scholarly journals Impact of medical and behavioural factors on influenza-like illness, healthcare-seeking, and antiviral treatment during the 2009 H1N1 pandemic: USA, 2009–2010

2013 ◽  
Vol 142 (1) ◽  
pp. 114-125 ◽  
Author(s):  
M. BIGGERSTAFF ◽  
M. A. JHUNG ◽  
C. REED ◽  
S. GARG ◽  
L. BALLUZ ◽  
...  
Keyword(s):  
Heart Disease ◽  
High Risk ◽  
Antiviral Treatment ◽  
Healthcare Access ◽  
Cross Sectional ◽  
Financial Barriers ◽  
Influenza Like Illness ◽  
Healthcare Seeking ◽  
Treatment Practices ◽  
The Impact

SUMMARYWe analysed a cross-sectional telephone survey of U.S. adults to assess the impact of selected characteristics on healthcare-seeking behaviours and treatment practices of people with influenza-like illness (ILI) from September 2009 to March 2010. Of 216 431 respondents, 8·1% reported ILI. After adjusting for selected characteristics, respondents aged 18–64 years with the following factors were more likely to report ILI: a diagnosis of asthma [adjusted odds ratio (aOR) 1·88, 95% CI 1·67–2·13] or heart disease (aOR 1·41, 95% CI 1·17–1·70), being disabled (aOR 1·75, 95% CI 1·57–1·96), and reporting financial barriers to healthcare access (aOR 1·63, 95% CI 1·45–1·82). Similar associations were seen in respondents aged ⩾65 years. Forty percent of respondents with ILI sought healthcare, and 14% who sought healthcare reported receiving influenza antiviral treatment. Treatment was not more frequent in patients with high-risk conditions, except those aged 18–64 years with heart disease (aOR 1·90, 95% CI 1·03–3·51). Of patients at high risk for influenza complications, self-reported ILI was greater but receipt of antiviral treatment was not, despite guidelines recommending their use in this population.

scholarly journals COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK

2021 ◽  
pp. sextrans-2020-054768
Author(s):  
Iain Hyndman ◽  
Diarmuid Nugent ◽  
Gary George Whitlock ◽  
Alan McOwan ◽  
Nicolò Girometti
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Sexual Activity ◽  
Sexual Behaviour ◽  
Well Being ◽  
Categorical Variables ◽  
Cross Sectional ◽  
The Impact ◽  
Mental Well Being ◽  
Hiv Negative

ObjectivesThe COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services (SHS). We surveyed the impact on sexual behaviour of men having sex with men (MSM) to inform future SHS provision.MethodsWe conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended 56 Dean Street, a sexual health and HIV clinic. The survey was conducted over a 7-day period in August 2020. Data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown (defined as 23 March–30 June 2020) were extracted. Categorical and non-categorical variables were compared according to HIV pre-exposure prophylaxis (PrEP) use.Results814 MSM completed the questionnaire: 75% were PrEP users; 76% reported they have been sexually active, of which 76% reported sex outside their household. 75% reported fewer partners than prior to lockdown. Isolation/loneliness (48%) and anxiety/stress (27%) triggered sexual activity, and 73% had discussed COVID-19 transmission risks with their sexual partners. While 46% reported no change to emotions ordinarily experienced following sex, 20% reported guilt for breaching COVID-19 restrictions. 76% implemented one or more changes to their sexual behaviour, while 58% applied one or more steps to reduce COVID-19 transmission during sex. 36% accessed SHS and 30% reported difficulties in accessing testing/treatment. Of those who accessed SHS, 28% reported an STI diagnosis. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of SHS than non-PrEP users.ConclusionsCOVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in our survey respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to SHS provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.

Do Hospitals with a Higher Level of Maternal Care Designation Have Better Maternal Outcomes?

