Impact of comorbidity on health outcome after a transport-related injury

2019 ◽  
Vol 26 (3) ◽  
pp. 254-261
Author(s):  
Stella Samoborec ◽  
Pamela Simpson ◽  
Behrooz Hassani-Mahmooei ◽  
Rasa Ruseckaite ◽  
Melita Giummarra ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Health Outcomes ◽  
Chronic Back Pain ◽  
Healthcare Utilisation ◽  
Summary Score ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact ◽  
Time Since Injury

IntroductionUnderstanding the impact of comorbidity on health outcomes is important given that comorbidities can affect survival, morbidity, service delivery costs and healthcare utilisation. However, little is known about the types of comorbidities affecting specific health outcomes after minor to moderate road trauma.MethodsThis study involved 1574 participants who claimed injury compensation following transport-related injury. Cross sectional data were collected. Health outcomes were assessed using the EQ-5D-3L specific domains and summary score. Twelve self-reported pre-existing chronic conditions were assessed using a multivariate logistic regression, adjusting for demographic and injury characteristics.ResultsOut of 1574 participants, only 17 (1%) participants reported no pre-existing comorbidities, 72% reported one, 13% reported two and 14% reported three or more comorbidities. Hypertension (15%), depression (14%) and anxiety (14%) were the most commonly reported comorbidities, followed by arthritis (13%), chronic pain (11%) and asthma (11%). Participants with a history of arthritis (adjusted odds ratio [AOR] 1.90, 95% CI 1.24 to 2.91); chronic back pain (AOR 1.59, 95% CI, 1.04 to 2.43); other chronic pain (AOR 2.73, 95% CI 1.42 to 4.24); depression (AOR 2.55, 95% CI 1.60 to 4.05) and anxiety (AOR 2.08, 95% CI 1.32 to 3.26) were at increased risk of poorer health outcomes, after controlling for age, gender, type of injury and time since injury.ConclusionThis study found that comorbidities such as arthritis, chronic back pain, other chronic pain, depression and anxiety significantly increase the odds of poorer health postinjury, regardless of the time since injury. Regular screening of comorbid conditions may help identify people likely to have poorer outcomes, thereby enabling the implementation of interventions to optimise health despite the presence of comorbidities.

scholarly journals The impact of health literacy on health outcomes in individuals with chronic pain: a cross-sectional study

Physiotherapy ◽  
2019 ◽  
Vol 105 (3) ◽  
pp. 346-353
Author(s):  
Laura M. Mackey ◽  
Catherine Blake ◽  
Maire-Brid Casey ◽  
Camillus K. Power ◽  
Ray Victory ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Health Literacy ◽  
Health Outcomes ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

scholarly journals Differences in risk factors and chronic conditions between informal (family) carers and non-carers using a population-based cross-sectional survey in South Australia

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020173 ◽  
Author(s):  
Anne F Stacey ◽  
Tiffany K Gill ◽  
Kay Price ◽  
Anne W Taylor
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Health Outcomes ◽  
Chronic Conditions ◽  
Population Based ◽  
Computer Assisted ◽  
Family Carers ◽  
Cross Sectional ◽  
Increased Risk ◽  
The Impact

