Factors Associated with Adverse Reactions to BNT162b2 COVID-19 Vaccine in a Cohort of 3969 Hospital Workers

Factors associated with adverse reactions to BNT162b2 COVID-19 vaccine reported by hospital workers are unclear. Our aim was to collect all reported adverse events in a cohort of hospital workers and to analyze the factors associated with their presence. We conducted an observational longitudinal study on all hospital workers of our center who received COVID-19 vaccination from 27 December 2020 to 1 September 2021. Information on adverse events was reported telephonically and confirmed through clinical records. Chi-square and t tests as well as multivariate logistic regression models were used. Cluster analysis was designed to explore associations between reactions. A total of 3969 hospital workers were included in the sample. Of the total sample, 182 workers (4.6%) reported adverse events. The most frequent symptoms were general malaise (n = 95), fever (n = 92), arthromyalgia (n = 80), and headache (n = 47). The factors associated with adverse events in adjusted analyses were an antecedent of COVID-19 infection (OR = 2.09, 95% CI: 1.47–2.98), female sex (OR = 1.51, 95% CI: 1.03–2.20), and professional category (OR for physicians = 0.41, 95% CI: 0.21–0.80). We report a low frequency of adverse events in hospital workers after COVID-19 vaccination and no severe reaction. Men and physicians underreported their symptoms. These data should guide future strategies for recording adverse events and future research on COVID-19 vaccination safety.

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Factors associated with mechanical and systemic adverse events after colonoscopy (France, 2010-2015)

European Journal of Public Health ◽

10.1093/eurpub/ckz186.606 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M Laanani ◽

A Weill ◽

P O Blotière ◽

J Pouchot ◽

F Carbonnel ◽

...

Keyword(s):

Renal Failure ◽

Acute Renal Failure ◽

Adverse Events ◽

Older Patients ◽

Public Hospitals ◽

Serious Adverse Events ◽

Logistic Regression Models ◽

Factors Associated ◽

Increased Risk ◽

Experienced Endoscopists

Abstract Background More than one million colonoscopies are performed every year in France. They are associated with risks of mechanical and systemic serious adverse events (SAEs) which can be associated with patient, procedure, endoscopist, and facility characteristics. We tried to identify the factors associated with colonic perforation, gastrointestinal bleeding, splenic injury, shock, myocardial infarction, stroke, pulmonary embolism, acute renal failure, and urolithiasis after colonoscopy. Methods We analysed data from the French national claims databases (SNDS). A total of 4,088,799 patients, 30 years or older, undergoing a first screening or diagnostic colonoscopy between 2010 and 2015 were identified. SAE rates were estimated, and risk factors associated with SAEs were identified using multilevel logistic regression models, adjusted for patient, colonoscopy, endoscopist, and facility characteristics. Results Increasing age was associated with an increasing incidence of mechanical and systemic SAEs. Cancer and cardiovascular comorbidities were associated with mechanical SAEs, and a higher number of pre-existing conditions was associated with shock and acute renal failure. Polypectomy, especially of polyps larger than 1 cm, was associated with an increased risk of perforation (OR = 4.1; 95% CI, 3.4-5.0) and bleeding (OR = 13.3; 95% CI, 11.7-15.1). Mechanical SAEs were associated with the endoscopist’s experience, while systemic SAEs were more frequent in public hospitals than in private clinics. Conclusions SAEs related to colonoscopy were more frequent in older patients and in those with comorbidities. Mechanical SAEs were more frequent when colonoscopy was performed by less experienced endoscopists. Systemic SAEs were more frequent in public hospitals, reflecting patient selection processes. The risk of both mechanical and systemic SAEs should be taken into account when deciding to perform colonoscopy, particularly in older patients with multiple pre-existing conditions. Key messages Systemic SAEs are not uncommon after colonoscopy and, together with intestinal SAEs, should be considered when considering the need for colonoscopy. Patients at risk of SAEs should be identified and colonoscopy should be performed by experienced endoscopists in these patients. Less invasive alternatives should also be considered in these patients.

