scholarly journals Sociocultural and geographical disparities in immunization among different geographical regions of Maharashtra

2021 ◽  
Author(s):  
Rushikesh Khadse ◽  
Badal Thool ◽  
Sunil Sarode
Keyword(s):  
Multinomial Logistic Regression ◽  
Action Plan ◽  
Univariate Analysis ◽  
Herd Immunity ◽  
Media Exposure ◽  
Child Health Services ◽  
Child Immunization ◽  
Geographical Regions ◽  
To Receive ◽  
Full Immunization

Abstract Background In Maharashtra, child immunization is an essential factor in maternal and child health services and effective in reduced child morbidity and mortality. The study focuses on the prevalence of child immunization in different geographical regions of Maharashtra. It also depicts the immunization status (no immunization, partial immunization, and full immunization) according to various socio-demographic characteristics and determinants of full Immunization and partial Immunization among children of age 12–23 months in Maharashtra Data source and Methodology: The fourth round of the National Family Health Survey (NFHS-4) has been used for this study. The univariate analysis and simple chi-square test were conducted to test association. The Multinomial logistic regression model was conducted to determine the determinants of partial and full immunization. Result In the wealth category, the middle and richest are more likely to receive full immunization than the poorest people statically significant effect. In religion, Muslims less likely to receive full Immunization, and Buddhists more likely to use full immunization compare to Hindu people. In the different geographical regions of Maharashtra, North-Maharashtra, West-Maharashtra, Konkan is less likely to have full immunization correspond to the Vidarbha region. Mothers who have any media exposure are more likely to have full immunization compare to no media exposure. Conclusions To conclude, the study shows a need to adopt a multi-pronged strategy while formulating an action plan for immunization by keeping in mind that vaccination is a right of every child. An appropriate proportion of childhood immunization is required to develop “Herd Immunity” to protects other unimmunized children. The most “efficient” and “equitable” way should be chosen to deliver vaccination services to identify the population's risk group. Who has remained unimmunized? As immunization in the different geographical regions in Maharashtra remained very far from the target set by Mission Indradhushya. Hence, there is a need to focus more on responsible socio-demographic factors while implementing immunization services.

scholarly journals Intention to receive a vaccine against SARS-CoV-2 in Italy and its association with trust, worry and beliefs about the origin of the virus

2020 ◽  
Vol 35 (6) ◽  
pp. 505-511
Author(s):  
Gabriele Prati
Keyword(s):  
Multinomial Logistic Regression ◽  
Herd Immunity ◽  
Successful Implementation ◽  
Institutional Trust ◽  
Vaccination Programs ◽  
Natural Origin ◽  
Conspiracy Beliefs ◽  
Socio Demographic Factors ◽  
High Level ◽  
To Receive

Abstract The aim of the current study was to determine the extent to which Italian people intend to receive a vaccine against SARS-CoV-2 and to investigate its associations with worry, institutional trust and beliefs about the non-natural origin of the virus. A sample of 624 people living in Italy was recruited in April 2020 using an online platform. The survey included questions about intention to receive a vaccine against SARS-CoV-2, trust, worry and beliefs about the origin of the virus. Most respondents (75.8%) intended to receive a vaccine, while 32 (5.1%) and 63 (10.1%) participants responded ‘No’ and ‘I do not know’, respectively. The remaining participants (9.0%) chose not to respond to this question. Controlling for socio-demographic factors, a multinomial logistic regression model revealed that no intention to receive a vaccine was associated with lower levels of worry and institutional trust, while increased odds for responding ‘do not know’ were found among participants holding beliefs about the non-natural origin of the virus. Vaccine acceptance may not be sufficient to establish a high level of herd immunity and a successful implementation of new pandemic vaccination programs should take into account trust, conspiracy beliefs and worry.

scholarly journals 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals Predictive CT features for the diagnosis of primary pulmonary mucoepidermoid carcinoma: comparison with squamous cell carcinomas and adenocarcinomas

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaohua Ban ◽  
Xinping Shen ◽  
Huijun Hu ◽  
Rong Zhang ◽  
Chuanmiao Xie ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Roc Curve ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Ct Imaging ◽  
Squamous Cell Carcinomas ◽  
Curve Analysis ◽  
Imaging Features ◽  
Roc Curve Analysis ◽  
Ct Features

