The interaction between parental concern and socioeconomic status in pediatric hydrocephalus management

2021 ◽  
Vol 27 (1) ◽  
pp. 16-22
Author(s):  
Rebecca A. Reynolds ◽  
Makayla Dixon ◽  
Stephen Gannon ◽  
Shilin Zhao ◽  
Christopher M. Bonfield ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Status ◽  
Medical Condition ◽  
Medical Center ◽  
Pediatric Neurosurgery ◽  
Cross Sectional Study ◽  
Third Ventriculostomy ◽  
Parental Concern ◽  
Cross Sectional ◽  
Patient Reported

OBJECTIVEParent or guardian involvement is implicit in the care of pediatric patients with hydrocephalus. Some parents and guardians are more engaged than others. The relationship between socioeconomic status (SES), the level of parental concern about their child’s hydrocephalus management and future, and overall health status has not been clearly delineated. In this study, the authors sought to clarify this connection using hydrocephalus patient-reported health outcomes.METHODSThis cross-sectional study included children with surgically managed hydrocephalus whose parent or guardian completed the validated Hydrocephalus Outcome Questionnaire (HOQ) and Hydrocephalus Concern Questionnaire for parents (HCQ-P) on a return visit to the pediatric neurosurgery clinic at Vanderbilt University Medical Center between 2016 and 2018. Patients were excluded if the questionnaires were not completed in full. The calculated Overall Health Score (OHS) was used to represent the child’s global physical, emotional, cognitive, and social health. The HCQ-P was used to assess parental concern about their child. Type of insurance was a proxy for SES.RESULTSThe HOQ and HCQ-P were administered and completed in full by 170 patient families. In the cohort, 91% of patients (n = 155) had shunt-treated hydrocephalus, and the remaining patients had undergone endoscopic third ventriculostomy. The mean (± SD) patient age was 12 ± 4 years. Half of the patients were male (n = 90, 53%), and most were Caucasian (n = 134, 79%). One in four patients lived in single-parent homes or with a designated guardian (n = 45, 26%). Public insurance and self-pay accounted for 38% of patients (n = 64), while the remaining 62% had private or military insurance. In general, parents with higher concern about their child’s medical condition indicated that their son or daughter had a higher OHS (χ2 = 17.07, p < 0.001). Patients in families with a lower SES did not have different OHSs from those with a higher SES (χ2 = 3.53, p = 0.06). However, parents with a lower SES were more worried about management of their child’s hydrocephalus and their child’s future success (χ2 = 11.49, p < 0.001). In general, parents were not preoccupied with one particular aspect of their child’s hydrocephalus management.CONCLUSIONSMore engaged parents, regardless of their family’s SES, reported a better OHS for their child. Parents with public or self-paid insurance were more likely to report higher concern about their child’s hydrocephalus and future, but this was not associated with a difference in their child’s current health status.

scholarly journals PROMIS Scales for Assessment of Persistent Post-COVID Symptoms: A Cross Sectional Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110304
Author(s):  
Ravindra Ganesh ◽  
Aditya K. Ghosh ◽  
Mark A. Nyman ◽  
Ivana T. Croghan ◽  
Stephanie L. Grach ◽  
...  
Keyword(s):  
Health Status ◽  
Social Roles ◽  
Disease Process ◽  
Cross Sectional Study ◽  
Large Sample Size ◽  
Sectional Study ◽  
Cross Sectional ◽  
Data Set ◽  
Patient Reported ◽  
The Impact

Objective Persistent post-COVID symptoms are estimated to occur in up to 10% of patients who have had COVID-19. These lingering symptoms may persist for weeks to months after resolution of the acute illness. This study aimed to add insight into our understanding of certain post-acute conditions and clinical findings. The primary purpose was to determine the persistent post COVID impairments prevalence and characteristics by collecting post COVID illness data utilizing Patient-Reported Outcomes Measurement Information System (PROMIS®). The resulting measures were used to assess surveyed patients physical, mental, and social health status. Methods A cross-sectional study and 6-months Mayo Clinic COVID recovered registry data were used to evaluate continuing symptoms severity among the 817 positive tested patients surveyed between March and September 2020. The resulting PROMIS® data set was used to analyze patients post 30 days health status. The e-mailed questionnaires focused on fatigue, sleep, ability to participate in social roles, physical function, and pain. Results The large sample size (n = 817) represented post hospitalized and other managed outpatients. Persistent post COVID impairments prevalence and characteristics were determined to be demographically young (44 years), white (87%), and female (61%). Dysfunction as measured by the PROMIS® scales in patients recovered from acute COVID-19 was reported as significant in the following domains: ability to participate in social roles (43.2%), pain (17.8%), and fatigue (16.2%). Conclusion Patient response on the PROMIS® scales was similar to that seen in multiple other studies which used patient reported symptoms. As a result of this experience, we recommend utilizing standardized scales such as the PROMIS® to obtain comparable data across the patients’ clinical course and define the disease trajectory. This would further allow for effective comparison of data across studies to better define the disease process, risk factors, and assess the impact of future treatments.

