Dates of birth and seasonal changes in well-being among 4904 subjects completing the seasonal pattern assessment questionnaire

Background: Abnormal distributions of birthdates, suggesting intrauterine aetiological factors, have been found in several psychiatric disorders, including one study of out-patients with Seasonal Affective Disorder (S.A.D.). We investigated birthdate distribution in relation to seasonal changes in well-being among a cohort who had completed the Seasonal Pattern Assessment Questionnaire (SPAQ). Method: A sample of 4904 subjects, aged 16 to 64, completed the SPAQ. 476 were cases of S.A.D. on the SPAQ and 580 were cases of sub-syndromal S.A.D. (S-S.A.D.). 92 were interview confirmed cases of S.A.D. Months and dates of birth were compared between S.A.D. cases and all others, between S.A.D. and S-S.A.D. cases combined and all others, and between interview confirmed cases and all others. Seasonality, as measured through seasonal fluctuations in well-being on the Global Seasonality Scores (GSS) of the SPAQ, was compared for all subjects by month and season of birth. Results: There was no evidence of an atypical pattern of birthdates for subjects fulfilling criteria for S.A.D., for the combined S.A.D. / S-S.A.D. group or for interview confirmed cases. There was also no relationship between seasonality on the GSS and month or season of birth. Limitations: Diagnoses of S.A.D. made by SPAQ criteria are likely to be overinclusive. Conclusion: Our findings differ from studies of patients with more severe mood disorders, including psychiatric out-patients with S.A.D. The lack of association between seasonality and birthdates in our study adds credence to the view that the aetiology of S.A.D. relates to separable factors predisposing to affective disorders and to seasonality

Assessment of Health and Nutritional Status Under the Integrated Child Development Services: in the Field Practice Area of Rural Training Health Centre, Nadayara, Travancore Medical College, Kollam-India

Assessment of health and nutritional status was carried out in Anganwadi Children in the Field Practice Area of Rural Training Health Centre, Nadayara, Travancore Medical College, Kollam. This is a cross sectional study within community base setting. Data were collected by a pretested structured questionnaire and analyzed by applying SPSS. Undernourished children in the Anganwadis under study were 21 %. Growth pattern of these children were significantly associated with the birth weight and the episodes of diarrhea. A significant proportion of children are missing the booster doses. DPT booster (16-24 months) is only 74.1 % and DT booster (5-6 years) is only a meager of 13.6

Postpartum Safety and Satisfaction Following Early Discharge

Two Ontario sites were involved in the evaluation of an obstetrical discharge program. Before program implementation a group of eligible women were enrolled as the preprogram control group (n = 542). During the program, eligible women who agreed to early discharge (ED) became the ED group (n = 319), and those opting not to go home early but consenting to participate in the evaluation became the concurrent group (n = 456). All groups were mailed a self-administered postpartum questionnaire. On demographic characteristics, safety and satisfaction, the ED group was comparable to the concurrent group. Hospital readmission rates did not differ across groups after stratification by site or hospital. Multiple classification analyses revealed a similar pattern for overall satisfaction levels. This unique ED program, which allowed pre- or postnatal enrollment and did not require an initial home assessment, appears to be a safe, effective and flexible approach to obstetrical care

Role of appetitive phenotype trajectory groups on child body weight during a family-based treatment for children with overweight or obesity

OBJECTIVE:Emerging evidence suggests that individual appetitive traits may usefully explain patterns of weight loss in behavioral weight loss treatments for children. The objective of this study was to identify trajectories of child appetitive traits and the impact on child weight changes over time.METHODS:Secondary data analyses of a randomized noninferiority trial conducted between 2011 and 2015 evaluated children's appetitive traits and weight loss. Children with overweight and obesity (mean age = 10.4; mean BMI z = 2.0; 67% girls; 32% Hispanic) and their parent (mean age = 42.9; mean BMI = 31.9; 87% women; 31% Hispanic) participated in weight loss programs and completed assessments at baseline, 3, 6,12, and 24 months. Repeated assessments of child appetitive traits, including satiety responsiveness, food responsiveness and emotional eating, were used to identify parsimonious grouping of change trajectories. Linear mixed-effects models were used to identify the impact of group trajectory on child BMIz change over time.RESULTS:One hundred fifty children and their parent enrolled in the study. The three-group trajectory model was the most parsimonious and included a high satiety responsive group (HighSR; 47.4%), a high food responsive group (HighFR; 34.6%), and a high emotional eating group (HighEE; 18.0%). Children in all trajectories lost weight at approximately the same rate during treatment, however, only the HighSR group maintained their weight loss during follow-ups, while the HighFR and HighEE groups regained weight (adjusted p-value < 0.05).CONCLUSIONS:Distinct trajectories of child appetitive traits were associated with differential weight loss maintenance. Identified high-risk subgroups may suggest opportunities for targeted intervention and maintenance programs

Midwifery education and technology enhanced learning: Evaluating online story telling in preregistration midwifery education

Background A major issue regarding the implementation of blended learning for preregistration health programmes is the analysis of students' perceptions and attitudes towards their learning. It is the extent of the embedding of Technology Enhanced Learning (TEL) into the higher education curriculum that makes this analysis so vital. Objectives This paper reports on the quantitative results of a UK based study that was set up to respond to the apparent disconnect between technology enhanced education provision and reliable student evaluation of this mode of learning. Design Employing a mixed methods research design, the research described here was carried to develop a reliable and valid evaluation tool to measure acceptability of and satisfaction with a blended learning approach, specifically designed for a preregistration midwifery module offered at level 4. Methods Feasibility testing of 46 completed blended learning evaluation questionnaires - Student Midwife Evaluation of Online Learning Effectiveness (SMEOLE) - using descriptive statistics, reliability and internal consistency tests. Results Standard deviations and mean scores all followed predicted pattern. Results from the reliability and internal consistency testing confirm the feasibility of SMEOLE as an effective tool for measuring student satisfaction with a blended learning approach to preregistration learning. Conclusions The analysis presented in this paper suggests that we have been successful in our aim to produce an evaluation tool capable of assessing the quality of technology enhanced, University level learning in Midwifery. This work can provide future benchmarking against which midwifery, and other health, blended learning curriculum planning could be structured and evaluated

The prevalence of domestic violence among pregnant women in Nigeria: a systematic review.

