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1.
Chemosphere ; 286(Pt 1): 131555, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34303048

RESUMO

Coal combustion can release large amounts of polycyclic aromatic hydrocarbons (PAHs), which persist in various environment matrices (e.g., road dust) and hence cause the carcinogenic risk to human health. In this study, an exhaustive characterization of road dust samples coupling their physicochemical characteristics and stable isotope compositions (δ13C and δ15N) was conducted to evaluate the source, level, spatial distribution, and carcinogenic risk of PAHs in a typical coal-utilization city. Concentrations of Σ16 PAHs ranged from 605.5 to 25,374.3 ng/g with a mean concentration of 4083.0 ng/g. Pollution levels of sites around the coal-fired power plant (Zone 1) were significantly higher than those in other zones (p < 0.05). PAH concentration showed significant correlations with both C and N fractions (p < 0.01). Compositions of δ13C and δ15N in road dust coupled to principal component analysis and the partitions and diagnostic ratios of PAHs contributed to associating road dust to several local sources of contamination. Coal combustion and vehicular exhaust were major sources of PAHs around the power plant and urban area. Results of incremental lifetime cancer risk showed 81.5% of all sampling sites suffered potential risk (>10-6) for both adults and children, while children around the power plant suffered the highest risk. Despite the estimation of only potential risk being posed by PAHs in road dust, human exposure to the various environmental matrices, scientific and systematic assessment of carcinogenic risks by PAHs in the total environment warrants further investigations.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos , Adulto , Criança , China , Cidades , Carvão Mineral/análise , Poeira/análise , Monitoramento Ambiental , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Medição de Risco
2.
J Sci Food Agric ; 102(1): 417-424, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34143904

RESUMO

BACKGROUND: Thiamethoxam is widely used to control pests in Chinese kale, popularly consumed leafy vegetables. The potential risk to the environment and human health has aroused much public concern. Therefore, it is important to investigate the degradation behavior, residue distribution and dietary risk assessment of thiamethoxam in Chinese kale. RESULTS: A sensitive analytical method for determination of thiamethoxam and its metabolite clothianidin residue in Chinese kale was established and validated through a quick, easy, cheap, effective, rugged, and safe (QuEChERS) technique with ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The recoveries were 85.4-101.2% for thiamethoxam and 79.5-108.1% for clothianidin, with the relative standard deviations (RSDs) of 0.9-10.2% and 1.8-6.0%, respectively. For the dissipation kinetics, the data showed that thiamethoxam in Chinese kale was degraded with the half-lives of 4.1 to 4.5 days. In the terminal residue experiments, the residues of thiamethoxam were 0.017-0.357 mg kg-1 after application 2-3 times with a preharvest interval (PHI) of 7 days under the designed dosages. The chronic and acute dietary exposure assessment risk quotient (RQ) values of thiamethoxam in Chinese kale for different Chinese consumers were 0.08-0.19% and 0.05-0.12%, respectively, and those of clothianidin were 0.01-0.04% and 0.02-0.04%, respectively, all of the RQ values were lower than 100%. CONCLUSION: Thiamethoxam in Chinese kale was rapidly degraded following first-order kinetics models. The dietary risk of thiamethoxam and clothianidin through Chinese kale was negligible to consumers. The results from this study are important reference for Chinese governments to developing criteria for the safe and rational use of thiamethoxam, setting maximum residue levels (MRLs), monitoring the quality safety of agricultural products and protecting consumer health. © 2021 Society of Chemical Industry.


Assuntos
Brassica/química , Cromatografia Líquida/métodos , Guanidinas/metabolismo , Neonicotinoides/metabolismo , Resíduos de Praguicidas/química , Resíduos de Praguicidas/metabolismo , Espectrometria de Massas em Tandem/métodos , Tiametoxam/química , Tiametoxam/metabolismo , Tiazóis/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brassica/metabolismo , Criança , Pré-Escolar , China , Exposição Dietética/efeitos adversos , Exposição Dietética/análise , Feminino , Contaminação de Alimentos/análise , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Medição de Risco , Verduras/química , Verduras/metabolismo , Adulto Jovem
3.
Sci Total Environ ; 804: 150091, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34517316

