A comparison of opioid use between WCB recipients and other Manitobans for knee,shoulder, back and carpal tunnel release procedures

Background

This study's objectives were to evaluate whether WCB claimants with conditions requiring certain surgical procedures are more likely to be prescribed outpatient opioids than other Manitobans and whether those prescribed opioids are more likely to still be on opioid medications 6 months post procedure.

Methods

We compared 7,246 WCB claims for a number of surgical procedures to 65,032 similar procedures performed in other Manitobans. Logistic regression was used to explore the association between being a WCB claimant and being prescribed opioids, while controlling for type of surgical procedure and other potential confounders.

Results

WCB claimants were more likely than other Manitobans to be prescribed opioids (adjusted OR 1.38; 95%CI 1.30–1.47). Amongst those prescribed opioids, the odds of being still on opioids 6 months post‐procedure were not significantly elevated for WCB claimants (adjusted OR 1.09 95%CI 0.97–1.23).

Conclusions

WCB claimants are prescribed opioids more often than non‐claimants for similar procedures. Am. J. Ind. Med. 59:257–263, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.     

Vitamin D testing patterns among general practitioners in a major Victorian primary health care service

Objective: To examine 25(OH)D testing patterns and frequency among general practitioners in a major community health service. Method: A clinical audit of patient records at a community health centre in Melbourne was undertaken. Patients aged 18 years and above were included. Univariate and multivariate logistic regression was used to examine the association between vitamin D testing and socio‐demographic characteristics while Poisson regression was used for the frequency of testing. Results: There were 1,217 patients tested for serum 25(OH)D. The community health centre was served by 12 general practitioners and an infectious disease specialist. The odds of vitamin D testing showed a positive, albeit weak, association with age (OR 1.01, 95%CI 1.00–1.02, p<0.05), were higher among females than males (OR 1.42, 95%CI 1.18–1.70, p<0.05) and higher among migrants compared to non‐migrants (OR 2.57, 95%CI 2.14–3.09, p<0.05). The frequency of testing was also higher among females than males (IRR 1.17, 95%CI 1.07–1.28, p<0.05) and higher among migrants than non‐migrants (IRR 1.19, 95%CI 1.08–1.31, p<0.05). Conclusion: Advancing age, being female and being a migrant were associated with an increased likelihood of vitamin D testing. Implications: Development of evidence‐based policies and guidelines are needed to manage over‐testing of vitamin D in Australia. Studies that include health services from different areas are required to understand vitamin D testing patterns among the general practitioners.     

Awareness and use of family planning methods among iTaukei women in Fiji and New Zealand

Objective : iTaukei women's awareness and practice of family planning methods was investigated in New Zealand and Fiji to ascertain differences in behaviour within the context of changing developmental settings. Methods : The study was cross‐sectional in nature and recruited women aged 18 years and over from three suburbs in Suva, Fiji, and five cities in New Zealand. Results : Overall, 352 women participated in the study, 212 in Fiji and 140 in New Zealand. The study found that living in New Zealand was significantly associated with lower odds of being aware of family planning (OR 0.4, 95%CI 0.2–0.9, p=0.029) and using family planning methods (OR 0.5, 95%CI 0.2–0.9, p=0.027). Tertiary education was found to increase the odds of being aware (OR 2.8, 95%CI 1.3–6.2, p=0.009) and of using (OR 3.9, 95%CI 1.9–7.8, p=0.000) family planning. Conclusions : Despite the greater availability of services and higher standards of living experienced in New Zealand compared with Fiji, there was no improvement in awareness and use of family planning among New Zealand participants. Implications for public health : Reduced awareness and use of family planning in New Zealand indicates a need for better targeting of services among minority Pacific ethnic groups.     

Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012‐2015

Background

Workplace violence is a substantial occupational hazard for healthcare workers in the United States.

Methods

We analyzed workplace violence injury surveillance data submitted by hospitals participating in the Occupational Health Safety Network (OHSN) from 2012 to 2015.

Results

Data were frequently missing for several important variables. Nursing assistants (14.89, 95%CI 10.12‐21.91) and nurses (8.05, 95%CI 6.14‐10.55) had the highest crude workplace violence injury rates per 1000 full‐time equivalent (FTE) workers. Nursing assistants' (IRR 2.82, 95%CI 2.36‐3.36) and nurses' (IRR 1.70, 95%CI 1.45‐1.99) adjusted workplace violence injury rates were significantly higher than those of non‐patient care personnel. On average, the overall rate of workplace violence injury among OHSN‐participating hospitals increased by 23% annually during the study period.

