Telephone Interview Questionnaire Research Articles

Investigating the associations between personality functioning, cognitive biases, and (non-)perceptive clinical high-risk symptoms of psychosis in the community.

Beyond psychosis prediction, clinical high-risk (CHR-P) symptoms show clinical relevance by their association with functional impairments and psychopathology, including personality pathology. Impaired personality functioning is prioritized in recent dimensional personality disorder models (DSM-5, ICD-11), yet underexplored in CHR-P, as are associations with cognitive biases, which early studies indicate as possibly linking CHR-P-symptoms and personality pathology. A community sample (N=444, 17-60years, 61.8% female) was assessed via clinical telephone interview and online questionnaires. Using zero-inflated Poisson models, we explored associations of personality functioning, cognitive biases, current psychopathology, and psychosocial functioning with likelihood and severity of overall CHR-P, as well as perceptive (per-) and non-perceptive (nonper-)CHR-P-symptoms distinctly. Higher nonper-CHR-P-symptom likelihood was associated with more impaired personality functioning and psychosocial functioning, while more severe cognitive biases were associated with higher CHR-P- and per-CHR-P-symptom likelihood, alongside higher CHR-P- and nonper-CHR-P-symptom severity. Further, more axis-I diagnoses were linked to higher CHR-P-, per-CHR-P-, and nonper-CHR-P-symptom likelihood, and younger age to higher CHR-P- and per-CHR-P-symptom severity, with CHR-P-symptom severity appearing higher in females. In an exploratory analysis, personality functioning elements identity and self-direction, and cognitive biases dichotomous thinking, emotional reasoning, and catastrophizing, respectively, showed multifaceted associations with nonper-CHR-P-symptom likelihood and overall CHR-P-symptom expression. Our study supports the association of CHR-P-symptoms with multiple mental health factors. Findings suggest intricate associations between personality functioning impairments and cognitive biases with CHR-P-symptom expression in non-help-seeking populations, possibly contributing to different per-CHR-P- and nonper-CHR-P-symptom expression patterns. Therefore, they should be targeted in future longitudinal studies, aiming at better understanding CHR-P-manifestations to inform preventive intervention.

Comparison of DN4 and DN4 Interview Tests in the Identification of Neuropathic Pain after Fracture Surgery.

Objective: This study aimed to compare results obtained with the DN4 (in-person interview) and DN4i (telephone interview) questionnaires in identifying neuropathic pain after fracture surgery. Methods: This study was methodological, using questionnaires administered in person (DN4) or via telephone (DN4i). The participants were at least 18 years old, underwent fracture surgery at a university hospital between January 2017 and July 2020, signed the Informed Consent Form (ICF), and could go to the Orthopedics and Traumatology Hospital. Pearson's correlation coefficient determined the agreement between the total score obtained during in-person and telephone interviews. The kappa coefficient evaluated the agreement between individual questionnaire items. Results: Of the 53 participants, 50 presented the same result for neuropathic pain screening in DN4 and DN4i, including 41 with a positive score for neuropathic pain and 12 with a negative score. The Pearson's correlation coefficient and kappa coefficient were r = 0.84. Conclusion: DN4 and DN4i presented a strong agreement between individual items of the questionnaires and the total scores obtained.

A deep learning method for intelligent decision-making in enterprise management based on the Internet of Things

