Suchergebnisse

Abstract Background Antibiotic overuse and misuse for upper respiratory tract infections in children is widespread and fuelled by public attitudes and expectations. This study assessed knowledge, beliefs, and practices regarding antibiotic use for these paediatric infections among children's caregivers' in Trinidad and Tobago in the English speaking Caribbean. Methods In a cross-sectional observational study, by random survey children's adult caregivers gave a telephone interview from November 1998 to January 1999. On a pilot-tested evaluation instrument, respondents provided information about their knowledge and beliefs of antibiotics, and their use of these agents to treat recent episodes (< previous 30 days) of upper respiratory tract infections in children under their care. Caregivers were scored on an antibiotic knowledge test and divided based on their score. Differences between those with high and low scores were compared using the chi-square test. Results Of the 417 caregivers, 70% were female and between 18–40 years, 77% were educated to high school and beyond and 43% lived in urban areas. Two hundred and forty nine (60%) respondents scored high (≥ 12) on antibiotic knowledge and 149 (34%) had used antibiotics in the preceding year. More caregivers with a high knowledge score had private health insurance (33%), (p < 0.02), high school education (57%) (p < 0.002), and had used antibiotics in the preceding year (p < 0.008) and within the last 30 days (p < 0.05). Caregivers with high scores were less likely to demand antibiotics (p < 0.05) or keep them at home (p < 0.001), but more likely to self-treat with antibiotics (p < 0.001). Caregivers administered antibiotics in 241/288 (84%) self-assessed severe episodes of infection (p < 0.001) and in 59/126 (43%) cough and cold episodes without visiting a health clinic or private physician (p < 0.05). Conclusions In Trinidad and Tobago, caregivers scoring low on antibiotic knowledge have erroneous beliefs and use antibiotics inappropriately. Children in their care receive antibiotics for upper respiratory tract infections without visiting a health clinic or a physician. Educational interventions in the community on the consequences of inappropriate antibiotic use in children are recommended. Our findings emphasise the need to address information, training, legislation and education at all levels of the drug delivery system towards discouraging self-medication with antibiotics in children.

This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Journals of Gerontology Series a-Biological Sciences and Medical Sciences following peer review. The definitive publisher-authenticated version Laddu, D., Parimi, N., Cauley, J. A., Cawthon, P. M., Ensrud, K. E., Orwoll, E., . . . Osteoporotic Fractures Men Mr, O. S. (2018). The Association Between Trajectories of Physical Activity and All-Cause and Cause-Specific Mortality. Journals of Gerontology Series a-Biological Sciences and Medical Sciences, 73(12), 1708-1713. doi:10.1093/gerona/gly037 is available online at: indigo.uic.edu. ; Background: The benefits of physical activity (PA) for health have primarily been evaluated during midlife. Whether patterns of change in late-life PA associate with overall and cause-specific mortality remains unclear. Methods: We examined the association between PA trajectories and subsequent mortality among 3,767 men aged ≥ 65 years. Men self-reported PA using the Physical Activity Scale for the Elderly scale (PASE) at up to 4 time points from 2000 through 2009 (Year 7); mortality was assessed over an average of 7.1 years after the Year 7 contact. Group-based trajectory modeling identified patterns of PA change. Cox proportional hazards models described associations between patterns of change in PA, Year 7 PA, and subsequent mortality risk. Results: Three discrete PA patterns were identified, all with declining PA. Compared to low-activity declining men, moderate (HR = 0.78; 95% CI: 0.70, 0.88) and high-activity (HR = 0.69, 95% CI: 0.57, 0.83) declining groups were associated with lower risk of all-cause mortality. Among models with a single time-point, the last time point (Year 7 PA score) was a strong predictor of mortality with HR = 0.85 (95% CI: 0.78, 0.93) per SD increase in PASE score. PA patterns were not a risk factor for mortality after adjustment for the Year 7 PA score. Conclusions: Recent PA levels are a stronger indicator of subsequent mortality risk than PA patterns reported over the prior 7 years or prior PA level, suggesting that current PA rather than history of PA is the most relevant parameter in clinical settings. ; The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA); the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); the National Center for Advancing Translational Sciences (NCATS); and NIH Roadmap for Medical Research (grant numbers U01 AG027810, U01 AG042124, U01 AG042139, U01 AG042140, U01 AG042143, U01 AG042145, U01 AG042168, U01 AR066160, and UL1 TR000128). This manuscript is the result of work supported with resources and use of facilities of the Minneapolis VA Health Care System. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.