9 research outputs found
Beyond the Shaker: Quantifying Salt Intake in Tirana through Urinary Sodium Analysis
No full textBackground: High salt intake is associated with high blood pressure and adverse cardiovascular health. To figure out average salt intake, we investigated the dietary salt intake from 24-h urinary sodium excretion with a random adult sample from Tirana, the capital city of Albania. Materials and Methods: One hundred and fifty adults aged 18–75 years were randomly selected from a sample of 100000 people from 2 quarters of Tirana’s adult population. Anthropometric measures and sodium excretion in a 24-h urine collection were measured. The accuracy of urine collections was verified using creatinine excretion in relation to weight. Results: The mean Na excretions over 24 h were 202.54 (standard deviation [SD] 93.56) mmol/day. Urinary sodium excretion was significantly higher in men (223.85 [SD 106.51] mmol Na/day) than in women (190.80 [SD 83.96] mmol Na/d); P = 0,045. Average salt intake was 11.8 (SD 5.48) g/d, higher in men than in women (13.08 [SD 6.23] vs. 11,09 [SD 4.92] g/d, respectively). Salt intake increases slightly with increasing age, but there was no significant correlation between age and salt intake. It was also seen that salt consumption increased with increasing body mass index (r = 0.183, P = 0.001). Conclusion: Dietary salt intake in Tirana adults was high, which exceeds the World Health Organization recommended population nutrient intake. Reducing the intake of table salt and traditionally processed foods will be an important strategy to reduce sodium intake among our adults. A national program for reducing salt intake in Albania needs to be conducted through systematic efforts, including public education and involving the health-care sector and the food industry
COMORBIDITATEA ȘI POLIMORBIDITATEA LA PACIENȚII ADULȚI DIN ALBANIA
No full textBackground: Our aim was to assess the prevalence and “predictors” of comorbidity and multimorbidity in adult patients in Albania, a former communist country in the Western Balkans. Methods: This was a case-series study conducted during August 2013–June 2014 including 974 patients (46.6% men aged 61.2±13.8 years and 53.4% women aged 61.3±13.1 years) admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa”, Tirana. Data on socio-demographic factors, lifestyle characteristics and a detailed clinical profile was collected for all study participants. Binary logistic regression was used to assess the association between comorbidity and multimorbidity with socio-demographic characteristics and lifestyle factors. Results: About 54% of the patients were ≥61 years old; about 38% of participants were residing in Tirana; and about 46% of the patients were currently employed. Overall, the prevalence of smoking was 16% (30.4% in men vs. 3.5% in women, PContext: Scopul studiului a fost de a evalua prevalența și "predictorii" comorbidității și polimorbidității la pacienții adulți din Albania, o fostă țară comunistă din Balcanii de Vest. Metode: A fost realizat un studiu de serii de caz în perioada august 2013 - iunie 2014, și a inclus 974 pacienți (46,6% bărbați cu vârste de 61,2 ± 13,8 ani și 53,4% femei cu vârste de 61,3 ± 13,1 ani) internați în Serviciul de Medicină Internă și Hipertensiune arterială a Centrului "Maica Teresa" din Spitalul Universitar, Tirana. Au fost colectate pentru toți participanții la studiu date privind factorii socio-demografici, caracteristicile stilului de viață și profilul clinic detaliat. A fost utilizată regresia logistică binară pentru a evalua asocierea dintre comorbiditate și polimorbiditate cu caracteristicile socio-demografice și a stilului de viață. Rezultate: Aproximativ 54% dintre pacienți aveau vârsta de ≥61 ani; aproximativ 38% dintre participanți locuiau în Tirana și aproximativ 46% dintre pacienți erau angajați la momentul studiului. În general, prevalența fumatului a fost de 16% (30,4% la bărbați versus 3,5% la femei, P <0,001), în timp ce prevalența consumului de alcool a fost de 9% (17,4% la bărbați față de 1,7% la femei, P <0,001 ). După ajustarea multivariată a tuturor caracteristicilor socio-demografice și a factorilor legați de stilul de viață, doar grupa de vârstă a participanților la studiu a reprezentat un "predictor" puternic și semnificativ statistic al comorbidității și polimorbidității (OR = 4,3, 95% IC = 2,0-9,1). Concluzii: Acest studiu oferă informații despre prevalența și factorii determinanți selectivi ai comorbidității și polimorbidității în rândul pacienților spitalizați din Albania. Rezultatele studiului arată că povara comorbidității și polimorbidității este mai mare în special în rândul pacienții albanezi în vârstă. Studiile viitoare vor trebui să estimeze importanța și distribuția comorbidității și polimorbidității în populația generală din Albania. Cuvinte cheie: Albania, comorbiditate, afecțiuni asociate, medicină internă, polimorbiditat
Evidence of a higher burden of multimorbidity among female patients in Albania
No full textAim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe.
Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors.
Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0).
Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population.
 
Evidence of a higher burden of multimorbidity among female patients in Albania
No full textAim: The purpose of this study was to assess sex-differences in the prevalence of multimorbidity and the number of comorbid conditions among hospitalized patients in Tirana, the capital of Albania, a transitional country in Southeastern Europe.Methods: The current study was a case-series, which was carried out in the period August 2013–June 2014. Overall, 974 patients were enrolled (46.6% men with a mean age of 61.2±13.8 years, and 53.4% women with a mean age of 61.3±13.1 years), who were admitted at the Service of Internal Medicine and Hypertension, University Hospital Center “Mother Teresa” in Tirana. A comprehensive clinical profile was assembled for all patients in addition to socio-demographic data and information on lifestyle factors. General linear model was used to assess the association between multimorbidity (total number of diseases/conditions) and sex of the patients, controlling for socio-demographic characteristics and lifestyle factors. Results: In crude (unadjusted) models and in age-adjusted models, female patients had a higher mean value of diseases/conditions compared to males (for both: 4.4 vs. 4.1, respectively, P=0.03). Likewise, upon adjustment for all socio-demographic characteristics, the mean number of disease/conditions was significantly higher in female patients compared to their male counterparts (4.2 vs. 3.9, respectively; P=0.03). After additional adjustment for lifestyle factors, the association between sex and number diseases/conditions was not significant anymore (p=0.16), notwithstanding the evidence of a higher mean value in women compared to men (4.2 vs. 4.0). Conclusion: Current evidence from transitional Albania suggests a higher burden of multimorbidity among female patients compared to males, which is a cause of concern. These findings should raise the awareness of health professionals and particularly policymakers and decision-makers in order to address gender issues and inequity gaps in health outcomes and burden of disease of the Albanian population.
