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Shaw J, Bannister C, Ariyibi A, Fothergill R. Emergency medical dispatchers' experiences of using the Medical Priority Dispatch System telephone triage to identify maternity emergencies: a qualitative focus group study. BMJ Open 2024; 14:e078787. [PMID: 38508612 PMCID: PMC10952860 DOI: 10.1136/bmjopen-2023-078787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/20/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES The ambulance service plays a pivotal role in the provision of care in out-of-hospital maternity emergencies. Telephone triage of this patient group is complex and must be sensitive to an emergency situation to prevent unnecessary delays in treatment. This study aimed to explore emergency medical dispatchers' (EMDs) perceptions of the structured protocol they use. DESIGN Voluntary participation in semistructured phenomenological focus groups. The participants were asked to discuss their experiences of using Medical Priority Dispatch System Protocol 24 (pregnancy, childbirth and miscarriage). Thematic analysis was applied to code and group topics. Discussion between the EMDs is presented for each theme and their experiences, including quotes, are presented to offer an overview of the maternity protocol and its use. SETTING A large urban UK ambulance service. PARTICIPANTS 23 control room staff. RESULTS Perceptions of maternity emergencies, challenges with key questions, the need for sensitivity surrounding miscarriage, using prearrival instructions and postdispatch instructions to help patients and ideas for additional ProQA functionality emerged as the five overarching themes. Protocol 24 was considered to reflect many of the clinical factors EMDs associate with maternity emergencies although further factors, including some non-clinical, were suggested for inclusion. Miscarriage and termination-related calls were thought to be challenging as the language of the protocol is designed for pregnancy. However, instructions were generally considered well written and user-friendly, although some were thought to be unnecessary. EMDs were largely positive regarding the ProQA software, but felt backward navigation was difficult if a situation changed. CONCLUSIONS Maternity calls were considered rewarding but complex by EMDs. We suggest changes including the use of more sensitive language in response to miscarriage and termination and make recommendations for the omission and inclusion of specific instructions, as well as enhancements to key questions and functionality. Further research is needed to ensure focus group findings are generalisable to other services, particularly in other countries.
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Affiliation(s)
- Joanna Shaw
- Clinical Audit and Research Unit, London Ambulance Service NHS Trust, London, UK
| | | | | | - Rachael Fothergill
- Clinical Audit and Research Unit, London Ambulance Service NHS Trust, London, UK
- Warwick Clinical Trials Unit, University of Warwick, Coventry, UK
- Faculty of Health, Social Care and Education, Kingston University of London and St George's University of London, London, UK
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Abstract
BACKGROUND The prevalence of hypertension (HTN) in Blacks is among the highest in the world. For Black women, 46% experience stage 2 HTN (blood pressure [BP] ≥140/90 mm Hg) as compared with 42% of Black men. Because of higher rates of stage 2 HTN, Black women have greater rates of cardiovascular disease and stroke. For reasons unknown, nonadherence to lifestyle modifications and antihypertensive medications continues. An understudied potential factor associated with poor adherence to the treatment regimen and negative health outcomes is stigma. OBJECTIVE The aim of this study was to gain insight and describe the psychological factor of stigma as an influence on poorly controlled HTN in Black women. METHODS Hypertensive Black women attending a 6-week self-management program were invited to participate in an open-ended questionnaire. Six groups were held with 62 women aged 24 to 70 years, with group size ranging from 10 to 15. Women anonymously wrote their answer to 2 questions to capture individual responses without group persuasion. Data were analyzed using thematic analysis. RESULTS Five themes were generated inductively from the data and included (1) desire to get control, (2) shame and embarrassment, (3) obesity characterizations, (4) stereotype threats, and lastly, (5) disrupted normality. During member checking, younger participants were more vocal about stigma, whereas older participants did not view stigma as problematic. CONCLUSIONS Hypertension stigma could potentially deter adherence to high BP treatment. Further research is needed to explore the prevalence of stigma in this population and its impact on behaviors that hinder BP control.
