scholarly journals Scaling a Community-Wide Campaign Intervention to Manage Hypertension and Weight Loss

2021 ◽  
Vol 8 ◽  
Author(s):  
Belinda M. Reininger ◽  
Lisa A. Mitchell-Bennett ◽  
MinJae Lee ◽  
Paul G. Yeh ◽  
Amanda C. Davé ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Logistic Regression ◽  
Low Income ◽  
Regression Models ◽  
Mean Difference ◽  
Exposure Group ◽  
High Exposure ◽  
Low Exposure ◽  
Outreach Visits

Public health impacts can be achieved when evidence-based interventions are implemented to those most in need. Too often implementation never or slowly occurs. The community-wide campaign intervention Tu Salud ¡Si Cuenta! has evidence of improving health outcomes related to chronic disease among low-income, Latinos. Using the RE-AIM Framework, this study examined if the scaled-up version of the intervention is associated with improvements in hypertension and obesity in 12 locations. Each element of the RE-AIM framework was examined. For “Effectiveness,” we examined outcomes overall and by implementing location. We used linear and logistic regression to assess if exposure in the intervention was associated with improvement in hypertension and weight loss. Participants were stratified into “low exposure” (2–3 outreach visits) vs. “high exposure” (4–5 outreach visits). Based on the RE-AIM Framework, the intervention “reached” its intended population of low-income Latinos, demonstrated “effectiveness” in improving hypertension and obesity, was “adopted” at a high level in all but one site, was “implemented” with fidelity to the intervention model with moderate success across locations, and showed high “maintenance” over time. For effectiveness specifically, we found that out of 5,019 participants, 2,508 (50%) had a baseline hypertensive blood pressure (BP) reading. Of the 2,508, 1,245 (49.9%) recovered to normal blood pressure or pre-hypertension stage by last follow-up. After adjusting for baseline BP and potential confounders in multivariable linear regression models, the high exposure group had significantly more reduction in systolic BP (adjusted mean difference in % change = −0.96; p = 0.002) and diastolic BP (adjusted mean difference in % change = −1.61; p < 0.0001) compared to the low exposure group. After controlling for baseline weight and other confounders, the high exposure group had significantly greater decrease in weight compared to the low exposure group (adjusted mean difference in % change = −1.28; p < 0.0001). Results from the multivariable logistic regression models indicated that compared to the low exposure group the high exposure group was more likely to achieve a clinically significant minimum 5% weight loss [adjusted odds ratio (OR) = 2.97; p < 0.0001). This study contributes evidence that a Community-Wide Campaign model holds promise for addressing hypertension and obesity among low-income Latinos.

Abstract P180: Does Poverty Consistently Affect Food Consumption in Childhood? Evidence from a Longitudinal Study in Children

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Lisa Kakinami ◽  
Marie Lambert ◽  
Lise Gauvin ◽  
Louise Séguin ◽  
Béatrice Nikiéma ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Food Consumption ◽  
Low Income ◽  
Fruits And Vegetables ◽  
Latent Class ◽  
Group Analysis ◽  
High Exposure ◽  
Low Exposure ◽  
Statistics Canada ◽  
The Relationship

Background: Childhood poverty is associated with poorer food consumption patterns but longitudinal data on this association is limited. To assess if the relationship between food consumption and poverty differs depending on the child’s age and pattern of poverty, we analyzed the relationship between consumption of selected foods and poverty trajectories at various ages in a birth cohort. Methods: The 1998-2010 "Quebec Longitudinal Study of Child Development" (n=2,120) cohort was used for these analyses. Household income was measured annually with poverty defined as income below the low-income thresholds established by Statistics Canada adjusted for household size and geographic region. Frequency of children’s consumption of dairy (milk, cheese, yogurt), fruits, and vegetables were reported by parents using a food frequency questionnaire. Analyses were conducted on the 739 children with food consumption data. Trajectories of poverty at 6, 8, 10, and 12 years were characterized with latent class group analysis using maximum likelihood in a semiparametric mixture model. Multivariable logistic regression predicted the likelihood of having less than 2 servings a day of dairy, fruits and vegetables based on poverty trajectories after adjusting for age and sex. Results: The poverty trajectories were stable and fell into 1 lower exposure category (consistently low exposure (73%, n=537)) and 3 higher exposure categories (increasing: 8%, n=61; decreasing: 10%, n=73; or consistently high exposure: 9%, n=68)). Compared to children experiencing low exposure to poverty, children with increasing or high exposure to poverty were less likely to have at least two servings of fruit a day at all ages, but the results were not significant. Compared to children experiencing low exposure to poverty, children with high exposure were 55% (CI: 0.2-0.8, p=0.001), 31% (CI: 0.4-1.2, p=0.23), 67% (CI: 0.2-0.6, p<.0001), and 49% (CI: 0.3-0.8, p=0.001) less likely to have at least two servings of dairy a day at 6, 8, 10, and 12 years, respectively. Compared to children with low exposure to poverty, children with high exposure were 43% (CI: 0.3-0.9, p=0.02), 46% (CI: 0.3-0.9, p=0.02), 55% (CI: 0.3-0.8, p=0.003), and 47% (CI: 0.3-0.9, p=0.02) less likely to have at least two servings of vegetables a day at 6, 8, 10, and 12 years, respectively. Children at all ages with decreasing or increasing exposure to poverty were less likely to have at least two servings of vegetables a day, but the results were not statistically significant. Conclusion: Experiencing high exposure to poverty has consistent effects on food consumption throughout childhood. In addition, compared to children with low exposure to poverty, children with increasing or decreasing exposure were less likely to have at least 2 servings of fruits and vegetables a day, suggesting any exposure to poverty may have detrimental effects on consumption of selected foods.

