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1.
Susan M. Meffert Clare Henn-Haase Thomas J. Metzler Meng Qian Suzanne Best Ayelet Hirschfeld Shannon McCaslin Sabra Inslicht Thomas C. Neylan Charles R. Marmar 《PloS one》2014,9(7)
Introduction
It has been reported that posttraumatic stress disorder (PTSD) is associated with secondary spouse/partner (S/P) emotional distress and relationship violence.Objective
To investigate the relationships between PTSD, S/P emotional distress and relationship violence among police recruits using a prospective design.Methods
Two hypotheses were tested in 71 S/Ps: (1) Police officer reports of greater PTSD symptoms after 12 months of police service will be associated with greater secondary trauma symptoms among S/Ps; (2) Greater secondary trauma symptoms among S/Ps at 12 months will be associated with S/P reports of greater relationship violence.Methods
71 police recruits and their S/Ps were assessed at baseline and 12 months after the start of police officer duty. Using linear and logistic regression, we analyzed explanatory variables for 12 month S/P secondary traumatic stress symptoms and couple violence, including baseline S/P variables and couple violence, as well as exposure and PTSD reports from both S/P and officer.Results
S/P perception of officer PTSD symptoms predicted S/P secondary traumatic stress. OS/P secondary trauma was significantly associated with both total couple violence (.34, p = .004) and S/P to officer violence (.35, p = .003).Conclusions
Although results from this relatively small study of young police officers and their S/Ps must be confirmed by larger studies in general populations, findings suggest that S/P perception of PTSD symptoms may play a key role in the spread of traumatic stress symptoms across intimate partner relationships and intimate partner violence in the context of PTSD. 相似文献2.
Donald Edmondson Safiya Richardson Jennifer K. Fausett Louise Falzon Virginia J. Howard Ian M. Kronish 《PloS one》2013,8(6)
Background and Purpose
Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke and transient ischemic attack (TIA). This study estimated the prevalence of stroke or TIA-induced posttraumatic stress disorder (PTSD) using systematic review and meta-analysis.Methods
Potentially relevant peer-reviewed journal articles were identified by searching the Ovid MEDLINE, PsycINFO, PILOTS Database, The Cochrane Library and Scopus from inception to January 2013; all searches were conducted on January 31, 2013. Observational cohort studies that assessed PTSD with specific reference to a stroke or TIA that occurred at least 1 month prior to the PTSD assessment were included. PTSD rates and characteristics of the study and sample were abstracted from all included studies. The coding of all articles included demographics, sample size, study country, and method and timing of PTSD assessment.Results
Nine studies (N = 1,138) met our inclusion criteria. PTSD rates varied significantly across studies by timing of PTSD assessment (i.e., within 1 year of stroke/TIA versus greater than 1 year post-stroke/TIA; 55% of heterogeneity explained; Q 1 = 10.30; P = .001). Using a random effects model, the estimated rate of PTSD following stroke or TIA was 23% (95% CI, 16%–33%) within 1 year of the stroke or TIA and 11% (95% CI, 8%–14%) after 1 year.Conclusions
Although PTSD is commonly thought to be triggered by external events such as combat or sexual assault, these results suggest that 1 in 4 stroke or TIA survivors develop significant PTSD symptoms due to the stroke or TIA. Screening for PTSD in a large population-based prospective cohort study with cardiovascular outcome assessments is needed to yield definitive prevalence, and determine whether stroke or TIA-induced PTSD is a risk factor for subsequent cardiovascular events or mortality. 相似文献3.
