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Braz. j. biol ; 84: e254816, 2024. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1355894


Abstract Pakistan is an agricultural country and fisheries play a very important role in the economic development of the country. Different diseases are prevalent in Pakistani fish but information related to the causative agents is not well-known. Keeping in view the significance of bacterial pathogens as the causative agents of multiple fish diseases, the present study was conducted for identification, characterization and analysis of virulence genes of Aeromonas spp. isolated from diseased fishes. A total of fifty fish samples having multiple clinical indications were collected from different fish farms of district Kasur, Punjab Pakistan. For isolation of Aeromonas spp. samples were enriched and inoculated on Aeromonas isolation medium. Isolates were identified and characterized by different biochemical tests, Analytical Profile Index (API) 20E kit and Polymerase Chain Reaction (PCR) assays. All isolates were screened for three putative virulence genes including aerolysin (aer), haemolysin (hyl) and heat labile cytotonic enterotoxin (alt). Seven isolates of Aeromonas (A.) hydrophila were retrieved and identified based on API 20E. These isolates were further confirmed as A. hydrophila on the basis of PCR assays. Three isolates were detected positive for the presence of virulence genes (alt and hyl). Whereas aerolysin (aer) gene was not present in any of A. hydrophila isolates. The present study confirmed A. hydrophila as the causative agent of epizootic ulcerative syndrome and motile Aeromonas septicemia in fish farms of district Kasur, Punjab Pakistan. Moreover, detection of two virulence genes (alt and hyl) in A. hydrophila isolates is a threat for fish consumers of study area.

Resumo O Paquistão é um país agrícola, onde a pesca desempenha um papel muito importante para o desenvolvimento econômico. Diferentes doenças são prevalentes em peixes do Paquistão, mas as informações relacionadas aos agentes causadores não são bem conhecidas. Tendo em vista a importância dos patógenos bacterianos como agentes causadores de múltiplas doenças em peixes, o presente estudo foi conduzido para identificação, caracterização e análise de genes de virulência de isolados de Aeromonas spp. de peixes doentes. Foram coletadas 50 amostras de peixes com múltiplas indicações clínicas em diferentes fazendas do distrito de Kasur, Punjab, Paquistão. Para isolar Aeromonas spp., as amostras foram enriquecidas e inoculadas em meio de isolamento. Os isolados foram identificados e caracterizados por diferentes testes bioquímicos, kit Analytical Profile Index (API) 20E, e ensaios de reação em cadeia da polimerase (PCR). Todos os isolados foram selecionados para três genes de virulência putativos, incluindo aerolisina (aer), hemolisina (hyl) e enterotoxina citotônica termolábil (alt). Sete isolados de Aeromonas hydrophila foram recuperados e identificados com base no API 20E. Esses isolados foram posteriormente confirmados como A. hydrophila de acordo com ensaios de PCR. Três isolados indicaram a presença de genes de virulência (alt e hyl), enquanto o gene aerolisina (aer) não esteve presente em nenhum dos isolados de A. hydrophila. O presente estudo confirmou A. hydrophila como o agente causador da síndrome ulcerativa epizoótica e septicemia móvel por Aeromonas em fazendas de peixes, no distrito de Kasur, Punjab, Paquistão. Além disso, a detecção de dois genes de virulência (alt e hyl) em isolados de A. hydrophila é uma ameaça para os consumidores de peixes da área de estudo.

Animais , Infecções por Bactérias Gram-Negativas/veterinária , Infecções por Bactérias Gram-Negativas/epidemiologia , Aeromonas/genética , Paquistão , Aeromonas hydrophila/genética , Enterotoxinas/genética , Peixes
Food Chem ; 399: 133959, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36001928


Advances in understanding the biological effects of dietary flavonoids and flavonoid-rich foods have been reported. Improving knowledge about their beneficial effects, and mechanisms of action, is crucial for better utilization. However, mechanisms responsible for their health benefits are still unclear. Previous research considered has suggested that gut microbiota might be linked to the metabolism of dietary flavonoids. To understand the bioactivities of dietary flavonoids/flavonoid-rich foods better, and the role of microbiota, we explored systematically 1) types of dietary flavonoids and associated health benefits, 2) low bioaccessibilities and metabolic characteristics, 3) gut microbiota role in regulation, and 4) crosstalk between regulation mechanisms. Current challenges and future perspectives were also considered, offering new research directions and identifying trends in the development of flavonoid-rich food products.

