Written Questionnaire Research Articles

Variations in Opioid Use Following Robotic Radical Prostatectomy in South Florida.

Introduction: Opioid dependency has been a persistent issue in the United States over the past two decades. Increased efforts have been made to reduce opioid prescribing. Our objective was to quantify at-home opioid requirements following radical prostatectomy. Methods: Written questionnaires were administered to patients 1 week following robot-assisted laparoscopic radical prostatectomy (RALP). Patients provided data on opioid use, pain levels, and demographic characteristics. Results: Sixty-five patients were included. Median age (interquartile range [IQR]) was 69 (62-72) years. The majority were white (85%) and hispanic (67%). Prescriptions ranged from 6 to 15 pills of 5-mg oxycodone equivalents. Twenty-two percent (145/663) of the prescribed pills in the study were consumed. Fifty-four percent (35/65) of patients did not take opioids. Of the 30 patients who took opioids, median use (IQR) was 4.5 (3-6) pills. Forty-six percent (30/65) reported catheter-related pain. Patients who took opioids reported higher levels of pain. On generalized linear regression, younger age, lower levels of education, and living with a family member were factors associated with increased risk for opioid use (all p < 0.05). Conclusions: Despite the Florida Department of Health's restriction on narcotic prescriptions to 3-day supplies, opioids are still overprescribed in our region. The majority of patients do not require opioids after RALP, and patients who do require an opioid analgesic can be adequately managed with less than 6 pills of 5-mg oxycodone equivalents.

Periodontitis-Related Knowledge and Its Relationship with Oral Health Behavior among Adult Patients Seeking Professional Periodontal Care.

Background: Periodontitis is a chronic inflammatory disease that not only damages the stomatognathic system, but may also adversely influence other systems and organs. Patients with low oral health literacy levels are more prone to gingivitis/periodontitis and have a more severe disease course. Methods: A written questionnaire was carried out to assess the knowledge of patients of the Outpatient Clinic of Department of Periodontal and Oral Mucosa Diseases, Medical University of Bialystok, Poland. The questions concerned knowledge regarding the causes of periodontal disease, its risk factors, and the connection between periodontal disease and general health status. To analyze the population, patients were divided according to gender, age and if they were first-time or regular outpatients. Results: Written questionnaires were completed by a total of 302 patients. In the studied population, we noted knowledge deficits, particularly related to weaker periodontal disease risk factors (stress, diabetes, osteoporosis, obesity) and the genetic factor, which is the determinant of periodontitis. The patients’ awareness of the role of plaque bacteria and the effect of smoking on the periodontium was at a relatively high level. The respondents were also aware of the impact of periodontal disease on general health as well as the role of oral hygiene in preventing the disease. At the same time, few of them (26%) used interdental brushes or an irrigator (8%). Conclusions: We demonstrated that patients have an insufficient level of knowledge related to risk factors as well as the prevention of periodontal disease. Awareness of the extent of oral health literacy among patients will help to identify key issues connected with health education interventions

Cancer Patient Satisfaction and Perception of Chemotherapy Services During COVID-19 Pandemic in Central Java, Indonesia

Background: The COVID-19 pandemic affects all healthcare services, including cancer care. Consequently, our institution implemented several changes in accordance with the National guidelines for managing COVID-19 transmission. However, the patients’ perception of such changes is unknown. The objective of this study is to explore the knowledge of cancer patients on COVID-19, their perceptions towards the changes in oncology service, and to identify key elements that contribute to their level of anxiety or comfort. Methods: Written questionnaires were given out to cancer patients indicated or undergoing chemotherapy between 23rd June and 3rd July 2020 in a tertiary referral hospital. Data collection was performed 75 days after the implementation of hospital and oncology services changes in response to COVID-19. Results: A total of 221 cancer patients participated in this study. The majority of patients possess adequate knowledge and practice appropriate preventive actions. They expressed a positive attitude towards the changes in hospital policies and contented with the consistency of chemotherapy services. The television and internet (social media, communication apps) were the main sources of information for the patient.Conclusion: Our institution managed to maintain the consistency of chemotherapy services, despite the implementation of several changes in hospital and treatment policies. With adequate education, patients can remain content and express a positive attitude towards the changes in their treatment experience. Both health care personnel and policymakers should consistently be updated with the continuous surge of publications regarding COVID-19 and adjust their decisions with the best evidence-based practice.