2018 ◽  
Vol 36 (06) ◽  
pp. 653-658 ◽  
Author(s):  
Sindhu Srinivas ◽  
Katy Kozhimannil ◽  
Peiyin Hung ◽  
Laura Attanasio ◽  
Judy Jou ◽  
...  
Keyword(s):  
High Risk ◽  
Maternal Care ◽  
Maternal Morbidity ◽  
Cross Sectional Study ◽  
Severe Maternal Morbidity ◽  
Maternal Outcomes ◽  
Cross Sectional ◽  
Discharge Data ◽  
Logistic Regression Models ◽  
The Impact

Background A recent document by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine introduced the concept of uniform levels of maternal care (LMCs). Objective We assessed LMC across hospitals and measured their association with maternal morbidity, focusing on women with high-risk conditions. Study Design We collected data from hospitals from May to November 2015 and linked survey responses to Statewide Inpatient Databases (SID) hospital discharge data in a retrospective cross-sectional study of 247,383 births admitted to 236 hospitals. Generalized logistic regression models were used to examine the associations between hospitals' LMC and the risk of severe maternal morbidity. Stratified analyses were conducted among women with high-risk conditions. Results High-risk pregnancies were more likely to be managed in hospitals with higher LMC (p < 0.001). Women with cardiac conditions had lower odds of maternal morbidity when delivered in level I compared with level IV units (adjusted odds ratio: 0.29; 95% confidence interval: 0.08–0.99; p = 0.049). There were no other significant associations between the LMC and severe maternal morbidity. Conclusion A higher proportion of high-risk pregnancies were managed within level IV units, although there was no overall evidence that these births had superior outcomes. Further prospective evaluation of LMC designation with patient outcomes is necessary to determine the impact of regionalization on maternal outcomes.

Impact of the implantable cardioverter defibrillator on confidence to undertake physical activity in inherited heart disease: A cross-sectional study

2017 ◽  
Vol 16 (8) ◽  
pp. 742-752 ◽  
Author(s):  
Joanna Sweeting ◽  
Kylie Ball ◽  
Julie McGaughran ◽  
John Atherton ◽  
Christopher Semsarian ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Disease ◽  
Implantable Cardioverter Defibrillator ◽  
Vigorous Physical Activity ◽  
Survey Study ◽  
Accelerometer Data ◽  
Cross Sectional ◽  
Physical Activity Guidelines ◽  
Cardioverter Defibrillator ◽  
The Impact

Background: Physical activity is associated with improved quality of life. Patients with an implantable cardioverter defibrillator (ICD) face unique clinical and psychological challenges. Factors such as fear of ICD shock may negatively impact on physical activity, while a sense of protection gained from the ICD may instil confidence to be active. Aim: We aimed to examine the impact of an ICD on physical activity levels and factors associated with amount of activity. Methods: Two cross-sectional studies were conducted. Accelerometer data (seven-day) was collected in March–November 2015 for 63 consecutively recruited hypertrophic cardiomyopathy patients, with or without an ICD, aged ⩾18 years. A survey study was conducted in July–August 2016 of 155 individuals aged ⩾18 years with an inherited heart disease and an ICD in situ. Results: Based on the International Physical Activity Questionnaire, mean leisure time physical activity was 239 ± 300 min/week with 51% meeting physical activity guidelines. Accelerometry showed that mean moderate–vigorous physical activity was the same for patients with and without an ICD (254 ± 139 min/week versus 300 ± 150 min/week, p=0.23). Nearly half of survey participants ( n=73) said their device made them more confident to exercise. Being anxious about ICD shocks was the only factor associated with not meeting physical activity guidelines. Conclusions: Patients with inherited heart disease adjust differently to their ICD device, and for many it has no impact on physical activity. Discussion regarding the appropriate level of physical activity and potential barriers will ensure best possible outcomes in this unique patient group.

scholarly journals Malaria in pregnancy in rural Gabon: a cross-sectional survey on the impact of seasonality in high-risk groups

2013 ◽  
Vol 12 (1) ◽  
pp. 412 ◽  
Author(s):  
Mario J Jäckle ◽  
Christian G Blumentrath ◽  
Rella M Zoleko ◽  
Daisy Akerey-Diop ◽  
Jean-Rodolphe Mackanga ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Groups ◽  
Malaria In Pregnancy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Impact ◽  
In Pregnancy

scholarly journals The impact of clinical and population strategies on coronary heart disease mortality: an assessment of Rose’s big idea

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohadeseh Ahmadi ◽  
Bruce Lanphear
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Coronary Heart Disease Mortality ◽  
Cross Sectional ◽  
Population Strategy ◽  
Chd Risk Factors ◽  
The Impact ◽  
Clinical Strategy

