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PURPOSE: This study aims to identify whether selected patient and ward-related factors are associated with the use of coercive measures. Data were collected as part of the EUNOMIA international collaborative study on the use of coercive measures in ten European countries. METHODS: Involuntarily admitted patients (N = 2,027) were divided into two groups. The first group (N = 770) included patients that had been subject to at least one of these coercive measures during hospitalization: restraint, and/or seclusion, and/or forced medication; the other group (N = 1,257) included patients who had not received any coercive measure during hospitalization. To identify predictors of use of coercive measures, both patients' sociodemographic and clinical characteristics and centre-related characteristics were tested in a multivariate logistic regression model, controlled for countries' effect. RESULTS: The frequency of the use of coercive measures varied significantly across countries, being higher in Poland, Italy and Greece. Patients who received coercive measures were more frequently male and with a diagnosis of psychotic disorder (F20-F29). According to the regression model, patients with higher levels of psychotic and hostility symptoms, and of perceived coercion had a higher risk to be coerced at admission. Controlling for countries' effect, the risk of being coerced was higher in Poland. Patients' sociodemographic characteristics and ward-related factors were not identifying as possible predictors because they did not enter the model. CONCLUSIONS: The use of coercive measures varied significantly in the participating countries. Clinical factors, such as high levels of psychotic symptoms and high levels of perceived coercion at admission were associated with the use of coercive measures, when controlling for countries' effect. These factors should be taken into consideration by programs aimed at reducing the use of coercive measures in psychiatric wards.
- MeSH
- dospělí MeSH
- duševní poruchy psychologie terapie MeSH
- hospitalizace MeSH
- lidé středního věku MeSH
- lidé MeSH
- nátlak * MeSH
- percepce MeSH
- průzkumy zdravotní péče MeSH
- psychiatrické oddělení nemocnice * MeSH
- sexuální faktory MeSH
- teoretické modely MeSH
- ústavy pro duševně nemocné * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Polsko MeSH
OBJECTIVES: Health status is represented by people's subjective assessment of their sense of well-being and ability to perform social roles and has been well accepted as a health indicator of different populations. The aim of this study was to determine health-related quality of life in Slovenian population. METHODS: We performed a cross-sectional postal survey in a random stratified sample of 1,000 adult Slovenian inhabitants. The questionnaire consisted of the respondents' demographic data (sex, age, education level, employment status, living environment), self-reported chronic conditions, self-reported use of health services and EQ-5D instrument for measuring quality of life. RESULTS: The response rate was 41% (53.1% men, mean age 51.5 years). Respondents reported most problems in the pain dimension of EQ-5D (59.3%), following by mobility (30.4%), anxiety/depression (30.3%), daily activities (29.8%) and self-care (9.0%). At least one moderate problem was reported by 272 (66.3%) respondents. Independent factors, associated with problems in any EQ-5D dimension were primary and vocational education, older age, high blood pressure, rheumatic diseases, back problems, anxiety/depression, a visit to the emergency department in the past year, and a house visit from a family doctor in the past year. CONCLUSIONS: The present study showed that the health-related quality of life of the Slovenian inhabitants is lower than the one found in some other European countries. This finding is surprising and also worrying. Because we cannot find any perceptible reason for this observation, larger and prospective studies are needed to confirm those results and to determine the reasons for that.
