GLORIA

GEOMAR Library Ocean Research Information Access

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Abstract: There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2985-3
    detail.hit.zdb_id: 2006309-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 2
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 106, No. 2 ( 2019-01-08), p. e103-e112
    Abstract: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P & lt; 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P & lt; 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference −9·4 (95 per cent c.i. −11·9 to −6·9) per cent; P & lt; 0·001), but the relationship was reversed in low-HDI countries (+12·1 (+7·0 to +17·3) per cent; P & lt; 0·001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0·60, 0·50 to 0·73; P & lt; 0·001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2985-3
    detail.hit.zdb_id: 2006309-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 3
    In: BJS Open, Oxford University Press (OUP), Vol. 3, No. 3 ( 2019-06), p. 403-414
    Type of Medium: Online Resource
    ISSN: 2474-9842 , 2474-9842
    URL: Issue
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2902033-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 4
    In: The Lancet Infectious Diseases, Elsevier BV, Vol. 18, No. 5 ( 2018-05), p. 516-525
    Type of Medium: Online Resource
    ISSN: 1473-3099
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2018
    detail.hit.zdb_id: 2061641-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 5
    Online Resource
    Online Resource
    Wiley ; 2002
    In:  Tropical Medicine & International Health Vol. 7, No. 5 ( 2002-05), p. 471-476
    In: Tropical Medicine & International Health, Wiley, Vol. 7, No. 5 ( 2002-05), p. 471-476
    Abstract: The recently cloned glucose regulated protein 78 (GRP78) of Leishmania donovani has been suggested as a new and promising Leishmania vaccine candidate. We assessed antibody and T‐cell reactivity to GRP78 in an enzyme‐linked immunosorbent assay (ELISA) and in lymphoproliferative assays. Serological evaluation of plasma samples obtained in Sudan revealed that 89% of patients with visceral leishmaniasis (VL), 78% with post kala‐azar dermal leishmaniasis (PKDL), and 85% with cutaneous leishmaniasis (CL) had antibody reactivity to this Leishmania antigen. Plasma from healthy Sudanese individuals living in an area endemic for malaria but free of leishmaniasis and plasma from healthy Danes was negative in the assay. GRP78 antibody was detected in 10% and 5% of plasma samples from Sudanese and Ghanaian malaria patients, respectively, whereas 35% of plasma samples from otherwise healthy Sudanese individuals with a positive leishmanin skin test showed antibody reactivity to recombinant GRP78 (rGRP78). In lymphoproliferative assays, 9 of 13 isolates of peripheral blood mononuclear cells (PBMC) from individuals previously infected with L. donovani and one of three individuals previously infected with L. major showed a response to rGRP78, whereas PBMC isolates from Danish control individuals did not respond. These findings, in addition to our previous observations in experimental CL ( Jensen et al . 2001 ), confirm GRP78 as a possible vaccine antigen.
    Type of Medium: Online Resource
    ISSN: 1360-2276 , 1365-3156
    Language: English
    Publisher: Wiley
    Publication Date: 2002
    detail.hit.zdb_id: 2018112-7
    detail.hit.zdb_id: 1314080-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 6
    Online Resource
    Online Resource
    Oxford University Press (OUP) ; 2024
    In:  Occupational Medicine Vol. 74, No. Supplement_1 ( 2024-07-05), p. 0-0
    In: Occupational Medicine, Oxford University Press (OUP), Vol. 74, No. Supplement_1 ( 2024-07-05), p. 0-0
    Abstract: Organophosphorus (OP) insecticides are cholinesterase inhibitors and are commonly applied around the world. Although their use has been phased out, they are still applied in developing countries due to their low cost and effectiveness. Children are exposed to pesticides through their diet, living near fields where pesticides are applied, and through para-occupational exposure. Furthermore, children and adolescents may be engaged in agricultural activities, often working on family farms, performing the same tasks as adults. International labor laws allow children at younger ages to work in agriculture compared to other industries. Studies examining pesticide exposure in children have focused on prenatal or early life exposures and there are limited studies focused on adolescents who may be working as pesticide applicators or in fields where pesticides are applied. Fewer studies have examined occupational exposure among children, and most have only utilized a single time point and not repeated measures of exposure. Our goal was to determine the impact of repeated exposure to chlorpyrifos, an OP insecticide, on biomarkers of exposure and neurobehavioral performance in adolescents across an application season. Information about the exposure pathways was used to develop an intervention to reduce exposure. Adolescents in Egypt are exposed to pesticides through both occupational and non-occupational pathways. Male adolescents (applicators and non-applicators) were assessed before, during, and after the pesticide application season. At each session, participants completed a neurobehavioral test battery, symptom questionnaires, and urine was collected for analysis of the chlorpyrifos metabolite 3,5,6-trichloro-2 pyridinol (TCPy). Blood samples were collected at several time points to assess cholinesterase activity. TCPy metabolite levels increased during the application season and decreased after application ended. Butyrylcholinesterase activity was inhibited during the application season and recovered after application ended. Increased symptoms, neurobehavioral deficits, and reduced lung function were found in applicators compared to non-applicators. Changes in neurobehavioral performance across the application season showed a pattern of impaired performance among the high exposed compared to the low exposed, deficits increased during the application season and remained after application ended. The findings indicate that neurobehavioral deficits increase during the application season, as exposure also increases, and remain after the application ends, even when the biomarkers of exposure are reduced. In addition, a dose-response gradient was found between urinary TCPy levels and attention deficit hyperactivity disorder (ADHD). Recognizing the need to reduce exposures, an intervention was developed in partnership with the Ministry of Agriculture focused on behaviors during pesticide application and hygiene practices. An educational intervention, incorporating a behavioral change theory, led to an immediate increase in knowledge and awareness of risks associated with pesticides. This increase was sustained over time and led to changes in behavior. This work was supported by the National Institute of Environmental Health Sciences and the Fogarty Institute through R21 ES017223 and R01 ES022163.
