scholarly journals Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

2018 ◽  
Vol 23 (21) ◽  
Author(s):  
Kamilla Laut ◽  
Leah Shepherd ◽  
Roxana Radoi ◽  
Igor Karpov ◽  
Milosz Parczewski ◽  
...  
Keyword(s):  
Best Practice ◽  
Western Europe ◽  
Antiretroviral Treatment ◽  
Temporal Trends ◽  
Virological Suppression ◽  
Hiv Care ◽  
Cross Sectional ◽  
Eurosida Study ◽  
Over Time ◽  
Country Specific

Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004–05, 2009–10 and 2014–15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004–05 (67.8%) to 2014–15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004–05, 87.7% in 2014–15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014–15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014–15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13–0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

Temporal Trends in the Severity and Mortality of Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Hypothermia

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Cristina Vega-Del-Val ◽  
Juan Arnaez ◽  
Sonia Caserío ◽  
Elena Pilar Gutiérrez ◽  
Marta Benito ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Cross Sectional Study ◽  
Annual Incidence ◽  
Hypoxic Ischemic Encephalopathy ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Changes Over Time ◽  
Ischemic Encephalopathy ◽  
Annual Decline ◽  
Over Time

<b><i>Introduction:</i></b> There is a paucity of studies examining temporal trends in the incidence and mortality of moderate-to-severe hypoxic-ischemic encephalopathy (HIE) during the last decade of therapeutic hypothermia (TH). <b><i>Methods:</i></b> Multicenter cross-sectional study of all infants ≥35 weeks gestational age diagnosed with moderate-to-severe HIE within 6 h of birth in an extensive region of Spain between 2011 and 2019, in order to detect trend changes over time in the (1) annual incidence, (2) severity of neurological and systemic organ involvement, and (3) neonatal death from HIE. <b><i>Results:</i></b> Annual incidence rate of moderate-to-severe HIE was 0.84 (95% confidence interval [CI] 0.7–0.97) per 1,000 births, without trend changes over time (<i>p</i> = 0.8), although the proportion of severe HIE infants showed an average annual decline of 0.86 points (95% CI 0.75–0.98). There were 102 (70%) infants diagnosed with moderate HIE and 44 (30%) with severe HIE. TH was offered to 139/146 (95%) infants. Infants with clinical and/or electrical seizures showed a decreasing trend from 56 to 28% (<i>p</i> = 0.006). Mortality showed a nonstatistically significant decline (<i>p</i> = 0.4), and the severity of systemic damage showed no changes (<i>p</i> = 0.3). Obstetric characteristics remained unchanged, while higher perinatal pH values (<i>p</i> = 0.03) and Apgar scores (<i>p</i> = 0.05), and less need for resuscitation (<i>p</i> = 0.07), were found over time. <b><i>Conclusion:</i></b> The annual incidence of moderate-to-severe HIE has stabilized at around 1 per 1,000 births, with a temporal trend toward a decrease in severe HIE infants and a slight decline of mortality. No association was found between temporal trends and changes in perinatal/obstetric characteristics over time.

scholarly journals Ongoing challenges to understanding multidrug and rifampicin-resistant tuberculosis in children versus adults

2020 ◽  
pp. 2002504
Author(s):  
C. Finn McQuaid ◽  
Ted Cohen ◽  
Anna S. Dean ◽  
Rein M.G.J. Houben ◽  
Gwenan M. Knight ◽  
...  
Keyword(s):  
Soviet Union ◽  
Former Soviet Union ◽  
Odds Ratio ◽  
Western Europe ◽  
Resistant Tuberculosis ◽  
The Usa ◽  
The Uk ◽  
Tuberculosis In Children ◽  
Over Time ◽  
Country Specific

