Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya

SARS-Cov-2 infection, a pandemic disease since March 2020, is associated with a high percentage of cardiovascular complications mainly of a thromboembolic (TE) nature. Although clinical patterns have been described for the assessment of patients with increased risk, many TE complications occur in patients with apparently moderate risk. Notably, a recent statement from the European Society of Cardiology (ESC) atherosclerosis and vascular biology working group pointed out the key role of vascular endothelium for the recruitment of inflammatory and thrombotic pathways responsible for both disseminated intravascular coagulation and cardiovascular complications. Therefore, a better understanding of the pathophysiological process linking infection to increased TE risk is needed in order to understand the pathways of this dangerous liaison and possibly interrupt it with appropriate treatment. In this review, we describe the histological lesions and the related blood coagulation mechanisms involved in COVID-19, we define the laboratory parameters and clinical risk factors associated with TE events, and propose a prophylactic anticoagulation treatment in relation to the risk category. Finally, we highlight the concept that a solid risk assessment based on prospective multi-center data would be the challenge for a more precise risk stratification and more appropriate treatment.

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Individual- and Community-Level Risk Factors Associated with Childhood Diarrhea in Ethiopia: A Multilevel Analysis of 2016 Ethiopia Demographic and Health Survey

International Journal of Pediatrics ◽

10.1155/2021/8883618 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Setegn Muche Fenta ◽

Teshager Zerihun Nigussie

Keyword(s):

Risk Factors ◽

Drinking Water ◽

Health Survey ◽

Community Level ◽

World Health ◽

Childhood Diarrhea ◽

Individual Level ◽

Factors Associated ◽

Health Organization ◽

The Individual

Background. Diarrhea is the second cause of child deaths globally. According to World Health Organization reports, in each year, it kills more than 525,000 children under 5 years. More than half of these deaths occur in five countries including Ethiopia. This study is aimed at identifying both individual- and community-level risk factors of childhood diarrhea in Ethiopia. Methods. Ethiopian demography and health survey of 2016 data were used for the analysis. A total of 10,641 children aged 0–59 months were included in the analysis. A multilevel mixed-effects logistic regression model was used to identify both individual- and community-level risk factors associated with childhood diarrhea. Result. The incidence of childhood diarrhea was 12% (95% CI: 11.39, 12.63). The random-effects model revealed that 67% of the variability of childhood diarrhea was explained by individual- and community-level factors. From the individual-level factors, children aged 36–59 months ( AOR = 3.166 ; 95% CI: 2.569, 3.900), twin child ( AOR = 1.871 ; 95% CI: 1.390, 2.527), birth order 5 and above ( AOR = 2.210 , 95% CI: 1.721, 2.839), not received any vaccination ( AOR = 1.197 ; 95% CI: 1.190, 1.527), smaller size of child at birth ( AOR = 1.303 ; 95% CI: 1.130, 1.504), and never breastfed children ( AOR = 2.91 ; 95% CI: 2.380, 3.567) associated with the higher incidence of childhood diarrhea. From the community-level factors, living in a rural area ( AOR = 1.505 ; 95% CI: 1.233, 1.836)), unprotected source of drinking water ( AOR = 1.289 ; 95% CI: 1.060, 1.567), and availability of unimproved latrine facilities (OR: 1.289; 95% CI: 1.239, 1.759) associated with the higher incidence of childhood diarrhea. Besides, children who live in Afar, Amhara, Benishangul-Gumuz, Gambella, SNNPR, and Dire Dawa regions had higher incidence of childhood diarrhea. Conclusion. The incidence of childhood diarrhea was different from cluster to cluster in Ethiopia. Therefore, integrated child health intervention programs including provisions of toilet facility, access to a clean source of drinking water, educate parents about the importance of breastfeeding, and vaccination have to be strongly implemented in order to reduce the high incidence of childhood diarrhea among children in Ethiopia.

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404 - Factors associated with diagnostic delay in younger-onset dementia iagnostic delay in younger-onset dementia

International Psychogeriatrics ◽

10.1017/s1041610221001630 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 31-31

Author(s):

Samantha M. Loi ◽

Anita M. Goh ◽

Dhamidhu Eratne ◽

Ramon Mocellin ◽

Sarah Farrand ◽

...

