Search

Many existing student persistence and retention studies overlooked the different types of departure (e.g., dropout, transfer) and aggregate them into a single departure variable, as a result, the estimates from these studies are spurious when one is interested in what student characteristics prompt dropout but not transfer. This can be especially relevant when studying the departure behavior of specific student subgroups, such as first-generation students. In response to this shortcoming in previous studies, this study longitudinally analyzed first-generation students' dropout and transfer behaviors. Paired with nationally represented data, this study uncovered how various student characteristics impact dropout and transfer behaviors differently over time. First-generation students were more likely than students with college-educated parents to leave the system than to transfer. A higher sense of belonging was found to reduce the likelihood of students transferring to other institutions academic years one through four. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common skin disorder linked to systemic inflammation and immune dysregulation. It is believed to involve activated T cells and neutrophils. Recent research has highlighted the potential role of hematological ratios, such as neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), eosinophil‐to‐lymphocyte ratio (ELR), eosinophil‐to‐neutrophil ratio (ENR), and eosinophil‐to‐monocyte ratio (EMR), as markers for inflammatory skin diseases, including psoriasis. Objectives: We aimed to investigate hematological ratios between children and adults, patients and controls, and patients with moderate‐to‐severe and mild psoriasis. Materials and Methods: This national retrospective cohort study included over 16,000 psoriasis patients in Israel. Patients with comorbidities influencing blood counts were excluded. Ratios were calculated from blood counts taken within 30 days of diagnosis. Multivariable logistic regression, including age, gender, ethnicity, smoking status, and socioeconomic status, was performed. Results: Findings revealed age‐specific variations in blood counts, hematological ratios, and differences between mild and moderate–severe patients and patients versus controls. Moderate–severe psoriasis patients had elevated neutrophil and eosinophil counts (4.57 vs. 4.25, P < 0.001, and 0.24 vs. 0.22, P = 0.047, respectively), as well as increased NLR (2.46 vs. 2.29, P < 0.001). Multivariable logistic regression analysis confirmed the significance of neutrophil and platelet counts as well as NLR and PLR in predicting psoriasis severity. Limitations: This was a retrospective study without subjective data on disease severity. Conclusion: This study highlights hematologic ratios' diagnostic and prognostic potential in psoriasis. [ABSTRACT FROM AUTHOR]

Objective: The impact of sex on outcomes following carotid endarterectomy (CEA) and carotid artery stenting (CAS) is not fully elucidated. The aim of this study was to analyze the association between sex and outcomes of asymptomatic patients who underwent primary carotid interventions in France. Methods: This nationwide retrospective study was performed using the French National Health Insurance Information System and included asymptomatic patients who underwent primary carotid intervention over a 10-year period (1 January 2013 to 31 August 2023). Symptomatic patients and patients who had peri-operative neurologic events were excluded. The primary endpoints were the occurrence of death and stroke/transient ischaemic attack (TIA) at 30 days, 1 and 5 years after patients' discharge. Results: In total, 115,879 patients were admitted for an index CEA (29.4% women) and 6500 for CAS (29.8% women). In the CEA group, no significant sex-related difference was observed for 30-day mortality; however, women had significantly lower 1-year and 5-year mortality rates compared to men (1.9% vs. 2.6%, p < 0.001 and 7.9% vs. 11.1%, p < 0.001). In the CAS group, women had lower 30-day, 1-year and 5-year mortality (0.6% vs. 1.0%, p = 0.040, 3.8% vs. 4.9%, p = 0.048, and 10.4% vs. 15.0%, p < 0.001). A multivariate analysis showed that sex was not associated with the risk of stroke/TIA and mortality at 30 days (OR 0.84 (95% CI 0.67–1.04) and 1.27 (95% CI 0.98–1.64)). Male sex was associated with a higher risk of 1-year and 5-year mortality (OR 1.24 (95% CI 1.13–1.36) and 1.25 (95% CI 1.18–1.31)), but a lower risk of stroke/TIA than female sex. Conclusions: No significant sex-related difference was observed at 30 days in patients being discharged alive and without peri-operative neurologic events. Male sex was associated with a higher risk of mortality but a lower risk of stroke/TIA at 1 and 5 years. [ABSTRACT FROM AUTHOR]

Purpose: To describe temporal trends in inpatient care use for adult mental disorders in Czechia from 1994 until 2015. Methods: Data from the nationwide register of inpatient care use and yearly census data were used to calculate (a) yearly admissions rates, (b) median length of stay, and (c) standardized inpatient-years for adult mental disorders (ICD-10 codes F0-F6] or G30). Segmented regressions were used to analyze age- and sex-specific temporal trends. Results: Admission rates were increasing in adults (average annual percent change = 0.51; 95% confidence interval = 0.16 to 0.86 for females and 1.01; 0.63 to 1.40 for males) and adolescents and emerging adults (3.27; 2.57 to 3.97 for females and 2.98; 2.08 to 3.88 for males), whereas in seniors, the trend was stable (1.22; -0.31 to 2.73 for females and 1.35; -0.30 to 2.98 for males). The median length of stay for studied mental disorders decreased across all age and sex strata except for a stable trend in male adolescents and emerging adults (-0.96; -2.02 to 0.10). Standardized inpatient-years were decreasing in adults of both sexes (-0.85; -1.42 to -0.28 for females and -0.87; -1.19 to -0.56 for males), increasing in female adolescents and emerging adults (0.95; 0.42 to 1.47), and stable in the remaining strata. Conclusion: Psychiatric hospital admissions were increasing or stable coupled with considerable reductions in median length of stay, suggesting that inpatient episodes for adult mental disorders have become more frequent and shorter over time. The overall psychiatric inpatient care use was decreasing or stable in adults and seniors, potentially implying a gradual shift away from hospital-based care. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionIdentifying barriers experienced by individuals with vision difficulty (VD) in accessing healthcare is crucial to inform public health policies to provide equitable healthcare. We examined the association between VD with healthcare access measures in the United States (U.S.).We used data on 1,258,919 participants surveyed from the 2019, 2020, and 2021 cycles of the Behavioral Risk Factor Surveillance System (BRFSS), a national telephone-based survey of U.S. adults ≥ 18 years. The following outcome of healthcare access were examined: no healthcare coverage, no healthcare provider, >1 year since last checkup, inability to afford healthcare. VD was self-reported blindness/serious difficulty seeing even when wearing glasses. Survey-weighted, multivariable logistic regression models were used to examine the relationship between VD and the outcomes of interest, adjusting for confounders.Of the 1,258,919 participants surveyed from 2019 to 2021, 5.1% reported having VD. Adjusted models showed that adults with VD had greater odds of having no healthcare coverage (OR = 1.14, 95% CI = 1.04-1.24), no provider (OR = 1.12; 95% CI = 1.05-1.20), a health checkup > 1 year ago (OR = 1.12; 95% CI = 1.04-1.21), and of being unable to afford care (OR = 1.62, 95% CI = 1.52-1.73).Adults reporting VD faced more barriers accessing healthcare. These disparities could be explained by a differential distribution of social determinants of health, lack of accessibility of medical facilities and communication barriers. Policies aimed at strengthening provisions around accessibility of healthcare facilities might result in increased access to healthcare for this population. [ABSTRACT FROM AUTHOR]

