scholarly journals Differential Risk Factor Profiles in the Prediction of General and Pain-Specific Functional Limitations 12 Months after Major Pediatric Surgery

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 360
Author(s):  
Brittany N. Rosenbloom ◽  
P. Maxwell Slepian ◽  
M. Gabrielle Pagé ◽  
Lisa Isaac ◽  
Fiona Campbell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anxiety Sensitivity ◽  
Pediatric Surgery ◽  
Functional Disability ◽  
Surgical Complication ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Major Surgery ◽  
Chronic Post Surgical Pain ◽  
Highly Correlated

Pediatric chronic post-surgical pain is a surgical complication associated with various levels of functional limitation. Two commonly used measures of functional limitations in youth are the Functional Disability Inventory (FDI) and the PROMIS Pediatric Pain Interference Scale (PPIS), where the former is general, and the latter, pain specific. The aim of the present study was to prospectively compare pre-surgical youth and parent risk factors for youth functional limitations, assessed by the FDI and PPIS, 12 months after major pediatric surgery. Risk factors for the FDI and PPIS were compared in 79 dyads consisting of youth (58% female, M = 14.56 years; SD = 2.31) undergoing major surgery and one of their parents. The FDI and PPIS were highly correlated prior to surgery (r = 0.698, p < 0.001) and even more so 12 months after surgery (r = 0.807, p < 0.001). Parent pre-surgical anxiety sensitivity and youth pre-surgical functional disability significantly predicted 12-month FDI (F(6,56) = 4.443, p = 0.001, Adjusted R2 = 0.25), whereas parent pre-surgical anxiety sensitivity, trait anxiety, pain anxiety, as well as youth pain-related anxiety and worry significantly predicted 12-month PPIS (F(6,45) = 4.104, p = 0.002, Adjusted R2 = 0.27). Risk factors for 12-month general and pain-specific functional limitations differ by dyad member and type. Functional limitations in youth after surgery are predicted by youth and parent factors, however the risk factors differ between the FDI and the PPIS.

scholarly journals FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.2-808
Author(s):  
N. Hammam ◽  
G. Salem ◽  
D. Fouad ◽  
S. Rashad
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Functional Limitations ◽  
Functional Limitation ◽  
C Reactive Protein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Distribution Width ◽  
Reactive Protein ◽  
Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

scholarly journals Pediatric Chronic Postsurgical Pain And Functional Disability: A Prospective Study Of Risk Factors Up To One Year After Major Surgery

2019 ◽  
Vol Volume 12 ◽  
pp. 3079-3098 ◽  
Author(s):  
Brittany N Rosenbloom ◽  
M Gabrielle Pagé ◽  
Lisa Isaac ◽  
Fiona Campbell ◽  
Jennifer N Stinson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Functional Disability ◽  
Major Surgery ◽  
Postsurgical Pain ◽  
Chronic Postsurgical Pain ◽  
One Year ◽  
A Prospective Study

PREP — The Preoperative Risk Education Package: an online educational resource for primary care clinicians to encourage community based prehabilitation prior to major surgery

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697277
Author(s):  
James Durrand ◽  
F McHardy ◽  
E Land ◽  
Z Llewellyn ◽  
C Norman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Perioperative Risk ◽  
Perioperative Outcomes ◽  
Major Surgery ◽  
Educational Resource ◽  
Major Step ◽  
Early Evaluation ◽  
Risk Education ◽  
Primary Care Clinicians

BackgroundPrehabilitation prior to major surgery mandates cross-sector working. Utilising the preoperative window from referral requires clinician engagement. Awareness of perioperative risk factors is crucial. A national survey uncovered gaps in knowledge and understanding.AimCreate an open-access, online educational resource for primary care clinicians.MethodOur multidisciplinary team developed a focused CPD resource targeting lifestyle factors and chronic health conditions influencing perioperative risk (www.prepwell.co.uk).ResultsPREP highlights seven risk factors influencing perioperative risk: Smoking, alcohol, inactivity, anaemia, cognitive impairment, frailty and low BMI. A case study frames each factor alongside perioperative impact and prehabilitation strategies.ConclusionPREP is the first educational resource of its type. Early evaluation through local clinicians, the RCGP and RCOA has resulted in very positive feedback. We are working with Royal College representatives to gain formal endorsement and facilitate wider scale rollout, a major step towards raised clinician awareness and enhanced collaboration for improved perioperative outcomes.

