851
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Correa L, Rea LD, Bentzen R, O'Hara TM. Assessment of mercury and selenium tissular concentrations and total mercury body burden in 6 Steller sea lion pups from the Aleutian Islands. Mar Pollut Bull 2014; 82:175-182. [PMID: 24661459 PMCID: PMC4123997 DOI: 10.1016/j.marpolbul.2014.02.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 02/07/2014] [Accepted: 02/18/2014] [Indexed: 06/03/2023]
Abstract
Concentrations of total mercury ([THg]) and selenium ([TSe]) were measured in several tissue compartments in Steller sea lion (Eumetopias jubatus) pups; in addition we determined specific compartment and body burdens of THg. Compartmental and body burdens were calculated by multiplying specific compartment fresh weight by the [THg] (summing compartment burdens equals body burden). In all 6 pup tissue sets (1) highest [THg] was in hair, (2) lowest [THg] was in bone, and (3) pelt, muscle and liver burdens contributed the top three highest percentages of THg body burden. In 5 of 6 pups the Se:Hg molar ratios among compartments ranged from 0.9 to 43.0. The pup with the highest hair [THg] had Se:Hg molar ratios in 9 of 14 compartments that were ⩽ 0.7 potentially indicating an inadequate [TSe] relative to [THg].
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Affiliation(s)
- Lucero Correa
- Department of Chemistry and Biochemistry, University of Alaska Fairbanks, PO Box 755940, Fairbanks, AK 99775-5940, USA.
| | - Lorrie D Rea
- Division of Wildlife Conservation, Alaska Department of Fish and Game and Institute of Northern Engineering, Water and Environmental Research Center, University of Alaska Fairbanks, PO Box 755910, Fairbanks, AK 99775-5910, USA
| | - Rebecca Bentzen
- Institute of Arctic Biology and Department of Veterinary Medicine, University of Alaska Fairbanks, PO Box 757000, Fairbanks, AK 99775-5940, USA
| | - Todd M O'Hara
- Institute of Arctic Biology and Department of Veterinary Medicine, University of Alaska Fairbanks, PO Box 757000, Fairbanks, AK 99775-5940, USA
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852
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van der Lee J, Bakker TJ, Duivenvoorden HJ, Dröes RM. Multivariate models of subjective caregiver burden in dementia: a systematic review. Ageing Res Rev 2014; 15:76-93. [PMID: 24675045 DOI: 10.1016/j.arr.2014.03.003] [Citation(s) in RCA: 213] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 03/11/2014] [Accepted: 03/17/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Burden in dementia caregivers is a complex and multidimensional construct. Several models of burden and other representations of burden like depression or mental health are described in literature. To clarify the state of science, we systematically reviewed complex models that include both patient and caregiver determinants of caregiver burden. OBJECTIVE A review of determinant models of caregiver burden. DESIGN Systematic review. DATA SOURCES Electronic databases PubMed, PsycInfo and EMbase were searched in December 2013. STUDY SELECTION AND ANALYSIS Research studies with quantitative outcome measures of caregiver burden or burden-related concepts, including both patient and caregiver functional characteristics as determinants. We categorized the determinant variables in the models and calculated the percentages of proven determinants within each category. RESULTS We found 32 studies with burden models and 24 depression and mental health models. Patient behavioral problems, caregiver coping and personality traits and competence are most consistent determinants of caregiver burden, depression and mental health. Behavioral problems are more significant than cognitive disorders or lack of self-care. Of all measured caregiver personality traits, neuroticism has the strongest impact on caregiver burden. Regarding caregiver competences, feeling competent or enjoying higher self-efficacy in general diminish caregiver burden and promote caregiver mental health.
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853
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Affiliation(s)
- Bo Xi
- School of Public Health, Shandong University, Jinan, China
| | - Fangchao Liu
- Fu Wai Hospital & Cardiovascular Institute, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | | | - Hongbo Dong
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China
| | - Jie Mi
- Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
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854
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Park RM, Bouchard MF, Baldwin M, Bowler R, Mergler D. Respiratory manganese particle size, time-course and neurobehavioral outcomes in workers at a manganese alloy production plant. Neurotoxicology 2014; 45:276-84. [PMID: 24721790 DOI: 10.1016/j.neuro.2014.03.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 02/24/2014] [Accepted: 03/06/2014] [Indexed: 11/21/2022]
Abstract
The progression of manganism with chronic exposure to airborne manganese (Mn) is not well understood. Here, we further investigate the findings on exposure and neurobehavioral outcomes of workers from a silico- and ferromanganese production plant and non-exposed workers from the same community in 1990 and 2004, using a variety of exposure metrics that distinguish particle size and origin within the range of respirable airborne exposures. Mn exposure matrices for large respirable particulate (Mn-LRP, dust) and small respirable particulate (Mn-SRP, fume), based on process origins, were used together with detailed work histories since 1973 (plant opening), to construct exposure metrics including burdens and cumulative burdens with various clearance half-lives. For three out of eight 1990 neurobehavioral tests analyzed with linear regression models, duration of Mn exposure was the best predictor: Luria-Nebraska Neuropsychological Battery - Motor Scale, Trail-Making B and Finger Tapping. The Luria-Nebraska Motor Scale had the strongest association (t ∼ 5.0, p < 10(-6)). For outcomes on three other tests, the duration and Mn-SRP metrics were comparable: Trail Making Test A, Cancellation H and Stroop Color-Word Test (color/word subtest). Delayed Word Recall was best predicted by Mn-SRP (based on square root or truncated air-concentrations). The Word score on the Stroop Color-Word Test was the only outcome for which Mn-LRP was the leading predictor (t = -2.92, p = 0.003), while performance on the WAIS-R Digit Span Test was not significantly predicted by any metric. For outcomes evaluated in both 1990 and 2004, a mixed-effect linear regression model was used to examine estimates of within-individual trends. Duration and Mn-SRP were associated with performance on the Luria-Nebraska Motor Scale, as well as with other outcomes that appeared to have both reversible and progressive features, including Trail Making A and B, Cancellation H and Delayed Word Recall. With the mixed-effect model, Digit Span exhibited a significant irreversible association with exposure duration (t = -2.34, p = 0.021) and Mn-SRP (square root; t = -2.38, p = 0.019) metrics. The strong prediction using duration of exposure is consistent with effective homeostatic regulation of tissue-level Mn in the observed exposure range of respirable Mn (< 0.2mg/m(3)).
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855
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Jagannathan A, Thirthalli J, Hamza A, Nagendra HR, Gangadhar BN. Predictors of family caregiver burden in schizophrenia: Study from an in-patient tertiary care hospital in India. Asian J Psychiatr 2014; 8:94-8. [PMID: 24655636 DOI: 10.1016/j.ajp.2013.12.018] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 12/24/2013] [Accepted: 12/26/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Family caregivers experience significant burden in taking care of their patients with schizophrenia. Research on predictors of caregiver burden in India, where families are the primary caregivers of schizophrenia patients, is lacking. AIM To study the predictors of burden experienced by the family caregivers of first admission in-patient schizophrenia patients in India. METHODS AND MATERIALS Family caregivers of 137 schizophrenia patients admitted to an in-patient facility of a hospital in south India were interviewed using the Burden Assessment Schedule. The coping, knowledge about schizophrenia, perceived social support of the caregivers and illness severity, psychopathology and disability experienced by the patients were also assessed. STATISTICAL ANALYSIS Bivariate correlation and multivariate regression analysis were used to study the association of different factors on burden. RESULTS Duration of illness and levels of psychopathology and disability had significant direct correlation with total burden score; perceived social support had significant inverse correlation with total burden score. There was a high correlation between psychopathology and disability (p<0.001). Two separate regression analyses, each including total PANSS score (psychopathology) or total IDEAS score (disability) showed that duration of illness and perceived social support were significant predictors of burden in addition to psychopathology and disability. CONCLUSION During the first hospitalization, in addition to symptom reduction and disability limitation, focus should be on enhancing social support in order to reduce caregiver burden among family members of schizophrenia patients.
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Affiliation(s)
- Aarti Jagannathan
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), Bangalore, India.
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - Ameer Hamza
- Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.
| | - H R Nagendra
- Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA), Bangalore, India.
| | - B N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bangalore 560029, India.
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856
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Las Hayas C, Padierna JÁ, Bilbao A, Martín J, Muñoz P, Quintana JM. Eating disorders: predictors of change in the quality of life of caregivers. Psychiatry Res 2014; 215:718-26. [PMID: 24418049 DOI: 10.1016/j.psychres.2013.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 01/31/2023]
Abstract
Eating disorders (EDs) have a strong impact on the quality of life (QoL) of caregivers. This study explores the longitudinal changes in the QoL of ED caregivers at 1 (T1; n=109) and 2 years (T2; n=32) follow-up, and identifies predictors of improvement at 1-year follow-up. ED outpatients also completed a battery of tests at T1 (n=69) and T2 (n=11). Multivariate hierarchical linear mixed models were used, in which the caregivers' 1-year changes in QoL, anxiety and depression scores were analysed as the dependent variables. Predictor variables were the caregivers' perception of burden, perception of the severity of the patient's ED, kinship data, and the ED person's scores on QoL, anxiety depression and ED symptoms. Higher scores in mental health and low perception of burden at baseline predicted improved caregiver QoL at 1-year follow-up. The caregivers' QoL improved if the perception of burden decreased over time and if depression of the patient improved. The results suggest that interventions directed to reduce the caregivers' perception of burden and to improve the mental health of the ED patients would lead to improved caregiver QoL. The high attrition rate at T2 made prediction analyses unviable.
