Displaying publications 1 - 20 of 100 in total

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  1. Allotey P, Reidpath DD, Pokhrel S
    Health Res Policy Syst, 2010 Oct 21;8:32.
    PMID: 20961461 DOI: 10.1186/1478-4505-8-32
    Centuries of scientific advances and developments in biomedical sciences have brought us a long way to understanding and managing disease processes, by reducing them to simplified cause-effect models. For most of the infectious diseases known today, we have the methods and technology to identify the causative agent, understand the mechanism by which pathology is induced and develop the treatment (drugs, vaccines, medical or surgical procedures) to cure, manage or control.Disease, however, occurs within a context of lives fraught with complexity. For any given infectious disease, who gets it, when, why, the duration, the severity, the outcome, the sequelae, are bound by a complex interplay of factors related as much to the individual as it is to the physical, social, cultural, political and economic environments. Furthermore each of these factors is in a dynamic state of change, evolving over time as they interact with each other. Simple solutions to infectious diseases are therefore rarely sustainable solutions. Sustainability would require the development of interdisciplinary sciences that allow us to acknowledge, understand and address these complexities as they occur, rather than rely solely on a form of science based on reducing the management of disease to simple paradigms.In this review we examine the current global health responses to the 'neglected' tropical diseases, which have been prioritised on the basis of an acknowledgment of the complexity of the poverty-disease cycle. However research and interventions for neglected tropical diseases, largely neglect the social and ecological contextual, factors that make these diseases persist in the target populations, continuing instead to focus on the simple biomedical interventions. We highlight the gaps in the approaches and explore the potential of enhanced interdisciplinary work in the development of long term solutions to disease control.
  2. Reidpath DD, Allotey P, Pokhrel S
    Health Res Policy Syst, 2011 Jan 06;9:1.
    PMID: 21210997 DOI: 10.1186/1478-4505-9-1
    BACKGROUND: There are strong arguments for social science and interdisciplinary research in the neglected tropical diseases. These diseases represent a rich and dynamic interplay between vector, host, and pathogen which occurs within social, physical and biological contexts. The overwhelming sense, however, is that neglected tropical diseases research is a biomedical endeavour largely excluding the social sciences. The purpose of this review is to provide a baseline for discussing the quantum and nature of the science that is being conducted, and the extent to which the social sciences are a part of that.

    METHODS: A bibliographic analysis was conducted of neglected tropical diseases related research papers published over the past 10 years in biomedical and social sciences. The analysis had textual and bibliometric facets, and focussed on chikungunya, dengue, visceral leishmaniasis, and onchocerciasis.

    RESULTS: There is substantial variation in the number of publications associated with each disease. The proportion of the research that is social science based appears remarkably consistent (<4%). A textual analysis, however, reveals a degree of misclassification by the abstracting service where a surprising proportion of the "social sciences" research was pure clinical research. Much of the social sciences research also tends to be "hand maiden" research focused on the implementation of biomedical solutions.

    CONCLUSION: There is little evidence that scientists pay any attention to the complex social, cultural, biological, and environmental dynamic involved in human pathogenesis. There is little investigator driven social science and a poor presence of interdisciplinary science. The research needs more sophisticated funders and priority setters who are not beguiled by uncritical biomedical promises.

