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1.
Langmuir ; 39(18): 6324-6336, 2023 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-37093655

RESUMO

In this article, we present the synthesis of calcium sulfate nanoparticles (CaSO4 NPs) from waste chalk powder by the calcination method. These CaSO4 NPs were utilized for the construction of a mesoporous graphitic carbon nitride-calcium sulfate (mpg-C3N4-CaSO4) photocatalyst. Synthesized materials were confirmed by several characterization techniques. The photocatalytic performance of the synthesized samples was tested by the degradation of methylene blue (MB) in the presence of both UV-vis light and sunlight. The efficiency of photocatalytic degradation of MB dye using the optimized mpg-C3N4-CaSO4-2 composite reached 91% within 90 min in the presence of UV-vis light with superb photostability and recyclability after five runs compared to individual mpg-C3N4 and CaSO4 NPs and reached 95% within 120 min under sunlight. Histotoxicological studies on fish liver and ovary indicated that the dye containing the solution damaged the structure of the liver and ovary tissues, whereas the photodegraded solution of MB was found to be less toxic and caused negligible alterations in their typical structure similar to the control group.

2.
Matern Child Nutr ; : e13437, 2023 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-36994620

RESUMO

School system is a promising platform for addressing all forms of malnutrition in adolescents. However, little is known about the impact of integrated school health and nutrition programmes on adolescent nutrition and educational outcomes in low- and middle-income countries (LMICs). This systematic review sought to characterize school-based health and nutrition interventions among adolescents in LMICs and analyze their effects on nutritional status and educational outcomes. Four databases were searched for studies evaluating school-based health and nutrition interventions for adolescents in LMICs, reporting changes in either nutritional status or educational outcomes. A narrative synthesis was used to analyze and describe the evidence. Our review included 68 articles evaluating 58 interventions, of which a third had moderate to strong methodological quality. Forty-two studies evaluated single-domain interventions, while 26 evaluated multi-component interventions. A third of all interventions were based on a theoretical framework. Three-fourths of the interventions were shorter than 11 months, which may make identifying their effect difficult. The results of the effectiveness of these interventions were mixed and inconsistent across intervention types. Sixteen out of 21 studies evaluating multi-component interventions and 12 out of 23 studies evaluating nutrition education reported improving nutritional or diet-related outcomes. One out of six studies reported positive effects on educational outcomes. Our review has identified that research needs include: a greater inclusion of theory-based approaches to guide the implementation of interventions; more studies of integrated interventions that involve parents and the wider community in LMICs; and extension of outcomes beyond nutritional status to include educational outcomes.

3.
Matern Child Nutr ; : e13415, 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-36999963

RESUMO

Adolescent diets may be influenced by the retail food environment around schools. However, international research to examine associations between the proximity of retail food outlets to schools and diet provides equivocal support for an association. This study aims to understand the school food environment and drivers for adolescents' consumption of unhealthy foods in Addis Ababa, Ethiopia. Mixed-methods research was conducted, 1200 adolescents (10-14 years) from randomly selected government schools were surveyed, along with vendors within 5-min' walk of the schools and focus group discussions (FGDs) with adolescent groups. Mixed-effect logistic regression investigated the relationship between the number of vendors around the schools and the consumption of selected unhealthy foods. Thematic analysis was used to summarize findings from the FGDs. Consumption of sweets and sugar-sweetened beverages (S-SSB) and deep-fried foods (DFF) at least once a week was reported by 78.6% and 54.3% of the adolescents, respectively. Although all schools were surrounded by food vendors selling DFF and S-SSB, consumption was not associated with the number of vendors available around the school. However, adolescents' awareness and perception of healthy food, and their concerns about the safety of foods in the market, influenced their dietary choices and behaviours. Lack of financial resources to purchase food as desired also played a role in their selection of food and eating habits. Reported unhealthy food consumption is high among adolescents in Addis Ababa. Thus, further research is warranted to come up with school-based interventions that promote access and healthy food choices among adolescents.

4.
Matern Child Nutr ; : e13479, 2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37014175

RESUMO

The prevalence of overweight/obesity in adolescents has increased globally, including in low- and middle-income countries. Early adolescence provides an opportunity to develop and encourage positive health and behavioural practices, yet it is an understudied age group with limited information to guide and inform appropriate interventions. This study aims to determine the prevalence of overweight/obesity in young adolescents, aged between 10 and 14 years attending public schools in Addis Ababa, Ethiopia, and to explore the contributing factors. A cross-sectional school-based study was conducted. Adolescents completed individual questionnaires. Weight (kg) and height (m) measurements were converted to BMI-for-age and gender z-scores. Multivariate regression analysis was conducted to determine the associated factors. The overall prevalence of overweight/obesity was 8% among adolescents aged 10-14 years and it was significantly higher in females (13%) than males (2%). The diet quality for the majority of the adolescents was inadequate, putting them at risk for poor health outcomes. The contributors to overweight/obesity were different between males and females. Age and no access to a flush toilet were negatively associated with overweight/obesity in males and access to a computer, laptop or tablet was positively associated. In females, menarche was positively associated with overweight/obesity. Living with only their mother or another female adult and an increase in physical activity were negatively associated with overweight/obesity. There is a need to improve the diet quality of young adolescents in Ethiopia and understand the reasons why females are less physically active to limit the risk of poor diet-related health outcomes.

