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Prevalence of Cesarean Section at Georgetown Public Hospital Corporation, Guyana: An Institution-Based Cross-Sectional Study
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作者 Gary Joseph Cecil Boston Gbenankpon Mathias Houvessou 《Open Journal of Clinical Diagnostics》 2023年第3期29-47,共19页
The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to Se... The International Healthcare Community recommends that countries do not exceed a 15% rate for cesarean section (CS). Our objective was to determine the prevalence and factors associated with CS at GPHC from July to September 2022. Methods: A cross-sectional study was carried out and data were collected from 1296 mothers, who met the inclusion criteria, through face-to-face interviews after obtaining prior informed consent. We performed descriptive analyses both for the outcome and independent variables. Bivariate and multiple logistic regression were used to identify factors associated with CS with a p-value Results: The prevalence of CS at GPHC was 28.9% (95%CI: 26.5-31.5). Factors associated factors with CS were mothers aged 20 to 34 years (AOR: 1.56, 95%CI: 1.02 - 2.39, P = 0.039);mothers who received more than three minimum wages (AOR: 1.95, 95%CI: 1.29 - 2.97, P = 0.002) and who attended prenatal care at both public and private health facilities (AOR: 2.49, 95% CI: 1.19 - 5.22, P = 0.022). Likewise, the highest Odds of CS were observed in mothers with gestational hypertension (AOR: 2.00, 95%CI: 1.35 - 2.96, P Conclusion: The prevalence of CS is higher than the ideal rate recommended by the International Healthcare Community. More studies are needed to understand the reasons for such high prevalence at GPHC. 展开更多
关键词 Cesarean Section Delivery Georgetown Public Hospital Corporation GUYANA
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Cost-effectiveness analysis of beta-blockers vs endoscopic surveillance in patients with cirrhosis and small varices 被引量:1
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作者 Lorenza Di Pascoli Alessra Buja +4 位作者 Massimo Bolognesi Sara Montagnese Angelo Gatta Dario Gregori Carlo Merkel 《World Journal of Gastroenterology》 SCIE CAS 2014年第30期10464-10469,共6页
AIM: To evaluate the most cost-effectiveness strategy for preventing variceal growth and bleeding in patients with cirrhosis and small esophageal varices.
关键词 Pharmaco-economical analysis CIRRHOSIS Esophageal varices Variceal bleeding Primary prophylaxis
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Characteristics of Geriatric Health Service Facilities Designated as Sites of Death
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作者 Mitsumi Ono Hideyuki Kanda +1 位作者 Yuko Takeda Sachiko Hara 《Health》 2015年第10期1275-1282,共8页
There are many deaths occurring among the aged population in Japan. Geriatric Health Service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was t... There are many deaths occurring among the aged population in Japan. Geriatric Health Service Facilities (GHSFs) are highlighted as some of the chosen facilities designated as sites of death. The aim of our study was to clarify the characteristics and related factors, including physical signs first noticed by staff at the end-of-life period, in GHSFs designated as sites of death, using a nationwide survey in Japan. We administered a questionnaire to 3971 GHSFs in Japan. Eligible responses for the study were obtained from 854 GHSFs. We found that GHSFs designated as sites of death were more likely to have basic policies and documented preferences regarding end-of-life care. We also found that staff members in GHSFs designated as sites of death were less likely to first notice physical signs of pain. We found that GHSFs designated as sites of death tended to identify earlier symptoms, such as reduced oral intake and less vigor. Our results would enable elderly persons, their families, and staff in GHSFs to prepare for the elderly’s death more efficiently though earlier identification of the end-of-life period. We hope that GHSFs have an important role to play in end-of-life care provision to elderly persons in Japan, through the strengthening of these intermediate facilities. 展开更多
关键词 GERIATRIC Health Service Facility END-OF-LIFE Care Basic Policy PREFERENCE Documented Physical SIGNS
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Physical activity levels in American and Japanese men from the ERA-JUMP Study and associations with metabolic syndrome
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作者 Naoko Sagawa Bonny Rockette-Wagner +7 位作者 Koichiro Azuma Hirotsugu Ueshima Takashi Hisamatsu Tomoko Takamiya Aiman El-Saed Katsuyuki Miura Andrea Kriska Akira Sekikawa 《Journal of Sport and Health Science》 SCIE 2020年第2期170-178,共9页
