STUDY DESIGN: Systematic review.
SETTING & POPULATION: Adults requiring maintenance hemodialysis.
SELECTION CRITERIA: All randomized controlled trials and trial protocols reporting vascular access outcomes identified from ClinicalTrials.gov, Embase, MEDLINE, and the Cochrane Kidney and Transplant Specialized Register from January 2011 to June 2016.
INTERVENTIONS: Any hemodialysis-related intervention.
OUTCOMES: The frequency and characteristics of vascular access outcome measures were analyzed and classified.
RESULTS: From 168 relevant trials, 1,426 access-related outcome measures were extracted and classified into 23 different outcomes. The 3 most common outcomes were function (136 [81%] trials), infection (63 [38%]), and maturation (31 [18%]). Function was measured in 489 different ways, but most frequently reported as "mean access blood flow (mL/min)" (37 [27%] trials) and "number of thromboses" (30 [22%]). Infection was assessed in 136 different ways, with "number of access-related infections" being the most common measure. Maturation was assessed in 44 different ways at 15 different time points and most commonly characterized by vein diameter and blood flow. Patient-reported outcomes, including pain (19 [11%]) and quality of life (5 [3%]), were reported infrequently. Only a minority of trials used previously standardized outcome definitions.
LIMITATIONS: Restricted sampling frame for feasibility and focus on contemporary trials.
CONCLUSIONS: The reporting of access outcomes in hemodialysis trials is very heterogeneous, with limited patient-reported outcomes and infrequent use of standardized outcome measures. Efforts to standardize outcome reporting for vascular access are critical to optimizing the comparability, reliability, and value of trial evidence to improve outcomes for patients requiring hemodialysis.
METHODS: All-cause and cause-specific mortality estimates were obtained from the 2013 Global Burden of Disease Study. Data were extracted from 1990 to 2013 for the developmental age range from 1 to 24 years, for both sexes. Trends in all-cause and cause-specific mortality for the major epidemiological causes were estimated.
RESULTS: From 1990 to 2013, all-cause mortality decreased in all age groups. Reduction of all-cause mortality was greatest in 1- to 4-year-olds (2.4% per year reduction) and least in 20- to 24-year-olds (.9% per year reduction). Accordingly, in 2013, all-cause mortality was highest in 20- to 24-year-old males (129 per 100,000 per year). In 1990, the principal cause of death for 1- to 9-year boys and girls was vaccine preventable diseases. By 2013, neoplasms had become the major cause of death in 1-9 year olds of both sexes. The major cause of death in 10- to 24-year-old females was typhoid in 1990 and neoplasms in 2013, whereas the major cause of death in 10- to 24-year-old males remained road traffic injuries.
CONCLUSIONS: The reduction in mortality across the epidemiological transition in Malaysia has been much less pronounced for adolescents than younger children. The contribution of injuries and noncommunicable diseases to adolescent mortality suggests where public health strategies should focus.
METHODS: A subset of elderly (≥65year) participants from the UK Adult Dental Health Survey 2009 data was used. OHRQoL was assessed by means of the OHIP-14 additive score. The number of missing teeth; presence of active caries, dental pain, root caries, tooth wear, periodontal pockets>4mm, loss of attachment>9mm; having PUFA>0 (presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula and abscess); and wearing a denture were used as predictor variables. Age, gender, marital status, education level, occupation and presence of any long standing illness were used as control variables. Multivariate zero-inflated Poisson regression analysis was performed using R-project statistical software.
RESULTS: A total of 1277 elderly participants were included. The weighted mean(SE) OHIP-14 score of these participants was 2.95 (0.17). Having active caries (IRR=1.37, CI=1.25;1.50), PUFA>0 (IRR=1.17, CI=1.05;1.31), dental pain (IRR=1.34, CI=1.20;1.50), and wearing dentures (IRR=1.30, CI=1.17;1.44), were significantly positively associated with OHIP-14 score. Having periodontal pockets>4mm, at least one bleeding site, and anterior tooth wear were not significantly associated with the OHIP-14 score.
