scholarly journals Determinants of inequalities in years with disability: an international-comparative study

2020 ◽  
Author(s):  
Wilma J Nusselder ◽  
José Rubio Valverde ◽  
Matthias Bopp ◽  
Henrik Brønnum-Hansen ◽  
Patrick Deboosere ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Risk Factor ◽  
Low Income ◽  
Vegetable Consumption ◽  
High Body Weight ◽  
High Body ◽  
International Comparative ◽  
Low Educated ◽  
Manual Occupation

Abstract Background Persons with a lower socioeconomic position spend more years with disability, despite their shorter life expectancy, but it is unknown what the important determinants are. This study aimed to quantify the contribution to educational inequalities in years with disability of eight risk factors: father’s manual occupation, low income, few social contacts, smoking, high alcohol consumption, high body-weight, low physical exercise and low fruit and vegetable consumption. Methods We collected register-based mortality and survey-based disability and risk factor data from 15 European countries covering the period 2010–14 for most countries. We calculated years with disability between the ages of 35 and 80 by education and gender using the Sullivan method, and determined the hypothetical effect of changing the prevalence of each risk factor to the prevalence observed among high educated (‘upward levelling scenario’), using Population Attributable Fractions. Results Years with disability among low educated were higher than among high educated, with a difference of 4.9 years among men and 5.5 years among women for all countries combined. Most risk factors were more prevalent among low educated. We found the largest contributions to inequalities in years with disability for low income (men: 1.0 year; women: 1.4 year), high body-weight (men: 0.6 year; women: 1.2 year) and father’s manual occupation (men: 0.7 year; women: 0.9 year), but contributions differed by country. The contribution of smoking was relatively small. Conclusions Disadvantages in material circumstances (low income), circumstances during childhood (father’s manual occupation) and high body-weight contribute to inequalities in years with disability.

scholarly journals Predictive risk factors of failed laryngeal mask airway insertion at first attempt

2018 ◽  
Vol 46 (5) ◽  
pp. 1973-1981
Author(s):  
Jia Wang ◽  
Xiaoping Shi ◽  
Tao Xu ◽  
Geng Wang
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Laryngeal Mask Airway ◽  
Cuff Pressure ◽  
Significant Risk ◽  
Laryngeal Mask ◽  
Laryngeal Mask Airway Insertion ◽  
High Body Weight ◽  
High Body ◽  
Lidocaine Gel

Objectives A failed first attempt at laryngeal mask airway (LMA) insertion could increase the risk of laryngospasm, hypoxemia, and postoperative sore throat. This study was performed to investigate the risk factors for failed first-attempt LMA placement. Methods In total, 461 patients who underwent general anesthesia with a Supreme LMA (Teleflex Medical, Shanghai, China) and who had an American Society of Anesthesiologists (ASA) physical status of I to III were prospectively enrolled. The LMA was inserted after anesthetic induction. We recorded the insertion conditions and each patient’s age, ASA status, body weight, body mass index (BMI), duration of anesthesia, size of LMA, and cuff pressure; the years of work experience of the anesthesiologists; and the use or nonuse of lidocaine gel as a lubricant. Results Successful first-attempt placement of the Supreme LMA was achieved in 438 (95.10%) patients, while first-attempt placement failed in 23 (4.99%). Significant risk factors for failure of first-attempt LMA insertion included high age, high body weight, BMI of <20 kg/m2, and insertion without using lidocaine gel. Conclusions A patient age of >61 years, high body weight, BMI of <20 kg/m2, and insertion without lidocaine gel could significantly increase the risk of failed first-attempt Supreme LMA insertion.

scholarly journals Low Back Pain in Athletes Is Associated with General and Sport Specific Risk Factors: A Comprehensive Review of Longitudinal Studies

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Vahideh Moradi ◽  
Amir-Hossein Memari ◽  
Monir ShayestehFar ◽  
Ramin Kordi
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Low Back Pain ◽  
Back Pain ◽  
Longitudinal Studies ◽  
Methodological Quality ◽  
Low Back ◽  
Lumbar Flexion ◽  
High Body

