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1.
BMJ Open Ophthalmol ; 9(1)2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38575344

RESUMO

PURPOSE: Effective visual perceptual processing is one of the many components of surgical competence. Human face identification is most efficient when viewed upright. However, it is not yet clear how this perception sensitivity impacts eyelid symmetry. This study investigates surgeons' and laypeople's accuracy and efficiency in perceiving eyelid asymmetry from different spatial perspectives. METHODS: A prospective psychometric experiment was conducted where oculoplastic surgeons were recruited from the American Society of Ophthalmic Plastic and Reconstructive Surgery and the Brazilian Oculoplastic Surgery Society, and control participants were recruited via crowdsourcing (Amazon's Mechanical Turk). Standard illustrations of the human face with varying degrees of eyelid abnormality, laterality, gender and rotation were presented to participants who were asked to judge whether the eyelids were symmetric or asymmetric. RESULTS: The survey was completed by 75 oculoplastic surgeons (49.33% male; mean age of 46.9±10.7) and 192 lay individuals (54.6% male; mean age 34.6±11.3 years). Among oculoplastic surgeons, deviation from upright was significantly associated with increased reaction time and decreased proportion correct (OR per 45° for peak 0.68, 95% CI 0.60 to 0.77, p<0.001; OR per 45° for ptosis 0.52, 95% CI 0.32 to 0.87, p=0.012; OR per 180° for aggregate responses 0.56, 95% CI 0.51 to 0.61, p<0.001). Oculoplastic surgeons demonstrated increasing accuracy and decreasing reaction time with additional trials for both peak and ptosis. CONCLUSION: Oculoplastic surgeons perceive eyelid asymmetries more accurately and can better compensate for inverted sensory information. However, accuracy increases and reaction time decreases with additional trials, suggesting trainability and potential for improvement in inversion disability.


Assuntos
Blefaroptose , Doenças Palpebrais , Humanos , Masculino , Estados Unidos , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Feminino , Estudos Prospectivos , Pálpebras/cirurgia , Blefaroptose/cirurgia , Doenças Palpebrais/cirurgia , Percepção
2.
Arch Esp Urol ; 77(2): 158-163, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38583008

RESUMO

OBJECTIVE: This study aims to investigate the influence of delirium following radical prostatectomy on cognitive function and health perception during the recovery period. METHODS: Data were collected from patients who underwent radical prostatectomy at our institution between May 2020 and May 2022. Postoperative delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), categorising patients into delirium and non-delirium groups. The Montreal Cognitive Assessment (MoCA) and the Brief Illness Perception Questionnaire (BIPQ) were employed to evaluate patients' mental health pre-and post-surgery. Comparative analyses were conducted between patients with and without delirium in the critical care unit, and correlation analyses were performed. RESULTS: The study revealed a delirium incidence rate of 19.13%. Patients in the delirium group exhibited significantly higher age and ICU length of stay compared to those without delirium (p < 0.05). No significant differences were observed in MoCA scores one day before surgery and seven days after surgery, as well as BIPQ scores one day before surgery, five days after surgery and seven days after surgery between the delirium and non-delirium groups (p > 0.05); However, the MoCA scores in the delirium group were significantly lower than those of the non-delirium group on the second and fifth days post-surgery. Additionally, the BIPQ scores in the delirium group were significantly higher than those in the non-delirium group two days after surgery (p < 0.001). A moderate negative correlation was observed between MoCA scores and CAM-ICU scores, and a moderate positive correlation was identified between BIPQ scores and CAM-ICU scores (p < 0.001). CONCLUSIONS: Patients experiencing delirium after radical prostatectomy are at a higher risk of cognitive function impairment and disease threat perception. A significant correlation exists between postoperative delirium and cognitive function as well as health perception.


Assuntos
Delírio , Delírio do Despertar , Masculino , Humanos , Delírio/epidemiologia , Delírio/etiologia , Delírio/psicologia , Delírio do Despertar/complicações , Cognição , Prostatectomia/efeitos adversos , Percepção
3.
BMC Med Educ ; 24(1): 402, 2024 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-38605334

RESUMO

BACKGROUND: Simulation now is widely used for training and education in different fields including healthcare education. Medicine and healthcare students can be trained in a secure, efficient, and engaging setting by Simulation-based Education (SBE). Therefore, this study aimed to assess the perception of faculty members in the community health departments towards SBE to be used in practical subjects for clinical nutrition undergraduate courses. METHOD: This cross-sectional survey was conducted among community health sciences faculty members. The perception was assessed using a self-administered questionnaire that included three sections. RESULTS: This questionnaire was completed by 125 faculty members, of whom 36 (28.8%) were male and 89 (71.2%) were female. Overall, faculty members had positive perceptions, with a mean score of 3.86 ± 0.74, but a high level of anxiety toward SBE, with a mean score of 3.42 ± 0.75. There was a statistically significant difference between the responses of the faculty members based on the training they received in simulation (P = 0.001). CONCLUSION: The study results indicate that community health sciences faculty members' perception of SBE in Saudi Arabia is generally positive. However, the results show high levels of anxiety among faculty members toward SBE.


