Many studies have investigated causes of COVID-19 and explored safety measures for preventing COVID-19 infections.Unfortunately,these studies fell short to address disparities in health status and resources among dece...Many studies have investigated causes of COVID-19 and explored safety measures for preventing COVID-19 infections.Unfortunately,these studies fell short to address disparities in health status and resources among decentralized communities in the United States.In this study,we utilized an advanced modeling technique to examine complex associations of county-level health factors with COVID-19 mortality for all 3141 counties in the United States.Our results indicated that counties with more uninsured people,more housing problems,more urbanized areas,and longer commute are more likely to have higher COVID-19 mortality.Based on the nationwide population-based data,this study also echoed prior research that used local data,and confirmed that county-level sociodemographic factors,such as more Black,Hispanic,and older subpopulations,are attributed to high risk of COVID-19 mortality.We hope that these findings will help set up priorities on high risk communities and subpopulations in future for fighting the novel virus.展开更多
Humans and animals can be exposed to Dioxins and Furans through ingestion of fatty food, skin contact, and breathing contaminated air. Resulting health problems include skin disease, immune problems, and cancers. Mana...Humans and animals can be exposed to Dioxins and Furans through ingestion of fatty food, skin contact, and breathing contaminated air. Resulting health problems include skin disease, immune problems, and cancers. Managing the release of these chemicals is therefore important. The Stockholm Convention on Persistent Organic Pollutants requires parties to adopt measures that reduce sources of these chemicals. Sierra Leone developed its National Implementation Plan (NIP) in 2008, in compliance with this requirement. However, no known further steps have been taken, particularly at community level. In 2013, the UNDP’s GEF/SGP funded a pilot project to manage the release of Dioxins and Furans from two dumpsites in Freetown, Sierra Leone. This work was sponsored with funds from that project. The work sought to delineate the exposure of communities within and around the Bormeh-Kingtom dumpsite (Kingtom, Kolleh town, Ascension town, Crab town, and Congo town) to the chemicals. The study considered sources of exposure, relative quantities generated per year, and the routes of exposure. This exposure study is a first step in managing the release from those sources. Enumerators deployed at the dumpsite every day, 7:00 AM to 6:00 PM, for three months, quantifying and recording source materials. The amount of source materials dumped per day informed calculation of Dioxin/Furan releases in grams toxicity equivalence per year. The results revealed a release of 128.914 g TEQ/year in air and residue. This implies that the communities are at high risk of inhalation and dermal exposure. Livestock, mainly pigs, are also exposed as they feed on the waste deposited in the dumpsite. Humans in turn feed on the livestock, a recipe for biomagnification. The project team has been working on developing Best Management Practices to suppress the release of the chemicals.展开更多
This special issue of The Journal of Biomedical Research presents rigorous empirical analysis related to COVID-19 research in responding to the current global COVID-19 pandemic.Selected articles from different discipl...This special issue of The Journal of Biomedical Research presents rigorous empirical analysis related to COVID-19 research in responding to the current global COVID-19 pandemic.Selected articles from different disciplines not only offer broader perspectives on combating the outbreaks,but also disseminate the most updated findings on this new challenge for human being to the field.展开更多
Oral diseases are associated with systemic diseases;such as type II diabetes, cardiovascular disease, rheumatoid arthritis (RA), and neurological diseases. Coincidentally, the oral microbiome (fluids or extracts) is r...Oral diseases are associated with systemic diseases;such as type II diabetes, cardiovascular disease, rheumatoid arthritis (RA), and neurological diseases. Coincidentally, the oral microbiome (fluids or extracts) is readily accessible and easily sampled;therefore, serving as a diagnostic or prognostic tool for health status. The oral microbiome is a useful research model for studying fundamental questions of the human microbiome. In this narrative literature review, we examine the characteristics of oral microorganisms, the relationship between oral microorganisms and human diseases, and the important role of oral microorganisms in disease prevention. Also, we illustrate the usefulness of sampling the oral microbiome in developing the diagnosis and prognostic treatment strategies for oral and systemic diseases to accelerate their clinical application. Selective saliva biomarkers and microbiome can serve for useful indices to oral diseases and systemic diseases, and as a model research tool, the oral cavity has many uses in the clinical and research environment. The relationships between oral health and systemic diseases are quite profound, and future research will illuminate opportunities for fruitful preventative measures and therapeutics.展开更多
Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American I...Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years;BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) Results: Only 12 of the 22 participants remained?in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was observed in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.展开更多
