scholarly journals Analysis of Trend and Associated Factors of Neuropsychological Development of Infants and Toddlers Based on Longitudinal Data

Children ◽  
2021 ◽  
Vol 8 (10) ◽  
pp. 866
Author(s):  
Deng Chen ◽  
Yunzhe Huang ◽  
Andrew Swain ◽  
Xiaoguang Yang ◽  
Jinming Yu
Keyword(s):  
Associated Factors ◽  
Self Care ◽  
Physiological Age ◽  
Age Group ◽  
Infants And Toddlers ◽  
Gross Motor ◽  
Neuropsychological Development ◽  
High Age ◽  
The Impact

Objective: To explore the trend and associated factors of neuropsychological development of infants and toddlers in China. Methods: A longitudinal study was conducted among 619 infants and toddlers (2914 person-times) aged 0 to 36 months from different provinces or cities in China from January 2013 to December 2019. Results: The development age of each area increased with the extension of follow-up time, but this upward trend slowed down with physiological age at first measurement increasing. Among a low age group and each area, most of the development qualification rates in different follow-up periods were higher than that in the baseline (p < 0.05); however, many of them were not higher than that in the baseline among the medium or high age group (p > 0.05). For the areas of gross motor and self-care, the growth of qualification rate with the extension of follow-up was not obvious in the medium and high age group (both p trend > 0.05). Some impact factors of development in all areas were identified. Conclusions: The neuropsychological development delay of various areas of infants and toddlers, especially that of gross motor and self-care, should be paid early (within 1 years old) and constant attention. The impact of gender and maternal age on the development of young children has been further confirmed in the present study.

scholarly journals Medication Adherence and Associated Factors among Chronic Heart Failure Clients on Follow Up Oromia Region, West Ethiopia

2019 ◽  
Vol 17 (2) ◽  
pp. 104-114
Author(s):  
Getahun Fetensa ◽  
Birhanu Yadecha ◽  
Tadesse Tolossa ◽  
Tariku Tesfaye Bekuma
Keyword(s):  
Heart Failure ◽  
Medication Adherence ◽  
Chronic Heart Failure ◽  
Health Education ◽  
Study Design ◽  
Associated Factors ◽  
Multivariable Analysis ◽  
Self Care ◽  
P Value

Background: Chronic heart failure is a complex clinical syndrome with typical symptoms that can occur at rest or on effort. It requires patients to manage their lifestyle with their disease and when to notify their healthcare provider. The study was aimed to identify medication adherence and associated factors among chronic heart failure clients on follow up Oromia region, West Ethiopia, 2017. Methods: Institutional based cross-sectional study design was employed, after selecting three hospitals by lottery method and allocating respondents to the three hospitals proportionally. A total of 424 patients were admitted to the medical ward and/or chronic follow up of Nekemte referral, Gimbi, and Shambu hospitals. The data was collected using a structured questionnaire. The data was entered into Epi-data version 3.1, cleared, explored, and then exported to SPSS windows version 24.0 for further analysis. Variable having a p-value less than 0.05 in the bivariate analysis was a candidate for multivariable analysis and the effect of confounding variables was observed. Variables having a p-value less than 0.05 in the multivariable analysis were assumed significant. Results: A total of 424 respondents were included in the final analysis giving a 95.3% response rate. The result indicated that more than half of the study participants have adhered to prescribed medication. Respondents with good medication adherence were more likely to adhere to good self-care behavior [AOR (95% CI of OR) = 3.5(2.044, 5.96)]. Respondents whose limited fluid intake was one or half-liter per day were more likely to adhere to the medication [AOR (95% CI of OR) = 2.5(1.43, 4.49)]. It was also found that those patients who avoided spices, sauces and others in food are more likely to adhere to the medication [AOR (95% CI of OR) = 2.2 (1.152, 4.039)]. Conclusion and Recommendation: Even if more than half of the study respondents have good medication and self-care adherence, still it needs great attention in health education over their visit. Health institutions are strongly recommended to give health education for clients and researchers to use advanced study design for measuring medication adherence and self-care behaviors.

scholarly journals Do Depressive Symptoms Shape Blacks’ Perceptions of Stress Over Time?

