scholarly journals Influenza risk groups in Norway by education and employment status

2021 ◽  
pp. 140349482110606
Author(s):  
Birgitte Klüwer ◽  
Kjersti Margrethe Rydland ◽  
Ida Laake ◽  
Megan Todd ◽  
Lene Kristine Juvet ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Employment Status ◽  
Risk Group ◽  
Public Funding ◽  
Compulsory Education ◽  
Risk Groups ◽  
Study Data ◽  
Full Time ◽  
Medical Risk ◽  
Severe Influenza

Aims: This study aimed to estimate the size of the risk group for severe influenza and to describe the social patterning of the influenza risk group in Norway, defined as everyone ⩾65 years of age and individuals of any age with certain chronic conditions (medical risk group). Methods: Study data came from a nationally representative survey among 10,923 individuals aged 16–79 years. The medical risk group was defined as individuals reporting one or more relevant chronic conditions. The associations between educational attainment, employment status, age and risk of belonging to the medical risk group were studied with logistic regression. Results: Nearly a fifth (19.0%) of respondents reported at least one chronic condition, while 29.4% belonged to the influenza risk group due to either age or chronic conditions. Being older, having a low educational level (comparing compulsory education to higher education, odds ratio (OR)=1.4, 95% confidence interval (CI) 1.2–1.8 among women, and OR=1.3, 95% CI 1.1–1.7 among men) and a weaker connection to working life (comparing disability pension to working full-time, OR=6.8, 95% CI 5.3–8.7 among women, and OR=6.5, 95% CI 4.9–8.5 among men) was associated with a higher risk of belonging to the medical risk group for severe influenza. Conclusions: This study indicates that the prevalence of medical risk factors for severe influenza is disproportionally distributed across the socio-economic spectrum in Norway. These results should influence both public funding decisions regarding influenza vaccination and communication strategies towards the public and health professionals.

scholarly journals The Risk of Invasive Pneumococcal Disease Differs between Risk Groups in Norway Following Widespread Use of the 13-Valent Pneumococcal Vaccine in Children

2021 ◽  
Vol 9 (8) ◽  
pp. 1774
Author(s):  
Brita Askeland Winje ◽  
Didrik Frimann Vestrheim ◽  
Richard Aubrey White ◽  
Anneke Steens
Keyword(s):  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Risk Group ◽  
Population Data ◽  
Risk Groups ◽  
The Elderly ◽  
Population Based ◽  
Childhood Vaccination ◽  
Medical Risk ◽  
Icd 10

The elderly and adults with medical risk conditions remain at high risk of invasive pneumococcal disease (IPD), highlighting the importance of adequate preventive efforts. In an observational population-based study in Norway (pop ≥ 5 years, 2009–2017) covering six years post-PCV13 implementation, we explored the incidence and risk of IPD associated with age and comorbidities. We obtained the data on 5535 IPD cases from the Norwegian Surveillance System for Communicable Diseases and the population data from Statistics Norway. To define comorbidities, we obtained ICD-10 codes from the Norwegian Patient Registry for the cases and the Norwegian population. The average annual decrease in PCV13 IPD incidence was significant in all risk groups and decreased post-PCV13 introduction by 16–20% per risk group, implying a nondifferential indirect protection from the childhood vaccination. The IPD incidence remained high in the medical risk groups. The relative importance of medical risk conditions was 2.8 to 6 times higher in those aged 5–64 versus ≥65 years for all types of IPD, since age itself is a risk factor for IPD. In groups without medical risk, the risk of IPD was eight times higher in those aged ≥65 compared to those 5–64 years (RR 8.3 (95% CI 7.3–9.5)). Our results underscore the need for age- and risk-group-based prevention strategies.

scholarly journals Patients at high risk for a severe clinical course of COVID-19 — small-area data in support of vaccination and other population-based interventions in Germany