- MeSH
- charakteristiky bydlení MeSH
- chronická nemoc MeSH
- činnosti denního života MeSH
- dospělí MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- péče o sebe MeSH
- průřezové studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- socioekonomické faktory MeSH
- věkové faktory MeSH
- zdravotní stav * MeSH
- zdravotnické přehledy statistika a číselné údaje MeSH
- zdravotnické služby statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovinsko epidemiologie MeSH
AIMS: Diabetic complications, and in particular diabetic foot ulcers (DFUs), are associated with low health-related quality of life (HRQoL). We evaluated whether the presence of diabetic complications also influenced the improvement of HRQoL during DFU treatment. METHODS: 1088 patients presenting for DFU treatment at the centers participating in the Eurodiale study were followed prospectively up to one year. HRQoL was measured both at presentation and after healing or at end of follow up, using EQ-5D: a standardized instrument consisting of five domains and a summary index. The influence of diabetic comorbidity on the course of HRQoL was evaluated for each of the EQ-5D outcomes in multi-level linear regression analyses, adjusting for baseline characteristics. RESULTS: HRQoL improved in all EQ-5D outcomes over the course of treatment for those DFUs that healed. The few significant differences in the development of HRQoL between patients with and without comorbidity showed a more beneficial development for patients with comorbidity in DFUs that did not heal or healed slowly. CONCLUSIONS: Comorbidity does not hamper improvement of HRQoL in DFU treatment. On the contrary, HRQoL improved sometimes more in patients with certain comorbidity with hard-to-heal ulcers.
- Klíčová slova
- Comorbidity, Diabetes mellitus, Diabetic foot ulcer, Health-related quality of life, Longitudinal study,
- MeSH
- činnosti denního života * MeSH
- deprese epidemiologie MeSH
- diabetická noha epidemiologie psychologie terapie MeSH
- hojení ran MeSH
- kohortové studie MeSH
- kombinovaná terapie škodlivé účinky MeSH
- komorbidita MeSH
- komplikace diabetu epidemiologie psychologie terapie MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- osobní újma zaviněná nemocí * MeSH
- prospektivní studie MeSH
- psychiatrické posuzovací škály MeSH
- self-management MeSH
- senioři MeSH
- úzkost epidemiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
- Geografické názvy
- Evropa epidemiologie MeSH
The increased survival in malignant cutaneous melanoma (melanoma) is probably due to early diagnosis combined with improved treatment most recently. National health campaigns and screening programs for melanoma detection were started in Sweden several decades ago. We want to assess the influence of tumor characteristics, based on the TNM classification, and of second primary cancers on overall survival in melanoma. We used the Swedish Cancer Registry to assess all-cause survival in melanoma from 2003 to 2015. Hazard ratios (HRs) were estimated using multivariable Cox regression models. A total of 19,773 melanoma patients were diagnosed with TNM data. Survival showed a strong improving trend over time (p-trend <.001). T1a was the most common classification (48.0% of all), while higher T class was associated systematically with worse survival (p-trend <.001). For distant metastases, the HR was 3.17, accounting for 0.9% of the patients. Any types of second primary cancers, other than melanoma, were associated with an HR of 2.00, accounted for 6.7% of all cases. Even if melanoma survival in Sweden ranks among the best national rates, the large percentage of patients with advanced tumors (T3b, T4a, and T4b, 17%) and 21% of deaths with T1a call for improved preventive and follow-up strategies.
- Klíčová slova
- TNM, metastasis, prognosis, survival, tumor characteristics,
- MeSH
- analýza přežití MeSH
- Kaplanův-Meierův odhad MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- melanom patologie MeSH
- multivariační analýza MeSH
- nádory kůže patologie MeSH
- pravděpodobnost MeSH
- proporcionální rizikové modely MeSH
- sekundární malignity diagnóza patologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Švédsko MeSH
PURPOSE: Many important details of health-related quality of life (HRQoL) after diagnosis and treatment of Hodgkin lymphoma (HL) are still unknown because large longitudinal studies of HRQoL are rare. Therefore, we analyzed a systematically assessed, comprehensive range of HRQoL domains in patients with HL of all stages from diagnosis up to 5 years of survivorship. PATIENTS AND METHODS: We included patients with HL age 18-60 years at diagnosis from the German Hodgkin Study Group trials HD13, HD14, and HD15. We analyzed HRQoL using all functional and symptom scales of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 including deviations from reference values. We estimated the effect of different disease, patient, and treatment characteristics using multiple regression and repeated measures analysis and computed correlations of HRQoL scores. RESULTS: We analyzed 4,215 patients with any HRQoL assessment within 5 years after treatment. Higher tumor burden at diagnosis was associated with impaired baseline scores in many HRQoL domains. During survivorship, cognitive, emotional, role, and social functioning and fatigue, dyspnea, sleep, and financial problems were severely and persistently affected. From year 2 on, mean deviations from reference values ranged between 12 and 29 points, with 10 points being a commonly used margin of clinical relevance. In all 3 trials, HRQoL domains 2 and 5 years after therapy were significantly influenced by baseline scores and age but not by randomized treatments. Fatigue was most closely correlated with other symptoms and scales. CONCLUSION: Our results show a high and persistent amount of different HRQoL deficits in survivors of HL that are largely independent of the applied chemotherapies. Our analysis underscores the high, unmet medical need of these rather young survivors of HL regarding the psychosocial adverse effects of the cancer experience.
