scholarly journals Tap Water Avoidance Decreases Rates of Hospital-onset Pulmonary Nontuberculous Mycobacteria

2020 ◽  
Author(s):  
Arthur W Baker ◽  
Jason E Stout ◽  
Deverick J Anderson ◽  
Daniel J Sexton ◽  
Becky Smith ◽  
...  
Keyword(s):  
High Risk ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Nontuberculous Mycobacteria ◽  
Tap Water ◽  
Protocol Implementation ◽  
The Impact

Abstract We analyzed the impact of a hospital tap water avoidance protocol on respiratory isolation of nontuberculous mycobacteria (NTM). After protocol implementation, hospital-onset episodes of respiratory NTM isolation on high-risk units decreased from 41.0 to 9.9 episodes per 10 000 patient-days (incidence rate ratio, 0.24; 95% confidence interval, .17–.34; P < .0001).

Gender Differences in Anterior Cruciate Ligament Injury vary with Activity

2007 ◽  
Vol 35 (10) ◽  
pp. 1635-1642 ◽  
Author(s):  
Sally B. Mountcastle ◽  
Matthew Posner ◽  
John F. Kragh ◽  
Dean C. Taylor
Keyword(s):  
Anterior Cruciate Ligament ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Men And Women ◽  
Incidence Proportion ◽  
Anterior Cruciate

Background Previous studies have shown that women involved in similar activities as men are at increased risk for anterior cruciate ligament injuries. Hypothesis The incidence rate of complete anterior cruciate ligament tears for men and women in our athletic, college-aged population is similar. Study Design Descriptive epidemiology study. Methods Students graduating in class years 1994 to 2003 at our institution who sustained complete anterior cruciate ligament tears were assessed for mechanism of injury and type of sport played at time of injury. We calculated the incidence proportion, an estimation of risk, by gender and class year, and the incidence proportion ratio comparing men and women by class year. We also calculated incidence rates by gender and type of sport played and incidence rate ratios comparing men and women. Results There were 353 anterior cruciate ligament injuries in the 10 classes studied. We found an overall, 4-year incidence proportion of 3.24 per 100 (95% confidence interval, 2.89-3.63) for men and 3.51 (95% confidence interval, 2.65-4.65) for women (incidence proportion ratio, 1.09 [95% confidence interval, 0.80-1.47]). The overall anterior cruciate ligament injury rate, excluding male-only sports, was significantly greater in women (incidence rate ratio, 1.51 [95% confidence interval, 1.03-2.21]). We found significantly greater injury rates among women in a gymnastics course (incidence rate ratio, 5.67 [95% confidence interval, 1.99-16.16]), indoor obstacle course test (incidence rate ratio, 3.72 [95% confidence interval, 1.25-11.10]), and basketball (incidence rate ratio, 2.42 [95% confidence interval, 1.05-5.59]). Conclusion We found little gender difference in the overall risk of an anterior cruciate ligament tear; however, there were gender differences in injury rates when specific sports and activities were compared and when male-only sports were removed from the overall rate assessment.

scholarly journals The incidence and admission rate for first-episode psychosis in young people before and during the COVID-19 pandemic in Melbourne, Australia

2021 ◽  
pp. 000486742110535
Author(s):  
Brian O’Donoghue ◽  
Hannah Collett ◽  
Sophie Boyd ◽  
Yuanna Zhou ◽  
Emily Castagnini ◽  
...  
Keyword(s):  
Young People ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Odds Ratio ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
First Episode Psychosis ◽  
First Episode ◽  
Episode Psychosis ◽  
Incident Cases