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
DeAnnah R Byrd ◽  
Roland J Thorpe ◽  
Keith E Whitfield
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Perceived Stress ◽  
Ordinary Least Squares ◽  
Community Dwelling ◽  
Stressful Events ◽  
Age Group ◽  
The Impact ◽  
Over Time

Abstract Background and Objectives Previous studies have linked stress to multiple negative mental health outcomes, including depression. This established stress–depression association is typically examined in one direction and cross-sectionally. This study examined the bidirectional relationships between depressive symptoms and changes in perceived stress over time in Blacks. Research Design and Methods The present study uses a community-dwelling sample of 450 Black adults, aged 51–96 years old, who participated in the Baltimore Study of Black Aging—Patterns of Cognitive Aging. Perceived stress—measured by the Perceived Stress Scale—and depressive symptoms—measured using the Center for Epidemiologic Studies Depression scale—were both assessed at baseline and follow-up 33 months later. Ordinary least squares regression was used to examine 2 bidirectional longitudinal relationships between (1) stress–depression and (2) depression–stress, and whether these associations are modified by age. Results Initial analyses testing the typical stress–depression relationship showed an effect in the expected direction, that is stress leading to more depressive symptoms over time, adjusting for model covariates, but the effect was not statistically significant (b = 0.014, p = .642). After accounting for baseline perceived stress level, age, sex, education, and chronic health conditions, depressive symptoms were positively associated with follow-up stress (b = 0.210, p &lt; .000). The depression–stress association further varied by age group such that the impact of baseline depression on changes in perceived stress was greatest in Blacks in their 60s versus those in their 50s (b = 0.267, p = .001), controlling for model covariates. Discussion and Implications Contrary to previous work, the results suggest that an individual’s mental health shapes his/her perception of stressful events and this relationship varies by age group. While the typical finding (stress impacting depression) was not significant, the findings reported here highlight the importance of considering the possible bidirectional nature of the relationships between psychosocial measures of stress and mental health in later life among Blacks.

Impact of parental onchocerciasis and intensity of transmission on development and persistence ofOnchocerca volvulusinfection in offspring: an 18 year follow-up study

Parasitology ◽  
2003 ◽  
Vol 127 (4) ◽  
pp. 327-335 ◽  
Author(s):  
A. K. KIRCH ◽  
H. P. DUERR ◽  
B. BOATIN ◽  
W. S. ALLEY ◽  
W. H. HOFFMANN ◽  
...  
Keyword(s):  
Associated Factors ◽  
Multiple Logistic Regression Analysis ◽  
Infection Intensity ◽  
Control Programme ◽  
Multiple Logistic Regression ◽  
Transmission Potential ◽  
Follow Up Study ◽  
The Impact ◽  
Onchocerciasis Control

This study analysed the impact and the extent by which parentalOnchocerca volvulusinfection, intensity of transmission ofO. volvulusinfective 3rd-stage larvae (L3) and anthropometric factors may influence the acquisition, development and persistence ofO. volvulusinfection in offspring. A total of 15 290 individuals in 3939 families with 9640 children were surveyed for microfilariae ofO. volvulus, and prevalence and level ofO. volvulusinfection in children aged 0 to 20 years from infected and non-infected parents were followed longitudinally for 18 years. Children fromO. volvulus-infected mothers had not only a substantially higher risk to become infected; they also acquired infection earlier in life and developed higher infection levels. Multiple logistic regression analysis showed that maternalO. volvulusinfection and children's age are the predominant predictors for patentO. volvulusinfection, while the intensity of transmission, measured by the annual transmission potential (ATP) ofO. volvulusL3, was less decisive. Longitudinal follow up of children showed that during vector control activities by the Onchocerciasis Control Programme (OCP) and in low-level transmission areas, infection persisted at higher levels in children fromO. volvulus-positive mothers. In summary, the dominant risk factor for children to become infected is maternal onchocerciasis, and also age-associated factors will strongly impact on the development of patentO. volvulusinfection in offspring.

scholarly journals Self-care Practice and Associated Factors Among Hypertensive Follow Up Patients at East Gojam Zone Public Hospitals, North West Ethiopia, 2021

2021 ◽  
Author(s):  
Haymanot Mitiku Zeleke ◽  
Birtuka Assefa ◽  
Teshager Sergo ◽  
Nakachew Mekonnen
Keyword(s):  
Social Support ◽  
Associated Factors ◽  
Self Care ◽  
Public Hospitals ◽  
Care Practice ◽  
Co Morbidity ◽  
Poor Social Support ◽  
Care Practices ◽  
Unfavorable Attitude

