Comparison Of Demographic Characteristics Research Articles

Comparison of Demographic Characteristics and Social Determinants of Health Between Adults With Diagnosed HIV and All Adults in the U.S.

Quantifying disparities in social determinants of health between people with HIV and the total population could help address health inequities, and ensure health and well-being among people with HIV in the U.S., but estimates are lacking. Several representative data sources were used to assess differences in social determinants of health between adults with diagnosed HIV (Centers for Disease Control and Prevention Medical Monitoring Project) and the total adult population (U.S. Census Bureau's decennial census, American Community Survey, Household Pulse Survey, the Current Population Survey Annual Social and Economic Supplements; the Department of Housing and Urban Development's point-in-time estimates of homelessness; and the Bureau of Justice Statistics). The differences were quantified using standardized prevalence differences and standardized prevalence ratios, adjusting for differences in age, race/ethnicity, and birth sex between people with HIV and the total U.S. population. Overall, 35.6% of people with HIV were living in a household with an income at or below the federal poverty level, and 8.1% recently experienced homelessness. Additionally, 42.9% had Medicaid and 27.6% had Medicare; 39.7% were living with a disability. Over half (52.3%) lived in large central metropolitan counties and 20.6% spoke English less than very well based on survey responses. After adjustment, poverty (standardized prevalence difference=25.1%, standardized prevalence ratio=3.5), homelessness (standardized prevalence difference=8.5%, standardized prevalence ratio=43.5), coverage through Medicaid (standardized prevalence difference=29.5%, standardized prevalence ratio=3.0) or Medicare (standardized prevalence difference=7.8%), and disability (standardized prevalence difference=30.3%, standardized prevalence ratio=3.0) were higher among people with HIV than the total U.S. population. The percentage of people with HIV living in large central metropolitan counties (standardized prevalence difference=13.4%) or who were recently incarcerated (standardized prevalence ratio=5.9) was higher than the total U.S. population. These findings provide a baseline for assessing national-level disparities in social determinants of health between people with HIV and the total U.S. population, and it can be used as a model to assess local disparities. Addressing social determinants of health is essential for achieving health equity, requiring a multipronged approach with interventions at the provider, facility, and policy levels.

Hackathons as extracurricular activities: Unraveling the motivational orientation behind student participation

AbstractThe education sector is constantly progressing its competency paradigm by establishing a nexus between practical, theoretical, and technical dimensions of teaching and learning. In the modern age of education, hackathons are becoming increasingly prominent in providing an optimal academic environment that connects classroom learnings to real‐life scenarios. This study explored the motivational orientation behind student participation in hackathons through the framework provided by self‐determination theory. Specifically, it investigated the role of intrinsic and extrinsic motivations in encouraging initial and continuous hackathon participation. The partial least squares‐structural equation modeling method was used to analyze data collected from 437 students in 12 countries. According to the findings, although intrinsic motivation influences participation intention, extrinsic motivation drives continuance participation. When intrinsic and extrinsic motivational constructs were analyzed individually, it was found that continuance participation demands both motivational orientations. Comparisons of demographic characteristics indicate that older students with more extensive educational experience may have higher intentions to participate and continue participating in these events. This study offers insights into how the education sector can increase hackathon participation by tapping on students’ motivational orientation. From a methodological point of view, it is apparent to recommend the promotion of hackathons as a core extracurricular activity at a school level, and more indispensably, as pedagogy at a classroom level. In a world where students are encouraged to fail early, fast, and often, participating in hackathons is a tactical preparation for eventual success.

Characterizing the Global Crowd Workforce: A Cross-Country Comparison of Crowdworker Demographics

Since its emergence roughly a decade ago, micro-task crowdsourcing has been attracting a heterogeneous set of workers from all over the globe. This paper sets out to explore the characteristics of the international crowd workforce to date and offers a cross-national comparison of crowdworker populations from ten hand-selected countries. We provide an analysis and comparison of demographic characteristics and shed light on the significance of micro-task income for workers situated in different national contexts. With over 11,000 individual responses, this study is the first large-scale country-level analysis of the characteristics of workers on the platform Figure Eight (formerly CrowdFlower), one of the two platforms dominating the micro-task market. We find large differences between the characteristics of the crowd workforces of different countries, both regarding demography and regarding the importance of micro-task income for workers. Furthermore, we find that the composition of the workforce in the ten countries was largely stable across samples taken at different points in time.

Poster 171: No Difference in Clinical Outcomes for Arthroscopic Suprapectoral versus Open Subpectoral Bicep Tenodesis: A Randomized Prospective Analysis

Objectives:Our group has previously reported the 1-year outcomes arthroscopic suprapectoral biceps tenodesis (ASPBT) versus open subpectoral biceps for the management of long head of the biceps tendon (LHBT) pathology. While patients had similar 1-year biceps strength and pain, any ongoing changes in functional outcomes is yet unknown. We aimed to directly compare clinical outcomes of ASPBT versus OSPBT with interference screw fixation, distal to the bony bicipital groove, at 2 years follow-up.Methods:Eighty-seven patients undergoing biceps tenodesis for LHBT disease were randomized into the ASPBT group or OSPBT group. Both techniques utilized polyether ether ketone (PEEK) inference screws for tenodesis fixation. Patients completed American Shoulder and Elbow Surgeon (ASES), Constant subjective, and Single Assessment Numeric Evaluation (SANE) questionnaires preoperatively, and again at 6 months, 12 months and final follow-up at minimum 24 months.Results:Seven-five patients (37/46 randomized to ASPBT [80%], 38/41 randomized to OSPBT [93%]) with a mean age of 50.3 ± 10.4 years and a mean body mass index of 28.9 ± 6.3 were included in clinical outcome analyses. Mean final follow-up was 35.1 months (ASPBT: 35.4 months, OSPBT: 34.9 months, range 24-63 months). Comparison of demographic characteristics and intraoperative findings showed no significant difference in age, gender, concomitant procedures, and rotator cuff disease. No statistically significant differences in ASES (P =.26), Constant subjective scores (P = .60), and SANE scores (P = .74) were found at final follow-up. Clinical outcomes scores showed no significant improvement from 12.6 months to final follow-up at 35.1 months (ASPBT: ASES, P=0.42; Constant, P=0.23; SANE, P=0.43 v. OSPBT: ASES, P=0.76; Constant, P=0.57; SANE, P=0.64). The mean SANE score in the ASPBT group had a statistically nonsignificant, 6.1-point increase from 1 to 3 years post-operatively (p = .23), which was greater than the minimal clinically importance difference (MCID). No patients required revision of biceps tenodesis in either group.Conclusions:No significant differences in patient-reported outcomes and complication rates were found at any time point between subjects undergoing ASPBT or OSPBT, utilizing the same interference screw technique, for the management of LHBT pathology.Table 1Patient Demographic and Other CharacteristicsTable 2Intraoperative FindingsTable 3Patient Reported Outcome measuresTable 4Patient Reported Outcome Measures Difference from 12 Months to Final Follow-Up

No Difference in Clinical Outcomes for Arthroscopic Suprapectoral Versus Open Subpectoral Biceps Tenodesis at Midterm Follow-up: A Randomized Prospective Analysis

Background: We have previously reported the 1-year outcomes of arthroscopic suprapectoral biceps tenodesis (ASPBT) versus open subpectoral biceps tenodesis (OSPBT) for the management of long head of the biceps tendon (LHBT) pathology. While patients had similar 1-year biceps muscle strength and pain, longer-term functional outcomes are unknown. Purpose: To directly compare clinical outcomes of ASPBT versus OSPBT with interference screw fixation, distal to the bony bicipital groove, at a minimum of 2 years’ follow-up. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 85 patients undergoing biceps tenodesis (BT) for LHBT disease were randomized into the ASPBT or OSPBT group. Both techniques utilized polyether ether ketone inference screws for tenodesis fixation. Patients completed American Shoulder and Elbow Surgeons (ASES), Constant subjective, and Single Assessment Numeric Evaluation (SANE) questionnaires preoperatively and again at 6 months, 12 months, and at the final follow-up at a minimum of 24 months. Results: A total of 73 patients (37/42 randomized to ASPBT [88%]; 36/42 randomized to OSPBT [86%]) with a mean age of 50.4 ± 10.3 years and a mean body mass index of 29 ± 7.9 were included in clinical outcome analyses. The mean final follow-up was 2.9 years (ASPBT, 3 years; OSPBT, 2.8 years [range 2-5.2 years]). Comparison of demographic characteristics and intraoperative findings showed no significant differences in age, sex, concomitant procedures, and rotator cuff disease. No statistically significant differences in the ASES (P = .25), Constant subjective (P = .52), and SANE scores (P = .61) were found at the final follow-up. Clinical outcomes scores showed no significant improvement from a mean of 12.6 months to the final follow-up at 34.5 months (ASPBT: ASES, P = .43; Constant, P = .25; SANE, P = .45 vs OSPBT: ASES, P = .65; Constant, P = .78; SANE, P = .70). No patients required revision of BT in either group. Conclusion: This study reported a minimum of 2-year follow-up of patients undergoing ASPBT or OSPBT, utilizing the same interference screw technique, for the management of LHBT pathology in the setting of concomitant shoulder procedures. There were no significant differences in patient-reported outcomes and complication rates found at any time point. Registration: NCT02192073 (ClinicalTrials.gov identifier).