We aimed to examine systematically the available evidence on risk factors of low back pain (LBP) in athletes. We performed search without language restriction in PubMed, Ovid, Google Scholar, Scopus, and CINAHL. Longitudinal studies that examined possible risk factors of LBP in athletes were included in this systematic review. Based on methodological quality of studies, a best-evidence synthesis was conducted. Seven longitudinal studies were included, four of which had high methodological quality. Results showed that previous LBP, decreased lumbar flexion, and decreased lumbar extension are positively associated with LBP. There was moderate evidence for hip flexor tightness and high body weight as a risk factor. We found insufficient evidence for association between forward bending, previous injury, and amount of training per week, active years, age, and sex with LBP. In conclusion this study would provide a list of risk factors for LBP in athletes, though it showed a strong evidence for only a few including decrease lumbar flexion or extension, previous LBP, and high body weight. This review indicated a high heterogeneity of study characteristics including assessed risk factors and statistical techniques might limit the quality of evidence.

scholarly journals Changing Epidemiology of Acute Respiratory Infections in Under-Two Children in Dhaka, Bangladesh

2022 ◽  
Vol 9 ◽  
Author(s):  
Karine Vidal ◽  
Shamima Sultana ◽  
Alberto Prieto Patron ◽  
Irene Salvi ◽  
Maya Shevlyakova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Low Income ◽  
Respiratory Infections ◽  
Monsoon Season ◽  
Low Income Countries ◽  
Health Study ◽  
Acute Respiratory Infections ◽  
Respiratory Pathogens ◽  
Prevention Measures

Objectives: Risk factors for acute respiratory infections (ARIs) in community settings are not fully understood, especially in low-income countries. We examined the incidence and risk factors associated with ARIs in under-two children from the Microbiota and Health study.Methods: Children from a peri-urban area of Dhaka (Bangladesh) were followed from birth to 2 years of age by both active surveillance of ARIs and regular scheduled visits. Nasopharyngeal samples were collected during scheduled visits for detection of bacterial facultative respiratory pathogens. Information on socioeconomic, environmental, and household conditions, and mother and child characteristics were collected. A hierarchical modeling approach was used to identify proximate determinants of ARIs.Results: Of 267 infants, 87.3% experienced at least one ARI episode during the first 2 years of life. The peak incidence of ARIs was 330 infections per 100 infant-years and occurred between 2 and 4 months of age. Season was the main risk factor (rainy monsoon season, incidence rate ratio [IRR] 2.43 [1.92–3.07]; cool dry winter, IRR 2.10 [1.65–2.67] compared with hot dry summer) in the first 2 years of life. In addition, during the first 6 months of life, young maternal age (&lt;22 years; IRR 1.34 [1.01–1.77]) and low birth weight (&lt;2,500 g; IRR 1.39 [1.03–1.89]) were associated with higher ARI incidence.Conclusions: Reminiscent of industrialized settings, cool rainy season rather than socioeconomic and hygiene conditions was a major risk factor for ARIs in peri-urban Bangladesh. Understanding the causal links between seasonally variable factors such as temperature, humidity, crowding, diet, and ARIs will inform prevention measures.

scholarly journals Body Weight at Birth: The Only Risk Factor Associated with Contralateral Clavicular Fracture in Patients with Congenital Muscular Torticollis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Zeeihn Lee ◽  
Joo Young Cho ◽  
Byung Joo Lee ◽  
Jong Min Kim ◽  
Donghwi Park
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Risk Factor ◽  
The Body ◽  
Youden Index ◽  
Clavicular Fracture ◽  
Congenital Muscular Torticollis ◽  
Factors Associated ◽  
Significant Difference ◽  
Muscular Torticollis

