Factors associated with patients' trust in their general practitioner: a cross-sectional survey.

This study aimed to identify factors that are associated with patients' overall trust in their general practitioner (GP). A survey of patients in ten general practices in the East Midlands was conducted. Most patients (76%) reported high levels of trust in their GP. Regression analysis showed that measures of the quality of the GP-patient relationship (GP-patient communication, interpersonal care, and knowledge of the patient) were strongly associated with trust in a patient's usual GP, whereas patients' reports of duration of registration with the practice, and proportion of visits to the usual GP were not.     

Neurofibromatosis type 1 in Israel: survey of young adults.

Neurofibromatosis type 1 (NF1) (von Recklinghausen's disease) is one of the most common human autosomal dominant disorders. In a survey of 374440 17 year old Jewish recruits for military service, 390 cases of NF1 were discovered, with a prevalence of 1.04/1000 (0.94/1000 for males and 1.19/1000 for females), or two to five times the reported prevalence of this disease. NF1 was more common in youngsters whose parents were of North African and Asian origin (1.81/1000 and 0.95/1000, respectively) and less common in those of European and North American origin (0.64/1000). All these differences were statistically significant and may be partially explained by the more advanced parental age of the NF group (as suggested by the larger number of children in the North African and Asian families) or by founder effect or both. The height and weight of the NF1 subjects was significantly lower than those of the controls. The intelligence score of persons with NF1 was similar to that of the control group when corrected for gender and ethnic origin. No significant increase in epilepsy or mental illnesses was found. This study provides evidence of the high overall prevalence of NF1 among Jews in Israel, with significantly increased prevalence in certain ethnic groups.     

Internet use for information seeking in clinical practice: a cross-sectional survey among French general practitioners

BackgroundMedical information needs regarding patient care are particularly large for general practitioners (GPs). The Internet seems to be a relevant but underused tool to seek medical information.ObjectiveWe aimed to describe the characteristics of the French GPs using the Internet for information seeking, to identify the barriers to its use and the factors that could facilitate it.MethodWe conducted a cross-sectional survey among GPs currently practicing in France, using an online questionnaire, in July 2009. We analysed the answers of 721 respondents.ResultsMost of the respondents used the Internet to seek information. They were significantly younger, worked in group practice, had Internet training and had Internet access at the practice. The main barriers were related to the physician (lack of knowledge or specific skills), to the practice conditions (lack of time, concerns about relationship with patient, financial non-recognition) and to the information (information overload, quality concerns, low relevance, language barrier). Practitioners wanted more reliable and more relevant documents for daily practice. Websites with already selected resources could increase the GPs use of the Internet for medical information seeking.ConclusionThe reported obstacles were largely common with those previously described in other countries, except the language barrier and the financial non-recognition. Even if the generalization of our results to all French GPs should be cautious, the study provided better insights into the obstacles to the Internet use to seek clinical information in family practice and the factors that could facilitate it.     

Frontal EEG asymmetry and sensation seeking in young adults

Sensation seeking has been characterized as a desire to seek novel, intense sensations, and the willingness to take risks in pursuing them. In two separate studies of young adults, we examined the relation between measures of sensation seeking and the pattern of resting frontal EEG asymmetry, thought to reflect a biological predisposition to approach new experiences. As predicted, high sensation seeking was related to a greater relative left frontal activity at rest in both studies, which may be specific to men. How greater relative left frontal cortical activity at rest is related to a tendency to engage in sensation-seeking and risky behaviors is discussed.     

Factors associated with asthma in young Danish adults.

