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1.
Appetite ; 193: 107153, 2024 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-38072086

RESUMO

This study explores how adolescents engage with unhealthy food and beverage marketing in online settings, from a gender perspective. Employing an online ethnography approach and using go-along interviews, we explored the experiences of adolescent boys and girls aged 13-17 as they navigated their online experiences with digital food and beverage marketing. Notable themes emerged, including the identification of predatory actions by food companies, the role of protective factors such as family, and the influence of social media influencers in shaping adolescent dietary preferences. Importantly, this research unearthed gender disparities in the participants' responses. Girls, in particular, exhibited a heightened awareness of the protective role played by their families, emphasized the influence of color in marketing strategies, recognized the significance of gender in marketing, and reported exposure to alcohol advertisements-findings that boys less frequently echoed. The study underscores the importance of adolescence as a critical phase in development, during which food companies target these impressionable individuals, driven by their independence and potential for brand loyalty. Moreover, it highlights the potential avenue of gender-specific marketing, offering valuable insights into the gendered dimensions of adolescents' food marketing experiences. By examining the interplay between digital food marketing and gender, this research addresses a critical gap in the literature, shedding light on how gender influences adolescents' perceptions, responses, and behaviors in the context of food marketing strategies. These findings have the potential to inform adolescents of the marketing techniques that target them and guide policymakers in developing and implementing evidence-based regulations aimed at safeguarding adolescents from exposure to unhealthy food marketing.


Assuntos
Alimentos , Marketing , Masculino , Feminino , Adolescente , Humanos , Fatores Sexuais , Marketing/métodos , Bebidas , Dieta , Indústria Alimentícia
2.
Appl Opt ; 62(1): 91-101, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36606856

RESUMO

The tool influence function (TIF) during sub-aperture belt-on-wheel polishing has been evaluated as a function of various process conditions (belt use/wear, dwell time, displacement, belt velocity, and wheel modulus and diameter) on fused silica glass workpieces using C e O 2 polishing media. TIF spots are circular or elliptical in shape with a largely flat bottom character. The volumetric removal rate varies significantly with belt use (or wear), stabilizing after ∼15m i n of use. A modified Preston model, where the pressure dependence is adjusted using a different scaling of the wheel modulus (E w0.5), largely predicts the volumetric removal rate over the range of process conditions evaluated. The relatively high volumetric removal rate of 30-60m m 3/h using a fixed C e O 2-in-resin-host belt offers a rapid, and hence, more economical, initial polish of aspheric and freeform optics.

3.
Appetite ; 91: 357-65, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25936339

RESUMO

PROBLEM: Current versions of Canada's Food Guide (CFG) aim to inform a culturally diverse population, but it is not known how intended audiences from different cultural and linguistic groups within Canada's diverse population understand and apply its messages. METHODS: We analyzed data from qualitative interviews conducted with 32 newcomer mothers of children aged 1-5 years to explore how conceptions of food and health change with migration to Canada among Spanish-speaking Latin American and Tamil Speaking Sri Lankan newcomers and may influence the appropriateness and applicability of Canada's Food Guide (CFG) as a nutrition education tool. We applied Jordan's model of authoritative knowledge to identify different forms of newcomer maternal nutrition knowledge, how they influence child feeding practices, and shifts causing some forms of knowledge to be devalued in favor of others. RESULTS: Awareness of CFG differed between groups, with all Latin American and only half of Tamil participants familiar with it. Three distinct, overlapping ways of knowing about the relationship between food and health are identified within both groups of mothers: "natural" foods as healthy; influence of foods on illness susceptibility, and the nutritional components of food. CFG was found to be limited in its representations of recommended foods and its exclusive utilization of biomedical concepts of nutrition. CONCLUSIONS: Development of new, culturally competent versions of CFG that depict a variety of ethno-culturally meaningful diets and encompass both non-biomedical conceptualizations of food and health has the potential to enhance effective knowledge translation of CFG's key messages to an increasingly cosmopolitan Canadian population.