Assuntos
Docentes , Saúde Pública , Humanos , Masculino , Feminino , Estudos Transversais , Estudantes , Percepção
4.
BMC Public Health ; 24(1): 990, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594646

RESUMO

BACKGROUND: Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS: A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS: The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS: Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.


Assuntos
Abandono do Hábito de Fumar , Feminino , Humanos , Gravidez , Tomada de Decisões , Etanol , Percepção , Cuidado Pré-Natal , Pesquisa Qualitativa , Abandono do Hábito de Fumar/métodos
5.
Plast Aesthet Nurs (Phila) ; 44(2): 140-146, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38639973

RESUMO

In this systematic review, we searched electronic databases for literature addressing physician use of chaperones during examinations of patients undergoing plastic surgery from the perspective of the patient, physician, and chaperone from inception of the database until April 2023. After screening 939 articles, we included seven studies in a systematic review. We conducted an inductive thematic analysis of four domains (physician perspective, patient perspective, chaperone perspective, and chaperone documentation). The results of the analysis showed that surgeons who are experienced, are men, or have received education related to using chaperones are more likely to provide chaperones during patient examinations for medicolegal protection and patient comfort. A small percentage of surgeons have faced accusations from patients of inappropriate behavior. Most of these incidents have occurred without a chaperone present. Patients who have long associations with a particular plastic surgery practice are less likely to want a chaperone. When physicians examine nonsensitive areas, most patients prefer having no chaperone. However, young patients and patients undergoing reconstructive procedures are more likely to request chaperones. Patients prefer having family members or friends serve as chaperones. Notably, despite the presence of a chaperone, we found that documentation of the presence of a chaperone was inadequate. Using a chaperone helps establish trust and ensure patient comfort. Further research, including qualitative studies and multinational approaches, is warranted to gain deeper insights and develop comprehensive guidelines for chaperone use that empowers both patients and health care providers.


Assuntos
Acompanhantes Formais em Exames Físicos , Relações Médico-Paciente , Cirurgiões , Cirurgia Plástica , Feminino , Humanos , Masculino , Percepção , Inquéritos e Questionários
6.
PLoS One ; 19(4): e0301515, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38557563

RESUMO

INTRODUCTION: Results of the impact of lockdowns and stay-at-home orders during the COVID-19 pandemic on changes in cigarette smoking are mixed. Previous studies examining smoking changes during the early stages of the pandemic in 2020 have mainly focused on smoker's perception of changes in cigarette consumption. Such measure has not been widely used in other contexts, and therefore we aim to compare the discrepancy between smokers' perceived changes in cigarette smoking and the actual change in the number of cigarettes smoked, using repeated measurements. METHODS: We included 134 smokers from the French TEMPO cohort with repeated measurements of their perceived changes in smoking habits during the first phase of the COVID-19 pandemic and the number of cigarettes smoked repeatedly from March to May 2020. We used generalized estimation equations (GEE) to examine the association between changes in the number of cigarettes smoked and the odds of mismatched answers. RESULTS: The results suggest that at each study wave, 27-45% of participants provided mismatching answers between their perceived change in smoking habits and the actual change in the number of cigarettes smoked daily, measured repeatedly. Results from GEE analysis demonstrated that a mismatching assessment of smoking behavior was elevated among those who had an increase (OR = 2.52 [1.37;4.65]) or a decrease (OR = 5.73 [3.27;10.03]) in number of cigarettes smoked. DISCUSSION: Our findings highlight the possibility of obtaining different results depending on how changes in tobacco smoking are measured. This highlights the risk of underestimating the actual changes in cigarette smoking during the COVID-19 pandemic, but also more generally when validating public health interventions or smoking cessation programs. Therefore, objective measures such as the actual consumption of psychoactive substances should be utilized, preferably on a longitudinal basis, to mitigate recall bias.


