Health-related quality of life after 12 months post discharge in patients hospitalised with COVID-19-related severe acute respiratory infection (SARI): a prospective analysis of SF-36 data and correlation with retrospective admission data on age, disease severity, and frailty

Long-term outcome and ‘health-related quality of life’ (HRQoL) following hospitalisation for COVID-19-related severe acute respiratory infection (SARI) is limited.
Objective
To assess the impact of HRQoL in patients hospitalised with COVID-19-related SARI at 1 year post discharge, focusing on the potential impact of age, frailty, and disease severity.

Method
Routinely collected outcome data on 1207 patients admitted with confirmed COVID-19 related SARI across all three secondary care sites in our NHS trust over 3 months were assessed in this retrospective cohort study. Of those surviving 1 year, we prospectively collected 36-item short form (SF-36) HRQoL questionnaires, comparing three age groups (

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Marzo 2024

Inequities and trends of polio immunisation among children aged 12-23 months in Ethiopia: a multilevel analysis of Ethiopian demographic and health survey

Introduction
Despite Ethiopia’s policy intention to provide recommended vaccination services to underprivileged populations, inequity in polio immunisation persists.

Objective
This study examined inequity and trends in polio immunisation and determinant factors among children aged 12–23 months in Ethiopia between 2000 and 2019.

Methods
Cross-sectional data from 2000, 2005, 2011, 2016 and 2019 Ethiopian demographic and health surveys were analysed with the updated version of the WHO’s Health Equity Assessment Toolkit software. Six standard equity measures: equity gaps, equity ratios, population attributable risk, population attributable fraction, slope index of inequality and relative index of inequality were used. Datasets were analysed and disaggregated by the five equality stratifiers: economic status, education, place of residence, sex of the child and regions. Multilevel logistic regression analysis was used to identify determinant factors.

Results
Polio immunisation coverage was increased from 34.5% (2000) to 60.0% (2019). The wealth index-related inequity, in coverage of polio immunisation between quintiles 5 and 1, was 20 percentage points for most surveys. The population attributable risk and population attributable fraction measure in 2011 indicate that the national polio immunisation coverage in that year could have been improved by nearly 36 and 81 percentage points, respectively, if absolute and relative wealth-driven inequity, respectively, had been avoided. The absolute difference between Addis Ababa and Afar Region was 74 percentage points in 2000 and 60 percentage points in 2019. In multilevel analysis result, individual-level factors like wealth index, maternal education antenatal care and place of delivery showed statistical significance.

Conclusion
Although polio immunisation coverage gradually increased over time, in the 20-year survey periods, still 40% of children remained unvaccinated. Inequities in coverage by wealth, educational status, urban–rural residence and administrative regions persisted. Increasing service coverage and improving equitable access to immunisations services may narrow the existing inequity gaps.

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Marzo 2024

12 Facilitating inclusivity: a collaborative approach to research in care homes

Research taking place in care homes for older adults has rapidly increased in recent decades, which was seen even more during the COVID-19 pandemic. Challenges in including older adults, particularly those living with a level of cognitive decline, have prevented resident voices being at the forefront of research. Furthermore, lack of resources and time pressures within care homes create barriers to accessing staff and care homes. It is important to consider the whole care context within research, alongside resident voices, to consider lived experiences and provide productive and realistic suggestions for change. Co-production is becoming more common in research, and is committed to facilitating inclusion and overcoming individual, social or contextual barriers to communication and inclusivity. The CHAPPI (Care Home Activity Providers Facilitating Public Involvement in Research as a Meaningful Activity for Care Home Residents) project has collaborated with key stakeholders, including care home managers, activity providers and lived experience experts to ensure gaps in knowledge between academia and industry are bridged from project inception. During this ‘Q&A style’ presentation, we (a care home manager and a researcher) will present our experiences of participating in or conducting research, including during the COVID-19 pandemic. We will also highlight lessons learned within the CHAPPI project so far, to discuss how we (as researchers and industry experts) can creatively proceed together, to improve care home research. Finally, we will explore how we can adapt research to fit with care homes to bring an understanding of what is needed to succeed and how we can do better, even during times of extraordinary measures.

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Marzo 2024