Patcho N. Santiago Robert J. Ursano Christine L. Gray Robert S. Pynoos David Spiegel Roberto Lewis-Fernandez Matthew J. Friedman Carol S. Fullerton 《PloS one》2013,8(4)
Objective
We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD.Methods
We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1) review rates of PTSD in the first year after a traumatic event; (2) examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional); and (3) identify the clinical course of PTSD (early onset, later onset, chronicity, remission, and resilience). Of the 2537 identified articles, 58 articles representing 35 unique subject populations met the proposed DSM-5 criteria for experiencing a traumatic event, and assessed PTSD at two or more time points within 12 months of the traumatic event.Results
The mean prevalence of PTSD across all studies decreases from 28.8% (range = 3.1–87.5%) at 1 month to 17.0% (range = 0.6–43.8%) at 12 months. However, when traumatic events are classified into intentional and non-intentional, the median prevalences trend down for the non-intentional trauma exposed populations, while the median prevalences in the intentional trauma category steadily increase from 11.8% to 23.3%. Across five studies with sufficient data, 37.1% of those exposed to intentional trauma develop PTSD. Among those with PTSD, about one third (34.8%) remit after 3 months. Nearly 40% of those with PTSD (39.1%) have a chronic course, and only a very small fraction (3.5%) of new PTSD cases appears after three months.Conclusions
Understanding the trajectories of PTSD over time, and how it may vary by type of traumatic event (intentional vs. non-intentional) will assist public health planning and treatment. 相似文献4.
Aim
PTSD symptoms were pervasive among children and adolescents after experiencing or exposure to traumatic events. Screening and diagnosis of PTSD symptoms is crucial in trauma-related research and practice. The 13-item Children''s Revised Impact of Event Scale (CRIES) has been demonstrated to be a valid and reliable tool to achieve this goal. This study was designed to examine the psychometric properties of the 13-item CRIES in a sample of Chinese debris flood victims.Methods
A total of 268 participants (145 girls, 123 boys) aged 8–18 years were recruited from an integral part of a service oriented project, supported by the Institute of Psychology, Chinese Academy of Sciences following the debris flood. The participants were given the 13-item CRIES 3 months after the debris flood.Results
The results of confirmatory factor analysis indicated that a two-factor structure (intrusion+arousal vs avoidance) emerged as the model best fit in total sample, boys and girls subsamples, respectively. The scale was also demonstrated to have good internal consistency (Cronbach''s alpha = 0.83).Conclusion
The study confirmed the good psychometric properties of the CRIES and its'' applicability to Chinese children and adolescents. Moreover, these findings imply that the CRIES factor structure is stable across age, gender, and different types of trauma. 相似文献5.
Background
Lifetime victimization experiences, including child sexual abuse (CSA), child physical abuse (CPA), adult sexual assault (ASA), and adult physical assault (APA), are associated with health problems.Purpose
To examine relationships between cumulative victimization and physical health among heterosexual and lesbian women and determine whether these relationships differ by sexual identity.Methods
Large samples of heterosexual (n = 482) and lesbian women (n = 394) were interviewed. Questions included lifetime victimization experiences and physical health problems.Results
Compared to women who reported no childhood victimization, those who reported experiencing both CSA and CPA were 44% more likely to report health problems and women who experienced all four types of victimization (CSA, CPA, APA, ASA) were nearly 240% as likely to report physical health problems. Interaction analyses revealed the association between victimization and physical health did not differ by sexual identity.Conclusions
Although lesbians were more likely to report all types of victimization, results suggest that victimization conferred increased physical health risks regardless of sexual identity. 相似文献6.