Objectives: Our objective was to investigate trends in the treatment of patients with late-onset rheumatoid arthritis (LORA) using data from the National Database of Rheumatic Diseases in Japan (NinJa). Methods: Patients registered in the National Database of Rheumatic Diseases in Japan were classified according to the disease onset: at <65 years (young-onset rheumatoid arthritis); at 65–74 years (early LORA); and at ≥75 years (late LORA). Chronological changes in the treatment and disease activity were compared. Results: A total of 7178, 13,171, 15,295, and 15,943 patients were evaluated in 2010, 2013, 2016, and 2019, respectively. In all groups, the use of methotrexate gradually decreased, whereas that of biological/targeted synthetic disease-modifying antirheumatic drugs (DMARDs) increased; the use of tumor necrosis factor inhibitors decreased, whereas that of non-tumor necrosis factor inhibitors increased. LORA was characterized by more single DMARD use and less methotrexate and biological/targeted synthetic DMARD use. Tumor necrosis factor inhibitors and interleukin-6 inhibitors were used less frequently, whereas abatacept was utilized more frequently in late versus early LORA. Conventional synthetic DMARD (excluding methotrexate) and glucocorticoid use was higher in late versus early LORA. Conclusions: This analysis revealed chronological changes in the treatment of LORA in Japan. Differences between early and late LORA suggest that patients are not a homogeneous population. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare the mental health of undergraduates before the COVID-19 pandemic lockdown to their mental health one year later. Participants: Data from the American College Health Association (ACHA)'s National College Health Assessment III (ACHA-NCHAIII) were used, averaging a sample size of 54,844 undergraduate students and 106 schools nationwide per time point of assessment in the study. Methods: Secondary analyses of the ACHA-NCHAIII compared undergraduates' scores on five measures of mental health measures (loneliness, psychological distress, suicidality, flourishing, and resilience) from Spring 2020 to Spring 2021. Results: Undergraduates' responses showed an increase in loneliness, psychological distress, and suicidality as well as a decrease in flourishing and resilience. Conclusions: The worsening of undergraduates' mental health calls for greater action by schools to alleviate students' distress and improve their wellbeing. [ABSTRACT FROM AUTHOR]

Abstract Background Older adults receiving home care have a higher risk of visiting the emergency department (ED) than community-dwelling older adults not receiving home care. This may result from a higher incidence of comorbidities and reduced functional autonomy in home care recipients. Since people receive different types of home care because of their different comorbidities and autonomy profiles, it is possible that distinguishing between the form of home care can help identify subpopulations with different risks for ED visits and help develop targeted interventions. This study aimed to compare the risk of visiting the ED in older adults receiving different forms of home care with those living at home without receiving home care in a national cohort in one year. Methods A retrospective cohort study using claims data collected in 2019 on the Dutch population aged ≥ 65 years (N = 3,314,440) was conducted. Participants were classified as follows: no claimed home care (NO), household help (HH), personal care (PC), HH + PC, and nursing home care at home (NHH). The primary outcome was the number of individuals that visited the ED. Secondary outcomes were the number of individuals whose home care changed, who were institutionalized, or who died. Exploratory logistic regression was applied. Results There were 2,758,093 adults in the NO group, 131,260 in the HH group, 154,462 in the PC group, 96,526 in the HH + PC group, and 34,612 in the NHH group. More ED visits were observed in the home care groups than in the NO group, and this risk increased to more than two-fold for the PC groups. There was a significant change to a more intensive form of home care, institutionalization, or death in all groups. Conclusions Distinguishing between the form of home care older adults receive identifies subpopulations with different risks for ED visits compared with community-dwelling older adults not receiving home care on a population level. Home care transitions are frequent and mostly involve more intensive care or death. Although older adults not receiving home care have a lower risk of ED visits, they contribute most to the absolute volume of ED visits.

Background: Older adults receiving home care have a higher risk of visiting the emergency department (ED) than community-dwelling older adults not receiving home care. This may result from a higher incidence of comorbidities and reduced functional autonomy in home care recipients. Since people receive different types of home care because of their different comorbidities and autonomy profiles, it is possible that distinguishing between the form of home care can help identify subpopulations with different risks for ED visits and help develop targeted interventions. This study aimed to compare the risk of visiting the ED in older adults receiving different forms of home care with those living at home without receiving home care in a national cohort in one year. Methods: A retrospective cohort study using claims data collected in 2019 on the Dutch population aged ≥ 65 years (N = 3,314,440) was conducted. Participants were classified as follows: no claimed home care (NO), household help (HH), personal care (PC), HH + PC, and nursing home care at home (NHH). The primary outcome was the number of individuals that visited the ED. Secondary outcomes were the number of individuals whose home care changed, who were institutionalized, or who died. Exploratory logistic regression was applied. Results: There were 2,758,093 adults in the NO group, 131,260 in the HH group, 154,462 in the PC group, 96,526 in the HH + PC group, and 34,612 in the NHH group. More ED visits were observed in the home care groups than in the NO group, and this risk increased to more than two-fold for the PC groups. There was a significant change to a more intensive form of home care, institutionalization, or death in all groups. Conclusions: Distinguishing between the form of home care older adults receive identifies subpopulations with different risks for ED visits compared with community-dwelling older adults not receiving home care on a population level. Home care transitions are frequent and mostly involve more intensive care or death. Although older adults not receiving home care have a lower risk of ED visits, they contribute most to the absolute volume of ED visits. [ABSTRACT FROM AUTHOR]

Introduction: Atopic dermatitis (AD) is a common chronic skin disease with an inflammatory pathophysiology that includes the activation of the innate and adaptive immune systems. We aimed to investigate the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), and eosinophil-to-neutrophil ratio (ENR) in AD patients, according to age and disease severity. Methods: This is a retrospective, population-based cohort study conducted between the years 2005 and 2020, comparing hematological markers of AD patients and sex-age-ethnicity-matched controls. AD patients were further divided by age and disease severity (mild, moderate-to-severe AD). We created a decision tree to predict moderate-severe AD. Results: A total of 13,928 patients with AD were included in this study: 6,828 adults and 7,100 children, with 13,548 controls. NLR, PLR, and ELR were lower in children compared to adults (p values <0.001). NLR, PLR, ELR, and ENR were increased in moderate-severe AD patients compared to mild AD patients (p values <0.001). PLR, ELR, and ENR were increased in AD patients versus controls (p values <0.001), with an additional increase in the NLR of moderate-to-severe AD patients. Patients with an ELR <0.21, a PLR >161, and ENR ≤0.016 should be considered high risk for developing severe AD, as well as patients with an ELR >0.21 and age at diagnosis <30 or age >30 years and mean platelet volume ≤9. Conclusion: Hematological ratios were significantly higher in moderate-to-severe AD patients, compared to mild AD patients. Hematological markers were lower in children with AD compared to adults, except for ENR, likely reflecting age-related changes in blood count parameters. These markers can assist in the management and follow-up of AD patients. [ABSTRACT FROM AUTHOR]

