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1.
Wiad Lek ; 74(9 cz 1): 2207-2212, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34725302

RESUMO

The article examines the legal and regulatory basis for ambient air protection as an essential element of the environment that affects biological security the health and livelihoods of the population. Proper legal regulation of ambient air protection is important in the implementation of various measures aimed at preserving its quality and, accordingly, preventing possible adverse effects on human health. Ambient air protection is a certain activity directed at reducing the number of pollutants that get into the air by one means or another. In the process of environmental protection in general and ambient air protection in particular, the legal basis and case law are important components that aimed to minimize the occurrence of potential hazards that could threaten the health and lives of the population, and in case of such situations, identify the causes of their occurrence and respond to them proportionally.


Assuntos
Poluentes Atmosféricos , Saúde Pública , Poluentes Atmosféricos/efeitos adversos , Causalidade , Humanos
3.
Artigo em Inglês | MEDLINE | ID: mdl-34769714

RESUMO

Beliefs about cause and effect, including health beliefs, are thought to be related to the frequency of the target outcome (e.g., health recovery) occurring when the putative cause is present and when it is absent (treatment administered vs. no treatment); this is known as contingency learning. However, it is unclear whether unvalidated health beliefs, where there is no evidence of cause-effect contingency, are also influenced by the subjective perception of a meaningful contingency between events. In a survey, respondents were asked to judge a range of health beliefs and estimate the probability of the target outcome occurring with and without the putative cause present. Overall, we found evidence that causal beliefs are related to perceived cause-effect contingency. Interestingly, beliefs that were not predicted by perceived contingency were meaningfully related to scores on the paranormal belief scale. These findings suggest heterogeneity in pseudoscientific health beliefs and the need to tailor intervention strategies according to underlying causes.


Assuntos
Inquéritos e Questionários , Causalidade , Probabilidade
4.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(11): 1364-1370, 2021 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-34749483

RESUMO

The adverse health effects of air pollution remains a daunting public health problem globally. The research of the health effects of air pollution provides important evidence for ambient air quality standard establishments and air pollution interventions. In recent years, causal inference has been gradually introduced into the observational study of environmental epidemiology, which provides more statistical method options for the study of causal relationships between air pollution and population health effects. Controlling confounders in observational studies is a major challenge for causal inference. This study introduces the causal inference methods for the identification and control of confounding factors currently used in the study of air pollution and population health effects, in order to provide methodological reference and basis for the causal inference study of air pollution and population health effects in China.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Causalidade , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Saúde Ambiental , Humanos , Material Particulado
5.
Pulm Med ; 2021: 4712406, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34765263

RESUMO

Periodontal diseases are a range of polymicrobial infectious disorders, such as gingivitis and periodontitis, which affect tooth-supporting tissues and are linked to playing a role in the exacerbation of several pulmonary diseases. Pulmonary diseases, such as pneumonia, chronic obstructive pulmonary disease (COPD), asthma, tuberculosis, COVID-19, and bronchiectasis, significantly contribute to poor quality of life and mortality. The association between periodontal disease and pulmonary outcomes is an important topic and requires further attention. Numerous resident microorganisms coexist in the oral cavity and lungs. However, changes in the normal microflora due to oral disease, old age, lifestyle habits, or dental intervention may contribute to altered aspiration of oral periodontopathic bacteria into the lungs and changing inflammatory responses. Equally, periodontal diseases are associated with the longitudinal decline in spirometry lung volume. Several studies suggest a possible beneficial effect of periodontal therapy in improving lung function with a decreased frequency of exacerbations and reduced risk of adverse respiratory events and morbidity. Here, we review the current literature outlining the link between the oral cavity and pulmonary outcomes and focus on the microflora of the oral cavity, environmental and genetic factors, and preexisting conditions that can impact oral and pulmonary outcomes.


Assuntos
Microbiota , Boca/microbiologia , Doenças Periodontais/complicações , Doença Pulmonar Obstrutiva Crônica/complicações , Causalidade , Meio Ambiente , Humanos
6.
MMW Fortschr Med ; 163(20): 10, 2021 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-34767198
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(9): 1168-1172, 2021 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-34619939

RESUMO

Regression discontinuity design (RDD) is a rigorous quasi-experimental method. Based on the randomness of the distribution of samples around the critical value, the data on both sides are used for regression respectively, so as to avoid the interference of potential confounding factors and provide strong evidence for the inference of causal correlation. This study introduces the RDD and its research progress, and expounds its application in detail combined with cases, in order to provide reference for the application of RDD in epidemiological research.