Background:Metabolic syndrome(MetS) is a global health problem.Physical activity(PA) is a known modifiable risk factor for MetS and individual MetS components.However,the role of PA could differ between sub-population... Background:Metabolic syndrome(MetS) is a global health problem.Physical activity(PA) is a known modifiable risk factor for MetS and individual MetS components.However,the role of PA could differ between sub-populations due to differences in the variability of PA and other MetS risk factors.To examine these differences,multi-country studies with standardized outcome measurement methods across cohorts are needed.Methods:Cross-sectional PA levels(total and domain specific) in healthy middle-aged(44-56 years) men in the Risk Factor Assessment among Japanese and U.S.Men in the Post-World War Ⅱ Birth Cohort(ERA-JUMP) Study(n=730;American:n=417;Japanese:n=313;from population-representative samples in Pittsburgh,Pennsylvania,USA,and Kusatsu,Shiga,Japan) were compared.The relationships between PA levels and MetS(overall and specific components) in/across the American and Japanese sub-cohorts(adjusting for age,smoking,and alcohol consumption)were also assessed using the same instruments(pedometer and validated questionnaire) to measure PA in both cohorts.Results:A total of 510 individuals provided complete data on PA(American:n=265;Japanese:n=245).The American cohort had significantly lower mean±SD steps/day(7878±3399 steps/day) vs.the Japanese cohort(9055±3797 steps/day)(p <0.001) but had significantly higher self-reported moderate-vigorous leisure PA(American:15.9(7.4-30.3) metabolic task equivalent hours per week(MET-b/week) vs.Japanese:4.0(0-11.3) METh/week,p <0.0001).In both sub-cohorts,each 1000 steps/day increase was associated with lower odds of having MetS(American:OR=0.90,95%CI:0.83-0.98;Japanese:OR=0.87,95%CI:0.79-0.95) and the individual MetS component of high waist circumference(American:OR=0.86,95%CI:0.79-0.94;Japanese:OR=0.87,95%CI:0.80-0.95).In the American cohort only,higher self-reported leisure PA(Met-b/week) was associated with lower odds of MetS and high waist circumference(OR=0.98,95%CI:0.97-0.99 for MetS and waist circumference,respectively).Conclusion:Higher total step counts/day had an important protective effect on MetS prevalence in both the Japanese and American cohorts,despite differences in PA levels and other MetS risk factors.The effect of steps/day(across all intensity levels) was much greater than domainspecific moderate-vigorous PA captured by questionnaire,suggesting the need for measurement tools that can best capture total movement when examining the effects of PA on MetS development. 展开更多
关键词 EPIDEMIOLOGY METABOLIC syndrome PEDOMETER Physical activity QUESTIONNAIRE
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Active Molecular Network Discovery Links Lifestyle Variables to Breast Cancer in the Long Island Breast Cancer Study Project
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作者 Miao Yu Qian Li +4 位作者 Georgia Dolios Peijun Tu Susan Teitelbaum Jia Chen Lauren Petrick 《Environment & Health》 2024年第6期401-410,共10页
A healthy lifestyle has been associated with decreased risk of developing breast cancer.Using untargeted metabolomics profiling,which provides unbiased information regarding lifestyle choices such as diet and exercise... A healthy lifestyle has been associated with decreased risk of developing breast cancer.Using untargeted metabolomics profiling,which provides unbiased information regarding lifestyle choices such as diet and exercise,we aim to identify the molecular mechanisms connecting lifestyle and breast cancer through network analysis.A total of 100 postmenopausal women,50 with breast cancer and 50 cancer-free controls,were selected from the Long Island Breast Cancer Study Project(LIBCSP).We measured untargeted plasma metabolomics using liquid chromatography-high-resolution mass spectrometry(LCHRMS).Using the“enet”package,we retained highly correlated metabolites representing active molecular network(AMN)clusters for analysis.LASSO was used to examine associations between cancer status and AMN metabolites and covariates such as BMI,age,and reproductive factors.LASSO was then repeated to examine associations between AMN metabolites and 10 lifestyle-related variables including smoking,physical activity,alcohol consumption,meat consumption,fruit and vegetable consumption,and supplemental vitamin use.Results were displayed as a network to uncover biological pathways linking lifestyle factors to breast cancer status.After filtering,851“active”metabolites out of 1797 metabolomics were retained in 197 correlation AMN clusters.Using LASSO,breast cancer status was associated with 71“active”metabolites.Several of these metabolites were associated