One-year Prevalence Research Articles

Worldwide Prevalence of Occupational Exposure to Needle Stick Injury among Healthcare Workers: A Systematic Review and Meta-Analysis.

Background Healthcare workers are at high risk of occupational exposure to needle stick injury worldwide. Occupational exposure to needle stick injury represents the most common sources of infection such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Thus, this review aimed to determine the career time and previous one-year global pooled prevalence of occupational exposure to needle stick injury among healthcare workers. Methods The review considered articles written in English language and published from 2012 to 2020. The articles were searched using nine electronic databases (PubMed, Google Scholar, CINAHL, MEDLINE, Cochrane library, Web of Science, SCOPUS, MedNar, and ScienceDirect) using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings, and keywords. Quality assessment was performed to determine the relevance of the articles using Joanna Briggs Institute critical appraisal tools. Several steps of assessment and evaluation were taken to select and analyze the relevant articles. Results The worldwide pooled prevalence of needle stick injuries among healthcare workers during career time and previous one year was 56.2% (95% CI: 47.1, 64.9) and 32.4% (95% CI: 22.0, 44.8), respectively. The career time pooled prevalence of needle stick injuries based on the socioeconomic development and study area was 54.8% and 55.1%, respectively, and one-year pooled prevalence of needle stick injury was 26.0% and 20.9%. Conclusion The review found a high prevalence of occupational exposure to needle stick injury among healthcare workers and suggests the need to improve occupational health and safety services in the healthcare systems.

The prevalence of sickness absence among primary school pupils \u2013 reason to be worried?

BackgroundAbsence from school can lead to lower educational achievement and poor health. Little is known about school absence in primary education. This study’s first aim was to examine the prevalence of school absence in primary schools and differing types of absence, including sickness absence. The second aim was to determine which pupil characteristics and types of absence were associated with extensive sickness absence.MethodsThe school absence registries for the school year 2015–2016 were analysed retrospectively in eight mainstream primary schools with 2216 pupils, and six schools for special primary education with 1000 pupils in the West-Brabant region of the Netherlands. Descriptive analyses, χ2-tests, Mann-Whitney U tests and logistic regression analyses were performed.ResultsThe one-year prevalence of school absence was 85% in mainstream primary schools and 79% in special schools. Sickness absence was the most prevalent type of absence, occurring in 75 and 71% of pupils, respectively The prevalence of extensive sickness absence was 13 and 23%, respectively. In mainstream schools, extensive sickness absence was associated with a young age, low parental educational level, more doctor’s visits and unauthorised absence, and in special schools with more doctor’s visits, other authorised absence, tardiness and unauthorised absence.ConclusionsThe prevalence of extensive sickness absence was high, and as this was associated with other types of absence, these pupils missed even more days of school. Public health research, policy and practice should address sickness absence among primary school pupils, to prevent adverse effects on children’s development.

A Cross-sectional Study to Assess Psychiatric Co-morbidity among Patients of Migraine and Other Headaches

Introduction: Migraine is the most common cause of vascular headache with a one-year prevalence as high as 6-14.3%. Having various pathophysiological theories, it occurs in much co-morbidity with several medical as well as psychiatric disorders like mood disorders, phobia, anxiety spectrum, etc. Migraine, especially when co-morbid with psychiatric illness stands markedly burdensome economically, diagnostically, therapeutically and prognostically. Hence, needs even further research. Aim: To study patients with migraine versus other types of headache and to study psychiatric co-morbidity among patients with migraine. Materials and Methods: This cross-sectional study was conducted on total 100 patients presenting with headache, meeting the criteria were taken up for the study and divided into two groups. Patients meeting International Headache Society (IHS) criteria for migraine were enrolled under group A and patients suffering from headache other than migraine under group B. Having subjected to detailed history and evaluation, patients were subjected to Symptom checklist-80, Hamilton’s Anxiety Rating Scale (HARS) and Montgomery Asberg Depression Rating Scale (MADRS), International Classification of Diseases (ICD)-10 criteria. The data so collected was subjected to statistical analysis and association of psychiatric morbidity with migraine patients was assessed. Results: Patients with migraine (group A) and among those too, patients having psychiatric morbidity had significantly (p<0.01) longer duration of illness (≥8 years), more frequent attacks ≥5 attacks per month and had longer duration of each attack >24 hours compared to the other groups. Patients having migraine had significantly (p<0.01) higher psychiatric morbidity, more SCL-80 symptoms (mean score 83.05); more depressive symptoms (mean MADRS score was 31.9±9.2) and more anxiety with the mean Hamilton Anxiety score was 23.3 than in patients without psychiatric morbidity. Conclusion: A thorough evaluation of psychiatric disorders in migraine is important so as to propose a non segregated model of care to direct the burden and deterioration associated with psychiatric co-morbidity in migraine.

