Aims Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. Methods and results We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable Poisson regression models were fitted to assess the association between different types of pre-existing heart disease and in-hospital mortality. A total of 16 511 patients with COVID-19 were included (21.1% aged 66–75 years; 40.2% female) and 31.5% had a history of heart disease. Patients with heart disease were older, predominantly male, and often had other comorbid conditions when compared with those without. Mortality was higher in patients with cardiac disease (29.7%; n = 1545 vs. 15.9%; n = 1797). However, following multivariable adjustment, this difference was not significant [adjusted risk ratio (aRR) 1.08, 95% confidence interval (CI) 1.02–1.15; P = 0.12 (corrected for multiple testing)]. Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for heart failure (aRR 1.19, 95% CI 1.10–1.30; P < 0.018) particularly for severe (New York Heart Association class III/IV) heart failure (aRR 1.41, 95% CI 1.20–1.64; P < 0.018). None of the other heart disease subtypes, including ischaemic heart disease, remained significant after multivariable adjustment. Serious cardiac complications were diagnosed in <1% of patients. Conclusion Considerable heterogeneity exists in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with heart failure are at greatest risk of death when hospitalized with COVID-19. Serious cardiac complications are rare during hospitalization.
Motivation Higher education is regarded as a key instrument to enhance socioeconomic mobility and reduce inequalities. Recent literature reviews have examined inequalities in the higher education systems of high‐income countries, but less is known about the situation in low‐ and middle‐income countries, where higher education is expanding fast. Purpose The article reviews the academic literature on higher education in low‐ and middle‐income countries using a research framework inspired by social justice and capability approaches. It considers the financial, sociocultural, human and political resource domains on which people draw, and how they relate to access, participation and outcomes in higher education. Methods A literature search for studies explicitly discussing in‐country inequalities in higher education revealed 22 publications. Substantial knowledge gaps remain, especially regarding the political (and decision‐making) side of inequalities; the ideologies and philosophies underpinning higher education systems; and the linkages between resource domains, both micro and macro. Findings The review highlights key elements for policy‐makers and researchers: (1) the financial lens alone is insufficient to understand and tackle inequalities, since these are also shaped by human and other non‐financial factors; (2) sociocultural constructs are central in explaining unequal outcomes; and (3) inequalities develop throughout one’s life and need to be considered during higher education, but also before and after. The scope of inequalities is wide, and the literature offers a few ideas for short‐term fixes, such as part‐time and online education. Policy implications Inclusive policy frameworks for higher education should include explicit goals related to (in)equality, which are best measured in terms of the extent to which certain actions or choices are feasible for all. Policies in these frameworks, we argue, should go beyond providing financial support, and also address sociocultural and human resource constraints and challenges in retention, performance and labour market outcomes. Finally, they should consider relevant contextual determinants of inequalities.
re-use of eDiaries previously used by patients doing fingerstick tests poses a low and acceptable risk; flexibility for handling measurements should be incorporated in the eDiary design including batch and individual reporting, reporting hypoglycaemic events as part of a meal event or as a standalone event and edit checks should be included to identify where a number of low measurements relate to the same event; there should be clear guidance to patientson how to transfer measurements to the eDiary; a method for managing control test measurementsshould be incorporated; and integrating glucometer measurements decreases patient burden and increases patient engagement.
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