scholarly journals Effect of ethnicity and socioeconomic status on vascular access provision and performance in an urban NHS hospital

2016 ◽  
pp. sfw099
Author(s):  
Teun Wilmink ◽  
Anika Wijewardane ◽  
Kathryn Lee ◽  
Alexander Murley ◽  
Lee Hollingworth ◽  
...  
2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20531-e20531
Author(s):  
Y. Manikyam ◽  
G. G. Hanna ◽  
R. J. Harte ◽  
P. G. Henry ◽  
R. F. Houston ◽  
...  

e20531 Background: The survival advantage for combination chemotherapy in advanced gastroesophageal adenocarcinoma is well documented. Epirubicin and cisplatin in combination with either 5FU (ECF) or capecitabine (ECX) result in response rates of 35–46% and a median survival of around 9 months in RCT. We report the impact of socioeconomic status on the outcome of ECF and ECX treatment in advanced gastroesophageal cancer patients in Northern Ireland between 2000 and 2007. Methods: All patients with advanced esophageal (O), gastric (G), or esophagogastric junction (OGJ) adenocarcinoma, receiving palliative chemotherapy from January 2000 to August 2007, were identified from our institutional database. Baseline demographics, clinical characteristics, treatment details, and clinical outcomes were recorded. Patients receiving chemotherapy in a clinical trial were excluded. Survival was estimated using the Kaplan-Meier method. Deprivation was assessed using the patient's home address deprivation index (DPI) (Northern Ireland Multiple Deprivation Measure 2005; May 2005. Northern Ireland Statistics and Research Agency. www.nisra.gov.uk ). Results: 274 eligible patients (m=200, f=74, O=114, OGJ=19, G=141) were identified. Median age was 62 years (range 22–83). 172 (62.8%) had ECOG performance status 0 or 1. 231 patients (84.3%) had metastatic disease, 43 (15.7%) had locally advanced disease. 216 (78.8%) patients received ECF and 58 (21.2%) patients received ECX. Overall median survival was 7.3 months. Treatment response and performance status were strong predictors of survival, however disease extent did not influence survival. Median survival was significantly longer in those with DPIs in the upper two quintiles than the lower 3 quintiles (9.5 months vs. 6.8 months, p=0.032). Conclusions: Outcomes achieved with palliative ECF/ECX treatment are similar to the reference clinical trials. Socioeconomic deprivation is significantly associated with reduced survival in this group of patients and is unrelated to disease extent at presentation; however it may be related to nutritional status and comorbidity and requires further investigation. No significant financial relationships to disclose.


1977 ◽  
Vol 40 (1) ◽  
pp. 139-145 ◽  
Author(s):  
Alan S. Appelbaum ◽  
June M. Tuma

Comparability of IQs yielded by the Peabody and the revised Wechsler scale, the WISC-R, is important to interpret IQ estimates obtained from these two scales. In the present study, 40 normal 10-yr.-old children (20 male and 20 female, half of whom were from high and half from low socioeconomic status) were compared for performance on the Peabody, the WISC and the WISC-R. IQs obtained on Forms A and B of the Peabody correlate highly and, thus, the two Peabody forms are essentially parallel and equivalent forms. Concurrent validity coefficients ranging from .71 to .83 were obtained between the Peabody IQs and Verbal and Full Scale IQs of the WISC and the WISC-R. Much lower validity coefficients were obtained between the Peabody and Performance IQs of the WISC and the WISC-R. Large differences in IQ between children from low socioeconomic backgrounds and those from high socioeconomic backgrounds were obtained on all four tests. The Peabody IQs were closer in magnitude to the WISC-R IQs than to the WISC in the low socioeconomic group. The results support administering the Peabody to children for obtaining valid IQ estimates. Interpretations of Peabody scores in relation to the WISC-R should be somewhat different from those of the Peabody and the WISC, however, in view of the effects of socioeconomic status (and therefore ability level) on estimates of IQ.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255020
Author(s):  
Ji Eun Kim ◽  
Shin Young Ahn ◽  
Soo Ick Cho ◽  
Young Joo Kwon ◽  
SuHwan Shin ◽  
...  

Background Hemodialysis is a life-saving renal replacement treatment for patients with chronic kidney disease, but various complications occur during hemodialysis and associated procedures. This study was conducted to analyze the specific characteristics of hemodialysis-related complications and malpractice that have led to legal disputes. Methods Judgments from cases litigated between 1991 and 2019 due to complications related to hemodialysis or vascular access were analyzed using the database of the Korean Supreme Court Judgment System. Results Of 32 dialysis-related litigation cases, 14 cases were dismissed and malpractice was recognized in 18 cases. Among all cases and those in which malpractice was recognized, the most common clinical complication was associated with central venous catheter (CVC) insertion (25.0% and 42.9%, respectively). In 22 of 32 (68.8%) cases, complications occurred before or after (not during) dialysis, and performance error was the most common clinical error leading to legal disputes (58.3%). Complications resulted in death in 59.4% of cases, and CVC-related complications were associated with the largest proportion (63.2%) of deaths. Conclusions Hemodialysis was implicated in various medical disputes, and CVC-related complications were the most common and serious adverse events. Clinicians’ awareness of the incidence and severity of possible complications of hemodialysis procedures should be increased.


