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Peter Baltrus Junjun Xu Lilly Immergluck Anne Gaglioti Adeola Adesokan George Rust 《The Journal of asthma》2017,54(1):53-61
Objective: Disparities in asthma outcomes are well documented in the United States. Interventions to promote equity in asthma outcomes could target factors at the individual and community levels. The objective of this analysis was to understand the effect of individual (race, gender, age, and preventive inhaler use) and county-level factors (demographic, socioeconomic, health care, air-quality) on asthma emergency department (ED) visits among Medicaid-enrolled children. This was a retrospective cohort study of Medicaid-enrolled children with asthma in 29 states in 2009. Multilevel regression models of asthma ED visits were constructed utilizing individual-level variables (race, gender, age, and preventive inhaler use) from the Medicaid enrollment file and county-level variables reflecting population and health system characteristics from the Area Resource File (ARF). County-level measures of air quality were obtained from Environmental Protection Agency (EPA) data. Results: The primary modifiable risk factor at the individual level was found to be the ratio of long-term controller medications to total asthma medications. County-level factors accounted for roughly 6% of the variance in the asthma ED visit risk. Increasing county-level racial segregation (OR=1.04, 95% CI=1.01-1.08) was associated with increasing risk of asthma ED visits. Greater supply of pulmonary physicians at the county level (OR=0.81, 95% CI=0.68-0.97) was associated with a reduction in risk of asthma ED visits. Conclusions: At the patient care level, proper use of controller medications is the factor most amenable to intervention. There is also a societal imperative to address negative social determinants, such as residential segregation. 相似文献
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Marshall Hagins PT PhD Andrew Rundle PH Nathan S. Consedine PhD Sat Bir S. Khalsa PhD 《Journal of clinical hypertension (Greenwich, Conn.)》2014,16(1):54-62
The purpose of this study was to compare the effects of yoga with an active control (nonaerobic exercise) in individuals with prehypertension and stage 1 hypertension. A randomized clinical trial was performed using two arms: (1) yoga and (2) active control. Primary outcomes were 24‐hour day and night ambulatory systolic and diastolic blood pressures. Within‐group and between‐group analyses were performed using paired t tests and repeated‐measures analysis of variance (time × group), respectively. Eighty‐four participants enrolled, with 68 participants completing the trial. Within‐group analyses found 24‐hour diastolic, night diastolic, and mean arterial pressure all significantly reduced in the yoga group (?3.93, ?4.7, ?4.23 mm Hg, respectively) but no significant within‐group changes in the active control group. Direct comparisons of the yoga intervention with the control group found a single blood pressure variable (diastolic night) to be significantly different (P=.038). This study has demonstrated that a yoga intervention can lower blood pressure in patients with mild hypertension. Although this study was not adequately powered to show between‐group differences, the size of the yoga‐induced blood pressure reduction appears to justify performing a definitive trial of this intervention to test whether it can provide meaningful therapeutic value for the management of hypertension. 相似文献
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Factors Associated with Reported Infection and Lymphedema Symptoms among Individuals with Extremity Lymphedema 下载免费PDF全文
Jie Deng PhD RN OCN Mei R. Fu PhD RN APRN‐BC FAAN Jane M. Armer PhD RN FAAN Janice N. Cormier MD MPH M. Elise Radina PhD CFLE Saskia R.J. Thiadens RN Jan Weiss PT DHS CLT‐LANA Catherine M. Tuppo PT MS CLT‐LANA Mary S. Dietrich PhD Sheila H. Ridner PhD RN FAAN 《Rehabilitation nursing》2015,40(5):310-319
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M Krawczuk-Rybak A Grabowska PT Protas K Muszynska-Roslan A Holownia J Braszko 《Advances in medical sciences》2012,57(2):266-272
PurposeChemo- and radiotherapy used in acute lymphoblastic leukemia (ALL) can influence on brain functioning in the future. In a prospective study we analysed the cognitive functions of ALL survivors in relation to Tau protein as a marker of white matter injury.Material and methodsThirty-one survivors of childhood ALL (6.3 years after diagnosis); without the signs of CNS involvement, treated with chemotherapy alone, rested in first remission; underwent Intelligence tests- Wechsler Intelligence Scales (WISC-R, WAIS-R). Their results were analyzed in relation to the levels of Tau in cerebrospinal fluid (CSF) obtained during the treatment.ResultsThe analysis showed that all survivors attained the average scores in intelligence tests. A negative correlation was found between methotrexate (MTX) doses and Freedom from Distractibility (FFD). Females had higher values of Performance Intelligence Quotient (PIQ) than males. A negative correlation was noted of Tau protein levels obtained from the last CSF with: Total and Verbal Intelligence Quotient, PIQ, Perceptual Organisation Index and FFD but not with Verbal Comprehension Index.ConclusionOur results suggest the possibility of white matter injury during the treatment for ALL with chemotherapy alone. Elevated Tau protein level in CSF at the end of treatment might indicate future difficulties in neurocognitive functioning. 相似文献
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Stacy Schantz Wilkins PhD Rebecca J. Melrose PhD Katherine S. Hall PhD Erin Blanchard MS Steven C. Castle MD Teresa Kopp PT MBA Leslie I. Katzel MD PhD Alice Holder MHS PT Neil Alexander MD Michelle K.S. McDonald BA OT Arti Tayade MD CMD HMDC Daniel E. Forman MD Lauren M. Abbate MD PhD Rebekah Harris PT DPT PhDc Willy M. Valencia MD Miriam C. Morey PhD Cathy C. Lee MD 《Journal of the American Geriatrics Society》2021,69(4):1045-1050