- The study aimed to determine if the risk of pneumonia for patients prescribed honey thick liquids is equal to or lower than the general population by analyzing medical records of 100 patients prescribed honey thick liquids.
- The cumulative incidence of pneumonia was 5% at 3 months for both the honey thick liquid group and general population, 1% higher for the honey thick liquid group at 6 months, and 4% lower for the honey thick liquid group at 12 months.
- No definitive conclusions could be drawn due to limitations including sample size, variability in medical histories, and pneumonia diagnoses not specifically being aspiration pneumonia. Larger studies were recommended.
Long term effect of a self regulation education on inhaled anti-inflammatory
Noreen M. Clark
Center for Managing Chronic Disease
University of Michigan
Acrolein and COPD in a Nationally Representative Sample of United States Adul...REY DECASTRO
BACKGROUND: Acrolein is an air toxic and tobacco smoke toxicant that laboratory studies suggest may adversely affect pulmonary function. There is strikingly little epidemiology available, however, even though US EPA's 2005 National-Scale Air Toxics Assessment (NATA) estimates that acrolein is responsible for about 75 percent of non-cancer respiratory health effects attributable to air toxics in the United States. AIMS: Characterize the association between model-estimated outdoor acrolein exposure and the prevalence of self-reported COPD. METHODS: Sample-weighted statistical analysis characterized the association between self-reported doctor-diagnosed COPD ("emphysema") and NATA acrolein exposure estimates at the census tract geographically linked to residences of subjects ≥55-years-old in the National Health Interview Survey (NHIS) 2000 - 2009 (n = 89,475). RESULTS: Preliminary results indicate that among never smokers and never & former smokers, outdoor acrolein exposure (1.38E-4 to 4.57E-1 ug/m3) was not associated with COPD prevalence at a statistically significant level, controlling for potential confounders. CONCLUSIONS: Outdoor acrolein exposure is unrelated to COPD prevalence in a nationally representative sample of United States adults 55 and over.
Clinical Trials in Peru have been declining in the last 6 years, Counting number of protocols presented per Year is not necessarily a good metrics. Here is something different that merits a debate.
Dr Martin Bardsley: Use of Retrospective Matching Methods 30 June 2014Nuffield Trust
Martin Bardsley, Director of Research, Nuffield Trust explores the use of retrospective matching methods to study health services and other sectors.
Dr Martin Bardsley spoke at the Nuffield Trust event: The future of the hospital, in June 2014.
My SRH My Choice: Wading through University Student’s Engagement in High Risk...iConferences
Prepared by Mary Njeri Wanjau, Pan Africa Christian University Kenya for International Conference on Public Health and Well-being 2019, 4-5 April, Negombo, Sri Lanka
A series of Be Clear on Cancer awareness events were held prior to the campaign launch in Autumn 2013. These slides are from the London event on 10 September 2012
The events included:
An update on the 'Blood in Pee' campaign Oct-Nov 2013
Sharing experiences from BCOC pilots
A review of the impact of the BCOC campaigns
Latest plans for BCOC February 20145 campaigns
An opportunity for delegates to feedback on experience of campaigns and make suggestions for improvement
Events were aimed at SCNs - Programme leads, Clinicians, Public Health, National NAEDI Partners - DH, Public Health England, NHS England and Charities
Long term effect of a self regulation education on inhaled anti-inflammatory
Noreen M. Clark
Center for Managing Chronic Disease
University of Michigan
Acrolein and COPD in a Nationally Representative Sample of United States Adul...REY DECASTRO
BACKGROUND: Acrolein is an air toxic and tobacco smoke toxicant that laboratory studies suggest may adversely affect pulmonary function. There is strikingly little epidemiology available, however, even though US EPA's 2005 National-Scale Air Toxics Assessment (NATA) estimates that acrolein is responsible for about 75 percent of non-cancer respiratory health effects attributable to air toxics in the United States. AIMS: Characterize the association between model-estimated outdoor acrolein exposure and the prevalence of self-reported COPD. METHODS: Sample-weighted statistical analysis characterized the association between self-reported doctor-diagnosed COPD ("emphysema") and NATA acrolein exposure estimates at the census tract geographically linked to residences of subjects ≥55-years-old in the National Health Interview Survey (NHIS) 2000 - 2009 (n = 89,475). RESULTS: Preliminary results indicate that among never smokers and never & former smokers, outdoor acrolein exposure (1.38E-4 to 4.57E-1 ug/m3) was not associated with COPD prevalence at a statistically significant level, controlling for potential confounders. CONCLUSIONS: Outdoor acrolein exposure is unrelated to COPD prevalence in a nationally representative sample of United States adults 55 and over.