Abstract To date and to the best of our knowledge, there have been limited studies on the risk factor of clavicle fracture combined with congenital muscular torticollis (CMT), despite it being the most common fracture in newborns. So, the aim of this study was to investigate the risk factors associated with clavicular fracture combined with CMT, and its effect on prognosis. In this study, a total of 134 infants with CMT were included. The risk factors associated with clavicular fracture combined with CMT were analyzed. To analyze the correlation between the clinical parameters and the clavicular fracture in patients with CMT, demographic data, such as body weight at birth, maternal age, gender, gestational age, delivery method, sternocleidomastoid (SCM) thickness of ipsilateral side, its ratio between the ipsilateral and contralateral side, and the first visitation date after birth were evaluated. In the results of this study, the clavicular fracture was found in 15 of 134 patients with CMT (19%). In multivariate logistic analysis, the body weight at birth was the only significant parameter for predicting clavicular fracture in patients with CMT (p-value < 0.05). However, there was no significant difference of treatment duration between CMT infants with or without clavicular fracture. In infants with CMT, the area under the ROC curve of the body weight at birth for predicting clavicular fracture was 0.659 (95% CI, 0.564–0.745.; p < 0.05). The optimal cut-off value obtained from the maximum Youden index J was 3470 g (sensitivity: 57.14%, specificity: 75.76%), and the odd ratio of clavicular fracture in patients with CMT increased by 1.244 times for every 100 g of body weight at birth. In conclusion, birth weight appears to be a clinical predictor of clavicular fracture in infants with CMT. More studies and discussions are needed on whether any screening should be recommended for detecting the concurrent clavicular fracture in subjects with CMT.

scholarly journals Disparity in Risk Factor Severity for Early Childhood Blood Lead among Predominantly African-American Black Children: The 1999 to 2010 US NHANES

2020 ◽  
Vol 17 (5) ◽  
pp. 1552 ◽  
Author(s):  
Deniz Yeter ◽  
Ellen C. Banks ◽  
Michael Aschner
Keyword(s):  
Risk Factors ◽  
Early Childhood ◽  
African American ◽  
Risk Factor ◽  
Low Income ◽  
Racial Disparity ◽  
Blood Lead ◽  
Black Children ◽  
The United States ◽  
American Black

There is no safe detectable level of lead (Pb) in the blood of young children. In the United States, predominantly African-American Black children are exposed to more Pb and present with the highest mean blood lead levels (BLLs). However, racial disparity has not been fully examined within risk factors for early childhood Pb exposure. Therefore, we conducted secondary analysis of blood Pb determinations for 2841 US children at ages 1–5 years with citizenship examined by the cross-sectional 1999 to 2010 National Health and Nutrition Examination Survey (NHANES). The primary measures were racial disparities for continuous BLLs or an elevated BLL (EBLL) ≥5 µg/dL in selected risk factors between non-Hispanic Black children (n = 608) and both non-Hispanic White (n = 1208) or Hispanic (n = 1025) children. Selected risk factors included indoor household smoking, low income or poverty, older housing built before 1978 or 1950, low primary guardian education <12th grade/general education diploma (GED), or younger age between 1 and 3 years. Data were analyzed using a regression model corrected for risk factors and other confounding variables. Overall, Black children had an adjusted +0.83 µg/dL blood Pb (95% CI 0.65 to 1.00, p < 0.001) and a 2.8 times higher odds of having an EBLL ≥5 µg/dL (95% CI 1.9 to 3.9, p < 0.001). When stratified by risk factor group, Black children had an adjusted 0.73 to 1.41 µg/dL more blood Pb (p < 0.001 respectively) and a 1.8 to 5.6 times higher odds of having an EBLL ≥5 µg/dL (p ≤ 0.05 respectively) for every selected risk factor that was tested. For Black children nationwide, one in four residing in pre-1950 housing and one in six living in poverty presented with an EBLL ≥5 µg/dL. In conclusion, significant nationwide racial disparity in blood Pb outcomes persist for predominantly African-American Black children even after correcting for risk factors and other variables. This racial disparity further persists within housing, socio-economic, and age-related risk factors of blood Pb outcomes that are much more severe for Black children.

