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1.
Sensors (Basel) ; 19(12)2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31226858

RESUMO

Heart attack is one of the leading causes of human death worldwide. Every year, about 610,000 people die of heart attack in the United States alone-that is one in every four deaths-but there are well understood early symptoms of heart attack that could be used to greatly help in saving many lives and minimizing damages by detecting and reporting at an early stage. On the other hand, every year, about 2.35 million people get injured or disabled from road accidents. Unexpectedly, many of these fatal accidents happen due to the heart attack of drivers that leads to the loss of control of the vehicle. The current work proposes the development of a wearable system for real-time detection and warning of heart attacks in drivers, which could be enormously helpful in reducing road accidents. The system consists of two subsystems that communicate wirelessly using Bluetooth technology, namely, a wearable sensor subsystem and an intelligent heart attack detection and warning subsystem. The sensor subsystem records the electrical activity of the heart from the chest area to produce electrocardiogram (ECG) trace and send that to the other portable decision-making subsystem where the symptoms of heart attack are detected. We evaluated the performance of dry electrodes and different electrode configurations and measured overall power consumption of the system. Linear classification and several machine algorithms were trained and tested for real-time application. It was observed that the linear classification algorithm was not able to detect heart attack in noisy data, whereas the support vector machine (SVM) algorithm with polynomial kernel with extended time-frequency features using extended modified B-distribution (EMBD) showed highest accuracy and was able to detect 97.4% and 96.3% of ST-elevation myocardial infarction (STEMI) and non-ST-elevation MI (NSTEMI), respectively. The proposed system can therefore help in reducing the loss of lives from the growing number of road accidents all over the world.

2.
Sensors (Basel) ; 19(12)2019 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-31226869

RESUMO

One of the major causes of death all over the world is heart disease or cardiac dysfunction. These diseases could be identified easily with the variations in the sound produced due to the heart activity. These sophisticated auscultations need important clinical experience and concentrated listening skills. Therefore, there is an unmet need for a portable system for the early detection of cardiac illnesses. This paper proposes a prototype model of a smart digital-stethoscope system to monitor patient's heart sounds and diagnose any abnormality in a real-time manner. This system consists of two subsystems that communicate wirelessly using Bluetooth low energy technology: A portable digital stethoscope subsystem, and a computer-based decision-making subsystem. The portable subsystem captures the heart sounds of the patient, filters and digitizes, and sends the captured heart sounds to a personal computer wirelessly to visualize the heart sounds and for further processing to make a decision if the heart sounds are normal or abnormal. Twenty-seven t-domain, f-domain, and Mel frequency cepstral coefficients (MFCC) features were used to train a public database to identify the best-performing algorithm for classifying abnormal and normal heart sound (HS). The hyper parameter optimization, along with and without a feature reduction method, was tested to improve accuracy. The cost-adjusted optimized ensemble algorithm can produce 97% and 88% accuracy of classifying abnormal and normal HS, respectively.

3.
Medicine (Baltimore) ; 98(18): e15419, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31045799

RESUMO

BACKGROUND: Respiratory viruses are the leading cause of early life wheezing that may contribute to the development of childhood asthma leading to increasing morbidity and socioeconomic burden. The aim of this review is to identify whether respiratory viral infections during first year of life were associated with development of childhood asthma. METHODS: We will search major scientific databases (MEDLINE, CINAHL, Web of Science, Cochrane Library, and ClinicalTrials.gov) using truncated and phrase-searched keywords and relevant subject headings. Observational studies including case-control studies, cohort studies, and randomized control trails published in English will be included in this review. Case reports, qualitative studies, and narrative overviews will be excluded. Exposure will be defined as laboratory-confirmed viral respiratory tract infection in the first year of life and outcome will be defined as development of asthma between ages 5 and 18 years. Effect sizes in bivariate and multivariate analyses will be presented as odds or prevalence ratios. We will explore for heterogeneity of the standard errors across the studies, and if appropriate, we will perform a meta-analysis using a random-effects model to present a summary estimate of the odds or prevalence ratios. RESULTS: This review will assess whether respiratory viral infections during first year of life increases the risk of childhood asthma development. CONCLUSIONS: This systematic review will evaluate published literature, assessing the link between early life viral infection and childhood asthma. Pooled data may provide evidence that infantile respiratory viral infection results in higher incidence of recurrent wheezing and asthma, thereby stimulating further research into the cost-effectiveness of pharmaceutical interventions such as vaccines and nonpharmaceutical interventions such as hand-washing and respiratory hygiene promotion to young children. Implementing the results of such research may then reduce the burden of acute viral respiratory infections and subsequent recurrent wheezing and asthma. SYSTEMATIC REVIEW REGISTRATION: This systematic review has been registered on PROSPERO (CRD42018105519).


