scholarly journals SWK-07. A MULTINATIONAL SURVEY OF PAEDIATRIC NEURO-ONCOLOGY SERVICES: A EUROPEAN RESEARCH NETWORK (ERN) PAEDCAN PROJECT

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii465-iii466
Author(s):  
Katherine Cooper ◽  
Barry Pizer ◽  
Steven Lane ◽  
Stefan Rutkowski
Keyword(s):  
Economic Status ◽  
Proton Beam Therapy ◽  
Paediatric Oncology ◽  
Interdisciplinary Cooperation ◽  
Research Network ◽  
Online Questionnaire ◽  
Support Design ◽  
Mortality And Morbidity ◽  
Group Members ◽  
Patient Advice

Abstract BACKGROUND Brain tumours are clinically and biologically highly diverse and account for 25% of paediatric neoplasms. They carry the highest mortality and morbidity of tumour groups. Their management presents significant challenges with performing modern diagnostic assessments, applying multimodal treatment and establishing interdisciplinary cooperation. Outcomes across Europe differ significantly with varying 5year survival reports of 42–79%. This SIOP-Europe PaedCan survey assessed the structures and facilities for individual states and highlight areas for cooperation and support. DESIGN: An online questionnaire was sent to SIOP-Europe Brain Tumour Group members. This had 55 questions assessing pathology, staging, surgery, radiotherapy and paediatric oncology infrastructure. For analysis of the data we divided countries into lower and higher economic status according to GDP (World Bank 2019) with a cut off of $30,100. RESULTS There were 388 respondents from 44 countries in 181 different institutions. In the lower GDP group we noted decreased access to biological characterisation of tumours and interdisciplinary tumour boards. In this group of nations, patients were less likely to have treatment by a paediatric specialist neurosurgeon, paediatric neuro-oncologist, neuroradiologist, and paediatric radiation oncologist. There was also less availability to perform early MRI (ventilated) and less access to proton beam therapy. This study supports the aim of the ERN to produce a roadmap document with specific standards and publish guidelines for all relevant diagnostic and therapeutic components of care. The ERN also aims to identify a network of institutions to provide patient advice and training to equalise treatment and outcomes for all children across Europe.

523 Retrospective Outcomes Analysis of Tracheostomy in Paediatric Burn Population

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S108-S109
Author(s):  
Nicholas Iglesias ◽  
Anesh Prasai ◽  
George Golovko ◽  
Deepak K Ozhathil ◽  
Steven E Wolf
Keyword(s):  
Inhalation Injury ◽  
Smoke Inhalation ◽  
Research Network ◽  
Burn Patients ◽  
Pulmonary Injury ◽  
Smoke Inhalation Injury ◽  
Mortality And Morbidity ◽  
Laryngeal Injury ◽  
Icd 10 ◽  
Potential Benefits

Abstract Introduction For decades, controversy has raged regarding the placement of tracheostomy in severe paediatric burns. Numerous variables including extent of smoke inhalation injury, % TBSA burned, age of the patient, and co-morbidities among others complicate reaching consensus. Furthermore, paediatric patients are particularly susceptible to complications including inadvertent loss of airway and long-term swallowing and other anatomic issues. Additionally, previous analysis of the efficacy of tracheostomy in paediatric burn patients appears to be hindered by a lack of nationwide analysis. The aim of this study was to explore the efficacy of tracheostomy in the general paediatric burn patient population. Methods De-identified patient data was obtained from the TriNetX Research Network database. Two cohorts were identified: paediatric burn patients with tracheostomy (cohort A) and paediatric burn patients without tracheostomy (cohort B). Burn patients were identified using the ICD-10 codes T20-T25 & T30-T32. Tracheostomy was identified using the ICD-10 codes 1005887, 1014613, 31600, 31601, 31603, 31604, 31610, and Z93.0. A total of 132 patients were identified in cohort A in 23 HCOs and 83,117 patients were identified in cohort B in 38 HCOs. Infection, hypovolemia, pulmonary injury, laryngeal injury, pneumonia, and death were compared between the cohorts. Results Cohort A had a mean age of 11 (SD=5) and Cohort B had a mean age of 9 (SD=5). Paediatric burn patients with tracheostomy had a higher risk for death, infection, hypovolemia, pulmonary injury, laryngeal injury, and pneumonia when compared to their non-tracheostomy counterparts. The risk ratios for these outcomes were 62.452, 4.713, 9.267, 26.483, 116.163, and 18.154, respectively. Conclusions The analysis of the longitudinal outcomes of pediatric burn patients with tracheostomy as compared to those without tracheostomy demonstrated the tracheostomy cohort suffered much worse mortality and morbidity across several metrics. The potential benefits of tracheostomy placement in pediatric burn patients should be weighed against these outcomes.