Assuntos
Cultura , Dieta , Emigração e Imigração , Conhecimentos, Atitudes e Prática em Saúde , Saúde , Mães , Política Nutricional , Adulto , Canadá , Pré-Escolar , Competência Cultural , Comportamento Alimentar , Feminino , Educação em Saúde , Humanos , Lactente , Pessoa de Meia-Idade , Valor Nutritivo , Poder Familiar , Pesquisa Qualitativa , América do Sul/etnologia , Sri Lanka/etnologia , Adulto Jovem
4.
Res Vet Sci ; 168: 105154, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38290405

RESUMO

An existing model was used to identify key drivers of profitability and estimate the impact on environmental sustainability when immunizing finishing pigs against GnRF with Improvac®. The model estimated performance and economic differences between immunized (IM) and non-IM pigs from the perspective of producers and packers, based on two recent meta-analyses in male and female pigs. It was populated with data from 9 countries in four continents (Europe, Asia, North and Latin-America). One-way sensitivity analyses (OWSA) were used to define key drivers of profitability. When changing the country specific input data over a range of ±20%, most OWSA did not reverse the mathematical sign of incremental net return between IM and non-IM pigs as calculated in base case analyses. Only the difference in feed conversion rate between IM and untreated female pigs was a key driver of profitability. The parameters with the highest impact on outcomes were similar across countries and expectable (feed costs), or explainable (parameters with statistical differences between IM and non-IM pigs in meta-analyses). In both single-gender herds, Improvac® reduced the environmental impact of pig production by improving feed efficiency (FE), the key driver of environmental burden. In a 50/50 mixed gender herd, IM pigs consumed less feed and gained more weight in 7 out of 9 countries; in the other two countries the FE calculated for the additional weight gain in IM pigs was >1.00, i.e., each additional kilogram of weight gain was associated with less than one additional kilogram of feed consumed.


Assuntos
Imunização , Vacinação , Suínos , Feminino , Masculino , Animais , Imunização/veterinária , Vacinação/veterinária , Hormônio Liberador de Gonadotropina , Aumento de Peso , Gonadotropinas
5.
Anaesthesia ; 67(4): 402-6, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22324890

RESUMO

The GlideScope(®) videolaryngoscope is widely utilised in the management of the difficult airway. However, complications such as mucosal injury, palatal and tonsillar perforations have been reported with its use. The Shikani optical stylet has shown promise in aiding difficult intubations. This randomised controlled trial evaluates the Shikani optical stylet as an alternative to the GlideScope videolaryngoscope in patients undergoing anaesthesia, with a simulated difficult airway. Sixty patients were randomised to undergo tracheal intubation with either the GlideScope videolaryngoscope (n = 30) or the Shikani optical stylet (n = 30). All patients had rigid cervical collars applied to simulate a difficult airway. Tracheal intubation was successful in all patients, with first attempt success rates of 97% (29/30) the GlideScope group compared with 93% (28/30) in the Shikani group compared with 93% (28/30) in the Shikani group (p = 0.5). The mean (SD) time to intubation was 64 (37) s when using the GlideScope and 58 (26) s in the Shikani group (p = 0.48). A higher incidence of airway mucosal injury was noted in patients intubated with the GlideScope videolaryngoscope, compared with the Shikani optical stylet (5 vs 0, respectively, p = 0.05). This trial suggests that the Shikani optical stylet is a viable alternative to the GlideScope videolaryngoscope in the management of the difficult airway.


Assuntos
Obstrução das Vias Respiratórias , Intubação Intratraqueal/instrumentação , Laringoscópios , Laringoscopia/instrumentação , Gravação em Vídeo , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Res Vet Sci ; 150: 170-178, 2022 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-35842948

RESUMO

Porcine reproductive and respiratory syndrome virus (PRRSV) is currently one of the most economically important health challenges in the global swine industry. The primary aim of this study was to evaluate the overall efficacy of a modified live virus vaccine Fostera® PRRS (F-PRRS) compared to no vaccination as reported in published studies, using meta-analytic techniques. Additionally, we aimed to evaluate the potential impact of age at vaccination and F-PRRS cross-protection against different genetically distanced PRRS strains. In total, 20 papers fulfilled the predefined inclusion criteria. Vaccinated pigs had on average 38.52 g/d higher daily weight gain and a 65% lower mortality (relative risk = 0.35) compared to non-vaccinates. F-PRRS reduced the maximum macroscopic lung lesion score on average by 16.82% points and the maximum viral load in serum by 1.36 log10 PRRSV RNA copies. Vaccination at 1 day and 21 days of age was similarly effective, and the pathogenic PRRS strain(s) used for challenge or being endemic in field studies (PRRSV-1, PRRSV-2, or PRRSV-1 & -2) did not significantly influence the outcomes. Our findings confirm the effectiveness of F-PRRS against heterologous PRRSV infection.