Assuntos
Asma/epidemiologia , Infecções Respiratórias/epidemiologia , Viroses/epidemiologia , Adolescente , Antiasmáticos/administração & dosagem , Asma/tratamento farmacológico , Criança , Pré-Escolar , Humanos , Incidência , Prevalência , Projetos de Pesquisa , Infecções Respiratórias/virologia , Fatores de Risco
4.
COPD ; 16(1): 58-65, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31032662

RESUMO

The relationship of body mass index (BMI) with lung function and COPD has been previously described in several high-income settings. However, few studies have examined this relationship in resource-limited settings where being underweight is more common. We evaluated the association between BMI and lung function outcomes across 14 diverse low- and middle-income countries. We included data from 12,396 participants aged 35-95 years and used multivariable regressions to assess the relationship between BMI with either COPD and lung function while adjusting for known risk factors. An inflection point was observed at a BMI of 19.8 kg/m2. Participants with BMI < 19.8 kg/m2 had a 2.28 greater odds (95% CI 1.83-2.86) of having COPD and had a 0.21 (0.13-0.30) lower FEV1 and 0.34 (0.27-0.41) lower FEV1/FVC z-score compared to those with BMI ≥ 19.8 kg/m2. The association with lung function remained even after excluding participants with COPD. Individuals with lower BMI were more likely to have COPD and had lower lung function compared to those in higher BMI. The association with lung function remained positive even after excluding participants with COPD, suggesting that being underweight may also play a role in having worse lung function.

5.
Sensors (Basel) ; 19(7)2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30935150

RESUMO

There is an utmost requirement for technology to control a driver's phone while driving, which will prevent the driver from being distracted and thus saving the driver's and passenger's lives. Information from recent studies has shown that 70% of the young and aware drivers are used to texting while driving. There are many different technologies used to control mobile phones while driving, including electronic device control, global positioning system (GPS), on-board diagnostics (OBD)-II-based devices, mobile phone applications or apps, etc. These devices acquire the vehicle information such as the car speed and use the information to control the driver's phone such as preventing them from making or receiving calls at specific speed limits. The information from the devices is interfaced via Bluetooth and can later be used to control mobile phone applications. The main aim of this paper is to propose the design of a portable system for monitoring the use of a mobile phone while driving and for controlling a driver's mobile phone, if necessary, when the vehicle reaches a specific speed limit (>10 km/h). A paper-based self-reported questionnaire survey was carried out among 600 teenage drivers from different nationalities to see the driving behavior of young drivers in Qatar. Finally, a mobile application was developed to monitor the mobile usage of a driver and an OBD-II module-based portable system was designed to acquire data from the vehicle to identify drivers' behavior with respect to phone usage, sudden lane changes, and abrupt breaking/sharp speeding. This information was used in a mobile application to control the driver's mobile usage as well as to report the driving behavior while driving. The application of such a system can significantly improve drivers' behavior all over the world.