Conclusion

Improved data collection is needed for OHSN to realize its full potential. Workplace violence is a serious, increasingly common problem in OHSN‐participating hospitals. Nursing assistants and nurses have the highest injury risk.

     

Common mental disorders and intimate partner violence in pregnancy

OBJECTIVE

To investigate the association between common mental disorders and intimate partner violence during pregnancy.

METHODS

A cross sectional study was carried out with 1,120 pregnant women aged 18-49 years old, who were registered in the Family Health Program in the city of Recife, Northeastern Brazil, between 2005 and 2006. Common mental disorders were assessed using the Self-Reporting Questionnaire (SRQ-20). Intimate partner violence was defined as psychologically, physically and sexually abusive acts committed against women by their partners. Crude and adjusted odds ratios were estimated for the association studied utilizing logistic regression analysis.

RESULTS

The most common form of partner violence was psychological. The prevalence of common mental disorders was 71.0% among women who reported all form of violence in pregnancy and 33.8% among those who did not report intimate partner violence. Common mental disorders were associated with psychological violence (OR 2.49, 95%CI 1.8;3.5), even without physical or sexual violence. When psychological violence was combined with physical or sexual violence, the risk of common mental disorders was even higher (OR 3.45; 95%CI 2.3;5.2).

CONCLUSIONS

Being assaulted by someone with whom you are emotionally involved can trigger feelings of helplessness, low self-esteem and depression. The pregnancy probably increased women`s vulnerability to common mental disorders     

Violence against emergency medical services personnel: A systematic review of the literature

Background

Violence against emergency medical services (EMS) personnel is a growing concern. The aim of this systematic review is to synthesize the current literature on violence against EMS personnel.

Methods

We examined literature from 2000 to 2016. Eligibility criteria included English‐language, peer‐reviewed studies of EMS personnel that described violence or assaults. Sixteen searches identified 2655 studies; 25 studies from nine countries met the inclusion criteria.

Results

The evidence from this review demonstrates that violence is a common risk for EMS personnel. We identified three critical topic areas: changes in risk over time, economic impact of violence and, outcomes of risk‐reduction interventions. There is a lack of peer reviewed research of interventions, with the result that current intervention programs have no reliable evidence base.

Conclusions

EMS leaders and personnel should work together with researchers to design, implement, evaluate and publish intervention studies designed to mitigate risks of violence to EMS personnel.

     

Unreported workers’ compensation claims to the BLS Survey of Occupational Injuries and Illnesses: Establishment factors

Background

Studies suggest employers underreport injuries to the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII); less is known about reporting differences by establishment characteristics.

Methods

We linked SOII data to Washington State workers’ compensation claims data, using unemployment insurance data to improve linking accuracy. We used multivariable regression models to estimate incidence ratios (IR) of unreported workers’ compensation claims for establishment characteristics.

Results

An estimated 70% of workers’ compensation claims were reported in SOII. Claims among state and local government establishments were most likely to be reported. Compared to large manufacturing establishments, unreported claims were most common among small educational services establishments (IR = 2.47, 95%CI: 1.52–4.01) and large construction establishments (IR = 2.05, 95%CI: 1.77–2.37).

Conclusions

Underreporting of workers’ compensation claims to SOII varies by establishment characteristics, obscuring true differences in work injury incidence. Findings may differ from previous research due to differences in study methods. Am. J. Ind. Med. 59:274–289, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.     

Practice area and work demands in nurses' aides: a cross-sectional study

Background

This paper examines the association between use of protective devices, frequency of acute health problems and health-protection information received by participants engaged in the Prestige oil spill clean-up in Asturias and Cantabria, Spain.

Methods

We studied 133 seamen, 135 bird cleaners, 266 volunteers and 265 paid workers selected by random sampling, stratified by type of worker and number of working days. Information was collected by telephone interview conducted in June 2003. The association of interest was summarized, using odds ratios (OR) obtained from logistic regression.

Results

Health-protection briefing was associated with use of protective devices and clothing. Uninformed subjects registered a significant excess risk of itchy eyes (OR:2.89; 95%CI:1.21–6.90), nausea/vomiting/dizziness (OR:2.25; 95%CI:1.17–4.32) and throat and respiratory problems (OR:2.30; 95%CI:1.15–4.61). There was a noteworthy significant excess risk of headaches (OR:3.86: 95%CI:1.74–8.54) and respiratory problems (OR:2.43; 95%CI:1.02–5.79) among uninformed paid workers. Seamen, the group most exposed to the fuel-oil, were the worst informed and registered the highest frequency of toxicological problems.