The prevalence of diagnosed specific back pain in primary health care in Region Västra Götaland: a register study of 1.7 million inhabitants.

To evaluate the one-year prevalence of diagnosed specific back pain in Region Västra Götaland, inhabiting 1.7 million people. A retrospective register study. Data from 2014 to 2019 were extracted from the VEGA register, which holds all health data from all publicly funded health care establishments in Region Västra Götaland. Aggregated data are presented as the one-year prevalence of unique individuals diagnosed with International Statistical Classification of Diseases and Related Health Problems - Tenth Revision codes representing specific back pain. All inhabitants in Region Västra Götaland. The one-year prevalence of diagnosed specific back pain stratified by age, sex, and health care level. In 2019, the one-year prevalence of diagnosed specific back pain in public primary health care centres was 0.82%, rehabilitation care 0.35%, and the combined increase was 156% from 2014. In specialized health care, the diagnosed prevalence during 2014-2019 has remained relatively unchanged. The prevalence was significantly higher among women in primary health care and rehabilitation care. M48.0 (spinal stenosis) and M51.1K (lumbar disc herniation with radiculopathy) were the most common sub-classifications. For M48.0, prevalence increased by age, whereas M51.1K peaked within the 45-64 years category. The one-year prevalence of diagnosed specific back pain in primary health care was 1.17% in 2019 and has increased since 2014. Women were diagnosed considerably more frequently than men, which is not reflected in surgical treatment prevalence.

Prevalence, vulnerability and epidemiological characteristics of snakebite in agricultural settings in rural Sri Lanka: A population-based study from South Asia.

BackgroundThe burden of snakebite remains poorly characterised because of the paucity of population-based data. Further, factors determining the vulnerability of individuals within rural communities to snakebite have been rarely investigated. We undertook a population-based study to determine the prevalence, vulnerability and epidemiological characteristics of snakebite in rural Sri Lanka.Methods and findingsA population-based cross-sectional study was conducted among 8707 current residents in the district of Ampara, representing typical rural Sri Lanka. The sample was recruited using multi-stage cluster sampling with probability proportionate-to-size. Snakebite victims were identified using the WHO criteria. Data were collected using a pre-tested interviewer-administered questionnaire.Each household had on average 3.8 persons; mean age 28.3 years (SD = 18.2); 51.3% males. The one-year point prevalence of snakebites was 17.6 per 1000 residents (95% CI: 15–20.6) and 6.12 per 100 households (95% CI: 5.25–7.13), while the lifetime prevalence was 9.4 per 100 residents (95% CI: 8.8–10.0) and 30.5 per 100 households (95% CI: 28.6–32.2) with a case fatality ratio of 0.033. Venomous snakebites accounted for 28.1%; snakes were unidentified among 30.1%. Compared to the non-snakebite victims, being single, males, of Sinhala ethnicity, aged >19 years, low education and socioeconomic status, engaging in farming or unskilled outdoor occupations denoted vulnerability to snakebites. Outdoor bites (77.8%) were more common among males; during daytime; mostly while walking; within the rural terrains and home gardens; on lower limbs; mostly by hump-nosed and Russell viper. Indoor bites were more common among females; during night-time; while sleeping and barefooted; on lower limbs; mostly by hump-nosed vipers, kraits and non-venomous snakes.ConclusionsThe burden of snakebite is considerably high among rural populations. The concept of vulnerability can be useful in healthcare decision-making and resource allocation.