Abstract Background: Self-care practice is crucial for the prevention and management of Hypertension. Poorly controlled hypertension leads to cardiovascular complication as well as organ damage. Despite the availability of several effective pharmacologic and non-pharmacologic therapies, hypertension control remains suboptimal. Self-care practices allow hypertensive patients to have improved quality of life by avoiding complication and decrease health care expenditure. Objective: we assessed self-care practice and its associated factors among Hypertensive Follow up patients at East Gojjam Zone public hospitals, Northwest Ethiopia, 2020.Methods: Institution based cross sectional study was conducted by both quantitative and qualitative methods from October 1-30, 2020. Epi data version 3.1 and SPSS version 25.0 were used for data entry and for analysis respectively. Descriptive statistics and binary logistic regression analysis was employed. Adjusted odds ratios were used to ascertain effect sizes for any association between the dependent and associated variables while significance level at p value of 0.05 was determined using 95% confidence intervals. Result: Out of 480 patients included in the study 51% have Poor self-care practices. About 44.6%, 92.5%, 82.8%, 62.5% of respondents were poor adherent to antihypertensive medications, low diet quality, poor practiced to physical activity, poor practice to weight management respectively. Some of the respondents 3.3%, 9.8% were smokers and were alcohol drinkers respectively. Educational status who cannot read and write (AOR=3.153, 95% CI: 1.674-5.939), no co morbidity (AOR = 0.418, 95% CI: 0.263-0.663), uncontrolled blood pressure status (AOR = 2.141, 95% CI: 1.271- 3.609), poor social support status (AOR = 2.587, 95% CI: 1.544-4.334) and unfavorable attitude (AOR= 3.193, 95% CI: 1.951-5.225) showed significant statistical association with poor self-care practice.Conclusion: The level of hypertension self-care practices found to be low. Therefore, education towards hypertension self-care practices should be strengthened for patients living with hypertension. Special attention should be given to patients with low educational level that cannot read and write, patients with co morbidity, uncontrolled state of hypertension, poor social support and those with unfavorable attitude towards hypertension management modalities.

scholarly journals Nonadherence to Self-Care Practices, Antihypertensive Medications, and Associated Factors among Hypertensive Patients in a Follow-up Clinic at Asella Referral and Teaching Hospital, Ethiopia: A Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Addisu Dabi Wake ◽  
Techane Sisay Tuji ◽  
Addisu Tadesse Sime ◽  
Mekuria Tesfaye Mekonnin ◽  
Taju Mohamed Taji ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Associated Factors ◽  
Formal Education ◽  
Self Care ◽  
Multivariable Logistic Regression Analysis ◽  
Antihypertensive Medications ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Care Practices

Background. Hypertension is one of the most common noncommunicable diseases affecting several individuals globally. However, the level of nonadherence to self-care practices, antihypertensive medications, and associated factors among hypertensive patients in a follow-up clinic at Asella Referral and Teaching Hospital is unknown. Objective. To assess the level of nonadherence to self-care practices, antihypertensive medications, and associated factors among hypertensive patients in a follow-up clinic at Asella Referral and Teaching Hospital, Arsi Zone, Oromia Regional State, Ethiopia, in 2020. Methods. An institution-based cross-sectional survey was conducted on 115 hypertensive patients who visited the follow-up clinic at Asella Referral and Teaching Hospital from December 24, 2020, to January 15, 2021. Data were entered into EpiData version 4.2.0.0 and exported to SPSS version 21.0 for statistical analysis. Binary and multivariable logistic regression analysis was used to assess the presence of statistical association between dependent and independent variables. Results. A total of 115 hypertensive patients were enrolled into the study, giving a response rate of 98.29%. The mean age of the study participants was 55.17 years (SD = 17.986). More than half of them (59 (51.3%)) were females. More than half of them (58 (50.4%)) were married. Nearly two-thirds of them (79 (68.7%)) had formal education. The level of nonadherence to self-care practices was 67.0% (n = 77, 95% CI: 60.0, 75.7). Meanwhile, the patient’s level of nonadherence to antihypertensive medications was 16.5% (n = 19, 95% CI: 10.4, 24.3). The multivariable logistic regression analysis showed that age >45 years (AOR = 2.89, 95% CI: 1.16, 7.18), having no formal education (AOR = 1.67, 95% CI: 1.32, 3.74), and having ≤5 years’ duration since diagnoses of hypertension (AOR = 1.56, 95% CI: 1.07, 3.25) were factors significantly associated with nonadherence to self-care practices. Being male (AOR = 2.09, 95% CI: 1.93, 9.59), being married (AOR = 4.22, 95% CI: 1.29, 13.76), and having an average monthly income of ≤2500 ETB (AOR = 1.58, 95% CI: 1.09, 7.08) were factors significantly associated with nonadherence to medications. Conclusion. In the present study, the level of both nonadherence to self-care practices and antihypertensive medications was relatively high. There is a need to initiate programs that could create awareness about adherence to self-care practices and antihypertensive medications among hypertensive patients to improve their level of adherence.