The safety of water is usually determined by comparing its quality to recommended standards. The objective of this work was to determine whether the water supplied on Njala Campus is safe for drinking. The quality par...The safety of water is usually determined by comparing its quality to recommended standards. The objective of this work was to determine whether the water supplied on Njala Campus is safe for drinking. The quality parameters investigated include coliform bacteria, turbidity, conductivity, total dissolved solids and nitrates. Samples were stored in a cooler with ice and transported to the laboratory within 30 minutes of collection. A checklist of questions to know the perception of residents was administered. According to the physical and biological results, the water is not safe for consumption. The turbidity and microbial counts were too high in most samples both in the wet and dry seasons. Additionally, over 80% of the respondents did not trust the water supply system. Most of them treat the supplied water by either boiling or disinfection before use. Most respondents complained of water-borne diseases but were not clear whether it is related to the water supplied. The chemical parameters, however, were acceptable: nitrate levels were low. In conclusion, the water is not safe for consumption as far as the physical and biological parameters are concerned. The campus water supply system needs improvement in terms of conveying raw and finished water, filter optimization, and satisfying the chlorine demand.展开更多
Background Physical activity programs using components of resistance have the potential to improve health in school chil-dren.The purpose of this study was to examine the effect of a school-based resistance exercise p...Background Physical activity programs using components of resistance have the potential to improve health in school chil-dren.The purpose of this study was to examine the effect of a school-based resistance exercise program on physical fitness in elementary school students.Methods The sample was 256 children(mean age=8.3±2.5 years;119 girls)from kindergarten to 5th grade.Participants performed a 10-min resistance exercise 2-3 times in each school day.Physical fitness outcomes were assessed using President’s Physical Fitness Challenge test.Measures were collected at baseline and at a 6-month post-test time point.A 2×2 doubly MANOVA was employed to examine the effect of sex and time.Results The multivariate model was statistically significant with a main time effect(Wilks’λ=0.19,F=290.9,P<0.001).Follow-univariate tests found significant differences between time-points on flex arm hang(P=0.033),shuttle run(P<0.001),and 1-mile run/walk times(P<0.001).Conclusions A 6-month resistance exercise program improved upper body strength and cardiorespiratory endurance in elementary school aged children.The use of resistance exercise intervention during school day can be effectively used to promote physical fitness and ultimately improve the health of children.展开更多
Lassa Fever is endemic to the eastern region of Sierra Leone. It is a haemorrhagic disease that is often transmitted from rats to humans and then human to humans. Ecological disturbances such as changes in land use in...Lassa Fever is endemic to the eastern region of Sierra Leone. It is a haemorrhagic disease that is often transmitted from rats to humans and then human to humans. Ecological disturbances such as changes in land use involving conversion of natural ecosystems to agriculture, mining or for urban expansion are reported to bring humans into close contact with animals such as the Mastomys rat that carries the Lassa Fever virus thereby posing health problems.The nature and extent of such ecological disturbances or land use changes within areas known to be endemic to Lassa Fever are not clearly understood from a research context in Sierra Leone. This study was therefore undertaken to identify the pattern of changes in land use and cropping practices and their potential to bring humans into close interactions with the Mastomys rat that is the host for the Lassa Fever virus. Four communities were chosen for the study, two rural (Lalehun and Majihun) and two urban (Lambayama section in Kenema City and Largo Square section in Segbwema Town). Different vegetation and land use/cropping practices were identified and observations were made on the pattern of changes at different times in the cropping year. There were four common vegetation and cropping practices found in all communities: upland rice intercropping, old fallow, young fallow, and swamp rice cultivation. The study revealed the variations in land use patterns and cropping practices between urban and rural settlements. Agro-forestry practices such as perennial cash crops cacao and rubber plantations were more common in rural communities. The study also revealed that while fallow vegetation persisted in rural areas there had been expansion of settlements into old fallow vegetation indicating a greater threat to the persistence of natural ecosystem in urban than in rural settlements. These disturbances resulted in habitat fragmentation and increased the likelihood of contact between humans and animal species (e.g. Mastomys rat) associated with various habitats.展开更多