Diane M. Harper Britney M. Else Mitchell J. Bartley Anne M. Arey Angela L. Barnett Beth E. Rosemergey Christopher A. Paynter Inge Verdenius Sean M. Harper George D. Harris Jennifer A. Groner Gerard J. Malnar Jeffrey Wall Aaron J. Bonham 《PloS one》2014,9(7)
Objectives
Obesity adversely inhibits antibody response to vaccination. Three doses of HPV4 may or may not provide adequate long term protection against HPV 16/18 in obese females. The aim of this study was to determine whether adherence to HPV4 vaccination in a safety net population was reduced with increasing body mass index (BMI).Methods
We designed a historical prospective study evaluating the number and dates of HPV4 dosing that occurred from July 1, 2006 through October 1, 2009 by the demographic characteristics of the 10–26 year old recipient females. The defined dosing intervals were adapted from the literature and obesity categories were defined by the WHO.Results
1240 females with BMI measurements received at least one dose of HPV4; 38% were obese (class I, II and III) and 25% were overweight. Females with normal BMI received on-time triplet dosing significantly more often than did the obese class II and III females (30% vs. 18%, p<0.001). Obese class II/III females have a significant 45% less chance of completing the on-time triplet HPV4 series than normal women (OR = 0.55, 95% CI: 0.37, 0.83). Pregnancy history has a significant influence on BMI and HPV4 dosing compliance in this safety net population where 71% had been gravid. Hispanic females were less likely to complete HPV4 dosing regardless of BMI (aOR = 0.39, 95% CI: 0.16, 0.95).Conclusions
Obesity, as well as gravidity and Hispanic race, are risk factors for lack of HPV4 vaccine adherence among young females in a safety net population. 相似文献7.
TA Odeny RC Bailey EA Bukusi JM Simoni KA Tapia K Yuhas KK Holmes RS McClelland 《PloS one》2012,7(9):e43832
Background
Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled seven-day post-operative visit. We evaluated the effect of short message service (SMS) text messages on attendance at this important visit.Methodology
We enrolled 1200 participants >18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600) or usual care (n = 600). The primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-to-treat.Principal Findings
Of participants receiving SMS, 387/592 (65.4%) returned, compared to 356/596 (59.7%) in the control group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00–1.20; p = 0.04). Men who paid more than US$1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤US$1.25 (adjusted relative risk [aRR] 1.35, 95% CI 1.15–1.58; p<0.001). Men with secondary or higher education had a lower risk of failure to return compared to those with primary or less education (aRR 0.87, 95% CI 0.74–1.01; p = 0.07).Conclusions
Text messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision. Factors associated with failure to return were mainly structural, and included transportation costs and low educational level.Trial Registration
ClinicalTrials.gov NCT01186575 相似文献8.
Isaac R. Galatzer-Levy Yael Ankri Sara Freedman Yossi Israeli-Shalev Pablo Roitman Moran Gilad Arieh Y. Shalev 《PloS one》2013,8(8)
Context
Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder''s pathogenesis and prophylaxis.Objectives
To describe discrete symptom trajectories and examine their relevance for preventive interventions.Design
Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data.Setting
Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Participants
Adult survivors of potentially traumatic events consecutively admitted to the hospital''s emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months.Approach
We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample.Main Outcome Measure
Latent trajectories of PTSD symptoms; effects of CBT on these trajectories.Results
Three trajectories were identified: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes.Conclusions
The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder and preventing its occurrence. Studies of the pathogenesis of PTSD may benefit from using clustered symptom trajectories as their dependent variables. 相似文献9.
Renée A. Scheepers Kiki M. J. M. H. Lombarts Marcel A. G. van Aken Maas Jan Heineman Onyebuchi A. Arah 《PloS one》2014,9(5)
Background
Worldwide, attending physicians train residents to become competent providers of patient care. To assess adequate training, attending physicians are increasingly evaluated on their teaching performance. Research suggests that personality traits affect teaching performance, consistent with studied effects of personality traits on job performance and academic performance in medicine. However, up till date, research in clinical teaching practice did not use quantitative methods and did not account for specialty differences. We empirically studied the relationship of attending physicians'' personality traits with their teaching performance across surgical and non-surgical specialties.Method
We conducted a survey across surgical and non-surgical specialties in eighteen medical centers in the Netherlands. Residents evaluated attending physicians'' overall teaching performance, as well as the specific domains learning climate, professional attitude, communication, evaluation, and feedback, using the validated 21-item System for Evaluation of Teaching Qualities (SETQ). Attending physicians self-evaluated their personality traits on a 5-point scale using the validated 10-item Big Five Inventory (BFI), yielding the Five Factor model: extraversion, conscientiousness, neuroticism, agreeableness and openness.Results
Overall, 622 (77%) attending physicians and 549 (68%) residents participated. Extraversion positively related to overall teaching performance (regression coefficient, B: 0.05, 95% CI: 0.01 to 0.10, P = 0.02). Openness was negatively associated with scores on feedback for surgical specialties only (B: −0.10, 95% CI: −0.15 to −0.05, P<0.001) and conscientiousness was positively related to evaluation of residents for non-surgical specialties only (B: 0.13, 95% CI: 0.03 to 0.22, p = 0.01).Conclusions
Extraverted attending physicians were consistently evaluated as better supervisors. Surgical attending physicians who display high levels of openness were evaluated as less adequate feedback-givers. Non-surgical attending physicians who were conscientious seem to be good at evaluating residents. These insights could contribute to future work on development paths of attending physicians in medical education. 相似文献10.
