53,542 results
Search Results
202. Evidence-Based Research Series-Paper 1:What Evidence-Based Research is and why is it important?
- Author
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Donna Ciliska, Hans Lund, Karen A. Robinson, Carsten Bogh Juhl, Klara Brunnhuber, and Robin Christensen
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Biomedical Research ,Evidence-based practice ,Epidemiology ,Computer science ,Context (language use) ,Clinical health research ,Medical ethics ,Ethics, Research ,Research ethics ,03 medical and health sciences ,0302 clinical medicine ,Clinical trials ,Humans ,030212 general & internal medicine ,Clinical Trials as Topic ,Evidence-Based Medicine ,Series (mathematics) ,Reproducibility of Results ,Data science ,Evidence-based research ,Clinical trial ,Treatment Outcome ,Research Design ,Evidence synthesis ,Systematic review ,Needs Assessment ,030217 neurology & neurosurgery ,Systematic Reviews as Topic - Abstract
Objectives There is considerable actual and potential waste in research. Evidence-based research ensures worthwhile and valuable research. The aim of this series, which this article introduces, is to describe the evidence-based research approach. Study Design and Setting In this first article of a three-article series, we introduce the evidence-based research approach. Evidence-based research is the use of prior research in a systematic and transparent way to inform a new study so that it is answering questions that matter in a valid, efficient, and accessible manner. Results We describe evidence-based research and provide an overview of the approach of systematically and transparently using previous research before starting a new study to justify and design the new study (article #2 in series) and—on study completion—place its results in the context with what is already known (article #3 in series). Conclusion This series introduces evidence-based research as an approach to minimize unnecessary and irrelevant clinical health research that is unscientific, wasteful, and unethical.
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- 2021
203. The use of dried cerebrospinal fluid filter paper spots as a substrate for PCR diagnosis of the aetiology of bacterial meningitis in the Lao PDR
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Daniel H. Paris, Sabine Dittrich, A. Sengduanphachanh, Ivo Elliott, Paul N. Newton, and Phonelavanh Phoumin
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DNA, Bacterial ,Paper ,Microbiology (medical) ,Adolescent ,Epidemiology ,Bacterial meningitis ,030231 tropical medicine ,Biology ,medicine.disease_cause ,cerebrospinal fluid ,Meningitis, Bacterial ,Microbiology ,03 medical and health sciences ,Lao PDR ,0302 clinical medicine ,Cerebrospinal fluid ,Limit of Detection ,Streptococcus pneumoniae ,medicine ,Humans ,filter paper ,Prospective Studies ,030212 general & internal medicine ,Child ,Colony-forming unit ,Detection limit ,Bacteria ,Spots ,Filter paper ,Neisseria meningitidis ,Infant ,General Medicine ,medicine.disease ,Bacterial Load ,3. Good health ,Molecular Typing ,Infectious Diseases ,Laos ,Child, Preschool ,Meningitis - Abstract
We investigated whether dried cerebrospinal fluid (CSF) conserved on filter paper can be used as a substrate for accurate PCR diagnosis of important causes of bacterial meningitis in the Lao PDR. Using mock CSF, we investigated and optimized filter paper varieties, paper punch sizes, elution volumes and quantities of DNA template to achieve sensitive and reliable detection of bacterial DNA from filter paper specimens. FTA Elute Micro Card™ (Whatman, Maidstone, UK) was the most sensitive, consistent and practical variety of filter paper. Following optimization, the lower limit of detection for Streptococcus pneumoniae from dried mock CSF spots was 14 genomic equivalents (GE)/μL (interquartile range 5.5 GE/μL) or 230 (IQR 65) colony forming units/mL. A prospective clinical evaluation for S. pneumoniae, S. suis and Neisseria meningitidis was performed. Culture and PCR performed on fresh liquid CSF from patients admitted with a clinical diagnosis of meningitis (n = 73) were compared with results derived from dried CSF spots. Four of five fresh PCR-positive CSF samples also tested PCR positive from dried CSF spots, with one patient under the limit of detection. In a retrospective study of S. pneumoniae samples (n = 20), the median (IQR; range) CSF S. pneumoniae bacterial load was 1.1 × 104 GE/μL (1.2 × 105; 1 to 6.1 × 106 DNA GE/μL). Utilizing the optimized methodology, we estimate an extrapolated sensitivity of 90%, based on the range of CSF genome counts found in Laos. Dried CSF filter paper spots could potentially help us to better understand the epidemiology of bacterial meningitis in resource-poor settings and guide empirical treatments and vaccination policies. © 2013 The Authors. Clinical Microbiology and Infection published by John Wiley and Sons Ltd on behalf of the European Society of Clinical Microbiology and Infectious Disease.
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- 2013
204. Culturally Congruent Health Care of COVID-19 in Minorities in the United States: A Clinical Practice Paper From the National Coalition of Ethnic Minority Nurse Associations
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Martha A. Dawson, Sandy Littlejohn, Leo-Felix M. Jurado, Elizabeth Aquino, Lillian Tom-Orme, Norma G. Cuellar, Young Shin Lee, Mary Joy Garcia-Dia, Eun-Ok Im, and Debra A. Toney
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,Ethnic group ,Health Services Accessibility ,03 medical and health sciences ,Race (biology) ,Betacoronavirus ,0302 clinical medicine ,Nursing ,Health care ,Epidemiology ,medicine ,Ethnicity ,Humans ,030212 general & internal medicine ,Social determinants of health ,Sociology ,Healthcare Disparities ,Pandemics ,General Nursing ,Minority Groups ,030504 nursing ,business.industry ,SARS-CoV-2 ,COVID-19 ,Health Status Disparities ,Health equity ,United States ,Clinical Practice ,Socioeconomic Factors ,0305 other medical science ,business ,Coronavirus Infections - Abstract
Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial–ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method: NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial–ethnic groups. Results: Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion: This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country.
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- 2020
205. Evidence-Based Research Series-Paper 2 : Using an Evidence-Based Research approach before a new study is conducted to ensure value
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Peter Tugwell, Robin Christensen, Mike Clarke, Eva Draborg, Birgitte Nørgaard, Carsten Bogh Juhl, Klara Brunnhuber, Caroline Blaine, Marius Henriksen, Janet Martin, Mona Nasser, Hans Lund, Jane Andreasen, Karen A. Robinson, and Donna Ciliska
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Value (ethics) ,Sociology of scientific knowledge ,Evidence-based practice ,Biomedical Research ,Epidemiology ,Process (engineering) ,Computer science ,research ethics ,Clinical health research ,Medical ethics ,Research ethics ,03 medical and health sciences ,0302 clinical medicine ,Clinical trials ,systematic review ,Humans ,030212 general & internal medicine ,evidence-based research ,clinical trials ,Clinical Trials as Topic ,Evidence-Based Medicine ,End user ,evidence synthesis ,Reproducibility of Results ,Data science ,Evidence-based research ,Treatment Outcome ,medical ethics ,Evidence synthesis ,Research Design ,Key (cryptography) ,Systematic review ,030217 neurology & neurosurgery ,Needs Assessment ,clinical health research ,Systematic Reviews as Topic - Abstract
BACKGROUND AND OBJECTIVES: There is considerable actual and potential waste in research. The aim of this article is to describe how using an evidence-based research approach before conducting a study helps to ensure that the new study truly adds value.STUDY DESIGN AND SETTING: Evidence-based research is the use of prior research in a systematic and transparent way to inform a new study so that it is answering questions that matter in a valid, efficient, and accessible manner. In this second article of the evidence-based research series, we describe how to apply an evidence-based research approach before starting a new study.RESULTS: Before a new study is performed, researchers need to provide a solid justification for it using the available scientific knowledge as well as the perspectives of end users. The key method for both is to conduct a systematic review of earlier relevant studies.CONCLUSION: Describing the ideal process illuminates the challenges and opportunities offered through the suggested evidence-based research approach. A systematic and transparent approach is needed to provide justification for and to optimally design a relevant and necessary new study.
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- 2020
206. Agreement between the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) interview and a paper-administered adaption
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Almuth Berg, Steffen Fleischer, and Marion Burckhardt
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Quality of life ,Male ,Schedule ,Psychometrics ,Epidemiology ,Health Informatics ,A-weighting ,03 medical and health sciences ,0302 clinical medicine ,Clinical trials ,Germany ,Surveys and Questionnaires ,Statistics ,Humans ,030212 general & internal medicine ,Mathematics ,Aged ,lcsh:R5-920 ,030503 health policy & services ,Data Collection ,Cardiac surgery ,Crossover study ,Patient reported outcome measures ,Confidence interval ,humanities ,Weighting ,Female ,lcsh:Medicine (General) ,0305 other medical science ,Seiqol dw ,Research Article - Abstract
Background The Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW) is a prevalent face-to-face interview method for measuring quality of life by integrating respondent-generated dimensions. To apply this method in clinical trials, a paper-administered alternative would be of interest. Therefore, our study aimed to analyze the agreement between the SEIQoL-DW and a paper questionnaire version (SEIQoL-PF/G). Methods In a crossover design, both measures were completed in a random sequence. 104 patients at a heart surgery hospital in Germany were randomly assigned to receive either the SEIQoL-DW or the SEIQoL-PF/G as the first measurement in the sequence. Patients were approached on their earliest stable day after surgery. The average time between both measurements was 1 day (mean 1.3; SD 0.8). Agreement regarding the indices, ratings, and weightings of nominated life areas (cues) was explored using Bland-Altman plots with 95% limits of agreement (LoA). Agreement of the SEIQoL indices was defined as acceptable if the LoA did not exceed a threshold of 10 scale points. Data from n = 99 patients were included in the agreement analysis. Results Both measures led to similarly nominated cues. The most frequently nominated cues were “physical health” and “family”. In the Bland-Altman plot, the indices showed a mean of differences of 2 points (95% CI, − 1 to 6). The upper LoA showed a difference of 36 points (95% CI, 30 to 42), and the lower LoA showed a difference of − 31 points (95% CI, − 37 to − 26). Thus, the LoAs and confidence intervals exceeded the predefined threshold. The Bland-Altman plots for the cue levels and cue weights showed similar results. The SEIQoL-PF/G version showed a tendency for equal weighting of cues, while the weighting procedure of the SEIQoL-DW led to greater variability. Conclusions For cardiac surgery patients, use of the current version of the SEIQoL-PF/G as a substitute for the SEIQoL-DW is not recommended. The current questionnaire weighting method seems to be unable to distinguish weighting for different cues. Therefore, the further design of a weighting method without interviewer support as a paper-administered measure of individual quality of life is desirable.
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- 2020
207. Going web or staying paper? The use of web-surveys among older people
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Susanne Kelfve, Magnus Lindwall, Boo Johansson, and Marie Kivi
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Gerontology ,Male ,Non-response ,Epidemiology ,Population ,education ,050801 communication & media studies ,Health Informatics ,Sample (statistics) ,Web-push methodology ,Survey mode ,Older adults ,Web-survey ,Generalizability ,Retirement ,Sociodemographic differences ,03 medical and health sciences ,Arbetsmedicin och miljömedicin ,0508 media and communications ,0302 clinical medicine ,Surveys and Questionnaires ,Humans ,Generalizability theory ,030212 general & internal medicine ,Association (psychology) ,Baseline (configuration management) ,Depression (differential diagnoses) ,Aged ,lcsh:R5-920 ,education.field_of_study ,05 social sciences ,Public Health, Global Health, Social Medicine and Epidemiology ,Occupational Health and Environmental Health ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Research Design ,Educational Status ,Female ,Self Report ,lcsh:Medicine (General) ,Older people ,Psychology ,Retirement age ,Research Article - Abstract
Background Web-surveys are increasingly used in population studies. Yet, web-surveys targeting older individuals are still uncommon for various reasons. However, with younger cohorts approaching older age, the potentials for web-surveys among older people might be improved. In this study, we investigated response patterns in a web-survey targeting older adults and the potential importance of offering a paper-questionnaire as an alternative to the web-questionnaire. Methods We analyzed data from three waves of a retirement study, in which a web-push methodology was used and a paper questionnaire was offered as an alternative to the web questionnaire in the last reminder. We mapped the response patterns, compared web- and paper respondents and compared different key outcomes resulting from the sample with and without the paper respondents, both at baseline and after two follow-ups. Results Paper-respondents, that is, those that did not answer until they got a paper questionnaire with the last reminder, were more likely to be female, retired, single, and to report a lower level of education, higher levels of depression and lower self-reported health, compared to web-respondents. The association between retirement status and depression was only present among web-respondents. The differences between web and paper respondents were stronger in the longitudinal sample (after two follow-ups) than at baseline. Conclusions We conclude that a web-survey might be a feasible and good alternative in surveys targeting people in the retirement age range. However, without offering a paper-questionnaire, a small but important group will likely be missing with potential biased estimates as the result.
