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Application of a Fragment-based Reactivity Profiler for the Prediction of Human Health and Environmental Toxicity Endpoints: Skin Sensitisation Potency and Aquatic Toxicity.

Ebbrell, David Jonathan; Madden, Judith Clare; Cronin, Mark T D; Schultz, Terry Wayne; Enoch, Steven J
| Idioma(s): Inglés
Toxicological effects, such as skin sensitisation and aquatic toxicity, can occur as a result of covalent bond formation between electrophilic chemicals and biological nucleophiles. One common mechanism through which covalent bonds may form is Michael addition. In silico profilers, consisting of structural alerts, have been developed that are able to identify the potential for a chemical to act as a Michael acceptor. However, such in silico profilers provide no information on rate of covalent bond formation (reactivity). This study outlines the ability of a previously developed fragment-based reactivity profiler to predict aquatic toxicity and skin sensitisation for Michael acceptors. The study also outlines the need to consider endpoint specific applicability domains, with the results showing the domain for the in vivo LLNA assay to be more complex. The study demonstrates the utility of being able to predict thiol reactivity using a fragment-based profiler, such approaches are important as part of non-animal methods for the prediction of toxicity, especially for endpoints where electrophilic reactivity is the driving force behind toxicity.
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Conflict of Interest and Funding Disclosure Policies of Environmental, Occupational, and Public Health Journals.

Resnik, David B; Konecny, Brandon; Kissling, Grace E
| Idioma(s): Inglés
OBJECTIVE: The aim of this study was to analyze conflict of interest (COI) and funding disclosure policies of 224 journals listed in Journal Citation Reports as focusing on environmental, occupational, or public health research. METHODS: A survey of journal policies and content analysis. RESULTS: About 96.0% of the policies required COI disclosure, 92.4% required funding disclosure, 75.9% defined COIs, 69.6% provided examples of COIs, 68.8% addressed nonfinancial COIs, 33.9% applied to editors and reviewers, 32.1% required discussion of the role of the funding source, and 1.8% included enforcement mechanisms. Policies were significantly associated with journal impact factor and publisher. CONCLUSION: Although a high percentage of journals in our sample have COI policies that provide substantial guidance to authors, there is a room for improvement. Journals that have not done so should consider developing enforcement mechanisms and applying COI policies to editors and reviewers.
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Evaluating and Refining the Conceptual Model Used in the Study of Health and Activity in Preschool Environments (SHAPES) Intervention.

Saunders, Ruth P; Pfeiffer, Karin; Brown, William H; Howie, Erin K; Dowda, Marsha; O'Neill, Jennifer R; McIver, Kerry; Pate, Russell R
| Idioma(s): Inglés
This study investigated the utility of the Study of Health and Activity in Preschool Environments (SHAPES) conceptual model, which targeted physical activity (PA) behavior in preschool children, by examining the relationship between implementation monitoring data and child PA during the school day. We monitored implementation completeness and fidelity based on multiple elements identified in the conceptual model. Comparing high-implementing, low-implementing, and control groups revealed no association between implementation and outcomes. We performed post hoc analyses, using process data, to refine our conceptual model's depiction of an effective preschool PA-promoting environment. Results suggest that a single component of the original four-component conceptual model, providing opportunities for moderate-to-vigorous physical activity through recess for 4-year-old children in preschool settings, may be a good starting place for increasing moderate-to-vigorous physical activity. Interventions that are implemented with optimal levels of completeness and fidelity are more likely to achieve behavior change if they are based on accurate conceptual models. Examining the mechanisms through which an intervention produces its effects, as articulated in the conceptual model that guides it, is particularly important for environmentally focused interventions because they are guided by emerging frameworks. The results of this study underscore the utility of using implementation monitoring data to examine the conceptual model on which the intervention is based.
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Preventing Depression in Adults With Subthreshold Depression: Health-Economic Evaluation Alongside a Pragmatic Randomized Controlled Trial of a Web-Based Intervention.

Buntrock, Claudia; Berking, Matthias; Smit, Filip; Lehr, Dirk; Nobis, Stephanie; Riper, Heleen; Cuijpers, Pim; Ebert, David
| Idioma(s): Inglés
BACKGROUND: Psychological interventions for the prevention of depression might be a cost-effective way to reduce the burden associated with depressive disorders. OBJECTIVE: To evaluate the cost-effectiveness of a Web-based guided self-help intervention to prevent major depressive disorder (MDD) in people with subthreshold depression (sD). METHODS: A pragmatic randomized controlled trial was conducted with follow-up at 12 months. Participants were recruited from the general population via a large statutory health insurance company and an open access website. Participants were randomized to a Web-based guided self-help intervention (ie, cognitive-behavioral therapy and problem-solving therapy assisted by supervised graduate students or health care professionals) in addition to usual care or to usual care supplemented with Web-based psycho-education (enhanced usual care). Depression-free years (DFYs) were assessed by blinded diagnostic raters using the telephone-administered Structured Clinical Interview for DSM-IV Axis Disorders at 6- and 12-month follow-up, covering the period to the previous assessment. Costs were self-assessed through a questionnaire. Costs measured from a societal and health care perspective were related to DFYs and quality-adjusted life years (QALYs). RESULTS: In total, 406 participants were enrolled in the trial. The mean treatment duration was 5.84 (SD 4.37) weeks. On average, participants completed 4.93 of 6 sessions. Significantly more DFYs were gained in the intervention group (0.82 vs 0.70). Likewise, QALY health gains were in favor of the intervention, but only statistically significant when measured with the more sensitive SF-6D. The incremental per-participant costs were €136 (£116). Taking the health care perspective and assuming a willingness-to-pay of €20,000 (£17,000), the intervention's likelihood of being cost-effective was 99% for gaining a DFY and 64% or 99% for gaining an EQ-5D or a SF-6D QALY. CONCLUSIONS: Our study supports guidelines recommending Web-based treatment for sD and adds that this not only restores health in people with sD, but additionally reduces the risk of developing a MDD. Offering the intervention has an acceptable likelihood of being more cost-effective than enhanced usual care and could therefore reach community members on a wider scale. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00004709; (Archived by WebCite at
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The economic burden of dementia in China, 1990-2030: implications for health policy.