with lifestyle variables including meat consumption,alcohol consumption,and supplementalβ-carotene,B12,and folate use.Those metabolites could potentially serve as molecular-level biological intermediaries connecting healthy lifestyle factors to breast cancer,even though direct associations between breast cancer and the investigated lifestyles at the phenotype level are not evident.In particular,DiHODE,a metabolite linked with inflammation,was associated with breast cancer status and connected toβ-carotene supplement usage through an AMN.We found several plasma metabolites associated with lifestyle factors and breast cancer status.Future studies investigating the mechanistic role of inflammation in linking supplement usage to breast cancer status are warranted. 展开更多
关键词 Metabolomics exposome machine learning network analysis public health
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5-ASA colonic mucosal concentrations resulting from different pharmaceutical formulations in ulcerative colitis 被引量:4
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作者 Renata D’Incà Martina Paccagnella +4 位作者 Romilda Cardin Surajit Pathak Vincenzo Baldo Maria Cecilia Giron Giacomo Carlo Sturniolo 《World Journal of Gastroenterology》 SCIE CAS 2013年第34期5665-5670,共6页
AIM:To compare the mucosal concentrations of 5-aminosalicylic acid(5-ASA)resulting from different pharmaceutical formulations and analyse the influence of inflammation on the mucosal concentrations.METHODS:The study i... AIM:To compare the mucosal concentrations of 5-aminosalicylic acid(5-ASA)resulting from different pharmaceutical formulations and analyse the influence of inflammation on the mucosal concentrations.METHODS:The study included 130 inflammatory bowel disease(IBD)patients receiving 5-ASA as pH-dependent-release formulations(73 patients),time-dependent-release formulations(11 patients),or pro-drugs(18patients).In addition,28 patients were receiving topical treatment(2-4 g/d)with pH-dependent-release formulations.Endoscopic biopsies were obtained from the sigmoid region during the colonoscopy.The 5-ASA concentrations(ng/mg)were measured in tissue homogenatesusing high-pressure liquid chromatography with electrochemical detection.The t test and Mann-Whitney test,when appropriate,were used for statistical analysis.RESULTS:Patients receiving pH-dependent-release formulations showed significantly higher mucosal concentrations of 5-ASA(51.75±5.72 ng/mg)compared with patients receiving pro-drugs(33.35±5.78 ng/mg,P=0.01)or time-dependent-release formulations(38.24±5.53 ng/mg,P=0.04).Patients with endoscopic remission had significantly higher mucosal concentrations of5-ASA than patients with active disease(60.14±7.95ng/mg vs 35.66±5.68 ng/mg,P=0.02).Similar results were obtained when we compared patients with the histological appearance of remission and patients with active histological inflammation(67.53±9.22 ng/mg vs 35.53±5.63 ng/mg,P<0.001).Significantly higher mucosal concentrations of 5-ASA were detected in patients treated with both oral and topical treatments in combination compared with patients who received oral treatment with pH-dependent-release formulations alone(72.33±11.23 ng/mg vs 51.75±5.72 ng/mg,P=0.03).CONCLUSION:IBD patients showed significant variability in mucosal 5-ASA concentrations depending on the type of formulation,and the highest mean concentration was achieved using pH-dependent-release formulations. 展开更多
关键词 5-aminosalicylic acid INFLAMMATORY BOWEL diseases MUCOSAL concentration
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Imaging plaque inflammation in asymptomatic cocaine addicted individuals with simultaneous positron emission tomography/magnetic resonance imaging 被引量:2
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作者 Keren Bachi Venkatesh Mani +4 位作者 Audrey E Kaufman Nadia Alie Rita Z Goldstein Zahi A Fayad Nelly Alia-Klein 《World Journal of Radiology》 CAS 2019年第5期62-73,共12页
BACKGROUND Chronic cocaine use is associated with stroke, coronary artery disease and myocardial infarction, resulting in severe impairments or sudden mortality. In the absence of clear cardiovascular symptoms, indivi... BACKGROUND Chronic cocaine use is associated with stroke, coronary artery disease and myocardial infarction, resulting in severe impairments or sudden mortality. In the absence of clear cardiovascular symptoms, individuals with cocaine use disorder (iCUD) seeking addiction treatment receive mostly psychotherapy and psychiatric pharmacotherapy, with no attention to vascular disease (i.e., atherosclerosis). Little is known about the pre-clinical signs of cardiovascular risk in iCUD and early signs of vascular disease are undetected in this underserved population. AIM To assess inflammation, plaque burden and plaque composition