5.
Matern Child Nutr ; : e13492, 2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37014188

RESUMO

Mental health in adolescence is important for health and well-being throughout the life course, but evidence from Sub-Saharan Africa is sparse. This study aimed to assess the correlates of internalizing, externalizing and cumulative problems among early adolescents. This study used cross-sectional survey data from 3516 school-going adolescents in Ouagadougou, Burkina Faso; Addis Ababa, Ethiopia and Dar es Salaam, Tanzania. We used a 25-item Strengths and Difficulties Questionnaire to measure internalizing, externalizing and cumulative problems. We carried out multi-variable linear regression analyses with the estimation of adjusted mean differences and 95% confidence intervals, to determine the factors associated with internalizing, externalizing and cumulative problems. Overall, 1 in 8 adolescents had internalizing problems, while 1 in 10 had externalizing problems. In two sites, having friends was related to lower internalizing problems, while repeating a grade, physical fights and household food insecurity were related to greater internalizing problems. Household food insecurity and involvement in physical fights were associated with greater externalizing problems across sites, while repeating a grade was linked with greater externalizing problems in two sites. Having a caring adult in school was associated with fewer externalizing problems across sites, while having friends was associated with fewer externalizing problems in two sites. Overall, having friends was related to fewer cumulative problems, while physical fights and household food insecurity were related to higher cumulative problems. School-based mental health and food programs may be useful in addressing social-emotional problems among school-aged adolescents in Burkina Faso, Ethiopia and Tanzania.

6.
Matern Child Nutr ; : e13439, 2023 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-36994612

RESUMO

Anaemia among adolescents is a global health problem. However, evidence regarding its burden and risk factors, particularly for younger adolescents and in sub-Saharan Africa (SSA), remains scarce. We aimed to assess the prevalence and potential determinants of anaemia among urban and semi-urban in-school young adolescents in Ethiopia, Sudan and Tanzania. We conducted a school-based survey among 3558 adolescents aged 10-14 years. A capillary blood sample was used to assess haemoglobin concentration. We assessed anaemia prevalence and examined associations between measures at the individual, household and school levels and anaemia using Poisson regression models adjusted for school and country-level clustering. The prevalence of anaemia was 32.0% overall, and 10.8% in Ethiopia, 25.0% in Sudan and 58.3% in Tanzania. Being a boy [adjusted risk ratio (RR): 1.11, 95% confidence interval (CI): 1.08-1.15, p < 0.001], poorer diet quality (RR: 1.12, 95% CI: 1.02-1.23 p = 0.015), no school handwashing stations (RR: 1.26, 95% CI: 1.20-1.32, p < 0.001) and food insecurity (RR for moderate/severe anaemia: 1.06, 95% CI: 1.02-1.10, p = 0.002) were associated with increased anaemia risk. Younger age (RR: 0.91, 95% CI: 0.86-0.96, p < 0.001) and increasing height-for-age z-score (RR: 0.93, 95% CI: 0.91-0.95, p < 0.001) were associated with decreased anaemia risk. Associations were consistent for moderate or severe anaemia. There was no evidence of effect modification by sex. This study highlights anaemia as a public health problem and identified nutritional, dietary and hygiene measures as key risk factors of anaemia among young adolescents in SSA. School-based interventions addressing these factors could reduce the burden of anaemia in adolescence.

7.
Matern Child Nutr ; : e13411, 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-36999967

RESUMO

In Sub-Saharan Africa (SSA), adolescents make up around one-quarter of the population who are growing up in a rapidly urbanizing environment, with its associated risks and benefits, including impacts on health, psychosocial development, nutrition, and education. However, research on adolescents' health and well-being in SSA is limited. The ARISE (African Research, Implementation Science and Education) Network's Adolescent Health and Nutrition Study is an exploratory, school-based study of 4988 urban adolescents from five countries: Burkina Faso, Ethiopia, South Africa, Sudan, and Tanzania. A multistage random sampling strategy was used to select the schools and adolescents. Adolescent boys and girls aged 10-15 years were interviewed using a standardized questionnaire by trained enumerators. The questionnaire covered multiple domains including demographic and socioeconomic characteristics, water, sanitation and hygiene practices, antimicrobial resistance, physical activity, dietary behaviours, socioemotional development, educational outcomes, media use, mental health, and menstrual hygiene (only for girls). Additionally, a desk review of health and school meal policies and programs and a qualitative investigation into health and food environments in schools were conducted with students, administrators, and food vendors. In this paper, we describe the study design and questionnaire, present profiles of young adolescents who participated in the study, and share field experiences and lessons learned for future studies. We expect that this study along with other ARISE Network projects will be a first step toward understanding young people's health risks and disease burdens, identifying opportunities for interventions and improving policies, as well as developing potential research capacities on adolescent health and well-being in the SSA region.

