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1.
Sex Health ; 18(1): 50-57, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33573716

RESUMEN

Background In high-income countries (HICs), migrants often have higher rates of late diagnosis of HIV than the host population. Timely HIV testing has significant implications for HIV prevention and management. Newer HIV testing approaches, namely provider-initiated testing and counselling (PITC), HIV rapid testing (HIV RT) and HIV self-testing (HIV ST), aim to reach those populations most at risk and, particularly, those who have not previously tested for HIV. METHODS: This study used semi-structured interviews to examine the (un)acceptability, barriers and facilitators to newer HIV testing approaches (i.e. PITC, HIV RT and HIV ST) among Vietnamese-born migrants (n = 10) in greater-Brisbane, Queensland, Australia. RESULTS: Vietnamese-born migrants had mixed perspectives on the (un)acceptability of newer HIV testing approaches. PITC was largely viewed by participants as a facilitator to HIV testing for Vietnamese-born migrants. Likewise, HIV RT (undertaken by a doctor in a medical setting, as opposed to a trained community member in a community setting) was generally considered to facilitate HIV testing. HIV ST was largely not considered acceptable to Vietnamese-born migrants and they would prefer to go to a doctor for HIV testing. Several factors were identified that either facilitate or act as barriers to newer HIV testing approaches, including privacy; cost of (accessing) HIV testing; comfort and convenience; healthcare provider relationship; risk perception; symptoms; and technical and emotional support. CONCLUSIONS: There is a need to understand migrants' HIV testing preferences if poorer HIV-related outcomes are to be overcome. The findings from this study show a preference for doctor-centred HIV testing, due to enhanced privacy, accuracy and support.


Asunto(s)
Infecciones por VIH , Migrantes , Pueblo Asiatico , Australia , Infecciones por VIH/diagnóstico , Prueba de VIH , Humanos , Queensland
2.
Matern Child Nutr ; 16(1): e12896, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31885221

RESUMEN

This cluster randomised controlled trial tested the effectiveness of a locally produced, fish-based, ready-to-use supplementary food (RUSF) to prevent growth faltering (decline in z-scores). Cambodian infants (n= 485), aged 6 to 11 months, were randomised by site to receive the RUSF, Corn-Soy Blend++ (CSB++), micronutrient powders (MNP), or no supplement (control). The intervention was for 6 months. In unadjusted analysis, the control group had statistically significantly decreased weight-for-age z-scores (WAZ; -0.02, 95%CI = -0.03 - -0.01, P= 0.001) and height-for-age z-scores (HAZ; -0.07, 95%CI = -0.09 - -0.05, P < 0.001), and increased mid-upper arm-circumference (MUAC; 0.02cm, 95%CI = 0.01 - 0.04, P = 0.010), but no statistically significant change in weight-for-height z-scores (WHZ). The RUSF group did not differ significantly from the control for WAZ, HAZ or WHZ (in other words, WAZ and HAZ decreased and WHZ did not change), but had increased MUAC in comparison to the control (0.04cm, 95%CI = 0.01 - 0.06, P = 0.008). There were no statistically significant differences between the RUSF group and the CSB++ or MNP groups with respect to WAZ, HAZ, WHZ or MUAC. Interestingly, in adjusted analysis, low consumers of RUSF had increased WAZ, WHZ and MUAC (0.03, 95%CI = 0.01-0.06, P = 0.006; 0.04, 95%CI = 0.01-0.08, P = 0.026; and 0.05cm, 95%CI = 0.02-0.09, P = 0.004, respectively) compared with the control. The novel RUSF, particularly in small quantities, protected against ponderal growth faltering, but the improvements were of limited clinical significance.