Functional results with active middle ear implant or semi-implantable bone conduction device in patients with comparable hearing loss

Objective In patients with conductive (CHL) or mixed hearing loss (MHL), hearing rehabilitation with an implantable hearing system, active middle ear implant (AMEI) or a semi-implantable bone-conduction device (SIBCD), is an option when conventional hearing aids are insufficient, or patients are unable to wear them. Design Retrospective analysis of 20 consecutive patients (24 implants) with a comparison of demographic characteristics and audiometric results (air-bone gap = ABG, effective hearing gain = EHG, functional hearing gain = FHG, Freiburg Monosyllabic Test in quiet, Oldenburg Sentence Test in noise = OLSA). Study sample Patients, eligible for both devices, who received either AMEI or SIBCD due to CHL or MHL. Results Analysis showed no significant differences in post-operative functional hearing results between the group of AMEI vs. SIBCD (ABG-reduction: 31.6 ± 12.4 dB HL vs. 28.0 ± 11.8 dB HL; p = 0.702; EHG: −1.6 ± 7.7 dB HL vs. −1.2 ± 4.2 dB HL; p = 0.090; FHG: 33.4 ± 12.6 dB HL vs. 26.1 ± 11.7 dB HL; p = 0.192; Freiburg: 83.0 ± 15.6% vs. 83.6 ± 14.2%; Freiburg-improvement: 57.7 ± 26.8% vs. 68.2 ± 19.7%; p = 0.294; OLSA: −2.7 ± 3.0 SNR vs. −1.4 ± 3.6 SNR; OLSA-improvement: 2.6 ± 2.1 dB vs. 3.7 ± 2.8 dB; p = 0.323). Four patients had the AMEI explanted due to insufficient functioning and later received a SIBCD. Conclusions Due to more challenging anatomical conditions, a surgical technique for the AMEI is more complex. However, functional results are comparable to the SIBCD. Therefore, proper patient counselling and cautious choice of the device are mandated before surgery.

Sleep Quality and Associated Factors in Premenopausal, Perimenopausal, and Postmenopausal Women in Korea: Findings from the K-Stori 2016.

PurposePoor sleep quality is a common problem among middle-aged women. Few studies, however, have assessed differences in sleep quality among premenopausal, perimenopausal, and postmenopausal women and related risk factors in Korea women. The aim of this study was to assess sleep quality and factors associated therewith according to menopausal status in Korean women.Patients and MethodsThis study was based on the 2016 Korean Study of Women’s Health Related Issues (K-Stori), a cross-sectional survey employing nationally representative random sampling. In total, 3000 Korean women aged 45 to 64 years completed the Pittsburgh Sleep Quality Index (PSQI). Comparison of demographic characteristics and sleep quality among pre-, peri-, and postmenopausal women was conducted.ResultsAmong the participants, 26% suffered from poor sleep quality based on the PSQI. The prevalence of poor sleep quality increased with later menopausal stage (from 18.8% in the premenopausal stage to 29.5% in the postmenopausal stage P <0.001). Multivariate logistic regression analysis showed that peri- and postmenopausal women were 1.50 and 1.73 times more likely to have poor sleep quality in comparison to premenopausal women, respectively. Chronic disease, depression, at-risk drinking, taking dietary supplements, and single women were associated with a higher likelihood of having poor sleep quality. Health status, at-risk drinking, chronic illness, dietary supplementation, and depression were significantly associated with poor sleep quality.ConclusionPoor sleep quality appears to be prevalent in peri- and postmenopausal women in Korea. The management of sleep quality during menopause transition is important, and further research on how sleep disturbances influence the health status of women in menopausal transition is required.

