preventative

预防性
  • 文章类型: Journal Article
    背景:牛跛行是畜牧业面临的重大福利和经济问题。已发表的研究调查了奶牛群中的足部修剪做法,但是对牛群的做法知之甚少。因此,这项研究的目的是获得有关英国境内肉牛的专业牛脚修剪器当前做法的信息。
    方法:使用联合信息系统委员会平台创建了一个包含16个问题的在线调查。该调查已开放3个月。
    结果:接受预防性足部修剪的奶牛和肉牛的比例之间存在显着差异(p<0.05)。数字皮炎是受访者修剪跛脚牛肉动物时最常见的跛脚原因,其次是白线病。提出了对脚部修剪者对牛肉农场参与障碍的看法的主题分析,除了他们对兽医参与牛肉跛行的意见。
    结论:分布偏差可能影响了结果,因为该调查是在牛蹄护理标准委员会和全国牛蹄修剪协会的支持下在线分发的。不属于任何专业机构的脚部修剪器的百分比是未知的。
    结论:进一步研究跛行对奶牛和育成牛的影响,包括调查减少牛肉系统跛行的预防措施,是有保证的。
    BACKGROUND: Cattle lameness is a significant welfare and economic problem facing the livestock industry. Published research has investigated foot trimming practices in dairy herds, but little is known about the practices in beef herds. Therefore, the objective of this study was to obtain information about the current practices of professional cattle foot trimmers concerning beef cattle within the UK.
    METHODS: An online survey comprising 16 questions was created using the Joint Information Systems Committee platform. The survey was open for 3 months.
    RESULTS: There was a significant difference (p < 0.05) between the proportions of dairy cattle and beef cattle receiving preventative foot trims. Digital dermatitis was the most commonly recorded cause of lameness when a lame beef animal was trimmed by the respondents, followed by white line disease. A thematic analysis of foot trimmers\' opinions of barriers to engagement on beef farms is presented, in addition to their opinions on veterinary involvement with beef lameness.
    CONCLUSIONS: Distribution bias may have affected the results, as the survey was distributed online with support from the Cattle Hoof Care Standards Board and the National Association of Cattle Hoof Trimmers. The percentage of foot trimmers not affiliated with either professional body is not known.
    CONCLUSIONS: Further research on the impact of lameness on suckler and finishing cattle, including investigations into preventative actions to reduce lameness in beef systems, is warranted.
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  • 文章类型: Journal Article
    背景:COVID-19大流行的开始导致美国高等教育机构以前所未有的水平实施非药物干预措施。在新出现的大流行的背景下,年轻的成年人(例如,大学生)的SARS-CoV-2严重结局的总体风险较低,这使该人群成为具有高易感性和负面健康结局的年龄组的潜在传播源。我们研究了大学生对COVID-19的关注程度如何受到不同信息来源的影响,他们的生活状态,收入水平,和其他人口统计学特征及其与预防行为变化的关联。
    目标:我们试图检查关注程度,定义为参与者通过使用个人防护设备(如口罩)采取纠正措施以减轻感染或传播病毒(给家人或朋友)的程度,练习社交距离,并遵循其他公共卫生建议,在COVID-19大流行期间的大学生中。
    方法:横截面,基于网络的调查是在2021年对185名18-41岁的大学生进行的,大多数人居住在纽约市和美国(n=134,72.4%)。在185名大学生中,94提供了他们的邮政编码,这些大学生中有51人表示他们住在纽约市地区。参与者通过QR码完成了调查。未完成完整调查或不是美国任何学院或大学的大学生的研究参与者被排除在外。使用R(版本4.2.2;R统计计算基金会)进行分析。
    结果:在185名受访者中,25(13.5。%)使用了他们学校的电子邮件,51(27.6%)使用主流媒体,109人(58.9%)使用社交媒体和其他来源获取有关COVID-19的信息。在从社交媒体上了解大流行的109名参与者中,91人(83.5%)感到关切;然而,只有63%(32/51)和60%(15/25)的参与者从主流媒体及其学校的电子邮件中获取信息,分别,关注。Further,从社交媒体和其他来源获得信息的参与者关注COVID-19的可能性是通过电子邮件从大学获得信息的参与者的3倍(P=.036;OR=3.07,95%CI:1.06~8.83)..
