scholarly journals PREDICTION OF PROBABILITY OF THE LONG TERM FATAL OUTCOME OF STROKE BY THE DATA OF TERRITORY AND POPULATIONAL REGISTRY

2018 ◽  
Vol 17 (3) ◽  
pp. 33-37
Author(s):  
О. A. Klochikhina ◽  
L. V. Stakhovskaya ◽  
Е. A. Polunina
Keyword(s):  
Prediction Model ◽  
Clinical Guidelines ◽  
Management Strategy ◽  
Fatal Outcome ◽  
Individual Probability ◽  
Definition Of ◽  
High Level ◽  
First Time ◽  
Long Term Mortality

Aim. To develop a prediction model of individual probability of long term (within first 28 days from the onset) outcome of stroke.Material and methods. By the method of territory-populational registry, in 2009-2016 in 16 regions of Russia, an analysis performed, of significant predictors of fatal stroke outcome. Overall, 50902 strokes registered in persons older 25 y. In 1553 there were no data on long term mortality. By the results of revealed significant predictors of the fatal outcome of stroke by LOTUS method, a tree-branching was done for development of probability of long term fatal outcome during the first 28 days from disease presentation.Results. The significant predictors were acquired, of the fatal outcome of stroke, and graded by odds ratio. Based on the definition of significant predictors of fatal outcome, first time a prediction model developed of probability of long term stroke fatal outcome taken heterogeneity and multifactorial nature of the disease. Clinical guidelines proposed.Conclusion. The developed prediction model of individual probability of long term stroke fatal outcome shows high level of sensitivity and specificity. Application of such model and of proposed clinical guidelines at various stages of patients management will facilitate diagnostical search, management strategy selection and improvement of prevention.

scholarly journals Establishing an ad hoc COVID-19 mortality surveillance during the first epidemic wave in Belgium, 1 March to 21 June 2020

2021 ◽  
Vol 26 (48) ◽  
Author(s):  
Françoise Renard ◽  
Aline Scohy ◽  
Johan Van der Heyden ◽  
Ilse Peeters ◽  
Sara Dequeker ◽  
...  
Keyword(s):  
Ad Hoc ◽  
Participation Rate ◽  
Term Care ◽  
Data Flows ◽  
Care Facilities ◽  
Definition Of ◽  
High Level ◽  
Mortality Surveillance ◽  
Related Mortality

Background COVID-19-related mortality in Belgium has drawn attention for two reasons: its high level, and a good completeness in reporting of deaths. An ad hoc surveillance was established to register COVID-19 death numbers in hospitals, long-term care facilities (LTCF) and the community. Belgium adopted broad inclusion criteria for the COVID-19 death notifications, also including possible cases, resulting in a robust correlation between COVID-19 and all-cause mortality. Aim To document and assess the COVID-19 mortality surveillance in Belgium. Methods We described the content and data flows of the registration and we assessed the situation as of 21 June 2020, 103 days after the first death attributable to COVID-19 in Belgium. We calculated the participation rate, the notification delay, the percentage of error detected, and the results of additional investigations. Results The participation rate was 100% for hospitals and 83% for nursing homes. Of all deaths, 85% were recorded within 2 calendar days: 11% within the same day, 41% after 1 day and 33% after 2 days, with a quicker notification in hospitals than in LTCF. Corrections of detected errors reduced the death toll by 5%. Conclusion Belgium implemented a rather complete surveillance of COVID-19 mortality, on account of a rapid investment of the hospitals and LTCF. LTCF could build on past experience of previous surveys and surveillance activities. The adoption of an extended definition of ‘COVID-19-related deaths’ in a context of limited testing capacity has provided timely information about the severity of the epidemic.

scholarly journals Comparing conceptual frameworks for a fish community MSY (FCMSY) using management strategy evaluation—an example from the North Sea

2019 ◽  
Vol 76 (4) ◽  
pp. 813-823 ◽  
Author(s):  
Robert B Thorpe ◽  
José A A De Oliveira
Keyword(s):  
North Sea ◽  
Management Strategy ◽  
Fish Community ◽  
Parameter Uncertainties ◽  
Management Strategy Evaluation ◽  
The North ◽  
Strategy Evaluation ◽  
The North Sea ◽  
Definition Of

Abstract Maximum sustainable yield (MSY) is a well-established concept that is mandated by legislation, and has a clear theoretical meaning in terms of a single stock. However, its definition is problematic in a multispecies setting, which makes it more difficult to apply the MSY principle. In this study of the North Sea fish community, we consider several possible MSY candidates, and evaluate them in terms of their ability to produce optimum long-term yield whilst avoiding unacceptable risk of stock impairment. We perform this evaluation with an ensemble of size-structured models using a management strategy evaluation approach, in which harvest control rules (HCRs) are used to determine levels of fishing as a function of the proposed MSY target and stock status, taking account of recruitment and model parameter uncertainties. We find that HCRs of the type considered here are always useful in the scenarios we tested, as they reduce overfishing risk much more than average long-term yield. This is independent of the precise form of the HCR, so it is more important to implement one rigorously than obsess over the rule details. For a lax definition of overfishing, which accepts relatively severe stock depletion (B < 10% B0), and using HCRs, risks are “low” across all strategies, and the Nash equilibrium is the best performing MSY approach considered here. For more stringent definitions of “at risk” (e.g. likelihood of B < 20% of B0), the application of HCRs can allow a range of alternative formulations of MSY. Thus, the definition of MSY may be sensitive to judgements about acceptable levels of risk, and consistent application of a sensible management framework may be more important than developing the best possible theoretical definition of MSY.