Vitiligo is characterized by depigmented skin lesions involving melanocyte defects and immune dysregulation. Haematological markers like neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been explored in various skin disorders. Given vitiligo’s proposed pathogenesis, we hypothesized differences in NLR and PLR in vitiligo patients compared to controls. In a national retrospective cohort study (2005–2020) in Israel, blood count data from patients diagnosed with vitiligo (ICD-10 codes) were analysed, excluding patients with recent infections, surgeries, or malignancies. Controls matched for age and sex were selected. Sub-analyses examined age groups, treatment type, and matched controls. Children (n = 3,796) and adults (n = 38,608) with vitiligo showed significant differences in gender distribution, cell counts, and ratios. Vitiligo patients (n = 38,358) exhibited lower NLR, decreased neutrophils and platelets, and increased lymphocytes compared with controls. Non-systemically treated vitiligo patients (n = 33,871) displayed lower NLR and neutrophils compared with matched controls. Systemically treated vitiligo patients (n = 4,487) showed lower NLR, higher PLR, and reduced lymphocytes. Logistic regression identified associations between increased lymphocyte and platelet counts and being systemically treated. This study highlights significant haematological differences in vitiligo patients, emphasizing the potential utility of NLR as an accessible tool for vitiligo assessment. Further investigations are warranted to elucidate the roles of neutrophils and lymphocytes in vitiligo pathogenesis.

Chronic spontaneous urticaria (CSU) is a disturbing skin condition often severely detrimental to quality of life. Haematological markers of inflammation such as neutrophil-to-lymphocyte and platelet-to-lymphocyte may be used in the assessment of inflammatory skin diseases. Their usefulness in urticaria is unknown. Neutrophil- to-lymphocyte, platelet-to-lymphocyte, and total serum IgE were investigated in urticaria patients: acute spontaneous urticaria (ASU) versus CSU, children versus adults with CSU, and patients with mild-to-moderate versus severe CSU. This retrospective cohort study included patients of all ages diagnosed with urticaria between 2005 and 2020 and blood counts within 30 days of diagnosis. Patients with comorbidities influencing blood cells (infection, surgery, malignancy) were excluded. Neutrophil-to-lymphocyte and platelet-to-lymphocyte were evaluated in patients with ASU vs CSU and mild-to-moderate CSU vs severe CSU (defined by the use of systemic medications or hospitalizations). A total of 13,541 urticaria patients were included in the study. CSU patients (n = 5,021) had higher neutrophil-to-lymphocyte and platelet-to-lymphocyte, as well as serum IgE levels compared with ASU patients (n = 8,520). Adults had higher neutrophil-to-lymphocyte and platelet-to-lymphocyte than children. Severely affected patients (n = 53) had higher neutrophil-to-lymphocyte and platelet-to-lymphocyte compared with mild-to-moderately affected patients (n = 4,968). Patients with higher neutrophil-to-lymphocyte and platelet-to-lymphocyte had higher odds of having CSU rather than ASU and severe urticaria rather mild-to-moderate. In conclusion, neutrophil-to-lymphocyte and platelet-to-lymphocyte are simple and available markers that can be used to predict and assess severe and chronic urticaria.

Summary: Looking at SRHR as an isolated set of elements, as is the current practice, does not do justice to the needs and rights of people and communities and may be one of the reasons why challenges remain in the attainment of SRHR for all. SRHR Infographic snapshots were developed for all 194 WHO Member States and included 120 indicators covering a broad range of policy, health systems and service delivery interventions. The snapshots were created using data less than 10 years old publicly available in data repositories maintained by international and global agencies. Data availability was not consistent across countries with low and lower-middle income countries having higher data availability (71%) compared to high income countries (40%). SRHR data that is easily accessible and consistently reported can improve accountability and opportunities for learning to improve people-centred approaches to accelerate the attainment of SRHR for all.

Plain Language Summary Reproductive coercion (RC) is a type of abuse where a partner asserts control over a woman’s reproductive health trajectories. While RC was conceptualized in the United States, recent research highlights that it may be prominent in other geographies, including sub-Saharan Africa. Existing national surveillance programs, including the Demographic and Health Surveys, have included a single item on RC beginning in 2018. Given the phased approach to Demographic and Health Survey roll-out, no studies have examined this single item across diverse contexts. Further, this single item may miss the range of abusive experiences women face when seeking to manage their fertility. Using annual national cross-sections in 10 diverse contexts (eight countries), we sought to: (1) validate a comprehensive RC measure; (2) calculate prevalence of RC and specific behaviors; (3) understand risk factors for RC across contexts. We found that the comprehensive RC measure performed well across sites. Prevalence of past-year RC was highest in the Kongo Central region of the Democratic Republic of Congo (20.3%) and lowest in Niger (3.1%). Polygynous marriage was associated with increased risk of RC across six sites, whereas increased partner education levels were protective against RC in two sites. Understanding the prevalence of RC within a given context and range of specific abusive behaviors, as well as risk profiles, can help alert local service providers to women’s needs. A thorough understanding of commonalities and divergence of RC experiences and drivers across sites can help inform prevention and response programming to address RC and its health effects.

Background: Reproductive coercion (RC) is a type of abuse where a partner asserts control over a woman's reproductive health trajectories. Recent research emphasizes that RC experiences may differ within and across low- and middle-income countries (LMICs), as compared to higher income contexts, given social pressures surrounding childbearing. To date, nationally representative surveys have lacked comprehensive measures for RC, leading to gaps in understanding its prevalence and risk factors. Across eight LMICs (10 sites), we aimed to (1) validate the RC Scale; (2) calculate prevalence of RC and specific behaviors; and (3) assess correlates of RC. Methods: This analysis leverages cross-sectional Performance Monitoring for Action (PMA) data collected from November 2020 to May 2022. Analyses were limited to women in need of contraception (Burkina Faso n = 2767; Côte d'Ivoire n = 1561; Kongo Central, Democratic Republic of Congo (DRC) n = 830; Kinshasa, DRC n = 846; Kenya n = 4588; Kano, Nigeria n = 535; Lagos, Nigeria n = 612; Niger n = 1525; Rajasthan, India n = 3017; Uganda n = 2020). Past-year RC was assessed via five items adapted from the original RC Scale and previously tested in LMICs. Confirmatory factor analysis examined fit statistics by site. Per-item and overall prevalence were calculated. Site-specific bivariate and multivariable logistic regression examined RC correlates across the socioecological framework. Results: Confirmatory factor analysis confirmed goodness of fit across all sites, with moderate internal consistency (alpha range: 0.66 Cote d'Ivoire–0.89 Kinshasa, DRC/Lagos, Nigeria). Past-year reported prevalence of RC was highest in Kongo Central, DRC (20.3%) and lowest in Niger (3.1%). Prevalence of individual items varied substantially by geography. Polygyny was the most common RC risk factor across six sites (adjusted odds ratio (aOR) range: 1.59–10.76). Increased partner education levels were protective in Kenya and Kano, Nigeria (aOR range: 0.23–0.67). Other assessed correlates differed by site. Conclusions: Understanding RC prevalence and behaviors is central to providing woman-centered reproductive care. RC was most strongly correlated with factors at the partner dyad level; future research is needed to unpack the relative contributions of relationship power dynamics versus cultural norms surrounding childbearing. Family planning services must recognize and respond to women's immediate needs to ensure RC does not alter reproductive trajectories, including vulnerability to unintended pregnancy. Plain Language Summary: Reproductive coercion (RC) is a type of abuse where a partner asserts control over a woman's reproductive health trajectories. While RC was conceptualized in the United States, recent research highlights that it may be prominent in other geographies, including sub-Saharan Africa. Existing national surveillance programs, including the Demographic and Health Surveys, have included a single item on RC beginning in 2018. Given the phased approach to Demographic and Health Survey roll-out, no studies have examined this single item across diverse contexts. Further, this single item may miss the range of abusive experiences women face when seeking to manage their fertility. Using annual national cross-sections in 10 diverse contexts (eight countries), we sought to: (1) validate a comprehensive RC measure; (2) calculate prevalence of RC and specific behaviors; (3) understand risk factors for RC across contexts. We found that the comprehensive RC measure performed well across sites. Prevalence of past-year RC was highest in the Kongo Central region of the Democratic Republic of Congo (20.3%) and lowest in Niger (3.1%). Polygynous marriage was associated with increased risk of RC across six sites, whereas increased partner education levels were protective against RC in two sites. Understanding the prevalence of RC within a given context and range of specific abusive behaviors, as well as risk profiles, can help alert local service providers to women's needs. A thorough understanding of commonalities and divergence of RC experiences and drivers across sites can help inform prevention and response programming to address RC and its health effects. [ABSTRACT FROM AUTHOR]