To determine the effect of combinations of statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors in the secondary prevention of all cause mortality in patients with ischaemic heart disease. Desig...To determine the effect of combinations of statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors in the secondary prevention of all cause mortality in patients with ischaemic heart disease. Design: Open prospective cohort study with nested case control analysis. Setting: 1.18 million patients registered with 89 general practices across 23 strategic health authority areas within the United Kingdom. Practices had longitudinal data for a minimum of eight years and were contributing to QRESEARCH, a new database. Patients: All patients with a first diagnosis of ischaemic heart disease between January 1996 and December 2003. Cases were patients with ischaemic heart disease who died. Controls were patients with ischaemic heart disease who were matched for age, sex, and year of diagnosis and were alive at the time their matched case died. Main outcome measures: Odds ratio with 95% confidence interval for risk of death in cases compared with controls. Exposure was current use of different combinations of statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors before death in cases, or the equivalent date in controls. Results: 13 029 patients had a first diagnosis of ischaemic heart disease(incidence rate 338 per 100 000 person years). 2266 cases were matched to 9064 controls. Drug combinations associated with the greatest reduction in all cause mortality were statins, aspirin, and β blockers(83% reduction, 95% confidence interval 77% to 88% ); statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors(75% reduction, 65% to 82% ); and statins, aspirin, and angiotensin converting enzyme inhibitors(71% reduction, 59% to 79% ). Treatments associated with the smallest reduction in all cause mortality were β blockers alone(19% reduction, 37% reduction to 4% increase), angiotensin converting enzyme inhibitors alone(20% reduction, 1% to 35% ), and combined statins and angiotensin converting enzyme inhibitors(31% reduction, 57% reduction to 12% increase). Conclusions: Combinations of statins, aspirins, and β blockers improve survival in high risk patients with cardiovascular disease, although the addition of an angiotensin converting enzyme inhibitor conferred no additional benefit despite the analysis being adjusted for congestive cardiac failure.展开更多
Objective: To evaluate an occupational therapy intervention to improve outdoo r mobility after stroke. Design: Randomised controlled trial. Setting General pr actice registers, social services departments, a primary c...Objective: To evaluate an occupational therapy intervention to improve outdoo r mobility after stroke. Design: Randomised controlled trial. Setting General pr actice registers, social services departments, a primary care rehabilitation service, and a ger iatric day hospital. Participants: 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the interventio n group and 82 to the control group. Interventions: Leaflets describing local tr ansport services for disabled people (control group) and leaflets with assessmen t and up to seven intervention sessions by an occupational therapist (interventi on group). Main outcome measures: Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures wer e response to how many journeys outdoors had been made in the past month and sco res on the Nottingham extended activities of daily living scale, Nottingham leis ure questionnaire, and general health questionnaire. Results: Participants in th e treatment group were more likely to get out of the house as often as they want ed at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2. 37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journe ys outdoors in the month before assessment at both four months (median 37 in int ervention group, 14 in control group: P < 0.01) and 10 months (median 42 in inte rvention group, 14 in control group: P < 0.01). At four months the mobility scor es on the Nottingham extended activities of daily living scale were significantl y higher in the intervention group, but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months. Conclusion:A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke.展开更多
Background:Malaria surveillance system strengthening is essential in the progress towards malaria elimination.In Nigeria,more attention is being given to this recently as the country is striving towards achieving elim...Background:Malaria surveillance system strengthening is essential in the progress towards malaria elimination.In Nigeria,more attention is being given to this recently as the country is striving towards achieving elimination.However,the surveillance system performance is fraught with challenges including poor data quality with varying magnitude by state.This study evaluated the operation of the Kano State malaria surveillance system and assessed its key attributes.Methods:An observational study design comprising a survey,record review and secondary data analysis,and mixed methods data collection approach were used.Four key stakeholders’and 35 Roll Back Malaria Focal Persons(RBMs)semi-structured interviews on operation of the system and attributes of the surveillance system,were conducted.We analyzed the abstracted 2013–2016 National Health Management Information System web-based malaria datasets.The surveillance system was evaluated using the“2001 United States Centers for Disease Control’s updated guidelines for Evaluating Public Health Surveillance Systems”.Data were described using means,standard deviation,frequencies and proportions.Chi-squared for linear trends was used.Results:Overall,24 RBMs(68.6%)had≤15-year experience on malaria surveillance,29(82.9%)had formal training on malaria surveillance;32 RBMs(91.4%)reported case definitions were easy-to-use,reporting forms were easy-to-fill and data flow channels were clearly defined.Twenty-seven respondents(69.2%)reported data tools could accommodate changes and all RBMs understood malaria case definitions.All