- MeSH
- dospělí MeSH
- Hodgkinova nemoc diagnóza mortalita patologie psychologie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- longitudinální studie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- přežívající onkologičtí pacienti MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Německo epidemiologie MeSH
BACKGROUND: Previous studies investigating hospitalizations in dialysis patients have focused primarily on patient-centered factors. We analyzed the impact of hospital and dialysis unit characteristics on pediatric dialysis patients' hospitalizations for access-related complications (ARCs). METHODS: This cross-sectional study involved 102 hemodialysis (HD) and 163 peritoneal dialysis (PD) patients. Data between July 2017 and July 2018 were analyzed. RESULTS: Children's hospitals (CHs) had more pediatric nephrologists and longer PD experience (years) than general hospitals (GHs) (p = 0.026 and p = 0.023, respectively). A total of 53% of automated PD (APD) and 6% of continuous ambulatory PD (CAPD) patients were in CHs (p < 0.001). Ninety-three percent of APD and 69% of CAPD patients were treated in pediatric-specific PD units (p = 0.001). CHs had a higher prevalence in providing hemodiafiltration (HDF) than GHs (83% vs. 30%). Ninety-seven percent of HDF vs. 66% for conventional HD (cHD) patients, and 94% of patients with arteriovenous fistula (AVF) vs. 70% of those with central venous catheters (CVC), were dialyzed in pediatric-specific HD units (p = 0.001 and p = 0.016, respectively). Eighty patients (51 PD and 29 HD) had 135 (84 PD, 51 HD) hospitalizations. CAPD was an independent risk factor for hospitalizations for infectious ARCs (I-ARCs) (p = 0.009), and a health center's PD experience negatively correlated with CAPD patient hospitalizations for I-ARCs (p = 0.041). cHD and dialyzing in combined HD units significantly increased hospitalization risk for non-infectious (NI-)ARCs (p = 0.044 and p = 0.017, respectively). CONCLUSIONS: CHs and pediatric-specific dialysis units have higher prevalence of APD and HDF use. Hospitalizations for I-ARCs in CAPD are lower in centers with longer PD experience, and pediatric HD units are associated with fewer hospitalizations due to NI-ARCs. A higher resolution version of the Graphical abstract is available as Supplementary information.