Microbioma Gastrointestinal , Microbiota , Flavonoides/metabolismo , Promoção da Saúde , Polifenóis/farmacologia
Eur J Oper Res ; 304(1): 292-307, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34955589


Despite its efficiency in reducing the impact of pandemics (e.g., the COVID-19), whether to introduce telemedicine as an additional way to serve chronically ill patients remains controversial for hospitals in many countries. This paper builds a stylized model to investigate a hospital's telemedicine strategy and the corresponding impacts on its operations regarding outpatient management of chronic diseases. We implement our analysis from three key concerns of the hospital in the presence of a pandemic: the differences in medical consumption and reimbursement between in-person and telemedicine modalities and the effort cost of infection reduction resulting from the pandemic. We find that in the absence of the pandemic, the hospital prefers to introduce telemedicine when the differences in medical consumption and reimbursement are both small. In the presence of the pandemic, we find that the introduction of telemedicine does not always benefit the hospital and that it is better not to introduce telemedicine in some cases since it may exacerbate the negative influence of the pandemic on the hospital's total costs. Furthermore, we surprisingly find that the hospital may set greater in-person capacity but less telemedicine capacity in response to the outbreak of the pandemic under certain conditions, which contradicts public beliefs. Finally, we show that social welfare can be improved by introducing telemedicine when the effort cost of infection reduction and the difference in reimbursement are both of moderate size. The condition under which social welfare is improved tightens with a greater difference in medical consumption.

Expert Syst Appl ; 211: 118185, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35873111


To cater to the increasing demands, particularly during diseases such as Covid-19, the design and planning of home health care systems is of significant importance. The current study proposes a multi-objective mixed-integer linear model for a home health care network in two stages; the first is the opening of efficient health centres, and the second is the routing and scheduling considering corporate social responsibility and efficiency. There are multiple objectives that we consider, including minimization of total costs and inefficiency considerations, and maximization of social aspects. A novel aspect of this study is the consideration of social responsibility, which includes employment opportunities and regional economic development, and efficiency in terms of time, energy, and mismanagement of budgets. To measure efficiency, an augmented version of the data envelopment analysis approach is incorporated into the proposed optimization model. Additionally, the TH approach is developed as an interactive fuzzy method to deal with the proposed multi-objective model. Within the HHC problem, costs, social factors, and service time are inherently uncertain, and hence, to solve this problem, a robust-fuzzy approach is proposed. The ensuing model is applied to a real case study of Kermanshah in Iran. Moreover, several problem instances motivated by real cases are generated with different characteristics to measure the performance of the proposed model and approach. The results show that decision-makers' preferences play a key role in human resource planning and regional development. Furthermore, the results confirm the efficiency of the proposed approach in different instances within reasonable time frames.

Braz. j. biol ; 83: e245585, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1339413


Abstract Many soil microorganisms' i.e., bacteria and fungi produce secondary metabolites called antibiotics. These are used for the treatment of some of the bacterial, fungal and protozoal diseases of humans. There is a need for isolation of a broad spectrum of antibiotics from microorganisms due to the emergence of antibiotic resistance. In the present study two antibiotic producing bacteria Klebsiella pneumoniae and Bacillus cereus were isolated from pharmaceutical and poultry feed industry of Hattar, Haripur Pakistan. Total 10 waste samples were collected from different industries (Marble, Ghee, Soap, Mineral, Steel, Poultry Feed, Pharmaceutical, Qarshi, Cosmetic and Glass). Thirty-three bacterial strains were isolated from industrial wastes of these ten different industries. Fourteen out of thirty-three bacterial strains exhibited antimicrobial activities against at least one of the test microbes considered in this study including Escherchia coli, Staphylococcus aureus and Salmonella typhi. The bacteria were isolated by standard serial dilution spread plate technique. Morphological characterization of the isolates was done by Gram staining. Nine bacterial isolates out of fourteen were initially identified as B. cereus and five as K. pneumoniae through biochemical characterization. The antibacterial activities were tested by well diffusion method. Maximum number of antibiotic producing bacteria were isolated from pharmaceutical and poultry feed industry based on the results of primary screening, the most potential isolates S9, S19, S20, S22 and S23 were selected for secondary screening. The maximum activity against E. coli and S. aureus was recorded by bacterial isolate S19 i.e zones of inhibition of 6.5mm and 9mm while S20 showed 7.5mm and 6mm zones respectively. Molecular identification was carried out on the basis of 16S rRNA sequence analysis. Finally, the isolates were identified as B. cereus accession number LC538271and K. pneumoniae accession number MT078679. Analysis of bacterial extract S20 through GC-MS indicated the presence of 8 compounds of diverse nature and structure. Present study suggests that wastes of pharmaceutical and poultry feed industry may have antibiotic producing bacteria. These bacteria could be utilized for the production of antibiotics. B. cereus and K. pneumoniae isolated from wastes of poultry feed and pharmaceutical industries have the potential to produce antibiotics and could be used to control the microbial growth.

