Demographic Characteristics Of Adults Research Articles

A study of the clinical and demographic characteristics of adults with an intellectual disability who remain in learning disability assessment and treatment units despite being clinically ready for discharge

AbstractBackgroundThis study investigated differences in the clinical and demographic characteristics of individuals with intellectual disabilities delayed in assessment and treatment hospitals versus individuals who were not delayed. The study further investigated the clinical outcomes of the individuals whose discharge from the hospital was delayed.MethodThis was a cohort study using secondary data collected from patient records. Variables included age, ethnicity, levels of deprivation, areas of origin, diagnoses, and the provision of a care and treatment review. A comparison was made between individuals who became delayed despite being clinically ready for discharge and those who were discharged on time.FindingsIndividuals with severe intellectual disabilities were more likely to experience delayed discharge from hospital (p = 0.001). Similarly, people who were admitted to hospitals away from their home areas were also more likely to experience delayed discharge (p < 0.001). There were no significant differences between the delayed and nondelayed groups for other factors such as age, deprivation or ethnicity. Individuals who experienced a delay in discharge did not experience an increased rate of adverse incidents compared to the period of active treatment and clinical improvements were maintained during the period of delay. There were low rates of completion of care and treatment reviews before admission, although people who were delayed were more likely to have received a review during admission (78.8% vs. 27.1%).ConclusionIt is important for clinicians and service development leads to be aware that people who are admitted away from their home area and people with severe intellectual disabilities may be at higher risk of experiencing significantly delayed discharge from the hospital. More broadly, many people remained in hospital for a substantial length of time after being assessed as clinically ready for discharge. Due to the low rates of completion before admission, the expansion of community‐based care and treatment reviews should also be explored. While people did not suffer increased rates of adverse incidents during their extended stay, their liberty was still restricted, hence there should be a focus on effective community provision. The current model of relying on the willingness of independent providers to support the care of complex individuals requires significant reform.

Characteristics of Adults Undergoing Soft Tissue and Orthognathic Surgery for Obstructive Sleep Apnea.

To identify clinical and demographic characteristics of adults with obstructive sleep apnea (OSA) undergoing soft tissue and orthognathic sleep surgery, assess temporal trends in surgery type and proportion of women undergoing surgery, and provide clinical perspective before wide-spread implementation of hypoglossal nerve stimulation (HGNS). In a retrospective cohort study, adults diagnosed with OSA from 2009 to 2016 were identified in a large integrated healthcare system. Characteristics between cohort members who did and did not undergo sleep surgeries were compared. Multivariable logistic regression models examined associations of different characteristics with whether surgery was performed. Of 172,216 adults with OSA, 2,262 (1.3%) underwent sleep surgery during 2009-2017. The most common sleep surgery was palate surgery (56.9%), which decreased proportionately over time. In multivariable analysis, older age and obesity were associated with lower odds of undergoing surgery. Those who underwent tonsillectomy and adenoidectomy were more likely to have larger tonsils and not require additional surgery, whereas tongue reduction recipients were more likely to have severe OSA and require multiple surgery types. The proportion of women undergoing surgery increased over time (p< 0.001 from trend test). Clinical and demographic characteristics associated with soft tissue and orthognathic sleep surgery were identified in a large adult cohort prior to widespread implementation of HGNS. An increase in sleep surgery among women and a decrease in palate surgery over time were observed. The findings provide clinical perspective on sleep surgery performed prior to implementation of HGNS and may inform future studies examining its associations with patient characteristics. 3 Laryngoscope, 133:1262-1270, 2023.

Clinical Features of Patients Hospitalized for All Routes of Anthrax, 1880-2018: A Systematic Review.

Anthrax is a toxin-mediated zoonotic disease caused by Bacillus anthracis, with a worldwide distribution recognized for millennia. Bacillus anthracis is considered a potential biowarfare agent. We completed a systematic review for clinical and demographic characteristics of adults and children hospitalized with anthrax (cutaneous, inhalation, ingestion, injection [from contaminated heroin], primary meningitis) abstracted from published case reports, case series, and line lists in English from 1880 through 2018, assessing treatment impact by type and severity of disease. We analyzed geographic distribution, route of infection, exposure to anthrax, and incubation period. Data on 764 adults and 167 children were reviewed. Most cases reported for 1880 through 1915 were from Europe; those for 1916 through 1950 were from North America; and from 1951 on, cases were from Asia. Cutaneous was the most common form of anthrax for all populations. Since 1960, adult anthrax mortality has ranged from 31% for cutaneous to 90% for primary meningitis. Median incubation periods ranged from 1 day (interquartile range [IQR], 0-4) for injection to 7 days (IQR, 4-9) for inhalation anthrax. Most patients with inhalation anthrax developed pleural effusions and more than half with ingestion anthrax developed ascites. Treatment and critical care advances have improved survival for those with systemic symptoms, from approximately 30% in those untreated to approximately 70% in those receiving antimicrobials or antiserum/antitoxin. This review provides an improved evidence base for both clinical care of individual anthrax patients and public health planning for wide-area aerosol releases of B. anthracis spores.