Asunto(s)
Proteínas de Peces en la Dieta/administración & dosificación , Alimentos Fortificados , Trastornos de la Nutrición del Lactante/prevención & control , Fenómenos Fisiológicos Nutricionales del Lactante , Antropometría , Estatura , Peso Corporal , Cambodia/epidemiología , Femenino , Humanos , Lactante , Masculino , Micronutrientes/administración & dosificación , Glycine max , Zea mays
3.
BMC Public Health ; 19(1): 1200, 2019 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-31470824

RESUMEN

BACKGROUND: Rates of childhood undernutrition are persistently high in Cambodia. Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness. Therefore, our project developed and trialled a locally-produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) with therapeutic and supplementary versions. This ready-to-use food (RUF) is innovative in that, unlike many RUFs, it contains fish instead of milk. Development began in 2013 and the RUF was finalised in 2015. From 2015 until the present, both the RUTF and the RUSF versions were trialled for acceptability and effectiveness. METHODS: This paper draws on project implementation records and semi-structured interviews to describe the partnership between the Cambodian Ministries of Health and Agriculture, Forestry and Fisheries, UNICEF, the French National Research Institute for Sustainable Development (IRD), universities, and Vissot factory. It discusses the project implementation and lessons learned from the development and trialling process, and insights into positioning nutrition on the health agenda in low and middle-income countries. RESULTS: The lessons learned relate to the importance of project planning, management, and documentation in order to seize opportunities in the research, policy, advocacy, and programming environment while ensuring adequate day-to-day project administration and resourcing. CONCLUSIONS: We conclude that projects such as ours, that collaborate to develop and test novel, locally-produced RUTFs and RUSFs, offer an exciting opportunity to respond to both local programmatic and broader research needs.


Asunto(s)
Trastornos de la Nutrición del Niño/prevención & control , Suplementos Dietéticos , Comida Rápida , Cambodia/epidemiología , Niño , Trastornos de la Nutrición del Niño/epidemiología , Humanos
4.
Matern Child Nutr ; 15(3): e12780, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-30690869

RESUMEN

In Cambodia, existing food products for treating or preventing undernutrition have met with limited success. Therefore, in 2014, alternative ready-to-use foods were developed. This trial aimed to assess the acceptability of the novel ready-to-use supplementary food (RUSF) as a snack or mixed with borbor (white rice porridge), compared with corn-soy blend plus plus (CSB++) and borbor fortified with micronutrient powder (MNP). The nonblinded, randomised 4 × 4 crossover trial recruited 95 children aged 9-23 months from communities in peri-urban Phnom Penh. Small quantities (100 g for porridges, 42 g for snack) of each food were offered for three consecutive days at testing sites (homes of health volunteers). Main outcomes were children's consumption, caregivers' assessment of children's preferences, and caregivers' ranking of the foods. Median percentage consumed of the test food servings ranged from 21 to 50% (p = 0.003). The odds of children consuming over 50% were greatest for borbor fortified with MNP versus RUSF snack (unadjusted OR = 6.79, CI = 2.80-16.47, p < 0.001). However, the median energy children received when consuming the RUSF with borbor (57 kcals) or as a snack (48 kcals) was greater than with CSB++ (15 kcals) or borbor fortified with MNP (18 kcals; p < 0.001). Therefore, although children ate less RUSF, it provided approximately three times more kilocalories. Caregivers reported that their children had the highest preference for borbor fortified with MNP. Caregivers themselves ranked the novel RUSF snack highest. Thus, the innovative RUSF was considered sufficiently acceptable to proceed to an effectiveness trial.


Asunto(s)
Comida Rápida , Preferencias Alimentarias/fisiología , Alimentos Fortificados , Fenómenos Fisiológicos Nutricionales del Lactante/fisiología , Cambodia , Cuidadores , Estudios Cruzados , Ingestión de Energía/fisiología , Humanos , Lactante , Trastornos de la Nutrición del Lactante/dietoterapia , Trastornos de la Nutrición del Lactante/prevención & control , Micronutrientes
5.
Nutr J ; 17(1): 39, 2018 03 16.
Artículo en Inglés | MEDLINE | ID: mdl-29548287

