Misclassification of seat belt useIn a recent article, Robertson 1 commented on our study of seat belts and death in a crash. 2 Robertson wrote: "What is not explained adequately by the theory [about misclassification of seat belt use] is the sudden gap in police reported use by the dead and survivors that appeared in the mid-1980s".Robertson's criticism seems misplaced, as we offered no theory to explain changes in the prevalence of belt use. We reported that among front seat occupant pairs in which one or both died, the prevalence of belt use decreased from 12% in 1975 to 4% in 1980, and then rose to 40% in 1998. 2 Explaining these changes, however, was not the focus of our paper. Using matched cohort methods, we noted that the risk ratio for death, comparing belted with unbelted occupants, was 0.59 using data from 1975-83, and 0.39 using data from 1986-98. We examined theories that might explain why these risk ratio estimates changed over time. 3 We presented evidence against the theory that seat belts have become truly more effective and against the theory that estimates changed because of changes in crash characteristics. The observed change in risk ratio estimates could be explained by either, or both, of two theories:(1) Differential misclassification. Seat belt misclassification is differential when the proportion misclassified is related to the outcome (death). Risk ratio estimates could move away from their true value and toward 0 if, over time, an increasing proportion of crash survivors were classified as belted, when they were not, or an increasing proportion of those who died were classified as unbelted, when they were: this possible mechanism is illustrated with hypothetical data in the top half of table 1. (For simplicity, the table ignores the matching used in our published analysis.) (2) Non-differential misclassification. Without regard to death or survival, some belt users could be classified as not belted, or some nonusers as belted, or both. Non-differential misclassification of a binary variable tends to bias risk ratio estimates toward 1. 4If nondifferential error decreased over time, more recent risk ratio estimates could be less subject to this bias; they could move away from 1 toward their true value. However, even if non-differential error was constant over time, more recent risk ratios might also tend to be less biased, because of the influence of changing seat belt prevalence: bottom half of table 1.For both differential and non-differential misclassification, the size and direction of any change over time in risk ratio estimates will be related to the size and direction of the errors and changes in the prevalence of seat belt use. The observed changes in risk ratio estimates alone cannot tell us which estimates are least subject to bias.One of us has reported that there is some degree of both differential and nondifferential misclassification of belt use; but the amount of error in recent data suitable for a matched-cohort analysis was so trivial, and biases toward 1 and tow...
Primary Dysmenorrhea (PD) is characterized by painful cramps before or during menstruation. It is generally treated with nonpharmacological methods. However, with the advancement of research and the passage of time, physiotherapy plays an increasingly important role in treating patients with PD. Electrotherapy and exercise therapy are conservative methods to treat PD. Alternative methods to minimize reliance on medicinal-based treatments are the need of the hour. This review aims to determine the efficacy of exercise-based therapies and electrotherapy modalities in treating PD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses standards have been used in the present systematic review and meta-analysis. Cochrane, PubMed, and Google Scholar were searched to facilitate the same. The articles from 2011 to 2021 were included in this review. The quality of the review was assessed using the Cochrane risk of bias tool. The visual analog scale was taken as a measure of pain intensity in the meta-analysis, and other outcomes have been included in the systematic review discussed. A total of 15 publications have been included, with a meta-analysis of 7. All included studies were of high quality (PEDro ≥ 5), and demonstrated the efficacy of exercise-based therapies and electrotherapy modalities in treating pain in females with PD. This review aims to check the impact of exercise and electrotherapy in females suffering from PD.
Background Government guidelines for lockdown and quarantine measures impacted the daily lives and health of individuals amid the coronavirus disease 2019 (COVID-19) pandemic. The pandemic caused significant changes in the daily routine and lifestyles of individuals worldwide with the simultaneous emergence of mental health disorders. Stress caused by COVID-19 pandemic outbreaks and consequent social isolation significantly influenced the mental health and quality of life of professionals among Indian population. This study aimed to evaluate the mental health and quality of life among Indian professionals embarked as COVID-19 survivors. Methods A 20-item self-administered questionnaire was developed and circulated among the participants with the following domains: helplessness, apprehension, mood swing, physical activity, restlessness, insomnia, irritation, mental stress, and emotional instability to assess their mental health and quality of life. Results Of the total 322 participants, 73.6% of individuals experienced helplessness, 56.2% felt the need for counseling, 65.5% reported feeling irritated even over minor issues, 62.1% experienced negative thoughts during isolation, 76.5% experienced difficulty in falling asleep, and 71.9% felt restless during their course of illness. Conclusion The study concludes that mental health and quality of life among COVID-19 survivors was affected by sleep, physical activities, emotional instability, and job profile, as well as support from others, mood swings, and the need for counseling.
Aim: To determine the prevalence of Rotavirus diarrhea among children up to 2 years of age Study design: A cross-sectional study Place and Duration: This study was conducted at Khairpur Medical College Hospital Khairpur Mir’s, Pakistan from June 2019 and December 2020. Methodology: The children's clinical profiles were examined, and the presence of rotavirus antigen in their stool with the ELISA method was detected. Results: The study included a total of 135 children who were suffering from diarrhea, among them 65 (48.14%) were boys, and 70 (51.85%) were girls. It was observed that minimum participation was from zero to 5 months (n=27, 20%), and a maximum number of the patients were in the age group 6 to 12 months (n=41, 30.37%). Rotavirus diarrhea was reported in 48.88% (n=66) of the children. In the age group of 19 to 24 months, 55.88% were Rotavirus positive. No significant association between the age and presence and absence of Rotavirus has been observed. (X2= 1.3241, P=0.723). A significant association has been observed between the feeding habits and the occurrence of Rotavirus diarrhea. (X2= 26.5539, P< 0.00001) Conclusion: Rotavirus infection was found in 48.88 % of these children, and there is a link between rotavirus infection and the method of feeding. Keywords: Infant, Diarrhea, Rotavirus, Breastfeeding
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