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Search Results: 1 - 10 of 39948 matches for " Wolf-Peter Schmidt "
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The Effect of Handwashing with Water or Soap on Bacterial Contamination of Hands
Maxine Burton,Emma Cobb,Peter Donachie,Gaby Judah,Val Curtis,Wolf-Peter Schmidt
International Journal of Environmental Research and Public Health , 2011, DOI: 10.3390/ijerph8010097
Abstract: Handwashing is thought to be effective for the prevention of transmission of diarrhoea pathogens. However it is not conclusive that handwashing with soap is more effective at reducing contamination with bacteria associated with diarrhoea than using water only. In this study 20 volunteers contaminated their hands deliberately by touching door handles and railings in public spaces. They were then allocated at random to (1) handwashing with water, (2) handwashing with non-antibacterial soap and (3) no handwashing. Each volunteer underwent this procedure 24 times, yielding 480 samples overall. Bacteria of potential faecal origin (mostly Enterococcus and Enterobacter spp.) were found after no handwashing in 44% of samples. Handwashing with water alone reduced the presence of bacteria to 23% (p < 0.001). Handwashing with plain soap and water reduced the presence of bacteria to 8% (comparison of both handwashing arms: p < 0.001). The effect did not appear to depend on the bacteria species. Handwashing with non-antibacterial soap and water is more effective for the removal of bacteria of potential faecal origin from hands than handwashing with water alone and should therefore be more useful for the prevention of transmission of diarrhoeal diseases.
Formative research on the feasibility of hygiene interventions for influenza control in UK primary schools
Wolf-Peter Schmidt, Catherine Wloch, Adam Biran, Val Curtis, Punam Mangtani
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-390
Abstract: A pilot study in four primary schools in East London was conducted to establish the current need for enhanced hand hygiene interventions, identify barriers to their implementation and to test their acceptability and feasibility. The pilot study included key informant interviews with teachers and school nurses, interviews, group discussions and essay questions with the children, and testing of organised classroom hand hygiene activities.In all schools, basic issues of personal hygiene were taught especially in the younger age groups. However, we identified many barriers to implementing intensive hygiene interventions, in particular time constraints and competing health issues. Teachers' motivation to teach hygiene and enforce hygienic behaviour was primarily educational rather than immediate infection control. Children of all age groups had good knowledge of hygiene practices and germ transmission.The pilot study showed that intensive hand hygiene interventions are feasible and acceptable but only temporarily during a period of a particular health threat such as an influenza pandemic, and only if rinse-free hand sanitisers are used. However, in many settings there may be logistical issues in providing all schools with an adequate supply. In the absence of evidence on effectiveness, the scope for enhanced hygiene interventions in schools in high income countries aiming at infection control appears to be limited in the absence of a severe public health threat.Although generally not having the highest mortality, school children bear a substantial burden of influenza-related morbidity and other infections [1,2]. Clinical attack rates in children in the current H1N1 influenza A epidemic may be twice that of adults [3]. Schools and school children have been shown to play a major role in the spread of influenza during epidemics [4,5]. As a component of the layered interventions for mitigating a pandemic (that may include vaccination, prophylactic use of antiviral drugs and
Male commuters in north and south England: risk factors for the presence of faecal bacteria on hands
Laura Dodrill, Wolf-Peter Schmidt, Emma Cobb, Peter Donachie, Valerie Curtis, Mícheál de Barra
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-31
