The Study of Outcomes for Capd versus Hemodialysis Patients

1996 ◽  
Vol 16 (6) ◽  
pp. 628-633 ◽  
Author(s):  
Friedrich K. Port ◽  
Robert A. Wolfe ◽  
Wendy E. Bloembergen ◽  
Philip J. Held ◽  
Eric W. Young
Keyword(s):  
Study Design ◽  
Mortality Risk ◽  
Cox Model ◽  
Hemodialysis Patients ◽  
Dialysis Dose ◽  
Study Results ◽  
Dialytic Modality ◽  
Outcome Differences ◽  
Dose Patient

Objective To discuss potential reasons for reported differences in the results of several recent studies comparing mortality risk among continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis patients, and to assess the role of statistical methods and study design. Data Sources Recent published reports comparing mortality risk among patients treated with CAPD and hemodialysis. Conclusions Differences in study design, study populations, sample size, data collection, and availability of data likely account in part for the differences in available study results. The Cox model is a valuable tool, particularly for observational studies. Observed outcome differences for CAPD and hemodialysis patients may be due to either the dialytic modality itself or other factors such as differences in patient selection, practice patterns, dialysis dose, patient compliance, etc. Relative mortality rates for hemodialysis and CAPD patients may vary by country, as these factors may differ internationally. A randomized clinical trial is necessary to best determine the effect of the modality itself.

scholarly journals Impact of residual kidney function on hemodialysis adequacy and patient survival

2018 ◽  
Vol 33 (10) ◽  
pp. 1823-1831 ◽  
Author(s):  
Mengjing Wang ◽  
Yoshitsugu Obi ◽  
Elani Streja ◽  
Connie M Rhee ◽  
Jing Chen ◽  
...  
Keyword(s):  
Kidney Function ◽  
Proportional Hazards ◽  
Cox Model ◽  
Hemodialysis Patients ◽  
Cox Proportional Hazards ◽  
Dialysis Dose ◽  
Residual Kidney Function ◽  
Hazard Ratios ◽  
Laboratory Variables

ABSTRACTBackgroundBoth dialysis dose and residual kidney function (RKF) contribute to solute clearance and are associated with outcomes in hemodialysis patients. We hypothesized that the association between dialysis dose and mortality is attenuated with greater RKF.MethodsAmong 32 251 incident hemodialysis patients in a large US dialysis organization (2007–11), we examined the interaction between single-pool Kt/V (spKt/V) and renal urea clearance (rCLurea) levels in survival analyses using multivariable Cox proportional hazards regression model.ResultsThe median rCLurea and mean baseline spKt/V were 3.06 [interquartile range (IQR) 1.74–4.85] mL/min/1.73 m2 and 1.32 ± 0.28, respectively. A total of 7444 (23%) patients died during the median follow-up of 1.2 years (IQR 0.5–2.2 years) with an incidence of 15.4 deaths per 100 patient-years. The Cox model with adjustment for case-mix and laboratory variables showed that rCLurea modified the association between spKt/V and mortality (Pinteraction = 0.03); lower spKt/V was associated with higher mortality among patients with low rCLurea (i.e. <3  mL/min/1.73 m2) but not among those with higher rCLurea. The adjusted mortality hazard ratios (aHRs) and 95% confidence intervals of the low (<1.2) versus high (≥1.2) spKt/V were 1.40 (1.12–1.74), 1.21 (1.10–1.33), 1.06 (0.98–1.14), and 1.00 (0.93–1.08) for patients with rCLurea of 0.0, 1.0, 3.0 and 6.0 mL/min/1.73 m2, respectively.ConclusionsIncident hemodialysis patients with substantial RKF do not exhibit the expected better survival at higher hemodialysis doses. RKF levels should be taken into account when deciding on the dose of dialysis treatment among incident hemodialysis patients.

scholarly journals Predictors of mortality in hemodialysis patients.

1993 ◽  
Vol 3 (9) ◽  
pp. 1613-1622 ◽  
Author(s):  
P Goldwasser ◽  
N Mittman ◽  
A Antignani ◽  
D Burrell ◽  
M A Michel ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Mortality Risk ◽  
Treatment Time ◽  
Cox Model ◽  
Hemodialysis Patients ◽  
The Other ◽  
Baseline Serum ◽  
Increased Risk ◽  
Risk Predictor ◽  
Low Serum