Objective: The COVID-19 pandemic has had a profound effect on global mental health, with one-third of infected individuals developing a psychiatric or neurological disorder 6 months after infection. The risk of infection and the associated restrictions introduced to reduce the spread of the virus have also impacted help-seeking behaviours. Therefore, this study aimed to determine whether there was a difference during the COVID-19 pandemic in the treated incidence of psychotic disorders and rates of admission to hospital for psychosis (including involuntary admission). Methods: Incident cases of first-episode psychosis in young people, aged 15 to 24, at an early intervention service in Melbourne from an 8-month period before the pandemic were compared with rates during the pandemic. Hospital admission rates for these periods were also compared. Results: Before the pandemic, the annual incidence of first-episode psychosis was 104.5 cases per 100,000 at-risk population, and during the pandemic it was 121.9 (incidence rate ratio = 1.14, 95% confidence interval = [0.92, 1.42], p = 0.24). Immediately after the implementation of restrictions, there was a non-significant reduction in the treated incidence (incidence rate ratio = 0.80, 95% confidence interval = [0.58, 1.09]), which was followed by a significant increase in the treated incidence in later months (incidence rate ratio = 1.94, 95% confidence interval = [1.52, 2.49]; incidence rate ratio = 1.64, 95% confidence interval = [1.25, 2.16]). Before the pandemic, 37.3% of young people with first-episode psychosis were admitted to hospital, compared to 61.7% during the pandemic (odds ratio = 2.71, 95% confidence interval = [1.73, 4.24]). Concerning the legal status of the admissions, before the pandemic, 27.3% were admitted involuntarily to hospital, compared to 42.5% during the pandemic (odds ratio = 1.97, 95% confidence interval = [1.23, 3.14]). Conclusion: There was a mild increase, which did not reach statistical significance, in the overall incidence of first-episode psychosis; however, the pattern of presentations changed significantly, with nearly twice as many cases presenting in the later months of the restrictions. There was a significant increase in both voluntary and involuntary admissions, and the possible explanations for these findings are discussed.

scholarly journals Self-harm following release from prison: A prospective data linkage study

2016 ◽  
Vol 51 (3) ◽  
pp. 250-259 ◽  
Author(s):  
Rohan Borschmann ◽  
Emma Thomas ◽  
Paul Moran ◽  
Megan Carroll ◽  
Ed Heffernan ◽  
...  
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Confidence Interval ◽  
Mental Disorder ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
History Of ◽  
Self Harm ◽  
Release From Prison

Objective: Prisoners are at increased risk of both self-harm and suicide compared with the general population, and the risk of suicide after release from prison is three times greater than for those still incarcerated. However, surprisingly little is known about the incidence of self-harm following release from prison. We aimed to determine the incidence of, identify risk factors for and characterise emergency department presentations resulting from self-harm in adults after release from prison. Method: Cohort study of 1325 adults interviewed prior to release from prison, linked prospectively with State correctional and emergency department records. Data from all emergency department presentations resulting from self-harm were secondarily coded to characterise these presentations. We used negative binomial regression to identify independent predictors of such presentations. Results: During 3192 person-years of follow-up (median 2.6 years per participant), there were 3755 emergency department presentations. In all, 83 (6.4%) participants presented due to self-harm, accounting for 165 (4.4%) presentations. The crude incidence rates of self-harm for males and females were 49.2 (95% confidence interval: [41.2, 58.7]) and 60.5 (95% confidence interval: [44.9, 81.6]) per 1000 person-years, respectively. Presenting due to self-harm was associated with being Indigenous (incidence rate ratio: 2.01; 95% confidence interval: [1.11, 3.62]), having a lifetime history of a mental disorder (incidence rate ratio: 2.13; 95% confidence interval: [1.19, 3.82]), having previously been hospitalised for psychiatric treatment (incidence rate ratio: 2.68; 95% confidence interval: [1.40, 5.14]) and having previously presented due to self-harm (incidence rate ratio: 3.91; 95% confidence interval: [1.85, 8.30]). Conclusion: Following release from prison, one in 15 ex-prisoners presented to an emergency department due to self-harm, within an average of 2.6 years of release. Demographic and mental health variables help to identify at-risk groups, and such presentations could provide opportunities for suicide prevention in this population. Transition from prison to the community is challenging, particularly for those with a history of mental disorder; mental health support during and after release may reduce the risk of adverse outcomes, including self-harm.

scholarly journals Effect of newborn screening for critical CHD on healthcare utilisation

