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1.
Immunol Cell Biol ; 102(2): 79-84, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38135277

RESUMO

This Commentary article reviews the history of veterinary immunology in Australia from the 1980s and discusses the key people and areas of research during this period.


Assuntos
Alergia e Imunologia , Medicina Veterinária , Austrália , Medicina Veterinária/história , Alergia e Imunologia/história , História do Século XX
2.
Eur Child Adolesc Psychiatry ; 32(7): 1305-1316, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35064828

RESUMO

We investigated risk and facilitating factors related to families' change in finances and employment over 5 years following adoption of a child from local authority care in a prospective, longitudinal study of children placed for adoption between 2014 and 2015 (N = 96). Parents completed questionnaires at approximately 5, 21, 36, 48 and 60 months post-placement. We used time series analysis to examine the impact of child (e.g. pre-placement experiences, mental health), family structure (e.g. number of siblings, parent relationship status), and parent (e.g. mental health) factors on change in household income and parent employment status after adoption. We also examined the tendency for parents to comment on employment and finances and the emotional valence of their comments to gauge their concern about their circumstances. Children's mental health problems were associated with primary caregivers reducing their time spent in employment and parents' tendency to comment on their financial and work circumstances. Children who experienced more moves in care were more likely to have a primary caregiver not in full-time work, as were children with higher prosocial behaviour scores. Being in full-time work was associated with parents' symptoms of anxiety. We also detected associations between structural features of the family and changes in income and employment. This study represents one of the first empirical investigations of factors associated with the socioeconomic features of adoptive families' lives and informs ongoing discussion regarding the support needs of families and the timing, nature, and delivery of post-adoption professional services.


Assuntos
Emprego , Pais , Criança , Humanos , Estudos Longitudinais , Estudos Prospectivos , Pais/psicologia , Saúde Mental
3.
Eur Child Adolesc Psychiatry ; 30(5): 721-732, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32468437

RESUMO

Children adopted from the public care system are likely to experience a cluster of inter-related risk factors that may place them on a trajectory of mental health problems that persist across the life course. However, the specific effects of putative risk factors on children's mental health post-placement are not well understood. We conducted a prospective, longitudinal study of children placed for adoption between 2014 and 2015 (N = 96). Adoptive parents completed questionnaires at approximately 5, 21, 36, and 48 months post-placement. We used time series analysis to examine the impact of pre-adoptive risk factors [adverse childhood experiences [ACEs], number of moves, days with birth parents and in care] on children's internalizing and externalizing problems, and prosocial behavior over 4 years post-placement. Adoptees' internalizing and externalizing problems remained consistently high over the 4-year study period, but more ACEs predicted increases in internalizing and externalizing problems. Contrary to expectations, more pre-placement moves and time in care predicted fewer problems over time, but exploratory analyses of interactive effects revealed this was only the case in rare circumstances. We identify pre- and post-removal factors that may incur benefits or have a deleterious impact on adoptees' outcomes in post-adoptive family life. Our findings provide knowledge for front-line professionals in the support of adoptive families and underscore the vital need for effective early intervention.


Assuntos
Adoção/psicologia , Experiências Adversas da Infância/psicologia , Emoções/fisiologia , Comportamento Problema/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários
4.
AJR Am J Roentgenol ; 200(6): 1238-43, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23701059

RESUMO

OBJECTIVE: The purpose of this study was to determine whether an autologous intraparenchymal blood patch reduces the rate of pneumothorax and the rate of pneumothorax requiring chest tube placement after percutaneous lung biopsy. SUBJECTS AND METHODS: A prospective randomized controlled trial enrolling 242 patients was conducted. Adult patients undergoing percutaneous biopsy of lung or mediastinal lesions of undetermined cause were candidates. Patients were excluded if aerated lung tissue was not crossed during the biopsy. A standard biopsy procedure was followed for all patients until an adequate tissue sample was obtained. Patients were then randomized. For patients randomized to the treatment group, an intraparenchymal blood patch was administered through the guiding needle on removal. The same postbiopsy procedures were followed for both the treatment and control groups. Data collected included development of pneumothorax and placement of a chest tube. RESULTS: The rate of pneumothorax was reduced from 35% to 26% (p = 0.12) with the use of the blood patch, but the reduction was not significant. The rate of pneumothorax requiring chest tube placement was significantly reduced from 18% to 9% (p = 0.048). There was a greater benefit in the blood patch group when a 19-gauge guiding needle was used: Pneumothorax requiring chest tube placement was reduced from 19% to 3% whereas an increase from 16% to 20% was seen with a 17-gauge needle (p = 0.029). CONCLUSION: The use of an autologous intraparenchymal blood patch significantly reduces the rate of pneumothorax requiring chest tube placement. It seems to be more beneficial when a 19-gauge guiding needle is used.