Resumo Muitos microrganismos do solo, ou seja, bactérias e fungos produzem metabólitos secundários chamados antibióticos. Eles são usados ​​para tratamento de algumas doenças bacterianas, fúngicas e protozoárias em humanos. Há necessidade de isolamento de um amplo espectro de antibióticos de microrganismos devido ao surgimento de resistência aos antibióticos. No presente estudo, duas bactérias produtoras de antibióticos, Klebsiella pneumoniae e Bacillus cereus, foram isoladas da indústria farmacêutica e de ração avícola de Hattar, Haripur, Paquistão. Um total de 10 amostras de resíduos foi coletado de diferentes indústrias (mármore, ghee, sabão, mineral, aço, ração para aves, farmacêutica, Qarshi, cosmética e vidro). Trinta e três cepas bacterianas foram isoladas de resíduos industriais dessas dez diferentes indústrias. Quatorze das 33 cepas bacterianas exibiram atividades antimicrobianas contra pelo menos um dos micróbios de teste considerados neste estudo, incluindo Escherchia coli, Staphylococcus aureus e Salmonella typhi. As bactérias foram isoladas pela técnica de placa de diluição em série padrão. A caracterização morfológica dos isolados foi feita por coloração de gram. Nove isolados bacterianos de 14 foram inicialmente identificados como B. cereus e cinco como K. pneumoniae por meio de caracterização bioquímica. As atividades antibacterianas foram testadas pelo método de difusão em poço. O número máximo de bactérias produtoras de antibióticos foi isolado da indústria farmacêutica e de ração avícola com base nos resultados da triagem primária, os isolados mais potenciais S9, S19, S20, S22 e S23 foram selecionados para a triagem secundária. A atividade máxima contra E. coli e S. aureus foi registrada pelo isolado bacteriano S19, ou seja, zonas de inibição de 6,5 mm e 9 mm, enquanto S20 mostrou zonas de 7,5 mm e 6 mm, respectivamente. A identificação molecular foi realizada com base na análise da sequência 16S rRNA. Finalmente, os isolados foram identificados como B. cereus número de acesso LC538271 e K. pneumoniae número de acesso MT078679. A análise do extrato bacteriano S20 por meio de GC-MS indicou a presença de oito compostos de natureza e estrutura diversas. O presente estudo sugere que resíduos da indústria farmacêutica e de ração para aves podem conter bactérias produtoras de antibióticos. Essas bactérias podem ser utilizadas para a produção de antibióticos B. cereus e K. pneumoniae isolados de resíduos de rações de aves e indústrias farmacêuticas têm potencial para produzir antibióticos e podem ser usados ​​para controlar o crescimento microbiano.

Humanos , Staphylococcus aureus , Resíduos Industriais , RNA Ribossômico 16S , Extratos Vegetais , Testes de Sensibilidade Microbiana , Escherichia coli , Cromatografia Gasosa-Espectrometria de Massas , Antibacterianos/farmacologia
Braz. j. biol ; 83: e244551, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1285626


Abstract Origanum vulgare has been of great interest in academia and pharma industry due to its antioxidant, antifungal and antitumor properties. The present study aimed to find the anti-MRSA potential and in vivo toxicity assessments of O. vulgare. O. vulgare extract was used to monitor anti-MRSA activity in mice. Following MRSA established infection in mice (Mus musculus), treatment with O. vulgare was continued for 7 days. Autopsies were performed and re-isolation, gross lesion scoring and bacterial load in various organs were measured. Additionally, blood sample was analysed for hematological assays. Toxicity assessment of O. vulgare potential as medicine was done at 200 mg/kg and 400 mg/kg by evaluating liver and kidney functions. Bacterial load and gross lesion in lungs and heart were significantly low compared to positive control following O. vulgare treatment. Likewise, O. vulgare treated groups had hematological, neutrophil and TLC values similar to control groups. Increased AST, ALP and total bilirubin alongwith marked hepatocellular degeneration and distortion around the central vein, inflammatory cell infiltration, and cytoplasmic vacuolization of hepatic cells was observed at higher dose. It is concluded that crude extract of O. vulgare may contain beneficial secondary metabolites and in future may be explored for curing infectious diseases.

