scholarly journals 1717. Relationship between Neighborhood Census-tract Level Poverty and Respiratory Syncytial Virus (RSV)-associated Hospitalizations in U.S. adults, 2015-2017

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S842-S843
Author(s):  
Jenna Holmen ◽  
Art Reingold ◽  
Erica Bye ◽  
Lindsey Kim ◽  
Evan J Anderson ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Census Tract ◽  
Case Fatality ◽  
Demographic Characteristics ◽  
Emerging Infections ◽  
Poverty Level ◽  
Catchment Areas ◽  
Syncytial Virus ◽  
Four Levels ◽  
The U.S

Abstract Background In the U.S., RSV is increasingly recognized as a cause of hospitalization for adults with respiratory illness. In adults > 50 years of age, it accounts for up to 12% of medically-attended acute respiratory illnesses and has a case fatality proportion of ~ 6–8%. Poverty can have important influences on health on both the individual level as well as the community level. Few studies have evaluated the relationship of RSV and poverty level, and no identified studies have evaluated this relationship among adults. We evaluated the incidence of RSV-associated hospitalizations in adults across multiple sites in the U.S. by census-tract (CT) level poverty. Methods Medical record data abstraction was conducted for all adults with a laboratory-confirmed RSV infection admitted to a hospital within the Centers for Disease Control and Prevention’s Emerging Infections Program catchment areas within California, Georgia, Maryland, Minnesota, New York, and Tennessee during the 2015–2017 RSV seasons (October-April). Patient addresses were geocoded to their corresponding CT. CTs were divided into four levels of poverty, as selected in prior publications, based on American Community Survey data of percentage of people living below the poverty level: 0–4.9%, 5–9.9%, 10-19.9%, and ³20%. Incidence rates were calculated by dividing the number of RSV cases in each CT poverty-level (numerator) by the number of adults living in each CT poverty level (denominator), as determined from the 2010 US census, and standardized for age. Results There were 1713 RSV case-patients with demographic characteristics (Table 1). The incidence of RSV-associated hospitalizations of adults increased with increasing CT level poverty (Figure 1 and Table 2). The risk of RSV-associated hospitalization was 2.58 times higher in census tracts with the highest (20%) versus the lowest (< 5%) percentages of individuals living below the poverty level. Table 1: Demographic characteristics of adults with an RSV-associated hospitalization, 2015-2017. Figure 1. Age-adjusted incidence rate of RSV-associated hospitalizations of adults by census-tract poverty level, 2015-2017 Table 2. Incidence rate ratios for RSV-associated hospitalizations of adults by census-tract poverty level, 2015-2017. Conclusion The incidence rate of RSV-associated hospitalization in adults appears to have a positive association with increasing CT level of poverty; however, this trend reached significance only among cases living in CTs with higher percentages of poverty (≥ 10%). Disclosures Evan J. Anderson, MD, Sanofi Pasteur (Scientific Research Study Investigator)

scholarly journals Relationship between neighborhood census-tract level socioeconomic status and respiratory syncytial virus-associated hospitalizations in U.S. adults, 2015–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenna E. Holmen ◽  
Lindsay Kim ◽  
Bryanna Cikesh ◽  
Pam Daily Kirley ◽  
Shua J. Chai ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Respiratory Syncytial Virus ◽  
Incidence Rate ◽  
Census Tract ◽  
Population Based ◽  
Poverty Level ◽  
Icu Admission ◽  
Binomial Regression ◽  
Rsv Infection ◽  
Syncytial Virus

Abstract Background Respiratory syncytial virus (RSV) infection causes substantial morbidity and mortality in children and adults. Socioeconomic status (SES) is known to influence many health outcomes, but there have been few studies of the relationship between RSV-associated illness and SES, particularly in adults. Understanding this association is important in order to identify and address disparities and to prioritize resources for prevention. Methods Adults hospitalized with a laboratory-confirmed RSV infection were identified through population-based surveillance at multiple sites in the U.S. The incidence of RSV-associated hospitalizations was calculated by census-tract (CT) poverty and crowding, adjusted for age. Log binomial regression was used to evaluate the association between Intensive Care Unit (ICU) admission or death and CT poverty and crowding. Results Among the 1713 cases, RSV-associated hospitalization correlated with increased CT level poverty and crowding. The incidence rate of RSV-associated hospitalization was 2.58 (CI 2.23, 2.98) times higher in CTs with the highest as compared to the lowest percentages of individuals living below the poverty level (≥ 20 and < 5%, respectively). The incidence rate of RSV-associated hospitalization was 1.52 (CI 1.33, 1.73) times higher in CTs with the highest as compared to the lowest levels of crowding (≥5 and < 1% of households with > 1 occupant/room, respectively). Neither CT level poverty nor crowding had a correlation with ICU admission or death. Conclusions Poverty and crowding at CT level were associated with increased incidence of RSV-associated hospitalization, but not with more severe RSV disease. Efforts to reduce the incidence of RSV disease should consider SES.

