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1.
Yi-Hao Ho Yue-Cune Chang Wei-Cheng Huang Hsin-Yi Chen Che-Chen Lin Fung-Chang Sung 《Journal of epidemiology / Japan Epidemiological Association》2015,25(1):15-19
Background
To date, the relationship between zolpidem use and subsequent risk of glaucoma in a Taiwanese population has not been assessed.Methods
We used data from the National Health Insurance system to investigate whether zolpidem use was related to glaucoma risk. A 1:4 matched case-control study was conducted. The cases were patients newly diagnosed with glaucoma from 2001 to 2010. The controls were randomly selected non-glaucoma subjects matched by sex and age (±5 years). Zolpidem exposure and/or the average dosage of zolpidem used (mg/year) were evaluated. Medical comorbidities were considered as confounding factors. Multiple logistic regression models were used to evaluate the potential risk of zolpidem exposure on glaucoma with/without adjustment for the effects of confounding variables.Results
The exposure rate of zolpidem use in the glaucoma group was significantly higher than that of the control group (2.8% vs. 2.0%, P < 0.0001). The adjusted odds ratio (OR) of the risk of glaucoma for those with zolpidem use vs. those without was 1.19 (95% confidence interval [CI], 1.02–1.38). Compared to non-zolpidem users, zolpidem users with an average dose of more than 200 mg/year had significantly increased risk of glaucoma (OR 1.31, 95% CI 1.03–1.68).Conclusions
This study suggests that the use of zolpidem might increase the risk of subsequent glaucoma. Further confirmatory studies are recommended to clarify this important issue.Key words: zolpidem, glaucoma, Taiwanese 相似文献2.
N. Romero-Sandoval C. Parra G. Gallegos A. Guanopatín M. F. Campa?a M. Haro S. Calapaqui C. Moreta F. Viteri M. Feijoo-Cid M. Martin 《Public Health Action》2013,3(1):85-89
Objective:
To characterise the risk factors of haematophagous bat bites and to provide information to contribute to the prevention of rabies in Ecuador.Design:
Cross-sectional study based on interviews with 3518 individuals, from which two sets of variables were generated: characteristics of haematophagous bat attacks in the previous year among humans and risk factors for being bitten.Methods:
Data were analysed using multivariate logistic regression models, taking history of bat bites in the previous year as the response variable.Results:
In the previous year 723 (20.6%, 95%CI 19.3–21.9) of the participants declared having received haematophagous bat bites and 50.4% in the previous month, giving an incidence rate of 10.4% (95%CI 9.6–11.6) per month. Sleeping on the floor or in a hammock (adjusted odds ratio [aOR] 1.58, 95%CI 1.21–2.06), not using a protective bed net (aOR 1.25, 95%CI 1.03–1.50) and living in a dwelling with permanent openings in the structure (aOR 1.49, 95%CI 1.12–1.95) were associated with a higher probability of bat bites. Those most affected were the group aged ≤12 years (age 13–19 years, aOR 0.39, 95%CI 0.32–0.48; age ≥20 years, aOR 0.67, 95%CI 0.50–0.90).Conclusion:
Primary prevention based on pre-exposure vaccination would be justifiable given the high dispersion of the population and the high incidence of bat bites. As a secondary protective measure, communities should work towards increasing the use of protective measures and putting barriers in permanent openings in their dwellings. 相似文献3.
Thana Khawcharoenporn Alan D Tice Andrew Grandinetti Dominic Chow 《Hawai'i Journal of Medicine & Public Health》2010,69(10):232-236
Objectives
To identify the risk factors for community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) cellulitis.Methods
A review of risk factors for CA-MRSA skin and soft tissue infection in previously published literature was first performed. A retrospective cohort study was then conducted in a teaching ambulatory-care clinic of a tertiary medical center in Honolulu, Hawai‘i.Results
Of 137 cases with cellulitis diagnosed from January 2005 to December 2007, MRSA was recovered from 85 (62%) of patients who presented with either abscesses or skin ulcers. The recovery of MRSA was significantly associated with obesity (p=0.01), presence of abscesses (p=0.01), and lesions involving the head and neck (p=0.04). Independent risk factors by multivariate logistic regression analysis included the presence of abscesses [adjusted odds ratio (aOR) 2.72; 95% confidence interval (CI) 1.27–5.83; p=0.01] and obesity (aOR 2.33; 95% CI 1.10–4.97; p =0.03). Patients with CA-MRSA were less likely to receive an appropriate antibiotic (p=0.04) and were more likely to require antibiotic change at evaluation in one week (p=0.04) compared with patients infected with non-MRSA bacteria.Conclusions
The presence of abscesses and obesity were signifi cantly associated with CA-MRSA cellulitis. Empiric therapy with antibiotics active against MRSA should be guided by these risk factors. 相似文献4.
