scholarly journals Risk of Weight Loss in Adult Patients and the Effect of Staffing Registered Dietitians in Kaifukuki (Convalescent) Rehabilitation Wards: A Retrospective Analysis of a Nationwide Survey

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 753
Author(s):  
Shinta Nishioka ◽  
Yoji Kokura ◽  
Takatsugu Okamoto ◽  
Masako Takayama ◽  
Ichiro Miyai
Keyword(s):  
Weight Loss ◽  
Odds Ratio ◽  
Lower Risk ◽  
Nationwide Survey ◽  
Adult Patients ◽  
Weight Class ◽  
Registered Dietitians ◽  
Lower Odds ◽  
Nutrition Care ◽  
Class 1

There is scarce evidence regarding the risk of weight loss and the effect of having registered dietitians (RDs) on staff in rehabilitation wards on weight loss. We aimed to examine the effects of RDs in Kaifukuki (convalescent) rehabilitation wards (KRWs) on the prevention of weight loss in adult patients. Data from 2-year nationwide annual surveys on KRWs in Japan were retrospectively analysed. Weight loss was defined as loss of ≥5% weight during the KRW stay. Risk of weight loss in class 1 KRWs (obligated to provide nutrition care) was compared with that in class 2–6 KRWs (not obligated). Risk of weight loss in class 2–6 KRWs with RDs was compared to those without. Overall, 17.7% of 39,417 patients lost weight. Class 1 KRWs showed a lower risk of weight loss than class 2–6 KRWs (17.3% vs. 18.5%, p = 0.003). KRWs with RDs showed a significantly lower incidence of weight loss than those without RDs (16.1% vs. 18.8%, p = 0.015). Class 1 KRWs and exclusively staffed RDs were independently associated with lower odds of weight loss (odds ratio = 0.915 and 0.810, respectively). Approximately 18% of KRW patients lost weight, and having RDs on staff can lower the risk of weight loss.

Pacifiers and Exclusive Breastfeeding: Does Risk for Postpartum Depression Modify the Association?

2017 ◽  
Vol 33 (4) ◽  
pp. 692-700 ◽  
Author(s):  
Heather L. Sipsma ◽  
Katelin Kornfeind ◽  
Laura R. Kair
Keyword(s):  
High Risk ◽  
Postpartum Depression ◽  
Exclusive Breastfeeding ◽  
Odds Ratio ◽  
Lower Risk ◽  
Regression Models ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Receive Treatment ◽  
To Receive

Background: Postpartum depression is associated with lower rates of breastfeeding. Evidence describing the effect of pacifiers on breastfeeding is inconsistent, and previous research suggests that pacifiers may help vulnerable mothers breastfeed. Research aim: This study aimed to determine (a) how receiving a pacifier in the hospital affects exclusive breastfeeding (EBF) at 1 week and 3 months postpartum and (b) whether this association is modified by risk for postpartum depression (PPD). Methods: Data were derived from Listening to Mothers III. We included participants ( n = 1,349) who intended to breastfeed and delivered at term. Mothers were considered at high risk for PPD if they reported feeling the need to receive treatment for depression during pregnancy. We used weighted multivariable logistic regression models to adjust for covariates. Results: Receiving a pacifier in the hospital was not significantly associated with EBF at 1 week (odds ratio [ OR] = 0.84, 95% confidence interval [CI] [0.62, 1.12]) but was significantly associated with lower odds of EBF at 3 months postpartum ( OR = 0.72, 95% CI [0.54, 0.95]). Risk for PPD modified this association. Among mothers at high risk for PPD, receiving a pacifier was significantly associated with increased odds of EBF ( OR = 3.31, 95% CI [1.23, 8.97] at 1 week and OR = 5.27, 95% CI [1.97, 14.12] at 3 months); however, among mothers who were at lower risk for PPD, receiving a pacifier was associated with decreased odds of EBF ( OR = 0.75, 95% CI [0.56, 1.02] at 1 week and OR = 0.62, 95% CI [0.46, 0.82] at 3 months). Conclusion: Pacifiers may help protect against early cessation of EBF among mothers at high risk for depression. Additional research is needed to better understand this association.

scholarly journals Fruit and vegetable consumption before and during pregnancy and developmental delays in offspring aged 2 years in Japan