The volume of mechanical thrombectomy (MT) performed at hospitals is used as one of the criteria for advanced-level designation for stroke care.Our study sought to determine the relationship between annual MT procedural volume and in-hospital outcomes in acute ischemic stroke patients undergoing MT in the United States.We analyzed the National Inpatient Sample from 2016 to 2020. The hospitals were grouped into quartiles based on the volume of MT procedures performed within the calendar year. We compared the rates of routine discharge/home health care; in-hospital mortality, and post-treatment intracranial hemorrhage (ICH) between the quartiles after adjusting for potential confounders.Patients undergoing MT ranged from 15,395 in quartile 1 to 78,510 MT in quartile 4. There were lower rates of discharge home/self-care of 22.5%, 20.8%, and 20.8% for quartiles 2, 3, and 4, respectively, compared with 34.9% in quartile 1. The odds of ICH increased to 1.81 (p < 0.001), 1.84 (p < 0.001), and 1.98 (p < 0.001) among the quartiles from lowest to highest procedural volumes. The odds of home discharge/self-care decreased to 0.66 (p < 0.001), 0.60 (p < 0.001), and 0.63 (p < 0.001) among the quartiles from lowest to highest procedural volumes. The odds of in-hospital mortality increased to 1.92 (p < 0.001), 1.99 (p < 0.001), and 1.84 (p < 0.001) among the quartiles from lowest to highest procedural volumes.We observed a paradoxical relationship between adverse outcomes and the annual procedural volume of MT at the hospital presumably due to the higher severity of acute ischemic stroke treated at high-volume hospitals. [ABSTRACT FROM AUTHOR]

Acute hospitalization, recurrent admissions, institutionalization, and death are important adverse health outcomes. Older adults receiving home care are especially at risk of these outcomes, yet it remains unclear if this risk differs between older adults receiving different types of home care and older adults not receiving home care. Retrospective cohort study using national claims data from 2019. Community-dwelling Dutch individuals aged ≥ 65 years (N = 3,174,953). Participants were categorized: no home care, household help, personal care, household help combined with personal care, or nursing home care at home. The primary outcomes were the number of people experiencing acute hospitalization, recurrent admissions, institutionalization, or death. Logistic regression models were applied. In total, 2,758,093 adults were included in the no home care group, 131,260 in the household help group, 154,462 in the personal care group, 96,526 in the household help combined with personal care group, and 34,612 in the nursing home care at home group. The risk of adverse outcomes differed between home care groups, with all showing higher odds compared with the no home care group. Individuals receiving household help combined with personal care had the highest odds for acute hospitalization [odds ratio (OR), 2.60; 95% CI, 2.55–2.64] and recurrent admissions (OR, 2.60; 95% CI, 2.55–2.65), while those receiving nursing home care at home had the highest odds for death (OR, 7.59; 95% CI, 7.35–7.85) and institutionalization (OR, 63.22; 95% CI, 60.94–65.58). Differentiating between the type of home care older adults receive identifies subpopulations with different risks for adverse health outcomes compared with older adults not receiving home care. Older adults receiving personal care (nurse based) are at high risk for these outcomes and represent a substantial population with prevention potential. Future research should focus on developing effective interventions for this group. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of performing neurotization during breast reconstruction on total operating time and post-operative morbidity. The 2015 through 2019 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) databases were utilized to identify patients who underwent breast reconstruction with and without neurotization. Baseline demographics, comorbidities, operative characteristics and outcomes were examined for each group. Thirty-day complication and readmission rates were compared using univariable and multivariable logistic regressions. Of 73,507 patients identified who underwent breast reconstruction, 240 had reconstruction with neurotization. Autologous reconstruction was more prevalent for patients with neurotization (90.8% vs. 18.5%, p<.001). Average operating time was longer when neurotization was performed during both autologous (527.1 ± 152.4 vs. 414.8 ± 186.3, p<.001) and alloplastic-only reconstruction (310.9 ± 115.9 vs. 173.0 ± 94.3, p<.001). The likelihood total operating time exceeded 521 min (two standard deviations above average) increased when neurotization was performed (OR 2.464, CI 1.864–3.255, p<.001). Thirty-day complications occurred in 13.8% of patients with neurotization and 6.8% without (p<.001). Similarly, 30-day readmission rates were higher for patients with neurotization (7.5% vs. 4.2%, p<.001). However, when adjusted for comorbidities and operative characteristics, neurotization did not significantly impact 30-day complication rates (OR 0.802, CI 0.548–1.174, p=.256) or 30-day readmission rates (OR 1.352, CI 0.822–2.223, p=.077). Although neurotization during breast reconstruction increases operating time, comorbidities and procedural characteristics play a greater role in post-operative outcomes than neurotization alone. [ABSTRACT FROM AUTHOR]