SAT-445 ASSESSMENT OF MICROALBUMINURIA AND ITS CLINICAL AND BIOCHEMICAL CORRELATES IN INDIVIDUALS WITH SICKLE CELL GENE

Sickle Cell Disease (SCD) is a major genetic disease noted to be prevalent in most countries in Sub-Saharan Africa. Patients with SCD may develop a glomerulopathy with proteinuria and progressive renal insufficiency, leading to end stage renal disease (ESRD) with consequent need for renal replacement therapy. Microalbuminuria (MA) has been shown to be an early predictor of Nephropathy in SCD. The aim of this study was to determine the prevalence of MA in sickle cell disease and trait and to also determine the clinical and biochemical correlates of MA in individuals with the sickle cell gene. This cross-sectional study involved a total of 300 individuals with sickle cell disease, sickle cell trait and haemoglobin AA as controls diagnosed using haemoglobin electrophoresis. A structured pro-forma was administered and detailed physical examination performed. Data was analysed on a personal computer using Statistical Package for Social Sciences (SPSS) software version 20.0. Normally distributed numeric variables were summarised using their mean and standard deviation (Mean± SD). Categorical variables are summarized and presented using frequency tables with proportions and charts as appropriate. The chi-square test was used for comparison of categorical variables while independent sample t- test was used to compare means. Binary logistic regression model was also used to determine further associations between continuous variables. In instances where mean values of parameters were compared by variables with three or more categories, the one way analysis of variance (ANOVA) was performed. A P-value of 0.05 was taken to be statistically significant. All the 300 studied subjects completed the study. The mean ages for the three studied groups (SCD, SCT and control group) were 28.8(9.9) years, 29.0(8.6) years and 28.7(8.7) years respectively. Microalbuminuria was significantly higher in the SCD subjects compared to the SCT and control groups (61% vs 12% vs 8%, p<0.0001). The SCD subjects had median (interquartile range) UACR of 40(20.0-100.0) mg/g; this is higher compared to the SCT and control groups {17.6(10.0-26.3) mg/g and 16.7(10.0-24.0) mg/g respectively, p<.0001}. The comparison of demographic characteristics in SCD subjects with or without MA revealed that age was a distinguishing factor (p= 0.012). The mean eGFR of the SCD subjects {143.4(37.4) ml/min} was higher compared to the SCT group and controls {110.3(21.1) ml/min and 106.1(20.6) ml/min respectively (p<.0001)}. In SCD subjects with microalbuminuria, eGFR was found to be significantly lower (p=0.044). There was significant difference in reticulocyte index, serum albumin and aspartate aminotransferase (AST) values between SCD subjects with or without MA. Using binary logistic regression model, reticulocyte index, serum aspartate aminotransferase and serum albumin remained statistically significant. No association was found between MA and the clinical and laboratory indices in SCT subjects. MA is very common in subjects with sickle cell disease in contrast to the other genotype groups and should be a routine method of detecting early onset of sickle cell nephropathy among SCD subjects. Other risk factors for sickle cell nephropathy among SCD subjects in this study are increasing age, hypoalbuminemia, reduced reticulocyte index and elevated serum aspartate aminotransferase.

Comparative evaluation of 2% turmeric extract with nanocarrier and 1% chlorhexidine gel as an adjunct to scaling and root planing in patients with chronic periodontitis: A pilot randomized controlled clinical trial.

Context:Nanoparticles, owing to their smaller size, penetrate regions inaccessible to other delivery systems, such as periodontal pockets. Thus, the present study aimed to comparatively evaluate efficacy of 2% curcumin with nanocarrier and 1% chlorhexidine gel as a local drug delivery (LDD) in the treatment of periodontal pockets.Materials and Methods:Forty-five chronic periodontitis patients with pocket depth 5–7 mm in two or more teeth were selected. Full-mouth scaling and root planing (SRP) was done for all patients followed by random allocation to the three treatment groups, namely SRP group (Group 1), 2% curcumin with nanogel (Group 2), and 1% chlorhexidine gel (Group 3). Clinical parameter assessment and microbiological analysis of subgingival plaque samples for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf) was done at baseline, 21st day, and 45th day.Results:The results showed that when the two LDD agents were used as an adjunct to SRP in chronic periodontitis, there was an improvement in all clinical parameters. Evaluation of microbiological parameters also showed a significant reduction in Aa, Pg, and Tf levels. Comparison of 2% turmeric extract with a nanocarrier system with 1% chlorhexidine gel showed that both the agents had a comparable antibacterial effect on the three selected periodontopathic bacteria.Conclusion:The present study showed that both the LDD agents showed an effective improvement of clinical and microbiologic parameters. 2% curcumin delivered with a nanocarrier system showed results comparable to chlorhexidine gel and hence shows promising future as an LDD agent in the treatment of periodontal pockets.