respondents(4 stakeholders and 34 RBMs[97.1%])expressed willingness to continue using the system and 33(84.6%)reported analyzed data were used for decision-making.Public health facilities constituted the main data source.Overall,65.0%of funding were from partner agencies.Trend of malaria cases showed significant decline(χ2 trend=7.49;P=0.0006).Timeliness of reporting was below the target(≥80%),except being 82%in 2012.Conclusions:Malaria surveillance system in Kano State was simple,flexible,acceptable,useful and donor-driven but the data were not representative of all health facilities.Timeliness of reporting was suboptimal.We recommended reporting from private health facilities,strengthening human resource capacity for supportive supervision and ensuring adequate government funding to enhance the system’s representativeness and improve data quality.展开更多
Purpose To compare physical activity and sedentary behavior between four commonly used subjective and objective meas-ures:the 7-day Physical Activity Recall (7DPAR),International Physical Activity Questionnaire (IPAQ)...Purpose To compare physical activity and sedentary behavior between four commonly used subjective and objective meas-ures:the 7-day Physical Activity Recall (7DPAR),International Physical Activity Questionnaire (IPAQ),pedometer,and accelerometer.Methods A total of 130 college students completed four measures for the same 7 days.Body composition was measured using a bioelectric impedance analyzer.Wilcoxon signed rank tests and Spearman correlations were performed to compare estimates between activity measures.The Spearman correlations between different activity measures were further examined separately for the higher and the lower body fat groups.Results Compared with accelerometer-derived data,both the 7DPAR and the IPAQ overestimated light physical activity(P < 0.001) while underestimated sedentary behavior (P < 0.001).Across comparisons,the highest correlation was found between accelerometers and pedometers on steps/day (r =0.72,P < 0.001).The 7DPAR and the IPAQ were correlated with each other for all physical activity variables and sedentary behavior (r =0.37-0.45).There were low correlations (r=0.20-0.47) between the 7DPAR,the IPAQ,and accelerometers in sedentary behavior,light physical activity,and vigorous physical activity.Higher correlations between different activity modalities were observed among individuals with lower body fat(r=0.41-0.80) than among those with higher body fat (r=0.31-0.65).Conclusions The 7DPAR and the IPAQ yielded comparable estimation of moderate physical activity relative to accelerom-eters.There were significant differences in sedentary time across activity measures.Body compositions should be considered when comparing the estimates of activity levels between subjective and objective instruments.展开更多
文摘Many studies have investigated causes of COVID-19 and explored safety measures for preventing COVID-19 infections.Unfortunately,these studies fell short to address disparities in health status and resources among decentralized communities in the United States.In this study,we utilized an advanced modeling technique to examine complex associations of county-level health factors with COVID-19 mortality for all 3141 counties in the United States.Our results indicated that counties with more uninsured people,more housing problems,more urbanized areas,and longer commute are more likely to have higher COVID-19 mortality.Based on the nationwide population-based data,this study also echoed prior research that used local data,and confirmed that county-level sociodemographic factors,such as more Black,Hispanic,and older subpopulations,are attributed to high risk of COVID-19 mortality.We hope that these findings will help set up priorities on high risk communities and subpopulations in future for fighting the novel virus.
文摘Humans and animals can be exposed to Dioxins and Furans through ingestion of fatty food, skin contact, and breathing contaminated air. Resulting health problems include skin disease, immune problems, and cancers. Managing the release of these chemicals is therefore important. The Stockholm Convention on Persistent Organic Pollutants requires parties to adopt measures that reduce sources of these chemicals. Sierra Leone developed its National Implementation Plan (NIP) in 2008, in compliance with this requirement. However, no known further steps have been taken, particularly at community level. In 2013, the UNDP’s GEF/SGP funded a pilot project to manage the release of Dioxins and Furans from two dumpsites in Freetown, Sierra Leone. This work was sponsored with funds from that project. The work sought to delineate the exposure of communities within and around the Bormeh-Kingtom dumpsite (Kingtom, Kolleh town, Ascension town, Crab town, and Congo town) to the chemicals. The study considered sources of exposure, relative quantities generated per year, and the routes of exposure. This exposure study is a first step in managing the release from those sources. Enumerators deployed at the dumpsite every day, 7:00 AM to 6:00 PM, for three months, quantifying and recording source materials. The amount of source materials dumped per day informed calculation of Dioxin/Furan releases in grams toxicity equivalence per year. The results revealed a release of 128.914 g TEQ/year in air and residue. This implies that the communities are at high risk of inhalation and dermal exposure. Livestock, mainly pigs, are also exposed as they feed on the waste deposited in the dumpsite. Humans in turn feed on the livestock, a recipe for biomagnification. The project team has been working on developing Best Management Practices to suppress the release of the chemicals.