scholarly journals 2325. Relationship Between Neighborhood Census-Tract-Level Poverty and Respiratory Syncytial Virus Infection in hospitalized Adults in the San Francisco Bay area, CA 2015–2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S798-S798
Author(s):  
Jenna Holmen ◽  
Bryanna Cikesh ◽  
Lindsay Kim ◽  
Art Reingold
Keyword(s):  
Respiratory Syncytial Virus ◽  
San Francisco ◽  
Census Tract ◽  
San Francisco Bay ◽  
San Francisco Bay Area ◽  
Poverty Level ◽  
Census Tracts ◽  
Bay Area ◽  
Census Tract Level ◽  
Syncytial Virus

Abstract Background In the United States, respiratory syncytial virus (RSV) is a leading cause of admission for adults with respiratory illness. In adults > 50 years of age, it accounts for up to 12% of medically-attended acute respiratory illnesses and has a case fatality proportion of ~6–8%. Poverty can have an important influence on health. Few studies have evaluated the relationship of RSV incidence and poverty level, and no identified studies have evaluated this relationship among adults. We evaluated the incidence of RSV-associated hospitalizations in adults in the San Francisco Bay Area, CA by census-tract-level poverty. Methods Medical record data abstraction was conducted for all adults with a laboratory-confirmed RSV infection who were admitted to a hospital within the 3 counties comprising the catchment area (Alameda, Contra Costa, and San Francisco counties) during the 2015–2016 and 2016–2017 RSV seasons. Patient addresses were geocoded to their corresponding census-tract (CT). Census tracts were divided into four levels of poverty based on American Community Survey data of percentage of people living below the poverty level: 0–4.9%, 5–9.9%, 10-–9.9%, and ³20%. Incidence rates were calculated by dividing the number of RSV cases in each CT poverty-level (numerator) by the number of adults living in each CT poverty level (denominator), as determined from the 2010 US census, and standardized for age. Results There were 526 RSV case-patients with demographic characteristics as outlined in Table 1. The highest incidence of RSV-associated hospitalization was in CTs associated with the highest levels of poverty (>20%). However, the second highest incidence of RSV-associated hospitalization occurred among adults living in CTs with <5% poverty (Figure 1 and Table 2). Conclusion The incidence rate of RSV-associated hospitalization in adults appears to be positively correlated with highest census-tract level of poverty; however, there is a high incidence among adults living in the lowest poverty census-tracts. Disclosures All authors: No reported disclosures.

scholarly journals Economic Disparities and Syphilis Incidence in Massachusetts, 2001-2013

2017 ◽  
Vol 132 (3) ◽  
pp. 309-315
Author(s):  
Laura Smock ◽  
Evan Caten ◽  
Katherine Hsu ◽  
Alfred DeMaria
Keyword(s):  
Incidence Rate ◽  
Census Tract ◽  
Black People ◽  
Census Bureau ◽  
Incidence Rates ◽  
Poverty Level ◽  
Syphilis Infection ◽  
Economic Disparities ◽  
Us Census ◽  
Population Counts

