Total Population Study Research Articles

Assessment of burnout amongst resident doctors in Benin City, Edo State, Nigeria.

Burnout amongst healthcare professionals has gained significant attention over the last few decades. As a result of the intense demand from the work environment, clinicians are susceptible to developing burnout beyond the usual workplace stress. Residency training, in particular, can cause significant degree of burnout. The aim was to determine the prevalence and pattern of burnout amongst resident doctors in Benin City. This study utilised a descriptive, cross-sectional study design. A total population study was carried out amongst resident doctors in Benin City. The tool for data collection was a pretested Maslach Burnout Inventory Questionnaire-Human Services Survey for Medical Personnel. Data were analysed with IBM SPSS version 22.0 software. The level of significance was set at P < 0.05. A total of 448 resident doctors with a mean age (standard deviation) of 33.9 ± 0.4 years participated in this study. A higher proportion (279, 62.3%) of the respondents were males. A total of 267 (59.6%) respondents suffered emotional exhaustion (EE), while depersonalisation and reduced personal accomplishments were suffered amongst 211 (47.1%) and 153 (34.2%), respectively. The overall prevalence of burnout was 41.7%. Long duration of call hours (P < 0.001) and speciality (P = 0.039) were found to be significantly associated with burnout. Burnout was prevalent amongst resident doctors in Benin City. EE was the most reported type. There is a need for relevant stakeholders to re-structure the residency programme by reducing the duration of call hours and increasing the number of resident doctors on call per shift to further address modifiable risks amongst the would-be specialists.

Descriptive Assessment of Medical Outreach Services, Benefits and Factors Influencing Success of Outreach Program in Rural Communities of Enugu State

Medical outreach services is evidence based strategy aimed to improve universal access to healthcare of underserved or rural populations. This study is aimed to describe the healthcare services delivered during medical outreach, benefits and the factors influencing the success of outreach program in a rural low resource country. The study was a community based descriptive cross sectional study of 660 adult participant in Enugu State with health complains within the services of an ongoing medical outreach. A two - stage sampling technique was used to select the communities where a total population study was done. A mobile fixed method of outreach was used and data collected were analyzed using proportions and chi – square. About half, 52.5% of participants received promotive services as a gateway to the outreach services. One quarter (27.4%) of adults screened was positive for malaria parasite. The prevalence of HIV (1.8%), diabetes (4.1%), hypertension (45.6%), overweight (27.0%) and obesity (10.9%) were within the national levels. As many as 86.1% received treatment for common illnesses. The commonest factors for success of the outreach were free services, presence of doctors, nurses and drugs, nearness of communities and influence of community leaders of which free services was associated with uptake of services. Medical outreach services mirrors primary healthcare services and when standardized for actors and players willing to use it for cooperate social responsibilities, it will serve as a useful tool for universal health access.

Gender-Affirming Surgery Linked to Positive MH Outcomes Over Time

Gender-Affirming Surgery Linked to Positive MH Outcomes Over Time

Reduction in mental health treatment utilization among transgender individuals after gender-affirming surgeries: A total population study

Abstract Background Despite professional recommendations to consider gender-affirming hormonal and surgical interventions for transgender individuals with gender dysphoria, the long-term effect of such interventions on mental health is largely unknown. This study aims to ascertain the prevalence of mood and anxiety disorder healthcare visits and antidepressant and anxiolytic prescriptions in 2015 as a function of gender dysphoria diagnosis and gender-affirming medical treatment in the entire Swedish population. Methods This study used the Swedish Total Population Register (n = 9,747,324), linked to the National Patient Register and Prescribed Drug Register. Among those who received a gender dysphoria diagnosis between 2005 and 2015 (n = 2,679), mental health treatment in 2015 was examined as a function of length of time since gender-affirming medical treatment. The main outcome measure was mood and anxiety disorder healthcare visits and antidepressant and anxiolytic prescriptions. Results Compared to the general population, individuals diagnosed with gender dysphoria were about six times as likely to have had a mood and anxiety disorder healthcare visit and more than three times as likely to have been prescribed antidepressants and anxiolytics. Years since initiating hormones was not significantly related to likelihood of mental health treatment (AOR: 1.01; 95% CI: 0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (AOR: 0.92; 95% CI: 0.87, 0.98). Conclusions In this first total population study of transgender individuals diagnosed with gender dysphoria, the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them. Main messages: This study lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.