Assuntos
Condução de Veículo/estatística & dados numéricos , Comportamento , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Condução de Veículo/psicologia , Telefone Celular , Feminino , Sistemas de Informação Geográfica , Humanos , Masculino , Aplicativos Móveis , Projetos Piloto , Adulto Jovem
6.
JGH Open ; 2(2): 39-46, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30483562

RESUMO

Background and Aim: Non-alcoholic fatty liver disease (NAFLD) is a significant cause of hepatic dysfunction and liver-related mortality. As there is a lack of population-based prevalence data in a representative sample of general population, we aimed to estimate the prevalence and risk factors of NAFLD in Bangladesh. Methods: A cross-sectional study was conducted both in urban and rural areas of Bangladesh from December 2015 to January 2017. Data were collected using a pretested structured questionnaire followed by ultrasonography of hepatobiliary system for screening of NAFLD. Multivariate logistic regression was used to estimate the risk factors of NAFLD. Results: A total of 2782 (1694 men and 1088 women) participants were included in the study, with a mean age of 34.21 (±12.66) years. The overall prevalence of NAFLD was 33.86% (95% confidence interval [CI]: 32.12, 35.64). Females living in the rural areas and midlife adults (45-54 years) had the highest prevalence of NAFLD (P < 0.05). Multivariable logistic regression model demonstrated that increasing age, diabetes, elevated body mass index, and married individuals are significantly associated with NAFLD. Individuals with diabetes (adjusted odds ratio: 2.71, 95% CI: 1.85, 3.97) and hypertension were at a higher risk of having NAFLD. The odds of having NAFLD were 4.51 (95% CI: 3.47, 5.86) and 10.71 (95% CI: 7.80, 14.70) times higher among overweight and obese participants, respectively, as compared to normal-weight participants. Conclusions: About one-third of the population of Bangladesh is affected by NAFLD. Individuals with higher body mass index (overweight and obese), diabetics, midlife adults, married individuals, and rural women were more at risk of having NAFLD than others.

7.
Artigo em Inglês | MEDLINE | ID: mdl-30291842

RESUMO

BACKGROUND: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) represents the confluence of bronchial airway hyperreactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. OBJECTIVE: We aimed to describe the prevalence and risk factors for ACO among adults across 6 low- and middle-income countries (LMICs). METHODS: We compiled cross-sectional data for 11,923 participants aged 35 to 92 years from 4 population-based studies in 12 settings. We defined COPD as postbronchodilator FEV1/forced vital capacity ratio below the lower limit of normal, asthma as wheeze or medication use in 12 months or self-reported physician diagnosis, and ACO as having both. RESULTS: The prevalence of ACO was 3.8% (0% in rural Puno, Peru, to 7.8% in Matlab, Bangladesh). The odds of having ACO were higher with household exposure to biomass fuel smoke (odds ratio [OR], 1.48; 95% CI, 0.98-2.23), smoking tobacco (OR, 1.28 per 10 pack-years; 95% CI, 1.22-1.34), and having primary or less education (OR, 1.35; 95% CI, 1.07-1.70) as compared to nonobstructed nonasthma individuals. ACO was associated with severe obstruction (FEV1 %, <50; 31.6% of ACO vs 10.9% of COPD alone) and severe spirometric deficits compared with participants with asthma (-1.61 z scores FEV1; 95% CI, -1.48 to -1.75) or COPD alone (-0.94 z scores; 95% CI, -0.78 to -1.10). CONCLUSIONS: ACO may be as prevalent and more severe in LMICs than has been reported in high-income settings. Exposure to biomass fuel smoke may be an overlooked risk factor, and we favor diagnostic criteria for ACO that include environmental exposures common to LMICs.

8.
SAHARA J ; 15(1): 121-127, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30249174

RESUMO

Women in Bangladesh share a greater risk of Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) infection compared to men. Levels of knowledge and awareness largely contribute to the prevalence of the HIV epidemic and its consequences. So, it is required to conduct studies based on most recent data to explore the determinants of HIV awareness. Therefore, we aimed to find the awareness level and factors influencing HIV related awareness among the married women in Bangladesh. We used data from 2014 Bangladesh Demographic and Health Survey (BDHS). About two-third of total respondents who heard about the HIV/AIDS were selected and interviewed successfully (n = 12,593) about 11 basic questions related to individual's awareness. A score of the respondent's knowledge and awareness was determined based on these questions. We used logistic regression models for analysing the data. We found about 62% of the respondents had an adequate knowledge and consciousness about the HIV/AIDS. Respondents' education status, mass-media access, place of living, and working status played significant role on the awareness. As expected, respondents with higher education were more aware than those with no education (odds ratio (OR) = 3.56, 95% confidence interval (CI): 2.99-4.23). Moreover, respondents who had access to the mass media were more likely to be aware compared to those who did not have the access (OR = 1.14, 95% CI: 1.04-1.26). Although a sizeable proportion of women had an adequate knowledge and awareness regarding the HIV/AIDS, we recommend implementing educational programmes related to HIV/AIDS in the curriculum to ensure a standard level of awareness throughout the nation. Since the respondents from rural areas scored significantly lower than the urban areas, awareness through mass media, particularly in rural areas, is of prime concern for raising awareness.