With the development and progress of various sensors, the Internet of Things technology has continued to penetrate into people’s lives. Successful application cases of the Internet of Things technology have been seen in various industries. Some scholars have begun to try to apply the Internet of Things technology to the management of various industries. Deep learning technology belongs to the category of artificial intelligence technology. Its main goal is to combine a large number of training samples to train the trained object into an object that can learn sample patterns independently. At present, deep learning has a large number of applications in various intelligent operations and key intelligent recognition fields. Due to the characteristics of its learnable training set, deep learning techniques are often used in the direction of decision analysis. The research adopts a combination of questionnaire survey and modeling analysis to explore the construction of in-depth learning methods for enterprise management intelligent decision-making in the context of the Internet of Things. The research was conducted by telephone interview and online questionnaire, and was supported by nearly 100 technical backbone personnel from 25 large enterprises. The research finds that applying the Internet of Things and deep learning technology to enterprise intelligent management decisions can improve the decision-making accuracy of enterprises, and also provide enterprises with more significant decision-making analysis advantages in the industry competition. This paper first describes the concepts of the Internet of Things, deep learning and intelligent decision-making of enterprise management. Then, in order to sort out the problems existing in the current intelligent decision-making of enterprise management, the author conducted interviews and questionnaires. Through the analysis of the questionnaire data, he found the problems existing in the current intelligent decision-making of enterprise management. Finally, he designed a new strategy of intelligent decision-making of enterprise management based on the Internet of Things and deep learning technology, through the simulation and subsequent investigation and analysis of the newly designed strategy. It is found that the enterprise management intelligent decision-making method designed by combining the Internet of Things and deep learning technology is superior to the traditional enterprise decision-making method in all aspects. The design of the system has been reformed mainly from the aspects of human resource management, digital file management and real-time monitoring of production and operation, so that the popularity of the enterprise’s comprehensive information management has reached 84.2%, the efficiency of intelligent decision-making increased by 28.7% on average. The achievements of the research not only prove the role of IoT technology in promoting enterprises’ in-depth learning, but also put forward new ideas for enterprises’ scientific decision-making.

Prognosis of traumatic spinal cord injury in children: Follow-up of 86 patients

The long-term situation of children with spinal cord injury (SCI) was investigated, and suggestions for helping them better return to the society were provided. SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed. Information including motor function, complications, characteristic changes, self-care abilities, school attendance and social participation were collected by telephone interview and electronic questionnaire. All the answers were statistically analyzed. A total of 86 cases were enrolled, 77 girls and 9 boys, with a median injury age of 6 years and 2 months. The follow-up time was 3-130 months. The main cause of trauma in these children was sport injury (66.3%), the thoracic spinal cord was involved the most (91.9%), and complete SCIs accounted for the majority (76.7%). In terms of complications, children with complete SCIs were more likely to have urinary incontinence, constipation and characteristic changes (p<0.05); whereas the incomplete SCIs often have spasticity (p<0.05). As to the daily living abilities, children with incomplete lumbar SCIs were more capable to accomplish personal hygiene, transfer, and bathing independently than those with complete injuries, or cervical/thoracic SCIs, respectively (p<0.05). Moreover, children older than 9 years care more able to dress and transfer independently than the youngers (p<0.05). Wheelchair users accounted for 84.9% and more than half of them were able to propel wheelchair independently, and those who move passively in wheelchairs were mostly introverted kids (p<0.05). Almost all (93.8%) children with incomplete injuries were able to walk independently. Most (79.1%) children continued to attending school, and 41.9% participated in interest classes. Unfortunately, 67.4% of the children spent less time playing with their peers than before the injury. SCIs impair physical structures and function of children, affect their independence in daily living, and restrict school attendance and social interaction. Comprehensive rehabilitation after injury is a systematic work. Medical staff and caregivers should not only pay attention to neurological function, but also help them improve self-care abilities. It is also important to balance rehabilitation training and school work and social participation.

Incident Cytopenia in a National Cohort Study: The Reasons for Geographic and Racial Differences in Stroke