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- 2020
208. Call for Papers-Journal of Epidemiology Reprints of Pioneering Papers Series: Spotlighting Little-Known Non-English Language Research Papers From Japan and Around the World
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Naoki Kondo
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Publishing ,lcsh:R5-920 ,medicine.medical_specialty ,business.industry ,Epidemiology ,policy implication ,Public health ,Spotlighting ,public health ,Library science ,General Medicine ,English language ,Global Health ,pioneering studies ,Editorial ,Japan ,Others ,medicine ,Humans ,Periodicals as Topic ,lcsh:Medicine (General) ,business ,Language - Published
- 2019
209. Statistical approaches in published ophthalmic clinical science papers: a comparison to statistical practice two decades ago
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Harrison G Zhang and Gui-Shuang Ying
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medicine.medical_specialty ,Biomedical Research ,Biometry ,genetic structures ,Paired comparison ,Clinical science ,Article ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Research community ,Epidemiology ,medicine ,Humans ,Statistical analysis ,030212 general & internal medicine ,business.industry ,Individual level ,eye diseases ,United Kingdom ,Sensory Systems ,Ophthalmology ,Current practice ,030221 ophthalmology & optometry ,Optometry ,Periodicals as Topic ,business - Abstract
The aim of this study is to evaluate the current practice of statistical analysis of eye data in clinical science papers published in British Journal of Ophthalmology (BJO) and to determine whether the practice of statistical analysis has improved in the past two decades. All clinical science papers (n=125) published in BJO in January–June 2017 were reviewed for their statistical analysis approaches for analysing primary ocular measure. We compared our findings to the results from a previous paper that reviewed BJO papers in 1995. Of 112 papers eligible for analysis, half of the studies analysed the data at an individual level because of the nature of observation, 16 (14%) studies analysed data from one eye only, 36 (32%) studies analysed data from both eyes at ocular level, one study (1%) analysed the overall summary of ocular finding per individual and three (3%) studies used the paired comparison. Among studies with data available from both eyes, 50 (89%) of 56 papers in 2017 did not analyse data from both eyes or ignored the intereye correlation, as compared with in 60 (90%) of 67 papers in 1995 (P=0.96). Among studies that analysed data from both eyes at an ocular level, 33 (92%) of 36 studies completely ignored the intereye correlation in 2017, as compared with in 16 (89%) of 18 studies in 1995 (P=0.40). A majority of studies did not analyse the data properly when data from both eyes were available. The practice of statistical analysis did not improve in the past two decades. Collaborative efforts should be made in the vision research community to improve the practice of statistical analysis for ocular data.
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- 2018
210. A White Paper on Global Wheat Health Based on Scenario Development and Analysis
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Serge Savary, Paul D. Esker, Pawan K. Singh, J. Kumar, Jonathan Yuen, Laetitia Willocquet, Laurence V. Madden, Vittorio Rossi, Sébastien Saint-Jean, J. M.C. Fernandes, E. M. Del Ponte, C. Pope de Vallavielle, Andrea Ficke, Pierce A. Paul, Laurent Huber, Neil McRoberts, Annika Djurle, Université de Toulouse, Swedish University of Agricultural Sciences (SLU), Norwegian Institute of Bioeconomy Research (NIBIO), Università Cattolica del Sacro Cuore, Universidad de Costa Rica (UCR), Empresa Brasileira de Pesquisa Agropecuária (Embrapa), Ministério da Agricultura, Pecuária e Abastecimento [Brasil] (MAPA), Governo do Brasil-Governo do Brasil, Universidade Federal de Vicosa (UFV), Ohio State University, Partenaires INRAE, Dept Plant Pathol, University of California [Davis] (UC Davis), University of California-University of California, International Maize and Wheat Improvement Center (CIMMYT), Consultative Group on International Agricultural Research [CGIAR], Ecologie fonctionnelle et écotoxicologie des agroécosystèmes (ECOSYS), Institut National de la Recherche Agronomique (INRA)-AgroParisTech, Université Paris Saclay (COmUE), BIOlogie et GEstion des Risques en agriculture (BIOGER), SMaCH, (RAW) Workshop, CNPq, AGroécologie, Innovations, teRritoires (AGIR), Institut National de la Recherche Agronomique (INRA)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Istituto di Entomologia e Patologia vegetale, Centre for Environmental Biology, Lisbon University, University of Lisbon, G.B. Pant University of Agriculture & Technology, Ohio State University [Columbus] (OSU), University of California, Université Paris-Saclay, AgroParisTech-Institut National de la Recherche Agronomique (INRA), JOSE MAURICIO CUNHA FERNANDES, CNPT., Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Universidade de Lisboa (ULISBOA), Consultative Group on International Agricultural Research [CGIAR] (CGIAR), and AgroParisTech-Université Paris-Saclay-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
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0106 biological sciences ,[SDV]Life Sciences [q-bio] ,Plant Science ,01 natural sciences ,SMALL-GRAIN CEREALS ,Theoretical ,Doença de planta ,Models ,wheat ,Plant Pathosystems ,Triticum ,Epidemiology ,2. Zero hunger ,CLIMATE-CHANGE ,FUSARIUM HEAD BLIGHT ,Environmental resource management ,food and beverages ,MYCOSPHAERELLA-GRAMINICOLA ,04 agricultural and veterinary sciences ,WINTER-WHEAT ,Plant disease ,Wheat ,[SDE]Environmental Sciences ,Settore AGR/12 - PATOLOGIA VEGETALE ,Risk assessment ,Crops, Agricultural ,Risk ,Risk analysis ,Climate Change ,[SDE.MCG]Environmental Sciences/Global Changes ,Climate change ,Crops ,Trigo ,Biology ,Scenario development and analysis ,agrosystem ,Computer Simulation ,Scenario analysis ,Epidemiologia ,Plant Diseases ,YELLOW DWARF VIRUS ,Agricultural ,SEPTORIA-TRITICI BLOTCH ,Plant disease epidemiology ,business.industry ,NORTH-WEST EUROPE ,Simulation modeling ,pathogens ,Models, Theoretical ,15. Life on land ,[SDV.BV.PEP]Life Sciences [q-bio]/Vegetal Biology/Phytopathology and phytopharmacy ,A white paper ,MAPPING POTENTIAL EPIDEMICS ,13. Climate action ,PLANT-DISEASES ,040103 agronomy & agriculture ,0401 agriculture, forestry, and fisheries ,fungi ,[SDE.BE]Environmental Sciences/Biodiversity and Ecology ,business ,Septoria like ,Agronomy and Crop Science ,010606 plant biology & botany - Abstract
International audience; Scenario analysis constitutes a useful approach to synthesize knowledge and derive hypotheses in the case of complex systems that are documented with mainly qualitative or very diverse information. In this article, a framework for scenario analysis is designed and then, applied to global wheat health within a timeframe from today to 2050. Scenario analysis entails the choice of settings, the definition of scenarios of change, and the analysis of outcomes of these scenarios in the chosen settings. Three idealized agrosystems, representing a large fraction of the global diversity of wheat-based agrosystems, are considered, which represent the settings of the analysis. Several components of global changes are considered in their consequences on global wheat health: climate change and climate variability, nitrogen fertilizer use, tillage, crop rotation, pesticide use, and the deployment of host plant resistances. Each idealized agrosystem is associated with a scenario of change that considers first, a production situation and its dynamics, and second, the impacts of the evolving production situation on the evolution of crop health. Crop health is represented by six functional groups of wheat pathogens: the pathogens associated with Fusarium head blight; biotrophic fungi, Septoria-like fungi, necrotrophic fungi, soilborne pathogens, and insect-transmitted viruses. The analysis of scenario outcomes is conducted along a risk-analytical pattern, which involves risk probabilities represented by categorized probability levels of disease epidemics, and risk magnitudes represented by categorized levels of crop losses resulting from these levels of epidemics within each production situation. The results from this scenario analysis suggest an overall increase of risk probabilities and magnitudes in the three idealized agrosystems. Changes in risk probability or magnitude however vary with the agrosystem and the functional groups of pathogens. We discuss the effects of global changes on the six functional groups, in terms of their epidemiology and of the crop losses they cause. Scenario analysis enables qualitative analysis of complex systems, such as plant pathosystems that are evolving in response to global changes, including climate change and technology shifts. It also provides a useful framework for quantitative simulation modeling analysis for plant disease epidemiology.
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- 2017
211. Series: Pragmatic trials and real world evidence: Paper 8. Data collection and management
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Anna Katharina Meinecke, Mira G. P. Zuidgeest, Paco M J Welsing, George Kafatos, Gaëlle Nachbaur, Des Burke, Maria Kubin, Sven Trelle, and Matthias Egger
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Evidence-Based Medicine ,Data collection ,Electronic data capture ,Epidemiology ,business.industry ,Process (engineering) ,Management science ,Data Collection ,Level of detail (writing) ,030204 cardiovascular system & hematology ,Real world evidence ,Data science ,03 medical and health sciences ,0302 clinical medicine ,Data access ,Pragmatic Clinical Trials as Topic ,Health care ,Electronic Health Records ,Humans ,Medicine ,030212 general & internal medicine ,business ,Case report form - Abstract
Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory, and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice. Furthermore, it should allow for the involvement of a representative sample of practices, physicians, and patients who prescribe/receive treatment in routine care. This paper discusses challenges that are related to the different methods of data collection and presents potential solutions where possible. No one-size-fits-all recommendation can be given for the collection of data in pragmatic trials, although in general the application of existing routinely used data-collection systems and processes seems to best suit the pragmatic approach. However, data access and privacy, the time points of data collection, the level of detail in the data, and the lack of a clear understanding of the data-collection process were identified as main challenges for the usage of routinely collected data in pragmatic trials. A first step should be to determine to what extent existing health care databases provide the necessary study data and can accommodate data collection and management. When more elaborate or detailed data collection or more structured follow-up is required, data collection in a pragmatic trial will have to be tailor-made, often using a hybrid approach using a dedicated electronic case report form (eCRF). In this case, the eCRF should be kept as simple as possible to reduce the burden for practitioners and minimize influence on routine clinical practice.
- Published
- 2017
212. An experimental comparison of web-push vs. paper-only survey procedures for conducting an in-depth health survey of military spouses.
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McMaster, Hope Seib, LeardMann, Cynthia A., Speigle, Steven, Dillman, Don A., and Millennium Cohort Family Study Team
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MILITARY spouses ,INTERNET surveys ,RESEARCH methodology ,EPIDEMIOLOGY ,ACQUISITION of data ,COMPARATIVE studies ,INDUSTRIES ,INTERNET ,LONGITUDINAL method ,MEDICAL cooperation ,POSTAL service ,RESEARCH ,MILITARY personnel ,SPOUSES ,SURVEYS ,EVALUATION research - Abstract
Background: Previous research has found that a "web-push" approach to data collection, which involves contacting people by mail to request an Internet survey response while withholding a paper response option until later in the contact process, consistently achieves lower response rates than a "paper-only" approach, whereby all respondents are contacted and requested to respond by mail.Method: An experiment was designed, as part of the Millennium Cohort Family Study, to compare response rates, sample representativeness, and cost between a web-push and a paper-only approach; each approach comprised 3 stages of mail contacts. The invited sample (n = 4,935) consisted of spouses married to U.S. Service members, who had been serving in the military between 2 and 5 years as of October, 2011.Results: The web-push methodology produced a significantly higher response rate, 32.8% compared to 27.8%. Each of the 3 stages of postal contact significantly contributed to response for both treatments with 87.1% of the web-push responses received over the Internet. The per-respondent cost of the paper-only treatment was almost 40% higher than the web-push treatment group. Analyses revealed no meaningfully significant differences between treatment groups in representation.Conclusion: These results provide evidence that a web-push methodology is more effective and less expensive than a paper-only approach among young military spouses, perhaps due to their heavy reliance on the internet, and we suggest that this approach may be more effective with the general population as they become more uniformly internet savvy. [ABSTRACT FROM AUTHOR]- Published
- 2017
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213. Office Paper
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Epidemiology ,Business, international - Abstract
Request for quotations : office paper 1. office paper, class a 100 packs, 900 byn2. office paper, class b 1,000 packs, 8,500 byn3. office paper, class c 500 packs, 4 [...]
- Published
- 2021
214. Paper For Office Equipment For A Branch In The South-west Administrative District
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Epidemiology ,Electronic office machines ,Business, international - Abstract
Tenders are invited for paper for office equipment for a branch in the south-west administrative district Paper and paper products Major organization : FEDERAL BUDGETARY INSTITUTION OF HEALTHCARE 'CENTER OF [...]