New Statistical Methods Inspired by Data Collected from Alcohol and Substance Abuse Research

2018 ◽  
Author(s):  
Anne Buu ◽  
Runze Li
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Longitudinal Data ◽  
Developmental Trajectories ◽  
Regression Splines ◽  
Simulation Studies ◽  
Process Data ◽  
Measurement Reactivity ◽  
Longitudinal Association ◽  
Highly Correlated

This chapter provides a nontechnical review of new statistical methodology for longitudinal data analysis that has been published in statistical journals in recent years. The methodology has applications in four important areas: (1) conducting variable selection among many highly correlated risk factors when the outcome measure is zero-inflated count; (2) characterizing developmental trajectories of symptomatology using regression splines; (3) modeling the longitudinal association between risk factors and substance use outcomes as time-varying effects; and (4) testing measurement reactivity and predictive validity using daily process data. The excellent statistical properties of the methods introduced have been supported by simulation studies. The applications in alcohol and substance abuse research have also been demonstrated by graphs on real longitudinal data.

scholarly journals Increased development of radiographic hip osteoarthritis in individuals with high bone mass: a prospective cohort study

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
April Hartley ◽  
Sarah A. Hardcastle ◽  
Monika Frysz ◽  
Jon Parkinson ◽  
Lavinia Paternoster ◽  
...  
Keyword(s):  
Bone Mass ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Mineral Density ◽  
High Bone Mass ◽  
High Bone ◽  
Subchondral Sclerosis

Abstract Background Individuals with high bone mass (HBM) have a greater odds of prevalent radiographic hip osteoarthritis (OA), reflecting an association with bone-forming OA sub-phenotypes (e.g. osteophytosis, subchondral sclerosis). As the role of bone mineral density (BMD) in hip OA progression is unclear, we aimed to determine if individuals with HBM have increased incidence and/or progression of bone-forming OA sub-phenotypes. Methods We analysed an adult cohort with and without HBM (L1 and/or total hip BMD Z-score > + 3.2) with pelvic radiographs collected at baseline and 8-year follow-up. Sub-phenotypes were graded using the OARSI atlas. Superior/inferior acetabular/femoral osteophyte and medial/superior joint space narrowing (JSN) grades were summed and Δosteophyte and ΔJSN derived. Pain and functional limitations were quantified using the WOMAC questionnaire. Associations between HBM status and change in OA sub-phenotypes were determined using multivariable linear/logistic regression, adjusting for age, sex, height, total body fat mass, follow-up time and baseline sub-phenotype grade. Generalised estimating equations accounted for individual-level clustering. Results Of 136 individuals, 62% had HBM at baseline, 72% were female and mean (SD) age was 59 (10) years. HBM was positively associated with both Δosteophytes and ΔJSN (adjusted mean grade differences between individuals with and without HBM βosteophyte = 0.30 [0.01, 0.58], p = 0.019 and βJSN = 0.10 [0.01, 0.18], p = 0.019). Incident subchondral sclerosis was rare. HBM individuals had higher WOMAC hip functional limitation scores (β = 8.3 [0.7, 15.98], p = 0.032). Conclusions HBM is associated with the worsening of hip osteophytes and JSN over an average of 8 years, as well as increased hip pain and functional limitation.

scholarly journals Social integration and its relationship with functional limitations in Chilean older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L de Albuquerque Araújo ◽  
G Icaza Noguera ◽  
C Albala Brevis
Keyword(s):  
Older Adults ◽  
Social Integration ◽  
Daily Living ◽  
Protective Factor ◽  
Public Policies ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Lower Prevalence ◽  
Community Groups ◽  
Recreational Activities