Prevalence of Newly Diagnosed Malignancies in Patients with Polymyalgia Rheumatica and Giant Cell Arteritis, Comparison of 18F-FDG PET/CT Scan with Chest X-ray and Abdominal Ultrasound: Data from a 40 Week Prospective, Exploratory, Single Centre Study.

The aim of the study was to identify the prevalence of newly diagnosed malignancies in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), with the aid of 18F-FDG PET/CT scan compared to conventional imaging techniques: Chest X-ray (CXR) and abdominal ultrasound (US). Secondarily, to examine the relative diagnostic accuracy of these two imaging modalities for the detection of cancer. Eighty consecutive patients with newly diagnosed PMR, GCA, or concomitant PMR and GCA, were included and followed up for 40 weeks. All patients underwent an 18F-FDG PET/CT scan, CXR, and abdominal US at diagnosis. Imaging findings were dichotomously categorized into malignant or benign. Among 80 patients, three patients were diagnosed with seronegative rheumatoid arthritis and were excluded from the analysis. Of the remaining 77, 64 (83.1%) patients were diagnosed with pure PMR, 3 (3.9%) with pure GCA, and 10 (13.0%) with concomitant PMR and GCA. Five types of cancer that were more prevalent than the one-year prevalence of 1.2% among the background population were found in four (5.2%; 95%CI: 1.4–12.8%) patients. CXR/abdominal US could detect the solid cancer in one patient, whereas 18F-FDG PET/CT could identify all four solid cancers. Furthermore, four (5.2%; 95%CI: 1.4–12.8%) cases of monoclonal gammopathy of undetermined significance (MGUS) were found. An increase in C reactive protein (CRP) implicated an increased risk for cancer of 2.4% (OR: 1.024, 95%CI: 1.001–1.047; p = 0.041). 18F-FDG PET/CT can reveal occult cancers at an early stage with a high negative predictive value, and it is specifically beneficial in PMR/GCA patients with nonspecific symptoms.

A comprehensive analytical process, from NPS threat identification to systematic screening: Method validation and one-year prevalence study

Several New Psychoactive Substances (NPS) enter the illicit drug market each year. This constant evolution of compounds to screen is challenging to law enforcement and drug chemists, and even more so to forensic toxicologists, who need to detect such compounds which might be at low concentrations in complex biological matrices. While some technological solutions are better suited than others to address such a challenge (e.g., high resolution mass spectrometry), laboratories with limited instrumental and financial resources are faced with a complex task: systematically screening for a rapidly evolving NPS panel using an accredited method run on standard equipment (e.g., liquid chromatography coupled to tandem mass spectrometry (LC–MS/MS)). This work presents a solution to this challenge: a complete workflow from the detection of a regional NPS threat to its implementation in a method accredited under the ISO 17025:2017 norm. Initial LC–MS/MS method included 55 NPS and metabolites (31 Novel Synthetic Opioids (NSO), 22 NSO metabolites and 2 designer benzodiazepines). Following their identification as relevant territorial threats, flualprazolam, then isotonitazene, were added to the contingent. By relying on development aiming for maximal integration to the current analysis workflow, systematic NPS screening using this method was easily implemented. Between March 2019 and March 2020, the 5 079 forensic cases analyzed in the province of Québec (Canada) revealed a NPS positivity rate of 3.4%. While 94% involved designer benzodiazepines, 5% involved NSO. This process, combining high efficiency, simple detection technology, ISO accreditation and rapid response to new threats resulted in a four-fold increase in NPS detection.

Factors Associated with Needle Stick and Sharp Injuries Among Healthcare Workers in North East Ethiopia.