- Published
- 2021
215. Response to the Opinion paper 'Why do we disagree?'
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Shira Kramer and Colin L. Soskolne
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Text mining ,Epidemiology ,business.industry ,Political science ,General Medicine ,business ,Data science - Published
- 2021
216. Phyloseq R object accompanying the paper Temporal Dynamics Cloacal Microbiota 16S metataxonomics
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16S v3v4 ,Epidemiologie ,Epidemiology ,Bioinformatica & Diermodellen ,Bio-informatics & Animal models ,DaDa2 ,microbiota ,phyloseq R object - Abstract
This ready to load phyloseq R S4 object contains the ASV table, taxonomy table and sample metadata. This data was build using the DaDa2 (version 1.6.0) and phyloseq (version 1.223) R packages using our raw MiSeq PE300 sequencing data deposited at NCBI-SRA under BioProject: PRJNA673103. Associations between animal health and performance, and the host’s microbiota have been recently established. In poultry, changes in the intestinal microbiota have been linked to housing conditions and host development, but how the intestinal microbiota respond to environmental changes under farm conditions is less well understood. To gain insight into the microbial responses following a change in the host’s immediate environment, we monitored four indoor flocks of adult laying chickens three times over 16 weeks, during which two flocks were given access to an outdoor range, and two were kept indoors. To assess changes in the chickens’ microbiota over time, we collected cloacal swabs of 10 hens per flock and performed 16S rRNA gene amplicon sequencing. The poultry house (i.e., the stable in which flocks were housed) and sampling time explained 9.2 % and 4.4 % of the variation in the microbial community composition of the flocks, respectively. Remarkably, access to an outdoor range had no detectable effect on microbial community composition, the variability of microbiota among chickens of the same flock, or microbiota richness, but the microbiota of outdoor flocks became more even over time. Fluctuations in the composition of the microbiota over time within each poultry house were mainly driven by turnover in rare, rather than dominant, taxa and were unique for each flock. We identified 16 amplicon sequence variants that were differentially abundant over time between indoor and outdoor housed chickens, however none were consistently higher or lower across all chickens of one housing type over time. Our study shows that cloacal microbiota community composition in adult layers is stable following a sudden change in environment, and that temporal fluctuations are unique to each flock. By exploring microbiota of adult poultry flocks within commercial settings, our study sheds light on how the chickens’ immediate environment affects the microbiota composition.
- Published
- 2021
217. Obesity-related hypertension: Pathogenesis, cardiovascular risk, and treatment-A position paper of theThe Obesity Societyand theAmerican Society of Hypertension
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Lewis Landsberg, James R. Sowers, Valerie Burke, Donald M. Lloyd-Jones, Louis J. Aronne, Lawrence J. Beilin, and Leon I. Igel
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medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Medicine (miscellaneous) ,medicine.disease ,Obesity ,Lifestyle management ,Pathogenesis ,Endocrinology ,Blood pressure ,Epidemiology ,medicine ,Physical therapy ,Position paper ,Metabolic syndrome ,Intensive care medicine ,business - Abstract
In light of the worldwide epidemic of obesity, and in recognition of hypertension as a major factor in the cardiovascular morbidity and mortality associated with obesity, The Obesity Society and The American Society of Hypertension agreed to jointly sponsor a position paper on obesity-related hypertension to be published jointly in the journals of each society. The purpose is to inform the members of both societies, as well as practicing clinicians, with a timely review of the association between obesity and high blood pressure, the risk that this association entails, and the options for rational, evidenced-based treatment. The position paper is divided into six sections plus a summary as follows: pathophysiology, epidemiology and cardiovascular risk, the metabolic syndrome, lifestyle management in prevention and treatment, pharmacologic treatment of hypertension in the obese, and the medical and surgical treatment of obesity in obese hypertensive patients.
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- 2012
218. Immune trypanolysis test with blood spotted on filter paper for epidemiological surveillance of sleeping sickness.
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Camara, Oumou, Camara, Mamadou, Lejon, Veerle, Ilboudo, Hamidou, Sakande, Hassane, Léno, Mamadou, Büscher, Philippe, Bucheton, Bruno, and Jamonneau, Vincent
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IMMUNE response , *BLOOD filtration , *FILTER paper , *EPIDEMIOLOGY , *PATIENT monitoring , *IMMUNOGLOBULINS - Abstract
Objectives The immune trypanolysis test ( TL) is an accurate sero-diagnostic tool increasingly implemented for sleeping sickness medical surveillance, but it is restricted to the reference laboratories. To facilitate storage and transport of the test specimen, we developed a protocol for the examination of blood spotted on filter paper ( TL-fp) that can be stored and shipped at ambient temperature. We compared its performance with the classical TL on plasma ( TL-pl) that needs to be kept frozen until use. Methods The study was conducted in active foci of the Republic of Guinea. In total, 438 specimens from treated and untreated sleeping sickness patients and serological suspects were tested with both methods. Result TL-fp gave significantly less positive results than TL-pl, but all the confirmed sleeping sickness cases were positive with the TL-fp protocol. Conclusion TL-fp appears to offer a good compromise between feasibility and sensitivity to detect currently infected subjects who play a role in the transmission of Trypanosoma brucei gambiense and is useful for contributing to the elimination of gambiense sleeping sickness. [ABSTRACT FROM AUTHOR]
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- 2014
- Full Text
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219. European Laryngological Society position paper on laryngeal dysplasia part I: aetiology and pathological classification
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Odell, Edward, Eckel, Hans Edmund, Simo, Ricard, Quer, Miquel, Paleri, Vinidh, Klussmann, Jens Peter, Remacle, Marc, Sjögren, Elisabeth, Piazza, Cesare, and Universitat Autònoma de Barcelona
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Carcinoma in situ ,Dysplasia ,Laryngeal carcinoma ,Laryngeal intraepithelial neoplasia ,Humans ,Hyperplasia ,Leukoplakia ,Head and Neck Neoplasms ,Laryngeal Neoplasms ,Larynx ,Precancerous Conditions ,0301 basic medicine ,medicine.medical_specialty ,Review Article ,Malignant transformation ,03 medical and health sciences ,0302 clinical medicine ,Epidemiology ,Medicine ,Grading (tumors) ,Pathological ,business.industry ,General Medicine ,medicine.disease ,Dermatology ,030104 developmental biology ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Etiology ,business - Abstract
Purpose of review To give an overview of the current knowledge regarding the aetiology, epidemiology, and classification of laryngeal dysplasia (LD) and to highlight the contributions of recent literature. As most cases of dysplasia occur at the glottic level and data on diagnosis and management are almost exclusively from this location, laryngeal dysplasia in this position paper is taken to be synonymous with dysplasia of the vocal folds. Summary LD has long been recognized as a precursor lesion to laryngeal squamous cell carcinoma (SCC). Tobacco and alcohol consumption are the two single most important etiological factors for the development of LD. There is currently insufficient evidence to support a role of reflux. Although varying levels of human papillomavirus have been identified in LD, its causal role is still uncertain, and there are data suggesting that it may be limited. Dysplasia has a varying presentation including leukoplakia, erythroleukoplakia, mucosal reddening or thickening with exophytic, “tumor-like” alterations. About 50% of leukoplakic lesions will contain some form of dysplasia. It has become clear that the traditionally accepted molecular pathways to cancer, involving accumulated mutations in a specific order, do not apply to LD. Although the molecular nature of the progression of LD to SCC is still unclear, it can be concluded that the risk of malignant transformation does rise with increasing grade of dysplasia, but not predictably so. Consequently, grading systems are inherently troubled by the weak correlation between the degree of the dysplasia and the risk of malignant transformation. The best data on LD grading and outcomes come from the Ljubljana group, forming the basis for the World Health Organization classification published in 2017.
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- 2020
220. Developing trustworthy recommendations as part of an urgent response (1-2 weeks): a GRADE concept paper GRADE Rapid Guidelines project group
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Alexander G. Mathioudakis, Rachel Rodin, Jan Brozek, Mohammed T. Ansari, Francesco Nonino, Maicon Falavigna, Laura Amato, Nicole Skoetz, Rebecca L Morgan, Andrew A. Rooney, Gregory Traversy, Srinivasa Vittal Katikireddi, Gerald Gartlehner, Arnav Agarwal, John J. Riva, Andrea J. Darzi, Craig Lockwood, Michael McCaul, Silvia Minozzi, Reem A. Mustafa, Holger J. Schünemann, Miranda W. Langendam, Joerg J Meerpohl, Jitka Klugarová, Amir Qaseem, Thomas Piggott, Kris Thayer, Elie A. Akl, Carlos Alva-Diaz, Manoj J. Mammen, Hector Pardo-Hernandez, Valerie King, Brian S. Alper, Philipp Dahm, Derek K. Chu, Nigar Sekercioglu, Brandiese E. J. Beverly, Epidemiology and Data Science, APH - Mental Health, APH - Methodology, and APH - Quality of Care
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medicine.medical_specialty ,Process management ,Consensus ,Computer science ,Epidemiology ,Information Management ,Multidisciplinary team ,03 medical and health sciences ,0302 clinical medicine ,Outcome Assessment, Health Care ,medicine ,Humans ,Guideline development ,trustworthy guideline ,030212 general & internal medicine ,Grading (education) ,Project group ,urgent recommendation ,Evidence-Based Medicine ,Public health ,pandemic ,3. Good health ,Trustworthiness ,GRADE ,Practice Guidelines as Topic ,Original Article ,030217 neurology & neurosurgery ,Healthcare system ,Systematic Reviews as Topic - Abstract
Objective To propose an approach for developing trustworthy recommendations as part of urgent responses (1-2 weeks) in the clinical, public health, and health systems fields. Study design and setting We conducted a review of the literature, outlined a draft approach, refined the concept through iterative discussions, a workshop by the GRADE Rapid Guidelines project group, and obtained feedback from the larger GRADE working group. Results A request for developing recommendations within two weeks is the usual trigger for an urgent response. While the approach builds on the general principles of trustworthy guideline development, we highlight the following steps: (1) assess the level of urgency; (2) assess feasibility; (3) set up the organizational logistics; (4) specify the question(s); (5) collect the information needed; (6) assess the adequacy of identified information; (7) develop the recommendations using one of four potential approaches: adopt existing recommendations; adapt existing recommendations; develop new recommendations using existing adequate systematic review; or develop new recommendations using expert panel input; and (8) consider an updating plan. Conclusion An urgent response for developing recommendations requires building a cohesive, skilled and highly motivated multidisciplinary team with the necessary clinical, scientific, and methodological expertise, adapting to shifting needs, complying with the principles of transparency and properly managing conflicts of interest., Highlights • The proposed approach for developing trustworthy recommendations as part of urgent responses (1-2 weeks) builds on the general principles of trustworthy guideline development; • The approach proposes the following steps: (1) assess the level of urgency; (2) clarify and focus the scope of question(s); (3) prioritize and collect the information needed; (4) assess the adequacy of identified information; and then (5) develop recommendations; • Developing recommendations can consist of a) adopting existing recommendations; (b) adapting existing recommendations; c) developing new recommendations using existing systematic reviews; or d) developing new recommendations using identified information and panel input.
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- 2020
221. A protocol paper: community engagement interventions for cardiovascular disease prevention in socially disadvantaged populations in the UK: an implementation research study
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Sibyl Anthierens, Geofrey Musinguzi, Papreen Nahar, Harm W.J. van Marwijk, Elizabeth Ford, Stephen Bremner, Hilde Bastiaens, Mark Bowyer, Jean Yves Le Reste, Linda Gibson, and Tholene Sodi
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Counseling ,medicine.medical_specialty ,Implementation research ,Health (social science) ,Epidemiology ,Psychological intervention ,030204 cardiovascular system & hematology ,Risk Assessment ,Vulnerable Populations ,State Medicine ,03 medical and health sciences ,Study Protocol ,0302 clinical medicine ,Nursing ,Health care ,medicine ,Stakeholder analysis ,030212 general & internal medicine ,Stepped-wedge cluster randomised trial ,Community engagement ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Public health ,1. No poverty ,Public Health, Environmental and Occupational Health ,Community Participation ,lcsh:RA1-1270 ,CVD risk prevention ,United Kingdom ,3. Good health ,Disadvantaged ,England ,Cardiovascular Diseases ,Community health ,Human medicine ,business ,Psychology - Abstract
Background Cardiovascular disorders (CVD) are the single greatest cause of mortality worldwide. In the UK, the National Health Service (NHS) has launched an initiative of health checks over and above current care to tackle CVD. However, the uptake of Health Checks is poor in disadvantaged communities. This protocol paper sets out a UK-based study (Sussex and Nottingham) aiming to co-produce a community delivered CVD risk assessment and coaching intervention to support community members to reduce their risk of CVD. The overall aim of the project is to implement a tailored-to-context community engagement (CE) intervention on awareness of CVD risks in vulnerable populations in high, middle and low-income countries. The specific objectives of the study are to enhance stakeholder’ engagement; to implement lifestyle interventions for cardiovascular primary prevention, in disadvantaged populations and motivate uptake of NHS health checks. Methods This study uses both qualitative and quantitative methods in three phases of evaluation, including pre-, per- and post-implementation. To ensure contextual appropriateness the ‘Scaling-up Packages of Interventions for Cardiovascular disease prevention in selected sites in Europe and Sub-Saharan Africa: An implementation research’ (SPICES) project will organize a multi-component community-engagement intervention. For the qualitative component, the pre-implementation phase will involve a contextual assessment and stakeholder mapping, exploring potentials for CVD risk profiling strategies and led by trained Community Health Volunteers (CHV) to identify accessibility and acceptability. The per-implementation phase will involve healthy lifestyle counselling provided by CHVs and evaluation of the outcome to identify fidelity and scalability. The post-implementation phase will involve developing sustainable community-based strategies for CVD risk reduction. All three components will include a process evaluation. A stepped wedge cluster randomised trial of the roll out will focus on implementation outcomes including uptake and engagement and changes in risk profiles. The quantitative component includes pre and post-intervention surveys. The theory of the socio-ecological framework will be applied to analyse the community engagement approach. Discussion Based on the results ultimately a sustainable community engagement-based strategy for the primary prevention of CVD risk will be developed to enhance the performance of NHS health care in the UK. The Trial Registration number is ISRCTN68334579.
