Age, Gender, and Liver Enzyme Impact Hospital Stay in COVID-19 Minority Patient with Cancer in the USA: Does Race Matters in the Pandemic?

Patients with cancer are known to have a poor prognosis when infected with SARS-CoV-2 infection. We aimed in this study to assess health outcomes in COVID-19 patients with different cancers in comparison to non-cancer COVID-19 patients from different centers in the United States (US). We evaluated medical records of 1,943 COVID-19 Cancer patients from 3 hospitals admitted between December 2019 to October 2021 and compared them with non-cancer COVID-19 patients. Among 1,943 hospitalized COVID-19 patients, 18.7% (n=364) have an active or previous history of cancer. Among these 364 cancer patients, 222 were African Americans (61.7%) and 121 were Caucasians (33.2%). Cancer patients had significantly longer hospitalization compared to controls (8.24 vs 6.7 days). Overall, Lung cancer is associated with high mortality. Patients with a previous history of cancer were more prone to death (p=0.04) than active cancer patients. In univariate and multivariate analyses, predictors of death among cancer patients were male sex, older age, presence of dyspnea, elevated troponin, elevated AST (0.001) and ALT (0.05), low albumin (p=0.04) and mechanical ventilation (p=0.001). Patients with a previous history of cancer were more prone to death when compared to active cancer COVID-19 patients. Early recognition of cancer COVID-19 patients' death-associated risk factors can help determine appropriate treatment and management plans for better prognosis and outcome.

Factors affecting psychological well-being: Evidence from two nationally representative surveys.

Financial status is thought to be an important determinant of psychological well-being. We investigate this relationship, and the effect of other factors, using a parametric mixed modelling approach for panel data, controlling the problem of unobservable heterogeneity. Two nationally representative surveys, the British Household Panel Survey (BHPS) and the Understanding Society Survey (USS), were used to construct a unified data set which measured psychological well-being and associated factors using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 score for the head of the household was used as the dependant variable and its relationship with multiple independent demographic and financial status variables was investigated. Following assessment of growth curve characteristics with linear, curvilinear and higher-order polynomial modelling; several variance-covariance structures were tested to assess the error covariance structure of the longitudinal data. The random intercept and random slope were allowed to vary across participants, and methods such as natural splines and B-splines were used to improve the fit of some variables. Our final model demonstrated the most important variables affecting self-reported psychological well-being, as determined by GHQ-12, were perception and expectation of future financial situation and problems meeting household expenditure. Gender, age, marital status, number of children at home, highest qualification and job status were also significantly implicated. Unlike previous studies however we did not find that size of income was significant. These results provide further strong evidence of the impact that financial concerns have on self-reported measures of psychological well-being.

Physical activity levels in adults with intellectual disabilities: A systematic review.

Despite evidence that inactivity is a major factor causing ill health in people with intellectual disabilities (pwID) there are gaps in our knowledge of their physical activity (PA). To date, there is no published systematic review of their PA levels. Therefore, we performed a systematic review from January-October 2015, comprising studies from across the globe to establish PA levels, determine how they were measured, and what factors influenced PA in adults with intellectual disabilities (awID). Five databases were searched. Studies were included if written in English, peer-reviewed, had primary research data, and measured PA levels of awID. Quality was assessed using a 19-item checklist. Meta-summary of the findings was performed and a meta-analysis of factors influencing PA using multiple regression. Fifteen studies were included consisting of 3159 awID, aged 16-81 years, 54% male and 46% female. Only 9% of participants achieved minimum PA guidelines. PA levels were measured using objective and subjective methods. ID severity, living in care, gender, and age were independently significantly correlated with the number of participants achieving PA guidelines with the strongest predictor being ID severity (Beta 0.631, p < 0.001). Findings should be in the context that most of the participants were in the mild/moderate range of ID severity and none of the studies objectively measured PA in people with profound ID. To inform measurement and intervention design for improved PA, we recommend that there is an urgent need for future PA studies in awID population to include all disability severity levels. PROSPERO registration number CRD42015016675.

The role of foot and ankle assessment of patients with lower limb osteoarthritis.

OBJECTIVES: Physiotherapists do not routinely examine the feet of patients with lower limb osteoarthritis, and there is no widely used tool for measuring foot posture. However, differences in foot posture have been demonstrated between patients with medial compartment osteoarthritis of the knee and osteoarthritis of the hip, and guidelines for managing these patients include interventions such as orthotics which presume foot assessment. This study considers a new clinical tool, the Foot Posture Index (FPI). It examines its utility in a physiotherapy outpatient setting with a cohort of patients with medial compartment osteoarthritis of the knee and osteoarthritis of the hip, and investigates the relationship of FPI scores with the range of dorsiflexion of the ankle. DESIGN: Cross-sectional observational study. SETTING: A specialist orthopaedic hospital. PARTICIPANTS: In total, there were 60 participants: 20 patients with medial compartment osteoarthritis of the knee, 20 patients with osteoarthritis of the hip, and a control group of 20 age-matched healthy volunteers. OUTCOME MEASURES: A single measurement of the FPI and range of dorsiflexion. RESULTS: Significant differences in FPI scores and range of dorsiflexion were seen between groups. On average, patients with osteoarthritis of the hip had more supinated, plantarflexed feet, and patients with medial compartment osteoarthritis of the knee had pronated feet. Healthy controls fell within the normal range. Patients with osteoarthritis of the hip had a median FPI score of -4.5, patients with medial compartment osteoarthritis of the knee had a median FPI score of 7.0, and the healthy controls had a median FPI score of 1.0. The median difference in FPI scores between patients with osteoarthritis of the hip and medial compartment osteoarthritis of the knee was 12 [95% confidence interval (CI) 10 to 13]; between patients with osteoarthritis of the hip and the healthy group was 6 (95% CI 3 to 9); and between patients with medial compartment osteoarthritis of the knee and the healthy group was 5 (95% CI 3 to 8). The median difference in dorsiflexion scores between patients with osteoarthritis of the hip and medial compartment osteoarthritis of the knee was 10 degrees (95% CI 8 to 15); between patients with osteoarthritis of the hip and the healthy group was 10 degrees (95% CI 7 to 15); and between patients with medial compartment osteoarthritis of the knee and the healthy group was 0 degrees (95% CI -3 to 5). Foot posture and range of dorsiflexion were moderately positively correlated (rho 0.57), with pronated feet having a greater range of dorsiflexion. CONCLUSION: The FPI is sufficiently sensitive to measure differences in foot posture of patients with medial compartment osteoarthritis of the knee and osteoarthritis of the hip, and is easy to use. Accurate foot assessment is useful as foot postures may be influenced by specific physiotherapy treatment modalities and orthotic interventions.

Identifying the perception of needs of family members visiting and nurses working in the intensive care unit.

Recent initiatives encourage a family presence during cardiopulmonary resuscitation and invasive procedures and more open visitation policies in intensive care units (ICUs). This study investigated perceptions of needs of those visiting and working in six ICUs. The needs of family members visiting patients with critical illness and nurses working in ICUs were measured using the Critical Care Family Needs Inventory. Data were collected prospectively using a convenience sample of 101 patients, family members, and nurses. Hierarchical cluster analysis identified the themes of (a) emotional resources and support, (b) trust and facilitation of needs, (c) treatment information, and (d) feelings. Family members and nurses differed significantly on three of the four themes (p = .000). This is important information for neuroscience nurses and other healthcare professionals to consider in providing care, setting visiting policies in ICUs, and developing approaches such as family-centered care.