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  • ISSN: 2379-0547
    Volume 5, Issue 2
    Research Article
    Adeola Sonaike* and Scott McDoniel
    Epidemiologic surveillance indicates increased susceptibility to obesity among children with special health care needs (SHCN) in comparison to children without SHCN. Focusing on the impact that patient-provider interactions have on health behaviors and health outcomes, this paper explores clinician-initiated obesity management counseling received by children with SHCN by conducting a retrospective medical review. An independent two-tailed sample t-test compared the incidence of obesity management counseling received by children with and without SHCN over a 2-year timeframe. This t-test revealed a statistically significant difference between the frequency of weight management counseling received by youth with SHCN in the 2-year timeframe (M= 1.0, SD =0.46498) and the frequency of weight management counseling received by youth without SHCN in the 2-year timeframe (M = 2.0, SD = 0.74975), t(100) = 7.826, p = 0.000, a = 0.05. This paper supports the theory that disparities in obesity-related health outcomes experienced by children with SHCN can be partially attributed to limitations in standardized clinician-initiated health practices for specialized populations. As disparities in health outcomes for people with SHCN continue to grow, it is recommended that standardized preventive health practices and diagnosis-specific preventive health screening tools be developed and provided to current and future general health practitioners.
    Ekram W. Abd El-Wahab* and Noha S. Moustafa
    Background: Smoking is an avoidable behavioral cause of premature morbidity and mortality. The initiation, continuation and dependence of smoking are associated with several personal, environmental and socio-cultural factors which vary between age groups and geographical regions.
    Objective: To investigate the pattern of smoking cessation and the extent of the smoking dependence among smokers in urban and rural societies in Egypt.
    Methods: A cross-sectional study was conducted targeting a random sample of 552 adult smokers aging 11-75 years. All participants were inquired about their demographic features, life style and behaviors, motives for smoking cessation and quitting attempts using a predesigned interviewing questionnaire. Nicotine dependence was assessed using Fagerström scoring scale.
    Results: About 28.1% of the participants admitted a motivation to quit smoking and about 61.1% had at least an attempt. The longest duration of quitting was =5 years as reported by utmost 4.0% of the smokers. The drive to quit smoking was advice of a family member (39.9%) or a doctor (30.1%), concerns about smoking hazards (19.7%) or due to financial limitations (12.7%). The more frequently used method to quit smoking were cold turkey (23.4%), gradual reduction (15.9%), and the use of nicotine replacement therapy (12.5%). Moderate and high nicotine dependence was achieved by 46.7% and 24.6% respectively. Moderate and high nicotine dependence was achieved by 46.7% and 24.6% respectively. Male gender was the single predictor of smoking dependence. Motivation to stop smoking was associated with the presence of social support and having low dependence score.
    Conclusion: Nicotine dependence was significant at younger ages. Therefore, smoking cessation program should be a top priority and targeted to prevent smoking in adolescence. Appropriate interventions addressing individuals' motives and considering pharmacotherapy are needed to encourage successful quit attempts.
    Enabulele O, Ajokpaniovo J, and Enabulele JE*
    Background: Waiting time is an important indicator of patient satisfaction and the operational effectiveness and efficiency of a health facility. This study assessed patient waiting and consultation time in the General Practice Clinic of the University of Benin Teaching Hospital as well as assessed the association between waiting time and patient satisfaction with care received.
    Materials and Methods: This was a cross-sectional analytic study conducted in the General Practice Clinic of University of Benin Teaching Hospital, Nigeria. Analysis was done using Chi-square test, Mann Whitney U test, Kruskal Wallis test to test the association between waiting and consultation times with care satisfaction. We used binary logistic regression to evaluate the independent predictors of care satisfaction.