Resumo Origanum vulgare tem despertado grande interesse na academia e na indústria farmacêutica devido às suas propriedades antioxidantes, antifúngicas e antitumorais. O presente estudo teve como objetivo encontrar o potencial anti-MRSA e avaliações de toxicidade in vivo de O. vulgare. O extrato de O. vulgare foi usado para monitorar a atividade anti-MRSA em camundongos. Após infecção estabelecida por MRSA em camundongos (Mus musculus), o tratamento com O. vulgare foi continuado por 7 dias. As autópsias foram realizadas e o reisolamento, pontuação das lesões grosseiras e carga bacteriana em vários órgãos foram medidos. Além disso, a amostra de sangue foi analisada para ensaios hematológicos. A avaliação da toxicidade do potencial de O. vulgare como medicamento foi feita com 200 mg / kg e 400 mg / kg, avaliando as funções hepática e renal. A carga bacteriana e as lesões graves nos pulmões e no coração foram significativamente baixas em comparação com o controle positivo após o tratamento com O. vulgare. Da mesma forma, os grupos tratados com O. vulgare apresentaram valores hematológicos, de neutrófilos e de TLC semelhantes aos grupos de controle. Aumento de AST, ALP e bilirrubina total juntamente com degeneração hepatocelular marcada e distorção ao redor da veia central, infiltração de células inflamatórias e vacuolização citoplasmática de células hepáticas foram observados em doses mais altas. Conclui-se que o extrato bruto de O. vulgare pode conter metabólitos secundários benéficos e, no futuro, pode ser explorado para a cura de doenças infecciosas.

Animais , Coelhos , Óleos Voláteis , Origanum , Anti-Infecciosos/toxicidade , Extratos Vegetais/toxicidade , Fígado , Antioxidantes
J Korean Med Sci ; 37(12): e95, 2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35347903


BACKGROUND: To evaluate the drug prescription patterns for men diagnosed with benign prostatic hyperplasia (BPH) in Korea. METHODS: We extracted the data of 3% of the national patient samples including men aged ≥ 40 years between 2012 and 2017 from the Health Insurance Review and Assessment database and investigated the drugs prescribed for men with the BPH code N40. Men with a diagnosis of BPH but not receiving treatment were excluded. The primary outcome was the drugs prescribed and the changes in drug prescription pattern over 6 years for men first diagnosed with BPH. RESULTS: Alpha blockers were the most commonly prescribed drugs in men with BPH, and tamsulosin was the most common. The proportion of prescriptions increased steadily. The number of prescriptions for anticholinergics (ACH) increased, but decreased with the start of mirabegron prescriptions in 2015. Prescriptions of mirabegron are increasing rapidly and replacing ACH. Based on the prescription pattern by drug category, alpha blocker monotherapy decreased, whereas combination therapies such as alpha blocker + 5-alpha-reductase inhibitors (5ARI), and alpha blocker + 5ARI + ACH increased steadily. As for the number of prescriptions by drug ingredient, tamsulosin monotherapy was the most common, and the combination therapy of tamsulosin and mirabegron increased. CONCLUSION: Alpha blockers were the most commonly prescribed drug for men first diagnosed with BPH in Korea from 2012 to 2017, and tamsulosin was the most common alpha blocker. Prescriptions of combination therapy and mirabegron are gradually increasing.

Sintomas do Trato Urinário Inferior , Hiperplasia Prostática , Adulto , Prescrições de Medicamentos , Humanos , Seguro Saúde , Sintomas do Trato Urinário Inferior/tratamento farmacológico , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/complicações , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/tratamento farmacológico , Tansulosina/uso terapêutico
Gen Psychiatr ; 35(1): e100751, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35372787


China's population has rapidly aged over the recent decades of social and economic development as neurodegenerative disorders have proliferated, especially Alzheimer's disease (AD) and related dementias (ADRD). AD's incidence rate, morbidity, and mortality have steadily increased to make it presently the fifth leading cause of death among urban and rural residents in China and magnify the resulting financial burdens on individuals, families and society. The 'Healthy China Action' plan of 2019-2030 promotes the transition from disease treatment to health maintenance for this expanding population with ADRD. This report describes related epidemiological trends, evaluates the economic burden of the disease, outlines current clinical diagnosis and treatment status and delineates existing available public health resources. More specifically, it examines the public health impact of ADRD, including prevalence, mortality, costs, usage of care, and the overall effect on caregivers and society. In addition, this special report presents technical guidance and supports for the prevention and treatment of AD, provides expertise to guide relevant governmental healthcare policy development and suggests an information platform for international exchange and cooperation.

