scholarly journals Effects of Contact Precautions on Patient Perception of Care and Satisfaction: A Prospective Cohort Study

2013 ◽  
Vol 34 (10) ◽  
pp. 1087-1093 ◽  
Author(s):  
Preeti Mehrotra ◽  
Lindsay Croft ◽  
Hannah R. Day ◽  
Eli N. Perencevich ◽  
Lisa Pineles ◽  
...  

Objective.Contact precautions decrease healthcare worker-patient contact and may impact patient satisfaction. To determine the association between contact precautions and patient satisfaction, we used a standardized interview for perceived issues with care.Design.Prospective cohort study of inpatients, evaluated at admission and on hospital days 3, 7, and 14 (until discharged). At each point, patients underwent a standardized interview to identify perceived problems with care. After discharge, the standardized interview and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey were administered by telephone. Responses were recorded, transcribed, and coded by 2 physician reviewers.Participants.A total of 528 medical or surgical patients not admitted to the intensive care unit.Results.A total of 528 patients were included in the primary analysis, of whom 104 (20%) perceived some issue with their care. On multivariable logistic regression, contact precautions were independently associated with a greater number of perceived concerns with care (odds ratio, 2.05 [95% confidence interval, 1.31–3.21]; P<.01), including poor coordination of care (P = .02) and a lack of respect for patient needs and preferences (P = .001). Eighty-eight patients were included in the secondary analysis of HCAHPS. Patients under contact precautions did not have different HCAHPS scores than those not under contact precautions (odds ratio, 1.79 [95% confidence interval, 0.64–5.00]; P = .27).Conclusions.Patients under contact precautions were more likely to perceive problems with their care, especially poor coordination of care and a lack of respect for patient preferences.


2019 ◽  
Vol 09 (03) ◽  
pp. e298-e301
Author(s):  
Emily Gregory ◽  
Craig V. Towers ◽  
Jaclyn van Nes ◽  
Kristina Shumard ◽  
Kim B. Fortner ◽  
...  

Abstract Objective To evaluate fetomaternal bleeding following routine cesarean delivery compared with cesarean delivery involving transplacental transection. Study Design A prospective cohort study evaluating cesarean delivery in which the placenta was transected (cases) versus controls (placenta not transected) from January 2016 to April 2018. A maternal Kleihauer–Betke's (KB) test and newborn hematocrit were performed shortly after delivery. Results The rate of a positive KB test was not significantly different between cases (n = 31) and controls (n = 61) (19 vs. 14%; odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.46–4.49; p = 0.74). Median neonatal hematocrits were not different. However, the rate of newborn hematocrits <40% at delivery was higher in cases compared with controls (23 vs. 3%; OR: 8.90; 95% CI: 1.72–45.90; p = 0.005). Conclusion A cesarean requiring transplacental transection to accomplish delivery does not significantly increase the rate of fetomaternal bleeding but is associated with a higher likelihood of newborn hematocrit <40% at delivery.



2016 ◽  
Vol 23 (5) ◽  
pp. 754-762 ◽  
Author(s):  
Shinsuke Mizutani ◽  
Daisuke Ekuni ◽  
Mayu Yamane-Takeuchi ◽  
Tetsuji Azuma ◽  
Ayano Taniguchi-Tabata ◽  
...  

The purpose of this prospective cohort study was to investigate whether Type D personality was related to periodontal disease in Japanese university students. Among students ( n = 600) who were interested in receiving oral health examinations, logistic regression analysis showed that the risk of developing periodontal disease during a 3-year period was associated with body mass index ⩾ 25 (odds ratio: 2.543; 95% confidence interval: 1.297–4.989; p = 0.007) and Type D personality (odds ratio: 1.473; 95% confidence interval: 1.027–2.111; p = 0.035). In this short-term prospective cohort study, a significant association between periodontal disease and Type D personality was observed in Japanese university students.



BMJ ◽  
2018 ◽  
pp. k3547 ◽  
Author(s):  
Julie C Antvorskov ◽  
Thorhallur I Halldorsson ◽  
Knud Josefsen ◽  
Jannet Svensson ◽  
Charlotta Granström ◽  
...  

