scholarly journals The women’s Alzheimer’s prevention center at Cleveland Clinic: Centering women in Alzheimer’s prevention care and research

2021 ◽  
Vol 17 (S10) ◽  
Author(s):  
Jessica ZK Caldwell ◽  
Ida Crocker‐Sabbagh ◽  
Nikki Kaplan ◽  
Marwan N Sabbagh
Keyword(s):  
Cleveland Clinic ◽  
Prevention Center

Gender Differences in Suicidal Intent and Choice of Method Among Suicide Attempters

Crisis ◽  
2008 ◽  
Vol 29 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Merete Nordentoft ◽  
Jacob Branner
Keyword(s):  
Gender Differences ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Suicidal Intent ◽  
Suicide Intent ◽  
Suicidal Intention ◽  
National Patient ◽  
Prevention Center ◽  
Suicide Prevention Center

The objective was to examine gender differences in choice of method and suicidal intent among persons referred to a suicide prevention center. A total of 351 consecutive patients who had attempted suicide were interviewed using the European Parasuicide Study Interview Schedule I (EPSIS I) while participating in a 2-week inpatient treatment program. They were invited to a 1-year follow-up interview, and followed in the National Patient Register. Compared to women, men who had attempted suicide were older, had better self-esteem, fewer depressive symptoms, and higher total suicidal intention scores, but they were not more likely to use violent methods. Neither use of violent method nor dangerousness of the attempt was associated with suicidal intention. Although men had higher suicide intent scores than women, there were no significant gender differences in the number of repeat suicide attempts during a 1-year follow-up period. Suicidal intent was not related to dangerousness of suicide method.

The Probability of A1C Goal Attainment in Patients with Uncontrolled Type-2 Diabetes in a Large Integrated Delivery System: A Prediction Model

2020 ◽  
Author(s):  
Kevin M Pantalone ◽  
Anita D Misra-Hebert ◽  
Todd M Hobbs ◽  
Sheldon X Kong ◽  
Xinge Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Goal Attainment ◽  
Index Date ◽  
Cleveland Clinic ◽  
Patient Characteristics ◽  
Psychiatric Disease ◽  
Lower Probability ◽  
Factors Associated ◽  
One Year

<b>Objective:</b> To assess patient characteristics and treatment factors associated with uncontrolled type 2 diabetes (T2D) and the probability of A1C goal attainment. <p><b>Research Design and Methods</b>: Retrospective cohort study using the electronic health record at Cleveland Clinic. Patients with uncontrolled T2D (A1C>9%) were identified on the index date of 12/31/2016 (n=6,973), grouped by attainment (n=1,653 [24.7%) or non-attainment (n=5,320 [76.3%]) of A1C<8% by 12/31/2017, and subgroups compared on a number of demographic and clinical variables. Based on these variables, a nomogram was created for predicting probability of A1C goal attainment. </p> <p><b>Results:</b> For the entire population, median age at index date was 57.7 years (53.3% male), and the majority were white (67.2%). Median A1C was 10.2%. Obesity (50.6%), cardiovascular disease (46.9%) and psychiatric disease (61.1%) were the most common comorbidities. Metformin (62.7%) and sulfonylureas (38.7%) were the most common anti-diabetes medications. Only 1,653 (24%) patients achieved an A1C <8%. Predictors of increased probability of A1C goal attainment were older age, white/non-Hispanic race/ethnicity, Medicare health insurance, lower baseline A1C, higher frequency of endocrinology/primary care visits, DPP-4i use, thiazolidinedione use, metformin use, GLP-1RA use, and fewer classes of anti-diabetes drugs. Factors associated with lower probability included insulin use and longer time in the T2D database (both presumed as likely surrogates for duration of T2D). </p> <p><b>Conclusions:</b> A minority of patients with an A1C>9% achieved an A1C<8% at one year. While most identified predictive factors are non-modifiable by the clinician, pursuit of frequent patient engagement and tailored drug regimens may help improve A1C goal attainment. </p>

The Conference on Security and Cooperation in Europe and Other European Fora on Migration