CONCLUSION: Whereas previous research has suggested a moderate relationship between oral disease and quality of life in this large scale survey of older adults, the presence of active caries and the presence of one or more of the PUFA indicators are associated with impaired oral health related quality of life in older adults, but not indicators of periodontal status. The implication of this is that whilst focussing on prevention of disease, there is an ongoing need for oral health screening and treatment in this group.
DESIGN: A cross-sectional pilot study was conducted.
SETTING: An urban setting in Kuala Lumpur.
PARTICIPANTS: 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers.
PRIMARY OUTCOME MEASURE: The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff.
RESULTS: The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers.
CONCLUSIONS: The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers.
DESIGN AND SETTINGS: This is a retrospective study of all patients who had undergone coronary angioplasty from 2007 to 2009 in 11 hospitals across Malaysia.
METHODS: Data were obtained from the NCVD-PCI Registry, 2007 to 2009. Patients were categorized into 2 groups-young and old, where young was defined as less than 45 years for men and less than 55 years for women and old was defined as more than or equals to 45 years for men and more than or equals to 55 years for women. Patients' baseline characteristics, risk factor profile, extent of coronary disease and outcome on dis.charge, and 30-day and 1-year follow-up were compared between the 2 groups.
RESULTS: We analyzed 10268 patients, and the prevalence of young CAD was 16% (1595 patients). There was a significantly low prevalence of Chinese patients compared to other major ethnic groups. Active smoking (30.2% vs 17.7%) and obesity (20.9% vs 17.3%) were the 2 risk factors more associated with young CAD. There is a preponderance toward single vessel disease in the young CAD group, and they had a favorable clinical outcome in terms of all-cause mortality at discharge (RR 0.49 [CI 0.26-0.94]) and 1-year follow-up (RR 0.47 [CI 0.19-1.15]).
CONCLUSION: We observed distinctive features of young CAD that would serve as a framework in the primary and secondary prevention of the early onset CAD.
METHODS: The study was conducted in two stages. First, the factors affecting nutritional behaviors associated with cardiovascular disease on 350 women who were referred to Fasa urban health centers were determined based on the TPB. In the second stage, based on the results of a cross-sectional study, quasi-expeimental study was performed on 200 women covered by Fasa health centers. The questionnaire used for the study was a questionnaire based on TPB. The questionnaire was completed by the experimental and control groups before and three months after the intervention. Data were analyzed by SPSS software using logistic regression, paired t-test, independent sample t-test, and chi-square test. The level of significance is considered 0.05.
RESULT: The constructs of attitude, subjective norms, and perceived behavioral control (PBC) were predictors of nutritional behaviors associated with cardiovascular disease in women. The constructs predicted 41.6% of the behavior. The results showed that mean scores of attitude, subjective norms, PBC, intention, nutritional performance related to the cardiovascular disease before intervention were, respectively, 24.32, 14.20, 18.10, 13.37 and 16.28, and after the intervention, were, respectively, 42.32, 25.40, 33.72, 30.13 and 41.38. All the constructs except the attitude in the intervention group were significantly higher (p
METHODS: Period abridged life tables were constructed to derive the life expectancy of the Singapore population from 1965 to 2009 using data from the Department of Statistics and the Registry of Births and Deaths, Singapore.
RESULTS: All 3 of Singapore's main ethnic groups, and both genders, experienced an increase in life expectancy at birth and at 65 years from 1965 to 2009, though at substantially different rates. Although there has been a convergence in life expectancy between Indians and Chinese, the (substantial) gap between Malays and the other two ethnic groups has remained. Females continued to have a higher life expectancy at birth and at 65 years than males throughout this period, with no evidence of convergence.
CONCLUSIONS: Ethnic and gender differences in life expectancy persist in Singapore despite its rapid economic development. Targeted chronic disease prevention measures and health promotion activities focusing on people of Malay ethnicity and the male community may be needed to remedy this inequality.