Incidence Rates and Risk of Hospital Registered Infections among Schizophrenia Patients before and after Onset of Illness: A Population-Based Nationwide Register Study

Infections in schizophrenia patients are associated with an increased premature mortality. However, our knowledge about the burden of infections in schizophrenia is scarce. The aims of this study were to (1) determine the prevalence of clinically important hospital registered infections in the period of five years prior to and five years after the diagnosis, (2) estimate the risk of infections before and after the schizophrenia diagnosis and, (3) evaluate the impact of comorbidity on the risk of infections in schizophrenia. Using combined data from Danish national registers, we sampled a cohort of all persons born in Denmark in the period 1975–1990 and obtained health-related records from 1995–2013. Occurrence patterns and the risk of infections were measured as annual incidence rates and incidence rates ratios, estimated using Poisson models. Medical conditions from the Charlson Index were considered as a measure of comorbidity. The analyses showed that schizophrenia patients had a significantly elevated risk of almost all types of hospital registered infections during the period of the study when compared to the controls. Comorbidity increased rates of infections by 176%. The results suggest that the risk of infections is elevated in the schizophrenia population and physical illness is an important risk factor.

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Effect of Integrated Neuromuscular Exercise in Physical Education Class on Health-Related Fitness in Female Children

Healthcare ◽

10.3390/healthcare9030312 ◽

2021 ◽

Vol 9 (3) ◽

pp. 312

Author(s):

Marijana Sinđić ◽

Draženka Mačak ◽

Nikola Todorović ◽

Bianka Purda ◽

Maja Batez

Keyword(s):

Physical Education ◽

Muscular Fitness ◽

Female Children ◽

Before And After ◽

Health Related ◽

The Republic ◽

Almost All ◽

And Control ◽

Cardiorespiratory Endurance ◽

Health Related Fitness

Integrated neuromuscular training (INT) showed benefits for improving fundamental movement skills (FMS). However, the INT health-related fitness (HRF) effects are lacking. The current study aimed to determine the effects of INT implemented during physical education (PE) in a primary school in the Republic of Serbia on HRF in female children. The sample consisted of 72 healthy girls who were divided into the intervention (EG: n = 37; mean ± SD: age = 8.17 ± 0.31) and control (CG: n = 35; age = 8.11 ± 0.31) groups. The EG and CG performed the INT program and traditional PE activities two times per week within the first ~15 min of PE class, respectively. The Fitnessgram battery tests assessed the HRF (body composition, cardiorespiratory endurance, muscular fitness, and flexibility) before and after the program. After eight weeks, the EG significantly reduced all fat measures, while the CG decreased only triceps skinfold but to a smaller extent (F = 5.92, p < 0.02, ŋ2 = 0.09). Both groups significantly improved the performance of almost all muscular fitness tests (curl-ups, trunk lift, push-ups); however, the EG increased the push-ups more than the CG (F = 9.01, p < 0.01, ŋ2 = 0.14). The EG additionally improved the modified pull-ups (F = 14.09, p < 0.01, ŋ2 = 0.19) and flexed arm hang (F = 28.82, p < 0.01, ŋ2 = 0.33) tests. The flexibility and cardiorespiratory endurance of both groups did not significantly change after eight weeks. This approach of exercise showed positive acceptance and relatively good results after only eight weeks.

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Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽

10.1136/bmjopen-2021-048744 ◽

2021 ◽

Vol 11 (5) ◽

pp. e048744

Author(s):

Andreea Bratu ◽

Taylor McLinden ◽

Katherine Kooij ◽

Monica Ye ◽

Jenny Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

British Columbia ◽

Cohort Study ◽

Population Based ◽

Incidence Rates ◽

Trend Test ◽

People Living With Hiv ◽

Age Related ◽

Hiv Serostatus ◽

The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

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The Demerger Impact upon Sustainable Development of Economic Entities: Evidence from Romania

Sustainability ◽

10.3390/su13158316 ◽

2021 ◽

Vol 13 (15) ◽

pp. 8316

Author(s):