    Results: A total of 336 participants were recruited for the study. Participants comprised of 216 females and 120 males. The waiting time spent by the patients before they had their first contact with the medical doctor ranged from 11-354 minutes with a mean of146.75±55.38 minutes. The consultation time ranged from 3-88 minutes with a mean of 22.43±12.12 minutes. Those who rated the medical care as poor were observed to have had longer waiting time (mean waiting time of 219.88±65.95 minutes). While, those who rated the medical care received as excellent had the highest mean consulting time of 25.57±13.23 minutes.
    Conclusion: Compared to the recommended average patient waiting time of 30 minutes, patient waiting time in this study was prolonged and was a significant independent predictor of satisfaction with medical care.
    However, the consultation time was close to the recommended average consultation time of 15 minutes. This study advocates the need for future studies to assess the reasons responsible for the prolonged waiting time in order to provide remedial solutions aimed at improving the quality of care rendered to patients.
    Zemenu Shiferaw* and Liyew Mekonen
    Background: Currently, Ethiopia is placed heavy emphasis on the rationale of family planning. Although contraceptives prevalence has been increasing; switching and discontinuation still remains high. Examining factors of contraceptive switching is important in order to reduce switching rate which in turn, can impact levels of unintended pregnancy, induced abortion, and fertility rates.
    Objective: This study assessed prevalence and factors affecting contraceptive switching among women of Child bearing age (15-49) in Jijiga town, Eastern Ethiopia, 2015.
    Methods: A community based cross- sectional study design was conducted in Jijiga town among 537 women whoever had contraceptive use history in the last three years before the survey. Systematic random sampling was employed. The data was collected using pretested structured questionnaire and analyzed using SPSS version 21 and MS-Excel. Life table analysis and Cox-regressions was done.
    Results: A total of 703 contraceptive segments and 537 women were analyzed in the life table. At the end of 12 month of use 19% of use segments were discontinued and 16% were switched, i.e. switching accounts 86.8% of discontinuation. Type of contraceptive method (AHR: 3.62 95% CI: 2.5, 5.13), use intention (AHR: 1.43, 95% CI: 1.00, 2.05), parity (AHR: 2.09 95% CI: 1.31, 3.35) and quality of service with counseling (AHR: 2.49, 95% CI: 1.704, 3.65) were found to be predictors of contraceptive method switching.
    Conclusion: Majority of discontinued contraceptive use segments were switched to the other method. Lack of proper counseling, use of short acting methods, and high parity were predictors of switching. Side effects, need of more effective method and method inconvenience were widely reported reasons for switching. Hence, family planning programs need to emphasize on eminence of FP counseling, lowering fertility rates and increase access and use of long acting contraception.
    Adegbola Meeden Ige, Adekunle Joseph Ariba, Sunday Olukayode Malomo, Oluwaseun Solomon Ojo*
    Background: The detection of microalbuminuria (MAL) is a point of care test in primary care that indicates early kidney disease among patients with essential hypertension. Despite the strong prognosticating index of UAE in hypertension, there is a dearth of local studies at primary care setting that elucidate the relationship between UAE and BP level. The aim of the study was to assess the relationship between UAE and BP level in patients with essential hypertension attending a primary care clinic in South West Nigeria.
    Methods: This was a cross-sectional hospital based study. Data were collected through a pre-tested interviewer administered questionnaire. Systematic random sampling technique was used in selecting 360 respondents with essential hypertension. They were screened for MAL using Micral Test strip- II from Roche Diagnostics. Statistical Package for Social Sciences (SPSS) version 17.0 was used to analyze data.
    Results: The prevalence of MAL was 77.5%. BP was controlled in 24.7% of the respondents. Microalbuminuric respondents had higher mean BP compared to their normo-albuminuric counterparts (P<0.001). Urinary MAL was directly associated with age (P=0.02) and severity of hypertension according to JNC VII criteria (P=0.01).
    Conclusions: The high prevalence of MAL in this study underscores the significance of screening for MAL in patients with essential hypertension at diagnosis and at intervals during therapy. This is particularly more important among those with uncontrolled BP and elderly patients. This will assist in risk stratification and appropriate management.
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