Search Results for: Diagnosi di COVID-19: dal sospetto alla conferma

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Prevalence of urinary incontinence among nulliparous women and its association with underweight body mass index: a secondary analysis of a nationwide cross-sectional study in China

Objectives
To estimate the prevalence of urinary incontinence (UI) and its subtypes among nulliparous Chinese women with associated risk factors. The prevalence of UI among those living in urban or rural communities was also analysed with potential risk factors.

Design
This is a secondary analysis of epidemiological survey data on UI in Chinese women. The original study was designed as a nationwide cross-sectional study involving 56 460 adult women conducted from October 2019 to December 2021.

Setting
Seven geographic regions of China.

Participants
Nulliparous women who were aged ≥20 years old and were permanent residents were included in this secondary analysis. Participants who had severe mental or physical disorders or were pregnant were excluded. Data on demographic characteristics, health status and medical history were collected.

Primary and secondary outcome measures
The primary outcome was the prevalence of UI, whereas secondary outcome measures were adjusted odds ratios (aOR) for risk factor analysis.

Results
A total of 6244 nulliparous women were included in the analysis. The prevalence of UI was 1.9% for nulliparous Chinese women, with stress, urgency and mixed UI being prevalent at 0.9%, 0.3% and 0.7%, respectively. The prevalence of UI was 2.1% and 1.6% for urban and rural subgroups. Abnormal body mass index was significantly associated with UI in the nulliparous group (underweight, aOR: 1.88, 95% CI: 1.03 to 3.45, p=0.041; overweight, aOR: 2.26, 95% CI: 1.37 to 3.73, p=0.001; and obesity, aOR: 3.64, 95% CI: 1.86 to 7.15, p

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Do structured career counselling initiatives influence specialty preferences in medical students? A longitudinal observational survey study

Objective
This longitudinal study aimed to document shifts in specialty preferences, career pathways and intended practice locations among medical students following the implementation of structured career initiatives during the 2023–2024 academic year.

Design
A longitudinal observational survey study.

Setting
A private, not-for-profit institution, VinUniversity in Hanoi, Vietnam during the 2023–2024 academic year.

Participants
All year 2, year 3 and year 4 medical students (n=144 eligible), of whom 105 (73%) completed both baseline and follow-up surveys.

Interventions
Structured career counselling initiatives introduced at the start of the academic year, including academic mentoring, clinical mentoring, hands-on clinical exposure in year 4 and multiple career counselling activities.

Primary and secondary outcome measures
The primary outcome was change in specialty preference over time, measured by students’ self-reported first-choice specialty at baseline and follow-up. Secondary outcomes included shifts in factors influencing career decisions (eg, personal interest, income and family expectations), intended practice location (domestic or international) and preferred career pathways (residency, Specialist Level I, master’s degree or direct workforce entry).

Results
Personal interest remained the strongest influence on specialty choice from baseline to follow-up (mean scores 4.27 vs 4.36 on a 5-point scale). A notable decrease occurred in the importance of income (3.82 to 3.22; p

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Access to dental services for children: a scoping review on the impact of COVID-19 and implications for future models of care

Background
The COVID-19 pandemic had detrimental effects on routine health and social care as countries instituted widespread public health measures to control transmission of SARS-CoV-2. This affected care delivery for many chronic and non-communicable diseases, including oral health and dental diseases with implications in the postpandemic period.

Objectives
This scoping review, conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Review guidelines, aims to synthesise evidence regarding the impact of COVID-19 on access to dental services among children and their implications for future models of care, especially for children from low-income families, to inform policy decision making around subsidised dental services in Australia.

Data sources
PubMed, Web of Science, Embase, Cochrane Library of Systematic Reviews and Cochrane Central Register of Controlled Trials.

Eligibility criteria
Primary studies of any design published between 1 January 2020 and 31 July 2024. Included studies described provision of paediatric dental services, considered components of access or utilisation and were published in English. Excluded studies were those that only evaluated maxillofacial services.

Data extraction and synthesis
Data were extracted using a standardised template in MS Excel then analysed to thematically classify findings based on key areas of impact. Quality assessment of studies was not conducted.

Results
54 articles from 17 countries were included. Studies identified reductions in service availability and utilisation, including patient and parent-driven demand. Changes to the configuration of services included greater rates of emergency treatment, reductions in use of aerosol-generating procedures and more use of teledentistry, as well as self-management and prevention approaches. Substantial delays to routine dental care, leading to more dental problems and ongoing need, especially untreated dental caries, were observed with a disproportionate impact on socioeconomically disadvantaged and vulnerable children and families.

Conclusion
The COVID-19 pandemic has had pronounced negative effects on the provision of primary and secondary dental care for children around the world. Access to care was affected by disruptions to service availability and by changes in demand for services related to parental anxiety around the risk of COVID-19 transmission. Delays in receipt of routine dental care and changes to oral health behaviours are likely to lead to an increased need for oral health services, with service adaptations needed to ensure this increased demand can be met.

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