Assuntos
Síndrome Respiratória e Reprodutiva Suína , Vírus da Síndrome Respiratória e Reprodutiva Suína , Doenças dos Suínos , Vacinas Virais , Animais , Anticorpos Antivirais , Síndrome Respiratória e Reprodutiva Suína/prevenção & controle , Suínos , Vacinas Atenuadas
7.
Nat Med ; 5(1): 71-7, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9883842

RESUMO

Adeno-associated virus 2 (AAV)-based vectors have gained attention as a potentially useful alternative to the more commonly used retroviral and adenoviral vectors for human gene therapy. Although AAV uses the ubiquitously expressed cell surface heparan sulfate proteoglycan (HSPG) as a receptor, the transduction efficiency of AAV vectors varies greatly in different cells and tissues in vitro and in vivo. We demonstrate here that cell surface expression of HSPG alone is insufficient for AAV infection, and that AAV also requires human fibroblast growth factor receptor 1 (FGFR1) as a co-receptor for successful viral entry into the host cell. We document that cells that do not express either HSPG or FGFR1 fail to bind AAV and, consequently, are resistant to infection by AAV. These non-permissive cells are successfully transduced by AAV vectors after stable transfections with cDNAs encoding the murine HSPG and the human FGFR1. Furthermore, AAV infection of permissive cells, known to express both FGFR1 and the epidermal growth factor receptor, is abrogated by treatment of cells with basic fibroblast growth factor, but not with epidermal growth factor. The identification of FGFR1 as a co-receptor for AAV should provide new insights not only into its role in the life cycle of AAV, but also in the optimal use of AAV vectors in human gene therapy.


Assuntos
Dependovirus/fisiologia , Proteoglicanas de Heparan Sulfato/metabolismo , Receptores Proteína Tirosina Quinases , Receptores de Fatores de Crescimento de Fibroblastos/metabolismo , Receptores Virais/metabolismo , Células 3T3 , Animais , Proteínas de Ligação a DNA/metabolismo , Dependovirus/metabolismo , Fatores de Crescimento de Fibroblastos/metabolismo , Fatores de Crescimento de Fibroblastos/farmacologia , Células HeLa , Proteoglicanas de Heparan Sulfato/genética , Humanos , Camundongos , Fosforilação , Receptor Tipo 1 de Fator de Crescimento de Fibroblastos , Receptores de Fatores de Crescimento de Fibroblastos/genética , Receptores Virais/genética , Ribonucleoproteínas/metabolismo , Transgenes , Células Tumorais Cultivadas
8.
Sci Rep ; 11(1): 1938, 2021 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-33479449

RESUMO

The broiler industry in the Middle East (ME) faces many challenges related to bacterial infections, including M. gallisepticum, M. synoviae, E. coli, and other gram-negative bacteria, exacerbated by various errors in the brooding process. Antibiotics use in the first three days of life, such as Linco-Spectin 100 SP, tilmicosin, enrofloxacin, tylosin, colistin, and doxycycline, is the trend in the market to control such challenges. This study aimed to evaluate the efficacy of the newly introduced aroA E. coli vaccine (Poulvac E. coli) and its ability to reduce over-reliance on the heavy use of antibiotics in the ME. The study was conducted on 160 broiler chicks, divided into eight even groups. Each group was treated differently in terms of antibiotic therapy and ages at the time of Poulvac E. coli administration and the challenge of virulent avian pathogenic E. coli (APEC), serotype O78. Spray application of Poulvac E. coli at seven days of age plus Linco-Spectin 100 SP during the first three days provided the best results for zero mortality after challenge with APEC, while Poulvac E. coli at seven days with enrofloxacin during the early three days resulted in 10% mortality. Poulvac E. coli hatchery vaccination protected birds against mortality but reduced body weight gain compared to the 7-day group vaccinated with Linco-Spectin 100 SP during the first three days. Poulvac E. coli given on day one or day seven did not affect the immune response to concurrent respiratory viral vaccines and, in some cases, improved response. This study shows that Poulvac E. coli at seven days of age, together with Linco-Spectin 100 during the first three days, has produced the best results in terms of protection and performance in the ME high presence of avian pathogenic E. coli field challenge.