Camelia Mirela Baba ◽

Constantin Duguleană ◽

Marius Sorin Dincă ◽

Liliana Duguleană ◽

Gheorghița Dincă

Keyword(s):

Sustainable Development ◽

Business Strategies ◽

The Sustainable Development ◽

Ex Post ◽

Before And After ◽

Almost All ◽

The Impact ◽

Profitability Ratios ◽

Positive Effect

The Covid-19 induced economic crisis has significantly affected almost all businesses from nearly every sector, causing severe financial problems, lack of cash assets, and decrease of revenues. In this context, the economic entities were forced to look for adjustment and rescue solutions of their activities. One possible solution for the recovery and reorganization of economic entities’ activities is demerger. This paper evaluates the impact of demerger upon the sustainable development of economic entities in terms of economic efficiency and financial performances. To achieve this goal, a statistical analysis of profitability ratios before and after the demerger, as well as a structural analysis of 268 demerger projects for the April 2012–April 2021 period, were performed. The results attest there are no significant differences between the ex-ante and ex-post financial performances. However, demerger seems to have a positive effect upon analyzed companies helping them to overcome economic hardships, rethink their business strategies, and continue their activity in the medium and long-term time horizon.

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PP164 Identifying Complications Of Partial Nephrectomy Using Physician Claims

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646231800288x ◽

2018 ◽

Vol 34 (S1) ◽

pp. 130-131

Author(s):

Jian Sun ◽

Tania Stafinski ◽

Fernanda Inagaki Nagase ◽

Devidas Menon

Keyword(s):

Ambulatory Care ◽

Partial Nephrectomy ◽

Kidney Cancer ◽

International Classification Of Diseases ◽

Population Based ◽

Incidence Rates ◽

Open Group ◽

Robot Assisted ◽

Before And After ◽

Chi Squared

Introduction:Many population-based studies identify surgical complications using hospital discharge abstract databases (DAD). With DAD, however, complications occurring after the discharge date cannot be followed up. This study used physician claims data to identify the complications of partial nephrectomy, and to compare the rates of complications of open, laparoscopic, and robot-assisted nephrectomies.Methods:Physician claims, DAD, and ambulatory care data from April 2003 to March 2016 were provided by Alberta Health. DAD and ambulatory care data were used to extract information on patients with kidney cancer who underwent partial nephrectomy. All physician claims within 30 days before and after surgery for the cohort were extracted. The numbers of the same International Classification of Diseases, Ninth Revision (ICD-9), codes before and after surgery were compared. If a number increased after surgery, this diagnosis was initially identified as a complication. All diagnoses with neoplasms were excluded. The incidence rates of complications for the three surgery groups were calculated. Chi-squared tests were conducted for the following nephrectomy comparisons: laparoscopic versus open; robot-assisted versus open; and robot-assisted versus laparoscopic.Results:A total of 1,890 kidney cancer patients had partial nephrectomies. Among them, 1,080, 411, and 399 had open, laparoscopic, and robot-assisted nephrectomies, respectively. One patient who had two different nephrectomies on the same day was excluded from analysis. The robot-assisted group had lower rates of digestive complications (ICD-9: 537–578, 787, 789, 998.6) and infections (ICD-9: 004–041, 998.5) than the open group, and higher rates of genitourinary complications (ICD-9: 584–599, 788, 997.5) than the laparoscopy group. The robot-assisted group had lower rates than the open group for most of the complication categories, but the differences were not statistically significant.Conclusions:Robot-assisted surgery appears to be superior to open surgery, but no better than laparoscopic surgery, in terms of minimizing the risk of complications following partial nephrectomy.