Assuntos
COVID-19 , Fumar Cigarros , Humanos , Estudos Longitudinais , Pandemias , Fumar Cigarros/epidemiologia , Tabaco , COVID-19/epidemiologia , Percepção
7.
Front Public Health ; 12: 1223362, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38655523

RESUMO

Background: The emergence of COVID-19 pandemic has led to heightened fear and uncertainty among parents of children with cancer. This study was conducted to evaluate the parental perceptions toward effects of COVID-19 infection to children with cancer, determine their stress level and factors contributing to high stress level during the pandemic. Methods: This cross-sectional study was conducted in three paediatric oncology centres in Malaysia from September 2020 until December 2022. A total of 167 parents were recruited. Parents completed a set of questionnaires to assess their perception on effect of COVID-19 infection to children with cancer and COVID Stress Scale (CSS) to assess the parents' stress level. Results: Patients' mean age at study entry was 8.75 years (SD 4.38). Ninety-one (54.5%) patients were still on active treatment. More than 80% of the parents obtained information regarding COVID-19 infection from mass media and social networking. Fear of their children contracting COVID-19 infection was high especially among patients who were still on treatment. Forty-nine (29.3%) parents were significantly affected by the pandemic leading to loss of job or monthly income. Twenty-nine (17.4%) patients required treatment modification during the pandemic. The median total score for CSS was 78.0 (IQR 25th 64.0; 75th 95.0). Ninety-one (54.5%) respondents were very/extremely stressed based on the CSS scores. Components with high scores were xenophobia (median score 18.0; IQR 25th 13.0, 75th 22.0), fear of danger (median score 17.0; IQR 25th 14.0, 75th 20.0) and contamination fears (median score 16.0; IQR 25th 12.0, 75th 19.0). Lower household income was associated with higher stress level (p = 0.006). Conclusion: Our study demonstrated high awareness regarding risk of COVID-19 infection among parents of oncology children. Half of the parents had high stress level, with low household income identified as a factor associated with high stress level.


Assuntos
COVID-19 , Neoplasias , Pais , Estresse Psicológico , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Pais/psicologia , Estudos Transversais , Feminino , Masculino , Neoplasias/psicologia , Criança , Malásia/epidemiologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Adulto , Pré-Escolar , SARS-CoV-2 , Pandemias , Adolescente , Medo/psicologia , Percepção
8.
JCO Clin Cancer Inform ; 8: e2300187, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38657194

RESUMO

PURPOSE: Use of artificial intelligence (AI) in cancer care is increasing. What remains unclear is how best to design patient-facing systems that communicate AI output. With oncologist input, we designed an interface that presents patient-specific, machine learning-based 6-month survival prognosis information designed to aid oncology providers in preparing for and discussing prognosis with patients with advanced solid tumors and their caregivers. The primary purpose of this study was to assess patient and caregiver perceptions and identify enhancements of the interface for communicating 6-month survival and other prognosis information when making treatment decisions concerning anticancer and supportive therapy. METHODS: This qualitative study included interviews and focus groups conducted between November and December 2022. Purposive sampling was used to recruit former patients with cancer and/or former caregivers of patients with cancer who had participated in cancer treatment decisions from Utah or elsewhere in the United States. Categories and themes related to perceptions of the interface were identified. RESULTS: We received feedback from 20 participants during eight individual interviews and two focus groups, including four cancer survivors, 13 caregivers, and three representing both. Overall, most participants expressed positive perceptions about the tool and identified its value for supporting decision making, feeling less alone, and supporting communication among oncologists, patients, and their caregivers. Participants identified areas for improvement and implementation considerations, particularly that oncologists should share the tool and guide discussions about prognosis with patients who want to receive the information. CONCLUSION: This study revealed important patient and caregiver perceptions of and enhancements for the proposed interface. Originally designed with input from oncology providers, patient and caregiver participants identified additional interface design recommendations and implementation considerations to support communication about prognosis.


Assuntos
Inteligência Artificial , Cuidadores , Neoplasias , Humanos , Cuidadores/psicologia , Neoplasias/psicologia , Neoplasias/terapia , Prognóstico , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Grupos Focais , Adulto , Pesquisa Qualitativa , Comunicação , Percepção , Interface Usuário-Computador
9.
Sci Rep ; 14(1): 9460, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38658620

RESUMO

Health-related quality of life (HRQoL) has recently gained importance as treatment options for tumors of the upper GI tract lead to improved long-term survival. HRQoL is often estimated by physicians even though their reliability and the impact of outside factors such as contact time and level of medical education is unclear. Therefore, in this study we investigated the correlation between physicians', students', and patients' assessment of HRQoL. 54 patients presenting with tumors of the upper GI tract were included and asked to fill out the standardized HRQoL questionnaires EORTC QLQ-C30 and QLQ-OG25. Attending physicians and medical students filled out the same questionnaires through estimation of patients' HRQoL. Correlation was assessed through Pearson's and Kendall's τb coefficients. Physicians' and patients' assessments correlated for one out of six of the functional and a third of the symptom scores. Students' and patients' assessments correlated for one third of the functional and two thirds of the symptom scores. Students tended to underestimate patients' symptom burden while physicians tended to overestimate it. Physicians failed to correctly assess several pathognomonic symptoms in this study. Students showed higher correlation with patients' symptoms than physicians. Even so, this adds to mounting evidence that shows the benefit of using patient-reported outcomes as a gold standard regarding HRQoL.