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jakob Holstiege ◽  
Manas K. Akmatov ◽  
Claudia Kohring ◽  
Lotte Dammertz ◽  
Frank Ng ◽  
...  
Keyword(s):  
High Risk ◽  
Chronic Conditions ◽  
Small Area ◽  
Risk Group ◽  
Regional Analysis ◽  
Age Groups ◽  
Risk Groups ◽  
The Elderly ◽  
German Population ◽  
Social Law

Abstract Background Research has shown that the risk for a severe course of COVID-19 is increased in the elderly population and among patients with chronic conditions. The aim of this study was to provide estimates of the size of vulnerable populations at high risk for a severe COVID-19 course in Germany based on the currently available risk factor data. Methods We used nationwide outpatient claims data from the years 2010 to 2019 collected according to § 295 of the Code of Social Law V, covering data for all statutory health insurees (SHI) which is nearly 87% of the entire German population. We considered 15 chronic disorders based on the current state of knowledge about clinically relevant risk factors. Three risk groups for a severe COVID-19 course were defined: 1. individuals in the age group 15 to 59 years with at least two comorbid disorders; 2. individuals aged 60 to 79 years with at least one disorder and 3. all individuals 80 years and older irrespective of the presence of chronic conditions. Regional analysis was conducted at the level of administrative districts (n = 401). Results Overall, 26% of individuals over 15 years were at high risk for a severe COVID-19 course in 2019 amounting to a total number of nearly 18.5 million individuals in Germany. This included 3.8 million individuals in risk group 1, 9.2 million in risk group 2, and 5.4 million in risk group 3, corresponding to 8, 50 and 100% of German inhabitants in the respective age groups. On the level of the 17 administrative regions formed by the Association of SHI Physicians (ASHIP regions), the proportion of individuals at high risk ranged between 21% in Hamburg and 35% in Saxony-Anhalt. Small-area estimates varied between 18% in Freiburg (Baden-Württemberg) and 39% in the district Elbe-Elster (Brandenburg). Conclusions The present study provides small-area estimates of populations at high risk for a severe COVID-19 course. These data are of particular importance for planning of preventive measures such as vaccination. Trial registration not applicable.

scholarly journals A prognostic nomogram based on LASSO Cox regression in patients with alpha-fetoprotein-negative hepatocellular carcinoma following non-surgical therapy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dongdong Zhou ◽  
Xiaoli Liu ◽  
Xinhui Wang ◽  
Fengna Yan ◽  
Peng Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Therapy ◽  
Calibration Curve ◽  
Cox Regression ◽  
Validation Cohort ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Alpha Fetoprotein ◽  
Clinicopathologic Characteristics

Abstract Background Alpha-fetoprotein-negative hepatocellular carcinoma (AFP-NHCC) (< 8.78 ng/mL) have special clinicopathologic characteristics and prognosis. The aim of this study was to apply a new method to establish and validate a new model for predicting the prognosis of patients with AFP-NHCC. Methods A total of 410 AFP-negative patients with clinical diagnosed with HCC following non-surgical therapy as a primary cohort; 148 patients with AFP-NHCC following non-surgical therapy as an independent validation cohort. In primary cohort, independent factors for overall survival (OS) by LASSO Cox regression were all contained into the nomogram1; by Forward Stepwise Cox regression were all contained into the nomogram2. Nomograms performance and discriminative power were assessed with concordance index (C-index) values, area under curve (AUC), Calibration curve and decision curve analyses (DCA). The results were validated in the validation cohort. Results The C-index of nomogram1was 0.708 (95%CI: 0.673–0.743), which was superior to nomogram2 (0.706) and traditional modes (0.606–0.629). The AUC of nomogram1 was 0.736 (95%CI: 0.690–0.778). In the validation cohort, the nomogram1 still gave good discrimination (C-index: 0.752, 95%CI: 0.691–0.813; AUC: 0.784, 95%CI: 0.709–0.847). The calibration curve for probability of OS showed good homogeneity between prediction by nomogram1 and actual observation. DCA demonstrated that nomogram1 was clinically useful. Moreover, patients were divided into three distinct risk groups for OS by the nomogram1: low-risk group, middle-risk group and high-risk group, respectively. Conclusions Novel nomogram based on LASSO Cox regression presents more accurate and useful prognostic prediction for patients with AFP-NHCC following non-surgical therapy. This model could help patients with AFP-NHCC following non-surgical therapy facilitate a personalized prognostic evaluation.