Background: In the past decade, the prevalence of end-stage inflammatory elbow arthritis has declined with consequential changes in indications and utilization of total elbow arthroplasty (TEA). Current literature lacks future projections for the utilization of TEA. The aim of this study is to review the trends in the utilization of TEA in the last 2 decades and determine the projections of utilization for TEA (primary and revision) through 2060., Methods: This analysis used the publicly available 2000-2019 data from the CMS Medicare Part-B National Summary. Procedure volumes including TEA, and revision TEA, were determined using Current Procedural Terminology codes and were uplifted to account for the growing number of Medicare eligible patients covered under Medicare Advantage. Using these volumes, log-linear, Poisson, negative binomial regression, and autoregressive integrated moving average models were applied to generate projections from 2020 to 2060. The Poisson model was chosen to display the data based on error analysis and prior literature., Results: The projected annual growth rates from 2020 to 2060 for primary and revision TEAs are 1.03% (95% confidence interval: 0.82%-1.25%) and 5.17% (95% confidence interval: 3.02%-6.97%), respectively. By 2060, the demand for primary TEA and revision TEA is projected to be 2084 procedures (95% forecast interval: 1995-2174) and 3161 procedures (95% forecast interval: 3052-3272), respectively. The procedure volume for revision TEA is estimated to outnumber primary TEA by year 2050., Conclusion: The overall procedural volume of primary TEA and revision TEA continues to be low. Although it is estimated that the incidence of primary and revision TEAs will continue to increase in the next 40 years, the utilization trends only show a mild increase, which is 5 times higher for revision TEA than primary TEA., (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

The aim of this study was to investigate phase IV efficacy, of the PD-1 inhibitor nivolumab among an unselected and unbiased national cohort of recurrent/metastatic Head and Neck Squamous Cell Carcinoma (rmHNSCC) patients. Inclusion criteria included histologically confirmed rmHNSCC and nivolumab as a second-line palliative treatment. Data were collected from patient files at the five Danish head and neck cancer centers and from the DAHANCA database. The iRECIST criteria were used for treatment evaluation. Endpoints were response rate (RR), overall survival (OS), and progression-free survival (PFS), calculated from the start of treatment to the date of event/censoring by the KM-method. Descriptive statistics were used to describe patients and treatment. Analyses were two-sided, with p <.05 considered significant. A total of 146 patients were identified in the period 2017–2020. They had a RR of 14%, median OS of 10.2 months [95% CI: 8.2–12.2] and median PFS of 3.1 months [95% CI: 2.3–4.2]. Patient age (≥ 70 years) or comorbidity did not significantly affect outcome. WHO performance status (PS) =1 was associated with an increased risk of death (HR: 2.1 [95% CI: 1.2–4.0], p =.02) and progression (HR: 1.9 [95% CI: 1.2–3.2], p =.01). Concomitant glucocorticoid-treatment during immunotherapy (≥ 50% of treatment time) appeared important for risk of death (HR: 6.4 [95% CI: 2.3–17.8], p <.001) and risk of progression (HR: 4.8 [95% CI: 1.8–12.5], p =.001). PD-L1 expression ≥ 20% was associated with a lowered risk of progression (HR: 0.5 [95% CI: 0.3–0.7], p =.001), but not lowered risk of death. In this unselected national cohort, outcome of second-line treatment reflects data from the registration studies. Furthermore, the results suggest that immunotherapy should be used with great care in treatment of rmHNSCC in patients with poor performance. [ABSTRACT FROM AUTHOR]

Background: In Benin, access to water, sanitation and hygiene (WASH) remains an issue. This study aims to provide an overview of household access to basic WASH services based on nationally representative data. Method: Secondary analyses were run using the 'HOUSEHOLD' dataset of the fifth Demographic and Health Survey 2017–2018. The dependent variables were household access to individual and combined basic WASH services. The characteristics of the household head and those related to the composition, wealth and environment of the household were independent variables. After a descriptive analysis of all study variables, multivariate logistic regression was performed to identify predictors of outcome variables. Results: The study included 14,156 households. Of these, 63.98% (95% CI = 61.63–66.26), 13.28% (95% CI = 12.10–14.57) and 10.11% (95% CI = 9.19–11.11) had access to individual basic water, sanitation and hygiene facilities, respectively. Also, 3% (95% CI = 2.53–3.56) of households had access to combined basic WASH services. Overall, the richest households and few, and those headed by people aged 30 and over, female and with higher levels of education, were the most likely to have access to individual and combined basic WASH services. In addition, disparities based on the department of residence were observed. Conclusion: The authors suggest a multifactorial approach that addresses the identified determinants. [ABSTRACT FROM AUTHOR]

Since the beginning of 2020, COVID-19 has been the biggest public health crisis in the world. To help develop appropriate public health measures and deploy corresponding resources, many governments have been actively tracking COVID-19 in real time within their jurisdictions. However, one of the key unresolved issues is whether COVID-19 was distributed differently among different age groups and between the two sexes in the ongoing pandemic. The objectives of this study were to use publicly available data to investigate the relative distributions of COVID-19 cases, hospitalizations, and deaths among age groups and between the sexes throughout 2020; and to analyze temporal changes in the relative frequencies of COVID-19 for each age group and each sex. Fifteen countries reported age group and/or sex data of patients with COVID-19. Our analyses revealed that different age groups and sexes were distributed differently in COVID-19 cases, hospitalizations, and deaths. However, there were differences among countries in both their age group and sex distributions. Though there was no consistent temporal change across all countries for any age group or either sex in COVID-19 cases, hospitalizations, and deaths, several countries showed statistically significant patterns. We discuss the potential mechanisms for these observations, the limitations of this study, and the implications of our results on the management of this ongoing pandemic.

Introduction: Monitoring antimicrobial consumption is important to encourage the prudent use of antifungal drugs and to minimize antifungal selective pressure. There is limited data on the national consumption of systemic antifungals in Turkey. This study aimed to investigate the antifungal consumption data of Turkey in ambulatory care and inpatients during 2013-2019 and to compare the consumption data of systemic antifungals in Turkey to that of European countries in 2019. Materials and Methods: Data were obtained retrospectively from the records of the Medicines and Medical Devices Agency of Turkey. The consumption of systemic antifungals according to the Anatomical Therapeutic Chemical (ATC) was calculated using the ATC/Defined Daily Dose (DDD) methodology. In addition, the systemic antifungals consumption data of European countries in 2019 according to eCDC was obtained and compared with that of Turkey obtained in this study expressed in [Defined Inhabitant Dose (DID) - DDD per 1000 inhabitants daily]. Results: Terbinafine (overall median DID: 0.5288), itraconazole (DID: 0.1648), and fluconazole (DID: 0.1068) were the most consumed agents in the outpatient setting. Azoles (DID: 0.0291) were the most commonly consumed agent in inpatients setting, followed by amphotericin-B (DID: 0.0173) and echinocandins (DID: 0.0051). Total antifungal consumption in Turkey was 1.52 DID for outpatients and 0.08 DID for inpatients in 2019. Conclusion: To the best of our knowledge, this study reported the national antifungal consumption data of Turkey for the first time. Antifungals use among outpatients in Turkey showed a decreasing trend from 2016 to 2019 compared to consumption between 2013 and 2016. However, Turkey is still one of the leading antifungal consumers among European countries, especially in ambulatory care.

