Qualification of nursing potential in maternal mortality in Mexico

ObjectivesTo develop a method that measures nursing potential through the factor analysis of relevant nursing data and social context by taking maternal mortality as the study problem.MethodsA Cross-sectional and analytical study, a multivariate analysis was performed. The Nursing Coverage Index, the Human Development Index, population density and the proportion of nurses with a bachelor’s degree or upper degree, are studied by federative entity, only data from government sources are used. The Index of Nursing Qualification in Mexico (INQM) was constructed through principal component analysis.ResultsThe highest correlation was between the INQM and the Nursing Coverage Prioritization Index (NCPI), which was 0.849 (P < 0.01) and showed a strong positive linear relationship. The Population Density Prioritization Index (PDPI) shows a strong positive correlation with the INQM (0.716, P < 0.01). Three factors were extracted by principal component analysis and the INQM was generated with the three main components in a model. There is very low correlation between INQM and maternal mortality rate (MMR) and no statistical significance was found.ConclusionsThis study shows that nursing qualification must include economic, geographic and social variables. The INQM is an indicator that summarises the potential of each federative entity. Given these results, a contribution is provided for the application of these indices, which can help determine nursing potential in a specific geographical region.     

Prevalence,correlates and outcomes of multimorbidity among the middle-aged and elderly: Findings from the China Health and Retirement Longitudinal Study

BackgroundThe multimorbidity associated with ageing has been prevalent worldwide and poses major challenges to the health care system. However, the research about multimorbidity in China is far from sufficient. Additionally, international studies on the influencing factors of multimorbidity and the impact on disability/mortality are still inconsistent. The aim of this study was to examine the prevalence, correlates and outcomes of multimorbidity among the middle-aged and elderly Chinese population.MethodsWe used data from the China Health and Retirement Longitudinal Study (CHARLS). Logistic regression was performed to analyze the influencing factors of multimorbidity. The Cox proportional hazard model was used to evaluate the impact of multimorbidity on functional disability and all-cause mortality.ResultsThe prevalence of multimorbidity was 55.12 % in the whole study population and 65.60 % among people aged ≥ 65 years. Multimorbidity was significantly associated with old age (OR: 2.76, 95 % CI: 2.31–3.30), females (OR: 1.21, 95 % CI: 1.01–1.44), ex-smoker (OR: 2.07, 95 % CI: 1.58–2.72), ex-drinker (OR: 2.18, 95 % CI: 1.66–2.87), obesity (OR: 2.87, 95 % CI: 2.30–3.57), lower education (OR:1.32, 95 % CI: 1.08–1.61), living alone (OR: 1.26, 95 % CI: 1.02–1.55) and unemployment (OR: 1.66, 95 % CI: 1.11–2.48). Moreover, multimorbidity was correlated with disability (HR: 2.27, 95 % CI: 1.93–2.66) and all-cause mortality (HR: 1.95, 95 % CI: 1.36–2.80) after multivariable adjustment.ConclusionsMultimorbidity is highly prevalent in China and possesses significantly negative effects on health outcomes. Identification of the key population and tailored interventions on their modifiable risk factors should be paid much importance.     

Relevance of Fitness to Mortality Risk in Men Receiving Contemporary Medical Care

BackgroundAn inverse association between cardiorespiratory fitness and mortality was robustly demonstrated 3 decades ago.ObjectivesThe purpose of this study was to determine whether significant advances in disease prevention, detection, and treatment since that time have modified this association.MethodsA total of 47,862 men completed baseline examinations, including a maximal treadmill test. Cohort 1 (n = 24,475) was examined during 1971 to 1991 and followed for mortality through 1992. Cohort 2 (n = 23,387) was examined during 1992 to 2013 with follow-up through 2014. Men were categorized as low fit, moderate fit, or high fit using Cooper Clinic normative data. Hazard ratios (HRs) for all-cause, cardiovascular disease, and cancer mortality were determined across fitness categories in the 2 cohorts.ResultsA significant inverse trend between fitness categories and all-cause (HR: 1.0, 0.60, and 0.53 in cohort 1 and HR: 1.0, 0.76, and 0.52 in cohort 2) and cardiovascular disease mortality (HR: 1.0, 0.55, and 0.43 in cohort 1 and HR: 1.0, 0.84, and 0.52 in cohort 2) was observed (p trend <0.001 for all). The trend across fitness categories and cancer mortality was significant for cohort 1 (HR: 1.0, 0.62, and 0.48; p < 0.001), but not for cohort 2 (HR: 1.0, 1.08, and 0.74; p = 0.19). HRs for all-cause mortality were 0.86 (95% confidence interval: 0.82 to 0.90) and 0.87 (95% confidence interval: 0.83 to 0.91) per 1-MET increment in fitness for cohorts 1 and 2, respectively (p < 0.001 for both). Similar values were seen for cardiovascular disease and cancer mortality.ConclusionsDespite significant advances in disease prevention, detection, and treatment since fitness was first shown to be associated with mortality, the inverse association between fitness and mortality remains consistent in a contemporary cohort of men.     

Incidence,Characteristics, and Outcome of COVID-19 in Adults on Kidney Replacement Therapy: A Regionwide Registry Study

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Diferencias epidemiológicas podrían explicar la mayor mortalidad infantil de Chile comparada con Cuba

IntroductionCuba has the lowest infant mortality rate in Latin America, while Chile has an infant mortality rate above the average of Organization for Economic Cooperation and Development (OECD) countries.ObjectiveTo compare the epidemiology of infant mortality between Chile and Cuba in order to find characteristics that may explain the differences found.MethodComparative analysis between Chile and Cuba of infant mortality rate, causes of mortality, live birth weight, and maternal age, in 2015.ResultsCuba had a lower infant, neonatal, early and late mortality than Chile, with no differences in post-neonatal mortality. Chile had a higher infant mortality due to, alterations of the nervous system, urinary system, chromosomal alterations, respiratory distress syndrome, and disorders related to the short duration of gestation. Chile had a higher frequency of mothers ≥ 35 years old and live births weighing <2,500 g. The possible effects of health inequities could not be analyzed due to lack of data.ConclusionsIt is possible to attribute the lower infant mortality rate in Cuba to: selective abortion due to congenital malformations and chromosomal anomalies, lower epidemiological risk of the Cuban pregnant population, and lower frequency of live births with low birth weight.