scholarly journals Neonatal resuscitation: EN-BIRTH multi-country validation study

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Ashish KC ◽  
◽  
Kimberly Peven ◽  
Shafiqul Ameen ◽  
Georgina Msemo ◽  
...  
Keyword(s):  
Time Pressure ◽  
Health Workers ◽  
Neonatal Resuscitation ◽  
Population Based ◽  
Absolute Difference ◽  
Individual Level ◽  
Survey Report ◽  
Labour Ward ◽  
Sensitivity Specificity ◽  
Bag Mask Ventilation

Abstract Background Annually, 14 million newborns require stimulation to initiate breathing at birth and 6 million require bag-mask-ventilation (BMV). Many countries have invested in facility-based neonatal resuscitation equipment and training. However, there is no consistent tracking for neonatal resuscitation coverage. Methods The EN-BIRTH study, in five hospitals in Bangladesh, Nepal, and Tanzania (2017–2018), collected time-stamped data for care around birth, including neonatal resuscitation. Researchers surveyed women and extracted data from routine labour ward registers. To assess accuracy, we compared gold standard observed coverage to survey-reported and register-recorded coverage, using absolute difference, validity ratios, and individual-level validation metrics (sensitivity, specificity, percent agreement). We analysed two resuscitation numerators (stimulation, BMV) and three denominators (live births and fresh stillbirths, non-crying, non-breathing). We also examined timeliness of BMV. Qualitative data were collected from health workers and data collectors regarding barriers and enablers to routine recording of resuscitation. Results Among 22,752 observed births, 5330 (23.4%) babies did not cry and 3860 (17.0%) did not breathe in the first minute after birth. 16.2% (n = 3688) of babies were stimulated and 4.4% (n = 998) received BMV. Survey-report underestimated coverage of stimulation and BMV. Four of five labour ward registers captured resuscitation numerators. Stimulation had variable accuracy (sensitivity 7.5–40.8%, specificity 66.8–99.5%), BMV accuracy was higher (sensitivity 12.4–48.4%, specificity > 93%), with small absolute differences between observed and recorded BMV. Accuracy did not vary by denominator option. < 1% of BMV was initiated within 1 min of birth. Enablers to register recording included training and data use while barriers included register design, documentation burden, and time pressure. Conclusions Population-based surveys are unlikely to be useful for measuring resuscitation coverage given low validity of exit-survey report. Routine labour ward registers have potential to accurately capture BMV as the numerator. Measuring the true denominator for clinical need is complex; newborns may require BMV if breathing ineffectively or experiencing apnoea after initial drying/stimulation or subsequently at any time. Further denominator research is required to evaluate non-crying as a potential alternative in the context of respectful care. Measuring quality gaps, notably timely provision of resuscitation, is crucial for programme improvement and impact, but unlikely to be feasible in routine systems, requiring audits and special studies.

scholarly journals The Effect of Surrounding Greenness on Type 2 Diabetes Mellitus: A Nationwide Population-Based Cohort in Taiwan

2020 ◽  
Vol 18 (1) ◽  
pp. 267
Author(s):  
Hui-Ju Tsai ◽  
Chia-Ying Li ◽  
Wen-Chi Pan ◽  
Tsung-Chieh Yao ◽  
Huey-Jen Su ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
Population Based ◽  
Research Database ◽  
Individual Level ◽  
The Relationship

This study determines whether surrounding greenness is associated with the incidence of type 2 diabetes Mellitus (T2DM) in Taiwan. A retrospective cohort study determines the relationship between surrounding greenness and the incidence of T2DM during the study period of 2001–2012 using data from the National Health Insurance Research Database. The satellite-derived normalized difference vegetation index (NDVI) from the global MODIS database in the NASA Earth Observing System is used to assess greenness. Cox proportional hazard models are used to determine the relationship between exposure to surrounding greenness and the incidence of T2DM, with adjustment for potential confounders. A total of 429,504 subjects, including 40,479 subjects who developed T2DM, were identified during the study period. There is an inverse relationship between exposure to surrounding greenness and the incidence of T2DM after adjustment for individual-level covariates, comorbidities, and the region-level covariates (adjusted HR = 0.81, 95% CI: 0.79–0.82). For the general population of Taiwan, greater exposure to surrounding greenness is associated with a lower incidence of T2DM.

scholarly journals How does area-level deprivation depress an individual’s self-rated health and life satisfaction? Evidence from a nationwide population-based survey in Japan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takashi Oshio ◽  
Hiromi Kimura ◽  
Toshimi Nishizaki ◽  
Takashi Omori
Keyword(s):  
Life Satisfaction ◽  
Health Behavior ◽  
Well Being ◽  
Population Based ◽  
Internet Survey ◽  
Subjective Well Being ◽  
Individual Level ◽  
Self Rated Health ◽  
Level Data ◽  
The Impact