Assuntos
Projetos de Pesquisa , Causalidade , Estudos Epidemiológicos , Humanos , Análise de Regressão
10.
Zhonghua Yan Ke Za Zhi ; 57(10): 791-795, 2021 Oct 11.
Artigo em Chinês | MEDLINE | ID: mdl-34619952

RESUMO

In recent years, the application of Mendelian randomization has become more and more widely in the world. By taking genes as instrumental variables, it can eliminate the interference of confounding factors and reverse causality in the system, and effectively judge the causal correlation between exposure factors and outcomes, which has a unique advantage for etiological exploration in the medical field. This article reviews the application of Mendelian randomization in ophthalmology and provides new ideas for the development of correlational and causal studies in Ophthalmology. (Chin J Ophthalmol, 2021, 57: 791-795).


Assuntos
Análise da Randomização Mendeliana , Oftalmologia , Causalidade , Humanos
12.
Cad Saude Publica ; 37(9): e00224920, 2021.
Artigo em Português | MEDLINE | ID: mdl-34669774

RESUMO

Mortality in prisons, a basic indicator of the right to health for incarcerated persons, has never been studied extensively in Brazil. An assessment of all-cause and cause-specific mortality in prison inmates was conducted in 2016-2017 in the state of Rio de Janeiro, based on data from the Mortality Information System and Prison Administration. Mortality rates were compared between prison population and general population after standardization. The leading causes of death in inmates were infectious diseases (30%), cardiovascular diseases (22%), and external causes (12%). Infectious causes featured HIV/AIDS (43%) and TB (52%, considering all deaths with mention of TB). Only 0.7% of inmates who died had access to extramural health services. All-cause mortality rate was higher among prison inmates than in the state's general population. Among inmates, mortality from infectious diseases was 5 times higher, from TB 15 times higher, and from endocrine diseases (especially diabetes) and cardiovascular diseases 1.5 and 1.3 times higher, respectively, while deaths from external causes were less frequent in prison inmates. The study revealed important potentially avoidable excess deaths in prisons, reflecting lack of care and exclusion of this population from the Brazilian Unified National Health System. This further highlights the need for a precise and sustainable real-time monitoring system for deaths, in addition to restructuring of the prison staff through implementation of the Brazilian National Policy for Comprehensive Healthcare for Persons Deprived of Freedom in the Prison System in order for inmates to fully access their constitutional right to health with the same quality and timeliness as the general population.


Assuntos
Doenças Cardiovasculares , Prisioneiros , Brasil/epidemiologia , Causalidade , Humanos , Prisões
13.
Artigo em Inglês | MEDLINE | ID: mdl-34639426

RESUMO

As the urbanization and industrialization of China's urban agglomerations reach increasingly high levels, residents are voicing a growing demand for improved green public sport and recreational space. The coordination of ecological land restoration (ELR) and recreational use at the regional level is therefore urgent. This study demonstrates the spatiotemporal evolution of coupled ELR and the recreational use of ecological land (RUoEL) in the Pearl River Delta urban agglomeration based on spatial interpretation, remote sensing mapping, and spatial statistical analysis. A geographical and temporally weighted regression is used to test the spatial effects of the RUoEL on the evolution of the ELR patterns. The results show that the RUoEL (mainly greenways and ecological recreational spaces) and ELR exert a certain degree of coupled spatial characteristics, and that the former significantly impacts the latter. These spatial differences are more notable in areas with high-level ecological recreational spaces, or which are located near densely populated built-up areas. Recreation-oriented ELR is therefore relatively easy to develop in these areas. The results provide important guidelines for the development of ecosystem service patterns in urban agglomerations that include the coexistence of ELR and recreational use, which will strengthen the academic support for regional ELR planning and improve public health.


