1,284 research outputs found
Translation of questions: the international study of asthma and allergies in childhood (ISAAC) experience
No full textOBJECTIVE:
To explore the consequences of translating the International Study of Asthma and Allergies in Childhood (ISAAC) English core questionnaires on asthma, rhinitis and eczema symptoms into other languages.
DESIGN:
ISAAC Phase III developed 49 language translations for adolescents and 42 for children following standardised guidelines, which included back-translating the questionnaires into English to check their accuracy and meaning. Language deviations were categorised and analysed with regard to influences on the reported symptom prevalence.
RESULTS:
Category 1 deviations for one or more questions were found in seven translations (14%) for adolescents and in three translations (7%) for children. Data for these questions were excluded from the worldwide analyses. Category 2 deviations were identified in the publications, and Category 3 deviations were ignored.
CONCLUSIONS:
Translations of questionnaires should follow a consistent protocol in global epidemiological research. Cultural norms need to be considered when evaluating back-translations into English, as disease labels are not available in every language, nor are they understood in the same way. Deviations from literal translations of English should be permitted if the intent of the original meaning is retained. A web-based tool of medical terminology would be useful for international research requiring the use of translations
Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One.
No full textThe International Study of Asthma and Allergies in Childhood (ISAAC) Phase One showed large worldwide variations in the prevalence of symptoms of asthma, rhinoconjunctivitis and eczema, up to 10 to 20 fold between countries. Ecological analyses were undertaken with ISAAC Phase One data to explore factors that may have contributed to these variations, and are summarised and reviewed here.In ISAAC Phase One the prevalence of symptoms in the past 12 months of asthma, rhinoconjunctivitis and eczema were estimated from studies in 463,801 children aged 13 - 14 years in 155 centres in 56 countries, and in 257,800 children aged 6-7 years in 91 centres in 38 countries. Ecological analyses were undertaken between symptom prevalence and the following: Gross National Product per capita (GNP), food intake, immunisation rates, tuberculosis notifications, climatic factors, tobacco consumption, pollen, antibiotic sales, paracetamol sales, and outdoor air pollution.Symptom prevalence of all three conditions was positively associated with GNP, trans fatty acids, paracetamol, and women smoking, and inversely associated with food of plant origin, pollen, immunisations, tuberculosis notifications, air pollution, and men smoking. The magnitude of these associations was small, but consistent in direction between conditions. There were mixed associations of climate and antibiotic sales with symptom prevalence.The potential causality of these associations warrant further investigation. Factors which prevent the development of these conditions, or where there is an absence of a positive correlation at a population level may be as important from the policy viewpoint as a focus on the positive risk factors. Interventions based on small associations may have the potential for a large public health benefit
Urbanisation is associated with prevalence of childhood asthma in diverse, small rural communities in Ecuador.
No full textBACKGROUND: Studies conducted in transitional communities from Africa and Asia have pointed to the process of urbanisation as being responsible for the increase in asthma prevalence in developing regions. In Latin America, there are few published data available on the potential impact of urbanisation on asthma prevalence. The aim of the present study was to explore how the process of urbanisation may explain differences in asthma prevalence in transitional communities in north-eastern Ecuador. METHODOLOGY/PRINCIPAL FINDINGS: An ecological study was conducted in 59 communities in Esmeraldas Province, Ecuador. Indicators of urbanisation were grouped into three indices representing the processes associated with urbanisation: socioeconomic, lifestyle and urban infrastructure. Categorical principal components analysis was used to generate scores for each index and a fourth index--a summary urbanisation index--was derived from the most representative variables in each of the three indices. The authors analysed the associations between community asthma prevalence and the indices, as well as with each indicator variable of every group. The overall prevalence of asthma was 10.1% (range 0-31.4% between communities). Three of the four indices presented significant associations with community asthma prevalence: socioeconomic (r = 0.295, p = 0.023), lifestyle (r = 0.342, p = 0.008) and summary urbanisation index (r = 0.355, p = 0.006). Variables reflecting better socioeconomic status and a more urban lifestyle were associated with greater asthma prevalence. CONCLUSIONS: These data provide evidence that the prevalence of asthma increases with increasing levels of urbanisation in transitional communities, and factors associated with greater socioeconomic level and changes towards a more urban lifestyle may be particularly important
Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three
No full textBACKGROUND:
In 1999, The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One reported the prevalence of eczema symptoms in 715,033 children from 154 centers in 56 countries by using standardized epidemiologic tools.
OBJECTIVE:
To update the world map of eczema prevalence after 5 to 10 years (ISAAC Phase Three) and include additional data from over 100 new centers.
METHODS:
Cross-sectional surveys using the ISAAC questionnaire on eczema symptoms were completed by adolescents 13 to 14 years old and by parents of children 6 to 7 years old. Current eczema was defined as an itchy flexural rash in the past 12 months and was considered severe eczema if associated with 1 or more nights per week of sleep disturbance.