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857
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Abstract
Background: The burden of tuberculosis (TB) in Nigeria is high. Unfortunately, the data from the TB programme of the States’ ministries of health are usually unpublished, which possibly contribute to the prevailing ignorance and poor attitude of Nigerians to the disease. This study determined the trends of TB burden and treatment outcome in Enugu state, Nigeria; and relate the State's disease burden to that of the Nation. Materials and Methods: A descriptive study of secondary data from the TB control programme, Ministry of Health, Enugu state, the National annual report of 2008, and World Health Organisation (WHO) TB database for the 10-year period of 2000-2009. Results: The number of female TB cases was higher than males within the 0-14 age group only. The annual number of all TB cases showed a rising trend from 914 cases in the year 2000 to 1684 in 2009; but the proportion of new sputum smear (ss+) pulmonary tuberculosis (PTB) cases declined (Trend X2 = 7.37, P = 0.007). The average number of extra-pulmonary TB cases increased fourfold from 2000-2004 to 2005-2009 (36 versus 150 cases). The median treatment success rate was 82% (range: 78-85). For the period 2004-2008, 2.0% of all new ss + PBT cases reported in Nigeria, originated from Enugu state. The proportion of new ss + PTB reported in Enugu state was significantly higher than national value (59.6% versus 52.6%) [P < 0.001, OR = 1.33 (95% CI: 1.26, 1.40)]. Conclusion: The burden of TB in Enugu state of Nigeria had increased over the period reviewed. However, the State's contribution to the disease burden in Nigeria was low.
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Affiliation(s)
- Cyril C Dim
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Ngozi R Dim
- Department of Radiation Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
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858
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Pompili M, Harnic D, Gonda X, Forte A, Dominici G, Innamorati M, Fountoulakis KN, Serafini G, Sher L, Janiri L, Rihmer Z, Amore M, Girardi P. Impact of living with bipolar patients: Making sense of caregivers' burden. World J Psychiatry 2014; 4:1-12. [PMID: 24660140 PMCID: PMC3958651 DOI: 10.5498/wjp.v4.i1.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 12/19/2013] [Accepted: 01/13/2014] [Indexed: 02/05/2023] Open
Abstract
The aim of the present review was to examine objective and subjective burdens in primary caregivers (usually family members) of patients with bipolar disorder (BD) and to list which symptoms of the patients are considered more burdensome by the caregivers. In order to provide a critical review about caregiver's burden in patients with bipolar disorder, we performed a detailed PubMed, BioMedCentral, ISI Web of Science, PsycINFO, Elsevier Science Direct and Cochrane Library search to identify all papers and book chapters in English published during the period between 1963 and November 2011. The highest levels of distress were caused by the patient's behavior and the patient's role dysfunction (work, education and social relationships). Furthermore, the caregiving role compromises other social roles occupied by the caregiver, becoming part of the heavy social cost of bipolar affective disorder. There is a need to better understand caregivers' views and personal perceptions of the stresses and demands arising from caring for someone with BD in order to develop practical appropriate interventions and to improve the training of caregivers.
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859
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Affiliation(s)
- Eric A Finkelstein
- Health Services and Systems Research Program, Duke-NUS Graduate Medical School, Singapore, and Duke University Global Health Institute, Durham, North Carolina.
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860
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Barber C, Ille S, Vergison A, Coates H. Acute otitis media in young children - what do parents say? Int J Pediatr Otorhinolaryngol 2014; 78:300-6. [PMID: 24374143 DOI: 10.1016/j.ijporl.2013.11.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 11/21/2013] [Accepted: 11/24/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The Ear infections Attitudes Research study investigated parental attitudes and awareness towards acute otitis media (AOM) and evaluated the burden of AOM for affected children, their families, and parental work capabilities. METHODS This study, conducted via online interviews in October-November 2010, included parents (N=2867) from 12 countries, whose children aged ≤3.5 years had experienced ≥1 professionally diagnosed AOM episode in the last 6 months (AOM-experienced group; N=1438) or had never experienced any professionally diagnosed AOM episode (non AOM-experienced group; N=1429). The interviews consisted of questions with multiple-choice, five-point scaled or free-text answers. Answers to multiple-choice questions were presented as frequencies of particular responses and those to scaled questions as mean values or percentages of parents considering each aspect as applicable. RESULTS Parents considered that the main AOM burdens for affected children were pain (mean values on five-point scales: 4.4 and 4.5), disturbed sleep (4.3 and 4.3) and irritability (4.2 and 4.0) and for their families, sleepless nights (4.2 and 3.8) and worries about the child's recovery (4.1 and 4.3) and about potential long-term implications (4.0 and 4.3) in the AOM-experienced and non AOM-experienced groups, respectively. During their child's most recent AOM episode, 95% of parents in the AOM-experienced group used antibiotics, 76% reported that their doctors prescribed antibiotics for immediate use, 13% were advised to return for antibiotic prescription if symptoms did not abate and 9% received a prescription for antibiotics to use if symptoms did not improve. Both reported prescription and usage rates for antibiotics were higher than expected. When their child had AOM, 73% of parents had to be absent from work or rearrange their working hours. Among those who took leave from work, 67% stayed at home for 2-7 days. CONCLUSIONS Parents perceive AOM to be a burden for their child and families, particularly the pain and disturbed sleep due to AOM, and this disease had a significant effect on parents' ability to attend work. Given how common AOM is, this loss of workdays may lead to substantial financial burden for families and the society. Antibiotics were almost invariably used in all countries despite current guidelines.
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Affiliation(s)
- Colin Barber
- Department of Paediatric Otolaryngology, Starship Hospital, 2 Park Road, Grafton, Auckland 1023, New Zealand.
| | | | - Anne Vergison
- Department of Paediatric Infectious Diseases, Infection Control and Epidemiology Unit, ULB-Hopital Universitaire Des Enfants, J.J. Crocq 15, 1020 Brussels (Laken), Belgium.
| | - Harvey Coates
- School of Paediatrics and Child Health, The University of Western Australia, Perth, 208 Hampden Road, Nedlands, Western Australia 6009, Australia.
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861
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Okelo SO, Eakin MN, Riekert KA, Teodoro AP, Bilderback AL, Thompson DA, Loiaza-Martinez A, Rand CS, Thyne S, Diette GB, Patino CM. Validation of parental reports of asthma trajectory, burden, and risk by using the pediatric asthma control and communication instrument. J Allergy Clin Immunol Pract 2014; 2:186-92. [PMID: 24607047 DOI: 10.1016/j.jaip.2013.10.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/29/2013] [Accepted: 10/15/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Despite a growing interest, few pediatric asthma questionnaires assess multiple dimensions of asthma morbidity, as recommended by national asthma guidelines, or use patient-reported outcomes. OBJECTIVE To evaluate a questionnaire that measures multiple dimensions of parent-reported asthma morbidity (Direction, Bother, and Risk). METHODS We administered the Pediatric Asthma Control and Communication Instrument (PACCI) and assessed asthma control (PACCI Control), quality of life, and lung function among children who presented for routine asthma care. The PACCI was evaluated for discriminative validity. RESULTS A total of 317 children participated (mean age, 8.2 years; 58% boys; 44% African American). As parent-reported PACCI Direction changed from "better" to "worse," we observed poorer asthma control (P < .001), mean Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) scores (P < .001), and FEV1% (P = .025). Linear regression showed that, for each change in PACCI Direction, the mean PACQLQ score decreased by -0.6 (95% CI, -0.8 to -0.4). As parent-reported PACCI Bother changed from "not bothered" to "very bothered," we observed poorer asthma control (P < .001) and lower mean PACQLQ scores (P < .001). Linear regression showed that, for each change in PACCI Bother category, the mean PACQLQ score decreased by -1.1 (95% CI, -1.3 to -0.9). Any reported PACCI Risk event (emergency department visit, hospitalization, or use of an oral corticosteroid) was associated with poorer asthma control (P < .05) and PACQLQ scores (P < .01). CONCLUSIONS PACCI Direction, Bother, and Risk are valid measures of parent-reported outcomes and show good discriminative validity. The PACCI is a simple clinical tool to assess multiple dimensions of parent-reported asthma morbidity, in addition to risk and control.
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Affiliation(s)
- Sande O Okelo
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif.
| | - Michelle N Eakin
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Kristin A Riekert
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Alvin P Teodoro
- Department of Pediatrics, New York Presbyterian/Weill Medical College of Cornell University, New York, NY
| | | | | | | | - Cynthia S Rand
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Shannon Thyne
- Department of Pediatrics, University of California San Francisco, San Francisco, Calif
| | - Gregory B Diette
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Cecilia M Patino
- Department of Preventive Medicine, University of Southern California, Los Angeles, Calif
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862
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Khattab A, Shaheen M, Kamel T, El Faramay A, El Rahman SA, Nabil D, Gouda M. Burden of pediatric influenza A virus infection post swine-flu H1N1 pandemic in Egypt. ASIAN PAC J TROP MED 2014; 6:693-8. [PMID: 23827145 DOI: 10.1016/s1995-7645(13)60120-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 07/15/2013] [Accepted: 08/15/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To screen children with influenza like illness or with symptoms of acute respiratory tract infections for influenza A virus infection - post swine flu pandemic era - using rapid influenza diagnostic tests. METHODS During two years (2010 & 2011), 1 200 children with influenza like illness or acute respiratory tract infections (according to World Health Organization criteria) were recruited. Their ages ranged from 2-60 months. Nasopharyngeal aspirates specimens were collected from all children for rapid influenza A diagnostic test. RESULTS Influenza A virus rapid test was positive in 47.5% of the children; the majority (89.6%) were presented with lower respiratory tract infections. Respiratory rate and temperature were significantly higher among positive rapid influenza test patients. CONCLUSIONS Influenza A virus infection is still a major cause of respiratory tract infections in Egyptian children. It should be considered in all cases with cough and febrile episodes and influenza like symptoms even post swine flu pandemic.
