1179. PCV13 Pediatric Routine Schedule Completion and Adherence Before and During the COVID-19 Pandemic in the US

Abstract Background Coronavirus Disease 2019 (COVID) mitigation measures may have unintended consequences, such as reduced or delayed access to routine immunizations. This study examined (1) PCV13 routine vaccination completion and adherence (C&A) among US infants before and during the COVID pandemic and (2) the relationship between primary dose C&A and booster dose C&A. Methods Retrospective data from the Optum’s de-identified Clinformatics Data Mart Database were used to create 3 cohorts: C1, Pre-COVID; C2, During COVID; C3, Cross-COVID (Figure 1). The completion was defined as number of PCV13 doses received within 8 months of birth, and the adherence was defined number of doses received at ACIP recommended time (@2, 4, 6 months, +/- 5 days). Univariable logistic regression was used to compare the odds of primary dose C&A in cohorts C1 and C3 vs C2 and descriptive analyses were used to explore primary dose C&A in relation to booster dose C&A. Figure 1: Study population and inclusion criteria Results A total of 172,916, 70,049, and 34,854 infants were included in C1, C2, and C3. Among infants with > 8 months of follow-up from birth (N=132,183 for C1&C3, 16,522 for C3), 3-primary dose completion was statistically significantly higher before COVID than during COVID (crude OR = 1.10, 95% CI: 1.06-1.15). The 3-primary dose adherence was also higher before COVID than during COVID (crude OR = 1.10, 95% CI: 1.05-1.15). Among infants with ≥2, 4 and 6 months of follow-up, adherence of each individual dose was consistently higher before COVID than during COVID (1st dose: OR = 1.03, 95% CI: 1.01–1.04; 2nd dose: OR = 1.04, 95% CI: 1.01 – 1.06; 3rd dose: OR = 1.12, 95% CI: 1.08 – 1.15) (Table 1). Booster dose completion was higher in infants who completed or adhered to 3 primary doses than infants who completed or adhered to only 1 or 2 primary doses (Figure 2, Overall) and booster dose C&A was generally higher before COVID than during COVID (Figure 2, Cohort 1 vs. Cohort 3). Table 1. Comparison of completion and adherence of primary dosing series per-COVID vs. during-COVID era Figure 2: Booster dose completion and adherence in relation to primary dosing completion (A) and adherence (B) Conclusion These results indicated that PCV13 full completion was statistically lower during COVID, but the magnitude of the difference in infants was not extensive. Infants who completed or adhered to all three primary doses were more likely to complete or adhere to the booster dose. Further research is warranted as structured datasets mature to capture the full time span of COVID-19 mitigation measures. Disclosures Liping Huang, MD, MA, MS, Pfizer Inc (Employee) Jennifer L Nguyen, ScD, MPH, Pfizer Inc. (Employee) Johnna Perdrizet, MPH, Pfizer Inc (Employee) Tamuno Alfred, PhD, Pfizer Inc. (Employee) Adriano Arguedas, MD, Pfizer (Employee)

Download Full-text

Inheritance and reflection: “re-study” of three anthropology fieldwork sites in China’s Yunnan Province

International Journal of Anthropology and Ethnology ◽

10.1186/s41257-021-00050-9 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Mingming Wang

Keyword(s):

Rural Society ◽

Research Report ◽

Ancestor Worship ◽

Land System ◽

Peking University ◽

The Difference ◽

And Shifts ◽

West Town ◽

The Relationship

AbstractThis article is a research report involving three anthropological studies conducted during the period of “Kuige” and their “re-studies.” By narrating the project, I set forth my views on the connections and differences between Chinese anthropological explorations from two historical periods. These anthropological explorations refer to the study of Lu Village conducted by Fei Xiaotong, that of “West Town” (Xizhou) by Francis L. K. Hsu, and that of “Pai-IPai” (Dai) villages by Tien Ju-Kang. They were all completed in the late 1930s and early 1940s. Each writer extracted a framework to analyze the land system, ancestor worship, and the relationship between humans and gods from the writer’s own field experience. Despite the difference in research methods, all three studies noticed the cultural differences between rural society and modernity. Since 2000, Peking University and Yunnan Minzu University have launched a “Province-university Cooperation Project.” During the project, a research team formed of several young scholars revisited Lu Village, “West Town” (Xizhou), and Namu Village. These writers’ works were based on the data acquired in their fieldwork and drew upon the opinions raised by global anthropologists on “re-study” in recent decades. Considering the dual effects of social change and shifts in academic concepts around “follow-up research,” the scholars put forward several points of view with their ethnographies, which all featured the characteristics of inheritance and reflection. Based on the results of the three “re-studies,” this article emphasizes the importance of the study of public rituals for the research of rural society. This article also attempts to re-examine the methodology of “human ecology,” which profoundly impacts Chinese anthropology and sociology.

