Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-17 (of 17 Records) |
Query Trace: Hannan J [original query] |
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Impact of COVID-19-related care disruptions on blood pressure management and control in community health centers.
Meador M , Coronado F , Roy D , Bay RC , Lewis JH , Chen J , Cheung R , Utman C , Hannan JA . BMC Public Health 2022 22 (1) 2295 BACKGROUND: Uncontrolled hypertension is a leading risk factor for cardiovascular disease. To ensure continuity of care, community health centers (CHCs) nationwide implemented virtual care (telehealth) during the pandemic. CHCs use the Centers for Medicare & Medicaid Services (CMS) 165v8 Controlling High Blood Pressure measure to report blood pressure (BP) control performance. CMS 165v8 specifications state that if no BP is documented during the measurement period, the patient's BP is assumed uncontrolled. METHODS: To examine trends in BP documentation and control rates in CHCs as telehealth use increased during the pandemic compared with pre-pandemic period, we assessed documentation of BP measurement and BP control rates from December 2019 - October 2021 among persons ages 18-85 with a diagnosis of hypertension who had an in-person or telehealth encounter in 11 CHCs. Rates were compared between CHCs that did and did not implement self-measured BP monitoring (SMBP). RESULTS: The percent of patients with hypertension with no documented BP measurement was 0.5% in December 2019 and increased to 15.2% (overall), 25.6% (non-SMBP CHCs), and 11.2% (SMBP CHCs) by October 2021. BP control using CMS 165v8 was 63.5% in December 2019 and decreased to 54.9% (overall), 49.1% (non-SMBP), and 57.2% (SMBP) by October 2021. When assessing BP control only in patients with documented BP measurements, CHCs largely maintained BP control rates (63.8% in December 2019; 64.8% (overall), 66.0% (non-SMBP), and 64.4% (SMBP) by October 2021). CONCLUSIONS: The transition away from in-person to telehealth visits during the pandemic likely increased the number of patients with hypertension lacking a documented BP measurement, subsequently negatively impacting BP control using CMS 165v8. There is an urgent need to enhance the flexibility of virtual care, improve EHR data capture capabilities for patient-generated data, and implement expanded policy and systems-level changes for SMBP, an evidence-based strategy that can build patient trust, increase healthcare engagement, and improve hypertension outcomes. |
Impacts of the COVID-19 Pandemic on Nationwide Chronic Disease Prevention and Health Promotion Activities.
Balasuriya L , Briss PA , Twentyman E , Wiltz JL , Richardson LC , Bigman ET , Wright JS , Petersen R , Hannan CJ , Thomas CW , Barfield WD , Kittner DL , Hacker KA . Am J Prev Med 2022 64 (3) 452-458 The coronavirus disease 2019 (COVID-19) pandemic has underscored the need to prevent chronic disease and promote health.1 , 2 More than a million American lives have been lost to COVID-19, and life expectancy decreased between 2018 and 2020.3 , 4 Chronic diseases are major risk factors for COVID-19 morbidity and mortality.5 In addition, COVID-19 morbidity and mortality have been higher among persons from racial and ethnic groups such as those who are African American, Hispanic or Latino, and American Indian or Alaska Native as well as those living at lower SES.6 This has magnified pre-existing health inequities in chronic disease.1 , 2 , 7 |
Two cases of monkeypox-associated encephalomyelitis - Colorado and the District of Columbia, July-August 2022
Pastula DM , Copeland MJ , Hannan MC , Rapaka S , Kitani T , Kleiner E , Showler A , Yuen C , Ferriman EM , House J , O'Brien S , Burakoff A , Gupta B , Money KM , Matthews E , Beckham JD , Chauhan L , Piquet AL , Kumar RN , Tornatore CS , Padgett K , O'Laughlin K , Mangla AT , Kumar PN , Tyler KL , O'Connor SM . MMWR Morb Mortal Wkly Rep 2022 71 (38) 1212-1215 Monkeypox virus (MPXV) is an orthopoxvirus in the Poxviridae family. The current multinational monkeypox outbreak has now spread to 96 countries that have not historically reported monkeypox, with most cases occurring among gay, bisexual, and other men who have sex with men (1,2). The first monkeypox case in the United States associated with this outbreak was identified in May 2022 in Massachusetts (1); monkeypox has now been reported in all 50 states, the District of Columbia (DC), and one U.S. territory. MPXV is transmitted by close contact with infected persons or animals; infection results in a febrile illness followed by a diffuse vesiculopustular rash and lymphadenopathy. However, illness in the MPXV current Clade II outbreak has differed: the febrile prodrome is frequently absent or mild, and the rash often involves genital, anal, or oral regions (3,4). Although neuroinvasive disease has been previously reported with MPXV infection (5,6), it appears to be rare. This report describes two cases of encephalomyelitis in patients with monkeypox disease that occurred during the current U.S. outbreak. Although neurologic complications of acute MPXV infections are rare, suspected cases should be reported to state, tribal, local, or territorial health departments to improve understanding of the range of clinical manifestations of and treatment options for MPXV infections during the current outbreak. |
Commitment to Hypertension Control During the COVID-19 Pandemic: Million Hearts Initiative Exemplars.