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Affiliation(s)
- Adel Khattab
- Influenza Advisory Board, Egyptian Ministry of Health, Cairo, Egypt
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863
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Derendorf H, Meltzer EO, Hermann R, Canonica GW. Clinical development of an advanced intranasal delivery system of azelastine hydrochloride and fluticasone propionate. Drugs Today (Barc) 2014; 50:15-31. [PMID: 24524103 DOI: 10.1358/dot.2014.50.1.2094806] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is no shortage of pharmacologic treatments available for the management of allergic rhinitis (AR), but none regularly provide full relief from all symptoms. MP29-02 (Dymista®) is a novel intranasal formulation of azelastine hydrochloride (AZE) and fluticasone propionate (FP), benefiting from an enhanced formulation and improved device characteristics compared to marketed intranasal corticosteroid (INS) formulations. Results from large, randomized, double-blind, placebo-controlled, head-to-head trials versus first-line therapies, confirmed MP29-02 as the evidence-based drug-of-choice for AR treatment. MP29-02 was twice as effective as AZE or FP for nasal and ocular symptom relief in moderate to severe seasonal AR patients, with superiority documented regardless of season, and in more severe patients. More MP29-02-treated patients experienced clinically relevant responses (i.e., halving of nasal symptom burden and complete/near-to-complete relief) days faster than those on INS or intranasal antihistamine monotherapy. MP29-02's efficacy was sustained long-term versus FP (up to 52 weeks) in chronic rhinitis patients (perennial AR or nonallergic rhinitis), with 7 out of 10 patients first becoming symptom-free following 1 month's treatment with MP29-02, and days faster than with the INS. These results confirm MP29-02's superiority over the historical gold-standard therapy for AR (i.e., INS), and position it now as first-line treatment for moderate to severe AR patients, the majority of whom are uncontrolled on existing medications.
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Affiliation(s)
- H Derendorf
- College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, California, USA
| | - R Hermann
- Clinical Research Appliance, Gelnhausen, Germany
| | - G W Canonica
- University of Genova, IRCCS AOU S. Martino, Genoa, Italy.
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864
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Feeley CA, Turner-Henson A, Christian BJ, Avis KT, Heaton K, Lozano D, Su X. Sleep quality, stress, caregiver burden, and quality of life in maternal caregivers of young children with bronchopulmonary dysplasia. J Pediatr Nurs 2014; 29:29-38. [PMID: 23999065 PMCID: PMC4056670 DOI: 10.1016/j.pedn.2013.08.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Revised: 07/19/2013] [Accepted: 08/02/2013] [Indexed: 10/26/2022]
Abstract
Little is known about the influence of sleep quality, stress, and caregiver burden on quality of life in maternal caregivers of young children with bronchopulmonary dysplasia (BPD). In 61 maternal caregivers (mean age 29.59 years) of young children with BPD (mean age 13.93 months), caregivers reported sleeping a mean of 5.8 hours, and significant correlations were found between sleep quality and depressive symptoms and stress, as well as an inverse correlation with quality of life. Sleep quality was found to be the most significant predictor of quality of life in maternal caregivers.
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Affiliation(s)
- Christine A Feeley
- University of Alabama at Birmingham School of Nursing, Birmingham, AL; Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA.
| | | | - Becky J Christian
- University of Alabama at Birmingham School of Nursing, Birmingham, AL
| | - Kristin T Avis
- UAB Department of Pediatrics at Children's of Alabama, Birmingham, AL
| | - Karen Heaton
- University of Alabama at Birmingham School of Nursing, Birmingham, AL
| | - David Lozano
- UAB Department of Pediatrics at Children's of Alabama, Birmingham, AL
| | - Xiaogang Su
- University of Alabama at Birmingham School of Nursing, Birmingham, AL
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865
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Pahlavanzade S, Khosravi N, Moeini M. The effect of a family need-based program on burden of caregivers of leukemia patients in Isfahan in 2013-2014. Iran J Nurs Midwifery Res 2014; 19:629-34. [PMID: 25558261 PMCID: PMC4280728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Accepted: 09/02/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND The family of cancer patients experience burden of care because of their caring role. Therefore, appropriate and effective interventions are essential in order to decrease burden. The goal of the present research was to determine the effect of a family need-based program on the burden of care in caregivers of leukemia patients. MATERIALS AND METHODS In this clinical research, 70 caregivers of leukemia patients who referred to Sayed Al-Shohada Medical Center in Isfahan, Iran were chosen and divided, through convenient sampling method and using table of random numbers, into two groups, experimental and control. Caregivers of the experimental group attended five training sessions. The data collection tool of this study was the Zarit Burden Scale. It was completed by members of both groups before, immediately after, and 1 month after the intervention. The data obtained were analyzed with SPSS software. RESULTS During the study period, burden slowly decreased in the experimental group and increased in the control group. Mean burden of care score before, immediately after, and 1 month after the intervention was 63.6, 30.4, and 23.03, respectively, in the experimental group and 62.5, 67.3, and 68.8, respectively, in the control group. In addition, the mean burden score in the experimental group significantly decreased in comparison with the control group (P < 0.001). CONCLUSION This family need-based program can decrease burden in caregivers of leukemia patients and may potentially improve the quality of life of both patients and caregivers.
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Affiliation(s)
- Saeed Pahlavanzade
- Department of Psychiatric Nursing, Member of Nursing and Midwifery Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Narjes Khosravi
- Department of Psychiatric Nursing, Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Narjes Khosravi, MSC of Nursing, Sayed Al-Shohada Hospital, Department of Psychiatric Nursing Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Mahin Moeini
- Department of Medical surgical Nursing, Member of Nursing and Midwifery Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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866
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Etemadifar S, Bahrami M, Shahriari M, Farsani AK. The effectiveness of a supportive educative group intervention on family caregiver burden of patients with heart failure. Iran J Nurs Midwifery Res 2014; 19:217-23. [PMID: 24949057 PMCID: PMC4061619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Living with heart failure patients is a complex situation for family caregivers. Few studies have been conducted to examine the effects of interventional programs to ease this condition. The purpose of this study was to determine the effectiveness of a supportive educative group intervention in reducing family caregivers' burden of caregiving. MATERIALS AND METHODS This randomized clinical trail was conducted at a selective teaching hospital in Isfahan, Iran in 2012. The intervention consisted of four weekly multimedia training sessions of 2 h that included education and family support for 50 family caregivers. Caregiver burden was measured using the Zarit Burden Interview (ZBI). Paired t-test, Student's t-tests, and repeated measures analysis of variance (ANOVA) were used to test for significant differences of the mean scores of burden between the intervention and control groups over a 3-month period. RESULTS The intervention was successful in reducing caregiver burden over time both at the end of the intervention period (P = 0.000) and 3 months after the intervention (P = 0.000). CONCLUSIONS Nurses and other healthcare providers can use the findings of this study in order to implement effective programs to reduce family caregivers' challenges and to provide them more support.
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Affiliation(s)
- Shahram Etemadifar
- Faculty of Nursing and Midwifery, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Masoud Bahrami
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan university of medical sciences, Isfahan, Iran,Address for correspondence: Dr. Masoud Bahrami, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Mohsen Shahriari
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan university of medical sciences, Isfahan, Iran,Department of Cardiology, Isfahan Hypertension Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi Farsani
- Department of Cardiology, Isfahan Hypertension Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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867
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Martín J, Padierna A, Aguirre U, González N, Muñoz P, Quintana JM. Predictors of quality of life and caregiver burden among maternal and paternal caregivers of patients with eating disorders. Psychiatry Res 2013; 210:1107-15. [PMID: 23998363 DOI: 10.1016/j.psychres.2013.07.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 04/08/2013] [Accepted: 07/30/2013] [Indexed: 01/04/2023]
Abstract
This prospective study investigated quality of life and caregiver burden of 244 parent caregivers of 113 Spanish patients with Eating Disorders (ED). One hundred eleven mothers and 70 fathers fulfilled the inclusion criteria. ED patients completed the Hospital Anxiety and Depression Scale (HADS) and the Eating Attitudes Test-26. Caregivers completed the HADS, the Short Form-12 (SF-12), the Involvement Evaluation Questionnaire-EU version, and the Anorectic Behaviour Observation Scale. Descriptive statistics, ANOVA, Chi-square and Fisher's exact test were applied. Among mothers, anxiety and depression and patient age contributed to poorer quality of life. Caregiver variables that affected the burden for mothers were marital status, the mental subscale of the SF-12, and the mother's perception of the severity of her child's illness. Caregiver variables that affected the burden for fathers were the caregiver's anxiety and the physical domain of the SF-12. Among mothers but not fathers, being married was a protective factor of caregiver burden. Our findings suggest that mothers and fathers have different perceptions of their quality of life and caregiver burden, and that mothers of patients with ED may be in considerable need for extra psychosocial support.
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Affiliation(s)
- Josune Martín
- Research Unit, Galdakao-Usansolo Hospital, Barrio Labeaga s/n, Galdakao, 48960 Bizkaia, Spain.