Serum biochemical measures suggestive of undernutrition have been reported to correlate with 1-yr mortality risk in prevalent groups of hemodialysis patients. The predictive power of these variables has not been reported in newly diagnosed patients or in patients whose dialysis prescription is guided by urea kinetics. The relationship of these predictors to mortality over periods of longer than 1 yr is also unreported. Therefore, the survival of 184 hemodialysis patients was examined for up to 44 months (1987 to 1991) with the Cox proportional hazards model. Baseline demographic, clinical, and biochemical parameters were used as independent variables. To adjust for bias in patient selection, the survival of patients with 12 months or less of prior dialysis at the time of enrollment ("new cases") was analyzed separately from that of patients with more than 1 yr of prior treatment ("long-standing cases"). Serum albumin was less than 3.5 g/dL in 31% of new cases and in 12% of long-standing cases. Adjusting for the other variables, low serum albumin was the strongest mortality risk predictor in both new and long-standing cases. Low serum cholesterol was an independent risk predictor in both groups. Diabetes and race were not significant predictors. Mean age at enrollment was nearly a decade higher for nonsurvivors than for survivors, in both new and long-standing groups. Yet, age was not an independent risk predictor in the Cox model for the new group because of an unexpectedly high death rate among young black men. Female gender, which was confounded by increased age, took the place of age in the model for the new group. For each model, there was good agreement between observed and predicted mortality for up to 24 months. To assess the influence of dialysis treatment time and dose (measured as pre-to-post treatment urea ratio) on risk, survival was examined in a subset of 139 patients monitored for up to 22 months, from 1989 to 1991, a period when the urea ratio was used routinely. Adjusting for the other variables, low serum albumin and cholesterol again independently increased risk. The urea ratio was also a significant independent predictor. The pattern of mortality by urea ratio was U shaped, with minimum risk for values between 2.5 and 3.4 Treatment time did not influence risk. It was concluded that baseline serum values of albumin and cholesterol strongly influence survival for up to 2 yr in new and long-standing hemodialysis patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 406-414 ◽  
Author(s):  
Raimondo Maria Pavarin ◽  
Angelo Fioritti ◽  
Francesca Fontana ◽  
Silvia Marani ◽  
Alessandra Paparelli ◽  
...  
Keyword(s):  
Emergency Department ◽  
Metropolitan Area ◽  
Suicidal Behavior ◽  
Mortality Risk ◽  
Illicit Drugs ◽  
Attempted Suicide ◽  
Cox Model ◽  
Emergency Department Admission ◽  
Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

Moderating Role of Gender in the Relationship between Cognitive Errors and Anxiety among Adolescents

2020 ◽  
Vol 4 (1) ◽  
pp. 86-102
Author(s):  
Tasnim Rehna ◽  
Rubina Hanif ◽  
Muhammad Aqeel
Keyword(s):  
Mental Health Problems ◽  
Adolescent Psychopathology ◽  
Future Research ◽  
Cognitive Errors ◽  
Adolescent Anxiety ◽  
Study Results ◽  
The Status ◽  
Manifest Anxiety ◽  
The Relationship

Background: Widespread social paradigms on which the status variances are grounded in any society, gender plays pivotal role in manifestation of mental health problems (Rutter, 2007). A hefty volume of research has addressed the issue in adults nonetheless, little is vividly known about the role of gender in adolescent psychopathology. Sample: A sample of 240 adolescents (125 boys, 115 girls) aging 12-18 years was amassed from various secondary schools of Islamabad with the approval of the Federal Directorate of Education (FDE), relevant authorities of the schools and the adolescents themselves. Instruments: Taylor Manifest Anxiety Scale (Taylor & Spence, 1953) and Children’s Negative Cognitive Errors Questionnaire (CNCEQ) by Leitenberg et al., (1986) were applied in present study. Results: Multiple regression analysis revealed that cognitive errors jointly accounted for 78% of variance in predicting anxiety among adolescents. Findings also exhibited that gender significantly moderated the relationship between cognitive errors and adolescent anxiety. Implications of the findings are discoursed for future research and clinical practice.

Work Life Balance and Job Satisfaction - A Structural Equation Modeling

GIS Business ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. 156-162
Author(s):  
Dr. D. Shoba ◽  
Dr. G. Suganthi
Keyword(s):  
Job Satisfaction ◽  
Structural Equation ◽  
Well Being ◽  
Work Life ◽  
Work Life Balance ◽  
Equation Modeling ◽  
Subjective Well Being ◽  
Life Balance ◽  
Study Results

Work-Life balance has its importance from ancient days and the concept is very old, from the day the world has been created. There was a drastic change that has occurred in the market of teachers and their personal profiles. There are tremendous changes in various families which have bartered from the ‘breadwinner’ role of traditional men to single parent families and dual earning couples. This study furnishes an insight into work life balance and job satisfaction of teachers working in School of Villupuram District. The sample comprises of 75 school teachers from Government and private schools in Villupuram District. The Study results that there is increasing mediating evidence in Work-life balance as well as Job satisfaction of teachers are not affected by the type of school in which they are working. Job satisfaction or Pleasure of life will be affected as a whole by Work life balance of an individual which is the main which can be calculated by construct of subjective well being.