Abbas A , Hannan J , Stolp H , Coronado F , Sperling LS . Prev Chronic Dis 2022 19 E47 Hypertension is a major risk factor for cardiovascular diseases, but 3 of 4 US adults do not have their blood pressure adequately controlled. Million Hearts (US Department of Health and Human Services) is a national initiative that promotes a set of priorities and interventions to optimize delivery of evidence-based strategies to manage cardiovascular disease, including hypertension. The COVID-19 pandemic, however, has disrupted routine care and preventive service delivery. We identified examples of clinical and health organizations that adapted services and care processes to continue a focus on monitoring and controlling hypertension during the pandemic. Eight Hypertension Control Exemplars were identified and interviewed. They reported various adapted care strategies including telemedicine, engaging patients in self-measured blood pressure monitoring, adapting or implementing medication management services, activating partnerships to respond to patient needs or expand services, and implementing unique patient outreach approaches. Documenting these hypertension control strategies can help increase adoption of adaptive approaches during public health emergencies and routine care. |
Improving hypertension control and cardiovascular health: An urgent call to action for nursing
Hannan JA , Commodore-Mensah Y , Tokieda N , Smith AP , Gawlik KS , Murakami L , Cooper J , Koob S , Wright KD , Cassarino D , Arslanian-Engoren C , Melnyk BM . Worldviews Evid Based Nurs 2022 19 (1) 6-15 BACKGROUND: Hypertension is a leading cause of cardiovascular disease (CVD) and affects nearly one in two adults in the United States when defined as a blood pressure of at least 130/80 mm Hg or on antihypertensive medication (Virani et al., 2021, Circulation, 143, e254). Long-standing disparities in hypertension awareness, treatment, and control among racial and ethnic populations exist in the United States. High-quality evidence exists for how to prevent and control hypertension and for the role nurses can play in this effort. In response to the 2020 Surgeon General's Call to Action to Control Hypertension, nursing leaders from 11 national organizations identified the critical roles and actions of nursing in improving hypertension control and cardiovascular health, focusing on evidence-based nursing interventions and available resources. AIMS: To develop a unified "Call to Action for Nurses" to improve control of hypertension and cardiovascular health and provide information and resources to execute this call. METHODS: This paper outlines roles that registered nurses, advanced practice nurses, schools of nursing, professional nursing organizations, quality improvement nurses, and nursing researchers can play to control hypertension and prevent CVD in the United States. It describes evidence-based interventions to improve cardiovascular health and outlines actions to bring hypertension and CVD to the forefront as a national priority for nursing. LINKING EVIDENCE TO ACTION: Evidence-based interventions exist for nurses to lead efforts to prevent and control hypertension, thus preventing much CVD. Nurses can take actions in their communities, their healthcare setting, and their organization to translate these interventions into real-world practice settings. |
Addressing Oral Health Inequities, Access to Care, Knowledge, and Behaviors
Hannan CJ , Ricks TL , Espinoza L , Weintraub JA . Prev Chronic Dis 2021 18 E27 Oral health is essential to overall health (1), and dental publichealth is a field of public health and a specialized field of dentistrythat focuses on improving access to oral health care and understandingthe factors that contribute to improving oral health from apopulation health perspective (2). This collection of articles inPreventing Chronic Disease (PCD), “Oral Health Behaviors andAvailability of Dental Services Among Children and Adults,” features8 articles that discuss contemporary dental public healthchallenges and opportunities. These include inequities in access todental care, disparities in the prevalence of oral disease, risk behaviorsrelated to oral disease, the relationship between oral healthand chronic diseases, and the effect of the COVID-19 pandemicon oral health © 2021, Preventing Chronic Disease. All Rights Reserved. |
Association between NICU admission and supine sleep positioning, breastfeeding, and postnatal smoking among mothers of late preterm infants