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Cancer beliefs in cancer survivors, cancer relatives and persons with no cancer experience

Scandinavian Journal of Public Health ◽

10.1177/1403494817715380 ◽

2017 ◽

Vol 47 (5) ◽

pp. 497-503 ◽

Cited By ~ 1

Author(s):

Anette Fischer Pedersen ◽

Peter Vedsted

Keyword(s):

Socioeconomic Position ◽

Reference Group ◽

Population Based ◽

Death Sentence ◽

Cross Sectional ◽

Telephone Interviews ◽

Health Related ◽

Cancer Experience ◽

Cancer Beliefs ◽

The Impact

Aims: Negative cancer beliefs have been associated with late stage at cancer diagnosis. High levels of negative cancer beliefs have been found among individuals with low socioeconomic position and ethnic minority women, but the impact of cancer experience on cancer beliefs is unexamined. The aim of this study was to examine whether cancer beliefs are associated with cancer experience. Methods: This was a cross-sectional population-based study. Telephone interviews of 2992 Danish residents (30+) were carried out using the Awareness and Beliefs about Cancer Measure (ABC). Respondents reported whether they or someone close had been diagnosed with cancer and whether they agreed/disagreed with three positively and three negatively framed cancer beliefs. Results: Respondents with someone close diagnosed was reference group. Compared with these, respondents with no cancer experience (RRadj=0.91, 95% CI=0.84–0.98) or who had had cancer themselves (RRadj=0.87, 0.77–0.98) were less likely to believe that cancer treatment is worse than the cancer itself, and respondents with no cancer experience were less likely to believe that a diagnosis of cancer is a death sentence (RRadj=0.83, 0.70–0.98), but more likely to report that they did not want to know if they had cancer (RRadj=1.31, 1.01–1.71). Conclusions: The results suggest that cancer beliefs are sensitive to cancer experience. This is an important addition to previous results focusing on the association between cancer beliefs and static factors such as socioeconomic position and ethnicity. Since cancer beliefs may determine health-related behaviour, it is important that negative cancer beliefs are addressed and possibly reframed in population-based interventions.

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A Prospective, Population-based Study to Determine the Incidence and Bacteriology of Bacterial Conjunctivitis in Children <2 Years of Age Following 7-Valent and 13-Valent Pneumococcal Conjugate Vaccine Sequential Implementation

Clinical Infectious Diseases ◽

10.1093/cid/ciaa197 ◽

2020 ◽

Author(s):

Ron Dagan ◽

Shalom Ben-Shimol ◽

David Greenberg ◽

Noga Givon-Lavi

Keyword(s):

Medical Center ◽

Population Based ◽

Clinical Microbiology Laboratory ◽

Nontypeable Haemophilus Influenzae ◽

Bacterial Conjunctivitis ◽

National Immunization ◽

Herd Protection ◽

Before And After ◽

Rate Ratios ◽

The Impact

Abstract Background Bacterial conjunctivitis is most commonly caused by nontypeable Haemophilus influenzae (NTHi), followed by Streptococcus pneumoniae. No population-based data on the impact of pneumococcal conjugate vaccines (PCVs) on the incidence of bacterial conjunctivitis have been published. We assessed rate dynamics of overall, pneumococcal, and NTHi conjunctivitis in children aged 2–23 months in southern Israel before and after PCV implementation. Methods This is a 12-year prospective, population-based surveillance, from July 2004 through June 2017. Our medical center serves a captive population of approximately 30 000 children < 2 years of age, and its clinical microbiology laboratory processes > 80% of all community-derived cultures, enabling incidence calculation. The 7-valent and 13-valent PCVs (PCV7 and PCV13, respectively) were implemented in the national immunization program in July 2009 and November 2010, respectively. Pneumococci, NTHi, Moraxella catarrhalis, and Streptococcus pyogenes were considered pathogens. Continuous annual incidences and incidence rate ratios comparing the PCV13 period (2015–2017) to the pre-PCV period (2004–2008) were calculated. Results Disease caused by PCV13 serotypes declined by 93%, without significant replacement with non-PCV13 serotypes. Rates of pneumococcal, NTHi, and overall culture-positive episodes declined by 59%, 41%, and 42%, respectively, while rates of culture-negative and other pathogens episodes did not change significantly. An overall reduction in all submitted culture rates of 35% was observed. This pattern was seen across all ages, including infants aged 2–5 months. Conclusions PCV7/PCV13 implementation resulted in a marked and significant decline in pneumococcal, NTHi, and overall conjunctivitis rates in children < 2 years of age. The impact on NTHi episodes alludes to the role of pneumococcus–NTHi interaction in conjunctivitis. The impact in infants aged < 6 months suggests herd protection.