    Type of Medium: Online Resource
    ISSN: 0962-7480 , 1471-8405
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 2042824-8
    detail.hit.zdb_id: 1103950-4
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 7
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Adolescents are engaged in agricultural work, including pesticide application, around the world. Adolescent pesticide applicators are more likely to be exposed to pesticides than their adult counterparts because of their application practice and hygiene habits surrounding pesticide use. There is a need for low-cost interventions to reduce pesticide exposure. We evaluated a theoretically-based educational intervention to change perceptions about the risk of pesticide use and hygiene habits during and after pesticide application for adolescent and young adult pesticide applicators in Egypt. Methods Young adult and adolescent male pesticide applicators were given a one-hour educational intervention to inform them about the risk of pesticide use and how to reduce pesticide exposure. The median age of participants was 18 years old. Changes in perceived susceptibility and effectiveness were measured with a survey pre and post-intervention ( n  = 119) on the same day. The same survey ( n  = 95) was given 8-months post-intervention to identify sustained effects. Observational checklists of pesticide application practice were also completed during application seasons before and after the intervention. Results There was an increase in the proportion of individuals who viewed pesticides as being a long-term health risk (74.7% pre-intervention to 97.9% post-intervention, McNemar test p   〈  0.001). This change remained significant when surveyed at the 8-month follow-up (90.5%, p   〈  0.001). There was also a sustained improvement regarding participants’ views of proper hygiene practice surrounding pesticide application. Applicators were observed wearing goggles, shoes, and masks more frequently post-intervention. Conclusion This theoretically-based intervention is an example of a low-cost solution that can improve adolescents’ and young adults’ practices regarding pesticide application and personal hygiene practices during and after pesticide application. The intervention can be applied in other countries with similar safety culture surrounding pesticide application.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041338-5
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 8
    Online Resource
    Online Resource
    MDPI AG ; 2014
    In:  International Journal of Environmental Research and Public Health Vol. 11, No. 12 ( 2014-12-16), p. 13117-13129
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 11, No. 12 ( 2014-12-16), p. 13117-13129
    Abstract: Chlorpyrifos (CPF) is a commonly used organophosphate insecticide (OP). In adults, exposure to OPs has been inconsistently associated with reduced lung function. OP exposure and lung function has not been assessed in adolescents. The objective of this study was to assess CPF exposure and lung function among Egyptian adolescents. We conducted a 10-month study of male adolescent pesticide applicators (n = 38) and non-applicators of similar age (n = 24). Urinary 3,5,6-trichloro-2-pyridinol (TPCy), a CPF-specific metabolite, was analyzed in specimens collected throughout the study. Spirometry was performed twice after pesticide application: day 146, when TCPy levels were elevated and day 269, when TCPy levels were near baseline. Applicators had higher levels of TCPy (mean cumulative TCPy day 146 = 33,217.6; standard deviation (SD) = 49,179.3) than non-applicators (mean cumulative TCPy day 146 = 3290.8; SD = 3994.9). Compared with non-applicators, applicators had higher odds of reporting wheeze, odds ratio = 3.41 (95% CI: 0.70; 17.41). Cumulative urinary TCPy was inversely associated with spirometric measurements at day 146, but not at day 269. Although generally non-significant, results were consistent with an inverse association between exposure to CPF and lung function.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2014
    detail.hit.zdb_id: 2175195-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
  • 9
    In: NeuroToxicology, Elsevier BV, Vol. 74 ( 2019-09), p. 1-6
    Type of Medium: Online Resource
    ISSN: 0161-813X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 800820-6
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...