Forensic Sci Int Genet ; 57: 102657, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34973558


In recent years, extraordinary progress has been made in genome sequencing technologies, which has led to a decrease in cost and an increase in the diversity of sequenced genomes. Nanopore sequencing is one of the latest genome sequencing technologies. It aims to sequence longer contiguous pieces of DNA, which are essential for resolving structurally complex regions, and provides a new approach for forensic genetics to detect longer markers in real time. To date, multiple studies have been conducted to sequence forensic markers using MinION from Oxford Nanopore Technologies (ONT), and the results indicate that nanopore sequencing holds promise for forensic applications. Qitan Technology (QitanTech) recently launched its first commercial nanopore genome sequencer, QNome. It could achieve a read length of more than 150 kbp, and could generate approximately 500 Mb of data in 8 h. In this pilot study, we explored and validated this alternative nanopore sequencing device for microhaplotype (MH) profiling using a custom set of 15 MH loci. Seventy single-contributor samples were divided into 7 batches, each of which included 10 samples and control DNA 9947A and was sequenced by QNome. MH genotypes generated from QNome were compared to those from Ion Torrent sequencing (Ion S5XL system) to evaluate the accuracy and stability. Twelve samples randomly selected from the last three batches and Control DNA 9947A were also subjected to ONT MinION sequencing (with R9.4 flow cell) for parallel comparison. Based on MHtyper, a bioinformatics workflow developed for automated MH designation, all MH loci can be genotyped and reliably phased using the QNome data, with an overall accuracy of 99.83% (4 errors among 2310 genotypes). Three occurred near or in the region of homopolymer sequences, and one existed within 50 bp of the start of the sequencing reaction. In the last 15 samples (12 individual samples and 3 replicates of control DNA 9947A), two SNPs located at 4-mer homopolymers failed to obtain reliable genotypes on the MinION data. This study shows the potential of state-of-the-art nanopore sequencing methods to analyze forensic MH markers. Given the rapid pace of change, sporadic and nonrepetitive errors presented in this study are expected to be resolved by further developments of nanopore technologies and analysis tools.

Sequenciamento por Nanoporos , Nanoporos , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Projetos Piloto , Análise de Sequência de DNA/métodos
Front Psychol ; 13: 860204, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35369272


The global progress empowers the development of new business and expansion of existing business. The availability of sufficient accounting professional are necessary to manage and document the business activities. However, youth are less inclined to purse accounting as profession to keep the progress of global and local economic development. The current study aimed to explore the formation of the intention to pursue Certified Professional Accountancy Qualification (CPAQ) with factor of capabilities, career opportunities, job security with respect to the extended theory of planned behavior (TPB), i.e., attitude, subjective norms and perceived behavioral control. The study adopted a cross-sectional design and collected quantitative data from a total of 339 accounting students from Malaysia using an online survey. The finding revealed that capabilities and career opportunities influenced the students' intention to pursue CPAQ. Meanwhile, perceived behavioral control had significantly affect the students' decision to pursue CPAQ, which is in line with the TPB. The study concentrated on the importance of these factors in influencing the students' intention and decision to pursue CPAQ. The study offered vital implications for accounting educators and educational institutions to promote the accounting profession as choice and students engage in pursuing CPAQ. The Malaysian government should encourage and support accounting students financially for pursuing CPAQ by providing job security and enhancing subjective norms that may enable these students to complete the required professional qualifications. The study's limitations and future research opportunities are documented at the end of this article.

Rev. enferm. UERJ ; 30: e65662, jan. -dez. 2022.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1372342


Objetivo: identificar fatores associados à procura por pronto atendimento entre gestantes e puérperas com infecção pela COVID-19. Métodos: estudo transversal, com coleta de dados realizada entre agosto de 2021 e janeiro de 2022, baseado nas respostas de 258 mulheres que estiveram gestantes ou pariram durante a pandemia, após aprovação do Comitê de Ética em Pesquisa da instituição. Resultados: entre as entrevistadas, 27,1% tiveram COVID-19, sendo mais comumente relatados os sintomas perda de olfato e fadiga. A prevalência de procura por pronto atendimento foi de 30,4%, explicada por casos de maior gravidade, em que houve necessidade de internação (p < 0,001); portadoras de asma (p <0,001) e de hipertensão crônica (p <0,001). Conclusão: o Pronto atendimento foi o local de maior procura na presença dos sintomas, principalmente nos casos de maior gravidade e comorbidades, embora os resultados sejam divergentes das orientações constantes nos protocolos nacionais e internacionais voltados para assistência à população obstétrica.

Objective: to identify factors associated with demand for emergency health services from pregnant/puerperal women with COVID-19. Method: in this cross-sectional study, data were collected between August 2021 and January 2022 from the responses of 258 women who were pregnant or gave birth during the pandemic, after research ethics committee approval. Results: 27.1% of respondents had COVID-19, with loss of smell and fatigue being the most commonly reported symptoms. The highest prevalence of seeking emergency hospital care (30.4%) was accounted for by the more serious cases, who sought emergency care needing hospitalization (p < 0.001), patients with asthma (p < 0.001) and chronic hypertension (p < 0.001). Conclusion: the emergency facility was the service most accessed in the presence of symptoms, especially in cases of greater severity and comorbidities, although the results are at variance with the guidelines contained in national and international protocols on care for the obstetric population.

