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نتیجه جستجو - epidemiology

تعداد مقالات یافته شده: 49
ردیف عنوان نوع
1 Accounting for cross-immunity can improve forecast accuracy during influenza epidemics
حسابداری برای مصونیت متقابل می تواند دقت پیش بینی را در طول اپیدمی های آنفلوانزا بهبود بخشد-2021
Previous exposure to influenza viruses confers cross-immunity against future infections with related strains. However, this is not always accounted for explicitly in mathematical models used for forecasting during influenza outbreaks. We show that, if an influenza outbreak is due to a strain that is similar to one that has emerged previously, then accounting for cross-immunity explicitly can improve the accuracy of real-time forecasts. To do this, we consider two infectious disease outbreak forecasting models. In the first (the ‘‘1-group model’’), all individuals are assumed to be identical and cross-immunity is not accounted for. In the second (the ‘‘2-group model’’), individuals who have previously been infected by a related strain are assumed to be less likely to experience severe disease, and therefore recover more quickly, than immunologically naive individuals. We fit both models to estimated case notification data (including symptomatic individuals as well as laboratory-confirmed cases) from Japan from the 2009 H1N1 influenza pandemic, and then generate synthetic data for a future outbreak by assuming that the 2-group model represents the epidemiology of influenza infections more accurately. We use the 1-group model (as well as the 2-group model for comparison) to generate forecasts that would be obtained in real-time as the future outbreak is ongoing, using parameter values estimated from the 2009 epidemic as informative priors, motivated by the fact that without using prior information from 2009, the forecasts are highly uncertain. In the scenario that we consider, the 1-group model only produces accurate outbreak forecasts once the peak of the epidemic has passed, even when the values of important epidemiological parameters such as the lengths of the mean incubation and infectious periods are known exactly. As a result, it is necessary to use the more epidemiologically realistic 2-group model to generate accurate forecasts. Accounting for cross-immunity driven by exposures in previous outbreaks explicitly is expected to improve the accuracy of epidemiological modelling forecasts during influenza outbreaks.
keywords: مدلسازی ریاضی | پیش بینی آنفلوانزا | Real-timeForecast | مصونیت متقابل | 2009 H1N1 پاندمی | Mathematicalmodelling | Influenzaforecasting | Real-timeforecast | Cross-immunity | 2009H1N1pandemic
مقاله انگلیسی
2 Knowledge gaps and perceptions of future research directions on management of diabetes during Ramadan fasting: An online survey of physicians
شکاف های دانش و درک دستورالعمل های تحقیقاتی آینده در مدیریت دیابت در طول روزهداری ماه رمضان: مرور آنلاین پزشکان-2021
Objectives: Current knowledge and research on diabetes and Ramadan form the basis for evidence-based clinical practice. In this context, we aimed to explore physicians’ perceptions of current knowledge gaps about research fasting (RF), barriers to, and foreseeable directions for advancement of the field.
Methods: We conducted an online survey of a convenience sample of 260 physicians from 27 countries. The survey questionnaire addressed three main domains: perceived current knowledge gaps and unmet needs in research about RF and diabetes, barriers to the conduct of research, and future directions for furthering the evidence in this field.
Results: Majority of respondents (65.7%) were senior physicians in adult endocrinology/diabetes (45.9%) working at tertiary centers (65.2%). The majority (67.3%) reported seeing an average of 20+ patients with diabetes weekly and felt ‘‘very or fairly confident” in managing diabetes during RF (67.7%). The knowledge gaps identified were the management of highrisk patients with diabetes (54.1%), such as renal impairment (59.8%), and pregnancy (61.5%). The main barriers to research were lack of adequate funding to academic centers (75.7%) and lack of interest of institutions in the subject (64.6%). Future efforts should be directed at the conduct of large epidemiological studies (49.5%) or double-blinded, placebo-controlled clinical trials (48.6%) to address the former gaps. Research findings should be widely disseminated via hands-on workshops (recommended by 70.3% of respondents) or international conferences (61.2%).