文摘This special issue of The Journal of Biomedical Research presents rigorous empirical analysis related to COVID-19 research in responding to the current global COVID-19 pandemic.Selected articles from different disciplines not only offer broader perspectives on combating the outbreaks,but also disseminate the most updated findings on this new challenge for human being to the field.
文摘Oral diseases are associated with systemic diseases;such as type II diabetes, cardiovascular disease, rheumatoid arthritis (RA), and neurological diseases. Coincidentally, the oral microbiome (fluids or extracts) is readily accessible and easily sampled;therefore, serving as a diagnostic or prognostic tool for health status. The oral microbiome is a useful research model for studying fundamental questions of the human microbiome. In this narrative literature review, we examine the characteristics of oral microorganisms, the relationship between oral microorganisms and human diseases, and the important role of oral microorganisms in disease prevention. Also, we illustrate the usefulness of sampling the oral microbiome in developing the diagnosis and prognostic treatment strategies for oral and systemic diseases to accelerate their clinical application. Selective saliva biomarkers and microbiome can serve for useful indices to oral diseases and systemic diseases, and as a model research tool, the oral cavity has many uses in the clinical and research environment. The relationships between oral health and systemic diseases are quite profound, and future research will illuminate opportunities for fruitful preventative measures and therapeutics.
文摘Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years;BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) Results: Only 12 of the 22 participants remained?in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was observed in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.
文摘The safety of water is usually determined by comparing its quality to recommended standards. The objective of this work was to determine whether the water supplied on Njala Campus is safe for drinking. The quality parameters investigated include coliform bacteria, turbidity, conductivity, total dissolved solids and nitrates. Samples were stored in a cooler with ice and transported to the laboratory within 30 minutes of collection. A checklist of questions to know the perception of residents was administered. According to the physical and biological results, the water is not safe for consumption. The turbidity and microbial counts were too high in most samples both in the wet and dry seasons. Additionally, over 80% of the respondents did not trust the water supply system. Most of them treat the supplied water by either boiling or disinfection before use. Most respondents complained of water-borne diseases but were not clear whether it is related to the water supplied. The chemical parameters, however, were acceptable: nitrate levels were low. In conclusion, the water is not safe for consumption as far as the physical and biological parameters are concerned. The campus water supply system needs improvement in terms of conveying raw and finished water, filter optimization, and satisfying the chlorine demand.
文摘Background Physical activity programs using components of resistance have the potential to improve health in school chil-dren.The purpose of this study was to examine the effect of a school-based resistance exercise program on physical fitness in elementary school students.Methods The sample was 256 children(mean age=8.3±2.5 years;119 girls)from kindergarten to 5th grade.Participants performed a 10-min resistance exercise 2-3 times in each school day.Physical fitness outcomes were assessed using President’s Physical Fitness Challenge test.Measures were collected at baseline and at a 6-month post-test time point.A 2×2 doubly MANOVA was employed to examine the effect of sex and time.Results The multivariate model was statistically significant with a main time effect(Wilks’λ=0.19,F=290.9,P<0.001).Follow-univariate tests found significant differences between time-points on flex arm hang(P=0.033),shuttle run(P<0.001),and 1-mile run/walk times(P<0.001).Conclusions A 6-month resistance exercise program improved upper body strength and cardiorespiratory endurance in elementary school aged children.The use of resistance exercise intervention during school day can be effectively used to promote physical fitness and ultimately improve the health of children.