RESULTS:
For the age group 6 to 7 years, data on 385,853 participants from 143 centers in 60 countries showed that the prevalence of current eczema ranged from 0.9% in India to 22.5% in Ecuador, with new data showing high values in Asia and Latin America. For the age group 13 to 14 years, data on 663,256 participants from 230 centers in 96 countries showed prevalence values ranging from 0.2% in China to 24.6% in Columbia with the highest values in Africa and Latin America. Current eczema was lower for boys than girls (odds ratio, 0.94 and 0.72 at ages 6 to 7 years and 13 to 14 years, respectively).
CONCLUSION:
ISAAC Phase Three provides comprehensive global data on the prevalence of eczema symptoms that is essential for public health planning. New data reveal that eczema is a disease of developing as well as developed countries
Repetitive current control of two-level and interleaved three-phase PWM utility connected converters
No full textThis thesis is mainly concerned with investigations into digital repetitive current controlof two-level and interleaved utility connected PWM converters. The research ismotivated by the relatively poor performance of classical (PI) controllers when theutility voltage harmonic distortion is high. This is due to the low gain, and poordisturbance rejection of the PI controller at the utility harmonic frequencies. Repetitivefeedback controllers have the ability to track or reject periodic disturbances, such asutility harmonics, as they naturally have high gains at the utility voltage harmonicfrequencies, assuming that these frequencies do not change.Repetitive controllers (RC) are known for being sensitive to variations in systemparameters and disturbance frequency, which in practice renders them either ineffectiveor unstable. Another challenge arises from the memory requirements of RC in case ofthe absence of even harmonics, which can make its practical implementation difficultand expensive. In addition, another problem that has not been investigated extensivelyin the literature is that the effectiveness of RC is severely limited by the limitedbandwidth of the plant (the utility connected converter and its filter). Theoreticalanalysis and simulation results presented in this thesis show that RC could noteffectively reject disturbances at frequencies above the closed loop system bandwidth.The design of the converter's output filter bandwidth and the values of its componentsneed to be selected carefully, to enable RC to be used effectively.The research in this thesis focuses on investigating the practical implementation andperformance limits of two types of repetitive controllers (conventional and oddharmonics),used for current control of two-level utility connected converter with LCLoutput filter. The odd-harmonic repetitive controller halves the memory requirementand offers higher gains only at odd harmonic frequencies of interest. The overall controlscheme consists of the traditional classical tracking controller with a dual loop feedbacksystem and RC. The results indicate that the repetitive controller improves the steadystate error and the total harmonic distortion of the output current, provided that theplant's bandwidth is sufficiently large.Finally, a repetitive controller for an interleaved utility connected converter has beendesigned and investigated in this study. The interleaved converter system has higherbandwidth than the two-level converter, which improves the effectiveness of RC. Itprovides good disturbance rejection compared to classical controllers which results inlow output current THD. The RC was demonstrated to be robust despite uncertainty inutility impedance, while achieving a fast almost zero error convergence. The proposedRC has been experimentally implemented using a DSP and the results indicate that thequality of output current complies with international standards on harmonic limits andmatches simulation results obtained from the Matlab/Simulink model of the system
Evaluation and analysis of impact of subsidies on small scale renewable energy technologies dissemination: a case study of Nepal
No full textThe report has analysed the status of rural electrification using renewable energy technologies (RETs) and the current subsidy delivery modality of RETs in Nepal. As the Government of Nepal is subsidizing small scale renewable energy projects, it is important to evaluate and analyse the programme to make sure that a programme is running in an effective and efficient way while reaching the target group.
During the course of the research, primary information collected from the field has been compiled using appropriate tools/software (such as MS Office) and analyzed. Different sets of questionnaires were prepared, targeting different personnel ranging from the users’ level to the government policy level. The field survey methods include field observations of RETs installations and operations along with interviews with selected users on a random sampling basis to identify barriers to subsidy delivery and possible measures to overcome these barriers; to determine user satisfaction level and time period for subsidy delivery mechanisms.
The report started with the country background information and the rationale behind the study. This is followed by the literature review and information on the current status of small scale RETs in the country. Next it deals with the organizational structure and current subsidy delivery modality of RETs in the country. The evaluation of the effectiveness of the subsidy with the current subsidy delivery modality has been analyzed based on six parameters; Targets and Achievements, Impact of RETs, Subsidy Delivery System Efficiency, Transparency, Sustainability and Effectiveness.
