scholarly journals Cannulation technique and complications in arteriovenous fistulas: a Swedish Renal Registry-based cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Karin Staaf ◽  
Anders Fernström ◽  
Fredrik Uhlin
Keyword(s):  
Cohort Study ◽  
Lower Risk ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
National Registry ◽  
The Other ◽  
Arteriovenous Fistulas ◽  
Cannulation Technique ◽  
Using Data ◽  
The Relationship

Abstract Background The four cannulation techniques, rope ladder (RL), area puncture (AP), buttonhole with blunt needles (BHb), and buttonhole with sharp needles (BHs), affects the arteriovenous fistula (AVF) in different ways. The aim of this study was to describe the relationship between the different cannulation techniques and the occurrence of AVF complications. Methods The study was performed as a national registry-based cohort study using data from the Swedish Renal Registry (SRR). Data were collected from January 2014 to October 2019. Seventy of Sweden’s dialysis units participate in the registry. We analyzed a total of 1328 AVFs in this study. The risk of complications was compared between the four different cannulation techniques. The risk of AVF complications was measured by the incidence and incidence rate ratio (IRR). We compared the IRRs of complications between different cannulation techniques. Results BHs is the most common cannulation technique in Sweden. It has been used in 55% of the AVFs at some point during their functional patency. BHb (29%), RL (13%), and AP (3%) has been used less. BHb had the lowest risk of complications compared to the other techniques, and a significantly lower risk of stenosis, infiltration, cannulation difficulties, compared to RL and BHs. Cannulation difficulties were significantly more common using AP compared to BHs, and BHb. Infections were not significantly increased using the buttonhole technique. Conclusions BHb had the lowest risk of complications. Infections were not significantly increased using the buttonhole technique. Dialysis units with a low infection rate may continue to use the buttonhole technique, as the risk of complications is lower.

Ontwikkelingen In Het Gebruik Van Streektalen En Dialecten In De Periode 1995-2003

2006 ◽  
Vol 75 ◽  
pp. 103-113 ◽  
Author(s):  
Geert Driessen
Keyword(s):  
Cohort Study ◽  
Language Proficiency ◽  
The Other ◽  
National Cohort ◽  
Dutch Language ◽  
Using Data ◽  
The One ◽  
Language Areas ◽  
Regional Languages ◽  
The Relationship

Usage of Dutch regional languages and dialects is very much in decline in favour of usage of standard Dutch. This paper analyses the developments in usage in the period 1995-2003 using data from five measurement points of the national cohort study Primai y Education (PRIMA). A total of 35,000 pupils and their parents were involved in this study. In addition, this paper analyses the relationship between usage of regional languages and dialects on the one hand and a number of family demographical characteristics and the children's Dutch language proficiency on the other. The results show that it is imperative to treat the Netherlands not as a whole but to differentiate between language areas. In contrast to the other regional languages and dialects the future of Limburgish seems less gloomy.

Incidence of chronic immune-mediated inflammatory diseases after diagnosis with Kawasaki disease: a population-based cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Stephen G Fung ◽  
Richard Webster ◽  
M Ellen Kuenzig ◽  
Braden D Knight ◽  
Michelle Batthish ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cohort Study ◽  
Liver Disease ◽  
Kawasaki Disease ◽  
Sclerosing Cholangitis ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Population Based ◽  
Immune Mediated ◽  
Increased Risk

Abstract Objectives Kawasaki disease (KD) is an immune-mediated vasculitis of childhood with multi-organ inflammation. We determined the risk of subsequent immune-mediated inflammatory disease (IMID), including arthritis, type 1 diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis and multiple sclerosis. Methods We conducted a matched population-based cohort study using health administrative data from Ontario, Canada. Children aged <18 years born between 1991 and 2016 diagnosed with KD (n = 3753) were matched to 5 non-KD controls from the general population (n = 18 749). We determined the incidence of IMIDs after resolution of KD. Three- and 12-month washout periods were used to exclude KD-related symptoms. Results There was an elevated risk of arthritis in KD patients compared with non-KD controls, starting 3 months after index date [103.0 vs 12.7 per 100 000 person-years (PYs); incidence rate ratio 8.07 (95% CI 4.95, 13.2); hazard ratio 8.08 (95% CI 4.95, 13.2), resulting in the overall incidence of IMIDs being elevated in KD patients (175.1 vs 68.0 per 100 000 PYs; incidence rate ratio 2.58 (95% CI 1.93, 3.43); hazard ratio 2.58, 95% CI 1.94, 3.43]. However, there was no increased risk for diabetes, IBD, autoimmune liver disease, primary sclerosing cholangitis or multiple sclerosis in KD patients. Similar results were observed using a 12-month washout period. Conclusion Children diagnosed with KD were at increased risk of arthritis following the acute KD event, but not other IMIDs. Health-care providers should monitor for arthritis in children following a diagnosis of KD.