Comparison of Demographic Characteristics, Health and Quality of Life between General Adults and Adults Living with Dementia Patients : The 2016 Community Health Survey

Comparison of Demographic Characteristics, Health and Quality of Life between General Adults and Adults Living with Dementia Patients : The 2016 Community Health Survey

OC12.02: A comparison of demographic characteristics between women with benign and malignant endometrium: results of the IETA‐1 multicentre prospective study

OC12.02: A comparison of demographic characteristics between women with benign and malignant endometrium: results of the IETA‐1 multicentre prospective study

Bone Marrow Concentrate Does Not Improve Osseous Integration of Osteochondral Allograft Transplants in the Knee: A Comparative Magnetic Resonance Imaging Analysis

Objectives:Fresh osteochondral allograft transplantation (OCA), which transfers viable, mature hyaline cartilage and subchondral bone into full-thickness chondral defects, has demonstrated good long-term results in the knee. However, incomplete osseous trabecular integration of allograft bone with the host bone is correlated with inferior patient-reported outcomes (Williams et al, JBJS, 2007) and can lead to graft failure. As a result, augmentation of OCA with bone marrow aspirate concentrate (BMAC) has been hypothesized to improve osseous incorporation of the allograft compared to OCA alone. The purpose of this study was to compare the appearance of osseous integration at the host-graft junction on magnetic resonance imaging (MRI) in patients treated with BMAC+OCA versus patients treated with OCA alone.Methods:Between February 2013 and June 2016, 29 patients with full-thickness cartilage defects were treated with BMAC+OCA (n = 10) or OCA alone (n = 19) and followed prospectively with an MRI at approximately 12 months after surgery. Intraoperatively, bone marrow aspirate was harvested from the ipsilateral iliac crest (Magellan, Arteriocyte), and the allograft plug was soaked in BMAC prior to implantation. No patients received a concomitant meniscus allograft transplantation, realignment osteotomy, or anterior ligament reconstruction. Bone, cartilage, and ancillary features on postoperative MRI were assessed and graded using the Osteochondral Allograft MRI Scoring System (OCAMRISS) by a blinded musculoskeletal radiologist. This is a system that scores subchondral bone plate congruity, bone marrow signal intensity, osseous integration, and cystic changes of the graft and host-graft junction as part of the bone features assessment (Meric et al, Cartilage, 2015) (Table 1). Comparisons of demographic characteristics and OCAMRISS scores between groups were performed with the Mann-Whitney test.Results:The mean ages of the BMAC and control groups were 32.9 and 33.4 years, respectively (p = 0.95). Males comprised 60% of the BMAC group and 68% of the control group (p = 0.70). MRIs for the BMAC and control groups were obtained at a mean of 11.2 (range, 9-14) and 11.3 (range, 8-15) months after surgery, respectively (p = 0.87). Mean total OCAMRISS scores were not significantly different between groups (BMAC - 7.8, control - 8.0; p = 0.93). Furthermore, mean bone (BMAC - 2.3, control - 2.8; p = 0.22), cartilage (BMAC - 3.3, control - 3.0; p = 0.55), and ancillary (BMAC - 2.2, control - 2.3; p = 0.92) feature scores were not significantly different between groups. Imaging for 5 patients (50%) in the BMAC and 11 patients (59%) in the control groups (p = 0.71) demonstrated a persistent discernible cleft without crossing trabeculae at the host-graft junction (Figure 1). Almost all grafts (over 90%) demonstrated persistent subchondral marrow edema relative to the epiphyseal bone.Conclusion:The addition of autogenous BMAC to OCA did not enhance osseous integration and bony features at the host-graft junction compared to OCA alone at 12 months. Although more MRI follow-up of patients treated with BMAC+OCA is needed to confirm this finding, these results suggest that any augmentative biologic effect of BMAC for OCA, if one exists, is likely to be small.Table 1.Osteochondral Allograft Magnetic Reponance Imaging Scoring System (OCAMRISS) (adapted from Metric et al) MRI Feature MRI Score Bone Features1. Subchondral bone plate congruity of graft and host-graft junction0: Intract and flush; 1: Disrupted or not flush by >1 subchondral thickness 2. Subchondral bone marrow signal intensity of graft relative to epiphyseal bone0: Normal; 1: Abnormal (bone marrow edema pattern or hypointensity on all sequences) 3. Osseous integration at host-graft junction0: Crossing trabeculae; 1: Discernible cleft 4. Presence of cystic changes of graft and host-graft junction0: Absent; 1: PresentCartilage Features5. Cartilage signal of graft0: Normal; 1: Altered intensity (either hypointense of hyperintense, but not fluid); 2: Fluid signal intensity on all sequences 6. Cartilage “fill” of graft (percentage of volume)0: 76-100%; 1: 51-75% or >100%; 2: <50% 7. Cartilage edge integration at host-graft junction0: No discernible boundary; 1: Discernible boundary; 2: Discernible fissure >1 mm 8. Cartilage surface congruity of graft and host-graft junction0: Flush; 1: <50% offset of host cartilage; 2: >50% offset of host cartilage 9. Calcified cartilage integrity of graft0: Intract, thin, and smooth; 1: Altered (disrupted, thickened or blurred)Ancillary Features10. Opposing cartilage0: Normal; 1: Abnormal (bone marrow edema pattern or hypointensity on all sequences) 11. Meniscal tears0: Absent; 1: Present 12. Synovitis0: Absent; 1: Present 13. Fad pad scarring0: Absent; 1: PresentFigure 1.Representative 12-month coronal and sagittal MRI sections in a (A,B) 20-year-old male, demonstrating crossing trabeculae and minimal subchondral marrow edema, and (C,D) 16-year-old-male, demonstrating discernible clefts at the host-graft junction and significant subchondral marrow edema. Both were treated with BMAC+OCA