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Factors Associated With Educational Support in Young Adolescents With ADHD

Journal of Attention Disorders ◽

10.1177/1087054718804351 ◽

2018 ◽

Vol 24 (5) ◽

pp. 750-757 ◽

Cited By ~ 1

Author(s):

Nardia Zendarski ◽

Emma Sciberras ◽

Fiona Mensah ◽

Harriet Hiscock

Keyword(s):

Support Groups ◽

Behavioral Problems ◽

Catholic School ◽

Future Research ◽

Academic Risk ◽

Educational Support ◽

Logistic Regression Models ◽

Factors Associated ◽

Students With Adhd ◽

Education Support

Objective: This study aimed to examine patterns of use and factors associated with education support use in students with ADHD during early adolescence. Method: Participants were 130 adolescents ( M = 13.7 years, SD = 1.1) with ADHD. Educational support use and the factors associated with use were collected by parent and teacher questionnaires and standardized academic tests during the 2014-2015 school years. Support rates and categories are described. Logistic regression models examine individual, family, and school variables associated with support versus no support. Results: About two thirds of students with ADHD (60%) had accessed education support in the current school year, which included social support (36%), Individualized Educational Plans (IEPs; 22%), Student Support Groups (SSGs; 18%), counseling (17%), mentoring (15%), and homework support (9%). Academic risk (adjusted odds ratio [OR] = 2.30, 95% confidence interval [CI] = [1.03, 5.14], p = .04), behavioral problems (adjusted OR = 1.47, 95% CI = [1.01, 2.14], p = .047), and attending a Catholic school (adjusted OR = 5.10, 95% CI = [1.59, 16.42], p = .006) were associated with receiving support independent of adolescent age, gender, ADHD medication use, and socioeconomic status. Conclusions: Future research needs to determine whether education support makes a difference to long-term outcomes for students with ADHD and to determine why some students at academic risk receive no support.

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Pancreaticobiliary endoscopic ultrasound in England 2007 to 2016: Changing practice and outcomes

Endoscopy International Open ◽

10.1055/a-1534-2558 ◽

2021 ◽

Vol 09 (11) ◽

pp. E1731-E1739

Author(s):

Nigel Trudgill ◽

Kofi W. Oppong ◽

Umair Kamran ◽

Dominic King ◽

Amandeep Dosanjh ◽

...

Keyword(s):

Pancreatic Cancer ◽

Adverse Events ◽

Endoscopic Ultrasound ◽

Emergency Admission ◽

Population Level ◽

Needle Aspiration ◽

Logistic Regression Models ◽

Factors Associated ◽

Changing Practice ◽

Level Data

Abstract Background and study aims Population-level data on the outcomes of pancreaticobiliary endoscopic ultrasound (PB-EUS) are limited. We examined national PB-EUS and fine-needle aspiration (FNA) activity, its relation to pancreatic cancer therapy, associated mortality and adverse events. Patients and methods Adults undergoing PB-EUS in England from 2007–2016 were identified in Hospital Episode Statistics. A pancreatic cancer cohort diagnosed within 6 months of PB-EUS were studied separately. Multivariable logistic regression models examined associations with 30-day mortality and therapies for pancreatic cancer. Results 79,269 PB-EUS in 68,908 subjects were identified. Annual numbers increased from 2,874 (28 % FNA) to 12,752 (35 % FNA) from 2007 to 2016. 8,840 subjects (13 %) were diagnosed with pancreatic cancer. Sedation related adverse events were coded in 0.5 % and emergency admission with acute pancreatitis in 0.2 % within 48 hours of PB-EUS. 1.5 % of subjects died within 30 days of PB-EUS. Factors associated with 30-day mortality included increasing age (odds ratio 1.03 [95 % CI 1.03–1.04]); male sex (1.38 [1.24–1.56]); increasing comorbidity (1.49 [1.27–1.74]); EUS-FNA (2.26 [1.98–2.57]); pancreatic cancer (1.39 [1.19–1.62]); increasing deprivation (least deprived quintile 0.76 [0.62–0.93]) and lower provider PB-EUS volume (2.83 [2.15–3.73]). Factors associated with surgical resection in the pancreatic cancer cohort included lower provider PB-EUS volume (0.44 [0.26–0.74]) and the least deprived subjects (1.33 [1.12–1.57]). 33 % of pancreatic cancer subjects who underwent EUS, did not subsequently receive active cancer treatment. Conclusions Lower provider PB-EUS volume was associated with higher 30-day mortality and reduced rates of both pancreatic cancer surgery and chemotherapy. These results suggest potential issues with case selection in lower-volume EUS providers.