BACKGROUND: The prevalence of asthma appears to be increasing, but our knowledge about factors associated with asthma in young adults is limited. Factors associated with asthma were studied in 624 (66% of those invited) young Danish adults (aged 19 to 29 years). OBJECTIVE: The purpose of this study was to investigate the prevalence and predictors of asthma in young Danish adults. METHODS: Case history, including respiratory symptoms, smoking habits, education, and employment, was obtained by interview, and a questionnaire and was used to evaluate the presence or absence of asthma. Pulmonary function, beta2-reversibility, airway responsiveness to histamine, and blood eosinophil count were measured using standard techniques. RESULTS: The lifetime prevalence of asthma in these young Danish adults was 17%, and the prevalence of current asthma was 9%. The proportion of current smokers was disturbingly high, 41%, and, further, the proportion of current smokers was significantly higher among those with asthma than among those without asthma (52% and 38%, respectively; P < 0.01). Asthma was significantly associated with current smoking, with lower than predicted forced expiratory volume in 1 second, with lower than predicted ratio of forced expiratory volume in 1 second/forced vital capacity, atopy, higher eosinophil count, and higher degree of airway responsiveness to histamine. The proportion of subjects with no education after junior high school was higher among those with asthma than among those without asthma (P < 0.05). Further, 16 of the 103 (16%) people with asthma had work-related worsening of their respiratory symptoms. CONCLUSIONS: The presence of current asthma was predicted by current smoking, lower level of lung function, less education, higher blood eosinophil count, and more pronounced airway responsiveness. Further, the proportion of current smokers was higher among asthmatic subjects than among nonasthmatic subjects. Greater efforts must be made to encourage young people with asthma not to smoke.     

General practitioners with special clinical interests: a cross-sectional survey.

A survey was conducted to identify general practitioners with special clinical interests (GPSCIs) and to obtain views about their role. Approximately, 16% of GPs in the United Kingdom (n = 4000) provide specialist clinical services outside their core general practice commitments. This pool of expertise has important implications for the implementation of the NHS Plan and for workforce planning within primary care trusts.     

Factors influencing the participation of adolescents and young adults with a congenital heart disease in a transition education program: A prospective multicentre controlled study

ObjectiveTransition education programs dedicated to adolescents and young adults with congenital heart disease (CHD) aim to facilitate transfer to adult cardiology and bring more autonomy to teenagers. This prospective controlled multicentre study analysed the factors influencing the participation in a transition education program.MethodsCHD patients aged 13–25 y were offered to participate in the transition program. A multiple linear regression identified the explanatory factors for participation in the program.ResultsA total of 123 patients (mean age 19.6 ± 3.4 y) were included in the study, with 57 participants and 66 non-participants. Both groups showed similar socio-demographic and quality of life characteristics, low level of physical activity with muscular deconditioning and high exposure to risk behaviours (71% patients with ≥1 risk factor). Patients with complex CHD (OR = 4.1, P = 0.03), poor disease knowledge (OR = 0.3, P = 0.02), risk behaviours (body piercing, OR = 5.53, P = 0.01; alcohol, OR = 3.12, P = 0.06), and aged <20 y (OR = 0.29, P = 0.03), were more likely to join the program.ConclusionMany risk factors influencing the participation of adolescents and young adults with CHD in transition education programs are controllable.Practice implicationFurther randomized studies are necessary to evaluate the impact of transition education program on quality of life, successful transfer to adult centre and, ultimately, prognosis.     

Factors associated with herbal use among urban multiethnic primary care patients: a cross-sectional survey

Background  

The use of herbal supplements in the United States has become increasingly popular. The prevalence of herbal use among primary care patients varies in previous studies; the pattern of herbal use among urban racially/ethnically diverse primary care patients has not been widely studied. The primary objectives of this study were to describe the use of herbs by ethnically diverse primary care patients in a large metropolitan area and to examine factors associated with such use. The secondary objective was to investigate perceptions about and patterns of herbal use.     

Allergic rhinitis and asthma comorbidity in a survey of young adults in Italy

BACKGROUND: Several studies have provided evidence of a strong association between asthma and allergic or nonallergic rhinitis, leading to the hypothesis that allergic rhinitis (AR) and asthma represent a continuum of the same disease. AIM: The aims of our study were: (i) to measure the comorbidity of AR and asthma and asthma-like symptoms and (ii) to assess whether asthma, AR, and their coexistence share a common pattern of individual risk factors. METHODS: The subjects are participants from the Italian multicentre, cross-sectional survey on respiratory symptoms in the young adult general population (Italian Study of Asthma in Young Adults, ISAYA). The relationship between individual risk factors and asthma, AR and their coexistence, was studied by means of a multinomial logistic regression. RESULTS: About 60% of asthmatics reported AR. On the other hand, subjects with AR presented an eightfold risk of having asthma compared to subjects without AR. Age was negatively associated with asthma [OR = 0.89, 95% confidence interval (CI): 0.82-0.96], AR (OR = 0.92, 95% CI: 0.86-0.98), and asthma associated with AR (OR = 0.83, 95% CI: 0.79-0.88). The risk of AR without asthma was significantly higher in the upper social classes (OR = 1.23, 95% CI: 1.08-1.39). Active current smoking exposure was positively associated with asthma alone (OR = 1.24, 95% CI: 1.09-1.41) and negatively associated with AR with (OR = 0.69, 95% CI: 0.54-0.88) or without (OR = 0.76, 95% CI: 0.69-0.84) asthma. CONCLUSIONS: Asthma and AR coexist in a substantial percentage of patients; bronchial asthma and AR, when associated, seem to share the same risk factors as AR alone while asthma without AR seems to be a different condition, at least with respect to some relevant risk factors.     

