Browsing by Subject "mortality rates"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Evidence Based Breast Cancer Interventions Targeting Black American Women
    (Office of the Vice Chancellor for Research, 2015-04-17) Watts, Thomasina; Henry-Anthony, Ronda
    In the United States, Black American women tend to have more invasive types of breast cancer at a younger age than White American women, and also tend to have a higher mortality rates than White, Latina, and Asian-American women (DeSantis, 2013). In order to address these issues, public health research has focused on developing early detection programs and increasing mammography availability. Despite these efforts, there has been a continuous rise in the incidence rates among Black American women throughout the United States, suggesting that there have been complications with program execution. This research project examines the evidence based interventions that have been proven to be effective within minority and Black American communities. Research has proven that there are some health interventions that are particularly effective for disadvantaged minorities. Examples include lay education, social network outreach, and culturally appropriate intervention delivery. Research has so far included reviews of current literature and interviews with public health workers who specialize in minority health interventions. Future community health research will explore the possibility of large scale replication in both urban and rural communities, which could lead to an overall decrease in breast cancer incidences population wide.
  • Thumbnail Image
    Item
    Infection Fatality Ratios for COVID-19 Among Noninstitutionalized Persons 12 and Older: Results of a Random-Sample Prevalence Study
    (ACP, 2021-01) Blackburn, Justin; Yiannoutsos, Constantin T.; Carroll, Aaron E.; Halverson, Paul K.; Menachemi, Nir; Health Policy and Management, School of Public Health
  • Thumbnail Image
    Item
    Microfinance, retention in care, and mortality among patients enrolled in HIV 2 Care in East Africa
    (Wolters Kluwer, 2021-10) Genberg, Becky L.; Wilson-Barthes, Marta G.; Omodi, Victor; Hogan, Joseph W.; Steingrimsson, Jon; Wachira, Juddy; Pastakia, Sonak; Tran, Dan N.; Kiragu, Zana W.; Ruhl, Laura J.; Rosenberg, Molly; Kimaiyo, Sylvester; Galárraga, Omar; Medicine, School of Medicine
    Objective: To measure associations between participation in community-based microfinance groups, retention in HIV care, and death among people with HIV (PWH) in low-resource settings. Design and methods: We prospectively analyzed data from 3609 patients enrolled in an HIV care program in western Kenya. HIV patients who were eligible and chose to participate in a Group Integrated Savings for Health Empowerment (GISHE) microfinance group were matched 1 : 2 on age, sex, year of enrollment in HIV care, and location of initial HIV clinic visit to patients not participating in GISHE. Follow-up data were abstracted from medical records from January 2018 through February 2020. Logistic regression analysis examined associations between GISHE participation and two outcomes: retention in HIV care (i.e. >1 HIV care visit attended within 6 months prior to the end of follow-up) and death. Socioeconomic factors associated with HIV outcomes were included in adjusted models. Results: The study population was majority women (78.3%) with a median age of 37.4 years. Microfinance group participants were more likely to be retained in care relative to HIV patients not participating in a microfinance group [adjusted odds ratio (aOR) = 1.31, 95% confidence interval (CI) 1.01–1.71; P = 0.046]. Participation in group microfinance was associated with a reduced odds of death during the follow-up period (aOR = 0.57, 95% CI 0.28–1.09; P = 0.105). Conclusion: Participation in group-based microfinance appears to be associated with better HIV treatment outcomes. A randomized trial is needed to assess whether microfinance groups can improve clinical and socioeconomic outcomes among PWH in similar settings.
  • Thumbnail Image
    Item
    Mortality Rates in Mechanically Ventilated Patients with COVID-19
    (Indiana University, 2020-12) Class, Jonathan; Khan, Sikandar; Khan, Babar; Medicine, School of Medicine
    Background/Objective: High mortality rates among mechanically ventilated COVID-19 intensive care unit (ICU) patients have raised concerns regarding use of mechanical ventilation in management of patients with COVID-19. Additional data is needed in this discussion to better understand treatment strategies for this vulnerable population. We conducted a study to examine length of stay, duration of mechanical ventilation, mortality, and risk factors for death in critically ill patients with COVID-19. Methods: Observational study in patients admitted to Eskenazi Health and Indiana University Health Methodist ICUs. Participants were 18 years and older patients admitted to the ICU from March 1 2020 to April 27, 2020 who tested positive for COVID-19. Primary outcomes for this study were in-hospital mortality, duration of mechanical ventilation, and the length of stay in the ICU. Results: The study cohort was made up of 242 patients. The mortality rate was 19.8% (48/242) for the overall cohort and 20.5% (38/185) for mechanically ventilated patients. Age was a significant risk factor for in-hospital mortality [increased hazard in in-hospital mortality: age 65-74 years (HR: 3.1, 95%Cl=1.2-7.9, p=0.021), age 75+ (HR: 4.1, 95%CI=1.6-10.5, p=0.003) compared to those younger than 65]. In our Cox’s proportional hazard model, ESRD (HR:5.9, 95%CI=1.3-26.9, p=0.021) along with age were the only risk factors with statistical significance. The median duration of mechanical ventilation in the overall cohort was 9.3 days (IQR=-5.7-13.7). In patients that died, median ICU length of stay was 8.7 days (IQR=4.0-14.9), compared to 9.2 days (IQR=4.0-14.0) in those discharged alive. Conclusion/Clinical Impact: We found lower mortality rates and longer length of stays in our cohort than in previous studies. While more data is needed, this study supports continued use of mechanical ventilation ARDS recommendations for treating patients with ARDS from COVID-19. Further, this data potentially shows a benefit to not having a strained healthcare system.