17 resultados para Prevalence and risk factors

em CentAUR: Central Archive University of Reading - UK


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A cross-sectional study was carried out on 200 randomly selected farms in each of the Iringa and Tanga regions of Tanzania to estimate the prevalence and risk factors for subclinical mastitis in dairy cows kept by smallholders. Subclinical mastitis was assessed using the California mastitis test (CMT), and by the bacteriological culture of 1500 milk samples collected from 434 clinically normal cows. The percentages of the cows (and quarters) with subclinical mastitis were 75.9 per cent (46.2 per cent) when assessed by the CMT and 43.8 per cent (24.3 per cent) when assessed by culture. Factors significantly associated with an increased risk of a CMT-positive quarter were Boran breed (odds radio [OR]=3.51), a brought-in cow (rather than homebred) (OR=2.39), peak milk yield, and age. The stripping method of hand milking was associated with a significantly lower prevalence Of CMT-positive quarters (OR=0.51). The CMT-positive cows were more likely to be culture positive (OR=4.51), as were brought-in (OR=2.10) and older cows.

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A cross-sectional serological survey of A. marginale was conducted on 200 randomly selected smallholder farms in each of the Tanga and Iringa Regions of Tanzania between January and April 1999. Sera, from dairy cattle of all ages, sexes and breeds were tested for antibodies against A. marginale using an indirect enzyme-linked immunosorbent assay. Antibodies to A. marginale were present in cattle throughout the study areas and the overall prevalence was 20% for Tanga and 37% for Iringa. The forces of infection based on the age seroprevalence profile were estimated at 8 for Tanga and 15 for Iringa per 100 cattle years-risk, respectively. In both regions, seroprevalence increased with age (β = 0.01 and 0.017 per year of age, p < 0.005, in Tanga and Iringa, respectively). Older animals in Iringa were significantly and negatively associated with decreased seropositivity (β = −0.002, p = 0.0029). Further results of logistic regression models reveal that geographic location of animals in Tanga was associated with seropositivity (odds ratio (OR) = 2.94, p = 0.005, for Tanga Rural and OR = 2.38, p = 0.066, for Muheza). Animals acquired as a gift in Iringa had higher odds for seropositivity than brought-in cattle (OR = 2.44, p = 0.005). Our study has identified and quantified some key risk factors that can guide planners devising disease control strategies.

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A cross-sectional serological survey of A. marginale was conducted on 200 randomly selected smallholder farms in each of the Tanga and Iringa Regions of Tanzania between January and April 1999. Sera, from dairy cattle of all ages, sexes and breeds were tested for antibodies against A. marginale using an indirect enzyme-linked immunosorbent assay. Antibodies to A. marginale were present in cattle throughout the study areas and the overall prevalence was 20% for Tanga and 37% for Iringa. The forces of infection based on the age seroprevalence profile were estimated at 8 for Tanga and 15 for Iringa per 100 cattle years-risk, respectively. In both regions, seroprevalence increased with age (beta = 0.01 and 0.017 per year of age, p < 0.005, in Tanga and Iringa, respectively). Older animals in Iringa were significantly and negatively associated with decreased seropositivity (beta = -0.002, p = 0.0029). Further results of logistic regression models reveal that geographic location of animals in Tanga was associated with seropositivity (odds ratio (OR) = 2.94, p = 0.005, for Tanga Rural and OR = 2.38, p = 0.066, for Muheza). Animals acquired as a gift in Iringa had higher odds for seropositivity than brought-in cattle (OR = 2.44, p = 0.005). Our study has identified and quantified some key risk factors that can guide planners devising disease control strategies.

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Diets low in fruit and vegetables are reportedly responsible for 2.7 million deaths annually from cardiovascular diseases (CVD) and certain cancers. A daily fruit and vegetable intake of five 80 g portions is recommended for chronic disease prevention. However, in the UK, average adult consumption is less than three portions. It is suggested that fruit juice should only count as one portion. However, fruit juices are a beneficial source of phytochemicals. The preliminary results of two randomized, controlled, crossover, dietary intervention studies investigating the effects of chronic and acute consumption of fruit and vegetable puree and juice based drinks (FVPJ) on bioavailability, antioxidant status, vascular reactivity, and risk factors for CVD are reported. In the first study, 39 volunteers consumed 200 ml FVPJ, or fruit-flavoured control, daily for six weeks. In the second study, 24 volunteers consumed 400 mL FVPJ, or sugar-matched control, on the morning of the study day. Blood and urine samples were collected throughout both studies and real-time measurements of vascular tone were performed using laser Doppler imaging with iontophoresis. Overall, the studies showed that the fruit and vegetable puree and juice based drink increased dietary phytochemicals. There was a trend towards increased vasodilation following both acute and chronic fruit juice consumption. Measurements of antioxidant status, oxidative stress and other cardiovascular disease risk factors are currently being determined.

