains and eastern India had higher YLL (∼1 years) than other regions. The residential sector was the largest contributor to PM2.5 concentrations (∼40 µg m−3), total premature mortality (0.58 million), and YLL (∼0.2 years). Other important sources included industry (∼20 µg m−3), agriculture (∼10 µg m−3), and energy (∼5 µg m−3) with their national averaged contributions of 0.21, 0.12, and 0.07 million to premature mortality, and 0.12, 0.1, and 0.05 years to YLL. Reducing PM2.5 concentrations would lead to a significant reduction of premature mortality and YLL. For example, premature mortality in Uttar Pradesh (including Delhi) due to PM2.5 exposures would be reduced by 79 % and YLL would be reduced by 83 % when reducing PM2.5 concentrations to 10 µg m−3.

scholarly journals Health effects of long-term exposure to air pollution: An overview of major respiratory and cardiovascular diseases and diabetes

2012 ◽  
Vol 18 (4-2) ◽  
pp. 617-622 ◽  
Author(s):  
Zorana Jovanovic-Andersen
Keyword(s):  
Air Pollution ◽  
Human Health ◽  
Health Effects ◽  
Convincing Evidence ◽  
Urban Setting ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Limit Values ◽  
Public Health Burden

Large number of studies provided convincing evidence for adverse effects of exposure to outdoor air pollution on human health, and served as basis for current USA and EU Air Quality Standards and limit values. Still, new knowledge is emerging, expanding our understanding of vast effects of exposure to air pollution on human health of this ubiquitous exposure affecting millions of people in urban setting. This paper focuses on the studies of health effects of long-term (chronic) exposures to air pollution, and includes major chronic and acute diseases in adults and especially elderly, which will present increasing public health burden, due to improving longevity and projected increasing numbers of elderly. The paper gives overview over the most relevant and latest literature presented by different health outcomes: chronic obstructive pulmonary disease, asthma, pneumonia, cardiovascular disease, and diabetes.

scholarly journals Reversal of a Suspected Paradoxical Reaction to Zopiclone with Flumazenil

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Zarah Jordahn ◽  
Cheme Andersen ◽  
Anne Marie Roust Aaberg ◽  
Frank Christian Pott
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Receptor Agonist ◽  
Elderly Woman ◽  
Behavioral Changes ◽  
Chronic Obstructive ◽  
Paradoxical Reaction ◽  
Obstructive Pulmonary Disease ◽  
To Receive

We describe the care for an elderly woman who was admitted to the intensive care unit (ICU) to receive noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease. After administration of the sleeping pill zopiclone, a nonbenzodiazepine receptor agonist (NBRA), the patient became agitated and was confused, a possible paradoxical reaction to benzodiazepines. These symptoms were immediately resolved after treatment with flumazenil, usually used to reverse the adverse effects of benzodiazepines or NBRAs and to reverse paradoxical reactions to benzodiazepines. This case indicates that zopiclone induced behavioral changes resembling a paradoxical reaction to benzodiazepines and these symptoms may be treated with flumazenil.

scholarly journals Non-Malignant Respiratory Illnesses in Association with Occupational Exposure to Asbestos and Other Insulating Materials: Findings from the Alberta Insulator Cohort

2020 ◽  
Vol 17 (19) ◽  
pp. 7085
Author(s):  
Subhabrata Moitra ◽  
Ali Farshchi Tabrizi ◽  
Kawtar Idrissi Machichi ◽  
Samineh Kamravaei ◽  
Noushin Miandashti ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Pulmonary Function Tests ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Chronic Obstructive ◽  
Ceramic Fibers ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Insulating Materials ◽  
Respiratory Illnesses

Many insulating materials are used in construction, although few have been reported to cause non-malignant respiratory illnesses. We aimed to investigate associations between exposures to insulating materials and non-malignant respiratory illnesses in insulators. In this cross-sectional study, 990 insulators (45 ± 14 years) were screened from 2011–2017 in Alberta. All participants underwent pulmonary function tests and chest radiography. Demographics, work history, and history of chest infections were obtained through questionnaires. Chronic obstructive pulmonary disease (COPD) was diagnosed according to established guidelines. Associations between exposures and respiratory illnesses were assessed by modified Poisson regression. Of those screened, 875 (88%) were males. 457 (46%) participants reported having ≥ 1 chest infection in the past 3 years, while 156 (16%) were diagnosed with COPD. In multivariate models, all materials (asbestos, calcium silicate, carbon fibers, fiberglass, and refractory ceramic fibers) except aerogels and mineral fibers were associated with recurrent chest infections (prevalence ratio [PR] range: 1.18–1.42). Only asbestos was associated with COPD (PR: 1.44; 95% confidence interval [CI]: 1.01, 2.05). Therefore, occupational exposure to insulating materials was associated with non-malignant respiratory illnesses, specifically, recurrent chest infections and COPD. Longitudinal studies are urgently needed to assess the risk of exposure to these newly implemented insulation materials.

scholarly journals Inhalation Toxicology of Vaping Products and Implications for Pulmonary Health

2020 ◽  
Vol 21 (10) ◽  
pp. 3495 ◽  
Author(s):  
Hussein Traboulsi ◽  
Mathew Cherian ◽  
Mira Abou Rjeili ◽  
Matthew Preteroti ◽  
Jean Bourbeau ◽  
...  
Keyword(s):  
Health Effects ◽  
Historical Context ◽  
Specific Reference ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Clinical Disorders ◽  
Lung Injuries ◽  
Preclinical And Clinical Studies ◽  
Respiratory Outcomes

E-cigarettes have a liquid that may contain flavors, solvents, and nicotine. Heating this liquid generates an aerosol that is inhaled into the lungs in a process commonly referred to as vaping. E-cigarette devices can also contain cannabis-based products including tetrahydrocannabinol (THC), the psychoactive component of cannabis (marijuana). E-cigarette use has rapidly increased among current and former smokers as well as youth who have never smoked. The long-term health effects are unknown, and emerging preclinical and clinical studies suggest that e-cigarettes may not be harmless and can cause cellular alterations analogous to traditional tobacco smoke. Here, we review the historical context and the components of e-cigarettes and discuss toxicological similarities and differences between cigarette smoke and e-cigarette aerosol, with specific reference to adverse respiratory outcomes. Finally, we outline possible clinical disorders associated with vaping on pulmonary health and the recent escalation of acute lung injuries, which led to the declaration of the vaping product use-associated lung injury (EVALI) outbreak. It is clear there is much about vaping that is not understood. Consequently, until more is known about the health effects of vaping, individual factors that need to be taken into consideration include age, current and prior use of combustible tobacco products, and whether the user has preexisting lung conditions such as asthma and chronic obstructive pulmonary disease (COPD).

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