Abstract Background Area-level deprivation is well known to have an adverse impact on mortality, morbidity, or other specific health outcomes. This study examined how area-level deprivation may affect self-rated health (SRH) and life satisfaction (LS), an issue that is largely understudied. Methods We used individual-level data obtained from a nationwide population-based internet survey conducted between 2019 and 2020, as well as municipality-level data obtained from a Japanese government database (N = 12,461 living in 366 municipalities). We developed multilevel regression models to explain an individual’s SRH and LS scores using four alternative measures of municipality-level deprivation, controlling for individual-level deprivation and covariates. We also examined how health behavior and interactions with others mediated the impact of area-level deprivation on SRH and LS. Results Participants in highly deprived municipalities tended to report poorer SRH and lower LS. For example, when living in municipalities falling in the highest tertile of municipality-level deprivation as measured by the z-scoring method, SRH and LS scores worsened by a standard deviation of 0.05 (p < 0.05) when compared with those living in municipalities falling in the lowest tertile of deprivation. In addition, health behavior mediated between 17.6 and 33.1% of the impact of municipality-level deprivation on SRH and LS, depending on model specifications. Conclusion Results showed that area-level deprivation modestly decreased an individual’s general health conditions and subjective well-being, underscoring the need for public health policies to improve area-level socioeconomic conditions.

Vicarious trauma: Strategies for legal practice and law schools

2021 ◽  
pp. 1037969X2199985
Author(s):  
Kelley Burton ◽  
Amanda Paton
Keyword(s):  
Mental Health ◽  
Vicarious Trauma ◽  
Health Workers ◽  
Mental Health Workers ◽  
Future Research ◽  
First Year ◽  
Helping Professionals ◽  
Legal Practice ◽  
Law Schools ◽  
Individual Level

We examine the effect of vicarious trauma on various stakeholders in the legal profession. Criminal lawyers are likely to experience higher levels of vicarious trauma than other lawyers. Additionally, lawyers are at a heightened risk of vicarious trauma compared to other helping professionals such as mental health workers. We identify a range of strategies that can be implemented at an organisational or individual level to address vicarious trauma. Future research should evaluate the effectiveness of vicarious trauma strategies and initiatives. Importantly, we argue that vicarious trauma initiatives should begin in first-year law courses and continue over a career.

Abstract WP199: Higher Stroke Prevalence Rates among Ribeirinhos Compared to Townsmen in the Brazilian Amazon.

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Tiotrefis G Fernandes ◽  
Isabela M Bensenor ◽  
Paulo A Lotufo
Keyword(s):  
Urban Area ◽  
Health Workers ◽  
Prevalence Ratio ◽  
Epidemiological Studies ◽  
Population Based ◽  
Cerebrovascular Diseases ◽  
Prevalence Rates ◽  
Family Health Program ◽  
Stroke Prevalence ◽  
The Family

There is a lack of epidemiological studies addressing cerebrovascular diseases in remote places as the Amazon river basin. We aimed to calculate the stroke prevalence rates among "ribeirinhos", rural inhabitants who living in riverbanks fishing and extracting fruit and nuts, in the rainforest comparing to townsmen in the same municipality. Methods: From May to October 2011, 6216 residents aged over 35 years in the of Coari, a municipality that is coverage by the Family Health Program with of 76 000 inhabitants, 35% of them are "ribeirinhos”. We trained all community health workers to carry out a door-to-door application of the “Stroke Symptom Questionnaire” for people over 35 years-old. This tool was applied first for the family for stroke screening and further for the index stroke case, including questions about six key functional impairment. It was previously translated to Portuguese and validated by a neurologist. Results: From a total of of 4897 respondents of urban area and 1028 "ribeirinhos", we calculated crude prevalence of stroke of 6.3% (95% CI; 5.0-7.7) among the "ribeirinhos" and of 3.7% (95% CI; 3.3-4.1) among townsmen. This difference was maintained after sex-age-adjustment. The female:male prevalence ratio was 1.37 (95% CI; 1.02-1.85) in urban area and the rural area of 0.93 (95% CI; 0.57-1.52). Among stroke suffers, the "ribeirinhos" were those with less access to medical care (32.1% vs. 52.5%, p=0.01) and a lower proportion of stroke survivors requiring help with least 1 activity of daily living (16.9% vs. 39.3%, p=0.001) in comparison to townsmen. Conclusion: To our knowledge it was the first study that provided a population-based stroke survey in the Amazon rainforest revealing a higher stroke prevalence among "ribeirinhos" compared to townsmen of the same municipality.

scholarly journals Predicting the duration of sickness absence spells due to back pain: a population-based study from Sweden