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Gato WE, Acquah S, Nsiah P, Opoku ST, Apenteng BA, Johnson BK. Blood pressure control, glycemic control, and dyslipidemia among healthy adults in the Cape Coast metropolis, Ghana. Diabetes Metab Syndr 2019; 13:56-61. [PMID: 30641765 DOI: 10.1016/j.dsx.2018.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 08/21/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND The World Health Organization recommends the implementation of interventions focused on the early detection of clinical risk factors for cardiovascular disease (CVD) as effective strategies for the control of CVD in low resource settings. However, due to health system resource constraints, surveillance capacity for the identification of high-risk populations for non-communicable diseases, including CVD have been inadequate. The purpose of this study was to describe the prevalence of CVD clinical risk factors among healthy adults residing in the Cape Coast metropolis of Ghana. The clinical risk factors assessed included glycemic control, insulin sensitivity, lipid control and blood pressure. METHODS The study participants included 70 healthy adults without a previous diagnosis of CVD from Cape Coast metropolis. Blood samples, blood pressure and anthropometric measurement were obtained for each participant. Serum glycated hemoglobin (HbA1c), insulin, glucose, triglycerides, and cholesterol levels were measured. RESULTS Approximately four out of ten participants were either overweight or obese. Almost three-quarters of the sample were considered prehypertensive or hypertensive. About three in ten were clinically prediabetic. About a third of the participants had high non-HDL cholesterol levels. Triglyceride concentration levels were found to be high in almost 10 percent of the study sample. Approximately six percent were identified as having metabolic syndrome. CONCLUSION A significant proportion of the study participants were identified to be at risk for CVD. There is the need for adaptive and less resource-intensive CVD risk-factor screening interventions to allow for the timely detection and management of CVD risk factors in low-resource settings.
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Affiliation(s)
- Worlanyo Eric Gato
- Department of Chemistry & Biochemistry, Georgia Southern University, Statesboro, GA, 30458, USA.
| | - Samuel Acquah
- Department of Medical Biochemistry, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Paul Nsiah
- Department of Chemical Pathology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Tawiah Opoku
- Department of Health Policy & Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30458, USA
| | - Bettye Appiah Apenteng
- Department of Health Policy & Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, 30458, USA
| | - Benjamin Kwasi Johnson
- Department of Medical Biochemistry, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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van Laer SD, Snijder MB, Agyemang C, Peters RJ, van den Born BJH. Ethnic differences in hypertension prevalence and contributing determinants - the HELIUS study. Eur J Prev Cardiol 2018; 25:1914-1922. [PMID: 30296837 DOI: 10.1177/2047487318803241] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
AIMS There are important ethnic differences in the prevalence of hypertension and hypertension-mediated cardiovascular complications, but there is ongoing debate on the nature of these differences. We assessed the contribution of lifestyle, socio-economic and psychosocial variables to ethnic differences in hypertension prevalence. METHODS We used cross-sectional data from the Healthy Life In an Urban Setting (HELIUS) study, including 21,520 participants aged 18-70 years of South-Asian Surinamese ( n = 3032), African Surinamese ( n = 4124), Ghanaian ( n = 2331), Turkish ( n = 3594), Moroccan ( n = 3891) and Dutch ( n = 4548) ethnic origin. Ethnic differences in hypertension prevalence rates were examined using logistic regression models. RESULTS After adjustment for a broad range of variables, significant higher hypertension prevalence compared to the Dutch population remained in Ghanaian men (odds ratio 2.62 (95% confidence interval 2.14-3.22)) and women (4.16 (3.39-5.12)), African Surinamese men (1.62 (1.37-1.92)) and women (2.70 (2.29-3.17)) and South-Asian Surinamese men (1.22 (1.15-1.46)) and women (1.84 (1.53-2.22)). In contrast, Turkish men (0.72 (0.60-0.87)) and Moroccan men (0.50 (0.41-0.61)) and women (0.57 (0.46-0.71)) had a lower hypertension prevalence compared with the Dutch population. The differences in hypertension prevalence were present across different age groups and persisted after stratification for body mass index and waist-to-hip ratio. CONCLUSION Large ethnic differences in hypertension prevalence exist that are already present in young adulthood. Adjustment for common variables known to be associated with a higher risk of hypertension explained the higher adjusted prevalence rates among Turks and Moroccans, but not in African and South-Asian descent populations who remained to have a higher rate of hypertension compared to the Dutch host population.