RESUMEN

BACKGROUND: Existing ready-to-use supplementary and therapeutic foods (RUSFs and RUTFs) have had limited acceptance and effectiveness in Cambodia. This has hampered the treatment and prevention of child malnutrition. An innovative, locally produced, multiple micronutrient fortified lipid-based nutrient supplement (LNS) has been developed for use as an RUSF. Unlike most RUSFs, which contain milk, this product contains fish as the animal protein. Few RUSFs have been formulated using non-milk animal-source foods and they have not been widely tested. An acceptability trial that was conducted on this novel RUSF in June 2015 demonstrated that children will eat the RUSF and that caregivers will feed it to their children. The current trial aims to evaluate the effectiveness of the RUSF in preventing growth faltering and improving micronutrient status in Cambodian children. METHODS AND ANALYSIS: This trial is a six-month, prospective, cluster randomised, non-blinded controlled trial among infants in peri-urban Phnom Penh. The trial aims to establish the superiority of the novel RUSF, compared to three alternatives (Corn-Soy Blend Plus Plus (CSB++) and Sprinkles micronutrient powders as active comparators, and the unimproved diet as a control). The allocation ratio is 1:1. Healthy children (N = 540) aged six to eleven months will be recruited. Data will be collected at baseline, and monthly thereafter for a period of six months. Participants will be provided with a monthly supply of the food to which their village has been allocated. DISCUSSION: There is an urgent need to develop locally produced and culturally acceptable RUSFs, and to compare these with existing options in terms of their potential for preventing malnutrition, in Cambodia and elsewhere. This trial will contribute much-needed data on the effectiveness of supplementary foods with an animal-source food other than milk, by comparing a novel RUSF based on fish to one that uses milk (CSB++). Moreover, it will deepen the understanding of the impact of multiple micronutrients provided with or without macronutrients, by comparing the novel RUSF and CSB++, which combine macronutrients with multiple micronutrients, to Sprinkles, which contains no macronutrients. In addition, it will augment the body of evidence from Asia. TRIAL REGISTRATION: ClinicalTrials.gov, Identifier: LNS-CAMB-INFANTS-EFF; NCT02257762 .


Asunto(s)
Alimentos Infantiles , Trastornos de la Nutrición del Lactante/prevención & control , Fenómenos Fisiológicos Nutricionales del Lactante , Micronutrientes/administración & dosificación , Animales , Composición Corporal , Estatura , Peso Corporal , Cambodia/epidemiología , Proteínas en la Dieta/administración & dosificación , Peces , Alimentos Fortificados , Humanos , Lactante , Trastornos de la Nutrición del Lactante/epidemiología , Recién Nacido , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto
6.
Br J Psychiatry ; 208(4): 374-80, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26795423

RESUMEN

BACKGROUND: Management of long-term depression is a significant problem in primary care populations with considerable on-going morbidity, but few studies have focused on this group. AIMS: To evaluate whether structured, nurse-led proactive care of patients with chronic depression in primary care improves outcomes. METHOD: Participants with chronic/recurrent major depression or dysthymia were recruited from 42 UK general practices and randomised to general practitioner (GP) treatment as usual or nurse intervention over 2 years (the ProCEED trial, trial registration:ISRCTN36610074). RESULTS: In total 282 people received the intervention and there were 276 controls. At 24 months there was no significant improvement in Beck Depression Inventory (BDI-II) score or quality of life (Euroquol-EQ-VAS), but a significant improvement in functional impairment (Work and Social Activity Schedule, WSAS) of 2.5 (95% CI 0.6-4.3,P= 0.010) in the intervention group. The impact per practice-nurse intervention session was -0.37 (95% CI -0.68 to -0.07,P= 0.017) on the BDI-II score and 70.33 (95% CI 70.55 to -0.10,P= 0.004) on the WSAS score, indicating that attending all 10 intervention sessions could lead to a BDI-II score reduction of 3.7 points compared with controls. CONCLUSIONS: The intervention improved functioning in these patients, the majority of whom had complex long-term difficulties, but only had a significant impact on depressive symptoms in those engaging with the full intervention.


Asunto(s)
Enfermería de Práctica Avanzada , Trastorno Depresivo Mayor/terapia , Médicos Generales , Atención Primaria de Salud/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
7.
Int J Geriatr Psychiatry ; 31(6): 656-65, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26489776