2019 ◽  
Vol 77 (2) ◽  
pp. 115-121
Author(s):  
Annina Ropponen ◽  
Katalin Gémes ◽  
Paolo Frumento ◽  
Gino Almondo ◽  
Matteo Bottai ◽  
...  
Keyword(s):  
Back Pain ◽  
Sickness Absence ◽  
A Priori ◽  
Population Based ◽  
Final Model ◽  
Individual Level ◽  
Discriminatory Accuracy ◽  
C Statistic ◽  
International Statistical Classification ◽  
The Individual

ObjectivesWe aimed to develop and validate a prediction model for the duration of sickness absence (SA) spells due to back pain (International Statistical Classification of Diseases and Related Health Problems 10th Revision: M54), using Swedish nationwide register microdata.MethodsInformation on all new SA spells >14 days from 1 January 2010 to 30 June 2012 and on possible predictors were obtained. The duration of SA was predicted by using piecewise constant hazard models. Nine predictors were selected for the final model based on a priori decision and log-likelihood loss. The final model was estimated in a random sample of 70% of the SA spells and later validated in the remaining 30%.ResultsOverall, 64 048 SA spells due to back pain were identified during the 2.5 years; 74% lasted ≤90 days, and 9% >365 days. The predictors included in the final model were age, sex, geographical region, employment status, multimorbidity, SA extent at the start of the spell, initiation of SA spell in primary healthcare and number of SA days and specialised outpatient healthcare visits from the preceding year. The overall c-statistic (0.547, 95% CI 0.542 to 0.552) suggested a low discriminatory capacity at the individual level. The c-statistic was 0.643 (95% CI 0.634 to 0.652) to predict >90 days spells, 0.686 (95% CI 0.676 to 0.697) to predict >180 spells and 0.753 (95% CI 0.740 to 0.766) to predict >365 days spells.ConclusionsThe model discriminates SA spells >365 days from shorter SA spells with good discriminatory accuracy.

scholarly journals Prevalence of eczema among older persons: A population-based cross-sectional study

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Vijayan Neena ◽  
Neelakandhan Asokan ◽  
Rajany Jose ◽  
A. Sarin
Keyword(s):  
Older Persons ◽  
Health Workers ◽  
Age Groups ◽  
Medical Knowledge ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Community Based Interventions ◽  
Community Based ◽  
Cross Sectional ◽  
Lichen Simplex Chronicus

Background: There are very few population-based studies on the prevalence of eczema among older persons Aims: To estimate the prevalence and types of eczema in those aged 65 years or more in the community and to evaluate the effectiveness of community-based interventions for case finding. Methods: In the first stage of this cross-sectional survey, trained health workers of a non-governmental organization surveyed the eligible population and identified persons likely to have eczema. In the second stage, dermatologists examined such persons to ascertain the diagnosis. Statistical analysis was done using Epi Info software version 7. Prevalence of eczema was expressed in percentages. Chi-square test was used for comparing the difference in prevalence of eczema in various age groups and sex. Results: Health workers identified 98 persons as possible cases of eczema after interviewing 385 older persons in the community. Among them 95 persons were examined by dermatologists and 44 were confirmed to have eczema (diagnostic accuracy of health workers = 46.3%).Point prevalence of eczema was 11.4% (44/385). Prevalence was similar in males and females. It was greater (18.2 %) among persons aged 81 years or more. Asteatotic eczema, gravitational eczema and lichen simplex chronicus were the more common types of eczema. Limitations: Possible underestimation of the prevalence rates due to limited medical knowledge of health workers; limited facilities for examination and investigations at the medical camps and home visits. Conclusion: There appears to be a considerable burden of eczema among older persons in the community. A community-based approach involving non-governmental organizations has the potential to identify cases and offer care close to their homes.

scholarly journals Cohort Profile: The China Multi-Ethnic Cohort (CMEC) Study

2020 ◽  
Author(s):  
Xing Zhao ◽  
Feng Hong ◽  
Jianzhong Yin ◽  
Wenge Tang ◽  
Gang Zhang ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Disease Incidence ◽  
Data Access ◽  
Population Based ◽  
Baseline Survey ◽  
Individual Level ◽  
Long Term Storage ◽  
Level Data ◽  
The Individual ◽  
Study Participants