When solidarity hurts: (Intra)cultural trust, cultural betrayal sexual trauma, and PTSD in culturally diverse minoritized youth transitioning to adulthood

2021 ◽  
pp. 136346152110629
Author(s):  
Jennifer M. Gómez
Keyword(s):  
Mental Health ◽  
Sexual Trauma ◽  
Mental Health Problems ◽  
Culturally Competent ◽  
Online Questionnaire ◽  
Trauma Outcomes ◽  
Trauma Research ◽  
Group Members ◽  
Clinically Significant ◽  
Societal Inequality

Sexual trauma is associated with PTSD, with perpetrators putting women and girls more at risk than men and boys. Young adulthood is a time where risk of victimization and susceptibility to mental health problems increase. Certain contributors of costly trauma outcomes may be affected by the larger context of societal inequality. Cultural betrayal trauma theory (CBTT) highlights cultural betrayal in within-group trauma in minoritized populations as a dimension of harm that affects outcomes. In CBTT, within-group trauma violates the (intra)cultural trust—solidarity, love, loyalty, connection, responsibility—that is developed between group members to buffer against societal inequality. This violation, termed a cultural betrayal, can contribute to poorer mental health. The purpose of the current study is to address a gap in the CBTT literature by examining the role of (intra)cultural trust on the association between cultural betrayal sexual trauma and symptoms of PTSD among diverse minoritized youth transitioning to adulthood. Participants ( N = 173) were diverse minoritized college students, who completed a 30-min online questionnaire at a location of their own choosing. Participants received course credit and could decline to answer any question without penalty. The results reveal that the interaction between cultural betrayal sexual trauma and (intra)cultural trust predicted clinically significant symptoms of PTSD. These findings have implications for increased cultural and contextual specificity in trauma research in minoritized populations, which can aid in the development and implementation of culturally competent interventions for diverse minoritized youth survivors of sexual trauma.

scholarly journals Obesity, stigma and reflexive embodiment: Feeling the ‘weight’ of expectation

2018 ◽  
Vol 24 (4) ◽  
pp. 421-441 ◽  
Author(s):  
Oli Williams ◽  
Ellen Annandale
Keyword(s):  
Weight Loss ◽  
Weight Gain ◽  
Subjective Experience ◽  
Lifestyle Modification ◽  
Participant Observation ◽  
Economic Status ◽  
Social Significance ◽  
Structured Interviews ◽  
Obesity Stigma ◽  
Group Members

The dominant obesity discourse which emphasises individual moral responsibility and lifestyle modification encourages weight-based stigma. Existing research overwhelmingly demonstrates that obesity stigma is an ineffective means by which to reduce the incidence of obesity and that it promotes weight-gain. However, the sensate experiences associated with the subjective experience of obesity stigma as a reflexively embodied phenomenon have been largely unexamined. This article addresses this knowledge gap by providing a phenomenological account. Data are derived from 11 months of ethnographic participant observation and semi-structured interviews with three single-sex weight-loss groups in England. Group members were predominantly overweight/obese and of low-socio-economic status. The analysis triangulates these two data sources to investigate what/how obesity stigma made group members feel. We find that obesity stigma confused participant’s objective and subjective experiences of their bodies. This was primarily evident on occasions when group members felt heavier after engaging in behaviours associated with weight-gain but this ‘weight’ did not register on the weighing scales. We conceptualise this as the weight of expectation which is taken as illustrative of the perpetual uncertainty and morality that characterises weight-management. In addition, we show that respondents ascribed their sensate experiences of physiological responses to exercise with moral and social significance. These carnal cues provided a sense of certainty and played an important role in attempts to negotiate obesity stigma. These findings deepen the understanding of how and why obesity stigma is an inappropriate and ineffective means of promoting weight-loss.

scholarly journals A comprehensive analysis on cigarettes smoking and its determinants in Bangladesh using logistic regression model