Objectives: We used area-level indicators of poverty to describe economic disparities in the incidence rate of infectious syphilis in Massachusetts to (1) determine whether methods developed in earlier AIDS analyses in Massachusetts could be applied to syphilis and (2) characterize syphilis trends during a time of increased rates of syphilis incidence. Methods: Using census tract data and population counts from the US Census Bureau and Massachusetts data on syphilis, we analyzed the incidence rate of syphilis infection from 2001 to 2013 by the poverty level of the census tract in which people with syphilis resided, stratified by age, sex, and race/ethnicity. Results: The syphilis incidence rate increased in all census tract groups in Massachusetts from 2001 to 2013, and disparities in incidence rates by area poverty level persisted over time. The overall incidence rate of syphilis increased 6.9-fold from 2001 to 2013 in all census tract poverty-level groupings (from 1.5 to 10.3 per 100 000 population), but the rise in rate was especially high in the poorest census tracts (from 5.6 to 31.0 per 100 000 population) and among men (from 2.2 to 19.4 per 100 000 population). The highest syphilis incidence rate was among non-Hispanic black people. The largest changes in incidence rate occurred after 2010. One region had a disproportionate increase in incidence rates and a disproportionate impact on the statewide trend. Conclusions: Census tract poverty analyses can inform the targeting of interventions that make progress toward reducing disparities in rates of syphilis incidence possible.

scholarly journals Did We Lose the War on Poverty?

1998 ◽  
Vol 12 (1) ◽  
pp. 79-96 ◽  
Author(s):  
Dale W Jorgenson
Keyword(s):  
Household Income ◽  
Well Being ◽  
War On Poverty ◽  
Support Programs ◽  
Accurate Assessment ◽  
Income Support ◽  
Poverty Level ◽  
The Impact ◽  
The U.S ◽  
Economic Well Being

Official U.S. poverty statistics based on household income imply that the proportion of the U.S. population below the poverty level reached a minimum in 1973, giving rise to the widespread impression that the elimination of poverty is impossible. By contrast, poverty estimates based on household consumption have fallen through 1989 and imply that the war on poverty was a success. This paper recommends replacing income by consumption in official estimates of poverty in order to obtain a more accurate assessment of the impact of income support programs and economic growth on the level and distribution of economic well-being among households.

scholarly journals FAKTOR-FAKTOR YANG BERPENGARUH DALAM LUARAN KLINIS PASIEN TETANUS DI RSUP DR. MOHAMMAD HOESIN PALEMBANG

2018 ◽  
Vol 35 (3) ◽  
Author(s):  
Luther Theng ◽  
Theresia Christin ◽  
Erial Bahar
Keyword(s):  
Mortality Rate ◽  
Clinical Outcome ◽  
Incidence Rate ◽  
Medical Record ◽  
Case Fatality ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Isolation Room ◽  
Reduce Mortality Rate

FACTORS AFFECTING THE CLINICAL OUTCOME OF TETANUS PATIENTS IN MOHAMMAD HOESIN GENERAL HOSPITAL PALEMBANGABSTRACTIntroduction: Tetanus is a serious health problem with mortality rate up to 60% despite the decreasing incidence rate every year. Knowledge about factors affecting clinical outcome of tetanus patients may reduce mortality rate, better understanding on prevention and management of the disease. The clinical outcomeAim: To know the incidence and factors that affect the clinical outcome of tetanus patients.Method: Retrospective study with cross sectional analytic using hospital-based secondary data. Inclusion criteria were hospitalized tetanus patients within 3 years period (2013-2015) and complete medical record. Incidence, case fatality rate and other which other factors associated with clinical outcome were counted from medical record and analyzed by univariate and bivariate analysis, and logistic regression for multivariate analysis.Result: The incidence rate of tetanus patients in 2013 was (4.28%), 2014 (1.62%), 2015 (2.87%) and the mortality rate reaches 28.41%. From 41 subjects, univariate, bivariate and multivariate analyses were performed. The four selected variables were gender, port d’entrée, onset, and isolation room. Dsicussion: Mortality rate reached 28.41% despite the decreasing incidence every year. Sex, port d’entrée, onset, and isolation room treatment are factors that affect clinical outcome of tetanus patients.Keywords: Clinical outcome, mortality rate, tetanusABSTRAKPendahuluan: Tetanus merupakan masalah kesehatan serius dapat menyebabkan angka kematian mencapai 60% walaupun angka insiden semakin menurun setiap tahunnya. Pengetahuan mengenai faktor-faktor yang memengaruhi luaran klinis pasien dapat menurunkan angka kematian, upaya pencegahan penyakit dan keberhasilan penatalaksanaan.Tujuan: Mengetahui insiden serta faktor–faktor yang memengaruhi luaran klinis pasien tetanus.Metode: Studi bersifat retrospektif dengan metode potong lintang analitik dengan data sekunder berbasis RS. Kriteria inklusi adalah pasien tetanus yang dirawat sejak tiga periode 2013-2015 dan memiliki data rekam medis lengkap. Insiden, angka kematian dan hal-hal yang diperkirakan berhubungan dengan luaran ditelusuri dari rekam medis kemudian dilakukan analisis univariat, bivariat, dan multivariat menggunakan regresi logistik.Hasil: Angka insiden tetanus tahun 2013 (4,28%), 2014 (1,62%), 2015 (2,87%) dengan angka kematian rata-rata28,41%. Dari 41 subjek penelitian dilakukan analisis univariat, bivariat, dan multivariat. Empat variabel yang terpilih adalah jenis kelamin, port d’entrée, onset, dan perawatan pasien ruang isolasi.Diskusi: Angka kematian kasus tetanus masih mencapai 28,41% walaupun angka insiden semakin menurun setiap tahunnya. Jenis kelamin, port d’entry, onset, dan perawatan di ruang isolasi merupakan faktor-faktor berpengaruh terhadap luaran klinis pasien tetanus.Kata kunci: Angka kematian, luaran klinis, tetanus