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Given the long-term negative outcomes associated with depression in adolescence, there is a pressing need to develop brief, evidence based treatments that are accessible to more young people experiencing low mood. Behavioural Activation (BA) is an effective treatment for adult depression, however little research has focused on the use of BA with depressed adolescents, particularly with briefer forms of BA. In this article we outline an adaptation of brief Behavioral Activation Treatment of Depression (BATD) designed for adolescents and delivered in eight sessions (Brief BA). This case example illustrates how a structured, brief intervention was useful for a depressed young person with a number of complicating and risk factors.

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Objective: Autism spectrum disorders are now recognized to occur in up to 1% of the population and to be a major public health concern because of their early onset, lifelong persistence, and high levels of associated impairment. Little is known about the associated psychiatric disorders that may contribute to impairment. We identify the rates and type of psychiatric comorbidity associated with ASDs and explore the associations with variables identified as risk factors for child psychiatric disorders. Method: A subgroup of 112 ten- to 14-year old children from a population-derived cohort was assessed for other child psychiatric disorders (3 months' prevalence) through parent interview using the Child and Adolescent Psychiatric Assessment. DSM-IV diagnoses for childhood anxiety disorders, depressive disorders, oppositional defiant and conduct disorders, attention-deficit/hyperactivity disorder, tic disorders, trichotillomania, enuresis, and encopresis were identified. Results: Seventy percent of participants had at least one comorbid disorder and 41% had two or more. The most common diagnoses were social anxiety disorder (29.2%, 95% confidence interval [CI)] 13.2-45.1), attention-deficit/hyperactivity disorder (28.2%, 95% CI 13.3-43.0), and oppositional defiant disorder (28.1%, 95% CI 13.9-42.2). Of those with attention/deficit/hyperactivity disorder, 84% received a second comorbid diagnosis. There were few associations between putative risk factors and psychiatric disorder. Conclusions: Psychiatric disorders are common and frequently multiple in children with autism spectrum disorders. They may provide targets for intervention and should be routinely evaluated in the clinical assessment of this group.

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Logistic regression, supported by other statistical analyses was used to explore the possible association of risk factors with the fluoroquinolone (FQ)-resistance status of 108 pig finisher farms in Great Britain. The farms were classified as 'affected' or 'not affected' by FQ-resistant E. coli or Campylobacter spp. on the basis of isolation of organisms from faecal samples on media containing 1 mg/l FQ. The use of FQ was the most important factor associated with finding resistant E. coli and/or Campylobacter, which were found on 79% (FQ-resistant E. coli) and 86% (FQ-resistant Campylobacter) of farms with a history of FQ use. However, resistant bacteria were also found on 19% (FQ-resistant E. coli) and 54% (FQ-resistant Campylobacter) of farms with no history of FQ use. For FQ-resistant E. coli, biosecurity measures may be protective and there was strong seasonal variation, with more farms found affected when sampled in the summer. For FQ-resistant Campylobacter, the buying-in of grower stock may increase risk and good on-farm hygiene may be protective. The findings suggest that resistant organisms, particularly Campylobacter, may spread between pig farms.

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Background: Animal studies suggest that prebiotics and probiotics exert protective effects against tumor development in the colon, but human data supporting this suggestion are weak. Objective: The objective was to verify whether the prebiotic concept (selective interaction with colonic flora of nondigested carbohydrates) as induced by a synbiotic preparation-oligofructose-enriched inulin (SYN1) + Lactobacillus rhamnosus GG (LGG) and Bifidobacterium lactis Bb12 (BB12)-is able to reduce the risk of colon cancer in humans. Design: The 12-wk randomized, double-blind, placebo-controlled trial of a synbiotic food composed of the prebiotic SYN1 and probiotics LGG and BB12 was conducted in 37 colon cancer patients and 43 polypectomized patients. Fecal and blood samples were obtained before, during, and after the intervention, and colorectal biopsy samples were obtained before and after the intervention. The effect of synbiotic consumption on a battery of intermediate biomarkers for colon cancer was examined. Results: Synbiotic intervention resulted in significant changes in fecal flora: Bifidobacterium and Lactobacillus increased and Clostridium perfringens decreased. The intervention significantly reduced colorectal proliferation and the capacity of fecal water to induce necrosis in colonic cells and improve epithelial barrier function in polypectomized patients. Genotoxicity assays of colonic biopsy samples indicated a decreased exposure to genotoxins in polypectomized patients at the end of the intervention period. Synbiotic consumption prevented an increased secretion of interleukin 2 by peripheral blood mononuclear cells in the polypectomized patients and increased the production of interferon gamma in the cancer patients. Conclusions: Several colorectal cancer biomarkers can be altered favorably by synbiotic intervention.

