Proceedings of Patient Reported Outcome Measure’s (PROMs) Conference Oxford 2017: Advances in Patient Reported Outcomes Research

A33-Effects of Out-of-Pocket (OOP) Payments and Financial Distress on Quality of Life (QoL) of People with Parkinson’s (PwP) and their Carer

World Health Organization cardiovascular disease risk charts: revised models to estimate risk in 21 global regions

BACKGROUND: To help adapt cardiovascular disease risk prediction approaches to low-income and middle-income countries, WHO has convened an effort to develop, evaluate, and illustrate revised risk models. Here, we report the derivation, validation, and illustration of the revised WHO cardiovascular disease risk prediction charts that have been adapted to the circumstances of 21 global regions. METHODS: In this model revision initiative, we derived 10-year risk prediction models for fatal and non-fatal cardiovascular disease (ie, myocardial infarction and stroke) using individual participant data from the Emerging Risk Factors Collaboration. Models included information on age, smoking status, systolic blood pressure, history of diabetes, and total cholesterol. For derivation, we included participants aged 40-80 years without a known baseline history of cardiovascular disease, who were followed up until the first myocardial infarction, fatal coronary heart disease, or stroke event. We recalibrated models using age-specific and sex-specific incidences and risk factor values available from 21 global regions. For external validation, we analysed individual participant data from studies distinct from those used in model derivation. We illustrated models by analysing data on a further 123 743 individuals from surveys in 79 countries collected with the WHO STEPwise Approach to Surveillance. FINDINGS: Our risk model derivation involved 376 177 individuals from 85 cohorts, and 19 333 incident cardiovascular events recorded during 10 years of follow-up. The derived risk prediction models discriminated well in external validation cohorts (19 cohorts, 1 096 061 individuals, 25 950 cardiovascular disease events), with Harrell's C indices ranging from 0·685 (95% CI 0·629-0·741) to 0·833 (0·783-0·882). For a given risk factor profile, we found substantial variation across global regions in the estimated 10-year predicted risk. For example, estimated cardiovascular disease risk for a 60-year-old male smoker without diabetes and with systolic blood pressure of 140 mm Hg and total cholesterol of 5 mmol/L ranged from 11% in Andean Latin America to 30% in central Asia. When applied to data from 79 countries (mostly low-income and middle-income countries), the proportion of individuals aged 40-64 years estimated to be at greater than 20% risk ranged from less than 1% in Uganda to more than 16% in Egypt. INTERPRETATION: We have derived, calibrated, and validated new WHO risk prediction models to estimate cardiovascular disease risk in 21 Global Burden of Disease regions. The widespread use of these models could enhance the accuracy, practicability, and sustainability of efforts to reduce the burden of cardiovascular disease worldwide. FUNDING: World Health Organization, British Heart Foundation (BHF), BHF Cambridge Centre for Research Excellence, UK Medical Research Council, and National Institute for Health Research

Siglo cero : boletín de la Federación Española de Asociaciones Protectoras de Subnormales

Resumen tomado de la revistaEste artículo utiliza los criterios establecidos por Zarb para describir investigaciones llevadas a cabo con personas con dificultades de aprendizaje en el contexto del paradigma emancipatorio que está surgiendo. Primero, se plantea la pregunta de ¿quién controla la investigación y de qué trata? Así, tiene en cuenta la consulta a las personas con dificultades de aprendizaje, la influencia de la organización en los servicios públicos y un comité ético. En segundo lugar, el artículo evalúa cuánto se involucran las personas con discapacidad en el proceso de investigación y discute las cuestiones relacionadas con la inclusión de personas con dificultades de aprendizaje como informadores, acerca de cómo se obtiene el consentimiento de la información y acerca de la participación de los cuidadores en las entrevistas. Finalmente, el artículo analiza las siguientes preguntas: ¿qué oportunidades existen para las personas con discapacidad para criticar la investigación e influir en su futura dirección? y ¿qué pasa con los resultados de la investigación? También se describen el papel de un estudio piloto, las oportunidades para ofrecer retroalimentación y las estrategias de diseminación de la información.MadridBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; [email protected] de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; [email protected]