BackgroundPercutaneous exposure to blood and body fluids through contaminated needle sticks and sharps are serious occupational hazards for morbidity and mortality from infections from blood-borne pathogens among healthcare workers. However, limited studies have been conducted to identify factors associated with needle stick and sharp injuries among healthcare workers in the study area. Therefore, this study aimed at identifying factors associated with needle stick and sharp injuries among healthcare workers.MethodsInstitution-based cross-sectional study was conducted among healthcare workers at health facilities in Dessie from January to March 2018. A simple random sampling technique was used to recruit 362 healthcare workers. Data were collected using a structured self-administered questionnaire. The association between dependent and independent variables was checked using binary logistic regression and p-value ≤0.05 was used as a cut-off point for significance.ResultsThe entire work time and one-year prevalence of needle stick and sharp injury among healthcare workers were 60.2% and 40.1%, respectively. Working in private hospital (AOR = 9.619, 95% CI: 2.476, 27.373), working in private clinic (AOR = 3.308, 95% CI: 1.038, 8.506), less work experience (AOR = 2.762, 95% CI: 1.381, 4.521), higher workload (AOR = 3.794, 95% CI: 2.268, 6.346) and all-time availability of sharp storage and disposal containers (AOR = 0.435, 95% CI: 0.215, 0.879) were significant predictors of needle stick and sharp injuries.ConclusionPrevalence of needle stick and sharp injury was high. Working in private health institutions, less work experience, higher workload and all-time availability of sharp storage and disposal containers were significant predictors of needle stick and sharp injuries. Therefore, efforts have to be made to reduce the workload of healthcare workers and to available sharp storage and disposal containers all the time in the workplaces.

Prevalence, expenditures, and associated factors of purchasing non-prescribed Chinese herbal medicine in Taiwan.

Background and aimsPurchasing Chinese herbal medicine (CHM) without a physician’s prescription may have adverse effects on health. However, the recent status of purchasing non-prescribed CHM and the associated factors are not completely understood. We aimed to report the prevalence of purchasing CHM and associated factors.MethodsUsing data from the 2017 Taiwan Survey of Family Income and Expenditure, we identified 16,528 individuals (householders) aged 18 years and older. Sociodemographic factors, expenditures on medical services and health behaviours were compared between people with and without a history of purchasing non-prescribed CHM by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in a multiple logistic regression analysis.ResultsThe one-year prevalence of purchasing non-prescribed CHM was 74.8% in Taiwan. In addition to sociodemographics, marital status (OR 2.14, 95% CI 1.88–2.44), the use of traditional Chinese medicine (OR 3.62, 95% CI 3.30–3.97), the purchasing of non-prescribed biochemical medications (OR 3.09, 95% CI 2.75–3.48), the purchasing of health foods (OR 2.59, 95% CI 2.33–2.86), the use of folk therapy (OR 2.27, 95% CI 1.95–2.64), and a high level of expenditure on alcohol (OR 3.79, 95% CI 3.29–4.36) were strongly correlated with purchasing non-prescribed CHM.ConclusionThe one-year prevalence of purchasing non-prescribed CHM is very high in Taiwan and is correlated with sociodemographics, health behaviours, and the utilization of medical care. The interaction of non-prescribed CHM with physician-prescribed herbal medicine and biomedical medications requires more attention.

Outpatient health care utilization and health expenditures of asylum seekers in Halle (Saale), Germany - an analysis of claims data

BackgroundAsylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations.MethodsUsing claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision.ResultsThe estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector.ConclusionThe analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

Association between one's own consumption and harm from others' drinking: Does education play a role?

Introduction: We examined (a) whether risky drinking behaviour is related to experienced harm from others' drinking (EHFOD) and (b) whether any found relationship is modified by educational level, such that those of lower socio-economic status (SES) experience more harm even when adjusted for drinking behaviour. Method: Data from the Danish national alcohol and drug survey of 2011 (N=5133) were linked with registry data from Statistics Denmark. Eight EHFOD indicators were grouped into nuisance, harassment or harm/damage categories. Indicators for mean alcohol consumption, Alcohol Use Disorder Identification Test (AUDIT) and binge drinking were examined in relation to respondents' EHFOD with multiple logistic regression, stratified by sex and education (proxy for SES). Results: One-year prevalence of EHFOD was 50%. We found a positive and significant relationship between own alcohol consumption and EHFOD categories of harassment as well as harm/damage. Effect modification of education was significant for harassment. Among men, odds ratios for the association between risky drinking behaviour and harassment were 5.50 (95% confidence interval (CI) 3.49-8.65) in the low educational group versus 1.42 (95% CI 0.98-2.07) in the high educational group. Conclusions: Our study confirmed an overall positive relationship between EHFOD and drinking behaviour, but it varied by type of EHFOD. Furthermore, education modified this effect for harassment, suggesting evidence of the alcohol harm paradox with respect to EHFOD. More research is necessary to understand better how drinking patterns diverge between low and high educational groups as well as sex, and how this differentially affects risk for alcohol-related harms, including EHFOD.