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868
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Abstract
Late-life depression (LLD) has detrimental effects on family caregivers that may be compounded when caregivers believe that depressive behaviors are volitional or within the patient's capacity to control. In this study we examined three person-centered caregiver attributions that place responsibility for LLD on the patient (i.e., character, controllability, and intention), and the impact of such attributions on levels of general caregiver burden and burden specific to patient depressive symptoms. Participants were 212 spouses and adult children of older adults enrolled in a depression treatment study. Over one third of caregivers endorsed character attributions, which significantly predicted greater levels of both general and depression-specific burden. Intention attributions were significantly associated with general burden, but not depression-specific burden. Contrary to our expectation, controllability attributions did not predict either type of burden. Our findings suggest that the assessment of family caregiver attributions for LLD may be useful in identifying caregivers at risk for burden and subsequent health effects, as well as those who may need education and support to provide effective care to a vulnerable population of older adults.
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Affiliation(s)
- Courtney Allyn Polenick
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA
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869
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Broese van Groenou MI, de Boer A, Iedema J. Positive and negative evaluation of caregiving among three different types of informal care relationships. Eur J Ageing 2013; 10:301-311. [PMID: 28804305 PMCID: PMC5549208 DOI: 10.1007/s10433-013-0276-6] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Based on the caregiver stress model, we examined how care demands, caregiver motivation, coping style and external support are associated with positive evaluation and caregiver burden among spousal, adult child and other types of care relations. Data from a sample of Dutch informal caregivers of 1,685 older persons (55 and older) were analyzed employing multivariate linear regression analyses for each of the care relationship types. Spouses (N = 206) report high positive evaluation and high burden, adult children (N = 1,093) report low positive evaluation, and other caregivers (N = 386) report high positive evaluation and a low burden. Multivariate linear regression analyses showed that motives and external support were important for positive evaluation but the impact varied among types of caregivers, whereas care demands and not asking for help were associated with burden for all types. Only among 'other' caregiver relationships, positive evaluation was negatively associated with burden. It is concluded that results confirm the dual nature of caregiving among spouses and children. The care context and motivation of the different types of caregivers explain their differences in care evaluation. Various interventions for types of caregivers are discussed.
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Affiliation(s)
| | - Alice de Boer
- The Netherlands Institute of Social Research, the Hague, the Netherlands
| | - Jurjen Iedema
- The Netherlands Institute of Social Research, the Hague, the Netherlands
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870
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Abstract
Hepatitis C virus (HCV) is a major health burden infecting 170-210 million people worldwide. Additional 3-4 millions are newly-infected annually. Prevalence of pediatric infection varies from 0.05%-0.36% in the United States and Europe; up to 1.8%-5.8% in some developing countries. The highest prevalence occurs in Egypt, sub-Saharan Africa, Amazon basin and Mongolia. HCV has been present in some populations for several centuries, notably genotypes 1 and 2 in West Africa. Parenteral anti-schistosomal therapy practiced in the 1960s until the early 1980s had spread HCV infection throughout Egypt. Parenteral acquisition of HCV remains a major route for infection among Egyptian children. Insufficient screening of transfusions, unsterilized injection equipment and re-used needles and syringes continue to be major routes of HCV transmission in developing countries, whereas vertical transmission and adolescent high-risk behaviors (e.g., injection drug abuse) are the major routes in developed countries. The risk of vertical transmission from an infected mother to her unborn/newborn infant is approximately 5%. Early stages of HCV infection in children do not lead to marked impairment in the quality of life nor to cognitive, behavioral or emotional dysfunction; however, caregiver stress and family system strain may occur. HCV slowly progresses to serious complications as cirrhosis (1%-2%) and hepatocellular carcinoma (HCC) especially in the presence of risk factors as hemolytic anemias, obesity, treated malignancy, and concomitant human immune deficiency and/or hepatitis B virus co-infection. HCV vaccine remains elusive to date. Understanding the immune mechanisms in patients who successfully cleared the infection is essential for vaccine development. The pediatric standard of care treatment consists of pegylated interferon-α 2a or b plus ribavirin for 24-48 wk. The new oral direct acting antivirals, approved for adults, need further evaluation in children. Sustained virologic response varies depending on the viral load, genotype, duration of infection, degree of aminotransferase elevation, adiposity and single nucleotide polymorphisms of interleukin (IL)-28B locus. The goals of treatment in individual patients are virus eradication, prevention of cirrhosis and HCC, and removing stigmatization; meanwhile the overall goal is decreasing the global burden of HCV. IL-28B polymorphisms have been also associated with spontaneous clearance of vertically acquired HCV infection. The worldwide economic burden of HCV for children, families and countries is estimated to be hundreds of millions of US dollars per year. The United States, alone, is estimated to spend 199-336 million dollars in screening, monitoring and treatment during one decade. The emotional burden of having an HCV infected child in a family is more difficult to estimate.
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871
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Rabinowitz J, Berardo CG, Bugarski-Kirola D, Marder S. Association of prominent positive and prominent negative symptoms and functional health, well-being, healthcare-related quality of life and family burden: a CATIE analysis. Schizophr Res 2013; 150:339-42. [PMID: 23899997 DOI: 10.1016/j.schres.2013.07.014] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 07/02/2013] [Accepted: 07/03/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is an increased interest in evaluating the impact of core symptoms of schizophrenia, both positive and negative, on functioning and burden of disease. OBJECTIVE To examine the extent to which prominent positive and prominent negative symptoms impact functional health, well-being, health-related quality of life (HRQoL), and family burden. METHODS Data on symptomatology, HRQoL, and resource use from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) were analyzed (n=1447). Patients were divided into four groups based on the Positive and Negative Syndrome Scale (PANSS) using published criteria as having (a) neither prominent positive nor prominent negative symptoms (n=575; 39.7%); (b) only prominent negative symptoms (n=274; 18.9%); (c) only prominent positive symptoms (n=295; 20.4%); or (d) both prominent positive and negative symptoms (n=303; 20.9%). Differences were examined for overall significance between the groups and for a linear trend. RESULTS There was a significant linear decline in the outcome measures with each subsequent symptom group, with the combination of prominent positive and negative symptoms incrementing the decline further on quality-adjusted life-years derived from the PANSS, Short-Form-12, Index of Functioning, HRQoL measures, and number of workdays missed by caregiver during the month prior to CATIE (all p<0.001). CONCLUSIONS Both prominent positive and prominent negative symptoms of schizophrenia are independently associated with significant decline in functionality, HRQoL, and caregiver lost workdays. An increased burden is observed in patients with highest symptomatology. Further research is needed to determine predictors of poor outcomes and burden of schizophrenia.
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872
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Aubin HJ, Daeppen JB. Emerging pharmacotherapies for alcohol dependence: a systematic review focusing on reduction in consumption. Drug Alcohol Depend 2013; 133:15-29. [PMID: 23746430 DOI: 10.1016/j.drugalcdep.2013.04.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 03/15/2013] [Accepted: 04/22/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND European Medicines Agency guidelines recognize two different treatment goals for alcohol dependence: abstinence and reduction in alcohol consumption. All currently approved agents are indicated for abstinence. This systematic review aimed to identify drugs in development for alcohol dependence treatment and to establish, based upon trial design, if any are seeking market authorization for reduction in consumption. METHODS We searched PubMed and Embase (December 2001-November 2011) to identify agents in development for alcohol dependence treatment. Additional studies were identified by searching ClinicalTrials.gov and the R&D Insight and Clinical Trials Insight databases. Studies in which the primary focus was treatment of comorbidity, or n≤20, were excluded. Studies were then classified as 'abstinence' if they: described a detoxification/alcohol withdrawal period; enrolled patients who had undergone detoxification previously; or presented relapse/abstinence rates as the primary outcome. Studies in patients actively drinking at baseline were classified as 'reduction in consumption'. RESULTS Of 602 abstracts identified, 45 full-text articles were eligible. Five monotherapies were in development for alcohol dependence treatment: topiramate, fluvoxamine, aripiprazole, flupenthixol and nalmefene. Nalmefene was the only agent whose sponsor was clearly seeking definitive approval for reduction in consumption. Development status was unclear for topiramate, fluvoxamine, aripiprazole and flupenthixol. Fifteen agents were examined in published exploratory investigator-initiated trials; the majority focused on abstinence. Ongoing (unpublished) trials tended to focus on reduction in consumption. CONCLUSIONS While published studies generally focused on abstinence, ongoing trials focused on reduction in consumption, suggesting a change in emphasis in the approach to treating alcohol dependence.
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873
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Martín-Carrasco M, Domínguez-Panchón AI, Muñoz-Hermoso P, González-Fraile E, Ballesteros-Rodríguez J. [Assessment tools to measure burden in the informal caregiver of patients with dementia]. Rev Esp Geriatr Gerontol 2013; 48:276-84. [PMID: 24161356 DOI: 10.1016/j.regg.2013.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 06/14/2013] [Accepted: 06/20/2013] [Indexed: 10/26/2022]
Abstract
UNLABELLED The complexity of dementia caregiver burden concept has led to a significant number of assessment tests using various approaches. For this reason, a review of these measurementss could be useful for clinical or research purposes. OBJECTIVE The objective of the study is to perform an updated review on the tools available, classifying them according to the burden criterion by studying their characteristics and psychometric properties, and providing those most relevant for application. METHOD The method applied consisted of a database search -Pubmed, PsycINFO, Embase and Psicodoc (1980-2012). RESULTS A total of 31 assessment tools were selected, grouped on the basis of the burden concept evaluated: objective/subjective burden, burden from a multidimensional approach, and as distress associated with patient impairment. CONCLUSIONS This study provides a suitable tool for using caregiver burden assessment tools accurately. A marked conclusion is the need to establish agreements in the assessment methods, in order to develop standard knowledge and application to healthcare practice.