Yang YH Lai JN Lee CH Wang JD Chen PC 《Journal of epidemiology / Japan Epidemiological Association》2011,21(1):37-43
Background
Several epidemiological and experimental studies have found a positive association between the risk of motor vehicle accidents (MVAs) and use of zopiclone and benzodiazepines. There is, however, little evidence of any risk of MVA attributable to the use of zolpidem 1 day before such accidents. We attempted to determine whether the use of zolpidem 1 day before is associated with an increased risk of an MVA.Methods
Using a 1-million-person randomly sampled cohort from the Taiwan National Health Insurance reimbursement database, 12 929 subjects were identified as having been hospitalized between 1998 and 2004 due to an MVA. Using a case–crossover design, we selected the day before an MVA as the case period for each subject, and the 91st, 182nd, and 273rd days before the case period as 3 retrospective control periods. Conditional logistical regression models were constructed to calculate the odds ratio (OR) of having an MVA and the exposure of zolpidem 1 day before. We calculated doses of benzodiazepines, zopiclone, and zolpidem based on their defined daily dose.Results
The adjusted OR for involvement in an MVA after taking 1 defined daily dose of zolpidem was 1.74 (95% confidence interval: 1.25–2.43). There were also positive effects for different washout periods and cumulative doses at 7, 14, 21, and 28 days before the occurrence of an MVA.Conclusions
Use of zolpidem 1 day before might be associated with an increased risk of MVA. Thus, precautionary warnings should be provided when prescribing zolpidem.Key words: zolpidem, benzodiazepines, motor vehicle accidents, case–crossover design, pharmacoepidemiology 相似文献5.
Khuwaja AK Khawaja S Motwani K Khoja AA Azam IS Fatmi Z Ali BS Kadir MM 《Yebang Ŭihakhoe chi》2011,44(5):210-217
Objectives
The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents.Methods
In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis.Results
Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% were also current smokers. More than one-third of participants chewed betel nut, and one-quarter used oral tobacco. More girls were physically inactive (OR, 4.07; 95% CI, 2.69 to 6.17), whereas a greater proportion of boys were current smokers (OR, 2.17; 95% CI, 1.19 to 3.91), exposed to passive smoking (OR, 2.57; 95% CI, 1.72 to 3.83), and using betel nut (OR, 2.03; 95% CI, 1.34 to 3.06). Only 3.1% of the participants were without any preventable lifestyle risk factor for NCDs, and over 80% had ≥2 factors. Co-existence of risk factors was independently associated with fathers being blue-collar workers (aOR, 3.57; 95% CI, 1.07 to 11.92) and parents not treating their child fairly (aOR, 5.05; 95% CI, 1.29 to 19.78).Conclusions
Most of the adolescents studied had preventable risk factors for NCDs. These results warrant comprehensive and integrated interventions to prevent lifestyle risk factors, and parents are front-line stakeholders. 相似文献6.
Background
Assessing the real-world comparative effectiveness of common interventions is challenged by unmeasured confounding.Objective
To determine whether the mortality benefit shown for drug-eluting stents (DES) over bare metal stents (BMS) in observational studies persists after controls for/tests for confounding.Data Sources/Study Setting
Retrospective observational study involving 38,019 patients, 65 years or older admitted for an index percutaneous coronary intervention receiving DES or BMS in Pennsylvania in 2004–2005 followed up for death through 3 years.Study Design
Analysis was at the patient level. Mortality was analyzed with Cox proportional hazards models allowing for stratification by disease severity or DES use propensity, accounting for clustering of patients. Instrumental variables analysis used lagged physician stent usage to proxy for the focal stent type decision. A method originating in work by Cornfield and others in 1954 and popularized by Greenland in 1996 was used to assess robustness to confounding.Principal Findings
DES was associated with a significantly lower adjusted risk of death at 3 years in Cox and in instrumented analyses. An implausibly strong hypothetical unobserved confounder would be required to fully explain these results.Conclusions
Confounding by indication can bias observational studies. No strong evidence of such selection biases was found in the reduced risk of death among elderly patients receiving DES instead of BMS in a Pennsylvanian state-wide population. 相似文献7.