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Sea water desalination and removal of iodine: effect on thyroid function

Journal of Water and Health ◽

10.2166/wh.2018.372 ◽

2018 ◽

Vol 16 (3) ◽

pp. 472-475

Author(s):

Gideon Koren ◽

Yona Amitai ◽

Meital Shlezinger ◽

Rachel Katz ◽

Varda Shalev

Keyword(s):

Thyroid Function ◽

Sea Water ◽

Population Based ◽

Thyroid Stimulating Hormone ◽

Water Desalination ◽

Thyroid Function Tests ◽

School Aged Children ◽

Before And After ◽

Using Data ◽

The Impact

Abstract In Israel, about 55% of drinking water is derived from desalination (DSW) which removes all iodine. A recent study from Israel demonstrated high rates of iodine deficiency among school-aged children and pregnant women. There are concerns that low iodine may lead to impaired thyroid function. However, to date, the impact of consuming DSW on body iodine status has not been studied. The objective was to assess whether the increased use of DSW is associated with increased rates of hypothyroidism. Using data from a large health fund in Israel, we compared proportions of patients with higher than normal thyroid stimulating hormone (TSH), and lower than normal T3 and T4 levels before and after a massive desalination project became operational in August 2013 in areas with high vs. low use of DSW. Over 400,000 cases were compared in 2010–2013 vs. 2014–2016. Overall, there was no increase in the proportion of individuals with higher than normal TSH levels, or lower than normal T3 and T4 levels. In conclusion, in this population-based study, following the introduction of DSW, there was no evidence of increased incidence of low thyroid function tests, and the trends were similar in both areas highly consuming, or not consuming, DSW.

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The Effect of Initiation of Anti-TNF Therapy on the Subsequent Direct Health Care Costs of Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izz063 ◽

2019 ◽

Vol 25 (10) ◽

pp. 1718-1728 ◽

Cited By ~ 10

Author(s):

Laura E Targownik ◽

Eric I Benchimol ◽

Julia Witt ◽

Charles N Bernstein ◽

Harminder Singh ◽

...

Keyword(s):

Health Care ◽

Health Care Expenditures ◽

Population Based ◽

World Population ◽

Median Cost ◽

Future Health ◽

Before And After ◽

Future Health Care ◽

The Cost ◽

The Impact

Abstract Background Anti–tumor necrosis factor (anti-TNF) drugs are highly effective in the treatment of moderate-to-severe Crohn’s disease (CD) and ulcerative colitis (UC), but they are very costly. Due to their effectiveness, they could potentially reduce future health care spending on other medical therapies, hospitalization, and surgery. The impact of downstream costs has not previously been quantified in a real-world population-based setting. Methods We used the University of Manitoba IBD Database to identify all persons in a Canadian province with CD or UC who received anti-TNF therapy between 2004 and 2016. All inpatient, outpatient, and drug costs were enumerated both in the year before anti-TNF initiation and for up to 5 years after anti-TNF initiation. Costs before and after anti-TNF initiation were compared, and multivariate linear regression analyses were performed to look for predictors of higher costs after anti-TNF initiation. Results A total of 928 people with IBD (676 CD, 252 UC) were included for analyses. The median cost of health care in the year before anti-TNF therapy was $4698 for CD vs $6364 for UC. The median cost rose to $39,749 and $49,327, respectively, in the year after anti-TNF initiation, and to $210,956 and $245,260 in the 5 years after initiation for continuous anti-TNF users. Inpatient and outpatient costs decreased in the year after anti-TNF initiation by 12% and 7%, respectively, when excluding the cost of anti-TNFs. Conclusions Direct health care expenditures markedly increase after anti-TNF initiation and continue to stay elevated over pre-initiation costs for up to 5 years, with only small reductions in the direct costs of non-drug-related health care.

