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1.
Br J Anaesth ; 133(1): 77-85, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38782617

RESUMO

BACKGROUND: Within the perioperative period, depression-related diagnoses are associated with postoperative complications. We developed a perioperative depression screening programme to assess disease prevalence and feasibility for intervention. METHODS: Adult patients in multiple surgical departments at a single academic centre were screened for depression via the electronic health record patient portal or preoperative anaesthesia clinic before surgery, using the Patient Health Questionnaire (PHQ)-2 and -8. We utilised a broad method, screening all patients, and a focused method, only screening patients with a history of depression. Logistic regression was used to identify characteristics associated with clinically significant depression (PHQ-8 ≥10). Symptomatic patients were administered a brief psychoeducational intervention and referred for mental health services. RESULTS: A total of 3735 patients were identified by the broad and focused screens, of whom 2940 (79%) returned PHQ-2 data and were included in analysis. The broad screen (N=1216) found 46 (4%) patients who reported symptoms of moderate or greater severity. The focused screen (N=1724) found 242 (14%) patients with symptoms of moderate or greater severity and over all higher rates of depression across the symptom severity scale. Using the total screened pool, logistic regression identified a history of depression as the strongest associated patient characteristic variable but this did not capture most cases. Finally, we found that 66% of patients who were contacted about mental health services accepted referrals or sought outside care. CONCLUSIONS: At least 4% of preoperative patients have clinically significant symptoms of depression, most of whom do not have a chart history of depression.


Assuntos
Depressão , Cuidados Pré-Operatórios , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Depressão/epidemiologia , Prevalência , Adulto , Idoso , Cuidados Pré-Operatórios/métodos , Período Pré-Operatório , Programas de Rastreamento/métodos , Estudos de Viabilidade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/psicologia
2.
Med Mycol ; 57(7): 893-896, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-30544205

RESUMO

Four Blastomyces antigens ERC-2 (B. gilchristii, dog, Wisconsin), B5929 (human, Minnesota), 597 (human, Wisconsin), and T-27 (polar bear, Tennessee) were tested against 31 serum specimens from dogs with blastomycosis and 19 from healthy dogs. All antigens detected antibody; efficacy varied. ERC-2 showed the highest ELISA mean absorbance value of 3.00 followed by T-27. Test performance varied by sample geographic origin. Further study is needed to determine if ERC-2 antigens may be clinically useful, and whether the combination of the particular fungal species as antigen source, host animal, and the species and geographic location of the patient being tested is important for optimum test characteristics.


Assuntos
Anticorpos Antifúngicos/sangue , Antígenos de Fungos/imunologia , Blastomyces/imunologia , Blastomicose/veterinária , Doenças do Cão/diagnóstico , Animais , Blastomicose/diagnóstico , Doenças do Cão/microbiologia , Cães , Ensaio de Imunoadsorção Enzimática
3.
PLOS Glob Public Health ; 3(12): e0002696, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38150409

RESUMO

Since 2011, Syria has been engulfed in a complex conflict marked by both targeted and indiscriminate attacks on civilians and civilian infrastructure. Water infrastructure has been continuously targeted, exacerbating problems with contamination of and access to clean adequate drinking water, and increasing the risk of waterborne diseases. We aimed to determine whether having access to more functional and chlorinated water stations is associated with a reduced risk of waterborne disease in northwest Syria. We examined the effect of functioning chlorinated water stations on the incidence of waterborne disease in 10 districts of Northwest Syria between January 1, 2017, and June 30, 2021, using weekly reported disease surveillance data and data from a water, sanitation, and hygiene (WASH) system evaluation program of the Assistance Coordination Unit (ACU). We ran eight negative binomial models to examine the association between functioning chlorinated water stations and the incidence of four of the five waterborne diseases: acute bloody diarrhea (ABD), acute other diarrhea (AOD), acute jaundice syndrome (AJS), and severe typhoid fever (STF). Dose-response models were used to investigate how the incidence of disease can theoretically be reduced as functioning and chlorinated water stations strategically increase. Compared to areas with lower quintiles of functioning and chlorinated water stations, the rates of the four waterborne diseases were lower in areas with higher quintiles of functioning and chlorinated water stations. Exposure to functioning water stations had a stronger association with lower rates of waterborne diseases than exposure to chlorinated water stations. Dose-response models demonstrate a potential for curbing the incidence of acute diarrhea and acute jaundice syndrome. The results of this study provide an understanding of the effects of water station functionality and chlorination in conflict settings. These findings support greater prioritization of WASH activities in countries experiencing violence against civilian infrastructure.

4.
Front Psychol ; 13: 754233, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35712159

RESUMO

First-generation college students and those from ethnic groups such as African Americans, Latinx, Native Americans, or Indigenous Peoples in the United States are less likely to pursue STEM-related professions. How might we develop conceptual and methodological approaches to understand instructional differences between various undergraduate STEM programs that contribute to racial and social class disparities in psychological indicators of academic success such as learning orientations and engagement? Within social psychology, research has focused mainly on student-level mechanisms surrounding threat, motivation, and identity. A largely parallel literature in sociology, meanwhile, has taken a more institutional and critical approach to inequalities in STEM education, pointing to the macro level historical, cultural, and structural roots of those inequalities. In this paper, we bridge these two perspectives by focusing on critical faculty and peer instructor development as targets for inclusive STEM education. These practices, especially when deployed together, have the potential to disrupt the unseen but powerful historical forces that perpetuate STEM inequalities, while also positively affecting student-level proximate factors, especially for historically marginalized students.

5.
BMJ Glob Health ; 6(10)2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34598977

RESUMO

BACKGROUND: Hundreds of thousands of people have been killed during the Syrian civil war and millions more displaced along with an unconscionable amount of destroyed civilian infrastructure. METHODS: We aggregate attack data from Airwars, Physicians for Human Rights and the Safeguarding Health in Conflict Coalition/Insecurity Insight to provide a summary of attacks against civilian infrastructure during the years 2012-2018. Specifically, we explore relationships between date of attack, governorate, perpetrator and weapon for 2689 attacks against five civilian infrastructure classes: healthcare, private, public, school and unknown. Multiple correspondence analysis (MCA) via squared cosine distance, k-means clustering of the MCA row coordinates, binomial lasso classification and Cramer's V coefficients are used to produce and investigate these correlations. RESULTS: Frequencies and proportions of attacks against the civilian infrastructure classes by year, governorate, perpetrator and weapon are presented. MCA results identify variation along the first two dimensions for the variables year, governorate, perpetrator and healthcare infrastructure in four topics of interest: (1) Syrian government attacks against healthcare infrastructure, (2) US-led Coalition offensives in Raqqa in 2017, (3) Russian violence in Aleppo in 2016 and (4) airstrikes on non-healthcare infrastructure. These topics of interest are supported by results of the k-means clustering, binomial lasso classification and Cramer's V coefficients. DISCUSSION: Findings suggest that violence against healthcare infrastructure correlates strongly with specific perpetrators. We hope that the results of this study provide researchers with valuable data and insights that can be used in future analyses to better understand the Syrian conflict.


Assuntos
Direitos Humanos , Violência , Atenção à Saúde , Humanos , Síria
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