2021 ◽  
pp. 1-28
Author(s):  
Yudai Yonezawa ◽  
Fumihiko Ueno ◽  
Taku Obara ◽  
Takahiro Yamashita ◽  
Mami Ishikuro ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Lower Risk ◽  
Developmental Delays ◽  
Vegetable Consumption ◽  
Fruit And Vegetable Consumption ◽  
Physical Growth ◽  
Neurological Development ◽  
Fruit And Vegetable ◽  
Food Frequency ◽  
Lower Odds

Abstract The association between fruit and vegetable consumption before and during pregnancy and offspring’s physical growth has been well reported, but no study has focused on offspring’s neurological development. We aimed to explore the association between maternal fruit and vegetable consumption before and during pregnancy and developmental delays in their offspring aged 2 years. Between July 2013 and March 2017, 23,406 women were recruited for the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Fruit and vegetable consumption were calculated using food frequency questionnaire, and offspring’s developmental delays were evaluated by the Ages & Stages Questionnaires, Third Edition (ASQ-3) for infants aged 2 years. Finally, 10,420 women and 10,543 infants were included in the analysis. Totally 14.9% of children had developmental delay when screened using the ASQ-3. Women in the highest quartile of vegetable consumption from pre-pregnancy to early pregnancy and from early to mid-pregnancy had lower odds of offspring’s developmental delays (odds ratio (OR) 0.74; 95% confidence interval (CI) 0.63, 0.89 and OR 0.70; 95% CI 0.59, 0.84, respectively) than women in the lowest quartile. Women in the highest quartile of fruit consumption from early to mid-pregnancy had lower odds of offspring’s developmental delays (OR 0.78; 95% CI 0.66, 0.92) than women in the lowest quartile. In conclusion, high fruit and vegetable consumption before and during pregnancy was associated with a lower risk of developmental delays in offspring aged 2 years.

Reduced Risk of Relapse In Pediatric ALL After Haploidentical Transplantation of T-Cell Depleted Grafts From KIR Haplotype B Donors,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4133-4133
Author(s):  
Lena Oevermann ◽  
Sebastian Michaelis ◽  
Markus Mezger ◽  
Matthias Pfeiffer ◽  
Peter Lang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Lower Risk ◽  
Adult Patients ◽  
Hla System ◽  
Kir Genes ◽  
Haploidentical Transplantation ◽  
Pediatric All ◽  
Haplotype A ◽  
Reduced Risk ◽  
Risk Of Relapse

Abstract Abstract 4133 The Killer immunoglobulin-like receptor (KIR) gene family consists of 17 genes (15 KIR genes and 2 pseudogenes) encoding for the different receptors and is a key regulator of Natural Killer (NK) cells. Their diversity is similar to the HLA-system, however they segregate independently from the HLA-system and every human being possesses an individual pattern of KIR genes which can be assigned to either KIR haplotype A or B. Haplotype A is characterized by a relatively fixed gene content of inhibitory receptors. The presence of at least one activating KIR-receptor is necessary for defining haplotype B. The importance of the KIR system has been demonstrated in haploidentical as well as in HLA-matched transplantation in adult patients with AML, but not with ALL. Patients who received a haploidentical transplant from a KIR ligand-ligand mismatched donor had a significant lower risk of relapse. In more recent studies in adult patients with AML but not with ALL, a significant influence of the donor KIR haplotype was demonstrated after allogeneic transplantation from HLA-matched sibling or unrelated donors, and patients who received grafts from haplotype B donors had a significant lower risk of relapse. In contrast to the results in adult patients, it has been shown in pediatric ALL that children who received an haploidentical transplant from KIR receptor-ligand mismatched donors had a better event-free survival. The influence of the donor KIR haplotype in pediatric haploidentical transplantation in patients with ALL has not yet been investigated sofar. We have therefore analyzed the influence of the donor KIR haplotype on the risk of relapse in 48 children with very high risk ALL, who received an allogeneic transplant from a haploidentical donor at our center. The presence or absence of the 15 KIR genes was determined by real-time PCR as described by Alves et al. (Tissue Antigens 2008) and donors were assigned the A/A or B/x haplotype. Genotypes for the centromeric (Cen) or telomeric (Tel) parts of the KIR locus were assigned according to the absence or presence of one or more B haplotype defining KIR genes. Most of the patients (n=28) were conditioned with a non-TBI-based reduced intensity regimen, whereas 20 patients received a TBI-based preparative regimen. At time of transplant, 38 patients were in remission and 10 children had refractory leukaemia. The graft comprised mobilised peripheral stem cells depleted ex-vivo from T-cells by either CD34+ positive selection or CD3/19 negative depletion. Of the 48 donors, 12 had KIR haplotype A and 36 KIR haplotype B. Patients grafted with a KIR haplotype A donor were more likely to relapse (odds ratio 4.90; p=0.02), whereas patients who received a graft from a KIR haplotype B donor had a five-fold lower risk of relapse. We also analysed the risk of relapse according to the haplotype B-content-score system (from 0 to 4) described by Cooley et.al (Blood 2010). Briefly, the B-content score is calculated by adding the number of CenB and/or TelB motifs in each genotype.We found a reduced risk of relapse with an increasing B-content score, with 58% of relapse for a score of 0 (n=12), 31% for a score of 1 (n=16), 20% for a score of 2 (n=15) and 0% for a score of 3 (n=5). In addition, the risk of relapse was much lower in patients grafted with a donor TelB haplotype (odds ratio 7.3, p<0.01). We conclude from our results that a donor KIR B haplotype with a high B-content score should be favored as haploidentical donor and that KIR genotyping should be implemented in the donor selection algorithm in haploidentical transplantation for children with ALL. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Breastfeeding and Prevalence of Metabolic Syndrome among Perimenopausal Women