The Global Prevalence of Suicidal Attempt among Medical Students: a Systematic Review and Meta-Analysis.

Even though suicidal attempt among medical students is a major public health concern, there are no prior studies that reported its consolidated magnitude worldwide. To the best of our knowledge, this systematic review is the first to quantitatively analyze the prevalence of suicidal attempts among medical students. We systematically searched PubMed, Embase, and Scopus for English language articles that assessed the prevalence of suicide attempts among medical students. A random-effect meta-analysis was used to combine data from individual studies. The heterogeneity across the studies was evaluated using Cochran's Q- and the I2 test. We assessed publication bias using Egger's test and visual inspection of the symmetry in funnel plots. A total of 14 articles were selected for meta-analysis according to the PRISMA guideline. The pooled lifetime prevalence of suicidal attempt was found to be 2.19% (95% CI; 1.17-4.07). The pooled one-year prevalence was estimated to be 1.64 (95% CI; 0.60-4.45). The estimated prevalence of suicidal attempt was considerably high among medical studies in low and middle-income countries than medical studies in high-income countries. The estimated prevalence of suicidal attempt also varies by gender of participants Given the high prevalence estimate of suicidal attempt among medical students and its potential in resulting death by suicide, early identification, and interventions should be considered among medical students.

Seizure-like events leading to hospital referrals in infants: A retrospective population-based study.

To identify the aetiology and outcome of seizure-like events leading to hospital referrals in infants and to identify early predictors of epilepsy and delayed neurodevelopment. This Norwegian population-based study focused on all children born in Sør-Trøndelag county, who were up to one year of age in 2014-2015. They were identified by diagnostic codes for seizure-like events and electroencephalography (EEG) examinations. Hospital records were examined up to 1.5years of age. The one-year prevalence of seizure-like events was 1.5% (114/7430). Epilepsy was diagnosed in 17%, 57% had non-epileptic paroxysmal events (NEPE), 16% had febrile seizures, and 10% had other acute symptomatic epileptic seizures. Neurodevelopmental delay occurred in 21%. The cumulative incidence was 0.22% for epilepsy and 0.79% for NEPE. Abnormal brain magnetic resonance imaging, abnormal first EEGs and neonatal care increased the likelihood of epilepsy and delayed development. Identifying situation-related factors decreased the epilepsy risk. Occurrence at a younger age increased the risk of delayed development. Absence of unambiguous motor symptoms was less common in epilepsy than in NEPE. Seizure-like events were common in infants and most were not caused by epilepsy. Specific anamnestic clues, and detailed descriptions of the entire event, helped to predict adverse outcomes.

Prevalence and Correlation of Depression in Patients Suffering From Type 2 diabetes Mellitus

Depression is one of the commonest psychiatric disorders and is a prominent reason for major health problems worldwide. The prevalence and the dysfunction, morbidity, suffering, and economic burden. Depression can lead to upsurge in the health-seeking performance, diminished excellence of life and increased propensity for desperate tendencies. In the majority of the cases, the affected patients report late and owing to various scales of assessing depression, patients with depressive disorder are often undertreated. As per the Global Burden of Disease report the prevalence of depression is 1.9% among men and 3.2% for women and the overall one-year prevalence increases to 5.8% in men and 9.5% in women. Given the existing epidemiological evolution and demographic, the impact of unhappiness can be tremendous by 2020 with the burden of depression at about 5.7% of all the illnesses. The morbidity bearing will be so huge that and it would be the most important reason for disability-adjusted life years (DALYs), next only to ischemic heart disease. This education expected at to assess the prevalence and correlates of depression among type 2 diabetes mellitus patients and impact of treatment on diabetic status, glycemic quality and control of life after 6 months. The scales used in this study was Mini international neuropsychiatric interview – 6.0 , Hamilton Depression Scale (HAM-D), WHO Quality Of Life (WHO-QOL) – BREF scales, Morisky 8-item Medication Adherence Questionnaire. The study has highlighted the prevalence of depression in the study population, positive impact of depression on the treatment compliance, glycemic control and quality of life of the affected patients.