Trans-Religious Dancing Dialogues: Michel Henry on Dionysus and the Crucified

2021 ◽  
Vol 9 (2) ◽  
pp. 243-264
Author(s):  
Joshua M. Hall
Keyword(s):  
Transcendental Subjectivity ◽  
The Arts ◽  
The Social ◽  
Religious Dialogue ◽  
Michel Henry ◽  
New Interpretation ◽  
Four Levels ◽  
The U.S

Abstract Perhaps owing to frictions between his Christological worldview and the dominant secularism of contemporary French thought as taken up in the U.S., and persistent worries about a seeming solipsism in his phenomenology, Michel Henry’s innovative contributions to aesthetics have received unfortunately little attention in English. The present investigation addresses both issues simultaneously with a new interpretation of his recently-translated 1996 interview, “Art and Phenomenology.” Inspired by this special issue’s theme, “French Thought in Dialogue,” it emphasizes four levels of dialogue in the interview, as follows: (1) the interview as such, with Jean-Marie Brohm; (2) its titular dialogue between art and phenomenology; (3) what I term a “trans-religious” dialogue between Christianity’s Jesus and Friedrich Nietzsche’s Dionysus; and (4) a related dialogue between painting (Henry’s favored genre) and dance that is “Dionysian” (in Nietzsche’s sense). It concludes with new phenomenological accounts of a literal and a figurative dance, namely the social Latin dance called bachata, and an improvised musical dialogue with the mockingbirds of my hometown. In sum, thanks to Henry’s engagement with various forms of dialogue, including with Brohm, the arts, paganism, and dance, one can find room in his transcendental subjectivity of Life for others, dancingly transcending even humanity.

scholarly journals The effectiveness of training in emergency obstetric care: a systematic literature review

2019 ◽  
Vol 34 (4) ◽  
pp. 257-270 ◽  
Author(s):  
Charles A Ameh ◽  
Mselenge Mdegela ◽  
Sarah White ◽  
Nynke van den Broek
Keyword(s):  
Clinical Practice ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Emergency Obstetric Care ◽  
Case Fatality ◽  
Obstetric Care ◽  
Team Work ◽  
Knowledge And Skills ◽  
Effectiveness Of Training ◽  
Four Levels

Abstract Providing quality emergency obstetric care (EmOC) reduces the risk of maternal and newborn mortality and morbidity. There is evidence that over 50% of maternal health programmes that result in improving access to EmOC and reduce maternal mortality have an EmOC training component. The objective was to review the evidence for the effectiveness of training in EmOC. Eleven databases and websites were searched for publications describing EmOC training evaluations between 1997 and 2017. Effectiveness was assessed at four levels: (1) participant reaction, (2) knowledge and skills, (3) change in behaviour and clinical practice and (4) availability of EmOC and health outcomes. Weighted means for change in knowledge and skills obtained, narrative synthesis of results for other levels. One hundred and one studies including before–after studies (n = 44) and randomized controlled trials (RCTs) (n = 15). Level 1 and/or 2 was assessed in 68 studies; Level 3 in 51, Level 4 in 21 studies. Only three studies assessed effectiveness at all four levels. Weighted mean scores pre-training, and change after training were 67.0% and 10.6% for knowledge (7750 participants) and 53.1% and 29.8% for skills (6054 participants; 13 studies). There is strong evidence for improved clinical practice (adherence to protocols, resuscitation technique, communication and team work) and improved neonatal outcomes (reduced trauma after shoulder dystocia, reduced number of babies with hypothermia and hypoxia). Evidence for a reduction in the number of cases of post-partum haemorrhage, case fatality rates, stillbirths and institutional maternal mortality is less strong. Short competency-based training in EmOC results in significant improvements in healthcare provider knowledge/skills and change in clinical practice. There is emerging evidence that this results in improved health outcomes.