2020 ◽  
Vol 30 (8) ◽  
pp. 1157-1164
Author(s):  
Rie Sakai-Bizmark ◽  
Hiraku Kumamaru ◽  
Eliza J. Webber ◽  
Dennys Estevez ◽  
Laurie A. Mena ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Healthcare Utilisation ◽  
Interrupted Time Series ◽  
Sensitivity Analyses ◽  
Health Issues ◽  
Increasing Trend ◽  
The Impact

AbstractObjective:To evaluate the impact of state-mandated policies for pulse oximetry screening on healthcare utilisation, with a focus on use of echocardiograms.Data sources/study setting:Healthcare Cost and Utilisation Project, Statewide Inpatient Databases from 2008 to 2014 from six states.Methods:We defined pre- and post-mandate cohorts based on dates when pulse oximetry became mandated in each state. Linear segmented regression models for interrupted time series assessed associations between implementation of the screening and changes in rate of newborns with Critical CHD-negative echocardiogram results. We also evaluated the changes in rate of newborns who underwent echocardiogram but were not diagnosed with any health issues that could cause hypoxemia.Results:We identified 5967 critical CHD-negative echocardiograms (2847 and 3120 in the pre- and post-mandate periods, respectively). Our models detected a statistically significant increasing trend in rate of critical CHD-negative echocardiograms in the pre-mandate period (Incidence Rate Ratio: 1.08, p = 0.02), but did not detect any statistical differences in changes between pre- and post-mandate periods (Incidence Rate Ratio: 0.93, p = 0.14). Among non-Whites, an increasing trend of Critical CHD-negative echocardiogram during the pre-mandate period was detected (Incidence Rate Ratio 1.12, p < 0.01) and was attenuated during the post-mandate period (Incidence Rate Ratio 0.89, p = 0.02). Similar results were observed in the sensitivity analyses among both Whites and non-Whites.Conclusions:Results suggest that mandatory state screening policies are associated with reductions in false-positive screening rates for hypoxemic conditions, with reductions primarily attributed to trends among non-Whites.

scholarly journals Increased Risk for Nonmedullary Thyroid Cancer in the First Degree Relatives of Prevalent Cases of Nonmedullary Thyroid Cancer: A Hospital-Based Study

2001 ◽  
Vol 86 (11) ◽  
pp. 5307-5312 ◽  
Author(s):  
Tuya Pal ◽  
Florian D. Vogl ◽  
Pierre O. Chappuis ◽  
Richard Tsang ◽  
James Brierley ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Genetic Basis ◽  
Incidence Rate Ratio ◽  
Cancer Susceptibility ◽  
Degree Relative ◽  
First Degree Relatives ◽  
Increased Risk

The genetic basis for nonmedullary forms of thyroid cancer (NMTC) is less well established than that of medullary thyroid cancer. However, epidemiological and family studies suggest that a proportion of NMTC may be due to inherited predisposition. To estimate the familial risk of thyroid cancer, we conducted a hospital-based case-control study at the Princess Margaret Hospital in Toronto, Ontario, Canada, and at 2 university hospitals in Montréal, Québec, Canada. We obtained pedigrees from 339 unselected patients diagnosed with NMTC and from 319 unaffected ethnically matched controls. Family histories of cancer were obtained from the cases and controls for 3292 first degree relatives of cases and controls. Seventeen cases (5.0%) and 2 controls (0.6%) reported at least one first degree relative with thyroid cancer. In relatives of patients with thyroid cancer, the incidence of any type of cancer (including NMTC) was 38% higher than in relatives of controls (incidence rate ratio, 1.4; 95% confidence interval, 1.1–1.7). The relative risk for thyroid cancer was 10-fold higher in relatives of cancer patients than in controls (incidence rate ratio, 10.3; 95% confidence interval, 2.2–47.6). Our findings suggest that hereditary or other familial factors are important in a small proportion of NMTC. Molecular studies are needed to determine the genetic basis of cancer susceptibility in these families.

scholarly journals Accuracy of inter-hospital transfer information in Australian hospital administrative databases