scholarly journals A cross-sectional study of socioeconomic status and sickness presenteeism in Japanese workers during the COVID-19 pandemic

2021 ◽  
Author(s):  
Masashi Masuda ◽  
Tomohiro Ishimaru ◽  
Ayako Hino ◽  
Hajime Ando ◽  
Seiichiro Tateishi ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Health Status ◽  
Cross Sectional Study ◽  
Financial Instability ◽  
Sectional Study ◽  
Lifestyle Habits ◽  
Cross Sectional ◽  
Sickness Presenteeism ◽  
Japanese Workers ◽  
The Relationship

Background: We examined the relationship between socioeconomic and health status, and lifestyle habits and sickness presenteeism among Japanese workers during the COVID-19 epidemic. Methods: A cross-sectional study using Internet monitors was conducted in December, 2020 in Japan. Of 33,302 survey participants, we analysed 27,036 (13,814 males and 13,222 females) who reported experience with sickness presenteeism. Results: The OR of sickness presenteeism associated with unmarried versus married status was 1.15. Respective figures for other variables were 1.11 for manual laboring work compared to desk work; 1.79 and 2.29 for loss of employment at the time the pandemic began and continuation of unemployment compared to maintaining employment during the pandemic; and 3.34 for a feeling of financial instability compared to stability. Conclusion: The issue of sickness presenteeism has been highlighted by COVID-19.

scholarly journals Healthcare utilization and costs among prolactinoma patients: a cross-sectional study and analysis of determinants

Pituitary ◽  
2020 ◽  
Author(s):  
Merel van der Meulen ◽  
Amir H. Zamanipoor Najafabadi ◽  
Daniel J. Lobatto ◽  
Wilbert B. van den Hout ◽  
Cornelie D. Andela ◽  
...  
Keyword(s):  
Health Status ◽  
Healthcare Utilization ◽  
Short Form ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Specialist Care ◽  
Cross Sectional ◽  
Tertiary Referral Center ◽  
Patient Reported ◽  
Self Reported Health Status

Abstract Purpose Prolactinomas are the most prevalent functioning pituitary adenomas. They affect gonadal function as well as health-related quality of life (HRQoL). This study aimed to report healthcare utilization and costs, including their determinants, for prolactinoma patients. Methods Cross-sectional study of 116 adult prolactinoma patients in chronic care in a Dutch tertiary referral center. Patients completed four validated questionnaires, assessing healthcare utilization and costs over the previous 12 months (Medical Consumption Questionnaire), disease bother and needs (Leiden Bother and Needs Questionnaire Pituitary), HRQoL (Short Form-36), and self-reported health status (EuroQol 5D). Regression analyses were used to assess associations between disease-related characteristics and healthcare utilization and costs. Results Mean age was 52.0 years (SD 13.7) and median follow-up was 15.0 years (IQR 7.6–26.1). Patients visited the endocrinologist (86.2%), general practitioner (37.9%), and ophthalmologist (25.0%) most frequently. Psychological care was used by 12.9% of patients and 5% were admitted to hospital. Mean annual healthcare costs were €1928 (SD 3319), mainly for pituitary-specific medication (37.6% of total costs), hospitalization (19.4%) and specialist care (16.1%). Determinants for higher healthcare utilization and costs were greater disease bother and needs for support, lower HRQoL, elevated prolactin, and longer disease duration, while tumor size, hypopituitarism and adrenal insufficiency were not significantly associated with healthcare utilization and costs. Conclusion Healthcare utilization and costs of prolactinoma patients are related to patient-reported HRQoL, bother by disease and needs for support. Therefore, addressing patients’ HRQoL and needs is a way forward to improve efficiency of care and patients’ health status.

scholarly journals Clinical significance of self-reported cough intensity and frequency in patients with interstitial lung disease: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ryuhei Sato ◽  
Tomohiro Handa ◽  
Hisako Matsumoto ◽  
Takeshi Kubo ◽  
Toyohiro Hirai
Keyword(s):  
Health Status ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cough Frequency ◽  
Patient Reported ◽  
Clinical Indices