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- 2020
222. Improvement of cognitive function after paper‐based cognitive training intervention in early‐stage Alzheimer's disease
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Min Ju Kang and Jeong Ho Han
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Epidemiology ,business.industry ,Health Policy ,Neuropsychology ,Cognition ,Disease ,medicine.disease ,Cognitive training ,Psychiatry and Mental health ,Cellular and Molecular Neuroscience ,Developmental Neuroscience ,Intervention (counseling) ,medicine ,Dementia ,Neurology (clinical) ,Geriatrics and Gerontology ,Stage (cooking) ,Cognitive decline ,business ,Clinical psychology - Published
- 2020
223. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists
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Peter-John Wormald, Christos Georgalas, Bob Kern, David Price, Richard G. Douglas, Rodney J. Schlosser, Nick Jones, Joachim Mullol, Guy Joos, Anders Cervin, Richard J. Harvey, Herbert Riechelmann, Elina Toskala, Richard Louis Voegels, De Yun Wang, Wytske Fokkens, Brent A. Senior, Claus Bachert, Noam A. Cohen, Peter Hellings, Isam Alobid, Herman Goossens, Mike Thomas, Fuad M. Baroody, Livije Kalogjera, Philippe Gevaert, Claire Hopkins, Valerie J. Lund, and Marek L. Kowalski
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medicine.medical_specialty ,Evidence-based practice ,Chronic rhinosinusitis ,business.industry ,General Medicine ,Disease ,medicine.disease ,Dermatology ,Otorhinolaryngology ,Epidemiology ,Acute rhinosinusitis ,medicine ,Position paper ,Aspirin exacerbated respiratory disease ,Nasal polyps ,business - Abstract
The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also proposed definitions for difficult to treat rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.
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- 2012
224. Scientific authorship and collaboration network analysis on malaria research in Benin: papers indexed in the web of science (1996–2016)
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Zachary James Harper, Susan McRoy, Charles M. Welzig, Fiacre R. Agossa, and Roseric Azondekon
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Health (social science) ,Epidemiology ,Computer science ,Collaborative network ,030231 tropical medicine ,Closeness ,Giant component ,World Wide Web ,03 medical and health sciences ,0302 clinical medicine ,Betweenness centrality ,Benin ,030212 general & internal medicine ,Clustering coefficient ,Research ,Health Policy ,lcsh:Public aspects of medicine ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Complex network ,Co-authorship ,Hierarchical clustering ,Malaria ,Scientific collaboration ,Network analysis - Abstract
Background To sustain the critical progress made, prioritization and a multidisciplinary approach to malaria research remain important to the national malaria control program in Benin. To document the structure of the malaria collaborative research in Benin, we analyze authorship of the scientific documents published on malaria from Benin. Methods We collected bibliographic data from the Web Of Science on malaria research in Benin from January 1996 to December 2016. From the collected data, a mulitigraph co-authorship network with authors representing vertices was generated. An edge was drawn between two authors when they co-author a paper. We computed vertex degree, betweenness, closeness, and eigenvectors among others to identify prolific authors. We further assess the weak points and how information flow in the network. Finally, we perform a hierarchical clustering analysis, and Monte-Carlo simulations. Results Overall, 427 publications were included in this study. The generated network contained 1792 authors and 116,388 parallel edges which converted in a weighted graph of 1792 vertices and 95,787 edges. Our results suggested that prolific authors with higher degrees tend to collaborate more. The hierarchical clustering revealed 23 clusters, seven of which form a giant component containing 94% of all the vertices in the network. This giant component has all the characteristics of a small-world network with a small shortest path distance between pairs of three, a diameter of 10 and a high clustering coefficient of 0.964. However, Monte-Carlo simulations suggested our observed network is an unusual type of small-world network. Sixteen vertices were identified as weak articulation points within the network. Conclusion The malaria research collaboration network in Benin is a complex network that seems to display the characteristics of a small-world network. This research reveals the presence of closed research groups where collaborative research likely happens only between members. Interdisciplinary collaboration tends to occur at higher levels between prolific researchers. Continuously supporting, stabilizing the identified key brokers and most productive authors in the Malaria research collaborative network is an urgent need in Benin. It will foster the malaria research network and ensure the promotion of junior scientists in the field.
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- 2018
225. Seroepidemiological study of human cysticercosis with blood samples collected on filter paper, in Lages, State of Santa Catarina, Brazil, 2004-2005
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Noeli Maria Espíndola, Diana Ana Pereira, Alberto Hiroshi Iha, Maria Marcia Imenes Ishida, M.S.S Almeida, Theopi Rados Varvakis, Jean Gabriel de Souza, and Adelaide José Vaz
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Male ,Paper ,Rural Population ,Microbiology (medical) ,Taenia crassiceps ,lcsh:Arctic medicine. Tropical medicine ,lcsh:RC955-962 ,Swine ,Epidemiology ,Immunoblotting ,Antibodies, Helminth ,Enzyme-Linked Immunosorbent Assay ,Biology ,Imunodiagnóstico ,Animals ,Humans ,Immunodiagnosis ,Epidemiologia ,Blood Specimen Collection ,Taenia ,Cysticercosis ,Cisticercose ,biology.organism_classification ,Molecular biology ,Infectious Diseases ,Socioeconomic Factors ,Female ,Parasitology ,Epidemiologic Methods ,Brazil - Abstract
INTRODUCTION: Human serofrequency of antibodies against Taenia solium antigens was determined and risk factors for cysticercosis transmission were identified. METHODS: Individuals (n=878) from periurban and rural locations of Lages, SC, were interviewed to gather demographic, sanitary and health information. Interviews and blood sample collections by finger prick on Whatman filter paper were performed from August 2004 to May 2005. Observation determined that 850 samples were suitable for analysis and were tested by ELISA using vesicular fluid of Taenia crassiceps heterologous antigen. To ensure the reliability of the results, 77 samples of the dried blood were matched with sera. The reactive samples were submitted to a serum confirmatory immunoblot (IB) test using purified Taenia crassiceps glycoproteins. RESULTS: The ELISA results for the dried blood and serum samples were statistically consistent. ELISA was positive in 186 (21.9%) out of 850 individuals. A group of 213 individuals were asked to collect vein blood for IB (186 with positive result in ELISA and 27 with inappropriate whole blood samples) and 130 attended the request. The IB was positive in 29 (3.4%) out of 850 individuals. A significant correlation (p = 0.0364) was determined among individuals who tested positive in the IB assay who practiced both pig rearing and kitchen gardening. CONCLUSIONS: ELISA with dried blood eluted from filter paper was suitable for cysticercosis population surveys. In Lages, human infection was associated with pig rearing and kitchen gardening. The prevalence index was compatible with other Latin American endemic areas. INTRODUÇÃO: O primeiro levantamento sobre cisticercose humana e identificação dos fatores de risco associados à transmissão, foram realizados em Lages, SC. MÉTODOS: Oitocentos e setenta e sete voluntários de regiões periurbana e rural foram entrevistados e forneceram informações demográficas e condições sanitárias e de saúde. Amostras de sangue foram coletadas por meio de punção digital em papel filtro entre agosto 2004 e maio 2005. Verificou-se que 850 amostras estavam adequadas para análise. No ELISA, utilizou-se o antígeno heterólogo liquido vesicular de Taenia crassiceps. Para assegurar a confiabilidade dos resultados de ELISA, foram pareadas 77 amostras de soro e sangue eluido do papel filtro. A confirmação do diagnóstico sorológico foi feita por immunoblot (IB) com glicoproteínas purificadas de Taenia crassiceps. RESULTADOS: A reatividade de IgG eluída de sangue em papel filtro mostrou-se compatível com a dos soros correspondentes. A triagem por ELISA de 850 indivíduos revelou 186 (21,9%) positivos. De 213 pessoas convidadas a colher soro para IB (186 ELISA positivo e 27 com amostras de sangue total inadequadas), compareceram 130. O IB foi positivo em 29 (3,4%) de 850 amostras. Houve correlação significativa entre IB positivo e a prática de criação de suínos e de horta caseira (p = 0,0364). CONCLUSÕES: ELISA com sangue total em papel filtro mostrou-se adequado para inquéritos populacionais para cisticercose. A transmissão da cisticercose humana na área estudada mostrou correlação com criação suína domestica e horta caseira. A prevalência obtida foi semelhante à relatada em áreas endêmicas da América Latina.
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- 2011
226. Improvement of leptospirosis surveillance in remote Pacific islands using serum spotted on filter paper
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Van-Mai Cao-Lormeau, Claudine Roche, Martin Bel, Didier Musso, Eric J. Nilles, and Maria Marfel
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Microbiology (medical) ,Prioritization ,medicine.medical_specialty ,Suspected dengue ,Disease ,Real-Time Polymerase Chain Reaction ,Filter paper ,Sensitivity and Specificity ,Dengue fever ,Dengue ,Environmental health ,Epidemiology ,medicine ,Humans ,Leptospirosis ,Retrospective Studies ,business.industry ,Neglected Disease ,General Medicine ,medicine.disease ,Serum samples ,Virology ,PCR ,Infectious Diseases ,Population Surveillance ,Dried Blood Spot Testing ,Neglected disease ,business ,Micronesia - Abstract
Summary Objectives Leptospirosis is a serious neglected disease in the Pacific. Because sensitive and specific laboratory tests are largely unavailable, the burden of disease and epidemiological data are often unreliable and do not allow informed disease prioritization and efficient control. We report the use of serum spotted on filter paper to improve the surveillance of leptospirosis in remote and resource-limited settings. Methods A total of 172 acute-phase serum samples collected from patients with suspected dengue at Yap State Hospital, Federated States of Micronesia, were spotted on filter paper and sent by regular mail to the Institut Louis Malarde, French Polynesia. Real-time PCR protocols for dengue and leptospirosis confirmation were performed on all specimens. Results A total of five leptospirosis infections were detected amongst the patients with suspected dengue. Conclusions This study confirms the use of filter paper as a convenient tool to improve leptospirosis surveillance capacity in remote areas. New surveillance strategies, notably based on the regular use of this type of tool, are essential to more adequately describe the epidemiology and burden of neglected diseases.