scholarly journals Dose–response effects in an outbreak of Salmonella enteritidis

1994 ◽  
Vol 112 (1) ◽  
pp. 13-23 ◽  
Author(s):  
E. D. Mintz ◽  
M. L. Cartter ◽  
J. L. Hadler ◽  
J. T. Wassell ◽  
J. A. Zingeser ◽  
...  
Keyword(s):  
Incubation Period ◽  
Salmonella Enteritidis ◽  
Subjective Rating ◽  
Exposure Group ◽  
Group V ◽  
High Exposure ◽  
Shell Eggs ◽  
Duration Of Illness ◽  
Low Exposure

SummaryThe effects of ingested Salmonella enteritidis (SE) dose on incubation period and on the severity and duration of illness were estimated in a cohort of 169 persons who developed gastroenteritis after eating hollandaise sauce made from grade–A shell eggs. The cohort was divided into three groups based on self–reported dose of sauce ingested. As dose increased, median incubation period decreased (37 h in the low exposure group 21 h in the medium exposure group v. 17·5 h. in the high exposure group, P = 0.006) and greater proportions reported body aches (71 v. 85 v. 94%, P = 0.0009) and vomiting (21 v. 56 v. 57%, P = 0.002). Among 118 case-persons who completed a follow–up questionnaire, increased dose was associated with increases in median weight loss in kilograms (3.2 v. 4.5 v. 5.0, P = 0.0001), maximum daily number of stools (12.5 v. 15.0 v. 20.0, P = 0.02), subjective rating of illness severity (P = 0.0007), and the number of days of confinement to bed (3.0 v. 6.5, P = 0.04). In this outbreak, ingested dose was an important determinant of the incubation period, symptoms and severity of acute salmonellosis.

scholarly journals P.2.14 Pulmonary dysfunction in indium tin oxide exposed workers

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A91.1-A91
Author(s):  
Saou-hsing Liou ◽  
Yuan-Ting Hsu ◽  
Wei-Jin Li ◽  
Wei-Te Wu
Keyword(s):  
Tin Oxide ◽  
Indium Tin Oxide ◽  
Interstitial Pneumonitis ◽  
Reference Group ◽  
Surfactant Protein ◽  
Surfactant Protein D ◽  
Exposure Group ◽  
High Exposure ◽  
Lung Dysfunction ◽  
Low Exposure

AimTo investigate the relationship between indium exposure and lung effects markers among indium tin oxide (ITO) manufacturing workers without job change.MethodsWe enrolled 179 male workers from ITO target manufacturing and recycling factories in Taiwan. Plasma indium (P-In), urine indium (U-In) and creatinine adjusted U-In (U-In/Creat.) were used as internal dose of indium exposure. Plasma Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) were used as markers of interstitial pneumonitis. Forced vital capacity (FVC), forced expiratory volume at 1 st second (FEV1), and FEV1/FVC were also evaluated by spirometry.ResultsAfter adjusted for covariates by linear regression, plasma, urinary and creatinine adjusted indium were increased in high exposure group (P-In: β=1.13, p<0.001; U-In: β=0.54, p<0.05; U-In/Cre: β=0.63, p<0.01) and low exposure group (P-In: β=0.75, p<0.05; U-In/Cre: β=0.52, p<0.05) with comparison to reference group. Plasma KL-6 was higher in high exposure group (β=0.24, p<0.05) compared to reference group, but not for surfactant protein D (SP-D). Furthermore, FVC and FEV1 were reduced in both high exposure group (FVC: β=−0.08, p<0.01; FEV1: β=−0.05, p<0.05) and low exposure group (FVC: β=−0.06, p<0.05) compared to reference group.ConclusionOur findings indicate indium exposure was related to restrictive lung dysfunction, decreased lung function for both FEV1 and FVC test but not for FEV1/FVC ratio. Meanwhile, increased plasma KL-6 in high exposure group also supports that indium exposure results in increased risk of interstitial pneumonitis among direct indium exposure workers. Our study provided an explanation to the consequence of indium exposure- interstitial pneumonitis-restrictive lung dysfunction.