Karine Marques Costa dos Reis Cristine Alves Costa de Jesus 《Revista latino-americana de enfermagem》2015,23(6):1130-1138
Objective:
to determine the incidence of falls in elderly residents of long-stay institutions of the Federal District, to identify the aspects involved in the falls, in terms of risk factors, from the application of scales and the Taxonomy II of NANDA-I, and to define the level of accuracy with its sensitivity and specificity for application in the clinical nursing practice.Method:
this was a cohort study with the evaluation of 271 elderly people. Cognition, functionality, mobility and other intrinsic factors were evaluated. After six months, the elderly people who fell were identified, with significance analysis then performed to define the risk factors.Results:
the results showed an incidence of 41%. Of the 271 patients included, 69 suffered 111 episodes of falls during the monitoring period. Risk factors were the presence of stroke with its sequelae (OR: 1.82, 95% CI 1.01 - 3.28, p=.045), presenting more than five chronic diseases (OR: 2.82, 95% CI 1.43 - 5.56, p=.0028), foot problem (OR: 2.45, 95% CI 1.35 - 4.44, p=.0033) and motion (OR: 2.04, 95% CI 1.15 - 3.61, p=.0145).Conclusion:
the taxonomy has high validity regarding the detection of elderly people at risk of falling and should be applied consistently in the clinical nursing practice. 相似文献8.
Hind Sbihi Ryan W. Allen Allan Becker Jeffrey R. Brook Piush Mandhane James A. Scott Malcolm R. Sears Padmaja Subbarao Tim K. Takaro Stuart E. Turvey Michael Brauer 《Environmental health perspectives》2015,123(9):902-908
Background
The role of traffic-related air pollution (TRAP) exposure in the development of allergic sensitization in children is unclear, and few birth cohort studies have incorporated spatiotemporal exposure assessment.Objectives
We aimed to examine the association between TRAP and atopy in 1-year-old children from an ongoing national birth cohort study in four Canadian cities.Methods
We identified 2,477 children of approximately 1 year of age with assessment of atopy for inhalant (Alternaria, Der p, Der f, cat, dog, cockroach) and food-related (milk, eggs, peanuts, soy) allergens. Exposure to nitrogen dioxide (NO2) was estimated from city-specific land use regression models accounting for residential mobility and temporal variability in ambient concentrations. We used mixed models to examine associations between atopy and exposure during pregnancy and the first year of life, including adjustment for covariates (maternal atopy, socioeconomic status, pets, mold, nutrition). We also conducted analyses stratified by time-location patterns, daycare attendance, and modeled home ventilation.Results
Following spatiotemporal adjustment, TRAP exposure after birth increased the risk for development of atopy to any allergens [adjusted odds ratio (aOR) per 10 μg/m3 NO2 = 1.16; 95% CI: 1.00, 1.41], but not during pregnancy (aOR = 1.02; 95% CI: 0.86, 1.22). This association was stronger among children not attending daycare (aOR = 1.61; 95% CI: 1.28, 2.01) compared with daycare attendees (aOR = 1.05; 95% CI: 0.81, 1.28). Trends to increased risk were also found for food (aOR = 1.17; 95% CI: 0.95, 1.47) and inhalant allergens (aOR = 1.28; 95% CI: 0.93, 1.76).Conclusion
Using refined exposure estimates that incorporated temporal variability and residential mobility, we found that traffic-related air pollution during the first year of life was associated with atopy.Citation
Sbihi H, Allen RW, Becker A, Brook JR, Mandhane P, Scott JA, Sears MR, Subbarao P, Takaro TK, Turvey SE, Brauer M. 2015. Perinatal exposure to traffic-related air pollution and atopy at 1 year of age in a multi-center Canadian birth cohort study. Environ Health Perspect 123:902–908; http://dx.doi.org/10.1289/ehp.1408700 相似文献9.