2017 ◽  
Vol 25 (3) ◽  
pp. 960-972 ◽  
Author(s):  
Hassan Assareh ◽  
Helen M Achat ◽  
Jean-Frederic Levesque
Keyword(s):  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Care Delivery ◽  
Hospital Performance ◽  
Administrative Databases ◽  
Accuracy Rate ◽  
Hospital Variation ◽  
Hospital Administrative

Inter-hospital transfers improve care delivery for which sending and receiving hospitals both accountable for patient outcomes. We aim to measure accuracy in recorded patient transfer information (indication of transfer and hospital identifier) over 2 years across 121 acute hospitals in New South Wales, Australia. Accuracy rate for 127,406 transfer-out separations was 87 per cent, with a low variability across hospitals (10% differences); it was 65 per cent for 151,978 transfer-in admissions with a greater inter-hospital variation (36% differences). Accuracy rate varied by departure and arrival pathways; at receiving hospitals, it was lower for transfer-in admission via emergency department (incidence rate ratio = 0.52, 95% confidence interval: 0.51–0.53) versus direct admission. Transfer-out data were more accurate for transfers to smaller hospitals (incidence rate ratio = 1.06, 95% confidence interval: 1.03–1.08) or re-transfers (incidence rate ratio > 1.08). Incorporation of transfer data from sending and receiving hospitals at patient level in administrative datasets and standardisation of documentation across hospitals would enhance accuracy and support improved attribution of hospital performance measures.

scholarly journals Cognitive function predicts work disability among multiple sclerosis patients

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731882213 ◽  
Author(s):  
Andrius Kavaliunas ◽  
Petter Tinghög ◽  
Emilie Friberg ◽  
Tomas Olsson ◽  
Kristina Alexanderson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Function ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Work Disability ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
One Year ◽  
Multiple Sclerosis Patients

Background In multiple sclerosis various aspects of cognitive function can be detrimentally affected. More than that, patients´ employment and social functioning is likely to be impacted. Objective To determine whether work disability among multiple sclerosis patients could be predicted by the symbol digit modalities test. Methods A register-based cohort study was conducted. Individual data on work disability, operationalised as annual net days of sickness absence and/or disability pension were retrieved at baseline, when the symbol digit modalities test was performed, after one-year and 3-year follow-up for 903 multiple sclerosis patients. The incidence rate ratios for work disability were calculated with general estimating equations using a negative binomial distribution and were adjusted for gender, age, educational level, family composition, type of living area and physical disability. Results After one year of follow-up, the patients in the lowest symbol digit modalities test quartile were estimated to have a 73% higher rate of work disability when compared to the patients in the highest symbol digit modalities test quartile (incidence rate ratio 1.73, 95% confidence interval 1.42‒2.10). This estimate after 3-year follow-up was similar (incidence rate ratio 1.68, 95% confidence interval 1.40‒2.02). Conclusion Cognitive function is to a high extent associated with multiple sclerosis patients’ future work disability, even after adjusting for other factors.

scholarly journals The Impact of Large-scale Social Restriction on COVID-19 Incidence: A Case Study of Four Regions in Indonesia

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Izza Suraya ◽  
Mochamad Iqbal Nurmansyah ◽  
Emma Rachmawati ◽  
Badra Al Aufa ◽  
Ibrahim Isa Koire
Keyword(s):  
Incidence Rate ◽  
Government Policy ◽  
Poisson Regression ◽  
Rate Ratio ◽  
Large Scale ◽  
Incidence Rate Ratio ◽  
Interaction Model ◽  
Social Restriction ◽  
The Impact