Assuntos
Infecções por Escherichia coli/microbiologia , Vacinas contra Escherichia coli/farmacologia , Doenças das Aves Domésticas/microbiologia , Vacinas Atenuadas/farmacologia , Animais , Galinhas/microbiologia , Escherichia coli/efeitos dos fármacos , Escherichia coli/patogenicidade , Infecções por Escherichia coli/prevenção & controle , Infecções por Escherichia coli/veterinária , Doenças das Aves Domésticas/prevenção & controle , Sorogrupo
9.
Res Vet Sci ; 136: 127-137, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33609970

RESUMO

Reproductive cycling in fattening gilts can be associated with undesirable effects, such as estrus-related aggressive behavior, reduced feed intake and, in production systems where gilts are co-housed with entire males, unwanted pregnancy. Immunization against Gonadotrophin Releasing Factor (IM) can temporarily suppress ovarian activity, including related negative consequences on animal welfare and productivity. Feed intake has been shown to be higher after IM, resulting in both increased growth and increased carcass fat. A series of studies was conducted to confirm these effects on production and look at their dynamics over time. Three trials were performed to a similar design, each involving 240 gilts divided into 4 experimental groups at 12 weeks of age. One group remained untreated while the others had the two dose, IM course completed 8, 6 or 4 weeks before harvest, which was on a single day at 24, 25 or 26 weeks of age depending on the study. Feed intake was measured daily and bodyweight weekly, allowing growth parameters to be calculated on a weekly basis and for specific longer periods. Carcass weight, backfat depth and lean meat percentage were recorded at harvest. No effects were observed before the second application of the immunological product (V2) and completion of the IM course. Starting in the second week after V2 all IM groups showed a marked and consistent increase in Average Daily Feed Intake (ADFI), typically peaking at over 120% of the control group 3 to 4 weeks after V2 and then slowly declining, but still remaining elevated at 8 weeks. Weekly Average Daily Gain (ADG) showed a similar pattern but with a faster decline, resulting in the initially favorable impact on feed efficiency becoming less favorable as the V2 to harvest interval (V2H) progressed. Carcass weights were higher in IM gilts and backfat depths were greater, with the effects increasing with increasing V2H. Correspondingly, carcass lean meat percentage tended to decrease, although the higher carcass weights meant that the absolute weight of lean meat remained similar or higher. Carcass yield was generally unaffected by IM, but some between-group differences were statistically significant, and it is possible that different factors predominated at different times after V2, creating a complex relationship with V2H duration. The optimum IM protocol will depend on local conditions and production objectives but, as a generalization and assuming ad libitum feeding, a shorter V2H will favor efficient growth, while a longer duration will maximize carcass changes, such as increased fat coverage. It is suggested that the growth performance changes seen after IM in gilts might be viewed as a process of adjustment to a heavier and fatter target body type.


Assuntos
Hormônio Liberador de Gonadotropina/metabolismo , Imunização/veterinária , Carne/análise , Sus scrofa/fisiologia , Animais , Feminino , Sus scrofa/crescimento & desenvolvimento , Sus scrofa/imunologia , Fatores de Tempo
10.
Res Vet Sci ; 131: 159-172, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32387811

