The open epidemiology journal最新文献_第2页

Factors Affecting the Uptake of Anti-Malarial Drugs by Children in Public Primary Health Facilities in Cross River State, Nigeria 影响尼日利亚克罗斯河州公共初级卫生机构儿童服用抗疟疾药物的因素

The open epidemiology journal Pub Date : 2012-06-06 DOI: 10.2174/1874297101205010021

E. Ezedinachi, F. Odey, S. Ameh, O. Oduwole, Ekpereonne Esu, R. Ejemot-Nwadiaro, G. Ntadom, A. Etokidem, E. Udoh, V. Asiegbu, Iyam Ugot, P. Asuquo, A. Alaribe, J. Charles, E. Nwokolo, M. Meremikwu

{"title":"Factors Affecting the Uptake of Anti-Malarial Drugs by Children in Public Primary Health Facilities in Cross River State, Nigeria","authors":"E. Ezedinachi, F. Odey, S. Ameh, O. Oduwole, Ekpereonne Esu, R. Ejemot-Nwadiaro, G. Ntadom, A. Etokidem, E. Udoh, V. Asiegbu, Iyam Ugot, P. Asuquo, A. Alaribe, J. Charles, E. Nwokolo, M. Meremikwu","doi":"10.2174/1874297101205010021","DOIUrl":"https://doi.org/10.2174/1874297101205010021","url":null,"abstract":"Background: Despite the supply of artemisinin-based combination therapy (ACT) drugs to public health facilities in Nigeria, the uptake of these drugs appear to have remained suboptimal with low improvement in childhood morbidity and mortality. Aim: To use a controlled study to estimate the factors affecting the uptake of ACT in public health facilities in Cross River State (CRS), Nigeria. Methods: The design of this study was cross sectional analytical. The study was carried out in two sites, Akpabuyo (experimental) and Obudu (control) Local Government Areas (LGA) in the south and northern parts of CRS, Nigeria, respectively. Multidisciplinary research team consists of health professionals, biomedical and social scientists who worked with staff of the target facilities. Validated semi-structured questionnaires were administered by trained interviewers on respondents of consecutive households selected by multi-stage sampling procedure. Results: A total of 1250 households (588 in Akpabuyo and 662 in Obudu LGAs) were assessed. More informants in Obudu had formal education than in Akpabuyo (p<0.0001). Mortality of U5 children was higher in Akpabuyo. Stepwise regression analysis showed that farmers (p = 0.009) and people without formal education (p = <0.0001) were less likely than older age group (p = <0.0001) to access anti-malaria drugs in Akpabuyo. Religious beliefs (p=0.003) also predicted uptake of ACTs in Obudu. Conclusion: Informants' occupation, age, education and religious beliefs were key determinants of uptake of ACTs in public health facilities in Nigeria. We recommend targeted malaria education programmes to explore the belief systems in treating fevers in children in this population.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"5 1","pages":"21-26"},"PeriodicalIF":0.0,"publicationDate":"2012-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68063159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Confounding in Observational Studies Explained 解释观察性研究中的混淆

The open epidemiology journal Pub Date : 2012-05-16 DOI: 10.2174/1874297101205010018

Bikaramjit S. Mann, Evan Wood

引用次数: 7

Environmental Predictors of Pathogenic Vibrios in South Florida Coastal Waters 南佛罗里达沿海水域致病性弧菌的环境预测因子

The open epidemiology journal Pub Date : 2012-03-26 DOI: 10.2174/1874297101205010001

K. Yamazaki, N. Esiobu

引用次数: 11

Assessment of the Reported Effectiveness of Five Different Quality- Improvement Initiatives for the Prevention of Central Line-Associated Bloodstream Infections in Intensive Care Units 重症监护病房预防中央静脉相关血流感染的五种不同质量改进措施的有效性评估

The open epidemiology journal Pub Date : 2012-03-26 DOI: 10.2174/1874297101205010005