    结论:从社交媒体和其他来源收到信息的大学生比通过电子邮件从学校收到信息的学生更可能担心COVID-19。
    BACKGROUND: The start of the COVID-19 pandemic resulted in the implementation of nonpharmaceutical interventions by US institutions of higher education at an unprecedented level. During the backdrop of an emerging pandemic, younger adults (eg, college students) had an overall lower risk for severe outcomes for SARS-CoV-2, making this population a potential source of transmission for age groups with high susceptibility and negative health outcomes. We examine how college students\' level of concern for COVID-19 was influenced by different sources of information, their living status, income level, and other demographic identifiers and its association with prevention behavior change.
    OBJECTIVE: We sought to examine the level of concern, defined as the extent to which the participant would take corrective action to mitigate contracting or spreading the virus (to family or friends) by using personal protective equipment such as a face mask, practicing social distancing, and following other public health recommendations, among college students during the COVID-19 pandemic.
    METHODS: A cross-sectional, web-based survey was conducted in 2021 among 185 college students aged 18-41 years, with most living in New York City and the United States (n=134, 72.4%). Out of 185 college students, 94 provided their zip codes, with 51 of those college students indicating they lived in New York City areas. The participants completed the survey via a QR code. Study participants who did not complete the full survey or were not college students in any US college or university were excluded. Analyses were conducted using R (version 4.2.2; R Foundation for Statistical Computing).
    RESULTS: Of 185 respondents participated in the study, 25 (13.5.%) used emails from their schools, 51 (27.6%) used mainstream media, and 109 (58.9%) used social media and other sources to obtain information about COVID-19. Of the 109 participants who learned about the pandemic from social media, 91 (83.5%) were concerned; however, only 63% (32/51) and 60% (15/25) of the participants who sourced information from mainstream media and their schools\' email, respectively, were concerned. Further, the participants who received information from social media and other sources were about 3 times more likely to be concerned about COVID-19 than participants who received information from the university via email (P=.036; OR=3.07, 95% CI: 1.06-8.83)..
    CONCLUSIONS: College students who received information from social media and other sources were more likely to be concerned about COVID-19 than students who received information from their school via emails.
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  • 文章类型: Journal Article
    背景:了解影响个体健康决策的因素是一个动态的研究问题。特别是,在中国宣布放松对COVID-19疫情的管制后,健康风险迅速升级。“不再受控制”的病毒和信息流行病的融合创造了一个独特的社会时期,在此期间,多种因素可能会影响人们的决策。在这些因素中,老年人的预防意图,作为一个易受影响的健康团体,值得特别注意。
    目的:本研究旨在探讨老年人从事预防行为的意向及其影响因素,包括社会,媒体,和个人因素,在继后时代的背景下。借鉴沟通的结构影响模型,本研究检验了3种不同类型媒体曝光在认知和结构社会资本与保护行为意向之间的潜在中介作用,以及负面情绪在社会资本和媒体曝光之间的调节作用。
    方法:在本研究中,网络调查被用来收集自我报告的社会资本定量数据,媒体曝光,负面情绪,以及在中国60岁以上(N=399)的老年人中预防COVID-19的意图。
    结果:结果表明,认知社会资本显著影响保护行为意图(P<.001)。手机暴露发挥了额外的影响作用(P<.001)。相比之下,报纸、广播和电视暴露介导了结构性社会资本对保护行为意向的影响(P<.001)。此外,负面情绪在认知社会资本与手机暴露的关系中起调节作用(P<.001)。
    结论:这项研究表明,在各种媒体渠道中使用量身定制的传播策略可以有效地提高应对中国主要流行病的老年人的健康意识。考虑到他们多样化的社会资本特征和情绪状态。
    BACKGROUND: Understanding the factors influencing individuals\' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of \"no longer controlled\" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people\'s decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention.