The Politics of Part-Time Work: Gender, Employment Status, and Preferences for Redistribution

2020 ◽  
pp. 1-38
Author(s):  
David S. Pedulla ◽  
Michael J. Donnelly
Keyword(s):  
Employment Status ◽  
General Social Survey ◽  
The United States ◽  
Limited Attention ◽  
Full Time ◽  
Cross Sectional ◽  
Preferences For Redistribution ◽  
Time Work ◽  
Part Time ◽  
Part Time Work

Abstract The social and economic forces that shape attitudes toward the welfare state are of central concern to social scientists. Scholarship in this area has paid limited attention to how working part-time, the employment status of nearly 20% of the U.S. workforce, affects redistribution preferences. In this article, we theoretically develop and empirically test an argument about the ways that part-time work, and its relationship to gender, shape redistribution preferences. We articulate two gender-differentiated pathways—one material and one about threats to social status—through which part-time work and gender may jointly shape individuals’ preferences for redistribution. We test our argument using cross-sectional and panel data from the General Social Survey in the United States. We find that the positive relationship between part-time employment, compared to full-time employment, and redistribution preferences is stronger for men than for women. Indeed, we do not detect a relationship between part-time work and redistribution preferences among women. Our results provide support for a gendered relationship between part-time employment and redistribution preferences and demonstrate that both material and status-based mechanisms shape this association.

Nurses’ Experiences of Transitional Care in Multiple Chronic Conditions

2021 ◽  
pp. 108482232110021
Author(s):  
Alireza Nikbakht Nasrabadi ◽  
Leila Mardanian Dehkordi ◽  
Fariba Taleghani
Keyword(s):  
Patient Safety ◽  
Data Collection ◽  
Continuity Of Care ◽  
Chronic Conditions ◽  
Transitional Care ◽  
Major Elements ◽  
Study Data ◽  
Multiple Chronic Conditions ◽  
University Hospitals ◽  
Levels Of Care

Transitional care is a designed plan to ensure the continuity of care received by patients as they transfer between different locations or levels of care. The aim of this paper is to explore nurses’ experiences of transitional care in multiple chronic conditions. A qualitative method with a conventional content analysis approach was utilized. The study was conducted at university hospitals in 2 big cities (Isfahan and Tehran) of Iran. This study is performed from November 2018 to December 2019 using deep, semi-structured, and face-to-face interviews which are focused on nurses’ experiences of transitional care. Data collection continued until saturation was reached. Finally, 15 nurses take part in this study. Data collection and data analysis were conducted concurrently. Data were analyzed using Graneheim and Lundman’s techniques. Two main themes providing a descriptive summary of the major elements of transitional care identified: “threat to patient safety” and “Care breakdown”. Findings showed an exclusive image of unsafe transitional care which was done unplanned without appropriate delegating care to family and threat patient safety. There is still a gap in the transition from hospital to home. Nursing managers can address this issue by creating a culture of teamwork, training competent nurses by continuum education, and more supervision of nursing care. Policymakers can ensure continuity of care by developing policies and programs about transitional care.

scholarly journals Quantitative proteomic analysis of aberrant expressed lysine acetylation in gastrointestinal stromal tumors

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Bo Wang ◽  
Long Zhao ◽  
Zhidong Gao ◽  
Jianyuan Luo ◽  
Haoran Zhang ◽  
...  
Keyword(s):  
Risk Group ◽  
Risk Groups ◽  
Quantitative Information ◽  
Differentially Expressed ◽  
High Rate ◽  
Lysine Acetylation ◽  
Kegg Pathways ◽  
Tandem Mass Tag ◽  
Cell Components ◽  
Nih Classification