AbstractCohort purposeThe China Multi-Ethnic Cohort (CMEC) is a community population-based prospective observational study aiming to address the urgent need for understanding NCD prevalence, risk factors and associated conditions in resource-constrained settings for ethnic minorities in China.Cohort BasicsA total of 99 556 participants aged 30 to 79 years (Tibetan populations include those aged 18 to 30 years) from the Tibetan, Yi, Miao, Bai, Bouyei, and Dong ethnic groups in Southwest China were recruited between May 2018 and September 2019.Follow-up and attritionAll surviving study participants will be invited for re-interviews every 3-5 years with concise questionnaires to review risk exposures and disease incidence. Furthermore, the vital status of study participants will be followed up through linkage with established electronic disease registries annually.Design and MeasuresThe CMEC baseline survey collected data with an electronic questionnaire and face-to-face interviews, medical examinations and clinical laboratory tests. Furthermore, we collected biological specimens, including blood, saliva and stool, for long-term storage. In addition to the individual level data, we also collected regional level data for each investigation site.Collaboration and data accessCollaborations are welcome. Please send specific ideas to corresponding author at: [email protected].

scholarly journals Higher Ultraviolet Radiation During Early Life Reduces Risk of Childhood Type 1 Diabetes in Boys

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Kate Miller
Keyword(s):  
Type 1 Diabetes ◽  
Ultraviolet Radiation ◽  
Western Australia ◽  
Early Life ◽  
Population Based ◽  
First Year ◽  
Third Trimester ◽  
Individual Level ◽  
First Year Of Life

IntroductionThere is increasing evidence that environmental exposures may be important in the pathogenesis of type 1 diabetes (T1D). Ultraviolet radiation (UVR) is of interest in relation to the development of T1D because of its immunoregulatory actions. Ecological studies testing the correlation between levels of UVR and T1D have shown a significant inverse relationship for both incidence and prevalence. Objectives and Approach We used large linked datasets to test ambient UVR during early life against T1D risk at the individual level. We conducted a nested case-control study using linked data from state-wide administrative datasets and NASA satellites. Cases (n=1819) were all children born in Western Australia from 1980-2014 with a diagnosis of T1D on the population-based Western Australian Children’s Diabetes Database between 0-16 years of age. Controls (n=27 259) were randomly selected from all live births in Western Australia and matched to cases on sex and date of birth. Daily UVR data from NASA satellites, that were date-and location-specific for each individual, were used to estimate total UVR dose for each trimester of pregnancy and the first year of life. ResultsConditional logistic regression showed that T1D risk was 44% lower in boys of mothers with UVR levels in the highest quartile (compared to the lowest quartile) during their third trimester of pregnancy (p=0.04). Higher UVR in the first year of life was also associated with a significantly lower risk of T1D in later childhood among boys. Among girls, there was no evidence of an association between total UVR dose and T1D risk. ConclusionHigher UVR in the third trimester and first year of life appears to interact with sex-specific factors to lower T1D risk among boys (but not girls) in Western Australia.

Can an automated sleep detection algorithm for waist-worn accelerometry replace sleep logs?

2018 ◽  
Vol 43 (10) ◽  
pp. 1027-1032
Author(s):  
Tiago V. Barreira ◽  
Jessica G. Redmond ◽  
Tom D. Brutsaert ◽  
John M. Schuna ◽  
Emily F. Mire ◽  
...  
Keyword(s):  
Detection Algorithm ◽  
Good Evidence ◽  
Mean Difference ◽  
Absolute Difference ◽  
Individual Level ◽  
Wake Time ◽  
Highly Correlated ◽  
Mean Differences ◽  
Dependent Sample ◽  
The Individual

The purpose of this study was to test whether estimates of bedtime, wake time, and sleep period time (SPT) were comparable between an automated algorithm (ALG) applied to waist-worn accelerometry data and a sleep log (LOG) in an adult sample. A total of 104 participants were asked to log evening bedtime and morning wake time and wear an ActiGraph wGT3X-BT accelerometer at their waist for 24 h/day for 7 consecutive days. Mean difference and mean absolute difference (MAD) were computed. Pearson correlations and dependent-sample t tests were used to compare LOG-based and ALG-based sleep variables. Effect sizes were calculated for variables with significant mean differences. A total of 84 participants provided 2+ days of valid accelerometer and LOG data for a total of 368 days. There was no mean difference (p = 0.47) between LOG 472 ± 59 min and ALG SPT 475 ± 66 min (MAD = 31 ± 23 min, r = 0.81). There was no significant mean difference between bedtime (2348 h and 2353 h for LOG and ALG, respectively; p = 0.14, MAD = 25 ± 21 min, r = 0.92). However, there was a significant mean difference between LOG (0741 h) and ALG (0749 h) wake times (p = 0.01, d = 0.11, MAD = 24 ± 21 min, r = 0.92). The LOG and ALG data were highly correlated and relatively small differences were present. The significant mean difference in wake time might not be practically meaningful (Cohen’s d = 0.11), making the ALG useful for sample estimates. MAD, which gives a better estimate of the expected differences at the individual level, also demonstrated good evidence supporting ALG individual estimates.

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