Reproductive health can be affected by obesity through various mechanisms. Obesity-associated inflammatory markers and altered hormones can have direct and indirect impacts on female reproductive health. However, little is known about obesity prevalence and trend among infertile women and obesity association with infertility in reproductive-age women of the U.S. In a cross-sectional study, we sought to conduct a secondary analysis of National Survey of Family Growth (NSFG) data from 2011 to 2019. A total of 6,035 infertile and non-pregnant fecund women aged 20–44 years were included in a nationally representative sample of the U.S. The weighted prevalence of obesity (BMI ≥ 30) among infertile women was 41.63% for the period 2011–2019. Obese women had 62% higher odds of infertility (95% CI 1.24, 2.17) compared to non-obese women of reproductive age (20–44 years). However, there was no specific trend of obesity among infertile and non-pregnant fecund women aged 20–44 years in the U.S. from 2011 to 2019. Given the negative impact of obesity on female reproductive health and in light of our results, it is important to counsel obese infertile reproductive-age women of the U.S. about behavioral changes that include weight management. Future longitudinal studies are needed to evaluate the risk of infertility among obese women. [ABSTRACT FROM AUTHOR]

Introduction: Monitoring antimicrobial consumption is important to encourage the prudent use of antifungal drugs and to minimize antifungal selective pressure. There is limited data on the national consumption of systemic antifungals in Turkey. This study aimed to investigate the antifungal consumption data of Turkey in ambulatory care and inpatients during 2013-2019 and to compare the consumption data of systemic antifungals in Turkey to that of European countries in 2019. Materials and Methods: Data were obtained retrospectively from the records of the Medicines and Medical Devices Agency of Turkey. The consumption of systemic antifungals according to the Anatomical Therapeutic Chemical (ATC) was calculated using the ATC/Defined Daily Dose (DDD) methodology. In addition, the systemic antifungals consumption data of European countries in 2019 according to eCDC was obtained and compared with that of Turkey obtained in this study expressed in [Defined Inhabitant Dose (DID) - DDD per 1000 inhabitants daily]. Results: Terbinafine (overall median DID: 0.5288), itraconazole (DID: 0.1648), and fluconazole (DID: 0.1068) were the most consumed agents in the outpatient setting. Azoles (DID: 0.0291) were the most commonly consumed agent in inpatients setting, followed by amphotericin-B (DID: 0.0173) and echinocandins (DID: 0.0051). Total antifungal consumption in Turkey was 1.52 DID for outpatients and 0.08 DID for inpatients in 2019. Conclusion: To the best of our knowledge, this study reported the national antifungal consumption data of Turkey for the first time. Antifungals use among outpatients in Turkey showed a decreasing trend from 2016 to 2019 compared to consumption between 2013 and 2016. However, Turkey is still one of the leading antifungal consumers among European countries, especially in ambulatory care. [ABSTRACT FROM AUTHOR]

Background: Anaesthesia is required to assist the treatment of postpartum haemorrhage (PPH) when manual removal of the placenta or emptying of the uterine cavity is required. The choice between general or regional anaesthesia may depend upon factors such as existing epidural, airway, hypovolaemia, and tradition. Methods: Data from a randomized controlled trial of PPH (FIB‐PPH) was used to reveal differences between delivery centres. In addition, national data of 5,601 PPH procedures requiring anaesthesia during 2010–2015 was collected from the Danish Medical Birth Registry, the National Danish Patient Registry, and the Danish Anaesthesia Database. The aim is to describe the variation in choice of anaesthesia for treatment of PPH. Results: Data from the randomized trial showed large differences in practice between centres not explained by physiological factors. Using national Danish registry data, we show that large delivery centres as compared to small centres prefer regional anaesthesia for PPH procedures in opposed to general anaesthesia. Sevoflurane was used despite it causing uterine relaxation. The use of general anaesthesia was associated with younger parturients, larger blood loss, and larger Body‐Mass Index. Aspiration was recorded in one case (0.02%). In the postoperative care‐unit general anaesthesia was associated with a shorter stay, but also higher pain score at admission. Conclusion: Practice varies immensely between delivery centres with large centres preferring regional anaesthesia. Difference in practice might be explained by level of experience, here large centres might be more confident using regional anaesthesia. Knowledge is being extrapolated from literature on caesarean sections. Future studies should address the optimal choice of anaesthesia for PPH procedures. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmada Türkiye’de birinci basamakta düzenlenen reçetelerin ayrıntılarının incelenmesi ve bunların yıllara göre değişiminin değerlendirilmesi amaçlandı.Gereç ve Yöntem: Türkiye’de 2013-2016 tarihleri arasında birinci basamak hekimleri tarafından yazılan ve Reçete Bilgi Sistemi’nde kayıtlı tüm elektronik reçetelerdeki ilaçların ayrıntıları incelendi. Hastaların cinsiyetleri ve yaş grupları özelinde reçete başına düşen ortalama ilaç sayıları (RBDİS) belirlendi. İncelenen yıllarda en sık karşılaşılan ilk yirmi ilacın yer aldığı reçetelerin yüzdeleri belirlendi. Dört yıllık süreçte tek tanılı reçeteler içerisinde en sık karşılaşılan on tanının yer aldığı reçetelerin yüzdesi ve RBDİS incelendi. Bulgular: Dört yılın toplamında 518.335.821 adet reçetede 1.457.034.275 kalem ilaç reçetelendiği ve RBDİS’nin 2,81 olduğu tespit edildi. Tüm yıllarda reçetelerde en fazla yer alan ilaçlar “diğer soğuk algınlığı preparatları” (%19,2-%19,7) ve “amoksisilin+beta-laktamaz inhibitörü” (%9,9-%10,5) idi. Dört yılın toplamında tek tanılı reçetelerde hipertansiyon (%6,9, RBDİS: 2,00) ve “akut üst solunum yolu enfeksiyonu, tanımlanmamış” (ÜSYE), (%6,5, RBDİS: 2,61) tanıları ilk sıralardaydı.Sonuç: Birinci basamaktaki reçetelerin daha çok kadınlara ve yaşlılara yazıldığı ve ÜSYE ile hipertansiyon endikasyon alanlarında yoğunlaştığı anlaşılmaktadır. Soğuk algınlığı preparatları, NSAİİ’ler, PPİ’ler, analjezikler ve geniş spektrumlu antibiyotiklerin fazla reçeteleniyor olması birinci basamakta rasyonel reçeteleme davranışı ile ilgili önemli sorunların varlığına işaret etmektedir.

AIMS OF THE STUDY Although many studies have investigated the influence of personal characteristics on recidivism, knowledge about the impact of correctional policies remains limited. The present study adds to this debate by investigating the effect of the dualistic system of custodial sanctions in Switzerland over time. Specifically, we: (1) tested the influence that different types of custodial sanctions – sentences (offering regular prison treatment) and measures (offering crime-related rehabilitation programmes) – have on reconviction rates; and (2) forecasted future reconviction rates to estimate their value in the year 2020. METHODS National level data from the Swiss Federal Statistical Office were collected, including 3-year reconviction rates after release from custody and the number of persons serving custodial sentences and measures. A time series framework was used for the analyses, which included data available from 1988 to 2013 (n = 26 years). RESULTS The number of persons serving custodial sentences had no effect on recidivism (p = 0.582); however, a higher number of persons serving custodial measures was significantly associated with a decrease in recidivism (p = 0.003). For the year 2020, a reconviction rate of 28% (range 23–33%) was predicted. CONCLUSIONS Custodial measures seem to be associated with a reduction in recidivism. However, owing to the indeterminate time associated with some custodial measures, often at the cost of the prisoners’ rights and the criminal justice system, future studies are needed to determine the optimal serving time for custodial measures.