RESUMO

The vaccine against gonadotropin releasing factor (GnRF), Improvac®, has recently emerged as an option for rearing market gilts up to heavier harvest weights. Improvac's® temporary suppression of the ovarian function and gonadal hormones results in greater feed intake and better welfare from avoidance of sexual behavioral problems. Based on 22 published articles, our meta-analysis has quantified the effect of immunizing gilts against GnRF on parameters relevant for pig producers, pork packers and retailers/consumers. The meta-analyses included growth performance and final harvest parameters, general carcass traits and yield of valuable meat, meat and fat quality parameters. Primary analyses considered studies without ractopamine, subgroup and additional analyses assessed the impact of co-variates. From the perspective of pig producers, primary analyses showed that immunized (IM) gilts have significantly (P < 0.001) increased average daily gain (+45.1 g/day) and daily feed intake (+0.19 kg/day), higher final live weight (+4.0 kg) and more backfat (+2.8 mm). From the perspective of the pork packers, IM gilts have heavier carcasses (+3.2 kg; P < 0.001), whereas dressing percentage is similar. IM gilts are less lean (-1.5% units; P < 0.001) and have 0.21% units more intramuscular fat (P = 0.001). The yield of ham, shoulder, and loin is similar, whereas the yield of belly is significantly higher (+0.28 kg; P < 0.001). There are no differences in meat quality parameters (color, pH24, and drip loss) between IM gilts and untreated gilts, whereas a lower iodine value in IM gilts indicates an improved fat quality. Further subgroup and additional analyses confirmed the validity of our meta-analysis.


Assuntos
Composição Corporal , Hormônio Liberador de Gonadotropina/imunologia , Carne de Porco/normas , Animais , Feminino , Imunização , Carne de Porco/economia , Suínos , Vacinação
11.
Anal Chim Acta ; 1100: 88-96, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31987156

RESUMO

Multiple reaction monitoring (MRM) mode using liquid-chromatography tandem mass spectrometry (e.g., LC-QqQ-MS/MS) has been extensively employed in the small molecule analysis with trace levels in complex samples owing to its high sensitivity. However, most of the reported MRM methods are developed using authentic standards, which are often costly yet not readily available. To address this question, a practical platform for the MRM method transfer between different LC-QqQ-MS/MS instruments, assisted by the high-resolution mass spectrometry (LC-HRMS) and retention time (RT) prediction, has been developed in this study. The reported platform can take advantage of both the high sensitivity of LC-MRM method and ion transition pairs from the previous publications. LC-HRMS can provide the accurate mass measurement of the compounds, though high-quality MS/MS fragments are usually difficult to obtain for chemicals at trace levels. Retention time matching and peaks matching between both instrumental platforms rule out isobaric candidates. With an additional retention time prediction filter from quantitative structure retention relationship (QSRR) model based on random forest feature selection (Pearson r2 = 0.63), identification of small molecules is achieved at a high confidence level without using authentic standards. The developed platform has been validated with robustness by examining spiked environmental chemicals in sludge water samples, biological urine, and cell extracts.


Assuntos
Fenóis/análise , Esgotos/análise , Bibliotecas de Moléculas Pequenas/análise , Poluentes Químicos da Água/análise , Cromatografia Líquida , Células Hep G2 , Humanos , Modelos Lineares , Espectrometria de Massas , Fenóis/metabolismo , Relação Quantitativa Estrutura-Atividade , Fatores de Tempo , Eliminação de Resíduos Líquidos
12.
Gene Ther ; 16(6): 724-33, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19262614

RESUMO

A serious impediment to gene and protein replacement therapy in hemophilia A is the development of inhibitors. Mechanisms responsible for inhibitor development include T-cell-dependent adaptive immune responses and the CD28-B7 signaling pathway that eventually leads to the formation of antibodies directed against factor VIII (FVIII). Indoleamine 2,3-dioxygenase (IDO) is a potent immunosuppressive enzyme that can inhibit T-cell responses and induce T-cell apoptosis by regulation of tryptophan metabolism. Kynurenine, one of the metabolites of tryptophan, has been implicated as an immune modulator. Here we hypothesize that co-delivery of the genes for FVIII and IDO can attenuate inhibitor formation. Using transposon-based gene delivery, we observed long-term therapeutic FVIII expression and significantly reduced inhibitor titers when the genes were co-delivered. Co-expression of FVIII and IDO in the liver was associated with increased plasma kynurenine levels, an inhibition of T-cell infiltration and increased apoptosis of T cells within the liver. These experiments suggest that modulation of tryptophan catabolism through IDO expression provides a novel strategy to reduce inhibitor development in hemophilia gene/protein therapy.