8.
Matern Child Nutr ; : e13462, 2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37014184

RESUMO

Digital technologies provide unprecedented opportunities for health and nutrition interventions among adolescents. The use of digital media and devices among young adolescents across diverse settings in sub-Saharan Africa is unclear. This cross-sectional study aimed to assess the use of digital media and devices and the socioeconomic determinants of use among young adolescents in Burkina Faso, Ethiopia, South Africa, Sudan and Tanzania. The study included 4981 adolescents aged 10-15 from public schools selected by multistage sampling. Access to various digital media and devices was self-reported by adolescents. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between sociodemographic characteristics and access to digital media and devices. Approximately 40% of the adolescents in Burkina Faso and South Africa, 36% in Sudan, 13% in Ethiopia and 3% in Tanzania owned mobile phones. Compared with boys, girls had a lower ownership of mobile phones (odds ratio [OR] = 0.79; 95% confidence interval [CI]: 0.68, 0.92; p = 0.002), computers (OR = 0.83; 95% CI: 0.70, 0.99; p = 0.04) and social media accounts (OR = 0.68; 95% CI: 0.56, 0.83; p < 0.001). Higher maternal education and greater household wealth were positively associated with access to digital media and devices. While digital media and devices are promising platforms for interventions in some settings due to relatively high levels of access, their utility in delivering health and nutrition interventions to adolescents in these contexts should be further examined.

9.
Matern Child Nutr ; : e13463, 2023 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37014190

RESUMO

Adolescents face the risk of the triple burden of malnutrition-the co-existence of micronutrient deficiencies, underweight and overweight and obesity and related noncommunicable diseases. Poor-quality diets are a modifiable risk factor for all forms of malnutrition in adolescents. However, there is limited knowledge about diet quality for African adolescents. We analyzed data from 4609 school-going adolescents aged 10-15 years in Burkina Faso, Ethiopia, Sudan and Tanzania. Dietary intake was assessed using food frequency questionnaires, and diet quality computed using the Global Diet Quality Score (GDQS). Generalized estimating equations linear regression models were used to evaluate factors associated with adolescent diet quality. Mean adolescent age was 12.4 (±1.4) years and 54% of adolescents were female. Adolescents reported physical activity on 1.5 (±1.7) days/week. The mean GDQS (±SD) was 20.6 (±4.0) (maximum 40). Adolescent consumption of vegetables, fruit, nuts and seeds, eggs, fish and poultry was low, and refined grain consumption was relatively high. Boys consumed unhealthy foods less frequently but consumed fewer cruciferous vegetables and deep orange tubers. Older adolescents had higher fish and lower red meat consumption. Having an unemployed mother versus farmer (estimate -2.60, 95% confidence interval [CI]: -4.81, -0.39), and having 3-4 days of physical activity per week versus none (estimate 0.64, 95% CI: 0.11, 1.17) were associated with GDQS. We found evidence of poor-quality adolescent diets and gender and age differences in the consumption of healthy diets. Programs to address poor-quality diets should consider tailoring interventions for adolescent girls and boys of different ages and also consider the role of physical activity in these contexts.

10.
Langmuir ; 38(44): 13543-13557, 2022 11 08.
Artigo em Inglês | MEDLINE | ID: mdl-36282958

RESUMO

The waste of tungsten filament materials in the environment is one of the reasons for environmental pollution, and it is very dangerous to animals and plants. To date, not much attention has been given to its utility or recyclability. Herein, the present work reported the synthesis of tungsten trioxide nanoparticles (WO3 NPs) by the utilization of cost-free waste tungsten filament by a simple calcination method. A mesoporous graphitic carbon nitride-tungsten trioxide (mpg-C3N4-WO3) composite designed from the WO3 NPs produced from tungsten filament waste and thiourea as a carbon and nitrogen precursor by a one-step calcination method. The synthesized samples were characterized and confirmed by different characterization techniques. The photocatalytic behavior of the synthesized mpg-C3N4-WO3 composite was assessed, with respect to the effect of initial pH, amount of photocatalyst, dye concentration, and reaction time, as well for the degradation of Methylene Blue (MB) dye under sunlight. The best photocatalytic performance (92%) was achieved using mpg-C3N4-WO3 with experimental condition ([photocatalyst] = 100 mg/L, [MB]0 = 10 mg/L, pH 8, and time = 120 min) under sunlight irradiation with excellent photostability than that of isolated mpg-C3N4 and WO3 NPs. The histotoxicological studies also showed that the photodegraded products of MB were found to be nontoxic and did not structurally changes in the gill architecture as well as brain tissues of freshwater fish Labeo rohita.