Magnitude of bacteraemia is a predictor of mortality during 1 year of follow-up

2008 ◽  
Vol 137 (1) ◽  
pp. 94-101 ◽  
Author(s):  
K. O. GRADEL ◽  
M. SØGAARD ◽  
C. DETHLEFSEN ◽  
H. NIELSEN ◽  
H. C. SCHØNHEYDER
Keyword(s):  
Surgical Patients ◽  
Adjusted Risk ◽  
High Magnitude ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Cox's Regression ◽  
First Time ◽  
Long Term Mortality

SUMMARYWe evaluated magnitude of bacteraemia as a predictor of mortality, comprising all adult patients with a first-time mono-microbial bacteraemia. The number of positive bottles [1 (reference), 2, or 3] in the first positive blood culture (BC) was an index of magnitude of bacteraemia. We used Cox's regression analysis to determine age and comorbidity adjusted risk of mortality at days 0–7, 8–30, and 31–365. Of 6406 patients, 31·1% had BC index 1 (BCI 1), 18·3% BCI 2, and 50·6% BCI 3. BCI 3 patients had increased risk of mortality for days 0–7 (1·30, 95% CI 1·10–1·55) and days 8–30 (1·37, 95% CI 1·12–1·68), but not thereafter. However, in surgical patients mortality increased only beyond day 7 (8–30 days: 2·04, 95% CI 1·25–3·33; 31–365 days: 1·27, 95% CI 0·98–1·65). Thus, high magnitude of bacteraemia predicted mortality during the first month with a shift towards long-term mortality in surgical patients.

scholarly journals Daouidi v Bootes Plus SL and the Concept of ‘Disability’ in EU Anti-Discrimination Law

2019 ◽  
Vol 10 (1) ◽  
pp. 69-84 ◽  
Author(s):  
Delia Ferri
Keyword(s):  
Medical Model ◽  
Social Model ◽  
Social Model Of Disability ◽  
Attitudinal Barriers ◽  
Direct Discrimination ◽  
The Social ◽  
Social Environmental ◽  
Definition Of ◽  
First Time

Daouidi v Bootes Plus SL is one the latest decisions in which the CJEU has been directly confronted with the concept of disability in the realm of EU anti-discrimination legislation. In particular, in this judgment, the Court attempted to identify when the dismissal of a worker due to temporary incapacity of an unknown duration may constitute direct discrimination on the grounds of disability. This decision appears to be significant in that, for the first time, the CJEU discusses the meaning of ‘long-term limitation’ for the purpose of Directive 2000/78. Although the Court treads carefully, it attempts to further elucidate and bring new elements to the definition of disability in EU anti-discrimination law. In spite of the fact that the Court is potentially widening the notion of disability, it appears, once again, quite reticent in its approach to the role of social, environmental and attitudinal barriers in disabling an individual, and remains somewhat ‘trapped’ in the medical model of disability. All in all, this analysis endeavors to highlight that the CJEU is struggling to move beyond a rhetorical recognition of the social model of disability and to apply this in practice.

scholarly journals Yoga Research and Public Health

2016 ◽  
Vol 8 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Avinash R. Patwardhan
Keyword(s):  
Public Health ◽  
Health Utility ◽  
Medical Application ◽  
Point Of View ◽  
Proof Of Concept ◽  
Social Body ◽  
Key Stakeholders ◽  
Definition Of ◽  
High Level

Research on yoga is witnessing an unprecedented proliferation currently, partly because of great interest in yoga’s health utility. However, yoga research does not seem to be sufficiently public health oriented, or its quality corresponding to its quantity. Yoga research is falling short to enable key stakeholders like end users, prescribers, and payers to meaningfully, confidently, and fruitfully answer the questions like: Is it generalizable? Is it standardizable? Which yoga style should be used/recommended/paid for? Or will it be worth the money? Therefore, it is important to examine the alignment to purpose or value of yoga research from a public health point of view so as to make it more practical. The issues such as lack of clear definition of yoga, wide variation in its dosage, cacophony of lineage-based styles, no data about comparative effectiveness between the yoga components, confounders and biases clouding the evidence regarding its benefits, too little data on long-term adherence, equivocal results about its cost effectiveness, discussions lacking embrace of better methods in research, and absence of a theory of yoga are examined. This is not a detailed discussion of every issue yoga research faces, but a high-level overview of those that have direct practical bearing. In the end, a few pragmatic approaches are offered. The article suggests that yoga-component analysis, development of a theory of yoga, adoption of a health-aligned functional typology of yoga, development and testing of a simple universal basic prototype of yoga intervention, emphasis on research about long-term adherence, and discouragement for mere proof of concept research might make yoga research serve the stakeholders better. It urges the research community to practice “context cognizant scholarship” to disentangle health compatible yoga from its historical-cultural-social body before examining it for health or medical application.

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