Assuntos
Biópsia por Agulha/efeitos adversos , Tubos Torácicos , Pleurodese/métodos , Pneumotórax/prevenção & controle , Idoso , Distribuição de Qui-Quadrado , Feminino , Humanos , Modelos Logísticos , Masculino , Pleurodese/instrumentação , Estudos Prospectivos , Interpretação de Imagem Radiográfica Assistida por Computador , Radiografia Intervencionista , Estatísticas não Paramétricas , Tomografia Computadorizada por Raios X
5.
3D Print Med ; 4(1): 15, 2018 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-30649656

RESUMO

OBJECTIVES: The purpose was to create a time sequential three-dimensional virtual reality model, also referred to as a four-dimensional model, to explore its possible benefit and clinical applications. We hypothesized that this novel solution allows for the visuospatial benefits of the 3D model and the dynamic benefits of other existing imaging modalities. BACKGROUND: We have seen how 3D models hold great value in medical decision making by eliminating the variable visuospatial skills of practitioners. They have proved especially invaluable concerning the correction of congenital heart defects and have altered the course of many surgeries. There are, however, limitations to three-dimensional models. The static models only show what the heart looks like in one snapshot of its cycle and do not allow for an understanding of the physiological and dynamic processes. METHODS: This solution segments a 3D heart derived from a 2D image stack, times the 18 phases of a cardiac cycle and creates a 4D model that can be manipulated in space and time through the use of virtual reality. RESULTS: We believe the 4D heart provides a unique understanding of in situ cardiac anatomy not possible with other imaging techniques. Our expanding case series of clinician experiences and their immediate recognition of the potency of this technique is highly encouraging and reveals the future of functional and dynamic 4D representations of anatomy. CONCLUSIONS: The 4D heart improved our understanding around complex 3D relationships over time. We propose time and effort dedicated to 4D cardiac imaging analysis of dynamic cardiac pathologies such as hypertrophic obstructive cardiomyopathy or a pre-op Rastelli repair with a narrow outflow tract could offer tremendous insight into the medical decision-making process.

6.
EGEMS (Wash DC) ; 3(1): 1195, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26793736

RESUMO

INTRODUCTION: Large-scale distributed data networks consisting of diverse stakeholders including providers, patients, and payers are changing health research in terms of methods, speed and efficiency. The Vaccine Safety Datalink (VSD) set the stage for expanded involvement of health plans in collaborative research. EXPANDING SURVEILLANCE CAPACITY AND PROGRESS TOWARD A LEARNING HEALTH SYSTEM: From an initial collaboration of four integrated health systems with fewer than 10 million covered lives to 16 diverse health plans with nearly 100 million lives now in the FDA Sentinel, the expanded engagement of health plan researchers has been essential to increase the value and impact of these efforts. The collaborative structure of the VSD established a pathway toward research efforts that successfully engage all stakeholders in a cohesive rather than competitive manner. The scientific expertise and methodology developed through the VSD such as rapid cycle analysis (RCA) to conduct near real-time safety surveillance allowed for the development of the expanded surveillance systems that now exist. BUILDING ON SUCCESS AND LESSONS LEARNED: These networks have learned from and built on the knowledge base and infrastructure created by the VSD investigators. This shared technical knowledge and experience expedited the development of systems like the FDA's Mini-Sentinel and the Patient Centered Outcomes Research Institute (PCORI)'s PCORnet. CONCLUSION: This narrative reviews the evolution of the VSD, its contribution to other collaborative research networks, longer-term sustainability of this type of distributed research, and how knowledge gained from the earlier efforts can contribute to a continually learning health system.

7.
Bone ; 81: 196-207, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26151121

RESUMO

Reduced functional loads cause adaptations in organs. In this study, temporal adaptations of bone-ligament-tooth fibrous joints to reduced functional loads were mapped using a holistic approach. Systematic studies were performed to evaluate organ-level and tissue-level adaptations in specimens harvested periodically from rats (N=60) given powder food for 6 months over 8,12,16,20, and 24 weeks. Bone-periodontal ligament (PDL)-tooth fibrous joint adaptation was evaluated by comparing changes in joint stiffness with changes in functional space between the tooth and alveolar bony socket. Adaptations in tissues included mapping changes in the PDL and bone architecture as observed from collagen birefringence, bone hardness and volume fraction in rats fed soft foods (soft diet, SD) compared to those fed hard pellets as a routine diet (hard diet, HD). In situ biomechanical testing on harvested fibrous joints revealed increased stiffness in SD groups (SD:239-605 N/mm) (p<0.05) at 8 and 12 weeks. Increased joint stiffness in early development phase was due to decreased functional space (at 8 weeks change in functional space was -33 µm, at 12 weeks change in functional space was -30 µm) and shifts in tissue quality as highlighted by birefringence, architecture and hardness. These physical changes were not observed in joints that were well into function, that is, in rodents older than 12 weeks of age. Significant adaptations in older groups were highlighted by shifts in bone growth (bone volume fraction 24 weeks: Δ-0.06) and bone hardness (8 weeks: Δ-0.04 GPa, 16 weeks: Δ-0.07 GPa, 24 weeks: Δ-0.06 GPa). The response rate (N/s) of joints to mechanical loads decreased in SD groups. Results from the study showed that joint adaptation depended on age. The initial form-related adaptation (observed change in functional space) can challenge strain-adaptive nature of tissues to meet functional demands with increasing age into adulthood. The coupled effect between functional space in the bone-PDL-tooth complex and strain-adaptive nature of tissues is necessary to accommodate functional demands, and is temporally sensitive despite joint malfunction. From an applied science perspective, we propose that adaptations are registered as functional history in tissues and joints.