Assuntos
Resíduo Eletrônico , Purificação da Água , Tungstênio/toxicidade , Tungstênio/química , Catálise , Purificação da Água/métodos , Azul de Metileno/química
11.
PLoS Med ; 17(2): e1003021, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32045409

RESUMO

BACKGROUND: Strengthening Evidence base on scHool-based intErventions for pRomoting adolescent health (SEHER) is a multicomponent, whole-school health promotion intervention delivered by a lay counsellor or a teacher in government-run secondary schools in Bihar, India. The objective of this study is to examine the effects of the intervention after two years of follow-up and to evaluate the consistency of the findings observed over time. METHODS AND FINDINGS: We conducted a cluster randomised trial in which 75 schools were randomised (1:1:1) to receive the SEHER intervention delivered by a lay counsellor (SEHER Mitra [SM]) or a teacher (Teacher as SEHER Mitra [TSM]), respectively, alongside a standardised, classroom-based life skills Adolescence Education Program (AEP), compared to AEP alone (control group). The trial design was a repeat cross-sectional study. Students enrolled in grade 9 (aged 13-15 years) in the 2015-2016 academic year were exposed to the intervention for two years and the outcome assessment was conducted at three time points─at baseline in June 2015; 8-months follow-up in March 2016, when the students were still in grade 9; and endpoint at 17-months follow-up in December 2016 (when the students were in grade 10), the results of which are presented in this paper. The primary outcome, school climate, was measured with the Beyond Blue School Climate Questionnaire (BBSCQ). Intervention effects were estimated using mixed-effects linear or logistic regression, including a random effect to adjust for within-school clustering, minimisation variables, baseline cluster-level score of the outcome, and sociodemographic characteristics. In total, 15,232 students participated in the 17-month survey. Compared with the control group, the participants in the SM intervention group reported improvements in school climate (adjusted mean difference [aMD] = 7.33; 95% CI: 6.60-8.06; p < 0.001) and most secondary outcomes (depression: aMD = -4.64; 95% CI: -5.83-3.45; p < 0.001; attitude towards gender equity: aMD = 1.02; 95% CI: 0.65-1.40; p < 0.001; frequency of bullying: aMD = -2.77; 95% CI: -3.40 to -2.14; p < 0.001; violence victimisation: odds ratio [OR] = 0.08; 95% CI: 0.04-0.14; p < 0.001; and violence perpetration: OR = 0.16; 95% CI: 0.09-0.29; p < 0.001). There was no evidence of an intervention effect in the TSM group compared with control group. The effects of the lay counsellor-delivered intervention were larger for most outcomes at 17-months follow-up compared with those at 8 months: school climate (effect size [ES; 95% CI] = 2.23 [1.97-2.50] versus 1.88 [1.44-2.32], p < 0.001); depression (ES [95% CI] = -1.19 [-1.56 to -0.82] versus -0.27 [-0.44 to -0.11], p < 0.001); attitude towards gender equity (ES [95% CI] = 0.53 [0.27-0.79] versus 0.23 [0.10-0.36], p < 0.001); bullying (ES [95% CI] = -2.22 [-2.84 to -1.60] versus -0.47 [-0.61 to -0.33], p < 0.001); violence victimisation (OR [95% CI] = 0.08 [0.04-0.14] versus 0.62 [0.46-0.84], p < 0.001); and violence perpetration (OR [95% CI] = 0.16 [0.09-0.29] versus 0.68 [0.48-0.96], p < 0.001), suggesting incremental benefits with an extended intervention. A limitation of the study is that 27% of baseline participants did not complete the 17-month outcome assessment. CONCLUSIONS: The trial showed that the second-year outcomes were similar to the first-year outcomes, with no effect of the teacher-led intervention and larger benefits on school climate and adolescent health accruing from extending lay counsellor-delivered intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT02907125.


Assuntos
Saúde do Adolescente , Atitude , Bullying/estatística & dados numéricos , Vítimas de Crime/estatística & dados numéricos , Depressão/epidemiologia , Serviços de Saúde Escolar , Meio Social , Violência/estatística & dados numéricos , Adolescente , Feminino , Humanos , Índia/epidemiologia , Masculino , Sexismo
12.
Lancet ; 392(10163): 2465-2477, 2018 12 08.
Artigo em Inglês | MEDLINE | ID: mdl-30473365

