SEARCH · PubMed Health

Results for “Educational Status”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,045 records · Page 58Linked to original sources

PubMed2000

Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in Ile-Ife, Nigeria.

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61%) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61%. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.

Adolescent↗

PubMed2006

Neighborhood safety and overweight status in children.

OBJECTIVE: To determine if there is a relationship between parental perception of neighborhood safety and overweight at the age of 7 years. DESIGN: Cross-sectional analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING: Ten urban and rural US sites. PARTICIPANTS: A total of 768 children selected via conditional random sampling with complete data at follow-up. MAIN OUTCOME MEASURES: Parents reported demographics and perception of neighborhood safety by standardized questionnaire. Child overweight status was defined as a body mass index greater than or equal to the 95th percentile for age and sex from measured anthropometrics at the age of 7 years. The base model included relationship of the safety reporter to the child, sex, and baseline body mass index z score at the age of 4.5 years. Covariates tested included maternal marital status, education, and depressive symptoms; child race/ethnicity; participation in structured after-school activities; Home Observation for Measurement of the Environment total score; and neighborhood social cohesiveness. RESULTS: The sample was 85% white, and 10% of the children were overweight. Neighborhood safety ratings in the lowest quartile were independently associated with a higher risk of overweight at the age of 7 years compared with safety ratings in the highest quartile (adjusted odds ratio, 4.43; 95% confidence interval, 2.03-9.65). None of the candidate covariates altered the relationship between perception of neighborhood safety and child overweight status. CONCLUSIONS: Perception of the neighborhood as less safe was independently associated with an increased risk of overweight at the age of 7 years. Public health efforts may benefit from policies directed toward improving both actual and perceived neighborhood safety.

Body Mass Index↗

PubMed2003

Educational level, socioeconomic status and aphasia research: a comment on Connor et al. (2001)--effect of socioeconomic status on aphasia severity and recovery.

Is there a relation between socioeconomic factors and aphasia severity and recovery? describe correlations between the educational level and socioeconomic status of aphasic subjects with aphasia severity and subsequent recovery. As stated in the introduction by, studies of the influence of educational level and literacy (or illiteracy) on aphasia severity have yielded conflicting results, while no significant link between socioeconomic status and aphasia severity and recovery has been established. In this brief note, we will comment on their findings and conclusions, beginning first with a brief review of literacy and aphasia research, and complexities encountered in these fields of investigation. This serves as a general background to our specific comments on, which will be focusing on methodological issues and the importance of taking normative values in consideration when subjects with different socio-cultural or socio-economic backgrounds are assessed.

Aphasia↗

PubMed1999

Unchanged survival of gastric cancer in the southeastern Netherlands since 1982: result of differential trends in incidence according to Laurén type and subsite.

Despite widespread use of endoscopy and improved surgical treatment, the prognosis for gastric cancer remains poor. Although the incidence has been declining for more than 2 decades, unfavourable changes in relative frequency of histological subtypes and subsites may have occurred. We therefore assessed the nature and impact of these changes in association with socio-economic status in a population-based study during the period 1983-1995. Furthermore, tumour characteristics were analysed as predictors of survival for 1,543 cases recorded in the Eindhoven Cancer Registry during the period 1983-1992. Overall 5-year relative survival remained at 22%, being 70%, 37% and 11% for stage I, II and III, respectively. The Laurén histological type and location were also found to have prognostic value. Tumours with the worst prognosis (diffuse type and located at the cardia) developed predominantly in younger patients and were increasing. Moreover, unlike for other tumours, high educational status was associated with unfavourable prognosis. Stage at diagnosis and survival have remained unchanged, despite likely improvements in early detection through better access to endoscopy and better supportive care after surgical treatment. The unfavourable, in part relative, changes in incidence are likely to be responsible for the lack of improvement of survival rates.

Adult↗

PubMed2001

Standard of knowledge about their disease among patients with diabetes in Karachi, Pakistan.