Coping with sleep disturbances among young adults: a survey of first-year college students in Taiwan

Sleep problems are highly prevalent among young adults and affect different aspects of their quality of life. In this study, the authors aimed to investigate the young adults' coping strategies for these sleep disturbances and the effectiveness of the coping strategies upon sleep quality and daytime sleepiness. The subjects included 1,922 first-year college students, 44% of whom reported experiencing sleep problems, with insufficient sleep being the most common complaint (23.9%). Taking naps and adjusting sleep schedules were the coping strategies associated with better sleep quality. On the other hand, subjects who reported attempting a sleep-promoting activity, ignoring their sleep problems altogether, or trying unsuccessfully to find a way of coping with their sleep problems reported a poorer sleep quality. Although some coping strategies were associated with better sleep quality than others, the levels of daytime sleepiness were equally impaired in all coping groups to a degree that is equivalent to the sleepiness in patients with a moderate sleep-related breathing disorder.     

Factors related to allergic sensitization to aeroallergens in a cross-sectional study in adults: The Copenhagen Allergy Study

BACKGROUND: The factors underlying recent increases in the prevalence of respiratory allergy are largely unknown. OBJECTIVE: To assess the association between allergic sensitization and several lifestyle/environmental factors. METHODS: A cross-sectional population-based study of 15-69-year-olds in Copenhagen was carried out in 1990. The participation rate was 77.5% (1112/1435). Different lifestyle/environmental factors (explanatory variables) were defined based on questionnaire data. Dependent (outcome) variables were skin prick test (SPT) positivity or specific IgE positivity to common aeroallergens. Explanatory variables associated with outcome in univariate analysis (P < 0.25) were selected for multivariate analysis. Subsequently, a final model for each dependent variable was obtained by stepwise regression analysis (cut-off for entry/removal of variables: P < 0.1). RESULTS: Male sex, young age, low number of siblings, a positive family history of hay fever and never smoking, were independently associated with both SPT positivity and specific IgE positivity. Furthermore, SPT positivity was positively associated with alcohol consumption (dose-response relationship only), and negatively associated with previous keeping of a dog in the household. The association between alcohol consumption and SPT positivity was mainly due to the consumption of wine and remained after adjustment for educational level. Specific IgE positivity was furthermore associated with body mass index with no apparent dose-response relationship. CONCLUSION: Being male, young age, a positive family history of hayfever, low number of siblings and never smoking, were independently associated with allergic sensitization. In addition, the results indicated a possible relationship of alcohol consumption, body mass index and previous keeping of a dog in the household to allergic sensitization. There is a need for prospective studies of risk factors for respiratory allergy.     

Family influences in a cross-sectional survey of higher child attendance.