Benjamin Djulbegovic Ambuj Kumar Branko Miladinovic Tea Reljic Sanja Galeb Asmita Mhaskar Rahul Mhaskar Iztok Hozo Dongsheng Tu Heather A. Stanton Christopher M. Booth Ralph M. Meyer 《PloS one》2013,8(3)
Objective
To assess if commercially sponsored trials are associated with higher success rates than publicly-sponsored trials.Study Design and Settings
We undertook a systematic review of all consecutive, published and unpublished phase III cancer randomized controlled trials (RCTs) conducted by GlaxoSmithKline (GSK) and the NCIC Clinical Trials Group (CTG). We included all phase III cancer RCTs assessing treatment superiority from 1980 to 2010. Three metrics were assessed to determine treatment successes: (1) the proportion of statistically significant trials favouring the experimental treatment, (2) the proportion of the trials in which new treatments were considered superior according to the investigators, and (3) quantitative synthesis of data for primary outcomes as defined in each trial.Results
GSK conducted 40 cancer RCTs accruing 19,889 patients and CTG conducted 77 trials enrolling 33,260 patients. 42% (99%CI 24 to 60) of the results were statistically significant favouring experimental treatments in GSK compared to 25% (99%CI 13 to 37) in the CTG cohort (RR = 1.68; p = 0.04). Investigators concluded that new treatments were superior to standard treatments in 80% of GSK compared to 44% of CTG trials (RR = 1.81; p<0.001). Meta-analysis of the primary outcome indicated larger effects in GSK trials (odds ratio = 0.61 [99%CI 0.47–0.78] compared to 0.86 [0.74–1.00]; p = 0.003). However, testing for the effect of treatment over time indicated that treatment success has become comparable in the last decade.Conclusions
While overall industry sponsorship is associated with higher success rates than publicly-sponsored trials, the difference seems to have disappeared over time. 相似文献11.
Objective
To assess the clinical effect of medication monitoring using the West Wales Adverse Drug Reaction (ADR) Profile for Respiratory Medicine.Design
Single-site parallel-arm pragmatic trial using stratified randomisation.Setting
Nurse-led respiratory outpatient clinic in general hospital in South Wales.Participants
54 patients with chronic respiratory disease receiving bronchodilators, corticosteroids or leukotriene receptor antagonists.Intervention
Following initial observation of usual nursing care, we allocated participants at random to receive at follow up: either the West Wales ADR Profile for Respiratory Medicine in addition to usual care (‘intervention arm’ with 26 participants); or usual care alone (‘control arm’ with 28 participants).Main Outcome Measures
Problems reported and actions taken.Results
We followed up all randomised participants, and analysed data in accordance with treatment allocated. The increase in numbers of problems per participant identified at follow up was significantly higher in the intervention arm, where the median increase was 20.5 [inter-quartile range (IQR) 13–26], while that in the control arm was −1 [−3 to +2] [Mann-Whitney U test: z = 6.28, p<0.001]. The increase in numbers of actions per participant taken at follow up was also significantly higher in the intervention arm, where the median increase was 2.5 [1]–[4] while that in the control arm was 0 [−1.75 to +1] [Mann-Whitney U test: z = 4.40, p<0.001].Conclusion
When added to usual nursing care, the West Wales ADR Profile identified more problems and prompted more nursing actions. Our ADR Profile warrants further investigation as a strategy to optimise medication management.Trial Registration
Controlled-trials.com ISRCTN10386209 相似文献12.