BackgroundThere is growing discussion on the impact of informal caregiving on the health status and morbidity of family carers. Evidence suggests a proportion of carers may be at risk of poor health outcomes. However, there are limited population-based studies that provide representative data on specific risk factors among carers (eg, blood pressure, cholesterol, smoking status, activity and body mass index) and major chronic conditions (eg, asthma, diabetes and arthritis). This study aimed to redress that imbalance.MethodSelf-reported data were from the South Australian Monitoring and Surveillance System (SAMSS), a representative cross-sectional state-wide population-based survey of 600 randomly selected persons per month. SAMSS uses computer-assisted telephone interviewing (CATI) to monitor chronic health-related problems and risk factors and to assess health outcomes. In total, 2247 family carers were identified from 35 195 participants aged 16 years and older for the 5-year period from 2010 to 2015. Logistic regression analyses examined associations of being a carer with self-reported chronic diseases and health risk factors. In addition, the population attributable risk (PAR) of being a carer was examined for selected chronic conditions.ResultsThe prevalence of carers was 6.4%, and peak age group for carers was 50–59 years. Adjusted ORs for chronic conditions in carers were significant for all chronic conditions examined. Although there is a high prevalence of self-reported risk factors and chronic conditions among carers compared with non-carers at the population level, PAR findings suggest that caregiving is associated with a small to moderate increased risk of having these chronic conditions.ConclusionsMonitoring of carer health and morbidity particularly ‘at risk’ individuals such as female carers with asthma or diabetes remains important and provides an ongoing baseline for future surveys. To achieve this, caregiver-based studies need to become part of mainstream biomedical research at both epidemiological and clinical levels.

scholarly journals Acute and chronic back pain in adults and elderly in southern Brazil

2021 ◽  
Vol 31 (1) ◽  
pp. e39824
Author(s):  
Elizabet Saes-Silva ◽  
Vanise dos Santos Ferreira Viero ◽  
Fernanda de Oliveira Meller ◽  
Antônio Augusto Schäfer ◽  
Michele Vaz Canena ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Acute Pain ◽  
Chronic Back Pain ◽  
Multinomial Logistic Regression ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Work Related ◽  
Acute Back Pain

Aims: to determine the prevalence of acute and chronic back pain and associated factors and identify the consequences of this pain in adults and the elderly in southern Brazil.Methods: cross-sectional study conducted in 2019, in Criciúma, Santa Catarina, in individuals aged 18 and over. Acute back pain was pain in the cervical, thoracic, or lumbar regions not exceeding 3 months and chronic pain as pain for 3 months or more. Bivariate analyzes and multinomial logistic regression were performed.Results: among the 820 participants, the prevalence of back pain was 67.0%, acute pain 39.3% (95% CI: 35.5% to 43.3%) and chronic pain 27.4% (95% CI: 24.5% to 30.4%). Acute back pain was associated with women, overweight, obesity, and with WMSD/RSI, while chronic pain chronic pain was found mostly in women, being related to leisure inactivity ...were female, leisure inactivity, falls, Work-related musculoskeletal disorder/repetitive strain injury, and arthritis/rheumatism.Conclusions: acute pain was greater among overweight/obese and chronic pain contribute to absenteeism and demand for health services.

scholarly journals What is the impact of multimorbidity on the risk of hospitalisation in older adults? A systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e049974
Author(s):  
Luciana Pereira Rodrigues ◽  
Andréa Toledo de Oliveira Rezende ◽  
Letícia de Almeida Nogueira e Moura ◽  
Bruno Pereira Nunes ◽  
Matias Noll ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Study Protocol ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Increased Risk ◽  
Review Study ◽  
The Impact

IntroductionThe development of multiple coexisting chronic diseases (multimorbidity) is increasing globally, along with the percentage of older adults affected by it. Multimorbidity is associated with the concomitant use of multiple medications, a greater possibility of adverse effects, and increased risk of hospitalisation. Therefore, this systematic review study protocol aims to analyse the impact of multimorbidity on the occurrence of hospitalisation in older adults and assess whether this impact changes according to factors such as sex, age, institutionalisation and socioeconomic status. This study will also review the average length of hospital stay and the occurrence of hospital readmission.Methods and analysisA systematic review of the literature will be carried out using the PubMed, Embase and Scopus databases. The inclusion criteria will incorporate cross-sectional, cohort and case–control studies that analysed the association between multimorbidity (defined as the presence of ≥2 and/or ≥3 chronic conditions and complex multimorbidity) and hospitalisation (yes/no, days of hospitalisation and number of readmissions) in older adults (aged ≥60 years or >65 years). Effect measures will be quantified, including ORs, prevalence ratios, HRs and relative risk, along with their associated 95% CI. The overall aim of this study is to widen knowledge and to raise reflections about the association between multimorbidity and hospitalisation in older adults. Ultimately, its findings may contribute to improvements in public health policies resulting in cost reductions across healthcare systems.Ethics and disseminationEthical approval is not required. The results will be disseminated via submission for publication to a peer-reviewed journal when complete.PROSPERO registration numberCRD42021229328.