Previous analyses suggest children with tuberculosis (TB) are no more or no less likely to have multidrug- or rifampicin-resistant TB (MDR/RR-TB) than adults. However, the availability of new data, particularly for high MDR/RR-TB burden countries, suggest updates of country-specific estimates are warranted.We used data from population-representative surveys and surveillance collected between 2000 and 2018 to compare the odds ratio (OR) of MDR/RR-TB among children (<15 years) with TB, compared to the odds of MDR/RR-TB among adults (≥15 years) with TB.In most settings (45/55 countries), and globally as a whole, there is no evidence that age is associated with odds of MDR/RR-TB. However, in some settings such as former Soviet Union countries in general, and Georgia, Kazakhstan, Lithuania, Tajikistan and Uzbekistan in particular, as well as Peru, MDR/RR-TB is positively associated with age ≥15. Meanwhile, in Western Europe in general, and the UK, Poland, Finland and Luxembourg in particular, MDR/RR-TB is positively associated with age <15. Sixteen countries had sufficient data to compare over time between 2000–2011 and 2012–2018, with evidence for decreases in the OR in children compared to adults in Germany, Kazakhstan and the USA.Our results support findings that in most settings a child with TB is as likely as an adult with TB to have MDR/RR-TB. However, setting-specific heterogeneity requires further investigation. Further, the OR for MDR/RR-TB in children compared to adults is generally either stable or decreasing. There are important gaps in detection, recording and reporting of drug resistance among paediatric TB cases, limiting our understanding of transmission risks and measures needed to combat the global TB epidemic.

scholarly journals Increasing socioeconomic gap between the young and old: temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity, 2004–2015

2018 ◽  
Vol 72 (7) ◽  
pp. 636-644 ◽  
Author(s):  
Evangelos Kontopantelis ◽  
Mamas A Mamas ◽  
Harm van Marwijk ◽  
Iain Buchan ◽  
Andrew M Ryan ◽  
...  
Keyword(s):  
Relative Deprivation ◽  
Important Determinant ◽  
Temporal Trends ◽  
Population Characteristics ◽  
Government Policies ◽  
Real Wages ◽  
Regional Variability ◽  
Cross Sectional ◽  
Index Of Multiple Deprivation ◽  
Over Time

BackgroundAt a low geographical level, little is known about the associations between population characteristics and deprivation, and their trends, which would be directly affected by the house market, labour pressures and government policies. We describe temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity.MethodsRepeated cross-sectional whole population study for England, 2004–2015, at a low geographical level (average 1500 residents). We calculated weighted medians of the Index of Multiple Deprivation (IMD) for each subgroup of interest.ResultsOver time, we observed increases in relative deprivation for people aged under 30, and aged 30–59, while median deprivation decreased for those aged 60 or over. Subgroup analyses indicated that relative overall deprivation was consistently higher for young adults (aged 20–29) and infants (aged 0–4), with increases in deprivation for the latter. Levels of overall deprivation in 2004 greatly varied by ethnicity, with the lowest levels observed for White British and the highest for Blacks. Over time, small reductions were observed in the deprivation gap between White British and all other ethnic groups. Findings were consistent across overall IMD and its health and disability subdomain, but large regional variability was also observed.ConclusionsGovernment policies, the financial crisis of 2008, education funding and the increasing cost of houses relative to real wages are important parameters in interpreting our findings. Socioeconomic deprivation is an important determinant of health and the inequalities this work highlights may have significant implications for future fiscal and healthcare policy.

scholarly journals Age-Specific Rates of Onset of Cannabis Use in Mexico

2020 ◽  
Author(s):  
Mauricio López-Méndez ◽  
Angélica Ospina-Escobar ◽  
Rowan Iskandar ◽  
Fernando Alarid-Escudero
Keyword(s):  
Birth Cohort ◽  
Temporal Trends ◽  
Tobacco Consumption ◽  
Cannabis Use ◽  
Parametric Models ◽  
Birth Cohorts ◽  
Cross Sectional ◽  
Cannabis Consumption ◽  
Nationally Representative ◽  
Over Time