Keyword(s):

Symptom Onset ◽

Age Of Onset ◽

Genetic Disorders ◽

Diagnostic Delay ◽

Royal Melbourne Hospital ◽

Factors Associated ◽

Dementia Patients ◽

Appropriate Treatment ◽

Younger Age ◽

Niemann Pick

Background:Younger-onset dementia (YOD) is a dementia of which symptom onset occurs at 65 years or less. There are approximately 27000 people in Australia with a YOD and the causes can range from Alzheimer’s dementia (AD), frontotemporal dementia (FTD), metabolic and genetic disorders. It is crucial to obtain a definitive diagnosis as soon as possible in order for appropriate treatment to take place and future planning. Previous research has reported 4-5 years to get a diagnosis (Draper et al. 2016) and factors associated with delay include younger age (van Vliet et al. 2013) and psychiatric comorbidity (Draper et al. 2016). We report on our experience of diagnostic delay.Methods:This was a retrospective file review of 10 years of inpatients from Neuropsychiatry, Royal Melbourne Hospital, Australia. Neuropsychiatry is a tertiar service which provides assessment of people with cognitive, psychiatric, neurological and behavioural symptoms. Factors such as age of onset, number of services/specialists seen were extracted and analysed using multivariate regression.Results:Of the 306 individual patients who had a YOD, these were grouped into the major dementia groups (such as AD, FTD, Huntington’s disease, vascular dementia, alcohol-related dementia). The most commonly occurring dementia was AD (24.2%), followed by FTD (23%). There was an average of 3.7 years (SD=2.6), range 0.5-15 years, of delay to diagnosis. Cognitive impairment, as measured using the Neuropsychiatry Unit Cognitive Assessment (NUCOG) was moderate, with a mean score of 68.9 (SD=17.9). Within the groups of dementia, patients with Niemann-Pick type C (NPC) had the longest delay to diagnosis F(11,272)=3.677, p<0.0001, with 6.3 years delay. Age of symptom onset and number of specialists/services seen were the significant predictors of delay to diagnosis F(7, 212)=3.975, p<0.001, R211.6.Discussion and conclusions:This was an eclectic group of people with YOD. The results of regression suggests that there are other factors which contribute to the delay, which are not just demographic related. Rarer disorders, such as NPC which present at an early age, and present with symptoms that are not cognitive in nature, can contribute to diagnostic delay.

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Fortune Favors the Brave: Tactical Behaviors in the Middle-Distance Running Events at the 2017 IAAF World Championships

International Journal of Sports Physiology and Performance ◽

10.1123/ijspp.2018-0055 ◽

2018 ◽

Vol 13 (10) ◽

pp. 1386-1391 ◽

Cited By ~ 9

Author(s):

Arturo Casado ◽

Andrew Renfree

Keyword(s):

International Association ◽

Rank Order ◽

Intermediate Position ◽

Performance Characteristics ◽

Distance Running ◽

Factors Associated ◽

Performance Factors ◽

Early Stages ◽

Shared Variance ◽

And Performance

Purpose:To assess tactical and performance factors associated with progression from qualification rounds in the 800-m and 1500-m running events at the 2017 International Association of Athletics Federations World Championships.Methods:Official results were used to access final and intermediate positions and times, as well as performance characteristics of competitors. Shared variance between intermediate positions and rank order lap times with finishing positions were calculated, along with probability of automatic qualification, for athletes in each available race position at the end of every 400-m lap. Differences in race positions and lap times relative to season’s best performances were assessed between automatic qualifiers, fastest losers, and nonqualifiers.Results:Race positions at the end of each 400-m lap remained more stable through 800-m races than 1500-m races. Probability of automatic qualification decreased with both race position and rank order lap times on each lap, although rank order lap times accounted for a higher degree of shared variance than did intermediate position. In the 1500-m event, fastest losers ran at a higher percentage of season’s best speed and adopted positions closer to the race lead in the early stages. This was not the case in the 800-m.Conclusions:Intermediate positioning and the ability to produce a fast final race segment are strongly related to advancement from qualification rounds in middle-distance running events. The adoption of a more “risky” strategy characterized by higher speeds relative to season’s best may be associated with an increased likelihood of qualification as fastest losers in the 1500-m event.

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