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Affiliation(s)
- Stag D van Laer
- 1 Department of Internal and Vascular Medicine, Academic Medical Center, the Netherlands
| | - Marieke B Snijder
- 2 Department of Public Health, Amsterdam Public Health Research Institute, the Netherlands.,3 Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health Research Institute, the Netherlands
| | - Charles Agyemang
- 2 Department of Public Health, Amsterdam Public Health Research Institute, the Netherlands
| | - Ron Jg Peters
- 4 Department of Cardiology, Academic Medical Center, the Netherlands
| | - Bert-Jan H van den Born
- 1 Department of Internal and Vascular Medicine, Academic Medical Center, the Netherlands.,2 Department of Public Health, Amsterdam Public Health Research Institute, the Netherlands
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Variations in hypertension awareness, treatment, and control among Ghanaian migrants living in Amsterdam, Berlin, London, and nonmigrant Ghanaians living in rural and urban Ghana – the RODAM study. J Hypertens 2018; 36:169-177. [DOI: 10.1097/hjh.0000000000001520] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Ordúñez P, Kaufman JS, Benet M, Morejon A, Silva LC, Shoham DA, Cooper RS. Blacks and Whites in the Cuba have equal prevalence of hypertension: confirmation from a new population survey. BMC Public Health 2013; 13:169. [PMID: 23433343 PMCID: PMC3635894 DOI: 10.1186/1471-2458-13-169] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 02/21/2013] [Indexed: 12/05/2022] Open
Abstract
Background The excess burden of hypertension among blacks has been a prominent feature of the heath disparities literature, and many scientists presume it to be a stable and inevitable phenomenon. The underlying causes of this disparity can only be disentangled in a setting in which the population does not experience racial stratification of socioeconomic opportunities. While such conditions of racial equality remain uncommon, they may be approximated in Cuba, a country with a persistent policy of social inclusion over the last 5 decades. Methods We report on a 2010–2011 stratified probability sample of those aged 15–74 years from the urban population of Cienfuegos in central Cuba. A total of 1496 adults (880 women and 616 men) were recruited and assessed for blood pressure and anthropometrics according to standardized protocols, as well as medication use, educational attainment and observed skin tone (dichotomized into “black” and “white”). Weighted tabular and regression analyses were conducted to estimate adjusted prevalences of hypertension (> 140/90 mmHg) and adjusted prevalence odds ratios for contrasts between the two skin color groups. Results Mean pressures were higher for men than for women, but overall did not differ importantly between racial groups. About half of all diagnosed hypertensive men were on medication, a proportion that did not vary by racial group. For women, however, adjusted prevalence was somewhat higher among blacks, and treatment and control rates were also somewhat advantaged for white women. Conclusions Overall, skin color was unrelated to mean blood pressure or hypertensive status in this population, although among women specifically some racial advantage appears evident in adjusted prevalence and control, and should be investigated further. The overall null result suggests that Cuba may exemplify the social conditions in which racial excess in hypertension, characteristic of much of the western world, is not a necessary reality.