Assuntos
Ecossistema , Rios , Causalidade , China , Cidades , Conservação dos Recursos Naturais , Geografia , Urbanização
15.
BMJ ; 375: n2305, 2021 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-34666981

RESUMO

OBJECTIVE: To examine the risk of urogenital, colorectal, and neurological cancers after a first diagnosis of acute urinary retention. DESIGN: Nationwide population based cohort study. SETTING: All hospitals in Denmark. PARTICIPANTS: 75 983 patients aged 50 years or older with a first hospital admission for acute urinary retention during 1995-2017. MAIN OUTCOME MEASURES: Absolute risk of urogenital, colorectal, and neurological cancer and excess risk of these cancers among patients with acute urinary retention compared with the general population. RESULTS: The absolute risk of prostate cancer after a first diagnosis of acute urinary retention was 5.1% (n=3198) at three months, 6.7% (n=4233) at one year, and 8.5% (n=5217) at five years. Within three months of follow-up, 218 excess cases of prostate cancer per 1000 person years were detected. An additional 21 excess cases per 1000 person years were detected during three to less than 12 months of follow-up, but beyond 12 months the excess risk was negligible. Within three months of follow-up the excess risk for urinary tract cancer was 56 per 1000 person years, for genital cancer in women was 24 per 1000 person years, for colorectal cancer was 12 per 1000 person years, and for neurological cancer was 2 per 1000 person years. For most of the studied cancers, the excess risk was confined to within three months of follow-up, but the risk of prostate and urinary tract cancer remained increased during three to less than 12 months of follow-up. In women, an excess risk of invasive bladder cancer persisted for several years. CONCLUSIONS: Acute urinary retention might be a clinical marker for occult urogenital, colorectal, and neurological cancers. Occult cancer should possibly be considered in patients aged 50 years or older presenting with acute urinary retention and no obvious underlying cause.


Assuntos
Neoplasias Colorretais , Neoplasias do Sistema Nervoso , Medição de Risco , Retenção Urinária , Neoplasias Urogenitais , Assistência ao Convalescente/estatística & dados numéricos , Idoso , Causalidade , Estudos de Coortes , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/patologia , Dinamarca/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Neoplasias do Sistema Nervoso/epidemiologia , Neoplasias do Sistema Nervoso/patologia , Neoplasias da Próstata/epidemiologia , Sistema de Registros/estatística & dados numéricos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Retenção Urinária/diagnóstico , Retenção Urinária/epidemiologia , Neoplasias Urogenitais/epidemiologia , Neoplasias Urogenitais/patologia
16.
BMC Med Res Methodol ; 21(1): 226, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34689754

RESUMO

BACKGROUND: Mediation analysis methodology underwent many advancements throughout the years, with the most recent and important advancement being the development of causal mediation analysis based on the counterfactual framework. However, a previous review showed that for experimental studies the uptake of causal mediation analysis remains low. The aim of this paper is to review the methodological characteristics of mediation analyses performed in observational epidemiologic studies published between 2015 and 2019 and to provide recommendations for the application of mediation analysis in future studies. METHODS: We searched the MEDLINE and EMBASE databases for observational epidemiologic studies published between 2015 and 2019 in which mediation analysis was applied as one of the primary analysis methods. Information was extracted on the characteristics of the mediation model and the applied mediation analysis method. RESULTS: We included 174 studies, most of which applied traditional mediation analysis methods (n = 123, 70.7%). Causal mediation analysis was not often used to analyze more complicated mediation models, such as multiple mediator models. Most studies adjusted their analyses for measured confounders, but did not perform sensitivity analyses for unmeasured confounders and did not assess the presence of an exposure-mediator interaction. CONCLUSIONS: To ensure a causal interpretation of the effect estimates in the mediation model, we recommend that researchers use causal mediation analysis and assess the plausibility of the causal assumptions. The uptake of causal mediation analysis can be enhanced through tutorial papers that demonstrate the application of causal mediation analysis, and through the development of software packages that facilitate the causal mediation analysis of relatively complicated mediation models.


Assuntos
Análise de Mediação , Projetos de Pesquisa , Causalidade , Estudos Epidemiológicos , Humanos , Modelos Estatísticos , Estudos Observacionais como Assunto
18.
BMJ Open ; 11(10): e052737, 2021 10 04.
Artigo em Inglês | MEDLINE | ID: mdl-34607871