Abstract: Hand swabs from commuters (n = 308) at train stations in 4 cities were tested for the presence of faecal bacteria.The prevalence of hand contamination with faecal bacteria was again higher in cities in the north compared to the south (5% in London, 4% in Birmingham, 10% in Liverpool and 19% in Newcastle). Contamination risk decreased with age and better personal hygiene (self-reported). Soil contact and shaking hands increased contamination with faecal bacteria. However, in multivariable analysis, none of these factors fully explained the variation in contamination across cities.The study confirmed the north-south differences in faecal contamination of hands without finding a clear cause for the trend. Faecal contamination of hands was associated with personal hygiene indicators suggesting that microbiological testing may contribute to evaluating hygiene promotion campaigns.Total morbidity (both reported and the estimated unreported cases) for intestinal infectious disease within England has been estimated at 9.4 million cases per year, which scales to one person in five per year [1]. The Financial Services Authority estimated the cost of this burden to the UK economy at £350 million per year [2]. Faecal-oral carriage via the hands is thought to be an important transmission pathway for diarrhoea pathogens. The promotion of improved hand hygiene continues to be a key public health goal both in low and high income countries, in communities and in health care settings. Most previous research has been done into specific populations such as primary carers and healthcare workers [3-6], but little work has been done to investigate the carriage rate of the general population [7-9].Normal bacterial flora of the gastrointestinal tract includes a vast array of anaerobes (organisms that exist in the absence of oxygen), gram negative organisms of the family Enterobacteriaceae as well as gram positive Enterococci. Commonly found species of Enterobacteriaceae are Escherichia coli
Sampling strategies to measure the prevalence of common recurrent infections in longitudinal studies
Wolf-Peter Schmidt, Bernd Genser, Mauricio L Barreto, Thomas Clasen, Stephen P Luby, Sandy Cairncross, Zaid Chalabi
Emerging Themes in Epidemiology , 2010, DOI: 10.1186/1742-7622-7-5
Abstract: We developed a set of four empirical simulation models representing low and high risk settings with short or long episode durations. The model was used to evaluate different sampling strategies with different assumptions on recall period and recall error.The model identified three major factors that influence sampling strategies: (1) the clustering of episodes in individuals; (2) the duration of episodes; (3) the positive correlation between an individual's disease incidence and episode duration. Intermittent sampling (e.g. 12 times per year) often requires only a slightly larger sample size compared to continuous sampling, especially in cluster-randomized trials. The collection of period prevalence data can lead to highly biased effect estimates if the exposure variable is associated with episode duration. To maximize study power, recall periods of 3 to 7 days may be preferable over shorter periods, even if this leads to inaccuracy in the prevalence estimates.Choosing the optimal approach to measure recurrent infections in epidemiological studies depends on the setting, the study objectives, study design and budget constraints. Sampling at intervals can contribute to making epidemiological studies and trials more efficient, valid and cost-effective.The prevalence of common recurrent infections such as diarrhoea and respiratory infections in field studies is commonly estimated using repeated measurements in the same individuals. Many studies have used intensive surveillance, for example by conducting twice-weekly home visits to measure prevalence on every single day over the study period [1,2]. In other studies prevalence was measured at intervals, for example during only four home visits at 4-week intervals [3]. The differences in logistical effort are considerable. A study of 100 households over one year with twice-weekly surveillance visits would require 52 × 2 × 100 = 10,400 visits. Conducting only four visits per household in total requires only 4 × 100 = 400 v
The effect of improved rural sanitation on diarrhoea and helminth infection: design of a cluster-randomized trial in Orissa, India
Thomas Clasen, Sophie Boisson, Parimita Routray, Oliver Cumming, Marion Jenkins, Jeroen H J Ensink, Melissa Bell, Matthew C Freeman, Soosai Peppin, Wolf-Peter Schmidt
Emerging Themes in Epidemiology , 2012, DOI: 10.1186/1742-7622-9-7