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Affiliation(s)
- Manuel Martín-Carrasco
- Instituto de Investigaciones Psiquiátricas (IIP), Fundación M. Josefa Recio, CIBERSAM, G10, Bilbao, España.
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874
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Upadhyay RP, Misra P, Chellaiyan VG, Das TK, Adhikary M, Chinnakali P, Yadav K, Sinha S. Burden of diabetes mellitus and prediabetes in tribal population of India: a systematic review. Diabetes Res Clin Pract 2013; 102:1-7. [PMID: 23876547 DOI: 10.1016/j.diabres.2013.06.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/05/2013] [Accepted: 06/10/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the burden of diabetes mellitus and pre-diabetes in tribal populations of India. METHODS The authors reviewed studies from 2000 to 2011 that documented the prevalence of diabetes mellitus in various tribal populations of India. The search was performed using electronic and manual methods. Meta-analysis of data on point prevalence was performed. RESULTS A total of seven studies were retrieved. The prevalence of diabetes mellitus ranged from 0.7% to 10.1%. The final estimate of diabetes prevalence obtained after pooling of data from individual studies, was 5.9% (95% CI; 3.1-9.5%). The prevalence for impaired fasting glucose (IFG) varied from 5.1% to 13.5% and impaired glucose tolerance (IGT), from 6.6% to 12.9%. CONCLUSION Chronic disease research in tribal populations is limited. The reported prevalence of IFG/IGT was higher than the prevalence of diabetes and this observation could be suggestive of a potential increase in diabetes in the coming years. Given that lifestyle changes have occurred in the tribal populations, there is a need to synthesize evidence(s) relating to diabetes and other chronic diseases in these marginalized populations and inform policy makers.
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Affiliation(s)
- Ravi Prakash Upadhyay
- Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
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875
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Kate N, Grover S, Kulhara P, Nehra R. Relationship of caregiver burden with coping strategies, social support, psychological morbidity, and quality of life in the caregivers of schizophrenia. Asian J Psychiatr 2013; 6:380-8. [PMID: 24011684 DOI: 10.1016/j.ajp.2013.03.014] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Revised: 03/09/2013] [Accepted: 03/30/2013] [Indexed: 12/12/2022]
Abstract
AIM To evaluate the relationship of caregiver burden as assessed by using Hindi Involvement Evaluation Questionnaire (IEQ) with coping strategies, social support, psychological morbidity, and quality of life of caregivers of patients with schizophrenia. Additionally, the relationship of caregiver-burden with sociodemographic variables, and clinical variables, including severity of psychopathology and level of functioning of patients, was studied. METHODOLOGY The study included 100 patients with schizophrenia and their caregivers recruited by purposive random sampling. RESULTS Among the four domains of IEQ, highest number of correlations emerged with tension domain. Tension domain had positive correlation with the caregiver being single, time spent in caregiving per day, and use of avoidance, collusion, and coercion as coping strategies. Additionally, tension domain was associated with poor quality of life in all the domains of WHO-QOL Bref and was associated with higher psychological morbidity. Worrying urging-I domain of IEQ correlated with frequency of visits, higher use of problem focused coping and poor physical health as per the WHO-QOL Bref. Worrying urging-II domain of IEQ had positive correlation with higher level of positive symptoms, lower level of functioning of the patient, younger age of caregiver, caregiver being unmarried, and higher use problem focused and seeking social support as coping strategies. Supervision domain of IEQ correlated positively with lower income, being an unmarried caregiver, from an urban locality and non-nuclear family. Supervision domain was associated with poor physical health as assessed by WHO-QOL Bref. CONCLUSION Caregiving burden, especially tension is associated with use of maladaptive coping strategies, poor quality of life and higher level of psychological morbidity in caregivers.
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876
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Yildirim Z, Turkkani MH, Bozkurt H, Islek E, Mollahaliloglu S, Erkoc Y. Effects of the Health Transformation Programme on tuberculosis burden in Turkey. Respir Med 2013; 107:2029-37. [PMID: 24084061 DOI: 10.1016/j.rmed.2013.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 07/24/2013] [Accepted: 09/14/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The Fifty-ninth Turkish Government announced an emergency action plan and embarked on a comprehensive health reform named "Health Transformation Program" (HTP) in 2003. This study investigated the effects of HTP on tuberculosis (TB) burden from 2003 to 2010 in Turkey. DESIGN TB incidence, prevalence, mortality and case detection rates, treatment success and direct observed treatment strategy (DOTS) applications rate, and contribution of these applications in the success of the TB war were retrospectively investigated. RESULTS The annual decrease of incidence rate was 2.86 between 1995 and 2002, and 1.22 between and 2003 and 2010, (p < 0.05). The decrease of prevalence rate was 2.88 between 1995 and 2002 and 1.25 between 2003 and 2010 (p < 0.05). The annual declines in mortality were 0.44 between 1995 and 2002 and 0.22 between 2003 and 2010 (p < 0.005). The DOTS application rate increased from 0% in 2003 to 98% in 2010. After the HTP treatment success rate of TB at 85% of Turkey was firstly reached to 89% in 2005 and increased to 91% in 2007. Case detection rate of new pulmonary TB patients was 82% in 2005 and 81% in 2008 reaching the WHO target for the first time with HTP. CONCLUSION A trend of reduced TB burden began in Turkey in 1997. As a result of the implementation of HTP beginning in 2003, the target treatment success and DOTS application rates were achieved and progress has continued even in the face of the recent worldwide economic crisis.
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Affiliation(s)
- Zeki Yildirim
- Gazi University School of Medicine, Department of Pulmonary Medicine, Ankara, Turkey.
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877
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Karakis I, Montouris GD, Piperidou C, Luciano MS, Meador KJ, Cole AJ. The effect of epilepsy surgery on caregiver quality of life. Epilepsy Res 2013; 107:181-9. [PMID: 24054427 DOI: 10.1016/j.eplepsyres.2013.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 07/28/2013] [Accepted: 08/14/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE Epilepsy surgery has been shown to improve patient quality of life (QOL). Little is known about its effect on caregiver QOL. METHODS The study population comprised of 26 persons with epilepsy (PWE) who underwent long term video EEG monitoring at Massachusetts General Hospital for presurgical evaluation along with 16 caregivers. The PWE completed epilepsy directed QOL (QOLIE-31) and psychological (Beck depression-BDI and anxiety inventory-BAI) questionnaires before and after surgery. Their participating caregivers completed generic health related QOL (SF36v2) and disease burden (Zarit caregiver burden inventory-ZCBI) questionnaires before and after surgery. Demographic data for all participants and disease/surgery related data for the PWE were collected. Statistical analysis was performed to compare PWE and caregiver QOL before and after surgery. RESULTS Mean patient age was 37 years. Most (77%) suffered from symptomatic partial epilepsy for approximately 18 years prior to surgery, averaging 4 seizures per month and 2.2 antiepileptic drugs (AEDs). 78% of them underwent an anterior temporal lobectomy and the rest extra-temporal resections. On follow up at approximately 9 months, 69% had a surgical outcome of Engel class I, 23% of class II and 8% class IV. Postoperatively, the PWE remained on average on 1.9 AEDs. There was a statistically significant improvement for both the aggregate QOLIE-31 score and all its subscales (except for medication effects) as well as the BAI scores. 96% of the PWE felt that the decision to go through surgery was worthwhile. Mean caregivers age was 47 years. Half of them were spouses to the PWE and the majority of the rest their parents. 50% of them stated that their overall time devoted to patient's care decreased after surgery and 50% that it remained unchanged. The mental component scale (SF36v2, MCS) of caregiver QOL showed statistically significant improvement. ZCBI score and the physical component scale of their QOL (SF36v2, PCS) did not significantly vary before and after surgery. 75% of caregivers deemed their QOL better post surgery vs 19% similar. 94% of the caregivers felt that the decision to go through surgery was worthwhile. CONCLUSIONS Successful epilepsy surgery has a positive impact not only to patient QOL but also to their caregiver. To the best of our knowledge, this is the first pilot study to systematically address the impact of epilepsy surgery on caregivers providing additional support to epilepsy surgery as the optimal treatment modality in carefully selected patients. These findings call for further investigation on the caregiver quality of life in epilepsy and for its inclusion in the treatment plan and quality indicators for epilepsy surgery.
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Affiliation(s)
- Ioannis Karakis
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
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878
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Schulz J, Beicher A, Mayer G, Oertel WH, Knake S, Rosenow F, Strzelczyk A. Counseling and social work for persons with epilepsy: observational study on demand and issues in Hessen, Germany. Epilepsy Behav 2013; 28:358-62. [PMID: 23832132 DOI: 10.1016/j.yebeh.2013.05.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 05/21/2013] [Accepted: 05/22/2013] [Indexed: 11/16/2022]
Abstract
The goal of the social management of epilepsy is to decrease the physical, psychological, and social consequences for persons with epilepsy (PWEs). The objective of this observational study was to determine the needs and issues of PWEs in the utilization of epilepsy counseling services between 2008 and 2012 in the German state of Hessen. Sociodemographic data, employment status, counseling issues, and characteristics were collected at first and follow-up visits. An average of 492 (272 males, 55.3%) PWEs presented at counseling services per year. These were mainly children or adolescents below the age of 20years (22.4%) and PWEs in working age between 20 and 65years (73.6%). The majority of PWEs seeking counseling were employed (44.4%, annual average: 219 PWEs, SD: 39). However, a substantial part (114/219, 52.1%) of these employed PWEs reported problems or difficulties at their workplace associated with the diagnosis of epilepsy. We could identify four major issues addressed by the PWEs as 1) diagnosis of epilepsy, 2) employment, 3) family-related matters, and 4) social or medical aids linked with public authorities. This study demonstrated the continuous demand for epilepsy counseling with at least one out of twenty (5.8%) PWEs in need of counseling per year. Further studies are warranted to answer questions on outcome and long-term course. Epilepsy counseling should be available to all PWEs on a national level and may be helpful in preventing long-term unemployment and early retirement while maintaining quality of care for PWEs.