文摘Lassa Fever is endemic to the eastern region of Sierra Leone. It is a haemorrhagic disease that is often transmitted from rats to humans and then human to humans. Ecological disturbances such as changes in land use involving conversion of natural ecosystems to agriculture, mining or for urban expansion are reported to bring humans into close contact with animals such as the Mastomys rat that carries the Lassa Fever virus thereby posing health problems.The nature and extent of such ecological disturbances or land use changes within areas known to be endemic to Lassa Fever are not clearly understood from a research context in Sierra Leone. This study was therefore undertaken to identify the pattern of changes in land use and cropping practices and their potential to bring humans into close interactions with the Mastomys rat that is the host for the Lassa Fever virus. Four communities were chosen for the study, two rural (Lalehun and Majihun) and two urban (Lambayama section in Kenema City and Largo Square section in Segbwema Town). Different vegetation and land use/cropping practices were identified and observations were made on the pattern of changes at different times in the cropping year. There were four common vegetation and cropping practices found in all communities: upland rice intercropping, old fallow, young fallow, and swamp rice cultivation. The study revealed the variations in land use patterns and cropping practices between urban and rural settlements. Agro-forestry practices such as perennial cash crops cacao and rubber plantations were more common in rural communities. The study also revealed that while fallow vegetation persisted in rural areas there had been expansion of settlements into old fallow vegetation indicating a greater threat to the persistence of natural ecosystem in urban than in rural settlements. These disturbances resulted in habitat fragmentation and increased the likelihood of contact between humans and animal species (e.g. Mastomys rat) associated with various habitats.
文摘To determine the effect of combinations of statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors in the secondary prevention of all cause mortality in patients with ischaemic heart disease. Design: Open prospective cohort study with nested case control analysis. Setting: 1.18 million patients registered with 89 general practices across 23 strategic health authority areas within the United Kingdom. Practices had longitudinal data for a minimum of eight years and were contributing to QRESEARCH, a new database. Patients: All patients with a first diagnosis of ischaemic heart disease between January 1996 and December 2003. Cases were patients with ischaemic heart disease who died. Controls were patients with ischaemic heart disease who were matched for age, sex, and year of diagnosis and were alive at the time their matched case died. Main outcome measures: Odds ratio with 95% confidence interval for risk of death in cases compared with controls. Exposure was current use of different combinations of statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors before death in cases, or the equivalent date in controls. Results: 13 029 patients had a first diagnosis of ischaemic heart disease(incidence rate 338 per 100 000 person years). 2266 cases were matched to 9064 controls. Drug combinations associated with the greatest reduction in all cause mortality were statins, aspirin, and β blockers(83% reduction, 95% confidence interval 77% to 88% ); statins, aspirin, β blockers, and angiotensin converting enzyme inhibitors(75% reduction, 65% to 82% ); and statins, aspirin, and angiotensin converting enzyme inhibitors(71% reduction, 59% to 79% ). Treatments associated with the smallest reduction in all cause mortality were β blockers alone(19% reduction, 37% reduction to 4% increase), angiotensin converting enzyme inhibitors alone(20% reduction, 1% to 35% ), and combined statins and angiotensin converting enzyme inhibitors(31% reduction, 57% reduction to 12% increase). Conclusions: Combinations of statins, aspirins, and β blockers improve survival in high risk patients with cardiovascular disease, although the addition of an angiotensin converting enzyme inhibitor conferred no additional benefit despite the analysis being adjusted for congestive cardiac failure.
文摘Objective: To evaluate an occupational therapy intervention to improve outdoo r mobility after stroke. Design: Randomised controlled trial. Setting General pr actice registers, social services departments, a primary care rehabilitation service, and a ger iatric day hospital. Participants: 168 community dwelling people with a clinical diagnosis of stroke in previous 36 months: 86 were allocated to the interventio n group and 82 to the control group. Interventions: Leaflets describing local tr ansport services for disabled people (control group) and leaflets with assessmen t and up to seven intervention sessions by an occupational therapist (interventi on group). Main outcome measures: Responses to postal questionnaires at four and 10 months: primary outcome measure was response to whether participant got out of the house as much as he or she would like, and secondary outcome measures wer e response to how many journeys outdoors had been made in the past month and sco res on the Nottingham extended activities of daily living scale, Nottingham leis ure questionnaire, and general health questionnaire. Results: Participants in th e treatment group were more likely to get out of the house as often as they want ed at both four months (relative risk 1.72, 95% confidence interval 1.25 to 2. 37) and 10 months (1.74, 1.24 to 2.44). The treatment group reported more journe ys outdoors in the month before assessment at both four months (median 37 in int ervention group, 14 in control group: P < 0.01) and 10 months (median 42 in inte rvention group, 14 in control group: P < 0.01). At four months the mobility scor es on the Nottingham extended activities of daily living scale were significantl y higher in the intervention group, but there were no significant differences in the other secondary outcomes. No significant differences were observed in these measures at 10 months. Conclusion:A targeted occupational therapy intervention at home increases outdoor mobility in people after stroke.