Abstract Background To determine the predictive CT imaging features for diagnosis in patients with primary pulmonary mucoepidermoid carcinomas (PMECs). Materials and methods CT imaging features of 37 patients with primary PMECs, 76 with squamous cell carcinomas (SCCs) and 78 with adenocarcinomas were retrospectively reviewed. The difference of CT features among the PMECs, SCCs and adenocarcinomas was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis. Results CT imaging features including tumor size, location, margin, shape, necrosis and degree of enhancement were significant different among the PMECs, SCCs and adenocarcinomas, as determined by univariate analysis (P < 0.05). Only lesion location, shape, margin and degree of enhancement remained independent factors in multinomial logistic regression analysis. ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.805 (95%CI: 0.704–0.906). Conclusion The prediction model derived from location, margin, shape and degree of enhancement can be used for preoperative diagnosis of PMECs.

scholarly journals Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 256
Author(s):  
Pedro Plans-Rubió
Keyword(s):  
Vaccination Coverage ◽  
Action Plan ◽  
Herd Immunity ◽  
World Health ◽  
Immunization Programs ◽  
National Immunization ◽  
The World ◽  
Measles Vaccination ◽  
The Mean ◽  
Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

Which Patients are More Likely to Receive an Asthma Action Plan?

2006 ◽  
Vol 117 (2) ◽  
pp. S274
Author(s):  
D.C. Chaffin ◽  
K.K. Slish ◽  
M.D. Cabana ◽  
N.M. Clark
Keyword(s):  
Action Plan ◽  
To Receive ◽  
Asthma Action Plan

scholarly journals The mortality of ill infants with false tooth extraction in a rural Ugandan emergency department

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Amyna Husain ◽  
M. Douglas Baker ◽  
Mark C. Bisanzo ◽  
Martha W. Stevens
Keyword(s):  
Emergency Department ◽  
Tooth Extraction ◽  
Chart Review ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Cultural Practice ◽  
Fluid Bolus ◽  
Significant Difference ◽  
To Receive

False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE−) was 14% (P=0.22). The FTE+ study group, and FTE− comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE− infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE− infants.

scholarly journals Association between willingness to receive the COVID-19 vaccine and sources of health information among Japanese workers: a cohort study

2021 ◽  
Author(s):  
Ko Hiraoka ◽  
Tomohisa Nagata ◽  
TAKAHIRO MORI ◽  
Hajime Ando ◽  
Ayako Hino ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Information ◽  
Herd Immunity ◽  
Baseline Survey ◽  
Vaccination Programs ◽  
Japanese Workers ◽  
Company Policy ◽  
Sources Of Health Information ◽  
To Receive

Background: It is important to achieve herd immunity by vaccinating as many people as possible to end the COVID-19 pandemic. We investigated the relationship between willingness to receive vaccination and sources of health information among those who did not want to be vaccinated against COVID-19. Methods: This prospective cohort study collected data using a self-administered questionnaire survey. The baseline survey was conducted during December 22-25, 2020, and the follow-up survey during February 18-19, 2021. Participants were aged 20-65 years and worked at the time of the baseline survey (N=33,087). After excluding 6,051 invalid responses, we included responses from 27,036 participants at baseline. In total, 19,941 people responded to the follow-up survey (74% follow-up rate). We excluded 7,415 participants who answered "yes" to the question "If a COVID-19 vaccine becomes available, would you like to get it?" in the baseline survey. We finally analyzed 12,526 participants. Results: The odds ratio for change in willingness to be vaccinated from "no" to "yes" differed by source of health information. Compared with workers that used TV as a source of information, significantly fewer people who reported getting information from the Internet and friends/colleagues were willing to get the vaccine. Conclusions: It is important to approach workers who do not watch TV when implementing workplace vaccination programs. It is likely that willingness to be vaccinated can be increased through an active company policy whereby the top management recommend vaccination, coupled with an individual approach by occupational health professionals.

scholarly journals GP.04 Prevalence and determinants of seizure action plans in a pediatric epilepsy population