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2691
Author(s):  
Edyta Suliga ◽  
Elzbieta Ciesla ◽  
Martyna Gluszek-Osuch ◽  
Malgorzata Lysek-Gladysinska ◽  
Iwona Wawrzycka ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Odds Ratio ◽  
Lower Risk ◽  
International Diabetes Federation ◽  
Breastfeeding Duration ◽  
Lower Odds ◽  
Significant Difference ◽  
Perimenopausal Women ◽  
Reduced Risk

Little is known about the long-term benefits of breastfeeding for mother’s metabolic health. This study aimed to investigate the links between breastfeeding duration and the prevalence of metabolic syndrome (MetS) and its components in perimenopausal women. The analysis included a group of 7621 women aged 55.4 ± 5.4 years. MetS and its components were defined according to the International Diabetes Federation guidelines. Women who breastfed for 13–18 months and beyond 18 months were at lower risk of MetS (odds ratio OR) = 0.76, 95% CI 0.60–0.95; p = 0.017 and OR = 0.79, 95% CI 0.64–0.98; p = 0.030, respectively) than those who never breastfed. Meanwhile, women who breastfed for 7–12 months showed increased glucose concentration (OR = 0.77, 95% CI 0.63–0.94; p = 0.012) compared with those who had never breastfed. The additional analysis involving parity showed that women who had given birth to two babies and breastfed them had lower odds of MetS than those who never breastfed (p < 0.05), although there was no significant difference among women who breastfed for >18 months. Women who had given birth to at least three children and breastfed for 1–6 and 13–18 months had lower odds of MetS and increased triglyceride concentration (p < 0.05). Moreover, participants having breastfed for 1–6 months were found to have a reduced risk of abdominal obesity compared with those who had not breastfed (p < 0.05). Breastfeeding is associated with lower prevalence of MetS in perimenopausal women and can be recommended as a way of reducing the risk of MetS and its components.

scholarly journals Is maternal cigarette or water pipe use associated with stopping breastfeeding? Evidence from the Jordan population and family health surveys 2012 and 2017–18

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Esra Can Özalp ◽  
S. Songül Yalçın
Keyword(s):  
Odds Ratio ◽  
Maternal Smoking ◽  
Health Surveys ◽  
Family Health ◽  
Lactation Period ◽  
Water Pipe ◽  
Tobacco Products ◽  
Lower Odds ◽  
Lower Odds Ratio ◽  
Pipe Tobacco