Abstract Background The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices. Methods In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Scores on the Leicester Cough Questionnaire, chronic dyspnoea scale, and a frequency scale for symptoms of gastro-oesophageal reflux disease (FSSG) were collected. The correlations of cough intensity and frequency with potential predictor variables were tested using bivariate and multiple logistic regression analysis. Results The study included 70 patients with IIPs, 49 with CTD-ILD, and 10 with CHP. Patients with IIPs had the most severe cough intensity among the three patient groups. In patients with IIPs, both the intensity and frequency of cough were negatively associated with the diffusing capacity of the lung for carbon monoxide and positively with the Composite Physiologic Index (CPI). In CTD-ILD, both the intensity and frequency of cough were correlated with a higher FSSG score. In multivariate analysis of patients with ILD, IIPs and the FSSG score were independently associated with both components of cough, and CPI tended to be independently associated with cough frequency. Finally, we examined the features of the differences between cough intensity and frequency in all patients with ILD. Patients in whom cough frequency was predominant had a greater impairment of health status relative to other patients. Conclusions Cough intensity was greater in IIPs than in other ILDs. Different clinical indices were associated with patient-reported cough intensity and frequency according to the subtype of ILD. Cough frequency was more strongly associated with health status than was cough intensity. These findings suggest that medical staff could manage patients with ILD by considering cough-related factors when assessing the intensity and frequency of cough.

scholarly journals A cross-sectional study of the health status of Swiss primary care physicians

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paul Sebo ◽  
Thierry Favrod-Coune ◽  
Liv Mahler ◽  
Amir Moussa ◽  
Christine Cohidon ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Psychological Health ◽  
Primary Care Physicians ◽  
Medical Condition ◽  
Good Health ◽  
Cross Sectional Study ◽  
Cardiovascular Disorders ◽  
Cross Sectional ◽  
The Past

AbstractThere is limited data on the general health of primary care physicians (PCPs). We aimed to assess the physical and psychological health of Swiss PCPs. We selected a random sample of 1000 PCPs in Western Switzerland. They were asked about their self-rated health status, all medical conditions experienced in the past five years, and the number of days they were hospitalized and off work in 2019. They were also asked whether they had their own general practitioner (GP) and seen a psychiatrist/psychologist in the past 12 months. A total of 503 PCPs were included in the study (women = 51%, GPs = 67%, pediatricians = 19%, gynecologists = 14%). Ninety-four percent considered themselves in good or very good health. In the past five years, PCPs suffered mostly from depression/anxiety (21%), burnout (21%), dyslipidemia (19%) and hypertension (17%). Male and older PCPs had more often cardiovascular disorders, younger PCPs and GPs had more often psychiatric disorders. They were 9% to have been hospitalized (15% for PCPs over 60) and 20% to have been off work (32% for PCPs under 45). Only 47% had their own GP (37% for GPs). They were 16% (mostly female and younger PCPs) to have consulted a psychiatrist/psychologist. In conclusion, although PCPs considered themselves to be in good health, a substantial proportion suffered from a medical condition, mainly psychiatric (depression or burnout) and/or cardiovascular disorders, or were recently hospitalized or off work. Only half had a GP for themselves. These results may be useful for implementing specific health strategies targeting PCPs.

scholarly journals Clinical significance of self-reported cough intensity and frequency in patients with interstitial lung disease: a cross-sectional study

2019 ◽  
Author(s):  
Ryuhei Sato ◽  
Tomohiro Handa ◽  
Hisako Matsumoto ◽  
Takeshi Kubo ◽  
Toyohiro Hirai
Keyword(s):  
Health Status ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cough Frequency ◽  
Patient Reported ◽  
Clinical Indices

Abstract Background: The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices. Methods: In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Scores on the Leicester Cough Questionnaire, chronic dyspnoea scale, and a frequency scale for symptoms of gastro-oesophageal reflux disease (FSSG) were collected. The correlations of cough intensity and frequency with potential predictor variables were tested using bivariate and multiple logistic regression analysis. Results: The study included 70 patients with IIPs, 49 with CTD-ILD, and 10 with CHP. Patients with IIPs had the most severe cough intensity among the three patient groups. In patients with IIPs, both the intensity and frequency of cough were negatively associated with diffusing capacity of the lung for carbon monoxide and positively with the Composite Physiologic Index (CPI). In CTD-ILD, both the intensity and frequency of cough correlated with a higher FSSG score. In multivariate analysis of patients with ILD, IIPs and the FSSG score was independently associated with both components of cough, and CPI tended to be independently associated with cough frequency alone. Finally, we examined the features of differences between cough intensity and frequency in all patients with ILD. Patients in whom cough frequency was predominant had greater impairment of health status relative to other patients. Conclusions: The intensity of cough was greater in IIPs than in other ILDs. Different clinical indices were associated with patient-reported cough intensity and frequency according to the subtype of ILD. The frequency of cough was more strongly associated with health status than was the intensity of cough. These findings suggest that medical staff could manage patients with ILD by considering cough-related factors when assessing the intensity and frequency of cough.