Clinical Trials in Peru have been declining in the last 6 years, Counting number of protocols presented per Year is not necessarily a good metrics. Here is something different that merits a debate.
Dr Martin Bardsley: Use of Retrospective Matching Methods 30 June 2014Nuffield Trust
Martin Bardsley, Director of Research, Nuffield Trust explores the use of retrospective matching methods to study health services and other sectors.
Dr Martin Bardsley spoke at the Nuffield Trust event: The future of the hospital, in June 2014.
My SRH My Choice: Wading through University Student’s Engagement in High Risk...iConferences
Prepared by Mary Njeri Wanjau, Pan Africa Christian University Kenya for International Conference on Public Health and Well-being 2019, 4-5 April, Negombo, Sri Lanka
A series of Be Clear on Cancer awareness events were held prior to the campaign launch in Autumn 2013. These slides are from the London event on 10 September 2012
The events included:
An update on the 'Blood in Pee' campaign Oct-Nov 2013
Sharing experiences from BCOC pilots
A review of the impact of the BCOC campaigns
Latest plans for BCOC February 20145 campaigns
An opportunity for delegates to feedback on experience of campaigns and make suggestions for improvement
Events were aimed at SCNs - Programme leads, Clinicians, Public Health, National NAEDI Partners - DH, Public Health England, NHS England and Charities
A series of Be Clear on Cancer awareness events were held prior to the campaign launch in Autumn 2013. These slides are from the Leeds event on 4 September 2012
The events included
An update on the 'Blood in Pee' campaign Oct-Nov 2013
Sharing experiences from BCOC pilots
A review of the impact of the BCOC campaigns
Latest plans for BCOC February 20145 campaigns
An opportunity for delegates to feedback on experience of campaigns and make suggestions for improvement
Events were aimed at SCNs - Programme leads, Clinicians, Public Health, National NAEDI Partners - DH, Public Health England, NHS England and Charities
Functional kidney disorders and structural urinary tract abnormalities are the significant problems in paediatric age group.1 The main etiologic factors of chronic kidney disease (CKD) in children are steroid-resistant nephrotic syndrome, chronic glomerulonephritis
(e.g. lupus nephritis, Alport syndrome) and renal ciliopathies. Less common causes of CKD in children include thrombotic microangiopathies (especially atypical haemolytic uraemic syndrome), nephrolithiasis / nephrocalcinosis, Wilms tumour
infectious and interstitial diseases, and others. However, minor reductions in nephron numbers that are seen in low-birth weight and small for gestational age newborns are now emerging as important predisposing factors to CKD and will come to represent an important
in this slide you will learn about
what is screening
types and uses of screening
difference between screening and diagnostic tests
criteria of screening
and
evaluation of screening tests
Dr Paba Palihawadana, Chief Epidemiologist, World Hepatitis Day symposium was organized by the Sri Lanka College of Venereologists on world hepatitis day on 28. July 2015 at BMICH
'Use of linked health care data for research: experiences with the Hampshire ...Health Innovation Wessex
The fifth presentation delivered at the 'Big Data in health and care: using data to gain new insights’ event, hosted by Wessex Academic Health Science Network (AHSN) on 19 April 2015.
Acute otitis media (AOM), a viral or bacterial infection of the middle ear, is the common infection for which antibiotics are prescribed for children in the United States [1]. Direct and indirect costs of treatment and time lost from school and work because of acute otitis media totalled nearly $3 billion in 1996 Acute otitis media is most common between six and 24 months of age; by age three, more than 80 percent of children have been diagnosed. Otitis media with effusion is middle ear effusion in the absence of acute infection. About 2.3 million cases of otitis media with effusion occur annually in the United States. Chronic supportive otitis media is persistent infection and typically resultant perforation of the tympanic membrane [
1. Cleveland Clinic
Science Internship Program
A Retrospective Study of Patients Prescribed
Honey Thick Liquids on Pneumonia Incidence
Sunder Sai, Marianne Douglas, MS, CCC/SLP,
Carolyn Balogh, MA, CCC/SLP, Kelly Staruch, MA, CCC/SLP
Cleveland Clinic-Marymount Hospital
Hypothesis
Methodology
• The incidence of pneumonia in the population
receiving honey thick liquids does not exceed the
incidence in the general population of a regional
hospital
• 100 patients who were on honey thick liquids were
selected from medical records from the year 2010 to
July of 2012.