scholarly journals Risk of invasive bacterial infections by week of age in infants: prospective national surveillance, England, 2010–2017

2019 ◽  
Vol 104 (9) ◽  
pp. 874-878 ◽  
Author(s):  
Shamez N Ladhani ◽  
Katherine L Henderson ◽  
Berit Muller-Pebody ◽  
Mary E Ramsay ◽  
Andrew Riordan
Keyword(s):  
Staphylococcus Aureus ◽  
National Health Service ◽  
Rate Ratio ◽  
Bacterial Infections ◽  
Incidence Rate Ratio ◽  
Age Distribution ◽  
The Other ◽  
National Surveillance ◽  
Group B ◽  
Prevalent Pathogen

ObjectiveTo estimate the incidence of laboratory-confirmed, invasive bacterial infections (IBIs) by week of age in infants over a 7-year period.DesignAnalysis of prospective national surveillance data for England.SettingNational Health Service hospitals in England.PatientsInfants aged <1 year who were hospitalised with IBI.Main outcome measuresIBI incidence by week of age, incidence rate ratio (IRR) at 8, 12 and 16 weeks compared with the first week of life, and the main pathogens responsible for IBI.ResultsThere were 22 075 IBI episodes between 2010/2011 and 2016/2017. The lowest annual cases were in 2011/2012 (n=2 799; incidence, 412/100 000 population), increasing year-on-year to 3 698 cases in 2016/2017 (incidence, 552/100 000 population). The incidence was highest in the first week of life and then declined rapidly. In 2016/2017, compared with the first week of life, weekly IBI incidence was 92% lower at 8 weeks (IRR 0.08; 95% CI 0.06 to 0.10) and 96% lower at 16 weeks of age (IRR 0.04; 95% CI 0.03 to 0.06). In 2016/2017, Escherichia coli was the most prevalent pathogen responsible for IBI (n=592, 16.0%), followed by group B Streptococci (n=493, 13.3%), Staphylococcus aureus (n=400, 10.8%) and Enterococci (n=304, 8.2%). The other pathogens were individually responsible for <5% of total cases. There were differences in age distribution of the pathogens with increasing age.ConclusionIBI incidence declines rapidly after the first week of life, such that infants have a very low risk of IBI by the time they are eligible for their routine immunisations from 8 weeks of age.

scholarly journals Is paliperidone palmitate more effective than other long-acting injectable antipsychotics?

2017 ◽  
Vol 48 (10) ◽  
pp. 1616-1623 ◽  
Author(s):  
R. Patel ◽  
E. Chesney ◽  
M. Taylor ◽  
D. Taylor ◽  
P. McGuire
Keyword(s):  
Rate Ratio ◽  
Hospital Admissions ◽  
Incidence Rate Ratio ◽  
Psychiatric Inpatient ◽  
The Other ◽  
Paliperidone Palmitate ◽  
Before And After ◽  
Long Acting ◽  
Few Data ◽  
The Uk

AbstractBackgroundPaliperidone palmitate is one of the most widely prescribed long-acting injectable (LAI) antipsychotics in the UK. However, it is relatively expensive and there are few data comparing its effectiveness to that of other LAI antipsychotics. We sought to address this issue by analyzing a large anonymized electronic health record (EHR) dataset from patients treated with LAI antipsychotics.MethodsEHR data were obtained from 1281 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who started treatment with a LAI antipsychotic between 1 April 2011 and 31 January 2015. The number of days spent as a psychiatric inpatient and the number of admissions to a psychiatric hospital were analyzed in each of the 3 years before and after LAI prescription.ResultsPatients treated with paliperidone palmitate (n = 430; 33.6%) had a greater number of inpatient days and a greater number of admissions in the year prior to treatment than those treated with other LAI antipsychotics. Nevertheless, in the 3 years after initiation there were no significant differences between paliperidone and the other LAI antipsychotics in the number of days as an inpatient (B coefficient 5.4 days, 95% confidence interval (CI) −57.3 to 68.2, p = 0.86) or number of hospital admissions (Incidence rate ratio 1.07, 95% CI 0.62 to 1.83, p = 0.82).ConclusionPaliperidone palmitate was more likely to be prescribed in patients with more frequent and lengthy hospital admissions prior to initiation. However, the absence of differences in outcomes after initiation indicates that paliperidone palmitate was not more effective than other cheaper LAI antipsychotics.