Alimentação e sibilância em lactentes menores de 180 dias beneficiários do Programa Bolsa Família

Verificar a associação entre a alimentação de lactentes menores de 180 dias, beneficiários do Programa Bolsa Família (PBF) e a ocorrência de sibilância. Pesquisa de delineamento transversal. A população foi constituída por crianças menores de 180 dias, atendidas em 11 unidades de Estratégias Saúde da Família (ESF), da cidade de Santa Maria, Rio Grande do Sul. A coleta de dados foi obtida no momento das pesagens anuais obrigatórias do PBF. Utilizou-se um questionário padronizado e incluíram-se os Marcadores de Consumo Alimentar e o Questionário Escrito - Estudo Internacional de Sibilância em Lactentes (QE-EILS). Para análise dos dados utilizou-se o teste qui-quadrado e a razão de prevalência (RP) com intervalo de confiança de (IC) 95%. O nível de significância adotado foi de 5%. Foram avaliados 47 lactentes, com idade média de 123,49±55,54 dias, sendo 24(51,1%) do sexo masculino. Quanto ao QE-EILS, 26(55,3%) lactentes têm familiares com asma e 23(48,9%) apresentaram sibilância nos últimos seis meses. Houve associação estatisticamente significativa entre a sibilância nos últimos seis meses e o consumo de leite materno (RP 0,45; IC95%: 0,32-0,63), (p=0,021), suco de frutas (RP 1,85; IC95%: 1,14-2,99), (p=0,039), frutas (RP 2,08; IC95%: 1,29-3,36), (p=0,010) e de comida de sal (RP 1,96; IC95%: 1,21-3,16), (p=0,020). Crianças que não recebiam leite materno, e as que receberam frutas, comida de sal, leite de vaca, suco e água nos primeiros 180 dias de vida apresentaram maior prevalência de sibilância e outros sintomas respiratórios, motivo pelo qual é importante fomentar as recomendações de alimentação e nutrição adequadas na infância.

Environmental risk factors for asthma in 13-14 year old African children.

Background Asthma prevalence in African children is high. Factors driving the prevalence or disease severity are poorly understood. This study aims to investigate environmental factors associated with asthma and severity in African children. Methods Population based cross-sectional study of children aged 13-14 years from 10 African centers who participated in ISAAC III. Self-reported environmental exposures included engaging in physical exercise, television watching, various biomass and ETS exposure, consumption of paracetamol, large family sizes and having pets in the home. Univariable and multivariable analyses were done adjusting for center variations. Prevalences, odds ratio and 95% confidence intervals (CI) were calculated. Results There were 258 267 children recruited among the 13-14-year-old participants. Of these, 28,391 respondents from 232 schools completed both the written questionnaire (WQ) and environmental questionnaire (EQ). The prevalence of asthma and severe asthma were 12.8% (CI 12.4-13.2), and 8.7% (CI 8.4-8.0) respectively. Factors strongly associated with asthma were maternal smoking (OR = 1.41; 95%CI: 1.23-1.64), open fire heating (OR = 1.28; 95%CI: 1.08-1.51) electric heating (OR = 1.13; 95%CI: 1.01-1.28), physical exercise (OR = 1.29; 95%CI: 1.11-1.50), monthly paracetamol use (OR 1.23; 95%CI 1.13-1.33), having an elder sibling (OR = 0.87; 95%CI 0.77-0.98). Factors associated with severe asthma were maternal smoking (OR = 1.61; 95%CI: 1.38-1.89), cat pet (OR = 1.14; 95%CI: 1.04-1.25), frequent physical exercise (OR = 1.42; 95%CI: 1.23-1.64) and monthly paracetamol use (OR = 1.20; 95%CI 1.07, 1.34). Conclusion Several environmental exposures were associated with asthma and severe disease.