Objectives
A phase of mild cognitive impairment (MCI) precedes most forms of neurodegenerative dementia. Many definitions of MCI recommend the use of test norms to diagnose cognitive impairment. It is, however, unclear whether the use of norms actually improves the detection of individuals at risk of dementia. Therefore, the effects of age- and education-norms on the validity of test scores in predicting progression to dementia were investigated.Methods
Baseline cognitive test scores (Syndrome Short Test) of dementia-free participants aged ≥65 were used to predict progression to dementia within three years. Participants were comprehensively examined one, two, and three years after baseline. Test scores were calculated with correction for (1) age and education, (2) education only, (3) age only and (4) without correction. Predictive validity was estimated with Cox proportional hazard regressions. Areas under the curve (AUCs) were calculated for the one-, two-, and three-year intervals.Results
82 (15.3%) of initially 537 participants, developed dementia. Model coefficients, hazard ratios, and AUCs of all scores were significant (p<0.001). Predictive validity was the lowest with age-corrected scores (−2 log likelihood = 840.90, model fit χ2 (1) = 144.27, HR = 1.33, AUCs between 0.73 and 0.87) and the highest with education-corrected scores (−2 log likelihood = 815.80, model fit χ2 (1) = 171.16, HR = 1.34, AUCs between 0.85 and 0.88).Conclusion
The predictive validity of test scores is markedly reduced by age-correction. Therefore, definitions of MCI should not recommend the use of age-norms in order to improve the detection of individuals at risk of dementia. 相似文献13.
Laurence Dedeken Rudy Chapusette Phu Quoc Lê Catherine Heijmans Christine Devalck Sophie Huybrechts France Ziereisen Laurence Hanssens Laurence Rozen Denis Noubouossie Malou Ngalula Mujinga Alina Ferster 《PloS one》2014,9(10)
Background
The 6-minute walk test (6MWT) is used in adults and children affected by a wide range of chronic diseases to evaluate their sub-maximal exercise capacity. It reflects the global response of various physiological systems in a situation simulating a daily life activity.Methods
We analyzed factors affecting the 6MWT in 46 Sickle Cell Disease children. Forty-two were treated with hydroxyurea (HU). Patients with normal test (>80% of the age-standardized predicted value) were compared to patients with abnormal test (≤80%). Baseline hematological values, clinical events, cerebrovascular disease, cardio-pulmonary parameters and disease-modifying treatment were compared according to the performance of the test.Results
Among the 46 patients, 14 had an abnormal 6MWT. In univariate analysis, both groups were similar for biological and clinical data. Six of the 14 patients with an abnormal 6MWT had silent infarct (SI) compared to 6/32 with a normal test (P = 0.09). When excluding chronically transfused patients, 4 of the 11 patients with an abnormal 6MWT had SI compared to 1/26 (P = 0.02). Baseline pulse oximetry was normal in both groups but slightly lower in patients with abnormal 6MWT (P = 0.02). No patient presented exercise-induced desaturation. In multivariate analysis, the only factor associated with abnormal 6MWT was the presence of SI (P = 0.045).Conclusions
In our cohort of 46 patients characterized by high exposure rate to HU and by the absence of severe cardiopulmonary disease, the sole factor independently associated with 6MWT was the presence of SI. The lower exercise capacity of children with SI may reflect some subclinical neurological impairment as they do not differ by hemoglobin level or cardiopulmonary parameters. 相似文献14.