Since the beginning of 2020, COVID-19 has been the biggest public health crisis in the world. To help develop appropriate public health measures and deploy corresponding resources, many governments have been actively tracking COVID-19 in real time within their jurisdictions. However, one of the key unresolved issues is whether COVID-19 was distributed differently among different age groups and between the two sexes in the ongoing pandemic. The objectives of this study were to use publicly available data to investigate the relative distributions of COVID-19 cases, hospitalizations, and deaths among age groups and between the sexes throughout 2020; and to analyze temporal changes in the relative frequencies of COVID-19 for each age group and each sex. Fifteen countries reported age group and/or sex data of patients with COVID-19. Our analyses revealed that different age groups and sexes were distributed differently in COVID-19 cases, hospitalizations, and deaths. However, there were differences among countries in both their age group and sex distributions. Though there was no consistent temporal change across all countries for any age group or either sex in COVID-19 cases, hospitalizations, and deaths, several countries showed statistically significant patterns. We discuss the potential mechanisms for these observations, the limitations of this study, and the implications of our results on the management of this ongoing pandemic. [ABSTRACT FROM AUTHOR]

Purpose: The epidemiology of personality disorder is poorly understood. This study aims to describe the population in contact with mental health services with a diagnosis of personality disorder and compare service use between this group and those with a diagnosis of depression.Methods: Investigation of a routinely collected clinical data set across New Zealand was conducted. We used data from 2008 to 2017 and 1-year data from 2016, the most complete dataset. This allowed for variation over the years and confirmation within a 1-year prevalence. These data were analysed focusing on patients with a primary diagnosis of any personality disorder and the subset with borderline personality disorder (BPD). BPD was chosen as the most common clinical personality disorder diagnosis and that most researched.Results: 8884 (2.8%) of the population in contact with mental health services carried a primary diagnosis of personality disorder. Personality diagnosis other than antisocial personality disorder (ASPD) in men and borderline personality disorder (BPD) in either gender was negligible. Rates of personality pathology increased with social deprivation and were commonest in young adults. Multi-morbidity was the norm, with internalising disorder common. Maori diagnosed with PD were over-represented both in the patient group and by population.Conclusion: Borderline personality disorder and antisocial personality disorder are routinely diagnosed in routine clinical practice in New Zealand; however, other categorical diagnoses are not made. Patients with PD are significant users of resources in comparison to depressed patients. Resource utilisation was significantly greater in those with PD, in particular use of inpatient services compared to those with depression. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to profile high school students’ achievement as a function of their demographic characteristics, parent attributes (e.g., education), and school behaviors (e.g., number of absences). Students were nested within schools in the Saudi Arabia Kingdom. Out of a large sample of 500k, participants involved 3 random samples of 2,000 students measured during the years 2016, 2017, and 2018. Randomization was conducted at the student level to ensure that all school units will be represented and at their respective frequency. Students were nested within 50 high schools. We adopted the multilevel latent profile analysis protocol put forth by Schmiege et al. (2018) and Mäkikangas et al. (2018) that account for nested data and tested latent class structure invariance over time. Results pointed to the presence of a 4-profile solution based on BIC, the Bayes factor, and several information criteria put forth by Masyn (2013). Latent profile separation was mostly guided by parents’ education and the number of student absences (being positive and negative predictors of high achievement classes, respectively). Two models tested whether the proportions of level 1 profiles to level 2 units are variable and whether level 2 profiles vary as a function of level 1 profiles. Results pointed to the presence of significant variability due to schools.

The purpose of the present study was to profile high school students' achievement as a function of their demographic characteristics, parent attributes (e.g., education), and school behaviors (e.g., number of absences). Students were nested within schools in the Saudi Arabia Kingdom. Out of a large sample of 500k, participants involved 3 random samples of 2,000 students measured during the years 2016, 2017, and 2018. Randomization was conducted at the student level to ensure that all school units will be represented and at their respective frequency. Students were nested within 50 high schools. We adopted the multilevel latent profile analysis protocol put forth by Schmiege et al. (2018) and Mäkikangas et al. (2018) that account for nested data and tested latent class structure invariance over time. Results pointed to the presence of a 4-profile solution based on BIC, the Bayes factor, and several information criteria put forth by Masyn (2013). Latent profile separation was mostly guided by parents' education and the number of student absences (being positive and negative predictors of high achievement classes, respectively). Two models tested whether the proportions of level 1 profiles to level 2 units are variable and whether level 2 profiles vary as a function of level 1 profiles. Results pointed to the presence of significant variability due to schools. [ABSTRACT FROM AUTHOR]

Looking at SRHR as an isolated set of elements, as is the current practice, does not do justice to the needs and rights of people and communities and may be one of the reasons why challenges remain in the attainment of SRHR for all. SRHR Infographic snapshots were developed for all 194 WHO Member States and included 120 indicators covering a broad range of policy, health systems and service delivery interventions. The snapshots were created using data less than 10 years old publicly available in data repositories maintained by international and global agencies. Data availability was not consistent across countries with low and lower-middle income countries having higher data availability (71%) compared to high income countries (40%). SRHR data that is easily accessible and consistently reported can improve accountability and opportunities for learning to improve people-centred approaches to accelerate the attainment of SRHR for all., Competing Interests: The authors declare no competing interests., (© 2024 Published by Elsevier Ltd.)

The purpose of this study was to examine the connections that may exist between the student technology literacy performance in the national schools and teachers who have had technology-focused professional development. Utilizing the online NAEP data, the study examined two school-reported variables related to teacher technology-specific professional development and student TEL scores on a national level. The results presented here suggest that teachers with training in technology usage may be more successful with students than those without. This study may provide insight into understanding more about the relevance of teacher training with regards to technology

Objectives: To elucidate the epidemiological characteristics of patients with rheumatoid arthritis (RA) in Japan using data from the Comprehensive Survey of Living Conditions, a nationwide questionnaire survey conducted in 2016.Methods: In total, 222,365 men and 245,251 women aged ≥16 years were included in the study. RA patients were defined as those who reported 'currently receiving treatment for RA at hospitals, clinics, or a facility for Japanese traditional massage, acupuncture, moxibustion, or judo-orthopedics.' The number of RA patients was estimated from the age-specific prevalence and total Japanese population in 2016. Further, the prevalence of individuals experiencing difficulties in activities of daily living due to health problems and those with mental distress as evaluated by K6 Scale was examined.Results: The estimated number and prevalence of RA in Japan with 95% confidence interval was 822 (768-880) thousand and 0.75% (0.70-0.80%). The population peaked in the late 60s, and the prevalence continued increasing until the early 80s, regardless of sex. Compared with non-RA participants, RA patients were more likely to experience difficulties in activities and to be distressed.Conclusion: High prevalence of RA in older age and mental and physical burden among RA patients were confirmed. [ABSTRACT FROM AUTHOR]