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Affiliation(s)
- Pedro Ordúñez
- Project for Chronic Disease Prevention and Control, Pan American Health Organization, Washington, DC 20037, USA
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Lamina S, Okoye CG, Ezema CI, Ezugwu UA, Amaeze AA, Nwankwo MJ. Effects and correlates of continuous training programme on psychosocial status and white blood cell count in men with essential hypertension: A randomized controlled trial. Health (London) 2013. [DOI: 10.4236/health.2013.59191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Picon RV, Fuchs FD, Moreira LB, Riegel G, Fuchs SC. Trends in prevalence of hypertension in Brazil: a systematic review with meta-analysis. PLoS One 2012; 7:e48255. [PMID: 23118964 PMCID: PMC3485225 DOI: 10.1371/journal.pone.0048255] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 09/21/2012] [Indexed: 02/04/2023] Open
Abstract
Background The prevalence of hypertension in emerging nations was scarcely described to date. In Brazil, many population-based surveys evaluated the prevalence in cities throughout the country. However, there is no population-based nationwide study of prevalence of hypertension. In this study, we estimated the prevalence of hypertension for the country and analyzed the trends for the last three decades. Methods Cross-sectional and cohort studies conducted from 1980 to 2010 were independently identified by two reviewers, without language restriction, in the PubMed, Embase, LILACS, and Scielo electronic databases. Unpublished studies were identified in the Brazilian electronic database of theses and in annals of Cardiology congresses and meetings. In total, 40 studies were selected, comprising 122,018 individuals. Results Summary estimates of prevalence by the former WHO criteria (BP≥160/95 mmHg) in the 1980’s and 1990’s were 23.6% (95% CI 17.3–31.4%) and 19.6% (16.4–23.3%) respectively. The prevalence of hypertension by the JNC criteria (BP≥140/90 mmHg) in the 1980’s, 1990’s and 2000’s were 36.1% (95% CI 28.7–44.2%), 32.9% (29.9–36.0%), and 28.7% (26.2–31.4%), respectively (P<0.001). In the 2000’s, the pooled prevalence estimates of self-reported hypertension on telephone inquiries was 20.6% (19.0–22.4%), and of self-reported hypertension in home surveys was 25.2% (23.3–27.2%). Conclusions The prevalence of hypertension in Brazil seems to have diminished 6% in the last three decades, but it still is approximately 30%. Nationwide surveys by self-reporting by telephone interviews underestimate the real prevalence. Rates of blood pressure control decreased in the same period, corresponding currently to only one quarter of individuals with hypertension.
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Affiliation(s)
- Rafael V. Picon
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Flávio D. Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, and the National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
| | - Leila B. Moreira
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, and the National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
| | - Glaube Riegel
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sandra C. Fuchs
- Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Hospital de Clinicas de Porto Alegre, Division of Cardiology, and the National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail:
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Korkor MT, Meng FB, Xing SY, Zhang MC, Guo JR, Zhu XX, Yang P. Microarray analysis of differential gene expression profile in peripheral blood cells of patients with human essential hypertension. Int J Med Sci 2011; 8:168-79. [PMID: 21369372 PMCID: PMC3047082 DOI: 10.7150/ijms.8.168] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2010] [Accepted: 02/21/2011] [Indexed: 12/20/2022] Open
Abstract
The polygenic nature of essential hypertension and its dependence on environmental factors pose a challenge for biomedical research. We hypothesized that the analysis of gene expression profiles from peripheral blood cells would distinguish patients with hypertension from normotensives. In order to test this, total RNA from peripheral blood cells was isolated. RNA was reversed-transcribed and labeled and gene expression analyzed using significance Analysis Microarrays (Stanford University, CA, USA). Briefly, Significance Analysis Microarrays (SAM) thresholding identified 31 up-regulated and 18 down-regulated genes with fold changes of ≥2 or ≤0.5 and q-value≤5% in expression. Statistically significantly gene ontology (GO) function and biological process differentially expressed in essential hypertension were MHC class II receptor activity and immune response respectively. Biological pathway analysis identified several related pathways which are associated with immune/inflammatory responses. Quantitative Real-Time RT-PCR results were consistent with the microarray results. The levels of C-reactive protein were higher in hypertensive patients than normotensives and inflammation-related genes were increased as well. In conclusion, genes enriched for "immune/inflammatory responses" may be associated with essential hypertension. In addition, there is a correlation between systemic inflammation and hypertension. It is anticipated that these findings may provide accurate and efficient strategies for prevention, diagnosis and control of this disorder.