Relationship between the Computed Tomography - Measured Initial Primary Tumor Volume, Urine VMA Level and Stage in Neuroblastoma Patients

Background: Nowadays, volumetric data acquisition has allowed for the accurate quantification of volumetric tumor burden. However, few studies have focused on the relationship between neuroblastoma tumor volume and relevant clinical parameters. Objectives: The purpose of this study was to investigate the relationship of initial computed tomography - measured primary tumor volume (CTPTV) with 24 - hour urine vanillylmandelic acid (VMA) level and stage in patients with neuroblastoma. Patients and Methods: This retrospective study included 24 patients. The patients’ age, gender, urine VMA levels and stage at diagnosis were collected, and the CTPTVs were calculated. The correlation between urine VMA level and CTPTV was assessed. The differences in CTPTVs with respect to age of the patients (≤ 1.5 and > 1.5 years old), gender, urine VMA levels (≤ 9.8 and > 9.8 mg/24 hours) and stage (stage 4 and non - stage 4) were analyzed. Multivariate linear regression was conducted to estimate the effect of age, gender, urine VMA level, and stage at diagnosis for CTPTV. Finally, a comparison of demographic characteristics and stage between various CTPTV ranges ( 9.8 mg (P = 0.03) and in patients who were diagnosed with stage 4 (P = 0.002). The most effective variable for CTPTV was urine VMA level. When the urine VMA level increases 1 mg every 24 hours, the CTPTV will increase 4.85 cm3. Among the patients with a CTPTV ≥ 35 cm3, the median age was significantly higher (P = 0.011), and median urine VMA level was significantly higher (P = 0.001) than in patients with a CTPTV < 35 cm3. Additionally, all patients with a CTPTV ≥ 35 cm3 had stage 4 disease at the time of diagnosis (P = 0.001). Conclusion: A moderate positive quantitative correlation was observed between 24 - hour urine VMA levels and initial CTPTV. A CTPTV ≥ 35 cm3 may therefore be used as an indicator of advanced tumor stage in neuroblastoma.

Selective versus universal third trimester ultrasound: Time for a rethink? An audit of current practices at a metropolitan Sydney hospital.

Routine third-trimester ultrasound (T3US) is not recommended in evidence-based clinical guidelines despite occurring frequently. This study investigated the incidence, indication for, results and follow-up needs of T3US performed at a Sydney metropolitan teaching hospital. Audit of T3US amongst singleton pregnancies at St George Hospital, Sydney: retrospective review October-December 2012, prospective cohort with clinician survey February-April 2013. Data included are as follows: maternal demographics, aneuploidy screening results, T3US ordering patterns, results, follow-up management and pregnancy outcomes. Comparison of demographic characteristics and pregnancy outcomes was performed for women undergoing T3US vs. no T3US. One thousand and thirty-five women (623 retrospective, 412 prospective) were included, of whom 560 (54%) received at least one T3US. Characteristics of retrospective and prospective cohorts were similar, so combined data are presented. Most initial T3USs were for valid indications (463 of 560; 83%), most frequently low-lying placenta at morphology (19%), reduced fundal height (10%) and to follow-up fetal concerns at morphology ultrasound (9%). One hundred and sixty-two out of 560 (29%) of initial T3US were not normal, predominantly related to accelerated or reduced fetal growth. Detection of SGA babies was significantly higher in the T3US group (32% SGA babies detected vs. 0% if no T3US, P < 0.001). However, overall detection rates remained low, with 5.2% and 3.0% of babies who had a T3US unexpectedly <10th and <3rd centile birthweight, respectively. The majority of women received at least one, usually indicated, T3US in routine practice at our metropolitan Sydney hospital. This may impact obstetric care, resource allocation and patient well-being. Detection of small for gestational age fetuses was poor.