Does Screening for Intimate Partner Violence Using Written Questionnaires Increase Identification Rates Compared With Face-to-Face Interviews in Women in Their First Trimester of Pregnancy to 6 Weeks Postpartum?

Does Screening for Intimate Partner Violence Using Written Questionnaires Increase Identification Rates Compared With Face-to-Face Interviews in Women in Their First Trimester of Pregnancy to 6 Weeks Postpartum?

Prevalence of asthma-like symptoms by ISAAC video questionnaire in Mozambican schoolchildren

The International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire was developed to overcome the language and cultural differences in the assessment of asthma-like symptoms. 27 schools were included in the Maputo Asthma and Allergies in childhood Study (MAPAAS) using ISAAC methods, and a video questionnaire (VQ) was administered to 1614 adolescents 13-14 years old of 20 schools located in urban, suburban and semi-rural areas of Maputo (Mozambique). Simultaneously, they also replied to the ISAAC written questionnaire (WQ). According to the video questionnaire, the prevalence of current asthma was 11.9% (compared with 13.3% using the written questionnaire). Wheezing after exercise in the last year was reported by about 21%. Females reported more frequent wheezing after exercise than males (p < .001). The prevalence of nocturnal cough in the last year was 24.7%, and was more frequent in the suburban area (p < .001). "Severe attacks of asthma" was reported by 11.9% of the individuals. Teenagers instructed in the suburban schools reported more severe asthma-like symptoms than others (p < .05). There was a poor correlation between the WQ and the AVQ3.0 (kappa coefficients varied from 0.09 to 0.24). The lowest agreement was observed for the question regarding severe attacks of asthma. Agreement was better in terms of specificity than in terms of sensitivity. In spite of the poor agreement between the written and the video questionnaires, the prevalence of asthma symptoms estimated using the video questionnaire confirms that asthma is an important public health problem in Maputo.

Prevalence of asthma and allergic diseases in adolescents: nine‐year follow‐up study (2003‐2012)

ObjectiveTo determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13‐14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). MethodsThe ISAAC‐WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi‐squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. ResultsConsidering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician‐diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. ConclusionsThe prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012)

ObjectiveTo determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years) living in seven Brazilian cities, by applying the standardized written questionnaire (WQ) of the International Study of Asthma and Allergies in Childhood (ISAAC), and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3). MethodsThe ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher) tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. ResultsConsidering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5%) and an increase in the frequency of severe asthma (4.5% vs. 4.7%) and physician-diagnosed asthma (14.3% vs. 17.6%). An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. ConclusionsThe prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

The Written Questionnaire as a Sociolinguistic Data Gathering Tool

Self-reports in linguistic study, which were central to the dialect surveys of the twentieth century, have, by and large, been relegated to the sidelines by more advanced sociolinguistic techniques in recent years. This article probes into the validity of written self-report surveys in relation to the fieldwork method for Vancouver, British Columbia. Confirming Chambers’s general findings of equivalence, it produces insights into the preferred length of written questionnaires and offers recommendations as to question type. The present article also compares the written questionnaire results to acoustically analyzed recorded data for yod-dropping and the low-back vowels before /r/, identifying linguistic items that correlate well with results from self-reports and those that fail to produce reliable results because of ongoing linguistic change or reindexicalization in the case of yod-dropping. Overall, written self-report surveys are found to be highly reliable data gathering tools if certain factors are kept in mind.