Prescriber responsibility, predictors for initiation, and 20-year trends in use of non-aspirin non-steroidal anti-inflammatory drugs in patients with cardiovascular contraindications: a nationwide cohort study.

To examine whether prescription patterns complied with recommendations not to use non-steroidal anti-inflammatory drugs (NSAIDs) in patients with cardiovascular contraindications. Moreover, we examined predictors for initiation and prescriber responsibility. We used Danish medical databases to identify all patients with first-time cardiovascular disease during 1996-2017 (n = 628 834). We assessed standardized prevalence proportions, predictors from logistic regression, and prescriber identifiers. One-year prevalence of NSAID initiation increased 3.4% from 1996 (19.4%) to 2001 (22.7%) and declined by 2.7% thereafter until 2017 (13.5%). Trends were independent of age, sex, and disease subtype, although larger annual declines occurred for heart failure (3.9%) and ischaemic heart disease (3.5%) since 2002. One-year prevalence remained highest among patients with venous thromboembolism (16.6%) and angina (13.8%), and lowest for ST-segment elevation myocardial infarction (7.0%) and heart failure (8.8%). Initiators were predominantly prescribed ibuprofen (59%), diclofenac (23%), and etodolac (6%). Diclofenac and coxib use declined, while ibuprofen and naproxen use increased. Median prescribed pill dose of ibuprofen declined after 2008 from moderate/high (600 mg) to low (400 mg). Treatment duration declined for all NSAIDs, except celecoxib. Rheumatic, obesity, and pain-related conditions predicted NSAID initiation. General practitioners issued 86-91% of all NSAID prescriptions, followed by hospital prescribers (7.3-12%). Initiation of NSAIDs in patients with cardiovascular disease declined since 2002. Shorter treatment duration, declining COX-2 inhibition, and increasing use of naproxen and low-dose ibuprofen suggest adherence to guidelines when NSAIDs cannot be avoided. Still, NSAID use remained prevalent despite cardiovascular contraindications, warranting awareness of appropriateness of use among general practitioners in particular.

The applicability of web-based solutions in headache epidemiology research

BackgroundEpidemiological research of headache is vital but resource consuming prerequisite for evidence-based development in the field. Rapid evolution of information technology may provide new opportunities for population-based surveys. The aim of this study was to evaluate the applicability of web-based solutions in epidemiological studies of primary headaches.MethodsAn online survey was conducted among 20–64 year old Estonian citizens, using a previously validated headache questionnaire. The participants were accessed through most popular portals and e-mail domains to get the maximum coverage of Estonian digital community. The resulting one-year headache prevalences were compared to those acquired in parallel from a population-based cross-sectional person-to-person study in Estonia.ResultsFive thousand seven hundred eight entries were made by 5347 participants in the online study. Of the participants, 3896 (72.9%) had no headache, 1436 (26.8%) had only one and 15 (0.3%) had more than one type of headache. The study sample demographics were statistically significantly different from Estonian population and the prevalences were adjusted by age, gender, education and habitat. The proportion of headache sufferers was smaller in the online study sample (23.1% vs 41.0% in the population-based parallel person-to-person study). Among the headache sufferers the proportions of different headache diagnoses were similar across the two studies with the exceptions of episodic migraine and episodic tension-type headache. There were less migraine and more tension-type headache sufferers in the online study sample.DiscussionThis is the first study addressing applicability of web-based solutions in headache related large epidemiological studies. Online approach presents a much faster means of data collection, larger samples, has mechanisms of avoiding data contamination and distinguishes the proportions of most primary headache disorders among the headache sufferers. However, the present online survey was significantly biased towards the people without headache, leading to underestimation of headache prevalence. This stems from the shortcomings related to method of sampling, access and engagement.ConclusionOnline headache epidemiology research could be a resource saving alternative to person-to-person studies, however, further research is needed to overcome the problems related to methods of sampling, access and engagement.