Objetivo: identificar los factores asociados a la búsqueda de servicios médicos de urgencia por embarazadas y puérperas con infección por COVID-19. Método: estudio transversal, cuya recolección de datos tuvo lugar entre agosto de 2021 y enero de 2022, a partir de las respuestas de 258 mujeres que estuvieron embarazadas o dieron a luz durante la pandemia, previa aprobación del Comité de Ética en Investigación de la Institución. Resultados: entre las encuestadas, el 27,1% tuvo COVID-19, siendo más comunes los síntomas como pérdida del olfato y cansancio. La prevalencia de búsqueda de atención en urgencias fue del 30,4%, explicada por casos de mayor gravedad, en los que hubo necesidad de hospitalización (p < 0,001); asma (p <0,001) e hipertensión crónica (p <0,001). Conclusión: el Servicio de Urgencias fue el lugar más buscado ante la presencia de síntomas, especialmente en los casos de mayor gravedad y comorbilidades, aunque los resultados sean divergentes de las directrices contenidas em los protocolos nacionales e internacionales dirigidos a la atención de la población obstétrica.

Yakugaku Zasshi ; 142(9): 951-963, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-36047222


The anticipation of Japan's decreased birthrate and a shift to an aged society has led to the field of medical care to review the country's social security system. The review calls for a reform of the medical insurance system under the universal health coverage system to fit the changing demographic. The target year of 2025 has the government advocating for an "integrated community care system", with the 'baby-boom generation' turning 75. This is a sustainable regional system that can cope with the aging society and the declining birthrate simultaneously. Within this new system, I would like to discuss The Strategic Plan of the Japan Pharmaceutical Association, released with the aim of realizing pharmacists and pharmacy services that can immediately respond to the expectations of society; from the perspective of the theme of this symposium, "Communicating the image of pharmacists in a community-based society".

Assistência Farmacêutica , Farmácia , Idoso , Humanos , Japão , Farmacêuticos
Biosystems ; : 104770, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36075549


This paper describes an evolutionary process likely involved in hierarchic transitions in biological evolution at many levels, from genetics to social organization. It is related to the evolutionary process described as contingent neutral evolution (CNE). It involves a sequence of stages initiated by the spontaneous appearance of functional redundancy. This redundancy can be the result of gene duplication, symbiosis, cell-cell interactions, environmental supports, etc. The availability of redundant sources of biological functionality relaxes purifying selection and allows degenerative changes to accumulate in one or more of the duplicates, potentially degrading or otherwise fractionating its function. This degeneration will be effectively neutral so long as another maintains functional integrity. Sexual recombination can potentially sample different combinations of these sub functional alternatives, with the result that favorable synergistic interactions between independently degenerate duplicates will have a non-negligible probability of being uncovered. The expression of such a synergistic combinatorial effect will result in the irreversible degradation of any remaining autonomous functionality, thereby initiating selection to prevent breakup of co-dependency. This becomes relevant to the evolution of hierarchic transitions when two or more organisms reciprocally duplicate functions that each other requires. If the resulting relaxation of selection reliably persists for an extended evolutionary period it will tend to produce complementary degenerative effects in each organism, leading to their irreversible codependency and purifying selection to avoid loss of integrity of their higher order functional unity. This provides a partial inversion of Darwinian logic that explains how the potential costs of the loss of organism autonomy can be mitigated, enabling the incremental transition to a synergistic higher order unit of evolution.

Indian J Psychiatr Soc Work ; 13(1): 18-26, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36059927


Background: Worldwide, COVID-19 pandemic lockdown lead to disruptions of general health services and neurological services in particular. Hence, it is essential to report to the scientific community regarding the nature and range of psychiatric social work services provided for neurology patients during the pandemic lockdown. Aim: To study the profile of patients availed psychiatric social work (PSW) consultation during pandemic lockdown at neurology in-patient setting. Materials and Methods: The study was retrospective in nature. Data were analysed from an in-patient referral registry. For the study purpose, neurological patients referred from April 2020 - June 2020 were considered. All patients referred for psychiatric social work consultations were included in the study. The study was carried out in tertiary care teaching hospital. Frequency and percentages were used to analyse the data. Results: The diagnostic profile revealed Stroke (40%), Guillain-Barré syndrome (10%), meningitis (10%), autoimmune encephalitis (4%), and demyelination (4%), other chronic neurological disorders (30%). Common psychiatric social work services provided were casework with caregivers and patients regarding education about the illness, breaking the bad news, grief interventions, supportive therapy, addressing child care issues, ensuring medication compliance and follow-up services, pre-discharge counselling, assessing socio-economic condition to facilitate financial assistance towards concession in hospital charges, facilitating social welfare benefits, and tracing the family members. Conclusion: Stroke, Guillain-Barré syndrome, neuro-infections were the most common neurological disorders required psychiatric social work consultations. Educating the patient and their family about the illness, facilitating welfare benefits and financial assistance were the most common psychiatric social work services provided during the covid-19 pandemic lockdown.