RESUMEN

OBJECTIVE: Although available evidence is modest, exercise could be beneficial in reducing behavioural and psychological symptoms of dementia. We aim to evaluate the cost-effectiveness of a dyadic exercise regimen for individuals with dementia and their main carer as therapy for behavioural and psychological symptoms of dementia. METHODS: Cost-effectiveness analysis within a two-arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored, for 20-30 min at least five times per week). The study randomised 131 community-dwelling individuals with dementia and clinically significant behavioural and psychological symptoms with a carer willing and able to participate in the exercise regimen; 52 dyads provided sufficient cost data for analyses. RESULTS: Mean intervention cost was £284 per dyad. For the subsample of 52 dyads, the intervention group had significantly higher mean cost from a societal perspective (mean difference £2728.60, p = 0.05), but costs were not significantly different from a health and social care perspective. The exercise intervention was more cost-effective than treatment as usual from both societal and health and social care perspectives for the measure of behavioural and psychological symptoms (Neuropsychiatric Inventory). It does not appear cost-effective in terms of cost per quality-adjusted life year gain. CONCLUSIONS: The exercise intervention has the potential to be seen as cost-effective when considering behavioural and psychological symptoms but did not appear cost-effective when considering quality-adjusted life year gains.


Asunto(s)
Demencia/terapia , Terapia por Ejercicio , Anciano , Anciano de 80 o más Años , Costo de Enfermedad , Análisis Costo-Beneficio , Demencia/economía , Demencia/psicología , Terapia por Ejercicio/economía , Terapia por Ejercicio/métodos , Femenino , Costos de la Atención en Salud , Humanos , Masculino , Calidad de Vida , Años de Vida Ajustados por Calidad de Vida , Método Simple Ciego , Estrés Psicológico/prevención & control , Caminata
8.
Int Psychogeriatr ; 28(6): 881-7, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26652193

RESUMEN

BACKGROUND: Family carers of people with dementia frequently report acting abusively toward them and carer psychological morbidity predicts this. We investigated whether START (STrAtegies for RelaTives), a psychological intervention which reduces depression and anxiety in family carers also reduces abusive behavior in carers of people living in their own homes. We also explored the longitudinal course of carer abusive behavior over two year. METHODS: We included self-identified family carers who gave support at least weekly to people with dementia referred in the previous year to three UK mental health services and a neurological dementia service. We randomly assigned these carers to START, an eight-session, manual-based coping intervention, or treatment as usual (TAU). Carer abusive behavior (Modified Conflict Tactic Scale (MCTS) score ≥2 representing significant abuse) was assessed at baseline, 4, 8, 12, and 24 months. RESULTS: We recruited 260 carers, 173 to START and 87 to TAU. There was no evidence that abusive behavior levels differed between randomization groups or changed over time. A quarter of carers still reported significant abuse after two years, but those not acting abusively at baseline did not become abusive. CONCLUSION: There was no evidence that START, which reduced carer anxiety and depression, reduced carer abusive behavior. For ethical reasons, we frequently intervened to manage concerning abuse reported in both groups, which may have disguised an intervention effect. Future dementia research should include elder abuse as an outcome, and consider carefully how to manage detected abuse.


Asunto(s)
Adaptación Psicológica , Ansiedad/prevención & control , Cuidadores/psicología , Depresión/prevención & control , Abuso de Ancianos/mortalidad , Familia/psicología , Psicoterapia/métodos , Anciano , Ansiedad/diagnóstico , Ansiedad/etiología , Cuidadores/educación , Demencia/psicología , Depresión/diagnóstico , Depresión/etiología , Abuso de Ancianos/prevención & control , Abuso de Ancianos/psicología , Femenino , Humanos , Masculino , Evaluación de Resultado en la Atención de Salud , Calidad de Vida , Método Simple Ciego , Apoyo Social , Encuestas y Cuestionarios , Reino Unido
9.
Aging Ment Health ; 20(4): 362-9, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-25703391

RESUMEN

BACKGROUND: Improving quality of care for people with dementia is a high priority. Considerable resources have been invested in financial incentives, guideline development, public awareness and educational programmes to promote earlier diagnosis and better management. OBJECTIVES: Evaluating family physicians' concordance with guidelines on diagnosis and management of people with dementia, from first documentation of symptoms to formal diagnosis. METHOD: Analysis of medical records of 136 people with dementia recruited by 19 family practices in NW London and surrounding counties. RESULTS: Practices invited 763 people with dementia to participate, 167 (22%) agreed. Complete records were available for 136 (18%). The majority of records included reference to recommended blood tests, informant history and caregiver concerns. Presence or absence of symptoms of depression, psychosis, other behavioural and psychological symptoms of dementia, and cognitive function tests were documented in 30%-40% of records. Documentation of discussions about signs and symptoms of dementia, treatment options, care, support, financial, legal and advocacy advice were uncommon. Comparison of these findings from a similar study in 2000-2002 suggests improvements in concordance with blood tests, recording informant history, presence or absence of depression or psychosis symptoms. There was no difference in documenting cognitive function tests. Immediate referral to specialists was more common in the recent study. CONCLUSION: Five years after UK dementia guidelines and immediately after the launch of the dementia strategy, family physicians appeared concordant with clinical guidelines for dementia diagnosis (other than cognitive function tests), and referred most patients immediately. However, records did not suggest systematic dementia management.