- Klíčová slova
- Access-related complications, Children, Dialysis, Dialysis unit, Hospital, Hospitalization,
- MeSH
- chronické selhání ledvin * epidemiologie terapie MeSH
- dialýza ledvin škodlivé účinky MeSH
- dítě MeSH
- hospitalizace MeSH
- lidé MeSH
- nemocnice MeSH
- peritoneální dialýza * MeSH
- průřezové studie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
PURPOSE: Variants in IQSEC2, escaping X inactivation, cause X-linked intellectual disability with frequent epilepsy in males and females. We aimed to investigate sex-specific differences. METHODS: We collected the data of 37 unpublished patients (18 males and 19 females) with IQSEC2 pathogenic variants and 5 individuals with variants of unknown significance and reviewed published variants. We compared variant types and phenotypes in males and females and performed an analysis of IQSEC2 isoforms. RESULTS: IQSEC2 pathogenic variants mainly led to premature truncation and were scattered throughout the longest brain-specific isoform, encoding the synaptic IQSEC2/BRAG1 protein. Variants occurred de novo in females but were either de novo (2/3) or inherited (1/3) in males, with missense variants being predominantly inherited. Developmental delay and intellectual disability were overall more severe in males than in females. Likewise, seizures were more frequently observed and intractable, and started earlier in males than in females. No correlation was observed between the age at seizure onset and severity of intellectual disability or resistance to antiepileptic treatments. CONCLUSION: This study provides a comprehensive overview of IQSEC2-related encephalopathy in males and females, and suggests that an accurate dosage of IQSEC2 at the synapse is crucial during normal brain development.
- Klíčová slova
- IQSEC2, X-linked inheritance, epilepsy, intellectual disability, isoforms,
- MeSH
- fenotyp MeSH
- kojenec MeSH
- lidé MeSH
- mentální retardace epidemiologie genetika patofyziologie MeSH
- mozek růst a vývoj metabolismus MeSH
- mutace MeSH
- nemoci mozku epidemiologie genetika patofyziologie MeSH
- novorozenec MeSH
- pohlavní dimorfismus MeSH
- protein - isoformy genetika MeSH
- rodokmen MeSH
- výměnné faktory guaninnukleotidů genetika MeSH
- záchvaty epidemiologie genetika patofyziologie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- IQSEC2 protein, human MeSH Prohlížeč
- protein - isoformy MeSH
- výměnné faktory guaninnukleotidů MeSH
BACKGROUND: Understanding population health trends and their key determinants is essential for planning health services and implementing effective interventions. One of these determinants may be national cultural characteristics that are related to various health outcomes and health-related behaviours. However, little is known about their potential association to overall burden of disease. Thus, this study examined whether cultural characteristics expressed by Hofstede indexes are associated with the burden of disease. METHODS: We used data from open-source databases - Hofstede's Cultural Index, the Global Burden of Diseases (GBD) and the Human Development Index (HDI). The final sample comprised 69 countries covering all the continents. The burden of disease was measured using disability-adjusted life years (DALYs), years lived with disabilities (YLD), and years of life lost (YLL). National cultural characteristics were measured using Hofstede's dimensions. Bayesian correlation analyses were conducted to assess the relationships between cultural dimensions and health outcomes, stratified by countries' HDI levels. RESULTS: In countries with a very high HDI, there was strong evidence (Bayes Factor > 10) of a positive correlation of Power distance with the total disability-adjusted life years (r = 0.448) and years of life lost (r = 0.528), and Individualism (r = 0.667) and Indulgence (r = 0.494) with years lived with disabilities. In contrast, Long-term orientation negatively correlated of with years lived with disabilities (r = -0.527) and Indulgence with disability-adjusted life years (r = -0.437) and years of life lost (r = -0.537). Further, Power distance and Indulgence were correlated with the majority of the GBD indicators and Individualism with a few GBD indicators. In countries with a high and medium HDI, strong evidence of the associations was found in only a few cases. CONCLUSION: We found a correlation between national cultural characteristics and burden of disease. Policy-makers should consider integrating cultural factors into public health strategies to better align healthcare interventions with the local population's values and behaviours. Moreover, cross-cultural research and collaboration should increase to understand how cultural influences can be used to mitigate disease burdens and improve health outcomes globally. This study also opens a potentially new research area within population health research.