    OBJECTIVE: This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure.
    METHODS: In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China.
    RESULTS: The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001).
    CONCLUSIONS: This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.
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  • 文章类型: Clinical Trial Protocol
    背景:青春期是一个对发展中的心理健康问题更加脆弱的时期,在过去的十年里,这个年龄段的精神健康障碍的发病率有所增加。防止心理健康问题在根深蒂固之前发展,特别是在高危青少年中,是重要的研讨和临床目标。这里,我们报告了"通过社会情绪训练建立韧性"(ReSET)干预试验方案.RESET是一个新的,预防性干预,包括基于个人的情感培训技术和基于群体的社交和沟通技能培训。我们采取了一种诊断方法,关注与各种形式的精神病理学的发作和维持有关的情绪处理和社会机制。
    方法:采用集群随机分配设计,并在学年水平进行随机分配。五百四十名青少年(12-14岁)将被随机分配接受干预或不接受干预(被动控制)。干预包括为期8周的每周会议,补充两个单独的会议。主要成果,精神病理学症状和心理健康,将在干预前和干预后进行评估,在1年的随访中。次要结果是基于任务的情绪处理评估,基于同行提名的社交网络数据,和社会关系的主观评级。这些措施将在基线时采取,干预后和1年随访。将邀请一个参与者和利益攸关方分组参加焦点小组,以评估干预措施的可接受性。
    结论:该项目采用基于理论的方法来开发一种新的干预措施,旨在针对年轻人的情绪与人际关系之间的紧密联系。通过将干预嵌入学校环境中,并使用集群随机设计,我们的目标是开发和测试一种可行的,可扩展的干预措施,以防止青春期精神病理学的发作。
    背景:ISRCTN88585916。试用注册日期:2023年4月20日。
    BACKGROUND: Adolescence is a period of heightened vulnerability to developing mental health problems, and rates of mental health disorder in this age group have increased in the last decade. Preventing mental health problems developing before they become entrenched, particularly in adolescents who are at high risk, is an important research and clinical target. Here, we report the protocol for the trial of the \'Building Resilience through Socioemotional Training\' (ReSET) intervention. ReSET is a new, preventative intervention that incorporates individual-based emotional training techniques and group-based social and communication skills training. We take a transdiagnostic approach, focusing on emotion processing and social mechanisms implicated in the onset and maintenance of various forms of psychopathology.
    METHODS: A cluster randomised allocation design is adopted with randomisation at the school year level. Five-hundred and forty adolescents (aged 12-14) will be randomised to either receive the intervention or not (passive control). The intervention is comprised of weekly sessions over an 8-week period, supplemented by two individual sessions. The primary outcomes, psychopathology symptoms and mental wellbeing, will be assessed pre- and post-intervention, and at a 1-year follow-up. Secondary outcomes are task-based assessments of emotion processing, social network data based on peer nominations, and subjective ratings of social relationships. These measures will be taken at baseline, post-intervention and 1-year follow-up. A subgroup of participants and stakeholders will be invited to take part in focus groups to assess the acceptability of the intervention.
    CONCLUSIONS: This project adopts a theory-based approach to the development of a new intervention designed to target the close connections between young people\'s emotions and their interpersonal relationships. By embedding the intervention within a school setting and using a cluster-randomised design, we aim to develop and test a feasible, scalable intervention to prevent the onset of psychopathology in adolescence.
    BACKGROUND: ISRCTN88585916. Trial registration date: 20/04/2023.