2019 ◽  
Vol 46 (s1) ◽  
pp. S7
Author(s):  
M Chiu ◽  
S Peinhof ◽  
M Borhani ◽  
C DeGuzman ◽  
C Siu ◽  
...  
Keyword(s):  
Mobile Application ◽  
Chart Review ◽  
Primary Outcome ◽  
Action Plan ◽  
Univariate Analysis ◽  
Male Gender ◽  
Secondary Outcome ◽  
Pediatric Epilepsy ◽  
History Of ◽  
Timely Treatment

Background: Status epilepticus (SE) is the most common pediatric neurological emergency. Timely treatment is crucial, yet administration of rescue medications is often delayed and under-dosed. We aim to improve SE management by ensuring that every child at risk of SE in our province has an individualized seizure action plan (SAP) outlining the steps that should be taken during SE. Methods: A survey was distributed to parents of epilepsy patients aged 1 month to 19 years. Primary outcome was percentage of patients with SAPs. Secondary outcome was parental interest in a SAP mobile application. Following chart review, univariate and multivariate analysis was performed to identify variables that predict whether patients have SAPs. Results: Of 192 participants, 61.5% have SAPs. On univariate analysis, history of prior SE and male gender increased likelihood of having a SAP. On logistic regression, Nagelkerke R2 was 0.204 and our model correctly predicted 82.2% of patients with SAPs. 83.3% of parents were interested in a SAP mobile application. Conclusions: This is one of the first studies to examine SAP prevalence in a pediatric epilepsy population. There is a need to increase the percentage of epilepsy patients with SAPs. Most parents would find a SAP mobile application valuable in their child’s management.

Nonclinical Factors Associated with Treatment with Peritoneal Dialysis in Esrd Patients in Taiwan

2010 ◽  
Vol 30 (6) ◽  
pp. 638-643 ◽  
Author(s):  
Hsiu-Chen Huang ◽  
Jiun-Yi Wang ◽  
Chia-Chu Chang ◽  
Ping-Fang Chiu ◽  
Ming-Che Chiang ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Family Support ◽  
Univariate Analysis ◽  
Healthcare Providers ◽  
Early Referral ◽  
Factors Associated ◽  
Stage Renal Disease ◽  
End Stage ◽  
To Receive ◽  
Esrd Patients

ObjectivesLess than 10% of end-stage renal disease (ESRD) patients in Taiwan receive peritoneal dialysis (PD), which reveals the situation of underutilization of PD. We thus aimed to investigate factors associated with treatment with PD in ESRD patients in Taiwan.PatientsPatients that were 18 years of age or older and had been on dialysis for at least 3 months since 2001 were recruited and interviewed with a structured questionnaire.Results98 hemodialysis (HD) and 102 PD patients were recruited. In univariate analysis, age, sex, level of education, employment status, marital status, traffic time, family support, patient cognition, and receptivity were correlated with treatment with PD. Multivariate analysis showed that patients that were not married ( p = 0.006), that spent more time traveling to the dialysis clinic ( p = 0.006), that were not emergent at the start of dialysis ( p = 0.003), and that had better family support ( p = 0.045), a higher cognition of dialysis ( p = 0.034), and stronger receptivity to dialysis ( p < 0.001) were more likely to receive PD.ConclusionsWe recommend patients follow the standard process to obtain more exhaustive information, consultation, and early referral. In addition, we suggest healthcare providers remind patients to take into account such nonclinical factors as family support and patient receptivity when they choose their dialysis modality.

Renal Disease In Patients With Chronic Lymphocytic Leukemia (CLL)

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5302-5302 ◽  
Author(s):  
Tait D Shanafelt ◽  
Kari G. Rabe ◽  
Curtis A Hanson ◽  
Timothy G. Call ◽  
Susan Schwager ◽  
...  
Keyword(s):  
Renal Function ◽  
Chronic Lymphocytic Leukemia ◽  
Renal Insufficiency ◽  
Serum Creatinine ◽  
Research Funding ◽  
Univariate Analysis ◽  
Lymphocytic Leukemia ◽  
Disease Course ◽  
To Receive