Hubungan antara Perilaku Prososial dan Psychological Well-Being pada Remaja Awal

This research has a goal to know the relationship between prosocial behavior and psychological well-being on early adolescence. This research is using correlational design. Population and sample are junior high school X’s students in Surabaya. The sampling technique uses total population study. There are 153 samples in this research. Data collection uses a scale consisting of a scale of prosocial behavior and psychological well-being scale. The scale of prosocial behavior is adapted from the scale developed by Caprara and Steca (2007), while scale of psychological well-being adapted from the scale developed by Ryff (1989). Pearson Product Moment correlation test results showed that there was a positive correlation between prosocial behavior and psychological well-being in early adolescence (r = 0,299; p &lt;0,05). The more early adolescence perform prosocial behavior the better their psychological well-being.

Reduction in Mental Health Treatment Utilization Among Transgender Individuals After Gender-Affirming Surgeries: A Total Population Study.

Despite professional recommendations to consider gender-affirming hormone and surgical interventions for transgender individuals experiencing gender incongruence, the long-term effect of such interventions on mental health is largely unknown. The aim of this study was to ascertain the prevalence of mood and anxiety disorder health care visits and antidepressant and anxiolytic prescriptions in 2015 as a function of gender incongruence diagnosis and gender-affirming hormone and surgical treatment in the entire Swedish population. This study used the Swedish Total Population Register (N=9,747,324), linked to the National Patient Register and the Prescribed Drug Register. Among individuals who received a diagnosis of gender incongruence (i.e., transsexualism or gender identity disorder) between 2005 and 2015 (N=2,679), mental health treatment in 2015 was examined as a function of length of time since gender-affirming hormone and surgical treatment. Outcome measures were mood and anxiety disorder health care visits, antidepressant and anxiolytic prescriptions, and hospitalization after a suicide attempt. Compared with the general population, individuals with a gender incongruence diagnosis were about six times as likely to have had a mood and anxiety disorder health care visit, more than three times as likely to have received prescriptions for antidepressants and anxiolytics, and more than six times as likely to have been hospitalized after a suicide attempt. Years since initiating hormone treatment was not significantly related to likelihood of mental health treatment (adjusted odds ratio=1.01, 95% CI=0.98, 1.03). However, increased time since last gender-affirming surgery was associated with reduced mental health treatment (adjusted odds ratio=0.92, 95% CI=0.87, 0.98). In this first total population study of transgender individuals with a gender incongruence diagnosis, the longitudinal association between gender-affirming surgery and reduced likelihood of mental health treatment lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.

The prevention of child drowning: the causal factors and social determinants impacting fatalities in portable pools

There is a scarcity of research into portable pool drowning and its prevention. This total population study examines fatal drowning among children under five in portable pools in Australia. All child drowning deaths in portable pools for the period 1 July 2002 to 30 June 2018 were identified. A portable pool was defined as any structure used for swimming and wading which, when emptied, can be moved. Twenty-three children (aged 0-17years) drowned in portable pools. The drowning rate for children less than 5years of age was 0.09 per 100000 population. The peak age of death was 12-23months (RR=2.99; CI: 1.09-8.23), with the majority (n=20 deaths) aged 16-31months. Ninety per cent followed a fall into water. None were supervised. Children commonly resided in areas classified as socially and economically disadvantaged (85%; n=17). Drowning rates in very remote areas were 15 times greater (RR=15.41; CI: 0.03-7579.65) than city children. Eleven (55%) drowning deaths occurred in pools with a depth >300mm, of which 10 (91%) were known to be unfenced. Social determinants impact child drowning in portables pools, which can occur quickly and in just 150mm of water. Active supervision and a regulation-compliant barrier are effective prevention stratagems, factors which were absent from the deaths in this study. SO WHAT?: Portable pool drowning disproportionately impacts those aged 16-31months who reside in very remote areas and areas classified as having high socio-economic disadvantage. Education for these groups on fencing and supervision of children must be provided.

Hubungan antara Body Image dan Subjective Well-Being Pada Remaja Putri

The assessment of body shape or often called the body image is very common among female adolescents. Previous studies showed the body image greatly affected the psychological well-being of adolescents. Young women who considered themselves people with worse body tended to undergo depression. This perception is likely to inhibit their subjective well-beings. In reality, the body image did not affect subjective well-being of the individual. This research aims to investigate the relations between body image and subjective well-being in adolescent girls. This research is a correlational quantitative study. The subjects consisted of 175 Faculty of Fashion and Design Business of "X" University in Surabaya, aged 18-24 years. The data collection technique was Total Population Study. Having used SPSS, this study found the statistical calculation where ρ = 0.432 and p-value = 0.000 in the body image and subjective well-being satisfaction dimensions. Meanwhile, the body image and subjective well-being subjective dimensions were r = 0.474 and p-value = 0.000.