The Indonesian government has chosen to implement large-scale social restrictions, or Pembatasan Sosial Berskala Besar (PSBB), to minimize the spread of COVID-19. PSBB is a government policy aimed at restricting the internal movement of people in a bid to reduce the spread of SARS-CoV-2. This study aims to assess the impact of such large-scale social restriction measures on the incidence of COVID-19 cases in four provinces of Indonesia. Time series analysis was used to describe trends in COVID-19 cases by using surveillance data from the Ministry of Health of Indonesia. Quasi-Poisson regression with an interaction model was used to estimate the incidence rate ratio (IRR), and this was calculated to compare the incidence rate before and during PSBB implementation. The trend in COVID-19 cases in the provinces of West Java, East Java, Banten, and Jakarta has continued to fluctuate. These four provinces have continued to experience a significant increase in the COVID-19 incidence rate ratio after the implementation of the first and second PSBB periods compared to the  period before PSBB implementation. Lack of proper implementation of the large-scale social restrictions has led to PSBB’s ineffectiveness in reducing the number of COVID-19 cases in each of the provinces.

scholarly journals Mass Gatherings and Diarrheal Disease Transmission Among Rural Communities in Coastal Ecuador

2019 ◽  
Vol 188 (8) ◽  
pp. 1475-1483 ◽  
Author(s):  
Philip A Collender ◽  
Christa Morris ◽  
Rose Glenn-Finer ◽  
Andrés Acevedo ◽  
Howard H Chang ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Incidence Rate ◽  
Disease Transmission ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Diarrheal Disease ◽  
Coverage Rate ◽  
Epidemic Disease ◽  
Mass Gatherings ◽  
Epidemiologic Surveillance

Abstract Mass gatherings exacerbate infectious disease risks by creating crowded, high-contact conditions and straining the capacity of local infrastructure. While mass gatherings have been extensively studied in the context of epidemic disease transmission, the role of gatherings in incidence of high-burden, endemic infections has not been previously studied. Here, we examine diarrheal incidence among 17 communities in Esmeraldas, Ecuador, in relation to recurrent gatherings characterized using ethnographic data collected during and after the epidemiologic surveillance period (2004–2007). Using distributed-lag generalized estimating equations, adjusted for seasonality, trend, and heavy rainfall events, we found significant increases in diarrhea risk in host villages, peaking 2 weeks after an event’s conclusion (incidence rate ratio, 1.21; confidence interval, adjusted for false coverage rate of ≤0.05: 1.02, 1.43). Stratified analysis revealed heightened risks associated with events where crowding and travel were most likely (2-week-lag incidence rate ratio, 1.51; confidence interval, adjusted for false coverage rate of ≤0.05: 1.09, 2.10). Our findings suggest that community-scale mass gatherings might play an important role in endemic diarrheal disease transmission and could be an important focus for interventions to improve community health in low-resource settings.

scholarly journals Minocycline and the risk of acute psychiatric events in adolescence: A self-controlled case series

2019 ◽  
Vol 33 (4) ◽  
pp. 466-471 ◽  
Author(s):  
Ruth Brauer ◽  
Maria Herrero-Zazo ◽  
David J Barlow ◽  
Fiona Gaughran ◽  
David Taylor ◽  
...  
Keyword(s):  
United Kingdom ◽  
Confidence Interval ◽  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Psychiatric Symptoms ◽  
Case Series ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Psychiatric Referral

Background Minocycline has neurological anti-inflammatory properties and has been hypothesised to have antipsychotic effects. Aim The aim of this study was to investigate, using routinely collected United Kingdom primary health care data, whether adolescent men and women are more or less likely to receive an urgent psychiatric referral during treatment for acne with minocycline compared with periods of non-treatment. Method A self-controlled case series using United Kingdom Clinical Practice Research Datalink to calculate the incidence rate ratio of urgent psychiatric referrals for individuals, comparing periods during which minocycline was prescribed with unexposed periods, adjusted for age. Results We found 167 individuals who were at the time exposed to minocycline for a mean of 99 days and who received an urgent psychiatric referral. There was no difference in psychiatric referral risk during periods of exposure compared with periods of non-exposure: incidence rate ratio first 6 weeks of exposure 1.96, 95% confidence interval 0.82–4.71, p=0.132; incidence rate ratio remaining exposure period=1.97, 95% confidence interval 0.86–4.47, p=0.107. Conclusions We found no evidence in support of a protective effect of minocycline against severe psychiatric symptoms in adolescence.

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