RESUMO

BACKGROUND: School environments affect health and academic outcomes. With increasing secondary school retention in low-income and middle-income countries, promoting quality school social environments could offer a scalable opportunity to improve adolescent health and wellbeing. METHODS: We did a cluster-randomised trial to assess the effectiveness of a multi-component whole-school health promotion intervention (SEHER) with integrated economic and process evaluations in grade 9 students (aged 13-14 years) at government-run secondary schools in the Nalanda district of Bihar state, India. Schools were randomly assigned (1:1:1) to three groups: the SEHER intervention delivered by a lay counsellor (the SEHER Mitra [SM] group), the SEHER intervention delivered by a teacher (teacher as SEHER Mitra [TSM] group), and a control group in which only the standard government-run classroom-based life-skills Adolescence Education Program was implemented. The primary outcome was school climate measured with the Beyond Blue School Climate Questionnaire (BBSCQ). Students were assessed at the start of the academic year (June, 2015) and again 8 months later at the end of the academic year (March, 2016) via self-completed questionnaires. This study is registered with ClinicalTrials.gov, number NCT02484014. FINDINGS: Of the 112 eligible schools in the Nalanda district, 75 were randomly selected to participate in the trial. We randomly assigned 25 schools to each of the three groups. One school subsequently dropped out of the TSM group, leaving 24 schools in this group. The baseline survey included a total of 13 035 participants, and the endpoint survey included 14 414 participants. Participants in the SM-delivered intervention schools had substantially higher school climate scores at endpoint survey than those in the control group (BBSCQ baseline-adjusted mean difference [aMD] 7·57 [95% CI 6·11-9·03]; effect size 1·88 [95% CI 1·44-2·32], p<0·0001) and the TSM-delivered intervention (aMD 7·57 [95% CI 6·06-9·08]; effect size 1·88 [95% CI 1·43-2·34], p<0·0001). There was no effect of the TSM-delivered intervention compared with control (aMD -0·009 [95% CI -1·53 to 1·51], effect size 0·00 [95% CI -0·45 to 0·44], p=0·99). Compared with the control group, participants in the SM-delivered intervention schools had moderate to large improvements in the secondary outcomes of depression (aMD -1·23 [95% CI -1·89 to -0·57]), bullying (aMD -0·91 [95% CI -1·15 to -0·66]), violence victimisation (odds ratio [OR] 0·62 [95% CI 0·46-0·84]), violence perpetration (OR 0·68 [95% CI 0·48-0·96]), attitude towards gender equity (aMD 0·41 [95% CI 0·21-0·61]), and knowledge of reproductive and sexual health (aMD 0·29 [95% CI 0·06-0·53]). Similar results for these secondary outcomes were noted for the comparison between SM-delivered intervention schools and TSM-delivered intervention schools (depression: aMD -1·23 [95% CI -1·91 to -0·55]; bullying: aMD -0·83 [95% CI -1·08 to -0·57]; violence victimisation: OR 0·49 [95% CI 0·35-0·67]; violence perpetration: OR 0·49 [95% CI 0·34-0·71]; attitude towards gender equity: aMD 0·23 [95% CI 0·02-0·44]; and knowledge of reproductive and sexual health: aMD 0·22 [95% CI -0·02 to 0·47]). However, no effects on these secondary outcomes were observed for the TSM-delivered intervention schools compared with the control group (depression: aMD -0·03 [95% CI -0·70 to 0·65]; bullying: aMD -0·08 [95% CI -0·34 to 0·18]; violence victimisation: OR 1·27 [95% CI 0·93-1·73]; violence perpetration: OR 1·37 [95% CI 0·95-1·95]; attitude towards gender equity: aMD 0·17 [95% CI -0·09 to 0·38]; and knowledge of reproductive and sexual health: aMD 0·06 [95% CI -0·18 to 0·32]). INTERPRETATION: The multi-component whole-school SEHER health promotion intervention had substantial beneficial effects on school climate and health-related outcomes when delivered by lay counsellors, but no effects when delivered by teachers. Future research should focus on the evaluation of the scaling up of the SEHER intervention in diverse contexts and delivery agents. FUNDING: John D. and Catherine T. MacArthur Foundation, USA and the United Nations Population Fund India Office.


Assuntos
Promoção da Saúde/métodos , Serviços de Saúde Escolar , Meio Social , Adolescente , Comportamento do Adolescente , Criança , Análise Custo-Benefício , Conselheiros , Docentes , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde/economia , Humanos , Índia , Masculino , Pobreza , Serviços de Saúde Escolar/economia , Instituições Acadêmicas , Habilidades Sociais , Ensino , Adulto Jovem
13.
Soc Psychiatry Psychiatr Epidemiol ; 54(4): 405-414, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30607452