RESUMO

BACKGROUND: Ambient air pollution exposure has been associated with higher mortality risk in numerous studies. We assessed potential variability in the magnitude of this association for non-accidental, cardiovascular disease, respiratory disease, and lung cancer mortality in a country-wide administrative cohort by exposure assessment method and by adjustment for geographic subdivisions. METHODS: We used the Belgian 2001 census linked to population and mortality register including nearly 5.5 million adults aged ≥30 (mean follow-up: 9.97 years). Annual mean concentrations for fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone (O3) were assessed at baseline residential address using two exposure methods; Europe-wide hybrid land use regression (LUR) models [100x100m], and Belgium-wide interpolation-dispersion (RIO-IFDM) models [25x25m]. We used Cox proportional hazards models with age as the underlying time scale and adjusted for various individual and area-level covariates. We further adjusted main models for two different area-levels following the European Nomenclature of Territorial Units for Statistics (NUTS); NUTS-1 (n = 3), or NUTS-3 (n = 43). RESULTS: We found no consistent differences between both exposure methods. We observed most robust associations with lung cancer mortality. Hazard Ratios (HRs) per 10 µg/m3 increase for NO2 were 1.060 (95%CI 1.042-1.078) [hybrid LUR] and 1.040 (95%CI 1.022-1.058) [RIO-IFDM]. Associations with non-accidental, respiratory disease and cardiovascular disease mortality were generally null in main models but were enhanced after further adjustment for NUTS-1 or NUTS-3. HRs for non-accidental mortality per 5 µg/m3 increase for PM2.5 for the main model using hybrid LUR exposure were 1.023 (95%CI 1.011-1.035). After including random effects HRs were 1.044 (95%CI 1.033-1.057) [NUTS-1] and 1.076 (95%CI 1.060-1.092) [NUTS-3]. CONCLUSION: Long-term air pollution exposure was associated with higher lung cancer mortality risk but not consistently with the other studied causes. Magnitude of associations varied by adjustment for geographic subdivisions, area-level socio-economic covariates and less by exposure assessment method.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Adulto , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/análise , Poluição do Ar/estatística & dados numéricos , Censos , Estudos de Coortes , Exposição Ambiental/análise , Exposição Ambiental/estatística & dados numéricos , Humanos , Material Particulado/análise , Material Particulado/toxicidade
4.
Environ Pollut ; 292(Pt A): 118021, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34654571

RESUMO

CONTEXT: Accelerating evidence of endocrine-related morbidity has raised alarm about the ubiquitous use of phthalates in the human environment, but studies have not directly evaluated mortality in relation to these exposures. OBJECTIVES: To evaluate associations of phthalate exposure with mortality, and quantify attributable mortality and lost economic productivity in 2013-4 among 55-64 year olds. DESIGN: This nationally representative cohort study included 5303 adults aged 20 years or older who participated in the US National Health and Nutrition Examination Survey 2001-2010 and provided urine samples for phthalate metabolite measurements. Participants were linked to mortality data from survey date through December 31, 2015. Data analyses were conducted in July 2020. MAIN OUTCOME MEASURES: Mortality from all causes, cardiovascular disease, and cancer. RESULTS: Multivariable models identified increased mortality in relation to high-molecular weight (HMW) phthalate metabolites, especially those of di-2-ethylhexylphthalate (DEHP). Hazard ratios (HR) for continuous HMW and DEHP metabolites were 1.14 (95% CI 1.06-1.23) and 1.10 (95% CI 1.03-1.19), respectively, with consistently higher mortality in the third tertile (1.48, 95% CI 1.19-1.86; and 1.42, 95% CI 1.13-1.78). Cardiovascular mortality was significantly increased in relation to a prominent DEHP metabolite, mono-(2-ethyl-5-oxohexyl)phthalate. Extrapolating to the population of 55-64 year old Americans, we identified 90,761-107,283 attributable deaths and $39.9-47.1 billion in lost economic productivity. CONCLUSIONS: In a nationally representative sample, phthalate exposures were associated with all-cause and cardiovascular mortality, with societal costs approximating $39 billion/year or more. While further studies are needed to corroborate observations and identify mechanisms, regulatory action is urgently needed.