scholarly journals Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

2020 ◽  
Vol 17 (7) ◽  
pp. 2526 ◽  
Author(s):  
Shaanthana Subramaniam ◽  
Chin-Yi Chan ◽  
Ima-Nirwana Soelaiman ◽  
Norazlina Mohamed ◽  
Norliza Muhammad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Weight ◽  
Low Income ◽  
Operating Characteristics ◽  
Osteoporosis Screening ◽  
Malaysian Population ◽  
Reduced Body ◽  
Income Status ◽  
Screening Algorithm ◽  
Klang Valley

Background: The current osteoporosis screening instruments are not optimized to be used among the Malaysian population. This study aimed to develop an osteoporosis screening algorithm based on risk factors for Malaysians. Methods: Malaysians aged ≥50 years (n = 607) from Klang Valley, Malaysia were interviewed and their bone health status was assessed using a dual-energy X-ray absorptiometry device. The algorithm was constructed based on osteoporosis risk factors using multivariate logistic regression and its performance was assessed using receiver operating characteristics analysis. Results: Increased age, reduced body weight and being less physically active significantly predicted osteoporosis in men, while in women, increased age, lower body weight and low-income status significantly predicted osteoporosis. These factors were included in the final algorithm and the optimal cut-offs to identify subjects with osteoporosis was 0.00120 for men [sensitivity 73.3% (95% confidence interval (CI) = 54.1%–87.7%), specificity 67.8% (95% CI = 62.7%–85.5%), area under curve (AUC) 0.705 (95% CI = 0.608–0.803), p < 0.001] and 0.161 for women [sensitivity 75.4% (95% CI = 61.9%–73.3%), specificity 74.5% (95% CI = 68.5%–79.8%), AUC 0.749 (95% CI = 0.679–0.820), p < 0.001]. Conclusion: The new algorithm performed satisfactorily in identifying the risk of osteoporosis among the Malaysian population ≥50 years. Further validation studies are required before applying this algorithm for screening of osteoporosis in public.

Direct Oral Anticoagulant Concentrations in Obese and High Body Weight Patients: A Cohort Study

2020 ◽  
Author(s):  
Anne Céline Martin ◽  
William Thomas ◽  
Zahra Mahir ◽  
Maeve P. Crowley ◽  
Terry Dowling ◽  
...  
Keyword(s):  
Body Weight ◽  
Creatinine Clearance ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Factor Xa ◽  
High Body Weight ◽  
High Body ◽  
Trough Concentrations ◽  
Fxa Inhibitor ◽  
Age Range

Abstract Background Direct oral anticoagulants (DOACs) are prescribed for atrial fibrillation (AF) and venous thromboembolism (VTE) and both occur more frequently in obese patients. Outcomes from DOAC trials included few individuals ≥ 120 kg leading to uncertainty whether high body weight (BW) reduces DOAC concentrations. Objectives This article investigates the relationship between factor Xa (FXa) inhibitor concentrations, BW, and renal function, and compares them in high BW patients with unselected populations. Methods Consecutive patients in two United Kingdom centers, weighing ≥ 120 kg receiving 5 mg twice daily apixaban or 20 mg once daily rivaroxaban for AF or VTE were prospectively included. Peak or trough concentrations were measured using specific chromogenic assays, expressed in mean or median (5th–95th percentiles). On-therapy range was the interval from the 5th percentile trough concentration to the 95th percentile peak concentration. Results One hundred patients were included; age range: 23 to 78 years, 31% were women, 58% had AF, creatinine clearance range: 67 to 474 mL/min. Median BW was 139 kg, and 84% had body mass index (BMI) ≥ 40 kg/m2. DOAC peak and trough concentrations varied from 44 to 727 and 14 to 299 ng/mL, respectively. There was no linear relationship between FXa inhibitor concentrations at peak or trough and BW or BMI, and creatinine clearance. Apixaban troughs in AF and rivaroxaban peaks in VTE were lower than in unselected populations. However, only two trough concentrations were below the expected range, and 109/116 were within the on-therapy range. Conclusion These data indicated that obese or high BW patients generally achieve therapeutic FXa inhibitor concentrations. However, further investigations assessing clinical outcomes are required.

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