Abstract: Randomisation resulted in an acceptable balance between trial arms. The sample size requirements appear to be met for the main study outcomes. Delays in intervention roll-out caused logistical problems especially for the planning of health outcome follow-up surveys. Latrine coverage at the end of the construction period (55%) remained below the target of 70%, a result that may, however, be in line with many other TSC intervention areas in India.We discuss a number of methodological problems encountered thus far in this study that may be typical for sanitation trials. Nevertheless, it is expected that the trial procedures will allow measuring the effectiveness of a typical rural sanitation campaign, with sufficient accuracy and validity.Diseases associated with poor sanitation cause a large burden of disease worldwide. Diarrhoea alone causes an estimated 4 billion cases and 1.9 million deaths each year among children under 5 years, or 19% of all under-5 deaths in low income settings [1]. Other major diseases associated with poor sanitation are soil-transmitted worm infections, trachoma, lymphatic filariasis and schistosomiasis [2]. In contrast to other Millennium Development Goals, sanitation coverage remains low with 2.5 billion people still lacking access to sanitation. Only 6% of rural residents in India have access to improved sanitation, and about 69% practice open defecation [3].Systematic reviews have suggested that improved sanitation may reduce diarrhoeal diseases by 22% to 36% [2,4-8]. The studies included in these reviews were observational or small-scale before/after intervention studies that combined sanitation with water supplies or hygiene. The methodological quality of the studies was generally poor [2,5-8]. To date, there is no randomized controlled trial of sanitation interventions to prevent diarrhoeal diseases [2,4-8]. Large RCTs may have been deemed difficult due to logistical constraints, including the long time frame of sanitation campaigns bot
The role of age, ethnicity and environmental factors in modulating malaria risk in Rajasthali, Bangladesh
Ubydul Haque, Ricardo J Soares Magalh?es, Dipak Mitra, Korine N Kolivras, Wolf-Peter Schmidt, Rashidul Haque, Gregory E Glass
Malaria Journal , 2011, DOI: 10.1186/1475-2875-10-367
Abstract: A total of 4,200 (78.9%; N = 5,322) households were targeted in Rajasthali in July, 2009, and 1,400 individuals were screened using a rapid diagnostic test (Falci-vax). These data were linked to environmental and socio-economic data in a geographical information system. To describe the association between environmental factors and malaria risk, a generalized linear mixed model approach was utilized. The study investigated the role of environmental factors on malaria risk by calculating their population-attributable fractions (PAF), and used residual semivariograms to quantify the geographical clustering in malaria risk unaccounted by these factors.Overall malaria prevalence was 11.7%. Out of 5,322 households, 44.12% households were living in areas with malaria prevalence of ≥ 10%. The results from statistical analysis showed that age, ethnicity, proximity to forest, household density, and elevation were significantly and positively correlated with the malaria risk and PAF estimation. The highest PAF of malaria prevalence was 47.7% for third tertile (n = 467) of forest cover, 17.6% for second tertile (n = 467) of forest cover and 19.9% for household density >1,000.Targeting of malaria health interventions at small spatial scales in Bangladesh should consider the social and socio-economic risk factors identified as well as alternative methods for improving equity of access to interventions across whole communities.Malaria eradication is the ultimate goal of the World Health Organization (WHO) [1]. Most malaria endemic countries are presently shifting their efforts from malaria control to eradication [2]. The WHO has targeted eight to ten countries for elimination of malaria by 2015 and afterwards in all other endemic countries [1]. Although the long-term goal is world-wide eradication, there remains some debate over the feasibility of elimination in Africa and eleven Asian malaria endemic countries [2-5]. Accurate maps of malaria incidence are important tools in malar
Population Density, Water Supply, and the Risk of Dengue Fever in Vietnam: Cohort Study and Spatial Analysis
Wolf-Peter Schmidt,Motoi Suzuki,Vu Dinh Thiem,Richard G. White,Ataru Tsuzuki,Lay-Myint Yoshida,Hideki Yanai,Ubydul Haque,Le Huu Tho,Dang Duc Anh,Koya Ariyoshi
PLOS Medicine , 2011, DOI: 10.1371/journal.pmed.1001082
