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1.
Article in English | MEDLINE | ID: mdl-38877849

ABSTRACT

BACKGROUND: Several studies suggest that patients often under-estimate their asthma symptoms and over-estimate their level of asthma control, potentially putting them at risk of undertreatment with inhaled corticosteroids. OBJECTIVE: To determine the association and correlation between patient symptom perception and asthma control. METHODS: A rapid literature review comprising searches in MEDLINE, Embase and Cochrane Library identified English language articles published between 2011-2021 that included a statistical measure of the association or correlation between perceptions of symptoms and asthma control in patients with asthma (adults and/or children). [PROSPERO CRD42021230152]. The Joanna Briggs Institute (JBI) instrument was used for study quality appraisal. RESULTS: Of 22 identified studies, nine presented association data and 13 reported correlation analyses. Eight of nine association studies showed a discordance between patients perceived symptoms and level of asthma control or lung function; among these, patients more frequently overestimated their asthma control than they underestimated their asthma control. Of 10 studies reporting correlation coefficients, all reported a statistically significant correlation between increased symptoms and worse asthma control; however, the strength of the correlation was shown to be only weak or moderate in most studies (coefficients numerically ranged from 0.12 to 0.74). CONCLUSION: Many patients with asthma tend to overestimate their level of asthma control. Although more frequent or worse symptoms were shown to be statistically significantly correlated with worsening asthma control, there was wide variation in correlation strengths, most showing weak or moderate correlations. Research to further understand the reasons for patient symptom misperceptions are warranted.

2.
Am J Community Psychol ; 71(1-2): 3-7, 2023 03.
Article in English | MEDLINE | ID: mdl-36797981

ABSTRACT

This article introduces a special issue of the American Journal of Community Psychology that features racial reckoning, resistance and the revolution in the context of a syndemic, the historical subjugation of communities of Color (COC) to racial hierarchies and the coronavirus (COVID-19). More specifically, this special issue underscores the need for community psychology and other allied disciplines to address this syndemic facing COC. The special issue delivers on the stories of the lived experiences from researchers and community members as it relates to COVID-19 and COC. Twelve articles are illuminated to challenge the field to create social change.


Subject(s)
COVID-19 , Community Psychiatry , Racial Groups , Humans , COVID-19/ethnology , Racial Groups/psychology , Racial Groups/statistics & numerical data , United States/epidemiology , Social Change , Health Status Disparities , Male , Female , Adolescent , Young Adult , Adult
3.
Exp Eye Res ; 221: 109129, 2022 08.
Article in English | MEDLINE | ID: mdl-35649469

ABSTRACT

Preservation of retinal barrier function is critical to maintenance of retinal health. Therefore, it is not surprising that loss of barrier integrity is a pathologic feature common to degenerative retinal diseases such as diabetic retinopathy. Our prior studies demonstrate the importance of hydroxycarboxylic acid receptor 2/GPR109A (HCAR2/GPR109A) expression in the retinal pigment epithelium (RPE) to outer retinal barrier integrity. However, whether HCAR2/GPR109A is expressed in retinal endothelial cells and has a similar relationship to inner blood retinal barrier regulation is not known. In the current study, we examined relevance of receptor expression to endothelial cell dependent-blood retinal barrier integrity. siRNA technology was used to modulate HCAR2/GPR109A expression in human retinal endothelial cells (HRECs). Cells were cultured in the presence or absence of VEGF, a pro-inflammatory stimulus, and/or various concentrations of the HCAR2/GPR109A-specific agonist beta-hydyroxybutyrate (BHB). HCAR2/GPR109A expression was monitored by qPCR and electrical cell impedance sensing (ECIS) was used to evaluate barrier function. Complementary in vivo studies were conducted in wildtype and HCAR2/GPR109A knockout mice treated intraperitoneally with lipopolysaccharide and/or BHB. Vascular leakage was monitored using fluorescein angiography and Western blot analyses of albumin extravasation. Additionally, retinal function was evaluated by OptoMotry. Decreased (siRNA knockdown) or absent (gene knockout) HCAR2/GPR109A expression was associated with impaired barrier function both in vitro and in vivo. BHB treatment provided some protection, limiting disruptions in retinal barrier integrity and function; an effect that was found to be receptor (HCAR2/GPR109A)-dependent. Collectively, the present studies support a key role for HCAR2/GPR109A in regulating blood-retinal barrier integrity and highlight the therapeutic potential of the receptor toward preventing and treating retinal diseases such as diabetic retinopathy in which compromised barrier function is paramount.