scholarly journals COVID-19 mortality among Indigenous people in Brazil: a nationwide register-based study

2020 ◽  
Author(s):  
Victor Santana Santos ◽  
Adriano Antunes Souza Araújo ◽  
Jarbas Ribeiro de Oliveira ◽  
Lucindo José Quintans-Júnior ◽  
Paulo Ricardo Martins-Filho
Keyword(s):  
Mortality Rate ◽  
Incidence Rate ◽  
Indigenous People ◽  
Social Protection ◽  
Black People ◽  
Indigenous Population ◽  
Case Fatality ◽  
The North ◽  
Minority Ethnic Groups ◽  
The Impact

Abstract Coronavirus disease 2019 (COVID-19) has disproportionately affected Black people and minority ethnic groups, but there are limited data regarding the impact of disease on Indigenous people. Herein, we investigated the burden of COVID-19 on the Indigenous population in Brazil. We performed a populational-based study including all cases and deaths from COVID-19 among Brazilian Indigenous people from 26 February to 28 August 2020. Data were obtained from official Brazilian information systems. We calculated incidence, mortality and fatality rates for the Indigenous population for each of the five Brazilian regions. Brazil had an incidence and a mortality rate of 3546.4 cases and 65.0 deaths per 100 000 population, respectively. The case fatality rate (CFR) was 1.8%. The Central-West had the higher estimates of disease burden among Brazilian Indians (incidence rate: 3135.0/100 000; mortality rate: 101.2/100 000 and CFR: 3.2%) followed by the North region (incidence rate: 5664.4/100 000; mortality rate: 92.2/100 000 and CFR: 1.6%). Governmental actions should guarantee the isolation, monitoring and testing capabilities of Indigenous people and rapidly to provide social protection and health facilities.

scholarly journals Cross-Country Comparisons of Physical Activity and Sedentary Behavior among 5-Year-Old Children

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Kerry L. McIver ◽  
Russell R. Pate ◽  
Marsha Dowda ◽  
Suzanne Bennett Johnson ◽  
Jimin Yang ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behavior ◽  
Genetic Risk ◽  
Demographic Characteristics ◽  
Washington State ◽  
Future Studies ◽  
Country Differences ◽  
Cross Country ◽  
The U.S

Purpose. Previous studies have observed that physical activity (PA) levels tend to be lower in the U.S. population than in many other countries. Within the U.S., PA levels in children are lower in the South than in other regions. Cross-country and interregional differences in PA have not been studied in young children. Methods. In an ongoing study of children at genetic risk for Type 1 diabetes, PA was measured by accelerometry in samples of 5-year-old children (n=2008) from Finland (n=370), Germany (n=85), Sweden (n=706), and the U.S. (n=847). The U.S. sample was drawn from centers in Washington State, Colorado, and Georgia/Florida. Children wore accelerometers for 7 days, and the data were reduced to daily minutes of light-, moderate- (MPA), vigorous- (VPA), and moderate-to-vigorous- (MVPA) intensity PA and sedentary behavior. Multiple regression was used to compare children across countries and across regions in the U.S, adjusting for wear time, body mass index, and demographic characteristics. Results. After adjusting for previously mentioned factors, MVPA and MPA were lower in U.S. children than those in Finland and Sweden. Estimates of physical activity were higher in Finland than in other countries, although not all comparisons were significantly different. U.S children spent significantly more time in sedentary behavior than children in Finland (p<0.0001). Within the U.S., children’s PA was consistently lowest in Georgia/Florida and highest in Washington. Conclusions. Cross-country differences in PA, previously reported for adults and adolescents, are evident in 5-year-old children. In general, PA levels are lower in U.S. children than their European counterparts, and within the U.S., are lower in Georgia/Florida and Colorado than in Washington. Future studies should be designed to identify the factors that explain these differences.

Sign in / Sign up

Export Citation Format

Share Document