Download Full-text

Comparative analysis of sports consumption habits in Hungary, Poland and Germany

BMC Public Health ◽

10.1186/s12889-020-09442-6 ◽

2021 ◽

Vol 21 (S1) ◽

Author(s):

Dávid Paár ◽

Antal Kovács ◽

Miklós Stocker ◽

Márk Hoffbauer ◽

Attila Fazekas ◽

...

Keyword(s):

Physical Activity ◽

Material Wealth ◽

Important Indicator ◽

Sports Clubs ◽

Research Findings ◽

Study Population ◽

Sports Consumption ◽

The Difference ◽

Sports Venues ◽

The Relationship

Abstract Background The so-called sports consumption models are looking for the factors that influence the sports spending of households. This paper aims to examine the Hungarian, Polish and German households’ sports expenditures which can be an important indicator of physical activity and sporty lifestyle. Methods Surveying of households in three countries (Hungary, Poland and Germany) has been conducted with a self-designed questionnaire. We have used descriptive and bivariate non-parametric and parametric statistical methods: (1) χ2 test, Mann-Whitney test and Kruskal-Wallis test for checking the relationship between sociodemographic and physical activity variables and (2) independent sample t-test and ANOVA for checking the differences in sports expenditures. Results Our research concluded that men, especially previous athletes, exercise more than women and those who have no history as registered athletes. The choice of sports venues is obviously different between the countries in the sample. Members of the study population spend the most on sports services while they spend the least on sports equipment. German households have the highest spending rates compared to the other two countries. Conclusions Results are in line with our previous research findings and with other literatures. The difference in preferences of sports venues could have the reason of different supply of sports clubs or the different living standards too. It needs further researches to clear it. Material wealth, income level and sport socialisation can be a determining factor regarding the level of sports spending.

Download Full-text

Association between Anxiety Levels and Weight Change in the Multiethnic Study of Atherosclerosis

Journal of Obesity ◽

10.1155/2014/894627 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Katherine Rieke ◽

Ramon Durazo-Arvizu ◽

Kiang Liu ◽

Erin D. Michos ◽

Amy Luke ◽

...

Keyword(s):

Weight Change ◽

Inclusion Criteria ◽

Mixed Effect ◽

Effect Model ◽

Lower Baseline ◽

Multiethnic Cohort ◽

Baseline Weight ◽

Study Population ◽

The Relationship

Objective. To examine the association between anxiety and weight change in a multiethnic cohort followed for approximately 10 years.Methods. The study population consisted of participants of the multiethnic study of atherosclerosis who met specified inclusion criteria (n= 5,799). Weight was measured at baseline and four subsequent follow-up exams. Anxiety was analyzed as sex-specific anxiety quartiles (QANX). The relationship between anxiety level and weight change was examined using a mixed-effect model with weight as the dependent variable, anxiety and time as the independent variables, and adjusted for covariates.Results. Average annual weight change (range) was −0.17 kg (−6.04 to 4.38 kg) for QANX 1 (lowest anxiety), −0.16 kg (−10.71 to 4.45 kg) for QANX 2, −0.15 kg (−8.69 to 6.39 kg) for QANX 3, and −0.20 kg (−7.12 to 3.95 kg) for QANX 4 (highest anxiety). No significant association was noted between QANX and weight change. However, the highest QANX was associated with a −2.48 kg (95% CI = −3.65, −1.31) lower baseline weight compared to the lowest QANX after adjustment for all covariates.Conclusions. Among adults, age 45–84, higher levels of anxiety, defined by the STPI trait anxiety scale, are associated with lower average baseline weight but not with weight change.

