Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Children's cultural background knowledge and story telling performance

Contains fulltext : 62989.pdf (publisher's version ) (Closed access)The cultural context in which a child is raised influences her cognitive system and language behavior. In this paper, we explored the influence of cultural back ground knowledge on story telling performance of two groups of children living in the Netherlands: (1) bilingual ethnic minority children from immigrant families of Islamic background(2) monolingual Dutch children. Using a within-subject design, all children retold, continued, and finished three story beginnings: One story dealt with a topic related to the ethnic minority children's cultural background(Ramadan), one story dealt with a topic related to the Dutch children's cultural background(Carnival), and one story dealt with a topic both groups of children were familiar with (playing at the schoolyard). All children spoke in Dutch, which implies that the ethnic minority children performed all tasks in a language other than their family language, whereas the Dutch children performed the same tasks in their native language. It appeared that both quantitative and qualitative characteristics of the stories were influenced by the children's cultural background knowledge. Measurements of story length showed that ethnic minority children's Ramadan stories were longer than their Carnival stories, whereas Dutch children's Carnival stories were longer than their Ramadan stories. Likewise, the ethnic minority children's Ramadan stories containedmore connective ties(as indexed by the number of conjunctions used) than their Carnival stories, whereas the reverse pattern was observed in Dutch children. These findings indicate that cultural familiarity with a topic influences story telling performance in terms of story length and coherence.21 p