Determinants of international variation in the prevalence of disabling wrist and hand pain

Abstract Background Previous research has indicated that wide international variation in the prevalence of disabling low back pain among working populations is largely driven by factors predisposing to musculoskeletal pain more generally. This paper explores whether the same applies to disabling wrist/hand pain (WHP). Methods Using data from the Cultural and Psychosocial Influences on Disability (CUPID) study, we focused on workers from 45 occupational groups (office workers, nurses and other workers) in 18 countries. Among 11,740 participants who completed a baseline questionnaire about musculoskeletal pain and potential risk factors, 9082 (77%) answered a further questionnaire after a mean interval of 14 months, including 1373 (15%) who reported disabling WHP in the month before follow-up. Poisson regression was used to assess associations of this outcome with baseline risk factors, including the number of anatomical sites other than wrist/hand that had been painful in the 12 months before baseline (taken as an index of general propensity to pain). Results After allowance for other risk factors, the strongest associations were with general pain propensity (prevalence rate ratio for an index ≥6 vs. 0: 3.6, 95% confidence interval 2.9–4.4), and risk rose progressively as the index increased. The population attributable fraction for a pain propensity index > 0 was 49.4%. The prevalence of disabling WHP by occupational group ranged from 0.3 to 36.2%, and correlated strongly with mean pain propensity index (correlation coefficient 0.86). Conclusion Strategies to prevent disability from WHP among working populations should explore ways of reducing general propensity to pain, as well as improving the ergonomics of occupational tasks.

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Can risk modelling improve treatment decisions in asymptomatic carotid stenosis?

BMC Neurology ◽

10.1186/s12883-019-1528-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

James F. Burke ◽

Lewis B. Morgenstern ◽

Rodney A. Hayward

Keyword(s):

Risk Factors ◽

Risk Stratification ◽

Risk Model ◽

Absolute Risk ◽

Baseline Risk ◽

Asymptomatic Carotid Stenosis ◽

Asymptomatic Carotid ◽

Treatment Risk ◽

C Statistic ◽

Using Data

Abstract Background Carotid endarterectomy (CEA) is routinely performed for asymptomatic carotid stenosis, yet its average net benefit is small. Risk stratification may identify high risk patients that would clearly benefit from treatment. Methods Retrospective cohort study using data from the Asymptomatic Carotid Atherosclerosis Study (ACAS). Risk factors for poor outcomes were included in backward and forward selection procedures to develop baseline risk models estimating the risk of non-perioperative ipsilateral stroke/TIA. Baseline risk was estimated for all ACAS participants and externally validated using data from the Atherosclerosis Risk in Communities (ARIC) study. Baseline risk was then included in a treatment risk model that explored the interaction of baseline risk and treatment status (CEA vs. medical management) on the patient-centered outcome of any stroke or death, including peri-operative events. Results Three baseline risk factors (BMI, creatinine and degree of contralateral stenosis) were selected into our baseline risk model (c-statistic 0.59 [95% CI 0.54–0.65]). The model stratified absolute risk between the lowest and highest risk quintiles (5.1% vs. 12.5%). External validation in ARIC found similar predictiveness (c-statistic 0.58 [0.49–0.67]), but poor calibration across the risk spectrum. In the treatment risk model, CEA was superior to medical management across the spectrum of baseline risk and the magnitude of the treatment effect varied widely between the lowest and highest absolute risk quintiles (3.2% vs. 10.7%). Conclusion Even modestly predictive risk stratification tools have the potential to meaningfully influence clinical decision making in asymptomatic carotid disease. However, our ACAS model requires target population recalibration prior to clinical application.

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Associations of sickness absence for pain in the low back, neck and shoulders with wider propensity to pain

Occupational and Environmental Medicine ◽

10.1136/oemed-2019-106193 ◽

2020 ◽

Vol 77 (5) ◽

pp. 301-308

Author(s):

David Coggon ◽

Georgia Ntani ◽

Karen Walker-Bone ◽

Vanda E Felli ◽

Raul Harari ◽

...