  3. Allotey P, Reidpath DD, Yasin S, Chan CK, de-Graft Aikins A
    Lancet, 2011 Feb 5;377(9764):450-1.
    PMID: 21074257 DOI: 10.1016/S0140-6736(10)61856-9
  4. Reidpath DD, Ling ML, Yasin S, Rajagobal K, Allotey P
    Glob Health Action, 2012;5:14876.
    PMID: 22761601 DOI: 10.3402/gha.v5i0.14876
    INTRODUCTION: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers.
    METHOD: Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis.
    RESULTS: Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5-7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: -2.9 to -10.0) for diastolic blood pressure.
    CONCLUSION: The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.
    KEYWORDS: Malaysia; blood pressure; community workers; hypertension; measurement; screening
    Study site: urban, low-income community, of the Klang Valley near Kuala Lumpur, Malaysia
    Device: Mercury sphygmomanometers (Spirit brand, model number CK-101C), electronic, automatic blood pressure monitors (Omron brand model HEM-7203)
  5. Reidpath DD, Olafsdottir AE, Pokhrel S, Allotey P
    BMC Public Health, 2012;12 Suppl 1:S3.
    PMID: 22992346 DOI: 10.1186/1471-2458-12-S1-S3
    In the health systems literature one can see discussions about the trade off between the equity achievable by the system and its efficiency. Essentially it is argued that as greater health equity is achieved, so the level of efficiency will diminish. This argument is borrowed from economics literature on market efficiency. In the application of the economic argument to health, however, serious errors have been made, because it is quite reasonable to talk of both health equity being a desirable output of a health system, and the efficient production of that output. In this article we discuss notions of efficiency, and the equity-efficiency trade off, before considering the implications of this for health systems.
  6. Allotey P, Yasin S, Tang S, Chong SL, Cheah JC, Reidpath DD
    BMC Public Health, 2012;12 Suppl 1:S1.
    PMID: 22992275
  7. Soyiri IN, Reidpath DD
    Int J Gen Med, 2012;5:693-705.
    PMID: 22973117 DOI: 10.2147/IJGM.S34647
    Asthma is a global public health problem and the most common chronic disease among children. The factors associated with the condition are diverse, and environmental factors appear to be the leading cause of asthma exacerbation and its worsening disease burden. However, it remains unknown how changes in the environment affect asthma over time, and how temporal or environmental factors predict asthma events. The methodologies for forecasting asthma and other similar chronic conditions are not comprehensively documented anywhere to account for semistructured noncausal forecasting approaches. This paper highlights and discusses practical issues associated with asthma and the environment, and suggests possible approaches for developing decision-making tools in the form of semistructured black-box models, which is relatively new for asthma. Two statistical methods which can potentially be used in predictive modeling and health forecasting for both anticipated and peak events are suggested. Importantly, this paper attempts to bridge the areas of epidemiology, environmental medicine and exposure risks, and health services provision. The ideas discussed herein will support the development and implementation of early warning systems for chronic respiratory conditions in large populations, and ultimately lead to better decision-making tools for improving health service delivery.
  8. Allotey P, Verghis S, Alvarez-Castillo F, Reidpath DD
    BMC Public Health, 2012;12 Suppl 1(Suppl 1):S2.
    PMID: 22992314 DOI: 10.1186/1471-2458-12-S1-S2
  9. Soyiri IN, Reidpath DD
    PLoS One, 2012;7(10):e47823.
    PMID: 23118897 DOI: 10.1371/journal.pone.0047823
    The concept of forecasting asthma using humans as animal sentinels is uncommon. This study explores the plausibility of predicting future asthma daily admissions using retrospective data in London (2005-2006). Negative binomial regressions were used in modeling; allowing the non-contiguous autoregressive components. Selected lags were based on partial autocorrelation function (PACF) plot with a maximum lag of 7 days. The model was contrasted with naïve historical and seasonal models. All models were cross validated. Mean daily asthma admission in 2005 was 27.9 and in 2006 it was 28.9. The lags 1, 2, 3, 6 and 7 were independently associated with daily asthma admissions based on their PACF plots. The lag model prediction of peak admissions were often slightly out of synchronization with the actual data, but the days of greater admissions were better matched than the days of lower admissions. A further investigation across various populations is necessary.
  10. Soyiri IN, Reidpath DD
    Int J Gen Med, 2012;5:381-9.
    PMID: 22615533 DOI: 10.2147/IJGM.S31079
    Health forecasting forewarns the health community about future health situations and disease episodes so that health systems can better allocate resources and manage demand. The tools used for developing and measuring the accuracy and validity of health forecasts commonly are not defined although they are usually adapted forms of statistical procedures. This review identifies previous typologies used in classifying the forecasting methods commonly used in forecasting health conditions or situations. It then discusses the strengths and weaknesses of these methods and presents the choices available for measuring the accuracy of health-forecasting models, including a note on the discrepancies in the modes of validation.
  11. Soyiri IN, Reidpath DD