Assuntos
Fenômenos Biomecânicos/fisiologia , Cemento Dentário/fisiologia , Articulações/fisiologia , Ligamento Periodontal/fisiologia , Dente/fisiologia , Animais , Masculino , Mastigação/fisiologia , Ratos , Ratos Sprague-Dawley
8.
J Vis Exp ; (85)2014 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-24638035

RESUMO

This study demonstrates a novel biomechanics testing protocol. The advantage of this protocol includes the use of an in situ loading device coupled to a high resolution X-ray microscope, thus enabling visualization of internal structural elements under simulated physiological loads and wet conditions. Experimental specimens will include intact bone-periodontal ligament (PDL)-tooth fibrous joints. Results will illustrate three important features of the protocol as they can be applied to organ level biomechanics: 1) reactionary force vs. displacement: tooth displacement within the alveolar socket and its reactionary response to loading, 2) three-dimensional (3D) spatial configuration and morphometrics: geometric relationship of the tooth with the alveolar socket, and 3) changes in readouts 1 and 2 due to a change in loading axis, i.e. from concentric to eccentric loads. Efficacy of the proposed protocol will be evaluated by coupling mechanical testing readouts to 3D morphometrics and overall biomechanics of the joint. In addition, this technique will emphasize on the need to equilibrate experimental conditions, specifically reactionary loads prior to acquiring tomograms of fibrous joints. It should be noted that the proposed protocol is limited to testing specimens under ex vivo conditions, and that use of contrast agents to visualize soft tissue mechanical response could lead to erroneous conclusions about tissue and organ-level biomechanics.


Assuntos
Processo Alveolar/fisiologia , Ligamento Periodontal/fisiologia , Tomografia Computadorizada por Raios X/métodos , Dente/fisiologia , Animais , Fenômenos Biomecânicos , Ratos , Ratos Sprague-Dawley , Tomografia Computadorizada por Raios X/instrumentação
9.
J Biomech ; 46(3): 443-9, 2013 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-23219279

RESUMO

This study investigates bone-tooth association under compression to identify strain amplified sites within the bone-periodontal ligament (PDL)-tooth fibrous joint. Our results indicate that the biomechanical response of the joint is due to a combinatorial response of the constitutive properties of organic, inorganic, and fluid components. Second maxillary molars within intact maxillae (N=8) of 5-month-old rats were loaded with a µ-XCT-compatible in situ loading device at various permutations of displacement rates (0.2, 0.5, 1.0, 1.5, 2.0 mm/min) and peak reactionary load responses (5, 10, 15, 20 N). Results indicated a nonlinear biomechanical response of the joint, in which the observed reactionary load rates were directly proportional to displacement rates (velocities). No significant differences in peak reactionary load rates at a displacement rate of 0.2mm/min were observed. However, for displacement rates greater than 0.2mm/min, an increasing trend in reactionary rate was observed for every peak reactionary load with significant increases at 2.0mm/min. Regardless of displacement rates, two distinct behaviors were identified with stiffness (S) and reactionary load rate (LR) values at a peak load of 5 N (S(5 N)=290-523 N/mm) being significantly lower than those at 10 N (LR(5 N)=1-10 N/s) and higher (S(10 N-20 N)=380-684 N/mm; LR(10 N-20 N)=1-19 N/s). Digital image correlation revealed the possibility of a screw-like motion of the tooth into the PDL-space, i.e., predominant vertical displacement of 35 µm at 5 N, followed by a slight increase to 40 µm at 10 N and 50 µm at 20 N of the tooth and potential tooth rotation at loads above 10 N. Narrowed and widened PDL spaces as a result of tooth displacement indicated areas of increased apparent strains within the complex. We propose that such highly strained regions are "hot spots" that can potentiate local tissue adaptation under physiological loading and adverse tissue adaptation under pathological loading conditions.


Assuntos
Força Compressiva , Maxila/fisiopatologia , Modelos Biológicos , Dente Molar/fisiopatologia , Ligamento Periodontal/fisiopatologia , Estresse Fisiológico , Animais , Fenômenos Biomecânicos , Masculino , Maxila/patologia , Dente Molar/patologia , Ligamento Periodontal/patologia , Ratos , Ratos Sprague-Dawley
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