RESUMO
The public-private partnership (PPP) paradigm emerged as a form of global health governance in the mid-1990s to overcome state and market failures constraining access to essential medicines among populations with limited purchasing power in low- and middle-income countries. PPPs are now ubiquitous across the development spectrum. Yet while the narrative that the private sector must be engaged if complex health challenges are to be overcome is now dominant in development discourse, it does not yet appear to be shaping government approaches to addressing health inequalities within high-income welfare states such as Canada. This is significant as both the actions and inactions of firms factor heavily into why low-income Canadians face a disproportionate risk of developing diet-associated chronic diseases, such as type II diabetes. In the same ways PPPs have been an effective policy tool for strengthening public health in poor countries, this paper illuminates how the PPP model may have utility for mitigating poverty-associated food insecurity giving rise to diet-associated non-communicable diseases within the context of wealthy states.
Assuntos
Doença Crônica/economia , Dieta/efeitos adversos , Abastecimento de Alimentos/economia , Saúde Global/economia , Disparidades nos Níveis de Saúde , Parcerias Público-Privadas/economia , Seguridade Social/economia , Canadá , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Países Desenvolvidos/economia , Países Desenvolvidos/estatística & dados numéricos , Países em Desenvolvimento/economia , Países em Desenvolvimento/estatística & dados numéricos , Dieta/economia , Dieta/normas , Abastecimento de Alimentos/normas , Saúde Global/estatística & dados numéricos , Humanos , Modelos Organizacionais , Pobreza , Parcerias Público-Privadas/organização & administração , Seguridade Social/legislação & jurisprudênciaAssuntos
Antioxidantes/uso terapêutico , Atrofia Geográfica/tratamento farmacológico , Luteína/uso terapêutico , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/tratamento farmacológico , Xantofilas/uso terapêutico , Administração Oral , Ácido Ascórbico/uso terapêutico , Método Duplo-Cego , Quimioterapia Combinada , Atrofia Geográfica/fisiopatologia , Gluconatos/uso terapêutico , Humanos , Pessoa de Meia-Idade , Oligoelementos/uso terapêutico , Resultado do Tratamento , Vitamina E/uso terapêutico , Degeneração Macular Exsudativa/fisiopatologia , Zeaxantinas , Óxido de Zinco/uso terapêuticoRESUMO
Restrictions on nematicide usage underscore the need for novel control strategies for plant pathogenic nematodes such as Globodera pallida (potato cyst nematode) that impose a significant economic burden on plant cultivation activities. The nematode neuropeptide signalling system is an attractive resource for novel control targets as it plays a critical role in sensory and motor functions. The FMRFamide-like peptides (FLPs) form the largest and most diverse family of neuropeptides in invertebrates, and are structurally conserved across nematode species, highlighting the utility of the FLPergic system as a broad-spectrum control target. flp-32 is expressed widely across nematode species. This study investigates the role of flp-32 in G. pallida and shows that: (i) Gp-flp-32 encodes the peptide AMRNALVRFamide; (ii) Gp-flp-32 is expressed in the brain and ventral nerve cord of G. pallida; (iii) migration rate increases in Gp-flp-32-silenced worms; (iv) the ability of G. pallida to infect potato plant root systems is enhanced in Gp-flp-32-silenced worms; (v) a novel putative Gp-flp-32 receptor (Gp-flp-32R) is expressed in G. pallida; and, (vi) Gp-flp-32R-silenced worms also display an increase in migration rate. This work demonstrates that Gp-flp-32 plays an intrinsic role in the modulation of locomotory behaviour in G. pallida and putatively interacts with at least one novel G-protein coupled receptor (Gp-flp-32R). This is the first functional characterisation of a parasitic nematode FLP-GPCR.
Assuntos
FMRFamida/genética , Inativação Gênica , Proteínas de Helminto/genética , Receptores Acoplados a Proteínas G/genética , Solanum tuberosum/parasitologia , Tylenchoidea/fisiologia , Sequência de Aminoácidos , Animais , Sequência de Bases , Sistema Nervoso Central/anatomia & histologia , Sistema Nervoso Central/metabolismo , FMRFamida/metabolismo , Proteínas de Helminto/metabolismo , Interações Hospedeiro-Patógeno/genética , Ligantes , Moduladores de Transporte de Membrana/metabolismo , Dados de Sequência Molecular , Movimento , Doenças das Plantas/parasitologia , RNA Interferente Pequeno/genética , Receptores Acoplados a Proteínas G/metabolismo , Transdução de Sinais , Solanum tuberosum/metabolismoRESUMO
OBJECTIVES: To determine whether the daily use of 5% tea tree oil (TTO) body wash (Novabac 5% Skin Wash) compared with standard care [Johnson's Baby Softwash (JBS)] had a lower incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonization. PATIENTS: The study setting was two intensive care units (ICUs; mixed medical, surgical and trauma) in Northern Ireland between October 2007 and July 2009. The study population comprised 391 patients who were randomized to JBS or TTO body wash. METHODS: This was a Phase 2/3, prospective, open-label, randomized, controlled trial. TRIAL REGISTRATION: ISRCTN65190967. The primary outcome was new MRSA colonization during ICU stay. Secondary outcomes included the incidence of MRSA bacteraemia and maximum increase in sequential organ failure assessment score. RESULTS: A total of 445 patients were randomized to the study. After randomization, 54 patients were withdrawn; 30 because of a positive MRSA screen at study entry, 11 due to lack of consent, 11 were inappropriately randomized and 2 had adverse reactions. Thirty-nine (10%) patients developed new MRSA colonization (JBS nâ=â22, 11.2%; TTO body wash nâ=â17, 8.7%). The difference in percentage colonized (2.5%, 95% CI -â8.95 to 3.94; Pâ=â0.50) was not significant. The mean maximum increase in sequential organ failure assessment score was not significant (JBS 1.44, SD 1.92; TTO body wash 1.28, SD 1.79; Pâ=â0.85) and no study patients developed MRSA bacteraemia. CONCLUSIONS: Compared with JBS, TTO body wash cannot be recommended as an effective means of reducing MRSA colonization.