    Environ Health Prev Med, 2013 Jan;18(1):1-9.
    PMID: 22949173 DOI: 10.1007/s12199-012-0294-6
    Health forecasting is a novel area of forecasting, and a valuable tool for predicting future health events or situations such as demands for health services and healthcare needs. It facilitates preventive medicine and health care intervention strategies, by pre-informing health service providers to take appropriate mitigating actions to minimize risks and manage demand. Health forecasting requires reliable data, information and appropriate analytical tools for the prediction of specific health conditions or situations. There is no single approach to health forecasting, and so various methods have often been adopted to forecast aggregate or specific health conditions. Meanwhile, there are no defined health forecasting horizons (time frames) to match the choices of health forecasting methods/approaches that are often applied. The key principles of health forecasting have not also been adequately described to guide the process. This paper provides a brief introduction and theoretical analysis of health forecasting. It describes the key issues that are important for health forecasting, including: definitions, principles of health forecasting, and the properties of health data, which influence the choices of health forecasting methods. Other matters related to the value of health forecasting, and the general challenges associated with developing and using health forecasting services are discussed. This overview is a stimulus for further discussions on standardizing health forecasting approaches and methods that will facilitate health care and health services delivery.
  12. Reidpath DD, Ling ML, Wellington E, Al-Sadat N, Yasin S
    Nicotine Tob Res, 2013 Mar;15(3):729-33.
    PMID: 22990215 DOI: 10.1093/ntr/nts177
    INTRODUCTION: It is held that younger smoking initiates are more likely to become regular smokers. The definitions of smoking initiation (a puff, part of a cigarette, a whole cigarette) are inconsistent and raise questions about the robustness of the view. We sought to re-examine the relationship using adolescent smoking data from 3 European countries.
    METHODS: A stratified secondary, logistic regression analysis of Global Youth Tobacco Survey data was conducted using a design-based analysis. Subgroup analyses were conducted of 13- to 15-year olds from Latvia (high smoking prevalence), Slovenia (moderate prevalence), and Montenegro (low prevalence) who had initiated smoking. The outcome was current smoking--smoking everyday for the past 30 days, or smoking 10 or more days in the past 30 days. Smoking initiation was operationalized as a single puff of a cigarette, and age of smoking initiation was a derived continuous measure.
    RESULTS: In Latvia, there was a significant association between age of smoking initiation and current smoking for males (p < .05) and females (p < .001) when smoking was operationalized as smoking every day. It was only significant in female adolescents (p < .001) for smoking 10 or more days. In Slovenia and Montenegro, there was no significant relationship between age of smoking initiation and current smoking for either males or females.
    CONCLUSIONS: The evidence about the relationship between age of smoking initiation and current smoking is not clear. Explanations for the findings may relate to a lack of power, the specificity of the measure, or problems with the theory.
  13. Soyiri IN, Reidpath DD, Sarran C
    Chron Respir Dis, 2013 May;10(2):85-94.
    PMID: 23620439 DOI: 10.1177/1479972313482847
    Health forecasting can improve health service provision and individual patient outcomes. Environmental factors are known to impact chronic respiratory conditions such as asthma, but little is known about the extent to which these factors can be used for forecasting. Using weather, air quality and hospital asthma admissions, in London (2005-2006), two related negative binomial models were developed and compared with a naive seasonal model. In the first approach, predictive forecasting models were fitted with 7-day averages of each potential predictor, and then a subsequent multivariable model is constructed. In the second strategy, an exhaustive search of the best fitting models between possible combinations of lags (0-14 days) of all the environmental effects on asthma admission was conducted. Three models were considered: a base model (seasonal effects), contrasted with a 7-day average model and a selected lags model (weather and air quality effects). Season is the best predictor of asthma admissions. The 7-day average and seasonal models were trivial to implement. The selected lags model was computationally intensive, but of no real value over much more easily implemented models. Seasonal factors can predict daily hospital asthma admissions in London, and there is a little evidence that additional weather and air quality information would add to forecast accuracy.
  14. Ahmadi K, Reidpath DD, Allotey P, Hassali MA
    BMJ Open, 2013 May 28;3(5).
    PMID: 23793653 DOI: 10.1136/bmjopen-2013-002755
    INTRODUCTION: HIV/AIDS-related stigma affects the access and utilisation of health services. Although HIV/AIDS-related stigma in the health services has been studied, little work has attended to the relationship between professional development and stigmatising attitudes. Hence, in this study, we will extend earlier research by examining the relationship between the stage of professional development and the kinds of stigmatising attitudes held about people living with HIV/AIDS.