9.
Addict Behav Rep ; 8: 1-7, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30062100

RESUMO

Background: Quit attempts are very essential in population-based smoking cessation. Little is known about the correlates of making a quit attempt of smoking in Bangladesh. We aimed to examine correlates of making a quit attempt of smoking among adults in Bangladesh. Methods: We used data from the 2009 Global Adult Tobacco Survey, Bangladesh. A total of 2217 adult current smokers (2141 males and 76 females) aged 15 years and older who participated in the survey were included. We compared socio-demographic, behavioral, motivational, knowledge and attitudes towards smoking, quitting methods utilized, use of social media to quit smoking, and environmental characteristics of current smokers who made an attempt to quit with those who made no quit attempt during the previous 12 months of the survey. We applied multivariable logistic regression models for analyzing the data. Results: Among the 2217 current smokers, 1058 (47.72%) made attempt to quit. We found respondents who smoked their first cigarette within 6 to 30 min of waking up were more likely to make an attempt to quit than those who smoked their first cigarette within 5 min of waking. Moreover, among daily current smokers who smoked 10-19 manufactured cigarettes per day were less likely to make a quit attempt. We also found intention to quit smoking, smoking rules inside the home, and exposure to anti-smoking advertisements as significant correlates of making a quit attempt of smoking among adults in Bangladesh. Conclusions: Policymakers should consider our findings when implementing tobacco control programs in Bangladesh.

10.
BMJ Open ; 8(7): e018468, 2018 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-30030307

RESUMO

OBJECTIVE: To determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014. DESIGN: We analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys. SETTING: Bangladesh. PARTICIPANTS: Women aged 15-49 years. PRIMARY OUTCOME: Overweight/obesity. RESULTS: A total of 58 192 women were included in the analysis. The prevalence of overweight and obesity among women of reproductive age increased significantly from 7.53% (95% CI 6.83 to 8.29) and 1.82% (95% CI 1.48 to 2.24) in 1999 to 28.37% (95% CI 27.49 to 29.28) and 10.77% (95% CI 10.22 to 11.35) in 2014, respectively. Age, education, wealth index, watching television and contraceptive use were associated with overweight and obesity in both urban and rural areas. CONCLUSIONS: Overweight and obesity prevalence increased significantly among Bangladeshi women of reproductive age between 1999 and 2014. Development of effective low-cost strategies to address the increasing burden of obesity should be a high priority.

11.
Prev Chronic Dis ; 15: E44, 2018 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-29679481

RESUMO

INTRODUCTION: Overweight and obesity are associated with increased rates of chronic disease and death globally. In Kenya, the prevalence of overweight and obesity among women is high and may be growing. This study aimed to determine the national prevalence and predictors of overweight and obesity among women in Kenya. METHODS: We used cross-sectional data from the 2014 Kenya Demographic and Health Survey (KDHS). Data on body mass index for 13,048 women (aged 15-49 y) were analyzed by using multivariable logistic regression models. Overweight and obesity were classified by using World Health Organization categories (normal weight, 18.5 to <24.9; overweight, 25.0 to <29.9; and obese, ≥30.0). RESULTS: The prevalence of overweight was 20.5%, and the prevalence of obesity, 9.1%. Women aged 35 to 44 (odds ratio [OR] = 3.14; 95% confidence interval [CI], 2.58-3.81), with more than a secondary education (OR = 1.43; 95% CI, 1.05-1.95), married or living with a partner (OR = 1.73; 95% CI, 1.42-2.08), not working (OR = 1.27; 95% CI, 1.10-1.48), in the richest category (OR = 6.50; 95% CI, 5.08-8.30), and who used hormonal contraception (OR = 1.24; 95% CI, 1.07-1.43) were significantly more likely to be overweight or obese. CONCLUSION: A high proportion of women in Kenya are overweight or obese. Our study indicates that women from urban areas and women with high socioeconomic status make up the largest proportion of women who are overweight or obese. Targeted and tailored studies and interventions are needed to identify evidence-based obesity prevention strategies for high-risk women in Kenya.