Abstract Background Maternal smoking is suspected to have negative impacts on breastfeeding, such as decreasing the quantity of breast milk, and reducing vitamin and fat concentrations in the milk in the late lactation period. Cigarette and water pipe tobacco products are widely used in Jordan. We aimed to estimate the association between use of different tobacco products and the rates of current breastfeeding. Methods Data from Jordan’s Population and Family Health Surveys 2012 and 2017–18 were examined. Last-born, living children, aged < 25 months, from singleton births, ever breastfed, and living with their mother were included. The key outcome variables were the current breastfeeding (during last 24 h) and tobacco usage status [water pipe tobacco (hookah or narghile) and/or cigarette tobacco]. Complex sample multivariate logistic regression analysis was used to evaluate the association of the current breastfeeding with maternal smoking status. Results Overall, 6726 infants were included in the study. The current breastfeeding rate in infants aged 0–6 months was 87%, compared with 43.9% in infants aged 12–17 months and 19.4% in infants aged 18–24 months. Overall, 4.4% had mothers who smoked cigarettes, 5.4% smoked water pipe, and 1.6% both cigarettes and water pipe. The proportion of breastfed infants in non-smoking mothers was 57.7% and, those in smoke water pipe, cigarette and both tobacco products were 55.4, 44.9, and 51.0% respectively. Univariate analysis revealed that women cigarette smokers had a lower odds ratio (OR) for current breastfeeding (OR 0.60, 95% Confidence Interval [CI] 0.39, 0.92). Multivariate analysis revealed that maternal cigarette smoking was associated with a lower odds ratio for current breastfeeding compared with mothers who smoked neither water pipe nor cigarettes (AOR 0.51, 95% Cl 0.30, 0.87). Conclusions These results indicate that maternal smoking is associated with termination of breastfeeding, suggesting that structured training should be organized for healthcare professionals, expectant mothers and the general public about the association between maternal smoking and cessation of lactation.

scholarly journals TET2 Mutation and High miR-22 Expression as Biomarkers to Predict Clinical Outcome in Myelodysplastic Syndrome Patients Treated with Hypomethylating Therapy

2021 ◽  
Vol 43 (2) ◽  
pp. 917-931
Author(s):  
Jina Yun ◽  
Young Sok Ji ◽  
Geum Ha Jang ◽  
Sung Hee Lim ◽  
Se Hyung Kim ◽  
...  
Keyword(s):  
Myelodysplastic Syndrome ◽  
Odds Ratio ◽  
Lower Risk ◽  
Genetic Mutations ◽  
Dna Hypermethylation ◽  
Leukemic Transformation ◽  
Mutation Status ◽  
Similar Tendency ◽  
Tet2 Mutation ◽  
Expression Status

Tet methylcytosine dioxygenase 2 (TET2) is one of the most frequently mutated genes in myelodysplastic syndrome (MDS). TET2 is known to involve a demethylation process, and the loss of TET2 is thought to cause DNA hypermethylation. Loss of TET2 function is known to be caused by genetic mutations and miRNA, such as miR-22. We analyzed 41 MDS patients receiving hypomethylating therapy (HMT) to assess whether TET2 mutation status and miR-22 expression status were associated with their clinical characteristics and treatment outcomes. Responsiveness to HMT was not affected by both TET2 mutation (odds ratio (OR) 0.900, p = 0.909) and high miR-22 expression (OR 1.548, p = 0.631). There was a tendency for TET2 mutation to be associated with lower-risk disease based on IPSS (Gamma = −0.674, p = 0.073), lower leukemic transformation (OR 0.170, p = 0.040) and longer survival (Hazard ratio 0.354, p = 0.059). Although high miR-22 expression also showed a similar tendency, this tendency was weaker than that of TET2 mutation. In summary, the loss of TET2 function, including both TET2 mutation and high miR-22 expression, was not a good biomarker for predicting the response to HMT but may be associated with lower-risk disease based on IPSS, lower leukemic transformation and longer survival.

scholarly journals Practice Patterns for Older Adult Patients With Advanced Cancer: Physician Office Versus Hospital Outpatient Setting

2019 ◽  
Vol 15 (1) ◽  
pp. e30-e38 ◽  
Author(s):  
Allison Lipitz-Snyderman ◽  
Coral L. Atoria ◽  
Stephen M. Schleicher ◽  
Peter B. Bach ◽  
Katherine S. Panageas
Keyword(s):  
Older Adult ◽  
Advanced Cancer ◽  
Odds Ratio ◽  
Hierarchical Modeling ◽  
Outpatient Setting ◽  
Adult Patients ◽  
Medicare Beneficiaries ◽  
Hospital Outpatient ◽  
Outpatient Departments ◽  
Retrospective Comparative Study