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Analysis of the Impact of the Confinement Resulting from COVID-19 on the Lifestyle and Psychological Wellbeing of Spanish Pregnant Women: An Internet-Based Cross-Sectional Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165933 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5933 ◽

Cited By ~ 7

Author(s):

Gemma Biviá-Roig ◽

Valentina Lucia La Rosa ◽

María Gómez-Tébar ◽

Lola Serrano-Raya ◽

Juan José Amer-Cuenca ◽

...

Keyword(s):

Quality Of Life ◽

Pregnant Women ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Eating Pattern ◽

Before And After ◽

Related Quality ◽

Health Related ◽

The Impact

(1) Background: This study aimed to analyze the impact of the confinement due to the COVID-19 pandemics on the eating, exercise, and quality-of-life habits of pregnant women. (2) Methods: This was an internet-based cross-sectional survey which collected information about adherence to the Mediterranean diet, physical exercise, health-related quality of life (HRQoL), and perceived obstacles (in terms of exercise, preparation for delivery, and medical appointments) of pregnant women before and after the confinement. The survey was conducted in 18–31 May 2020. (3) Results: A total of 90 pregnant women participated in this study. There was a significant decrease in the levels of physical activity (p < 0.01) as well as in HRQoL (p < 0.005). The number of hours spent sitting increased by 50% (p < 0.001), 52.2% were unable to attend delivery preparation sessions because these had been cancelled. However, there were no significant differences in the eating pattern of these women (p = 0.672). Conclusions: These results suggest the need to implement specific online programs to promote exercise and reduce stress, thus improving the HRQoL in this population, should similar confinements need to occur again for any reason in the future.

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The economic impact of air pollution: a European assessment

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.084 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Conti ◽

P Ferrara ◽

L S D'Angiolella ◽

S C Lorelli ◽

G Agazzi ◽

...

Keyword(s):

Air Pollution ◽

Economic Burden ◽

Indirect Costs ◽

Premature Mortality ◽

Cochrane Library ◽

Policy Makers ◽

Life Years ◽

Health Related ◽

Disease Study ◽

The Impact

Abstract Background In 2017, the Global Burden of Disease Study estimated that in Europe 0.42 million deaths and 8.9 million disability-adjusted life years were attributable to air pollution. Monetizing this burden is a key step for estimating benefits of exposure reduction strategies. However, robust and synthetic estimates of direct (e.g. due to hospitalizations or medications) and indirect (e.g. due to premature mortality or loss of productivity) health-related costs of air pollution seem to be still lacking. We carried out a systematic review, aimed at identifying evidence from research in Europe. Methods We searched 5 electronic databases (MEDLINE, EMBASE, Cochrane Library, SCOPUS, Web Of Science) in which we applied algorithms tracing keywords such as “cost of illness”, “health care costs”, “economics” and synonyms, together with “air pollution” and synonyms. We limited our search to articles written in English and Italian, without date restriction. Results The initial search retrieved 2420 records. 200 were classified as relevant, and 38 fulfilled inclusion criteria. Most of them (68%) were published after 2010. 26% were multi-country studies, while the remaining focused on a single country or city. Investigated pollutants were usually particulate matter (79% of the studies) and nitrogen oxides (37%). The approaches to the economic analysis were heterogeneous: estimates could include direct and/or indirect costs. Among the studies, the most comprehensive one (12 countries) estimated that complying with WHO guidelines would avert €31 billion yearly, of which €19 million due to hospitalizations. Conclusions Over the last decade, progress has been made in evaluating the economic burden of air pollution. However, estimates based on indirect costs are affected by high levels of uncertainty, while those based on direct costs are more robust and should be further investigated, since they are crucial information for healthcare policy makers. Key messages Air pollution poses a high economic burden on European countries, mainly due to social costs. More attention should be devoted to estimating direct healthcare costs of air pollution, in order to properly inform policy makers about the impact on healthcare systems.

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