L. F. Muscarella

{"title":"Assessment of the Reported Effectiveness of Five Different Quality- Improvement Initiatives for the Prevention of Central Line-Associated Bloodstream Infections in Intensive Care Units","authors":"L. F. Muscarella","doi":"10.2174/1874297101205010005","DOIUrl":"https://doi.org/10.2174/1874297101205010005","url":null,"abstract":"Five studies that evaluated five different quality-improvement initiatives for the prevention of central line-associated bloodstream infections (CLABSIs) in adult, pediatric and/or neonatal intensive care units (ICUs) and that were published within the past two years in an infection-control and epidemiology journal were reviewed, assessed and compared. Each is a prospective cohort study that similarly concludes that the evaluated initiative was responsible for a significant and calculated reduction in the CLABSI rate, ranging from 30.3% to 85%. The soundness of these conclusions and calculations, however, like the legitimacy of several other common uses of CLABSI data, requires, in addition to satisfying a number of other criteria, that each study's CLABSI rates be accurate and complete. The primary goal of this analysis, therefore, was to confirm the hypothesis that each of these five studies had validated its CLABSI rates. The analysis found, however, that these five studies did not validate the accuracy and completeness of their CLABSI rates, which raises reasonable questions about each study's assessment of and conclusions about the initiative's effectiveness for the prevention of CLABSIs. In addition to their aims, calculations, and conclusions, these five studies share in common a number of features, as well as circumscribing qualities, which are discussed. The distinction between a qualitative assessment and a quantitative determination of an initiative's performance is also discussed. Both the circumspective use of CLABSI data that have not been validated and the cautious interpretation of conclusions about central-line care that are based on these CLABSI data are recommended.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"5 1","pages":"5-12"},"PeriodicalIF":0.0,"publicationDate":"2012-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68063099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

At Odds: Concerns Raised by Using Odds Ratios for Continuous or Common Dichotomous Outcomes in Research on Physical Activity and Obesity. 不一致:在体育活动和肥胖的研究中，对连续或共同二分结果使用优势比引起的关注。

The open epidemiology journal Pub Date : 2012-01-01 DOI: 10.2174/1874297101205010013

Gina S Lovasi, Lindsay J Underhill, Darby Jack, Catherine Richards, Christopher Weiss, Andrew Rundle

{"title":"At Odds: Concerns Raised by Using Odds Ratios for Continuous or Common Dichotomous Outcomes in Research on Physical Activity and Obesity.","authors":"Gina S Lovasi, Lindsay J Underhill, Darby Jack, Catherine Richards, Christopher Weiss, Andrew Rundle","doi":"10.2174/1874297101205010013","DOIUrl":"https://doi.org/10.2174/1874297101205010013","url":null,"abstract":"<p><p>PURPOSE: Research on obesity and the built environment has often featured logistic regression and the corresponding parameter, the odds ratio. Use of odds ratios for common outcomes such obesity may unnecessarily hinder the validity, interpretation, and communication of research findings. METHODS: We identified three key issues raised by the use of odds ratios, illustrating them with data on walkability and body mass index from a study of 13,102 New York City residents. RESULTS: First, dichotomization of continuous measures such as body mass index discards theoretically relevant information, reduces statistical power, and amplifies measurement error. Second, odds ratios are systematically higher (further from the null) than prevalence ratios; this inflation is trivial for rare outcomes, but substantial for common outcomes like obesity. Third, odds ratios can lead to incorrect conclusions during tests of interactions. The odds ratio in a particular subgroup might higher simply because the outcome is more common (and the odds ratio inflated) compared with other subgroups. CONCLUSION: Our recommendations are to take full advantage of continuous outcome data when feasible and to use prevalence ratios in place of odds ratios for common dichotomous outcomes. When odds ratios must be used, authors should document outcome prevalence across exposure groups.</p>","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"5 ","pages":"13-17"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3446823/pdf/nihms-394853.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30926911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 50

Imaging of Coronary Arteries Aid in Prevention of Atherosclerosis and Clinical Coronary Heart Disease 冠状动脉成像有助于预防动脉粥样硬化和临床冠心病

The open epidemiology journal Pub Date : 2011-12-30 DOI: 10.2174/1874297101104010152

