Persons In General Population Research Articles

Information access and preventive measures during COVID-19 among migrants and general population

BackgroundAccess to information and adherence to preventive measures are crucial for containing the COVID-19 outbreak. This study examines access to information and adherence to preventive measures during the COVID-19 pandemic among migrant origin persons and the general population.MethodsData from the Finnish MigCOVID Survey conducted 10/2020 to 2/2021 among persons aged 20 to 66 years was used (n = 3 668). Participants in Health 2017 follow-up survey were the reference group (n = 3 490). We examined age and sex-adjusted access to information by language skills and adherence to preventive measures (staying home if fluish; keeping a safety distance; wearing a face mask; good hand and coughing hygiene; avoiding traveling abroad; avoiding shaking hands with others; downloading the Koronavilkku contact tracing app).ResultsPersons with excellent Finnish/Swedish language skills (96.8%; 95% CI 95.0-97.9) reported receiving sufficient information more often those with intermediate (92.3; 95% CI 88.8-94.8) or basic (91.0%; 95% CI 88.0-93.3) language skills. Overall high adherence to preventive measures was observed both among the migrant origin and the general population. However, significant differences in the migrant origin population by region of origin were observed. More pronounced differences between migrant origin persons and general population persons were observed for avoiding traveling abroad (83.7%; 95% CI 81.1-86.0 vs. 96.6%; 95% CI 95.6-97.3) and downloading the Koronavilkku app (42.8%; 95% CI 39.8-45.9 vs. 64.3%; 95% CI 61.7-66.8).ConclusionsPoorer perceived access to information by language skills points to the continuous need for use of simple language and multilingual communication materials. Self-reported adherence to key preventive measures campaigned by health authorities was generally high both among persons of migrant origin and the general population, although concerns were noted in adherence to these recommendation in some regional groups.Key messages Multilingual and multichannel communication is central in crisis situations to ensure adequate access to information among different population groups.Higher incidence of COVID-19 among migrant origin persons is likely related not only to information access and adherence to preventive measures, but also to various social and structural factors.

A clinical primer on intellectual disability.

Between 1% and 3% of persons in general population are estimated to have some degree of intellectual disability. A diagnosis of intellectual disability is based on clinical history, level of intellectual ability and level of adaptive function. Both, the intellectual and adaptive functioning are measured using individually administered standardized tests. More than 75% of persons who have intellectual disability have mild intellectual disability and an underlying specific etiology is less likely to be identified; whereas, in a small percentage of persons with severe intellectual disability, an underlying specific biologic cause is highly likely to be identified. Genetic abnormalities, inborn errors of metabolism and brain malformations are major categories of causes identified in severe to profound intellectual disability. The initial clinical presentation and recognition depends on the severity and underlying cause of intellectual disability. The etiology, severity, cognitive abilities, and adaptive function, vary among persons with intellectual disability and need consideration in developing a treatment plan. The physician plays an essential role in the evaluation, treatment of associated medical conditions and preventive care, and in facilitating and coordinating consultative services and community based care.

Work participation and working life expectancy after a disabling shoulder lesion

ObjectiveTo examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.MethodsFrom a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners...

Drug-induced oral erythema multiforme: A diagnostic challenge

Trimethoprim-sulfamethoxazole (cotrimoxazole or TMP/SMX) is commonly used for the treatment of urinary or lower respiratory tract infections. A comprehensive review is presented of the world literature on adverse reactions to TMP/SMX since its first use in 1968, when concern was expressed about possible hematologic toxicity. The adverse reactions to TMP/SMX occur in approximately 1%–3% of persons in general population. Here, we report a case of oral erythema multiforme (EM) secondary to TMP/SMX that presented with oral and lip ulcerations typical of EM without any skin lesions and highlights the importance of distinguishing them from other ulcerative disorders involving oral cavity. The patient was treated symptomatically and given tablet prednisolone. The condition improved with stoppage of TMP/SMX therapy. It has been reported that primary attacks of oral EM is confined to the oral mucosa, but the subsequent attacks can produce more severe forms of EM involving the skin. Hence, it is important to identify for early diagnosis and management. Although EM is quite common with TMP/SMX, there are no reports of oral EM appearing after intake of this drug.