Hospital Utilization and Costs in Older Patients with Advanced Chronic Kidney Disease Choosing Conservative Care or Dialysis: A Retrospective Cohort Study

2020 ◽  
Vol 49 (4) ◽  
pp. 479-489
Author(s):  
Wouter R. Verberne ◽  
Gurbey Ocak ◽  
Liesbeth A. van Gils-Verrij ◽  
Johannes J.M. van Delden ◽  
Willem Jan W. Bos
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Incidence Rates ◽  
Hospital Utilization ◽  
Conservative Care ◽  
Outpatient Visits

Background: Nondialytic conservative care has been recognized as a viable alternative to chronic dialysis in older patients with end-stage kidney disease, but little is known about its consequences on hospital utilization and costs. Methods: We performed a retrospective cohort study to compare outpatient and inpatient hospital utilization, place of death, and hospital costs in patients aged ≥70 years old who chose conservative care (n = 100) or dialysis (n = 162) after shared decision making in a nonacademic teaching hospital between 2008 and 2016. Results: Patients who chose conservative care were older than patients who chose dialysis (82.5 vs. 76.3 years). Comorbidity did not differ between the 2 patient groups. The incidence rates of outpatient visits per year were 7.1 in patients who chose conservative care and 10.7 in patients who chose dialysis (incidence rate ratio 0.67, 95% CI 0.55–0.81). The incidence rates of in-hospital days per year were, respectively, 6.0 and 9.8 (incidence rate ratio 0.50, 95% CI 0.29–0.88). Also in the final month of life, patients on conservative care had less outpatient visits, were less frequently hospitalized, and died less frequently in hospital than the dialysis patient group. The cost rates per year, measured from original treatment decision, were EUR 5,859 in conservative care patients and EUR 28,354 in patients who chose dialysis comprising both the predialysis and dialysis period (cost rate ratio 0.42, 95% CI 0.27–0.65). Patients who chose dialysis had higher costs on dialysis sessions, outpatient care, inpatient care, laboratory tests, and medical imaging. Conclusions: Patients who decided to forego dialysis and chose conservative care had less outpatient and inpatient hospital utilization than patients who chose dialysis, including less intensive hospital utilization near the end of life. Both overall and nondialysis-related costs were lower in patients on a conservative care pathway.

scholarly journals Blood pressure, frailty status, and all-cause mortality in elderly hypertensives; The Nambu Cohort Study

2021 ◽  
Author(s):  
Taku Inoue ◽  
Mitsuteru Matsuoka ◽  
Tetsuji Shinjo ◽  
Masahiro Tamashiro ◽  
Kageyuki Oba ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Frailty Status ◽  
Frail Patients ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Using Data ◽  
The Relationship ◽  
Elderly Hypertensives

AbstractAntihypertensive therapy is pivotal for reducing cardiovascular events. The 2019 Guidelines for the Management of Hypertension set a target blood pressure (BP) of <140/90 mmHg for persons older than 75 years of age. Optimal BP levels for older persons with frailty, however, are controversial because evidence for the relationship between BP level and prognosis by frailty status is limited. Here, we evaluated the relationship between systolic BP and frailty status with all-cause mortality in ambulatory older hypertensive patients using data from the Nambu Cohort study. A total of 535 patients (age 78 [70–84] years, 51% men, 37% with frailty) were prospectively followed for a mean duration of 41 (34–43) months. During the follow-up period, 49 patients died. Mortality rates stratified by systolic BP and frailty status were lowest in patients with systolic BP < 140 mmHg and non-frailty, followed by those with systolic BP ≥ 140 mmHg and non-frailty. Patients with frailty had the highest mortality regardless of the BP level. The adjusted hazard ratios (95% confidence intervals) of each category for all-cause mortality were as follows: ≥140 mmHg/Non-frailty 3.19 (1.12–11.40), <140 mmHg/Frailty 4.72 (1.67–16.90), and ≥140 mmHg/Frailty 3.56 (1.16–13.40) compared with <140 mmHg/Non-frailty as a reference. These results indicated that frail patients have a poor prognosis regardless of their BP levels. Non-frail patients, however, with systolic BP levels <140 mmHg had a better prognosis. Frailty may be a marker to differentiate patients who are likely to gain benefit from antihypertensive medication among older hypertensives.

Religion and Support for Democracy in Bosnia-Herzegovina

2012 ◽  
Vol 5 (3) ◽  
pp. 609-633
Author(s):  
Marko Valenta ◽  
Zan Strabac
Keyword(s):  
Negative Influence ◽  
The Other ◽  
The Political ◽  
World Values Survey ◽  
Political Sphere ◽  
Wide Range ◽  
Support For Democracy ◽  
Using Data ◽  
The Relationship ◽  
Different Levels

AbstractThis article examines the relationship between religiosity and support for democracy in Bosnia-Herzegovina. Using data from the last World Values Survey, we examine levels of religiosity among Bosniaks, Serbs, and Croats, and their support for democracy. The influence of religiosity on support for democracy is also explored. The results indicate that religiosity has a negative influence on support for democracy, and it is particularly true for individuals who do not support the separation of the religious from the political sphere and who exhibit lower support for democracy. The article also examines different levels of religiosity among the three groups, controlling for a wide range of variables. We conclude that there is basically no difference in support for democracy between Croats and Bosniaks, while Serbs exhibit somewhat lesser support for democracy than members of the other two ethnic groups. Serbs also seem to be somewhat less religious than Bosniaks and Croats. Opposition to separation of the religious from the political sphere is a major source of lack of support for democracy among Croats and Bosniaks, but not among Serbs.