scholarly journals 412. Estimating the Impact of School Classroom Sizes on the Probability of Severe Acute Respiratory Syndrome Coronavirus-2 Infectivity or Exposure

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S307-S307
Author(s):  
Sanya J Thomas ◽  
Rebecca R Young ◽  
Ibukunoluwa Akinboyo ◽  
Michael J Smith ◽  
Tara Buckley ◽  
...  
Keyword(s):  
North Carolina ◽  
Severe Acute Respiratory Syndrome ◽  
Reproduction Number ◽  
The United States ◽  
Mitigation Strategies ◽  
Age Group ◽  
Cohort Size ◽  
Research Support ◽  
The Impact

Abstract Background Despite schools reopening across the United States in communities with low and high Coronavirus disease 2019 (COVID-19) prevalence, data remain scarce about the effect of classroom size on the transmission of severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) within schools. This study estimates the effect of classroom size on the risk of COVID-19 infection in a closed classroom cohort for varying age groups locally in Durham, North Carolina. Total number of Coronavirus Disease 2019 (COVID-19) infections over a 28-day follow-up period for varying classroom reproduction number (R0) and varying classroom cohort sizes of 15 students, 30 students and 100 students in Durham County, North Carolina. Methods Using publicly available population and COVID-19 case count data from Durham County, we calculated a weekly average number of new confirmed COVID-19 cases per week between May 3, 2020 and August 22, 2020 according to age categories: &lt; 5 years, 5-9 years, 10-14 years, and 15-19 years. We collated average classroom cohort sizes and enrollment data for each age group by grade level of education for the first month of the 2019-2020 academic school year. Then, using a SEIR compartmental model, we calculated the number of susceptible (S), exposed (E), infectious (I) and recovered (R) students in a cohort size of 15, 30 and 100 students, modelling for classroom reproduction number (R0) of 0.5, 1.5 and 2.5 within a closed classroom cohort over a 14-day and 28-day follow-up period using age group-specific COVID-19 prevalence rates. Results The SEIR model estimated that the increase in cohort size resulted in up to 5 new COVID-19 infections per 10,000 students whereas the classroom R0 had a stronger effect, with up to 88 new infections per 10,000 students in a closed classroom cohort over time. When comparing different follow-up periods in a closed cohort with R0 of 0.5, we estimated 12 more infected students per 10,000 students over 28 days as compared to 14 days irrespective of cohort size. With a R0 of 2.5, there were 49 more infected students per 10,000 students over 28 days as compared to 14 days. Conclusion Classroom R0 had a stronger impact in reducing school-based COVID-19 transmission events as compared to cohort size. Additionally, earlier isolation of newly infected students in a closed cohort resulted in fewer new COVID-19 infections within that group. Mitigation strategies should target promoting safe practices within the school setting including early quarantine of newly identified contacts and minimizing COVID-19 community prevalence. Disclosures Michael J. Smith, MD, M.S.C.E, Merck (Grant/Research Support)Pfizer (Grant/Research Support)

scholarly journals Intestinal schistosomiasis of Ijinga Island, north-western Tanzania: prevalence, intensity of infection, hepatosplenic morbidities and their associated factors

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Andreas Mueller ◽  
Antje Fuss ◽  
Uwe Ziegler ◽  
Godfrey M. Kaatano ◽  
Humphrey D. Mazigo
Keyword(s):  
Public Health ◽  
Associated Factors ◽  
Age Group ◽  
Intensity Of Infection ◽  
Left Liver Lobe ◽  
Periportal Fibrosis ◽  
Intestinal Schistosomiasis ◽  
The Impact ◽  
North Western ◽  
Western Tanzania