Work-related musculoskeletal disorders among Slovenian physiotherapists

Introduction: Work-related musculoskeletal disorders (WMSDs) represent a major problem for society, employers, and employees. These kinds of problems can cause discomfort, pain, and poor work performance. Among physiotherapists, the 1-year prevalence of WMSD ranges from 28 to 96%. Most problems occur in the lower back, with a 1-year prevalence of up to 83%. This study aimed to determine the prevalence of WMSD on a sample of physiotherapists from Slovenia and to identify associations between demographic/anthropometric variables, job satisfaction, and physical activity with WRMD aiming to contribute to the development of effective prevention and control strategies. Methods: The extended Nordic musculoskeletal questionnaire was used to obtain data from a sample of 102 physiotherapists. Data were presented with descriptive statistics and processing was performed with the Spearman’s rank correlation coefficient for non-parametric variables. The level of statistical significance was set as p ≤ 0.05. Results: The 1-year prevalence of WMSD was 92.2%. One-year prevalence of WMSD was highest for the neck (64%) and lower back (63%). Higher age and more years of practice were correlated with WMSD for shoulders and ankles/feet areas. Several patients treated by a physiotherapist were a risk factor for difficulties in the neck and multiple body areas. The level of physical activity was not correlated with WMSD in different body areas. Conclusion: The prevalence of WMSD found in our study sample was among the highest compared to other countries, despite probably having similar working conditions as elsewhere in Europe. The first WMSD of Slovenian physiotherapists mostly did not occur in the first 5 years of practice as other studies reported, which could be explained as a result of a good educational training of young physiotherapists. Possible reasons for the high prevalence of WMSD could be that our study sample represented only secondary and tertiary levels of health care; another reason could also be non-ergonomic and hard working conditions during their careers. Physiotherapists are mostly adequately physically active, however, that did not turn out to be effective WMSD prevention in our sample. The relatively high prevalence is indicating the need for better interventions and prevention of WMSD in Slovenian physiotherapists.

Effect of Smartphone Output Power on the Undetermined Headache among High School Students: Time-Series Study

Background: The undetermined headache, which is not classified as a primary headache, might be a mobile phone associated headache (MPAH). Objective: To investigate the smartphone electromagnetic radiation related to undetermined headaches among high school students. Materials and Methods: One hundred forty-five high school students in the Chiang Mai Province completed a headache diary according to the International Classification of Headache Disorders version 3 beta criteria. It was scored according to the diagnosis algorithm. The smartphone output power (SOP) as measured and recorded by the smartphone application was saved every five minutes and transmitted by email. The completed data included 12,969 entries. The smartphone use, sleep quality, anxiety, and depression were also assessed. Data were analyzed using the Generalized Estimating Equation adjusted for demographic data, smartphone use, and sleep quality, and other. Results: Most students were female 74.7% with a mean age of 17.63±1.01 years (range 16 to 20). The one-year headache prevalence was 92.6% (95% CI 90.8 to 94.1) with undetermined headaches at 18.7% and 16.9% in the first and second phase, respectively. Characteristically, the prevalence of MPAH was higher in the nature of short duration pain, pulsing and tightening, indefinite form of pain, pain occurring in the morning, one side headache at occipital or frontal areas, and low pain severity (p<0.05). The results revealed the strongest effect of SOP at 1.80×10⁻⁵ to 1.99×10⁻⁵ mW range on the undetermined headaches with ORadj 2.32; 95% CI 1.23 to 4.34. Furthermore, the undetermined headaches also had the strongest association with handfree use and internet use (ORadj 1.92; 95% CI 1.11 to 3.29 and ORadj 2.33; 95% CI 1.71 to 3.19, respectively), age, and anxiety (ORadj 1.49; 95% CI 1.26 to 1.76 and ORadj 1.12; 95% CI 1.07 to 1.17, respectively). Conclusion: The undetermined headache associated with SOP, which was a MPAH. These results suggest that an older age for starting smartphone use and utilizing a hand-free device were recommended to prevent chronic headaches. Keywords: Smartphone output power, Undetermined headache, Mobile phone associated headache