Shih-Wei Lai Kuan-Fu Liao Hsueh-Chou Lai Pang-Yao Tsai Cheng-Li Lin Pei-Chun Chen Fung-Chang Sung 《Journal of epidemiology / Japan Epidemiological Association》2013,23(2):109-114
Background
We investigated the association between cardiovascular disease (CVD) and the risk of major osteoporotic fracture in Taiwan.Methods
Using the Taiwan National Health Insurance Database for the period 2000–2007, we classified 43 874 patients aged 50 years or older with newly diagnosed CVD (coronary artery disease, heart failure, cerebrovascular disease, or peripheral atherosclerosis) as the CVD group and 43 874 subjects without CVD (frequency-matched by sex, age, and date selected) as the non-CVD group. Incidence and hazard ratios (HRs) for major osteoporotic fracture of the spine, hip, humerus, and forearm/wrist were estimated for the period until the end of 2010.Results
After adjustment for confounders, the overall HRs for major osteoporotic fracture were 1.24 (95% CI = 1.13, 1.36) in men with CVD and 1.18 (95% CI = 1.11, 1.25) in women with CVD, as compared with the non-CVD group. As compared with the non-CVD group, the adjusted HR for major osteoporotic fracture was highest among subjects with cerebrovascular disease (HR 1.31; 95% CI 1.23, 1.39), followed by those with heart failure (HR 1.18; 95% CI 1.11, 1.27), peripheral atherosclerosis (HR 1.12; 95% CI 1.04, 1.20), and coronary artery disease (HR 1.07; 95% CI 1.01, 1.12).Conclusions
CVD is associated with risk of major osteoporotic fracture in men and women in Taiwan.Key words: atherosclerosis, cardiovascular disease, cerebrovascular disease, fracture, heart failure 相似文献10.
Neda Laiteerapong M.D. M.S. James Kirby Ph.D. Yue Gao M.P.H. Tzy‐Chyi Yu M.H.A. Ph.D. Ravi Sharma Ph.D. Robert Nocon M.H.S. Sang Mee Lee Ph.D. Marshall H. Chin M.D. M.P.H. Aviva G. Nathan M.P.H. Quyen Ngo‐Metzger M.D. M.P.H. Elbert S. Huang M.D. M.P.H. 《Health services research》2014,49(5):1498-1518
Objective
To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings.Data Sources
A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004–2008).Study Design
HC patients were defined as those with ≥50 percent of outpatient visits at HCs in the first panel year. Outcomes included utilization and preventive care receipt from the second panel year. We used negative binomial and logistic regression models with propensity score adjustment for confounding differences between HC and non-HC patients.Principal Findings
Compared to non-HC patients, HC patients had fewer office visits (adjusted incidence rate ratio [aIRR], 0.63) and hospitalizations (aIRR, 0.43) (both p < .001). HC patients were more likely to receive breast cancer screening than non-HC patients (adjusted odds ratio [aOR] 2.78, p < .01). In subgroup analyses, uninsured HC patients had fewer outpatient and emergency room visits and were more likely to receive dietary advice and breast cancer screening compared to non-HC patients.Conclusions
Health centers add value to the health care system by providing socially and medically disadvantaged patients with care that results in lower utilization and maintained or improved preventive care. 相似文献11.
Chao-Chih Lai Dar-Der Ji Fang-Tzy Wu Jung-Jung Mu Ji-Rong Yang Donald Dah-Shyong Jiang Wen-Yun Lin Wei-Ting Chen Muh-Yong Yen Ho-Sheng Wu Tony Hsiu-Hsi Chen 《Journal of epidemiology / Japan Epidemiological Association》2016,26(4):216-223
Background
The causative pathogen is rarely identified in the emergency department (ED), since the results of cultures are usually unavailable. As a result, antimicrobial treatment may be overused. The aim of our study was to investigate the pathogens, risk factors of acute gastroenteritis, and predictors of acute bacterial gastroenteritis in the ED.Methods
We conducted a matched case-control study of 627 stool samples and 612 matched pairs.Results