Rev Iberoam Autom Informa Ind ; 19(3): 297-308, 2022 Jun 29.
Artigo em Espanhol | MEDLINE | ID: mdl-36061621


Physical inactivity is a major contributor to morbidity and mortality worldwide. Many current physical activity behavioral interventions have shown limited success addressing the problem from a long-term perspective that includes maintenance. This paper proposes the design of a decision algorithm for a mobile and wireless health (mHealth) adaptive intervention that is based on control engineering concepts. The design process relies on a behavioral dynamical model based on Social Cognitive Theory (SCT), with a controller formulation based on hybrid model predictive control (HMPC) being used to implement the decision scheme. The discrete and logical features of HMPC coincide naturally with the categorical nature of the intervention components and the logical decisions that are particular to an intervention for physical activity. The intervention incorporates an online controller reconfiguration mode that applies changes in the penalty weights to accomplish the transition between the behavioral initiation and maintenance training stages. Controller performance is illustrated using an ARX model estimated from system identification data of a representative participant for Just Walk, a physical activity intervention designed on the basis of control systems principles.

Inquiry ; 59: 469580221121511, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36062304


The implications of population aging for economic growth is not only the shrinking working-age population, but also the increasing health care burden of the elderly population. It is difficult to explain clearly the relationship between a country's aging population and its economy without considering health effects. Based on the Solow economic growth model, the aims of this study are to estimate the economic effects of the health care burden for elderly population, and to access whether reducing effective labor input for economic production. The analysis employs a set of econometric approaches including fixed effects, generalized method of moments, instrumental variable, and mediation regression analyses using a multinational multi-database covering the years 2000-2019. The empirical evidence indicates that the health care burden was negatively correlated with economic growth during the study period, with every 1% increase in the health care burden leading to a 0.083% decrease in the GDP growth rate. The results of heterogeneity analysis and mediating analysis further confirmed that worsening health in the elderly population could be associated with the deceleration in economic development through the indirect pathway that lowering the employment rate of working-age population. This study provides new empirical evidence on the economic impact of population aging that the poor health of elderly population can be one critical factor of limiting economic growth, for the reason the labor inputs in household production are likely crowded out by family caregiving.

Fardo do Cuidador , Países em Desenvolvimento , Idoso , Envelhecimento , Emprego , Humanos , Dinâmica Populacional , Fatores Socioeconômicos
Syst Rev ; 11(1): 192, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064472


BACKGROUND: Long-term sick leave is a serious concern in developed countries and the cost of sickness absence and disability benefits cause major challenges for both the individual and society as a whole. Despite an increasing body of research reported by existing systematic reviews, there is uncertainty regarding the effect on return to work of workrelated interventions for workers with different diagnoses. The objective of this systematic review was to assess and summarize available research about the effects of work-related interventions for people on long-term sick leave and those at risk of long-term sick leave. METHODS: We conducted a systematic review in accordance with international guidelines. Campbell Collaboration (Area: Social Welfare), Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Embase, Epistemonikos, MEDLINE, PsycINFO, Scopus, and Sociological Abstracts were systematically searched in March 2021. Two authors independently screened the studies. We conducted risk of bias assessments and meta-analyses of the available evidence in randomized controlled trials (RCTs). The remaining comparisons were synthesized narratively. The certainty of evidence for each outcome was assessed. RESULTS: We included 20 RCTs comprising 5753 participants at baseline from 4 different countries. The studies had generally low risk of bias. Our certainty in the effect estimates ranged from very low to moderate. Eight different interventions were identified. Meta-analysis revealed no statistically significant difference between multidisciplinary rehabilitation (MR) and usual care (US) (Risk Ratio [RR] 1.01; Confidence Interval [CI] 95% 0.70-1.48 at 12 months follow-up) and between MR and other active intervention (Risk Ratio [RR] 1.04; Confidence Interval [CI] 95% 0.86-1.25 at 12 months follow-up). Remaining intervention groups revealed marginal, or no effect compared to the control group. The results for the secondary outcomes (self-efficacy, symptom reduction, function, cost-effectiveness) showed varied and small effects in the intervention groups. CONCLUSION: Overall, the present data showed no conclusive evidence of which work-related intervention is most effective for return to work. However, a handful of potential interventions exist, that may contribute to a foundation for future research. Our findings support the need for adequately powered and methodologically strong studies.