Comparison of Prevalence and Risk Factors of Atopic Dermatitis by Physical Examination and Questionnaire Survey in Elementary School Children

Purpose The present study aimed to evaluate the accuracy of determining the prevalence of atopic dermatitis (AD) with a questionnaire by diagnosing AD with both a questionnaire and pediatricians' physical examinations and to determine the possible risk factors for AD. Methods A survey was conducted from December 2008 to February 2009 in four elementary schools. The Korean version of the International Study of Asthma and Allergies in Childhood written questionnaire (WQ) was used to identify AD ever and AD during the last 12 months. Current AD was diagnosed by well-trained pediatricians according to the Hanifin and Rajka's diagnostic criteria. A total of 2,729 children who completed the questionnaire and underwent a physical examination by pediatricians were included in this analysis. Results According to the WQ, the prevalence of AD in the entire life and in the last 12 months was 18.4% and 12.9%, respectively. The prevalence of clinically diagnosed AD by pediatricians was 8.8%. There was a significant positive relationship between the prevalence of AD diagnosed by physical examination and past history of allergic rhinitis (adjusted odds ratio [aOR], 1.45), allergy history of the mother (aOR, 2.48), and AD history of the mother (aOR, 1.61). According to the WQ, there was also a significant positive relationship between the prevalence of AD in the last 12 months and past history of asthma (aOR, 2.55) and AD history of the mother (aOR, 1.71). Conclusion Prevalence and risk factors of AD were different according to the survey methods. When prevalence of AD is determined with a questionnaire in the future, more careful attention should be used, because the result can be overestimated compared to the actual prevalence.

Preschool asthma in Italy: Prevalence, risk factors and health resource utilization

Asthma in preschool children is greatly under-diagnosed worldwide. Aim was to investigate prevalence of wheezing, and asthma risk factors, doctor diagnosis, treatment and health resource utilization in preschool children. About 1402 children (3-5 years) attending local kindergartens participated in the study. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire (WQ) was used with additional questions on risk factors, asthma diagnosis, treatments, resource utilization. Allergic sensitisation was evaluated by skin prick tests for the common allergens. Prevalence of "wheezing in previous 12 months" and "doctor diagnosed asthma" were 12.1% and 8.6%, respectively. 4.7% of children have had both wheezing in the last 12 months and asthma diagnosis. Significant risk factors for wheezing were rhinitis, parental history of atopy and sensitivity to mites and grass pollens. 27.3% of children with asthma diagnosis, but only 4.9% of children without diagnosis, received regular treatment during the previous year (p<0.0001). Children with more than 4 episodes of wheezing a year received more frequently an asthma diagnosis, but 68.6% were not on regular treatment. Asthma diagnosis was associated with a significant increase in control visits for wheezing (p<0.0001). The prevalence of children requiring at least one hospital emergency visit in the previous year was not different among the two groups (83.3% vs. 82.5%). In preschool children the prevalence of wheezing and asthma is elevated. Preschool asthma seems to be under-treated with few cases receiving regular therapy. The social cost of the disease at this age seems to be elevated because of the high frequency of control and emergency visits.

Prevalence of and factors associated with current asthma symptoms in school children aged 6–7 and 13–14 yr old in Bogotá, Colombia