Conclusions: There is a wide agreement regarding the knowledge gaps in the management of diabetes during RF. Future efforts should focus on addressing these critical deficiencies.
keywords: روزه رمضان | ادبیات | دیابت | هیپوگلیسمی | همهگیرشناسی | کتواسیدوز دیابتی | دیدگاه های بیماران | متخصصان مراقبت های بهداشتی | ادراک | بیماران پر خطر | کودکان و نوجوانان | Ramadan fasting | Literature | Diabetes | Hypoglycaemia | Epidemiology | Diabetic ketoacidosis | Patients’ perspectives | Health Care Professionals | perceptions | High-risk patients | Children and adolescents
مقاله انگلیسی
3 tr
دانش فعلی و مدیریت ترومبوز ورید پورتال در سیروز-2021
Portal vein thrombosis (PVT) is an increasingly recognised complication of cirrhosis whose incidence increases in parallel with the severity of cirrhosis. Several risk factors have been associated with the occurrence and progression of PVT. Although the negative effect of complete PVT on the surgical outcome of liver transplant recipients is clear, its impact on cirrhosis progression remains uncertain. Treatment options include anticoagulants and interventional thrombolytic therapies, which are chosen almost on a case-by-case basis depending on the characteristics of the patient and the thrombus. In this manuscript, we review current knowledge regarding the epidemiology, risk factors, diagnosis and classification, natural history, clinical consequences and treatment of non-neoplastic PVT in cirrhosis.
Keywords: Cirrhosis | Coagulopathy | Portal hypertension | Portal vein thrombosis | TIPS | Transplant
مقاله انگلیسی
4 Combining conventional and participatory approaches to identify and prioritise management and health-related constraints to smallholder pig production in San Simon, Pampanga, Philippines
تلفیق رویکردهای مرسوم و مشارکتی برای شناسایی و اولویت بندی مدیریت و محدودیتهای مرتبط با سلامتی در تولید خوک های خرده فروش در سن سیمون ، پامبانگا ، فیلیپین-2020
Pork is the main meat produced and consumed in the Philippines. The majority of pigs are raised by smallholders who experience a range of constraints to their pig production. This study presents the findings of the first part of an overarching project that used an Ecohealth approach and aimed to improve the production and competitiveness of the smallholder pig system in an area of the Philippines. A participatory approach was embraced, combining conventional and participatory epidemiology methods followed by a stakeholder discussion. The first aim was to identify management and health-related constraints to pig production among smallholder famers in San Simon, Pampanga, Philippines. The second aim was for the project team and stakeholders to jointly prioritise activities for the immediate future to address these constraints. Key management and health-related constraints identified included inadequate water supply to pigs, particularly lactating and gestating sows, and a range of feeding-related issues. Diarrhoea was recognised as the disease syndrome of highest priority and limited record keeping meant that farmers were unable to assess the productivity and profitability of their pig farming enterprises. Actions jointly prioritised by stakeholders and the project team were: the appointment of a project coordinator within each barangay; conduct two sets of seminars, the first covering water and nutrition and the second piglet management and diarrhoea, to be delivered by technical experts but with farmer “trusted sources” also sharing their experiences; development of easily understandable leaflets and posters covering key technical information; promotion of nipple drinkers attached to five-gallon water containers and creep boxes for piglets, and conduct of a record keeping workshop with a small group of innovative farmers to develop a useful and usable tool for record keeping. The use of multiple approaches to data-gathering enabled triangulation of study findings. Without any one of these components the understanding of the pig production system would have been less complete and it is possible that the proposed actions would not have been as well-tailored to the needs of the farmers. The participatory approach, in particular the stakeholder discussion, provided the opportunity to embrace the “deciding together” and “acting together” stances of participation rather than the lower “information giving” stance, thereby giving stakeholders greater ownership of the future activities of the overarching project and beyond.