Asunto(s)
Demencia/diagnóstico , Medicina Familiar y Comunitaria/normas , Adhesión a Directriz/estadística & datos numéricos , Médicos de Familia/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Atención Primaria de Salud/normas , Anciano , Anciano de 80 o más Años , Demencia/psicología , Demencia/terapia , Manejo de la Enfermedad , Femenino , Humanos , Masculino , Reino Unido
11.
AIDS Behav ; 19(11): 2012-24, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26025193

RESUMEN

Migrants, particularly from low- and middle-income countries, are at a heightened risk of adverse HIV outcomes. HIV testing may improve these outcomes. We reviewed and synthesised studies into migrants and HIV testing (outcome variable), published between January 1997 and April 2014. Papers using quantitative, qualitative and mixed methods designs, and samples with adult (≥18 years) migrants from low- and middle-income countries in high-income countries were included in the paper. Of 3155 papers retrieved, 31 met the inclusion criteria and are included in the review. A large number of barriers and facilitators to HIV testing were identified across the individual, social and structural levels. A number of study design and methodological issues, however, inhibited a comprehensive synthesis. There is no doubt that addressing HIV testing in migrants in high-income countries is complex; however, it has important implications for individual, community and population health, and a strong, empirically based response is warranted.


Asunto(s)
Países Desarrollados , Infecciones por VIH/prevención & control , Migrantes , Adulto , Consejo , Diagnóstico Tardío , Infecciones por VIH/diagnóstico , Infecciones por VIH/etnología , Infecciones por VIH/psicología , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Humanos , Renta , Masculino , Factores de Riesgo
12.
BMC Fam Pract ; 16: 67, 2015 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-26018127

RESUMEN

BACKGROUND: Sedentary behaviour is detrimental to health, even in those who achieve recommended levels of physical activity. Efforts to increase physical activity in older people so that they reach beneficial levels have been disappointing. Reducing sedentary behaviour may improve health and be less demanding of older people, but it is not clear how to achieve this. We explored the characteristics of sedentary older people enrolled into an exercise promotion trial to gain insights about those who were sedentary but wanted to increase activity. METHOD: Participants in the ProAct65+ trial (2009-2013) were categorised as sedentary or not using a self-report questionnaire. Demographic data, health status, self-rated function and physical test performance were examined for each group. 1104 participants aged 65 & over were included in the secondary analysis of trial data from older people recruited via general practice. Results were analysed using logistic regression with stepwise backward elimination. RESULTS: Three hundred eighty seven (35 %) of the study sample were characterised as sedentary. The likelihood of being categorised as sedentary increased with an abnormal BMI (<18.5 or >25 g/m(2)) (Odds Ratio 1.740, CI 1.248-2.425), ever smoking (OR 1.420, CI 1.042-1.934) and with every additional medication prescribed (OR 1.069, CI 1.016-1.124). Participants reporting better self-rated physical health (SF-12) were less likely to be sedentary; (OR 0.961, 0.936-0.987). Participants' sedentary behaviour was not associated with gender, age, income, education, falls, functional fitness, quality of life or number of co-morbidities. CONCLUSION: Some sedentary older adults will respond positively to an invitation to join an exercise study. Those who did so in this study had poor self-rated health, abnormal BMI, a history of smoking, and multiple medication use, and are therefore likely to benefit from an exercise intervention. TRIAL REGISTRATION: ISRCTN reference: ISRCTN43453770.