Assuntos
Autoanticorpos/imunologia , Fator VIII/genética , Técnicas de Transferência de Genes , Hemofilia A/imunologia , Indolamina-Pirrol 2,3,-Dioxigenase/genética , Linfócitos T/enzimologia , Animais , Apoptose/efeitos dos fármacos , Autoanticorpos/sangue , Western Blotting , Antígenos CD28/fisiologia , Linhagem Celular , Células Cultivadas , Fator VIII/imunologia , Citometria de Fluxo , Expressão Gênica , Terapia Genética/métodos , Hemofilia A/terapia , Terapia de Imunossupressão/métodos , Indolamina-Pirrol 2,3,-Dioxigenase/imunologia , Injeções Intravenosas , Cinurenina/metabolismo , Cinurenina/farmacologia , Fígado/citologia , Fígado/metabolismo , Camundongos , Plasmídeos , Transdução de Sinais/fisiologia , Transposases/administração & dosagem , Transposases/genética , Triptofano/metabolismo
13.
Res Vet Sci ; 119: 182-195, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29958153

RESUMO

Meta-analysis was used to compare pigs immunocastrated (IC) with Improvac® versus physically castrated (PC) or entire male (EM) pigs. Performance and carcass data as most relevant for producers and packers were analyzed and the risk of boar taint was assessed by comparing the number of pigs exceeding the consumer thresholds of detection (ToD) for skatole and androstenone. A total of 78 articles fulfilled pre-defined inclusion criteria. Compared to PC pigs, IC pigs have a higher average daily gain (ADG; +32.54 g/day, P < 0.0001) and more favorable feed conversion ratio (FCR; -0.234 kg/kg, P < 0.0001), higher live weight and percentage lean, and lower hot carcass weight (HCW) and dressing percentage. Compared to EM pigs, IC pigs have a higher ADG (+65.04 g/day, P < 0.0001), FCR (+0.075 kg/kg, P < 0.0001), live weight and HCW, and a similar dressing percentage. Conventionally raised IC pigs yield more valuable meat compared to PC (+0.628 kg) and EM (+1.385 kg) pigs. Heavy IC pigs (HCW > 97.7 kg) destined for the production of high-quality cured products gain approximately 0.3 kg more ham than their PC counterparts, with backfat and intramuscular fat still fulfilling the requirements for high-quality cured products. The risk of exceeding the ToD for skatole and androstenone is similar in IC and PC pigs, but significantly higher in EM pigs. Results from our meta-analyses confirm growth performance advantages of IC pigs compared with PC or EM pigs, and reveal a higher gain of valuable meat and a similar risk of boar taint as estimated for PC pigs.


Assuntos
Gonadotropinas/sangue , Imunização/veterinária , Suínos/crescimento & desenvolvimento , Animais , Masculino , Carne , Orquiectomia , Carne Vermelha , Escatol
14.
Can Commun Dis Rep ; 43(11): 242-244, 2017 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-29770054

RESUMO

BACKGROUND: The Canadian Immunization Guide (CIG) is published online by the Public Health Agency of Canada and summarizes guidance on vaccines for human use into a single resource. Chapters are reviewed and updated on a regular basis. Vaccine administration is a critical part of any immunization program. Recently, the CIG chapter on vaccine administration practices was updated. OBJECTIVE: To provide highlights of recent changes to the Vaccine Administration Practices chapter of the CIG. APPROACH: Vaccine-specific guidance in the CIG is based on National Committee on Immunization (NACI) and Committee to Advise on Tropical Medicine and Travel (CATMAT) recommendations as well as new recommendations developed by the CIG Working Group members and NACI Secretariat technical staff. New recommendations are based on a review of the literature, including systematic reviews when available, a review of guidance provided by other National Immunization Technical Advisory Groups and expert opinion. The revisions are approved by the Working Group chair, as well as NACI. RESULTS: Highlights of new recommendations include the following: vaccine providers should adhere to jurisdictional or organizational policies and procedures regarding combining the contents of multi-dose vials; clinical judgement should be used when selecting needle length for intramuscular injections that takes into account the vaccine recipient's weight, gender and age; filter needles are not recommended for vaccine administration as they may filter out active ingredients such as adjuvants; an injection site other than in an area where lymphatic drainage may be impaired should be considered; there is no evidence or theoretical rationale for avoiding injection through a tattoo or superficial birthmark; and immunization pain management strategies have now been developed for all ages. CONCLUSION: Recommendations in vaccine administration practices have recently been changed in some important ways. The Public Health Agency of Canada is committed to providing information on immunization in an easily accessible, reader-friendly format for healthcare providers and policy-makers.