1717. Relationship between Neighborhood Census-tract Level Poverty and Respiratory Syncytial Virus (RSV)-associated Hospitalizations in U.S. adults, 2015-2017

BackgroundIn the U.S., RSV is increasingly recognized as a cause of hospitalization for adults with respiratory illness. In adults > 50 years of age, it accounts for up to 12% of medically-attended acute respiratory illnesses and has a case fatality proportion of ~ 6–8%. Poverty can have important influences on health on both the individual level as well as the community level. Few studies have evaluated the relationship of RSV and poverty level, and no identified studies have evaluated this relationship among adults. We evaluated the incidence of RSV-associated hospitalizations in adults across multiple sites in the U.S. by census-tract (CT) level poverty.MethodsMedical record data abstraction was conducted for all adults with a laboratory-confirmed RSV infection admitted to a hospital within the Centers for Disease Control and Prevention’s Emerging Infections Program catchment areas within California, Georgia, Maryland, Minnesota, New York, and Tennessee during the 2015–2017 RSV seasons (October-April). Patient addresses were geocoded to their corresponding CT. CTs were divided into four levels of poverty, as selected in prior publications, based on American Community Survey data of percentage of people living below the poverty level: 0–4.9%, 5–9.9%, 10-19.9%, and ³20%. Incidence rates were calculated by dividing the number of RSV cases in each CT poverty-level (numerator) by the number of adults living in each CT poverty level (denominator), as determined from the 2010 US census, and standardized for age.ResultsThere were 1713 RSV case-patients with demographic characteristics (Table 1). The incidence of RSV-associated hospitalizations of adults increased with increasing CT level poverty (Figure 1 and Table 2). The risk of RSV-associated hospitalization was 2.58 times higher in census tracts with the highest (20%) versus the lowest (< 5%) percentages of individuals living below the poverty level.Table 1: Demographic characteristics of adults with an RSV-associated hospitalization, 2015-2017. Figure 1. Age-adjusted incidence rate of RSV-associated hospitalizations of adults by census-tract poverty level, 2015-2017 Table 2. Incidence rate ratios for RSV-associated hospitalizations of adults by census-tract poverty level, 2015-2017. ConclusionThe incidence rate of RSV-associated hospitalization in adults appears to have a positive association with increasing CT level of poverty; however, this trend reached significance only among cases living in CTs with higher percentages of poverty (≥ 10%).Disclosures Evan J. Anderson, MD, Sanofi Pasteur (Scientific Research Study Investigator)

Prediabetes and Their Contributed Factors: A Study in Semarang

&lt;p&gt;Background. Prediabetes is a condition when blood glucose levels are above normal but do not yet meet the criteria for diabetes mellitus. Many people have already been diagnosed with prediabetes. However, there is little data that shows the prevalence and characteristics of people with prediabetes.&lt;/p&gt;&lt;p&gt;Objective. To identify the prevalence and demographic characteristics of adults with prediabetes in Semarang, Central Java, Indonesia.&lt;/p&gt;&lt;p&gt;Method. A cross-sectional study conducted in 21 Puskesmas (public health centers) in Semarang which were randomly selected from a total of 37 Puskemas. Out of 123 respondents participating in this study, 105 respondents met the inclusion criteria of the study. Oral Glucose Test Tolerance (OGTT) was done after peripherally screening for random glucose levels. Univariate analysis was performed to calculate the frequency and percentage of each variable.&lt;/p&gt;&lt;p&gt;Results. The result shows that the prevalence of adult respondents with prediabetes in this study accounted for 17.14%. This study also found that the respondents’ mean age was 38.57 ± 14.84. The majority of the respondents were women (66.7%). They have normal BMI, yet higher waist circumference (23.82 ± 4.48; 83.13 ± 11.34), respectively.&lt;/p&gt;&lt;p&gt;Conclusion. Prediabetes is prevalent among adults in Semarang. Thus, to control the incidence of uncontrolled DM, screening needs to be done to identify individuals with prediabetes in order to prevent it from developing into DM. In addition, the application of healthy lifestyle interventions among adults at risk of diabetes also needs to be improved.&lt;/p&gt;

The relationship between the experience of stuttering and demographic characteristics of adults who stutter

PurposeThis study aims to examine the association between adults’ experience of stuttering and their age, gender and marital status, as well as to evaluate the psychometric properties of the Hebrew version of the OASES-A. MethodsThe Hebrew version of the OASES-A was administered to 91 adults-who-stutter. The validity of the translated version was evaluated using a subset of 43 participants, who also completed three additional instruments: (a) a Perceived Stuttering Severity (PSS) self-rating scale, (b) the Situation Avoidance Behavior Checklist (SABC), (c) the Students Life Satisfaction scale (SLSS). Finally, the correlations between the participants’ OASES-A scores and their age, gender and marital status were calculated. ResultsA negative correlation was found between the participants’ OASES-A impact scores and their age (p<0.01). In addition, married participants exhibited lower OASES-A impact scores compared with unmarried participants (p<0.05). On the other hand, the speakers’ gender was not associated with OASES-A impact scores. Resultsrevealed high internal consistency of the Hebrew OASES-A, and moderate to strong correlations with the additional examined instruments. Finally, results of the Hebrew version of the questionnaire were comparable with those obtained in other languages. ConclusionOur results indicated that, within our cohort, age and marital status are significantly associated with the personal experience of stuttering, whereas gender is not. In addition, the Hebrew version of the OASES-A is valid and comparable with equivalent versions in other languages. This facilitates the application of the OASES-A in future clinical and research settings.

The Socio‐Economic Determinants of HIV/AIDS Infection Rates in Lesotho, Malawi, Swaziland and Zimbabwe

Using data from the Demographic and Health Survey, this article analyses the relationship between HIV status and the socio‐economic and demographic characteristics of adults in Lesotho, Malawi, Swaziland and Zimbabwe. It constructs the risk profile of the average adult, computes the values of age, education and wealth where the estimated probability of infection assumes its highest value, and determines the percentage of adults for whom these three factors are positively correlated with that probability. It finds that in all four countries: (i) the probability of being HIV‐positive is higher for women than for men; (ii) the likelihood of infection is higher for urban than for rural residents; and (iii) there is an inverted‐U relationship between age and HIV status. Also that, unlike gender, rural/urban residence and age, the relationship between the probability of infection and wealth, education and marital status varies by country. The results provide support for country‐specific and more targeted HIV policies and programmes.