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Affiliation(s)
- Juliane Schulz
- Department of Neurology and Epilepsy Center Hessen, Philipps-University Marburg and University Hospital of Giessen and Marburg GmbH, Marburg, Germany
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879
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Abstract
BACKGROUND A substance-dependent person in the family affects almost all aspects of family life that also impact the lives of the significant others and causes enormous burden. OBJECTIVES This study was aimed to assess the pattern of burden borne by the family caregivers of patients with opioid-dependence-injecting drug users (IDU) and noninjecting drug users (NIDU). MATERIALS AND METHODS A cross-sectional study was conducted with ICD-10 diagnosed-opioid-dependent subjects (IDU and NIDU, N = 40 in each group) and their family caregivers attending a de-addiction centre at a multispecialty teaching hospital in North India. Family Burden interview schedule was used to assess the pattern of burden borne by the family caregivers. RESULTS The IDU group was characterized by older age, longer duration of substance dependence, greater subjective and objective family burden in all the areas compared to NIDU group, and single status and unemployment were associated with severe objective burden. The family burden was associated neither with age, education, or duration of dependence of the patients, nor with family size, type of caregiver or caregiver's education in either group. CONCLUSION All caregivers reported a moderate or severe burden, which indicates the significance and need for further work in this area.
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Affiliation(s)
- Naresh Nebhinani
- Department of Psychiatry, Postgraduate Institute Medical Science, Rohtak, Haryana, India
| | - B N Anil
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Debasish Basu
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
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880
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Williams EA, Keenan KE, Ansong D, Simpson LM, Boakye I, Boaheng JM, Awuah D, Nkyi CA, Nyannor I, Arhin B, Alder S, Benson LS, Dickerson TT. The burden and correlates of hypertension in rural Ghana: a cross-sectional study. Diabetes Metab Syndr 2013; 7:123-128. [PMID: 23953175 DOI: 10.1016/j.dsx.2013.06.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM Cardiovascular diseases (CVDs), of which hypertension is a major risk factor, are predicted to account for four times as many deaths as from communicable diseases by the year 2020. Hypertension, once rare, is rapidly becoming a major public health burden in sub-Saharan Africa (SSA). However, data on its prevalence, awareness, treatment and control are paltry, especially for rural communities. This study was done to determine the burden and correlates of adult hypertension in the rural Barekese sub-district of Ghana. METHODS A cross-sectional survey was conducted on 425 adults aged ≥ 35 in the Barekese sub district (estimated population 18,510). Socio-demographic characteristics, modifiable and non-modifiable risk factors, blood pressure (BP) and anthropometric measurements were collected using standardized protocols. RESULTS Overall, the proportion of hypertension and isolated systolic hypertension is 44.7% and 32.7% respectively in the study population. However, 64.9% of these were on treatment, with only 8.9% having controlled blood pressure (<140/90 mmHg). The mean systolic and diastolic BP were 134.38 mmHg (standard deviation, SD: 21.46) and 84.32 mmHg (SD: 12.44). Obesity (Body Mass Index, BMI>30 kg/m²) was found in 37 (10.4% of the population), out of whom 7 (15.9%) were extremely obese (BMI> 40 kg/m²). Increasing age and level of education were positively correlated with increasing blood pressure. CONCLUSION The high burden of hypertension in this population along with the considerable less detection, treatment and control is of great concern. There is the need to promote health education measures that will foster prevention and early detection of hypertension.
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881
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Shukri K. The Burden of Sepsis; A Call to Action in Support of World Sepsis Day 2013. Bull Emerg Trauma 2013; 1:52-55. [PMID: 27162824 PMCID: PMC4771223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 03/04/2013] [Accepted: 03/10/2013] [Indexed: 06/05/2023] Open
Affiliation(s)
- Khalid Shukri
- Department of Anesthesia and Intensive care, Taiba Hospital, Kuwait
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882
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Ball J, Carrington MJ, McMurray JJV, Stewart S. Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. Int J Cardiol 2013; 167:1807-24. [PMID: 23380698 DOI: 10.1016/j.ijcard.2012.12.093] [Citation(s) in RCA: 434] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 12/04/2012] [Accepted: 12/24/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) represents an increasing public health challenge with profound social and economic implications. METHODS A comprehensive synthesis and review of the AF literature was performed. Overall, key findings from 182 studies were used to describe the indicative scope and impact of AF from an individual to population perspective. RESULTS There are many pathways to AF including advancing age, cardiovascular disease and increased levels of obesity/metabolic disorders. The reported population prevalence of AF ranges from 2.3%-3.4% and historical trends reflect increased AF incidence. Estimated life-time risk of AF is around 1 in 4. Primary care contacts reflect whole population trends: AF-related case-presentations increase from less than 0.5% in those aged 40 years or less to 6-12% for those aged 85 years or more. Globally, AF-related hospitalisations (primary or secondary diagnosis) showed an upward trend (from ~35 to over 100 admissions/10,000 persons) during 1996 to 2006. The estimated cost of AF is greater than 1% of health care expenditure and rising with hospitalisations the largest contributor. For affected individuals, quality of life indices are poor and AF confers an independent 1.5 to 2.0-fold probability of death in the longer-term. AF is also closely linked to ischaemic stroke (3- to 5-fold risk), chronic heart failure (up to 50% develop AF) and acute coronary syndromes (up to 25% develop AF) with consistently worse outcomes reported with concurrent AF. Future projections predict at least a doubling of AF cases by 2050. SUMMARY AF represents an evolving, global epidemic providing considerable challenges to minimise its impact from an individual to whole society perspective.
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Affiliation(s)
- Jocasta Ball
- Centre of Research Excellence to Reduce Inequality in Heart Disease, Preventative Health, Baker IDI Heart and Diabetes Institute, Melbourne, Australia
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883
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Cheng ST, Lam LCW, Kwok T, Ng NSS, Fung AWT. The social networks of Hong Kong Chinese family caregivers of Alzheimer's disease: correlates with positive gains and burden. Gerontologist 2013; 53:998-1008. [PMID: 23371974 DOI: 10.1093/geront/gns195] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To examine the social networks of family caregivers of persons with Alzheimer's disease and the degree to which network characteristics were associated with satisfaction with social support, burden, and positive gains. DESIGN AND METHODS A total of 142 Chinese caregivers responded to measures of structural support, positive exchanges, and negative exchanges using the social convoy questionnaire, as well as to measures of social support satisfaction, burden, role overload, positive gains, self-rated health, and behavioral and psychological symptoms of dementia (BPSD) of the care recipient. Data were analyzed using multiple regression. RESULTS The caregivers had small networks (mean = 4.4 persons). They reported few negative exchanges with network members and higher emotional than instrumental support, while being rather satisfied with the social support obtained. Surprisingly, both spouse/sibling and adult child caregivers excluded many close kin, in particular ~40% of their children, from their networks. A larger network was associated with higher social support satisfaction and positive gains, and lower role overload. Controlling for network size and social support satisfaction, positive exchanges were associated with higher positive gains, whereas negative exchanges were associated with higher burden and overload. Caregivers who experienced more BPSD and poorer self-rated health also reported lower support satisfaction and positive gains, as well as higher burden and overload. IMPLICATIONS Under the influence of collectivism, individuals may shoulder the responsibilities of caregiving for the collective well-being of the family and end up being isolated and disappointed when expectations of family support were not forthcoming, to the extent that even ties with close kin may be severed.
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Affiliation(s)
- Sheung-Tak Cheng
- *Address correspondence to Sheung-Tak Cheng, Department of Psychological Studies, Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, N.T., Hong Kong. E-mail:
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884
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Miret M, Ayuso-Mateos JL, Sanchez-Moreno J, Vieta E. Depressive disorders and suicide: Epidemiology, risk factors, and burden. Neurosci Biobehav Rev 2013; 37:2372-4. [PMID: 23313644 DOI: 10.1016/j.neubiorev.2013.01.008] [Citation(s) in RCA: 110] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 01/03/2013] [Accepted: 01/04/2013] [Indexed: 10/27/2022]
Abstract
The social and economic impact of mood disorders and suicide is extremely high and may be even higher in coming years, and yet, research in mental health is largely underfunded. This report summarizes the most recent data concerning the epidemiology and burden of depression and suicide, and underlines the most recent initiatives to identify the barriers to effective treatment and prevention of mood disorders. Global cooperation and networks of research networks are proposed. Progress in the understanding of the pathophysiology and subtypes of depression, technological advances, emphasis on early prediction of response and prevention, and a paradigm shift in drug development are crucial to overcome the current challenges posed by increasing rates of depression and suicide.