RESUMO

PURPOSE: Mental health problems and suicide are the leading cause of mortality in young people globally. India is home to the largest number of adolescents in the world. This study was undertaken to assess the policy environment for addressing adolescent mental health in India. METHODS: We conducted a review of 6 policies and programs and 11 in-depth interviews with key stakeholders. The findings were analyzed using the policy triangle analysis framework (i.e., context, content, actors and process). RESULTS: There is no conformity of the age ranges addressed by these documents nor are vulnerable groups explicitly recognized. Stress, anxiety and depression were commonly identified as mental health concerns and diverse platforms such as community, family, school, digital and health facility were recommended to deliver preventive and treatment interventions. Some interventions specifically targeted some social determinants (like safe and supportive schools) but many others (like social norms) were not addressed. Preventive interventions were recommended for delivery through peers and other non-specialist providers while treatment interventions were recommended for delivery in healthcare facilities by specialist health professionals. There was very little engagement of young people in the development of these policies or in their implementation, except for peer educators mentioned in one policy. Stakeholders identified several major challenges in implementing these policies, notably the lack of inter-sectoral coordination and fragmentation of governance; budgetary constraints; and scanty human resources. CONCLUSIONS: Although there are now several policy instruments testifying to a comprehensive approach on adolescent mental health, there are gaps in the extent of engagement of young people and how these will be operationalized that may limit their impact on addressing the burden of mental health problems in young people in India.


Assuntos
Saúde do Adolescente/normas , Política de Saúde , Saúde Mental/normas , Adolescente , Feminino , Humanos , Índia , Masculino , Participação dos Interessados
14.
Mol Biol Rep ; 45(5): 1357-1365, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30105550

RESUMO

The present study was designed to investigate the protective effect of ferulic acid (FA) against isoproterenol (ISO)-induced cardiac toxicity in rats. Isoproterenol challenged in a dose of 85 mg/kg body weight (b.w.) subcutaneously for two consecutive days in the experimental group resulted in acute cardiac toxicity as evidenced by changes in electrocardiogram (ECG) pattern and marked elevation of serum cardiac enzymes viz aspartate aminotransferase (AST), alanine transaminase (ALT), creatinine kinase (CK-MB) and lactate dehydrogenase (LDH) also increases inflammatory cytokines. Moreover, acute toxicity effect was exhibited by disturbance in the antioxidant system as decrease in activities of superoxide dismutase (SOD) and glutathione (GSH) with the rise in activities of malondialdehyde (MDA) and nitric oxide (NO). Pre-treatment with FA at the increasing dose of (10, 20 and 40 mg/kg b.w.) orally for 28 consecutive days followed by isoproterenol injection for 2 days significantly attenuated changes in serum cardiac enzymes. Furthermore, histopathological evaluation confirmed the restoration of cellular architecture in FA pretreated rats. The cardioprotective effect of FA was comparable with standard drug treatment metoprolol. Taken together, FA demonstrated cardioprotective effect against ISO-induced cardiac toxicity by normalization of serum cardiac biomarkers, alleviating oxidative stress and augmenting endogenous antioxidant system.


Assuntos
Cardiotoxicidade/prevenção & controle , Ácidos Cumáricos/farmacologia , Isoproterenol/toxicidade , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Biomarcadores/sangue , Biomarcadores/metabolismo , Cardiotônicos/farmacologia , Cardiotoxicidade/metabolismo , Creatina Quinase Forma MB/metabolismo , Glutationa/metabolismo , Coração/efeitos dos fármacos , L-Lactato Desidrogenase/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/patologia , Miocárdio/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Superóxido Dismutase/metabolismo
15.
J Contemp Dent Pract ; 19(9): 1111-1116, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30287713

RESUMO

AIM: To assess the association of various clinical parameters and proinflammatory cytokines in the wound-healing process of dental implants with the presence or absence of antibiotic prophylaxis. MATERIALS AND METHODS: The present study included evaluation of early wound-healing process in patients undergoing dental implant placement procedures with and without antibiotic prophylaxis. A total of 50 patients with partial edentulous arch were included in the present study. All the subjects were broadly divided into two study groups depending upon the presence or absence of prophylactic antibiotic therapy, with 25 patients in each group. One group consisted of subjects who were given prophylactic amoxicillin (2 gm), 1 hour before the starting of the surgery, followed by 500 mg 3 times a day for 1 week. Detection of interleukin (IL)-1ß and -8 cytokine levels in the gingival crevicular fluid (GCF)/peri-implant crevicular fluid (PICF) was done immediately after the dental surgery. All the results were compiled and analyzed by Statistical Package for the Social Sciences (SPSS) software version 17.0. RESULTS: A significant increase in the PICF IL-1ß concentration at postoperative follow-up time was observed in the antibiotic group in comparison with the baseline values. A significant increase in the IL-8 concentration postoperatively in comparison with the baseline values in the antibiotic group was also observed. At the time of surgery, the IL-8 concentrations were statistically lower in the antibiotic group in comparison with the other study group. Concentration of amoxicillin, as observed by high-performance liquid chromatography (HPLC), was lower than the minimum detection levels. CONCLUSION: Detection of amoxicillin is not feasible within the GCF samples immediately after dental surgery procedure. CLINICAL SIGNIFICANCE: Clinical usefulness of prophylactic use of amoxicillin is still doubtful.