scholarly journals Application of Logistic Regression Models for the Marketability of Cucumber Cultivars

Agronomy ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 17 ◽  
Author(s):  
Manuel Díaz-Pérez ◽  
Ángel Carreño-Ortega ◽  
José-Antonio Salinas-Andújar ◽  
Ángel-Jesús Callejón-Ferre
Keyword(s):  
Weight Loss ◽  
Logistic Regression ◽  
Shelf Life ◽  
Regression Models ◽  
Chilling Injury ◽  
Binary Logistic Regression ◽  
Fruit Weight ◽  
Binary Logistic Regression Analysis ◽  
Cucumis Sativus L ◽  
Logistic Regression Models

The aim of this study is to establish a binary logistic regression method to evaluate and select cucumber cultivars (Cucumis sativus L.) with a longer postharvest shelf life. Each sample was evaluated for commercial quality (fruit aging, weight loss, wilting, yellowing, chilling injury, and rotting) every 7 days of storage. Simple and multiple binary logistic regression models were applied in which the dependent variable was the probability of marketability and the independent variables were the days of storage, cultivars, fruit weight loss, and months of evaluation. The results showed that cucumber cultivars with a longer shelf life can be selected by a simple and multiple binary logistic regression analysis. Storage time was the main determinant of fruit marketability. Fruit weight loss strongly influenced the probability of marketability. The logistic model allowed us to determine the cucumber weight loss percentage over which a fruit would be rejected in the market.

scholarly journals Weight Status and High Blood Pressure Among Low-Income African American Men

2010 ◽  
Vol 5 (3) ◽  
pp. 255-260 ◽  
Author(s):  
Marino A. Bruce ◽  
Bettina M. Beech ◽  
Christopher L. Edwards ◽  
Mario Sims ◽  
Isabel Scarinci ◽  
...  
Keyword(s):  
Blood Pressure ◽  
African American ◽  
High Blood Pressure ◽  
Low Income ◽  
Regression Models ◽  
Weight Status ◽  
African American Men ◽  
Logistic Regression Models ◽  
Biological Risk Factor ◽  
West Tennessee

Obesity is a biological risk factor or comorbidity that has not received much attention from scientists studying hypertension among African American men. The purpose of this study was to examine the relationship between weight status and high blood pressure among African American men with few economic resources. The authors used surveillance data collected from low-income adults attending community- and faith-based primary care clinics in West Tennessee to estimate pooled and group-specific regression models of high blood pressure. The results from group-specific logistic regression models indicate that the factors associated with hypertension varied considerably by weight status. This study provides a glimpse into the complex relationship between weight status and high blood pressure status among African American men. Additional research is needed to identify mechanisms through which excess weight affects the development and progression of high blood pressure.

scholarly journals Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study

2019 ◽  
Author(s):  
Senthil Packiasabapathy K ◽  
Varesh Prasad ◽  
Valluvan Rangasamy ◽  
David Popok ◽  
Xinling Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Outcome Prediction ◽  
Prediction Ability ◽  
Logistic Regression Models

Abstract Background Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We aimed to test the performance of Poincaré plots and coefficient of variation (CV) independently by measuring intraoperative BP variability.Methods In this retrospective, observational, cohort study, 3687 adult patients undergoing cardiac surgery from 2008 to 2013 were included. Poincaré plots from BP data and descriptors SD1, SD2 by ellipse fitting technique were computed. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability.Results Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (SD1, SD2 and CV) performed poorly in predicting postoperative 30-day mortality and renal failure. They did not add any significant value to the conventional prediction model.Conclusions We demonstrate the feasibility of applying Poincaré plots for BP variability analysis. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.