Abstract INTRODUCTION: Cytopenia, defined as low counts in 2 or more blood cell lines is commonly associated with nutritional deficiencies, medications and chronic inflammation. In some individuals, cytopenia may reflect a pre-malignant condition or precursor of hematologic cancer. We recently demonstrated that cytopenia is associated with increased risk of mortality and was predictive of stroke risk in Black individuals (Blacks). In the current study, we sought to determine the sociodemographic and clinical characteristics associated with incident cytopenia in a large biracial prospective study, REasons for Geographic and Racial Differences in Stroke (REGARDS). METHODS: The REGARDS study recruited 30,239 Black and White individuals ≥45 years in the United States (US) between 2003 and 2007 (44% Black, ~50% females, 56% living in the southeast US). Socio-demographics and medical history were obtained by telephone interview and self-administered questionnaires, and laboratory studies (including complete blood count [CBC]) from an in-home visit at baseline and at a 10 year follow up visit. Cytopenia was defined as presence of 2 or more of the following: i) Hemoglobin in age-, sex-, and race-specific ≤5th percentile; ii) White cell count in race-specific ≤5th percentile; iii) Platelet count in ≤5th percentile, and iv) Macrocytosis (mean corpuscular volume [MCV] &amp;gt;98fL), due to known differences in CBC based on these demographic characteristics. We excluded participants without CBC at study enrollment and at the 2nd follow up visit, those who had cytopenia at baseline or died before the 10 year follow up visit, yielding an analytic sample of 8,081 participants. Baseline characteristics of those with or without incident cytopenia were tabulated and compared using Chi-Square tests or t-tests. Multivariable logistic regression using a purposeful selection algorithm was performed to identify factors independently associated with incident cytopenia. RESULTS: Incident cytopenia occurred in 213 of 8,081 (2.6%) participants, with the highest incidence in White men ≥65 years (4.6%) and the lowest incidence in Black women &amp;lt;65 years (1.0%). Baseline factors univariately associated with cytopenia are shown in Table 1. The purposeful selection algorithm yielded a multivariable model including the following factors associated with incident cytopenia: older age, male sex, White race, heavy alcohol intake, coronary heart disease, abnormal blood counts at baseline visit including lower white count, lower platelet count, lower hemoglobin and high MCV (all p&amp;lt;0.05) (Table 2). The area under the receiver operating characteristic curve for this model was 0.81. CONCLUSION: In this large biracial cohort, the incidence of cytopenia was 2.6% over 10 years. Adjusting for baseline blood counts, risk factors for cytopenia included older age, male sex, White race, heavy alcohol intake and coronary heart disease. Baseline blood counts were also important predictors. This study provides valuable insights into the pattern of abnormal blood counts and the sociodemographic and clinical characteristics associated with incident cytopenia. Research is ongoing to define the cause(s) of cytopenia including the role of clonal mutations in the peripheral blood of this population. Figure 1 Figure 1. Disclosures Gangaraju: Alexion: Consultancy; Sanofi Genzyme: Consultancy.

The Effectiveness of Stroke Riskometer™ in Improving Stroke Risk Awareness in Malaysia: A Study Protocol of a Cluster-Randomized Controlled Trial

Background: Stroke is considered the second leading cause of mortality and disability worldwide. The increasing burden of stroke is strong evidence that currently used primary prevention strategies are not sufficiently effective. The Stroke Riskometer^™ application (app) represents a new stroke prevention strategy distinctly different from the conventional high-cardiovascular disease risk approach. Objective: This proposed study aims to evaluate the effectiveness of the Stroke Riskometer^™ app in improving stroke awareness and stroke risk probability amongst the adult population in Malaysia. Methods: A non-blinded, parallel-group cluster-randomized controlled trial with a 1:1 allocation ratio will be implemented in Kelantan, Malaysia. Two groups with a sample size of 66 in each group will be recruited. The intervention group will be equipped with the Stroke Riskometer^™ app and informational leaflets, while the control group will be provided with standard management, including information leaflets only. The Stroke Riskometer^™ app was developed according to the self-management model of chronic diseases based on self-regulation and social cognitive theories. Data collection will be conducted at baseline and on the third week, sixth week, and sixth month follow-up via telephone interview or online questionnaire survey. The primary outcome measure is stroke risk awareness, including the domains of knowledge, perception, and intention to change. The secondary outcome measure is stroke risk probability within 5 and 10 years adjusted to each participant’s socio-demographic and/or socio-economic status. An intention-to-treat approach will be used to evaluate these measures. Pearson’s χ² or independent t test will be used to examine differences between the intervention and control groups. The generalized estimating equation and the linear mixed-effects model will be employed to test the overall effectiveness of the intervention. Conclusion: This study will evaluate the effect of Stroke Riskometer^™ app on stroke awareness and stroke probability and briefly evaluate participant engagement to a pre-specified trial protocol. The findings from this will inform physicians and public health professionals of the benefit of mobile technology intervention and encourage more active mobile phone-based disease prevention apps. Trial Registration: ClinicalTrials.gov Identifier NCT04529681.