Abstract Objective To examine the association between prenatal gluten exposure and offspring risk of type 1 diabetes in humans. Design National prospective cohort study. Setting National health information registries in Denmark. Participants Pregnant Danish women enrolled into the Danish National Birth Cohort, between January 1996 and October 2002, Main outcome measures Maternal gluten intake, based on maternal consumption of gluten containing foods, was reported in a 360 item food frequency questionnaire at week 25 of pregnancy. Information on type 1 diabetes occurrence in the participants’ children, from 1 January 1996 to 31 May 2016, were obtained through registry linkage to the Danish Registry of Childhood and Adolescent Diabetes. Results The study comprised 101 042 pregnancies in 91 745 women, of whom 70 188 filled out the food frequency questionnaire. After correcting for multiple pregnancies, pregnancies ending in abortions, stillbirths, lack of information regarding the pregnancy, and pregnancies with implausibly high or low energy intake, 67 565 pregnancies (63 529 women) were included. The average gluten intake was 13.0 g/day, ranging from less than 7 g/day to more than 20 g/day. The incidence of type 1 diabetes among children in the cohort was 0.37% (n=247) with a mean follow-up period of 15.6 years (standard deviation 1.4). Risk of type 1 diabetes in offspring increased proportionally with maternal gluten intake during pregnancy (adjusted hazard ratio 1.31 (95% confidence interval 1.001 to 1.72) per 10 g/day increase of gluten). Women with the highest gluten intake versus those with the lowest gluten intake (≥20 v <7 g/day) had double the risk of type 1 diabetes development in their offspring (adjusted hazard ratio 2.00 (95% confidence interval 1.02 to 4.00)). Conclusions High gluten intake by mothers during pregnancy could increase the risk of their children developing type 1 diabetes. However, confirmation of these findings are warranted, preferably in an intervention setting.



Author(s):  
Tahmina Parvin ◽  
Elizabeth D. Thomas ◽  
Kelly Endres ◽  
Daniel Leung ◽  
Bhuyian Sazzadul ◽  
...  

There is limited evidence on the association between animal ownership and respiratory illness among young children in low- and middle-income countries. In this study, we examined the association between animal ownership and respiratory illness among children younger than 5 years of age enrolled in a prospective cohort study in urban Bangladesh. This prospective cohort study enrolled 884 participants younger than 5 years of age in Dhaka, Bangladesh. At baseline, trained research assistants administered caregivers of children younger than 5 years of age a questionnaire on household animal ownership. Animal ownership was defined as owning chickens, birds other than chickens, cats, and dogs. Respiratory surveillance was conducted monthly for children based on caregiver-reported coughing, rapid breathing, and difficult breathing in the past 2 weeks during the 12-month study period. At baseline, 48% of children (424 of 884) had reports of coughing, 5% (40 of 884) had difficulty breathing, 3% (25 of 884) had rapid breathing, and 49% (431 of 884) had reports of any of these three respiratory symptoms. Seventeen percent of children (151 of 884) resided in a household that owned an animal. Children residing in households reporting bird ownership had a significantly greater odds of coughing (odds ratio, 1.14; 95% CI, 1.02–1.28) and any of the three respiratory symptoms in the past 2 weeks (odds ratio, 1.14; 95% CI, 1.02–1.28). Household bird ownership was associated with respiratory illness in young children. These findings suggest that interventions aiming at reducing young children’s exposure to domestic animals should extend to include birds other than chickens.



2020 ◽  
Vol 4 (21) ◽  
pp. 5442-5448
Author(s):  
Daniela Tormene ◽  
Elena Campello ◽  
Chiara Simion ◽  
Giacomo Turatti ◽  
Michelangelo Marobin ◽  
...  

Abstract Although antithrombin, protein C, and protein S defects are well-recognized inherited risk factors for venous thromboembolism (VTE) in adults, whether they predispose children to these vascular disorders as well is undefined. In a prospective cohort study, we assessed the incidence of spontaneous and risk period–related VTE in children who were family members of adults who, after an episode of symptomatic VTE, had then been identified as carriers of these abnormalities. A total of 134 children from 87 families were enrolled. Seventy (51.5%) of these children were carriers of an inherited defect, and the remaining 64 were not; the mean observation period was 4 years (range, 1-16 years) and 3.9 years (range, 1-13), respectively. Sixteen risk periods were experienced by carriers, and 9 by noncarriers. Six VTE occurred in the 70 carriers during 287 observation-years, accounting for an annual incidence of 2.09% patient-years (95% confidence interval, 0.8-4.5), compared with none in the 64 noncarriers during 248 observation-years. Of the 14 children with thrombophilia who experienced a risk period for thrombosis, 4 (28.6%) developed a VTE episode. The overall incidence of risk-related VTE was 25% per risk period (95% confidence interval, 6.8-64). In conclusion, the thrombotic risk in otherwise healthy children with severe inherited thrombophilia does not seem to differ from that reported for adults with the same defects. Screening for thrombophilia in children who belong to families with these defects seems justified to identify those who may benefit from thromboprophylaxis during risk periods for thrombosis.



