RESUMO
INTRODUCTION: Child maltreatment (CM) is associated with adverse cognitive, behavioural, physical and social outcomes that often continue until adulthood. Systematic reviews on mediators and moderators of this relationship mostly investigate childhood adversities in general or only with regard to an adult population, single outcomes or single forms of maltreatment. The purpose of this review is to synthesise the evidence of variables that mediate and/or moderate the relationship between CM and diverse outcomes. METHOD: A systematic search will be performed in Scopus, PsychInfo, Medline and Web of Science until January 2022. Eligibility criteria include children under 18 years who have been maltreated and experienced adverse outcomes until the age of 21, moderators and/or mediators that influence the relationship between maltreatment and adverse outcomes must belong to the individual level and be amenable to change. After independent screening of studies by two reviewers, data extraction and study quality of included studies will be done using adapted checklists of similar reviews, the Strengthening the Reporting of Observational Studies in Epidemiology report, the COnsensus-based Standards for the selection of health Measurement INstruments checklist and Downs and Black Checklist. The results will be presented in narrative form and, if adequate, meta-analysis. ETHICS AND DISSEMINATION: Ethics approval will not be required. The results of this systematic review will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42022297982.
Assuntos
Maus-Tratos Infantis , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Humanos , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Criança , Adolescente , Pré-EscolarRESUMO
Fluorine-19 magnetic resonance imaging (19F MRI) with intravenously applied perfluorooctyl bromide-nanoemulsions (PFOB-NE) has proven its feasibility to visualize inflammatory processes in experimental disease models. This approach is based on the properties of monocytes/macrophages to ingest PFOB-NE particles enabling specific cell tracking in vivo. However, information on safety (cellular function and viability), mechanism of ingestion and impact of specific disease environment on PFOB-NE uptake is lacking. This information is, however, crucial for the interpretation of 19F MRI signals and a possible translation to clinical application. To address these issues, whole blood samples were collected from patients with acute ST-elevation myocardial infarction (STEMI), stable coronary artery disease (SCAD) and healthy volunteers. Samples were exposed to fluorescently-labeled PFOB-NE and particle uptake, cell viability and migration activity was evaluated by flow cytometry and MRI. We were able to show that PFOB-NE is ingested by human monocytes in a time- and subset-dependent manner via active phagocytosis. Monocyte function (migration, phagocytosis) and viability was maintained after PFOB-NE uptake. Monocytes of STEMI and SCAD patients did not differ in their maximal PFOB-NE uptake compared to healthy controls. In sum, our study provides further evidence for a safe translation of PFOB-NE for imaging purposes in humans.
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Imagem por Ressonância Magnética de Flúor-19 , Fluorocarbonos , Imagem Molecular , Monócitos/fisiologia , Nanopartículas , Fagocitose/fisiologia , Adulto , Biomarcadores , Sobrevivência Celular , Doença da Artéria Coronariana/diagnóstico , Emulsões , Imunofluorescência , Imagem por Ressonância Magnética de Flúor-19/métodos , Fluorocarbonos/química , Humanos , Hidrocarbonetos Bromados , Macrófagos , Imagem Molecular/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Fatores de TempoRESUMO
INTRODUCTION: Proximal femoral fractures (PFF) are among the most frequent fractures in older people. However, the situation of people with a PFF after hospital discharge is poorly understood. Our aim is to (1) analyse healthcare provision, (2) examine clinical and patient-reported outcomes (PROs), (3) describe clinical and sociodemographic predictors of these and (4) develop an algorithm to identify subgroups with poor outcomes and a potential need for more intensive healthcare. METHODS AND ANALYSIS: This is a population-based prospective study based on individually linked survey and statutory health insurance (SHI) data. All people aged minimum 60 years who have been continuously insured with the AOK Rheinland/Hamburg and experience a PFF within 1 year will be consecutively included (SHI data analysis). Additionally, 700 people selected randomly from the study population will be consecutively invited to participate in the survey. Questionnaire data will be collected in the participants' private surroundings at 3, 6 and 12 months after hospital discharge. If the insured person considers themselves to be only partially or not at all able to take part in the survey, a proxy person will be interviewed where possible. SHI variables include healthcare provision, healthcare costs and clinical outcomes. Questionnaire variables include information on PROs, lifestyle characteristics and socioeconomic status. We will use multiple regression models to estimate healthcare processes and outcomes including mortality and cost, investigate predictors, perform non-responder analysis and develop an algorithm to identify vulnerable subgroups. ETHICS AND DISSEMINATION: The study was approved by the ethics committee of the Faculty of Medicine, Heinrich-Heine-University Düsseldorf (approval reference 6128R). All participants including proxies providing written and informed consent can withdraw from the study at any time. The study findings will be disseminated through scientific journals and public information. TRIAL REGISTRATION NUMBER: DRKS00012554.