AbstractBackgroundOver the previous two decades, the prevalence of cannabis use has risen among the population in Mexico.AimsTo estimate the sex- and age-specific rates of onset of cannabis use over time.DesignTime-to-event flexible parametric models with spline specifications of the hazard function. Stratified analysis by sex, and control for temporal trends by year of data collection or decennial birth-cohort.SettingMexico.ParticipantsPooled sample of 141,342 respondents aged between 12 and 65 years from five nationally representative cross-sectional surveys, the Mexican National Surveys of Addictions (1998, 2002, 2008, 2012) and the Mexican National Survey on Drugs, Alcohol, and Tobacco Consumption (2016).MeasurementsWe estimated age-specific rates of onset of cannabis as the conditional rate of consuming cannabis for the first time at a specific age.FindingsAge-specific rates of onset of cannabis use per 1,000 individuals increased over time for both females and males. Peak rates per 1,000 ranged from 0.935 (95%CI= [0.754,1.140]) in 1998, to 5.390 (95%CI= [4.910,5.960]) in 2016 for females; and from 7.510 (95%CI= [5.516, 10.355]) in 1998, to 26.100 (95%CI= [23.162,30.169]) in 2016 for males. Across decennial birth-cohorts, peak rates of onset of cannabis use per 1,000 individuals for females ranged from 0.342 (95%CI= [0.127,0.898]) for those born in the 1930s, to 14.600 (95%CI= [13.200,16.100]) for those born in the 1990s; and for males, from 4.900 (95%CI= [0.768, 7.947]) for those born in the 1930s, to 38.700 (95%CI= [32.553,66.341]) for those born in the 1990s.ConclusionRates of onset of cannabis use for males are higher than for females; however, the change across recent cohorts of the rates of onset has increased at a faster rate among females. Our findings can inform and improve the implementation of policies around cannabis use by identifying subpopulations by age, sex, and birth-cohort that are at the highest risk of initiating cannabis consumption.

Erosion of the Mediterranean diet among adolescents: evidence from an Eastern Mediterranean Country

2020 ◽  
pp. 1-11
Author(s):  
Farah Naja ◽  
Nahla Hwalla ◽  
Fatima Hachem ◽  
Nada Abbas ◽  
Fatima Al Zahraa Chokor ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Dietary Pattern ◽  
Food System ◽  
Eastern Mediterranean ◽  
Temporal Trends ◽  
Mediterranean Country ◽  
Regression Analyses ◽  
Cross Sectional ◽  
The Mediterranean ◽  
Country Specific

Abstract At a time when the health benefits of the Mediterranean diet (MD) are pervasively recognised, a paradoxical observation is the decreasing adherence to this dietary pattern in its native countries. This study aims to investigate temporal trends in adherence to the MD among adolescents (10–19 years old) in Lebanon. Data were drawn from three national cross-sectional surveys conducted at three points in time: 1997 (n 2004), 2009 (n 3656) and 2015 (n 1204). Dietary intake was assessed using 24-h dietary recalls, and adherence to the MD was assessed using two country-specific indexes: the composite Mediterranean diet (c-MED) index and Lebanese Mediterranean diet (LMD) index. Significant decreases in c-MED and LMD scores and in the proportion of adolescents adhering to the MD were observed between 1997 and 2015, with more consistent results among females (P < 0·05). Projections for the year 2030 showed further decreases, with less than a quarter of adolescents remaining adherent to the MD. Based on linear regression analyses, belonging to the year 2009 was associated with significantly lower MD scores compared with 1997, even after adjustment for potential covariates (c-MED β = –0·16, 95 % CI –0·30, –0·01; LMD β = –0·42, 95 % CI –0·67, –0·17). Similar results were obtained when comparing survey year 2015 with 1997 (c-MED score β = –0·20, 95 % CI –0·33, –0·06; LMD score β = –0·60, 95 % CI –0·82, –0·37). Findings highlight the erosion of the MD among Lebanese adolescents and underline the need for a comprehensive food system approach that fosters the promotion of the MD as a nutritionally balanced and sustainable dietary pattern.

scholarly journals Temporal Trends of Emergency Department Visits of Patients with Atrial Fibrillation: A Nationwide Population-Based Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1485
Author(s):  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Seo-Young Lee ◽  
Euijae Lee ◽  
Kyung-Do Han ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Temporal Trends ◽  
Population Based ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Ed Visits ◽  
Management Approaches ◽  
Sectional Analysis ◽  
Over Time