Yvonne Jockel-Schneider Inga Harks Imme Haubitz Stefan Fickl Martin Eigenthaler Ulrich Schlagenhauf Johannes Baulmann 《PloS one》2014,9(8)
Aim
This single blind cross-sectional study compared the vascular health of subjects suffering from severe chronic periodontitis, severe aggressive periodontitis and periodontal healthy controls by evaluating pulse wave velocity (PWV), augmentation index (AIx) and pulse pressure amplification (PPA).Material and Methods
In a total of 158 subjects, 92 suffering from severe periodontitis and 66 matched periodontal healthy controls, PWV, AIx, central and peripheral blood pressure were recorded using an oscillometric device (Arteriograph).Results
Subjects suffering from severe chronic or aggressive periodontitis exhibited significantly higher PWV (p = 0.00004), higher AIx (p = 0.0049) and lower PPA (p = 0.028) than matched periodontal healthy controls.Conclusions
The results of this study confirm the association between periodontal inflammation and increased cardiovascular risk shown by impaired vascular health in case of severe periodontitis. As impaired vascular health is a common finding in patients suffering from severe periodontal disease a concomitant routine cardiovascular evaluation may be advised. 相似文献15.
Maliheh Hassani Mika Kivimaki Alexis Elbaz Martin Shipley Archana Singh-Manoux Séverine Sabia 《PloS one》2014,9(10)
Background
Accelerometers, initially waist-worn but increasingly wrist-worn, are used to assess physical activity free from reporting-bias. However, its acceptability by study participants is unclear. Our objective is to assess factors associated with non-consent to a wrist-mounted accelerometer in older adults.Methods
Data are from 4880 Whitehall II study participants (1328 women, age range = 60–83), requested to wear a wrist-worn accelerometer 24 h every day for 9 days in 2012/13. Sociodemographic, behavioral, and health-related factors were assessed by questionnaire and weight, height, blood pressure, cognitive and motor function were measured during a clinical examination.Results
210 participants had contraindications and 388 (8.3%) of the remaining 4670 participants did not consent. Women, participants reporting less physical activity and less favorable general health were more likely not to consent. Among the clinical measures, cognitive impairment (Odds Ratio = 2.21, 95% confidence interval: 1.22–4.00) and slow walking speed (Odds Ratio = 1.38, 95% confidence interval: 1.02–1.86) were associated with higher odds of non-consent.Conclusions
The rate of non-consent in our study of older adults was low. However, key markers of poor health at older ages were associated with non-consent, suggesting some selection bias in the accelerometer data. 相似文献16.
Isabelle Morard Sophie Clément Alexandra Calmy Alessandra Mangia Andrea Cerny Andrea De Gottardi Meri Gorgievski Markus Heim Raffaele Malinverni Darius Moradpour Beat Müllhaupt David Semela Stéphanie Pascarella Pierre-Yves Bochud Franco Negro 《PloS one》2014,9(9)
Background
The CCR5 receptor, expressed on Th1 cells, may influence clinical outcomes of HCV infection. We explored a possible link between a CCR5 32-base deletion (CCR5delta32), resulting in the expression of a non-functioning receptor, and clinical outcomes of HCV infection.Methods
CCR5 and HCV-related phenotypes were analysed in 1,290 chronically infected patients and 160 patients with spontaneous clearance.Results
Carriage of the CCR5delta32 allele was observed in 11% of spontaneous clearers compared to 17% of chronically infected patients (OR = 0.59, 95% CI interval 0.35–0.99, P = 0.047). Carriage of this allele also tended to be observed more frequently among patients with liver inflammation (19%) compared to those without inflammation (15%, OR = 1.38, 95% CI interval 0.99–1.95, P = 0.06). The CCR5delta32 was not associated with sustained virological response (P = 0.6), fibrosis stage (P = 0.8), or fibrosis progression rate (P = 0.4).Conclusions
The CCR5delta32 allele appears to be associated with a decreased rate of spontaneous HCV eradication, but not with hepatitis progression or response to antiviral therapy. 相似文献17.