Atypical Presentations in Neurofibromatosis- A Series of Five Cases

Neurofibromasis is the most common phacomatosis having a frequency of approximately 1 case per 3500 persons in general population. The syndrome of neurofibromasis consists of two distinct genetic diseases with considerable phenotype overlap.

Chronic obstructive pulmonary disease in the awareness of Polish society. Report from the public opinion survey by the Polish Respiratory Society and TNS Polska.

It is assumed that signs of chronic obstructive pulmonary disease (COPD) can be found in 9.3% subjects of more than 40 years of age in general population in Poland. The aim of the presented survey was to assess knowledge of COPD in adult general population in Poland. The study was performed in June 2013 in a representative sample of 1,000 persons of at least 15 years of age in Poland, using standardized direct interview. In 2013 only 3% Polish people admitted they had ever heard of COPD and knew what the acronym meant. Further 11% persons admitted having heard the term but had no further knowledge of the subject. Thus, the total of 14% persons in general population had previously heard of COPD albeit superficially. This figure is slightly higher as compared to the study performed in 2004. The second part of the study was performed in patients with COPD. Patients perceive the disease as a limiting factor in their daily lives, including negative impact on physical activity, causing loss of physical attractiveness (more often reported by women) or hurting their image of a strong and caring person (more often reported by men). The disease demands re-evaluation of the previous lifestyle, alienates patients from other people, and generates financial burden. Half of the entire studied general population either does not have any associations concerning potential causes of COPD or report various erroneous connotations (e.g. excessive alcohol consumption as a cause of the disease). Even patients with COPD have a similar view on causes of the disease. Importantly, the study revealed that awareness of the disease in smokers does not essentially differ from that in general public. Half of the res pondents admitted having no knowledge on prevention of COPD. There is an urgent need for widespread public education on preventive measures. Study results support the need of educating both healthy subjects and patients with COPD as to how effectively reduce the risk of developing the disease. One third of all respondents has no assumptions in this regard (i.e. explicitly declares having no knowledge at all on the subject), and more than 40% subjects have various misconceptions. Educators should therefore spread information about the disease but also correct these misconceptions.

The incidence and prevalance of idiopathic intracranial hypertension in south Sharaqiah region, Oman

Background:To determine the incidence and demographic features of idiopathic intracranial hypertension (IIH) in south Sharqiyah, Sultanate of Oman.Materials and Methods:A retrospective review of Omani patients diagnosed as IIH in Sur Regional Hospital from January 2001 to December 2011 was carried out. All patients fulfilled the modified Dandy criteria for IIH. Data collected included age and sex of patients, age of onset of the disease, body mass index (BMI), presence of comorbid conditions, and medication use. Findings of ophthalmic examination, neuroimaging, and neurological assessment were recorded. Total number of new outpatients in the study period and the 2010 south Sharqiyah mid-population statistics were also collected.Results:Forty patients were diagnosed as IIH during a period of 11 years from January 2001 to December 2011 in Sur Regional Hospital. The female to male ratio was 3:1; of the 40 patients; 30 (75%) females and 10 (25%) males. Thirteen patients (32.5%) were children below 15 years. Of females in the child bearing age (15-44 years), 60% were obese. As per 2010 census, the Omani population in south Sharqiyah region was 166,318. The calculated annual incidence per 100,000 persons of general population was 2.18. Annual incidence in women of all ages per 100,000 persons was 3.25 and in women of child bearing age was 4.14. In children below 15 years, the incidence was 1.9 per 100,000 children; it was 2.96 per 100,000 for female children.Conclusion:This study shows that the incidence in south Sharqiyah is comparable to that of other countries. Females and obese patients are at a higher risk of developing IIH. Obesity is not a risk factor in males and children. Nearly 60% of the females in the child bearing age were obese.