2020 ◽  
Vol 8 (5) ◽  
pp. 1733
Author(s):  
Afrin Sadia Rumana ◽  
Asia Khatun ◽  
Sukanta Das
Keyword(s):  
Logistic Regression ◽  
Causes Of Death ◽  
Significant Contribution ◽  
Religious Affiliation ◽  
Economic Status ◽  
Bivariate Analysis ◽  
Adult Males ◽  
Online Questionnaire ◽  
Explanatory Variables ◽  
Household Economic Status

Background: In Bangladesh, smoking is one of the leading preventable causes of death. Despite possessing knowledge about the consequences of smoking and the resultant non-communicable diseases, individuals have become considerably habituated to it. The study aims to identify the factors associated with smoking cigarettes and as well as to examine the existing situation of this issue among adult males in Bangladesh.Methods: Total 480 adult males were surveyed from Bangladesh through personal interview and online questionnaire, (from June 2018 to June 2019). To measure the effect of the explanatory variables on cigarettes smoking, authors perform χ2 test of independence as bivariate analysis. After performing bivariate analysis, a logistic regression analysis has been performed to assess the effect of the explanatory variables.Results: Findings of the study revealed that educational level, household economic status, media exposure, division have significant contribution for smoking cigarettes among the adult male in Bangladesh. A comparison of religious affiliation showed smoking cigarettes to be higher among non-muslim counterparts. Respondents living in rural area are found to have smoking cigarettes comparing with urban area.Conclusions: From the study it can be concluded that education and socio-economic status of male make a significant contribution in cigarettes smoking.

scholarly journals School Food Policies Related to Soft Drink and Fruit Juice Consumption as a Function of Education Type in Flanders, Belgium

2019 ◽  
Vol 16 (15) ◽  
pp. 2718
Author(s):  
Francisca Marro ◽  
Peter Bottenberg ◽  
Wolfgang Jacquet ◽  
Luc Martens
Keyword(s):  
Secondary Education ◽  
Fruit Juice ◽  
Soft Drink ◽  
Economic Status ◽  
Tooth Wear ◽  
Online Questionnaire ◽  
School Food ◽  
Drinking Habits ◽  
Food Policies ◽  
Acidic Beverages

Recent data on erosive tooth wear (ETW) in Belgium have associated a vocational/technical type of education with ETW risk. Since the role of schools is essential to the promotion of healthy diets, this study aimed to investigate school food policies (SFP) related to soft drink and fruit juice consumption and to detect differences among schools in Flanders, Belgium (BE-F). An online questionnaire related to the control of acidic beverages and promotion of healthy drinking habits was sent to all Flemish secondary schools. For analysis, schools (n = 275) were grouped by type of education (vocational secondary education (VSE) and general secondary education (GSE)), and by socioeconomic status. Multiple factor analyses (MFA) were performed to identify schools with a similar SFP profile. Additionally, descriptive analyses were performed to determine other associations. Overall, 44% of schools in BE-F claimed to have written SFP related to the consumption of soft drinks. SFP expressly prohibiting or limiting acidic beverages were significantly more frequent in GSE schools (p < 0.05), where a higher economic status was present. This study shows that a considerable group of schools in BE-F have no or incomplete rules concerning acidic beverage consumption. Such rules differ between types of education, with VSE schools reporting less control regarding the consumption of drinks.

scholarly journals Evaluating the impact of cycle helmet use on severe traumatic brain injury and death in a national cohort of over 11000 pedal cyclists: a retrospective study from the NHS England Trauma Audit and Research Network dataset

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027845 ◽  
Author(s):  
Nick Dodds ◽  
Rowena Johnson ◽  
Benjamin Walton ◽  
Omar Bouamra ◽  
David Yates ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Research Network ◽  
Lower Limb Injury ◽  
Helmet Use ◽  
Mortality And Morbidity ◽  
National Cohort ◽  
The Uk ◽  
The Impact