基金This study was supported by Cooperative Agreem ent Number NU2GGH001876 funded by the United States Centers for Disease Control and Prevention through African Field Epidemiology Network to the Nigeria Field Epidemiology and Laboratory Training Program.
文摘Background:Malaria surveillance system strengthening is essential in the progress towards malaria elimination.In Nigeria,more attention is being given to this recently as the country is striving towards achieving elimination.However,the surveillance system performance is fraught with challenges including poor data quality with varying magnitude by state.This study evaluated the operation of the Kano State malaria surveillance system and assessed its key attributes.Methods:An observational study design comprising a survey,record review and secondary data analysis,and mixed methods data collection approach were used.Four key stakeholders’and 35 Roll Back Malaria Focal Persons(RBMs)semi-structured interviews on operation of the system and attributes of the surveillance system,were conducted.We analyzed the abstracted 2013–2016 National Health Management Information System web-based malaria datasets.The surveillance system was evaluated using the“2001 United States Centers for Disease Control’s updated guidelines for Evaluating Public Health Surveillance Systems”.Data were described using means,standard deviation,frequencies and proportions.Chi-squared for linear trends was used.Results:Overall,24 RBMs(68.6%)had≤15-year experience on malaria surveillance,29(82.9%)had formal training on malaria surveillance;32 RBMs(91.4%)reported case definitions were easy-to-use,reporting forms were easy-to-fill and data flow channels were clearly defined.Twenty-seven respondents(69.2%)reported data tools could accommodate changes and all RBMs understood malaria case definitions.All respondents(4 stakeholders and 34 RBMs[97.1%])expressed willingness to continue using the system and 33(84.6%)reported analyzed data were used for decision-making.Public health facilities constituted the main data source.Overall,65.0%of funding were from partner agencies.Trend of malaria cases showed significant decline(χ2 trend=7.49;P=0.0006).Timeliness of reporting was below the target(≥80%),except being 82%in 2012.Conclusions:Malaria surveillance system in Kano State was simple,flexible,acceptable,useful and donor-driven but the data were not representative of all health facilities.Timeliness of reporting was suboptimal.We recommended reporting from private health facilities,strengthening human resource capacity for supportive supervision and ensuring adequate government funding to enhance the system’s representativeness and improve data quality.
基金supported by the MOST 102-2410-H-041-009,Taiwan,China。
文摘Purpose To compare physical activity and sedentary behavior between four commonly used subjective and objective meas-ures:the 7-day Physical Activity Recall (7DPAR),International Physical Activity Questionnaire (IPAQ),pedometer,and accelerometer.Methods A total of 130 college students completed four measures for the same 7 days.Body composition was measured using a bioelectric impedance analyzer.Wilcoxon signed rank tests and Spearman correlations were performed to compare estimates between activity measures.The Spearman correlations between different activity measures were further examined separately for the higher and the lower body fat groups.Results Compared with accelerometer-derived data,both the 7DPAR and the IPAQ overestimated light physical activity(P < 0.001) while underestimated sedentary behavior (P < 0.001).Across comparisons,the highest correlation was found between accelerometers and pedometers on steps/day (r =0.72,P < 0.001).The 7DPAR and the IPAQ were correlated with each other for all physical activity variables and sedentary behavior (r =0.37-0.45).There were low correlations (r=0.20-0.47) between the 7DPAR,the IPAQ,and accelerometers in sedentary behavior,light physical activity,and vigorous physical activity.Higher correlations between different activity modalities were observed among individuals with lower body fat(r=0.41-0.80) than among those with higher body fat (r=0.31-0.65).Conclusions The 7DPAR and the IPAQ yielded comparable estimation of moderate physical activity relative to accelerom-eters.There were significant differences in sedentary time across activity measures.Body compositions should be considered when comparing the estimates of activity levels between subjective and objective instruments.