This cross-sectional study of children aged 6-7 years and adolescents aged 13-14 years in Bogotá, Colombia, assessed the prevalence of asthma symptoms and their associations with dietary, health, and behavioral habits. This study is part of the International Study of Asthma and Allergies in Childhood (ISAAC)-phase III. Asthma prevalence among the children was assessed using a parental self-administered written questionnaire (WQ), and among adolescents using a WQ together with a video questionnaire (VQ). Associations were estimated with bivariate and multivariate analysis. The study found that the 6-7 year age-group were more likely to report current asthma symptoms than the 13-14 year age-group (10.4% [WQ] vs. 8.6% [WQ] and 8.0% [VQ], respectively). Factors associated with current asthma symptoms among the 6-7 year age-group included higher maternal education (OR = 1.7, [95% CI 1.2-2.6], p = 0.007), a cat in the home during the last year (OR = 1.5, [95% CI 1.0-2.3], p = 0.036), watching TV 1-2 hours/day (OR = 2.1, [95% CI 1.2-3.9], p = 0.013), and medication with acetaminophen in the first and most recent year of life (OR = 1.8, [95% CI 1.3-2.4], p < 0.001; OR = 2.2, [95% CI 1.7-2.8], p < 0.001, respectively) or antibiotics in the first year of life (OR = 1.9, [95% CI 1.4-2.5], p < 0.001). Among the 13-14 year age-group, factors associated with current asthma symptoms included medication with acetaminophen during the last year (OR = 1.8, [95% CI 1.4-2.3], p < 0.001); cereal, milk, and fruit consumption 3 or more times weekly (OR = 1.5, [95% CI 1.1-1.9], p = 0.010; OR = 0.8, [95% CI 0.6-1.0], p = 0.046; OR = 0.6, [95% CI 0.4-1.0], p = 0.031, respectively). Overall, compared with that in other Latin American centers, asthma prevalence in Bogotá is close the lower estimates. However, associations with dietary, health, and behavioral habits need further study to assess their complex relationship with asthma.

Risk Factors of Childhood Asthma in Sao Jose do Rio Preto, Sao Paulo, Brazil

Epidemiological studies have shown increased prevalence of asthma over the last decades and a considerable variation in these rates between different countries, mainly developed. Changes in lifestyle of different populations could explain the increasing prevalence of asthma and its different rates in different communities. A case-control study was conducted to investigate some risks factors associated to asthma in schoolchildren in São José do Rio Preto, São Paulo, Brazil. A total of 3793 self-administered written questionnaire (WQ) was filled in by parents of 6-7-year-old schoolchildren, applying the International Study of Asthma and Allergies in Childhood (ISAAC) protocol. Additionally, was added a supplementary WQ evaluating risk factors: gender, personal history of rhinitis and atopic eczema, familial history of atopy, older siblings, day care, breastfeeding, and exposure to pets and to cigarette smoking. Children whose parents responded affirmatively to question 'Has your child had wheezing in the past 12 monthsquest;' were identified as having current asthma. The prevalence of current asthma was 18.3%. In multivariate analysis the following risk factors were associated with asthma: rhinitis (OR = 10.6; 95% CI = 8.27-13.56), atopic eczema (OR = 1.54; 95% CI = 1.00-2.35), father with asthma (OR = 3.49; 95% CI = 1.83-6.67), mother with asthma (OR = 1.84; 95% CI = 1.11-3.05), current exposure to pets (OR = 1.83; 95% CI = 1.45-2.32) and passive tobacco smoking exposure (OR = 1.43; 95% CI = 1.12-1.83). Our results show that genetic background, environmental factors and the presence of co-morbidities such as rhinitis and atopic eczema are associated to the genesis of asthma in Brazilian schoolchildren.

Sensitisation to aeroallergens in Brazilian adolescents living at the periphery of large subtropical urban centres

To evaluate the sensitization to aeroallergens determined by skin prick test (SPT) in Brazilian adolescents, and to correlate its positivity with the diagnosis of asthma and/or rhinitis based on the written questionnaire (WQ) of ISAAC phase III study. A total of 996 adolescents (387 boys) were selected by systematic samples. A standard allergen extracts panel (positive/negative control, D pteronyssinus [Dpt], P americana [Pa], B germanica [Bg], dog, cat, fungal and grass mix) was used and its positivity compared with positive responses to asthma, rhinitis or both. Positive SPT to at least one allergen was observed in 466 adolescents (46.8 %), with sensitisation to Dpt in 79.1 %. Positivity to more than one allergen occurred in 232 students (49.8 %). The frequency of positive SPTs was significantly higher among adolescents with asthma (OR = 2.16), rhinitis (OR = 1.69), and asthma and rhinitis (OR = 2.03). Positive SPT to four or more allergens were higher among asthmatics (OR = 2.6) and among adolescents with asthma and rhinitis (OR = 3). A high sensitisation rate to aeroallergens was observed, significantly higher among those with asthma, rhinitis or a combination of both, especially in multiple sensitisations.