Viruses (41.3%) were the leading cause of gastroenteritis, with noroviruses (32.2%) being the most prevalent, followed by bacteria (26.8%) and Giardia lamblia (12.4%). Taking antacids (adjusted odds ratio [aOR] 4.10; 95% confidence interval [CI], 2.57–6.53), household members/classmates with gastroenteritis (aOR 4.69; 95% CI, 2.76–7.96), attending a banquet (aOR 2.29; 95% CI, 1.64–3.20), dining out (aOR 1.70; 95% CI, 1.13–2.54), and eating raw oysters (aOR 3.10; 95% CI, 1.61–5.94) were highly associated with gastroenteritis. Elders (aOR 1.04; 05% CI, 1.02–1.05), those with CRP >10 mg/L (aOR 2.04; 95% CI, 1.15–3.62), or those who were positive for fecal leukocytes (aOR 2.04; 95% CI, 1.15–3.62) or fecal occult blood (aOR 1.97; 95% CI, 1.03–3.77) were more likely to be hospitalized in ED. In addition, presence of fecal leukocytes (time ratio [TR] 1.22; 95% CI, 1.06–1.41), abdominal pain (TR 1.20; 95% CI, 1.07–1.41), and frequency of vomiting (TR 0.79; 95% CI, 0.64–0.98) were significantly associated with the duration of acute gastroenteritis. Presence of fecal leukocytes (aOR 2.08; 95% CI, 1.42–3.05), winter season (aOR 0.45; 95% CI, 0.28–0.74), frequency of diarrhea (aOR 1.69; 95% CI, 1.01–2.83), and eating shrimp or crab (aOR 1.53; 95% CI, 1.05–2.23) were highly associated with bacterial gastroenteritis. The area under the receiver operating characteristic curve of the final model was 0.68 (95% CI, 0.55–0.63).Conclusions
Acute bacterial gastroenteritis was highly associated with season, frequency of diarrhea, frequency of vomiting, and eating shrimp or crab.Key words: acute gastroenteritis, fecal leukocytes, fecal occult blood, norovirus, salmonella, Giardia lamblia, receiver operating characteristic, C-reactive protein 相似文献12.
13.
Susan Jordan Lynette Lim Janneke Berecki-Gisolf Chris Bain Sam-ang Seubsman Adrian Sleigh Emily Banks the Thai Cohort Team 《Journal of epidemiology / Japan Epidemiological Association》2013,23(6):435-442
Background
We investigated risk factors for fracture among young adults, particularly body mass index (BMI) and physical activity, which although associated with fracture in older populations have rarely been investigated in younger people.Methods
In 2009, 4 years after initial recruitment, 58 204 Thais aged 19 to 49 years were asked to self-report fractures incident in the preceding 4 years. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% CIs for associations of fracture incidence with baseline BMI and physical activity.Results
Very obese women had a 70% increase in fracture risk (OR = 1.73, 95% CI 1.21–2.46) as compared with women with a normal BMI. Fracture risk increased by 15% with every 5-kg/m2 increase in BMI. The effects were strongest for fractures of the lower limbs. Frequent purposeful physical activity was also associated with increased fracture risk among women (OR = 1.52, 95% CI 1.12–2.06 for 15 episodes/week vs none). Neither BMI nor physical activity was associated with fracture among men, although fracture risk decreased by 4% with every additional 2 hours of average sitting time per day (OR = 0.96, 95% CI 0.93–0.99).Conclusions
The increase in obesity prevalence will likely increase fracture burden among young women but not young men. While active lifestyles have health benefits, our results highlight the importance of promoting injury prevention practices in conjunction with physical activity recommendations, particularly among women.Key words: fracture, obesity, body size, physical activity, prevention, epidemiology, young adults 相似文献14.
Peer Reviewed: Smoking Status as a Predictor of Hip Fracture Risk in Postmenopausal Women of Northwest Texas
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Introduction
The purpose of this study was to determine the effect of cigarette smoking on the risk of hip fracture for postmenopausal women living in rural and urban areas of Northwest Texas.Methods
Using an unmatched case-control design, we compared postmenopausal women who had recently experienced osteoporotic hip fracture with women who had not. Both study groups completed a questionnaire on demographic, clinical, and behavioral risk factors for osteoporotic hip fracture. We categorized smoking status as never smoked, former smoker, and current smoker. Covariates included age, weight, age at menopause, physical activity, estrogen replacement, calcium supplementation, and rurality. We used univariate and multivariate logistic regressions to test the associations between hip fracture and the independent variables of interest.Results
We found an increased risk of hip fracture for former smokers (adjusted odds ratio [OR], 2.27; 95% confidence interval [CI], 1.22–4.21) and current smokers (adjusted OR, 3.72; 95% CI, 1.59–8.70). Residence in a rural county (population <100,000) also was associated with increased risk (adjusted OR, 2.71; 95% CI, 1.48–4.95).Conclusion
Former and current smoking increased the risk of hip fracture in this population of postmenopausal women. 相似文献15.