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  • 文章类型: Journal Article
    背景:冠心病(CHD)仍然是澳大利亚的主要死亡原因,幸存者中重复事件的残余风险很高。二级预防治疗对于降低死亡和其他主要不良心脏事件的风险至关重要。澳大利亚国家心脏基金会制定了一项面向消费者的支持计划,名为“我的心”,我的生活(MHML)来解决澳大利亚冠心病二级预防方面的差距。MHML试点计划为患者及其护理人员提供建议和支持,并在2019年11月至2020年6月的8个月内进行。
    目的:本研究旨在描述和检查一项名为MHML的新型多模态二级冠心病预防试点项目的实施情况。是通过小册子递送的,短信,电子邮件,和电话。
    方法:本试点研究由混合方法评估组成,涉及对参与者(患者和护理人员)和卫生专业人员的调查,深入采访,和数字通信(SMS短信,电子直邮,和通话记录分析)。这项研究是在2019年11月至2020年6月期间,通过澳大利亚国家心脏基金会网页,在38家澳大利亚医院的18岁以上急性冠状动脉综合征或心绞痛患者及其护理人员中进行的。主要成果措施是达成的,可访问性,可行性,障碍,以及实施该计划的推动者。
    结果:在1004名参与者中(838名患者和164名护理人员;2名失踪),60.9%(608/1001)为男性,50.7%(491/967)的患者年龄在45至64岁之间,27.4%(276/1004)来自贫困地区,2.5%(24/946)来自原住民或托雷斯海峡岛民背景,16.9%(170/1004)将英语作为第二语言。参与者(患者及其护理人员)和卫生专业人员报告对MHML计划的满意度很高(55/62,88.7%和33/38,87%,分别)。在接受调查的62名参与者中,88%(55/62)使用短信服务,并报告了非常高的满意度。大约94%(58/62)和89%(55/62)的参与者分别对快速指南手册1和2感到满意;79%(49/62)对每月电子邮件旅程感到满意,71%(44/62)对求助热线感到满意。大多数参与者报告说,MHML计划改善了预防行为,也就是说,其中73%(45/62)报告说他们保持了增加的身体活动,而84%(52/62)报告说他们即使在MHML计划之后也保持了健康的饮食。
    结论:我们的试点研究结果表明,多式联运支持计划,包括数字,打印,电话,和基于网络的媒体,对于冠心病的二级预防是有用的,并且可能是为急性冠脉综合征幸存者提供定制规模二级预防支持的潜在手段.
    BACKGROUND: Coronary heart disease (CHD) remains the leading cause of death in Australia, with a high residual risk of repeat events in survivors. Secondary prevention therapy is crucial for reducing the risk of both death and other major adverse cardiac events. The National Heart Foundation of Australia has developed a consumer-facing support program called My Heart, My Life (MHML) to address the gap in the secondary prevention of CHD in Australia. The MHML pilot program supplies advice and support for both patients and their caregivers, and it was conducted over 8 months from November 2019 to June 2020.
    OBJECTIVE: This study aims to describe and examine the implementation of a novel multimodality secondary CHD prevention pilot program called MHML, which was delivered through booklets, text messages, emails, and telephone calls.
    METHODS: This pilot study consists of a mixed methods evaluation involving surveys of participants (patients and caregivers) and health professionals, in-depth interviews, and digital communication (SMS text message, electronic direct mail, and call record analytics). This study was performed in people older than 18 years with acute coronary syndrome or angina and their caregivers in 38 Australian hospitals from November 2019 to June 2020 through the National Heart Foundation of Australia web page. The main outcome measures were reach, accessibility, feasibility, barriers, and enablers to implementation of this program.
    RESULTS: Of the 1004 participants (838 patients and 164 caregivers; 2 missing), 60.9% (608/1001) were males, 50.7% (491/967) were aged between 45 and 64 years, 27.4% (276/1004) were from disadvantaged areas, 2.5% (24/946) were from Aboriginal or Torres Strait Islander background, and 16.9% (170/1004) reported English as their second language. The participants (patients and their caregivers) and health professionals reported high satisfaction with the MHML program (55/62, 88.7% and 33/38, 87%, respectively). Of the 62 participants who took the survey, 88% (55/62) used the text messaging service and reported a very high level of satisfaction. Approximately 94% (58/62) and 89% (55/62) of the participants were satisfied with the quick guide booklets 1 and 2, respectively; 79% (49/62) were satisfied with the monthly email journey and 71% (44/62) were satisfied with the helpline calls. Most participants reported that the MHML program improved preventive behaviors, that is, 73% (45/62) of them reported that they maintained increased physical activity and 84% (52/62) reported that they maintained a healthy diet even after the MHML program.