Retorno ao Trabalho , Licença Médica , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
Arch Public Health ; 80(1): 202, 2022 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-36064615


BACKGROUND: Little research has explored the sexual and reproductive health (SRH) experience of female sex workers (FSW), including girls aged < 18 years who are commercially sexually exploited (CSE), in Papua New Guinea (PNG). This paper describes the SRH history of FSW and CSE girls and factors associated with their use of moderately or highly effective contraceptive methods in three settings in PNG. METHODS: From 2016 to 2017, respondent-driven sampling (RDS) surveys were conducted among FSW and CSE girls in Port Moresby, Lae, and Mt. Hagen. FSW and CSE girls who were born female, aged ≥12 years, sold or exchanged vaginal sex in the past 6 months, spoke English or Tok Pisin, and had a valid RDS study coupon were eligible to participate. Interviews were conducted face-to-face and participants were offered rapid routine HIV and syphilis testing. Survey logistic regression procedures were used to identify factors associated with the use of moderately or highly effective contraceptive methods. Weighted data analysis was conducted. RESULTS: A total of 2901 FSW and CSE girls (Port Moresby, 673; Lae, 709; and Mt. Hagen, 709) were enrolled. The proportion using moderately or highly effective contraceptive methods was 37.7% in Port Moresby, 30.9% in Lae, and 26.5% in Mt. Hagen. After adjusting for covariates, factors significantly associated with the use of moderately or highly effective contraceptive methods in Port Moresby were being age 20-24, being married, being divorced or separated, having one or more dependent children, being away from home for more than 1 month in the last 6 months, and having tested HIV negative. No factors were significantly associated in Lae or Mt. Hagen. ANC attendance amongst FSW and CSE girls who gave birth in last 3 years was highest in Port Moresby at 91.2%. HIV testing was inconsistently and inadequately offered at ANC across the three cities. CONCLUSIONS: Kauntim mi tu provides much-needed insight into the SRH experiences of FSW and CSE girls in PNG, where their use of moderately or highly effective contraceptive methods is low. We hope to shed light on the complicated reality they face due to illegality of sex work and multitude of complex healthcare experiences.

J Eat Disord ; 10(1): 133, 2022 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-36068623


OBJECTIVE: Technological and economic globalisation has been suggested as a cause of increasing rates of body dissatisfaction and eating disorders globally, especially as regards the impact of mass media on internalised body ideals. This process is rarely observed in action, however. The current work investigates multiple aspects of body ideals, body image, sociocultural attitudes and eating attitudes in 62 Creole and Mestizo women living in communities at differing stages of technological development on the Caribbean coast of Nicaragua METHOD/RESULTS: In Study 1, women used 3D avatar software to create their own 'ideal' body without the constraints of ready-made stimuli. Analyses of resulting avatars showed that components of the ideal body shape (upper and lower body curvaceousness) but not body size (body mass) were associated with levels of film and television consumption. In Study 2, women completed measures of variables in the sociocultural model of eating disorder risk. As expected, body dissatisfaction mediated the relationship between internalisation of sociocultural body ideals and pathological eating attitudes. In contrast, body appreciation reduced pathological eating attitudes, via reduced body dissatisfaction. Finally, Study 3 measured sociocultural influences, body image and eating attitudes at 2 or 3 timepoints per woman; body dissatisfaction covaried with pathological eating attitudes across time. Ethnicity varied in its effects across studies. DISCUSSION: Together these data show that even at early stages of media acculturation, women may show similar patterns of association between sociocultural internalisation, body dissatisfaction and eating disorder risk as in high income nations. However, they also demonstrate unique aspects of this population's body shape ideals, and the independent protective effect of body appreciation.

Body dissatisfaction and eating disorders are increasing on a global scale. It has been suggested that increasing access to globalised media maybe one factor in rising risk of eating disorders in low- and middle-income countries. We examined 3-dimensional body ideals, body satisfaction, and eating disorder risk in a population with relatively recent access to mass media. We find that although women in these communities maintain higher body weight ideals, and greater body appreciation, than Western women, those women who are internalising globalised cultural messaging about appearance are at greater risk of body dissatisfaction and, in turn, increased risk of eating disorders. This was true both when comparing between women and looking at how individual women's attitudes varied over time. These data show that cultural messaging about appearance has implications for body image and eating disorder risk even in populations which do not have a long history of promoting thin ideals.