Antioxidative vitamins and oxidative lipid and DNA damage in relation to nutrition

Nutrition is a key environmental factor influencing the incidence of chronic age related free radical induced diseases. The better antioxidant status by a sufficient consumption of food commodities with antioxidant compounds helps to minimize oxidative damage, and thus can delay or prevent pathological changes. In three groups of adult apparently healthy non-smoking population of different nutritional habits (93 persons of general population, non-vegetarians, NV; 77 semi-vegetarians, V-S; 64 lacto-ovo-vegetarians, V-LO) plasma concentrations of vitamins B9, C, E and β-carotene, potential prooxidant homocysteine and products of oxidative damage of lipids (total peroxides, malondialdehyde, oxidized LDL) as well as and oxidative DNA damage in lymphocytes (strand breaks, oxidized purines, oxidized pyrimidines) were measured. Vegetarian (V-S, V-LO) vs NV plasma concentrations of vitamin C, vitamin E, lipid standardized vitamin E, β-carotene and vitamin B9 were significantly higher. Plasma total homocysteine values are significantly higher in both vegetarian groups as a consequence of deficient vitamin B12 concentrations. Hyperhomocysteinemia, a marker of systemic or endothelial oxidative stress may promote the production of hydroxyl radicals which are the initiators of lipid oxidation. In spite of 28.5% and 40.6% incidence of hyperhomocysteinemia in V-S and V-LO, the concentrations of total peroxides, malondialdehyde as well as values of oxidized LDL were significantly reduced as a consequence of a better antioxidant status. Parameters of DNA damage as biomarkers of cancer risk in epidemiological studies are significantly reduced in two groups of vegetarians. The findings suggest that dominant consumption of plant food in vegetarians, higher intake of dietary antioxidants and their higher plasma concentrations in comparison to general population may have protective effects against oxidative damage of molecules and a preventive effect on incidence of chronic age related diseases.

Major depressive disorder following terrorist attacks: a systematic review of prevalence, course and correlates.

BackgroundTerrorist attacks are traumatic events that may result in a wide range of psychological disorders for people exposed. This review aimed to systematically assess the current evidence on major depressive disorder (MDD) after terrorist attacks.MethodsA systematic review was performed. Studies included assessed the impact of human-made, intentional, terrorist attacks in direct victims and/or persons in general population and evaluated MDD based on diagnostic criteria.ResultsA total of 567 reports were identified, 11 of which were eligible for this review: 6 carried out with direct victims, 4 with persons in general population, and 1 with victims and general population. The reviewed literature suggests that the risk of MDD ranges between 20 and 30% in direct victims and between 4 and 10% in the general population in the first few months after terrorist attacks. Characteristics that tend to increase risk of MDD after a terrorist attack are female gender, having experienced more stressful situations before or after the attack, peritraumatic reactions during the attack, loss of psychosocial resources, and low social support. The course of MDD after terrorist attacks is less clear due to the scarcity of longitudinal studies.ConclusionsMethodological limitations in the literature of this field are considered and potentially important areas for future research such as the assessment of the course of MDD, the study of correlates of MDD or the comorbidity between MDD and other mental health problems are discussed.

Estudio transversal basado en la población sobre la aceptabilidad de la vacuna y la percepción de la gravedad de la gripe A/H1N1: opinión de la población general y de los profesionales sanitarios

Objectives To determine the intention of general population and health professionals to vaccinate against the H1N1 influenza A virus. To determine the perception of severity of the H1N1 influenza A in both groups compared to that of seasonal influenza. Methods Cross-sectional telephone survey performed to a sample of population (obtained randomly from the Vitoria-Gasteiz telephone directory) and cross-sectional electronically-administered survey to a sample of health professionals from public health centres in Vitoria-Gasteiz, conducted between 6th and 16th November 2009. The relative and absolute frecuency of persons willing to be vaccinated and the proportion of those considering the H1N1 influenza A as a life-threatening risk were calculated in both groups. Results 219 (33%) persons out of 637 contacted telephone numbers answered the questionnaire, as well as 109 health professionals. 63.0% (n=138) of general population and 73.4% (n=80) of the professional group would not undergo vaccination, even if it was for free (p=0.595). If belonging to a high-risk group, the corresponding proportions of unwillingness were 14.6% (n=32) for general population and 40.4 (n=44) for professionals (p<0.001). The proportion of undecided persons is 25.6% (n=56) in general population, against 6.4% (n=7) among the professionals. Conclusions At the beginning of the vaccination campaign, the majority of population is unwilling to undergo immunization against the H1N1 influenza A virus. The proportion in general population is similar to that among the health professionals. However, when belonging to a high-risk group, there is a high proportion of undecided persons in general population.