Abstract Background Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children and does not include neither adult individuals nor other public health measures. The Ijinga schistosomiasis project examines the impact of an intensified treatment protocol with praziquantel MDA in combination with additional public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly endemic African setting using an integrated community-based approach. In preparation of this project, we report about baseline data on S.mansoni prevalence, intensity of infection, related hepatosplenic morbidities and their associated factors. Methods A cross sectional study was conducted among 930 individuals aged 1–95 years living at Ijinga Island, north-western Tanzania in September 2016. Single stool and urine samples were collected from each study participant and processed using Kato Katz (KK) technique and point-of-care Circulating Cathodic (POC-CCA) antigen test for detection of S.mansoni eggs and antigen respectively. Ultrasonographical examination for S.mansoni hepatosplenic morbidities was done to all participants. For statistical analyses Fisher’s exact test, chi-square test, student-t-test, ANOVA and linear regression were used where applicable. Results Overall based on KK technique and POC-CCA test, 68.9% (95%CI: 65.8–71.8) and 94.5% (95%CI: 92.8–95.8) were infected with S.mansoni. The overall geometrical mean eggs per gram (GMepg) of faeces was 85.7epg (95%CI: 77.5–94.8). A total of 27.1, 31.2 and 51.9% of the study participants had periportal fibrosis (PPF-grade C-F), splenomegaly and hepatomegaly. Risk factors for PPF were being male (aRR = 1.08, 95%CI: 1.02–1.16, P < 0.01), belong to the age group 16–25 years (aRR = 1.23, 95%CI: 105–1.44, P < 0.01), 26–35 years (aRR = 1.42, 95%CI: 1.21–1.67, P < 0.001), 36–45 years (aRR = 1.56, 95%CI:1.31–1.84, P < 0.001) and ≥ 46 years (aRR = 1.64, 95%CI:1.41–1.92, P < 0.001). The length of the left liver lobe was associated with being female (P < 0.03), belong to the age group 1–5 years (P < 0.013), 6–15 years (P < 0.04) and S.mansoni intensity of infection (P < 0.034). Male sex (aRR = 1.15, 95%CI:1.06–1.24, P < 0.001) and belonging to the age groups 16–25 years (aRR = 1.27, 95%CI:1.05–1.54, P < 0.02) or 26–35 years (aRR = 1.32, 95%CI:108–1.61, P < 0.01) were associated with splenomegaly. Conclusion Schistosoma mansoni infection and its related morbidities (hepatomegaly, splenomegaly, periportal fibrosis) are common in the study area. Age, sex and intensity of infection were associated with periportal fibrosis. The prevalence of S.mansoni was above 50% in each age group and based on the observed prevalence, we recommend MDA to the entire community.

Assessing the Impact of Age and Inhibitor Status on Functional Limitations of Patients with Severe and Moderately Severe Hemophilia a: Analysis from the Hemophilia and Thrombosis Research Society (HTRS) Registry.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3395-3395
Author(s):  
Cindy A. Leissinger ◽  
David L. Cooper ◽  
Caitlyn Wilke ◽  
Keyword(s):  
Hemophilia A ◽  
Self Care ◽  
Research Society ◽  
Physical Impairment ◽  
Activity Levels ◽  
Age Group ◽  
Severe Hemophilia ◽  
Thrombosis Research ◽  
Bleeding Episodes ◽  
The Impact

