scholarly journals Canadian Physicians' Use of Antiobesity Drugs and Their Referral Patterns to Weight Management Programs or Providers: The SOCCER Study

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
R. S. Padwal ◽  
S. Damjanovic ◽  
K. M. Schulze ◽  
R. Z. Lewanczuk ◽  
D. C. W. Lau ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Management ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Dietary Advice ◽  
Behavioral Management ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Antiobesity Drugs ◽  
Weight Management Programs

Antiobesity pharmacotherapy and programs/providers that possess weight management expertise are not commonly used by physicians. The underlying reasons for this are not known. We performed a cross-sectional study in 33 Canadian medical practices (36 physicians) examining 1788 overweight/obese adult patients. The frequency of pharmacotherapy use and referral for further diet, exercise, behavioral management and/or bariatric surgery was documented. If drug treatment or referral was not made, reasons were documented by choosing amongst preselected categories. Logistic regression models were used to identify predictors of antiobesity drug use. No single antiobesity management strategy was recommended by physicians in more than 50% of patients. Referral was most common for exercise (49% of cases) followed by dietary advice (46%), and only 5% of eligible patients were referred for bariatric surgery. Significant predictors of initiating/continuing pharmacotherapy were male sex (OR 0.70; 95% CI 0.52–0.94), increasing BMI (1.02; 95% CI 1.01–1.03), and private drug coverage (1.78; 95% CI 1.39–2.29). “Not considered” and “patient refusal” were the main reasons for not initiating further weight management. We conclude that both physician and patient factors act as barriers to the use of weight management strategies and both need to be addressed to increase uptake of these interventions.

scholarly journals Prevalence of Elevated Liver Stiffness Among Potential Candidates for Bariatric Surgery in the United States

2022 ◽  
Author(s):  
Stefano Ciardullo ◽  
Mattia Pizzi ◽  
Pietro Pizzi ◽  
Alice Oltolini ◽  
Emanuele Muraca ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Liver Disease ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
The United States ◽  
Cross Sectional Study ◽  
Metabolic Dysfunction ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Using Data

Abstract Purpose Obesity represents a well-known risk factor for metabolic-dysfunction associated fatty liver disease (MAFLD) and its progression towards cirrhosis. The aim of this study is to estimate the proportion of potential candidates to a bariatric surgery intervention that has an elevated liver stiffness on vibration-controlled transient elastography (VCTE). Materials and Methods This is a cross-sectional study performed using data obtained during the 2017–2018 cycle of the National Health and Nutrition Examination Survey. Potential candidates for a bariatric surgery intervention from the general US population were identified by applying criteria from international guidelines. All included participants were evaluated by VCTE. A controlled attenuation parameter (CAP) value ≥ 288 dB/m was considered indicative of steatosis while liver stiffness measurement (LSM) was considered elevated if ≥ 9.7 kPa. Multivariable logistic regression models were fitted to identify independent predictors of both outcomes. Results A total of 434 participants were included (mean age 42.9 ± 0.6 years; 54.4% women). Among them, 76.7% (95% CI 71.7–81.0) had steatosis, while 23.1% (95% CI 17.8–29.3) had an elevated LSM. Male sex, older age, γ-glutamyltranspeptidase levels, and body mass index (BMI) were independent predictors of steatosis, while BMI was the only independent predictor of elevated LSM. Non-Hispanic black participants were protected from both outcomes, while other ethnicities were not. Conclusion The prevalence of elevated LSM is high in potential candidates for a bariatric surgery intervention. Accurate screening for occult advanced liver disease might be indicated in this patient population. Graphical abstract

Services Provided for Lactating Mothers at Lactation Management Clinic in Selected Tertiary Level Hospitals

2020 ◽  
Vol 38 (2) ◽  
pp. 68-73
Author(s):  
Tarannum Tasnim ◽  
ANM Shamsul Islam ◽  
Mehedi Hasan Azad ◽  
Farhana Sharmin
Keyword(s):  
Breast Milk ◽  
Milk Production ◽  
Public Awareness ◽  
Cross Sectional Study ◽  
Dietary Advice ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Breast Milk Production ◽  
Lactating Mothers ◽  
Structured Questionnaire

Background: Children are the precious gift from the Almightily Allah and breast milk is an ideal product given to the human being by nature to fulfill all requirements of the offspring until they are matured enough to take adult food. Objective: To assess the services provided for lactating mothers at lactation management centre in selected tertiary level hospitals. Materials and Methods: This cross sectional study was conducted among 100 Lactating mothers who were selected conveniently and were interviewed by pre-tested semi-structured questionnaire and an observational checklist. Collected data were processed and analyzed using SPSS (Statistical Packages for Social Science) software. Results: Lactation management centre (LMC) is supervised by a consultant and separate room is allotted in both out-patient and in-patient departments. Mothers came with lactation problems were more likely in the first month of the baby (73%) and feeling of not enough milk production was common (49%).Highly significant relationship was found between breast problems of lactating mother and age of child (p<0.001). About 84% respondents received practical demonstration on position and attachment of the baby during lactation. About 91% respondents got dietary advice for enough breast milk production, 75% got dietary advice regarding their child’s weaning food chart and69% got health education. Maximum mothers were informed about LMC by doctor & nurse (82%). Conclusion: Information about LMC services should be disseminated across the country. Lactating mothers should be familiarized with LMC and public awareness should be enhanced for effective management of breastfeeding problem to promote, protect and support the breastfeeding. JOPSOM 2019; 38(2): 68-73

scholarly journals The number of household members as a risk factor for peptic ulcer disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mi Hong Yim ◽  
Keun Ho Kim ◽  
Bum Ju Lee
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Living Alone ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Logistic Regression Models ◽  
Household Members ◽  
H Pylori