Effect of method of administration on the oral health\u2013related quality of life assessment using the Early Childhood Oral Health Impact Scale (ECOHIS-G)

ObjectivesThe influence of the administration method used to collect oral health–related quality of life (OHRQoL) in children remains largely unknown. The aim of this study was to determine whether the OHRQoL information obtained using the Early Childhood Oral Health Impact Scale (ECOHIS) differed with different methods of data collection (face-to-face interview, telephone, or self-administered questionnaire).Materials and methodsThe OHRQoL of 38 preschool children, aged 1 to 5 years, was measured using the German version of the ECOHIS. The instrument was administered to the caregivers of these children using three different methods, with an interval of 1 week between each administration. Test-retest reliability for the repeated ECOHIS-G assessments across the three methods of administration, agreement, and convergent validity was determined.ResultsKappa coefficients for agreement between two different methods of administration, respectively, ranged from moderate to substantial (0.47 to 0.65). Test-retest reliability was moderate (ICC 0.65–0.79).ConclusionIn conclusion, the three methods of administration (face-to-face interview, telephone interview, or self-administered questionnaire) of the ECOHIS-G were comparable in 1- to 5-year-old preschool children.Clinical relevanceAll three methods of administration can be used to obtain valid and reliable OHRQoL information in German speaking countries.

Classifying potential users of live chat services and chatbots

Live chat services and chatbot functionalities are experiencing significant growth within companies in the financial sector and growing consumer interest. But which consumers (segments) are more or less interested in these tools? Companies with an online presence would be well advised to profile potential users of these two important tools. This study seeks to classify potential users of live chat services and chatbots. A telephone interview questionnaire is administered to 342 panelists of a recognized Canadian research firm. A two-step cluster analysis is used to reveal natural groupings in the data set. Research conducted identifies four distinct segments, namely Women divided interest, Men partially interested, Age 35–44 partially interested and Older disinterested. This study brings to the fore information essential to the development of effective marketing strategies for reaching the different segments [e.g. develop and evidence an online end-to-end purchasing process for segment (1); provide good Web visibility for segment (2); ensure the presence of competitive offers and Web comparators for segment (3); and, pursue a more traditional approach for segment (4)]. This study represents the first ever classification of individuals based on their interest in emerging services (live chat services and chatbots).

Association of the Mediterranean Diet With Onset of Diabetes in the Women’s Health Study

Higher Mediterranean diet (MED) intake has been associated with reduced risk of type 2 diabetes, but underlying biological mechanisms are unclear. To characterize the relative contribution of conventional and novel biomarkers in MED-associated type 2 diabetes risk reduction in a US population. This cohort study was conducted among 25 317 apparently healthy women. The participants with missing information regarding all traditional and novel metabolic biomarkers or those with baseline diabetes were excluded. Participants were invited for baseline assessment between September 1992 and May 1995. Data were collected from November 1992 to December 2017 and analyzed from December 2018 to December 2019. MED intake score (range, 0 to 9) was computed from self-reported dietary intake, representing adherence to Mediterranean diet intake. Incident cases of type 2 diabetes, identified through annual questionnaires; reported cases were confirmed by either telephone interview or supplemental questionnaire. Proportion of reduced risk of type 2 diabetes explained by clinical risk factors and a panel of 40 biomarkers that represent different physiological pathways was estimated. The mean (SD) age of the 25 317 female participants was 52.9 (9.9) years, and they were followed up for a mean (SD) of 19.8 (5.8) years. Higher baseline MED intake (score ≥6 vs ≤3) was associated with as much as a 30% lower type 2 diabetes risk (age-adjusted and energy-adjusted hazard ratio, 0.70; 95% CI, 0.62-0.79; when regression models were additionally adjusted with body mass index [BMI]: hazard ratio, 0.85; 95% CI, 0.76-0.96). Biomarkers of insulin resistance made the largest contribution to lower risk (accounting for 65.5% of the MED-type 2 diabetes association), followed by BMI (55.5%), high-density lipoprotein measures (53.0%), and inflammation (52.5%), with lesser contributions from branched-chain amino acids (34.5%), very low-density lipoprotein measures (32.0%), low-density lipoprotein measures (31.0%), blood pressure (29.0%), and apolipoproteins (23.5%), and minimal contribution (≤2%) from hemoglobin A1c. In post hoc subgroup analyses, the inverse association of MED diet with type 2 diabetes was seen only among women who had BMI of at least 25 at baseline but not those who had BMI of less than 25 (eg, women with BMI <25, age- and energy-adjusted HR for MED score ≥6 vs ≤3, 1.01; 95% CI, 0.77-1.33; P for trend = .92; women with BMI ≥25: HR, 0.76; 95% CI, 0.67-0.87; P for trend < .001). In this cohort study, higher MED intake scores were associated with a 30% relative risk reduction in type 2 diabetes during a 20-year period, which could be explained in large part by biomarkers of insulin resistance, BMI, lipoprotein metabolism, and inflammation.