Keyword(s):

Risk Factors ◽

Sickness Absence ◽

Musculoskeletal Pain ◽

Low Back ◽

Occupational Groups ◽

The Past ◽

Potential Risk Factors ◽

Psychosocial Influences ◽

Absence From Work

ObjectivesTo explore the association of sickness absence ascribed to pain at specific anatomical sites with wider propensity to musculoskeletal pain.MethodsAs part of the CUPID (Cultural and Psychosocial Influences on Disability) study, potential risk factors for sickness absence from musculoskeletal pain were determined for 11 922 participants from 45 occupational groups in 18 countries. After approximately 14 months, 9119 (78%) provided follow-up information about sickness in the past month because of musculoskeletal pain, including 8610 who were still in the same job. Associations with absence for pain at specific anatomical sites were assessed by logistic regression and summarised by ORs with 95% CIs.Results861 participants (10%) reported absence from work because of musculoskeletal pain during the month before follow-up. After allowance for potential confounders, risk of absence ascribed entirely to low back pain (n=235) increased with the number of anatomical sites other than low back that had been reported as painful in the year before baseline (ORs 1.6 to 1.7 for ≥4 vs 0 painful sites). Similarly, associations with wider propensity to pain were observed for absence attributed entirely to pain in the neck (ORs up to 2.0) and shoulders (ORs up to 3.4).ConclusionsSickness absence for pain at specific anatomical sites is importantly associated with wider propensity to pain, the determinants of which extend beyond established risk factors such as somatising tendency and low mood. Better understanding of why some individuals are generally more prone to musculoskeletal pain might point to useful opportunities for prevention.

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Prevalence of Musculoskeletal Disorders Symptoms among Czech Dental Students. Part 1: a Questionnaire Survey

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2018.131 ◽

2018 ◽

Vol 61 (4) ◽

pp. 131-136 ◽

Cited By ~ 1

Author(s):

Martin Kapitán ◽

Nela Pilbauerová ◽

Lenka Vavřičková ◽

Zdeňka Šustová ◽

Stanislav Machač

Keyword(s):

Risk Factors ◽

Musculoskeletal Disorders ◽

Musculoskeletal Pain ◽

Potential Risk ◽

Questionnaire Survey ◽

Dental Students ◽

University Faculty ◽

Lower Back ◽

Potential Risk Factors ◽

Pain Prevalence

Musculoskeletal disorders (MSDs) frequently occur among dentists and dental students. The first aim of this study was to gather and analyze information about the prevalence of symptoms of MSDs. The second aim was to determine a correlation between subjectively described complaints and the results of an objective examination of the spine using the Spinal Mouse® device; that part is described in the second section of this article. Dental students of the first, third and fifth years at Charles University, Faculty of Medicine in Hradec Králové were included. The participants filled out a questionnaire regarding the prevalence of symptoms of MSDs and the potential risk factors. From a total of 182 students that participated in this study, 71 reported musculoskeletal pain (prevalence 39%). The musculoskeletal pain was more frequent among women. During the studies its prevalence increased. The most frequent areas of pain were neck, lower back and upper back. The results indicate that musculoskeletal pain often begins and continues to develop throughout the dentistry studies.

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Predictors of mortality in newborns with esophageal atresia: a 6-year study in a single institution

Paediatrica Indonesiana ◽

10.14238/pi55.3.2015.131-5 ◽

2015 ◽

Vol 55 (3) ◽

pp. 131

Author(s):

Leecarlo Milano ◽

Nunik Agustriani ◽

Rochadi Rochadi

Keyword(s):

Risk Factors ◽

Protective Effect ◽

Esophageal Atresia ◽

Primary Anastomosis ◽

High Morbidity ◽

Chi Square ◽

Factors Associated ◽

Risk Of Death ◽

Potential Risk Factors ◽

Using Data

Background Esophageal atresia, with or without fistula, is a congenital defect that causes high morbidity and mortality in newborns. Risk factors of mortality need to be identified to establish the best approach for treating this condition in order to decrease morbidity and mortality.Objective To identify factors associated with mortality in newborns with oesophageal atresia.Methods We reviewed all newborns with esophageal atresia using data from their medical records at Sardjito General Hospital from January 2007 to December 2012. Potential risk factors were analyzed using Chi-square test, with a level of significance of P<0.05.Results Of 31 newborns that met our criteria, only 5 survived, and all 5 had one-stage surgery (primary anastomosis with fistula ligation). Thrombocytopenia and sepsis increased the risk of death with OR 10.857 (95%CI 1.029 to 114.578) and OR 13.333 (95% CI 1.242 to 143.151), respectively. However, anemia had a protective effect against mortality with OR 0.688 (95%CI 0.494 to 0.957).Conclusion Thrombocytopenia and sepsis are the risk factors associated with mortality in newborns with esophageal atresia at our institution. Anemia has a protective effect against mortality.