The research shows that the subsidized government program has been successful in achieving its goal to provide basic energy services in rural areas through RETs in terms of its quantitative target. Although the subsidized program is successful in electrifying the rural communities via RETs, the poorest of the poor families are still excluded from the subsidy. The program seems to benefit more the rich and upper middle class families rather than the poor families for which the subsidy was intended. The high capital cost and long subsidy delivery process are the main important reasons for this failure. The author has proposed a new modality which might overcome the time barriers and bureaucratic process in the subsidy delivery mechanism and will decrease the lead time. This will in turn help to reduce the operational cost of the private companies and will encourage more players to enter the market, increase competition and result in lower system costs.
After identifying gaps in the current subsidy delivery modality, the project report ends with the recommendation of a new modality improving the current modality and filling the gaps identified. As this study has some limitations, as described in chapter one, the scope of further works has been listed at the end
Research priorities for antimicrobial stewardship nurses in a middle‑income country: a nominal group technique study
No full textAvailability of data and materials: All data generated or analysed during this study are included in this published article [and its supplementary additional les]. Original data are available from the corresponding author upon reasonable request. Supplementary Information is available online at: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-02504-9#Sec13 .Consortia:
Workshop Participants Group:
Monik Gomes do Nascimento Lousada, Claudia Silva Marinho, Eliana Auxiliadora Magalhães Costa, Nayara Carvalho Oliveira, Waldélia Monteiro, Beatriz Murata Murakami, Andreza Manhezi, José Rodrigues do Carmo Filho, Zilah Cândida Pereira das Neves, Viviane Gonçalves Sena, Glaucia Ribeiro Goncalves, Ieda Pontes da Cruz, Fernando Augusto Pinheiro, Camila Piuco Preve, Eliane Carlosso Krummenauer, Renata Neto Pires, Amanda Luiz Pires Maciel, Ana Claudia Cascardo, Daiane Patrícia Cais, James Francisco Pedro dos Santos, Lilian Farah, Maria Fernanda Zorzi Gatti, Meire Cristina Novelli e Castro, Mônica Taminato, Thatiara Cardoso da Silva & Tiago Cristiano de LimaA preprint version of this article is available online at https://doi.org/10.21203/rs.3.rs-4391774/v1 under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/). It has not been certified by peer review.Background:
Antimicrobial stewardship programs (ASPs) have become important strategies for addressing antimicrobial resistance (AMR). Despite the increasing number of international publications identifying the important roles played by nurses as part of ASPs in low- and middle-income countries, this topic is yet poorly researched. This study aimed to identify priority research gaps in the Brazilian context concerning nurses’ performance in ASPs from the perspective of nursing professionals and explore the main themes among the ideas generated by these nurses.
Methods:
This qualitative study used the modified Nominal Group Technique (mNGT) during a three-day online workshop. Content analysis was performed on the basis of the ideas proposed by the participants after the clarification stage.
Results:
The participants suggested 68 ideas in the first phase. After the idea’s clarification phase, 45 ideas were included in the voting rounds. The ideas prioritized by participants voting addressed (i) attributions and competencies of nurses in the ASP; (ii) planning and implementation of ASP nurses’ activities; and (iii) use of information and communication technologies to assist nurses. The content analysis highlighted nine main themes in the initial ideas.
Conclusions:
The study identified significant gaps in research related to nurses’ roles in ASPs in the Brazilian context. These findings suggest that further investigation into nurses’ competences, the implementation of their roles, and the application of digital tools are priority subjects of future research to improve nurses’ participation in ASPs. These themes should be further studied in the Brazilian context but may be applicable to other similar socioeconomic contexts.This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001
Prevalência de asma e rinoconjuntivite por meio da aplicação do questionário SNOT - 22 e ISAAC em adolescente de 13 a 14 anos
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Ciências Médicas, Florianópolis, 2014.Introdução: A asma e a rinoconjuntivite isoladamente ou associadas, são doenças que interferem diretamente na produtividade e consequente qualidade de vida dos indivíduos, principalmente quando não diagnosticadas ou tratadas adequadamente. A utilização de questionários já validados permite a comparação de resultados entre os diversos estudos que utilizem as mesmas ferramentas, em diferentes culturas e países, culminando no diagnóstico e tratamento precoce, diminuindo, de forma significativa, a repercussão na vida dos sujeitos. Objetivo: Verificar a prevalência de asma e rinoconjuntivite em adolescentes de 13 a 14 anos, a associação com os domínios do questionário SNOT-22, e o impacto destas condições na vida dos adolescentes. Métodos: Estudo com delineamento transversal realizado por meio da aplicação de dois questionários, o ISAAC e o SNOT-22, em adolescentes com idade entre 13 e 14 anos, matriculados nas escolas das redes pública e privada da cidade de Florianópolis  SC, no período de maio a julho de 2012. Resultados: Do total de 2558 alunos participantes da pesquisa, 67,1% eram provenientes de escolas públicas e 50,9% eram meninas. A prevalência de asma foi de 11,1%, e de rinoconjuntivite foi de 31%, de acordo com o questionário ISAAC. A associação entre essas duas doenças esteve presente em 4,5% dos