    CONCLUSIONS: The findings of our pilot study suggest that a multimodal support program, including digital, print, phone, and web-based media, for the secondary prevention of CHD is useful and could be a potential means of providing customized at-scale secondary prevention support for survivors of acute coronary syndrome.
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  • 文章类型: Randomized Controlled Trial
    背景:炎症性肠病(IBD)患者的感染风险增加,骨折,和皮肤癌。
    目的:我们使用以患者为中心的方法开发了预防性健康视频,并测试了其对预防性健康的影响。
    方法:通过以患者为中心的焦点小组和访谈,迭代开发了五个解释IBD预防性健康建议的动画视频。然后在基于网络的IBD队列中进行了一项随机对照试验,以测试基于视频与基于文本的教育干预的影响。主要结果是接种流感疫苗。次要结果包括接受其他预防性卫生服务的意向。
    结果:用患者输入制作了五个动画视频。然后,共有1056名IBD患者被随机分配接受视频(n=511)或仅文本(n=545)干预;视频组的55%(281/511)和仅文本组的57%(311/545)在前一年接受了流感疫苗。在干预之后,73%(502/683)的患者报告他们打算接种疫苗,干预类型没有差异(75%,231/307,为视频组和72%,271/376,适用于纯文本组)。干预后实际接种流感疫苗的患者比例也没有因消息传递类型而异(P=.07)。接受和实际接受流感疫苗的意愿的最强预测指标是先前的流感疫苗接种。年龄也与更高的意愿接受(年龄36-75岁相对于18-35岁;P=.006)和实际接受(年龄>75岁相对于18-35岁;P=.05)流感疫苗的可能性相关。
    结论:两组接受流感疫苗的患者比例都很高,但在接受预防性健康建议或接受预防性健康建议的意向方面没有区别.值得注意的是,两组中的一部分患者原本打算接种疫苗,但最终没有接种疫苗.需要进一步评估患者教育策略,以改善IBD患者的预防性健康摄取。
    背景:ClinicalTrials.govNCT05997537;https://clinicaltrials.gov/ct2/show/NCT05997537。
    Patients with inflammatory bowel disease (IBD) are at increased risk of infections, bone fractures, and skin cancers.
    We developed preventive health videos using a patient-centered approach and tested their impact on preventive health uptake.
    Five animated videos explaining preventive health recommendations in IBD were iteratively developed with patient-centered focus groups and interviews. A randomized controlled trial was then conducted in a web-based IBD cohort to test the impact of video- versus text-based educational interventions. The primary outcome was receipt of the influenza vaccine. Secondary outcomes included intention to receive other preventive health services.
    Five animated videos were developed with patient input. A total of 1056 patients with IBD were then randomized to receive the video (n=511) or text-only (n=545) interventions; 55% (281/511) of the video group and 57% (311/545) of the text-only group had received their influenza vaccine in the prior year. Immediately after the intervention, 73% (502/683) of patients reported their intention to receive the vaccine, with no difference by the type of intervention (75%, 231/307, for the video group and 72%, 271/376, for the text-only group). The proportion of patients who actually received the influenza vaccine after the intervention also did not differ by messaging type (P=.07). The strongest predictor of both intention to receive and actual receipt of the influenza vaccine was prior influenza vaccination. Older age was also associated with a higher likelihood of the intention to receive (age 36-75 years relative to 18-35 years; P=.006) and actual receipt (age >75 years relative to 18-35 years; P=.05) of the influenza vaccine.
