Analysis of access flow using duplex ultrasonography and the ultrasound dilutional method

2021 ◽  
pp. 112972982199175
Author(s):  
Miju Bae ◽  
Chang Ho Jeon ◽  
Miyeun Han ◽  
Moran Jin ◽  
Hyo Jin Kim

Background: This study aimed to evaluate the correlation between duplex ultrasonography (DUS) and ultrasound dilution (UD) measurement’s results and determine the factors affecting the correlation of the measured values among other clinical factors in patients. Methods: This cross-sectional study was conducted from April 2020 to May 2020 and included 60 patients who visited our dialysis centre. The flow of the fistula was measured in the proximal brachial artery using DUS. While dialysis was performed on the same day, the access flow was measured using the UD method. The correlation and agreement between the access flows acquired by each measurement method were analysed. Similarly, the correlation was analysed by classifying the groups based on the predisposing factor, and statistically significant factors were observed through comparison. Results: Both measurements showed a moderate positive correlation ( r = 0.60, p < 0.01). The bias (mean of UD-DUS) between the two measurements was about 230 mL/min. When the measurement site of DUS was near the inflow artery and in the same anatomical section, a strong correlation with the measurement value of UD was observed (brachial based fistula: r = 0.85, radial based fistula: r = 0.87). Similarly, for patients without diabetes and those who regularly underwent access surveillance for the dialysis route, strong correlations were observed between the two measurements ( r = 0.79 and r = 0.88). Conclusions: Several factors can influence the correlation between UD and DUS. The findings showed a high correlation for DUS measurement sites within the same anatomical section as the inflow artery, patients without diabetes, and patients undergoing periodic surveillance.

2021 ◽  
Vol 2 (2) ◽  
pp. 73-76
Author(s):  
Rajesh Kumar Mandal ◽  
Nirmal Shakya ◽  
Sanket Kumar Risal

BACKGROUND: Organophosphorus (OP) are frequently used as pesticides and the most common agents of poisoning in developing countries including Nepal. There is paucity of data about characteristics of organophosphorus poisoning in our localities. Therefore, we aimed to evaluate its clinical pattern and factors affecting outcome. METHODS: It was a cross-sectional study conducted in Bheri Hospital Nepalgunj between 15th July 2019 to 14th July 2020. The hospital records of patients of acute organophosphorus poisonings were collected. Data regarding age, gender, predisposing factors, duration of hospitalization and outcome of the patients were recorded. Data was analyzed using SPSS 20. RESULTS: A total of 53 patients out of which 22(41.5%) were male and 31(58.49%) were female with F:M ratio of 1.40: 1. The maximum number of the patients 25(47.16%) were in the age group of 20 to 40 years. Incidence of poisoning was more common in married patients 36(67.92%) The suicidal motive for poisoning was found in 49 cases (92.45%). The most commonly used organophosphorus poison was Dichlorvos 32(60.34%) followed by methyl parathion 14(26.41%). Domestic quarrel was the most common predisposing factor 32(60.37%). 45(84.90%) of the patients were discharged after successful treatment while there was mortality of 3 patients (5.66%). CONCLUSIONS: Organophosphorus poisoning is a common mode of suicidal attempts leading to morbidity and mortality every year. Strict policies against the free availability and sale of insecticides is required to control organophosphorus poisoning. Mental health education programme should be conducted for the prevention of suicide and poisoning.


2018 ◽  
Vol 34 (2) ◽  
pp. 50
Author(s):  
Aning Isfandyari ◽  
Lutfan Lazuardi

Fatality and spatial analysis of road traffic accident in Gunung KidulPurposeThis study is aimed to conduct further analysis of road accidents fatality and accident-potential area using geographic information system.MethodsThis was an analytic observational study using cross-sectional study design. Samples are all traffic accident recorded in police departement accident registry from January 1st to December 31st 2015. Data will be analyzed using poisson regression with robust variance and accident location will be analyzed spatially using ArcGIS 10.4 software.ResultsThe result revealed that  06.00-11.59 a.m  (PR 0.31, 95% CI 0.144-0.687) or 12.00-17.59 p.m (PR 0.40; 95% CI 0.184-0.865),  uphill roadway geometric (PR 2.16, 95% CI 1.144-4.094) or winding roadway  (PR 1.80, 95% CI 1.013-3.213) and single accident type (PR 3.59; 95% CI 1.953-6.592) were significant factors affecting road traffic fatalities. Accident-prone locations to traffic accidents in Gunungkidul are clustered on several streets, such as Yogyakarta-Wonosari Street, Karangmojo-Semin Road, Wonosari Semanu Street and Wonosari Baron Street..ConclusionsFatal traffic accident in Gunungkidul are influenced by environmental conditions and accident types. Multisectoral coordination was needed to improve intervention to population at risk and stakeholders need to make efforts to modify the environment related to road geometric conditions to minimize the occurrence of accidents.


2021 ◽  
Vol 11 (2) ◽  
pp. 320-330
Author(s):  
Utako Sawada ◽  
Akihito Shimazu ◽  
Norito Kawakami ◽  
Yuki Miyamoto ◽  
Lisa Speigel ◽  
...  