12.
Neuroimage ; 173: 188-198, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29486322

RESUMO

Motion artefacts (MAs) are induced within EEG data collected simultaneously with fMRI when the subject's head rotates relative to the magnetic field. The effects of these artefacts have generally been ameliorated by removing periods of data during which large artefact voltages appear in the EEG traces. However, even when combined with other standard post-processing methods, this strategy does not remove smaller MAs which can dominate the neuronal signals of interest. A number of methods are therefore being developed to characterise the MA by measuring reference signals and then using these in artefact correction. These methods generally assume that the head and EEG cap, plus any attached sensors, form a rigid body which can be characterised by a standard set of six motion parameters. Here we investigate the motion of the head/EEG cap system to provide a better understanding of MAs. We focus on the reference layer artefact subtraction (RLAS) approach, as this allows measurement of a separate reference signal for each electrode that is being used to measure brain activity. Through a series of experiments on phantoms and subjects, we find that movement of the EEG cap relative to the phantom and skin on the forehead is relatively small and that this non-rigid body movement does not appear to cause considerable discrepancy in artefacts between the scalp and reference signals. However, differences in the amplitude of these signals is observed which may be due to differences in geometry of the system from which the reference signals are measured compared with the brain signals. In addition, we find that there is non-rigid body movement of the skull and skin which produces an additional MA component for a head shake, which is not present for a head nod. This results in a large discrepancy in the amplitude and temporal profile of the MA measured on the scalp and reference layer, reducing the efficacy of MA correction based on the reference signals. Together our data suggest that the efficacy of the correction of MA using any reference-based system is likely to differ for different types of head movement with head shake being the hardest to correct. This provides new information to inform the development of hardware and post-processing methods for removing MAs from EEG data acquired simultaneously with fMRI data.

13.
Am J Respir Crit Care Med ; 197(5): 611-620, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29323928

RESUMO

RATIONALE: Forty percent of households worldwide burn biomass fuels for energy, which may be the most important contributor to household air pollution. OBJECTIVES: To examine the association between household air pollution exposure and chronic obstructive pulmonary disease (COPD) outcomes in 13 resource-poor settings. METHODS: We analyzed data from 12,396 adult participants living in 13 resource-poor, population-based settings. Household air pollution exposure was defined as using biomass materials as the primary fuel source in the home. We used multivariable regressions to assess the relationship between household air pollution exposure and COPD outcomes, evaluated for interactions, and conducted sensitivity analyses to test the robustness of our findings. MEASUREMENTS AND MAIN RESULTS: Average age was 54.9 years (44.2-59.6 yr across settings), 48.5% were women (38.3-54.5%), prevalence of household air pollution exposure was 38% (0.5-99.6%), and 8.8% (1.7-15.5%) had COPD. Participants with household air pollution exposure were 41% more likely to have COPD (adjusted odds ratio, 1.41; 95% confidence interval, 1.18-1.68) than those without the exposure, and 13.5% (6.4-20.6%) of COPD prevalence may be caused by household air pollution exposure, compared with 12.4% caused by cigarette smoking. The association between household air pollution exposure and COPD was stronger in women (1.70; 1.24-2.32) than in men (1.21; 0.92-1.58). CONCLUSIONS: Household air pollution exposure was associated with a higher prevalence of COPD, particularly among women, and it is likely a leading population-attributable risk factor for COPD in resource-poor settings.