L. Kuller, D. Edmundowicz

{"title":"Imaging of Coronary Arteries Aid in Prevention of Atherosclerosis and Clinical Coronary Heart Disease","authors":"L. Kuller, D. Edmundowicz","doi":"10.2174/1874297101104010152","DOIUrl":"https://doi.org/10.2174/1874297101104010152","url":null,"abstract":"Prevention of progression of atherosclerosis is the best approach to reduce incidence of myocardial infarction, sudden coronary heart disease (CHD) death, stroke and peripheral vascular disease. Research over the past 40 years has identified the risk factors for atherosclerotic disease, noninvasive methods for measuring the extent of atherosclerosis in multiple vascular beds and very efficacious therapy to reduce the level of risk factors and prevent cardiovascular diseases. Cardiovascular incidence and death rates have declined. Nevertheless, rates of CHD and other vascular disease remain much higher in many countries and within select regions of certain countries than necessary. Prevention of atherosclerosis depends on 4 key steps: 1) a much more aggressive effort to lower modifiable risk factors, especially apolipoprotein-B (ApoB)-containing lipoproteins, low density lipoprotein (LDL) particles, LDL cholesterol, blood pressure, obesity, and smoking during adolescence and young adult years; 2) identify and treat elevated ApoB lipoproteins, diabetes and smoking cessation of very high risk young adults as early as possible; 3) use of imaging to identify atherosclerosis of coronary and other arteries for appropriate segments of the adult population and treatment of risk factors for those with identifiable atherosclerosis; and 4) improved approaches to deliver prevention of cardiovascular disease to large numbers of asymptomatic individuals identified by non invasive imaging to maximize adherence to therapies. The major missing piece is better methods to identify vulnerable coronary plaques on the verge of an atherothrombotic transition and better treatments to prevent \"acute\" events. However, the four steps above will still lead to very substantial reductions in CHD incidence and mortality.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"4 1","pages":"152-164"},"PeriodicalIF":0.0,"publicationDate":"2011-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68063570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Geography and Chronic Disease: Illustrations from the 1900s and 2000s of the Value and Perspectives of Epidemiology 地理与慢性病:20世纪和21世纪流行病学的价值和观点的例证

The open epidemiology journal Pub Date : 2011-12-02 DOI: 10.2174/1874297101104010147

T. Erren, Melissa S. Koch

{"title":"Geography and Chronic Disease: Illustrations from the 1900s and 2000s of the Value and Perspectives of Epidemiology","authors":"T. Erren, Melissa S. Koch","doi":"10.2174/1874297101104010147","DOIUrl":"https://doi.org/10.2174/1874297101104010147","url":null,"abstract":"This commentary demonstrates that 'Geography and chronic disease' can be associated in unique ways and may point to links in the chain of disease causation in epidemiological studies. Examples from the 1900s and 2000s evince that critical causal insights into disease were gained by utilizing opportunities provided by geography. In the 1940s, studies that investigated why some cancers were more frequent in specific geographical areas than in others have provided important etiological clues. After comparing disease incidences in Africans versus African-Americans, Kennaway suggested that environmental, rather than genetic or ethnic, factors contribute to hepatic cancers. Further clues into disease etiology were provided through the investigation of \"epidemiological islands\". One example is the discovery of \"new mechanisms for the origin and dissemination of infectious diseases,\" for which Gajdusek was honored as a co- laureate of a Nobel Prize in 1976. As early as the beginning of the 1900s, scientists suggested that studies of cancer development in regions around the Earth's North Pole could be a promising research avenue. Still today, studying cancer in populations that live at extreme latitudes seems to be a promising geographic approach to better understand public health, given that two of the world's most frequent malignancies, namely breast and prostate cancer, are very rare in populations residing north of the Arctic Circle. Overall, this commentary serves as a reminder that the geographically different distribution of chronic diseases across the globe may provide unique opportunities for investigating what protects geographically confined populations against, or what makes them more susceptible to, chronic disease.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"4 1","pages":"147-151"},"PeriodicalIF":0.0,"publicationDate":"2011-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68063558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Traumatic and Non-Traumatic Spinal Cord-Injured Patients in Quebec, Canada: 1. Epidemiological, Clinical and Functional Characteristics 加拿大魁北克省创伤性和非创伤性脊髓损伤患者:流行病学、临床和功能特征

The open epidemiology journal Pub Date : 2011-02-24 DOI: 10.2174/1874297101104010133

P. Rouleau, Edouard Ayoub, P. Guertin

{"title":"Traumatic and Non-Traumatic Spinal Cord-Injured Patients in Quebec, Canada: 1. Epidemiological, Clinical and Functional Characteristics","authors":"P. Rouleau, Edouard Ayoub, P. Guertin","doi":"10.2174/1874297101104010133","DOIUrl":"https://doi.org/10.2174/1874297101104010133","url":null,"abstract":"Objective: Differences between traumatic (TSCI) and non-traumatic (NTSCI) spinal cord-injured patients with comparable geographical and socio-economical background have rarely been studied. The objective was to examine and compare a set of epidemiological, clinical, and functional characteristics in TSCI and NTSCI patients. Methods: This is a community-based, cross-sectional study of medical records from a cohort of one hundred and seventy- five (175) chronic spinal cord-injured patients (94 TSCI and 81 NTSCI individuals) who were treated at the Interval Rehabilitation Center located in Trois-Rivieres, Province of Quebec, Canada. Results: Clear differences in age, gender, extent and level of injury or associated conditions (also called secondary complications) were found between TSCI and NTSCI patients. Only one (1/81) completely injured patients was identified among the NTSCI group whereas completely injured patients constituted 37.8% of all TSCI patients. The percentage of patients with associated conditions including neurogenic bladder, neurogenic bowel, urinary tract infection, and pressure ulcer problems was significantly greater in TSCI than NTSCI patients. In contrast, a comparable proportion of TSCI and NTSCI patients was experiencing neuropathic pain. Conclusions: Given these differences between groups as well as regional-specific differences reported in studies from some other countries, it may be suggested that therapeutic approaches developed to treat these health problems and so- called associated conditions could be targeted for specific groups and subgroups of spinal cord-injured patients.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"4 1","pages":"133-139"},"PeriodicalIF":0.0,"publicationDate":"2011-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68062529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 15