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.

scholarly journals Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

2020 ◽  
Author(s):  
Richard C Gerkin ◽  
Kathrin Ohla ◽  
Maria G Veldhuizen ◽  
Paule V Joseph ◽  
Christine E Kelly ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Respiratory Symptom ◽  
Respiratory Illness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Olfactory Loss ◽  
Visual Analog Scales ◽  
Cardinal Symptoms ◽  
Smell Loss

Abstract In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4&lt;OR&lt;10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.

Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study

2021 ◽  
Author(s):  
Larissa Cristina Lins Berber ◽  
Mariana Silva Melendez-Araújo ◽  
Eduardo Yoshio Nakano ◽  
Kênia Mara Baiocchi de Carvalho ◽  
Eliane Said Dutra
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grazing Behavior ◽  
Post Bariatric Surgery

Do Hospitals with a Higher Level of Maternal Care Designation Have Better Maternal Outcomes?

2018 ◽  
Vol 36 (06) ◽  
pp. 653-658 ◽  
Author(s):  
Sindhu Srinivas ◽  
Katy Kozhimannil ◽  
Peiyin Hung ◽  
Laura Attanasio ◽  
Judy Jou ◽  
...  
Keyword(s):  
High Risk ◽  
Maternal Care ◽  
Maternal Morbidity ◽  
Cross Sectional Study ◽  
Severe Maternal Morbidity ◽  
Maternal Outcomes ◽  
Cross Sectional ◽  
Discharge Data ◽  
Logistic Regression Models ◽  
The Impact

Background A recent document by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine introduced the concept of uniform levels of maternal care (LMCs). Objective We assessed LMC across hospitals and measured their association with maternal morbidity, focusing on women with high-risk conditions. Study Design We collected data from hospitals from May to November 2015 and linked survey responses to Statewide Inpatient Databases (SID) hospital discharge data in a retrospective cross-sectional study of 247,383 births admitted to 236 hospitals. Generalized logistic regression models were used to examine the associations between hospitals' LMC and the risk of severe maternal morbidity. Stratified analyses were conducted among women with high-risk conditions. Results High-risk pregnancies were more likely to be managed in hospitals with higher LMC (p < 0.001). Women with cardiac conditions had lower odds of maternal morbidity when delivered in level I compared with level IV units (adjusted odds ratio: 0.29; 95% confidence interval: 0.08–0.99; p = 0.049). There were no other significant associations between the LMC and severe maternal morbidity. Conclusion A higher proportion of high-risk pregnancies were managed within level IV units, although there was no overall evidence that these births had superior outcomes. Further prospective evaluation of LMC designation with patient outcomes is necessary to determine the impact of regionalization on maternal outcomes.

scholarly journals Demographic and social correlates and indicators for behavioural compliance with personal protection among Chinese community-dwellers during COVID-19: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041453
Author(s):  
Xin Xu ◽  
Kimberly Ann Chew ◽  
Xiaolin Xu ◽  
Zhihua Wu ◽  
Xiaohua Xiao ◽  
...  
Keyword(s):  
Middle Age ◽  
Social Indicators ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Inverse Association ◽  
Personal Protection ◽  
Cross Sectional ◽  
Protective Measures ◽  
Logistic Regression Models ◽  
Community Dwellers

ObjectivesExamine compliance with personal protective measures in communities for the prevention and control of local transmission of the COVID-19, and explore indicators for such behavioural compliance.DesignCross-sectional design with a self-selecting sample. Data collected in February 2020.SettingCommunity dwellers in China.Participants2956 participants aged 16 and above completed the study and were included in the analysis.Outcome measuresNationwide COVID-19 survey. Demographics and self-reported compliance with four personal protective measures—home quarantine, mask-wearing, temperature-taking and hand-sanitising were collected. Outbreak severity and timeliness of personal protection order were obtained from the China Center for Disease Control and Prevention website. Logistic regression models were employed to examine the association between demographic and social indicators and behavioural compliance.ResultsCompliance with home quarantine was only associated with gender (men, OR=0.61 (0.51–0.73), inverse association) but no other indicators. In contrast, men had higher compliance with mask-wearing (OR=1.79 (1.49–2.16)) and temperature-taking (OR=1.27 (1.05–1.53)). Compared with younger adults (≤20 years), the middle-age groups (31–40 and 41–50 years of age) were more compliant with all protective behaviours, except for home quarantine (OR=0.71 (0.54–0.93) and 0.67 (0.46–0.97), respectively).ConclusionMale gender was associated with lower compliance with home quarantine yet higher compliance with mask-wearing and temperature-taking. The middle-age participants (31–50 years) had lower compliance with home quarantine but higher with other measures. These findings may be supported by the economic considerations and the long-inherited Confucian values among Chinese. In light of the ongoing COVID-19 pandemic, public health authorities should tailor policy implementation to disparities in psychosocial indicators.

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