Tuberculous meningitis: Impact of timing of treatment initiation on mortality

Background. Diarrheal diseases are still one of the major causes of morbidity in under-five children in sub-Saharan Africa. In Ethiopia, diarrhea is responsible for 9% of all deaths and is the major cause of under-five mortality. Objective. To assess the impact of community-led total sanitation and hygiene on the prevalence of diarrheal disease and factors associated among under-five children in Gamo Gofa Zone. Methods. Community-based comparative cross-sectional study design was used to compare the impact of community-led total sanitation and hygiene intervention on under-five diarrheal disease. Multistage sampling method was employed. The data were collected by using pretested structured questionnaires. Data quality was ensured by daily supervision completeness and consistency. The data were coded, entered, and cleaned by using Epi Info version 7 and were analyzed by using SPSS version 20. Bivariate and multivariable analyses were carried out by using binary logistic regression. Significance was declared by using p value of <0.05 and AOR with 95% confidence intervals. Results. The response rate of this study was 93.3%. The overall diarrhea prevalence was 27.5% (CI = (24.06, 30.97)) which was 18.9% (CI = (14.94, 23.2)) in implemented and 36.2%. (CI = (30.41, 41.59)) in nonimplemented woredas. Children whose age was between 12 and 23 months (AOR = 1.6) and greater than 24 months (AOR = 5), availability of handwashing facilities (AOR = 4), disposal of waste in open field (AOR = 9.7), unimproved source of drinking water (AOR = 6.5), using only water for handwashing (AOR = 6), children who started complementary feeding less than 6 months (AOR = 5.6) and greater than 6 months (AOR = 5.2), and utensils used to feed children such as bottle (AOR = 3.9) were the factors positively associated with diarrhea. Conclusion. The overall prevalence of under-five diarrhea was 27.5%. The prevalence was low in CLTSH woredas as compared with non-CLTSH woredas. The study showed that handwashing facility, using only water for handwashing, open refuse disposal, and unimproved source of drinking water among under-five had a statistically significant association with diarrhea occurrence in CLTSH nonimplemented areas. Integrated efforts are needed from the Ministry of Health together with the WASH Project in improving drinking water, handwashing facilities, and solid waste disposal practices.

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The impact of health literacy on health outcomes in individuals with chronic pain: a cross-sectional study

Physiotherapy ◽

10.1016/j.physio.2018.11.006 ◽

2019 ◽

Vol 105 (3) ◽

pp. 346-353

Author(s):

Laura M. Mackey ◽

Catherine Blake ◽

Maire-Brid Casey ◽

Camillus K. Power ◽

Ray Victory ◽

...

Keyword(s):

Chronic Pain ◽

Health Literacy ◽

Health Outcomes ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

The Impact

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The impact of COVID-19 pandemic on training and mental health of residents: a cross-sectional study

BMC Medical Education ◽

10.1186/s12909-021-02655-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Eman Alshdaifat ◽

Amer Sindiani ◽

Wasim Khasawneh ◽

Omar Abu-Azzam ◽

Aref Qarqash ◽

...

Keyword(s):