Abstract Background Coronary heart disease (CHD), the leading cause of death worldwide, has declined in many affluent countries but it continues to rise in industrializing countries. Objective To quantify the relative contribution of the clinical and population strategies to the decline in CHD mortality in affluent countries. Design Meta-analysis of cross-sectional and prospective studies. Data sources PubMed and Web of Science from January 1, 1970 to December 31, 2019. Method We combined and analyzed data from 22 cross-sectional and prospective studies, representing 500 million people, to quantify the relative decline in CHD mortality attributable to the clinical strategy and population strategy. Result The population strategy accounted for 48% (range = 19 to 73%) of the decline in CHD deaths and the clinical strategy accounted for 42% (range = 25 to 56%), with moderate inconsistency of results across studies. Conclusion Since 1970, a larger fraction of the decline in CHD deaths in industrialized countries was attributable to reduction in CHD risk factors than medical care. Population strategies, which are more cost-effective than clinical strategies, are under-utilized.

scholarly journals The impact of managerial and firm characteristics on barriers in export businesses

2021 ◽  
Vol 8 (6) ◽  
pp. 110-117
Author(s):  
Jayanty Kuppusamy ◽  
◽  
R. N. Anantharaman ◽  
Keyword(s):  
Negative Relationship ◽  
Demographic Factors ◽  
Firm Characteristics ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Financial Barriers ◽  
Export Barriers ◽  
Employee Experience ◽  
The Impact ◽  
The Relationship

The growth of export in many countries all over the world signifies it as the most important mode of internationalization. However, some exporters face difficulties in managing export due to the barriers they face. It is, therefore, important to identify the factors that might influence export barriers. The study attempts to identify the relationship between demographic factors and export barriers which has not been much researched. Demographic factors are represented by managerial or executives’ characteristics as well as firm characteristics. A cross-sectional survey was conducted where a total of one thousand and four hundred and thirty-nine questionnaires were sent to the exporters. The respondents include executives who were in charge of exporting. Two hundred and twelve responses were found to be usable which formed the basis for the analysis. The response rate was 14.9%. The export barriers include marketing barriers, financial barriers, government barriers, informational barriers, administrative barriers, production barriers, and external barriers. Correlation analysis was used to conduct the analysis and it is found that age of executives, age of firms, size of firms, and export experience of firms have a negative relationship with some of the export barriers. On the other hand, there was no relationship between the employee experience and export barriers. This finding contributes to the limited knowledge on the relationship between demographic characteristics with export barriers. Thus, it provides support for the resource-based view. From a practical perspective, it essential for business to accumulate knowledge, expertise and experience in order to reduce the export barriers.

scholarly journals Exploratory study into awareness of heart disease and healthcare seeking behaviour among Emirati women (UAE) - Cross sectional descriptive study

2017 ◽  
Vol 1 (1) ◽  
pp. 41
Author(s):  
Sarah Khan
Keyword(s):  
Heart Disease ◽  
United Arab Emirates ◽  
Heart Diseases ◽  
Heart Association ◽  
Descriptive Study ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Healthcare Seeking ◽  
Atypical Symptoms ◽  
Associated Risk Factors

Introduction: Cardiovascular disease was the leading cause of death among women in the United Arab Emirates (UAE) in 2010. Heart attacks usually occur at an older age in women compared to men, consequently the atypical symptoms of heart disease that often appear among women are masked by symptoms of other chronic diseases. Non-recognition of symptoms could explain the reason behind delays in seeking healthcare and the high mortality following a heart attack among Emirati women. This study seeks to a) highlight the awareness of heart diseases among Emirati women and b) to understand Emirati women’s healthcare seeking behaviour.  Methods: A cross sectional, descriptive study was conducted using a survey     instrument adapted from the American Heart Association National survey. A    convenience sample of 676 Emirati women between the ages of 18-55 years completed the questionnaire. Results: The study showed low levels of awareness of heart disease and associated risk factors in Emirati women; only 19.4% participants were found to be aware of heart diseases. Awareness levels were highest in Dubai (OR 2.18, p<0.05) among all the other emirates and in the 18-45 years age group (OR 2.74, p<0.05). Despite low awareness levels, women paradoxically perceived themselves to be self-efficacious in seeking healthcare. Interestingly, just 49.1% Emirati women   believed that good quality and affordable healthcare was available in the UAE. Only 28.8% of the participants believed there were sufficient female doctors to respond to health needs of women in UAE. Furthermore, only 36.7% Emirati women chose to be treated in the UAE over treatment in other countries. Conclusion: Emirati women clearly lack knowledge on severity and vulnerability to heart disease in the region that is essential to improve cardiovascular related health outcomes. This study has identified the need for wider outreach that focuses on gender and age specific   awareness on heart disease risks and symptoms. The study has also highlighted  potential modifiable barriers in seeking healthcare that should be overcome to reduce morbidity and mortality due to heart disease among national women of UAE.