scholarly journals Cardiac Surgical Outcome Prediction by Blood Pressure Variability Indices Poincaré plot and Coefficient of Variation: an Observational Study

2020 ◽  
Author(s):  
Senthil Packiasabapathy K ◽  
Varesh Prasad ◽  
Valluvan Rangasamy ◽  
David Popok ◽  
Xinling Xu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Logistic Regression ◽  
Cardiac Surgery ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Outcome Prediction ◽  
Logistic Regression Models ◽  
C Statistic

Abstract Background Recent literature suggests a significant association between blood pressure variability (BPV) and postoperative outcomes after cardiac surgery. However, its outcome prediction ability remains unclear. Current prediction models use static preoperative patient factors. We explored the ability of Poincaré plots and coefficient of variation (CV) by measuring intraoperative BPV in predicting adverse outcomes. Methods In this retrospective, observational, cohort study, 3687 adult patients (> 18 years) undergoing cardiac surgery requiring cardio-pulmonary bypass from 2008 to 2014 were included. Blood pressure variability was computed by Poincare plots and CV. Standard descriptors (SD) SD1, SD2 were measured with Poincare plots by ellipse fitting technique. The outcomes analyzed were the 30-day mortality and postoperative renal failure. Logistic regression models adjusted for preoperative and surgical factors were constructed to evaluate the association between BPV parameters and outcomes. C-statistics were used to analyse the predictive ability. Results Analysis found that, 99 (2.7%) patients died within 30 days and 105 (2.8%) patients suffered from in-hospital renal failure. Logistic regression models including BPV parameters (standard descriptors from Poincare plots and CV) performed poorly in predicting postoperative 30-day mortality and renal failure [Concordance(C)-Statistic around 0.5]. They did not add any significant value to the standard STS risk score [C-statistic: STS alone 0.7, STS + BPV parmeters 0.7]. Conclusions In conclusion, BP variability computed from Poincare plots and CV were not predictive of mortality and renal failure in cardiac surgical patients. Patient comorbid conditions and other preoperative factors are still the gold standard for outcome prediction. Future directions include analysis of dynamic parameters such as complexity of physiological signals in identifying high risk patients and tailoring management accordingly.

scholarly journals Use and effectiveness of dapagliflozin in patients with type 2 diabetes mellitus: a multicenter retrospective study in Taiwan

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e9998
Author(s):  
Jung-Fu Chen ◽  
Yun-Shing Peng ◽  
Chung-Sen Chen ◽  
Chin-Hsiao Tseng ◽  
Pei-Chi Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Weight Loss ◽  
Type 2 Diabetes Mellitus ◽  
Logistic Regression ◽  
Body Weight ◽  
Retrospective Study ◽  
Multivariate Logistic Regression

Aims/Introduction To investigate the clinical outcomes of patients with type 2 diabetes mellitus (T2DM) who initiated dapagliflozin in real-world practice in Taiwan. Materials and Methods In this multicenter retrospective study, adult patients with T2DM who initiated dapagliflozin after May 1st 2016 either as add-on or switch therapy were included. Changes in clinical and laboratory parameters were evaluated at 3 and 6 months. Baseline factors associated with dapagliflozin response in glycated hemoglobin (HbA1c) were analyzed by univariate and multivariate logistic regression. Results A total of 1,960 patients were eligible. At 6 months, significant changes were observed: HbA1c by −0.73% (95% confidence interval [CI] −0.80, −0.67), body weight was -1.61 kg (95% CI −1.79, −1.42), and systolic/diastolic blood pressure by −3.6/−1.4 mmHg. Add-on dapagliflozin showed significantly greater HbA1c reduction (−0.82%) than switched therapy (−0.66%) (p = 0.002). The proportion of patients achieving HbA1c <7% target increased from 6% at baseline to 19% at Month 6. Almost 80% of patients experienced at least 1% reduction in HbA1c, and 65% of patients showed both weight loss and reduction in HbA1c. Around 37% of patients had at least 3% weight loss. Multivariate logistic regression analysis indicated patients with higher baseline HbA1c and those who initiated dapagliflozin as add-on therapy were associated with a greater reduction in HbA1c. Conclusions In this real-world study with the highest patient number of Chinese population to date, the use of dapagliflozin was associated with significant improvement in glycemic control, body weight, and blood pressure in patients with T2DM. Initiating dapagliflozin as add-on therapy showed better glycemic control than as switch therapy.