Assuntos
Neoplasias Gastrointestinais , Médicos , Qualidade de Vida , Estudantes de Medicina , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Médicos/psicologia , Inquéritos e Questionários , Estudantes de Medicina/psicologia , Adulto , Neoplasias Gastrointestinais/psicologia , Trato Gastrointestinal Superior/patologia , Idoso , Percepção
10.
Nutr Diabetes ; 14(1): 9, 2024 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-38448413

RESUMO

BACKGROUND AND OBJECTIVE: Large intestinal fermentation of dietary fiber may control meal-related glycemia and appetite via the production of short-chain fatty acids (SCFA) and the secretion of glucagon-like peptide-1 (GLP-1) and peptide YY (PYY). We investigated whether this mechanism contributes to the efficacy of the Roux-en-Y gastric bypass (RYGB) by assessing the effect of oligofructose-enriched inulin (inulin) vs. maltodextrin (MDX) on breath hydrogen (a marker of intestinal fermentation), plasma SCFAs, gut hormones, insulin and blood glucose concentrations as well as appetite in RYGB patients. METHOD: Eight RYGB patients were studied on two occasions before and ~8 months after surgery using a cross-over design. Each patient received 300 ml orange juice containing 25 g inulin or an equicaloric load of 15.5 g MDX after an overnight fast followed by a fixed portion snack served 3 h postprandially. Blood samples were collected over 5 h and breath hydrogen measured as well as appetite assessed using visual analog scales. RESULTS: Surgery increased postprandial secretion of GLP-1 and PYY (P ≤ 0.05); lowered blood glucose and plasma insulin increments (P ≤ 0.05) and reduced appetite ratings in response to both inulin and MDX. The effect of inulin on breath hydrogen was accelerated after surgery with an increase that was earlier in onset (2.5 h vs. 3 h, P ≤ 0.05), but less pronounced in magnitude. There was, however, no effect of inulin on plasma SCFAs or plasma GLP-1 and PYY after the snack at 3 h, neither before nor after surgery. Interestingly, inulin appeared to further potentiate the early-phase glucose-lowering and second-meal (3-5 h) appetite-suppressive effect of surgery with the latter showing a strong correlation with early-phase breath hydrogen concentrations. CONCLUSION: RYGB surgery accelerates large intestinal fermentation of inulin, however, without measurable effects on plasma SCFAs or plasma GLP-1 and PYY. The glucose-lowering and appetite-suppressive effects of surgery appear to be potentiated with inulin.


Assuntos
Derivação Gástrica , Insulinas , Humanos , Inulina/farmacologia , Apetite , Projetos Piloto , Glicemia , Estudos Cross-Over , Estudos Prospectivos , Peptídeo YY , Peptídeo 1 Semelhante ao Glucagon , Percepção
11.
Ageing Res Rev ; 96: 102276, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38499161

RESUMO

Amyloidosis of protein caused by fibrillation and aggregation are some of the most exciting new edges not only in protein sciences but also in molecular medicines. The present review discusses recent advancements in the field of neurodegenerative diseases and therapeutic applications with ongoing clinical trials, featuring new areas of protein misfolding resulting in aggregation. The endogenous accretion of protein fibrils having fibrillar morphology symbolizes the beginning of neuro-disorders. Prognostic amyloidosis is prominent in numerous degenerative infections such as Alzheimer's and Parkinson's disease, Amyotrophic lateral sclerosis (ALS), etc. However, the molecular basis determining the intracellular or extracellular evidence of aggregates, playing a significant role as a causative factor in neurodegeneration is still unclear. Structural conversions and protein self-assembly resulting in the formation of amyloid oligomers and fibrils are important events in the pathophysiology of the disease. This comprehensive review sheds light on the evolving landscape of potential treatment modalities, highlighting the ongoing clinical trials and the potential socio-economic impact of novel therapeutic interventions in the realm of neurodegenerative diseases. Furthermore, many drugs are undergoing different levels of clinical trials that would certainly help in treating these disorders and will surely improve the socio-impact of human life.


Assuntos
Amiloidose , Doenças Neurodegenerativas , Doença de Parkinson , Humanos , Amiloide/metabolismo , Amiloidose/metabolismo , Doenças Neurodegenerativas/metabolismo , Doença de Parkinson/metabolismo , Proteínas Amiloidogênicas , Percepção
12.
Nat Plants ; 10(3): 469-482, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38448725

RESUMO

N6-methyladenosine (m6A) is the most abundant internal modification in eukaryotic mRNAs, yet how plants recognize this chemical modification to swiftly adjust developmental plasticity under environmental stresses remains unclear. Here we show that m6A mRNA modification and its reader protein EVOLUTIONARILY CONSERVED C-TERMINAL REGION 8 (ECT8) act together as a key checkpoint for negative feedback regulation of abscisic acid (ABA) signalling by sequestering the m6A-modified ABA receptor gene PYRABACTIN RESISTANCE 1-LIKE 7 (PYL7) via phase-separated ECT8 condensates in stress granules in response to ABA. This partially depletes PYL7 mRNA from its translation in the cytoplasm, thus reducing PYL7 protein levels and compromising ABA perception. The loss of ECT8 results in defective sequestration of m6A-modified PYL7 in stress granules and permits more PYL7 transcripts for translation. This causes overactivation of ABA-responsive genes and the consequent ABA-hypersensitive phenotypes, including drought tolerance. Overall, our findings reveal that m6A-mediated sequestration of PYL7 by ECT8 in stress granules negatively regulates ABA perception, thereby enabling prompt feedback regulation of ABA signalling to prevent plant cell overreaction to environmental stresses.


Assuntos
Adenosina/análogos & derivados , Proteínas de Arabidopsis , Arabidopsis , Arabidopsis/metabolismo , Proteínas de Arabidopsis/genética , Proteínas de Arabidopsis/metabolismo , Ácido Abscísico/metabolismo , Retroalimentação , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Percepção , Regulação da Expressão Gênica de Plantas , Estresse Fisiológico/genética , Secas , Plantas Geneticamente Modificadas/genética
13.
J Glob Health ; 14: 04059, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38515430

RESUMO

Background: The heavy burden of non-communicable chronic diseases (NCDs) and the deficiency of health behaviours (HB) are threatening the middle- and older-aged population in China. However, little is known about the relational mechanism between health shocks (HS) and HBs, while the importance of patients' perception of lifestyle advice (PPLA) to initiate HB is insufficiently emphasised. In this study, we aimed to examine this perception as a mediator between HS and HB and the variety of mediation effects caused by the different contents of lifestyle advice. Methods: We retrieved panel data from the two latest waves of a nationally representative cohort, the China Health and Retirement Longitudinal Study (CHARLS). After constructing well-balanced groups through propensity score matching, we conducted descriptive and multilevel logistic regression analyses to analyse the state of and factors influencing PPLA. We employed the Preacher's Sobel test with 1000 replications bootstrap to examine the mediating effect of PPLA. Results: On a sample of 7922 respondents (post-propensity score matching), we found that HSs had a positive direct effect on HB, with observed decreases in smoking and drinking and increases in exercise. A limited and selected perception of lifestyle advice showed a gap between the advice given by providers and perceived by patients, with gender, education level, social support inside the family, self-reported health, comorbidity, treatment regimens, and utilisation of family doctors being significant influencing factors. Nevertheless, any content of lifestyle advice partially mediated the relationship in which HS increases non-addictive HB (exercise), while only the targeted and detailed content of lifestyle advice about corresponding behaviours partially mediated the effect between HS and addictive HB (smoking and drinking). Conclusions: This study provides the first evidence that PPLA partially mediates the positive effect of HS on HB. Personalised chronic disease management; targeted advice and interventions; and multiple social resources COULD BE beneficial for patients with HS to initiate HB.


Assuntos
Comportamentos Relacionados com a Saúde , Estilo de Vida , Humanos , Estudos Longitudinais , China/epidemiologia , Percepção
14.
Biochim Biophys Acta Biomembr ; 1866(4): 184309, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38460782

RESUMO

Continual synthesis and remodeling of the peptidoglycan layer surrounding Gram-positive cells is essential for their survival. Diverse antimicrobial peptides target the lipid intermediates involved in this process. To sense and counteract assault from antimicrobial peptides, low G + C content gram-positive bacteria (Firmicutes) have evolved membrane protein complexes known as Bce-modules. These complexes consist minimally of an ABC transporter and a two-component system that work in tandem to perceive and confer resistance against antimicrobial peptides. In this mini-review I highlight recent breakthroughs in comprehending the structure and function of these unusual membrane protein complexes, with a particular focus on the BceAB-RS system present in Bacillus subtilis.