Abstract Background Chronic lymphocytic leukemia (CLL) can effect renal function in a variety of ways including direct infiltration of the kidney, ureteral obstruction by lymphadenopathy, and treatment related tumor lysis syndrome (uric acid nephropathy). Rarely, CLL has also been reported to be associated with light chain nephropathy, renal amyloidosis, membranoproliferative glomerulonephritis (MPGN), granulomatous interstitial nephritis (GIN), and minimal change disease (MCD). Nearly all the data on the effects of CLL on renal function is at the case report level. We systematically evaluated the prevalence of renal insufficiency at diagnosis as well the incidence of acquired renal insufficiency during follow-up in a large cohort of patients with newly diagnosed CLL to more accurately define the effects of CLL on the kidney and its impact on clinical outcomes. Methods Between January 1995 -February 2013, previously untreated CLL patients seen in the Division of Hematology at Mayo Clinic at diagnosis (<12 months) and who had baseline assessment of serum creatinine were included in this analysis. Patients with serum creatinine (Cr) ≥1.5 mg/dL at baseline were classified as having renal insufficiency at diagnosis. Patients who initially had baseline creatinine <1.5 mg/dL but who developed a Cr≥1.5 mg/dL during the course of their disease were considered to have acquired renal insufficiency. Results Existing renal insufficiency at the time of CLL diagnosis: Of 2047 patients who met the eligibility criteria, 153 (7.5%) patients had renal insufficiency (Cr≥1.5 mg/dL) at the time of CLL diagnosis including 15 (0.7%) with a Cr≥3 mg/dL. Renal insufficiency was also more common among men (9.3% vs. 3.9%; p<0.00001), those with advanced stage disease (Rai 0=7.0%; Rai I-II=6.4%, Rai III-IV=20.2%; p<0.0001), and CD49d positive patients (6.8% vs. 3.8%; p<0.038). Patients with renal insufficiency at diagnosis were also older (median age 72.2 vs. 63.9; p<0.0001). No difference in the prevalence of renal insufficiency at diagnosis was observed based on cytogenetic abnormalities detected by FISH or CD38, ZAP-70 or IGHV gene mutation status. Although renal insufficiency at diagnosis was strongly associated with OS on univariate analysis (p<0.001), no association was observed between renal insufficiency and TTT or OS on multi-variate analysis adjusting for age, sex, and Rai stage. Acquired renal insufficiency during CLL disease course: Among the 1894 patients with normal renal function at diagnosis, 304 (16.1%) acquired renal insufficiency (Cr≥1.5 mg/dL) during the course of their CLL disease course including 43 (2.3%) with peak Cr≥3 mg/dL. In addition to age (older) and male sex, a number of CLL disease characteristics were associated with a higher likelihood of acquired renal insufficiency including: IGHV UM (OR=2.0; p=0.0001), unfavorable FISH (del17p- or 11q-; OR=2.0; p=0.001), and being CD49d+ (OR=1.8; p=0.002), ZAP-70+ (OR=1.6; p=0.004), or CD38+ (OR=1.4; p=0.0.032),. Shorter TTT (p<0.001) and OS (P<0.001) was observed among patients with initially normal creatinine who acquired renal insufficiency (Figure 1A and 1B). On MV analysis adjusting for age, sex, and stage at diagnosis, acquired renal insufficiency remained an independent predictor of TTT (OR=1.77; p=0.001) and OS (OR=2.67; p<0.001). Renal insufficiency and therapy selection After median follow-up of 4.5 years (range 0-18.0), 620 of 2047 (30.3%) patients have progressed to require treatment. Patients with renal insufficiency prior to treatment were less likely to receive purine nucleoside analogue based therapy and more likely to receive single agent alkylator based treatment. Conclusions Approximately 1 in every 13 patients (7.5%) with CLL has renal insufficiency at the time of diagnosis and an additional 16.1% acquire renal insufficiency during the course of the disease. The risk of developing renal insufficiency is associated with a variety of CLL B-cell characteristics and is associated with TTT and OS. Data on causes of acquired renal insufficiency is being abstracted and will be presented at the meeting. Disclosures: Shanafelt: Genentech: Research Funding; Glaxo-Smith-Kline: Research Funding; Cephalon: Research Funding; Hospira: Research Funding; Celgene: Research Funding; Polyphenon E International: Research Funding. Off Label Use: MK2206 in a phase 1 trial of CLL.

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