Assuntos
Poluentes Ambientais , Ácidos Ftálicos , Adulto , Estudos de Coortes , Custos e Análise de Custo , Exposição Ambiental , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Inquéritos Nutricionais
5.
Meat Sci ; 183: 108616, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34481232

RESUMO

This cross-country study investigates the potential to improve pig welfare by exploiting consumer demand, domestically and in export markets, for welfare pork produced in indoor production systems. The analysis is based on questionnaire data collected in 2019 focusing on demand for Danish welfare pork both in Denmark and in two nearby export markets, Sweden and Germany. To reduce hypothetical bias, a willingness-to-pay indicator is combined with an indicator of positive interest in buying a fictive Danish welfare labelled pork. We find that the market potential is relatively weak. Our findings indicate that there is some, albeit limited, potential in Denmark and Germany while demand is practically non-existing in Sweden, probably because the pig welfare guaranteed by Swedish legislation is similar to what is provided by the fictive welfare label employed in the study. Hence, consumer demand alone cannot secure enhanced pig welfare. Moreover, we found national differences in the characteristics of consumers who are interested in Danish welfare pork.


Assuntos
Bem-Estar do Animal , Comportamento do Consumidor/estatística & dados numéricos , Carne de Porco/normas , Adulto , Animais , Comportamento do Consumidor/economia , Estudos Transversais , Dinamarca , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Carne de Porco/economia , Inquéritos e Questionários , Suécia , Suínos
6.
Chemosphere ; 287(Pt 1): 132064, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34474389

RESUMO

The occurrence, spatial distribution, potential sources, and risk assessment of 14 perfluoroalkyl acids (PFAAs), including 11 perfluoroalkyl carboxylic acids and 3 perfluoroalkyl sulfonates acids, were investigated in 21 drinking water sources from the lower Yangtze River in November 2019. The total PFAAs (∑PFAAs) concentrations ranged from 39.3 to 220.3 ng/L, and perfluorooctanoic acid and perfluorooctanesulfonate were predominant with average concentrations of 19.4 and 15.4 ng/L, respectively. The higher ∑PFAAs concentrations in the southern shore and downstream could be attributed to industrial development and surface runoff/tide currents, respectively. Principal component analysis-multiple linear regression revealed that the primary sources of PFAAs were fluororesin coatings/metal plating, surface runoff/textile, effluent discharge/food packaging, and leather/fabrics. Human intake risks of PFAAs were assessed by target hazard quotient (THQ), which showed that human health risks of PFAAs decreased with increasing age, excluding 13-17 years age group. Moreover, the total exposure risks of PFOA/PFOS in all sampling sites to people aged over 18 years calculated based on contribution from drinking water were noted to be at safe level. The results obtained were helpful for improving our understanding of human health risks of PFAAs, and expanding our knowledge on PFAAs in drinking water.


Assuntos
Ácidos Alcanossulfônicos , Água Potável , Fluorcarbonetos , Poluentes Químicos da Água , Adolescente , Adulto , Ácidos Alcanossulfônicos/análise , Caprilatos/análise , China , Monitoramento Ambiental , Fluorcarbonetos/análise , Humanos , Pessoa de Meia-Idade , Medição de Risco , Poluentes Químicos da Água/análise
7.
Cien Saude Colet ; 26(10): 4397-4409, 2021 Oct.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34730631

RESUMO

This article aims to analyze if it is possible for Brazil to meet the Sustainable Development Goals (SDG) 3.1, based on a diagnosis of the situation of maternal mortality in the Health Regions (HRs) of Brazil, in 2018, and the main characteristics of this mortality between 1996 and 2018 in the country. The study consists of two articulated phases: (i) bibliographical analysis of maternal mortality in Brazil; (ii) study in the Mortality Information System (SIM, in Portuguese). In 2018, from the 450 HRs, 159 showed a maternal mortality rate (MMR) of above 70 per 100,000 live births (LBs). Between 1996 and 2018, in Brazil, there was a reduction among women 30 to 49 years of age. However, in the age group of 10 to 29 years, there was no change during the time studied. The dissemination of the Maternal Mortality Committees, the PHPN, the PNAISM, and the "Stork Network" have all contributed to improvements in late pregnancies; however, they were inefficient at preventing deaths among young mothers. Compliance with SDG 3.1 requires: prioritization of CIR with MMR greater than 70.0/100,000 LB; qualification of prenatal services, focusing on care among women aged 10 to 29 years and hypertensive complications; and legalization of abortion.


