Recall of medication during pregnancy: Validity and accuracy of an adjusted questionnaire

Objective — To study the validity and accuracy of an adjusted questionnaire on medical drug use during pregnancy eight years after the pregnancy. Methods — The ability of a questionnaire on medication during pregnancy to detect actual use (= sensitivity) was tested against information collected 8 years previously (in 1983–1984) from 473 women with high-risk pregnancies who delivered at the University Hospital Nijmegen, the Netherlands. Results — For separate drug groups, the sensitivity varied between 5% and 91%. The timing of use was recalled moderately well. Although specific questions on drug groups did improve the sensitivity as compared to an earlier questionnaire, the improvement was not enough to make the questionnaire valid. High maternal education, low birth weight, low gestational age and a low 5-min Apgar score were related to better recall. The sensitivity of the questionnaire depended on the behavioural score of the child, implying recall bias. Conclusion — Questionnaire data on drug use during pregnancy obtained eight years after delivery are not a valid source of information.     

Reproducibility and validity of a food frequency questionnaire in European and polynesian New Zealanders

The reproducibility and validity of a self‐administered 142‐item food‐frequency questionnaire (FFQ) was assessed in a population comprising 124 European and 52 Polynesian (17 Maori and 35 Pacific Island) New Zealanders aged 40–65 years. Reproducibility correlation coefficients, determined by administration of the same questionnaire on two occasions 3 years apart, were higher in European than Maori and Pacific Island. participants, ranging from 0.47 to 0.87 in Europeans (median 0.66) and from 0.41 to 0.79 in Maori and Pacific Island people (median 0.44). In general, there were no significant differences in mean nutrient intakes calculated from the two FFQs by Europeans or Maori and Pacific Island participants despite their cultural and language differences. When the FFQ was compared with a 3‐day food diary in a sub sample of 101 Europeans, 15 Maori and 22 Pacific Islanders, the validity was good for most nutrients, with overestimation of a few nutrients in each ethnic group. Correlation coefficients between the 3‐day food diary and FFQ ranged from 0.41 to 0.81 in Europeans (median 0.48) and from 0.36 to 0.56 in Maori and Pacific Island people (median 0.55). Ratios of energy intake to resting metabolic rate suggested that Maori and Pacific Island people were more likely to underestimate their habitual energy intake by the 3‐day diet diary method compared to Europeans, but that Europeans were more likely to underestimate total energy intake by the food frequency method and Pacific Island participants to overestimate it. Obese Europeans and Maori were more likely to under‐report dietary intakes by the 3‐day diary method. We conclude that our FFQ performed better in European than Maori and Pacific Island participants.     

A questionnaire examining learning in general practice

Vocational training is a key element of professional development in general practice. Learner-centred approaches to teaching bring a need for greater understanding of the individual learning styles and preferences of trainees. This paper reports the findings of a pilot study undertaken to determine factors that may influence learning among general practice trainees. A questionnaire survey of 261 trainees in six regions in the UK was carried out to explore attitudes to a series of themes identified in semi-structured interviews with trainees at the end of their training. Six distinct subscales were identified using principal components analysis. These are named 'Learning from Patients', 'Openness to Criticism', 'Negative Attitudes', 'Desire for Clear Guidelines', 'Peer Support', and 'Academic Approach'. Males scored significantly higher on 'Academic Approach' (   P < 0.05  ). Each of the subscales reflects themes that permeate the atmosphere of general pratice training. Further work is required to establish relationships between the subscales and the outcomes of learning and to explore the implications for continuing professional development. The questionnaire is an instrument that may prove useful in the future investigation of learning in general practice.     

社区传染性疾病技能培训问题调查

背景 社区卫生服务机构作为传染病防控工作的最基层单位,是传染病防治的前沿阵地和重要关口,基层医务工作者承担着辖区内疫情监测、预防接种、健康宣传及协助疾控部门调查处置暴发疫情和突发公共卫生事件等职责,在疾病群防群控、易感人群保护、传染源控制及健康宣教等方面发挥着积极作用,同时对有效防控传染病发挥关键作用。目的 了解基层医务工作者社区传染病的诊治能力,分析存在的问题和薄弱方面,有针对性地设计及开展传染病相关系列培训,提高基层传染病防控能力。方法 2021年11月—2022年3月以香港大学深圳医院全科医学科在2021年11月举办的国家级社区传染性疾病继续教育会议的所有参会者为研究对象。会前、会后通过问卷星二维码向参会者发放调查问卷,会前问卷内容包括参会者人口学特征,工作后是否参加过社区传染病培训,社区传染病诊治开展情况,社区传染病防治的主观态度（是否愿意管理社区传染病、对自己传染病诊治能力满意度）,传染病防治专业知识及会议内容相关知识,对慢性乙型肝炎的态度。会后问卷内容主要为会议内容相关知识、对慢性乙型肝炎的态度以及对本次线上会议满意度调查。会前共有301名基层医务工作者完成调查问卷,会前及...     

