At-risk internet addiction and related factors among senior high school teachers in Japan based on a Nationwide survey.

BACKGROUND: Internet addiction (IA) has been drawing attention to mental health. However, few reports have been found on the related factors of at-risk IA among regular workers by a nationwide survey. The study aimed to evaluate the characteristics of at-risk IA and identify related factors among senior high school teachers in Japan. METHODS: This survey was a cross-sectional survey of high schools across Japan in 2017. There were 3189 teachers (2088 males and 1098 female) who participated in this survey. The questionnaire asked about their devices, both the time and the activities of using their internet, and sociodemographic factors. IA was measured by the internet addiction test (IAT) by which 40-79 points were classified as at-risk IA, and more as IA. We compared the related factors of at-risk IA and non-IA using descriptive analysis and multivariable regression analysis. RESULTS: The rates of IA and at-risk IA were 0.09% (n = 3) and 6.91% (n = 220), respectively. At-risk IA was positively associated with activities on the internet for gaming, entertainment, net-surfing, and younger ages. In addition, the at-risk IA group had a longer time spent on the internet than the non-IA group. CONCLUSIONS: Around 7% of high school teachers are at-risk IA in this survey, though they have regular work. Our results suggest that at-risk IA may be reinforced not only by the active internet use such as gaming, but also by purposeless behaviors, such as net-surfing. Managing time on the internet may support preventing at-risk IA among senior high school teachers.

Evidence-Based Decision Making 6: Administrative Databases as Secondary Data Source for Epidemiologic and Health Service Research.

Health-care systems require reliable information on which to base health-care planning and make decisions, as well as to evaluate their policy impact. Administrative data, predominantly captured for non-research purposes, provide important information about health services use, expenditures, and clinical outcomes and may be used to assess quality of care. With increased digitalization and accessibility of administrative databases, this data is more readily available for health service research purposes, aiding evidence-based decision making. This chapter discusses the utility of administrative data for population-based studies of health and health care.

Parasitic stool testing in newly arrived refugees in Calgary, Alta.

OBJECTIVE: To determine the prevalence of intestinal parasites and rates of stool testing compliance, as well as associated patient characteristics, among newly arrived refugees at the Mosaic Refugee Health Clinic in Calgary, Alta. DESIGN: Retrospective chart review. SETTING: Primary care clinic for refugee patients. PARTICIPANTS: A total of 1390 new refugee patients at the clinic from May 1, 2011, to June 30, 2013. MAIN OUTCOME MEASURES: Stool ova and parasite test completion and proportion of positive test results. RESULTS: Of 1390 patients, 74.1% (95% CI 71.7% to 76.4%) completed at least 1 stool ova and parasite test. Among those completing tests, 29.7% (95% CI 26.9% to 32.6%) had at least 1 positive result. Patients aged 6 to 18 years were more likely to have positive test results (38.5%, 95% CI 32.2% to 45.0%) than patients aged 19 to 39 were, as were those last residing in Asia (36.4%, 95% CI 30.4% to 42.8%) or sub-Saharan Africa (30.9%, 95% CI 26.8% to 35.1%), compared with those arriving from the Middle East. Giardia lamblia, Blastocystis hominis, Dientamoeba fragilis, and Entamoeba histolytica or Entamoeba dispar were the most prevalent parasites. If B hominis and D fragilis are excluded because of their lower potential to cause harm, the overall prevalence was 16.3%. CONCLUSION: Given the high compliance of patients submitting stool ova and parasite tests and a high prevalence of positive test results in some refugee groups, targeted screening should be considered in newly arrived refugees at greater risk of intestinal parasites.

Interventions to Educate Family Physicians to Change Test Ordering: Systematic Review of Randomized Controlled Trials.

The purpose is to systematically review randomised controlled trials (RCTs) to change family physicians' laboratory test-ordering. We searched 15 electronic databases (no language/date limitations). We identified 29 RCTs (4,111 physicians, 175,563 patients). Six studies specifically focused on reducing unnecessary tests, 23 on increasing screening tests. Using Cochrane methodology 48.5% of studies were low risk-of-bias for randomisation, 7% concealment of randomisation, 17% blinding of participants/personnel, 21% blinding outcome assessors, 27.5% attrition, 93% selective reporting. Only six studies were low risk for both randomisation and attrition. Twelve studies performed a power computation, three an intention-to-treat analysis and 13 statistically controlled clustering. Unweighted averages were computed to compare intervention/control groups for tests assessed by >5 studies. The results were that fourteen studies assessed lipids (average 10% more tests than control), 14 diabetes (average 8% > control), 5 cervical smears, 2 INR, one each thyroid, fecal occult-blood, cotinine, throat-swabs, testing after prescribing, and urine-cultures. Six studies aimed to decrease test groups (average decrease 18%), and two to increase test groups. Intervention strategies: one study used education (no change): two feedback (one 5% increase, one 27% desired decrease); eight education + feedback (average increase in desired direction >control 4.9%), ten system change (average increase 14.9%), one system change + feedback (increases 5-44%), three education + system change (average increase 6%), three education + system change + feedback (average 7.7% increase), one delayed testing. The conclusions are that only six RCTs were assessed at low risk of bias from both randomisation and attrition. Nevertheless, despite methodological shortcomings studies that found large changes (e.g. >20%) probably obtained real change.

Evidence-based decision-making 6: Utilization of administrative databases for health services research.

Health-care systems require reliable information on which to base health-care planning and make decisions, as well as to evaluate their policy impact. Administrative data provide important information about health services use, expenditures, clinical outcomes, and may be used to assess quality of care. With increased digitalization and accessibility of administrative databases, these data are more readily available for health service research purposes, aiding evidence-based decision-making. This chapter discusses the utility of administrative data for population-based studies of health and health care.