1988 ◽  
Vol 66 (3) ◽  
pp. 847-854 ◽  
Author(s):  
Nolan E. Penn ◽  
Teresa C. Jacob ◽  
Malrie Brown

The Gorham Proverbs Test was administered to 278 black participants residing in a large metropolitan area in Southern California. Respondents were also asked to indicate whether they were familiar with each of the 40 proverbs in the test. Scores were significantly affected by respondents' ages, education, and perceived childhood socioeconomic status. Familiarity with a proverb increased the probability of its correct interpretation. Familiarity of proverbs and attempts to interpret them were significantly associated, that is, respondents tended not to attempt interpretation of unfamiliar proverbs. The number of familiar proverbs per test was not significantly associated with respondents' test scores. The mean Abstract score obtained in this study was comparable to mean scores previously reported in the literature, suggesting that ethnic differences do not significantly affect performance on the Proverbs Test.


2020 ◽  
Vol 21 (5) ◽  
pp. 665-672
Author(s):  
Chieh Suai Tan ◽  
Seck Guan Tan ◽  
Chi Leung Julian Wong ◽  
Bernard Wee ◽  
Weng Kin Wong ◽  
...  

Introduction: The ability to successfully cannulate the arteriovenous fistula reliably is a critical step in the delivery of hemodialysis therapy. The av-Guardian vascular access system (Advent Access, Singapore) is designed to overcome the technical barrier to establishing reliable blunt needle access in patients with mature arteriovenous fistula. Methods: This was a first-in-man, prospective, non-randomized trial (registered on the Australian New Zealand Clinical Trial Registry (ACTRN12617000501347)) performed to assess the safety and feasibility of achieving repeatable successful cannulation via av-Guardian vascular access system to facilitate blunt needling in patients with mature arteriovenous fistula. The primary endpoints of the study included rate of successful hemodialysis sessions via av-Guardian vascular access system cannulation over 3 months and safety of the implants. Results: A total of six patients (four patients with brachiocephalic and two with radiocephalic arteriovenous fistula) were enrolled in the study. A pair of av-Guardian vascular access system were implanted, one each at the arterial and venous cannulation sites, under local anesthesia. Overall, the rate of successful cannulation through the av-Guardian vascular access system over 3 months in 216 hemodialysis sessions was 98.1% (212/216) at the arterial site and 94.4% (204/216) at the venous site. Significantly, 90% and 85.5% of the cannulations at the arterial and venous site, respectively, were successful at first attempt. Blood flow rates within the arteriovenous fistula were unaffected by the devices. Conclusion: The results demonstrated the safety and feasibility of a subcutaneously implanted, extravascular device in achieving repeatable successful cannulation via a constant site, to facilitate blunt needling in matured arteriovenous fistula in limited number of patients.


PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 934-942
Author(s):  
Charlotte Neumann ◽  
Mary Alice McDonald ◽  
Marian Sigman ◽  
Nimrod Bwibo ◽  
Mark Marquardt

This study explored the extent to which morbidity in 110 mildly to moderately malnourished Kenyan toddlers was associated with developmental outcomes. Morbidity information was collected from the 18th to 30th months. Concurrent assessments of vocalization, play, and performance on the Bayley scales were obtained. At 5 years, a follow-up battery of cognitive tests was administered. Female toddlers who suffered more illness generally performed less well on developmental measures than their healthier female peers. These children vocalized and played less and performed less well on the Bayley Mental scales at 30 months and on the cognitive battery at 5 years. For the boys, development was largely independent of morbidity. Morbidity was related to patterns of care giving for both boys and girls, but it was not associated with socioeconomic status or food intake. However, girls who were ill more often were shorter and lighter. Relations between morbidity and development in the girls remained statistically significant when other variables, which were also related to development (such as care giving, socioeconomic status, parental IQ and literacy, food intake, and anthropometry) were considered. This suggests that morbidity, in these female toddlers, had an effect on development above and beyond other variables typically associated with malnutrition.


2020 ◽  
Author(s):  
Josephine Tan ◽  
Jon Jachimowicz

For many graduating college students entering the workforce, “pursue your passion” is not only a frequently repeated graduation mantra but also a commonly embraced ideal. In line with this view, prior academic research finds that passion connotes work-related benefits, including higher job satisfaction and performance. Here, we bring together social psychological, sociological, and organizational perspectives to suggest that the inclination to work in jobs that enable graduating students to pursue their passion differs based on their socioeconomic status (SES): those from lower SES backgrounds view the pursuit of passion as a privilege that excludes them. Across two correlational and experimental studies (N = 510; k = 1,562), we find that students from lower SES backgrounds feel that they are a worse fit for and lack the skills to thrive in jobs that call for passion, i.e., that they perceive the pursuit of passion as a privilege. We next examine whether this belief is accurate from the perspective of recruiters, and—across two additional experimental studies designed to test both overt and covert discrimination (N = 1,005; k = 9,713)—do not find supporting empirical evidence for discrimination against students from lower SES backgrounds in jobs that emphasize the pursuit of passion. These results suggest that the pursuit of passion may serve as an—unintentionally—exclusionary signal to graduating students from lower SES backgrounds, making them less likely to apply, and ultimately less likely to be hired. The pursuit of passion thus reflects a privilege that perpetuates inequalities along socioeconomic lines.


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