14.
Artigo em Inglês | MEDLINE | ID: mdl-30864409

RESUMO

Introduction University students generally face a variety of challenges. During this period of life, they practice some unhealthy eating patterns and lifestyles. Therefore, we aimed to assess the health awareness status of university students from the northeast part of Bangladesh and to evaluate its associated factors. Methods We conducted a cross-sectional study using a stratified random sampling among public and private university students from the northeast region of Bangladesh and interviewed 1143 students. We used a self-reported questionnaire, including questions related to awareness status, lifestyle practice, dietary habit and socio-demographic factors. To assess students' health awareness status and its association with their lifestyle practices and socio-demographic factors, we used logistic regression models. Results The majority (61%) of the students were not aware of better health status and their dietary habits were not adequate. Smokers [odds ratio (OR): 0.66; 95% confidence interval (CI): 0.44, 0.99] were less likely to be aware of better health status. The participants who thought that they were leading a healthy lifestyle were less likely (OR: 0.71; CI: 0.56, 0.92) to be aware. Moreover, frequency of participating in sports and the psychological factors related to eating behaviors were significantly (p < 0.05) associated with health awareness status. Conclusion Our study findings may help to create a foundation for possible interventional programs on health awareness and nutritional education to improve the health awareness status and dietary behavior of university students. To prevent students from poor eating habits while feeling happy, effective programs (e.g. seminars, projects and media campaigns) should be held, which may include enhancing healthy and recommended amounts of food consumption.

15.
Prev Med Rep ; 8: 122-128, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29021949

RESUMO

Having 21.9 million adult smokers, Bangladesh ranks among the top ten heaviest smoking countries in the world. Correlates of unsuccessful smoking cessation remain unknown. We aimed to identify the correlates of unsuccessful smoking cessation among adults in Bangladesh. We used data from the 2009 Global Adult Tobacco Survey (GATS) for Bangladesh. We compared socio-demographic, belief about health effect of smoking, and environmental characteristics of current smokers who had a recent failed quit attempt during the past 12 months of the survey (unsuccessful quitters) with those former smokers who had quit ≥ 12 months earlier of the survey and had not relapsed (successful quitters). Data were analyzed using logistic regression model and generalized estimating equations. A total of 1552 smokers (1058 unsuccessful quitters and 494 successful quitters) aged 15 years and older who participated in the survey was included in this study. Among the smokers, 1058 (68%) were unsuccessful quitters. Our analysis showed that older aged, female, and higher educated smokers were less likely to quit unsuccessfully. Moreover, who believed that smoking causes serious illness were also less likely to quit unsuccessfully. For the interaction between place of residence and smoking rules inside home, we found that among the smoker's, in those house smoking was allowed, and who lived in urban place were less likely to be unsuccessful in quitting than those who lived in rural place. Our findings suggest a cessation program that requires integrated approach with a view to considering these findings in setting up.

16.
Environ Health Perspect ; 125(5): 057007, 2017 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-28599268

RESUMO

BACKGROUND: Millions of coastal inhabitants in Southeast Asia have been experiencing increasing sodium concentrations in their drinking-water sources, likely partially due to climate change. High (dietary) sodium intake has convincingly been proven to increase risk of hypertension; it remains unknown, however, whether consumption of sodium in drinking water could have similar effects on health. OBJECTIVES: We present the results of a cohort study in which we assessed the effects of drinking-water sodium (DWS) on blood pressure (BP) in coastal populations in Bangladesh. METHODS: DWS, BP, and information on personal, lifestyle, and environmental factors were collected from 581 participants. We used generalized linear latent and mixed methods to model the effects of DWS on BP and assessed the associations between changes in DWS and BP when participants experienced changing sodium levels in water, switched from "conventional" ponds or tube wells to alternatives [managed aquifer recharge (MAR) and rainwater harvesting] that aimed to reduce sodium levels, or experienced a combination of these changes. RESULTS: DWS concentrations were highly associated with BP after adjustments for confounding factors. Furthermore, for each 100 mg/L reduction in sodium in drinking water, systolic/diastolic BP was lower on average by 0.95/0.57 mmHg, and odds of hypertension were lower by 14%. However, MAR did not consistently lower sodium levels. CONCLUSIONS: DWS is an important source of daily sodium intake in salinity-affected areas and is a risk factor for hypertension. Considering the likely increasing trend in coastal salinity, prompt action is required. Because MAR showed variable effects, alternative technologies for providing reliable, safe, low-sodium fresh water should be developed alongside improvements in MAR and evaluated in "real-life" salinity-affected settings. https://doi.org/10.1289/EHP659.