Hannan KE , Smith RA , Barfield WD , Hwang SS . J Pediatr 2020 227 114-120 e1 OBJECTIVE: To evaluate the association between neonatal intensive care unit (NICU) admission and breastfeeding practices, infant supine sleep positioning, and postnatal smoking among mothers of late preterm infants. STUDY DESIGN: Data from 36 states using the 2000-2013 Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed. Chi-square tests and 95% confidence intervals (CI) assessed infant and maternal characteristics and recommended care practices for late preterm infants based on NICU admission after birth. Adjusted prevalence ratios (APR) for BF initiation and continuation at 10 weeks, supine sleep position, and postnatal smoking were estimated using multivariable logistic regression models, controlling for infant and maternal characteristics. Analyses were weighted and standard errors accounted for the complex survey design. RESULTS: Our sample included 62,494 late preterm infants, representing a weighted population of 1,441,451 late preterm infants. In the adjusted analysis, mothers of late preterm infants admitted to a NICU were more likely to initiate BF (APR 1.07; 95% CI 1.05-1.09) and place their infants in supine sleep position (1.04; 95% CI 1.01-1.06) than mothers of late preterm infants not admitted to a NICU. There was no significant difference between groups for BF continuation or postnatal smoking. CONCLUSIONS: Mothers of late preterm infants admitted to a NICU were more likely to initiate BF and practice supine sleep position than mothers of late preterm infants not admitted to a NICU. Future work should seek to identify the drivers of these differences to develop effective strategies to engage mothers in these health promoting infant care practices. |
Accelerating use of self-measured blood pressure monitoring (SMBP) through clinical-community care models
Meador M , Hannan J , Roy D , Whelihan K , Sasu N , Hodge H , Lewis JH . J Community Health 2020 46 (1) 127-138 Self-measured blood pressure monitoring (SMBP), the regular measurement of blood pressure by a patient outside the clinical setting, plus additional support, is a proven, cost-effective but underutilized strategy to improve hypertension outcomes. To accelerate SMBP use, the Centers for Disease Control and Prevention (CDC) funded the National Association of Community Health Centers, the YMCA of the USA, and Association of State and Territorial Health Officials to develop cross-sector care models to offer SMBP to patients with hypertension. The project aimed to increase the use of SMBP through the coordinated action of health department leaders, community organizations and clinical providers. From 1/31/2017 to 6/30/2018, nine health centers in Kentucky, Missouri, and New York partnered with seven local Y associations (local Y) and their local health departments to design and implement care models that adapted existing primary care SMBP practices by leveraging capacities and resources in community and public health organizations. Nine collaborative care models emerged, shaped by available community assets, strategic priorities, and organizational culture. Overall, 1421 patients were recommended for SMBP; of those, 795 completed at least one cycle of SMBP (BP measurements morning and evening for at least three consecutive days). Of those recommended for SMBP, 308 patients were referred to a local Y to receive additional SMBP and healthy lifestyle support. Community and public health organizations can be brought into the health care delivery process and can play valuable roles in supporting patients in SMBP. |
Notes from the Field: Characteristics of Million Hearts hypertension control champions, 2012-2019
Ritchey MD , Hannan J , Wall HK , George MG , Sperling LS . MMWR Morb Mortal Wkly Rep 2020 69 (7) 196-197 Million Hearts is a national initiative co-led by CDC and the Centers for Medicare & Medicaid Services that aims to prevent 1 million heart attacks, strokes, and other related acute cardiovascular events by 2022 (1,2). On November 19, 2019, the initiative recognized 17 Million Hearts Hypertension Control Champions for achieving ≥80% blood pressure control rates among their patients with hypertension. These Champions include clinicians, practices, health centers, and health systems from 15 states that provide care for 201,045 adult patients, approximately one third (68,019) of whom have hypertension. The Hypertension Control Challenge is held annually to identify new Champions, with a call for applications in the spring, review and vetting in the summer, and announcement of Champions in the late fall. Since 2012, Million Hearts has recognized 118 Champions from 36 states and the District of Columbia who care for more than 15 million adult patients, including 5 million with hypertension (Table).* |
International Society of Cardiovascular Infectious Diseases Guidelines for the Diagnosis, Treatment and Prevention of Disseminated Mycobacterium chimaera Infection Following Cardiac Surgery with Cardiopulmonary Bypass.