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This study was aimed at determining whether an increase of 5 portions of fruits and vegetables in the form of soups and beverages has a beneficial effect on markers of oxidative stress and cardiovascular disease risk factors. The study was a single blind, randomized, controlled, crossover dietary intervention study. After a 2-wk run-in period with fish oil supplementation, which continued throughout the dietary intervention to increase oxidative stress, the volunteers consumed carotenoid-rich or control vegetable soups and beverages for 4 wk. After a 10-wk wash-out period, the volunteers repeated the above protocol, consuming the other intervention foods. Both test and control interventions significantly increased the % energy from carbohydrates and decreased dietary protein and vitamin B-12 intakes. Compared with the control treatment, consumption of the carotenoid-rich soups and beverages increased dietary carotenoids, vitamin C, alpha-tocopherol, potassium, and folate, and the plasma concentrations of alpha-carotene (362%), beta-carotene (250%) and lycopene (31%) (P < 0.01) and decreased the plasma homocysteine concentration by 8.8% (P < 0.01). The reduction in plasma homocysteine correlated weakly with the increase in dietary folate during the test intervention (r = -0.35, P = 0.04). The plasma antioxidant status and markers of oxidative stress were not affected by treatment. Consumption of fruit and vegetable soups and beverages makes a useful contribution to meeting dietary recommendations for fruit and vegetable consumption.

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The average UK adult consumes less than three portions of fruit and vegetables daily, despite evidence to suggest that consuming five portions daily could help prevent chronic diseases. It is recommended that fruit juice should only count as one of these portions, as juicing removes fibre and releases sugars. However, fruit juices contain beneficial compounds such as vitamin C and flavonoids and could be a useful source of dietary phytochemicals. Two randomised controlled cross-over intervention studies investigating the effects of chronic and acute consumption of commercially-available fruit- and vegetable-puree-based drinks (FVPD) on bioavailability, antioxidant status and CVD risk factors are described. Blood and urine samples were collected during both studies and vascular tone was measured using laser Doppler imaging. In the chronic intervention study FVPD consumption was found to significantly increase dietary carotenoids (P = 0.001) and vitamin C (P = 0.003). Plasma carotenoids were increased (P = 0.001), but the increase in plasma vitamin C was not significant. There were no significant effects on oxidative stress, antioxidant status and other CVD risk factors. In the acute intervention study FVPD were found to increase total plasma nitrate and nitrite (P = 0.001) and plasma vitamin C (P = 0.002). There was no effect on plasma lipids or uric acid, but there was a lower glucose and insulin peak concentration after consumption of the FVPD compared with the sugar-matched control. There was a trend towards increased vasodilation following both chronic and acute FVPD consumption. All volunteers were retrospectively genotyped for the eNOS G298T polymorphism and the effect of genotype on the measurements is discussed. Overall, there was a non-significant trend towards increased endothelium-dependent vasodilation following both acute and chronic FVPD consumption. However, there was a significant time x treatment effect (P < 0.05) of acute FVPD consumption in individuals with the GG variant of the eNOS gene.

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Social factors, including poverty, are known risk factors for depression. In a previous study conducted in Khayelitsha, a very poor peri-urban settlement near Cape Town, a 34.7% prevalence rate for postpartum depression was found, roughly three times the expected rate internationally. This article is a report on a logistical regression analysis, showing that the odds ratios for the probability of maternal depression at two months were: for the infant being unwanted, OR=4.33, 95% CI: (1.75; 11.60); for the father's negative attitude towards the infant, OR=6.03, 95% CI: (2.01; 20.09); and for the mother cohabiting with (as opposed to not living with) a male partner, OR=2.77, 95% CI: (1.08; 7.69). The odds ratios for the probability of the mother being insensitive towards the infant at two months were: for the mother aged 20 to 24 years, OR=0.40, 95% CI: (0.10; 1.42); for the mother aged 25 to 29 years, OR=0.24, 95% CI: (0.06; 0.77); for the mother aged 30 years or older, OR=0.27, 95% CI: (0.07; 0.90); and for the mother receiving no help from her partner, OR=2.12, 95% CI: (1.05; 4.33). Since data were collected cross-sectionally, it is not possible to draw conclusions about causal pathways. The findings support further investigation into the precursors of, and risk factors for, postpartum depression amongst poor South African women.

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Background:Excessive energy intake and obesity lead to the metabolic syndrome (MetS). Dietary saturated fatty acids (SFAs) may be particularly detrimental on insulin sensitivity (SI) and on other components of the MetS. Objective:This study determined the relative efficacy of reducing dietary SFA, by isoenergetic alteration of the quality and quantity of dietary fat, on risk factors associated with MetS. Design:A free-living, single-blinded dietary intervention study. Subjects and Methods:MetS subjects (n=417) from eight European countries completed the randomized dietary intervention study with four isoenergetic diets distinct in fat quantity and quality: high-SFA; high-monounsaturated fatty acids and two low-fat, high-complex carbohydrate (LFHCC) diets, supplemented with long chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) (1.2 g per day) or placebo for 12 weeks. SI estimated from an intravenous glucose tolerance test (IVGTT) was the primary outcome measure. Lipid and inflammatory markers associated with MetS were also determined. Results:In weight-stable subjects, reducing dietary SFA intake had no effect on SI, total and low-density lipoprotein cholesterol concentration, inflammation or blood pressure in the entire cohort. The LFHCC n-3 PUFA diet reduced plasma triacylglycerol (TAG) and non-esterified fatty acid concentrations (P<0.01), particularly in men. Conclusion:There was no effect of reducing SFA on SI in weight-stable obese MetS subjects. LC n-3 PUFA supplementation, in association with a low-fat diet, improved TAG-related MetS risk profiles.