scholarly journals Anxiety symptoms, cerebral amyloid burden and memory decline in healthy older adults without dementia: 3-year prospective cohort study

2014 ◽  
Vol 204 (5) ◽  
pp. 400-401 ◽  
Author(s):  
Robert H. Pietrzak ◽  
J. Cobb Scott ◽  
Alexander Neumeister ◽  
Yen Ying Lim ◽  
David Ames ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Memory Function ◽  
Beta Amyloid ◽  
Anxiety Symptoms ◽  
Memory Decline ◽  
Healthy Older Adults ◽  
Observational Cohort ◽  
Using Data ◽  
The Relationship

SummaryAlthough beta-amyloid, anxiety and depression have been linked cross-sectionally to reduced memory function in healthy older adults without dementia, prospective data evaluating these associations are lacking. Using data from an observational cohort study of 178 healthy older adults without dementia followed for 3 years, we found that anxiety symptoms significantly moderated the relationship between beta-amyloid level and decline in verbal (Cohen's d = 0.65) and episodic (Cohen's d = 0.38) memory. Anxiety symptoms were additionally linked to greater decline in executive function, irrespective of beta-amyloid and other risk factors. These findings suggest that interventions to mitigate anxiety symptoms may help delay memory decline in otherwise healthy older adults with elevated beta-amyloid.

A Study of Imperative Usage in Biblical Hebrew and English

1998 ◽  
Vol 22 (2) ◽  
pp. 391-446
Author(s):  
John Myhill
Keyword(s):  
Cultural Differences ◽  
Speech Acts ◽  
Speech Act ◽  
Biblical Hebrew ◽  
The Other ◽  
Structural Factors ◽  
Other Hand ◽  
Using Data ◽  
The Relationship ◽  
Interactive Factors

This paper reports the results of a detailed text-based study of the use of Imperative constructions in Biblical Hebrew and English, and shows that the two languages differ significantly in this regard. The use of the English Imperative in the database is conditioned largely by social and interactive factors, e.g. the relationship between the speaker and the listener, their relative social status, the sensitivity of the action of giving the command, the setting of the interaction, who will benefit from the action, etc.; on the other hand, the usage of the Imperative in the Hebrew database is mainly determined by semantic and structural factors, e.g. the point in time when the commanded action is to take place, the linguistic form of the preceding clause, whether the command is the first in a conversation, etc. The clear differences here show that there cannot be any uniform explanation about why Imperatives in general are used, as have been proposed in speech act theory (e.g. Searle 1975); on the other hand, these differences are sufficiently complex that they also cannot be accounted for with simple statements regarding cultural differences (e.g. Blum-Kulka 1991). The results of this study suggest that theories about speech acts should be based not upon philosophical speculations using data from a single language, or upon limited linguistic and cultural data carefully selected to support a particular theory, but upon extensive, detailed, and exhaustive linguistic analysis which will clearly establish the descriptive facts of speech act usage in a variety of languages.

Adherence to street code and violent victimization and delinquent offending of youth in Turkey: An analysis of mediation and moderation effects

2021 ◽  
pp. 147737082110069
Author(s):  
Haci Duru ◽  
Rustu Deryol ◽  
Taner Cam
Keyword(s):  
Incidence Rate ◽  
Rate Ratio ◽  
Incidence Rate Ratio ◽  
Violent Victimization ◽  
Direct And Indirect Effects ◽  
Moderation Effects ◽  
Street Culture ◽  
Lifestyle Measures ◽  
The Relationship ◽  
Mediation And Moderation

In this study, we estimated a model of youth violent victimization and delinquent offending in Turkey using the subculture of violence thesis. Specifically, we employed adherence to street code and risky lifestyle measures to understand the relationship between these factors and the odds of youth violent victimization and the incidence rate ratio of delinquent offending, controlling for social ties such as family and peer-related measures and demographics, in a sample of 2627 students from 18 schools in Bagcilar county of Istanbul, Turkey. Moreover, we also explored the mediation and moderation effects among adherence to street culture and lifestyle measures. We found that risky lifestyle corresponds with higher odds of victimization and a higher incidence rate ratio of offending. Moreover, we found that adherence to street code has direct and indirect effects on offending, but it has only an indirect effect on victimization. In other words, lifestyle measures fully mediated the effect of street culture on victimization. Finally, we also found moderation effects of adherence to street culture on the relationship between lifestyle, victimization, and delinquent offending. Implications of our findings are discussed.

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