    The proportion of patients receiving the influenza vaccine was high in both groups, but there was no difference in receipt of or in the intention to receive preventive health recommendations by type of messaging. Notably, a portion of patients in both groups had intended to be vaccinated but did not ultimately receive the vaccine. Further evaluation of patient-education strategies is warranted to improve preventive health uptake among patients with IBD.
    ClinicalTrials.gov NCT05997537; https://clinicaltrials.gov/ct2/show/NCT05997537.
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  • 文章类型: Case Reports
    背景:有高甘油三酯血症病史的孕妇发生急性胰腺炎的风险增加。当保守管理未能维持甘油三酯水平低于250-500mgdL-1时,必须考虑实施妊娠C类药物预防胰腺炎.血浆置换可迅速降低甘油三酯水平,并已被报道为在有限数量的孕妇中成功治疗高甘油三酯血症诱导的急性胰腺炎的三线疗法。预防性血浆去除术作为递送的桥梁的用途没有得到很好的表征。
    方法:我们报告了一名有糖尿病病史的妊娠患者的门诊血浆置换方案,用于控制高甘油三酯血症,高甘油三酯血症,远端胰腺切除术,重复怀孕失败。在妊娠中期,到妊娠28周时,难治性甘油三酯水平增加至3438mgdL-1。鉴于患者的复发性胰腺炎的高风险和有限的剩余胰腺实质,她在2天内接受了两次单次血浆容量置换和100%白蛋白的急性治疗,将甘油三酯水平降低至559mgdL-1。随后每7至9天血浆置换维持320-1296mgdL-1的甘油三酯水平。患者没有经历不良反应,并且在妊娠33周时因高血压成功计划分娩之前一直门诊。
    结论:对于选定的患者,早期增加血浆置换可以预防急性胰腺炎的发病率和死亡率.个性化的血浆置换方案可以作为分娩的桥梁,这需要多学科小组的密切观察和协调。
    BACKGROUND: Pregnant patients with a history of hypertriglyceridemia are at increased risk for development of acute pancreatitis. When conservative management fails to maintain triglyceride levels less than 250-500 mg dL-1 , implementation of pregnancy category C medications to prevent pancreatitis must be considered. Plasmapheresis rapidly reduces triglyceride levels and has been reported as a successful third-line therapy for hypertriglyceridemia-induced acute pancreatitis in a limited number of pregnant patients. Use of preventative plasmapheresis as a bridge to delivery is not well characterised.
    METHODS: We report an outpatient plasmapheresis regimen for the control of hypertriglyceridemia in a pregnant patient with a history of diabetes mellitus, hypertriglyceridemia, distal pancreatectomy, and repeat pregnancy loss. During the second trimester, refractory triglyceride levels increased up to 3438 mg dL-1 by 28 weeks gestation. Given the patient\'s high risk for recurrent pancreatitis and limited remaining pancreatic parenchyma, she was treated acutely with two single-plasma-volume exchanges with 100% albumin over 2 days, decreasing the triglyceride level to 559 mg dL-1 . Subsequent plasmapheresis every 7 to 9 days maintained a triglyceride level of 320-1296 mg dL-1 . The patient experienced no adverse effects and remained outpatient until successful scheduled delivery for hypertension at 33 weeks gestation.
    CONCLUSIONS: For select patients, early escalation to plasmapheresis may prevent morbidity and mortality associated with acute pancreatitis. An individualised plasmapheresis regimen can serve as a bridge to delivery, which requires close observation and the coordination of a multidisciplinary team.