Conclusion

Proper health-protection briefing was associated with greater use of protective devices and lower frequency of health problems. Among seamen, however, the results indicate poorer dissemination of information and the need of specific guidelines for removing fuel-oil at sea.     

The 3‐Year Longitudinal Impact of Sedentary Behavior on the Academic Achievement of Secondary School Students

BACKGROUND

Sedentary behavior is linked to many adverse health outcomes; however, its relationship with academic achievement is less understood. We examined sedentary behavior's impact on academic achievement over 3 years in 4408 adolescents from the COMPASS study.

METHODS

Sedentary behavior (screen‐based: watching/streaming television shows/movies, video/computer games, surfing the internet; communication‐based: texting/messaging/emailing, talking on the phone; and doing homework) and academic achievement (overall math and English marks) were self‐reported.

RESULTS

Holding time fixed, moving from the lowest quartile (Q1) to Q2, Q3, or Q4 of watching/streaming television shows/movies (Q2: OR = 0.90; 95%CI: 0.84‐0.97, Q3: OR = 0.85; 95%CI: 0.74‐0.98, Q4: OR = 0.74; 95%CI: 0.64‐0.85) or to Q2 of surfing the internet (Q2: OR = 0.87; 95%CI: 0.78‐0.97) decreased the likelihood of surpassing English standards. Moving from Q1 to Q2 of communication‐based sedentary behavior (OR = 0.90; 95%CI: 0.82‐0.99) decreased the likelihood of surpassing math standards. Moving from Q1 to Q4 (OR = 1.31; 95%CI: 1.15‐1.50) of watching/streaming television shows/movies increased the likelihood of surpassing math standards. Moving from Q1 to Q4 of doing homework (OR = 1.16; 95%CI: 1.02‐1.31) increased the likelihood of surpassing English standards.

CONCLUSIONS

Predicting academic achievement from total sedentary behavior is challenging. Targeting specific types of sedentary behavior should be considered for improving math and English achievement.

     

Nutritional risk,nutritional status and incident disability in older adults. The FRADEA Study

Objectives

To analyze if body mass index (BMI) and waist circumference (WC) as measures of nutritional status, and the Mini Nutritional Assessment Short Form (MNA-SF) as a nutritional risk measure are associated with increased risk of incident disability in basic activities of daily living (BADL) in a population based cohort of Spanish older adults.

Design

Concurrent cohort study.

Setting

Albacete City, Spain.

Participants

678 subjects over age 70 from the FRADEA Study (Frailty and Dependence in Albacete).

Measurements

BMI, WC and MNA-SF were recorded at the basal visit of the FRADEA Study. Incident disability in BADL was defined as loss of the ability to perform bathing, grooming, dressing, toilet use, or feeding from basal to follow-up visit, using the Barthel index. The association between nutritional status and nutritional risk with incident BADL disability was determined by Kaplan-Meier analysis and logistic regression adjusted for age, sex, basal function, comorbidity, cognitive decline, depression risk and frailty status.

Results

Each point less of MNA-SF (OR 1.17, 95%CI 1.04–1.31) and MNA-SF<14 (OR 2.33, 95%CI 1.39–3.89), but not MNA-SF<12 (OR 1.47, 95%CI 0.89–2.42) had a greater adjusted risk of incident disability in BADL. Neither BMI (OR 1.02, 95%CI 0.97–1.06) nor WC (OR 1.01, 95%CI 0.99–1.03) were associated. Weight loss (OR 1.75, 95%CI 1.08–2.83) and mobility impairment (OR 3.35, 95%CI 1.67–6.73) remained as adjusted predictors of incident BADL disability, while anorexia almost reached the significance (OR 1.65, 95%CI 0.94–2.87).

Conclusion

Nutritional risk measured with the MNA-SF is associated with incident disability in BADL in older adults, while nutritional status measured with BMI or WC is not.     

Substanzkonsum und Gewaltwiderfahrnisse Jugendlicher

Background

Teen dating violence is discussed as a potential risk factor for harmful behaviour. For prevention strategies it is interesting to see the extent to which evidence can be found in epidemiological studies.

Methods

We searched the databases CINAHL, EMBASE, PsycINFO, Cochrane Library, Web of Science as well as in the free web for longitudinal studies which examined substance consumption as a result of teen dating violence.