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Risk factors associated with the incidence of ketosis in dairy cows

Animal Science ◽

10.1017/s1357729800050372 ◽

1999 ◽

Vol 68 (3) ◽

pp. 379-386 ◽

Cited By ~ 23

Author(s):

L. K. Rasmussent ◽

B. L. Nielsen ◽

J. E. Pryce ◽

T. T. Mottram ◽

R. F. Veerkamp

Keyword(s):

Risk Factors ◽

Dairy Cattle ◽

Body Condition Score ◽

Live Weight ◽

Research Centre ◽

Factors Associated ◽

Condition Score ◽

Potential Risk Factors ◽

Using Data ◽

Available Information

AbstractVarious dairy cattle production and health characteristics were studied with a view to identify easily available and measurable factors associated with the incidence of ketosis. The analyses were carried out using data from the Langhill Dairy Cattle Research Centre. Two approaches were used to assess the relative risk to cows of getting ketosis: one using information known at the beginning of lactation and one using information collected as the lactation progressed. In both approaches analyses were carried out using different amounts of the available information to simulate differences between recording systems. In the first approach the following were found to relate significantly to the level of recorded ketotic incidents: parity; ketosis in the previous lactation; calving condition score; 305-day milk yield in the previous lactation; and the average milk protein percentage in the previous lactation. The effects of these were quantified. In the second approach, where the change in ketosis incidence rate over the weeks of lactation was investigated, the average dry-matter intake in the previous week and changes in live weight and body condition score over the previous week were found to have a significant effect on the probability of getting ketosis in the coming week. The risk assessments varied depending on the information used and a flexible approach is recommended if potential risk factors are to be successfully incorporated into decision support systems.

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Population Attributable fraction Estimation of the Cardiovascular Diseases–related factors: An Evidence from western part of Iran

10.21203/rs.2.20832/v1 ◽

2020 ◽

Author(s):

Zhila Javani ◽

Yahya Salimi ◽

Mahdi Moradinazar ◽

Farid Najafi

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Communicable Disease ◽

Population Attributable Fraction ◽

Directed Acyclic Graphs ◽

Attributable Fraction ◽

General Obesity ◽

Related Factors ◽

The Difference ◽

Using Data

Abstract Background: Cardiovascular diseases are the first cause of deaths and years of lost life due to disability, worldwide. The population attributable fraction has been widely used in literature to quantify an impact of removing risk factors in occurrence of diseases. This study was designed to estimate the population attributable fraction of prevalent cases of cardiovascular diseases associated with different risk factors, using data from people aged 35-65 years old in Ravansar County.Methods: Data of this study came from 9825 adults aged 35-65 years that were included in the study of Ravansar Non-Communicable disease (RaNCD). First, to identify the confounding variables, we did a comprehensive review of the available resources and then presented the relationship between different risk factors with directed acyclic graphs and for any risk factor. Sequential and average adjusted attributable fractions were used. To calculate 95% confidence intervals, the Monte Carlo simulation was conducted. All statistical analyses were performed using the ’averisk’ package in R version 3.4.4.Results: The age adjusted prevalence for cardiovascular diseases was 12.6% (95% CI: 11.9, 13.2%). Among the modifiable predictors of cardiovascular diseases, the highest amount of population attributable fraction after adjusting for age, sex, and other factors associated with cardiovascular diseases, in men were for hypertension 35.7% (95% CI: 30.2, 40.6%), dyslipidemia 12.2% (95% CI: 7.5, 17.6%), general obesity 5.7% (95% CI: -0.7, 11.9%) and for cigarette smoking 4.0% (95% CI: -6.3, 14.6%), and in women were hypertension 42.8% (95% CI: 36.5, 47.3%), general obesity 10.7% (95% CI: 6.2, 15.3%), central obesity 10.1% (95% CI: -7.0, 23.8%) and for dyslipidemia 9.7% (95% CI: 5.1, 14.5%).Conclusion: Due to the difference in the population attributable fraction of cardiovascular diseases- related factors in men and women, it is advisable to prioritize preventive cardiovascular diseases interventions by sex segregation. Special attention should be paid to control hypertension, dyslipidemia in men, and hypertension, general obesity and dyslipidemia in women, and priority should be given to strategies for preventing cardiovascular diseases.