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  • 文章类型: Journal Article
    使用预防心虫病的方法可以预防心虫病,但是据报道,在美国,预防使用心脏病的流行率很低,一些人估计约有50%的狗倒下。然而,对患病率及其相关因素的估计很少。
    我们旨在估计患病率和评估因素,包括疫苗接种情况,人口统计,生活方式,物理条件,药物和补充剂,环境和生活条件,在金毛犬寿命研究的大型数据集中,它们与预防使用心丝虫相关(N=2,998)。由于评估的预测因子数量众多,我们建立了一个自举弹性网络逻辑回归模型,这对过拟合和多重共线性是稳健的。通过计算协变量稳定性(>80%)和统计学显著性(p<0.02)来评估变量。
    在我们的示例中,使用心丝虫的患病率为39.5%.在我们的弹性网络模型中,接受疫苗接种(狂犬病,Bordetella,或任何其他疫苗),位于美国南部,被改变,有传染病或耳/鼻/喉系统疾病的诊断,过去使用心虫预防措施,目前正在预防滴答,在铺有混凝土地板的地方暴晒,住在有更多铺有地毯的房间的房子里,花时间在里面的硬木地板上与更大的预防使用心丝虫的几率有关。补充使用和处于身高的前四分位数与心丝虫预防性使用的几率较低相关。
    我们确定的解释性因素可用于改善客户沟通。此外,可以确定教育干预和外展的目标人群。未来的研究可以在更多样化的狗群中验证这些发现。
    UNASSIGNED: Heartworm disease is preventable with use of heartworm preventatives, but the reported prevalence of heartworm preventative use in the United States is low, some estimates falling around 50% of dogs. However, there are very few estimates of prevalence and its associated factors.
    UNASSIGNED: We aimed to estimate prevalence and evaluate factors, including vaccination status, demographics, lifestyle, physical conditions, medications and supplements, and environment and living conditions, for their association with heartworm preventative use in a large dataset from the Golden Retriever Lifetime Study (N = 2,998). Due to the large number of predictors evaluated, we built a bootstrapped elastic net logistic regression model, which is robust to overfitting and multicollinearity. Variables were evaluated by calculating covariate stability (>80%) and statistical significance (p<0.02).
    UNASSIGNED: In our sample, the prevalence of heartworm use was 39.5%. In our elastic net model, receiving vaccinations (rabies, Bordetella, or any other vaccine), being located in the Southern U.S., being altered, having an infectious disease or ear/ nose/throat system disease diagnosis, being on heartworm preventatives in the past, currently being on tick preventative, having sun exposure in an area with concrete flooring, living in a house with more rooms with carpeted floors, and spending time on hardwood flooring inside were associated with greater odds of heartworm preventative use. Supplementation use and being in the top quartile of height were associated with lower odds of heartworm preventative use.
    UNASSIGNED: The explanatory factors we identified can be used to improve client communication. In addition, target populations for educational interventions and outreach can be identified. Future studies can validate the findings in a more diverse population of dogs.
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  • 文章类型: Journal Article
    背景:药物过度使用性头痛(MOH)在原发性头痛疾病患者中非常普遍。
    目的:(1)提供流行病学的最新信息,危险因素,和MOH的治疗策略;(2)为MOH的管理提供建议。
    结果:MOH的患病率为0.5-7.2%。MOH的危险因素包括女性,较低的社会经济地位,一些精神病,和物质使用障碍,在其他人中。最近的大型临床试验支持预防性治疗作为MOH管理的一个组成部分。新兴的临床试验证据支持抗CGRPmAb作为偏头痛和MOH患者的有效预防性治疗。在大型临床试验中,坎地沙坦,托吡酯,阿米替林,和onabotulinumtoxinA是最常用的预防性疗法,为这些代理商提供进一步的支持。MOH管理需要多方面和以患者为中心的方法,涉及患者教育,行为干预,撤回过度使用的药物,并开始预防性药物治疗。
    Medication overuse headache (MOH) is highly prevalent among individuals with primary headache disorders.
    (1) Provide an update on epidemiology, risk factors, and treatment strategies of MOH and (2) provide recommendations on the management of MOH.