Impact of Mesh and Fixation on Chronic Inguinal Pain in Lichtenstein Hernia Repair: 5-Year Outcomes from the Finn Mesh Study

ObjectiveTo find out the mesh fixation technique that minimises chronic pain in Lichtenstein hernioplasty.Summary background dataMesh fixation may affect chronic pain and recurrence after inguinal hernia surgery, but long-term results of comparative trials are lacking.MethodsLichtenstein hernioplasty was performed under local anaesthesia on 625 patients in day care units. The patients were randomised to receive either a cyanoacrylate glue (n = 216), self-gripping mesh (n = 202) or non-absorbable 3–0 polypropylene sutures (n = 216) for the fixation of mesh. A standardised telephone interview or postal questionnaire was conducted 5 years after the index operation. The patients with complaints suggesting recurrence or chronic pain (visual analogue scale ≥ 3, 0–10) were examined clinically. The rate of occasional pain, chronic severe pain, recurrence, re-operations, daily use of analgesics, overall patient satisfaction and sensation of a foreign object were recorded.ResultsA total of 82% of patients (n = 514) completed the 5-year audit including 177, 167 and 170 patients in the glue, self-fixation and suture groups, respectively. There were no significant differences in the incidence of pain (7–8%), operated recurrences (2–4%), overall re-operations (4–5%), need for analgesics (1–2%), patient’s satisfaction (93–97%) or in the feeling of a foreign object (11–18%) between the study groups.ConclusionThe choice of the mesh or fixation method had no effect on the overall long-term outcome, pain or recurrence of hernia. Less penetrating fixation (glue or self-gripping mesh) is a safe option for the fixation of mesh in Lichtenstein hernia repair.

Perception of patients regarding telemedicine at times of COVID-19: Did they miss the personal touch?

260 Background: The patient-oncologist relationship is cultivated from the first clinic visit, trust and assurance established throughout the follow up period until the end of life. In March 2020, with the break of the COVID-19 pandemic, social distancing restrictions were implement throughout Israel. The adoptions of telemedicine services were incorporate as a response at our institution. Almost all ambulatory activity in the oncology division in Tel Aviv Medical Center was converted to telemedicine services. Several studies report favorable results regarding patient preference and cost effectiveness of telemedicine. Methods: We conducted a telephone interview questionnaire assessing patient satisfaction. Inclusion criteria included solid tumor patients over 18 years who utilized the telemedicine platform at Tel Aviv Sourasky Medical Center between March 2020 - May 2020. We aimed to evaluate patient's perspectives and preferences regarding telemedicine and assess whether this virtual communication affects the patient-doctor relationship. Results: Following the COVID-19 outbreak, 400 telephone calls were made to patients, 100 patients agreed to participate and surveyed. Fifty-two percent were female. The majority of patients independently downloaded the telemedicine application and did not encounter technical constraints (67%). Family members and friend attended 45% of telemedicine visits. Patients cancer diagnosis included colorectal cancer (47%), breast cancer (18%), genitourinary cancer (18%), sarcoma (9%) lung malignancies (6%), gynecological cancer (1%) and CNS tumors (2%). Visit intent included post-treatment follow up (40%), active treatment follow (53%), and first visit intake (7%). The majority of patients felt their emotional needs were met (88%) and felt that their treatment was not harmed due to absence of a physical visit (84%). Almost all patients (99%) felt their privacy was maintained. Ninety-five percent of patients affirmed that the virtual visit relieved their worries regarding treatment interruption. Importantly, 75% of patients affirmed their interest to continue telemedicine regardless of COVID-19 pandemic. Conclusions: Telemedicine is an acceptable platform that may replace follow up visits without comprising patients’ experience. Our data call for research and development of tools enabling long-term implementation of remote telemedicine and assess the patient-physician relationship and quality of care among oncology patients.