Abstract: Background Aedes aegypti, the major vector of dengue viruses, often breeds in water storage containers used by households without tap water supply, and occurs in high numbers even in dense urban areas. We analysed the interaction between human population density and lack of tap water as a cause of dengue fever outbreaks with the aim of identifying geographic areas at highest risk. Methods and Findings We conducted an individual-level cohort study in a population of 75,000 geo-referenced households in Vietnam over the course of two epidemics, on the basis of dengue hospital admissions (n = 3,013). We applied space-time scan statistics and mathematical models to confirm the findings. We identified a surprisingly narrow range of critical human population densities between around 3,000 to 7,000 people/km2 prone to dengue outbreaks. In the study area, this population density was typical of villages and some peri-urban areas. Scan statistics showed that areas with a high population density or adequate water supply did not experience severe outbreaks. The risk of dengue was higher in rural than in urban areas, largely explained by lack of piped water supply, and in human population densities more often falling within the critical range. Mathematical modeling suggests that simple assumptions regarding area-level vector/host ratios may explain the occurrence of outbreaks. Conclusions Rural areas may contribute at least as much to the dissemination of dengue fever as cities. Improving water supply and vector control in areas with a human population density critical for dengue transmission could increase the efficiency of control efforts. Please see later in the article for the Editors' Summary
Effectiveness and tolerability of a fixed-dose combination of olmesartan and amlodipine in clinical practice
Peter Bramlage, Wolf-Peter Wolf, Thomas Stuhr, et al
Vascular Health and Risk Management , 2010, DOI: http://dx.doi.org/10.2147/VHRM.S13441
Abstract: tiveness and tolerability of a fixed-dose combination of olmesartan and amlodipine in clinical practice Original Research (3930) Total Article Views Authors: Peter Bramlage, Wolf-Peter Wolf, Thomas Stuhr, et al Published Date August 2010 Volume 2010:6 Pages 803 - 811 DOI: http://dx.doi.org/10.2147/VHRM.S13441 Peter Bramlage1, Wolf-Peter Wolf2, Thomas Stuhr2, Eva-Maria Fronk3, Wolfhard Erdlenbruch2, Reinhard Ketelhut4, Roland E Schmieder5 1Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow; 2Daiichi Sankyo Deutschland GmbH, Munich, Germany; 3Daiichi Sankyo Europe GmbH, Munich, Germany; 4Department of Sports Medicine, Universit tsklinikum Berlin; 5Department of Nephrology and Hypertension, University Hospital of Erlangen, Germany Objectives: To assess the efficacy and tolerability of a fixed-dose combination of olmesartan and amlodipine in an unselected population of patients in primary care and to compare the results with recent randomized controlled trial evidence. Methods: A multicenter, noninterventional, noncontrolled observational study with 8241 hypertensive patients seen by 2187 physicians in daily practice. Blood pressure (BP) reduction, comorbid disease, pharmacotherapy, and tolerability were documented over a 12–18-week observational period. Results: Patients had a mean age of 62.8 ± 11.8 years (48.1% female), and 74.8% had at least one comorbid risk factor or condition. In total, 51.3% received olmesartan-amlodipine 20/5 mg, 30.6% received 40/5 mg, and 17.9% received 40/10 mg at baseline, mostly because of lack of efficacy on prior antihypertensive therapy (73.8%). BP at baseline was 161.8 ± 16.6/93.6 ± 10.2 mmHg (39.8% had Grade 2 hypertension), and the observed BP reduction was -29.0 ± 17.1/-13.5 ± 10.9 mmHg (P < 0.0001), with a significant correlation between BP at baseline and BP reduction (Spearman’s Rho -0.811 for systolic BP and -0.759 for diastolic BP). BP reduction appeared to be dependent on dose and prior antihypertensive therapy, but not on age, gender, body mass index, duration of hypertension, or the presence of diabetes. At the final visit, 69.4% (4.3% at baseline) were controlled (<140/90 mmHg). Adverse drug reactions were observed in 2.76% of the study population; 94.25% of these adverse drug reactions were judged as nonserious events, and 31.5% of all adverse drug reactions reported were peripheral edema. Conclusion: The fixed-dose olmesartan-amlodipine combination was effective and well tolerated in an unselected population of patients in primary care practice. These results confirm prior randomized controlled trial evidence.