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- 2014
227. Measurement agreement of the self-administered questionnaire of the Belgian Health Interview Survey: Paper-and-pencil versus web-based mode
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Stefaan Demarest, Sabine Drieskens, Johan Van der Heyden, Guido Van Hal, Jean Tafforeau, Lydia Gisle, Geert Molenberghs, Rana Charafeddine, Elise Braekman, and Finaba Berete
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Questionnaires ,Male ,020205 medical informatics ,Intraclass correlation ,Social Sciences ,lcsh:Medicine ,Self Administration ,02 engineering and technology ,Health informatics ,Database and Informatics Methods ,0302 clinical medicine ,Belgium ,Surveys and Questionnaires ,Medicine and Health Sciences ,0202 electrical engineering, electronic engineering, information engineering ,Psychology ,EPIDEMIOLOGY ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,Alcohol Consumption ,Multidisciplinary ,Depression ,Multidisciplinary Sciences ,Alcoholism ,Neurology ,Research Design ,RELIABILITY ,Science & Technology - Other Topics ,Female ,REPORTED OUTCOME MEASURES ,EQUIVALENCE ,Behavioral and Social Aspects of Health ,Engineering sciences. Technology ,Psychosocial ,Research Article ,Clinical psychology ,Adult ,Paper ,Substance-Related Disorders ,Addiction ,Health Informatics ,Research and Analysis Methods ,03 medical and health sciences ,Mental Health and Psychiatry ,Humans ,QUALITY ,INTERNET ,Categorical variable ,Nutrition ,Internet ,Survey Research ,Science & Technology ,Data collection ,Mood Disorders ,business.industry ,lcsh:R ,Biology and Life Sciences ,INSTRUMENTS ,Missing data ,Health Surveys ,Health indicator ,Diet ,SCL-90-R ,Sample size determination ,Sample Size ,lcsh:Q ,Sleep Disorders ,COLLECTION ,business - Abstract
Before organizing mixed-mode data collection for the self-administered questionnaire of the Belgian Health Interview Survey, measurement effects between the paper-and-pencil and the web-based questionnaire were evaluated. A two-period cross-over study was organized with a sample of 149 employees of two Belgian research institutes (age range 22-62 years, 72% female). Measurement agreement was assessed for a diverse range of health indicators related to general health, mental and psychosocial health, health behaviors and prevention with kappa coefficients and intraclass correlation (ICC). The quality of the data collected by both modes was evaluated by quantifying the missing, 'don't know' and inconsistent values and data entry mistakes. Good to very good agreement was found for all categorical indicators with kappa coefficients superior to 0.60, except for two mental and psychosocial health indicators namely the presence of a sleeping disorder and of a depressive disorder (kappa≥0.50). For the continuous indicators high to acceptable agreement was observed with ICC superior to 0.70. Inconsistent answers and data-entry mistakes were only occurring in the paper-and-pencil mode. There were no less missing values in the web-based mode compared to the paper-and-pencil mode. The study supports the idea that web-based modes provide, in general, equal responses to paper-and-pencil modes. However, health indicators based upon factual and objective items tend to have higher measurement agreement than indicators requiring an assessment of personal subjective feelings. A web-based mode greatly facilitates the data-entry process and guides the completing of a questionnaire. However, item non-response was not positively affected. ispartof: PLOS ONE vol:13 issue:5 ispartof: location:United States status: published
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- 2018
228. Severe Chronic Allergic (and Related) Diseases: A Uniform Approach – A MeDALL – GA2LEN – ARIA Position Paper
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J Rosado-Pinto, Valérie Siroux, Cynthia Hohmann, A. Mazon, Olivier Vandenplas, A. Mohammadi, M. P. Orru, W. J. Fokkens, K-H. Carlsen, G. Khayat, Jean Bousquet, Ronald Dahl, Gailen D. Marshall, Jan Brozek, Stefan Wöhrl, J. Ratomaharo, Nanshan Zhong, Paulo Augusto Moreira Camargos, Mario Sánchez-Borges, A. Yorgancioglu, Mariona Pinart, Mika J. Mäkelä, A. Bedbrook, Jordi Sunyer, Philippe-Jean Bousquet, G. Passalacqua, Raphaëlle Varraso, G. S. Ouedraogo, Ingrid Terreehorst, G.W. Canonica, Bianca Beghe, John Wright, Josep M. Antó, I. Pin, J. Ring, F. Kauffmann, Gerard H. Koppelman, William K. Dolen, B. Koffi N'Goran, K. C. Lødrup Carlsen, Brian J. Lipworth, Alkis Togias, A. Ben Kheder, Ruby Pawankar, Christophe Pison, Dennis M. Williams, Osman M. Yusuf, Eugene R. Bleecker, Holger J. Schünemann, M. Roman Rodriguez, Amiran Gamkrelidze, Elina Toskala, B. Hellquist-Dahl, Sergio Bonini, Bénédicte Jacquemin, Eleni Fthenou, E.H.D. Bel, Michael A. Kaliner, Ruta Dubakiene, C. S. Ang, E. Melen, Isabelle Momas, Elena Gimeno-Santos, Klaus F. Rabe, Ferran Ballester, Barbara Rogala, Antonino Romano, Stefano Guerra, Sam Oddie, E.D. Bateman, H. Douagui, Renato T. Stein, Claus Bachert, Robert M. Naclerio, Fernando D. Martinez, Talant Sooronbaev, Rudolph Valenta, K. C. Bergmann, Inger Kull, M. Morais-Almeida, Marjan Kerkhof, Nikolaos G. Papadopoulos, Josep Roca, L.-P. Boulet, L. T. Le, Daniela Porta, F. Martin, K. S. Bennoor, Alfredo Cesario, Piotr Kuna, William W. Busse, S. Nafti, Mübeccel Akdis, Dirkje S. Postma, Phil Lieberman, Désirée Larenas, Aziz Sheikh, Y. Z. Chen, J Mullol, T. Didi, D. Y. Wang, Marta Benet, Peter Schmid-Grendelmeier, David Price, Tari Haahtela, Dominique Valeyre, F. E. R. Simons, I. Annesi-Maesano, Magnus Wickman, A. Andrianarisoa, Giovanni Viegi, Pascal Demoly, A. El-Meziane, C. E. Baena-Cagnani, Ulf Darsow, S. Palkonen, F. Berrissoul, X. Basagana, R. Gerth van Wijk, J. O. B. Hourihane, B. Pigearias, A. L. Boner, T. D. Nyembue, B. Samolinski, Y. Okamoto, W. Carr, C. van Weel, Marek L. Kowalski, Christopher E. Brightling, Thomas Keil, D. Rezagui, D. J. Costa, Todor A. Popov, Eli O. Meltzer, Ioana Agache, Marcus Maurer, Thomas B. Casale, T. Bieber, Charles Auffray, Antonella Muraro, K. Ohta, T. Zuberbier, Yousser Mohammad, Henriette A. Smit, Manolis Kogevinas, Dermot Ryan, Iris Lavi, Marc Humbert, Sakari Reitamo, J. Just, Martijn C. Nawijn, M. Beji, Bassam Mahboub, F. Mihaltan, Peter H. Howarth, Alvaro A. Cruz, Cevdet Ozdemir, L. Namazova-Baranova, Y. Tremblay, M. E. Zernotti, Adnan Custovic, C. Bindslev Jensen, João Fonseca, Robyn E O'Hehir, O. Kalayci, H. Haddad, Andrew Bush, L. Cox, Mihaela Zidarn, Anca-Mirela Chiriac, H. J. Zar, Judith Garcia-Aymerich, G. K. Scadding, Peter J. Sterk, Richard G. Roberts, Maria Vassilaki, P. Panzner, and P W Hellings
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medicine.medical_specialty ,business.industry ,Public health ,Immunology ,macromolecular substances ,General Medicine ,Atopic dermatitis ,medicine.disease ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Disease severity ,Epidemiology ,medicine ,Physical therapy ,Immunology and Allergy ,Position paper ,Disease process ,030212 general & internal medicine ,Intensive care medicine ,business ,Chronic urticaria ,Asthma - Abstract
Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.
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- 2012
229. Introduction to the Trinity Nuclear Test Collection of Papers
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Steven L. Simon
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Radioactive Fallout ,Engineering ,Editorial ,Epidemiology ,business.industry ,Air Pollutants, Radioactive ,Health, Toxicology and Mutagenesis ,Humans ,Radiology, Nuclear Medicine and imaging ,Nuclear test ,Environmental Exposure ,business ,Data science - Published
- 2020
230. A counterpoint paper: Comments on the electrocardiographic part of the 2018 Fourth Universal Definition of Myocardial Infarction endorsed by the International Society of Electrocardiology and the International Society for Holter and Noninvasive Electrocardiology
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Iwona Cygankiewicz, Yochai Birnbaum, Ljuba Bacharova, Javier Garcia Niebla, Sergio Dubner, Antonio Luiz Pinho Ribeiro, Peter W. Macfarlane, Wojciech Zareba, Kjell Nikus, Miguel Fiol, and Antoni Bayés de Luna
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medicine.medical_specialty ,Myocardial ischemia ,Myocardial Infarction ,non‐invasive techniques ,Reviews ,Guidelines as Topic ,non-invasive techniques ,Review Article ,030204 cardiovascular system & hematology ,epidemiology/clinical trials ,Acute ischemia ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,medicine ,Diseases of the circulatory (Cardiovascular) system ,Humans ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Societies, Medical ,clinical trials ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Triage ,RC666-701 ,Risk stratification ,Cardiology ,epidemiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
The Fourth Universal Definition of Myocardial Infarction (FUDMI) focuses on the distinction between nonischemic myocardial injury and myocardial infarction (MI), along with the role of cardiovascular magnetic resonance, in order to define the etiology of myocardial injury. As a consequence, there is less emphasis on updating the parts of the definition concerning the electrocardiographic (ECG) changes related to MI. Evidence of myocardial ischemia is a prerequisite for the diagnosis of MI, and the ECG is the main available tool for (a) detecting acute ischemia, (b) triage, and (c) risk stratification upon presentation. This review focuses on multiple aspects of ECG interpretation that we firmly believe should be considered for incorporation in any future update to the Universal Definition of MI.
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- 2020
231. What Happens to Your Manuscript: Characteristics of Papers Published in Volume 188
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Catherine R Lesko, Sunni L Mumford, Andrea R Molino, Harriett Telljohann, Lori E Biddle, Enrique F Schisterman, and on behalf of the Editorial Board
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Publishing ,History ,Epidemiology ,MEDLINE ,Library science ,Humans ,Periodicals as Topic ,Volume (compression) - Published
- 2020
232. Cancer prevention – review paper
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Tomasz Lewandowski, Sławomir Rudzki, Marcin Rudzki, Barbara Laskowska, and Anna Lewandowska
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medicine.medical_specialty ,Population ,World Health Organization ,Neoplasms ,Environmental health ,Epidemiology ,Secondary Prevention ,medicine ,Humans ,cancer ,risk factors ,GE1-350 ,education ,Waste Management and Disposal ,Ecology, Evolution, Behavior and Systematics ,Health policy ,Cause of death ,education.field_of_study ,Cancer prevention ,cancer prevention ,business.industry ,Incidence (epidemiology) ,Public Health, Environmental and Occupational Health ,Cancer ,Agriculture ,medicine.disease ,Cancer registry ,Primary Prevention ,Environmental sciences ,Poland ,business - Abstract
Introduction Every year there is an increase in the number of cases and deaths due to the majority of cancers. Currently, these diseases constitute the second cause of death in Poland and the USA. The number of cases of malignant neoplasms in Poland has more than doubled over the last three decades. According to the National Cancer Registry, in Poland about 95.5 people per thousand die every year from malignant neoplasms. Current epidemiological data on cancer is worrying because the World Health Organization predicts a significant increase in the incidence of cancer in the general population. This problem, which is significant on the global scale, demands the search for more effective prevention methods so that more and more attention is paid to both primary and secondary prevention. Prevention and early detection of cancer have become a priority for the national health policy of many European countries. Numerous studies around the world prove that reducing the risk of cancer is most effective through adopting a healthy lifestyle, avoiding exposure to carcinogens, combined with regular screening. Objective The aim of the study was to review knowledge on cancer prevention, including the latest research results. Conclusions Due to the systematic increase in the incidence of cancer, a strong emphasis should be placed on prevention. Preventive actions bring benefits not only to the individual, but are an important aspect of health policy. The importance of primary prevention in relation to healthy people has been demonstrated, including secondary prevention aimed at controlling risk factors in relation to persons exposed to them. The combination of these activities becomes an important element in maintaining the health of the individual, as well as society.
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- 2020
233. Implications of identifying the recently defined members of the Staphylococcus aureus complex S. argenteus and S. schweitzeri: a position paper of members of the ESCMID Study Group for Staphylococci and Staphylococcal Diseases (ESGS).
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Becker, K., Schaumburg, F., Kearns, A., Larsen, A.R., Lindsay, J.A., Skov, R.L., and Westh, H.
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STAPHYLOCOCCUS aureus , *STAPHYLOCOCCAL diseases , *STAPHYLOCOCCUS , *METHICILLIN-resistant staphylococcus aureus , *INFECTION prevention - Abstract
Staphylococcus argenteus and Staphylococcus schweitzeri, previously known as divergent Staphylococcus aureus clonal lineages, have been recently established as novel, difficult-to-delimit, coagulase-positive species within the S. aureus complex. Methicillin-resistant strains of S. argenteus are known from Australia and the UK. Knowledge of their epidemiology, medical significance and transmission risk is limited and partly contradictory, hampering definitive recommendations. There is mounting evidence that the pathogenicity of S. argenteus is similar to that of 'classical' S. aureus , while as yet no S. schweitzeri infections have been reported. To provide decision support on whether and how to distinguish and report both species. PubMed, searched for S. argenteus and S. schweitzeri. This position paper reviews the main characteristics of both species and draws conclusions for microbiological diagnostics and surveillance as well as infection prevention and control measures. We propose not distinguishing within the S. aureus complex for routine reporting purposes until there is evidence that pathogenicity or clinical outcome differ markedly between the different species. Primarily for research purposes, suitably equipped laboratories are encouraged to differentiate between S. argenteus and S. schweitzeri. Caution is urged if these novel species are explicitly reported. In such cases, a specific comment should be added (i.e. 'member of the S.aureus complex') to prevent confusion with less- or non-pathogenic staphylococci. Prioritizing aspects of patient safety, methicillin-resistant isolates should be handled as recommended for methicillin-resistant Staphylococcus aureus (MRSA). In these cases, the clinician responsible should be directly contacted and informed by the diagnosing microbiological laboratory, as they would be for MRSA. Research is warranted to clarify the epidemiology, clinical impact and implications for infection control of such isolates. [ABSTRACT FROM AUTHOR]
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- 2019
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234. Epidemiological analysis and risk assessment of respiratory diseases in individuals residing in the area influenced by a large paper mill
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T.N. Unguryanu
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medicine.medical_specialty ,Operations research ,business.industry ,Health Policy ,Environmental health ,Epidemiology ,Public Health, Environmental and Occupational Health ,medicine ,Health Informatics ,Paper mill ,Risk assessment ,business - Published
- 2013
235. Measuring compliance with transmission-based isolation precautions: Comparison of paper-based and electronic data collection
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Elaine Larson, Melissa Marine, Timothy Landers, Rohit Chaudhry, Bevin Cohen, Barbara Ross, Maryam Behta, and Mei Chou
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Isolation (health care) ,Epidemiology ,Article ,law.invention ,Patient Isolation ,law ,Isolation precautions ,Humans ,Infection control ,Medicine ,Data collection ,business.industry ,Data Collection ,Protective Devices ,Health Policy ,Public Health, Environmental and Occupational Health ,Gold standard (test) ,Paper based ,medicine.disease ,Hospitals ,Infectious Diseases ,Transmission (mechanics) ,Electronic data ,Guideline Adherence ,Health Services Research ,Medical emergency ,business - Abstract
Background Decreasing the transmission of resistant organisms in hospitals is a key goal of infection prevention plans. Studies have consistently shown inadequate health care worker (HCW) compliance with isolation precautions. Evaluating adherence through direct observation of HCW behavior is considered the "gold standard" but is labor-intensive, requiring the collection and analysis of a large volume of observations. Methods Two methods of data collection to assess HCW compliance were evaluated: a manual method using a paper form (PF), with subsequent data entry into a database, and an electronic method using a Web-based form (WBF) with real-time data recording. Observations were conducted at 4 hospitals (a total of 2,065 beds) to assess the availability of gloves, gowns, and masks; isolation sign postings; and HCW isolation practices. Results A total of 13,878 isolation rooms were observed in 2009. The median number of rooms observed per day was 61 for PF and 60 for WBF, and the respective mean observation times per room were 149 seconds and 60 seconds. Thus, use of the WBF provided a time savings of 89 seconds per room. Conclusion Simple electronic forms can significantly decrease the required resources for monitoring HCW adherence to hospital policies. Use of the WBF decreased the observation time by 60%, allowing for increases in the frequency and intensity of surveillance activities.