Prevalence and risk factors for atopic dermatitis in preschool children

Atopic dermatitis (AD) is a common condition in infancy which usually disappears by 3 years of age in a significant proportion of children. The prognosis is mostly determined by severity and presence of atopic sensitization. To investigate prevalence of AD, comorbidities and risk factors in a population of preschool children aged 3-5 years. Children in kindergartens were evaluated. The International Study of Asthma and Allergies in Childhood written questionnaire (WQ) was used, with additional questions on risk factors. Atopy was investigated by skin prick tests. One thousand, four hundred and two valid WQs (92% response rate) were returned for evaluation. The prevalence of AD symptoms in the last 12 months in the whole population was 18.1% (254 cases). Seventy-two per cent of these children presented AD-specific localizations. The prevalence of eczema as a doctor's diagnosis in the total population was 15.4%. Positive atopic sensitization was present in 18.6% of the total and in 32.2% of the AD study population, respectively. Multiple sensitivities were observed in 58.2% of sensitized children. The prevalence of sensitization demonstrated that the most common sensitizing allergens in children with AD were mites and grass pollen. Rhinitis symptoms and wheezing were present in 32.2% and 24.2%, respectively, of children with AD. Allergic sensitization to egg, cat, grass pollen and mites, as well as the presence of symptoms of rhinitis, and a positive family history of atopy were all significant risk factors for AD. The study demonstrates a high prevalence of AD and a close relationship with rhinitis symptoms. Significant risk factors for AD were sensitization to food or inhalant allergens as well as parental history of atopy.

Prevalence of symptoms of asthma, rhinitis, and atopic eczema among adolescents living in urban and rural areas in different regions of Brazil

Background In Brazil, studies evaluating the prevalence of asthma and allergic diseases among children living in rural area compared to urban area are rare. Some authors identified as risk factors for higher prevalence of current wheezing to have a family history of asthma, to have contact with pets, and being student in an urban school. The International Study of Asthma and Allergies in Childhood (ISAAC) phase 3 has shown higher prevalence of wheezing, nasal symptoms and cutaneous rash in the last 12 months in centers from Northern (N) and Northeastern (NE) regions of Brazil. Objective To evaluate if adolescents with similar genetic background, living in a rural area are protected against the development of symptoms of asthma, rhinitis, and atopic eczema when compared to those living in an urban area in the same region of the country. Subjects and Method Adolescents (13-14 year-old) living in Caruaru (Pernambuco) and in Santa Maria (Rio Grande do Sul) were enrolled in this study (2002-2003). The adolescents filled in the ISAAC written questionnaire (WQ), previously translated and validated to the Brazilian culture (30-32). Data obtained were transcribed manually into a database (Epi-Info) supplied by ISAAC's coordinators and were statistically analyzed by the SSPS-12 software. Results The prevalence of asthma related symptoms were higher among those adolescents living in the urban centers in comparison to the rural ones. These differences were significant for wheezy ever, wheezy in the last 12 months, asthma ever, and wheezy with exercise in Caruaru and for wheezy ever and asthma ever, in Santa Maria. Comparing urban areas, the prevalence of asthma related symptoms in Caruaru was higher than in Santa Maria, except for wheezy ever and wheezy with exercise. The opposite was observed comparing rural areas: the prevalence of asthma (except for nocturnal cough) was higher in Santa Maria despite lesser severity of symptoms in this city.

Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire

Epidemiological evaluations of the prevalence of asthma are usually based on written questionnaires (WQs) in combination with validation by clinical investigation. In the present investigation, we compared parental assessment of asthma among their preschool children in response to a WQ with the corresponding medical records in the same region. An International Study of Asthma and Allergies in Childhood (ISAAC)-based WQ was answered by 75% of the parents of 6295 children aged 1-6 yr. Clinically diagnosed asthma, recorded in connection with admissions to the hospital or a visit to any of the outpatient clinics in the same region, were analysed in parallel. Finally, a complementary WQ was sent to the parents of children identified as asthmatic by either or both of this approaches. In response to the WQ 5.9% were claimed to suffer from asthma diagnosed by a doctor. According to the medical records, the prevalence of clinically diagnosed asthma was 4.9%. The estimated prevalence among children requiring treatment for their asthma was 4.4%. The sensitivity of the WQ was 77%, the specificity 97.5%. In the 1-2 yr age group the sensitivity was only 22%. This WQ was able to identify 54% of the children with a medical record of asthma. Forty percent of the children claimed by their parents to be asthmatic had no medical record of asthma. An ISAAC-based parentally completed WQ provided an acceptable estimation of the prevalence of asthma in children 2-6 yr of age, although only half of the individual patients identified in this manner are the same as those identified clinically.

Obstetrician-Gynecologists' Practice and Knowledge Regarding Spina Bifida

The purpose was to assess practicing obstetrician-gynecologists' knowledge about the prenatal diagnosis and postnatal prognosis of spina bifida. Written questionnaires designed to assess practicing obstetrician-gynecologists' knowledge of spina bifida were mailed to 1000 randomly selected American College of Obstetricians and Gynecologists Fellows. More than 50% did not identify many of the sonographic features indicative of an open neural tube defect in the fetus and more than one third overestimated the risks of stillbirth, whereas more than two thirds overestimated the risk for premature delivery in a pregnancy complicated by fetal spina bifida. Just more than 50% correctly estimated the 1-year survival rate and just less than 50% correctly estimated survival at 6 years. Sixty-six percent overestimated the incidence of mental retardation associated with spina bifida. Maternal-fetal medicine specialists returning the survey exhibited a much better understanding of the prenatal issues and prognostic and outcome factors related to spina bifida. There are gaps in obstetrician-gynecologists' knowledge about the diagnostic features of and prognosis for fetal spina bifida. It is important for them to take advantage of continuing medical education opportunities to learn more about the management of pregnancies complicated by fetal spina bifida and about the prognosis for affected individuals.

Food and activity in out of school hours care in Victoria

AbstractObjective: To describe characteristics of the Victorian out of school hours care (OSHC) sector to assess its potential role in promoting healthy lifestyles to children and their families.Design: Written questionnaires were sent to 1100 Victorian OSHC programs to collect information about the services, foods and activities offered to children, the training and resources utilised by staff and the type of information sent home to parents/guardians.Subjects: A total of 426 Victorian OSHC coordinators completed questionnaires in the present descriptive study (39% response rate).Setting: Out of school hours care provides care for 5–12 years olds before school, after school and/or during school holidays.Results: Over 80% of coordinators reported offering fruit, breads, cereals, and milk and dairy products. One‐third offer vegetables as part of meals or snacks. One‐third reported offering cakes, biscuits and/or slices, and chips and/or pastries. About 17% reported offering water, whereas 24% reported offering cordial/soft drinks and fruit juice. Cooking was offered as an after‐school activity by about half of those surveyed. Active games were common (62%) as were indoor active games and sports (36%). Sedentary activities were also commonplace (37–51%). Only about 30% of OSHC coordinators had participated in nutrition and/or physical activity training in the previous two years. Few OSHC programs sent home health information to parents/guardians.Conclusion and application: Opportunities exist to help Victorian OSHC programs with nutrition and physical activity information, resources and training. Although the findings of the present study are specific to Victoria, they highlight the potential role of the growing OSHC sector to help improve the health of Australian children.