ObjectivesIn the last 10 years there has been a significant increase in cycle traffic in the UK, with an associated increase in the overall number of cycling injuries. Despite this, and the significant media, political and public health debate into this issue, there remains an absence of studies from the UK assessing the impact of helmet use on rates of serious injury presenting to the National Health Service (NHS) in cyclists.SettingThe NHS England Trauma Audit and Research Network (TARN) Database was interrogated to identify all adult (≥16 years) patients presenting to hospital with cycling-related major injuries, during a period from 14 March 2012 to 30 September 2017 (the last date for which a validated dataset was available).Participants11 192 patients met inclusion criteria. Data on the use of cycling helmets were available in 6621 patients.Outcome measuresTARN injury descriptors were used to compare patterns of injury, care and mortality in helmeted versus non-helmeted cohorts.ResultsData on cycle helmet use were available for 6621 of the 11 192 cycle-related injuries entered onto the TARN Database in the 66 months of this study (93 excluded as not pedal cyclists). There was a significantly higher crude 30-day mortality in un-helmeted cyclists 5.6% (4.8%–6.6%) versus helmeted cyclists 1.8% (1.4%–2.2%) (p<0.001). Cycle helmet use was also associated with a reduction in severe traumatic brain injury (TBI) 19.1% (780, 18.0%–20.4%) versus 47.6% (1211, 45.6%–49.5%) (p<0.001), intensive care unit requirement 19.6% (797, 18.4%–20.8%) versus 27.1% (691, 25.4%–28.9%) (p<0.001) and neurosurgical intervention 2.5% (103, 2.1%–3.1%) versus 8.5% (217, 7.5%–9.7%) (p<0.001). There was a statistically significant increase in chest, spinal, upper and lower limb injury in the helmeted group in comparison to the un-helmeted group (all p<0.001), though in a subsequent analysis of these anatomical injury patterns, those cyclists wearing helmets were still found to have lower rates of TBI. In reviewing TARN injury codes for specific TBI and facial injuries, there was a highly significant decrease in rates of impact injury between cyclists wearing helmets and those not.ConclusionsThis study suggests that there is a significant correlation between use of cycle helmets and reduction in adjusted mortality and morbidity associated with TBI and facial injury.

Baby-Led-Weaning (BLW) from maternal perspective: Polish experience

2018 ◽  
Vol 87 (2) ◽  
pp. 75-81
Author(s):  
Barbara Poniedziałek ◽  
Natalia Paszkowiak ◽  
Piotr Rzymski
Keyword(s):  
Urban Areas ◽  
Complementary Feeding ◽  
Tertiary Education ◽  
Economic Status ◽  
Feeding Practice ◽  
Online Questionnaire ◽  
Maternal Experience ◽  
Dietary Choices ◽  
Polish Experience ◽  
Sensory Learning

Background. Baby-Led-Weaning (BLW) is increasingly popular as a complementary feeding practice although its safety, limitations and advantages have not been widely studied as yet. Material and Methods. The present survey employed an anonymous online questionnaire to learn from experience (their concerns, perceived advantages, disadvantages, and overall satisfaction) of Polish mothers (n = 373) that adopted BLW.Results. Most of surveyed mothers adopting BLW had tertiary education and good economic status, and inhabited urban areas. Non-scientific online resources were the most important source of knowledge on BLW; none of surveyed mentioned healthcare professionals as having played any role in this respect. The risk of choking was the greatest concern expressed while considering the BLW prospect. At least one choking event during B:W adoption was reported by 55.6%, mostly involving an apple, occurring at beginning of introduction, and perceived as non-serious. The BLW advantages included: (i) promotion of infant self-reliance, motor skills, biting and chewing of food and speech), sensory learning of food, and (ii) motivation to eat family meals and make more healthier dietary choices. The greatest disadvantage was an in-house mess. Nearly all mothers recommended the BLW adoption to other caregivers.Conclusion. In view of the scarcity of data on this feeding practice, the maternal experience demonstrated in the present study may offer valuable information for health professionals as well as future caregivers who consider the adoption of BLW to be a complementary feeding practice.