Information-seeking to Support Personal and Community Wellbeing: Report of a study of New Zealand Men Using Focus Groups

2016 ◽  
Author(s):  
Peta Wellstead
Keyword(s):  
New Zealand ◽  
Focus Groups ◽  
Support Services ◽  
Information Seeking ◽  
Service Providers ◽  
Structural Constraints ◽  
Health And Wellbeing ◽  
Study Results ◽  
Groupes De Discussion

This paper reports part of an ongoing study exploring the information behaviour of New Zealand men during periods of diminished health and wellbeing. Focus groups were used for this iteration of the study. Results indicate that New Zealand men face both personal and structural constraints to their information-seeking during periods when their health and wellbeing may be compromised. This study highlights that service providers need to develop more effective information delivery mechanisms and support services for men. These services need to be appealing to men and reflect men’s information seeking preferences. The role of LIS professionals in supporting this endeavour is discussed. Cet article présente une étude en cours explorant le comportement informationnel d’ hommes néo-zélandais durant des périodes où leur état de santé et de bien-être est amoindri. Des groupes de discussion ont été utilisés pour cette itération de l'étude. Les résultats indiquent que les hommes en Nouvelle-Zélande font face à des contraintes à la fois  personnelles et structurelles dans leur recherche d'information pendant les périodes où leur santé et leur bien-être peuvent être affaiblis. Cette étude met en évidence le besoin pour les fournisseurs de services de développer des mécanismes de diffusion de l'information plus efficaces et des services de soutien pour les hommes. Ces services doivent être attrayants et refléter les préférences des hommes dans leurs recherches d’information. Le rôle des professionnels de l'information dans le soutien à cette entreprise est discuté.

Exploring power in response inhibition tasks using the bootstrap: The impact of number of participants, number of trials, effect magnitude, and study design

2019 ◽  
Author(s):  
Curtis David Von Gunten ◽  
Bruce D Bartholow
Keyword(s):  
Study Design ◽  
Effect Size ◽  
Statistical Power ◽  
Bootstrap Sampling ◽  
Reliable Measure ◽  
Internal Reliability ◽  
The Impact ◽  
Power Analyses ◽  
Effect Magnitude

A primary psychometric concern with laboratory-based inhibition tasks has been their reliability. However, a reliable measure may not be necessary or sufficient for reliably detecting effects (statistical power). The current study used a bootstrap sampling approach to systematically examine how the number of participants, the number of trials, the magnitude of an effect, and study design (between- vs. within-subject) jointly contribute to power in five commonly used inhibition tasks. The results demonstrate the shortcomings of relying solely on measurement reliability when determining the number of trials to use in an inhibition task: high internal reliability can be accompanied with low power and low reliability can be accompanied with high power. For instance, adding additional trials once sufficient reliability has been reached can result in large gains in power. The dissociation between reliability and power was particularly apparent in between-subject designs where the number of participants contributed greatly to power but little to reliability, and where the number of trials contributed greatly to reliability but only modestly (depending on the task) to power. For between-subject designs, the probability of detecting small-to-medium-sized effects with 150 participants (total) was generally less than 55%. However, effect size was positively associated with number of trials. Thus, researchers have some control over effect size and this needs to be considered when conducting power analyses using analytic methods that take such effect sizes as an argument. Results are discussed in the context of recent claims regarding the role of inhibition tasks in experimental and individual difference designs.

scholarly journals Fibroblast Growth Factor 20 Gene Polymorphism in Parkinson’s Disease in Asian Population: A Meta-Analysis

Genes ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 674
Author(s):  
Han-Lin Chiang ◽  
Yih-Ru Wu ◽  
Yi-Chun Chen ◽  
Hon-Chung Fung ◽  
Chiung-Mei Chen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Lewy Bodies ◽  
Asian Population ◽  
Protective Role ◽  
Lewy Neurites ◽  
Chinese Populations ◽  
Study Results

Parkinson’s disease (PD) is a neurodegenerative disease with the pathological hallmark of Lewy bodies and Lewy neurites composed of α-synuclein. The SNP rs591323 is one of the risk loci located near the FGF20 gene that has been implicated in PD. The variation of FGF20 in the 3′ untranslated region was shown to increase α-synuclein expression. We examined the association of rs591323 with the risk of PD in a Taiwanese population and conducted a meta-analysis, including our study and two other studies from China, to further confirm the role of this SNP in Taiwanese/Chinese populations. A total of 586 patients with PD and 586 health controls (HCs) were included in our study. We found that the minor allele (A) and the AA + GA genotype under the dominant model are significantly less frequent in PD than in controls. The meta-analysis consisted of 1950 patients with PD and 2073 healthy controls from three studies. There was significant association between rs591323 and the risk of PD in the additive (Z = −3.96; p < 0.0001) and the dominant models (Z = −4.01; p < 0.0001). Our study results and the meta-analysis support the possible protective role of the rs591323 A allele in PD in Taiwanese/Chinese populations.

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