Assuntos
Pressão Sanguínea/efeitos dos fármacos , Água Potável/química , Hipertensão/epidemiologia , Salinidade , Sódio/análise , Abastecimento de Água , Adulto , Bangladesh/epidemiologia , Mudança Climática , Estudos de Coortes , Feminino , Água Subterrânea/química , Humanos , Pessoa de Meia-Idade
17.
BMC Health Serv Res ; 17(1): 47, 2017 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-28100208

RESUMO

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of global mortality. Among the CVDs, acute vascular events (AVE) mainly ischemic heart diseases and stroke are the largest contributors. To achieve 25% reduction in preventable deaths from CVDs by 2025, health systems need to be equipped with extended service coverage in order to provide person-centered care. The overall goal of this proposed study is to assess access to health care in-terms of service availability, care seeking patterns and barriers to access care after AVE in rural Bangladesh. We will consider myocardial infarction (MI) and stroke as acute vascular events. METHODS/DESIGN: We will conduct a mixed methods study in rural Matlab, Bangladesh. This study will comprise of a) health facility survey, b) structured questionnaire interview and c) qualitative study. We will assess service availabilities by creating an inventory of public and private health facilities. Readiness of the facilities to deliver services for AVE will be assessed through a health facility survey using 'service availability and readiness assessment' (SARA) tools of the World Health Organization (WHO). We will interview survivors of AVE and caregivers (present and accompanied the person during the event) of person who died from AVE for exploring patterns of care seeking during an AVE. For exploring barriers to access care for AVE, we will conduct in-depth interview with survivors of AVE and caregivers of the person who died from AVE. We will also conduct key informant interviews with the service providers at primary health care (PHC) facilities and government high level officials at central health administration of Bangladesh. DISCUSSION: This study will provide a comprehensive picture of access to primary health care services during acute cardiovascular events as stroke & MI in rural context of Bangladesh. It will explore available service facilities in rural area for management, utilization of services and barriers to access care during an acute emergency. This study will help to generate hypothesis, develop programs and policies for better access to care for AVE in similar rural settings considering barriers of access and improving utilization.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Acesso aos Serviços de Saúde , Áreas de Pobreza , Atenção Primária à Saúde , População Rural , Doença Aguda , Bangladesh , Cuidadores , Feminino , Pesquisas sobre Serviços de Saúde , Instalações de Saúde , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Sobreviventes/psicologia
18.
J Public Health Manag Pract ; 23(1): 54-58, 2017 Jan/Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27798529

RESUMO

Disaster shelter assessments are environmental health assessments conducted during disaster situations to evaluate the living environment of shelters for hygiene, sanitation, and safety conditions. We conducted a secondary data analysis of shelter assessment records available (n = 108) on ice storms, floods, and tornado events from 1 state jurisdiction. Descriptive statistics were used to analyze results of environmental health deficiencies found in the facilities. The greater numbers of environmental health deficiencies were associated with sanitation (26%), facility physical issues (19%), and food areas (17%). Most deficiencies were reported following ice storms, tornadoes, and flood events. This report describes the first analysis of environmental health deficiencies found in disaster shelters across a spectrum of disaster events. Although the number of records analyzed for this project was small and results may not be generalizable, this new insight into the living environment in shelter facilities offers the first analysis of deficiencies of the shelter operation and living environment that have great potential to affect the safety and health of shelter occupants.