OBJECTIVE: The aim of this study was to determine the standard of knowledge among people with diabetes. METHOD: Two hundred and thirty patients were randomly chosen from outpatient clinics and a 34-item multiple choice questionnaire administered to them. The questionnaire was structured to assess knowledge about the disease state, diagnostic tests, complications and management. RESULTS: The average score of correct answers for the group was 40%. A significantly higher score correlated with younger age (16-30 years), educational status and regular follow-up with a diabetic clinic. There was no significant difference in the knowledge score between males and females or between those on oral hypoglycemic agents (OHA) and insulin. Fifty percent of the patients could correctly answers questions regarding food and nutrition and only 60% were aware of target blood glucose levels for optimal control. It was alarming to learn that 75% of those on insulin did not know that using U-40 or U-100 insulin does not change the dose required. CONCLUSION: The study emphasizes the need for diabetes education at all levels, both for the patients as well as the health care providers to counter the pandemic of diabetes-related complications globally.

Adult↗

PubMed2001

Frequent attenders in general practice: quality of life, patient satisfaction, use of medical services and GP characteristics.

OBJECTIVE: To determine the predictors of frequent attendance in general practice. DESIGN: A postal survey using a questionnaire including instruments for measuring patient satisfaction (EUROPEP), quality of life (EUROQOL), anxiety and depression (DUKE-AD). SETTING: Primary health care in Slovenia. PATIENTS: A representative sample of 2160 adult patients. MAIN OUTCOME MEASURES: Number of contacts with the health care services, levels of self-care, patient satisfaction scores, quality of life scores, well-being scores, presence of chronic condition. RESULTS: Frequent attenders were more likely to have lower educational status, were more satisfied with their GP, had higher scores of anxiety and depression, and lower perceived quality of life. They were more likely to have a chronic disease. Frequent attenders were less likely to try self-care and more likely to use health services. They were more likely to visit more experienced GPs, GPs working a greater distance from other GPs and GPs who did not use the appointment system. The multivariable modelling explained 19.7% of the variation; 16.9% was attributed to patient characteristics and 3.1% to GP characteristics. CONCLUSIONS: The study confirmed that lower education levels, chronicity and higher use of other health services are predictors of higher attendance.

Family Practice↗

PubMed1985

Rehospitalization and spinal cord injury: cross-sectional survey of adults living independently.

A cross-sectional survey of 96 people living independently with spinal cord injuries (SCI) in Eastern Massachusetts shows that 57% had been hospitalized at least once in the year before the survey. Sample means were 1.0 admissions and 16.0 days/person/year. Eight percent of the sample (eight persons) accounted for 22% of admissions and 59% of total hospital days. For those hospitalized, the mean was 1.7 admissions and 45.1 days/person/year. Mean length-of-stay was 34.7 days/admission. Multiple regression analysis shows that three variables appear to be independently related to increased numbers of admissions: self-assessment of health; place of residence; and age (younger respondents at higher risk). One variable is independently associated with total days of hospitalization: leaving home at least once daily (as opposed to less frequently) is associated with lower risk. There were no statistically significant relationships between either numbers of hospitalizations or total days hospitalized and ADL or IADL status, education, employment, medical insurance, household composition, gender, age at onset of disability, time since onset of disability, substance use (alcohol, cannabis, or tobacco), level of SCI lesion, or social supports.

Activities of Daily Living↗

PubMed2002

Weekly chloroquine prophylaxis and the effect on maternal haemoglobin status at delivery.

Our aim was to determine the effectiveness of chloroquine prophylaxis in reducing the frequency of malaria-induced anaemia at delivery. We estimated the haemoglobin levels of 207 parturients; 82 (39.6%) had been on chloroquine prophylaxis [treatment group (TG)] while 125 (60.4%) did not take any malaria preventive medication antenatally [control group (CG)]. The proportion of women with malaria parasitaemia was significantly higher in CG than TG [risk ratio (RR=1.57, CI=1.05-2.34)]. The dose-response relationship between the severity of parasitaemia and the risk of being anaemic (P < 0.001) confirms a strong correlation between gestational malaria and maternal anaemia. There was a 35% reduction in risk for anaemia in the TG compared with the CG (RR=0.65, 0.40-1.06). The difference in risk was more pronounced after adjusting for disparity in place of residence, educational status and obstetric history (adjusted RR=0.54, CI=0.21-0.98). Primiparous mothers appeared to have benefited more from the antianaemic effects of malaria chemoprevention than mothers of higher parity (protective effectiveness 43% compared with 33%, respectively). In conclusion, despite reports of widespread Plasmodium falciparum resistance to chloroquine on the African continent, malaria chemosuppression with the drug was found beneficial in reducing the risk of anaemia at delivery among Cameroonian women.