PURPOSE: A shift in outpatient oncology care from the physician’s office to hospital outpatient settings has generated interest in the effect of practice setting on outcomes. Our objective was to examine whether medical oncologists’ prescribing of drugs and services for older adult patients with advanced cancer is used more in physicians’ offices compared with hospital outpatient departments. METHODS: This was a retrospective comparative study. SEER-Medicare data (2004 to 2011) were used to identify Medicare beneficiaries diagnosed with advanced breast, colon, esophagus, non–small-cell lung, pancreatic, or stomach cancer. Between physicians’ offices and hospital outpatient departments, we compared use of selected likely low-value supportive drugs, low-value therapeutic drugs, chemotherapy-related hospitalizations, and hospice. We used hierarchical modeling to assess differences between settings to account for correlation within physicians. RESULTS: Compared with patients treated in a hospital outpatient department, those treated in a physician’s office setting were more likely to receive erythropoiesis-stimulating agents (odds ratio, 1.72; 95% CI, 1.53 to 1.94) and granulocyte colony–stimulating factors (odds ratio, 1.28; 95% CI, 1.18 to 1.38). For combination chemotherapy and nanoparticle albumin-bound–paclitaxel in patients with breast cancer, there was a trend toward higher use in physicians’ offices, although this was not statistically significant. Chemotherapy-related hospitalizations and hospice did not vary by setting. CONCLUSION: We found somewhat higher use of several drugs for patients with advanced cancer in physicians’ office settings compared with hospital outpatient departments. Findings support research to dissect the mechanisms through which setting might influence physicians’ behavior.

Endovascular treatment with the Enterprise stent versus the Neuroform or Low-Profile Visualized Intraluminal Support stent for unruptured aneurysms

2021 ◽  
Vol 10 (4) ◽  
pp. 295-305
Author(s):  
Reade De Leacy ◽  
Emilie Kottenmeier ◽  
Stephanie HY Lee ◽  
Rahul Khanna ◽  
Alejandro M Spiotta
Keyword(s):  
Endovascular Treatment ◽  
Odds Ratio ◽  
Generalized Estimating Equations ◽  
Enterprise Group ◽  
Group Differences ◽  
Stent Group ◽  
Unruptured Intracranial Aneurysm ◽  
Lower Odds ◽  
Unruptured Aneurysms ◽  
Low Profile

Aim: To compare outcomes among patients undergoing endovascular treatment for unruptured intracranial aneurysm (UIA) with the Enterprise stent versus the Neuroform or Low-Profile Visualized Intraluminal Support (LVIS) stent. Patients & methods: Patients undergoing endovascular procedure for UIA were classified into Enterprise stent and Neuroform or LVIS stent group. Groups were propensity-score matched and generalized estimating equations were used for outcomes assessment. Results: There were no significant between-group differences in length of stay or mortality. The Enterprise group had significantly lower odds of UIA-related inpatient readmissions versus the Neuroform/LVIS group (odds ratio: 0.62; 95% CI: 0.42–0.91). Conclusion: Enterprise stent use was associated with significantly lower readmissions versus competitor stent, with no difference in other study outcomes.

scholarly journals Weight-Loss Behaviors of Avoiding Between Meal and Midnight Snack in Teenagers Associated with Gestational Diabetes: The Japan Environment and Children’s Study

2021 ◽  
Author(s):  
Marina Minami ◽  
Takafumi Watanabe ◽  
Masamitsu Eitoku ◽  
Nagamasa Maeda ◽  
Mikiya Fujieda ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Odds Ratio ◽  
Weight Control ◽  
Dietary Habits ◽  
Normal Weight ◽  
Crude Odds Ratio ◽  
Live Births ◽  
Weight Loss Behavior ◽  
Previous Cesarean