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Affiliation(s)
- Marta Miret
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IP), Universidad Autónoma de Madrid, Spain
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885
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Abstract
INTRODUCTION Neural tube defects (NTDs) are the second most common birth defects. Spina bifida (SB) and anencephaly make up approximately 90% of total NTDs. Given the number of infants born with an NTD each year, anyone who provides unpaid care for the child (especially caregivers) is affected. This literature review explores the humanistic burden on caregivers of people with SB, specifically myelomeningocele. METHODS A search using PubMed, PsycINFO, and Embase was performed to find studies from 1976 to 2010. Interpretative phenomenological analysis was performed on qualitative data and relevant extracts from the data were collated to form master themes. RESULTS A total of 168 abstracts met the inclusion and exclusion criteria. Of these, 25 articles related to caregivers of individuals with SB. Four master themes emerged: initial diagnosis, living with an individual with SB, social support, and coping. Different aspects of caregivers' lives were found to be affected by caring for a child with SB, including activities of daily living, work impact, time consumption, parental responsibilities, confidence, feelings and emotions, mental health, stress, social impact, psychological adjustment, and relationships. CONCLUSION NTDs, such as SB, present a multitude of issues to caregivers. Issues that affect caregivers of individuals with SB must be addressed in order to reduce the considerable burden that SB places on the caregiver. Continued and enhanced support from health services and patient advocacy groups is needed. For example, providing additional information, support, and empathy can help parents prepare themselves for dealing with the needs of a child with SB over their lifetime.
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Affiliation(s)
- Diana Rofail
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB UK
| | - Laura Maguire
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB UK
| | - Rebecca Heelis
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB UK
| | | | | | - Linda Abetz
- Adelphi Values, Adelphi Mill, Bollington, Cheshire, SK10 5JB UK
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886
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Riedel O, Emmrich A, Klotsche J, Dodel R, Förstl H, Maier W, Reichmann H, Wittchen HU. Alzheimer's Disease: Differences of Transdermal versus Oral Treatment on Caregiving Time. Dement Geriatr Cogn Dis Extra 2012; 2:468-80. [PMID: 23277781 PMCID: PMC3522452 DOI: 10.1159/000342929] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Data on indirect effects of dementia treatment on caregiver burden obtained from naturalistic studies are still lacking. We explored differences between patients with oral and transdermal application of acetylcholine esterase inhibitors regarding caregiver's time burden and psychopathology. Methods A cross-sectional naturalistic cohort study of 403 patients in outpatient care with three treatment groups (none, oral, and transdermal) was conducted. Assessments included a standardized clinical burden questionnaire and a standardized caregiver interview. Results Any treatment was associated with lower burden in most measures. Transdermal treatment was superior regarding (1) administration time (p < 0.001); (2) rates of administration problems (p = 0.031); (3) burden in activities of daily living (p = 0.008), and (4) caregiver anxiety (OR 0.25; 95% CI 0.05–0.99). Caregivers did not report better quality of life regarding mental/physical health. Physicians’ and caregivers’ ratings of patients’ improvements were not associated (κ = 0.01–0.06). Conclusions Benefits associated with transdermal treatment do not translate into a better ‘generic quality of life’ of the caregiver. The substantially different perceptions of patients’ improvements need to be considered in future studies.
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Affiliation(s)
- O Riedel
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Germany
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887
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Karami M, Khalili D, Eshrati B. Estimating the proportion of diabetes to the attributable burden of cardiovascular diseases in iran. Iran J Public Health 2012; 41:50-5. [PMID: 23113224 PMCID: PMC3469024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 05/12/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed at estimating the proportion of diabetes as a risk factor to the attributable burden of cardiovascular diseases in Iran. METHODS Comparative Risk Assessment methodology was used to calculating Potential Impact Fraction (PIF). To calculate PIF, data on the prevalence of newly diagnosed diabetes mellitus (NDM) and known diabetes mellitus (KDM) were obtained from 3rd Iranian surveillance of risk factors of non-communicable diseases and data on corresponding measures of effect were derived from a cohort study. PIF were estimated on both theoretical minimum and feasible minimum risk. Uncertainty for the attributable burden was estimated by Monte Carlo simulation-modeling techniques incorporating sources of uncertainty. RESULTS According to multivariate-adjusted hazard ratios, by reducing the prevalence of Iranian women with diabetes from 10.05 percent to the feasible minimum risk level i.e. 5 percent, 6.8% (95% uncertainty intervals: 3.5-9.8) of attributable Disability Adjusted Life Years (DALYs) to CVD are avoidable and the corresponding value for men were 3.1% (95% uncertainty intervals: 1.4-4.8). CONCLUSION Although data on the prevalence of diabetes and corresponding measures of associations were obtained from an updated and country-specific source, but to better priority setting, PIF should be applied to updated and revised burden of CVDs.
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Affiliation(s)
- M Karami
- Dept. of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran,Corresponding Author: E-mail address:
| | - D Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences; Dept. of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - B Eshrati
- Dept. of Epidemiology, Arak University of Medical Sciences, Arak, Iran
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888
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Abstract
BACKGROUND Caregivers of individuals suffering from psychiatric illness are at risk of being subjected to mental health consequences such as depression, anxiety and burnout. Community-based studies proved that 18-47% of caregivers land in depression. The caregiver burden can be quantified into objective, subjective and demand burdens. There is paucity of data comparing the caregiver burden of psychiatric patients and that of chronic medical illness patients. AIMS AND OBJECTIVES (1) To compare the caregiver burden in psychiatric illness and chronic medical illness. (2) To study the association of caregiver burden with demographic factors like age, gender, duration of caregiving. MATERIALS AND METHODS The study included two groups of caregivers, each of 50 members. Group 1 consisted of caregivers of psychiatric patients and group 2 consisted of caregivers of chronic medical illness patients. The Montgomery Borgatta Caregiver Burden scale was used to assess the burden in terms of objective, subjective and demand burdens. RESULTS AND CONCLUSION The caregiver burden scores in the caregivers of psychiatric patients were significantly higher than that of chronic medical illness (P<0.0001). The caregiver burden was found to increase with the duration of illness as well as with the age of caregiver. The caregiver burden in the sample population was less as the objective and demand burden did not cross the reference higher value in the given scale, whereas the emotional impact given by the subjective burden was on higher side.
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Affiliation(s)
- Prasanth Ampalam
- Department of Psychiatry, Andhra Medical College, Government Hospital for Mental Care, Visakhapatnam, Andhra Pradesh, India
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889
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Karami M, Soori H, Monfared AB. Estimating the contribution of selected risk factors in attributable burden to stroke in iran. Iran J Public Health 2012; 41:91-6. [PMID: 23113182 PMCID: PMC3468982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Accepted: 02/23/2012] [Indexed: 11/21/2022]
Abstract
BACKGROUND Knowledge of the magnitude of avoidable burden by risk factors is needed for health policy, priority setting, and preventing stroke. The aim of this study was to estimate the contribution of selected risk factors including hypertension, overweight, obesity, tobacco use, and physical inactivity to the attributable burden of stroke in Iran. METHODS The World Health Organization Comparative Risk Assessment (CRA) methodology was employed to calculate the Potential Impact Fraction (PIF) and percentage of avoidable burden of stroke, which attributed to its risk factors among Iranian adults in 2009. Prevalence of risk factors was obtained from the 5(th) STEPS survey of chronic disease risk factors which conducted in 2009. PIF was estimated on both theoretical minimum and feasible minimum risk. A simulation procedure incorporating sources of uncertainty was used to estimate the uncertainties for the attributable burden. RESULTS About 15.7% (95% uncertainty intervals: 5.8- 23.5) of attributable Disability Adjusted Life Years (DALYs) to stroke in adult males and 15.8% (95% uncertainty intervals: 5.8- 23.5) in adult females are avoidable after changing the current prevalence (16.0% and 16.1% for males and females, respectively) of hypertension to 10% in both sexes. CONCLUSION This work highlighted the important role of hypertension and overweight. Accordingly, policy makers are advised to consider these risk factors once implementing interventional program in Iran.
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Affiliation(s)
- M Karami
- Dept. of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding Author: Tel: +989188305496, E-mail address:
| | - H Soori
- Dept. of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Bahadori Monfared
- Dept. of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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890
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Abstract
The incidence and mortality of colorectal cancer (CRC) is rising rapidly in Asia. It seems that ethnicity has an important etiological role in CRC in Asia. However the incidence, anatomical distribution and mortality of CRC among Asian populations are not different from those in Western countries. There is little support by health authorities for CRC screening and very low public awareness of this emerging epidemic in Asia. The increasing rate of CRC in Asia means that we need to take action immediately to prevent CRC and to diagnose the disease at the early stages by introducing CRC screening in countries at high risk of an increasing burden of CRC.
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Affiliation(s)
- Mohamad Amin Pourhoseingholi
- Mohamad Amin Pourhoseingholi, Research Center for Gastroenterology and Liver diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985711151, Iran
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891
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Upadhyay RP. An overview of the burden of non-communicable diseases in India. Iran J Public Health 2012; 41:1-8. [PMID: 23113144 PMCID: PMC3481705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 12/12/2011] [Indexed: 11/01/2022]
Abstract
Non-communicable disease continues to be an important public health problem in India, being responsible for a major proportion of mortality and morbidity. Demographic changes, changes in the lifestyle along with increased rates of urbanization are the major reasons responsible for the tilt towards the non-communicable diseases. In India, there is no regular system for collecting data on non-communicable diseases (NCDs) which can be said to be of adequate coverage or quality. Lack of trained health care workers, primary care providers armed with inadequate knowledge and skills along with ill-defined roles of various health sectors i.e. public, private, and voluntary sectors in providing care have played key hurdles in combating the growing burden of non-communicable diseases. Empowerment of the community through effective health education, use of trained public health personnel along with provision of free health care and social insurance would prove beneficial in effectively controlling the growing prevalence of NCDs.