Abstract Background Gastrointestinal stromal tumor (GIST) is a common digestive tract tumor with high rate of metastasis and recurrence. Currently, we understand the genome, transcriptome and proteome in GIST. However, posttranscriptional modification features in GIST remain unclear. In the present study, we aimed to construct a complete profile of acetylome in GIST. Methods Five common protein modifications, including acetylation, succinylation, crotonylation, 2-hydroxyisobutyrylation, and malonylation were tested among GIST subgroups and significantly differentially- expressed lysine acetylation was found. The acetylated peptides labeled with Tandem Mass Tag (TMT)under high sensitive mass spectrometry, and some proteins with acetylation sites were identified. Subsequently, these proteins and peptides were classified into high/moderate (H/M) risk and low (L) risk groups according to the modified NIH classification standard. Furthermore, cell components, molecular function, biological processes, KEGG pathways and protein interaction networks were analyzed. Results A total of 2904 acetylation sites from 1319 proteins were identified, of which quantitative information of 2548 sites from 1169 proteins was obtained. Finally, the differentially-expressed lysine acetylation sites were assessed and we found that 42 acetylated sites of 38 proteins were upregulated in the H/M risk group compared with the L risk group, while 48 acetylated sites of 44 proteins were downregulated, of which Ki67 K1063Ac and FCHSD2 K24Ac were the two acetylated proteins that were most changed. Conclusions Our novel findings provide further understanding of acetylome in GIST and might demonstrate the possibility in the acetylation targeted diagnosis and therapy of GIST.

scholarly journals Swāsthya, an integrated chronic condition management programme for families of patients with hypertension and diabetes mellitus: a study protocol for a randomised controlled trial

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
M D Saju ◽  
Bindiya M Varghese ◽  
Lorane Scaria ◽  
Anuja Maria Benny ◽  
Shilpa V Yohannan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Randomised Controlled Trial ◽  
Social Cohesion ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Controlled Trial ◽  
Risk Groups ◽  
Care Model ◽  
Randomised Controlled

Abstract Background Kerala is known as the diabetes mellitus (DM) and hypertension (HTN) capital of the world, thus compelling health professionals to model strategies, addressing their social, behavioural, and cognitive risk factors and eliminating various barriers to management. This paper describes the protocol of our study that aims to examine the effectiveness and sustainability of an integrated care model for the management of chronic conditions and their risk factors through a family-based intervention. The proposed care model targets to modify systems and processes that predispose to chronic conditions by enhancing social cohesion and social networks, preventing lifestyle risks, developing iterative cognitive interventions, and engaging the family into customised treatment adherence strategies navigated by community health social workers (CHSWs). Methods A cluster randomised controlled trial (RCT) in selected participants will be conducted involving additional assessments prior to the baseline assessment. The assessment will identify and categorise patients into four risk groups, namely behavioural, social, cognitive, and multiple, based on dominant risks identified. Eligible participants will be randomly allocated (at a ratio of 1:1) into the intervention or control arm. The intervention arm will receive social, behavioural, and cognitive or multiple interventions corresponding to the identified risk groups, whereas the control arm will receive general intervention. Both the groups will be followed up at 6 months and 12 months post baseline to measure outcomes. The primary outcome will be the control of HTN and DM, and secondary outcomes include decreased depression and anxiety and improved functioning, social cohesion, and social network linkages. The sustainability and scalability of this intervention will be assessed through cost effectiveness, acceptability, and user friendliness of the integrated approach by performing a qualitative evaluation. Discussion This RCT will inform the potential paradigm shift from a medical model of chronic condition management to a multidimensional, multisystem, and multidisciplinary convergence model navigated by CHSWs. Such a model is not currently considered in the management of chronic conditions in Kerala. Trial registration Trial has been prospectively registered on Clinical Trial Registry of India- CTRI/2020/12/029474 on 1st December 2020.