1994 ◽  
Vol 28 (3) ◽  
pp. 580-590
Author(s):  
Jan Niessen
Keyword(s):  
Human Rights ◽  
The United States ◽  
Eastern European ◽  
Scientific Cooperation ◽  
High Commissioner ◽  
Protection Of Human Rights ◽  
Prevention Center ◽  
The Many ◽  
The Cold War ◽  
General Secretary

In the 1970s, during the Cold War era, European and North American states began a dialogue in Helsinki which became known as the Conference on Security and Cooperation in Europe (CSCE), or the Helsinki process. For Western states the CSCE served as a platform to raise questions related to security in Europe and the protection of human rights and fundamental freedoms. Eastern European states considered the CSCE as a means to secure the postwar borders and an opportunity to discuss economic and scientific cooperation. Today, 51 European States, plus the United States of America and Canada, participate in this process. Notwithstanding the many and often intense political tensions between the West and the East during those twenty years, quite a number of conferences, seminars and other meetings were held and a great many agreements were adopted and documents issued, dealing with matters related to CSCE's three main areas of concern: security in Europe; cooperation in the fields of economics, science, technology and environment; the promotion of human rights. In response to the fundamental changes in Europe in the late 1980s, the CSCE was given a new impetus and its operational framework was broadened. CSCE offices were established in Prague (CSCE Secretariat), Vienna (Conflict Prevention Center) and Warsaw (Office of Democratic Institutions and Human Rights) with the aim to strengthen and monitor compliance with CSCE commitments, especially in the area of human rights. A Parliamentary Assembly was established and met twice, first in Budapest and then in Helsinki. A General Secretary and a High Commissioner on Minorities were appointed, with offices in Vienna and The Hague, respectively.

scholarly journals Emergency Department Visits During Outpatient Parenteral Antimicrobial Therapy: A Cohort Study

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S333-S334
Author(s):  
So Lim Kim ◽  
Angela Everett ◽  
Susan J Rehm ◽  
Steven Gordon ◽  
Nabin Shrestha
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Hospital Admission ◽  
Vascular Access ◽  
Antimicrobial Therapy ◽  
Cleveland Clinic ◽  
Emergency Department Visits ◽  
Outpatient Parenteral Antimicrobial Therapy ◽  
Ed Visits ◽  
Access Complications

Abstract Background Outpatient parenteral antimicrobial therapy (OPAT) carries risk of vascular access complications, antimicrobial adverse effects, and worsening of infection. Both OPAT-related and unrelated events may lead to emergency department (ED) visits. The purpose of this study was to describe adverse events that result in ED visits and risk factors associated with ED visits during OPAT. Methods OPAT courses between January 1, 2013 and December 31, 2016 at Cleveland Clinic were identified from the institution’s OPAT registry. ED visits within 30 days of OPAT initiation were reviewed. Reasons and potential risk factors for ED visits were sought in the medical record. Results Among 11,440 OPAT courses during the study period, 603 (5%) were associated with 1 or more ED visits within 30 days of OPAT initiation. Mean patient age was 58 years and 57% were males. 379 ED visits (49%) were OPAT-related; the most common visit reason was vascular access complication, which occurred in 211 (56%) of OPAT-related ED visits. The most common vascular access complications were occlusion and dislodgement, which occurred in 99 and 34 patients (47% and 16% of vascular access complications, respectively). In a multivariable logistic regression model, at least one prior ED visit in the preceding year (prior ED visit) was most strongly associated with one or more ED visits during an OPAT course (OR 2.96, 95% CI 2.38 – 3.71, p-value &lt; 0.001). Other significant factors were younger age (p 0.01), female sex (p 0.01), home county residence (P &lt; 0.001), and having a PICC (p 0.05). 549 ED visits (71%) resulted in discharge from the ED within 24 hours, 18 (2%) left against medical advice, 46 (6%) were observed up to 24 hours, and 150 ED visits (20%) led to hospital admission. Prior ED visit was not associated with hospital admission among patients who visited the ED during OPAT. Conclusion OPAT-related ED visits are most often due to vascular access complications, especially line occlusions. Patients with a prior ED visit in the preceding year have a 3-fold higher odds of at least one ED visit during OPAT compared with patients without a prior ED visit. A strategy of managing occlusions at home and a focus on patients with prior ED visits could potentially prevent a substantial proportion of OPAT-related ED visits. Disclosures All authors: No reported disclosures.

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