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The Attenuation of Very Low Frequency Brain Oscillations in Transitions from a Rest State to Active Attention

Journal of Psychophysiology ◽

10.1027/0269-8803.23.4.191 ◽

2009 ◽

Vol 23 (4) ◽

pp. 191-198 ◽

Cited By ~ 26

Author(s):

Suzannah K. Helps ◽

Samantha J. Broyd ◽

Christopher J. James ◽

Anke Karl ◽

Edmund J. S. Sonuga-Barke

Keyword(s):

Brain Activity ◽

Sampling Rate ◽

Low Frequency ◽

Future Research ◽

Adhd Symptoms ◽

Default Mode ◽

Very Low Frequency ◽

Wide Range ◽

Interference Hypothesis ◽

Mode Interference

Background: The default mode interference hypothesis ( Sonuga-Barke & Castellanos, 2007 ) predicts (1) the attenuation of very low frequency oscillations (VLFO; e.g., .05 Hz) in brain activity within the default mode network during the transition from rest to task, and (2) that failures to attenuate in this way will lead to an increased likelihood of periodic attention lapses that are synchronized to the VLFO pattern. Here, we tested these predictions using DC-EEG recordings within and outside of a previously identified network of electrode locations hypothesized to reflect DMN activity (i.e., S3 network; Helps et al., 2008 ). Method: 24 young adults (mean age 22.3 years; 8 male), sampled to include a wide range of ADHD symptoms, took part in a study of rest to task transitions. Two conditions were compared: 5 min of rest (eyes open) and a 10-min simple 2-choice RT task with a relatively high sampling rate (ISI 1 s). DC-EEG was recorded during both conditions, and the low-frequency spectrum was decomposed and measures of the power within specific bands extracted. Results: Shift from rest to task led to an attenuation of VLFO activity within the S3 network which was inversely associated with ADHD symptoms. RT during task also showed a VLFO signature. During task there was a small but significant degree of synchronization between EEG and RT in the VLFO band. Attenuators showed a lower degree of synchrony than nonattenuators. Discussion: The results provide some initial EEG-based support for the default mode interference hypothesis and suggest that failure to attenuate VLFO in the S3 network is associated with higher synchrony between low-frequency brain activity and RT fluctuations during a simple RT task. Although significant, the effects were small and future research should employ tasks with a higher sampling rate to increase the possibility of extracting robust and stable signals.

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Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

Future Oncology ◽

10.2217/fon-2020-0425 ◽

2020 ◽

Vol 16 (32) ◽

pp. 2635-2643

Author(s):

Samantha L Freije ◽

Jordan A Holmes ◽

Saleh Rachidi ◽

Susannah G Ellsworth ◽

Richard C Zellars ◽

...

Keyword(s):

Cancer Patients ◽

Odds Ratio ◽

Regression Models ◽

Tumor Patients ◽

Logistic Regression Models ◽

Factors Associated ◽

Follow Up Care ◽

Risk Patients ◽

African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

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A Scoping Review of Resilience in Survivors of Human Trafficking

Trauma Violence & Abuse ◽

10.1177/1524838020985561 ◽

2021 ◽

pp. 152483802098556

Author(s):

Logan Knight ◽

Yitong Xin ◽

Cecilia Mengo

Keyword(s):

Interpersonal Relationships ◽

Scoping Review ◽

National Origin ◽

Future Research ◽

Research Needs ◽

Standardized Measures ◽

Factors Associated ◽

Current State ◽

Case Files ◽

Sexual Trafficking

Resilience is critical among survivors of trafficking as they are mostly vulnerable populations who face multiple adversities before, during, and after trafficking. However, resilience in survivors of trafficking is understudied. This scoping review aims to clarify the current state of knowledge, focusing on definitions of resilience, how resilience has been studied, and factors associated with resilience among survivors. Five databases were searched using key words related to trafficking and resilience. Studies were included if they were published in English between 2000 and 2019 and focused on resilience with the study design including at least one of these four features: (a) use of standardized measures of resilience, (b) qualitative descriptions of resilience, (c) participants were survivors or professionals serving survivors, and (d) data sources such as case files or program manuals directly pertained to survivors. Eighteen studies were identified. Findings indicated that resilience was primarily described as emergent from interactions between the survivor and the environment. Resilience in trafficking appeared largely similar to resilience in other kinds of victimization. Nonetheless, trafficking survivors also may display resilience in alternative ways such as refusing treatment. Positive interpersonal relationships were the most commonly mentioned resilience factor. In addition, current research lacks studies featuring longitudinal designs, interventions, participatory methods, types of trafficking other than sexual trafficking, and demographic characteristics such as age, gender, and national origin. Future research needs to establish definitions and measures of resilience that are culturally and contextually relevant to survivors and build knowledge necessary for designing and evaluating resilience-enhancing interventions.