    METHODS AND ANALYSIS: A serial cross-sectional design will be combined with a two-point in time longitudinal design to measure the levels of stigma among healthcare students from each year of undergraduate and graduate courses in Malaysia and Australia. In the absence of suitable measures, we will carry out a sequential mixed methods design to develop such a tool. The questionnaire data will be analysed using mixed effects linear models to manage the repeated measures.

    ETHICS AND DISSEMINATION: We have received ethical approval from the Monash MBBS executive committee as well as the Monash University Human Research Ethics Committee. We will keep the data in a locked filing cabinet in the Monash University (Sunway campus) premises for 5 years, after which the information will be shredded and disposed of in secure bins, and digital recordings will be erased in accordance with Monash University's regulations. Only the principal investigator and the researcher will have access to the filing cabinet. We aim to present and publish the results of this study in national and international conferences and peer-reviewed journals, respectively.

  15. Soyiri IN, Reidpath DD, Sarran C
    Int J Biometeorol, 2013 Jul;57(4):569-78.
    PMID: 22886344 DOI: 10.1007/s00484-012-0584-0
    Asthma is a chronic condition of great public health concern globally. The associated morbidity, mortality and healthcare utilisation place an enormous burden on healthcare infrastructure and services. This study demonstrates a multistage quantile regression approach to predicting excess demand for health care services in the form of asthma daily admissions in London, using retrospective data from the Hospital Episode Statistics, weather and air quality. Trivariate quantile regression models (QRM) of asthma daily admissions were fitted to a 14-day range of lags of environmental factors, accounting for seasonality in a hold-in sample of the data. Representative lags were pooled to form multivariate predictive models, selected through a systematic backward stepwise reduction approach. Models were cross-validated using a hold-out sample of the data, and their respective root mean square error measures, sensitivity, specificity and predictive values compared. Two of the predictive models were able to detect extreme number of daily asthma admissions at sensitivity levels of 76 % and 62 %, as well as specificities of 66 % and 76 %. Their positive predictive values were slightly higher for the hold-out sample (29 % and 28 %) than for the hold-in model development sample (16 % and 18 %). QRMs can be used in multistage to select suitable variables to forecast extreme asthma events. The associations between asthma and environmental factors, including temperature, ozone and carbon monoxide can be exploited in predicting future events using QRMs.
  16. Davey TM, Allotey P, Reidpath DD
    Public Health, 2013 Dec;127(12):1057-62.
    PMID: 24268545 DOI: 10.1016/j.puhe.2013.09.008
    Effective population-level solutions to the obesity pandemic have proved elusive. In low- and middle-income countries the problem may be further challenged by the perceived internal tension between economic development and sustainable solutions which create the optimal conditions for human health and well-being. This paper discusses some of the ecological obstacles to addressing the growing problem of obesity in 'aspiring' economies, using Malaysia as a case study. The authors conclude that current measures to stimulate economic growth in Malaysia may actually be exacerbating the problem of obesity in that country. Public health solutions which address the wider context in which obesity exists are needed to change the course of this burgeoning problem.
  17. Bonsu KO, Kadirvelu A, Reidpath DD
    Vasc Health Risk Manag, 2013;9:303-19.
    PMID: 23807852 DOI: 10.2147/VHRM.S44499
    Statins lower serum cholesterol and are employed for primary and secondary prevention of cardiovascular events. Clinical evidence from observational studies, retrospective data, and post hoc analyses of data from large statin trials in various cardiovascular conditions, as well as small scale randomized trials, suggest survival and other outcome benefits for heart failure. Two recent large randomized controlled trials, however, appear to suggest statins do not have beneficial effects in heart failure. In addition to lowering cholesterol, statins are believed to have many pleotropic effects which could possibly influence the pathophysiology of heart failure. Following the two large trials, evidence from recent studies appears to support the use of statins in heart failure. This review discusses the role of statins in the pathophysiology of heart failure, current evidence for statin use in heart failure, and suggests directions for future research.
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