adolescentes. A associação entre rinoconjuntivite com sintomas nasais e sinusais, seguindo os domínios do questionário SNOT-22, demonstrou correlação estatisticamente significativa entre todas as variáveis analisadas, revelando maior gravidade quando esta patologia estava presente. Em relação ao impacto que a rinoconjuntivite e a asma podem trazer à vida dos adolescentes, houve associação estatisticamente significativa dessas doenças com alterações de humor e diminuição da produtividade acadêmica e pessoal entre os jovens. Conclusão: A prevalência de asma foi de 11,1% e de rinoconjuntivite foi de 31%, havendo associação estatisticamente significativa dessas patologias com alterações de humor e diminuição da produtividade acadêmica e pessoal dos indivíduos.Abstract : Introduction: Asthma and rhinoconjunctivitis alone or in association are conditions that influence productivity and quality of life of human beings, particularly if they are not diagnosed or properly treated. Using validated questionnaires enables comparisons between studies that have used the same tool, in different cultures and countries, leading to early diagnoses and treatment and therefore, significant reduction on the impact in people's life. Objective: To estimate the prevalence of asthma and rhinoconjunctivitis among teenagers aged 13 to 14 years, its association with the domains of the questionnaire SNOT-22, and its impact in their lives. Methods: Cross-sectional study which consisted of two self-completed questionnaires, ISAAC and SNOT-22 applied in teenagers aged 13 to 14 years, currently enrolled in private and public schools of Florianopolis, SC. The study was performed between May and July of 2012. Results: From 2558 students, who participated in this survey, 67,1% were enrolled to a public school and 50,9% were girls. The prevalence of asthma and rhinoconjunctivitis were 11,1% and 31%. The association between the two diseases was present in 4,5% of the teenagers. The association between rhinoconjunctivitis and nasal and sinus symptoms, according to the domains of SNOT-22, showed statistically significant correlations between all the analyzed variables. The severity of the impact measured by the SNOT-22 showed it was worse when asthma was associated with rhinoconjunctivitis. This impact was measured by the statistically significant association of these conditions with mood changes and decreased academic and personal productivity among young people. Conclusion: Asthma prevalence was 11,1% and rhinoconjunctivitis 31%. There was a significant association of these pathologies with mood changes and decreased academic and personal productivity
Adapting to a new role: a study designed to help senior managers adapt to new positions after organisation restructuring
No full textThe work on which this thesis is based, studies the implementation phase of the total organisation restructure of the National Health Service in 1974 as experienced by a large group of Senior Pharmaceutical Managers who found it difficult to establish themselves in their new positions. The study starts in 1976 and researches to identify the nature and cause of the difficulties facing the managers. It is concluded that the probable cause is rooted in the sudden destruction of mechanisms developed before 1974 to assist new managers establish themselves in their positions. A solution is designed and tested before being implemented with the Senior Pharmaceutical Managers, By 1977 it had become clear that a similar situation faced other large groups of Senior Managers belonging to the Nursing and Works professions of the Health Service. As a result the project and study is continued to help these two other professions and with apparent equal success until 1985.A number of objectives are met during this study. A system is developed for facilitating role identification and implementation during a period of organisation restructuring as a means to help new managers adapt and become established in equally new positions. In addition this project is an example of the use of collaboration as a method to assist large numbers of senior managers belonging to Health Service professions meet radically new demands of role
Spatially structured genetic variation in a broadcast spawning bivalve: quantitative vs. molecular traits
No full textUnderstanding the origin, maintenance and significance of phenotypic variation is one of the central issues in evolutionary biology. An ongoing discussion focuses on the relative roles of isolation and selection as being at the heart of genetically based spatial variation. We address this issue in a representative of a taxon group in which isolation is unlikely: a marine broadcast spawning invertebrate. During the free-swimming larval phase, dispersal is potentially very large. For such taxa, small-scale population genetic structuring in neutral molecular markers tends to be limited, conform expectations. Small-scale differentiation of selective traits is expected to be hindered by the putatively high gene flow. We determined the geographical distribution of molecular markers and of variation in a shell shape measure, globosity, for the bivalve Macoma balthica (L.) in the western Dutch Wadden Sea and adjacent North Sea in three subsequent years, and found that shells of this clam are more globose in the Wadden Sea. By rearing clams in a common garden in the laboratory starting from the gamete phase, we show that the ecotypes are genetically different; heritability is estimated at 23%. The proportion of total genetic variation that is between sites is much larger for the morphological additive genetic variation (QST = 0.416) than for allozyme (FST = 0.000–0.022) and mitochondrial DNA cytochrome-c-oxidase-1 sequence variation (ΦST = 0.017). Divergent selection must be involved and intraspecific spatial genetic differentiation in marine broadcast spawners is apparently not constrained by low levels of isolation.
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