Abstract We are experiencing the highest levels of life expectancy and it poses challenges in the maintenance of the functional capacity in old age. This study seeks to determine the relation between social integration and functional limitation in Chilean older adults. Cross-sectional study with baseline of two cohort studies: the SABE cohort (born before 1940) and the Alexandros cohort (born between 1940 and 1948 from Primary Health Care centers), from Santiago. Were considered 1733 elderly. Performance variables were studied in seven Instrumental Activity of Daily Living (IADL): preparing food, managing money, leaving home alone, making purchases, making or receiving calls, doing light housework, organizing and taking medications, and six basic Activities of Daily Living (ADL): bathing, dressing, use of the bathroom, transfer, continence of urine and feeding. Having difficulties or inability to perform at least one activity was classified as having functional limitations. Social integration variables were: participation in community groups, clubs or organizations and in recreational activities. Adjustment variables were: sex, age, educational level, household income, depression, cognitive impairment and multimorbidity. Robust Poisson Regression was performed and prevalence ratios (PR) of functional limitation in ADL and IADL were reported. The level of significance was ≤0.5. Prevalence of functional limitations in ADL was 73.3% and in AIVD was 37.1%. Who participated in recreational activities have a lower prevalence of functional limitation in ADL (PR 0.85; 95%CI 0.80-0.90) and in IADL (PR 0.74; 95% CI0.63-0.86). Participation in community groups, clubs or organizations was associated with a lower prevalence of limitation in ADL (RP 0.78; 95%CI 0.71-0.87), although it was not significantly related to performance in IADL. Greater social integration in adulthood is a protective factor for limitation in ADL and IADL and should be the subject of public policies in Chile. Key messages Social integration seems to be a protective factor for functional limitation in Chilean older adults. Society and public policies should give greater opportunity for the elderly to participate in recreational activities and community groups.

scholarly journals Vascular lesions and functional limitations among older adults: does depression make a difference?

2014 ◽  
Vol 26 (9) ◽  
pp. 1501-1509 ◽  
Author(s):  
Celia F. Hybels ◽  
Carl F. Pieper ◽  
Lawrence R. Landerman ◽  
Martha E. Payne ◽  
David C. Steffens
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
White Matter ◽  
Functional Impairment ◽  
Functional Limitations ◽  
Late Life ◽  
Cognitive Status ◽  
Cerebral White Matter ◽  
Late Life Depression ◽  
Increased Risk

ABSTRACTBackground:The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.Methods:The study sample was 237 older adults diagnosed with major depression and 140 never depressed comparison adults, with both groups assessed at study enrollment. The dependent variable was the number of limitations in basic activities of daily living (ADL), instrumental ADLs, and mobility tasks. The independent variable was the total volume of cerebral white matter lesions or hyperintensities assessed though magnetic resonance imaging.Results:In analyses controlling for age, sex, race, high blood pressure, and cognitive status, a greater volume of WMH was positively associated with the total number of functional limitations as well as the number of mobility limitations among those older adults with late life depression but not among those never depressed, suggesting the association between WMH volume and functional status differs in the presence of late life depression.Conclusions:These findings suggest older patients with both depression and vascular risk factors may be at an increased risk for functional decline, and may benefit from management of both cerebrovascular risk factors and depression.

scholarly journals Relationship between symptom burden and health status: analysis of the MDASI-BT and EQ-5D

2017 ◽  
Vol 5 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Elizabeth Vera ◽  
Alvina A Acquaye ◽  
Tito R Mendoza ◽  
Mark R Gilbert ◽  
Terri S Armstrong
Keyword(s):  
Health Status ◽  
Functional Limitations ◽  
Performance Status ◽  
Functional Limitation ◽  
Symptom Burden ◽  
Tumor Grade ◽  
Walking Activity ◽  
Patient Health ◽  
And Performance ◽  
Md Anderson

Abstract Background Patients with glioma are highly symptomatic and often have functional limitations from the time of diagnosis. Measuring health status may have value in determining impact of disease. This study provided a description of health status and utility scores in glioma patients throughout the illness trajectory using the EQ-5D (a functional measure of general health status). Furthermore, it evaluated the information provided by the MD Anderson Symptom Inventory-Brain Tumor (MDASI-BT; a measure of symptom burden and interference) in describing health-related quality of life as assessed by the EQ-5D. Methods Glioma patients completed the EQ-5D and MDASI-BT. Disease and clinical details were collected by medical record review. Linear regression evaluated whether MDASI-BT scores adequately predict patient health outcomes measured by the EQ-5D. Results The sample included 100 patients (65% male, 78% with a glioblastoma, median age 52 [range, 20–75], 56% in active treatment). Seventy-two percent of patients reported functional limitations in at least 1 area. Extreme cases reported inability to perform usual activities (8%) and significant anxiety/depression (5%). The MDASI-BT neurologic factor and activity-related interference (walking/activity/work) explained 52% of the variability in the EQ-5D in this patient population while adjusting for the effect of tumor grade, recurrence status, and performance status. Conclusions The majority of glioma patients reported at least 1 functional limitation on the EQ-5D. Over half of the variance in the EQ-5D was explained by the MDASI-BT, performance status, tumor grade, and recurrence status. The resultant model demonstrates the significant contribution of symptom burden on health status in glioma patients.