scholarly journals Falls among patients with hypertension - preliminary study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
N Swiatoniowska-Lonc ◽  
E Jaciow ◽  
J Polanski ◽  
B Jankowska-Polanska
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
High Risk ◽  
Ischemic Heart Disease ◽  
Beta Blockers ◽  
The Elderly ◽  
Ischemic Heart ◽  
Risk Of Falling ◽  
Risk Of Falls ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background. Falls among the elderly are a major cause of injury, significant disability and premature death. Hypotension is a potential risk factor for falls in older adults, especially patients with hypertension (HTN) taking antihypertensive drugs. Furthermore, the cardiovascular benefit of treatment of hypertension in older patients is clear, findings from observational studies have raised concerns that antihypertensive therapies in the elderly might also induce adverse effects, including injurious falls.  In spite of the large number of issues related to this topic, the analysis of the causes of falls is insufficient. The aim of the study was to assess the frequency of falls and the impact of selected variables on the occurrence of risk of falls among patients with HTN. Material and methods. 100 patients, including 55 women, with HTN (mean age 69.4 ± 3.29 years) were enrolled into the study. The Tinetti test was used to assess the risk of falls. Sociodemographic and clinical data were obtained from the hospital register. Results. 89% of patients had a high risk of falls and 11% were prone to falls. The average number of falls during the last year in the study group was 1.86 ± 2.82 and in 30% of cases the fall was the cause of hospitalization. Single-factor analysis of the influence of selected variables on the risk of falls showed that higher values of SBP (-0.27; p = 0.007), DBP (-0.279; p = 0.005) and younger age of patients decrease the risk of falls (-0.273; p = 0.006). The linear regression model showed that independent predictors increasing the risk of falling are: use of diuretics (β=4.192; p &lt; 0.001), co-occurrence of ischemic heart disease (β=4.669; p = 0. 007) and co-occurrence of heart failure (β=3.494; p = 0.016), and predictors reducing the risk of falling patients with hypertension are: the use of beta-blockers (β= -4.033; p = 0.013) and higher DBP value (β= -0.123; p = 0.016). Conclusions. Patients with HTN have a high risk of falling. Independent determinants increasing the risk of falling patients with HTN are the use of diuretics and the co-occurrence of ischemic heart disease or heart failure, while beta-blockers and a higher DBP value are factors reducing the risk of falling. Fall risk assessment and implementation of fall prevention should be carried out in everyday practice.

scholarly journals Repeated CMV Infection in a Heart Transplantation Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Josep Melero-Ferrer ◽  
Ignacio J. Sanchez-Lazaro ◽  
Amparo Navea-Tejerina ◽  
Luis Almenar-Bonet ◽  
Marino Blanes-Julia ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Heart Disease ◽  
High Risk ◽  
Ischemic Heart Disease ◽  
Heart Transplantation ◽  
Viral Infection ◽  
Antiviral Treatment ◽  
First Year ◽  
Cmv Infection ◽  
Transplantation Patient

Infections are one of the leading causes of morbidity and mortality in heart transplantation (HTx). Cytomegalovirus (CMV) is the most common viral infection during the first year after HTx, but it is more unusual after this time. We present the case of a patient who underwent an HTx due to a severe ischemic heart disease. Although the patient did not have a high risk for CMV, infection, he suffered a reactivation during the first year and then up to six more episodes, especially in his eyes. The patient received different treatments against CMV and the immunosuppression was changed several times. Finally, everolimus was introduced instead of cyclosporine, and mycophenolate mofetil was withdrawn. The presented case provides an example of how the immunosupresion plays a key role in some infections in spite of being a suitable antiviral treatment.

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