in iCUD aiming to detect markers of atherosclerosis and vascular disease. METHODS The bilateral carotid arteries were imaged with positron emission tomography/magnetic resonance imaging (PET/MRI) in iCUD asymptomatic for cardiovascular disease, healthy controls, and individuals with cardiovascular risk. PET with 18F-fluorodeoxyglucose (18F-FDG) evaluated vascular inflammation and 3-D dark-blood MRI assessed plaque burden including wall area and thickness. Drug use and severity of addiction were assessed with standardized instruments. RESULTS The majority of iCUD and controls had carotid FDG-PET signal greater than 1.6 but lower than 3, indicating the presence of mild to moderate inflammation. However, the MRI measure of wall structure was thicker in iCUD as compared to the controls and cardiovascular risk group, indicating greater carotid plaque burden. iCUD had larger wall area as compared to the healthy controls but not as compared to the cardiovascular risk group, indicating structural wall similarities between the non-control study groups. In iCUD, wall area correlated with greater cocaine withdrawal and craving. CONCLUSION These preliminary results show markers of carotid artery disease burden in cardiovascular disease-asymptomatic iCUD. Broader trials are warranted to develop protocols for early detection of cardiovascular risk and preventive intervention in iCUD. 展开更多
关键词 3-D dark-blood magnetic RESONANCE imaging 18F-fluorodeoxyglucose POSITRON emission TOMOGRAPHY Simultaneous POSITRON emission TOMOGRAPHY Magnetic RESONANCE Substance use disorder COCAINE addiction Atherosclerosis PLAQUE burden Vascular INFLAMMATION
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Factors Related to Nocturia in Elderly People Living in Local Remote Area in Japan
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作者 Yuko Takeda Mitsumi Ono +2 位作者 Hideyuki Kanda Sachiko Hara Keiko Takeda 《Health》 2017年第4期657-668,共12页
The elderly people are prone to be affected by quality of life (QOL) by nocturia becoming the multiple times. A purpose of this study was to determine it about a factor associated with the night urination. This survey... The elderly people are prone to be affected by quality of life (QOL) by nocturia becoming the multiple times. A purpose of this study was to determine it about a factor associated with the night urination. This survey was conducted in 2015 as a cross-sectional study. Anonymous, self-administered questionnaires were used to prevent individuals from being identified. The analysis subjects were 699 elderly people with the nocturia which belonged to club of the aged 65 years or older. Those with nocturia were placed in the Nocturia-1 group if they reported experiencing nocturia once per night or in the Nocturia- ≥ 2 group if they reported experiencing nocturia two or more times per night. We analyzed the relationships between the characteristics, lower urinary tract symptoms, and opportunities to go outdoors in the Nocturia-1 and Nocturia- ≥ 2 groups based on sex using the χ2 test. In addition, to investigate the factors that influence the change from nocturia once per night to two or more times per night, we performed logistic regression analysis using the χ2 test on the characteristics and lower urinary tract symptoms that showed significant differences separately for men and women. Among the men, factors with a significant positive relation-ship were age, diabetes mellitus, lower back pain, daytime frequency, and urinary urgency. Among the women, factors with a significant positive relationship were age, requiring support 1-requiring long-term care 2, urinary urgency, and feeling of incomplete emptying. It was suggested that the life of elderly people improved by nocturia not increasing. 展开更多
关键词 ELDERLY NOCTURIA Quality of LIFE
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Changes in Public Perception and Behaviors under Compound Heatwave in COVID-19 Epidemic——Beijing,China,2020
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作者 Jie Ban Yue Sun +4 位作者 Yi Zhang Mike ZHe Qinghua Sun Chen Chen Tiantian Li 《China CDC weekly》 2021年第32期675-680,I0001,I0002,共8页
Summary What is already known about this topic?Dramatic heatwaves frequently occurred simultaneously with the coronavirus disease 2019(COVID-19)pandemic worldwide in 2020 and posed public health challenges.Public risk... Summary What is already known about this topic?Dramatic heatwaves frequently occurred simultaneously with the coronavirus disease 2019(COVID-19)pandemic worldwide in 2020 and posed public health challenges.Public risk perceptions and behavioral responses to this compound risk need to be addressed.What is added by this report? 展开更多
关键词 PUBLIC COV WAVE
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