Download Full-text

Influence of uric acid on the correlation between waist circumference and triglyceride glucose index: an analysis from CHARLS

Lipids in Health and Disease ◽

10.1186/s12944-021-01474-0 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Jia Zheng ◽

Min Jiang ◽

Yanxia Xie

Keyword(s):

Uric Acid ◽

Waist Circumference ◽

Mediation Effects ◽

Panel Model ◽

Triglyceride Glucose Index ◽

Study Population ◽

Relationship Of ◽

The Relationship ◽

Longitudinal Relationships

Abstract Background Waist circumference (WC) and uric acid (UA) are significantly related. Still, their temporal sequence and how the sequence works on future risk of triglyceride glucose (TyG) are unknown, especially in the Chinese population. Methods Cross-lagged panel model was used to analyze the reciprocal, longitudinal relationships among a set of interrelated variables. The mediation model was constructed to test the effect of the relationship between WC and UA on TyG. Results A total of 5727 subjects were enrolled in our study population, of which 53.5% were women, and the mean age was 59.0 (standard deviation, 8.62) years. After adjusting for traditional confounding factors, the results showed that a higher level of baseline WC was significantly associated with a higher level of follow-up UA (β = 0.003, P = 0.031) and follow-up TyG (β = 0.003, P < 0.001);. Simultaneously, there was no statistical association between the level of baseline UA and the level of follow-up WC (β = − 0.009, P = 0.951). The mediation effects of UA on WC-TyG were estimated to be 18.1% in adults, and 36.2% in women. Conclusions The current study demonstrated that higher baseline level of WC probably preceded UA’ level in general population. In addition, UA mediated the relationship of WC to TyG, especially in females. And the possible mechanism would require further clarification.

Download Full-text

The comparative effectiveness of direct oral anti-coagulants and low molecular weight heparins for prevention of recurrent venous thromboembolism in cancer: The CANVAS pragmatic randomized trial.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12020 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12020-12020

Author(s):

Deborah Schrag ◽

Hajime Uno ◽

Rachel Pam Greenerger Rosovsky ◽

Cynthia Rutherford ◽

Kristen Marie Sanfilippo ◽

...

Keyword(s):

Cancer Patients ◽

Comparative Effectiveness ◽

Pragmatic Trial ◽

Study Drug ◽

Recurrent Venous Thromboembolism ◽

The Us ◽

Recurrent Vte ◽

The Difference ◽

To Receive

12020 Background: Previous randomized trials in cancer patients suggest that DOACs are non-inferior to LMWH for preventing recurrent VTE but have higher risk of bleeding. However, the balance of benefits and burdens remains uncertain. Objective: The CANVAS pragmatic trial compared recurrent VTE, bleeding and death in cancer patients following an initial VTE treated with either DOAC or LMWH therapy. Methods: CANVAS was an unblinded hybrid comparative effectiveness non-inferiority trial, with randomized and preference cohorts. Between 12/16 and 4/20, 671 participants were randomized and followed for 6-months. Between 12/16 and 12/17, 140 participants declined randomization, chose their preferred anticoagulant and were followed for 6-months. The preference cohort was closed when predetermined stopping criteria were met. Final follow-up was 11/30/20. Randomized patients were assigned 1:1 to receive either a DOAC or a LMWH. If assigned to LMWH, transitions to warfarin were allowed. Physicians and patients could choose among any DOAC or LMWH. Doses were suggested based on FDA-approved labeling but not mandated. Patients from 67 practices in the US with any invasive solid tumor, lymphoma, multiple myeloma or CLL and a diagnosis of symptomatic or radiographically detected VTE within 30 days of enrollment were eligible. The 1° analysis was conducted in the randomized modified-into to treat popululation, (all subjects who received study drug). The 1° outcome was recurrent VTE. The aim was to establish noninferiority of anticoagulation with a DOAC as defined by the upper limit of the 2-sided 90% CI for the difference in the event rate at 6 months of < 3%. Secondary outcomes included death and bleeding. Hypothesis testing included only the randomized cohort but propensity score adjusted results for the preference and combined cohorts are also shown. Results: The non-inferiority criteria for recurrent VTE was met. Conclusions: Among adult cancer patients with VTE, the use of a DOAC compared with a LMWH resulted in a noninferior risk of recurrent VTE with no differences in rates of bleeding or death in randomized patients. Clinical trial information: NCT02744092. [Table: see text]

Download Full-text

Workforce Improvement and Lifelong Learning

Industry and Higher Education ◽

10.1177/095042229500900407 ◽

1995 ◽

Vol 9 (4) ◽

pp. 241-247

Author(s):

Richard L. Ferguson

Keyword(s):

Lifelong Learning ◽

Adult Life ◽

Full Time ◽

Common Language ◽

New Model ◽

Job Level ◽

Work Keys ◽

The Us ◽

Traditional Paradigm ◽

The Relationship

The author stresses the importance to the future of the US workforce of the recognition that the traditional notion of education (‘that education and adult life, especially work, are consecutive rather than concurrent’) is inappropriate to contemporary workforce preparation and skills needs. He contrasts the characteristics of the traditional paradigm with those which need to be adopted in a new model of the relationship between education and work. Against this background, Dr Ferguson describes the development and application of the Work Keys System which aims to provide a common language for education and business to participate in preparing people for the transition from full-time education to employment and from one job or job level to another.