Assuntos
Tempestades Ciclônicas , Planejamento em Desastres/normas , Desastres , Abrigo de Emergência/normas , Inundações , Gestão da Segurança/normas , Tornados , Humanos , Estados Unidos
19.
Int J Chron Obstruct Pulmon Dis ; 11: 2497-2507, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27785006

RESUMO

BACKGROUND: Socioeconomic status (SES) is a strong social determinant of health. There remains a limited understanding of the association between SES and COPD prevalence among low- and middle-income countries where the majority of COPD-related morbidity and mortality occurs. We examined the association between SES and COPD prevalence using data collected in Argentina, Bangladesh, Chile, Peru, and Uruguay. METHODS: We compiled lung function, demographic, and SES data from three population-based studies for 11,042 participants aged 35-95 years. We used multivariable alternating logistic regressions to study the association between COPD prevalence and SES indicators adjusted for age, sex, self-reported daily smoking, and biomass fuel smoke exposure. Principal component analysis was performed on monthly household income, household size, and education to create a composite SES index. RESULTS: Overall COPD prevalence was 9.2%, ranging from 1.7% to 15.4% across sites. The adjusted odds ratio of having COPD was lower for people who completed secondary school (odds ratio [OR] =0.73, 95% CI 0.55-0.98) and lower with higher monthly household income (OR =0.96 per category, 95% CI 0.93-0.99). When combining SES factors into a composite index, we found that the odds of having COPD was greater with lower SES (interquartile OR =1.23, 95% CI 1.05-1.43) even after controlling for subject-specific factors and environmental exposures. CONCLUSION: In this analysis of multiple population-based studies, lower education, lower household income, and lower composite SES index were associated with COPD. Since household income may be underestimated in population studies, adding household size and education into a composite index may provide a better surrogate for SES.


Assuntos
Países em Desenvolvimento , Disparidades nos Níveis de Saúde , Pobreza , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores Socioeconômicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Bangladesh/epidemiologia , Países em Desenvolvimento/economia , Escolaridade , Características da Família , Feminino , Humanos , Renda , Modelos Lineares , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Pobreza/economia , Prevalência , Análise de Componente Principal , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/economia , Fatores de Risco , América do Sul/epidemiologia
20.
BMC Public Health ; 16: 592, 2016 07 18.
Artigo em Inglês | MEDLINE | ID: mdl-27430897

RESUMO

BACKGROUND: The state of maternal healthcare (MHC) in Bangladesh is a grave concern especially in the remote haor areas. In this study, we aimed to determine the factors affecting the utilization of MHC services in the haor areas, to discover mothers' knowledge of MHC, and explore their attitudes toward MHC as well as practices in seeking MHC services. METHOD: In this cross-sectional survey (n = 400), we randomly selected mothers (aged 15-49 years) from haor areas of the Habiganj district of Bangladesh. The study participants' socio demographic information as well as the extent of their knowledge about MHC, their attitudes, and practices in seeking MHC services were ascertained. The degree of association between the respondents' socio-demographic characteristics and their health-seeking behavior (before, during, and after childbirth) was assessed by the odds ratio (OR) with 95 % confidence intervals (CI) estimated from the bivariate and multivariable logistic regression analyses. RESULTS: The mean age of the study participants was 27.26 years. Respondents had an average of 2.64 children, and 88.6 % had at best a primary education or less. Among the study participants, 61 % of mothers had no knowledge about the availability of MHC in the study area, and only 36 % received any antenatal care (ANC). Also, 47 % sought ANC from government healthcare institutions. Irrespective of complications and potential danger signs, 95 % of births were delivered at home with the assistance of untrained birth attendants. Only 19.75 % of mothers and 12.3 % of infants received postnatal care (PNC). Moreover, mothers who had a secondary or tertiary education level had a higher likelihood of receiving ANC (OR: 3.48, 95 % C.I: 1.49-7.63) compared to mothers with no education. Also, mothers aged 25 years or older were less likely (OR: 0.24, 95 % C.I: 0.06-0.095) to give birth in a health facility than mothers who were younger than 25. The low utilization of MHC services can be attributed to many factors such as a lack of communication, a lack of knowledge about MHC services, low income, decision making, and the lack of a companion with whom to visit health services. CONCLUSION: To improve MHC utilization, to reach national targets and to save the lives of mothers and newborns, boat or ship-based special healthcare and educational programs should be implemented in the haor areas.


Assuntos
Atitude Frente a Saúde , Parto Obstétrico/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Cuidado Pós-Natal/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Bangladesh , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Pobreza , Gravidez , Áreas Alagadas , Adulto Jovem
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