| 1. |
- Damlin, A., et al.
(författare)
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Associations between echocardiographic manifestations and bacterial species in patients with infective endocarditis: a cohort study
- 2019
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Ingår i: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: The diagnosis of infective endocarditis (IE) is based on microbiological analyses and diagnostic imaging of cardiac manifestations. Echocardiography (ECHO) is preferred for visualization of IE-induced cardiac manifestations. We investigated associations between bacterial infections and IE manifestations diagnosed by ECHO. Methods: In this cohort study, data from patients aged 18 years or above, with definite IE admitted at the Karolinska University Hospital between 2008 and 2017 were obtained from Swedish National Registry of Endocarditis. Bacteria registered as pathogen were primarily selected from positive blood culture and for patients with negative blood culture, bacteria found in culture or PCR from postoperative material was registered as pathogen. Patients with negative results from culture or PCR, and patients who did not undergo ECHO during hospital stay, were excluded. IE manifestations diagnosed by ECHO were obtained from the registry. Chi-squared test and two-sided Fisher's exact test was used for comparisons between categorical variables, and student's t test was used for continuous numerical variables. Multivariable analyses were performed using logistic regression. Secular trend analyses were performed using linear regression. Associations and the strength between the variables were estimated using odds ratios (ORs) with 95% confidence intervals (CIs). P < 0.05 was considered significant. Results: The most common bacteria were Staphylococcus aureus (n = 239, 49%) and viridans group streptococci (n = 102, 21%). The most common manifestations were vegetation in the mitral (n = 195, 40%), aortic (n = 190, 39%), and tricuspid valves (n = 108, 22%). Associations were seen between aortic valve vegetations and Enterococcus faecalis among patients with native aortic valves, between mitral valve vegetations and streptococci of group B or viridans group, between tricuspid valve vegetations and S. aureus among patients with intravenous drug abuse, and between perivalvular abscesses as well as cardiovascular implantable electronic device (CIED)-associated IE and coagulase negative staphylococci (all P < 0.05). Conclusions: Associations were found between certain bacterial species and specific ECHO manifestations. Our study contributes to a better understanding of IE manifestations and their underlying bacterial etiology, which pathogens can cause severe infections and might require close follow-up and surgical treatment.
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| 2. |
- Kalyanasundaram, M., et al.
(författare)
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Effects of improved information and volunteer support on segregation of solid waste at the household level in urban settings in Madhya Pradesh, India (I-MISS) : protocol of a cluster randomized controlled trial
- 2021
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Segregation of household waste at the source is an effective and sustainable strategy for management of municipal waste. However, household segregation levels remain insufficient as waste management approaches are mostly top down and lack local support. The realisation and recognition of effective, improved and adequate waste management may be one of the vital drivers for attaining environmental protection and improved health and well-being. The presence of a local level motivator may promote household waste segregation and ultimately pro-environmental behaviour. The present cluster randomized control trial aims to understand if volunteer based information on waste segregation (I-MISS) can effectively promote increased waste segregation practices at the household level when compared with existing routine waste segregation information in an urban Indian setting.Methods: This paper describes the protocol of an 18 month two-group parallel,cluster randomised controlled trialin the urban setting of Ujjain, Madhya Pradesh, India. Randomization will be conducted at ward level, which is the last administrative unit of the municipality. The study will recruit 425 households in intervention and control groups. Assessments will be performed at baseline (0 months), midline (6 months), end line (12 months) and post intervention (18 months). The primary outcome will be the comparison of change in proportion of households practicing waste segregation and change in proportion of mis-sorted waste across the study period between the intervention and control groups as assessed by pick analysis. Intention to treat analysis will be conducted. Written informed consent will be obtained from all participants.Discussion: The present study is designed to study whether an external motivator, a volunteer selected from the participating community and empowered with adequate training, could disseminate waste segregation information to their community, thus promoting household waste segregation and ultimately pro-environmental behaviour. The study envisages that the volunteers could link waste management service providers and the community, give a local perspective to waste management, and help to change community habits through information, constant communication and feedback.Trial registration: The study is registered prospectively with Indian Council of Medical Research- Clinical Trial Registry of India (CTRI/2020/03/024278).