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Several frailty parameters highly prevalent in middle age (50–65) are independent predictors of adverse events

Scientific Reports ◽

10.1038/s41598-021-88410-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lauriane Segaux ◽

Amaury Broussier ◽

Nadia Oubaya ◽

Claire Leissing-Desprez ◽

Marie Laurent ◽

...

Keyword(s):

Adverse Events ◽

Middle Age ◽

Executive Dysfunction ◽

Community Dwelling ◽

Living Alone ◽

Middle Aged ◽

Cross Sectional ◽

Balance Impairment ◽

Logistic Regression Models ◽

Paris Area

AbstractAlthough frailty can arise in middle age, very few studies have investigated frailty before 65 years. Our objectives were to assess the prevalence of frailty parameters in middle-aged individuals and probe the association with future adverse events. We performed cross-sectional and longitudinal analyses of community-dwelling individuals aged 50 to 65 (n = 411, median age: 59.0) having undergone a multidomain geriatric assessment (2010–2015) in an outpatient clinic in the greater Paris area of France (SUCCEED cohort). The primary outcome was a composite measure of adverse events (non-accidental falls, fractures, unplanned hospitalizations, death), recorded in 2016/2017. Multivariable logistic regression models were built to identify independent predictors. Six frailty parameters were highly prevalent (> 20%): low activity (40.1%), exhaustion (31.3%), living alone (28.5%), balance impairment (26.8%), weakness (26.7%), and executive dysfunction (23.2%). Female sex (odds ratio: 2.67 [95% confidence interval: 1.17–6.11]), living alone (2.39 [1.32–4.33]), balance impairment (2.09 [1.16–3.78]), executive dysfunction (2.61, [1.18–5.77]), and exhaustion (2.98 [1.65–5.39]) were independent predictors of adverse events. Many frailty parameters are already altered in middle-aged individuals and are predictive of adverse health events. Our findings highlight a possible need for frailty screening and preventive programs targeting middle-aged individuals.

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Do Migrants Receive Tuberculosis Education in China? Evidence From the China Migrants Dynamic Survey

Health Education & Behavior ◽

10.1177/10901981211000309 ◽

2021 ◽

pp. 109019812110003

Author(s):

Zheng Zhu ◽

Mengdi Guo ◽

Tingyue Dong ◽

Beibei Gong ◽

Xia Zhao ◽

...

Keyword(s):

Low Socioeconomic Status ◽

Age Groups ◽

Secondary Data ◽

Total Sample ◽

Self Report ◽

Primary Methods ◽

Logistic Regression Models ◽

Key Population ◽

Bulletin Boards ◽

Nationally Representative

Background Migrants are the key population for tuberculosis (TB) transmission in China. However, it remains unknown how many migrants have received TB education and through what means. Objectives To identify the rate and methods of TB education among migrants in China by using nationally representative data. Method This study used secondary data analysis. The data were derived from the China Migrants Dynamic Survey 2014–2017. A total sample of 745,926 migrants was included in the following analysis. Information on TB education was collected through a self-report questionnaire. We used hierarchical logistic regression models to explore the relationship between the independent variables and the receipt of TB education. Results Only 30.4% ( n = 226,458) received TB education. Among all age-groups, participants between 65 and 69 years old had the highest TB education rate (33.4%). Bulletin boards (86.5%–91%), media (73% to 86.7%), and books/magazines (59.2%–67.4%) were the most common ways for migrants to receive TB education. Conclusions Our study showed the rates of TB education in each region of China and indicated the significant disparity among the seven regions. Traditional media, off-line medical consultation, community advocacy, and bulletin boards should be the primary methods of delivering TB education. TB education campaigns targeting migrants with a low socioeconomic status should be actively promoted.

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Global Trigger Tool methodology to detect adverse events: pilot study at Academic Hospital of Udine

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.522 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

E Scarpis ◽

S Degan ◽

D De Corti ◽

F Mellace ◽

R Cocconi ◽

...