Hasse B , Hannan M , Keller PM , Maurer FP , Sommerstein R , Mertz D , Wagner D , Fernandez-Hidalgo N , Nomura J , Manfrin V , Bettex D , Conte AH , Durante-Mangoni E , Hing-Cheung Tang T , Stuart RL , Lundgren J , Gordon S , Jarashow MC , Schreiber PW , Niemann S , Kohl TA , Daley C , Stewardson AJ , Whitener CJ , Perkins K , Plachouras D , Lamagni T , Chand M , Freiberger T , Zweifel S , Sander P , Schulthess B , Scriven J , Sax H , van Ingen J , Mestres CA , Diekema D , Brown-Elliott BA , Wallace RJJr , Baddour LM , Miro JM , Hoen B . J Hosp Infect 2019 104 (2) 214-235 Mycobacterial infection-related morbidity and mortality in patients following cardiopulmonary bypass surgery is high and and there is a growing need for a consensus-based expert opinion to provide international guidance for diagnosing, preventing and treating in these patients. In this document the International Society for Cardiovascular Infectious Diseases (ISCVID) covers aspects of prevention (field of hospital epidemiology), clinical management (infectious disease specialists, cardiac surgeons, ophthalmologists, others), laboratory diagnostics (microbiologists, molecular diagnostics), device management (perfusionists, cardiac surgeons) and public health aspects. |
Application of a tool to identify undiagnosed hypertension - United States, 2016
Ciemins EL , Ritchey MD , Joshi VV , Loustalot F , Hannan J , Cuddeback JK . MMWR Morb Mortal Wkly Rep 2018 67 (29) 798-802 Approximately 11 million U.S. adults with a usual source of health care have undiagnosed hypertension, placing them at increased risk for cardiovascular events (1-3). Using data from the National Health and Nutrition Examination Survey (NHANES), CDC developed the Million Hearts Hypertension Prevalence Estimator Tool, which allows health care delivery organizations (organizations) to predict their patient population's hypertension prevalence based on demographic and comorbidity characteristics (2). Organizations can use this tool to compare predicted prevalence with their observed prevalence to identify potential underdiagnosed hypertension. This study applied the tool using medical billing data alone and in combination with clinical data collected among 8.92 million patients from 25 organizations participating in American Medical Group Association (AMGA) national learning collaborative* to calculate and compare predicted and observed adult hypertension prevalence. Using billing data alone revealed that up to one in eight cases of hypertension might be undiagnosed. However, estimates varied when clinical data were included to identify comorbidities used to predict hypertension prevalence or describe observed hypertension prevalence. These findings demonstrate the tool's potential use in improving identification of hypertension and the likely importance of using both billing and clinical data to establish hypertension and comorbidity prevalence estimates and to support clinical quality improvement efforts. |
Characteristics of health care practices and systems that excel in hypertension control
Young A , Ritchey MD , George MG , Hannan J , Wright J . Prev Chronic Dis 2018 15 E73 Approximately 1 in 3 US adults has hypertension, but only half have their blood pressure controlled. We identified characteristics of health care practices and systems (hereinafter practices) effective in achieving control rates at or above 70% by using data collected via applications submitted from April through June 2017 for consideration in the Million Hearts Hypertension Control Challenge. We included 96 practices serving 635,000 patients with hypertension across 34 US states in the analysis. Mean hypertension control rate was 77.1%; 27.1% of practices had a control rate of 80% or greater. Although many practices served large populations with multiple risk factors for uncontrolled hypertension, high control rates were achieved with implementation of evidenced-based strategies. |
Widespread recent increases in county-level heart disease mortality across age groups