• Using EPIC each patient was identified for pneumonia
1-3 months cumulative, 3-6 months cumulative, and 6-
12 months cumulative after prescribed honey thick
liquids
Diagnosis of pneumonia was diagnosed by the
physician and identified through medical records
• Urinary Tract Infection was tracked 6 months after
prescribed honey thick liquids
• Dehydration was tracked 12 months after prescribed
honey thick liquids
Data
Data
Conclusions
• No definitive conclusions can be made comparing sample
groups. The cumulative incidence of pneumonia at 3 months
cumulative for the honey thick liquid group was equal to the
general population group for the years 2010-2012 (5%)
• The cumulative incidence of pneumonia at 6 months was 1%
greater than the cumulative average pneumonia rate for the
years 2010-2012
• The cumulative incidence of pneumonia at 1 year was 4%
lower than the cumulative average pneumonia rate for the
years 2010-2012 (5%)
Recommendations
• Replicate the study with a larger sample size
• Repeat the study comparing patients on honey thick liquids
to another control group
• Narrow data collection for the pneumonia diagnosis from
general pneumonia to aspiration pneumonia
• Obtain data collection from subjects with similar medical
histories
• Analyze patient need for thickened liquids up to a year
following video swallow
• Examine UTI/Dehydration for further analysis
Introduction
• Pneumonia
Pneumonia is one of the leading causes of
hospitalization and mortality in the United States
(Niederman, MS, Mandell, LA, Anzueto, A, et al, 2001)
The most common cause of infectious death in
the U.S. among persons over age 65 (LaCroix,
Lipson, Miles, & White, 1989)
It is the third leading cause of death for
persons over 85 (LaCroix, Lipson, Miles, & White,
1989)
Pneumonia is the top ranked diagnoses at
Marymount hospital for the years 2010, 2011,
and 2012 (Marymount Data Analysis, 2012)
• Aspiration Pneumonia
Infection in the bases of the lungs secondary to
weakness, lack of coordination, or decrease
sensation of the throat muscles common in
stroke
• Diagnosis of Dysphagia
Dysphagia: difficulty/inability to swallow
safely/efficiently
Video swallow tests are taken to see the
patient’s swallowing
Patient swallows liquid barium while X-Ray
records images. This indicates if food/liquids
enter lungs
• Thicknesses of Liquids
If aspiration is noted then a certain thickness of
liquid is prescribed
The thickness of liquid in the diet is prescribed
to prevent further aspiration and ultimately
pneumonia
Study Aims
• Honey thick liquids are most commonly used to
prevent aspiration pneumonia (Groher & McKaig,
1995)
There is little evidence to evaluate the
effectiveness of honey thick liquids
• The aim is to determine if the risk of pneumonia
for patients receiving honey thick liquids is equal
or less than the general population
Sample Size
• 100 randomized patients on honey thick liquids from
1/6/2010 – 6/2/2011 will be analyzed
All underwent video swallow procedure
All received honey thick liquids
• All patients are from an age range of 50-100 years
Pneumonia Rate per 100 of Honey Thick Liquids
5
1
6
999495
0
10
20
30
40
50
60
70
80
90
100
1-3 months 3-6 months 6-12 months
Time
NumberofPatients
Yes
No
Dehydration 12months
After
95%
5%
Yes
No
UTI 6months After
11%
89%
Yes
No
2011
5%
95%
2010 4%
96%
Yes
No
2012
6%
94%
Marymount
Hospital
Pneumonia
Rate
Limitations
• Physician’s diagnosis of pneumonia as indicated in the
medical records, not verified by X-Ray
• Patient’s compliance with honey thick liquids upon
discharge from hospital
• Patient necessity of honey thick liquids up to a year
following video swallow
• Research from medical records in the EPIC online
database
• Pneumonia diagnosis in the Marymount population
included general pneumonia cases and not specifically
aspiration pneumonia
• Varied medical histories across the study and control
groups
• A previous study cited pneumonia incidence of 20-40% in
elderly patients with stroke, dementia, or Parkinson's
disease, or residing in nursing homes (Robbins 2008).
• In the same study pneumonia incidence for patients on all
interventions (chin down, nectar, and honey) was 11% at
the 3 month cumulative interval (Robbins 2008).
• The cumulative 3 month incidence rate of pneumonia in
our honey thick liquid sample group was 5%, thus
significantly lower than the 11% noted in the previous
study
Conclusions