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- 2011
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236. Hormone replacement therapy and cancer survival: a longitudinal cohort study: protocol paper
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Judith Burchardt, Ashley K Clift, Winnie Xue Mei, Christopher Cardwell, Sharon Dixon, Julia Hippisley-Cox, Pui San Tan, Carol Coupland, and Tom Alan Ranger
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medicine.medical_treatment ,Cohort Studies ,0302 clinical medicine ,Neoplasms ,Epidemiology ,Longitudinal Studies ,030212 general & internal medicine ,Young adult ,cancer survival ,education.field_of_study ,Estrogen Replacement Therapy ,Hormone Replacement Therapy - adverse effects ,Hormone replacement therapy (menopause) ,General Medicine ,Middle Aged ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,oncology ,Medicine ,epidemiology ,Female ,Public Health ,sex steroids & HRT ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Hormone Replacement Therapy ,Population ,Breast Neoplasms ,Young Adult ,03 medical and health sciences ,SDG 3 - Good Health and Well-being ,medicine ,Humans ,Cardiovascular Diseases - epidemiology ,education ,Aged ,business.industry ,Proportional hazards model ,Cancer ,Estrogen Replacement Therapy - adverse effects ,medicine.disease ,Emergency medicine ,business ,Body mass index - Abstract
IntroductionHormone replacement therapy (HRT) can help women experiencing menopausal symptoms, but usage has declined due to uncertainty around risks of cancer and some cardiovascular diseases (CVD). Moreover, improved cancer survival rates mean that more women who survive cancer go on to experience menopausal symptoms. Understanding these relationships is important so that women and their clinicians can make informed decisions around the risks and benefits of HRT. This study’s primary aim is to determine the association between HRT use after cancer diagnosis and the risk of cancer-specific mortality. The secondary aims are to investigate the risks of HRT on subsequent cancer, all-cause mortality and CVD.Methods and analysisWe will conduct a population-based longitudinal cohort study of 18–79 year-old women diagnosed with cancer between 1998 and 2020, using the QResearch database. The main exposure is HRT use, categorised based on compound, dose and route of administration, and modelled as a time-varying covariate. Analysis of HRT use precancer and postcancer diagnosis will be conducted separately. The primary outcome is cancer-specific mortality, which will be stratified by cancer site. Secondary outcomes include subsequent cancer diagnosis, CVD (including venous thrombo-embolism) and all-cause mortality. Adjustment will be made for key confounders such as age, body mass index, ethnicity, deprivation index, comorbidities, and cancer grade, stage and treatment. Statistical analysis will include descriptive statistics and Cox proportional hazards models to calculate HRs and 95% CIs.Ethics and disseminationEthical approval for this project was obtained from the QResearch Scientific Committee (Ref: OX24, project title ‘Use of hormone replacement therapy and survival from cancer’). This project has been, and will continue to be, supported by patient and public involvement panels. We intend to the submit the findings for peer-reviewed publication in an academic journal and disseminate them to the public through Cancer Research UK.
- Published
- 2021
237. Cochrane Qualitative and Implementation Methods Group guidance series—paper 5: methods for integrating qualitative and implementation evidence within intervention effectiveness reviews
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Andrew Booth, Janet Harris, Angela Harden, Jane Noyes, Kate Flemming, Margaret Cargo, Tomas Pantoja, Ruth Garside, Karin Hannes, James Thomas, Harden, Angela, Thomas, James, Cargo, Margaret, Harris, Janet, Pantoja, Tomas, Flemming, Kate, Booth, Andrew, Garside, Ruth, Hannes, Karin, and Noyes, Jane
- Subjects
Biomedical Research ,Evidence-Based Medicine ,Epidemiology ,Process (engineering) ,Computer science ,Management science ,Multimethodology ,Guidelines as Topic ,Context (language use) ,Evidence-based medicine ,03 medical and health sciences ,0302 clinical medicine ,Systematic review ,Intervention (counseling) ,Humans ,systematic reviews ,mixed methods research ,qualitative research ,implementation research ,process evaluations ,Cochrane collaboration ,qualitative evidence synthesis ,030212 general & internal medicine ,Implementation research ,Delivery of Health Care ,Qualitative Research ,030217 neurology & neurosurgery ,Systematic Reviews as Topic ,Qualitative research - Abstract
The Cochrane Qualitative and Implementation Methods Group develops and publishes guidance on the synthesis of qualitative and mixed-method evidence from process evaluations. Despite a proliferation of methods for the synthesis of qualitative research, less attention has focused on how to integrate these syntheses within intervention effectiveness reviews. In this article, we report updated guidance from the group on approaches, methods, and tools, which can be used to integrate the findings from quantitative studies evaluating intervention effectiveness with those from qualitative studies and process evaluations. We draw on conceptual analyses of mixed methods systematic review designs and the range of methods and tools that have been used in published reviews that have successfully integrated different types of evidence. We outline five key methods and tools as devices for integration which vary in terms of the levels at which integration takes place; the specialist skills and expertise required within the review team; and their appropriateness in the context of limited evidence. In situations where the requirement is the integration of qualitative and process evidence within intervention effectiveness reviews, we recommend the use of a sequential approach. Here, evidence from each tradition is synthesized separately using methods consistent with each tradition before integration takes place using a common framework. Reviews which integrate qualitative and process evaluation evidence alongside quantitative evidence on intervention effectiveness in a systematic way are rare. This guidance aims to support review teams to achieve integration and we encourage further development through reflection and formal testing. Refereed/Peer-reviewed
- Published
- 2018
238. Cochrane Qualitative and Implementation Methods Group guidance series—paper 4: methods for assessing evidence on intervention implementation
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Ruth Garside, Margaret Cargo, Karin Hannes, Janet Harris, James Thomas, Tomas Pantoja, Andrew Booth, Angela Harden, Jane Noyes, Kate Flemming, Cargo, Margaret, Harris, Janet, Pantoja, Tomas, Booth, Andrew, Harden, Angela, Hannes, Karin, Thomas, James, Flemming, Kate, Garside, Ruth, and Noyes, Jane
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Program evaluation ,Biomedical Research ,Epidemiology ,Process (engineering) ,Computer science ,Decision Making ,systematic reviews ,03 medical and health sciences ,0302 clinical medicine ,qualitative evidence synthesis ,Causal chain ,Humans ,Intervention implementation ,Review process ,030212 general & internal medicine ,implementation ,Qualitative Research ,Evidence-Based Medicine ,Management science ,030503 health policy & services ,mixed-method synthesis ,Work in process ,process evaluation ,Data Accuracy ,Cochrane ,Systematic review ,Process evaluation ,0305 other medical science ,Systematic Reviews as Topic - Abstract
Objectives: This article provides reviewers with guidance on methods for identifying and processing evidence to understand intervention implementation. Study Design and Setting: Strategies, tools, and methods are applied to the systematic review process to illustrate how process and implementation can be addressed using quantitative, qualitative, and other sources of evidence (i.e., descriptive textual and nonempirical). Results: Reviewers can take steps to navigate the heterogeneity and level of uncertainty present in the concepts, measures, and methods used to assess implementation. Activities can be undertaken in advance of a Cochrane quantitative review to develop program theory and logic models that situate implementation in the causal chain. Four search strategies are offered to retrieve process and implementation evidence. Recommendations are made for addressing rigor or risk of bias in process evaluation or implementation evidence. Strategies are recommended for locating and extracting data from primary studies. The basic logic is presented to assist reviewers to make initial review-level judgments about implementation failure and theory failure. Conclusion: Although strategies, tools, and methods can assist reviewers to address process and implementation using quantitative, qualitative, and other forms of evidence, few exemplar reviews exist. There is a need for further methodological development and trialing of proposed approaches. Refereed/Peer-reviewed
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- 2018
239. Quasi-experimental study designs series—paper 6: risk of bias assessment
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Barney Reeves, Eric W. Djimeu, Peter Tugwell, Hugh Waddington, Betsy Jane Becker, George A. Wells, Jorge Garcia Hombrados, and Ariel M. Aloe
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regression discontinuity ,Non-Randomized Controlled Trials as Topic ,Epidemiology ,Computer science ,media_common.quotation_subject ,BTC (Bristol Trials Centre) ,Risk Assessment ,Unobservable ,03 medical and health sciences ,0302 clinical medicine ,systematic review ,Bias ,risk of bias ,Econometrics ,Humans ,interrupted time series ,030212 general & internal medicine ,Internal validity ,natural experiment ,media_common ,quasi-experiment ,Selection bias ,instrumental variables ,difference in differences ,propensity score matching ,030503 health policy & services ,Instrumental variable ,meta-analysis ,Systematic review ,Research Design ,Meta-analysis ,Regression discontinuity design ,0305 other medical science ,Quasi-experiment - Abstract
Rigorous and transparent critical appraisal is a core component of high quality systematic reviews. Well-conducted quasi-experiments have been empirically shown to estimate credible, unbiased treatment quantities. Conversely, when inappropriately designed or executed, these estimates are likely to be biased. This paper draws on recent advances in risk of bias assessment. It presents an approach to evaluating the internal validity of credible quasi-experiments. These are non-randomised studies using design-based approaches to control for unobservable sources of confounding such as difference studies, instrumental variables, interrupted time series, natural experiments and regression discontinuity designs. Our review suggests that existing risk of bias tools provide, to different degrees, incomplete transparent criteria to assess the validity of credible quasi-experiments. We argue that a tool is needed to assess risk of bias consistently across credible quasi-experiments. Drawing on existing tools, in particular Cochrane’s new tool for non-randomized studies of interventions (Sterne et al., 2014), we discuss domains of bias and suggest directions for evaluation questions.
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- 2017
240. Analysis of Digital Documentation Speed and Sequence Using Digital Paper and Pen Technology During the Refugee Crisis in Europe: Content Analysis.
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Kehe, Kai, Girgensohn, Roland, Swoboda, Walter, Bieler, Dan, Franke, Axel, Helm, Matthias, Kulla, Martin, Luepke, Kerstin, Morwinsky, Thomas, Blätzinger, Markus, and Rossmann, Katalyn
- Subjects
ELECTRONIC paper ,CONTENT analysis ,DOCUMENTATION ,REFUGEE camps ,INTERNATIONAL relief ,EMERGENCY medical services communication systems - Abstract
Background: The Syria crisis has forced more than 4 million people to leave their homeland. As a result, in 2016, an overwhelming number of refugees reached Germany. In response to this, it was of utmost importance to set up refugee camps and to provide humanitarian aid, but a health surveillance system was also implemented in order to obtain rapid information about emerging diseases. Objective: The present study describes the effects of using digital paper and pen (DPP) technology on the speed, sequence, and behavior of epidemiological documentation in a refugee camp. Methods: DPP technology was used to examine documentation speed, sequence, and behavior. The data log of the digital pens used to fill in the documentation was analyzed, and each pen stroke in a field was recorded using a timestamp. Documentation time was the difference between first and last stroke on the paper, which includes clinical examination and translation. Results: For three months, 495 data sets were recorded. After corrections had been made, 421 data sets were considered valid and subjected to further analysis. The median documentation time was 41:41 min (interquartile range 29:54 min; mean 45:02 min; SD 22:28 min). The documentation of vital signs ended up having the strongest effect on the overall time of documentation. Furthermore, filling in the free-text field clinical findings or therapy or measures required the most time (mean 16:49 min; SD 20:32 min). Analysis of the documentation sequence revealed that the final step of coding the diagnosis was a time-consuming step that took place once the form had been completed. Conclusions: We concluded that medical documentation using DPP technology leads to both an increase in documentation speed and data quality through the compliance of the data recorders who regard the tool to be convenient in everyday routine. Further analysis of more data sets will allow optimization of the documentation form used. Thus, DPP technology is an effective tool for the medical documentation process in refugee camps. [ABSTRACT FROM AUTHOR]
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- 2019
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241. Filter Paper Blood Spot Enzyme Linked Immunoassay for Adiponectin and Application in the Evaluation of Determinants of Child Insulin Sensitivity.