Short-term risk stratification using CADILLAC risk score in patients with ST elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Satou ◽  
H Kitahara ◽  
K Ishikawa ◽  
T Nakayama ◽  
Y Fujimoto ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Risk ◽  
Adverse Events ◽  
Risk Score ◽  
Risk Group ◽  
Risk Groups ◽  
Low Risk ◽  
Short Term ◽  
Recurrent Myocardial Infarction ◽  
St Elevation

Abstract Background The recent reperfusion therapy for ST-elevation myocardial infarction (STEMI) has made the length of hospital stay shorter without adverse events. CADILLAC risk score is reportedly one of the risk scores predicting the long-term prognosis in STEMI patients. Purpose To invenstigate the usefulness of CADILLAC risk score for predicting short-term outcomes in STEMI patients. Methods Consecutive patients admitted to our university hospital and our medical center with STEMI (excluding shock, arrest case) who underwent primary PCI between January 2012 and April 2018 (n=387) were enrolled in this study. The patients were classified into 3 groups according to the CADILLAC risk score: low risk (n=176), intermediate risk (n=87), and high risk (n=124). Data on adverse events within 30 days after hospitalization, including in-hospital death, sustained ventricular arrhythmia, recurrent myocardial infarction, heart failure requiring intravenous treatment, stroke, or clinical hemorrhage, were collected. Results In the low risk group, adverse events within 30 days were significantly less observed, compared to the intermediate and high risk groups (n=13, 7.4% vs. n=13, 14.9% vs. n=58, 46.8%, p&lt;0.001). In particular, all adverse events occurred within 3 days in the low risk group, although adverse events, such as heart failure (n=4), recurrent myocardial infarction (n=1), stroke (n=1), and gastrointestinal bleeding (n=1), were substantially observed after day 4 of hospitalization in the intermediate and high risk groups. Conclusions In STEMI patients with low CADILLAC risk score, better short-term prognosis was observed compared to the intermediate and high risk groups, and all adverse events occurred within 3 days of hospitalization, suggesting that discharge at day 4 might be safe in this study population. CADILLAC risk score may help stratify patient risk for short-term prognosis and adjust management of STEMI patients. Initial event occurrence timing Funding Acknowledgement Type of funding source: None

scholarly journals Gains in employment status following antidepressant medication or cognitive therapy for depression

2015 ◽  
Vol 206 (4) ◽  
pp. 332-338 ◽  
Author(s):  
Jay C. Fournier ◽  
Robert J. DeRubeis ◽  
Jay Amsterdam ◽  
Richard C. Shelton ◽  
Steven D. Hollon
Keyword(s):  
Cognitive Therapy ◽  
Employment Status ◽  
Antidepressant Medication ◽  
Relative Advantage ◽  
Full Time ◽  
Treatment Interaction ◽  
Effect Of Treatment ◽  
Using Data ◽  
A Site ◽  
Full Time Employment

BackgroundDepression can adversely affect employment status.AimsTo examine whether there is a relative advantage of cognitive therapy or antidepressant medication in improving employment status following treatment, using data from a previously reported trial.MethodRandom assignment to cognitive therapy (n = 48) or the selective serotonin reuptake inhibitor paroxetine (n = 93) for 4 months; treatment responders were followed for up to 24 months. Differential effects of treatment on employment status were examined.ResultsAt the end of 28 months, cognitive therapy led to higher rates of full-time employment (88.9%) than did antidepressant medication among treatment responders (70.8%), χ21 = 5.78, P = 0.02, odds ratio (OR) = 5.66, 95% CI 1.16–27.69. In the shorter-term, the main effect of treatment on employment status was not significant following acute treatment (χ21 = 1.74, P = 0.19, OR = 1.77, 95% CI 0.75–4.17); however, we observed a site×treatment interaction (χ21 = 6.87, P = 0.009) whereby cognitive therapy led to a higher rate of full-time employment at one site but not at the other.ConclusionsCognitive therapy may produce greater improvements in employment v. medication, particularly over the longer term.

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