To identify, appraise, and synthesize research evidence on the prevalence of domestic violence (DV) among pregnant women in Nigeria. We conducted a systematic review of all published studies between April 2004 and June 2016. Comprehensive searches were conducted on electronic databases such as PubMed, CINAHL, Global Health, MEDLINE, PsycINFO, Directory of Open Access Journals, Google Scholar, and electronic libraries of the authors' institution. Identified articles were screened in two stages against the inclusion criteria with titles and abstract screened first followed by full-text screening. Selected articles were assessed using the "guidelines for evaluating prevalence studies," and findings were synthesized narratively. Among 19 studies that met the inclusion criteria, two articles were excluded due to low methodological quality and 17 articles were included in the review. The prevalence of DV during pregnancy in Nigeria ranged between 2.3% and 44.6% with lifetime prevalence rates ranging between 33.1% and 63.2%. Physical, sexual, psychological, and verbal abuses were the most frequent types of DV reported in this review. The most common perpetrators were husbands, as reported in 11 of the 17 studies. Pregnant women between the ages of 20 and 30 years were the most common victims of DV. Our review suggests high prevalence of DV in pregnancy among women in Nigeria and higher lifetime prevalence. However, determining an overall, synthesized accurate prevalence rate of DV within this population based on existing evidence presents a challenge. The findings have important implications for stakeholders such as planners, policy makers, maternity care providers, and researchers in public health and social policy at national, regional, and international levels toward combating the issue. OBJECTIVE METHOD RESULTS CONCLUSIO

Analysis of Required Investigations of Work-Related Musculoskeletal Disorders in Spain

Musculoskeletal disorders (MSD) are the most common source of occupational health problems in Western countries. In Spain, musculoskeletal disorders (MSDs) can be reported either as accidents or occupational diseases. When reported as an occupational disease, a full diagnosis is performed, as the compensation system needs the approval of the social security authority and a mandatory investigation has to be performed. Although many methods are available for investigating the causes of occupational accidents, occupational diseases have not been analysed with the same depth, and there is a lack of investigation methods. This paper aims to analyse the role of 43 occupational investigations of causes of musculoskeletal diseases in the prevention cycle. This study is based on the occupational investigations performed by workplaces’ occupational health and safety specialists when musculoskeletal diseases are reported. The analysis of the data involves descriptive statistics and the Φ coeffcient. Based on administrative data, 68 workplaces employing 15,260 workers were surveyed and 41 workplaces with 13,201 workers submitted valid questionnaires to be analysed. The most frequent cause of reported musculoskeletal disease, in terms of primary risk, is repetitive movement. The only proposed measure with a significant association to the exposure by repetitive movements is job rotation (alternating workers between tasks within a job or between activities as a means to vary different levels of exposure). The investigation of occupational diseases has been useful in most of the cases for proposing preventive measures. Most of the workplaces surveyed have performed investigations and adopted preventive measures, but the managers of some workplaces were not aware of any disease notification regarding their workers when surveyed. More research is needed to provide tools for this important task

Quality of Life in Chronic Pancreatitis is Determined by Constant Pain, Disability/Unemployment, Current Smoking, and Associated Co-Morbidities

OBJECTIVES: Chronic pancreatitis (CP) has a profound independent effect on quality of life (QOL). Our aim was to identify factors that impact the QOL in CP patients. METHODS: We used data on 1,024 CP patients enrolled in the three NAPS2 studies. Information on demographics, risk factors, co-morbidities, disease phenotype, and treatments was obtained from responses to structured questionnaires. Physical and mental component summary (PCS and MCS, respectively) scores generated using responses to the Short Form-12 (SF-12) survey were used to assess QOL at enrollment. Multivariable linear regression models determined independent predictors of QOL. RESULTS: Mean PCS and MCS scores were 36.7+/-11.7 and 42.4+/-12.2, respectively. Significant (P \u3c 0.05) negative impact on PCS scores in multivariable analyses was noted owing to constant mild-moderate pain with episodes of severe pain or constant severe pain (10 points), constant mild-moderate pain (5.2), pain-related disability/unemployment (5.1), current smoking (2.9 points), and medical co-morbidities. Significant (P \u3c 0.05) negative impact on MCS scores was related to constant pain irrespective of severity (6.8-6.9 points), current smoking (3.9 points), and pain-related disability/unemployment (2.4 points). In women, disability/unemployment resulted in an additional 3.7 point reduction in MCS score. Final multivariable models explained 27% and 18% of the variance in PCS and MCS scores, respectively. Etiology, disease duration, pancreatic morphology, diabetes, exocrine insufficiency, and prior endotherapy/pancreatic surgery had no significant independent effect on QOL. CONCLUSIONS: Constant pain, pain-related disability/unemployment, current smoking, and concurrent co-morbidities significantly affect the QOL in CP. Further research is needed to identify factors impacting QOL not explained by our analyses