Bing Zhu Yasuo Haruyama Takashi Muto Takako Yamazaki 《Journal of epidemiology / Japan Epidemiological Association》2015,25(4):332-336
Background
Metabolic syndrome has received increased global attention over the past few years. Eating behaviors, particularly eating speed, have long been of interest as factors that contribute to the development of obesity and diabetes. The aim of this study was to assess the relationship between eating speed and incidence of metabolic syndrome among middle-aged and elderly Japanese people.Methods
A total of 8941 community residents from Soka City in Saitama Prefecture, aged from 40 to 75 years and without a diagnosis of metabolic syndrome, participated in the baseline survey in 2008 and were followed until 2011. Anthropometric measurements and lifestyle factors were measured at baseline and follow-up. The association between eating speed and incidence of metabolic syndrome was evaluated using Cox proportional hazards models adjusted for potential confounding variables.Results
During the 3-year follow-up, 647 people were diagnosed with metabolic syndrome (25.0 cases/1000 person-years). The incidence rates of metabolic syndrome among non-fast-eating and fast-eating participants were 2.3% and 3.1%, respectively. The multivariate-adjusted hazard ratio for incidence of metabolic syndrome in the fast-eating group compared to the not-fast-eating group was 1.30 (95% confidence interval [CI], 1.05–1.60) after adjustment for the potential confounding factors. Eating speed was significantly correlated with waist circumference and high-density lipoprotein cholesterol (HDL-C) components of metabolic risk factors. Hazard ratios in the fast-eating group compared with the reference group were 1.35 (95% CI, 1.10–1.66) for waist circumference and 1.37 (95% CI, 1.12–1.67) for HDL-C.Conclusions
Eating speed was associated with the incidence of metabolic syndrome. Eating slowly is therefore suggested to be an important lifestyle factor for preventing metabolic syndrome among the Japanese.Key words: eating speed, metabolic syndrome, cohort study, risk factor, epidemiology 相似文献16.
Background
Previous studies of the risk of heart disease after shift work reached different estimates and review authors disagree about the validity of some of the studies. A cross sectional study showed that shift workers had a higher prevalence of nearly every unfavourable work environment factor investigated. Conflicts at work and low decision latitude were more frequent among shift workers, and all‐day walking or standing work and part‐time jobs were more often found among female shift workers.Objectives
To estimate the risk of circulatory disease in a prospective follow up of a representative sample of gainfully employed Danes, considering known or suspected confounding factors.Methods
A cohort of 5517 people who were gainfully employed in 1990 were followed up for all hospital treatments due to circulatory diseases (390–458, ICD‐8; I00–I99, ICD‐10) from 1991 to 2002 inclusive. A log linear Poisson regression model was applied to control confounding factors and calculate the relative risk for 927 men and women working nights, evenings, or other non‐day shifts compared to 4579 day workers.Results
Non‐day workers compared to day workers had a relative risk (RR) for all circulatory diseases of 1.31 (95% CI 1.06–1.63). Without control for BMI and smoking, the RR estimate was 1.33 (95% CI 1.07–1.65). For a subgroup of workers with at least three years'' seniority, the RR was 1.40 (95% CI 1.09–1.81). The population based aetiological fraction of shift work was estimated to 5%.Conclusion
This study adds to a growing body of evidence suggesting that shift work carries an excess risk of circulatory diseases. 相似文献17.
Objectives
We examined health care disparities in Korean urban homeless people and individual characteristics associated with the utilization of health care.Methods
We selected a sample of 203 homeless individuals at streets, shelters, and drop-in centers in Seoul and Daejeon by a quota sampling method. We surveyed demographic information, information related to using health care, and health status with a questionnaire. Logistic regression analysis was adopted to identify factors associated with using health care and to reveal health care disparities within the Korean urban homeless population.Results
Among 203 respondents, 89 reported that they had visited health care providers at least once in the past 6 months. Twenty persons (22.5%) in the group that used health care (n = 89) reported feeling discriminated against. After adjustment for age, sex, marital status, educational level, monthly income, perceived health status, Beck Depression Inventory score, homeless period, and other covariates, three factors were significantly associated with medical utilization: female sex (adjusted odds ratio [aOR, 15.95; 95% CI, 3.97 to 64.04], having three or more diseases (aOR, 24.58; 95% CI, 4.23 to 142.78), and non-street residency (aOR, 11.39; 95% CI, 3.58 to 36.24).Conclusions
Health care disparities in Seoul and Daejeon homeless exist in terms of the main place to stay, physical illnesses, and gender. Under the current homeless support system in South Korea, street homeless have poorer accessibility to health care versus non-street homeless. To provide equitable medical aid for homeless people, strategies to overcome barriers against health care for the street homeless are needed. 相似文献18.