妊娠早期女性非稳态负荷水平与抑郁的相关性研究

背景 已知慢性应激与抑郁发生相关,非稳态负荷（AL）作为评估机体慢性应激反应的综合生理指标可能在抑郁的发生过程中起着重要作用。目的 探讨妊娠早期女性AL水平与抑郁的关系。方法 采用便利抽样法,选取2021年11月—2022年6月于中国人民解放军联勤保障部队第901医院、六安市金安区妇幼保健院产检的630例妊娠早期女性为研究对象,根据有无抑郁分为抑郁组（n=162）和非抑郁组（n=468）。采用一般资料调查表、妊娠相关焦虑量表、爱丁堡产后抑郁量表进行问卷调查,通过体格检查和实验室检查收集AL相关数据。采用多因素Logistic回归模型分析妊娠早期女性AL与抑郁的相关性。结果 630例妊娠早期女性抑郁发生率为25.7%(162/630)。低水平AL(AL<3分)孕妇427例（67.8%）,高水平AL(AL≥3分)孕妇203例（32.2%）。多因素Logistic回归分析显示,高水平AL是妊娠早期女性抑郁的危险因素[OR=1.651,95%CI(1.096,2.489),P<0.05]。结论 妊娠早期女性AL与抑郁存在正向关联,高水平AL会增加抑郁的发生风险。     

Utility of the STOP-Bang and Epworth scales and the neck-to-height ratio to detect severe obstructive apnea-hypopnea syndrome in severe obesity

BackgroundObstructive sleep apnea–hypopnea syndrome (OSAHS) is present in 80% of patients evaluated for bariatric surgery (BS). Extensive evaluation is not widely available, but treatment is mandatory for severe cases. The Snore, Tiredness, Observed apneas and Pressure - Body mass index, Age, Neck circumference and Gender (STOP-Bang) and Epworth questionnaires and neck-to-height ratio (NHtR) are accessible clinical tools to screen for sleep and metabolic disturbances, but their utility to detect severe OSAHS in patients with severe obesity has not been determined.ObjectivesTo evaluate the cutoff point of those clinical tools that may predict severe OSAHS, confirmed by polysomnography in patients referred for BS.SettingTertiary referral center in Mexico City.MethodsWe applied the STOP-Bang and Epworth questionnaires, evaluated anthropometric characteristics, and collected samples for arterial gasometry and metabolic parameters from 68 patients with severe obesity, who were then referred for polysomnography before their evaluation for BS.ResultsOf the 68 patients participating in the study, 67.7% were female, with a median age of 43 years (35–49 years) and a body mass index (BMI) of 45.5 kg/m² (42.4–50.9 kg/m²; 28.3% had a BMI ≥ 50 kg/m²). A STOP-Bang cutoff >5 points had a sensitivity of 60% and specificity of 90% for detecting severe OSAHS (area under the curve [AUC] = .962); meanwhile, an NHtR >.25 had a sensitivity of 90% and specificity of 52.5% (AUC = .759). The Epworth scale score >11 points had a sensitivity of 57.1% and specificity of 83.3% (AUC = .802).ConclusionClinical data may be useful to detect severe sleep apnea in high-risk populations, allowing for rapid referral and better use of resources.     

Heterogeneidad en el perfil profesional y las actividades de los registros de mortalidad en España

ObjectiveThe mortality registries (MR) code death causes for the elaboration of the mortality statistics of the Spanish National Institute of Statistics (INE). Documentary research and medical training can improve this activity. Our objective was to analyse the professional profile and activities of the MR.MethodA survey was designed and distributed in February 2021. Professional profile, quality activities, medical training, and regular publications were the major topics. 16/18 MR participated. A cluster analysis was performed.ResultsEleven registries belong to Public Health. Five have an INE agreement, 39% provided training, and 56% made regular publications. Ten improved the causes of death, and 17% reviewed the automatic coding. The cluster analysis started from 5/16 groups of registries.ConclusionsThe MR were heterogeneous in professionals, quality and publications. Homogeneity implies documentary search, a sole INE agreement, and providing systemic medical training.     

How does French initial osteopathic training value relational competency,patient education,and the competency-based approach? A cross-sectional survey

BackgroundDespite the promotion of international osteopathic recommendations and registration guidelines, relational competencies and patient education practices present a challenge in the clinical setting due to lack of training. In France, the latest national osteopathic standards for education and practice defined a relational competency that includes patient education. Little is known about its integration in curricula and how French osteopathic practitioners are subsequently trained for relational competency.ObjectiveTo determine teaching, learning, and assessment methods related to relational competency in French initial osteopathic training programs and identify the role of patient education in this relational competency.MethodsAn online questionnaire was designed and sent to all initial training institutes in France (n = 28). Eight institutes answered the survey.ResultsThe relational competencies appeared in various courses, enhanced by clinical learning. However, the courses were not specific to this competency and the volume of hours was relatively low. Patient education was seen as part of relational competency but was poorly implemented. This competency-based approach is still considered an emerging practice in these institutes.ConclusionsThere is a misalignment among intended learning outcomes, teaching, and assessment. Current educational practices are not sufficient to support relational competency, specifically regarding patient education. Further research is needed on how French standards are understood, how they are assimilated by educators, and how they are translated into educational practice. In addition, the adequacy of educators' training for effective implementation of the competency-based approach should be questioned.     

Measuring physician practice site characteristics: A comparison of data from SK&A and a practice site survey

ObjectiveTo evaluate the comparability of commercially available practice site data from SK&A with survey data to understand the implications of using SK&A data for health services research.Data sourcesResponses to the Comprehensive Primary Care Plus (CPC+) Practice Survey and SK&A data.Study designComparison of CPC + Practice Survey responses to SK&A information for 2698 primary care practice sites.Data collectionCPC + Practice Survey data collected through a web‐only survey from April through September 2017, and SK&A data purchased in November 2016.Principal findingsInformation was similar across data sources, although some discrepancies were common. For example, 56% of practice sites had differences in the reported number of practitioners, and larger sites tended to have larger differences. Among practice sites with 1 practitioner in the survey, only 1.3% had a difference of 3 or more practitioners between the data sources, whereas 63% of practice sites with 11 or more practitioners had a difference of 3 or more practitioners.ConclusionsDiscrepancies between data sources could reflect differences of interpretation when defining practice site characteristics, changes over time in those characteristics, or data errors in either SK&A or the survey. Researchers using SK&A data should consider possible ramifications for their studies.