Assuntos
Aborto Induzido , Aborto Espontâneo , Adolescente , Adulto , Brasil/epidemiologia , Criança , Feminino , Humanos , Mortalidade Materna , Gravidez , Desenvolvimento Sustentável , Adulto Jovem
8.
Saudi Med J ; 42(11): 1195-1200, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732551

RESUMO

OBJECTIVES: To assess the quality of life (QoL) of patients with different dermatological diseases. Multiple international studies have evaluated the QoL among patients with different dermatological diseases; however, few studies of this kind have been conducted in Saudi Arabia. METHODS: This quantitative, observational, cross-sectional study was carried out in the dermatology outpatient clinics of King Saud University Medical City, Riyadh, Saudi Arabia, from September 2019 until February 2020. Data was collected using the validated Arabic version of the Dermatology of Life Quality Index (DLQI). RESULTS: A total of 391 patients ≥18 years participated in the study. The mean age of participants was 33 years (18-75 years). Most participants in this study reported that their dermatological disease had a small or no effect on their QoL (62.5%). The majority of patients who had acne vulgaris (79.7%), vitiligo (79.3%), hair disorders (76.9%), or rosacea (71.5%) reported a small to no effects on their QoL. However, diseases that reflected the largest percentages of a large to extremely large effect on QoL were urticaria (37.1%), eczema (26.6%), and psoriasis (24%). A total of 42.9% of the participants suffered from lichen planus and 66.7% of participants suffered from cutaneous neoplasms reported a moderate effect on their QoL. CONCLUSION: Understanding the impact of different dermatological diseases on QoL can help dermatologists to improve thier patients' QoL. Therefore, we recommend that further studies on this topic be conducted in multiple health centers.


Assuntos
Acne Vulgar , Psoríase , Vitiligo , Adulto , Estudos Transversais , Humanos , Qualidade de Vida
9.
Ann R Coll Surg Engl ; 103(10): 734-737, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34719960

RESUMO

INTRODUCTION: Insertion of foreign objects into the rectum is a well-described phenomenon and not an uncommon referral to the general surgeon on call. Although usually not life-threatening, there can be consequences following migration of the object or perforation of the large bowel. This study looks at the incidence of removal of foreign objects from the rectum over the last decade and the financial burden it presents to the NHS. METHODS: Hospital Episode Statistics for 2010-2019 were used to calculate the number of rectal foreign bodies that required removal in hospital. Data for age groups and genders have been compared. RESULTS: A total of 3,500 rectal foreign bodies were removed over the course of 9 years. Males accounted for 85.1% of rectal foreign bodies whilst 14.9% were females. This equates to 348 bed-days per annum. Admission peaks were observed in the second and fifth decades of life. CONCLUSION: This study shows that the incidence of rectal foreign bodies is higher in men and has been increasing over the period studied. Most foreign bodies can be removed trans-anally with the use of anaesthesia, with only a small proportion of patients requiring hospital stay over 24 hours (mean length of stay = 24 hours). Nearly 400 rectal foreign body removals are performed each year with an annual cost of £338,819, illustrating the effect this has on NHS resources.


Assuntos
Corpos Estranhos/cirurgia , Custos de Cuidados de Saúde/estatística & dados numéricos , Reto , Medicina Estatal/economia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Corpos Estranhos/economia , Corpos Estranhos/epidemiologia , Migração de Corpo Estranho/economia , Migração de Corpo Estranho/epidemiologia , Migração de Corpo Estranho/cirurgia , Humanos , Lactente , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Reto/cirurgia , Fatores Sexuais , Medicina Estatal/estatística & dados numéricos , Reino Unido/epidemiologia , Adulto Jovem
10.
Acta Biomed ; 92(5): e2021474, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34738553

RESUMO

Hyponatraemia is frequently encountered in adults with coronavirus disease 2019 (COVID-19) and is associated with poor prognosis. This review aims to describe for the first time the prevalence, aetiology, prognostic value, pathophysiology, and management of hyponatraemia in children and adolescents with COVID-19, taking into account all relevant studies published in PubMed and Cochrane Library studies until 26th September 2021. Literature search did not detect any studies evaluating the prevalence and prognostic value of sodium disorders in paediatric patients with COVID-19. A broader literature review showed a high prevalence of hyponatraemia in children with bacterial pneumonia, while some studies have reported that hyponatraemia is relatively common in Multisystem Inflammatory Syndrome in Children (MIS-C). In adults with COVID-19, an inverse association between sodium and interleukin-6 levels has been found, indicating that hyponatraemia could be used as a surrogate marker for the risk of cytokine storm and may facilitate the identification of patients who could benefit from immunomodulatory agents. Studies are urgently needed to evaluate the frequency and prognostic impact of electrolyte abnormalities in children with COVID-19. In the meantime, clinicians are urged to consider hyponatraemia in children with COVID-19 as a potential red flag, investigate the cause and administer fluids and other therapies accordingly.