Adult↗

PubMed2006

The prevalence of and variables associated with smoking in children and adolescents.

OBJECTIVE: To identify the prevalence of smoking and the presence of variables associated with the habit in children and adolescents of both sexes, aged 7 to 17 years, resident in the city of Maceió. METHODS: A cross-sectional epidemiological study of the student population of the both private and public education systems at elementary and high school level. Sample size was calculated based on the minimum predicted prevalence of a large number of variables, including smoking itself. Cluster sampling was employed. A questionnaire on smoking habits was completed during individual interviews with each student. Children who admitted having smoked on 1 or more day during the previous 30 were defined as current smokers. The variables analyzed were related to: the students (age, sex, previous experimentation with cigarettes and paid employment), their educational status (public/private school, daytime/evening lessons, grade and repeated years) and their families (economic status, smoking parents and separated parents). RESULTS: A total of 1,253 students were analyzed (547 were male, mean age was 12.4+/-2.9 years). Observed smoking prevalence was 2.4%. Multivariate statistical analysis demonstrated significant associations between smoking and: increased age (odds ratio: 1.31); previous experimentation with cigarettes (odds ratio: 33.96); studying during the evening (odds ratio: 5.43). It was observed that 286 students (22.8%) admitted having experimented with cigarettes (9% from 7 to 9 years; 21% from 10 to 14 years; 36% from 15 to 17 years). CONCLUSIONS: The prevalence of smoking among children and adolescents in the Maceió educational system is 2.4%, being most common among students aged 15 to 17 years, studying in the evening. Students who had experimented with cigarettes exhibited a 34 times greater chance of becoming smokers.

Adolescent↗

PubMed1996

Absence of negative attitudes toward childbearing among pregnant teenagers. A risk factor for a rapid repeat pregnancy?

OBJECTIVE: To test the hypothesis that adolescent mothers who conceive again during the first postpartum year express more positive attitudes toward childbearing while pregnant than do adolescent mothers who postpone further childbearing. METHOD: Prospective, cross-sectional, population-based survey. DESIGN: A racially diverse group of 200 consecutively enrolled, poor, pregnant 13- to 18-year-old patients in an adolescent-oriented maternity program were interviewed to determine why they had not used contraceptives prior to the index conception. The study participants were followed up prospectively for the first postpartum year. The data analysis included t tests, chi 2 tests, analysis of variance, and logistic regressions. RESULTS: The repeat pregnancy rate was 11.5% during the first postpartum year. As hypothesized, those who became pregnant again were more likely to have expressed positive attitudes toward childbearing during the index pregnancy (60.9% vs 39.6%; P = .05; odds ratio = 2.38; 95% confidence interval, 0.96-5.90). In addition, those who conceived again were more likely to have had a prior miscarriage, dropped out of school, abused illicit substances, moved away from home, and reported inadequate family support during the index pregnancy, and were less likely to plan to use levonorgestrel (Norplant) following delivery. The best model for predicting repeat pregnancy included education status, postpartum plans for Norplant use, and miscarriage history. Having a positive attitude toward childbearing during pregnancy was not included in the final model because it did not contribute to the model or affect any of the other parameters in the model. CONCLUSIONS: The sexually active teenaged mother who does not use contraception poses a perplexing diagnostic dilemma. The differential diagnosis is a long, complex one that includes ambivalent feelings about postponing future childbearing. This study demonstrates an indirect association between positive attitudes toward childbearing during pregnancy and repeat adolescent pregnancy. Our finding that this association operates through common linkages between maternal educational and contraceptive plans and both positive attitudes toward childbearing and repeat adolescent pregnancy suggests that interventions specifically targeting these underlying causes could reduce the unsafe sexual practices that persist among the participants in comprehensive adolescent-oriented maternity programs.