Xu, Junfang; Wang, Jian; Wimo, Anders; Fratiglioni, Laura; Qiu, Chengxuan
| Idioma(s): Inglés
OBJECTIVE: To quantify and predict the economic burden of dementia in China for the periods 1990-2010 and 2020-2030, respectively, and discuss the potential implications for national public health policy. METHODS: Using a societal, prevalence-based, gross cost-of-illness approach and data from multiple sources, we estimated or predicted total annual economic costs of dementia in China. We included direct medical costs in outpatient and inpatient settings, direct non-medical costs - e.g. the costs of transportation - and indirect costs due to loss of productivity. We excluded comorbidity-related costs. FINDINGS: The estimated total annual costs of dementia in China increased from 0.9 billion United States dollars (US$) in 1990 to US$ 47.2 billion in 2010 and were predicted to reach US$ 69.0 billion in 2020 and US$ 114.2 billion in 2030. The costs of informal care accounted for 94.4%, 92.9% and 81.3% of the total estimated costs in 1990, 2000 and 2010, respectively. In China, population ageing and the increasing prevalence of dementia were the main drivers for the increasing predicted costs of dementia between 2010 and 2020, and population ageing was the major factor contributing to the growth of dementia costs between 2020 and 2030. CONCLUSION: In China, demographic and epidemiological transitions have driven the growth observed in the economic costs of dementia since the 1990s. If the future costs of dementia are to be reduced, China needs a nationwide dementia action plan to develop an integrated health and social care system and to promote primary and secondary prevention.
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Over-reaching beyond disease activity: the influence of anxiety and medical economic burden on health-related quality of life in patients with inflammatory bowel disease.

Luo, Xia-Peng; Mao, Ren; Chen, Bai-Li; Qiu, Yun; Zhang, Sheng-Hong; He, Yao; Chen, Jie; Zeng, Zhi-Rong; Ben-Horin, Shomron; Chen, Min-Hu
| Idioma(s): Inglés
PURPOSE: Many patients with inflammatory bowel disease (IBD) have impaired health-related quality of life (HRQOL). The influence of psychological and economic factors on HRQOL has not been fully elucidated in IBD. Therefore, we aimed to identify the predictors of HRQOL in an IBD cohort. PATIENTS AND METHODS: This was a cross-sectional cohort study of patients presenting to our tertiary IBD center. HRQOL was measured using the 36-item Short Form Health Survey (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Perceived stress and perceived social support were also assessed by standardized scales. Demographic, socioeconomic and clinical data were obtained from a prespecified questionnaire and patients' medical records. Univariate analyses and multiple regression analysis were performed to identify predictors of HRQOL. RESULTS: A total of 242 IBD patients were recruited, and the questionnaire return rate was 90.5% (219/242). The prevalence rates of anxiety and depression were 24.7% and 17.4%, respectively. In all, 30.6% of the patients spent over half of their income to cover medical costs. Multivariate analysis revealed that anxiety symptoms ( <0.001), active disease ( <0.001) and higher medical expenditures ( =0.001) were strong and independent predictors of reduced HRQOL. CONCLUSION: Psychological factors and costs of medical care strongly impair HRQOL in IBD, independent of the disease activity. Psychological counseling and socioeconomic support programs should be considered for integration into the management of IBD patients.
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A review of AirQ Models and their applications for forecasting the air pollution health outcomes.

Oliveri Conti, Gea; Heibati, Behzad; Kloog, Itai; Fiore, Maria; Ferrante, Margherita
| Idioma(s): Inglés
Even though clean air is considered as a basic requirement for the maintenance of human health, air pollution continues to pose a significant health threat in developed and developing countries alike. Monitoring and modeling of classic and emerging pollutants is vital to our knowledge of health outcomes in exposed subjects and to our ability to predict them. The ability to anticipate and manage changes in atmospheric pollutant concentrations relies on an accurate representation of the chemical state of the atmosphere. The task of providing the best possible analysis of air pollution thus requires efficient computational tools enabling efficient integration of observational data into models. A number of air quality models have been developed and play an important role in air quality management. Even though a large number of air quality models have been discussed or applied, their heterogeneity makes it difficult to select one approach above the others. This paper provides a brief review on air quality models with respect to several aspects such as prediction of health effects.
Resultados  1-10 de 151.524