Assuntos
Antibacterianos , Peptídeos Antimicrobianos , Antibacterianos/farmacologia , Antibacterianos/metabolismo , Proteínas de Bactérias/química , Farmacorresistência Bacteriana , Peptídeos/metabolismo , Transportadores de Cassetes de Ligação de ATP/metabolismo , Percepção
15.
BMC Public Health ; 24(1): 667, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429644

RESUMO

BACKGROUND: Cervical cancer poses a heavy health burden in China, with the second highest incidence and mortality rate among female tumors, yet human papillomavirus (HPV) vaccination rate among female university students remain remains low. This study conducted a cross-sectional survey to assess the degree of HPV vaccine hesitancy among female university students and to explore the potential association between knowledge, risk perception, trust, and HPV vaccine hesitancy. METHODS: A total of 1,438 female university students from four Chinese cities were recruited through stratified, multistage, cluster sampling method. The mediation model was constructed using the Bootstrap method, introducing trust and risk perception as mediating variables to examine the effect of knowledge on HPV vaccine hesitancy. RESULTS: The study found that 8.9% (95%CI:7.4%∼10.4%) of the female university students exhibited HPV vaccine hesitancy. Pearson's correlation analysis revealed a negative association between vaccine hesitancy and knowledge, risk perception, and trust. The mediation model showed that knowledge had significant indirect effects on HPV vaccine hesitancy through trust (indirect effect: -0.224, 95% CI: -0.293 ∼ -0.167) and risk perception (indirect effect: -0.013, 95% CI: -0.033 ∼ -0.002). CONCLUSION: HPV vaccine hesitancy among female university students has mitigated, but still needs to be addressed. In addition, trust and risk perception are mediators mediating the relationship between knowledge with HPV vaccine hesitancy. Therefore, there is a need to strengthen public health education to improve knowledge, with a particular focus on providing information about trust and risk perception to reduce HPV vaccine hesitancy.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Humanos , Feminino , Estudos Transversais , Confiança , Infecções por Papillomavirus/prevenção & controle , Universidades , Hesitação Vacinal , China , Percepção , Estudantes
16.
BMC Public Health ; 24(1): 669, 2024 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-38429696

RESUMO

BACKGROUND: Perception of health risk can influence household rules, but little is known about how the perception of harm from cannabis secondhand smoke (cSHS) is related to having a complete ban on in-home cannabis smoking. We examined this association among a nationally representative sample of United States adults. METHODS: Respondents were 21,381 adults from the cross-sectional Marijuana Use and Environmental Survey recruited from December 2019-February 2020. Perceived harm of cSHS exposure (extremely harmful, somewhat harmful, mostly safe, or totally safe) and complete ban of cannabis smoking anywhere in the home (yes or no) were self-reported. Logistic regression for survey-weighted data estimated covariate-adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between perceived harm of cSHS and complete ban on in-home cannabis smoking. Stratified subgroup analyses (by cannabis smoking status, cannabis use legalization in state of residence, and children under age 6 living in the home) were conducted to quantify effect measure modification of the association between perception of harm and complete ban. RESULTS: A complete ban on in-home cannabis smoking was reported by 71.8% of respondents. Eight percent reported cSHS as "totally safe"; 20.5% "mostly safe"; 38.3% "somewhat harmful"; and 33.0% "extremely harmful". Those who reported cSHS as "extremely harmful" had 6 times the odds of a complete ban on in-home cannabis smoking (OR = 6.0, 95%CI = 4.9-7.2) as those reporting smoking as "totally safe". The odds of a complete ban were higher among those reporting cSHS as "somewhat harmful" (OR = 2.6, 95%CI = 2.2-3.1) or "mostly safe" (OR = 1.4, 95%CI = 1.2-1.7) vs those reporting cSHS as "totally safe". In each subgroup of cannabis smoking status, state cannabis use legalization, and children under the age of 6 living in the home, perceived harm was associated with a complete ban on in-home cannabis smoking. CONCLUSIONS: Our study demonstrates perceiving cSHS as harmful is strongly associated with having a complete in-home cannabis smoking ban. With almost a third of US adults perceiving cSHS as at least "mostly safe", there is strong need to educate the general population about potential risks associated with cSHS exposure to raise awareness and encourage adoption of household rules prohibiting indoor cannabis smoking.