Download Full-text

Hypertension Burden and the Risk of New-Onset Atrial Fibrillation

Hypertension ◽

10.1161/hypertensionaha.120.16659 ◽

2021 ◽

Vol 77 (3) ◽

pp. 919-928

Author(s):

So-Ryoung Lee ◽

Chan Soon Park ◽

Eue-Keun Choi ◽

Hyo-Jeong Ahn ◽

Kyung-Do Han ◽

...

Keyword(s):

Atrial Fibrillation ◽

Total Study Population ◽

Increased Risk ◽

Burden Scale ◽

History Of ◽

Study Population ◽

Korean National Health Insurance ◽

Stage 1 ◽

The Relationship

The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130–139 mm Hg or diastolic BP of 80–89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.

Download Full-text

Relationship between episodes of unsustained VTs detected early after an ICD implant and subsequent monomorphic VTs causing appropriate therapy

European Heart Journal ◽

10.1093/ehjci/ehaa946.0781 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

J Jimenez-Candil ◽

J Perez ◽

M Sanchez ◽

J Hernandez ◽

J.L Morinigo ◽

...

Keyword(s):

Estimating Equation ◽

Left Ventricular ◽

Adjusted Risk ◽

Bland Altman Method ◽

Appropriate Therapy ◽

The Difference ◽

Mean Cycle ◽

Ventricular Tachycardias ◽

The Relationship

Abstract Introduction Non-sustained ventricular tachycardias (NSVT) are observed frequently among ICD patients with left ventricular dysfunction (LVD). Purpose To analyze the relationship between episodes of NSVTs and monomorphic VTs (MVTs) that subsequently cause appropriate therapies. Methods 416 ICD patients with LVD (LVEF <45%) followed for 41±27 months. ICD programming (detection and therapies) was standardized. NSVT was defined as any VT of ≥5 beats which did not met the detection criteria occurring within the first 6 months after ICD implant. We analyzed 2201 NSVTs (10+7 beats), which occurred in 250 of the 416 patients (Median=2; IQR=0–7). The mean cycle length (CL) of NSVT was 323±32 ms (adjusted per multiple episodes/patient, generalized estimating equation method (GEEM)). Results During the follow-up, 1441 MVT occurred in 183 patients. After showing a significant correlation between burden of NSVT and the occurrence of appropriate therapies due to MVT (C coefficient=0.68; p<0.001), we observed that subjects with >5 NSVT presented an excess of adjusted risk: HR=1.97 (95% CI=1.45–2.72); p<0.001. However, the adjusted mean CL of NSVTs was similar in patients with (322±34) vs. without MVT (324±26 ms); p=0.3. Among patients who presented NSVTs and MVTs (n=145 subjects), we analyzed the relationship between the adjusted mean CL of the NSVTs (n=1288 episodes) and the CL of the first appropriate therapy due to MVT occurring subsequently. We found a significant and positive correlation between the two (r=0.88; p<0.001); the strongest correlation was observed in subjects with >5 NSVTs (r=0.97, n=52)). The robustness of such correlation was similar in individuals with ischemic (r=0.86; n=91) versus non-ischemic cardiomyopathy (r=0.90; n=54), and in primary (r=0.86; n=75) versus secondary prevention (r=0.90; n=70). The agreement between the CL of first MVT and the adjusted mean CL of NSVT episodes (GEEM) was determined according to the Bland-Altman Method. The difference between the two values was 2±8.3 ms, with only 7.6% (11/145) of patients in whom the difference between the two CL was outside the concordance limits. The agreement was greater, again, in individuals with >5 NSVTs. As shown in the Figure, in more than 95% of patients both values were within the interval of agreement (0.32±4 ms). Conclusions 1-The burden of NSVTs occurring early after an ICD implant, but not their CL, is associated with a higher incidence of appropriate therapies due to MVT at follow-up. 2-The CL of the NSVTs and that of the first and subsequent MVTs is virtually the same in patients with higher NSVT burden. Therefore, it could be the same tachycardia, but with different duration. Figure 1 Funding Acknowledgement Type of funding source: None