Assuntos
COVID-19 , Hiponatremia , Adolescente , Adulto , COVID-19/complicações , Criança , Humanos , Hiponatremia/epidemiologia , Hiponatremia/etiologia , Hiponatremia/terapia , Prevalência , Prognóstico , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica
11.
Reprod Health ; 18(1): 219, 2021 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-34740379

RESUMO

BACKGROUND: Young people living with HIV(YPLWH) in low-and middle-income countries are entering adolescence and young adulthood in significant numbers. The majority of the HIV-related research on these young people has focused on clinical outcomes with less emphasis on their sexual and reproductive health (SRH). There is an increasing awareness of the importance of understanding and addressing their SRH needs, as many are at elevated risk of transmitting HIV to their sexual partners and young women, in particular, are at significant risk for transmitting HIV to their infants. The purpose of this scoping review is to synthesize research investigating the SRH needs of young people living with HIV in low- and middle-income countries. METHODS: We searched electronic databases for studies focusing on young people aged 10-24 years and 27 studies met inclusion criteria. RESULTS: This review identified four themes characterizing research on SRH among young people living with HIV: knowledge of SRH, access to SRH services, sexual practices, and future family planning and childrearing. CONCLUSIONS: Our findings suggest a need for additional research on comprehensive sexuality education to equip YPLWH with knowledge to facilitate desirable SRH outcomes, interventions on sero-status disclosure and condom use, and health provider capacity to provide SRH services in their pre-existing HIV clinical care.


Assuntos
Infecções por HIV , Serviços de Saúde Reprodutiva , Saúde Sexual , Adolescente , Adulto , Países em Desenvolvimento , Feminino , Humanos , Saúde Reprodutiva , Comportamento Sexual , Adulto Jovem
12.
J Wound Care ; 30(11): 940-944, 2021 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-34747209

RESUMO

OBJECTIVE: To test the feasibility of using a standardised data collection tool to estimate the cost of stage 2-4 pressure ulcer (PU) care within an acute care setting. METHOD: Data on resource use and cost were obtained through a retrospective survey of nursing and medical notes collecting cost data for individual patients who received care for stage 2-4 PUs. RESULTS: Data for 20 patients (12 male/8 female) were analysed. The average patient age was 69 years (range: 37-95 years). Of this sample, seven patients had hospital-acquired PUs (HAPUs) and 14 patients had community-acquired PUs (CAPU) (one patient had both-in different anatomical areas). Over half of the total sample (55%; n=11) had a stage 2 PU. The average length of stay was 31.8 days (range: 5-119 days). Most of the patients (70%; n=14) had a CAPU. The average cost per patient with PU care was €878 (range: €39-2393). The mean cost for patients with a HAPU was €866 (SD: €1313) versus €911 (SD: €567) for patients with a CAPU. The majority of the cost related to equipment and staff time for treatment. CONCLUSION: Overall, the application of the standardised data collection tool to obtain cost data from retrospective inspection of nursing and medical notes is feasible. The cost of PU care in this sample was high, indicating that these wounds may impose a substantial burden on health systems. The costs varied greatly between patients in the sample, reflecting the complexity of PU care. Furthermore, given that costs increased with the higher PU stages, there is a potential to reduce costs by preventing the development of higher stage PUs. Larger-scale studies are required to understand the cost variation and full economic impact of PU care. DECLARATION OF INTEREST: The authors have no conflicts of interest.


Assuntos
Lesão por Pressão , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidados Críticos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/terapia , Estudos Retrospectivos , Inquéritos e Questionários
13.
Medicine (Baltimore) ; 100(41): e27457, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731120

