789 resultados para Competing risks
Resumo:
Il presente studio è stato effettuato per comprendere le abitudini degli studenti universitari britannici in termini di consumo di alcol e i rischi legati a due fenomeni frequenti nel Regno Unito: il binge drinking (consumo eccessivo di alcol in un breve lasso di tempo, spesso per raggiungere velocemente lo stato di ebbrezza) e, in misura minore, il drink spiking (contaminazione di bevande con droghe o alcol). Attraverso un’analisi di studi accademici, sondaggi e articoli della stampa britannica, verrà presentato nella prima parte il ruolo dell’alcol nel Regno Unito, verranno fornite varie definizioni di binge drinking ed evidenziate le variazioni di significato del termine nel tempo. Saranno, poi, presentati i livelli di assunzione di riferimento di alcol emessi dall’NHS, il sistema sanitario nazionale del Regno Unito, seguiti da un’analisi sull’uso dell’alcol nel Regno Unito. Per quanto riguarda gli studenti universitari, verranno analizzati i motivi che li spingono al consumo di alcol, il binge drinking e le NekNomination (giochi alcolici online), l’uso dei pre-drinks (ritrovi serali tra amici per bere alcol prima di uscire) e le modalità in cui college e università aiutano gli studenti per evitare loro di incorrere in rischi legati all’alcol. In particolare, verranno analizzati drink spiking, violenze sessuali e fisiche, rischi per la salute e morte accidentale, e verranno presentate alcune strategie applicate per evitarli. La seconda parte verterà sull’analisi e discussione dei risultati di un sondaggio realizzato a Durham (Regno Unito) nel febbraio 2015 attraverso interviste a studenti universitari britannici e portieri di college e proprietari e membri dello staff di pub e bar locali con domande basate sulle loro esperienze, opinioni ed eventuali testimonianze riguardo il consumo di alcol, i fenomeni e i rischi sopra menzionati. Lo studio ha portato a vari risultati che hanno permessi di confermare e ampliare conoscenze pregresse sui temi trattati.
Resumo:
The purpose of this paper is to review the epidemiologic evidence for the effects of tobacco use and tobacco use cessation on a variety of oral diseases and conditions. Exposures considered include cigarette and bidi smoking, pipe and cigar smoking, and smokeless tobacco use. Oral diseases and disorders considered include oral cancer and precancer, periodontal disease, caries and tooth loss, gingival recession and other benign mucosal disorders as well as implant failure. Particular attention is given to the impact of tobacco use cessation on oral health outcomes. We conclude that robust epidemiologic evidence exists for adverse oral health effects of tobacco smoking and other types of tobacco use. In addition, there is compelling evidence to support significant benefits of tobacco use cessation with regard to various oral health outcomes. Substantial oral health benefits can be expected from abstention and successful smoking cessation in a variety of populations across all ages.
Resumo:
Agricultural workers are exposed to various risks, including chemical agents, noise, and many other factors. One of the most characteristic and least known risk factors is constituted by the microclimatic conditions in the different phases of work (in field, in greenhouse, etc). A typical condition is thermal stress due to high temperatures during harvesting operations in open fields or in greenhouses. In Italy, harvesting is carried out for many hours during the day, mainly in the summer, with temperatures often higher than 30 degrees C. According to ISO 7243, these conditions can be considered dangerous for workers' health. The aim of this study is to assess the risks of exposure to microclimatic conditions (heat) for fruit and vegetable harvesters in central Italy by applying methods established by international standards. In order to estimate the risk for workers, the air temperature, radiative temperature, and air speed were measured using instruments in conformity with ISO 7726. Thermodynamic parameters and two more subjective parameters, clothing and the metabolic heat production rate related to the worker's physical activity, were used to calculate the predicted heat strain (PHS) for the exposed workers in conformity with ISO 7933. Environmental and subjective parameters were also measured for greenhouse workers, according to ISO 7243, in order to calculate the wet-bulb globe temperature (WBGT). The results show a slight risk for workers during manual harvesting in the field. On the other hand, the data collected in the greenhouses show that the risk for workers must not be underestimated. The results of the study show that, for manual harvesting work in climates similar to central Italy, it is essential to provide plenty of drinking water and acclimatization for the workers in order to reduce health risks. Moreover, the study emphasizes that the possible health risks for greenhouse workers increase from the month of April through July.
Resumo:
Data on the characteristics of female patients counselled for fertility preservation and the efficacy and risk of the applied procedures are still poor. We therefore analysed the registry of a network of 70 infertility centers which are involved in fertility preservation in Germany, Switzerland and Austria, called FertiPROTEKT ( hhtp://www.fertiprotekt.eu ).
Resumo:
Background Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings HIV-infected patients aged ≥18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells <100 cells/µl and 15.4% among patients starting with ≥350 cells/µL. The estimates from CR cumulative incidence were 22.9% and 13.6%, respectively. Little difference was found between naïve and CR analyses in Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings.