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1.
J Prev (2022) ; 2024 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-38587566

RESUMO

The purpose of this research is to develop preventive measures against smoking among youths living in Baan Eua Athon, underprivileged housing projects in Thailand. Utilizing a mixed-methods approach, this research encompassed quantitative and qualitative data collection in nine provinces of Thailand. Stratified multi-stage sampling was conducted, and data was gathered using questionnaires, in-depth interviews, and focus group discussions. Adapting Green and Kreuter's Precede-Proceed Planning Model, the researchers identified key factors influencing youth smoking initiation through extensive fieldwork from January to December 2021. The results show that the primary drivers for new smokers, in order of significance, are limited knowledge about the effects of smoking, values, perception of associated disease risk, stress and anxiety, influence by family and friends, smoking control policies and activities of educational institutions influencing risk behaviors for new smokers. Research respondents from multiple sectors formulated seven measures to prevent new smokers, namely (1) building the capacity of stakeholders to increase knowledge among the target group; (2) creating a body of knowledge and control with retail shop operators; (3) building a smoke-free network team in the area; (4) creating smoke-free families; (5) creating an application to assess risk behaviors and offer an online consulting system; (6) developing a search process; and (7) analyzing interests to promote the needs of youth. Recommendations from this study can be used to monitor risk behaviors for new smokers and guide policy decisions for substance abuse prevention practitioners in the area.

2.
Eur J Obstet Gynecol Reprod Biol ; 296: 239-243, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38484615

RESUMO

OBJECTIVES: To evaluate the association, if any, of homelessness or refuge accommodation on delivery and short term perinatal outcomes in an Irish tertiary maternity hospital. METHODS: A retrospective cohort study of 133 singleton pregnancies in women reporting to be homeless or living in refuge at their booking antenatal appointment between 2013 and 2022. Analysis compared sociodemographic characteristics and perinatal outcomes in this cohort to a reference population of 76,858 women with stable living arrangements. RESULTS: Women in the homeless/refuge population were statistically more likely to be single (75.2 % vs 39.5 %, p < 0.001), have an unplanned pregnancy (73.7 % vs 27.2 %, p < 0.001), report a history of psychiatric illness (42.9 % vs 22.4 %, p < 0.001), domestic violence (18.8 % vs 0.9 %, p < 0.001) alcohol consumption in pregnancy (3.0 % vs 0.8 %, p < 0.001) or smoking in pregnancy (41.3 % vs 9.7 %, p < 0.001). They were significantly more likely to have a preterm birth (adjusted OR 1.71 (1.01-2.87) p = 0.04). They also had a significantly lower median birth weight compared to the reference population (birthweight 3270 g vs 3420 g, p < 0.001). CONCLUSION: Women in the homeless and refuge population are more likely to experience poorer perinatal outcomes compared to women with stable living arrangements.


Assuntos
Pessoas Mal Alojadas , Gestantes , Campos de Refugiados , Humanos , Feminino , Gravidez , Adulto , Estudos Retrospectivos , Irlanda , Resultado da Gravidez , Nascimento Prematuro , Gravidez de Alto Risco
3.
Lab Anim Res ; 40(1): 10, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38532510

RESUMO

The ferret (Mustela putorius furo) is a small domesticated species of the family Mustelidae within the order Carnivora. The present article reviews and discusses the current state of knowledge about housing, care, breeding, and biomedical uses of ferrets. The management and breeding procedures of ferrets resemble those used for other carnivores. Understanding its behavior helps in the use of environmental enrichment and social housing, which promote behaviors typical of the species. Ferrets have been used in research since the beginning of the twentieth century. It is a suitable non-rodent model in biomedical research because of its hardy nature, social behavior, diet and other habits, small size, and thus the requirement of a relatively low amount of test compounds and early sexual maturity compared with dogs and non-human primates. Ferrets and humans have numerous similar anatomical, metabolic, and physiological characteristics, including the endocrine, respiratory, auditory, gastrointestinal, and immunological systems. It is one of the emerging animal models used in studies such as influenza and other infectious respiratory diseases, cystic fibrosis, lung cancer, cardiac research, gastrointestinal disorders, neuroscience, and toxicological studies. Ferrets are vulnerable to many human pathogenic organisms, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), because air transmission of this virus between them has been observed in the laboratory. Ferrets draw the attention of the medical community compared to rodents because they occupy a distinct niche in biomedical studies, although they possess a small representation in laboratory research.

4.
Brain Neurosci Adv ; 8: 23982128241238934, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38516557

RESUMO

Ischaemic stroke presents a significant problem worldwide with no neuroprotective drugs available. Many of the failures in the search for neuroprotectants are attributed to failure to translate from pre-clinical models to humans, which has been combatted with rigorous pre-clinical stroke research guidelines. Here, we present post hoc analysis of a pre-clinical stroke trial, conducted using intraluminal filament transient middle cerebral artery occlusion in the stroke-prone spontaneously hypertensive rat, whereby unscheduled changes were implemented in the animal housing facility. These changes severely impacted body weight post-stroke resulting in a change from the typical body weight of 90.6% of pre-surgery weight post-stroke, to on average 80.5% of pre-surgery weight post-stroke. The changes also appeared to impact post-stroke blood pressure, with an increase from 215.4 to 240.3 mmHg between housing groups, and functional outcome post-stroke, with a 38% increased latency to contact in the sticky label test. These data highlight the importance of tightly controlled housing conditions when using physiological or behavioural measurements as a primary outcome.

5.
Animals (Basel) ; 14(3)2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38338161

RESUMO

Cold conditions in northern China during winter may reduce sheep growth and affect their health, especially if they are young, unless housing is provided. We allocated 45 two-month-old female lambs to be housed in an enclosed building, a polytunnel, or kept outdoors, for 28 days. The daily weight gain and scalp and ear skin temperature of outdoor lambs were less than those of lambs that were housed in either a house or polytunnel; however, rectal temperature was unaffected by treatment. There was a progressive change in blood composition over time, and by the end of the experiment, outdoor lambs had reduced total antioxidant capacity (T-AOC), catalase (CAT), glutathione peroxidase (GSH-Px) and total superoxide dismutase (T-SOD) and increased malondialdehyde compared to those in the house or polytunnel. In relation to immune responses in the lambs' serum, in the polytunnel, immunoglobulin A (IgA), tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) were higher and immunoglobulin G (IgG) lower compared with the concentrations in lambs that were outdoors. Over the course of the experiment, genes expressing heat shock proteins and antioxidant enzymes increased in lambs in the outdoor treatment, whereas they decreased in lambs in the indoor treatments. It is concluded that although there were no treatment effects on core body temperature, the trends for progressive changes in blood composition and gene expression indicate that the outdoor lambs were not physiologically stable; hence, they should not be kept outdoors in these environmental conditions for long periods.

6.
Cities ; 1452024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38283871

RESUMO

The rising prevalence of non-communicable diseases (NCDs) has led to increased attention on understanding how built environments affect NCD risks. However, there's a significant gap in the literature regarding the relationship between housing vacancy duration and NCDs in metropolitan areas with varying development rates. Our research addresses this gap by examining the association between housing vacancy duration and NCDs across all U.S. metropolitan areas, considering growing, shrinking, and fluctuating counties. We used a Multiscale Geographically Weighted Regression (MGWR) model to analyze this relationship, finding that longer-term vacant housing (over 3 years) is more positively associated with NCDs compared to short-term vacancies. We also discovered that this association is non-uniform across metropolitan counties, except for cancer and stroke outcomes. Shrinking counties in the Northeast are particularly affected, emphasizing the need for targeted public health interventions in these areas. This study underscores the importance of revitalizing vacant homes, especially those vacant for over 3 years, in both shrinking and growing regions to improve public health. Policymakers should adopt tailored strategies, engage public health experts, and invest in healthcare infrastructure to effectively address the health risks linked to vacant housing.

7.
Artigo em Inglês | MEDLINE | ID: mdl-38248565

RESUMO

This study examines support for the Department of Housing and Urban Development's (HUD) mandatory smoke-free rule up to four years post-rule among smokers and non-smokers. A repeated cross-sectional design was used where District of Columbia public housing residents aged 18+ (n = 529) completed surveys during three time points: July 2018 (pre-rule), November 2018-March 2020 (post-rule), and September 2020-December 2022 (post-rule + COVID-19). Full support for the rule was indicated by agreeing that smoking should not be allowed in all indoor locations and within 25 feet of buildings. Descriptive statistics showed significant differences in support across time for smokers (5.3%, 30.7%, and 22.5%, respectively) and similar support across time for nonsmokers (48.2%, 52.2%, and 40.0%, respectively). In unstratified regression analysis, pre-rule support was lower than when the rule was in effect (aOR = 0.47, 95% CI = 0.25, 0.90), and tobacco users were less likely to support the rule (aOR = 0.34, 95% CI = 0.23, 0.50). Stratified logistic regression results showed that pre-rule support was lower among smokers compared to post-rule support (aOR = 0.14, 95% CI = 0.03, 0.59); support among nonsmokers did not vary by time. Findings overall indicate low support for the smoke-free rule up to 4 years post-implementation. Engaging residents with the rule and promoting health and well-being may further enhance policy effectiveness and acceptance.


Assuntos
COVID-19 , Habitação Popular , Humanos , Estudos Transversais , não Fumantes , Fumantes
8.
Cancer ; 2024 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-38280205

RESUMO

BACKGROUND: Social risks are common among cancer survivors who have the fewest financial resources; however, little is known about how prevalence differs by age at diagnosis, despite younger survivors' relatively low incomes and wealth. METHODS: The authors used data from 3703 participants in the Detroit Research on Cancer Survivors (ROCS) cohort of Black cancer survivors. Participants self-reported several forms of social risks, including food insecurity, housing instability, utility shut-offs, not getting care because of cost or lack of transportation, and feeling unsafe in their home neighborhood. Modified Poisson models were used to estimate prevalence ratios and 95% confidence intervals (CIs) of social risks by age at diagnosis, controlling for demographic, socioeconomic, and cancer-related factors. RESULTS: Overall, 35% of participants reported at least one social risk, and 17% reported two or more risks. Social risk prevalence was highest among young adults aged 20-39 years (47%) followed by those aged 40-54 years (43%), 55-64 years (38%), and 65 years and older (24%; p for trend < .001). Compared with survivors who were aged 65 years and older at diagnosis, adjusted prevalence ratios for any social risk were 1.75 (95% CI, 1.42-2.16) for survivors aged 20-39 years, 1.76 (95% CI, 1.52-2.03) for survivors aged 40-54 years, and 1.41 (95% CI, 1.23-1.60) for survivors aged 55-64 years at diagnosis. Similar associations were observed for individual social risks and experiencing two or more risks. CONCLUSIONS: In this population of Black cancer survivors, social risks were inversely associated with age at diagnosis. Diagnosis in young adulthood and middle age should be considered a risk factor for social risks and should be prioritized in work to reduce the financial effects of cancer on financially vulnerable cancer survivors.

10.
Res Sq ; 2023 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-38077013

RESUMO

Background: Post-operative complications present a challenge to the healthcare system due to the high unpredictability of their incidence. However, the socioeconomic factors that relate to postoperative complications are still unclear as they can be heterogeneous based on communities, types of surgical services, and sex and gender. Methods: In this study, we conducted a large population cross-sectional analysis of social vulnerability and the odds of various post-surgical complications. We built statistical logistic regression models of postsurgical complications with social vulnerability index as the independent variable along with sex interaction. Results: We found that social vulnerability was associated with abnormal heart rhythm with socioeconomic status and housing status being the main association factors. We also found associations of the interaction of social vulnerability and female sex with an increase in odds of heart attack and surgical wound infection. Conclusions: Our results indicate that social vulnerability measures such as socioeconomic status and housing conditions could be related to health outcomes. This suggests that the domain of preventive medicine should place social vulnerability as a priority to achieve its goals.

11.
Innov Aging ; 7(9): igad121, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38106373

RESUMO

Background and Objectives: Housing is one of the main places where falls occur; however, few studies have examined housing environmental factors driving fall risk. This study aimed to explore the associations between housing environmental factors and falls in China. Research Design and Methods: The study included data of middle-aged and older adults aged ≥45 years from 4 waves of the China Health and Retirement Longitudinal Study. We assessed 7 housing environmental factors: building materials, toilet types, household tidiness, household cooking fuels, and access to electricity, running water, and bathing facilities. Based on these, we divided housing environments into 3 types: good (0-2 poor factors), moderate (3-5 poor factors), and poor (6-7 poor factors). Falls incidence (yes or no) was self-reported during the survey period. We applied the Cox proportional hazard model to estimate the associations, adjusting for a set of covariates such as sociodemographic characteristics, lifestyles, and disease status. Results: A total of 12,382 participants were analyzed, and the incidence of falls was 31.7%. According to the fully adjusted model, having a squatting toilet (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.03-1.26), household untidiness (HR = 1.09, 95% CI = 1.01-1.18), and solid fuel use for cooking (HR = 1.10, 95% CI = 1.02-1.18) were associated with a higher risk of falls (ps < .05), compared to their counterparts. We found a linear relationship between housing environments and falls (p for trend = .001). Specifically, moderate (HR = 1.16, 95% CI = 1.06-1.27) and poor housing environments (HR = 1.21, 95% CI = 1.08-1.34) were associated with a higher risk of falls compared to a good housing environment. Discussion and Implications: Among middle-aged and older Chinese adults, a better household environment, including sitting toilets, tidy living conditions, and clean fuel use for cooking, may reduce the risk of falls. The evidence from our study suggests the need to implement age-friendly housing environments to prevent falls and disability in an aging society.

12.
Notas enferm. (Córdoba) ; 24(42): 46-57, nov.2023. graf. tablas
Artigo em Espanhol | LILACS, BDENF, UNISALUD, InstitutionalDB, BINACIS | ID: biblio-1527498

RESUMO

Objetivo: caracterizar las lesiones no intencionales domésticas en el hogar en niños de 5 a 10 años en dos barrios de Corrientes, Capital en el primer semestre del año 2022. Metodología: estudio observacional, descriptivo, transversal. Muestreo de tipo consecutivo. La muestra total fue de 185 encuestas aplicadas a los cuidadores principales en un período no mayor a 6 meses. Variables: edad del cuidador; sexo del cuidador; nivel educativo del cuidador principal; edad y sexo de niños/as; lesión no intencional y su frecuencia; circunstancias en que ocurren las lesiones no intencionales y modo de actuación ante el hecho de lesión no intencional. Resultados: grupo etario de los cuidadores principales de los niños/as con lesiones no intencionales fueron los adultos jóvenes (78%), siendo el género pre-dominante el femenino (78%); nivel de instrucción más alto obtenido corresponde al terciario incompleto (28%); los niños de 5 años de edad presentaron más lesiones no intencionales (27%), predominan-do el género femenino (57%). Las lesiones ocurrieron principalmente cuando se encontraban jugando (58%) y fueron principalmente las escoriaciones (20%); el modo de actuación más utilizado por los cuidadores principales correspondió a realización de primeros auxilios y posterior traslado al hospital (29%). Conclusiones: las lesiones no intencionales domésticas son muy frecuentes, entre ellas excoriaciones, quemaduras y contusiones. No hay grandes variaciones en sus tipos y frecuencias según el barrio en donde viven los infantes afectados. El modo de actuar más utilizado por el cuidador responsable ante estas lesiones son los primeros auxilios y el traslado a un hospital o cuidados en el hogar sin recurrir a un centro sanitario[AU]


Objectives: to characterize unintentional domestic injuries at home in children from 5 to 10 years old in two neighborhoods of Co-rrientes, Capital in the first semester of 2022. Methodology: obser-vational, descriptive, cross-sectional study. Consecutive type sam-pling. The total sample consisted of 185 surveys applied to the main caregivers in a period not exceeding 6 months. Variables: age of the caregiver; caregiver's sex; educational level of the main caregiver; age and sex of children; unintentional injury and its frequency; cir-cumstances in which unintentional injuries occur and mode of ac-tion in the event of unintentional injury. Results: age group of the main caregivers of children with unintentional injuries were young adults (78%), with the predominant gender being female (78%); highest level of education obtained corresponds to incomplete ter-tiary (28%); 5-year-old children presented more unintentional in-juries (27%), with a predominance of the female gender (57%). The injuries occurred mainly when they were playing (58%) and were mainly abrasions (20%); The mode of action most used by the main caregivers corresponded to first aid and subsequent transfer to the hospital (29%). Conclusions: unintentional domestic injuries are very frequent, including abrasions, burns and bruises. There are no great variations in its types and frequencies depending on the neighborhood where the affected infants live. The most used mode of action by the caregiver responsible for these injuries is first aid and transfer to a hospital or home care without resorting to a heal-th center[AU]


Objectivos: caracterizar as lesões domésticas não intencionais em crianças de 5 a 10 anos em dois bairros de Corrientes, Capital, no primeiro semestre de 2022. Metodologia: estudo observacional, descritivo, transversal. Amostragem de tipo consecutiva. A amos-tra total foi composta por 185 inquéritos aplicados aos cuidadores principais num período não superior a 6 meses. Variáveis: idade do cuidador; sexo do cuidador; escolaridade do cuidador principal; idade e sexo das crianças; lesão não intencional e sua frequência; circunstâncias em que ocorrem lesões não intencionais e modo de ação em caso de lesão não intencional. Resultados: a faixa etária dos principais cuidadores de crianças com lesões não intencionais eram adultos jovens (78%), com predomínio do sexo feminino (78%); o maior nível de escolaridade obtido corresponde ao ensino superior incompleto (28%); As crianças de 5 anos apresentaram mais lesões não intencionais (27%), com predominância do sexo feminino (57%). As lesões ocorreram principalmente durante o jogo (58%) e foram principalmente escoriações (20%); O modo de atuação mais utilizado pelos cuidadores principais correspondeu aos primei-ros socorros e posterior transferência para o hospital (29%). Con-clusões: lesões domésticas não intencionais são muito frequentes, incluindo escoriações, queimaduras e contusões. Não há grandes variações em seus tipos e frequências dependendo do bairro onde vivem os lactentes acometidos. A forma de atuação mais utilizada pelo cuidador responsável por estas lesões são os primeiros soco-rros e a transferência para um hospital ou cuidados domiciliários sem recorrer a um centro de saúde. caregivers corresponded to first aid and subsequent transfer to the hospital (29%). Conclusions: unintentional domestic injuries are very frequent, including abrasions, burns and bruises. There are no great variations in its types and frequencies depending on the neighborhood where the affected infants live. The most used mode of action by the caregiver responsible for these injuries is first aid and transfer to a hospital or home care without resorting to a heal-th center.Keywords: unintentional injury, infants, primary caregivers, accidents, home, housing, child, preschool[AU]


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Acidentes Domésticos
13.
J Cancer Surviv ; 2023 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-37798594

RESUMO

PURPOSE: As health care systems seek to screen for and address housing instability in patient populations, robust evidence linking unstable housing to patient-reported outcomes is needed. Housing instability may increase psychological distress in cancer survivors, potentially more so among African American cancer survivors who are also likely to experience disproportionate burden of housing instability. The purpose of this analysis was to estimate associations between housing instability and psychological distress in African Americans diagnosed with cancer. METHODS: We included survey responses from 2875 African American cancer survivors in the Detroit Research on Cancer Survivors (ROCS) study. We examined how housing instability at enrollment, using an item adapted from the Health Leads Screening Toolkit, related to psychological distress at enrollment, using Patient Reported Outcomes Measurement System (PROMIS) 4-item anxiety and depression short forms. Linear regression models adjusted for sociodemographic factors were used to estimate associations overall and stratified by stage at diagnosis. RESULTS: Approximately 12% of participants reported being unstably housed. Housing instability was associated with significant differences in PROMIS scores for both anxiety (difference: 6.79; 95% CI: 5.57-8.01) and depression (difference: 6.16; 95% CI: 4.99-7.34). We did not find meaningful differences stratifying by disease stage. CONCLUSION: Housing instability was experienced by over a tenth of this cohort of African American cancer survivors and was related to statistically and clinically meaningful differences in psychological distress even following adjustment for sociodemographics. IMPLICATIONS FOR CANCER SURVIVORS: These findings provide evidence supporting screening of housing instability in cancer survivors, especially those from medically underserved populations.

14.
Front Vet Sci ; 10: 1219572, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37675077

RESUMO

The study examined 24 primiparous sows (Landrace × Large white) and their offspring, which were grouped based on litter size: NORMAL (n = 8, average litter size 11.5 ± 1.2), with litter size between 7 and 14, and LARGE (n = 16, average litter size 15.9 ± 1.0), with litter size between 15 and 20. Sows were group-housed during gestation, and housed in an adjustable loose housing system (2.4 × 2.3 m) during farrowing and lactation. All the sows were confined in the farrowing crates (0.6 × 2.3 m) for 7 days after the onset of parturition. Saliva samples of sows were collected on days 35, 21, and 7 before farrowing (D-35, D-21 and D7, respectively), and on days 1, 7, and 28 after farrowing (D1, D7, and D28, respectively) to measure the levels of Trolox equivalent antioxidant capacity (TEAC), hydrogen peroxide (H2O2), advanced oxidation protein products (AOPP), and tumor necrosis factor-alpha (TNF-α). Colostrum samples were collected for oxytocin and prolactin assays. Nest-building behavior (NB) for 24 h before parturition and farrowing was observed through video analysis. The results showed that LARGE sows had higher levels of H2O2 on D1 and D7 and AOPP during late gestation (p < 0.05, for all) and lower TEAC levels during late gestation and on D7 and D28 after farrowing (p < 0.05, for all) than NORMAL sows. Additionally, LARGE sows tended to have higher levels of TNF-α on D1 and D7 (p < 0.10, for both). LARGE sows showed shorter duration and lower frequency of NB during 24-12 h before parturition (p < 0.05, for both), and tended to have lower prolactin levels (p = 0.10). Furthermore, large sows tended to show longer farrowing duration and higher stillbirth rate (p = 0.06, p = 0.07, respectively). In conclusion, this study confirmed that large litter size may increase oxidative stress in sows during late gestation and lactation. The data also suggested that this could adversely impact prolactin release, leading to reduced NB.

15.
Waste Manag ; 172: 60-70, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37714011

RESUMO

This study provides a meta-analysis on the relationships between cattle barn CH4, NH3 and N2O emission rates and their key drivers (i.e., housing type, floor type, environmental conditions). Understanding these relationships is essential to reduce uncertainties in emission inventories and suggest targeted mitigation measures. The total number of daily emission rates included in the analysis was 139 for CH4, 293 for NH3 and 100 for N2O emissions. Emission rates in the database showed a large variation with 45-803.5 g/LU d-1 for CH4, 0.036-146.7 gN LU-1 d-1 for NH3, and 0.002-18 gN LU-1 d-1 for N2O emissions. Despite the high emission variability, significant effects were identified·NH3 showed positive correlation with air temperature; NH3 emissions differed between housing types but not between floor types·NH3 emissions from tied stalls were lower than the ones from cubicle housing regardless of the floor type. Additionally, NH3 emissions from loose housings were lower than the ones from cubicle housing·NH3 and N2O emission rates from temperate wet zones were lower than the ones from temperate dry zones. CH4 emission rates were affected by environmental factors only and not by housing and floor type, showing negative correlation with air temperature and humidity. The factors investigated can be suggested as ancillary variables and descriptors when cattle barn emissions are measured, in order to make best use of emission data. Country-specific data of these key drivers can be included into national inventories to adapt them to different agroecosystems and support targeted policies.


Assuntos
Gases de Efeito Estufa , Bovinos , Animais , Gases de Efeito Estufa/análise , Amônia/análise , Abrigo para Animais , Esterco/análise , Óxido Nitroso/análise , Metano/análise
16.
Trials ; 24(1): 551, 2023 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-37608390

RESUMO

BACKGROUND: Smoke-free housing policies in multiunit housing are increasingly widespread interventions to reduce smoking and secondhand smoke exposure. Little research has identified factors that impede compliance with smoke-free housing policies in low-income multiunit housing and test corresponding solutions. METHODS: We are using an experimental design to test two compliance support interventions: (A) a "compliance through reduction (via relocation and reduction in personal smoking) and cessation" intervention targets households with smokers and involves support to shift smoking practices to areas beyond the apartment or building setting, reduce personal smoking, and deliver in-residence smoking cessation support services via trained peer educators and (B) a "compliance through resident endorsement" intervention involving voluntary adoption of smoke-free living environments through personal pledges, visible door markers, and/or via social media. We will compare randomly sampled participants in buildings that receive A or B or A plus B to the NYCHA standard approach. DISCUSSION: This RCT addresses key gaps in knowledge and capitalizes on key scientific opportunities by (1) leveraging the federal mandate to ban smoking in a public housing system of more than sufficient size to conduct an adequately powered RCT; (2) expanding our understanding of smoke-free policy compliance beyond policy implementation by testing two novel treatments: (a) in-residence smoking cessation and (b) resident endorsement, while (3) addressing population and location-specific tobacco-related disparities. At the conclusion of the study, this RCT will have leveraged a monumental policy shift affecting nearly half a million NYC public housing residents, many of whom disproportionately experience chronic illness and are more likely to smoke and be exposed to secondhand smoke than other city residents. This first-ever RCT will test the effects of much-needed compliance strategies on resident smoking behavior and secondhand smoke exposure in multiunit housing. TRIAL REGISTRATION: Clinical Trials Registered, NCT05016505. Registered on August 23, 2021.


Assuntos
Abandono do Hábito de Fumar , Poluição por Fumaça de Tabaco , Humanos , Habitação Popular , Fidelidade a Diretrizes , Poluição por Fumaça de Tabaco/efeitos adversos , Poluição por Fumaça de Tabaco/prevenção & controle , Políticas
17.
Isr J Health Policy Res ; 12(1): 26, 2023 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-37550735

RESUMO

A brief commentary on the need for policy change by the Israeli government to address the problem of tobacco smoke incursion in multi-unit housing. The commentary also includes a call for enhanced products, programs, and services to help smokers in Israel quit.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Humanos , Habitação , Israel/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle , Fumar/epidemiologia
18.
Isr J Health Policy Res ; 12(1): 25, 2023 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-37480100

RESUMO

BACKGROUND: Tobacco smoke incursion (TSI) into private residences is a widespread problem in many countries. We sought to assess the prevalence of self-reported TSI and public attitudes about TSI in Israel, a country with a relatively high smoking prevalence and high population density. METHODS: We conducted a random digit dial survey among residents in Israel (N = 285) in 2017, which examined the frequency, source, correlates of, and attitudes towards TSI and potential regulatory options. The cooperation rate was 63.9%. RESULTS: Among respondents, 44.7% reported ever experiencing home TSI, with higher exposure among residents of multi-unit housing (MUH) (MUH versus private homes: aOR (Adjusted Odds Ratio): 3.60, CI (Confidence Interval): [1.96, 6.58], p < .001). Most respondents (69.8%), including nearly half of smokers, prioritized the right of individuals to breath smoke-free air in their apartments over the right of smokers to smoke in their apartments. Women and non-smokers were more likely to support the right to breathe smoke-free air (Women versus men: aOR: 2.77 CI: [1.48, 5.16], p = .001; Nonsmokers versus smokers: aOR: 3.21 CI [1.59, 6.48], p = .001). However, only about a quarter (24.8%) of respondents who ever experienced TSI raised the issue with the neighbor who smoked, the neighbor's landlord, or the building committee. The vast majority (85.2%) of all respondents, including three-quarters of smokers, supported smoke-free legislation for multi-unit housing (MUH), with those ever-exposed to TSI and non-smokers more likely to support legislation (ever-exposed versus never-exposed aOR = 2.99, CI [1.28, 6.97], p = 0.011; nonsmokers versus smokers aOR = 3.00, CI [1.28, 7.01], p = 0.011). CONCLUSIONS: Among study participants, tobacco smoke incursion was a common, yet unwelcome experience. Most respondents believed that the right to breathe smoke-free air in one's apartment superseded that of neighbors to smoke anywhere in their home, and most supported legislation to prevent TSI. Though further study is needed to understand better TSI and effective methods for its prevention, our findings suggest that policy interventions, including legal action at the level of the Supreme Court and/or the Knesset, are needed. Regulation, policy initiatives and campaigns to denormalize smoking in proximity to other people and private residences globally could reduce the scope of this widespread problem, protect individuals from home TSI, and improve population health.