Download Full-text

Reduced Growth in Non-Small for Gestational Age Fetuses from 35 Weeks of Gestation to Birth and Perinatal Outcomes

Fetal Diagnosis and Therapy ◽

10.1159/000519639 ◽

2021 ◽

pp. 1-10

Author(s):

Peña Dieste Pérez ◽

Luis M. Esteban ◽

Ricardo Savirón-Cornudella ◽

Faustino R. Pérez-López ◽

Sergio Castán-Mateo ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Outcomes ◽

Entire Study ◽

Birth Weight Percentile ◽

Gestational Age At Delivery ◽

Study Population ◽

The Difference ◽

Relationship Of ◽

The Relationship

Objective: This study aimed to assess reduced fetal growth between 35 weeks of gestation and birth in non-small for gestational age fetuses associated with adverse perinatal outcomes (APOs). Material and Method: It is a retrospective cohort study of 9,164 non-small for gestational age fetuses estimated by ultrasound at 35 weeks. The difference between the birth weight percentile and the estimated percentile weight (EPW) at 35 weeks of gestation was calculated, and we studied the relationship of this difference with the appearance of APO. APOs were defined as cesarean or instrumental delivery rates for nonreassuring fetal status, 5-min Apgar score <7, arterial cord blood pH <7.10, and stillbirth. Fetuses that exhibited a percentile decrease between both moments were classified into 6 categories according to the amount of percentile decrease (0.01–10.0, 10.01–20.0, 20.01–30.0, 30.01–40.0, 40.01–50.0, and >50.0 percentiles). It was evaluated whether the appearance of APO was related to the amount of this percentile decrease. Relative risk (RR) was calculated in these subgroups to predict APOs in general and for each APO in particular. Receiver operating characteristic and area under curves (AUC) for the difference in the percentile was calculated, used as a continuous parameter in the entire study population. Results: The median gestational age at delivery in uncomplicated pregnancies was 40.0 (39.1–40.7) and in pregnancies with APOs 40.3 (49.4–41.0), p < 0.001. The prevalence of APOs was greater in the group of fetuses with a decrease in percentile (7.6%) compared to those with increased percentile (4.8%) (p < 0.001). The RR was 1.63 (95% CI: 1.365–1.944, p < 0.001). Although the differences were significant in all decreased percentile groups, RRs were significantly higher when decreased growth values were >40 points (RR: 2.036, 95% CI: 1.581–2.623, p < 0.001). The estimated value of the AUC for percentile decrease was 0.58 (0.56–0.61, p < 0.001). Conclusion: Fetuses with a decrease in the EPW between the ultrasound at 35 weeks of gestation and birth have a higher risk of APOs, being double in fetuses with a decrease of >40 percentile points.

Download Full-text

Economic Considerations of Climate Change and Health

Heat Advisory ◽

10.7551/mitpress/9780262034876.003.0009 ◽

2016 ◽

Author(s):

Alan H. Lockwood

Keyword(s):

Climate Change ◽

Full Time ◽

The Us ◽

Compensation Claims ◽

Property Loss ◽

Vector Borne ◽

The Cost ◽

The Relationship ◽

Economic Considerations ◽

Climate Change And Health

Economics govern the relationship between what could be done and what is actually done. A fundamental rule of public health posits that it is medically and economically desirable to prevent rather than to treat an illness. Heat leads to more deaths than any weather-related cause. In the July 2006 California heat wave there were over 16,000 excess emergency room visits and 1,100 hospitalizations. In Washington, there were 3.1 heat-related workman’s compensation claims per 100,000 full time employees. In India the economic burden of dengue is over one billion dollars per year. Puerto Rican data suggest it is the most important and costliest vector-borne disease. Property loss and burdens associated with the production of climate change refugees add to the cost of rising sea level. It’s no surprise that careful studies in the US show that those with the highest social vulnerability will be the most seriously affected. Agriculture will suffer: the 2012 megadrought cost around $30 billion. Economists estimate that heat-related increases in crime will cost each US citizens between $20 and $30 per year by the end of the century.

Download Full-text