Asunto(s)
Actividad Motora , Desempeño Psicomotor , Conducta Sedentaria , Anciano , Medicina Familiar y Comunitaria/métodos , Femenino , Evaluación Geriátrica/métodos , Conductas Relacionadas con la Salud , Promoción de la Salud/métodos , Disparidades en el Estado de Salud , Humanos , Masculino , Actividad Motora/efectos de los fármacos , Evaluación de Resultado en la Atención de Salud , Polifarmacia , Estadística como Asunto
13.
Int J Geriatr Psychiatry ; 29(8): 819-27, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24338799

RESUMEN

OBJECTIVE: The objective of this study is to evaluate the effectiveness of a simple dyadic (person with dementia and their main carer) exercise regimen as a therapy for the behavioural and psychological symptoms of dementia. METHOD: A two arm, pragmatic, randomised, controlled, single-blind, parallel-group trial of a dyadic exercise regimen (individually tailored walking regimen designed to become progressively intensive and last between 20-30 min, at least five times per week).Community-dwelling individuals with ICD-10 confirmed dementia with the following: clinically significant behavioural and psychological symptoms, a carer willing and able to co-participate in the exercise regimen, and no physical conditions or symptoms that would preclude exercise participation were invited by mental health or primary care services into the study. RESULTS: One hundred and thirty-one dyads were recruited to this study. There was no significant difference in Behavioural and Psychological Symptoms as measured by the Neuropsychiatric Inventory at week 12 between the group receiving the dyadic exercise regimen and those that did not (adjusted difference in means (intervention minus control) = -1.53, p = 0.6, 95% CI [-7.37, 4.32]). There was a significant between-group difference in caregiver's burden as measured by the Zarit Caregiver Burden Inventory at week 12 (OR = 0.18, p = 0.01, CI [0.05, 0.69]) favouring the exercise group. CONCLUSIONS: This study found that regular simple exercise does not appear to improve the behavioural and psychological symptoms of dementia, but did seem to attenuate caregiver burden. Further study to improve exercise uptake are needed.


Asunto(s)
Cuidadores/psicología , Demencia , Terapia por Ejercicio , Caminata , Anciano , Anciano de 80 o más Años , Costo de Enfermedad , Demencia/psicología , Demencia/terapia , Terapia por Ejercicio/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , Calidad de Vida , Estrés Psicológico/prevención & control
14.
Am J Phys Anthropol ; 154(2): 171-88, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24936604

RESUMEN

Bioarchaeologists have long noted two unusual trends in the dentitions of prehistoric Native Californian populations: high rates of wear and low prevalence of caries. The Central California site of CA-CCO-548 offers a unique opportunity to examine the relationship between oral pathology and extreme dental wear in a large (n = 480), ancient (4,300­3,100 BP), and temporally well-defined population sample. This study specifically examines three interrelated processes of the oral cavity in this population: dental wear, dental caries, and periodontal disease. The results show high levels of dental wear (average of 6.1, Smith system), low frequencies of carious lesions (2.5%), low frequencies of periodontal disease (17.8%), and high frequencies of periapical abscesses (10.7%). The pathological processes examined here have complicated multifactorial etiologies. However, they all share the common primary etiological agents of facultative pathogenic bacteria proliferation in the oral biofilm. Integration of the current etiological explanations for infections of the oral cavity, information from the ethnographic record pertaining to subsistence and activity patterns in Native Californian populations, and statistical analysis of specific disease and wear patterns leads to a novel explanation for the observed pattern of oral pathology in this population sample. Specifically, the introduction of antibacterial compounds through dietary items and non-alimentary tooth use is suggested as the most likely explanation for the unusually low prevalence of dental caries and periodontal disease.


Asunto(s)
Caries Dental , Indígenas Norteamericanos , Absceso Periapical , Desgaste de los Dientes , Adolescente , Adulto , California/epidemiología , Niño , Preescolar , Caries Dental/epidemiología , Caries Dental/etnología , Caries Dental/historia , Femenino , Historia Antigua , Humanos , Indígenas Norteamericanos/etnología , Indígenas Norteamericanos/historia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Paleodontología , Absceso Periapical/epidemiología , Absceso Periapical/etnología , Absceso Periapical/historia , Desgaste de los Dientes/epidemiología , Desgaste de los Dientes/etnología , Desgaste de los Dientes/historia , Adulto Joven
15.
Inj Prev ; 20(4): e6, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24478230