Background: Good social climate and high work engagement are important factors affecting outcomes in healthcare settings. This study observed the effects of a program called Civility, Respect, and Engagement in the Workplace (CREW) on social climate and staff work engagement in a psychiatric ward of a Japanese hospital. Methods: The program comprised 18 sessions installed over six months, with each session lasting 30-min. Participation in the program was recommended to all staff members at the ward, including nurses, medical doctors, and others, but it was not mandatory. A serial cross-sectional study collected data at four time-points. Nurses (n = 17 to 22), medical doctors (n = 9 to 13), and others (n = 6 to 10) participated in each survey. The analysis of variance was used to evaluate the changes in the following dependent variables, the Essen climate evaluation schema (EssenCES), the CREW civility scale, and the Utrecht work engagement scale (UWES) over time. Result: We found no significant effects. The effect size (Cohen’s d) for EssenCES was 0.35 from baseline to post-installation for all staff members. Effect sizes for EssenCES for medical doctors and UWES for nurses were 0.79 and 0.56, respectively, from baseline to post-program. Conclusions: Differences in social climate and work engagement among Japanese healthcare workers between the baseline and post-installation of the CREW program were non-significant.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leul Belachew Zewdu ◽  
Mebratu Mitiku Reta ◽  
Niguse Yigzaw ◽  
Koku Sisay Tamirat

Abstract Background Suicidal behaviors cover a range or continuum of acts from suicidal ideations to a series of actions, commonly known as suicidal attempts or deliberate self-harms. Though different mental disorders related studies were conducted among HIV/AIDS patients, there is a scarcity of information about the magnitude and determinants of suicidal thoughts among perinatal women. Therefore, this study aimed to determine the prevalence of suicidal ideation and associated factors among HIV positive perinatal women in the study setting. Methods An institution-based cross-sectional study was conducted among perinatal women on treatment to the prevention of mother to child transmission of HIV/AIDS at Gondar town health facilities. A total of 422 HIV-positive perinatal women were selected systematically and the data collected through medical record review and interview using a Composite International Diagnostic Interview (CIDI) toolkit. A binary and multivariable logistic regression model was employed to identify factors associated with suicidal ideation. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed to see the strength of association between outcome and independent variables. Characteristics having less than 0.05 p-value had been taken as significant factors associated with the outcome of interest. Result The prevalence of suicidal ideation was found to be 8.2% (95% CI; 5.7 to 11.3) and with a standard error of 0.013. Perinatal depression (AOR=4.40, 95%CI: 1.63 11.85), not disclosed HIV status (AOR=3.73, 95%CI: 1.44 9.65), and unplanned pregnancy (AOR=2.75, 95%CI: 1.21 6.21) were significant factors associated with suicidal ideation. Conclusion The magnitude of suicidal ideation among HIV positive perinatal women was found to be low. Perinatal depression, non-disclosed HIV status, and unplanned pregnancy were factors significantly associated with suicidal ideation. This finding suggests the integration of mental health services with maternal and HIV support programs.


2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988337 ◽  
Author(s):  
Toshiyuki Iwame ◽  
Tetsuya Matsuura ◽  
Naoto Suzue ◽  
Joji Iwase ◽  
Hirokazu Uemura ◽  
...  

Background: Soccer is played by many children younger than 12 years. Despite its health benefits, soccer has also been linked to a high number of sport-related injuries. Purpose: To investigate the relationship between clinical factors and knee or heel pain in youth soccer players. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants included 602 soccer players aged 8 to 12 years who were asked whether they had experienced episodes of knee or heel pain. Data were collected on age, body mass index, years of playing soccer, playing position, and training hours per week. Associations of clinical factors with the prevalence of knee or heel pain were examined by univariate and multivariate logistic regression analyses. Results: Episodes of knee and heel pain were reported by 29.4% and 31.1% of players, respectively. Multivariate analyses revealed that older age and more years of playing soccer were significantly and positively associated with the prevalence of knee pain ( P = .037 and P = .015 for trend, respectively) but did not identify any significant associations for heel pain. Conclusion: In this study of youth soccer players, knee pain was associated with older age and more years of play, but heel pain was not significantly associated with any factor.


Author(s):  
Perla Werner ◽  
Aviad Tur-Sinai ◽  
Hanan AboJabel

The present study aimed to assess dementia caregivers’ reports of the prevalence and correlates of forgone care regarding visits to a general practitioner (GP) and to a specialist during the COVID-19 lockdown in Israel, using Andersen’s Behavioral Model of Healthcare Utilization. A cross-sectional study using an online survey was conducted with 73 Israeli family caregivers of persons with dementia residing in the community (81% Jews, 86% female, mean age = 54). Overall, one out of two participants reported having to delay seeking needed help from a GP or a specialist for themselves, as well as for their relatives with dementia, during the COVID-19 lockdown period. Among the predisposing factor, education was associated with caregivers’ reports regarding forgone care for themselves as well as for their loved ones. Living with the care-receiver and income level were the enabling factors associated with forgone care for caregivers. Finally, feelings of burden were associated with caregivers’ forgone care and feelings of loneliness and perceptions of the care-receiver’s cognitive functioning were associated with care-receivers’ forgone care. Our findings show that it is essential that this population receive appropriate practical and emotional support at times of distress and crisis to enable them to continue with their caregiving role.


2020 ◽  
Vol 65 (11) ◽  
pp. 132-143
Author(s):  
Nam Pham Tien

The provision of social work service for cancer patients is facing many challenges. Therefore, this study aims to explore factors affecting the provision of social work services for cancer patients at the Vietnam National Cancer Hospital. This is a cross-sectional study that used 10 in-depth interviews, and three focus group discussions to collect data. Our findings showed that the factors such as specialized qualifications of social workers, available facilities, the network of social work collaborators, finance, and policy regimes hindered the provision of social work services for cancer patients at the hospital. Meanwhile, the financial factor contributed to promote social work services for cancer patients at the hospital. Besides, the demands for the provision of social work services for cancer patients were one of the factors that should be considered in the coming time. Our study suggested stakeholders pay more attention to these factors.


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