All-Terrain Vehicle-Related Injuries and Hospitalization: An Examination of the Influence of Age and Alcohol or Drugs 全地形车辆相关伤害和住院:年龄和酒精或药物影响的检验

The open epidemiology journal Pub Date : 2011-02-23 DOI: 10.2174/1874297101104010123

S. Bohl, M. Sharma, Chester S. Jones

{"title":"All-Terrain Vehicle-Related Injuries and Hospitalization: An Examination of the Influence of Age and Alcohol or Drugs","authors":"S. Bohl, M. Sharma, Chester S. Jones","doi":"10.2174/1874297101104010123","DOIUrl":"https://doi.org/10.2174/1874297101104010123","url":null,"abstract":"All-terrain vehicle (ATV) related injuries are a significant source of morbidity, mortality, disability, and hospitalization, and serious injuries among the elderly are increasing. In addition, alcohol and drug use are prevalent among those injured in ATV-related incidents. However, studies indicate varying alcohol and drug use patterns among age groups and less attention has been paid to the experience of older adults and to the influence of substance abuse (alcohol or drug involvement). Therefore, the purpose of this study was to examine the relationship between age, substance abuse and hospitalization resulting from ATV incidents among injured adults over the age of 21 (legally old enough to consume alcohol). A secondary purpose of this study was to explore the relationships between age and substance abuse, substance abuse and injured body sites, and age and injured body sites. Using a cross-sectional, quantitative approach and archival data from the National Electronic Injury Surveillance System (NEISS) from 2007, 1884 incidents were evaluated and results of multiple logistic regression analysis indicated that age and substance abuse add independent information in predicting the odds of hospitalization. Using the chi-square test, similar substance abuse involvement among young, middle-aged and older adults was found and differences in the distribution of injured body sites existed between those with and without substance abuse and between the three age groups. The results of this study suggest the need for age-specific prevention, specialized safety training for older adults, and more aggressive enforcement of drinking and driving restrictions while operating ATVs in order to reduce deaths, disabilities, and considerable financial costs associated with ATV-related hospitalizations.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"4 1","pages":"123-132"},"PeriodicalIF":0.0,"publicationDate":"2011-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68062515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Intermediate Effect Biomarkers--Alternatives to Direct Concentration- Response Data for Regulatory Benefits Analyses 中间效应生物标志物——直接浓度的替代品——用于监管效益分析的响应数据

The open epidemiology journal Pub Date : 2011-01-19 DOI: 10.2174/1874297101104010070

D. Hattis

{"title":"Intermediate Effect Biomarkers--Alternatives to Direct Concentration- Response Data for Regulatory Benefits Analyses","authors":"D. Hattis","doi":"10.2174/1874297101104010070","DOIUrl":"https://doi.org/10.2174/1874297101104010070","url":null,"abstract":"Perceived needs for extensive chemical-specific toxicological information have impeded efforts to assess risks and evaluate likely public health protection benefits of possible standards for hazardous air pollutants (HAPs). This paper discusses opportunities to use effects of HAPs on early effect biomarkers, such as birth weights, to predict likely changes in rare quantal effects of concern that would be relevant for the quantification of likely regulatory benefits from exposure reductions. In the birth weight example, even modest exposures to common air pollutants can be seen as producing a kind of tax on the limited resources available to the fetus to grow and develop. In contrast to teratogenic effects, dose response relationships for fetal growth restriction in animals are often nearly linear, suggesting that the developing fetus may not generally have untapped \"functional reserve capacity\" that is expected to buffer the effects of modest exposures to toxicants in the traditional toxicological paradigm. Given this mechanistic perspective, supported in part by parallel dose response relationships between reported cigarette smoking and both birth weight and infant mortality, restriction on fetal growth can be associated with changes in quantal end effects of concern that are more difficult to assess directly in epidemiological studies.","PeriodicalId":87834,"journal":{"name":"The open epidemiology journal","volume":"4 1","pages":"70-77"},"PeriodicalIF":0.0,"publicationDate":"2011-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68062345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0