RESUMO

OBJECTIVES: To analyse and present the occurrence and severity of spontaneous adverse drug reaction (ADR) reports prospectively registered at an ADR monitoring centre (AMC) in Central India. SETTING AND DATA: The survey was conducted between 2013 and 2019 at an ADR Monitoring Centre in Central India. ADRs were recorded using the standard 'Suspected ADR Reporting form'. OUTCOME MEASURES: The causality of the ADRs were categorised using the WHO causality assessment scale to assess the relationship between a drug and the occurrence of an ADR. RESULTS: Totally 1980 spontaneous ADRs were reported involving 960 patients and 1316 drugs prescriptions. The occurrence of ADRs was common among male patients (64%) and patients of age between 19 and 65 years (81%). Antimicrobials caused 29% ADRs, followed by drugs of antiretroviral therapy (19%). Zidovudine caused most ADRs (88%) followed by ethambutol and ciprofloxacin. The ADRs of skin and subcutaneous tissue disorders (28%) were most common among all system organ classes followed by gastrointestinal systems (18%). Four per cent of all reported ADRs were severe. A peak of ADR reports was attained in 2016 with 224 reports, which decreased to 127 in 2019. CONCLUSION: A high number of ADRs caused by antimicrobials is an alarming situation, which adds up to antimicrobial resistance. Judicious use of antimicrobials is yet again proven as need of the hour. Under-reporting of ADRs is evident in our study and is a major factor for the delay in the withdrawal of drugs responsible for causing ADRs. Interventions in terms of training and feedback are suggested to encourage and improve ADR reporting.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Adulto , Idoso , Causalidade , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
19.
Artigo em Alemão | MEDLINE | ID: mdl-34596700

RESUMO

BACKGROUND: Years of life lost (YLL) is a meaningful indicator of the relevance of causes of death, although it is rarely used in Germany. Numerous methods have been developed to calculate YLL. OBJECTIVE: Prototypical methods for calculating YLL are presented and critically appraised. An improved method is proposed that is based on cause-elimination life tables (CELTs). METHODS: The different methods are applied to deaths in Germany in 2018. Changes in comparison to 1998 are presented using the modified method. RESULTS: While in 2018 cardiovascular diseases were the leading cause of death by number of cases, cancer was responsible for most YLL. Different methods of calculating YLL lead to divergent ranks for less frequent causes of death. YLL on the basis of general life tables underestimate CELT-based YLL by up to 18.4% (cardiovascular diseases). Measured by CELT-based YLL, cardiovascular diseases were the most important cause of death in 1998. CONCLUSION: The calculation of YLL on the basis of CELTs avoids inconsistencies of established methods and leads to relevantly different results. Characteristics of the proposed method (violation of the egalitarian principle, lack of additivity) do not affect its usefulness as a tool for health planning.


Assuntos
Expectativa de Vida , Neoplasias , Causalidade , Causas de Morte , Alemanha , Humanos , Mortalidade
20.
BMC Musculoskelet Disord ; 22(1): 852, 2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610805

RESUMO

BACKGROUND: Post-arthroscopic osteonecrosis of the knee (PAONK) is a rare condition. No studies have analyzed the relationship between the meniscus extrusion and PAONK. The purpose of this retrospective study is to test a hypothesis that the degree of the medial meniscus (MM) extrusion might be significantly greater in the knees with PAONK than in the matched control knees both before and after the meniscectomy. METHODS: Ten knees with PAONK were detected out of a total of 876 knees which had undergone arthroscopic partial meniscectomy of the MM. Ten matched control knees were randomly selected out of the remaining 866 knees without PAONK. The clinical data of these 20 patients were retrospectively collected from the medical records. To evaluate the location of the menisci on the joint line, Extrusion width and Inner width were defined on a coronal section of magnetic resonance imaging (MRI). The intra- and inter-rater reliability was evaluated by calculating the intra- and inter-class coefficients. Statistical comparisons between the 2 groups were made using the 3 non-parametric tests. RESULTS: Before the meniscectomy, the Extrusion width of the MM (mean 4.7 ± 1.4 mm) was significantly greater than that (3.0 ± 1.3 mm) in the Control group (P = 0.0195). In the MRI taken in a range from 3 to 50 weeks after the meniscectomy, the Extrusion width of the MM (5.9 ± 1.1 mm) in the PAONK group was significantly greater than that (3.4 ± 1.4 mm) in the Control group (P = 0.0009), and the Inner width of the MM (0.6 ± 1.7 mm) in the PAONK group was significantly less than that (3.9 ± 1.0 mm) in the Control group (P = 0.0001). CONCLUSION: A significant relationship was found between the degree of the MM extrusion and the onset of PAONK. This study suggested that the extrusion of the MM is a potential predisposing factor for PAONK.


Assuntos
Osteonecrose , Lesões do Menisco Tibial , Artroscopia , Causalidade , Humanos , Meniscos Tibiais/diagnóstico por imagem , Meniscos Tibiais/cirurgia , Osteonecrose/diagnóstico por imagem , Osteonecrose/epidemiologia , Osteonecrose/etiologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Lesões do Menisco Tibial/diagnóstico por imagem , Lesões do Menisco Tibial/cirurgia
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