Treatment modality: a predictor of continued tobacco use after treatment in patients with laryngeal cancer

2014 ◽  
Vol 128 (2) ◽  
pp. 153-158 ◽  
Author(s):  
V Narwani ◽  
M Harries
Keyword(s):  
Tobacco Use ◽  
Laryngeal Cancer ◽  
Treatment Modality ◽  
Economic Status ◽  
Smoking Behaviour ◽  
Self Report ◽  
University Hospitals ◽  
Mortality And Morbidity ◽  
Patient Demographics ◽  
Risk Of Mortality

AbstractBackground:Laryngeal cancer patients who continue to smoke after treatment are at an elevated risk of mortality and morbidity. This study aimed to identify factors associated with continued tobacco use following treatment in patients with laryngeal cancer.Methods:A smoking behaviour questionnaire, a self-report measure, was sent to 112 patients who were diagnosed with laryngeal cancer during 2006–2011 at the Brighton and Sussex University Hospitals, Brighton, UK. Patient demographics, tumour and treatment-related variables, comorbidity and socio-economic status were obtained from the medical records.Results:Eighty-one per cent of patients responded to the survey; 22 per cent of these reported continued tobacco use after treatment. Treatment modality was found to be a predictor of post-therapeutic smoking (odds ratio: 4.9, p = 0.01); patients who received less invasive therapy (transoral laser microsurgery) were more likely to smoke after treatment.Conclusions:The findings of this preliminary study suggest that treatment modality influences smoking behaviour in patients with laryngeal cancer, which may have important implications for the design of anti-smoking interventions.

scholarly journals The role of community supported agriculture in the development of organic agriculture in Croatia

Geoadria ◽  
2013 ◽  
Vol 19 (1) ◽  
pp. 1 ◽  
Author(s):  
Ivan Sarjanović
Keyword(s):  
Local Community ◽  
Community Supported Agriculture ◽  
Cultural Dimension ◽  
Online Questionnaire ◽  
Social Motives ◽  
Economic Dimension ◽  
Large Cities ◽  
Highly Educated ◽  
The Social ◽  
Group Members

Community supported agriculture (CSA) refers to those agricultural activities that contrast with commercial agriculture. They consist of members who pay for fresh, untreated and locally grown food directly from farmers. In this way the risk is shared and the resellers are eliminated. This paper discusses the basic principles of CSA functioning and the historical circumstances of their development. Besides the economic dimension of the functioning of CSA groups, which is most important (ensuring of purchase), emphasis is also given to the social and cultural dimension of the groups activity. The basis of the work is the presentation of the functioning of CSA groups in Croatia and a comparison of social and economic characteristics of the group members and the farmers that collaborate to the groups with trends in the world. The results were collected by administering an online questionnaire among 46 group members and 5 famers. The survey has confirmed the starting hypothesis – that the group members are younger and highly educated persons who live in large cities or urbanized regions (Zagreb, Kvarner, Istria) and are driven by eco-social motives (ecological consciousness, healthy food, cooperation with group members). Farmers who cooperate with CSA groups are practicing ecological agriculture on farms that are smaller than an average Croatian farm. They collaborate with the groups because of easier selling of the products and they find that the groups have a positive effect on their income and involvement in the local community.

scholarly journals Changing pattern of birth weight over a decade in rural India

2017 ◽  
Vol 6 (10) ◽  
pp. 4625 ◽  
Author(s):  
Vidyadhar B. Bangal ◽  
Satyajit P. Gavhane ◽  
Swati D. Gagare ◽  
Kunal H. Aher ◽  
Dhruval K. Bhavsar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Nutritional Status ◽  
Economic Status ◽  
Tertiary Care ◽  
Childhood Mortality ◽  
Care Hospital ◽  
Maternal Weight ◽  
Mortality And Morbidity ◽  
The Government

Background: Birth weight is one of the important determinants of neonatal wellbeing. Birth weight has many determinants that mainly include maternal nutritional status and the term of gestation. Low birth weight is associated with high neonatal and childhood mortality and morbidity. Over the years the birth weight is showing the increasing trend in developing countries like India. The study aimed at finding out the changing pattern of birth weight over a decade in rural India.Methods: A retrospective analysis of over 45,000 births that took place in Tertiary care hospital from year 2008-2017was undertaken. The socio economic determinants of birth weight were studied.Results: The incidence of low birth weight declined from 47 percent to 35 percent over ten years. The mean rise in birth weight in ten years was observed in both male (176 grams) and female (151grams).The incidence of very low birth and extremely low birth was found declined. There was positive co relationship between improved birth weight and improved socio economic status, delay in age at marriage, higher maternal weight gain during pregnancy, improved pre pregnancy nutritional status of women.Conclusions: There is steady decline in incidence of low birth weight over last ten years in study area. Improved maternal health, better nutrition, improved quality of antenatal care and various efforts and actions from the government side have contributed in improving the birth weight.

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