Towards a harmonised approach to Carbapenemase-producing Enterobacteriaceae (CPE) screening and patient management in North East and Cumbria hospitals

In mid-2018, a Carbapenemase-producing Enterobacteriaceae (CPE) cluster was investigated in the North East of England, in which transmission had occurred across several hospital trusts. We undertook a survey of current CPE detection and management practices in North East and Cumbria (NEC) trusts to inform a harmonised approach that could be adopted across the region. A semi-structured survey was carried out with one consultant microbiologist per trust by telephone interview (n=6) or electronic questionnaire (n=3) to determine CPE screening procedures, laboratory techniques and patient management practices. Screening policies were in place in all trusts, including screening protocols for patients previously admitted outside of the UK or those known to be CPE positive, in accordance with PHE guidelines. Policies for screening patients who had been admitted to other UK hospitals varied across trusts, as did laboratory methods used. Over 80% of trusts communicated CPE status to patients and contacts by information leaflet. However, there was no uniform way of communicating CPE status to social care settings, GPs and other hospital trusts in the event of discharge or inter-hospital transfer. The results of the survey suggest improvements could be made to the way information on patient CPE status is shared to ensure that the risk of transmission is reduced. This includes improved communication with residential settings, primary care and other hospital trusts in the event of a discharge or inter-hospital transfer. In addition, this work will inform further discussions across NEC towards developing a single regional Infection Prevention and control strategy for CPE.

Patient reporting of complications after surgery: what impact does documenting postoperative problems from the perspective of the patient using telephone interview and postal questionnaires have on the identification of complications after surgery?

ObjectivesTo identify the frequency of postoperative complications, including problems identified by patients and complications occurring after discharge from hospital. To identify how these impact on quality of life (QoL) and...

The impact of keratoconus treatment with the Athens Protocol (partial topography-guided photorefractive keratectomy combined with higher-fluence corneal collagen cross-linking) on quality of life: a long-term study.

PurposeThe aim of this study was to evaluate the health-related quality of life (HRQoL) before and after the management of keratoconus (KCN) with Combined Topography-Guided Transepithelial partial photorefractive keratectomy (PRK) and corneal Cross-Linking: the Athens Protocol.Patients and methodsThirty-four consecutive patients treated for progressive KCN were selected for retrospective telephone interview and individual questionnaire submission. A disease-specific HRQoL questionnaire was administered before and after the Athens Protocol intervention, using the following administrative questionnaires: National Eye Institute Visual Function Questionnaire (NEI VFQ) 25/39 and IVI-28. The disease grade was ranked according to the Amsler–Krumeich classification (KCN severity). Reliability of collected data was evaluated with Cronbach’s α test.ResultsPatients’ age ranged from 15 to 51 years at the time of the operation. Mean time before the operation during which the questionnaires were administered was 52±6 months. General visual acuity, psychological well-being, and driving ability showed significant improvement. Younger keratoconic patients tend to have more enhanced psychological status and to cope better with difficulties in everyday activities (prior to operation) than older patients.ConclusionThe Athens Protocol treatment has been proven to be beneficial to patients in a large number of aspects.

Validated repeatability of patient-reported outcome measures following primary total hip replacement: a mode of delivery comparison study with randomized sequencing

Background and purpose — Patient-reported outcome measures (PROMs) are used to understand better the outcomes after total hip replacement (THR). These are administered in different settings using a variety of methods. We investigated whether the mode of delivery of commonly used PROMs affects the reported scores, 1 year after THR.Patients and methods — A prospective test–retest mode comparison study with randomized sequence was done in 66 patients who had undergone primary THR. PROMs were administered by 4 modes: self-administration, face-to-face interview, telephone interview, and postal questionnaire. PROMs included: Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Hip Score (OHS), EQ5D-3L (EQ5D), and Self-Administered Patient Satisfaction Scale (SAPS). Linear regression was used to estimate relationships between the mean scores for PROMs by mode. Individual paired differences by mode were calculated, relationships between modes were identified, and results adjusted by time delay and participant age.Results — There was no statistically significant difference between the mean PROM scores recorded for each mode of delivery for each score. Statistically significant differences in the individual paired differences were detected between modes for the WOMAC stiffness subscale, OHS, EQ5D, and SAPS. OHS difference in individual paired means between face-to-face and telephone interview exceeded the minimal clinically important difference.Interpretation — PROMs mode of administration can affect the recorded results. Modes should not be mixed and may not be comparable between studies. It should not be assumed that different modes will obtain the same results and where not already established this should be checked by researchers before use.