Abstract As many as 30% of patients with severe hemophilia A develop inhibitors that interfere with effective Factor VIII replacement therapy, and result in bleeding episodes that are difficult to treat. Poorly controlled joint bleeds lead to progressive joint disease and mobility dysfunction. It is presumed that the presence of inhibitors negatively impacts activity levels as well as employment and productivity throughout life. Few data exist on the relative impact of age and inhibitor status on activity levels among patients with severe and moderately severe hemophilia A. The Hemophilia and Thrombosis Research Society launched a registry in 1999 to collect information on subjects diagnosed with bleeding disorders and on their bleeding episodes. As of July 2008, there were 2497 patients registered in the database including 1340 with congenital hemophilia A (333 with inhibitors). Data on activity status was available for 330 subjects with hemophilia A who had ever had an inhibitor (inhibitor group), and 251 subjects with FVIII levels ≤ 2% who had never had an inhibitor (non-inhibitor group). The data was analyzed by age to compare children, adolescents, young adults and older adults. The results show that functional impairment increases with age in both the inhibitor group and non-inhibitor group (chi square, p<0.001 for both groups). Ordinal regression analysis shows patients in the inhibitor group demonstrate a trend towards increased physical impairment when compared to the non-inhibitor group when controlling for age effects (p=.053). Age Current Activity < 13 13–21 22–45 >45 Without Inhibitors, n 240 93 150 49 % Unrestricted 164 (68.3%) 55 (59.1%) 57 (38.0%) 16 (32.7%) % Full school/wk with limits 24 (10.0%) 10 (10.8%) 35 (23.3%) 13 (26.5%) % Limited school/wk 2 (0.8%) 5 (5.4%) 22 (14.7%) 8 (16.3%) % Limited school/wk & self care 0 (0.0%) 0 (0.0%) 9 (6.0%) 6 (12.2%) % Requires assistance 0 (0.0%) 1 (1.1%) 4 (2.7%) 0 (0.0%) % Unknown/Not Recorded 50 (20.8%) 22 (23.7%) 23 (15.3%) 6 (12.2%) With Inhibitors, n 186 58 69 17 % Unrestricted 127 (68.3%) 26 (44.8%) 10 (14.5%) 3 (17.6%) % Full school/wk with limits 17 (9.1%) 12 (20.7%) 21 (30.4%) 3 (17.6%) % Limited school/wk 12 (6.5%) 7 (12.1%) 15 (21.7%) 5 (29.4%) % Limited school/wk & self care 1 (0.5%) 0 (0.0%) 4 (5.8%) 2 (11.8%) % Requires assistance 1 (0.5%) 0 (0.0%) 6 (8.7%) 2 (11.8%) % Unknown/Not Recorded 28 (15.1%) 13 (22.4%) 13 (18.8%) 2 (11.8%) Highest and current inhibitor titers were characterized in 301 of 333 patients. Mean highest inhibitor titers (n=301) was 465 BU (median 50, range 0.6–20,000). Current mean inhibitor titer was 26.5 BU (median 0.1, range 0 – 602). Further analysis of the inhibitor group showed that while 67% of the under 13 age group had been exposed to immune tolerance induction (ITI), only 55% of the 13 – 21 age group had been exposed to ITI; the proportion of subjects exposed to ITI falls to 26% in the adults over age 21. The HTRS Registry contains one of the largest prospectively accumulated data sets of patients with congenital hemophilia with alloantibody inhibitors. A key advantage of this registry is that it tracks any patient with a history of inhibitors, rather than just current titers, making analysis of demographic data in this group possible. The most striking results from our review of the registry data are the extent to which inhibitor development poses the risk of progressive physical limitations to patients with severe and moderately severe hemophilia over and above effects of age, and confirms that the increased odds of physical impairment becomes apparent early, in the youngest cohort of patients, and continues to widen with advancing age. These results reaffirm the need for early eradication of inhibitors and better strategies for prevention of bleeds in both inhibitor and non-inhibitor patients. This analysis also highlights the benefit of ongoing study of these patients through HTRS.

scholarly journals The Influence of Age on the Likelihood of Catheter-Free Fistula Use in Hemodialysis Patients

2019 ◽  
Vol 6 ◽  
pp. 205435811986194
Author(s):  
Farah Ladak ◽  
Pietro Ravani ◽  
Matthew J. Oliver ◽  
Fareed Kamar ◽  
Alix Clarke ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Time Frame ◽  
Health Sciences ◽  
Hemodialysis Patients ◽  
Age Group ◽  
Similar Time ◽  
Median Percentage ◽  
The Impact ◽  
Dialysis Time