The immunology of hydrocephalus shunt infections

A serological test suitable for the detection of agglutinating antibody in ventriculoatrial (VA) shunt colonisation, developed twenty years ago, does not however, detect rising titres in ventriculoperitoneal (VP) shunt infections. Diagnosis of VP shunt colonisation depends upon clinical presentation which is variable and often unhelpful. A suitable serological test is therefore required as VP shunts now constitute the majority. Different antigens which included polysaccharide B extracted from the cell walls of coagulase negative staphylococci (CNSt) by buffers of differing pH, and a whole cell protein antigen obtained by sonication were used in an ELISA test. Both antigens were found to detect antibody in those with infected VA and VP shunts. Differences in the IgM and IgG response to infection could also be assessed. SDS-PAGE and immunoblotting studies were made to determine important epitopes involved in shunt infection due to CNSt. Three strains of St. epidermidis. two slime positive (F743 & FI 1) and one slime negative (F544) as determined by a quantitative assay were utilised. No bands were found in uninfected cases, but bands did appear in response to infection in both VA and VP shunts. Bands of between 29 and 205KDa were found in those with VA shunt infection but were limited to a molecular weight of up to 97KDa in those with VP shunts. The dissimilarity in band response suggests a difference in antigen processing and presentation. No major difference in band response using immunoblotting was noted between slime-producers and non-slime producers, although increased absorbance values were seen in those producing slime using ELISA, The antigenicity of purified slime was investigated by IV inoculation into rabbits. Antibody to slime was detected by ELISA but only in combination with other molecules indicating its role as a hapten. The excretion of slime in urine was also investigated by electrophoresis but results were disappointing. Bands were seen upon electrophoresis in those who were infected but could not be used to differentiate between different gram positive infections. These bands were thought to be peptidoglycan in nature. The agglutinating test was further examined and an IgM response defined. The action of proteolytic enzymes on the antigen used did not alter titres of known positive sera, but antibiotics affecting cell polysaccharide production did so, suggesting the importance of such an epitope in the immune response in this test. The importance of serology in shunt nephritis due to immune complexes was also reviewed

MAD ABOUT THE BOY / Noel Coward. DANCING ON THE CEILING / Richard Rodgers, Lorenz Hart. HOW DEEP IS THE OCEAN / Irving Berlin. SOMEDAY I'LL FIND YOU / Noel Coward ; orch. dir. Jackie Gleason

BnF-Partenariats, Collection sonore - BelieveContient une table des matière

Community Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 Disproportionately Affects the Latinx Population During Shelter-in-Place in San Francisco.

BackgroundThere is an urgent need to understand the dynamics and risk factors driving ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission during shelter-in-place mandates.MethodsWe offered SARS-CoV-2 reverse-transcription polymerase chain reaction (PCR) and antibody (Abbott ARCHITECT IgG) testing, regardless of symptoms, to all residents (aged ≥4 years) and workers in a San Francisco census tract (population: 5174) at outdoor, community-mobilized events over 4 days. We estimated SARS-CoV-2 point prevalence (PCR positive) and cumulative incidence (antibody or PCR positive) in the census tract and evaluated risk factors for recent (PCR positive/antibody negative) vs prior infection (antibody positive/PCR negative). SARS-CoV-2 genome recovery and phylogenetics were used to measure viral strain diversity, establish viral lineages present, and estimate number of introductions.ResultsWe tested 3953 persons (40% Latinx; 41% White; 9% Asian/Pacific Islander; and 2% Black). Overall, 2.1% (83/3871) tested PCR positive: 95% were Latinx and 52% were asymptomatic when tested; 1.7% of census tract residents and 6.0% of workers (non-census tract residents) were PCR positive. Among 2598 tract residents, estimated point prevalence of PCR positives was 2.3% (95% confidence interval [CI], 1.2%-3.8%): 3.9% (95% CI, 2.0%-6.4%) among Latinx persons vs 0.2% (95% CI, .0-.4%) among non-Latinx persons. Estimated cumulative incidence among residents was 6.1% (95% CI, 4.0%-8.6%). Prior infections were 67% Latinx, 16% White, and 17% other ethnicities. Among recent infections, 96% were Latinx. Risk factors for recent infection were Latinx ethnicity, inability to shelter in place and maintain income, frontline service work, unemployment, and household income <$50 000/year. Five SARS-CoV-2 phylogenetic lineages were detected.ConclusionsSARS-CoV-2 infections from diverse lineages continued circulating among low-income, Latinx persons unable to work from home and maintain income during San Francisco's shelter-in-place ordinance