Assuntos
Cannabis , Fumar Maconha , Poluição por Fumaça de Tabaco , Adulto , Criança , Humanos , Estados Unidos/epidemiologia , Estudos Transversais , Fumar Maconha/epidemiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Habitação , Percepção
17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 45(3): 417-424, 2024 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-38514319

RESUMO

Objective: To explore the association between occupational noise perception and cardiovascular disease (CVD), depression symptoms, as well as their comorbidity in occupational population and provide evidence for the prevention and control of physical and mental illnesses. Methods: A cross-sectional survey design was adopted, based on baseline data in population in 28 prefectures in Sichuan Province and Guizhou Province, and 33 districts (counties) in Chongqing municipality from Southwest Occupational Population Cohort from China Railway Chengdu Group Co., Ltd. during October to December 2021. A questionnaire survey was conducted to collect information about noise perception, depressive symptoms, and the history of CVD. Latent profile analysis model was used to determine identify noise perception type, and multinomial logistic regression analysis was conducted to explore the relationship between different occupational noise perception types and CVD, depression symptoms and their comorbidity. Results: A total of 30 509 participants were included, the mean age was (36.6±10.5) years, and men accounted for 82.0%. The direct perception of occupational noise, psychological effects and hearing/sleep impact of occupational noise increased the risk for CVD, depressive symptoms, and their comorbidity. By using latent profile analysis, occupational noise perception was classified into four levels: low, medium, high, and very high. As the level of noise perception increased, the association with CVD, depressive symptoms, and their comorbidity increased. In fact, very high level occupational noise perception were found to increase the risk for CVD, depressive symptoms, and their comorbidity by 2.14 (95%CI: 1.73-2.65) times, 8.80 (95%CI: 7.91-9.78) times, and 17.02 (95%CI: 12.78-22.66) times respectively compared with low-level occupational noise perception. Conclusions: Different types of occupational noise perception are associated with CVD and depression symptom, especially in the form of CVD complicated with depression symptom. Furthermore, the intensity of occupational noise in the work environment should be reduced to lower the risk for physical and mental health.


Assuntos
Doenças Cardiovasculares , Doenças Profissionais , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Doenças Cardiovasculares/epidemiologia , Depressão/psicologia , Estudos Transversais , Comorbidade , Audição , Condições de Trabalho , Percepção , Fatores de Risco , Doenças Profissionais/epidemiologia
18.
Reprod Health ; 21(1): 40, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38539219

RESUMO

BACKGROUND: The human papillomavirus (HPV), a prevalent sexually transmitted infection, is linked to a wide range of diseases, with cervical cancer being the most common and serious one. HPV vaccination is crucial for preventing cervical cancer and other HPV-related problems. The low acceptability of HPV vaccination among teenagers globally is largely due to a lack of understanding and information about HPV among parents. Our study aimed to evaluate the level of knowledge, attitude, intention, and HPV vaccination among parents in Lebanon as well as the variables influencing Lebanese mothers' intentions to vaccinate their children. METHODS: A cross-sectional survey-based study involving 392 participants was conducted between May and June 2022. The study assessed parents' intention to vaccinate their children against HPV, their knowledge about HPV, and the HPV vaccine. The data was collected through an anonymous electronic questionnaire. A bivariate analysis was conducted using Student t-test and ANOVA to examine the relationship between the dependent variable "Intention to vaccination" and the secondary variables. The level of statistical significance was set at 0.05 for all data. RESULTS: Our findings showed that only 63% of the 392 participants claimed they would give their child the HPV vaccination. A positive significant association was demonstrated between "Intention to vaccinate against HPV" and mother's nationality, father's educational level, family income per month, information received about the HPV vaccine, parents' HPV vaccination, insurance coverage of the HPV vaccine, children's vaccinations with all required vaccines, knowledge of HPV, and knowledge of the HPV vaccine. Furthermore, when parents know about HPV, their desire to vaccinate their child increases by a factor of 1.832 times, and by 1.207 times when their knowledge level increases by one point. CONCLUSION: The majority of parents lacked a general understanding of most HPV-related statements, which highlights the requirement for educational interventions to raise parental awareness, understanding, and attitudes toward HPV and, as a result, increase parental acceptance of vaccinating their children. To increase the vaccination rate among adolescents, government authorities should ensure that the HPV vaccine is available in all hospitals and clinics and should be provided free of charge.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Neoplasias do Colo do Útero , Criança , Feminino , Adolescente , Humanos , Mães , Infecções por Papillomavirus/prevenção & controle , Neoplasias do Colo do Útero/prevenção & controle , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Pais , Vacinas contra Papillomavirus/uso terapêutico , Vacinação , Inquéritos e Questionários , Percepção
19.
Support Care Cancer ; 32(4): 253, 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38536470