Vaughan AS , Ritchey MD , Hannan J , Kramer MR , Casper M . Ann Epidemiol 2017 27 (12) 796-800 PURPOSE: Recent national trends show decelerating declines in heart disease mortality, especially among younger adults. National trends may mask variation by geography and age. We examined recent county-level trends in heart disease mortality by age group. METHODS: Using a Bayesian statistical model and National Vital Statistics Systems data, we estimated overall rates and percent change in heart disease mortality from 2010 through 2015 for four age groups (35-44, 45-54, 55-64, and 65-74 years) in 3098 US counties. RESULTS: Nationally, heart disease mortality declined in every age group except ages 55-64 years. County-level trends by age group showed geographically widespread increases, with 52.3%, 58.5%, 69.1%, and 42.0% of counties experiencing increases with median percent changes of 0.6%, 2.2%, 4.6%, and -1.5% for ages 35-44, 45-54, 55-64, and 65-74 years, respectively. Increases were more likely in counties with initially high heart disease mortality and outside large metropolitan areas. CONCLUSIONS: Recent national trends have masked local increases in heart disease mortality. These increases, especially among adults younger than age 65 years, represent challenges to communities across the country. Reversing these trends may require intensification of primary and secondary prevention-focusing policies, strategies, and interventions on younger populations, especially those living in less urban counties. |
Defining arthritis for public health surveillance: Methods and estimates in four US population health surveys
Murphy LB , Cisternas MG , Greenlund KG , Giles W , Hannan C , Helmick CG . Arthritis Care Res (Hoboken) 2016 69 (3) 356-367 OBJECTIVE: To determine variability of arthritis prevalence in 4 US population health surveys. METHODS: We estimated annualized arthritis prevalence in 2011/12, among adults ≥ 20 years, using 2 definition methods, both based on self-report: 1) doctor/health care provider diagnosed arthritis in the Behavioral Risk Factor Surveillance Survey (BRFSS), National Health and Nutrition Examination Survey (NHANES), National Health Interview Survey (NHIS), and Medical Expenditure Panel Survey (MEPS); and 2) three ICD-9-CM based arthritis definitions in MEPS (National Arthritis Data Workgroup Arthritis and Rheumatic Conditions [NADW-AORC], Clinical Classification System [CCS], and Centers for Disease Control and Prevention [CDC]). RESULTS: Diagnosed arthritis prevalence percentages were within 3 percentage points (BRFSS= 26.2% [99% CI=26.0 - 26.4], MEPS= 26.1 [99% CI=25.0-27.2], NHIS=23.5 [99% CI = 22.9-24.1], NHANES=23.0% [99% CI=19.2-26.8]) and ICD-9-CM within 5 (CCS=25.8%; 99% CI=24.6-27.1; CDC=28.3%; 99% CI=27.0-29.6; and NADW=30.7%; 95% CI=29.4-32.1). Range in estimated number (in millions) affected with diagnosed arthritis was 7.8 (BRFSS=58.5 [99% CI=58.1-59.1]; MEPS=59.3 [99% CI=55.6-63.1]; NHANES=51.5 [99% CI=37.2-65.5], and NHIS=52.6 [99% CI=50.9-54.4]) and ICD-9-CM definitions was 11.1 (CCS=58.7 [99% CI=54.5-62.9]; CDC=64.3 [99% CI=59.9-68.6], and NADW=69.9 [99% CI=65.2-74.5]). Most (57% to 70%) reporting diagnosed arthritis also reported ICD-9-CM arthritis; respondents reporting diagnosed arthritis were older than those meeting ICD-9-CM definitions. Proxy response status affected arthritis prevalence differently across surveys. CONCLUSION: Public health practitioners and decision makers are frequently charged with choosing a single number to represent arthritis prevalence in the US population. We encourage them to consider the surveys' purpose, design, measurement methods, and statistical precision when choosing an estimate. |
Patients with undiagnosed hypertension: hiding in plain sight
Wall HK , Hannan JA , Wright JS . JAMA 2014 312 (19) 1973-4 According to the 2011–2012 National Health and Nutrition Examination Survey (NHANES), a nationally representative, cross-sectional survey of the noninstitutionalized US population that combines interviews and physical examinations, 1 of 3 US adults (estimated at approximately 71 million people) has high blood pressure and almost half of these individuals (48.2%) do not have their blood pressure under control.1 Closer examination of the population with uncontrolled blood pressure reveals that 36.2% (estimated at approximately 13 million people) are neither aware of their hypertension nor taking antihypertensive medications.1 | A common assumption might be that these individuals are among the uninsured population without regular access to the health care system and who, consequently, have not had an opportunity for detection and diagnosis of hypertension. However, data from analysis of 2009–2012 NHANES show that among the unaware, untreated, and uncontrolled hypertensive population, 81.8% have health insurance, 82.5% have a usual source of care, and 61.7% have received care 2 or more times in the past year (written communication from Cathleen Gillespie, MS, Centers for Disease Control and Prevention, October 30, 2014). These data suggest that potentially millions of people with uncontrolled high blood pressure are being seen by health care professionals each year but remain undiagnosed and “hiding in plain sight” within clinical settings. |