Subject(s)
Diabetic Retinopathy , Receptors, G-Protein-Coupled , Retinal Diseases , Animals , Blood-Retinal Barrier/metabolism , Carrier Proteins/metabolism , Diabetic Retinopathy/metabolism , Endothelial Cells/metabolism , Ketones/metabolism , Ketones/therapeutic use , Mice , RNA, Small Interfering/therapeutic use , Receptors, G-Protein-Coupled/genetics , Receptors, G-Protein-Coupled/metabolism , Retinal Diseases/metabolism
4.
BMC Vet Res ; 18(1): 124, 2022 Apr 01.
Article in English | MEDLINE | ID: mdl-35365153

ABSTRACT

BACKGROUND: Coronaviruses have the potential to cross species barriers. To learn the molecular intersections among the most common coronaviruses of domestic and close-contact animals, we analyzed representative coronavirus genera infecting mouse, rat, rabbit, dog, cat, cattle, white-tailed deer, swine, ferret, mink, alpaca, Rhinolophus bat, dolphin, whale, chicken, duck and turkey hosts; reference or complete genome sequences were available for most of these coronavirus genera. Protein sequence alignments and phylogenetic trees were built for the spike (S), envelope (E), membrane (M) and nucleocapsid (N) proteins. The host receptors and enzymes aminopeptidase N (APN), angiotensin converting enzyme 2 (ACE2), sialic acid synthase (SAS), transmembrane serine protease 2 (TMPRSS2), dipeptidyl peptidase 4 (DPP4), cathepsin L (and its analogs) and furin were also compared. RESULTS: Overall, the S, E, M, and N proteins segregated according to their viral genera (α, ß, or γ), but the S proteins of alphacoronaviruses lacked conservation of phylogeny. Interestingly, the unique polybasic furin cleavage motif found in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) but not in severe acute respiratory syndrome coronavirus (SARS-CoV) or Middle East respiratory syndrome coronavirus (MERS-CoV) exists in several ß-coronaviruses and a few α- or γ-coronaviruses. Receptors and enzymes retained host species-dependent relationships with one another. Among the hosts, critical ACE2 residues essential for SARS-CoV-2 spike protein binding were most conserved in white-tailed deer and cattle. CONCLUSION: The polybasic furin cleavage motif found in several ß- and other coronaviruses of animals points to the existence of an intermediate host for SARS-CoV-2, and it also offers a counternarrative to the theory of a laboratory-engineered virus. Generally, the S proteins of coronaviruses show crossovers of phylogenies indicative of recombination events. Additionally, the consistency in the segregation of viral proteins of the MERS-like coronavirus (NC_034440.1) from pipistrelle bat supports its classification as a ß-coronavirus. Finally, similarities in host enzymes and receptors did not always explain natural cross-infections. More studies are therefore needed to identify factors that determine the cross-species infectivity of coronaviruses.


Subject(s)
COVID-19 , Cattle Diseases , Deer , Dog Diseases , Middle East Respiratory Syndrome Coronavirus , Rodent Diseases , Swine Diseases , Animals , COVID-19/veterinary , Cattle , Dogs , Ferrets , Mice , Middle East Respiratory Syndrome Coronavirus/genetics , Phylogeny , Rabbits , Rats , SARS-CoV-2 , Spike Glycoprotein, Coronavirus , Swine
5.
Rev Med Chil ; 150(1): 23-32, 2022 Jan.
Article in Spanish | MEDLINE | ID: mdl-35856962

ABSTRACT

BACKGROUND: It is imperative to have effective programs to improve or maintain the health of aged people. AIM: To evaluate the effectiveness of an intervention based on a multidimensional program in Senior centers in Chile five months after its implementation, in the domains of physical and mental health, functionality and quality of life in aged people. MATERIAL AND METHODS: Sixty participants older than 60 years completed a multidimensional program for one month that included interventions of guided physical exercises, in addition to educational and social activities. They were evaluated at baseline and one and five months after the intervention. RESULTS: After the first and fifth months, significant improvements were observed in the five times sit to stand test (5TSTS) and gait speed (WST), in addition, significant improvements were observed in literacy measured by the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). At the fifth month, slight improvements were observed in the Yesavage and short Falls efficacy scales, Barthel index, Unipodal Station and EuroQol five-dimensional quality of life tests. CONCLUSIONS: A multidimensional program for aged people lasting one month, improved the physical health dimension and literacy by the fifth month of evaluation.