16.
Diabetes Care ; 20(1): 15-21, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9028687

RESUMO

OBJECTIVE: To determine whether automated voice messaging (AVM) systems could be used as an adjunct to primary care for diabetic patients, we examined whether patients were able to respond to AVM queries for clinical information, whether sufficient numbers of problems were identified to warrant the implementation of the service, and whether patients found the system helpful. RESEARCH DESIGN AND METHODS: The AVM system we examined uses specialized computer technology to telephone patients, communicate messages, and collect information. Sixty-five diabetic patients participated. Based on a review of the literature and the input of diabetes clinician-researchers, we developed an AVM monitoring protocol to inquire about patients' symptoms, glucose monitoring, foot care, diet, and medication adherence. Patients also were given the option to listen to health promotion messages and to report their satisfaction with the calls. Patients responded by using their touch-tone telephone keypads. RESULTS: A total of 216 AVM calls were successfully completed, an average of 3.3 out of four calls per patient. Patients reported a variety of health problems that signaled the need for follow-up. Many patients reported not checking their blood glucose or their feet, and one in four reported problems with medication and diet adherence. Health and self-care problems varied across patient subgroups in ways suggesting that the AVM reports were reliable and valid. Overall, 98% of all patients reported that the calls were helpful, 98% reported that they had no difficulty responding to the calls, and 77% reported that receiving AVM calls would make them more satisfied with their health care. CONCLUSIONS: This study demonstrates that diabetic patients can respond to AVM queries and find the calls helpful. Such calls are a feasible strategy for identifying health and self-care problems that would otherwise go unnoticed by clinicians.


Assuntos
Diabetes Mellitus , Promoção da Saúde/métodos , Satisfação do Paciente/estatística & dados numéricos , Telemedicina/métodos , Idoso , Complicações do Diabetes , Diabetes Mellitus/terapia , Emprego , Etnicidade , Feminino , Humanos , Insulina/uso terapêutico , Masculino , Estado Civil , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Autocuidado
17.
Diabetes Care ; 22(8): 1302-9, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10480775

RESUMO

OBJECTIVE: We examined whether low-income patients with diabetes were able and willing to use automated telephone disease management (ATDM) calls to provide health status information that could improve the quality of their care. RESEARCH DESIGN AND METHODS: A total of 252 adults with diabetes, 30 of whom spoke Spanish as their primary language, were enrolled at the time of clinic visits in a Department of Veterans Affairs health care system (n = 132) or a county health care system (n = 120). Patients received ATDM calls for 12 months and responded to queries using their touch-tone telephones. We examined 1) whether patients completed ATDM assessments consistently over the year and used the calls to report their self-monitored blood glucose (SMBG) levels, 2) the characteristics of patients most likely to use the system frequently, 3) whether patients responded consistently within ATDM assessments, and 4) whether ATDM assessments differentiated among groups of patients with different clinical profiles at baseline. RESULTS: Half of all patients completed at least 77% of their attempted assessments, and one-fourth completed at least 91%. Half of all patients reported SMBG levels during at least 86% of their assessments. Patients completed assessments and reported glucose levels consistently over the year. Health status indicators were the most important determinants of assessment completion rates, while socioeconomic factors were more strongly associated with patients' likelihood of reporting SMBG data during assessments. Patients' responses within assessments were consistent, and the information they provided during their initial assessments identified groups with poor glycemic control and other health problems. CONCLUSIONS: Most low-income patients with diabetes can and will use ATDM calls as part of their care. The information they provide is reliable and has clinical significance. ATDM calls could improve the information base for diabetes management while relieving some of the pressures of delivering diabetes care under cost constraints.