Keyword(s):

Patient Safety ◽

Adverse Events ◽

Academic Hospital ◽

Trigger Tool ◽

Hospital Acquired Infections ◽

Frequent Type ◽

Global Trigger Tool ◽

Clinical Records ◽

Hospital Acquired ◽

Over Time

Abstract Introduction Identification and measurement of adverse events (AEs) is crucial for patient safety in order to monitor them over time and to implement quality improvement programs, testing if they are effective. Global Trigger Tool (GTT) has been proposed as a low-cost method, being also the most effective to detect AEs. This study aims to describe the number of triggers, the rate and level of AEs identified by GTT and the most frequent type of AE. Methods The Italian version of the GTT was used. Ten paper-based clinical records (CRs) randomly selected every 2 weeks were reviewed from January to April 2019 by three independent reviewers (two nurses, one doctor) at the Academic Hospital of Udine. The AEs rates calculated are: AEs per 1,000 patient-days, AEs per 100 admissions, percentage of admissions with an AE. AEs were classified by harm levels according to National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Results CRs reviewed were 80. Mean age of the patients was 69.3±16.4, women were 37.5%. Mean hospitalisation was 16.8±15.3. Nine were the cases of re-hospitalisation within 30 days (11.3%). The total number of trigger was 156. AEs were 31, with at least one AE on 27.5% of admissions, 38.8 AEs per 100 admissions and 23 AEs per 1,000 patient-days. AEs with harm level E, F and H were respectively 5 (16.1%), 24 (77.4%) and 2 (6.5%). The most frequent type of AE were hospital acquired infections with 15 cases (48.4%). Conclusions The most frequent type of AE was the hospital acquired infections. Rates and levels of AEs were higher than other international studies, probably because of the limited number of CRs reviewed. Key messages Global Trigger Tool is an effective method to detect adverse patient safety events in order to monitor them over time. The most frequent type of adverse events was the hospital acquired infections.

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Insurance Status and Ethnicity Impact Health Disparities in Rates of Advance Directives in Trauma

The American Surgeon ◽

10.1177/00031348211011115 ◽

2021 ◽

pp. 000313482110111

Author(s):

Krista L. Haines ◽

Benjamin P. Nguyen ◽

Ioana Antonescu ◽

Jennifer Freeman ◽

Christopher Cox ◽

...

Keyword(s):

Mechanical Ventilation ◽

End Of Life ◽

Hospice Care ◽

Private Insurance ◽

Future Research ◽

Trauma Patients ◽

Improvement Program ◽

Advanced Directives ◽

Logistic Regression Models ◽

Discharge Disposition

Introduction Advanced directives (ADs) provide a framework from which families may understand patient’s wishes. However, end-of-life planning may not be prioritized by everyone. This analysis aimed to determine what populations have ADs and how they affected trauma outcomes. Methods Adult trauma patients recorded in the American College of Surgeons Trauma Quality Improvement Program (TQIP) from 2013-2015 were included. The primary outcome was presence of an AD. Secondary outcomes included mortality, length of stay (LOS), mechanical ventilation, ICU admission/LOS, withdrawal of life-sustaining measures, and discharge disposition. Multivariable logistic regression models were developed for outcomes. Results 44 705 patients were included in the analyses. Advanced directives were present in 1.79% of patients. The average age for patients with ADs was 77.8 ± 10.7. African American (odds ratio (OR) .53, confidence intervals [CI] .36-.79) and Asian (OR .22, CI .05-.91) patients were less likely to have ADs. Conversely, Medicaid (OR 1.70, CI 1.06-2.73) and Medicare (OR 1.65, CI 1.25-2.17) patients were more likely to have ADs as compared to those with private insurance. The presence of ADs was associated with increased hospital mortality (OR 2.84, CI 2.19-3.70), increased transition to comfort measures (OR 2.87, CI 2.08-3.95), and shorter LOS (CO −.74, CI −1.26-.22). Patients with ADs had an increased odds of hospice care (OR 4.24, CI 3.18-5.64). Conclusion Advanced directives at admission are uncommon, particularly among African Americans and Asians. The presence of ADs was associated with increased mortality, use of mechanical ventilation, admission to the ICU, withdrawal of life-sustaining measures, and hospice. Future research should target expansion of ADs among minority populations to alleviate disparities in end-of-life treatment.

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