Assuntos
Opinião Pública , Poluição por Fumaça de Tabaco , Masculino , Humanos , Feminino , Estudos Transversais , Israel/epidemiologia , Poluição por Fumaça de Tabaco/prevenção & controle , Políticas
19.
Front Physiol ; 14: 1201328, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37435308

RESUMO

Objective: Osteoarthritis (OA) is a common joint disorder often affecting the knee. It is characterized by alterations of various joint tissues including subchondral bone and by chronic pain. Anti-nerve growth factor (NGF) antibodies have demonstrated improvement in pain associated with OA in phase 3 clinical trials but have not been approved due to an increased risk of developing rapidly progressive OA. The aim of this study was to investigate effects of systemic anti-NGF-treatment on structure and symptoms in rabbits with surgically induced joint instability. Methods: This was elicited by anterior cruciate ligament transection and partial resection of the medial meniscus in right knee of 63 female rabbits, housed altogether in a 56 m2 floor husbandry. Rabbits received either 0.1, 1 or 3 mg/kg anti-NGF antibody intra-venously at weeks 1, 5 and 14 after surgery or vehicle. During in-life phase, static incapacitance tests were performed and joint diameter was measured. Following necropsy, gross morphological scoring and micro-computed tomography analysis of subchondral bone and cartilage were performed. Results: After surgery, rabbits unloaded operated joints, which was improved with 0.3 and 3 mg/kg anti-NGF compared to vehicle injection during the first half of the study. The diameter of operated knee joints increased over contralateral measures. This increase was bigger in anti-NGF treated rabbits beginning 2 weeks after the first IV injection and became dose-dependent and more pronounced with time. In the 3 mg/kg anti-NGF group, the bone volume fraction and trabecular thickness increased in the medio-femoral region of operated joints compared to contralateral and to vehicle-treated animals, while cartilage volume and to a lesser extent thickness decreased. Enlarged bony areas were found in right medio-femoral cartilage surfaces of animals receiving 1 and 3 mg/kg anti-NGF. Alterations of all structural parameters were particularly distinct in a subgroup of three rabbits, which also exhibited more prominent symptomatic improvement. Conclusion: This study showed that anti-NGF administration exerted negative impact on structure in destabilized joints of rabbits, while pain-induced unloading of joints was improved. Our findings open up the possibility to better understand the effects of systemic anti-NGF, particularly on subchondral bone, and thus the occurrence of rapidly progressive OA in patients.

20.
Prev Med Rep ; 35: 102311, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37455761

RESUMO

Tobacco cessation is reduced in U.S. military veterans experiencing homelessness. Mobile contingency management (mCM) is a promising treatment for tobacco use among populations experiencing homelessness, but past CM studies have largely been small, have relied on in-person follow-up, and/or lacked long-term biochemically verified abstinence measures. Veterans who smoked and were experiencing homelessness (N = 127) were randomly assigned to mCM treatment (4 weeks of mCM, 5 weeks of telehealth counseling, and the option of 12 weeks of pharmacotherapy) or VA standard care (3 biweekly group sessions and clinically appropriate pharmacotherapy), and all participants were randomly assigned to a $100 longer-term financial incentive for abstinence at 3-month follow-up. Participants were followed at 3-, 6-, and 12-months post-randomization, with the a priori main outcome designated as biochemically verified prolonged abstinence (with lapses) at 6-month follow-up. At 6-months, participants in the mCM group were significantly more likely to meet criteria for prolonged abstinence (OR = 3.1). Across time points, veterans in the mCM group had twice the odds of prolonged abstinence as those in the standard care group. However, by the 12-month follow-up, there was no statistically significant group difference in abstinence. Cost-effectiveness analysis indicated a modest increase in cost ($1,133) associated with an increase of one quality-adjusted life year saved for the intervention compared to standard care. mCM is a cost-effective approach to smoking cessation among veterans experiencing homelessness. Considering waning potency of this and other tobacco cessation interventions at 12-month follow-up, it is crucial to implement strategies to sustain abstinence for individuals experiencing homelessness.

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