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Martin, Richard M., Patel, Rita, Oken, Emily, Thompson, Jennifer, Zinovik, Alexander, Kramer, Michael S., Vilchuck, Konstantin, Bogdanovich, Natalia, Sergeichick, Natalia, Foo, Ying, and Gusina, Nina
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ENZYME-linked immunosorbent assay , *ADIPONECTIN , *FILTER paper , *CHILDREN'S health , *INSULIN resistance , *BIOMARKERS , *BLOOD sampling , *EPIDEMIOLOGY - Abstract
Background: Adiponectin is an adipocyte-derived hormone that acts as a marker of insulin sensitivity. Bloodspot sampling by fingerstick onto filter paper may increase the feasibility of large-scale studies of the determinants of insulin sensitivity. We first describe the validation of an enzyme-linked immunoassay (ELISA) for quantifying adiponectin from dried blood spots and then demonstrate its application in a large trial (PROBIT). Methods: We quantified adiponectin from 3-mm diameter discs (≈3 µL of blood) punched from dried blood spots obtained from: i) whole blood standards (validation); and ii) PROBIT trial samples (application) in which paediatricians collected blood spots from 13,879 children aged 11.5 years from 31 sites across Belarus. We examined the distribution of bloodspot adiponectin by demographic and anthropometric factors, fasting insulin and glucose. Results: In the validation study, mean intra-assay coefficients of variation (n = 162) were 15%, 13% and 10% for ‘low’ (6.78 µg/ml), ‘medium’ (18.18 µg/ml) and 'high’ (33.13 µg/ml) internal quality control (IQC) samples, respectively; the respective inter-assay values (n = 40) were 23%, 21% and 14%. The correlation coefficient between 50 paired whole bloodspot versus plasma samples, collected simultaneously, was 0.87 (95% CI: 0.78 to 0.93). Recovery of known quantities of adiponectin (between 4.5 to 36 µg/ml) was 100.3–133%. Bloodspot adiponectin was stable for at least 30 months at −80°C. In PROBIT, we successfully quantified fasting adiponectin from dried blood spots in 13,329 of 13,879 (96%) children. Mean adiponectin (standard deviation) concentrations were 17.34 µg/ml (7.54) in boys and 18.41 µg/ml (7.92) in girls and were inversely associated with body mass index, fat mass, triceps and subscapular skin-fold thickness, waist circumference, height and fasting glucose. Conclusions: Bloodspot ELISA is suitable for measuring adiponectin in very small volumes of blood collected on filter paper and can be applied to large-scale studies. [ABSTRACT FROM AUTHOR]
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- 2013
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242. Occupational exposure to chemical agents in the paper industry
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Korhonen, K., Liukkonen, T., Ahrens, W., Astrakianakis, G., Boffetta, P., Burdorf, A., Heederik, D.J.J., Kauppinen, T., Kogevinas, M., Osvoll, P., Rix, B.A., Saalo, A., Sunyer, J., Szadkowska-Stanczyk, I., Teschke, K., Westberg, H., Widerkiewicz, K., Universiteit Utrecht, Faculteit Diergeneeskunde, Korhonen, K., Liukkonen, T., Ahrens, W., Astrakianakis, G., Boffetta, P., Burdorf, A., Heederik, D., Kauppinen, T., Kogevinas, M., Osvoll, P., Rix, B.A., Saalo, A., Sunyer, J., Szadkowska-Stanczyk, I., Teschke, K., Westberg, H., Widerkiewicz, K., Universiteit Utrecht, Faculteit Diergeneeskunde, and Public Health
- Subjects
Paper ,Pulp and paper industry ,Threshold limit value ,Epidemiology ,Indoor bioaerosol ,Formaldehyde ,Coronacrisis-Taverne ,medicine.disease_cause ,Asbestos ,Hazardous Substances ,chemistry.chemical_compound ,Japan ,Paper industry ,Neoplasms ,Occupational Exposure ,medicine ,Humans ,Nitrogen dioxide ,Threshold Limit Values ,Paperboard ,business.industry ,Measurements ,Public Health, Environmental and Occupational Health ,Paper mill ,Occupational exposure ,humanities ,Europe ,Occupational Diseases ,chemistry ,visual_art ,Newsprint ,North America ,visual_art.visual_art_medium ,business - Abstract
As part of an International Agency for Research on Cancer (IARC) international epidemiological study of workers in the pulp and paper industry, previously unpublished exposure measurements were assembled in a database. This article summarizes the results of 3,873 measurements carried out in the production departments of paper and paperboard mills and recycling plants in 12 countries. In the paper and paperboard mills, most of the agents were measured in the pulping and refining departments and in on-machine coating and winding of paper/paperboard. Exposures to asbestos, carbon monoxide, formaldehyde, fungal spores, bacteria, nitrogen dioxide, minerals dusts, paper dust, sulphuric acid and different solvents sometimes exceeded exposure limit values. In the re-pulping and de-inking departments of recycling plants high exposures to formaldehyde, fungal spores, bacteria and paper dust were observed. High exposures to asbestos, bioaerosols, carbon monoxide and paper dust were found in many departments; ammonia, formaldehyde, mineral and paper dust and solvents were found in coating machines; and diphenyl and polychlorobiphenyls (PCBs) were found in some special circumstances. Measurements in the newsprint and uncoated paper machine departments revealed only a few elevated exposures. In nearly all departments, measurements of epichlorohydrin, PCBs, sulphur dioxide, hydrogen sulphide and mercaptans tended to be low, often even below their detection limits. In spite of some uncertainties in the measurement data, the study provides new insights into the level and variation of occupational exposures of production workers in the paper and paperboard industry. © Springer-Verlag 2004.
- Published
- 2004
243. Mortality from non-malignant diseases in a cohort of female pulp and paper workers in Norway
- Author
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Hilde Langseth and Kristina Kjærheim
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Adult ,Paper ,Gerontology ,medicine.medical_specialty ,Time Factors ,Respiratory Tract Diseases ,Disease ,Cohort Studies ,symbols.namesake ,Risk Factors ,Cause of Death ,Occupational Exposure ,Epidemiology ,Confidence Intervals ,medicine ,Humans ,Poisson regression ,Cause of death ,Norway ,business.industry ,Mortality rate ,Public Health, Environmental and Occupational Health ,Middle Aged ,Occupational Diseases ,Cardiovascular Diseases ,Relative risk ,Cohort ,symbols ,Female ,Original Article ,business ,Demography ,Cohort study - Abstract
Objectives: The objective of the present study was to investigate the risk of death from non-malignant diseases in female pulp and paper workers in Norway. Methods: A total of 3143 women first employed between 1920–93 were included in the study cohort. Information about each cohort member was obtained from personnel record files in the mills in order to identify employment periods and job categories. Data on cause and date of death were added by linkage to the Cause of Death Register using unique personal identification numbers. The follow up period was 1951–2000. Standardised mortality ratios (SMRs) with 95% confidence intervals (95% CIs) were calculated using the national female mortality rates as reference. Poisson regression analysis was used to examine internal relations between the duration of employment in paper departments and the risk of death from selected causes. Relative risks (RRs) and 95% CIs were calculated. Results: The study showed a significantly increased risk for total non-malignant mortality (SMR = 1.14, 95% CI 1.05 to 1.24), mainly due to increased mortality from ischaemic heart disease (SMR = 1.22, 95% CI 1.03 to 1.43) and cerebrovascular diseases (SMR = 1.16, 95% CI 0.94 to 1.42). Analysis by department showed the highest risk of death in paper department workers with short term employment. Internal analyses showed a 5% and 9% increase in risk of dying from ischaemic heart disease and respiratory diseases, respectively, among paper department workers exposed to paper dust. The risk decreased with increasing duration of employment. Conclusion: The increased risk of ischaemic heart diseases and respiratory diseases seen among employees of paper departments may be related to exposure to paper dust.
- Published
- 2006
244. Cross-sectional survey of diabetic neuropathy in Kanagawa and clinical significance of a touch test using tissue paper.
- Author
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Jin, Yasuyuki, Kanamori, Akira, Ito, Shogo, Matoba, Kiyokazu, Miyakawa, Masaaki, Kaneshige, Hideaki, Obana, Mitsuo, Takai, Masahiko, Takeda, Hiroshi, Machimura, Hideo, Minami, Nobuaki, Kawata, Takahiro, Honda, Shin, Aoyagi, Sachio, Amemiya, Hikaru, Sasai, Nobuo, Nakayama, Michio, Naka, Yoshikazu, Terauchi, Yasuo, and Matsuba, Ikuro
- Subjects
- *
DIABETIC neuropathies , *TYPE 2 diabetes , *TISSUE paper , *PEOPLE with diabetes , *DISEASE prevalence - Abstract
Aims/Introduction: The prevalence of diabetes mellitus is increasing rapidly in Japan, and diabetic neuropathy is a major factor decreasing diabetic patients' quality of life, as well as a risk factor for sudden death. The present study aimed to determine the prevalence of diabetic neuropathy and raise awareness about it among patients and their physicians. Materials and Methods: Diabetic outpatients ( N = 5077) at 249 medical institutions within Kanagawa Prefecture, Japan, were surveyed by questionnaire and underwent foot examinations. The questionnaire included 10 questions about sensory abnormalities of both feet, muscle cramps and autonomic symptoms. Foot examinations included testing for vibratory perception of the medial malleolus, Achilles tendon reflexes and touch sensation of the bottom of the great toe using tissue paper. Results: Of the 5077 patients surveyed, 70.4% reported symptoms. Overall, 75.4% of the patients underwent vibratory perception testing, of whom 44.9% had abnormal thresholds (≤10 s). On the tissue paper touch test, performed in 94.6% of patients, 11.9% had no touch sensation. Of the 2803 type 2 diabetic patients with known background factors who underwent foot examinations, 49.4% had diabetic neuropathy. There was a high prevalence of diabetic neuropathy (36.1%) in patients with <5-year history. Of the patients with no touch sensation on the tissue paper test, 81.3% had diabetic neuropathy. Conclusions: The present study identified the prevalence of diabetic neuropathy in Kanagawa Prefecture. The tissue paper test is a simple and excellent method of evaluating decreased superficial sensation that can help evaluate the severity of diabetic neuropathy. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00174.x, 2011) [ABSTRACT FROM AUTHOR]
- Published
- 2012
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245. Knowledge, attitude and practices of community pharmacists regarding COVID-19: A paper-based survey in Vietnam
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Huong Thi Thanh Nguyen, Van Minh Nguyen, and Dai Xuan Dinh
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Male ,Viral Diseases ,Health Knowledge, Attitudes, Practice ,Epidemiology ,Physiology ,Cross-sectional study ,Pharmacists ,Geographical Locations ,Medical Conditions ,0302 clinical medicine ,Hygiene ,Surveys and Questionnaires ,Medicine and Health Sciences ,Coughing ,Public and Occupational Health ,Medical Personnel ,030212 general & internal medicine ,Computer Networks ,Child ,Virus Testing ,Mass media ,media_common ,Multidisciplinary ,Masks ,Professions ,Infectious Diseases ,Vietnam ,language ,Medicine ,Female ,Psychology ,Research Article ,Computer and Information Sciences ,medicine.medical_specialty ,Asia ,Adolescent ,Science ,media_common.quotation_subject ,Vietnamese ,030231 tropical medicine ,MEDLINE ,Community Pharmacy Services ,03 medical and health sciences ,Signs and Symptoms ,Cronbach's alpha ,Diagnostic Medicine ,medicine ,Humans ,Pandemics ,Internet ,Government ,business.industry ,Biology and Life Sciences ,COVID-19 ,Covid 19 ,Bayes Theorem ,language.human_language ,Cross-Sectional Studies ,Family medicine ,People and Places ,Population Groupings ,Residence ,Clinical Medicine ,Physiological Processes ,business - Abstract
Objective To survey the knowledge, attitude, and practices of Vietnamese pharmacists regarding the COVID-19 pandemic. Method This cross-sectional, paper-based study was conducted from June to August 2020. A validated questionnaire (Cronbach’s alpha = 0.84) was used to interview 1,023 pharmacists in nine provinces of Vietnam. Analysis of covariance was employed to identify factors associated with the knowledge of pharmacists. The best model was chosen by using the Bayesian Model Averaging method in R software version 4.0.4. Results The mean knowledge score was 12.02 ± 1.64 (range: 6–15), which indicated that 93.4% of pharmacists had good knowledge of COVID-19. There was no difference in the average score between males and females (p > 0.05). The multivariate linear regression model revealed that the knowledge was significantly associated with pharmacists’ age, education level, and residence (p < 0.001). About attitude and practices, pharmacists daily sought and updated information on the COVID-19 pandemic through mass media and the internet (social network and online newspapers). Nearly 48% of them conceded that they communicated with customers when at least one person did not wear a face mask at the time of the COVID-19 outbreak. At medicine outlets, many measures were applied to protect pharmacists and customers, such as equipping pharmacists with face masks and hand sanitizers (95.0%), using glass shields (83.0%), and maintaining at least one-meter distance between two people (85.2%). Conclusion The pharmacists’ knowledge of COVID-19 transmission, symptoms, and prevention was good. Many useful measures against the spread of this perilous virus were applied in medicine outlets. However, pharmacists should restrict forgetting to wear face masks in communication with medicine purchasers. The government and health agencies should have practical remedies to reduce the significant differences in the COVID-19 knowledge of pharmacists among provinces and education-level groups.