2019 ◽  
Vol 14 (6) ◽  
pp. 829-840 ◽  
Author(s):  
Timothy J.H. Lathlean ◽  
Paul B. Gastin ◽  
Stuart V. Newstead ◽  
Caroline F. Finch

Purpose:To investigate associations between load (training and competition) and wellness in elite junior Australian Football players across 1 competitive season.Methods:A prospective cohort study was conducted during the 2014 playing season in 562 players from 9 teams. Players recorded their training and match intensities according to the session-rating-of-perceived-exertion (sRPE) method. Based on sRPE player loads, a number of load variables were quantified, including cumulative load and the change in load across different periods of time (including the acute-to-chronic load ratio). Wellness was quantified using a wellness index including sleep, fatigue, soreness, stress, and mood on a Likert scale from 1 to 5.Results:Players spent an average of 85 (21) min in each match and 65 (31) min per training session. Average match loads were 637 (232) arbitrary units, and average training loads were 352 (233) arbitrary units. Over the 24 wk of the 2014 season, overall wellness had a significant linear negative association with 1-wk load (B = −0.152; 95% confidence interval, −0.261 to −0.043;P = .006) and an inverseU-curve relationship with session load (B = −0.078; 95% confidence interval, 0.143 to 0.014;P = .018). Mood, stress, and soreness were all found to have associations with load.Conclusions:This study demonstrates that load (within a session and across the week) is important in managing the wellness of elite junior Australian Football players. Quantifying loads and wellness at this level will help optimize player management and has the potential to reduce the risk of adverse events such as injury.



2019 ◽  
Vol 69 (5) ◽  
pp. 873-876 ◽  
Author(s):  
Jason J Ong ◽  
Mahlape Precious Magooa ◽  
Admire Chikandiwa ◽  
Helen Kelly ◽  
Marie-Noelle Didelot ◽  
...  

Abstract This prospective cohort study of 622 women living with human immunodeficiency virus (HIV) from Johannesburg (2012) detected Mycoplasma genitalium in 7.4% (95% confidence interval [CI]: 5.5–9.7, 46/622), with detection more likely with lower CD4 counts(adjusted odds ratio [AOR] 1.02 per 10 cells/μL decrease, 95% CI: 1.00–1.03) and higher plasma HIV-1 RNA (AOR 1.15 per log copies/mL increase, 95% CI: 1.03–1.27). No mutations for macrolide/quinolone resistance was detected.



2005 ◽  
Vol 49 (2) ◽  
pp. 798-800 ◽  
Author(s):  
Ebbing Lautenbach ◽  
Anthony D. Harris ◽  
Eli N. Perencevich ◽  
Irving Nachamkin ◽  
Pam Tolomeo ◽  
...  

ABSTRACT Among 63 patients enrolled in a prospective cohort study of gut colonization with fluoroquinolone-resistant Escherichia coli, the sensitivity of perirectal swab compared to stool sample was 90% (95% confidence interval [CI], 70 to 99%) and the specificity was 100% (95% CI, 91 to 100%). For rectal swab, the sensitivity was 90% (95% CI, 68 to 99%) and the specificity was 100% (95% CI, 91 to 100%).



BMJ Open ◽  
2013 ◽  
Vol 3 (4) ◽  
pp. e002525 ◽  
Author(s):  
D F Hamilton ◽  
J V Lane ◽  
P Gaston ◽  
J T Patton ◽  
D MacDonald ◽  
...  


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E M Strømme ◽  
J Haj-Younes ◽  
W Hasha ◽  
L T Fadnes ◽  
B Kumar ◽  
...  

Abstract Background Conflict-driven disruption in continuity of care for non-communicable diseases (NCDs) is likely to have adverse public health impact. Yet, data on the prevalence and treatment coverage of NCDs among refugees is scarce. In this study we aim to assess the changes in prevalence of NCDs and use of relevant medication among Syrian refugees from a near-conflict phase in Lebanon to a resettlement phase in Norway. Methods This is a prospective cohort study. Survey data were collected during 2017-2018 among adult Syrian refugees in Lebanon selected for quota resettlement and at follow-up approximately one year after resettlement in Norway. Our primary outcomes were changes in NCDs as defined by the WHO and use of relevant medication. We calculated prevalence proportions with confidence intervals and assessed changes in prevalence over time using generalized estimating equations. Results Altogether 353 Syrians participated. The median age was 34 years and 51 percent were women. The overall prevalence of NCDs was 12 (9-16) percent at baseline and 9 (6-12) percent at follow-up. The odds ratio for reporting any NCD at follow-up compared to baseline was 0.68 (0.46, 1.00). Among those reporting NCDs, the prevalence of using either antithrombotic or cholesterol lowering medication, antihypertensives, antidiabetics, or drugs for asthma or chronic obstructive pulmonary disease was 55 (39-70) percent at baseline and 63 (44-80) percent at follow-up. The odds ratio for using relevant medication at follow-up compared to baseline was 1.01 (0.63, 2.05). Conclusions In our study around one tenth of the refugees reported at least one NCD. Nearly half of those reporting NCDs in a conflict-near setting did not seem to receive relevant medication, while the same was true for more than one third of respondents after resettlement. We call for innovative public health approaches and interventions to protect continuity of care for NCDs in settings of conflict-driven exodus. Key messages A high share of Syrian refugees reporting NCDs do not seem to receive relevant medication. The management of NCDs among refugees needs attention in order to avoid negative health effects.



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