Aiko Matsushima Akihisa Matsumoto Fumio Moriwaka Sanae Honma Kazunori Itoh Keiko Yamada Shun Shimohama Hirofumi Ohnishi Junichi Matsushima Mitsuru Mori 《Journal of epidemiology / Japan Epidemiological Association》2016,26(4):185-190
Objectives
We conducted a cross-sectional study to evaluate the socioeconomic systems supporting outpatients with Parkinson’s disease (PD) in Japan.Methods
The study was performed in 2013 at two private hospitals and one clinic in Hokkaido Prefecture, Japan. A survey was conducted with 248 consecutive PD patients, and the data from 237 PD outpatients were analyzed after excluding 11 patients who did not meet inclusion criteria. Monthly medical and transportation payments as a PD outpatient were selected as outcome variables, and their association with various explanatory variables, such as utilization of support systems for PD outpatients, were evaluated using logistic regression model analysis.Results
After controlling for potential confounding variables, the utilization of the system providing financial aid for treatment for patients with intractable disease was significantly inversely associated with monthly medical payment among PD outpatients (OR 0.46; 95% CI, 0.22–0.95). Experience of hospital admission for PD treatment was significantly positively associated with monthly transportation payment (OR 4.74; 95% CI, 2.18–10.32). Monthly medical payment was also significantly positively associated with monthly transportation payment (OR 4.01; 95% CI, 2.23–7.51).Conclusions
Use of Japanese public financial support systems may be associated with reductions in medical payments for PD outpatients. However, those systems may not have supported transportation payments, and higher transportation payments may be associated with an increased risk of hospitalization.Key words: Parkinson’s disease, medical payment, cross-sectional study 相似文献19.
Henry Mugerwa Denis K Byarugaba Simon Mpooya Penelope Miremba Joan N Kalyango Charles Karamagi Achilles Katamba 《Archives of Public Health》2013,71(1):7
Background
Uganda’s Ministry of Health registered a 12% increase in new Tuberculosis (TB) cases between 2001 and 2005. Of these, 20% were from Kampala district and most from Mulago national referral hospital where the largest and the oldest medical school is found. Medical students are likely to have an increased exposure to TB infection due to their training in hospitals compared to other university students. The study compared the prevalence of TB infection and associated factors among undergraduate medical and veterinary students in Makerere University, Uganda.Methods
This was a cross-sectional study with 232 medical and 250 veterinary undergraduate students. Socio-demographic and past medical history data was collected using questionnaires. A tuberculin skin test was performed on the volar aspect of the left forearm. An induration ≥10 mm in diameter after 48-72 hrs was considered positive. Logistic regression was used to determine association of independent variables with TB infection.Results
The prevalence of TB infection was higher in medical students (44.8%, 95% C.I= 38.4-51.3%) compared to veterinary students (35.2%, 95% C.I = 29.3-41.1%). The significant predictors of TB infection were: being a medical student (aOR=1.56, 95% CI = 1.05-2.31), male sex (aOR=1.75, 95% CI = 1.17-2.63), history of contact with a confirmed TB case (aOR=1.57, 95% CI = 1.06-2.31) and residing at home (aOR=2.08, 95% CI = 1.20-3.61). Among the medical students, having gone to a day compared to boarding high school (aOR=2.31, 95% CI = 1.06-5.04), involvement in extracurricular clinical exposure (aOR=3.39 95% CI = 1.60-7.16), male sex, residence at home, and history of contact with a TB case predicted TB infection.Conclusion
Medical students have a higher prevalence of TB infection than veterinary students probably due to increased exposure during training. There is a need to emphasize TB infection control measures in hospitals and the general community. 相似文献20.
Hajime Iwasa Ichiro Kai Yuko Yoshida Takao Suzuki Hunkyung Kim Hideyo Yoshida 《Journal of epidemiology / Japan Epidemiological Association》2014,24(1):52-59