RESUMEN

BACKGROUND: Although road traffic injury is reported as the leading cause of work-related death in Australia, it is not clear, due to limitations in previous methods used, just how large a burden it is. Many organisations are unaware of the extent of work-related road traffic injury and, importantly, what can be done to reduce the burden. The proposed research will (i) estimate the prevalence of work-related road traffic injury and (ii) identify the organisational determinants associated with work-related road traffic injury. METHODS AND DESIGN: The current study is designed to enumerate the problem and identify the individual driver-level, the supervisor-level and organisational-level factors associated with work-related road traffic injury. The multilevel systems protocol will involve a series of cross-sectional surveys administered to drivers of fleet vehicles (n=1200), supervisors of the drivers (n=1200) and senior managers (n=300) within the same organisation. DISCUSSION: The novel use of the multilevel systems protocol is critical to be able to accurately assess the specific determinants of driving safety within each context of an organisation. RESULTS: The results are expected to highlight that reducing injury in the workplace requires more than just individual compliance with safety procedures. It will also establish, for the first time, an occupational translation taskforce to ensure that the research findings are adopted into work-place practice and thereby directly contribute to reductions in work-related road traffic injury.


Asunto(s)
Accidentes de Trabajo/prevención & control , Accidentes de Tránsito/prevención & control , Accidentes de Trabajo/estadística & datos numéricos , Accidentes de Tránsito/estadística & datos numéricos , Australia , Conducción de Automóvil/normas , Humanos , Seguridad
16.
J Appl Psychol ; 109(2): 293-306, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37616111

RESUMEN

Previous research on the psychological effect of job change has revealed a honeymoon-hangover pattern during the turnover process. However, there is a dearth of evidence on how individuals react and adapt to multiple job changes over their working lives. This study distinguishes adaptation to a single job change in the short term from adaptation to the process of job change in the long term. Drawing on two large-scale, long-running panel data sets from Britain and Australia, it examined how job satisfaction trajectory evolved as individuals made a series of consecutive job changes since they first entered the labor market. Our fixed effect analyses show that in both countries, individuals experienced a stronger honeymoon effect with each successive job change, before gradually reverting to their baseline job satisfaction. In short, the amplitude of the honeymoon-hangover effect increased across multiple job changes. By distinguishing "adaptation to change" from "change in adaptation," this study generates original insights into the role of job mobility in facilitating career development and extends set point theory from understanding the impact of single life events to recurring life events. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Satisfacción en el Trabajo , Ocupaciones , Humanos , Australia , Satisfacción Personal
17.
Bioengineering (Basel) ; 11(5)2024 Apr 29.
Artículo en Inglés | MEDLINE | ID: mdl-38790308

RESUMEN

Divided and subtracted MRI is a novel imaging processing technique, where the difference of two images is divided by their sum. When the sequence parameters are chosen properly, this results in images with a high T1 or T2 weighting over a small range of tissues with specific T1 and T2 values. In the T1 domain, we describe the implementation of the divided Subtracted Inversion Recovery Sequence (dSIR), which is used to image very small changes in T1 from normal in white matter. dSIR has shown widespread changes in otherwise normal-appearing white matter in patients suffering from mild traumatic brain injury (mTBI), substance abuse, and ischemic leukoencephalopathy. It can also be targeted to measure small changes in T1 from normal in other tissues. In the T2 domain, we describe the divided echo subtraction (dES) sequence that is used to image musculoskeletal tissues with a very short T2*. These tissues include fascia, tendons, and aponeuroses. In this manuscript, we explain how this contrast is generated, review how these techniques are used in our research, and discuss the current challenges and limitations of this technique.