Adolescent↗

PubMed1990

Nutrition in the curriculum: medical experience.

Nutrition in the Curriculum--Medical experience, current practices, and educational status in U.S. medical schools are briefly reviewed. There continues to be a need for more adequate instruction of clinical nutrition to physicians in training and in practice. A major problem is the failure to provide patient oriented, case-related, nutrition teaching in the clinical years to all clinical clerks. Desirable changes are listed to help achieve better training in this field.

Clinical Clerkship↗

PubMed2000

Long-term trends of symptoms and disability in schizophrenia and related disorders.

BACKGROUND: Relatively few studies describe the long-term course of schizophrenia in well-defined cohorts of patients assessed soon after the illness onset. The aim of this paper is to describe the overall trend of schizophrenia in a 16-year follow-up study of patients and to explore the predictive value of several variables measured at the time of inclusion in the study. The course of the disorder is described along both a 'clinical' and a 'social' dimension. METHODS: The sample of 60 patients with a recent onset of a non-affective psychosis was first assessed in 1978-1980 as part of the study, coordinated by the WHO, on Reduction and Assessment of Psychiatric Disability. Data from the last follow-up are used to rate the overall trends of psychotic symptoms and of social disability. Based on a subdivision of the follow-up period into three sub-periods, the trend for the patients is rated for each of the two dimensions as improvement, deterioration, and no change or fluctuating. The associations of these trends with several predictor variables (age at onset, gender, martial status, education level, family history of mental illness, type of illness onset, personality assets) are explored by cross-tabulation (with calculation of the relative risk) and by a logistic regression model. RESULTS: The predominant pattern for psychotic symptoms is improvement (55% of the subjects), while the predominant pattern for social disability is deterioration (45% of the subjects). A trend of improvement of psychotic symptoms correlated significantly with a negative family history of severe psychiatric disorder and with an acute type of illness onset. Only the first variable entered the logistic regression model. A trend of improvement of social disability correlated significantly with gender, marital status, presence of personality assets, and type of illness onset. All of these predictors entered the logistic regression model, with the exception of marital status; age at onset also entered the logistic regression. CONCLUSIONS: Psychotic symptoms and social disability are relatively autonomous descriptors of the course of schizophrenia. A speculative hypothesis is that symptom course is more closely related to innate factors, while social disability is contingent upon the acquired level of personal and social competence at the time of illness onset. Future studies are needed to assess the effects of psychiatric interventions that could ameliorate the long-term prognosis of social disability in patients with schizophrenia.

Adolescent↗

PubMed1999

A population-based study of clinical and pathological prognostic characteristics of men with familial and sporadic prostate cancer.

OBJECTIVES: To compare traditional prognostic characteristics of familial vs sporadic prostate cancers and to investigate potential detection biases arising from differences in the use of screening and investigative procedures. PATIENTS AND METHODS: Familial and sporadic cancers were identified in a population-based sample of incident prostate cancers (total 318) in Auckland, New Zealand. To examine the potential for detection biases in these comparisons, the sociodemographic and clinical characteristics were determined according to family history status for a sample of 959 patients newly referred to Auckland urology clinics by general practitioners for the investigation of prostate-related conditions. RESULTS: Compared with sporadic prostate cancers, familial cancers were more likely to be diagnosed in patients at a younger age (P=0.05), after asymptomatic serum prostate-specific antigen (PSA) screening (P=0. 02), and to include a lower proportion with extraprostatic disease (P=0.009) and serum PSA levels before diagnosis of >20 ng/mL (P=0. 04). This was consistent with the observed trend for patients referred to urology clinics with a positive family history to be of higher socio-economic and educational status and to more frequently undergo screening and biopsy investigation. CONCLUSION: Familial prostate cancers appeared to be diagnosed at an earlier stage of disease progression in this study population, possibly as the result of the higher socio-economic status and greater use of screening and investigative procedures amongst patients reporting a positive family history. These features reduce the validity of cross-sectional comparisons of prognostic variables for familial vs sporadic prostate cancer and emphasize the need for further longitudinal prognostic studies.