RESUMO

PURPOSE: Patients with haematologic malignancies have less access to palliative care and are referred later than patients with solid tumours. We developed a survey to investigate this phenomenon, with the intention of analysing palliative care perceptions among health professionals who treat haematology patients and identifying barriers and facilitators to referrals to palliative care services. METHODS: This was a multicentre exploratory descriptive web-based survey. A questionnaire was administered to 320 medical and nursing staff members from five Italian haematological units and San Marino's hospital to investigate their perception of palliative care. Quantitative and qualitative analyses were performed. RESULTS: A total of 142/320 healthcare professionals completed the survey, achieving a 44% response rate. Most of the respondents supported the integration of haematology and palliative care and were aware of the role of palliative care. Despite this, only half had an in-hospital palliative care team, and only a few had previously attended a specific training course. The majority agreed with palliative care referral when the prognosis was less than 3 months or when the symptoms were incoercible and with blood transfusions even in the last stages of the disease. Many considered the presence of an in-hospital palliative care team or a case manager, as well as structured palliative care training, as fundamental facilitators of palliative care referrals. CONCLUSION: These results showed that healthcare professionals in haematology generally hold a favourable attitude and a high interest in integrating palliative care into their patients' care. The low referral rate could depend on clinical, cultural, and organisational issues.


Assuntos
Hematologia , Cuidados Paliativos , Humanos , Cuidados Paliativos/métodos , Atitude , Inquéritos e Questionários , Percepção
20.
Chin Clin Oncol ; 13(1): 5, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38453656

RESUMO

BACKGROUND: The management of chemotherapy induced anemia (CIA) remains challenging. The potential risk and benefits in providing patient-centered care need to be balanced; the disease is multifactorial; and the major treatments including red blood cell (RBC) transfusions, erythropoiesis-stimulating agents (ESAs) and intravenous injection (i.v.)iron supplementation have a unique set of strengths and limitations. Also, most previous survey based on the patient data could not reveal the process of evaluation and decision-making for CIA treatment from a physician's perspective. As the comparison of China Society of Clinical Oncology (CSCO), National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) guidelines, the standard of CIA treatment in China will vary from United States and Europe, for example, the initial hemoglobin (Hb) for RBC transfusions. In order to understand the diagnosis, treatment, and unmet medical needs of CIA patients, the China Medical Education Association (CMEA), in conjunction with Cancer Hope Medium, initiated the first national survey of Chinese physicians regarding the diagnosis and treatment of CIA. METHODS: The CMEA sent an online, 12-item questionnaire (via wjx.cn) to physicians across China from September 1, 2022 to October 22, 2022. Two hundred and sixty-five samples were calculated usingsurveyplanet.com. The questionnaire evaluated the impact of anemia on chemotherapy interruption, initial treatment, the target Hb level of CIA in, and the current status of ESAs prescription in clinical practice. Respondents were asked to score their reasons for not using ESAs (including safety issues, drug access in practice or adherence) and the risk options of the current treatment including ESAs, RBC transfusion, and i.v.iron. RESULTS: A total of 331 questionnaires among 5,000 web visits were gathered, covering 247 hospitals in 29 provinces across China, of which 130 (53%) were tier IIIA hospitals, 50 (20%) were tier III B hospitals, 59 (24%) were tier IIA hospitals, and 8 (3%) were tier II B hospitals. The frequency of chemotherapy dose delay/reduction due to anemia was 24% [standard deviation (SD) 49%]. Most responding physicians rated an initial Hb level for ESAs treatment to be 80 g/L, with a favorable Hb level for chemotherapy being 100 g/L (60%), which would not limit treatment availability. The majority (67.6%, n=221) of physicians who responded indicated that they had used ESAs for anemia correction, while the others (32.4%, n=106) reported never using them. CONCLUSIONS: This is the first study in conducting a large-scale survey on the diagnosis and treatment of CIA in China from a physicians' perspective. We found that in China, nearly one-quarter of patients undergoing chemotherapy with concurrent anemia may experience interruption of chemotherapy and that the initiation of anemia treatment is not adequately timed. In treating CIA, most physicians prioritize the completion of chemotherapy via Hb level over treating the symptoms of anemia.


Assuntos
Anemia , Antineoplásicos , Hematínicos , Neoplasias , Médicos , Humanos , Estados Unidos , Antineoplásicos/uso terapêutico , Anemia/induzido quimicamente , Anemia/tratamento farmacológico , Ferro/efeitos adversos , Hematínicos/efeitos adversos , Neoplasias/tratamento farmacológico , Neoplasias/complicações , Inquéritos e Questionários , Percepção
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