Objectively measured physical activity in population-representative parent-child pairs: parental modelling matters and is context-specific

BackgroundEvidence for the context-specific influence of parental modelling on physical activity (PA) in childhood remains inconclusive. This nationwide Swiss study assessed the cross-sectional association between objectively measured PA of parents and their children and whether it varied across different levels of sociodemographic and environmental factors. In a second step a structural equation-model (SEM) was used to assess, whether associations between children’s PA and sociodemographic and environmental factors are mediated by the parental PA behaviour.MethodsThe population-based sample of the SOPHYA-study consisted of 889 children aged 6 to 16 years living in Switzerland and 1059 parents. PA was measured using accelerometers. Information on sociodemographics, sports behaviour, family characteristics, and perceived environment was obtained by telephone interview and parental questionnaire. Objective environmental data was allocated to each family’s residential address using GIS (geographic information system). A structural equation model tested these factors for both independent associations with children’s PA and associations mediated through the parental PA behaviour.ResultsParental moderate to vigorous physical activity (MVPA) was associated with MVPA of their children in general (p < 0.001). Correlations between parents’ and children’s MVPA were stronger for children aged 10–12 years and for those living in the Italian speaking part of Switzerland. An increase of 1 min of mother’s and of father’s MVPA was associated with 0.24 and 0.21 min more MVPA in children, respectively. Father’s PA was associated with that of their sons, but not with that of their daughters, whereas the association of mothers’ and children’s PA did not depend on the parent-offspring sex-match. The pathway analysis in our structural equation model showed direct effects on children’s MVPA as well as indirect effects mediated by the parental PA behaviour.ConclusionsParental modelling seems relevant for children’s PA, but not to the same degree in all children. Interventions focusing on strengthening parental PA behaviour for the promotion of PA in the young must consider additional contextual factors related to the socio-cultural and structural environment.

Spiritual coping, perceived growth, and the moderating role of spiritual mindfulness in cancer survivors

ABSTRACTPurpose: This study examined the moderating role of spiritual mindfulness on the association between spiritual coping and perceived growth in individuals with and without current treatment for cancer. Design/Sample: Adults with a cancer history (N = 534) from the Midlife in the United States study completed a telephone interview and self-administered questionnaires. Methods/Findings: Moderated regression analyses, controlled for age and educational attainment, showed that mindfulness moderated the effect of spiritual coping on personal growth and on positive reinterpretation. High mindfulness amplified the effect of spiritual coping on both personal growth and positive reinterpretation. Further, this moderating effect was significantly different for adults with versus without current treatment for cancer for positive reinterpretation but not for personal growth. Conclusions/Implications: These findings highlight the potential amplifying effect of spiritual mindfulness on the effect of spiritual coping on perceived growth in cancer survivors.

Care for Acute Otitis Media in Children by General Practitioners in North Benin in 2017

Introduction: Acute otitis media (AOM) is a common childhood infection, subject to a wrongful prescription of antibiotics. The objective of this work was to evaluate the practices of general practitioners of North-Benin, in term of caring AOM in children. Methods: This was a cross-sectional, descriptive survey based on a telephone interview questionnaire with 112 general practitioners working in North Benin in 2017. The collected data were analyzed using EpiData Analysis and Open Epi software. The Khi2 test was used for comparisons. The significance threshold adopted was 0.05. Results: Of the 145 general practitioners listed, 112 participated in the survey for a participation rate of 77.2%. The mean age was 32 ± 6 years with a sex ratio of 4.04 and the median duration of seniority in the medical practice was 4 years with extremes of 1 and 32 years. Three main clinical signs suggestive of the diagnosis were, according to the respondents, otalgia (107; 95.5%), otorrhea (86; 76.8%) and fever (77; 68.8%). Tympanum inflammation and middle ear effusion association was considered as a diagnostic criterium by 17.9% of doctors. Therapeutic recommendations were known by 15 doctors (13.4%). Systematic antibiotic therapy was advocated by 86 doctors (76.8%). The main reasons for systematic antibiotics were the frequent use of antibiotics by parents in the self-medication (63 cases or 74.4%), the difficulty of following up the child (55 cases or 64 per cent) and the fear of the locoregional or systemic spread of infection (40 cases or 46.5%). The amoxicillin-clavulanic acid combination was prescribed as first-line by 68 respondents (62.4%). Forty doctors (36.7%) prescribed third-generation cephalosporins as second-line therapy. Systemic rhinopharyngeal disinfection was performed by 23 doctors (20.5%). In case of therapeutic failure, the opinion of an ENT doctor was requested by 66 general practitioners or 58.9% of the cases. Conclusion: It is necessary that Beninese medical companies develop national recommendations for managing the acute otitis media and ensure their diffusion through continuous medical training.