Adult↗

PubMedDate not supplied

["Quality of life" of the elderly population: a survey to evaluate elderly people's self -perceived health in 11 Italian regions (Argento Study, 2002).].

Self-perception of health influences the quality of life of the elderly. In order to identify the more vulnerable elderly and guide interventions to improve health in this population group, we evaluated self-perceived health of elderly people through a set of 4 questions called the "Healthy Days Measures", which were incorporated into the Argento Study. The latter is a study performed to evaluate the health status of the elderly population in 11 Italian regions (2002). Methods. Following cluster sampling, 2,369 elderly subjects (>64 years) were interviewed at home, by trained personnel, through a standardized questionnaire. Self-rated health (on a scale from poor to excellent) was estimated, as well as the average number of days during the previous month when physical or mental health was not good and the number of activity limitation days. Multivariate analysis was performed using Sudaan software and by considering the following outcomes: self-perceived health, physical or mental problems or activity limitations for more than 1 day. Prevalence rates by gender, age, civil status, education level, home situation, place of residence, chronic diseases, dependence on a caregiver, sedentariness and social isolation, were calculated. Results. 34.7% of interviewed subjects rated their health as good to excellent. A significantly lower proportion of women, older subjects (>75 years), those with a lower education level, those residing in southern Italy, those suffering from chronic illnesses, those dependent on a caregiver, and socially isolated or sedentary subjects rated their health favorably. The mean number of physically and mentally unhealthy days (summary index) was estimated to be 11.3 per month. Multivariate analysis showed that female gender was significantly associated with all outcomes considered; age and education level did not show any significant associations with the outcomes considered; depression was significantly associated with self-rated health and with number of mentally unhealthy days; physical dependence and sedentariness were associated with an increased risk for all outcomes, especially activity limitation days. Conclusions. These results suggest that depression, physical dependence and sedentariness influence self-perceived health more so than socio-demographic characteristics. Public Health may have a relevant role in promoting and guiding interventions to prevent these factors in the elderly. The introduction of Healthy Days measures in health surveillance systems may be an important public health tool for monitoring perceived health status and in intervention planning and evaluation at both the national and local levels.

Aged↗

PubMed1998

[Comparison of family physicians' and gynecologists' use of the intrauterine device (IUD)].

OBJECTIVE: To quantify differences between general practitioners (GPs) and gynaecologists in the technique of insertion and follow-up of the intra-uterine device (IUD). DESIGN: Multicentred, descriptive, longitudinal study. SETTING: Two urban health centres and a family guidance clinic. PARTICIPANTS: Target population (n = 1700) between January 1993 and January 1996. Estimated mean of complications was 25%. Sample size was 247 for alpha = 0.05 and 1-alpha = 0.95. The sample was extended to 300 to allow for possible losses of files, estimated at 20%. MEASUREMENTS AND MAIN RESULTS: The variables age, sex, marital status, educational level, parity, abortions, previous contraception, type of job, type of IUD, post-insertion and follow-up complications, subjective evaluation, removal and average follow-up time, were analysed. 158 (54.9%) of the 288 IUDs finally studied were inserted by GPs, and 130 (45.1%) by gynaecologists. 69.5% were anchor-shaped, and 30.5% T-shaped. In 85.5% no immediate complications were found. Mean follow-up time was 22.67 months (CI 95%, 21.3-24.0), during which time 36.6% had complications detected, which led to removal of the device in 22.3% of complications. We found no statistically significant differences between the two populations for age, marital status, subjective evaluation, number of abortions, parity or previous contraception. Likewise, no differences between G.P.s and gynaecologists were detected for post-insertion or follow-up complications, percentage of IUDs removed, or period of time evaluated. There were differences found for the type of IUD used, with more anchor-shaped IUDs in primary care. There were no differences for the type of IUD or complications requiring its removal. CONCLUSIONS: In the population studied we found no differences in immediate or later complications between IUDs inserted by GPs and by gynaecologists.