Assuntos
Diabetes Mellitus/terapia , Etnicidade , Telefone , Automação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação das Necessidades , Fatores Socioeconômicos
18.
Am J Med ; 108(1): 20-7, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11059437

RESUMO

PURPOSE: We sought to evaluate the effect of automated telephone assessment and self-care education calls with nurse follow-up on the management of diabetes. SUBJECTS AND METHODS: We enrolled 280 English- or Spanish-speaking adults with diabetes who were using hypoglycemic medications and who were treated in a county health care system. Patients were randomly assigned to usual care or to receive an intervention that consisted of usual care plus bi-weekly automated assessment and self-care education calls with telephone follow-up by a nurse educator. Outcomes measured at 12 months included survey-reported self-care, perceived glycemic control, and symptoms, as well as glycosylated hemoglobin (Hb A1c) and serum glucose levels. RESULTS: We collected follow-up data for 89% of enrollees (248 patients). Compared with usual care patients, intervention patients reported more frequent glucose monitoring, foot inspection, and weight monitoring, and fewer problems with medication adherence (all P -0.03). Follow-up Hb A,, levels were 0.3% lower in the intervention group (P = 0.1), and about twice as many intervention patients had Hb A1c levels within the normal range (P = 0.04). Serum glucose levels were 41 mg/dL lower among intervention patients than usual care patients (P = 0.002). Intervention patients also reported better glycemic control (P = 0.005) and fewer diabetic symptoms (P <0.0001 ), including fewer symptoms of hyperglycemia and hypoglycemia. CONCLUSIONS: Automated calls with telephone nurse follow-up may be an effective strategy for improving self-care behavior and glycemic control, and for decreasing symptoms among vulnerable patients with diabetes.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus/sangue , Diabetes Mellitus/terapia , Enfermeiras e Enfermeiros , Educação de Pacientes como Assunto , Autocuidado , Telefone , Adulto , Idoso , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Traduções
19.
Genet Test ; 3(2): 157-72, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10464664

RESUMO

Molecular genetic analyses have generated significant advances in our understanding of congenital heart disease. Techniques of genetic mapping with polymorphic microsatellites and fluorescence in situ hybridization (FISH) have provided informative tools for localization and identification of disease genes. Some cardiovascular diseases have proven to result from single gene defects. Others relate to more complex etiologies involving several genes and their interactions. Elucidation of the molecular genetic etiologies of congenital heart disease prompts consideration of DNA testing for cardiac disorders. Future integration of these diagnostic modalities with improved treatments may ultimately decrease morbidity and mortality from congenital heart diseases.


Assuntos
Cardiopatias Congênitas/genética , Animais , Feminino , Neoplasias Cardíacas/genética , Defeitos dos Septos Cardíacos/genética , Valvas Cardíacas/anormalidades , Humanos , Masculino , Camundongos , Biologia Molecular , Síndrome
20.
Pharmacol Biochem Behav ; 3(1): 1-5, 1975.
Artigo em Inglês | MEDLINE | ID: mdl-1168925

RESUMO

Water deprived rats were trained to drink from a water spout within an apparatus on each of 2 days. On the third day, passive avoidance of the spout was induced by giving the animal a 0.3 sec, 5 mA footshock after 1 lick at the spout. A test for retention of the avoidance learning was given 48 hr following training. ECS administered through cortical electrodes at 15 sec following the footshcok impaired retention. The amnesia was attenuated when amphetamine (1 mg/kg) was injected immediately but not at 6 hr following the ECS. In a second experiment, attentuation of amnesia by amphetamine was not found when the ECS occured at 4 sec instead of 15 sec following the footshock. The results are interpreted in terms of reactivation by amphetamine of a consolidation process that was interrupted by ECS.


Assuntos
Amnésia/tratamento farmacológico , Anfetamina/uso terapêutico , Aprendizagem da Esquiva/efeitos dos fármacos , Eletrochoque , Convulsões/fisiopatologia , Anfetamina/farmacologia , Animais , Comportamento de Ingestão de Líquido/efeitos dos fármacos , Humanos , Masculino , Memória/efeitos dos fármacos , Ratos , Fatores de Tempo
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