Results

Seven studies fulfilled the inclusion criteria. Each one study described teen dating violence to increase marijuana consumption among girls (odds ratio [OR] 2.1, 95% confidence interval [95% CI] 1.22–3.70) and boys (OR 1.34, 95% CI 1.03–1.74), two studies with mixed sex population in boys (class 8: b = 0.55, p < 0.01; class 12: b = 1.14, p < 0.001) and in both sexes (ERR = 1.21, 95% CI 0.96–1.52; ERR = 1.30, 95% CI 0.81–2.11). Four studies observed increased consumption of tobacco in mixed sex group populations (B = 0.31, SE = 0.14, p < 0.03), in girls (OR 2.28, 95% CI 1.39–3.74; OR 1.53, 95% CI 1.13–2.06; OR 2.15, 95% CI 1.07–4.35) or boys (OR 3.04, 95% CI 1.16–7.95), whereas alcohol consumption was measured in 2 studies: in girls (OR 1.44, 95% CI 1.03–1.74) and in mixed sex study populations (B = 0.25, SE = 0.14; p < 0.5). Two studies described an increased substance dependence in girls (ß = 0.16; CI 0.06–0.26) and in mixed sex study population (OR = 10.61; p < 0.011).

Conclusion

The low effect dimensions, limitations caused by the study design and the lack of consideration of confounders presuppose that such interpersonal violence cannot be considered as a risk factor.

     

Informed participation in the Valencian Community Colorectal Cancer Screening Programme from a gender perspective

Objective

To examine the factors that influence informed participation in a Colorectal Cancer Screening Programme (CRCSP) from a gender perspective.

Parental concern regarding obesity in children with autism spectrum disorder in the United States: National Survey of Children's Health 2016

Background

The prevalence of obesity in children with autism spectrum disorder (ASD) exceeds that of the general population, but the level of parental concern about obesity in these children is unexplored.

Injuries to 15–19-year olds in road traffic crashes: a cross sectional analysis of police crash data

Aim

To describe the circumstances in which 15–19-year-old vehicle occupants are injured in road traffic crashes, compared with older casualties.

Subjects and methods

Regression analysis of UK STATS19 police road traffic casualty data from 2008–2010. Odds ratios used to compare circumstances between 15 to 19 and 25 to 59-year-old passenger and driver casualty groups.

Results

Amongst 15–19-year olds, there were 27,552 car passenger casualties and 28,322 car driver casualties. 15–19-year olds were at greatest risk of being injured as passengers when being driven by a 17–19-year old (adjusted OR 25.4, 95 %CI 23.95–26.91) or between 9 pm and 5.59 am (adjusted OR 1.9, 95 %CI 1.83–2.01). Motorway driving was associated with a significantly reduced risk (adjusted OR 0.55, 95 %CI 0.49–0.61). For driver casualties, 15–19 year olds were at greatest risk when carrying a 15–19-year-old passenger (adjusted OR 12.1, 95 %CI 11.55–12.70) and between 9 pm and 5.59 am (adjusted OR 2.3, 9 %CI 2.22–2.39). Motorway travel again saw a significantly reduced risk (adjusted OR 0.37, 95 %CI 0.34–0.41).

Conclusion

The main risk factors for road traffic injury to 15–19-year olds are travelling with occupants of a similar age or between 9 pm and 5.59 am. Other countries have implemented an intervention, graduated driver licensing (GDL), to tackle precisely these risk factors. The UK Government needs to review the case for GDL as a matter of urgency.     

Metformin Safety Warnings and Diabetes Drug Prescribing Patterns for Older Nursing Home Residents

Objective

Diabetes mellitus is common in US nursing homes (NHs), and the mainstay treatment, metformin, has US Food and Drug Administration (FDA) boxed warnings indicating safety concerns in those with advanced age, heart failure, or renal disease. Little is known about treatment selection in this setting, especially for metformin. We quantified the determinants of initiating sulfonylureas over metformin with the aim of understanding the impact of FDA-labeled boxed warnings in older NH residents.

School Violence,Depressive Symptoms,and Help-seeking Behavior: A Gender-stratified Analysis of Biethnic Adolescents in South Korea

Objectives:

In South Korea (hereafter Korea), the number of adolescent offspring of immigrants has rapidly increased since the early 1990s, mainly due to international marriage. This research sought to examine the association between the experience of school violence and mental health outcomes, and the role of help-seeking behaviors in the association, among biethnic adolescents in Korea.

Methods:

We analyzed cross-sectional data of 3627 biethnic adolescents in Korea from the 2012 National Survey of Multicultural Families. Based on the victim’s help-seeking behavior, adolescents who experienced school violence were classified into three groups: ‘seeking help’ group; ‘feeling nothing’ group; ‘not seeking help’ group. Multivariate logistic regression was applied to examine the associations between the experience of school violence and depressive symptoms for males and females separately.