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Affiliation(s)
- R Prakash Upadhyay
- Center for Community Medicine, Old OT Block, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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892
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Kumar D, Kumar P, Singh AR, Bhandari SS. Knowledge and attitude towards mental illness of key informants and general population: a comparative study. Dysphrenia 2012; 3:57-64. [PMID: 32905487 PMCID: PMC7470139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Adverse attitudes to mental illness are found in all societies in the world. The belief that mental illness is incurable or self-inflicted can also be damaging, leading to patients not being referred for appropriate mental health care. Aims of the present study were (1) to assess the attitude towards mental illness of key informant of patients and general population and (2) to compare the two groups in respect to attitude towards mental illness. MATERIAL AND METHODS Sample based on purposive sampling technique consisting of 200 subjects (100 key informants and 100 from general population) within age range of 25-55 years had been taken. Sample of key informants was taken from Ranchi Institute of Neuro-Psychiatry & Allied Sciences (RINPAS) outpatients' department whereas the sample of general population was taken from Kanke area or within the radius of 5 K.M. from RINPAS, Kanke. Tools used were sociodemographic datasheet and self-developed checklist for assessing the attitude. RESULTS (1) Significant difference was found in the area of nature, cause, after effect and community mental health ideology between both groups. (2) There was no significant difference in the area of treatment and stigma. CONCLUSION The findings of the present study suggested that there was growing awareness about mental illness even in general population and the people were being more receptive of the mentally ill people.
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Affiliation(s)
- Dilip Kumar
- Psychiatric Social Worker, District Mental Health Programme, Ranchi Institute of Neuro-Psychiatry & Allied Sciences, Kanke, Ranchi, Jharkhand, India
| | - Pradeep Kumar
- Psychiatric Social Worker, State Institute of Mental Health, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Amool Ranjan Singh
- Professor and Head, Department of Clinical Psychology, Ranchi Institute of Neuro-Psychiatry & Allied Sciences, Kanke, Ranchi, Jharkhand, India
| | - Samrat Singh Bhandari
- Senior Resident of Psychiatry, Institute of Human Behaviour & Allied Sciences, Delhi, India
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893
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Abstract
BACKGROUND Family's expressed emotion has been shown to be predictive of outcome in mental and physical illnesses in a variety of cultural settings. The relationship between caregiver burden and high level of expressed emotions has demonstrated a high level of relapse among the psychiatric patients in the West. AIM The current study explores the relationship between caregivers' burden and level of expressed emotions by the patients with schizophrenia in Indian setting. MATERIALS AND METHODS The sample for the study consisted of totally 70 subjects comprising 35 schizophrenic patients and 35 caregivers. The schizophrenic patients who were attending the Day Care Center run by Department of Psychiatric and Neuro Rehabilitation Unit at National Institute of Mental Health and Neuro Sciences (NIMHANS) in Bangalore, India (a tertiary care center) and their primary caregivers were included. Family emotional involvement and criticism scale and The burden assessment schedule were administered to assess the expressed emotions and caregivers' burden. Carl Pearson Correlation test used to study the relationship between the variables. RESULTS AND CONCLUSION The study highlighted the need for addressing expressed emotion in comprehensive psychosocial intervention plan. More attention should be paid to the needs of the caregivers in order to alleviate their burden in managing mentally ill patients.
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Affiliation(s)
- B. P. Nirmala
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - M. N. Vranda
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
| | - Shanivaram Reddy
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, Karnataka, India
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894
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Abstract
BACKGROUND Schizophrenia not only influences the lives of those affected but also those around them, especially the caregivers. This study examines the different determinants that are likely to contribute to the caregivers' perception of burden of care across different countries namely Malaysia and India, using the burden assessment schedule. AIM The goals for this study were, to study the psychosocial and demographic aspects of patients suffering from schizophrenia, to study the levels of perceived burden of the Malaysian and Indian families caring for a relative with schizophrenia, and to study the determinants that contributes to the caregivers' perception of burden of care. MATERIALS AND METHODS The study was conducted in private hospitals, both in Malaysia as well as Mangalore after obtaining the necessary approval. 50 schizophrenia patients and their caregivers in Malaysia and India were chosen using the purposive sampling technique. The inclusion criteria were a minimum of 5 years since diagnosis of schizophrenia. RESULTS Although the Indian caregivers perceived difficulties in several areas such as finance, family relationship, well-being and health, they still perceived burden to be lesser compared to Malaysian counterpart. CONCLUSION Intensified community based care can reduce burden.
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Affiliation(s)
- Prashant Talwar
- FSS/University of Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, India
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895
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Abstract
BACKGROUND There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. MATERIALS AND METHODS The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS) during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981). The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients). METHODS The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS) during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981). The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients). RESULTS The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52%) and 15 (60%) male and female spouses, respectively, which was statistically found to be insignificant. CONCLUSION No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.
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Affiliation(s)
- Surekha Kumari
- Department of Psychiatric Social Work, RINPAS, Kanke, Ranchi, India
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896
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Morrow A, De Wals P, Petit G, Guay M, Erickson LJ. The burden of pneumococcal disease in the Canadian population before routine use of the seven-valent pneumococcal conjugate vaccine. Can J Infect Dis Med Microbiol 2007; 18:121-7. [PMID: 18923713 PMCID: PMC2533542 DOI: 10.1155/2007/713576] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2006] [Accepted: 07/26/2006] [Indexed: 02/06/2023]
Abstract
BACKGROUND In the United States, implementation of the seven-valent conjugate vaccine into childhood immunization schedules has had an effect on the burden of pneumococcal disease in all ages of the population. To evaluate the impact in Canada, it is essential to have an estimate of the burden of pneumococcal disease before routine use of the vaccine. METHODS The incidence and costs of pneumococcal disease in the Canadian population in 2001 were estimated from various sources, including published studies, provincial databases and expert opinion. RESULTS In 2001, there were 565,000 cases of pneumococcal disease in the Canadian population, with invasive infections representing 0.7%, pneumonia 7.5% and acute otitis media 91.8% of cases. There were a total of 3000 deaths, mainly as a result of pneumonia and largely attributable to the population aged 65 years or older. There were 54,330 life-years lost due to pneumococcal disease, and 37,430 quality-adjusted life-years lost due to acute disease, long-term sequelae and deaths. Societal costs were estimated to be $193 million (range $155 to $295 million), with 82% borne by the health system and 18% borne by families. Invasive pneumococcal infections represented 17% of the costs and noninvasive infections represented 83%, with approximately one-half of this proportion attributable to acute otitis media and myringotomy. CONCLUSIONS The burden of pneumococcal disease before routine use of the pneumococcal conjugate vaccine was substantial in all age groups of the Canadian population. This estimate provides a baseline for further analysis of the direct and indirect impacts of the vaccine.
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Affiliation(s)
- Adrienne Morrow
- Department of Social and Preventive Medicine, Laval University, Quebec City
| | - Philippe De Wals
- Department of Social and Preventive Medicine, Laval University, Quebec City
| | - Geneviève Petit
- Department of Social and Preventive Medicine, University of Montreal, Montreal
| | - Maryse Guay
- Department of Community Health Sciences, University of Sherbrooke, Sherbrooke
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897
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Thomas MK, Majowicz SE, Sockett PN, Fazil A, Pollari F, Doré K, Flint JA, Edge VL. Estimated Numbers of Community Cases of Illness Due to Salmonella, Campylobacter and Verotoxigenic Escherichia Coli: Pathogen-specific Community Rates. Can J Infect Dis Med Microbiol 2006; 17:229-34. [PMID: 18382633 PMCID: PMC2095082 DOI: 10.1155/2006/806874] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2006] [Accepted: 06/19/2006] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To estimate the annual number of cases of illness due to verotoxigenic Escherichia coli (VTEC), Salmonella and Campylobacter in the Canadian population, using data from the National Notifiable Disease registry (NND), estimates of under-reporting derived from several National Studies on Acute Gastrointestinal Illness, and the literature. METHODS For each of the three pathogens (VTEC, Salmonella and Campylobacter), data were used to estimate the percentage of cases reported at each step in the surveillance system. The number of reported cases in the NND for each pathogen was then divided by these percentages. In cases where the pathogen-specific estimates were unavailable, data on acute gastrointestinal illness were used, accounting for differences between those with bloody and nonbloody diarrhea. RESULTS For every case of VTEC, Salmonella and Campylobacter infection reported in the NND, there were an estimated 10 to 47, 13 to 37, and 23 to 49 cases annually in the Canadian population, respectively. CONCLUSIONS The authors estimate that a significant number of infections due to VTEC, Salmonella and Campylobacter occur each year in Canada, highlighting the fact that these enteric pathogens still pose a significant health burden. Recognizing the significant amount of under-reporting is essential to designing appropriate interventions and assessing the impact of these pathogens in the population.
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Affiliation(s)
- M Kate Thomas
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
| | - Shannon E Majowicz
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
- Department of Population Medicine, University of Guelph
| | - Paul N Sockett
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
- Department of Population Medicine, University of Guelph
| | - Aamir Fazil
- Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, Ontario
| | - Frank Pollari
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
- Department of Population Medicine, University of Guelph
| | - Kathryn Doré
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
- Department of Population Medicine, University of Guelph
| | - James A Flint
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
| | - Victoria L Edge
- Foodborne, Waterborne and Zoonotic Infections Division, Public Health Agency of Canada, Guelph and Ottawa
- Department of Population Medicine, University of Guelph
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