Hubungan Kepuasan Kerja dan Loyalitas Pada Karyawan

Human resource is one of many important aspects within a company; hence, it is imperative for the company to take the satisfaction and commitment regarding the employees into the account. Employees with a high level of loyalty will bring benefit towards the company. Preceding study shows a positive relation between job satisfaction and employee commitment. As a matter of fact, the relation between job satisfaction and employee commitment is a non-existent. This quantitative study would like to carry out the fact that the relation between job satisfaction and employee commitment exists. The researcher employs the job satisfaction scale used and adapted by Spector (2012) and organizational commitment by Mowdays, Steers, &amp; Porter (1979) as the measurements. The population is taken from the employees working in the sector of hospitality in Bali, Indonesia which, then, become the total population study and the result shows that ρ = 0.705 and p-value = 0.000.

Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population

Family and twin studies of Borderline Personality Disorder (BPD) have found familial aggregation and genetic propensity for BPD, but estimates vary widely. Large-scale family studies of clinically diagnosed BPD are lacking. Therefore, we performed a total-population study estimating the familial aggregation and heritability of clinically diagnosed BPD. We followed 1,851,755 individuals born 1973–1993 in linked Swedish national registries. BPD-diagnosis was ascertained between 1997 and 2013, 11,665 received a BPD-diagnosis. We identified relatives and estimated sex and birth year adjusted hazard ratios, i.e., the rate of BPD-diagnoses in relatives to individuals with BPD-diagnosis compared to individuals with unaffected relatives, and used structural equation modeling to estimate heritability. The familial association decreased along with genetic relatedness. The hazard ratio was 11.5 (95% confidence interval (CI) = 1.6–83.8) for monozygotic twins; 7.4 (95% CI = 1.0–55.3) for dizygotic twins; 4.7 (95% CI = 3.9–5.6) for full siblings; 2.1 (95% CI = 1.5–3.0) for maternal half-siblings; 1.3 (95% CI = 0.9–2.1) for paternal half-siblings; 1.7 (95% CI = 1.4–2.0) for cousins whose parents were full siblings; 1.1 (95% CI = 0.7–1.8) for cousins whose parents were maternal half-siblings; and 1.9 (95% CI = 1.2–2.9) for cousins whose parents were paternal half-siblings. Heritability was estimated at 46% (95% CI = 39–53), and the remaining variance was explained by individually unique environmental factors. Our findings pave the way for further research into specific genetic variants, unique environmental factors implicated, and their interplay in risk for BPD.

Exclusive Breastfeeding Knowledge, Intention to Practice and Predictors among Primiparous Women in Enugu South-East, Nigeria.

Breastfeeding is considered as the most complete nutritional source for infants because breast milk contains the essential carbohydrates, fats, proteins, and immunological factors needed for infants to thrive and resist infection in the formative first year of life. Knowledge of exclusive breastfeeding (EBF) among women is essential when promoting optimal breastfeeding practices. This cross-sectional descriptive survey assessed knowledge and intention to practice EBF and its associated factors during pregnancy among primiparous women in selected communities in Enugu State, Nigeria. A total population study that applied inclusion criteria was used to recruit 201 primiparous mothers attending their third trimester antenatal care from selected health facilities in rural and urban communities in Enugu State. A researcher-developed questionnaire was used to collect data on participants' knowledge and intention to practice EBF. Descriptive statistics of frequency, percentage, mean, and standard deviation were used to summarize categorical and continuous variables while Chi-square and Wald statistic tests predicted demographic data associated with knowledge status and intention to practice EBF of the participants. More than half (58.7%) of primiparous mothers had inadequate knowledge of EBF and only 62.7% had intention to exclusively breastfeed for 4–6 months. The Chi-square test result showed significant difference in the participants' place of residence (p = 0.024), EBF knowledge sources (p = 0.001), and EBF knowledge. The Wald statistic in Logistic regression model indicated the coefficient of age (p = 0.026), educational attainment (p = 0.046), EBF knowledge (p = 0.016), and sources of information about EBF (p = 0.027) to be significant predictors of good intention to practise EBF. Poor EBF knowledge and intention to practice in this population may be improved by combining facility-based and in-house methods of breastfeeding counseling, education, and support especially to intending and expectant mothers. Further studies are needed to be done using the multiparous women as well as assessing the effects of in-house EBF supportive-educative intervention to improve breastfeeding outcomes.