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Outbreak of cutaneous anthrax in Musalimadugu village, Chittoor district, Andhra Pradesh, India, July-August 2011

The Journal of Infection in Developing Countries ◽

10.3855/jidc.2635 ◽

2012 ◽

Vol 6 (10) ◽

pp. 695-699 ◽

Cited By ~ 9

Author(s):

Ramesh Reddy ◽

Geetha Parasadini ◽

Prasada Rao ◽

Chengappa K Uthappa ◽

Manoj V Murhekar

Keyword(s):

Risk Factors ◽

Attack Rate ◽

Andhra Pradesh ◽

Community Education ◽

Population Attributable Fraction ◽

Skin Lesions ◽

Suspected Case ◽

Gram Staining ◽

Potential Risk Factors ◽

Cutaneous Anthrax

Background: In August 2011, Chittoor district authorities reported a cluster of suspected human anthrax cases, to Andhra Pradesh state surveillance unit. We investigated this cluster to confirm its etiology, describe its magnitude, identify potential risk-factors and make recommendations for preventing similar outbreaks in future. Methods: We searched for suspected cutaneous anthrax cases defined as a painless skin lesion (papule, vesicle or eschar) that appeared between July-August 2011 in resident of Musalimadugu. We collected information about clinical details as well as smears from skin lesions from suspected case-patients and described the outbreak by time, place and person.We conducted a retrospective cohort study among villagers aged ≥ 15 years to identify risk factors for acquiring the infection. Results: During 24 June-7August 2011, 16 livestock in the village died. Smears from 5 animals showed gram positive, spore bearing, bacillus characteristic of Bacillus anthracis. Villagers butchered and skinned the dead animals, sold the skin and consumed the meat after boiling it for 2 hours. The outbreak in humans started on 30 July, and 9 suspected cases of cutaneous anthrax (attack rate: 2%, no deaths) occurred till 7 August. The attack rate was higher among those aged 15 years or more. All the smears were negative on gram staining. Persons who had handled [Relative risk (RR): 56, 95% confidence interval (CI): 8.4 -571.8, population attributable fraction (PAF): 87%)], skinned (RR: 28, 95% CI: 8.4-93, PAF=54%) and slaughtered (RR: 21, 95% CI: 6.5-68.4, PAF: 42%) dead animals were at higher risk. Conclusions: We recommended ciprofloxacin prophylaxis to close family contacts, community education to avoid slaughtering of dead/ ill livestock and vaccination of the livestock in the area.

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Hospitalization costs related to long-term management of patients undergoing CABG (PRIORITY project)

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1109 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Pagano ◽

A Evangelista ◽

P D'Errigo ◽

S Rosato ◽

F Seccareccia ◽

...

Keyword(s):