Erratum to: The challenge of the definition of early symptomatic knee osteoarthritis: a proposal of criteria and red flags from an international initiative promoted by the Italian Society for Rheumatology (Rheumatology International, (2017), 37, 8, (1227-1236), 10.1007/s00296-017-3700-y)
No full textThe aim of this study was to establish consensus for potential early symptomatic knee osteoarthritis (ESKOA) clinical definition and referral criteria from primary care to rheumatologists, based on available data from literature and a qualitative approach, in order to perform studies on patients fulfilling such criteria and to validate the obtained ESKOA definition. A complex methodological approach was followed including: (1) three focus groups (FG), including expert clinicians, researchers and patients; (2) a systematic literature review (SLR); (3) two discussion groups followed by a Delphi survey. FG and SLR were performed in parallel to inform discussion groups in order to identify relevant constructs to be included in the modified Delphi survey. ESKOA is defined in the presence of: (a) two mandatory symptoms (knee pain in the absence of any recent trauma or injury and very short joint stiffness, lasting for less than 10 min, when starting movement) even in the absence of risk factors, or (b) knee pain, and 1 or 2 risk factors or (c) three or more risk factors in the presence of at least one mandatory symptom, with symptoms lasting less than 6 months. These criteria are applicable in the absence of active inflammatory arthritis, generalized pain, Kellgren-Lawrence grade >0, any recent knee trauma or injury, and age lower than 40 years. Knee pain in the absence of any recent trauma lasting for less than 6 months was considered as the referral criterion to the rheumatologist for the suspicion of ESKOA. This consensus process has identified provisional clinical definition of ESKOA and defined potential referral criterion to rheumatologist, in order to test ESKOA obtained definition in prospective validation studies
A 56 YO WOMAN WITH MICROSCOPICAL POLYANGITIS, CHRONIC RENAL FAILURE AND HYPERTENSION WHO HAD BEEN PICKED BY HYALOMMA
No full textStrategies for the assessment of competences during rheumatology training across Europe: results of a qualitative study
No full textObjectives To gain insight into current methods and practices for the assessment of competences during rheumatology training, and to explore the underlying priorities and rationales for competence assessment.Methods We used a qualitative approach through online focus groups (FGs) of rheumatology trainers and trainees, separately. The study included five countries—Denmark, the Netherlands, Slovenia, Spain and the United Kingdom. A summary of current practices of assessment of competences was developed, modified and validated by the FGs based on an independent response to a questionnaire. A prioritising method (9 Diamond technique) was then used to identify and justify key assessment priorities.Results Overall, 26 participants (12 trainers, 14 trainees) participated in nine online FGs (2 per country, Slovenia 1 joint), totalling 12 hours of online discussion. Strong nationally (the Netherlands, UK) or institutionally (Spain, Slovenia, Denmark) standardised approaches were described. Most groups identified providing frequent formative feedback to trainees for developmental purposes as the highest priority. Most discussions identified a need for improvement, particularly in developing streamlined approaches to portfolios that remain close to clinical practice, protecting time for quality observation and feedback, and adopting systematic approaches to incorporating teamwork and professionalism into assessment systems.Conclusion This paper presents a clearer picture of the current practice on the assessment of competences in rheumatology in five European countries and the underlying rationale of trainers’ and trainees’ priorities. This work will inform EULAR Points-to-Consider for the assessment of competences in rheumatology training across Europe
Data integration for decision making in wheat breeding
No full textPlant breeding is a production process requiring the creation of germplasm through taking existing successful cultivars and crossing them with new parental lines with agronomic and quality attributes of interest. After crossing, F2 generations generally display all possible combinations between the parental lines. The process from this step is to identify elite crossbred lines and backcross these several times to the parental lines in order to generate new elite lines that are predominately equivalent to the cultivar but with specific novel and desirable attributes present.
Plant breeding continually requires judgements to identify elite plant germplasm containing traits that maximise plant performance. These judgements are often made using incomplete information resulting from the greater complexity in modern plant breeding decision making. Judgements can be improved through the utilisation of new technologies and a stronger scientific basis. This thesis uses decision and information management processes to contribute to:
• Pioneering the application of unbalanced datasets to wheat breeding. The methodologies were derived from tree and animal breeding experience and successfully applied to data sets from a wheat breeding program.
• Providing the first integration of molecular data into a decision-matrix framework.
• Building on the molecular integration in output-2 by establishing a more sophisticated integration of complex NIR spectral data with molecular data.
• Providing inputs into decision matrices for breeding using the outputs discussed above.
This thesis establishes the methodology to make use of new technologies to use unbalanced datasets with decision matrix methodology to make better decisions. This thesis has utilised multivariate methodologies more broadly to include complex data such as NIR fingerprint to differentiate flour samples between controls and breeding germplasm. These differences appear to be related to genetic factors as demonstrated after variability relating to the environment had been removed. This thesis first reviews the literature and then addresses this breeding processes through the use of decision and information management processes, and makes significant contributions in using these methodologies