Abstract Background: Dietary habits and weight control before pregnancy are important in preventing gestational diabetes. This study aims to examine whether the weight-loss behavior of avoiding between meal and midnight snacks in teenagers is associated with subsequent gestational diabetes mellitus (GDM).Methods: A total of 89,227 (85.7% of the total) mother-infant pairs of live births were included in our study of the Japan Environment and Children's Study (JECS). In the second or third trimesters, participants were asked to report their weight-loss behaviors during their teenage years. Response items included avoidance of meals and midnight snacking. The main outcome of our study was the prevalence of GDM.Results: Overall, 2,066 (2.3%) participants had GDM. Relative to those without GDM, women with GDM were older, were smokers, had a higher prevalence of hypertension, previous cesarean delivery, mental illness, and higher body mass index (BMI). Weight-loss behavior in their teenage years was associated with a decreased risk of GDM (unadjusted crude odds ratio, 0.83; 95% confidence interval [CI]: 0.76–0.91), model 1 (adjusted odds ratio [aOR], 0.86; 95% CI: 0.79–0.94), and model 2 (aOR, 0.80; 95% CI: 0.73–0.88). Weight-loss behavior in teens was associated with a decreased risk of GDM in the normal weight [aOR, 0.79; 95% CI: 0.70–0.89) and overweight (aOR, 0.82; 95% CI: 0.69–0.98) groups.Conclusions: The results suggest that weight-loss behaviors of avoiding in-between meals and midnight snacking as teenagers are associated with a decreased risk of developing GDM.

scholarly journals 1536. Impact of Type of Provider on Appropriateness of Treatment for Gonorrhea and Chlamydia in Outpatient Clinics

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Katherine Sittig ◽  
Rossana Rosa Espinoza
Keyword(s):  
Health System ◽  
Adult Patients ◽  
Outpatient Clinics ◽  
P Value ◽  
Lower Odds ◽  
Des Moines ◽  
Appropriate Treatment ◽  
Integrated Health ◽  
Pregnancy Status ◽  
The Impact

Abstract Background Patients with sexually transmitted infections (STIs) receive care in a variety of outpatient settings with medical providers of different levels of training and expertise, especially regarding STIs. We aimed to determine the impact of type of provider on the appropriateness of treatment for chlamydia and gonorrhea in a large integrated health system. Methods We conducted a retrospective cohort study of adult patients diagnosed with chlamydia and/or gonorrhea at any outpatient clinic within an integrated health system in Des Moines, Iowa. Nucleic-acid amplification tests were used for diagnosis, and all samples were processed at the same laboratory. Adequate treatment was defined as prescription for appropriate antibiotic, dose and duration within 7 days of the positive test. Logistic regression models with robust standard errors and adjusting for clustering by clinic were built. Results We identified 481 unique patients and a total of 515 unique encounters. Considering unique patients only, the median patient age was 23 years (IQR 20-26), 466/481 (96.9%) were female (96.9%), 15/481 (3.1%) were male, and 79/481 (16.4%) were pregnant. Table 1 shows the patient demographic and provider characteristics by appropriateness of treatment for individual visits. A total of 53 patients had inappropriate treatment, some with multiple errors which are described in Table 2. Provider type, age, type of infection, and pregnancy status were significantly associated with appropriateness of treatment. After adjusting for type of infection, pregnancy status and clustering by clinic, compared to physicians, certified nurse midwives (CNMs) had 33% lower odds of prescribing appropriate treatment (95% CI 0.49-0.91; p-value = 0.010), with no difference in appropriateness of prescribing by mid-level providers (OR 1.61, 95% CI 0.82-3.17; p-value = 0.167). Pregnancy was independently associated with lower odds of appropriate treatment (OR 0.35, 95% CI 0.24-0.52; p-value &lt; 0.001), as was infection with gonorrhea (OR 0.29, 95% CI 0.12-0.68; p-value = 0.004). Table 1. Demographic characteristics of adult patients diagnosed with chlamydia and/or gonorrhea in outpatient clinics by appropriateness of treatment. Des Moines, Iowa, January 1, 2019 to December 31, 2019 Table 2. Type of therapeutic errors encountered among patients diagnosed with chlamydia or gonorrhea Conclusion CNMs had lower odds of prescribing appropriate treatment for STIs. Efforts aimed at improving prescribing by healthcare providers should actively engage with this group. Disclosures All Authors: No reported disclosures

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