scholarly journals Dual Effects of Hearing Loss and Dementia on Functional Limitations in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 214-214
Author(s):  
Michael McKee ◽  
Yunshu Zhou ◽  
Joshua Ehrlich ◽  
Elham Mahmoudi ◽  
Jennifer Deal ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Self Care ◽  
Household Activity ◽  
Cross Sectional ◽  
Age Related ◽  
Increased Risk ◽  
Lower Mobility ◽  
Independent Effects ◽  
The Impact

Abstract Age-related hearing loss (HL) is both common and associated with elevated risk for cognitive decline and poorer health. To care for an aging population, it is critical to understand the effect of coexisting HL and dementia on functional activities. The effect of co-existing dementia and self-reported HL on daily functioning were assessed. A cross-sectional analysis was performed using nationally-representative data from the 2015 National Health and Aging Trends Study consisting of U.S. adults 65+. The sample included 1,829 adults with HL (22.8%) and 5,338 adults without HL. Multivariable Poisson regression was used to model the independent effects and interaction of self-reported HL and dementia status on three validated functional activity scales (self-care, mobility, and household). All analyses adjusted for sociodemographic and medical factors. HL participants were more likely to be white, older, male, less educated (p <0.01). 8.4% had possible dementia and 6.5% had probable dementia. Respondents with HL or possible or probable dementia had significantly lower mobility, self-care, and household activity scores (p<.001 for all comparisons) compared to their peers. A small yet significant interaction was present in all models, suggesting that HL respondents with co-occurring dementia had lower mobility, self-care, and household activity scores than predicted by the independent effects of dementia and self-reported HL (p<.001 for all comparisons). Older adults with co-occurring dementia and HL are at increased risk for poor functioning and should be screened by healthcare providers. Future work should consider the impact of intervention in this vulnerable/at-risk population.

Depression and its Somatic Consequences: Allostatic Load as the Connecting Link

2017 ◽  
Vol 41 (S1) ◽  
pp. S62-S62
Author(s):  
B. Penninx
Keyword(s):  
Health Outcomes ◽  
Psychiatric Disorders ◽  
Allostatic Load ◽  
Cellular Aging ◽  
Health Consequences ◽  
Somatic Health ◽  
Depressed Patients ◽  
Physiological Dysregulation ◽  
Increased Risk ◽  
The Impact

Stress-related psychiatric disorders, such as depressive and anxiety disorders, have been associated with increased risk of overall mortality as well as with the onset of various aging-related somatic diseases. In addition to unhealthy lifestyles and poorer (self) care, various stress-related physiological processes likely contribute to these detrimental health consequences of psychiatric disorders. Considering the fact that the impact of stress-related disorders is visible on many different somatic health outcomes, it is unlikely that contributing biological systems are very specific. In fact, it is likely that multiple dysregulations of stress systems, including the immune, HPA-axis and autonomic nervous systems, but also various general proteomic or metabolomic pathways are involved. The concept of Allostatic Load (AL) emphasizes the presence of a multi-system physiological dysregulation.In this talk I will summarize what the evidence is for somatic health consequences of psychiatric conditions, with depression as an important example. Subsequently, I will provide an overview of the various stress systems that are dysregulated in depressed patients. In addition, I will provide empirical data from the Netherlands Study of Depression and Anxiety (n = 2981) that illustrate that there is evidence that depressed patients are especially at risk for a dysregulation in multiple physiological stress systems. I will also illustrate how such a state of AL can impact on basis cellular aging indicators like telomere length and epigenetic age.In sum, this talk will highlight the current state-of-evidence for an association between depressions with the onset of many adverse somatic health outcomes, and will provide insight into the contributing role of a multisystem physiological dysregulation.Disclosure of interestThe author has not supplied his declaration of competing interest.