Adult↗

PubMedDate not supplied

Health-related quality of life among North Carolina adults with diabetes mellitus.

BACKGROUND: Previous research on health-related quality of life among people with diabetes used subgroups of diabetics who were not representative of a larger population and long questionnaires that are not practical for surveillance. OBJECTIVE: To identify people with diabetes in North Carolina who are at risk for a poor quality of lift based on demographic and medical characteristics using surveillance data. METHODS: Analysis of Behavior Risk Factor Surveillance System data from North Carolina, years 1998 through 2001, to examine associations between demographic and medical characteristics among people with diabetes and four different health-related quality-of-life outcome indicators, including general health status, physically unhealthy mentally unhealthy and functionally limited days. The demographic and medical characteristics studiedwere age, sex, ethnicity marital status, education, income, health insurance, obesity duration of diabetes, and insulin use. These same characteristics were also tested for independent associations with functionally limited days. RESULTS: Ethnicity and gender were not associated with any of the quality-of-life measures among people with diabetes. Those younger than age 65 were more likely to have mentally unhealthy days, but age was not related to the other outcomes. A household income of less than 20,000 dollars was related to poor general health and greater than one week each of physically unhealthy mentally unhealthy and functionally limited days. Subjects with a high school education or less, no health insurance, and those not married or cohabiting had at least one poor health-related quality-of-life outcome. Obesity duration of diabetes often or more years, and insulin use were also associated with at least one poor quality-of-life outcome. The only characteristic that was independently related to the number of functionally limited days was income. People with diabetes of working age and with low incomes were more likely to have greater than one week of functionally limited days (aOR = 10.3; 95% CI = 4.9-21.5). CONCLUSIONS: Our results suggest an association between poor quality of life and low-socioeconomic status among people with diabetes in North Carolina.

Adult↗

PubMed1994

Risk factors for dropping out of a parenting education program.

This study compared those who completed a clinic-based parenting program to dropouts in an attempt to identify risk factors for parents not completing the program. The program, aimed at mothers at risk for child maltreatment, was offered at three Seattle, Washington health centers providing comprehensive pediatric care to low-income families. We obtained baseline information from an intake questionnaire, the Nursing Child Assessment Teaching Scale (NCATS), and the Home Observation for Measurement of the Environment (HOME). Of the 172 enrollees, 124 (72%) completed the program. Univariate analyses showed that dropouts were more likely to be located at Clinic Site Three (42% vs. 10%, p < .001), teenaged (44% vs. 23%, p = .010), and African-American (56% vs. 32%, p = .010), and to have HOME scores less than 32 (57% vs. 33%, p = .023). There were no statistically significant differences between those who dropped out and those who didn't in marital status, education, referral rate to Child Protective Services prior to the start of parenting classes, or NCATS scores. Multivariate analyses showed that age less than 20 was significantly associated with dropping out when race and HOME scores were taken into account. There was significant interaction between age less than 20 and Clinic Site Three. These data suggest that program planners need to develop appropriate strategies to retain teenage mothers in parenting programs.

Adult↗

PubMed1995

Patient education and compliance issues associated with access devices.

OBJECTIVES: To explore the variables impacting patient education and to describe techniques for implementing successful education. CONCLUSIONS: Patients have the inherent right to be informed about all available options, significant risks, and treatment options. Throughout the teaching process, adequate time is needed for the patient to demonstrate skills in care and to voice concerns. Written literature and videos from the manufacturer or developed within the institution augment the nurse's teachings. Having a family member or significant other present is necessary to ensure that the teaching is complete. IMPLICATIONS FOR NURSING PRACTICE: Nurses are responsible for teaching patients about device care and how to troubleshoot complications. Nurses must be aware of factors that can affect learning, such as the patient's age, physical and emotional status, educational level, and current stress level. Failure to provide proper instruction may resort in the omission of vital steps, which may create problems with any type of device.

Catheterization, Central Venous↗