Effectiveness and tolerability of a fixed-dose combination of olmesartan and amlodipine in clinical practice
Peter Bramlage,Wolf-Peter Wolf,Thomas Stuhr,et al
Vascular Health and Risk Management , 2010,
Abstract: Peter Bramlage1, Wolf-Peter Wolf2, Thomas Stuhr2, Eva-Maria Fronk3, Wolfhard Erdlenbruch2, Reinhard Ketelhut4, Roland E Schmieder51Institute for Cardiovascular Pharmacology and Epidemiology, Mahlow; 2Daiichi Sankyo Deutschland GmbH, Munich, Germany; 3Daiichi Sankyo Europe GmbH, Munich, Germany; 4Department of Sports Medicine, Universit tsklinikum Berlin; 5Department of Nephrology and Hypertension, University Hospital of Erlangen, GermanyObjectives: To assess the efficacy and tolerability of a fixed-dose combination of olmesartan and amlodipine in an unselected population of patients in primary care and to compare the results with recent randomized controlled trial evidence.Methods: A multicenter, noninterventional, noncontrolled observational study with 8241 hypertensive patients seen by 2187 physicians in daily practice. Blood pressure (BP) reduction, comorbid disease, pharmacotherapy, and tolerability were documented over a 12–18-week observational period.Results: Patients had a mean age of 62.8 ± 11.8 years (48.1% female), and 74.8% had at least one comorbid risk factor or condition. In total, 51.3% received olmesartan-amlodipine 20/5 mg, 30.6% received 40/5 mg, and 17.9% received 40/10 mg at baseline, mostly because of lack of efficacy on prior antihypertensive therapy (73.8%). BP at baseline was 161.8 ± 16.6/93.6 ± 10.2 mmHg (39.8% had Grade 2 hypertension), and the observed BP reduction was -29.0 ± 17.1/-13.5 ± 10.9 mmHg (P < 0.0001), with a significant correlation between BP at baseline and BP reduction (Spearman’s Rho -0.811 for systolic BP and -0.759 for diastolic BP). BP reduction appeared to be dependent on dose and prior antihypertensive therapy, but not on age, gender, body mass index, duration of hypertension, or the presence of diabetes. At the final visit, 69.4% (4.3% at baseline) were controlled (<140/90 mmHg). Adverse drug reactions were observed in 2.76% of the study population; 94.25% of these adverse drug reactions were judged as nonserious events, and 31.5% of all adverse drug reactions reported were peripheral edema.Conclusion: The fixed-dose olmesartan-amlodipine combination was effective and well tolerated in an unselected population of patients in primary care practice. These results confirm prior randomized controlled trial evidence.Keywords: blood pressure, cardiovascular risk, antihypertensive treatment, observation
Magnetic properties of a metal-organic antiferromagnet on a distorted honeycomb lattice
Ivan Spremo,Florian Schuetz,Peter Kopietz,Volodymyr Pashchenko,Bernd Wolf,Michael Lang,Jan W. Bats,Chunhua Hu,Martin U. Schmidt
Physics , 2005, DOI: 10.1103/PhysRevB.72.174429
Abstract: For temperatures T well above the ordering temperature T*=3.0+-0.2K the magnetic properties of the metal-organic material Mn[C10H6(OH)(COO)]2x2H20 built from Mn^2+ ions and 3-hydroxy-2-naphthoic anions can be described by a S=5/2 quantum antiferromagnet on a distorted honeycomb lattice with two different nearest neighbor exchange couplings J2 \approx 2J1 \approx 1.8K. Measurements of the magnetization M(H,T) as a function of a uniform external field H and of the uniform zero field susceptibility \chi(T) are explained within the framework of a modified spin-wave approach which takes into account the absence of a spontaneous staggered magnetization at finite temperatures.
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