Keywords: Philippines | Pig | Smallholder | Constraints | Participatory epidemiology | Ecohealth
مقاله انگلیسی
5 The harmonizing effect of Smart Snacks on the association between state snack laws and high school students fruit and vegetable consumption, United States—2005–2017
اثر هماهنگ کننده میان وعده های هوشمند در ارتباط بین قوانین میان وعده ایالتی با مصرف میوه و سبزیجات دانش آموزان دبیرستانی ، ایالات متحده — 2005-2017-2020
Despite national guidelines recommending daily fruit and vegetable (FV) consumption, intake of FV among adolescents is low. Over the past 10–15 years, state and federal laws have reduced the availability of junk foods in schools. This study examined the association between state snack laws and high school (HS) student FV consumption. The overall sample included 99,785 HS students (outcome samples ranged from 96,209-97,328) included in the Youth Risk Behavior Survey (YRBS). National Cancer Institute Classification of Laws Associated with School Students data for 2004–2016 were lagged on to 2005–2017 YRBS data. Separate analyses examined the state law-youth FV consumption relationship pre- and post-federal Smart Snacks standards (effective school year 2014–2015). Analyses were conducted between 2018 and 2020. Overall, state laws were associated with any vegetable, salad, and other vegetable consumption. The relationship between state laws and vegetable consumption primarily occurred pre-Smart Snacks. Pre-Smart Snacks, state laws were associated with higher odds of youth consumption of any vegetable, salad, carrots, and other vegetables (all compared to students in states without snack laws). The only association post-Smart Snacks was between strong state laws and salads. This study illustrates the important role that standards restricting the availability of junk foods in schools can have on increasing student vegetable consumption. Given current efforts to roll-back federal school meal standards, findings from this study illustrate how federal standards harmonized the patchwork of state laws that existed prior to Smart Snacks and the important role that consistent national standards can play in supporting student consumption of vegetables.
Keywords: Legal epidemiology | Nutrition | Schools | Fruit | Vegetables
مقاله انگلیسی
6 روندهای فعلی و تحولات جدید در تحقیقات HIV (بیماری ایدز) و بیماری های پیرادندانی یا پریودنتال
سال انتشار: 2020 - تعداد صفحات فایل pdf انگلیسی: 28 - تعداد صفحات فایل doc فارسی: 36
با ظهور درمان‌های ضد ویروسی ترکیبی (‏cART)‏، چهره عفونت HIV به طور چشمگیری از یک بیماری تقریبا با مرگ و میر مشخص از نوع بیماری‌های جدی همراه، به یک بیماری مزمن قابل کنترل با طول عمر طولانی تغییر کرده ‌است. در این مقاله ما بررسی‌های اخیر در مورد اپیدمیولوژی، میکروبیولوژی و پاتوژنز بیماری‌های پریودنتال (پیرادندانی) در بیماران مبتلا به HIV و اثرات درمان‌های ضد ویروسی ترکیبی (cART) بر روی شیوع و پیشرفت این بیماری‌ها هم در بزرگسالان و هم در کودکان مبتلا به عفونت دوره نوزادی را ارائه می‌کنیم. علاوه بر این، مقایسه و فعل و انفعالات بالقوه بین میکروبیوم مرتبط با HIV، پاسخ‌های میزبان و پاتوژنز در حفره دهان با دستگاه گوارش و دیگر نواحی بدن نیز ارائه شده ‌است. و علاوه بر همه ی اینها، اثرات HIV و cART بر بیماری‌های همراه مانند کمبود بزاق، زوال عقل و پوکی استخوان در پیشرفت بیماری پریودنتال مورد بحث قرار می‌گیرند.
مقاله ترجمه شده
7 When there are no abortion laws: A case study of Canada
هنگامی که هیچ قانونی برای سقط جنین وجود ندارد: یک مطالعه موردی در کانادا-2020
Canada decriminalized abortion, uniquely in the world, 30 years ago. We present the timeline of relevant Canadian legal, political, and policy events before and since decriminalization. We assess implications for clinical care, health service and systems decisions, health policy, and the epidemiology of abortion in the absence of criminal legislation. As the criminal abortion law was struck down, dozens of similar private members bills, and one government bill, have been proposed, but none were passed. Key findings include that initially Canadian provinces attempted to provide restrictive regulations and legislation, all of which have been revoked and largely replaced with supportive policies that improve equitable, accessible, state-provided abortion service. Abortion rates have been stable over 30 years since decriminalization, and a falling proportion of abortions occur late in the second trimester. Canada demonstrates that abortion care can safely and effectively be regulated as a normal component of usual medical care.