RESUMO

ABSTRACT: Human papillomavirus (HPV) vaccination in young women is low. Women aged 21 to 65 years in the United States (U.S.) have not reached the Healthy People 2020 objective of 93% for cervical cancer screening. The main aim of this study was to investigate the association between HPV vaccination status and cervical cancer screening among privately insured women aged 21 to 26 years in the U.S.This was a retrospective cohort study using the IBM MarketScan database (2006-2016). The study population included 190,982 HPV-vaccinated women and 763,928 matched unvaccinated women. Adjusted incidence rate ratio (IRR) and the 95% confidence intervals (CIs) were obtained using the generalized estimating equations models with a Poisson distribution.Among a total of 954,910 women included in the analysis, age (mean [SD]) was 23.3 [1.6] years. During 967,317 person-years of follow-up, a total of 475,702 incidents of cervical cancer screening were identified. The incidence density rates of cervical cancer screening were 461 per 1000 person-years (PY) for unvaccinated women and 787 per 1000 PY for those who received 3 doses of the HPV vaccine. After adjusting for other covariates, the IRR of cervical cancer screening was 34% higher among HPV-vaccinated women with at least one vaccine dose than unvaccinated women (adjusted IRR = 1.34, 95% CI: 1.33-1.35; P < .0001). The IRR of cervical cancer screening varied by the dose of HPV vaccination. There was evidence of a linear dose-response relationship between the number of HPV vaccine doses and cervical cancer screening (P-trend < .0001). Compared with unvaccinated women, the IRR of cervical cancer screening were 14%, 39%, and 60% higher among those who received 1, 2, and 3 doses of the HPV vaccine, respectively.In this large retrospective cohort study of privately insured women, HPV-vaccinated women were more likely to be screened for cervical cancer compared with unvaccinated women.


Assuntos
Programas de Rastreamento/estatística & dados numéricos , Neoplasias do Colo do Útero/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Adulto , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Seguro Saúde/estatística & dados numéricos , Vacinas contra Papillomavirus/administração & dosagem , Vacinas contra Papillomavirus/imunologia , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto Jovem
14.
Front Public Health ; 9: 628931, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746068

RESUMO

Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary. Methods: Publicly available and globally acclaimed datasets (4 March 2020-30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made. Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries. Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.


Assuntos
COVID-19 , Pandemias , Adulto , Bangladesh/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Masculino , Pandemias/prevenção & controle , SARS-CoV-2 , Adulto Jovem
15.
Ann Glob Health ; 87(1): 103, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34722167

RESUMO

Background and objects: The study aimed to evaluate the long-term neurological sequelae and the disease burden of JE in Gansu, China. Methods: JE patients were included as study population from 2005-2011 in Gansu, and a follow-up survey was conducted in 2007-2014. Pair-matched healthy individuals were selected as controls. All subjects underwent a neurological examination and intelligence quotient (IQ) and memory quotient (MQ) assessments. Then, the disability-adjusted life years (DALYs), and direct and indirect medical expenses were systematic assessed. Results: Forty-four point seven percent of the JE patients had objective neurological deficits, compared with 2.4% of controls. Subnormal intelligence was found in 21.2% of JE subjects, compared with 1.2% control who exhibited a mildly reduced IQ. Abnormal MQ scores were noted in 56.3% JE subjects, compared with only 12.7% controls. Prevalence of each sequelae caused by JE were significantly higher in adults than in younger subjects. Furthermore, median DALY lost due to JE was 9.2 per subject. Median economic cost of JE was approximately $2776.6 per subject and significantly higher in adults than in younger subjects. Findings and Conclusions: JE patients suffered from severe neurological sequelae and high disease burden, resulting in a significant downstream burden for both the patients (especially adults) and the healthcare system.


Assuntos
Encefalite Japonesa , Adulto , China/epidemiologia , Efeitos Psicossociais da Doença , Progressão da Doença , Encefalite Japonesa/diagnóstico , Encefalite Japonesa/epidemiologia , Humanos , Anos de Vida Ajustados por Qualidade de Vida
16.
J Occup Health ; 63(1): e12287, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34734459

RESUMO

OBJECTIVES: Declining physical capacity caused by aging increases the risk of occupational falls on the same level and to lower levels. In emerging countries in Asia, the development of a program for older farmers to assess their risk of occupational falls is valuable. The current study aimed to evaluate the relationship between physical capacity and experience of occupational falls among middle-aged and older Thai farmers. METHODS: We conducted a cross-sectional survey of 419 Thai farmers aged 40 years and over during March and April, 2021. For the assessment of physical capacity, we used the Self-Check Risk Assessment of Falls and Other Accidents in the Workplace tool developed in Japan, consisting of five physical test components. Multiple logistic regression and receiver operating characteristic curves were used to analyze the data. RESULTS: The results revealed that 25.5% of participants had experienced occupational falls in the past 12 months. For each of the five physical test components, there was no significant association between physical capacity and experience of occupational falls. The area under the receiver operating characteristic curve was less than 0.60 for each of the five physical test components. A similar trend was observed when the analysis was limited to participants aged 50 years and over. CONCLUSIONS: The current study did not reveal any associations between physical capacity in each test and experience of occupational falls among middle-aged and older Thai farmers. Because the mechanisms underlying occupational falls are complex, multiple intervention approaches may be important for preventing accidents.