Assuntos
Amoxicilina/administração & dosagem , Amoxicilina/metabolismo , Antibioticoprofilaxia , Citocinas/metabolismo , Implantação Dentária , Implantes Dentários , Mediadores da Inflamação/metabolismo , Cicatrização/fisiologia , Adulto , Feminino , Líquido do Sulco Gengival/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
J Contemp Dent Pract ; 19(3): 292-295, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29603701

RESUMO

AIM: The purpose of the study is to evaluate the bacterial micro-leakage of three different materials, mineral trioxide aggregate (MTA), resin-modified glass ionomer cement (RMGIC), and flowable composite, as a coronal barrier against Enterococcus faecalis. MATERIALS AND METHODS: A total of 100 human extracted single-rooted teeth were selected. Access opening done, working length determined, and canals were cleaned and shaped with ProTaper F3 and obturated with AH26 and gutta-percha (GP) using lateral condensation technique. Samples were divided into three experimental and two control groups. Approximately 3 mm GP was removed from the coronal orifice and restored with one of the test materials. Teeth were suspended in glass tubes containing brain heart infusion (BHI) broth and equipped with microcaps, which were used to check bacterial leakage. A 24-hour broth of E. faecalis was placed in the pulp chamber. Tubes were incubated and checked for turbidity for 90 days. Data were analyzed using chi-squared test between the test and control groups and Fisher test between the test groups. RESULTS: Significantly lesser number of samples turned turbid in the RMGIC group followed by MTA group and the maximum number of samples turned turbid in the flowable composite group. CONCLUSION: The RMGIC is a better coronal sealer, followed by MTA and flowable composite. CLINICAL SIGNIFICANCE: Coronal sealing ability of RMGIC is more promising in comparison with the other agents.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Resinas Compostas/uso terapêutico , Cimentos de Ionômeros de Vidro/uso terapêutico , Óxidos/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Silicatos/uso terapêutico , Infiltração Dentária/prevenção & controle , Combinação de Medicamentos , Enterococcus faecalis/metabolismo , Humanos , Técnicas In Vitro , Selantes de Fossas e Fissuras/uso terapêutico
17.
Br J Psychiatry ; 208(4): 381-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26494875

RESUMO

BACKGROUND: Reducing the global treatment gap for mental disorders requires treatments that are economical, effective and culturally appropriate. AIMS: To describe a systematic approach to the development of a brief psychological treatment for patients with severe depression delivered by lay counsellors in primary healthcare. METHOD: The treatment was developed in three stages using a variety of methods: (a) identifying potential strategies; (b) developing a theoretical framework; and (c) evaluating the acceptability, feasibility and effectiveness of the psychological treatment. RESULTS: The Healthy Activity Program (HAP) is delivered over 6-8 sessions and consists of behavioral activation as the core psychological framework with added emphasis on strategies such as problem-solving and activation of social networks. Key elements to improve acceptability and feasibility are also included. In an intention-to-treat analysis of a pilot randomised controlled trial (55 participants), the prevalence of depression (Beck Depression Inventory II ⩾19) after 2 months was lower in the HAP than the control arm (adjusted risk ratio = 0.55, 95% CI 0.32-0.94,P= 0.01). CONCLUSIONS: Our systematic approach to the development of psychological treatments could be extended to other mental disorders. HAP is an acceptable and effective brief psychological treatment for severe depression delivered by lay counsellors in primary care.


Assuntos
Conselheiros , Transtorno Depressivo Maior/terapia , Psicoterapia Breve/métodos , Adulto , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Atenção Primária à Saúde/métodos , Desenvolvimento de Programas , Resultado do Tratamento , Adulto Jovem
18.
Nanotechnology ; 27(36): 365602, 2016 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-27479000

RESUMO

The synthesis of various nitrogen-doped (N-doped) carbon nanostructures has been significantly explored as an alternative material for energy storage and metal-free catalytic applications. Here, we reveal a direct growth technique of N-doped carbon nanofibers (CNFs) on flexible nichrome (NiCr) foil using melamine as a solid precursor. Highly reactive Cr plays a critical role in the nanofiber growth process on the metal alloy foil in an atmospheric pressure chemical vapor deposition (APCVD) process. Oxidation of Cr occurs in the presence of oxygen impurities, where Ni nanoparticles are formed on the surface and assist the growth of nanofibers. Energy-dispersive x-ray spectroscopy (EDXS) and x-ray photoelectron spectroscopy (XPS) clearly show the transformation process of the NiCr foil surface with annealing in the presence of oxygen impurities. The structural change of NiCr foil assists one-dimensional (1D) CNF growth, rather than the lateral two-dimensional (2D) growth. The incorporation of distinctive graphitic and pyridinic nitrogen in the graphene lattice are observed in the synthesized nanofiber, owing to better nitrogen solubility. Our finding shows an effective approach for the synthesis of highly N-doped carbon nanostructures directly on Cr-based metal alloys for various applications.