    The prevalence of MOH ranges from 0.5 to 7.2%. Risk factors for MOH include female sex, lower socioeconomic status, some psychiatric conditions, and substance use disorders, among others. Recent large clinical trials support preventative therapy as an integral component of MOH management. Emerging clinical trial evidence supports anti-CGRP mAbs as effective preventative treatments among individuals with migraine and MOH. Among the large clinical trials, candesartan, topiramate, amitriptyline, and onabotulinumtoxinA were the most used preventative therapies, providing further support for these agents. MOH management requires a multifaceted and patient-centered approach that involves patient education, behavioral interventions, withdrawal of the overused medication, and initiation of preventative medication.
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  • 文章类型: Journal Article
    目的:咳嗽的特点是咳嗽,吸气喘鸣,声音嘶哑和不同程度的呼吸窘迫。急性哮鸣发作常口服治疗,吸入,或者静脉注射皮质类固醇.经常性的臀部,定义为同一患者发生2-3次以上的急性臀部发作,可以模仿哮喘。我们假设在出现呼吸道病毒性前驱症状的第一个迹象时给予吸入性皮质类固醇(ICS)可以是一种安全的治疗方法,可以减少没有固定气道病变的儿童反复发作的频率。
    方法:在机构审查委员会(IRB)批准后,在一家大型三级护理儿科医院对接受18个月治疗的患者进行回顾性图表审查。21岁以下的患者转诊儿科肺科,耳鼻喉科,或胃肠病学的复发性臀部进行了人口统计学分析,病史,评估,治疗和临床改善。使用Fisher的双尾精确检验来比较干预前后的臀部发作次数。
    结果:124例患者纳入我们的分析:男性87例,女性34例,平均年龄54个月。其中,78有>5集的臀部,45例患者有3-5例,3例患者在首次就诊之前有2次发作。35例患者(27.8%)进行了直接喉镜/支气管镜检查,60%的患者检查正常,无固定病变。92例患者(74.2%)接受ICS治疗,24人失去了跟进。在其余68名接受治疗的患者中,59例(86.7%)的症状有所改善,严重程度和总体发作次数减少。此外,与<5(12)相比,>5发作(47)的患者更有可能使用ICS改善,(p=0.003)。ICS治疗没有不良反应报告。
    结论:在病毒性上呼吸道感染的最早征兆中,新型的ICS开始治疗有望作为一种安全的预防性治疗方法,以减轻反复发作的发作频率。
    OBJECTIVE: Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more than 2-3 episodes of acute croup in the same patient, can mimic asthma. We hypothesized that inhaled corticosteroids (ICS) given at the first sign of a respiratory viral prodrome can be a safe treatment to reduce the frequency of recurrent croup episodes in children without fixed airway lesions.
    METHODS: A retrospective chart review of patients being treated over an 18-month period was performed at a large tertiary care pediatric hospital following Institutional Review Board (IRB) approval. Patients under 21 years old referred to Pediatric Pulmonology, Otolaryngology, or Gastroenterology for recurrent croup were analyzed for their demographics, medical history, evaluation, treatment and clinical improvement. A Fisher\'s two-tailed exact test was used to compare the number of croup episodes before and after interventions.
    RESULTS: 124 patients were included in our analysis: 87 male and 34 female with a mean age of 54 months. Of these, 78 had >5 episodes of croup, 45 had 3-5, and 3 had 2 episodes prior to their first visit for recurrent croup. Operative direct laryngoscopy/bronchoscopy was performed in 35 patients (27.8%), with 60% showing a normal exam without fixed lesions. Ninety-two patients (74.2%) were treated with ICS, 24 were lost to follow up. Of the remaining 68 treated patients, 59 (86.7%) saw improvement with reduced severity and overall number of episodes of croup. Additionally, patients with >5 episodes of croup (47) as compared to <5 (12) were more likely to improve with ICS, (p = 0.003). There were no adverse reactions reported with ICS treatment.
    CONCLUSIONS: The novel initiation of ICS at the earliest sign of a viral upper respiratory infection shows promise as a safe preventative treatment to mitigate the frequency of recurrent croup episodes.
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