Background: Clinical practice guidelines recommend arteriovenous fistulas as the preferred form of vascular access for hemodialysis. However, some studies have suggested that older age is associated with poorer fistula outcomes. Objective: We assessed the impact of age on the outcomes of fistula creation and access-related procedures. Design: This was a prospective cohort study using data collected as part of the Dialysis Measurement Analysis and Reporting (DMAR) system. Setting: Participating Canadian dialysis programs, including Southern Alberta Renal Program, Manitoba Renal Program, Sunnybrook Health Sciences Centre (Toronto, Ontario), London Health Sciences Centre (London, Ontario), and The Ottawa Hospital (Ottawa, Ontario). Patients: Incident hemodialysis patients aged 18 years and older who started dialysis between January 1, 2004, and May 31, 2012. Measurements: The primary outcome was the proportion of all first fistula attempts that resulted in catheter-free fistula use, defined as independent use of a fistula for hemodialysis (ie, no catheter in place). Secondary outcomes included the time to catheter-free fistula use among patients with a fistula creation attempt, total number of days of catheter-free fistula use, and the proportion of a patient’s hemodialysis career spent with an independently functioning fistula (ie, catheter-free fistula use). Methods: We compared patient characteristics by age group, using t tests or Wilcoxon rank sum tests, and chi-square or Fisher exact tests, as appropriate. Logistic and fractional logistic regression were used to estimate the odds of achieving catheter-free fistula use by age group and the proportion of dialysis time spent catheter-free, respectively. Results: A total of 1091 patients met our inclusion criteria (567 age ≥ 65; 524 age < 65). Only 57% of first fistula attempts resulted in catheter-free fistula use irrespective of age (adjusted odds ratio [OR]≥65vs<65: 1.01; P = .93). The median time from hemodialysis start to catheter-free use of the first fistula did not differ by age when grouped into fistulas attempted pre- and post-dialysis initiation. The adjusted rates of access-related procedures were comparable (incidence rate ratio [IRR]≥65vs<65: 0.95; P = .32). The median percentage of follow-up time spent catheter-free was similar and low in patients who attempted fistulas (<65 years: 19% vs ≥65 years: 21%; P = .85). Limitations: The relatively short follow-up time may have underestimated the benefits of fistula creation and the observational study design precludes inferences about causality. Conclusions: In our study, older patients who underwent a fistula attempt were just as likely as younger patients to achieve catheter-free fistula use, within a similar time frame, and while requiring a similar number of access procedures. However, the minority of dialysis time was spent catheter-free.

scholarly journals Factors associated with headache and neck pain among telecommuters – a five days follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariève Houle ◽  
Arianne Lessard ◽  
Émile Marineau-Bélanger ◽  
Arnaud Lardon ◽  
Andrée-Anne Marchand ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neck Pain ◽  
Multivariate Regression ◽  
Associated Factors ◽  
Multivariate Regression Model ◽  
Work Related ◽  
Related Risk ◽  
The Impact ◽  
Headache And Neck Pain

Abstract Background The current sanitary crisis brought on by the COVID-19 recently forced a large proportion of workers to adopt telecommuting with limited time to plan transition. Given that several work-related risk factors are associated with headache and neck pain, it seems important to determine those associated with headache and neck pain in telecommuters. The main objective of this study was to identify which telecommuting and individual associated factors are related with headache and neck pain occurrence in telecommuters over a five days follow-up. The second objective was to evaluate the impact of wearing a headset on headache and neck pain intensity in telecommuters. Methods One hundred and sixty-two participants in telecommuting situation were recruited. Baseline assessment included sociodemographic data, headache and neck pain-related disability (6-item Headache Impact Test (HIT-6) and Neck Bournemouth Questionnaire (NBQ)), headache and neck pain frequency and intensity as well as questions about the wearing of a headset (headset wearing, headset type and headset wearing hours). A prospective data collection of headache, neck pain and headset wearing was conducted using daily e-mail over a 5-day follow-up. A stepwise multivariate regression model was performed to determine associated factors of headache or neck pain occurrence during the follow-up. A t-test was conducted to assess the impact of headset wearing on headache and neck pain intensity during the follow-up. Results Regarding headache, the stepwise multivariate regression model showed that the HIT-6 score was associated with future headache occurrence in telecommuters (OR (95% CI) = 1.094 (1.042–1.148); R2 = 0.094; p <  0.001). For neck pain, the stepwise multivariate regression showed that the NBQ score was related to future neck pain occurrence in telecommuters (OR (95% CI) = 1.182 (1.102–1.269); R2 = 0.182; p <  0.001). T-test showed no difference between participants that wore a headset and participant that did not wore a headset on mean headache (p = 0.94) and neck pain (p = 0.56) intensity during the five days follow-up. Conclusion Although several work-related risk factors are associated with headache and neck pain in workers, telecommuting did not present the same risks. Working set-up did not have a significant impact on headache and neck pain as headache-related disability was the only associated factor of future headache episodes and neck-pain related disability was the only associated factor of future neck pain episodes. Also, wearing a headset had no impact on headache and neck pain in telecommuters.

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