Assuntos
Acidentes por Quedas , Fazendeiros , Desempenho Físico Funcional , Autoavaliação (Psicologia) , Prevenção de Acidentes , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Tailândia
17.
BMC Psychol ; 9(1): 174, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34749830

RESUMO

BACKGROUND: Almost two decades of research produced mixed findings on the relationship between celebrity worship and cognitive skills. Several studies demonstrated that cognitive performance slightly decreases with higher levels of celebrity worship, while other studies found no association between these constructs. This study has two aims: (1) to extend previous research on the association between celebrity worship and cognitive skills by applying the two-factor theory of intelligence by Cattell on a relatively large sample of Hungarian adults, and (2) to investigate the explanatory power of celebrity worship and other relevant variables in cognitive performance. METHODS: A cross-sectional study design was used. Applying an online survey, a total of 1763 Hungarian adults (66.42% male, Mage = 37.22 years, SD = 11.38) completed two intelligence subtests designed to measure ability in vocabulary (Vocabulary Test) and digit symbol (Short Digit Symbol Test). Participants also completed the Celebrity Attitude Scale and the Rosenberg Self-esteem Scale. Subjective material wealth, current family income and general sociodemographics were also reported by participants. RESULTS: Linear regression models indicated that celebrity worship was associated with lower performance on the cognitive tests even after controlling for demographic variables, material wealth and self-esteem, although the explanatory power was limited. CONCLUSIONS: These findings suggest that there is a direct association between celebrity worship and poorer performance on the cognitive tests that cannot be accounted for by demographic and socioeconomic factors.


Assuntos
Pessoas Famosas , Adulto , Atitude , Cognição , Estudos Transversais , Feminino , Humanos , Inteligência , Masculino
18.
Medicine (Baltimore) ; 100(41): e27418, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731116

RESUMO

ABSTRACT: The occurrence of COVID-19 pandemic had a significant negative effect on health care systems over the last year. Health care providers were forced to focus mainly on COVID-19 patients, neglecting in many cases equally important diseases, both acute and chronic. Therefore, also screening and diagnostic strategies for HIV could have been significantly impaired.This retrospective, multicenter, observational study aimed at assessing the number and characteristics of new HIV/AIDS diagnoses during COVID-19 pandemic in Italy and compared characteristics of people living with HIV at diagnosis between pre- and post-COVID-19 era (2019 vs 2020).Our results showed a significant reduction of HIV diagnoses during pandemic. By contrast, people living with HIV during pandemic were older and were diagnosed in earlier stage of disease (considering CD4+ T cell count) compared to those who were diagnosed the year before. Moreover, there was a significant decrease of new HIV diagnoses among men who have sex with men, probably for the impact of social distancing and restriction applied by the Italian Government. Late presentation incidence, if numbers in 2020 were lower than those in 2019, is still an issue.Routinely performing HIV testing in patients with suspected SARS-CoV-2 infection is identifying and linking to care underdiagnosed people living with HIV earlier. Thus, combined tests (HIV and SARS-CoV-2) should be implemented in patients with SARS-CoV-2 symptoms overlapping HIV's ones. Lastly, our results lastly showed how urgent implementation of a national policy for HIV screening is necessary.


Assuntos
Atenção à Saúde/organização & administração , Infecções por HIV/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Adulto , Contagem de Linfócito CD4/estatística & dados numéricos , COVID-19/epidemiologia , Estudos Transversais , Feminino , Infecções por HIV/diagnóstico , Humanos , Itália/epidemiologia , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2
19.
Medicine (Baltimore) ; 100(41): e27515, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731139