Objective
To determine the frequency of obstructive sleep apnea syndrome (OSAS), metabolic syndrome and common mental disorders in the working population of 11 small enterprises and the feasibility of a program of action for health.Method
The clinical risk of OSAS, the prevalence of metabolic syndrome, and the level of psychological disorders were assessed during routine medical examination at the workplace in 2012. The response to medical advice was assessed in 2013.Results
12.3% of the workers were suspected of being affected by OSAS. One or more components of metabolic syndrome were present in 24.5% of cases. OSAS in “healthy” workers was significantly associated with the presence of one or more components of metabolic syndrome (OR = 3.83; 95%CI 1.45–10.13) and with a psychological disorders score in the highest quartile (OR = 4.67; 95%CI = 1.72–12.64). Workers with suspected OSAS were reluctant to follow advice about undergoing further tests under the NHS. However, in some cases, confirmation of the OSAS diagnosis and subsequent treatment led to an improvement in metabolic condition.Conclusion
Although participation in treatment was limited, anecdotal cases support the idea that prevention of obstructive sleep apnea in the workplace might be useful for workers’ health. 相似文献18.
Background
Common Mental Disorders (CMDs) are frequent among patients attending primary care. In Africa, CMDs are often misdiagnosed as physical illnesses because many of the patients complain of somatic symptoms of mental distress. We explored whether there was difference in the levels of CMD symptoms between patients with thick film confirmed and clinical cases of malaria with negative thick film in primary care.Methods
A cross-sectional comparative study was conducted on 300 adults with a clinical diagnosis of malaria in primary care centres in Jimma, Ethiopia. Patients were recruited consecutively until 100 cases of ‘malaria’ with a negative thick film and 200 cases of malaria with a positive thick film consented to participate. The 20-item Self-Reporting Questionnaire (SRQ-20) was used to measure CMD. The non-parametric Wilcoxon rank-sum test was used to explore the association between thick film result and CMD.Results
Participants had a mean age of 28.2 (S.D = 10.9) years and the majority (57.3%) were women. The prevalence of high CMD symptoms (six or more symptoms on the SRQ-20) was 24.5%. Suicidal ideation was reported by 13.8% of the participants. CMD symptoms were significantly higher in patients who had taken medication prior to visiting the primary care (p = 0.012) and in those whose symptoms had been present for seven days or more (p = 0.041). There was no statistically significant association between level of CMD symptoms and having a negative thick film result (OR 0.98; 95%CI 0.92, 1.04) or objective presence of fever (OR 1.04; 95%CI 0.93, 1.15).Conclusions
CMD symptoms among cases of malaria did not appear to be associated with a negative thick film result. The high levels of CMD symptoms, including suicidal ideation, calls for further studies to investigate the persistence and progression of these symptoms following resolution of the acute malarial episode. 相似文献19.
Objective
We investigated the role of state-level differences in modifiable cardiovascular (CV) risk factors in contributing to state disparities in cardiovascular mortality rates in the US.Methods
Adults aged 45–74 in 2010 were examined. We constructed a CV risk index summarizing state-level exposure to current smoking, obesity, physical inactivity, alcohol abstinence, hypertension, elevated cholesterol, and diabetes using the Behavioral Risk Factor Surveillance System. Outcomes were cardiovascular, coronary heart disease, and stroke mortality. Linear regression was used to estimate associations between the CV risk index and mortality outcomes. Models accounted for state-level socioeconomic characteristics and other potential confounders.Results
Risk factors were highly correlated at the state-level (Cronbach''s alpha 0.85 (men) and 0.92 (women). Each +1SD difference in the cardiovascular risk index was associated with higher adjusted cardiovascular mortality rates by 41.0 (95%CI = 26.3, 55.7) and 33.3 (95%CI = 24.4, 42.2) deaths per 100,000 for men and women, respectively. The index accounted for 8% (men) and 11% (women) of the variation in state-level cardiovascular mortality. Comparable associations were also observed for coronary heart disease and stroke mortality.Conclusions
CV risk factors were highly correlated at the state-level and were independently associated with state CV mortality, suggesting the utility of generalized CV risk reduction. 相似文献20.
Christina Dillahunt-Aspillaga Dezon Finch Jill Massengale Tracy Kretzmer Stephen L. Luther James A. McCart 《PloS one》2014,9(12)