Comparison of Demographic Characteristics and High-risk Behaviors Among 7342 Patients Treated With Maintenance Treatments in Iran

Introduction: The aim of this study was to answer the question as to how demographic characteristics and the history of high-risk behavior play a role for therapists to select the method of maintenance treatment or how other factors have been important in this selection. Methods: This cross-sectional study was conducted during the period 2015 to 2016 in maintenance treatment clinics in the North Khorasan province (North East of Iran). Besides demographic data, the studied variables include the type of drugs, duration of usage, age of first use, the type of maintenance therapy, and the presence or absence of lifetime risk behaviors (eg, injection, unsafe sex, prison history, and history of suicide attempt). Results: A total of 7342 patients from 79 centers were admitted to participate in this study. In all, 82.17% of the participants were male individuals, and 17.82% were female individuals. Opium and opium sap (88.53%) and heroin or crack (11.46%) were the most commonly used drugs among the studied subjects. The type of substance, demographic characteristics, and the history of high-risk behaviors (except for injection) showed significant differences in the treatment method with methadone, buprenorphine, and opium tincture. Conclusions: It seems that the selection made by Iranian therapists to enter the patients into maintenance treatments was based on the wrong criteria, and there was a financial relationship between the patients and the therapists in the centers being effective in selecting the type of treatment. This issue can greatly affect harm reduction policies in the maintenance treatment centers.

Changing Trends in Brain Imaging Technique for Pediatric Patients with Ventriculoperitoneal Shunts

Background: Children with ventriculoperitoneal shunts (VPS) undergoing brain computed tomography (CT) for shunt malfunction evaluation are at risk for later malignancy due to radiation exposure. We aimed to determine if and how hospitals have adopted radiation-avoiding magnetic resonance imaging (MRI) techniques. Methods: We performed a secondary analysis of the Pediatric Health Information System (PHIS) database. Children with VPS presenting to acute wards at 31 PHIS hospitals between January 1, 2007 and January 2, 2015 and receiving noncontrast neuroimaging on day of service 0/1 were included. Outcome measures were (1) incidence of MRI over time and (2) comparison of demographic characteristics between hospitals with MRI representing higher versus lower proportions (>15% or <15%) of total brain imaging. Results: MRIs increased by 18.1% from 2007 to 2015. Hospitals were assigned to high-use (n = 12) or minimal-use (n = 19) MRI groups based on year 2014/2015 MRI percentages. The only identified difference was an older mean age in the high-use group (8.1 vs. 7.5 years; p = 0.03). Conclusions: MRI is increasingly used to evaluate patients with VPS. Hospitals with more MRI use had older patients and no increase in cost or length of stay. Initiating local quality improvement projects may help identify barriers to MRI uptake and increase use.

Concealed use of herbal and dietary supplements among Thai patients with type 2 diabetes mellitus

BackgroundDiabetes mellitus (DM) has been one of the most common chronic diseases that create great impacts on both morbidities and mortalities. Many patients who suffering from this disease seek for complementary and alternative medicine. The aim of this study was to determine the prevalence and related factors of herbal and dietary supplement (HDS) use in patients with DM type 2 at a single university hospital in Thailand.MethodsA cross-sectional study was performed in 200 type 2 DM patients via face-to-face structured interviews using developed questionnaires comprised of demographic data, diabetes-specific information, details on HDS use, and medical adherence.ResultsFrom the endocrinology clinic, 61% of total patients reported HDS exposure and 28% were currently consuming. More than two-thirds of HDS users did not notify their physicians, mainly because of a lack of doctor concern; 73% of cases had no awareness of potential drug-herb interaction. The use of drumstick tree, turmeric and bitter gourd and holy mushroom were most frequently reported. The main reasons for HDS use were friend and relative suggestions and social media. Comparisons of demographic characteristics, medical adherence, and hemoglobin A1c among these non-HDS users, as well as current and former users, were not statistically significantly different.ConclusionsThis study revealed a great number of DM patients interested in HDS use. The use of HDS for glycemic control is an emerging public health concern given the potential adverse effects, drug interactions and benefits associated with its use. Health care professionals should aware of HDS use and hence incorporate this aspect into the clinical practice.