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| 3. |
- Lundborg, C. S., et al.
(författare)
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Pharmacoepidemiology at Nordic School of Public Health NHV: Examples from 1999 to 2014
- 2015
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 43:16 Suppl, s. 73-80
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pharmacoepidemiology is a branch of public health and had a place at the Nordic School of Public Health. Courses, Master's theses and Doctorates of Public Health (DrPH) in Pharmacoepidemiology were a relatively minor, but still important part of the school's activities. Methods: This paper gives a short background, followed by some snapshots of the activities at NHV, and then some illustrative case-studies. These case-studies list their own responsible co-authors and have separate reference lists. Results: In the Nordic context, NHV was a unique provider of training and research in pharmacoepidemiology, with single courses to complete DrPH training, as well as implementation of externally-funded research projects. Conclusions: With the closure of NHV at the end of 2014, it is unclear if such a comprehensive approach towards pharmacoepidemiology will be found elsewhere in the Nordic countries.
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| 4. |
- Rana, A. K. M. M., et al.
(författare)
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Health education improves both arthritis-related illness and self-rated health : An intervention study among older people in rural Bangladesh
- 2010
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Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 124:12, s. 705-712
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To examine changes in self-reported arthritis-related illness and self-rated health as a result of a health education intervention, and the association between self-reported arthritis-related illness and self-rated health. Study design: A quasi-experimental study was conducted in eight randomly selected villages in rural Bangladesh (intervention = 4; control = 4). Methods: The intervention consisted of home-based physical activities, health advice and aspects of healthcare management over 15 months followed by a 3-month latent period. Data were collected before the intervention and after the latent period. Analyses included 839 participants (>= 60 years of age) who participated in both surveys. Participants in the intervention area were further categorized into two groups who self-reported compliance or non-compliance with recommended health advice. Self-rated health was assessed using a single global question. Self-reported arthritis-related illness was indicated by the presence of arthritis, back and joint pain, biting sensation, swelling and inflammation in the joints. Results: Hierarchical logistic regression analyses revealed that positive effects on episodes of arthritis-related illness [ odds ratio (OR) 1.9, 95% confidence interval (CI) 1.3-2.8] and self-rated health (OR 1.4, 95% CI 1.0-1.9) were more likely among the compliant group compared with the control group. Furthermore, positive self-rated health was more likely among participants reporting a positive change in their arthritis-related illness (OR 2.2, 95% CI 1.5-3.2). The results also showed that literate and non-poor participants were more likely to report positive health, and participants with advancing age were less likely to report positive health. Conclusion: Community-based health education is effective in reducing the burden of arthritis-related illness and in enhancing general health in old age.
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| 5. |
- Rana, A.K.M. Masud, et al.
(författare)
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The impact of health education in managing self-reported arthritis-related illness among elderly persons in rural Bangladesh
- 2008
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Ingår i: Health Education Research. - Oxford : Oxford University Press. - 0268-1153 .- 1465-3648. ; 23:1, s. 94-105
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Tidskriftsartikel (refereegranskat)abstract
- This study examines the impact of health education on prevalenceof and expenditure on treatment of self-reported arthritis-relatedillness among elderly persons in rural Bangladesh. An interventionstudy was conducted, including 1135 elderly persons (60 years)from eight randomly selected villages, four each of an interventionand a control area. The analyses include 839 elderly personswho participated in both pre- and post-intervention surveys(intervention area: n = 425, control area: n = 414). Participantsof the intervention area were further categorized as compliant(n = 315) and non-compliant (n = 110) based on adherence tothe intervention instructions. The intervention that lastedfor 15 months comprised home-based physical exercise, dietaryinstructions and other aspects of management. Results show thatalthough there was no significant difference in self-reportedarthritis-related illness between the compliant and non-compliantgroups at baseline, it was significantly lower in the compliantgroup (71%) at post-intervention compared with the non-compliant(81%). Related monthly expenditure on treatment was significantlyreduced in the compliant group (from Taka 104 to Taka 52) butnot in the other two groups. Logistic regressions further showedthat the control group had a higher probability of increasedtreatment-related expenditure compared with the compliant group(OR 2.0, 95% CI 1.4–2.8).
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