BACKGROUND: A quarter of all consultations are for children, but there is little quantitative evidence documenting what parental factors are important in the decision to consult. AIM: To assess parental factors in higher child attendance (three or more times per year)--the 32% responsible for most (69%) general practice consultations with children. DESIGN OF STUDY: A random sample of 4000 individuals (one per household), including 670 children. SETTING: Six general practices within a 30-mile radius of the administrative centre. METHOD: Parents completed a postal questionnaire for themselves and their child. The adult questionnaire documented lifestyle, attitude to doctors and medicine, Kokko's personality types, perceived health, health anxiety, number of medical problems, medically unexplained somatic symptoms, and willingness to tolerate symptoms. The child questionnaire documented perceived health, the number of medical problems, somatic symptom inventory, willingness to tolerate symptoms, and self-reported attendance. RESULTS: (Adjusted odds ratios, test for trend, 95% confidence intervals.) A response rate of 490/670 (73%) paired adult and child questionnaires was obtained. Reported higher attendance was valid compared with the notes (likelihood ratio positive test = 5.2, negative test = 0.24), and was independently predicted by the child's age, medical problems, council house occupancy, and by the parents' assessment of the severity of the child's ill health. After controlling for these variables, higher attendance was more likely if the parents were higher attenders (adjusted OR = 3.71, 95% CI = 2.31-5.98), and if they perceived their children had medically unexplained physical symptoms (MUPS) (for 0, 1, 2, 3+ symptoms; adjusted ORs (95% CIs) = 1, 3.1 (1.7-5.7), 2.30 (0.97-5.5), 4.2 (1.8-9.6) respectively, P < or = 0.001). Attendance was less likely if they were willing to tolerate symptoms in their children (score for seven normally self-limiting scenarios = 0-17, 18-29 and 30+; adjusted ORs = 1, 0.71, 0.39 respectively, z for trend P = 0.03), willingness to tolerate symptoms and parental perception of child MUPS were associated with council house tenancy and health anxiety. Parents' perception of child MUPS also related to perception of child health and the parents' own MUPS. Parents of higher attenders were more likely to be depressed (HAD depression scale = 0-7, 8-10, 11+ respectively; adjusted ORs (95% CIs) = 1, 2.04 (1.27-3.27), 1.60 (0.75-3.42)) or anxious (anxiety scale 0-7, 8-10, 11+, respectively; adjusted ORs [95% CIs] = 1, 1.60 [0.99-2.58], 1.97 [1.20-3.26]). CONCLUSION: Important parental factors are council house tenancy, the parents' perception of and willingness to tolerate, somatic symptoms in the child, and the parents' own attendance history, health anxiety, and perception of somatic symptoms Doctors should be sensitive to the parental and family factors that underlie the decision to consult and of the needs of parents of high-attending children.     

Help seeking behavior and the Internet: a national survey

Health-related websites have the potential to powerfully influence the attitudes and behavior of consumers. Access to reliable disease information online has been linked to reduced anxiety, increased feelings of self-efficacy, and decreases in utilization of ambulatory care. Studies report that Internet health information seekers are more likely to have health concerns; adult seekers are more likely to rate themselves as having poor health status and adolescent seekers are more likely to demonstrate clinical impairment or depressive symptomatology compared to non-seekers. Although more and more Americans are using the Internet for healthcare information, little is known about how this information affects their health behaviors. The current study extends the literature by examining characteristics associated with help seeking, either from a healthcare provider or from peers, as a direct result of health information found online. Medical care seekers appear to be using the Internet to enhance their medical care; they report using the information online to diagnose a problem and feel more comfortable about their health provider's advice given the information found on the Internet. Support seekers tend to be of slightly lower income compared to non-support seekers. They are also significantly more likely to have searched for information about a loved one's medical or health condition, signaling that many of these consumers may be caretakers.     

Barriers to treatment seeking in primary insomnia in the United Kingdom: a cross-sectional perspective

STUDY OBJECTIVES: To examine the most commonly perceived barriers to treatment seeking among individuals in the United Kingdom diagnosed with primary insomnia. Although there are effective treatments, the rate of insomnia in the United Kingdom is 22%, which is substantially higher than in other parts of Europe and in the United States. DESIGN: Cross-sectional. SETTING: Treatment and research clinic at a university department of psychiatry. PARTICIPANTS: Fifty-six women and 29 men who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-TR criteria for primary insomnia who had (n = 48) or had not (n = 37) sought treatment. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: Endorsement of reasons for not seeking treatment on the Barriers to Treatment Questionnaire. The most commonly endorsed reasons for not seeking treatment were the perception of insomnia as benign, trivial, or a problem that one should be able to cope with alone. Other commonly endorsed barriers to treatment related to lack of awareness of treatment options and to perception of the available treatment options as ineffective and unattractive. CONCLUSIONS: Given the chronicity and serious adverse consequences of insomnia, this study suggests that programs of public health awareness designed to reduce the perception of insomnia as trivial and to increase awareness of the effective treatments available may be important for reducing the prevalence of insomnia in the United Kingdom.