Association of Musculoskeletal Joint Pain With Obstructive Sleep Apnea, Daytime Sleepiness, and Poor Sleep Quality in Men.

To investigate the association of musculoskeletal pain with objectively determined obstructive sleep apnea (OSA) and subjective sleep measures in a population-based sample. Participants were community-dwelling men (n = 360) age ≥35 years from the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study. Shoulder, back, hip, knee, hand, and foot pain were assessed by computer-assisted telephone interview or self-completed questionnaire. OSA was determined with full in-home unattended polysomnography (Embletta X100) scored by 2007 American Academy of Sleep Medicine alternative criteria. The Epworth Sleepiness Scale assessed daytime sleepiness and the Pittsburgh Sleep Quality Index assessed sleep quality. OSA was not associated with the presence of any joint pain (adjusted odds ratio [OR] 1.03 [95% confidence interval (95% CI) 0.61-1.76]). There was no association between OSA and pain in any specific joint (shoulder, back, hip, knee, hand, or foot), nor was the number of joints in pain associated with OSA. There was, similarly, no association between pain variables and excessive daytime sleepiness, except for hand pain (OR 3.10 [95% CI 1.50-6.39]). However, pain was associated with poor sleep quality: any pain (OR 2.19 [95% CI 1.25-3.82]), shoulder pain (OR 2.16 [95% CI 1.25-3.75]), back pain (OR 2.24 [95% CI 1.41-3.55]), and foot pain (OR 2.47 [95% CI 1.43-4.26]). The number of painful joints was also associated with poor sleep quality (5-6 joints versus no joints OR 7.34 [95% CI 2.30-23.42]). No association between OSA and pain or between daytime sleepiness and pain was found. Consistent with previous reports, poor sleep quality was associated with musculoskeletal pain in this population sample. The etiologic differences between OSA-related sleep disruption and poor subjective sleep quality require further investigation.

Hormone Contraception before the First Birth and Ovarian Cancer Risk

Abstract Introduction: Combined oral contraceptive (OC) use strongly and consistently reduces the risk for epithelial ovarian cancer (EOC); longer durations of use and more recent use are associated with the strongest reductions in risk. However, it is unknown if exclusive OC use before the first birth is associated with a reduction in EOC risk many years later. Therefore, we investigated the risk for EOC among parous women associated with exclusive OC use before the first birth. Methods: From a population-based case-control study in Alberta and British Columbia, Canada, 2001–2011, we included 1144 invasive EOC cases and 2513 controls who were &amp;gt;40 years at diagnosis/reference date. Participants reported OC use and all pregnancies via a telephone interview or self-administered questionnaire (in the early years of the study). Duration of OC use was evaluated as a continuous variable and by categories: non-users (never use or &amp;lt;6 months of use), &amp;lt;5, 5–&amp;lt;10, &amp;gt;10 years, unknown. Using logistic regression, we estimated adjusted odds ratios (aORs) and 95% confidence intervals (CI), controlling for study site, age, parity, breastfeeding, first degree family history of breast/ovarian cancer, tubal ligation, and BMI. Results: OC use at any time during reproductive life was associated with a 42% reduced risk for EOC relative to non-users (aOR = 0.58, 95% CI, 0.49–0.69). Among parous women, each additional year of exclusive OC use before the first birth conferred an 11% risk reduction relative to non-users (aOR = 0.89 95% CI, 0.86–0.94, linear trend p-value &amp;lt;0.01). Results were similar when we restricted to cases with high grade serous cancers (aOR = 0.90 95% CI, 0.84–0.95, linear trend p-value &amp;lt;0.01) and for cases with endometrioid/clear cell cancer (aOR 0.88 95% CI, 0.80–0.95, linear trend p-value &amp;lt; 0.01). Discussion: Among parous women, exclusive use of OCs before the first birth was associated with a strong reduction in EOC risk many years later. Because OCs stop ovulation, this reduced risk may be due to a reduction in lifetime ovulatory cycles. However, it is also possible that OC use at younger ages, before the first birth, represents a window of opportunity to have a substantial impact on reducing risk that remains for many years, informing possible prevention strategies.