P130 A comparison of demographic characteristics and workloads of independent nurse prescribers (INP) and nurses using patient group directions (PGDS) in sexual health clinics

IntroductionNurses legally deliver medication independently using INP or PGDs. Despite growing evidence of clinical application, there is limited sexual health research.MethodsINP and PGD nurses from five UK sexual health services completed a questionnaire, and recorded two weeks of clinical activity in a specifically designed diary, Aug 2015–Aug 2016.ResultsQuestionnaire response rate: 64% (61/95; INP=26/28, 93%; PGD=35/67, 52%). Respondents were mostly female (n=55/61, 90%), aged 35–44years (n=21/61, 34%). INP were mainly Band 7 or above (n=18/26, 69%), educated to Masters Level (n=16/26, 62%); PGD users were mostly Band 6 (n=24/35, 68.6%), educated to Diploma Level (n=13/35, 37%). INP had mean of 2.9 years more sexual health experience than PGD users (mean: INP=13.0; PGD=10.1years). Both groups reported access to medications was essential (n=56/61, 92%) and made their roles easier (n=60/61, 98%).Overall 61% (INP=17/26, 65%; PGD=20/35, 57%) of questionnaire respondents completed the diary. Of the total diary entries (INP=737; PGD=593), INP managed more ‘new’ care episodes (n=512/737, 70%) than PGD users (n=294/593, 50%). There was no difference in medication delivery frequency (INP=460/737, 62%; PGD=348/593, 59%; p=0.16). However, PGD users required additional medication delivery support from other healthcare professionals more often than INP (INP=419/460, 91%; PGD=240/348, 69%; p&lt;0.01). PGD users had marginally shorter patient consultations than INP (mean 22.8 vs. 24.9mins). Mean consultation support was 8mins/consultation (both groups).DiscussionSexual health nurses require independent access to medication for their roles. INP are more likely to practice autonomously, but may spend longer with patients.

Comparison of demographic characteristics and psychiatric comorbidity among methamphetamine-, heroin- and methamphetamine-heroin co- dependent males in Hunan, China

BackgroundThere is little research of psychiatric comorbidity differences among people with different types of drug dependence in Chinese population. We explored demographic and comorbid psychiatric differences among methamphetamine- dependent males (MDs), heroin-dependent males (HDs) and methamphetamine and heroin co-dependent males (M/HDs) in Hunan province, China.MethodsA cross-sectional, structured and clinical interview method was used to examine differences in DSM-IV-TR Axis I Disorders among 346 MDs, 698 HDs and 247 M/HDs from three compulsory rehabilitation centers and two voluntary rehabilitation centers in Hunan.ResultsMDs and M/HDs were younger, more likely to choose inhalation administration, less likely to have a family history of substance use, less likely to have undergone detoxification treatment, had higher incomes and shorter duration of drug use than HDs. Overall, methamphetamine-dependence related to higher rates of current and lifetime psychotic disorders, lifetime hallucinogen use disorders. Heroin-dependence related to higher rates of current and lifetime substance-induced mood disorders, sedative/hypnotic/anxiolytic and other drug use disorders and current alcohol use disorder. For M/HDs, they were more likely to have any other lifetime substance use disorders than MDs and HDs.ConclusionsThere were substantial differences in epidemiological characteristics and comorbidity among MD, HD and M/HD groups, which highlights the urgent need to develop treatment services and policies for drug-specific users in China.

Frontal Intermittent Rhythmic Delta Activity (FIRDA) in the Neurological Intensive Care: Prevalence, Determinants, and Clinical Significance

Frontal intermittent rhythmic delta activity (FIRDA), a transient rhythmic slow wave pattern over the anterior EEG leads, has been reported in a wide variety of cerebral lesions and different metabolic disturbances. Few authors have analyzed the frequency and clinical significance of FIRDA in the critical care setting. We aimed to better understand these issues in our intensive care cohort and if possible, try to delineate its underlying mechanisms. Video-EEG reports of consecutive adult patients in the neurological intensive care unit (NICU) since 2009 were retrospectively reviewed to identify cases with FIRDA. Demographic, clinical, and laboratory data were obtained from EEG reports and patient charts. Age- and sex-matched patients with acute stroke, hospitalized in NICU and no FIRDA on video-EEG monitoring served as the control group. Among 162 patients who underwent video-EEG monitoring, FIRDA was documented in 17%. Female prevalence was 50% and age ranged from 23 to 82 years. Twenty-three (82%) of patients with FIRDA had a diagnosis of stroke. Comparison of demographic characteristics, EEG findings, metabolic disturbances and prognoses revealed no differences between stroke cases with and without FIRDA, except for higher frequency of acute and chronic isolated posterior circulation infarcts in patients with FIRDA. FIRDA is more commonly encountered in the neurocritical care setting as compared with outpatient EEG clinics. Our findings in stroke patients indicate that involved vascular territories may be related to the generation of FIRDA.