Increased blood pressure variability after endovascular thrombectomy for acute stroke is associated with worse clinical outcome

2018 ◽  
Vol 10 (9) ◽  
pp. 823-827 ◽  
Author(s):  
Alicia E Bennett ◽  
Michael J Wilder ◽  
J Scott McNally ◽  
Jana J Wold ◽  
Gregory J Stoddard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Blood Pressure Variability ◽  
Regression Models ◽  
Ordinal Logistic Regression ◽  
Logistic Regression Models ◽  
Intravenous Tissue Plasminogen Activator ◽  
Point Increase ◽  
Tissue Plasminogen

Background and purposeBlood pressure variability has been found to contribute to worse outcomes after intravenous tissue plasminogen activator, but the association has not been established after intra-arterial therapies.MethodsWe retrospectively reviewed patients with an ischemic stroke treated with intra-arterial therapies from 2005 to 2015. Blood pressure variability was measured as standard deviation (SD), coefficient of variation (CV), and successive variation (SV). Ordinal logistic regression models were fitted to the outcome of the modified Rankin Scale (mRS) with univariable predictors of systolic blood pressure variability. Multivariable ordinal logistic regression models were fitted to the outcome of mRS with covariates that showed independent predictive ability (P<0.1).ResultsThere were 182 patients of mean age 63.2 years and 51.7% were female. The median admission National Institutes of Health Stroke Scalescore was 16 and 47.3% were treated with intravenous tissue plasminogen activator. In a univariable ordinal logistic regression analysis, systolic SD, CV, and SV were all significantly associated with a 1-point increase in the follow-up mRS (OR 2.30–4.38, all P<0.002). After adjusting for potential confounders, systolic SV was the best predictor of a 1-point increase in mRS at follow-up (OR 2.63–3.23, all P<0.007).ConclusionsIncreased blood pressure variability as measured by the SD, CV, and SV consistently predict worse neurologic outcomes as measured by follow-up mRS in patients with ischemic stroke treated with intra-arterial therapies. The SV is the strongest and most consistent predictor of worse outcomes at all time intervals.

scholarly journals Community health worker-led, technology-enabled private sector intervention for diabetes and hypertension management among urban poor: a retrospective cohort study from large Indian metropolitan city

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045246
Author(s):  
Sarang Deo ◽  
Preeti Singh
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Private Sector ◽  
Community Health ◽  
Low Income ◽  
Retrospective Cohort ◽  
Retention Rate ◽  
Fasting Blood Glucose ◽  
Mean Difference ◽  
Secondary Outcome

ObjectivesWe assessed the effectiveness of community health workers (CHWs)-led, technology-enabled programme as a large-scale, real-world solution for screening and long-term management of diabetes and hypertension in low-income and middle-income countries.DesignRetrospective cohort design.SettingForty-seven low-income neighbourhoods of Hyderabad, a large Indian metropolis.ParticipantsParticipants (aged ≥20 years) who subscribed to an ongoing community-based chronic disease management programme employing CHWs and technology to manage diabetes and hypertension.Primary and secondary outcome measuresWe used deidentified programme data between 1 March 2015 and 8 October 2018 to measure participants’ pre-enrolment and post-enrolment retention rate and within time-interval mean difference in participants’ fasting blood glucose and blood pressure using Kaplan-Meier and mixed-effect regression models, respectively.Results51 126 participants were screened (median age 41 years; 65.2% women). Participant acquisition rate (screening to enrolment) was 4%. Median (IQR) retention period was 163.3 days (87.9–288.8), with 12 months postenrolment retention rate as 16.5% (95% CI 14.7 to 18.3). Reduction in blood glucose and blood pressure levels varied by participants’ retention in the programme. Adjusted mean difference from baseline ranged from −14.0 mg/dL (95% CI −18.1 to −10.0) to −27.9 mg/dL (95% CI −47.6 to −8.1) for fasting blood glucose; −2.7 mm Hg (95% CI −7.2 to 2.7) to −7.1 mm Hg (95% CI −9.1 to −4.9) for systolic blood pressure and −1.7 mm Hg (95% CI −4.6 to 1.1) to −4.2 mm Hg (95% CI −4.9 to −3.6) for diastolic blood pressure.ConclusionsCHW-led, technology-enabled private sector interventions can feasibly screen individuals for non-communicable diseases and effectively manage those who continue on the programme in the long run. However, changes in the model (eg, integration with the public health system to reduce out-of-pocket expenditure) may be needed to increase its adoption by individuals and thereby improve its cost-effectiveness.

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