- Klíčová slova
- Burden of disease, Cultural characteristics, Hofstede’s index, Population health,
- MeSH
- Bayesova věta MeSH
- globální zátěž nemocemi * MeSH
- kulturní charakteristiky * MeSH
- lidé MeSH
- osobní újma zaviněná nemocí * MeSH
- počet let života s onemocněním MeSH
- zdravotní stav populace * statistika a číselné údaje MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The aim of this study was to compare socioeconomic characteristics of the Roma population living in Roma settlements with the majority population. Moreover, it was aimed to assess socioeconomic differences in health and health-related behaviour within the population living in Roma settlements. METHODS: Data from the cross-sectional HepaMeta study conducted in Slovakia in 2011 were used. The sample consisted of 452 Roma (mean age = 34.7; 35.2% men) and 403 non-Roma (mean age = 33.5; 45.9% men) respondents. Roma in selected settlements were recruited by local Roma community workers. Respondents from the major population were randomly selected from a list of patients from general practitioners. Data were collected via questionnaire, anthropometric measures and analysed blood samples. Differences in socioeconomic characteristics between the population living in Roma settlements and the majority population were tested using the chi-square test. The contribution of selected socioeconomic characteristics on health and health-related behaviour of the population living in Roma settlements was assessed by logistic regression models adjusted for age and gender. RESULTS: The population living in Roma settlements is characterised by significantly lower socioeconomic standards, and the living conditions are significantly worse compared with the majority. With few exceptions, the study did not confirm any significant association between socioeconomic indicators and health and health-related behaviour within the population living in Roma settlements. CONCLUSIONS: The deteriorating effect of living in Roma settlement on health and health-related behaviour seems to be immense regardless differences in socioeconomic characteristics or living condition within the settlement population.
- MeSH
- charakteristiky bydlení statistika a číselné údaje MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- odds ratio MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- Romové etnologie statistika a číselné údaje MeSH
- rozložení podle pohlaví MeSH
- socioekonomické faktory MeSH
- společenská třída * MeSH
- věkové rozložení MeSH
- venkovské obyvatelstvo statistika a číselné údaje MeSH
- zdravé chování etnologie MeSH
- zdravotní stav * MeSH
- zdravotnické přehledy metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Slovenská republika MeSH
OBJECTIVES: To determine the incidence and laboratory characteristics of primary Toxoplasma gondii infection in HIV-infected individuals. METHODS: This retrospective study was conducted between 1988 and 2012 on a cohort of 1130 HIV-infected patients at the AIDS Center Prague. Toxoplasma serology, standard laboratory parameters, and health status were evaluated at 3-6-month intervals for all patients. RESULTS: The total person-time of follow-up of patients at risk of Toxoplasma seroconversion was 3046.3 years; there were 14 primary T. gondii infections, yielding an incidence rate of 0.0046 (95% confidence interval 0.0027-0.0078). Most of the subjects were clinically asymptomatic, but in one case seroconversion was accompanied by transient cervical lymphadenopathy. The CD4+ T-lymphocyte count geometric mean increased from 418 (95% confidence interval 303-579) cells/μl before seroconversion to 501 (95% confidence interval 363-691) cells/μl after seroconversion (p = 0.004), while other parameters (CD8+ T-lymphocytes, natural killer cells, viral load, beta2-microglobulin, total immunoglobulins) remained unchanged. As compared to the control group, patients with primary toxoplasmosis had higher initial levels of total immunoglobulins IgA and IgG and a tendency to higher CD8+ T lymphocyte counts. CONCLUSIONS: Neither the incidence nor the course of the primary Toxoplasma infection was influenced by the immune status of the patients. Immune parameters of patients with primary Toxoplasma infection did not differ from those of the controls.
- Klíčová slova
- HIV, Incidence, Primary infection, Seroconversion, Toxoplasma gondii,
- MeSH
- dospělí MeSH
- HIV protilátky krev MeSH
- HIV séropozitivita epidemiologie imunologie MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- oportunní infekce doprovázející AIDS epidemiologie imunologie MeSH
- počet CD4 lymfocytů MeSH
- retrospektivní studie MeSH
- toxoplazmóza epidemiologie imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- HIV protilátky MeSH