18.
Diagnostics (Basel) ; 14(4)2024 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-38396456

RESUMEN

Background: Delayed Post-Hypoxic Leukoencephalopathy (DPHL), or Grinker's myelinopathy, is a syndrome in which extensive changes are seen in the white matter of the cerebral hemispheres with MRI weeks or months after a hypoxic episode. T2-weighted spin echo (T2-wSE) and/or T2-Fluid Attenuated Inversion Recovery (T2-FLAIR) images classically show diffuse hyperintensities in white matter which are thought to be near pathognomonic of the condition. The clinical features include Parkinsonism and akinetic mutism. DPHL is generally regarded as a rare condition. Methods and Results: Two cases of DPHL imaged with MRI nine months and two years after probable hypoxic episodes are described. No abnormalities were seen on the T2-FLAIR images with MRI, but very extensive changes were seen in the white matter of the cerebral and cerebellar hemisphere on divided Subtraction Inversion Recovery (dSIR) images. dSIR sequences may produce ten times the contrast of conventional inversion recovery (IR) sequences from small changes in T1. The clinical findings in both cases were of cognitive impairment without Parkinsonism or akinetic mutism. Conclusion: The classic features of DPHL may only represent the severe end of a spectrum of diseases in white matter following global hypoxic injury to the brain. The condition may be much more common than is generally thought but may not be recognized using conventional clinical and MRI criteria for diagnosis. Reappraisal of the syndrome of DPHL to include clinically less severe cases and to encompass recent advances in MRI is advocated.

19.
Hum Brain Mapp ; 34(1): 1-11, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21932258

RESUMEN

Regions of the fusiform gyrus (FG) respond preferentially to faces over other classes of visual stimuli. It remains unclear whether emotional face information modulates FG activity. In the present study, whole-head magnetoencephalography (MEG) was obtained from fifteen healthy adults who viewed emotionally expressive faces and made button responses based upon emotion (explicit condition) or age (implicit condition). Dipole source modeling produced source waveforms for left and right primary visual and left and right fusiform areas. Stronger left FG activity (M170) to fearful than happy or neutral faces was observed only in the explicit task, suggesting that directed attention to the emotional content of faces facilitates observation of M170 valence modulation. A strong association between M170 FG activity and reaction times in the explicit task provided additional evidence for a role of the fusiform gyrus in processing emotional information.


Asunto(s)
Corteza Cerebral/fisiología , Emociones/fisiología , Expresión Facial , Magnetoencefalografía , Reconocimiento Visual de Modelos/fisiología , Adulto , Atención/fisiología , Mapeo Encefálico/métodos , Potenciales Evocados Visuales/fisiología , Cara , Miedo , Femenino , Felicidad , Humanos , Masculino , Estimulación Luminosa/métodos , Tiempo de Reacción/fisiología , Adulto Joven
20.
Am J Orthod Dentofacial Orthop ; 143(4): 522-6, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23561414

RESUMEN

INTRODUCTION: The goal of this study was to compare the dimensions of maxillary lateral incisors in subjects with and without palatally displaced canines. METHODS: An experimental group of 40 patients with 46 palatally displaced canines (20 in boys, 26 in girls; mean age, 13.9 years; range, 10.5-15.9 years) was selected from the records of patients referred to a radiology practice specializing in cone-beam volumetric tomography imaging. The palatally displaced canine group was age- and sex-matched with 30 normal subjects with 60 canines (26 in boys, 34 in girls; mean age, 13.8 years; range, 10.4-15.7 years). Cone-beam volumetric tomography DICOM files were imported into Dolphin Imaging software (version 11.0; Dolphin Imaging & Management Solutions, Chatsworth, Calif), and the volumetric images were reoriented with the long axis of the lateral incisor vertical and then reconstructed into images of a sagittal slice through the maxillary lateral incisors and 3 axial slices across the maxillary lateral incisor root. The linear variables of the maxillary lateral incisors were measured by using digital measurement tools. The widths of the maxillary lateral incisor roots were registered at the cementoenamel junction level, 4 mm apical to the cementoenamel junction level and 8 mm apical to the cementoenamel junction level. An independent t test was used to test for differences between the groups, because the data were normally distributed. RESULTS: In the group with palatally displaced canines, the mean length of the maxillary lateral incisors was 2.1 mm shorter (P <0.001), and the mean root width was smaller, especially in the buccolingual dimension, by 0.7 mm (P <0.001). CONCLUSIONS: Lateral incisors adjacent to palatally displaced canines were smaller compared with those adjacent to normal canines.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Diente Canino/diagnóstico por imagen , Incisivo/diagnóstico por imagen , Odontometría/métodos , Diente Impactado/diagnóstico por imagen , Adolescente , Estudios de Casos y Controles , Niño , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Maxilar/diagnóstico por imagen , Hueso Paladar/diagnóstico por imagen , Estudios Retrospectivos , Cuello del Diente/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
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