Musculoskeletal disorders and their associations with health- and work-related factors: a cross-sectional comparison between Swedish air force personnel and army soldiers

BackgroundThe high numbers of musculoskeletal disorders (MSD) among soldiers in the Swedish Armed Forces has led to the implementation of an effective prevention program, the musculoskeletal screening protocol (MSP), including questionnaires, physical tests and individual intervention of their MSD. A corresponding MSP for the Swedish Air Force is also needed due to earlier reported high prevalence of MSD. We therefore investigated the prevalence of MSD in Swedish Air Force personnel (AF) and compared this to Swedish Army deployed soldiers (DS). Individual, health- and work-related factors associated with MSD were also investigated.MethodsCross-sectional questionnaire-based study on 166 male AF and 185 DS. AF consisted of fighter pilots, helicopter pilots and rear crew from one Swedish air base.ResultsThe one-year and point prevalence, respectively, of MSD were significantly higher for AF compared to DS with regard to both the upper quarter of the body (i.e. neck, shoulder and thoracic regions) (AF = 54.8 and 31.3%, DS = 26.1 and 13.6%, p = 0.01) and the lumbar region (AF = 38.0 and 18.7%, DS = 22.2 and 7.1%, p = 0.00). No significant differences were present between fighter pilots, helicopter pilots and rear crew regarding MSD prevalence.Factors significantly associated with having both upper quarter and lumbar regions MSD were group (i.e. greater odds for AF than DS) and self-reported physical health as less than excellent. Additionally, being older and taller were also factors associated with lumbar region MSD.DiscussionDespite a generally healthy lifestyle, MSD were commonly reported by AF and DS, with generally higher prevalence in AF who mainly reported MSD in the upper quarter of the body. The results from this study indicate that the MSP can be a meaningful tool to prevent MSD in air force personnel and that questions regarding general health and MSD in specific body regions should be included in screening protocols. The development of the preventive program MSP is therefore recommended for the Swedish Air Force.

Epidemic of chronic diseases and the related healthy lifestyle interventions in rural areas of Shandong Province, China

BackgroundThere were amounts of previous studies on chronic diseases, but few studies on the prevalence of chronic disease and the healthy lifestyle intervention in recent years, China. This study aimed to investigate the prevalence of chronic disease and the implementation of healthy lifestyle intervention in rural areas of China, so as to put forward health promotion measures to control the chronic diseases effectively.MethodA large cross-sectional study (N = 2168) on community diagnosis and chronic disease was carried out in Shandong province, China. The chronic disease questionnaire and the healthy lifestyle intervention questionnaires were recruited to survey the chronic diseases and the implementation of healthy lifestyle intervention. Physical examination and biochemical indicators examination were carried out by the medical staffs and clinical laboratory.ResultsThe current diagnosed prevalence of hypertension, diabetes, hyperlipidemia for total sample, female, male were 24.97, 24.6, 25.5, 7.60, 8.9, 6.0 and 40.27%, 45.9, 33.3% respectively in rural China. The one-year prevalence of myocardial infarction (MI) and stroke of the total sample, female, male were 1.06, 1.0, 1.1 and 2.09%, 2.2, 2.0% respectively.Healthy lifestyles interventions were not effective in rural China. The current active smoking rate and passive smoking rate were 25.68 and 42.65%. 27.86% of the population drunk alcohol within a month and 47.01% of them participated in the actions to control salt daily intake. Only 1.07 and 7.89% of the population participated in medium to high intensity physical exercises.ConclusionsThe prevalence of common chronic diseases were still high and the implementation of healthy lifestyle intervention were not optimal in rural area, China. Challenges to prevent chronic diseases were still severe, so medical institutes, government and individuals would put forward effective strategies to reduce the prevalence and public health promotion project should be effectively strengthened.