Mental Health ◽

Residency Training ◽

Training Programs ◽

Cross Sectional Study ◽

Protective Equipment ◽

Sectional Study ◽

Cross Sectional ◽

Surgical Residents ◽

Tertiary Center ◽

The Impact

Abstract Background Residency programs have been impacted by the Coronavirus disease 2019 (COVID-19) pandemic. In this study we aim to investigate and evaluate the impact of the pandemic on residents as well as residency training programs. Methods This was a cross-sectional study including a survey of 43 questions prepared on Google forms and electronically distributed among a convenience sample of residents training at a tertiary center in North Jordan during the COVID-19 pandemic. Data were collected in the period between October 30th and November 8th of 2020. The survey included questions that addressed the impact of the pandemic on residents’ health as well as training programs. The study participants included residents in training at KAUH in 2020 and were stratified according to the type of residency program (surgical residents (SRs) and non-surgical residents (NSRs)). Statistical methods included descriptive analysis, Chi-square or Fisher’s exact test, Mann Whitney U test, and Cramer’s V and r statistics as measures of effect sizes. Results Of all 430 residents, 255 (59%) responded to the survey. A total of 17 (7%) of residents reported being infected with COVID-19 and a significant difference was reported between SRs and NSRs (10% vs 4%, V = .124 “small effect” (95% CI; .017–.229), p = 0.048). Approximately, 106 (42%) reported a decrease in the number of staff working at the clinic and 164 (64%) reported limited access to personal protective equipment during the pandemic. On a 4-point Likert scale for the feeling of anxiety, the median was 2 (2–3 IQR) in the NSRs group, vs 2 (1–2 IQR) in the SRs groups, with the NSRs being more likely to feel anxious (r = 0.13 “small effect” (95% CI; 0.007–0.249), p = .044). Similarly, the proportion of residents who reported feeling anxious about an inadequacy of protective equipment in the work area was significantly greater in the NSRs group (90.3% vs 75.2%; V = .201 “small effect” (95% CI; .078–.313), p = .001), as well as the proportion of residents who reported feeling increased stress and anxiety between colleagues being also significantly higher in the NSRs group (88.1% vs 76%; V = .158 “small effect” (95% CI; .032–.279), p = .012). Conclusion The burden of the ongoing pandemic on the mental health status of residents is very alarming and so providing residents with psychological counseling and support is needed. Also, critical implications on the flow of residency training programs have been noticed. This necessitates adapting and adopting smart educational techniques to compensate for such limitations.

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Factors associated with emotional exhaustion in healthcare professionals involved in the COVID-19 pandemic: an application of the job demands-resources model

International Archives of Occupational and Environmental Health ◽

10.1007/s00420-021-01669-z ◽

2021 ◽

Author(s):

Serena Barello ◽

Rosario Caruso ◽

Lorenzo Palamenghi ◽

Tiziana Nania ◽

Federica Dellafiore ◽

...

Keyword(s):

Emotional Exhaustion ◽

Patient Engagement ◽

Healthcare Professionals ◽

Job Demands ◽

Cross Sectional Study ◽

Personal Resources ◽

Sectional Study ◽

Cross Sectional ◽

The Impact

Abstract Purpose The purpose of the present cross-sectional study is to investigate the role of perceived COVID-19-related organizational demands and threats in predicting emotional exhaustion, and the role of organizational support in reducing the negative influence of perceived COVID-19 work-related stressors on burnout. Moreover, the present study aims to add to the understanding of the role of personal resources in the Job Demands-Resources model (JD-R) by examining whether personal resources—such as the professionals’ orientation towards patient engagement—may also strengthen the impact of job resources and mitigate the impact of job demands. Methods This cross-sectional study involved 532 healthcare professionals working during the COVID-19 pandemic in Italy. It adopted the Job-Demands-Resource Model to study the determinants of professional’s burnout. An integrative model describing how increasing job demands experienced by this specific population are related to burnout and in particular to emotional exhaustion symptoms was developed. Results The results of the logistic regression models provided strong support for the proposed model, as both Job Demands and Resources are significant predictors (OR = 2.359 and 0.563 respectively, with p < 0.001). Moreover, healthcare professionals’ orientation towards patient engagement appears as a significant moderator of this relationship, as it reduces Demands’ effect (OR = 1.188) and increases Resources’ effect (OR = 0.501). Conclusions These findings integrate previous findings on the JD-R Model and suggest the relevance of personal resources and of relational factors in affecting professionals’ experience of burnout.

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A cross-sectional study on pelvic floor symptoms in women living with Female Genital Mutilation/Cutting

Reproductive Health ◽

10.1186/s12978-021-01097-9 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Alzbeta Binkova ◽

Marion Uebelhart ◽

Patrick Dällenbach ◽

Michel Boulvain ◽

Angèle Gayet-Ageron ◽

...

Keyword(s):