Dynamics of Japanese encephalitis virus transmission among pigs in northwest Bangladesh and the potential impact of pig vaccination
Khan SU , Salje H , Hannan A , Islam MA , Bhuyan AA , Islam MA , Rahman MZ , Nahar N , Hossain MJ , Luby SP , Gurley ES . PLoS Negl Trop Dis 2014 8 (9) e3166 BACKGROUND: Japanese encephalitis (JE) virus infection can cause severe disease in humans, resulting in death or permanent neurologic deficits among survivors. Studies indicate that the incidence of JE is high in northwestern Bangladesh. Pigs are amplifying hosts for JE virus (JEV) and a potentially important source of virus in the environment. The objectives of this study were to describe the transmission dynamics of JEV among pigs in northwestern Bangladesh and estimate the potential impact of vaccination to reduce incidence among pigs. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a comprehensive census of pigs in three JE endemic districts and tested a sample of them for evidence of previous JEV infection. We built a compartmental model to describe JEV transmission dynamics in this region and to estimate the potential impact of pig vaccination. We identified 11,364 pigs in the study area. Previous JEV infection was identified in 30% of pigs with no spatial differences in the proportion of pigs that were seropositive across the study area. We estimated that JEV infects 20% of susceptible pigs each year and the basic reproductive number among pigs was 1.2. The model suggest that vaccinating 50% of pigs each year resulted in an estimated 82% reduction in annual incidence in pigs. CONCLUSIONS/SIGNIFICANCE: The widespread distribution of historic JEV infection in pigs suggests they may play an important role in virus transmission in this area. Future studies are required to understand the contribution of pig infections to JE risk in humans and the potential impact of pig vaccination on human disease. |
Association of foot symptoms with self-reported and performance-based measures of physical function: the Johnston County osteoarthritis project
Golightly YM , Hannan MT , Shi XA , Helmick CG , Renner JB , Jordan JM . Arthritis Care Res (Hoboken) 2011 63 (5) 654-9 OBJECTIVE: To examine associations of foot symptoms with self-reported and performance-based measures of physical function in a large, biracial, community-based sample of individuals ages ≥45 years. METHODS: Data from 2,589 Johnston County participants (evaluated in 1999-2004) were used in cross-sectional analyses. The presence of foot symptoms was defined as pain, aching, or stiffness of at least one foot on most days. Physical function was assessed by the total Stanford Health Assessment Questionnaire (HAQ) score (0, >0 but <1, and ≥1), timed 5 repeated chair stands (completion time <12 seconds, ≥12 seconds, and unable), and 8-foot walk time (<3.35 seconds and ≥3.35 seconds). Separate multivariable logistic regression models examined associations between foot symptoms and physical function measures, controlling for age, race, sex, body mass index, radiographic knee osteoarthritis, radiographic hip osteoarthritis, knee symptoms, hip symptoms, and depressive symptoms. Interaction terms between each of the 3 physical function measures and each demographic and clinical characteristic were examined. RESULTS: The prevalence of foot symptoms was 37%. Participants with foot symptoms were more likely than those without symptoms to have higher HAQ scores (adjusted odds ratio [OR] 1.79, 95% confidence interval [95% CI] 1.50-2.12). Among obese participants, those with foot symptoms had longer chair stand (adjusted OR 1.38, 95% CI 1.04-1.87) and 8-foot walk times (adjusted OR 1.61, 95% CI 1.21-2.15) than those without symptoms. CONCLUSION: Foot symptoms were independently and significantly associated with 2 of 3 measures of poorer physical function. Interventions for foot symptoms may be important for helping patients prevent or deal with an existing decline in physical function. |
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