National bodies in Great Britain (GB) have expressed concern over young stock health and welfare and identified calf survival as a priority; however, no national data have been available to quantify mortality rates. The aim of this study was to quantify the temporal incidence rate, distributional features, and factors affecting variation in mortality rates in calves in GB since 2011. The purpose was to provide information to national stakeholder groups to inform resource allocation both for knowledge exchange and future research. Cattle birth and death registrations from the national British Cattle Movement Service were analyzed to determine rates of both slaughter and on-farm mortality. The number of births and deaths registered between 2011 and 2018 within GB were 21.2 and 21.6 million, respectively. Of the 3.3 million on-farm deaths, 1.8 million occurred before 24 mo of age (54%) and 818,845 (25%) happened within the first 3 mo of age. The on-farm mortality rate was 3.87% by 3 mo of age, remained relatively stable over time, and was higher for male calves (4.32%) than female calves (3.45%). Dairy calves experience higher on farm mortality rates than nondairy (beef) calves in the first 3 mo of life, with 6.00 and 2.86% mortality rates, respectively. The 0- to 3-mo death rate at slaughterhouse for male dairy calves has increased from 17.40% in 2011 to 26.16% in 2018, and has remained low (<0.5%) for female dairy calves and beef calves of both sexes. Multivariate adaptive regression spline models were able to explain a large degree of the variation in mortality rates (coefficient of determination = 96%). Mean monthly environmental temperature and month of birth appeared to play an important role in neonatal on-farm mortality rates, with increased temperatures significantly reducing mortality rates. Taking the optimal month of birth and environmental temperature as indicators of the best possible environmental conditions, maintaining these conditions throughout the year would be expected to result in a reduction in annual 0- to 3-mo mortality of 37,571 deaths per year, with an estimated economic saving of around £11.6 million (USD $15.3 million) per annum. National cattle registers have great potential for monitoring trends in calf mortality and can provide valuable insights to the cattle industry. Environmental conditions play a significant role in calf mortality rates and further research is needed to explore how to optimize conditions to reduce calf mortality rates in GB. [ABSTRACT FROM AUTHOR]

We explored the potential of mechanical thrombectomy (MT) for acute ischemic stroke patients at hospitals that perform percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in the United States. We analyzed nationally representative data between 2017 and 2020 to determine the numbers, characteristics, and outcomes of acute ischemic stroke patients admitted to hospitals that perform both primary PCI and MT, hospitals that perform primary PCI but not MT and hospitals that perform neither PCI or MT. Multiple logistic regressions were performed to evaluate the effect of hospital type on in-hospital mortality and discharge home (without palliative care). A total of 1,210,415, 1,002,950, and 488,845 acute ischemic stroke patients were admitted to hospitals that performed both primary PCI and MT, performed primary PCI but not MT, or performed neither PCI nor MT, respectively. Compared with hospitals that performed both PCI and MT, the odds of in-hospital mortality were lower in hospitals that performed PCI only (odds ratio (OR) 0.88 95 % confidence interval (CI) 0.86-0.91, p<0.001) and hospitals that performed neither PCI or MT (OR 0.85 95 %CI 0.82-0.89, p<0.0010). There was no significant difference in the odds of discharge home between the three types of hospitals. Almost 37 % the patients with acute ischemic stroke are admitted to hospitals that perform primary PCI (but not MT) supporting strategies to increase the performance of MT in such hospitals as an option to increase rapid availability of MT in the United States. [ABSTRACT FROM AUTHOR]

In this paper I aim to explore and present various statistics regarding special educational needs in England, to get an overview regarding schooling of pupils with Special Educational Needs (SEN) as it is at the time of writing, as well as historic patterns. I use publically available datasets to present answers to the following questions: What proportion of all children in schools in England have been identified as having special educational needs? How many children attend special schools? What proportion of children attend special schools? How have numbers of special schools changed? What is the balance of gender in i/ pupils identified with SEN, and ii/ in special schools? What are the proportions of children in different school types eligible for and receiving free school meals? The use of publically available national data is used to explore patterns, reporting these data give an overview of the number, profile and characteristics of the population in schools with SEN. They give indications on the progress of inclusion (or lack thereof), and highlight issues of disproportionality. Findings include the number of pupils identified with SEN in England decreases while the population of pupils in all schools rises. There is also a rise in the number of children attending special schools. Disproportionality with regards to gender; socio-economic status and age are also revealed.

Purpose: To explore the impact of objective vision measures on novel metrics of objectively-measured physical activity (PA) in a nationally representative sample of United States (US) older adults., Design: Cross-sectional analysis using data from the National Health and Aging Trends Study., Participants: Adults had their distance and near visual acuity (VA) and contrast sensitivity (CS) tested. Any objective vision impairment (VI), defined as any VI in distance VA, near VA, or CS, was the primary exposure. Physical activity data were collected using the Actigraph CentrePoint Insight Watch worn for 7 days., Methods: Multivariable regression models were used to investigate the association between vision and PA measures. All analyses accounted for the survey design and models were adjusted for age, sex, race, living arrangement, education, and comorbidities., Main Outcome Measures: Physical activity metrics included (1) total daily activity (active minutes per day, number of active bouts, and mean length of active bouts), (2) activity fragmentation, and (3) time until 75% activity. An active bout was defined as ≥ 1 consecutive active minute. Activity fragmentation was defined as the probability of an active minute being followed by a sedentary minute, with higher values indicating more fragmented activity. Time until 75% activity was defined as the time taken to complete 75% of daily PA starting from their first active bout., Results: Among 723 participants, sampled from 10 443 338 older adults in the US, 30% had any objective VI. Any objective VI was significantly associated with lower number of active minutes per day (7.8% fewer [95% confidence interval {CI}: -13.6% to -1.7%]), shorter active bouts (7.0% shorter [95% CI: -12.3% to -1.4%]), and greater activity fragmentation (2.5% [95% CI: 0.8% to 4.2%]), while no associations were found with number of active bouts. Time until 75% activity did not significantly differ between adults with any objective VI and those without ( P  = 0.34)., Conclusions: Older US adults with any objective VI displayed lower total daily activity, as well as more fragmented, shorter periods of PA, despite having a similar number of active bouts compared to their normally sighted counterparts. Implementing interventions that increase bout duration may help promote PA in adults with VI., Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article., (© 2023 by the American Academy of Ophthalmology.)

Although numerous studies have examined if students of color benefit from having a teacher of the same race/ethnicity, all attention has been paid to students without disabilities. We examine whether the same benefits hold for students with disabilities (SWDs). Using a nationally representative data set of kindergartners, we explored whether SWDs of color had different academic and social–emotional outcomes when with a teacher of the same race/ethnicity. We compared students of color with and without disabilities in the same classroom with regard to a same-race teacher match. Unlike students without disabilities, we do not find evidence in the data set that SWDs of color benefit from a same-race teacher match in terms of achievement and social–emotional development. Implications with regard to educational equity are discussed. [ABSTRACT FROM AUTHOR]