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Affiliation(s)
- Melvin T Korkor
- Department of Internal Medicine and Cardiology, China-Japan Union Hospital, Norman Bethune College of Medicine, Jilin University, China
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Agyemang C, Kunst A, Bhopal R, Zaninotto P, Unwin N, Nazroo J, Nicolaou M, Redekop WK, Stronks K. A cross-national comparative study of blood pressure and hypertension between English and Dutch South-Asian- and African-origin populations: the role of national context. Am J Hypertens 2010; 23:639-48. [PMID: 20300070 DOI: 10.1038/ajh.2010.39] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND We compare patterns of blood pressure (BP) and prevalence of hypertension between white-Dutch and their South-Asian and African minority groups with their corresponding white-English and their South-Asian and African ethnic minority groups; and the contribution of physical activity, body sizes, and socioeconomic position (SEP); and the quality of BP treatment that may underlie differences in mean BP. METHODS Secondary analyses of population-based studies of 13,999 participants from the United Kingdom and the Netherlands. RESULTS Compared with Dutch South-Asians, all English South-Asian men and women had lower BP and prevalence of hypertension except for systolic BP in English-Indian men. Among Africans, the systolic BP did not differ, but the diastolic BP levels were lower in English-Caribbean and English- (sub-Sahara) African men and women than in their Dutch-African counterparts. English-Caribbeans had a lower prevalence of hypertension than Dutch-Africans. Compared with white-Dutch, white-English men and women had higher systolic BP levels, but lower diastolic BP levels. There were no differences in the prevalence of hypertension between the white groups. Most differences remained unchanged after adjustment for SEP, lifestyle, and body sizes in all ethnic groups. BP control rates were substantially lower among Dutch-African and Dutch South-Asian hypertensives than among their English counterparts (except Indians). CONCLUSIONS We found marked variations in BP and hypertension prevalence between comparable ethnic groups in England and the Netherlands. Poor BP control among Dutch South-Asians and Africans contributed to their disadvantage of the relatively high BP levels.
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Atkin K, Bradby H, Harding S. Pressing scientific and policy issues around ethnicity and health. ETHNICITY & HEALTH 2010; 15:213. [PMID: 20552473 DOI: 10.1080/13557858.2010.481821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Collin J, Hughes D. [Drug therapy and hypertension in the newspapers]. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2010; 101:181-5. [PMID: 20524387 PMCID: PMC6973887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Accepted: 01/19/2010] [Indexed: 07/26/2024]
Abstract
OBJECTIVE The most recent country-wide Canadian data have revealed that only 33% of people with hypertension take medication and fewer than half of them have their blood pressure under control. One of the most important reasons for difficulty in controlling blood pressure is lack of drug treatment compliance. In addition, media coverage of health facts has an impact on beliefs, attitudes and behaviours related to health. Our goal was to analyze newspaper coverage of drugs related to hypertension. METHOD We conducted a thematic content analysis of newspapers covering medications related to hypertension. The study comprised 104 articles drawn from three of the most important francophone daily newspapers in Canada--a reference one, a general broadsheet and a tabloid. RESULTS We identified three major themes: 1) drugs as an effective treatment, 2) specific problematic cases, and 3) problems with the pharmacological approach in general. We noted a gradual change from positive to negative as we moved from the most serious newspaper to the most popular. We discuss the Fiske hypothesis which suggests that tabloid-format newspapers are a repository of popular opposition to the discourse of groups who hold power in society. CONCLUSION In the tabloid, the most widely-read newspaper in Quebec, medications are often presented in negative fashion in articles on hypertension. However, further studies are required to determine if there is a causal association between media discourse and the phenomenon of lack of drug treatment compliance.
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Affiliation(s)
- Johanne Collin
- Faculté de pharmacie, Université de Montréal, Case postale 6128, succursale Centre-ville, Montréal, Québec H3C 3J7.
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Wong SK, Wai-Chung Lai L, Ho DCW, Chau KW, Lo-Kuen Lam C, Hung-Fai Ng C. Sick building syndrome and perceived indoor environmental quality: A survey of apartment buildings in Hong Kong. HABITAT INTERNATIONAL 2009; 33:463-471. [PMID: 32287695 PMCID: PMC7124323 DOI: 10.1016/j.habitatint.2009.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The outbreak of a highly communicable disease, SARS, in Asia in 2003 has revealed the health risk of living in a high-density environment. To show the important connection between human health and environmental quality, this study surveys the prevalence of sick building syndrome (SBS) among apartment residents and their evaluation of indoor environmental quality (IEQ). Based on a sample of 748 households living in Hong Kong, two interesting findings are revealed: (1) nasal discomfort was the commonest home-related SBS symptom despite the absence of any central ventilation system in apartment buildings; (2) noise, rather than ventilation, was the major IEQ problem perceived by residents. Our statistical analysis further showed that residents with SBS symptoms were less satisfied with their IEQ than those without. That is, despite a positive evaluation of specific IEQ criteria with respect to the building residents lived in, if they reported feeling SBS related symptoms, the overall IEQ evaluation of their building could still be negative. This perception bias gives rise to a sample selection problem in measuring perceived IEQ, which has implications on housing management practices and the formulation of a healthy housing policy.