Keywords: Abortion | Induced | Decriminalization | Canada | Health policy | Health law
مقاله انگلیسی
8 Women in German forensic addiction treatment: Epidemiology and genderrelated decision making in jurisdiction
زنان آلمانی در درمان اعتیاد پزشکی قانونی : اپیدمیولوژی و تصمیم گیری جنسیتی در صلاحیت-2020
Purpose: Within the German legal framework, if an unlawful act is committed by a substance-addicted offender, courts shall make a forensic addiction treatment order (referred to as FAT). In 2010–2015, German courts applied this rule to 14,576 individuals. The article aims to explore the development of FAT sex ratios, its relation to other criminological measures and its regional distribution - and to describe gender-related differences within the FAT population. Methods: Yearly and state-specific sex ratios in FAT orders were calculated and related to general delinquency figures. Women were compared to men on various variables. We computed chi-square, t- and Kruskal-Wallis tests. Results: Compared to registered and sanctioned delinquency, women are steadily underrepresented, but the sex ratio differs largely among German states. Compared to men, women are 1 year older, have a less severe criminal history and a different distribution of addiction-related delinquency. Their average concurrent prison sentence is shorter, indicating less severe offences. Conclusions: Findings largely conform to epidemiological knowledge. However, it is unlikely that these effects explain the extent of womens underrepresentation concerning FAT. Instead, FAT-application seems to be influenced by gender-related decision biases in jurisdiction. Regional differences cannot be explained epidemiologically, they seem to indicate different juridical “cultures”.
Keywords: Forensic psychiatry | Substance abuse | Gender differences | Offender treatment | Epidemiology
مقاله انگلیسی
9 What Can We Learn About Drug Safety and Other Effects in the Era of Electronic Health Records and Big Data That We Would Not Be Able to Learn From Classic Epidemiology?
چه چیزی می توانیم درباره ایمنی دارو و سایر تأثیرات در عصر سوابق الکترونیکی سلامت و داده های بزرگی که نمی توانیم از اپیدمیولوژی کلاسیک یاد بگیریم؟-2020
As more and more health systems have converted to the use of electronic health records, the amount of searchable and analyzable data is exploding. This includes not just provider or laboratory created data but also data collected by instruments, personal devices, and patients themselves, among others. This has led to more attention being paid to the analysis of these data to answer previously unaddressed questions. This is especially important given the number of therapies previously found to be beneficial in clinical trials that are currently being re-scrutinized. Because there are orders of magnitude more information contained in these data sets, a fundamentally different approach needs to be taken to their processing and analysis and the generation of knowledge. Health care and medicine are drivers of this phenomenon and will ultimately be the main beneficiaries. Concurrently, many different types of questions can now be asked using these data sets. Research groups have become increasingly active in mining large data sets, including nationwide health care databases, to learn about associations of medication use and various unrelated diseases such as cancer. Given the recent increase in research activity in this area, its promise to radically change clinical research, and the relative lack of widespread knowledge about its potential and advances, we surveyed the available literature to understand the strengths and limitations of these new tools. We also outline new databases and techniques that are available to researchers worldwide, with special focus on work pertaining to the broad and rapid monitoring of drug safety and secondary effects.
Keywords: Electronic health record | Big data | Drug safety | Health care database | Cancer risk
مقاله انگلیسی
10 Epidemiological rage: Population, biography, and state responsibility in trans- health activism
خشم اپیدمیولوژیک : جمعیت ، زندگی نامه ، و مسئولیت دولت در فعالیت سلامت دو جنسیتی ها -2020
This article examines how social movements reconceptualized trans-health in Buenos Aires, Argentina. Looking ethnographically to medical and activist practice, the article analyzes “epidemiological biographies”, or activistproduced community-based studies blending quantitative and narrative data. It draws on population health, feminist science studies, transgender studies, and social theory to discuss the circulation and implications of these publications. Specifically, it describes how epidemiological biographies disputed health behavioral models by defining state violence and criminalization as primary conditions endangering health and life expectancy among travestis and trans-people. The article analyzes how activist researchers made state violence legible through logics of population health, even as the concept of “population” also emerged from techniques of state control. In contrast with models that place individual behavior at the locus of health interventions, activists instead advanced interventions that contested state securitization and shifted resource distribution. Epidemiological biographies had a considerable effect on national trans-health politics, providing an evidentiary basis for several regulatory shifts. These studies emerged in part through collective political action that reformulated dominant modes of statistical aggregation. This statistical turn—which I call “statistical collectivization”— produced contradictory effects. At one level, it obscured differential conditions of criminalization and violence. At another, it directed attention to the markedly racialized, sexualized, classed, and gendered forms of subjugation that materialize in landscapes of trans-health, and prioritized materially distributive regulation over and above civil protections. Through these contradictory actions, social movements reformulated dominant notions of health by challenging state securitization and contesting state power.
Keywords: Argentina | Travesti | Transgender health | Epidemiology | Statistics | State violence | Social movements | Science & technology studies
مقاله انگلیسی
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