Incidence, spectrum and outcome of congenital anomalies seen in a neonatal intensive care unit in Southern Nigeria.

Congenital anomalies (CAs) refer to defects that are present in a newborn but occurred during intrauterine life. They can be due to genetic, modifiable environmental or multifactorial causes. There was no prior report of their burden in our state. This study aims to describe the incidence, spectrum, predisposing factors and outcome of CAs in our setting. It was a total population study of all neonates with major birth defects admitted into the unit during the study period. Their clinical-demographic features, diagnoses and outcome were entered into an excel sheet. Clinical detection of birth defects was based on standard diagnostic criteria. The data were analysed using IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Patterns and outcome of birth defects were presented as proportions. Selected characteristics were tested for possible association with birth defect using Fisher's exact test. The level of significance was set at P < 0.05. The incidence of major CAs was 4.3/1000 live births. Female neonates were more affected (59.0%). Participants' mean gestational age was 37.7 ± 3.3 weeks. Central nervous system anomalies were the most common (38.5%) birth defects. These were followed by musculoskeletal, body wall and digestive system anomalies: 28.2%, 23.1% and 10.3%, respectively. One-third (33.3%) of the infants had multiple anomalies. Nearly three quarters of them (74.0%) were referred, 18.0% died while 5.0% were discharged alive. A wide range of CAs occur in our setting with dire consequences. Provision of relevant specialised multidisciplinary care is desirable. Furthermore, pubic enlightenment on its modifiable possible causes can reduce the burden.

Anesthesia for cesarean section in the University of Ilorin Teaching Hospital, Ilorin, Nigeria: A 5-year review

Background: Obstetric anesthesia service is peculiar in the practice of anesthesia because the anesthetist has to contend with the presence of two lives (the mother and the fetus) and the influence of changes in maternal physiology resulting from pregnancy. Cesarean section is the most frequently performed surgical procedure in obstetrics. With the increasing rates of cesarean deliveries in both developing and developed world, an audit of the outcome of anesthetic management is paramount to assess the safety of the procedure. Objective: The aim of this article is to audit obstetric anesthesia practice in the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria. Methods: The study was a total population study of all obstetric patients who had cesarean delivery at the UITH from January 1, 2010 to December 31, 2014. Results: A total of 14,155 deliveries were recorded from 2010 to 2014 out of which 3908 were cesarean sections giving a cesarean section rate of 27.6%. Ninety percent of the surgeries were emergencies. The most frequent indication for cesarean section was cephalopelvic disproportion (28.7%). Regional anesthesia was used in 92.1% whereas 7.9% had general anesthesia. The most frequent critical incident was hypotension (15.8%). Conclusion: Spinal anesthesia is the most frequently used form of anesthesia for cesarean section.

Hip displacement in children with cerebral palsy in Scotland: a total population study.

PurposeThe purpose of this study is to report the number of children from a total population of children with cerebral palsy (CP) in Scotland who had a displaced or dislocated hip at first registration in a national surveillance programme.MethodsMigration percentage (MP), laterality, Gross Motor Function Classification System (GMFCS) level, CP subtype, distribution of CP and age were analyzed in 1171 children. Relative risk was calculated with 95% confidence intervals. Hip displacement and dislocation were defined as a MP of 40 to 99 and > 100 respectively.ResultsRadiographs were available from the first assessment of 1171 children out of 1933 children registered on the system. In all, 2.5% of children had either one or both hips dislocated (29/1171) and dislocation only occurred in children of GMFCS levels IV and V. A total of 10% of children had a MP 40 to 99 in one or both hips (117/1171). An increasing GMFCS level was strongly associated with an abnormal MP. Hip dislocation was unusual in patients under the age of seven years. A MP of 40 to 99 was not seen in children with isolated dystonia. Displacement was more frequent in children with bilateral involvement and dislocation was only seen in spastic and mixed tone groups.ConclusionThis data gives an overview of the number of CP children who have hip displacement/dislocation in Scotland and who will possibly require surgery.Level of EvidenceI

The prevalence and general health status of people with intellectual disabilities and autism co-occurring together: a total population study.