Blink and masseter inhibitory reflexes in Parkinson's disease

Idiopathic Parkinson's disease (PD) is a chronic, progressive, neurodegenerative disorder with prevalence from 60 to 187 per 100 000 persons in general population. The aim of the study was to determine the abnormalities of the blink reflex (BR) and the masseter inhibitory reflex (MIR) in parkinsonian patients, as indices of the functional status of brainstem neuronal network, and abnormality level dependence on disease progression. The investigation was conducted at the Clinic of Neurology, Clinical Center Nis, comprising a group of 60 subjects of both sexes, suffering from idiopathic Parkinson's disease in I-IV stages, according to the Hoehn and Yahr scale. The control group included 30 healthy subjects of both sexes and corresponding age. Testing of the patients was performed during the "on" phase by registering MIR and BR. Latency of polysynaptic R2 and R2' blink reflex responses and latency of polysynaptic S2 response, as well as a silent period of MIR, are linearly shortened in the subjects with PD, and more expressed in the subsequent stages of the disease compared to the control group. There is a positive correlation between the applied neurophysiological tests results and clinical stage of PD.

Guidelines for Screening of Extracranial Carotid Artery Disease: A Comment

On behalf of the American Society for Neuroimaging Qureshi et al.1 presented guidelines for population wide screening on extracranial carotid artery disease. Their efforts obviously were considerable given the ambitious goals. The aim was to provide comprehensive and timely evidence-based recommendations for screening for asymptomatic carotid artery stenosis in the general population and selected patients groups. We also recognize the emerging “epidemic” of stroke and preceding (asymptomatic) atherosclerotic disease. However, the evidence presented regarding the prevalence of asymptomatic carotid artery stenosis is difficult to interpret because the definition used in the various publications varies markedly. Since, the frequency of carotid artery disease in the general population steadily increases with age, it is very relevant to provide age, ethnicity, and probably gender specific data on the prevalence of asymptomatic carotid stenosis, rather than giving study specific prevalence estimates. Furthermore, although Qureshi et al. present an extensive table on prevalence estimates of asymptomatic carotid artery stenosis, judicious inference remains problematic due to different definitions of carotid artery disease. Muiesen et al.2 and Salonen et al.3 for instance both use carotid intima-media thickness measurements (CIMT) while in other studies a percentage of stenosis was reported. CIMT provides information different from degree of stenosis. Still, the guideline claims that screening in selected groups is warranted, that is, high-risk persons in general population, patients undergoing heart surgery including coronary artery bypass surgery, patients with peripheral artery disease, and various others. As for the relevant treatment options for the condition these also have to be scrutinized. The claims regarding benefits of treatment, again, seem to be based on studies that are not representative in several aspects. The vast majority of studies referred to, are not general population based studies. Inclusion of individuals with hypertension for instance introduces bias when making recommendations for the general population.4 Also, immediate postoperative outcomes as well as long-term outcomes in nonselected populations and, importantly, nonselected surgical centers, continue to be discussed. The proper management of patients with asymptomatic carotid stenosis therefore remains controversial.5 Adequate evidence regarding the prognosis of patients with asymptomatic carotid stenosis and on the prognosis after optimal medical management as well as invasive therapy still seems lacking. Issues such as competing morbidity and mortality have not been taking into account, nor has the balance between costs and effects. Recently, another comprehensive review on the issue appeared.5 Again the importance of stroke and stroke prevention was recognized. However, in view the overall poor long-term survival we need to question the appropriateness of resource intense and ultimately invasive preventive strategies. Particularly, the fact that surgical procedures as well as stenting come at the cost of actual stroke and burden may tip the balance toward less aggressive management.