Assuntos
Antibacterianos/administração & dosagem , Portador Sadio/prevenção & controle , Desinfetantes/administração & dosagem , Desinfecção/métodos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Infecções Estafilocócicas/prevenção & controle , Óleo de Melaleuca/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/microbiologia , Bacteriemia/prevenção & controle , Portador Sadio/microbiologia , Estado Terminal , Feminino , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Irlanda do Norte , Resultado do TratamentoRESUMO
PURPOSE: To report the secondary outcomes in the Carotenoids with Coantioxidants in Age-Related Maculopathy trial. DESIGN: Randomized double-masked placebo-controlled clinical trial (registered as ISRCTN 94557601). PARTICIPANTS: Participants included 433 adults 55 years of age or older with early age-related macular degeneration (AMD) in 1 eye and late-stage disease in the fellow eye (group 1) or early AMD in both eyes (group 2). INTERVENTION: An oral preparation containing lutein (L), zeaxanthin (Z), vitamin C, vitamin E, copper, and zinc or placebo. Best-corrected visual acuity (BCVA), contrast sensitivity (CS), Raman spectroscopy, stereoscopic colour fundus photography, and serum sampling were performed every 6 months with a minimum follow-up time of 12 months. MAIN OUTCOME MEASURES: Secondary outcomes included differences in BCVA (at 24 and 36 months), CS, Raman counts, serum antioxidant levels, and progression along the AMD severity scale (at 12, 24, and 36 months). RESULTS: The differential between active and placebo groups increased steadily, with average BCVA in the former being approximately 4.8 letters better than the latter for those who had 36 months of follow-up, and this difference was statistically significant (P = 0.04). In the longitudinal analysis, for a 1-log-unit increase in serum L, visual acuity was better by 1.4 letters (95% confidence interval, 0.3-2.5; P = 0.01), and a slower progression along a morphologic severity scale (P = 0.014) was observed. CONCLUSIONS: Functional and morphologic benefits were observed in key secondary outcomes after supplementation with L, Z, and coantioxidants in persons with early AMD.
Assuntos
Antioxidantes/uso terapêutico , Luteína/uso terapêutico , Degeneração Macular/tratamento farmacológico , Xantofilas/uso terapêutico , Administração Oral , Idoso , Idoso de 80 Anos ou mais , Ácido Ascórbico/sangue , Ácido Ascórbico/uso terapêutico , Sensibilidades de Contraste/fisiologia , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Fluorometria , Humanos , Luteína/sangue , Degeneração Macular/sangue , Degeneração Macular/fisiopatologia , Masculino , Espectrometria de Massas , Pessoa de Meia-Idade , Análise Espectral Raman , Comprimidos , Oligoelementos/uso terapêutico , Resultado do Tratamento , Acuidade Visual/fisiologia , Vitamina E/sangue , Vitamina E/uso terapêutico , Xantofilas/sangue , ZeaxantinasRESUMO
Folk wisdom asserts that "the eyes are the window to the soul," and empirical science corroborates a prominent role for the eyes in the communication of emotion. Herein we examine variation in the ability to "read" the eyes of others as a function of social group membership, employing a widely used emotional state decoding task: "Reading the Mind in Eyes." This task has documented impaired emotional state decoding across racial groups, with cross-race performance on par with that previously reported as a function of autism spectrum disorders. The present study extended this work by examining the moderating role of social identity in such impairments. For college students more highly identified with their university, cross-race performance differences were not found for judgments of "same-school" eyes but remained for "rival-school" eyes. These findings suggest that impaired emotional state decoding across groups may thus be more amenable to remediation than previously realized.
Assuntos
Emoções , Autoimagem , Identificação Social , Adolescente , Expressão Facial , Feminino , Humanos , Relações Interpessoais , Masculino , Comunicação não Verbal , Adulto JovemRESUMO
Age-related macular degeneration (AMD), is the leading cause of blind registration in the Western World among individuals 65 years or older. Early AMD, a clinical state without overt functional loss, is said to be present clinically when yellowish deposits known as drusen and/or alterations of fundus pigmentation are seen in the macular retina. Although the etiopathogenesis of AMD remains uncertain, there is a growing body of evidence in support of the view that cumulative oxidative damage plays a causal role. Appropriate dietary antioxidant supplementation is likely to be beneficial in maintaining visual function in patients with AMD, and preventing or delaying the progression of early AMD to late AMD. The Carotenoids in Age-Related Maculopathy (CARMA) Study is a randomized and double-masked clinical trial of antioxidant supplementation versus placebo in 433 participants with either early AMD features of sufficient severity in at least one eye or any level of AMD in one eye with late AMD (neovascular AMD or central geographic atrophy) in the fellow eye. The aim of the CARMA Study is to investigate whether lutein and zeaxanthin, in combination with co-antioxidants (vitamin C, E, and zinc), has a beneficial effect on visual function and/or prevention of progression from early to late stages of disease. The primary outcome is improved or preserved distance visual acuity at 12 months. Secondary outcomes include improved or preserved interferometric acuity, contrast sensitivity, shape discrimination ability, and change in AMD severity as monitored by fundus photography. This article outlines the CARMA Study design and methodology, including its rationale.