Pelvic Floor ◽

Female Genital Mutilation ◽

Cross Sectional Study ◽

Background Information ◽

Sectional Study ◽

Cross Sectional ◽

Genital Mutilation ◽

Pelvic Floor Symptoms ◽

The Impact ◽

Female Genital

Abstract Background Female Genital Mutilation/Cutting (FGM/C) concerns over 200 million women and girls worldwide and is associated with obstetric trauma and long-term urogynaecological and psychosexual complications that are often under-investigated and undertreated. The aim of this study was to assess the pelvic floor distress and the impact of pelvic floor and psychosexual symptoms among migrant women with different types of FGM/C. Methods This cross-sectional study was conducted between April 2016 and January 2019 at the Division of Gynaecology of the Geneva University Hospitals. The participants were interviewed on socio-demographic and background information, underwent a systematic gynaecological examination to assess the presence and type of FGM/C and eventual Pelvic Organ Prolapse (POP), and completed six validated questionnaires on pelvic floor and psychosexual symptoms (PFDI-20 and PFIQ7 on pelvic floor distress and impact, FISI and WCS on faecal incontinence and constipation, PISQ-IR and FGSIS on sexual function and genital self-image). The participants’ scores were compared with scores of uncut women available from the literature. The association between selected variables and higher scores for distress and impact of pelvic floor symptoms was assessed using univariate and multivariable linear regression models. Results 124 women with a mean age of 31.5 (± 7.5), mostly with a normal BMI, and with no significant POP were included. PFDI-20 and PFIQ-7 mean (± SD) scores were of 49.5 (± 52.0) and 40.7 (± 53.6) respectively. In comparison with the available literature, the participants’ scores were lower than those of uncut women with pelvic floor dysfunction but higher than those of uncut women without such disorders. Past violent events other than FGM/C and forced or arranged marriage, age at FGM/C of more than 10, a period of staying in Switzerland of less than 6 months, and nulliparity were significantly associated with higher scores for distress and impact of pelvic floor symptoms, independently of known risk factors such as age, weight, ongoing pregnancy and history of episiotomy. Conclusions Women with various types of FGM/C, without POP, can suffer from pelvic floor symptoms responsible for distress and impact on their daily life. Trial registration. The study protocol was approved by the Swiss Ethics Committee on research involving humans (protocol n°15-224).

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Impact of COVID-19 Home Confinement in Children’s Refractive Errors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105347 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5347

Author(s):

Cristina Alvarez-Peregrina ◽

Clara Martinez-Perez ◽

Cesar Villa-Collar ◽

Cristina Andreu-Vázquez ◽

Alicia Ruiz-Pomeda ◽

...

Keyword(s):

Public Health Problem ◽

Cross Sectional Study ◽

World Population ◽

Sectional Study ◽

Cross Sectional ◽

School Aged Children ◽

Digital Devices ◽

Visual Screening ◽

Near Work ◽

The Impact

Background: Myopia is a public health problem, with estimations that 50% of the world population will be myopic by 2050. Some environmental factors, such as time spent outdoors, doing near work, and using digital devices, influence the development of myopia in children. Home confinement in Spain has increased these risk factors, so this study aims to investigate the impact of home confinement during the COVID-19 outbreak in the vision of school-aged children; Methods: A cross-sectional study in children between 5 and 7 years old that completed a visual screening and a questionnaire about their lifestyles at opticians in Spain in September and October of 2019 and 2020. Statistical analysis to compare lifestyles pre and post confinement, and vision in 2020 versus a similar cohort examined at the same opticians in 2019, was conducted; Results: Spanish children spent less time outdoors and more time doing near work in 2020 than in 2019 (p ≤ 0.001). There was a significant decrease of the spherical equivalent (mean ± standard deviation; 0.66 ± 2.03 D in 2019 vs. 0.48 ± 1.81 D in 2020; p ≤ 0.001); Conclusions: Lifestyles of Spanish children changed during the home confinement at the beginning of 2020. Together with changes in their lifestyles, spherical equivalents have decreased, which implies higher figures of myopia for children aged between 5 and 7.

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A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020476 ◽

2021 ◽

Vol 18 (2) ◽

pp. 476

Author(s):

Bum Jung Kim ◽

Sun-young Lee

Keyword(s):

Social Support ◽

Long Term Care ◽

Cross Sectional Study ◽

Care Staff ◽

Hierarchical Regression ◽

Sectional Study ◽

Cross Sectional ◽

Term Care ◽

The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

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PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

Journal of Primary Care & Community Health ◽

10.1177/21501327211030413 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110304

Author(s):

Ravindra Ganesh ◽

Aditya K. Ghosh ◽

Mark A. Nyman ◽

Ivana T. Croghan ◽

Stephanie L. Grach ◽

...

Keyword(s):

Health Status ◽

Social Roles ◽

Disease Process ◽

Cross Sectional Study ◽

Large Sample Size ◽

Sectional Study ◽

Cross Sectional ◽

Data Set ◽

Patient Reported ◽

The Impact

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

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