A Model of Risk Reduction for Older Adults Vulnerable to Nursing Home Placement

2014 ◽  
Vol 28 (2) ◽  
pp. 162-192 ◽  
Author(s):  
Janice L. Palmer ◽  
Joanne C. Langan ◽  
Jean Krampe ◽  
Mary Krieger ◽  
Rebecca A. Lorenz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Nursing Home ◽  
Health Care Providers ◽  
Functional Disability ◽  
Nursing Home Placement ◽  
Nursing Home Care ◽  
Multiple Chronic Conditions ◽  
Care Providers ◽  
Home Placement

Because of the cost of nursing home care and desire of older adults to stay in their homes, it is important for health care providers to understand the factors that place older adults at risk for nursing home placement. This integrative review of 12 years of research, as published in 148 articles, explores the risk factors for nursing home placement of older adults. Using the framework of the vulnerable populations conceptual model developed by Flaskerud and Winslow (1998), we explored factors related to resource availability, relative risks, and health status. Important factors include socioeconomic status, having a caregiver, the availability and use of home- and community-based support services, race, acute illness particularly if hospitalization is required, medications, dementia, multiple chronic conditions, functional disability, and falls. Few intervention studies were identified. Development of evidence-based interventions and creation of policies to address modifiable risk factors are important next steps.

scholarly journals Limited activity and social participation after hospital discharge from leprosy treatment in a hyperendemic area in north Brazil

2014 ◽  
Vol 17 (1) ◽  
pp. 91-104 ◽  
Author(s):  
Lorena Dias Monteiro ◽  
Carlos Henrique Alencar ◽  
Jaqueline Caracas Barbosa ◽  
Candice Cristiane Barros Santana Novaes ◽  
Rita de Cássia Pereira da Silva ◽  
...  
Keyword(s):  
Social Participation ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Cross Sectional Study ◽  
Activity Limitation ◽  
Cross Sectional ◽  
Dermatological Examination ◽  
Safety Awareness ◽  
North Brazil ◽  
Operational Classification

INTRODUCTION: Neural damages are among the main factors that contribute to physical disability in leprosy. Systematic monitoring using a broad physical, psychological and social approach is necessary. OBJECTIVE: The objective of this study was to characterize the limitation of activity and social participation and its correlation with disabilities and/or impairment in individuals after being discharged from a multidrug leprosy therapy. METHOD: A cross-sectional study conducted in Araguaína, state of Tocantins, which is a leprosy hyperendemic municipality. We included cases of patients who were discharged from treatment considered as cured from January 2004 to December 2009. We performed dermatological examination and applied the Screening Activity Limitation and Safety Awareness (SALSA) and social participation scales. RESULTS: We included 282 individuals (mean age: 45.8 years old). The paucibacillary operational classification was more common (170; 60.3%). The eye-hand-foot score ranged from 0 to 12 (mean: 0.7). A total of 84 (29.8%) individuals presented limited activity. A slight restriction in social participation occurred in 18 (6.3%) cases. There was a statistically significant correlation between activity limitation, age (r = 0.40; p < 0.0001) and degree of functional limitation (r = 0.54; p < 0.0001), as well as of restricted social participation, activity limitation (r = 0.56, p < 0.0001) and functional limitations (r = 0.54, p < 0.0001). CONCLUSION: Functional limitation due to leprosy had an impact on the conduct of activities and social participation after the discharge from a leprosy treatment. The association between Screening of Activity Limitation and Safety Awareness and participation scales will assist in designing evidence-based assistance measures.

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