Little is known about the population prevalence of co-occurring intellectual disabilities and autism, and its impact on general health status. The study aimed to investigate this, in comparison with the general population. Whole country data from Scotland's Census, 2011, were analysed. Descriptive statistics were generated; chi-squared tests were undertaken; and logistic regressions were undertaken both with the whole general population data, adjusted for age and gender, and within the population with co-occurring intellectual disabilities and autism. A total of 5709/5295403 (1.08/1000) people had co-occurring intellectual disabilities and autism; 2.58/1000 children/young people and 0.74/1000 adults. The peak reported prevalence was at age 10years (3.78/1000); 66.0% were male. Their general health status was substantially poorer than for the rest of the population, more so for children/young people, and they had more limitations in their day-to-day activities. Co-occurring intellectual disabilities and autism had odds ratio=48.8 (45.0-53.0) in statistically predicting poor health. This is the first study to report the population prevalence of coexisting intellectual disabilities and autism, and the substantial influence this double disadvantage has on general health status, apparent across the entire life course. This highlights a group in need of wider recognition for whom resources should be focused on and planned for, informed by evidence. Staff in services for people with either of these conditions need to be trained, equipped, resourced and prepared to address the challenge of working for people with this duality. This is essential, to address these substantial health inequalities.

Sickness absence among privately employed white-collar workers: a total population study

Sickness absence among privately employed white-collar workers: a total population study

Sickness absence among privately employed white-collar workers: a total population study

Sickness absence among privately employed white-collar workers: a total population study

Systematic review of high-cost patients' characteristics and healthcare utilisation.

ObjectivesTo investigate the characteristics and healthcare utilisation of high-cost patients and to compare high-cost patients across payers and countries.DesignSystematic review.Data sourcesPubMed and Embase databases were searched until 30 October 2017.Eligibility criteria and outcomesOur final search was built on three themes: ‘high-cost’, ‘patients’, and ‘cost’ and ‘cost analysis’. We included articles that reported characteristics and utilisation of the top-X% (eg, top-5% and top-10%) patients of costs of a given population. Analyses were limited to studies that covered a broad range of services, across the continuum of care. Andersen’s behavioural model was used to categorise characteristics and determinants into predisposing, enabling and need characteristics.ResultsThe studies pointed to a high prevalence of multiple (chronic) conditions to explain high-cost patients’ utilisation. Besides, we found a high prevalence of mental illness across all studies and a prevalence higher than 30% in US Medicaid and total population studies. Furthermore, we found that high costs were associated with increasing age but that still more than halve of high-cost patients were younger than 65 years. High costs were associated with higher incomes in the USA but with lower incomes elsewhere. Preventable spending was estimated at maximally 10% of spending. The top-10%, top-5% and top-1% high-cost patients accounted for respectively 68%, 55% and 24% of costs within a given year. Spending persistency varied between 24% and 48%. Finally, we found that no more than 30% of high-cost patients are in their last year of life.ConclusionsHigh-cost patients make up the sickest and most complex populations, and their high utilisation is primarily explained by high levels of chronic and mental illness. High-cost patients are diverse populations and vary across payer types and countries. Tailored interventions are needed to meet the needs of high-cost patients and to avoid waste of scarce resources.

Neurofibromatosis type 1 and birth size: A retrospective registry-based total population study in Finland

Neurofibromatosis type 1 and birth size: A retrospective registry-based total population study in Finland

Professionalism, governance and inclusive education – A total population study of Swedish special needs educators

ABSTRACTPrior research shows that special needs educators (SNEs) have had problems defining their occupational roles and jurisdiction, particularly regarding inclusive education. There are two occupational groups of SNEs in Sweden, namely special educational needs coordinators (SENCOs) and special education teachers. In this paper, we use the collective name SNEs to refer to both groups. Here, results from a total population study of Swedish SNEs are presented (N = 3367, response rate 75%). The aim is to explore differences in SNEs’ interpretation of school difficulties and if these differences are influenced by SNEs’ employment in different parts of the school organisation. Statistical cluster-analysis was used to categorise SNEs into five distinct groups based on how they view the problems of pupils in school difficulties. Key concepts employed in the analysis are, primarily organisational vs occupational governance in relation to professional jurisdiction. Findings suggest that SNEs are less unanimous in their views of school problems, than prior research indicates. The variance is partly due to where they work in the school organisation, but we also find indications that different groups of SNEs experience different forms of governance with regard to their professionalism. The results are important due to the scope of the data and method of analysis as well as the illustrated variance of professional values and situations of SNEs and the potential consequences for the development of inclusive education.