Interpretation of Normal and Abnormal Tympanogram Findings in Eustachian Tube Dysfunction

2020 ◽  
pp. 019459982096523
Author(s):  
Sean M. Parsel ◽  
Graham D. Unis ◽  
Spenser S. Souza ◽  
Heather Bartley ◽  
Jeffrey M. Bergeron ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Eustachian Tube Dysfunction ◽  
Asymptomatic Group ◽  
Cross Sectional ◽  
Symptomatic Group ◽  
Asymptomatic Patients ◽  
Patient Reported ◽  
Tube Dysfunction

Objective To characterize the relationship between objective tympanogram values and patient-reported symptoms and associations with common comorbid conditions. Study Design Cross-sectional study with prospective data collection. Setting Tertiary medical center. Methods Patients undergoing routine audiometric evaluation between October 2018 and June 2019 were included. Participants with temporomandibular joint dysfunction, inner ear hydrops, and similar conditions were excluded. Symptoms were assessed with the 7-item Eustachian Tube Dysfunction Questionnaire. Demographics and medical comorbidities were recorded from the medical record. Analysis of tympanometric peak pressure (TPP), demographics, and comorbidities was performed to determine associations with clinically significant eustachian tube dysfunction (ETD) symptoms. Results A total of 250 patients were included with similar demographics: 101 (40.4%) in the asymptomatic group and 149 (59.6%) in the symptomatic group. The median (interquartile range) TPP was –10 (20) daPa and –25 (100) daPa in the asymptomatic and symptomatic groups, respectively. A diagnosis of rhinitis was more likely to be associated with significant ETD symptoms (adjusted odds ratio, 2.61; 95% CI, 1.23-5.63). A subgroup analysis revealed that symptomatic patients with normal TPP values were negatively skewed as compared with asymptomatic patients. This symptomatic group had a higher prevalence of rhinitis and chronic rhinosinusitis than the asymptomatic group. Conclusion Patients with symptoms of ETD may have a TPP within a range typically considered normal per conventional standards. This suggests that the currently accepted interpretation of tympanometry findings may be insensitive for the diagnosis of less severe cases of ETD.

scholarly journals Clinical significance of self-reported cough intensity and frequency in patients with interstitial lung disease: a cross-sectional study

2019 ◽  
Author(s):  
Ryuhei Sato ◽  
Tomohiro Handa ◽  
Hisako Matsumoto ◽  
Takeshi Kubo ◽  
Toyohiro Hirai
Keyword(s):  
Health Status ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Multiple Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cough Frequency ◽  
Patient Reported ◽  
Clinical Indices

Abstract Background: The intensity and frequency of cough remain unclear in interstitial lung disease (ILD). The aim of this study was to evaluate the intensity and frequency of cough in idiopathic interstitial pneumonias (IIPs), connective tissue disease-associated interstitial lung disease (CTD-ILD), and chronic hypersensitivity pneumonia (CHP), and examine their associations with clinical indices. Methods: In this cross-sectional study, the intensity and frequency of cough were evaluated using a 100-mm visual analogue scale. Scores on the Leicester Cough Questionnaire, chronic dyspnoea scale, and a frequency scale for symptoms of gastro-oesophageal reflux disease (FSSG) were collected. The correlations of cough intensity and frequency with potential predictor variables were tested using bivariate and multiple logistic regression analysis. Results: The study included 70 patients with IIPs, 49 with CTD-ILD, and 10 with CHP. Patients with IIPs had the most severe cough intensity among the three patient groups. In patients with IIPs, both the intensity and frequency of cough were negatively associated with the diffusing capacity of the lung for carbon monoxide and positively with the Composite Physiologic Index (CPI). In CTD-ILD, both the intensity and frequency of cough were correlated with a higher FSSG score. In multivariate analysis of patients with ILD, IIPs and the FSSG score were independently associated with both components of cough, and CPI tended to be independently associated with cough frequency. Finally, we examined the features of the differences between cough intensity and frequency in all patients with ILD. Patients in whom cough frequency was predominant had a greater impairment of health status relative to other patients. Conclusions: Cough intensity was greater in IIPs than in other ILDs. Different clinical indices were associated with patient-reported cough intensity and frequency according to the subtype of ILD. Cough frequency was more strongly associated with health status than was cough intensity. These findings suggest that medical staff could manage patients with ILD by considering cough-related factors when assessing the intensity and frequency of cough.

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