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Affiliation(s)
- Siu-Kei Wong
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Lawrence Wai-Chung Lai
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Daniel Chi-Wing Ho
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Kwong-Wing Chau
- Department of Real Estate and Construction, The University of Hong Kong, Pokfulam Road, Hong Kong
| | - Cindy Lo-Kuen Lam
- Family Medicine Unit, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Chris Hung-Fai Ng
- Development Bureau, Hong Kong Special Administrative Region Government, Hong Kong
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Alvi FM, Hasnain S. ACE I/D and G2350A Polymorphisms in Pakistani Hypertensive Population of Punjab. Clin Exp Hypertens 2009; 31:471-80. [DOI: 10.1080/10641960902825479] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Agyemang C, Addo J, Bhopal R, Aikins ADG, Stronks K. Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review. Global Health 2009; 5:7. [PMID: 19671137 PMCID: PMC2734536 DOI: 10.1186/1744-8603-5-7] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 08/11/2009] [Indexed: 11/18/2022] Open
Abstract
Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe.
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Affiliation(s)
- Charles Agyemang
- Department of Social Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
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Abstract
AIMS Intrauterine growth restriction (IUGR) has been demonstrated to have serious consequences for health in adult age. These include an increased risk for metabolic syndrome, pulmonary and cardiovascular disorders. These disorders are in part secondary to the development of arterial hypertension, which has been demonstrated to be more frequent in individuals subjected to restricted intrauterine growth. METHODS A review on publications on pathogenesis and epidemiology of hypertension associated to IUGR. RESULTS Current concepts for this association include a reduced nephrogenesis and increased arterial stiffness, impaired sympathetic regulation and steroid metabolism secondary to IUGR. Early postnatal risk-modifying factors include among others catch-up growth leading to childhood overweight. CONCLUSION IUGR increases the risk of hypertension in adult life. Identifying relevant risk factors for arterial hypertension will be the basis for the development of preventive concepts to be applied for predisposed individuals.
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Affiliation(s)
- Ludwig Gortner
- University Children's Hospital, University of the Saarland, Germany.
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Abstract
The aim of this study was to assess blood pressure variability (BPV) and its determinants in untreated hypertensive children. The study group consisted of 124 children, 91 boys and 33 girls, aged 14.9+/-2.5 with essential hypertension and no use of antihypertensive drugs. The subjects underwent routine examination, blood tests and ambulatory blood pressure (BP) monitoring. BPV was defined as the value of the standard deviation of BP for day- and night time periods. Daytime BPV was higher than night time BPV, and systolic BPV was higher than diastolic BPV. Significant positive correlations between 24-h, day- and night time systolic blood pressure (SBP), but not for diastolic blood pressure (DBP), and BPV were observed. In univariate analysis, day- and night time systolic BPVs were correlated with fasting glucose (r=0.609, P=0.02 and r=0.439, P=0.04); daytime systolic BPV, daytime diastolic BPV and night time systolic BPV were correlated with birth length (r=0.428, P=0.04; r=0.426, P=0.04 and r=0.439, P=0.04, respectively), and night time systolic BPV and night time diastolic BPV were correlated with age (r=0.604, P=0.02 and r=0.833, P=0.0001). However, in multiple linear regression analysis, daytime diastolic BPV was determined only by gender and systolic 24-h BP; night time systolic BPV depended on age, daytime SBP and DBP values, and daytime SBP and DBPs were determinants of night time diastolic BPV. The results highlighted the complex nature of BPV, with favourable role of host factors in its aetiology. The determinants of BPV in children are consistent with those in adults. Relationships between BPV and its determinants in untreated hypertensive subjects ought to be investigated in further researches.
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Affiliation(s)
- L J Krzych
- Department of Paediatric Cardiology, Medical University of Silesia, Katowice, Poland.
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Affiliation(s)
- V J Karthikeyan
- Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK
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