19.
J Contemp Dent Pract ; 17(11): 934-938, 2016 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-27965504

RESUMO

INTRODUCTION: Dental implants form the mainstay of dental treatment involving rehabilitation of missing teeth. One of the major concerns for the clinicians doing dental implants is the postsurgical failure of dental implants. Success of dental implants is dependent upon the skills of the surgeon and the amount and quality of the bone remaining at the edentulous area where dental implant has to be placed. Myeloperoxidase (MPO) and nitrites are few of the enzymes and molecules which are said to be altered in inflammation. However, their exact role in the inflammatory processes around natural tooth and dental implant is still unclear. Hence we comparatively evaluated the levels of MPO and nitrites in the areas around the dental implants and natural teeth. MATERIALS AND METHODS: The present study comprises 42 patients who underwent prosthetic rehabilitation by dental implants from 2011 to 2014. Depth of probing value (DP), score of plaque index (SPI), gingival index (GI), and index of gingival bleeding time (GBT) were evaluated for the assessment of the periimplant soft tissue changes. Assessment of inflammation around the dental implant surface and around natural tooth was done based on the readings of these parameters. For the measurement of the MPO levels, spectrophotometric MPO assay was used. All the results were analyzed by Statistical Package for the Social Sciences (SPSS) software. RESULTS: The mean plaque index values were 1.56 and 0.97 in periodontitis cases of natural teeth and inflamed cases of dental implants respectively. While comparing mean plaque index, mean probing depth, and mean gingival bleeding index in between the two groups, significant difference was obtained. Mean MPO concentration in periodontitis and gingivitis cases in natural teeth were 0.683 and 0.875 U/µL, while in inflamed dental implant cases, the mean value was 0.622 U/µL. While comparing the total MPO levels, total nitrite levels, and total nitrite concentration in between two study groups, significant difference was obtained. On comparing the healthy and periodontitis cases in natural teeth, significant difference was obtained. CONCLUSION: In the inflammatory processes occurring around dental implant and natural teeth, MPO and NO make some amount of significant contribution. CLINICAL SIGNIFICANCE: The present study enforces on the role of MPO and nitrite as diagnostic and prognostic marker.


Assuntos
Biomarcadores/análise , Implantes Dentários , Inflamação/metabolismo , Nitritos/análise , Peroxidase/análise , Dente , Implantação Dentária Endóssea , Índice de Placa Dentária , Falha de Restauração Dentária , Gengiva/metabolismo , Líquido do Sulco Gengival/metabolismo , Hemorragia Gengival/metabolismo , Gengivite/metabolismo , Humanos , Boca Edêntula/metabolismo , Índice Periodontal , Bolsa Periodontal/metabolismo , Periodontite/metabolismo
20.
Alcohol Clin Exp Res ; 39(3): 522-31, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25704494

RESUMO

BACKGROUND: Despite harmful drinking causing a significant burden on global health, there is a large treatment gap, especially in low- and middle-income countries. A major barrier to care is the lack of adequately skilled human resources to deliver contextually appropriate treatments. This paper describes the systematic process used to develop Counselling for Alcohol Problems (CAP), a brief psychological treatment (PT) for delivery by lay counselors in routine primary care settings to men with harmful drinking in India. METHODS: CAP was developed using a methodology involving 3 sequential steps: (i) identifying potential treatment strategies; (ii) developing a theoretical framework for the treatment; and (iii) evaluating the acceptability and feasibility of the treatment. RESULTS: CAP is a 3-phase treatment delivered over 1 to 4 sessions based on a motivational interviewing (MI) stance and involves the following strategies: assessment and personalized feedback, family engagement, drink refusal skills, skills to address drinking urges, problem-solving skills and handling difficult emotions, and relapse prevention and management. Data from a case series were used to inform several adaptations to enhance the acceptability of CAP to the recipients and feasibility of delivery by lay counselors of the treatment, for example expansion of the target group to include alcohol-dependent patients and the extension of the delivery settings to include home-based delivery. There was preliminary evidence of the effectiveness of CAP. CONCLUSIONS: CAP is an acceptable brief PT for harmful drinking delivered by lay counselors in primary care whose effectiveness is currently being tested in a randomized controlled trial based in primary care in Goa, India.


Assuntos
Alcoolismo/terapia , Aconselhamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde , Atenção Primária à Saúde/métodos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/terapia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Aconselhamento/normas , Feminino , Humanos , Índia/epidemiologia , Masculino , Projetos Piloto , Atenção Primária à Saúde/normas , Distribuição Aleatória , Resultado do Tratamento
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