Risk Factors ◽

Artery Bypass ◽

Standard Of Care ◽

Baseline Risk ◽

Hospitalization Costs ◽

Using Data ◽

Intervention Costs ◽

Priority Project

Abstract Background Identifying potential tools that could help improving the standard of care and lead to a better allocation of economic resources represents a main objective of research in public health. Using data from the PRIORITY cohort, this study aims to describe inpatients costs after a discharge for isolated coronary artery bypass surgery (CABG). Methods The PRIORITY project was designed to evaluate the long-term outcomes of 2 large multicenter cohort studies on CABG conducted between 2002-04 and 2007-08. For each patient discharged alive after a CABG intervention, costs of hospitalizations were estimated as the sum of costs of all the admissions occurred during 3 years of follow-up. NHS reimbursement rates were used as standard costs (in Euros). Inpatients costs were analysed according to their baseline risk factors. Results Among the 7363 patients included in this analysis, the median 3-year hospitalization costs were 4341€ (IQR: 1865-11699). Median costs were around 4.000€ for subjects alive at the end of follow up but higher for patients dying within 1 (about 8.600€) and 2-3 years of follow up (about 20.000€). The presence of comorbidities (such as diabetes and cancer) lead to higher median hospitalization costs while the on-pump approach was associated to lower median cost. Sixteen per cent of patients were at zero cost having no re-hospitalizations during the 3 years of follow-up (97% alive). Subjects at zero cost received more frequently on-pump approach, had a lower frequency of cancer, arteriopathy and ictus, but a higher frequency of angina and infarction. Conclusions Inpatient costs after isolated CABG are affected by preoperative comorbidities and by operative variables that could be removed or managed. Identifying independent risk factors for re-hospitalization will lead to the definition of a preoperative clinical and decision-making path that will bring both a clinical advantage for the patient and an optimization of costs for the NHS. Key messages Inpatient costs after isolated CABG are affected by preoperative comorbidities and operative characteristics like the on-pump approach. Appropriate management of operative approaches mainly based on operator preferences can have important implications in terms of healthcare costs.

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Incidence, duration and risk factors associated with missed opportunities to diagnose herpes simplex encephalitis: A population-based longitudinal study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab400 ◽

2021 ◽

Author(s):

Aaron C Miller ◽

Scott Koeneman ◽

Alan T Arakkal ◽

Joseph E Cavanaugh ◽

Philip M Polgreen

Keyword(s):

Risk Factors ◽

Herpes Simplex ◽

Herpes Simplex Encephalitis ◽

Population Based ◽

Missed Opportunities ◽

Potential Risk Factors ◽

Number Of Visits ◽

Using Data ◽

Missed Diagnostic Opportunities ◽

Diagnostic Delays

Abstract Background Delays in diagnosing herpes simplex encephalitis (HSE) are associated with increased morbidity and mortality. The purpose of this paper is to determine the frequency and duration of diagnostic delays for HSE and risk factors for diagnostic delays. Methods Using data from the IBM Marketscan Databases, 2001-2017, we performed a retrospective cohort study of patients with HSE. We estimated the number of visits with HSE-related symptoms prior to diagnosis that would be expected to occur in the absence of delays and compared this estimate to the observed pattern of visits. Next, we used a simulation-based approach to compute the number of visits representing a delay, the number of missed diagnostic opportunities per case patient and the duration of delays. We also investigated potential risk factors for delays. Results We identified 2667 patients diagnosed with HSE. We estimated 45.9% (95% CI 43.6%-48.1%) of patients experienced at least one missed opportunity; 21.9% (95% CI 17.3%-26.3%) of these patients had delays lasting >7 days. Risk factors for delays included being seen only in the emergency department, age < 65, a history of sinusitis or schizophrenia. Conclusions Many patients with HSE experience multiple missed diagnostic opportunities prior to diagnosis.

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Premature Arterial Disease Associated with Familial Antithrombin III Deficiency

Thrombosis and Haemostasis ◽

10.1055/s-0038-1645677 ◽

1990 ◽

Vol 63 (01) ◽

pp. 013-015 ◽

Cited By ~ 15

Author(s):

E J Johnson ◽

C R M Prentice ◽

L A Parapia

Keyword(s):

Risk Factors ◽

Venous Thromboembolism ◽

Potential Risk ◽

Antithrombin Iii ◽

Arterial Disease ◽

Coagulation System ◽

Early Age ◽

Arterial Thromboembolism ◽

Potential Risk Factors ◽

Antithrombin Iii Deficiency

SummaryAntithrombin III (ATIII) deficiency is one of the few known abnormalities of the coagulation system known to predispose to venous thromboembolism but its relation to arterial disease is not established. We describe two related patients with this disorder, both of whom suffered arterial thrombotic events, at an early age. Both patients had other potential risk factors, though these would normally be considered unlikely to lead to such catastrophic events at such an age. Thrombosis due to ATIII deficiency is potentially preventable, and this diagnosis should be sought more frequently in patients with arterial thromboembolism, particularly if occurring at a young age. In addition, in patients with known ATIII deficiency, other risk factors for arterial disease should be eliminated, if possible. In particular, these patients should be counselled against smoking.

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