Results:

In the gender-stratified analysis, school violence was associated with depressive symptoms in the ‘not seeking help’ (odds ratio [OR], 7.05; 95% confidence interval [CI], 3.76 to 13.23) and the ‘seeking help’ group (OR, 2.77; 95% CI, 1.73 to 4.44) among male adolescents after adjusting for potential confounders, including the nationality of the immigrant parent and Korean language fluency. Similar associations were observed in the female groups. However, in the ‘feeling nothing’ group, the association was only significant for males (OR, 8.34; 95% CI, 2.82 to 24.69), but not females (OR, 0.77; 95% CI, 0.18 to 3.28).

Conclusions:

This study suggests that experience of school violence is associated with depressive symptoms and that the role of victims’ help-seeking behaviors in the association may differ by gender among biethnic adolescents in Korea.     

Informed community mobilization for dengue prevention in households with and without a regular water supply: Secondary analysis from the Camino Verde trial in Nicaragua

Background

Studies in different countries have identified irregular water supply as a risk factor for dengue virus transmission. In 2013, Camino Verde, a cluster-randomised controlled trial in Managua, Nicaragua, and Mexico’s Guerrero State, demonstrated impact of evidence-based community mobilisation on recent dengue infection and entomological indexes of infestation by Aedes aegypti mosquitoes. This secondary analysis of data from the trial impact survey asks: (1) what is the importance of regular water supply in neighbourhoods with and without the trial intervention and (2) can community interventions like Camino Verde reasonably exclude households with adequate water supply?

Methods

Entomological data collected in the dry season of 2013 in intervention and control communities allow contrasts between households with regular and irregular water supplies. Indicators of entomological risk included the House Index and pupa positive household index. Generalised linear mixed models with cluster as a random effect compared households with and without regular water, and households in intervention and control communities.

Results

For the House Index, regular water supply was associated with a protection in both intervention households (OR 0.7, 95%CI 0.6–0.9) and control households (OR 0.6, 95%CI 0.5–0.8). For the pupa positive household index, we found a similar protection from regular water supply in intervention households (OR 0.6, 95%CI 0.4–0.8) and control households (OR 0.7, 95%CI 0.5–0.9). The Camino Verde intervention had a similar impact on House Index in households with regular water supply (OR 0.7, 95%CI 0.5–1.0) and irregular water supply (OR 0.6, 95%CI 0.4–0.8); for the pupa positive household index, the effect of the intervention was very similar in households with regular (OR0.5, 95%CI 0.3–0.8) and irregular (OR 0.5, 95%CI 0.3–0.9) water supply.

Conclusion

While Aedes aegypti control efforts based on informed community mobilisation had a strong impact on households without a regular water supply, this intervention also impacted entomological indices in households with a regular water supply. These households should not be excluded from community mobilisation efforts to reduce the Aedes aegypti vector.

Trial registration

ISRCTN27581154.

     

Notified tuberculosis among Singapore residents by ethnicity, 2002–2011

Setting:

The National Tuberculosis Programme in Singapore where, among resident cases, higher tuberculosis (TB) rates have been reported in ethnic Malays.

Objective:

To describe the socio-demographic and clinical characteristics of resident TB cases by ethnicity, and to assess whether Malays differ from other groups in terms of the above parameters.

Design:

Cross-sectional review of records from the tuberculosis registry’s electronic database.

Results:

Among 15 622 resident cases notified, 72.2% were Chinese, 18.7% Malay, 5.8% Indian and 2.9% were from other minorities. Compared to other ethnicities, Malays were more likely to be incarcerated at the time of notification (odds ratio [OR] 3.70, 95%CI 3.03–4.52) and clustered at the same residential address (OR 1.65, 95%CI 1.44–1.89), but were less likely to be aged ≥65 years (OR 0.61, 95%CI 0.54–0.70) or to reside in high-cost housing (OR 0.11, 95%CI 0.07–0.17). In terms of disease characteristics, more Malays had diabetes mellitus (OR 1.54, 1.37–1.73), a highly-positive acid-fast bacilli smear (OR 1.64, 95%CI 1.47–1.83) and cavitary disease on chest X-ray (OR 1.41, 95%CI 1.28–1.55).

Conclusion:

Compared to other ethnicities, reported TB cases among Malays were more severe and were likely to be more infectious. Increased vigilance in case management and contact investigations, as well as an improvement in the socio-economic conditions of this community, are required to reduce TB rates in this ethnic group.