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- 2021
246. Chronic kidney disease in patients with cardiac rhythm disturbances or implantable electrical devices: clinical significance and implications for decision making-a position paper of the European Heart Rhythm Association endorsed by the Heart Rhythm Society and the Asia Pacific Heart Rhythm Society
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Francisco Marín, Gaetano La Manna, Marc A. Vos, Jens Cosedis Nielsen, Carsten W. Israel, Gerhard Hindricks, Bulent Gorenek, Laurent Fauchier, Charles J. Ferro, Angel Moya i Mitjans, Gregory Y.H. Lip, Deirdre A. Lane, Dennis H. Lau, Cecilia Linde, Giuseppe Boriani, Yoshihide Takahashi, Irina Savelieva, Gheorghe Andrei Dan, Mintu P. Turakhia, Joseph B. Morton, Gulmira Kudaiberdieva, Jean Claude Deharo, Mina K. Chung, Michele Brignole, Tatjana S. Potpara, Lomonosov Moscow State University (MSU), Colentina University Hospital, University of Medicine and Pharmacy 'Carol Davila' Bucharest (UMPCD), Service de cardiologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Children's Hospital [Bielefeld, Allemagne], University of Liverpool, Aalborg University [Denmark] (AAU), Aarhus University Hospital, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Éducation Éthique Santé EA 7505 (EES), Université de Tours (UT), University Cardiology Clinic, Clinical Center of Serbia (KCS), Boriani, G, Savelieva, I, Dan, Ga, Deharo, Jc, Ferro, C, Israel, Cw, Lane, Da, La Manna, G, Morton, J, Mitjans, Am, Vos, Ma, Turakhia, Mp, and Lip, Gy
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Epidemiology ,medicine.medical_treatment ,Arrhythmias ,urologic and male genital diseases ,Atrial fibrillation ,Cardiac implantable electrical devices ,Cardiac resynchronization therapy ,Chronic kidney disease ,Dialysis ,Drugs ,Hemodialysis ,Implantable cardioverter defibrillator ,Infection ,Pacemaker ,Sudden cardiac death ,Ventricular tachyarrhythmias ,Arrhythmias, Cardiac ,Asia ,Cardio-Renal Syndrome ,Cardiology ,Clinical Decision-Making ,Defibrillators, Implantable ,Europe ,Humans ,Kidney Function Tests ,Practice Guidelines as Topic ,Renal Insufficiency, Chronic ,Cardiology and Cardiovascular Medicine ,Physiology (medical) ,[SHS]Humanities and Social Sciences ,Medicine ,ComputingMilieux_MISCELLANEOUS ,Ehra Position Paper ,Acute kidney injury ,medicine.medical_specialty ,Renal function ,Internal medicine ,Intensive care medicine ,business.industry ,medicine.disease ,Arrhythmias, Atrial fibrillation, Ventricular tachyarrhythmias, Epidemiology, Chronic kidney disease, Dialysis, Hemodialysis, Drugs, Cardiac implantable electrical devices, Cardiac resynchronization therapy, Infection, Implantable cardioverter defibrillator, Pacemaker, Sudden cardiac death ,business ,Kidney disease - Abstract
The kidney exerts multiple functions, and pathophysiological interactions between the kidney and the heart have important clinical implications, but it has only recently become clear that these interactions should be studied across the whole spectrum of reduced kidney function and not only in cases with severe, end-stage renal disease (ESRD), as has been done for many years.1 The prevalence of chronic kidney disease (CKD), defined as a glomerular filtration rate (GFR) of 3 months, exceeds 10% in the adult population and reaches 47% in subjects older than 70 years, according to data from the USA, with a trend towards a recent increasing prevalence.1,2 Many interactions between kidney and cardiovascular functions have important implications for clinical management and health policy ( Figure 1 ), since even mild forms of kidney disease are associated with an increased risk of cardiovascular morbidity and overall mortality, and renal function may worsen over time.1,3 Figure 1 Stages of the development and progression of chronic kidney disease (CKD), including complications and strategies to improve outcomes. Modified from Eckardt et al. 1 GFR, glomerular filtration rate. Although cardiovascular disease (CVD) and cardiac disorders are more frequent and severe in CKD, they are often not recognized, or undertreated, in view of the complexity of patient management in this setting.4 On the other hand, the presence and evolution of CKD is often not evaluated and monitored in patients with various forms of heart diseases, including patients with cardiac rhythm disturbances, a setting where CKD is associated with challenging decision-making on the management of specific treatments and interventions. In patients with cardiac diseases, CKD predisposes to acute kidney injury and vice versa , and both may strongly influence clinical management of cardiac conditions. Considering the need for increasing the awareness of …
- Published
- 2015
247. Sudden cardiac arrest in sports - need for uniform registration: A Position Paper from the Sport Cardiology Section of the European Association for Cardiovascular Prevention and Rehabilitation
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Hein Heidbuchel, Kimberly G. Harmon, G. Thiene, François Carré, Sanjay Sharma, Elijah R. Behr, Cristina Basso, J. M. Alonso, Domenico Corrado, Erik Ekker Solberg, Hanne Rasmusen, Matthias Wilhelm, Jonathan A. Drezner, Josef Niebauer, Nicole M. Panhuyzen-Goedkoop, K.-P. Mellwig, Mats Börjesson, Mary N. Sheppard, D. Dugmore, Michael Papadakis, St George's, University of London, CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Università degli Studi di Padova = University of Padua (Unipd), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Universita degli Studi di Padova
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medicine.medical_specialty ,Registry ,Consensus ,Sports medicine ,Epidemiology ,medicine.medical_treatment ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Cardiology ,030204 cardiovascular system & hematology ,Sports Medicine ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,sudden cardiac arrest ,Cause of Death ,Terminology as Topic ,medicine ,Humans ,030212 general & internal medicine ,Registries ,Exercise ,Cause of death ,Doping in Sports ,Rehabilitation ,biology ,Athletes ,business.industry ,Incidence (epidemiology) ,athletes ,exercise ,registry ,sports ,Cardiology and Cardiovascular Medicine ,Data Collection ,Incidence ,Sudden cardiac arrest ,biology.organism_classification ,medicine.disease ,3. Good health ,Substance Abuse Detection ,Death, Sudden, Cardiac ,Physical therapy ,Position paper ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Autopsy ,medicine.symptom ,business ,Sports - Abstract
Item does not contain fulltext There are large variations in the incidence, registration methods and reported causes of sudden cardiac arrest/sudden cardiac death (SCA/SCD) in competitive and recreational athletes. A crucial question is to which degree these variations are genuine or partly due to methodological incongruities. This paper discusses the uncertainties about available data and provides comprehensive suggestions for standard definitions and a guide for uniform registration parameters of SCA/SCD. The parameters include a definition of what constitutes an 'athlete', incidence calculations, enrolment of cases, the importance of gender, ethnicity and age of the athlete, as well as the type and level of sporting activity. A precise instruction for autopsy practice in the case of a SCD of athletes is given, including the role of molecular samples and evaluation of possible doping. Rational decisions about cardiac preparticipation screening and cardiac safety at sport facilities requires increased data quality concerning incidence, aetiology and management of SCA/SCD in sports. Uniform standard registration of SCA/SCD in athletes and leisure sportsmen would be a first step towards this goal.
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- 2015
248. Series: Pragmatic trials and real world evidence: Paper 6. Outcome measures in the real world
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Maarten van Smeden, Paco M J Welsing, Iris Goetz, Katrien Oude Rengerink, Antonio Ciaglia, Sven Trelle, Aliki Taylor, Sue Collier, Laurent Eckert, Matthias Egger, and Gaëlle Nachbaur
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Blinding ,Standardization ,Endpoint Determination ,Epidemiology ,Decision Making ,Applied psychology ,Outcome measurement ,Context (language use) ,Time horizon ,Outcome (game theory) ,Pragmatic trial ,03 medical and health sciences ,0302 clinical medicine ,Outcome Assessment, Health Care ,Pragmatic Clinical Trials as Topic ,Journal Article ,Humans ,Relevance (law) ,Medicine ,Generalizability theory ,030212 general & internal medicine ,Randomized Controlled Trials as Topic ,Real-world evidence ,Evidence-Based Medicine ,Management science ,Surrogate endpoint ,business.industry ,Generalizability ,Research Design ,030220 oncology & carcinogenesis ,business - Abstract
Results from pragmatic trials should reflect the comparative treatment effects encountered in patients in real-life clinical practice to guide treatment decisions. Therefore pragmatic trials should focus on outcomes that are relevant to patients, clinical practice, and treatment choices. This 6(th) paper in the series (see box) discusses different types of outcomes and their suitability for pragmatic trials, design choices for measuring these outcomes and their implications and challenges. Measuring outcomes in pragmatic trials should not interfere with real-world clinical practice to ensure generalizability of trial results and routinely collected outcomes should be prioritized. Typical outcomes include mortality, morbidity, functional status, wellbeing and resource use. Surrogate endpoints are typically avoided as primary outcome. It is important to measure outcomes over a relevant time horizon and to obtain valid and precise results. As pragmatic trials are often open-label a less subjective outcome can reduce bias. Methods that decrease bias or enhance precision of the results, such as standardization and blinding of outcome assessment, should be considered when a high risk of bias or high variability is expected. The selection of outcomes in pragmatic trials should be relevant for decision making as well as feasible in terms of executing the trial in the context of interest. Therefore this should be discussed with all stakeholders as early as feasible to ensure the relevance of study results for decision making in clinical practice and the ability to perform the study.
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- 2017
249. Series: Pragmatic trials and real world evidence: Paper 3. Patient selection challenges and consequences
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Diederick E. Grobbee, Antonio Ciaglia, Alison Lightbourne, Elaine A. Irving, Rolf H.H. Groenwold, Katrien Oude Rengerink, Laurent Eckert, Susan Collier, Sally Worsley, and Shona Kalkman
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medicine.medical_specialty ,Epidemiology ,Alternative medicine ,Sample (statistics) ,Target population ,Real world evidence ,Pragmatic trial ,03 medical and health sciences ,0302 clinical medicine ,Enrollment ,Pragmatic Clinical Trials as Topic ,Journal Article ,Humans ,Medicine ,Generalizability theory ,030212 general & internal medicine ,Intensive care medicine ,Selection (genetic algorithm) ,Representativeness ,Real-world evidence ,business.industry ,Patient Selection ,Participant ,Recruitment ,business ,Research setting ,030217 neurology & neurosurgery - Abstract
This paper addresses challenges of identifying, enrolling and retaining participants in a in a trial conducted within a routine care setting. All patients that are potential candidates for the treatments in routine clinical practice should be considered eligible for a pragmatic trial. To ensure generalizability, the recruited sample should have a similar distribution of the treatment effect modifiers as the target population. In practice this can be best achieved by including - within the selected sites - all patients without further selection. If relevant heterogeneity between subgroups is expected, increasing the relative proportion of the subgroup of patients in the heterogeneous trial could be considered (oversampling), or a separate trial in this subgroup can be planned. Selection will nevertheless occur. Low enrolment and loss to follow-up can introduce selection and can jeopardize validity as well as generalizability. Pragmatic trials are conducted in clinical practice rather than in a dedicated research setting, which could reduce recruitment rates. However, if a trial poses a minimal burden to the physician and the patient, and routine clinical practice is maximally adhered to, the participation rate may be high and loss to follow-up will not be a specific problem for pragmatic trials.
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- 2017
250. Montreal Accord on Patient-Reported Outcomes (PROs) use series – Paper 1: introduction
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Susan J. Bartlett and Sara Ahmed
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Epidemiology ,business.industry ,Public relations ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,Healthcare policy ,Paradigm shift ,Health care ,Medicine ,030212 general & internal medicine ,business ,030217 neurology & neurosurgery ,Health policy - Abstract
Background Patient-centered health care, where we design and deliver care to address the needs and preferences of patients, represents an important paradigm shift. Patient-reported outcomes (PROs) are critical to capture the patient voice, understand how illness and treatments affect people, and establish how well services and treatments address what matters most to patients. Objective Originally developed for use in research, PROs are now used to monitor individuals and populations, manage care, evaluate services and providers, and inform policy. However, moving PROs beyond research settings incurs considerable methodological, organizational, technological, and ethical considerations. National collaborative networks of researchers, clinicians, patients, and other stakeholders can address these challenges by coordinating development, creating standards for use, sharing costs and delivery platforms, and improving widespread uptake of core sets of measures to better inform health care decisions and improve outcomes. Discussion We introduce eight papers from researchers, clinicians, patients, and decision makers who participated in deliberations around creating a national network to accelerate the application and harmonized use of PROs in Canada. They offer a snap shot of the strategies that pioneers and innovative thinkers are using to integrate the patient voice into comprehensive care, research, and health policy planning of chronic diseases.
- Published
- 2017
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