We aimed to describe temporal trends in emergency department (ED) visits of patients with atrial fibrillation (AF) over 12 years. A repeated cross-sectional analysis of ED visits in AF patients using the Korean nationwide claims database between 2006 and 2017 were conducted. We identified AF patients who had ≥1 ED visits. The incidence of ED visits among total AF population, cause of ED visit, and clinical outcomes were evaluated. During 12 years, the annual numbers of AF patients who attended ED at least once a year continuously increased (40,425 to 99,763). However, the annual incidence of ED visits of AF patients was stationary at about 30% because the number of total AF patients also increased during the same period. The most common cause of ED visits was cerebral infarction. Although patients had a higher risk profile over time, the 30-day and 90-day mortality after ED visit decreased over time. ED visits due to ischemic stroke, intracranial hemorrhage, and myocardial infarction decreased, whereas ED visits due to AF, gastrointestinal bleeding, and other major bleeding slightly increased among total AF population over 12 years. A substantial proportion of AF patients attended ED every year, and the annual numbers of AF patients who visited the ED significantly increased over 12 years. Optimized management approaches in a holistic and integrated manner should be provided to reduce ED visits of AF patients.

scholarly journals Temporal Trends and Predictors of Modern Contraceptive Use in Lusaka, Zambia, 2004–2011

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nancy L. Hancock ◽  
Carla J. Chibwesha ◽  
Marie C. D. Stoner ◽  
Bellington Vwalika ◽  
Sujit D. Rathod ◽  
...  
Keyword(s):  
Contraceptive Use ◽  
Temporal Trends ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Short Term ◽  
Cross Sectional ◽  
Oral Contraceptive Pills ◽  
Modern Methods ◽  
Modern Contraceptive Use ◽  
Over Time

Introduction. Although increasing access to family planning has been an important part of the global development agenda, millions of women continue to face unmet need for contraception.Materials and Methods. We analyzed data from a repeated cross-sectional community survey conducted in Lusaka, Zambia, over an eight-year period. We described prevalence of modern contraceptive use, including long-acting reversible contraception (LARC), among female heads of household aged 16–50 years. We also identified predictors of LARC versus short-term contraceptive use among women using modern methods.Results and Discussion. Twelve survey rounds were completed between November 2004 and September 2011. Among 29,476 eligible respondents, 17,605 (60%) reported using modern contraception. Oral contraceptive pills remained the most popular method over time, but use of LARC increased significantly, from less than 1% in 2004 to 9% by 2011 (p<0.001). Younger women (OR: 0.46, 95% CI: 0.34, 0.61) and women with lower levels of education (OR: 0.70, 95% CI: 0.56, 0.89) were less likely to report LARC use compared to women using short-term modern methods.Conclusions. Population-based assessments of contraceptive use over time can guide programs and policies. To achieve reproductive health equity and reduce unmet contraceptive need, future efforts to increase LARC use should focus on young women and those with less education.

Twitter Usage Using Common Reference to Tinnitus

2020 ◽  
Vol 29 (2) ◽  
pp. 206-217
Author(s):  
Jianyuan Ni ◽  
Monica L. Bellon-Harn ◽  
Jiang Zhang ◽  
Yueqing Li ◽  
Vinaya Manchaiah
Keyword(s):  
Nonprofit Organizations ◽  
Temporal Trends ◽  
Temporal Analysis ◽  
Cross Sectional ◽  
For Profit ◽  
Common Reference ◽  
Personal Experiences ◽  
Twitter Users ◽  
Sectional Analysis ◽  
Share Information

Objective The objective of the study was to examine specific patterns of Twitter usage using common reference to tinnitus. Method The study used cross-sectional analysis of data generated from Twitter data. Twitter content, language, reach, users, accounts, temporal trends, and social networks were examined. Results Around 70,000 tweets were identified and analyzed from May to October 2018. Of the 100 most active Twitter accounts, organizations owned 52%, individuals owned 44%, and 4% of the accounts were unknown. Commercial/for-profit and nonprofit organizations were the most common organization account owners (i.e., 26% and 16%, respectively). Seven unique tweets were identified with a reach of over 400 Twitter users. The greatest reach exceeded 2,000 users. Temporal analysis identified retweet outliers (> 200 retweets per hour) that corresponded to a widely publicized event involving the response of a Twitter user to another user's joke. Content analysis indicated that Twitter is a platform that primarily functions to advocate, share personal experiences, or share information about management of tinnitus rather than to provide social support and build relationships. Conclusions Twitter accounts owned by organizations outnumbered individual accounts, and commercial/for-profit user accounts were the most frequently active organization account type. Analyses of social media use can be helpful in discovering issues of interest to the tinnitus community as well as determining which users and organizations are dominating social network conversations.

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