Longitudinal Effects of Gendered Harassment Perpetration and Victimization on Mental Health Outcomes in Adolescence

2017 ◽  
Vol 35 (23-24) ◽  
pp. 5997-6016 ◽  
Author(s):  
Sarah J. Rinehart ◽  
Dorothy L. Espelage ◽  
Kristen L. Bub
Keyword(s):  
Mental Health ◽  
Sexual Harassment ◽  
Health Outcomes ◽  
Mental Health Outcomes ◽  
Depression Symptoms ◽  
Negative Outcomes ◽  
Cross Sectional ◽  
The Impact ◽  
Homophobic Name Calling ◽  
Gendered Harassment

Gendered harassment, including sexual harassment and homophobic name-calling, is prevalent in adolescents and is linked to negative outcomes including depression, anxiety, suicidality, substance abuse, and personal distress. However, much of the extant literature is cross-sectional and rarely are perpetrators of these behaviors included in studies of outcomes. Therefore, the current study examined the effects of longitudinal changes in gendered harassment perpetration and victimization on changes in mental health outcomes among a large sample of early adolescents. Given that these behaviors commonly occur in the context of a patriarchal society (males hold power), we also investigated the impact of gender on gendered harassment. Participants included 3,549 students from four Midwestern middle schools (50.4% female, 49% African American, 34% White) at two time points (13 and 17 years old). Results indicated that increases from age 13 to 17 years in sexual harassment perpetration and victimization and homophobic name-calling perpetration and victimization predicted increases in depression symptoms and substance use. Gender did not moderate these pathways. These findings highlight that negative outcomes are associated with changes in gendered harassment among adolescents and emphasize the importance of prevention efforts. Implications for school interventions are discussed.

scholarly journals Cross sectional analysis of depression and stress in medical students

2018 ◽  
Author(s):  
Tyler S. Jones ◽  
Deborah Rupert
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Help Seeking ◽  
Health Issues ◽  
Cross Sectional ◽  
Help Seeking Behaviors ◽  
Mental Health Issues ◽  
Increased Risk ◽  
Sectional Analysis ◽  
The Impact

Medical student wellbeing is a topic of growing concern. Medical students experience high levels of stress and burnout and are at increased risk for depression and suicidal ideation compared to the general population. Even more concerning, medical students are disproportionately less likely to seek help for their mental health issues. Identifying and preventing these problems early can have lasting positive consequences over the course of a physician’s lifetime. We implemented a wellness program at our medical school in the spring of 2016 with the goals of decreasing burnout and depression, heightening awareness of mental health issues, and encouraging help-seeking behaviors. To analyze the impact of our program, we have implemented a quality assurance survey. Here we report lifestyle factors associated with positive screens for depression from that data and propose institutional initiatives that can be spearheaded by medical students for medical students to impact positive change.

The periaqueductal gray and descending pain modulation: why should we study them and what role do they play in chronic pain?

2015 ◽  
Vol 114 (4) ◽  
pp. 2080-2083 ◽  
Author(s):  
Kasey S. Hemington ◽  
Marie-Andrée Coulombe
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Functional Connectivity ◽  
Recent Literature ◽  
Chronic Back Pain ◽  
Periaqueductal Gray ◽  
Pain Modulation ◽  
Pain Research ◽  
Descending Pain Modulation ◽  
Pain Patients

In this Neuro Forum we discuss the significance of a recent study by Yu et al. ( Neuroimage Clin 6: 100–108, 2014). The authors examined functional connectivity of a key node of the descending pain modulation pathway, the periaqueductal gray (PAG), in chronic back pain patients. Altered PAG connectivity to pain-related regions was found; we place results within the context of recent literature and emphasize the importance of understanding the descending component of pain in pain research.

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