RESUMO

ABSTRACT: Retrospective cohort studyTo characterize the learning curve of a spine surgeon during the first 2 years of independent practice by comparing to an experienced colleague. To stratify learning curves based on procedure to evaluate the effect of experience on surgical complexity.The learning curve for spine surgery is difficult to quantify, but is useful information for hospital administrators/surgical programs/new graduates, so appropriate expectations and accommodations are considered.Data from a retrospective cohort (2014-2016) were analyzed at a quaternary academic institution servicing a geographically-isolated, mostly rural area. Procedures included anterior cervical discectomy and fusion, posterior cervical decompression and stabilization, single and 2-level posterior lumbar interbody fusion, lumbar discectomy, and laminectomy. Data related to patient demographics, after-hours surgery, and revision surgery were collected. Operative time was the primary outcome measure, with secondary measures including cerebrospinal fluid leak and early re-operation. Time periods were stratified into 6 month quarters (quarter [Q] 1-Q4), with STATA software used for statistical analysis.There were 626 patients meeting inclusion criteria. The senior surgeon had similar operative times throughout the study. The new surgeon demonstrated a decrease in operative time from Q1 to Q4 (158 minutes-119 minutes, P < .05); however, the mean operative time was shorter for the senior surgeon at 2 years (91 minutes, P < .05). The senior surgeon performed more revision surgeries (odds ratio [OR] 2.5 [95% confidence interval [CI] 1.7-3.6]; P < .001). Posterior interbody fusion times remained longer for the new surgeon, while laminectomy surgery was similar to the senior surgeon by 2 years. There were no differences in rates of cerebrospinal fluid leak (OR 1.2 [95% CI 0.6-2.5]; P > .05), nor reoperation (OR 1.16 [95% CI 0.7-1.9]; P > .05) between surgeons.A significant learning curve exists starting spine practice and likely extends beyond the first 2 years for elective operations.


Assuntos
Vazamento de Líquido Cefalorraquidiano/epidemiologia , Associações de Prática Independente/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Coluna Vertebral/cirurgia , Cirurgiões/estatística & dados numéricos , Adulto , Idoso , Canadá/epidemiologia , Vértebras Cervicais/cirurgia , Competência Clínica/estatística & dados numéricos , Descompressão Cirúrgica/métodos , Discotomia/métodos , Discotomia/tendências , Feminino , Humanos , Associações de Prática Independente/tendências , Laminectomia/métodos , Curva de Aprendizado , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Avaliação de Resultados em Cuidados de Saúde , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/cirurgia , Reoperação/tendências , Estudos Retrospectivos , População Rural , Fusão Vertebral/métodos
20.
BMC Health Serv Res ; 21(1): 1214, 2021 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-34753487

RESUMO

BACKGROUND: The objective of this systematic review is to appraise evidence on the economic evaluations of advanced practice physiotherapy (APP) care compared to usual medical care. METHODS: Systematic searches were conducted up to September 2021 in selected electronic bibliographical databases. Economic evaluation studies on an APP model of care were included. Economic data such as health care costs, patient costs, productivity losses were extracted. Methodological quality of included studies was assessed with the Effective Public Health Practice Project tool and the Critical Appraisal Skills Programme checklist. Meta-analyses were performed and mean differences (MD) in costs per patient were calculated using random-effect inverse variance models. Certainty of the evidence was assessed with the GRADE Approach. RESULTS: Twelve studies (n = 14,649 participants) including four randomized controlled trials, seven analytical cohort studies and one economic modeling study were included. The clinical settings of APP models of care included primary, emergency and specialized secondary care such as orthopaedics, paediatrics and gynaecology. The majority of the included participants were adults with musculoskeletal disorders (n = 12,915). Based on low quality evidence, health system costs including salaries, diagnostic tests, medications, and follow-up visits were significantly lower with APP care than with usual medical care, at 2 to 12-month follow-up (MD: - 145.02 €/patient; 95%CI: - 251.89 to - 38.14; n = 7648). Based on low quality evidence, patient costs including travel and paid medication prescriptions, or treatments were significantly higher with APP care compared to usual medical care, at 2 to 6-month follow-up (MD: 22.18 €/patient; 95%CI: 0.40 to 43.96; n = 1485). Based on very low quality evidence, no significant differences in productivity losses per patient were reported between both types of care (MD: 450 €/patient; 95%CI: - 80 to 970; n = 819). CONCLUSIONS: This is the first systematic review and meta-analysis on the economic evaluation of APP models of care. Low quality evidence suggests that APP care might result in lower health care costs, but higher patient costs compared to usual medical care. Costs differences may vary depending on various factors such as the cost methodology used and on the clinical setting. More evidence is needed to evaluate cost benefits of APP models of care.


Assuntos
Doenças Musculoesqueléticas , Modalidades de Fisioterapia , Adulto , Criança , Análise Custo-Benefício , Prescrições de Medicamentos , Custos de Cuidados de Saúde , Humanos
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