Subject(s)
Quality of Life , Senior Centers , Adult , Aged , Chile , Educational Status , Exercise/psychology , Humans
6.
Rev Med Chil ; 150(3): 381-390, 2022 Mar.
Article in Spanish | MEDLINE | ID: mdl-36156723

ABSTRACT

BACKGROUND: The Learning Environment (LE) influences the performance of students, learning, social life, mental health, and the future of work. AIM: To assess the learning environment (LE) among medical residents of 64 specialties. MATERIAL AND METHODS: Two validated instruments "Postgraduate Hospital Education Environment Measure" (PHEEM) and "Ambulatory Care Learning Educational Environment" (ACLEEM), and open questions were answered online by 1259 residents from 15 universities. A descriptive and analytical statistical analysis and semantic deductive-inductive analyses of open questions were performed. RESULTS: LE was positive rather than negative (PHEEM of 100.5 points (79-116) and ACLEEM of 138.5 points (120-157)). An age over 32 years, male sex, studying in a private university, being in first year of residence and being in a non-surgical specialty were associated with a better PHEEM score (p < 0.05). For ACLEEM, the first year of specialty, a non-surgical specialty and studying in a private university were associated with better scores (p < 0.05). Two programs had excellent LE (Pathological Anatomy and Ophthalmology) and no specialty had a very poor performance or many problems. Aspects of teaching, clinical activities, and teachers were strengths reported by students. Aspects to improve were teaching, protected times and clinical activities. CONCLUSIONS: LE among medical specialties had more positive than negative features, but with areas that should be improved.


Subject(s)
Internship and Residency , Medicine , Adult , Chile , Education, Medical, Graduate , Hospitals, Teaching , Humans , Male , Perception , Surveys and Questionnaires , Universities
7.
J Community Psychol ; 50(6): 2537-2541, 2022 08.
Article in English | MEDLINE | ID: mdl-35567541

ABSTRACT

At the time of this special issue, coronavirus disease 2019 (COVID-19) is the leading cause of death in the United States and has contributed to millions of deaths worldwide. The world had no idea how the pandemic was going to impact our lives. COVID-19 exposed the inequities in our world and the individuals that were most impacted by it: vulnerable populations. Vulnerable populations may be defined as those living in poverty, living with disability, and racial, ethnic, sexual, and gender minorities. Additionally, as community psychologists we understand that the impact of inequities do not appear singlehandedly since as human beings we do not exist in a vacuum and there are multiple factors that create our level of health and well-being. Therefore, the idea of examining COVID-19 in a syndemic framework allows us to explore how a synergistic epidemic (i.e., the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions) exacerbates the prognosis and burden of disease, which can impact vulnerable populations simultaneously. The main goal of this special issue concentrates on how COVID-19 had a synergistic impact on vulnerable populations and how these populations reacted and coped with these events.


Subject(s)
COVID-19 , Humans , Pandemics , Racial Groups , SARS-CoV-2 , United States/epidemiology , Vulnerable Populations
8.
Environ Sci Technol ; 55(20): 13932-13941, 2021 10 19.
Article in English | MEDLINE | ID: mdl-34590828

ABSTRACT

Trophic magnification of cyclic volatile methyl siloxanes (cVMS) in a terrestrial food web was investigated by measuring concentrations of octamethylcyclotetrasiloxane (D4), decamethylcyclopentasiloxane (D5), and dodecamethylcyclohexasiloxane (D6) and two reference chemicals within air and biota samples from an avian food web located in a mixed urban-agricultural landscape. Terrestrial trophic magnification factors derived from lipid normalized concentrations (TMFLs) for D5 and D6 were 0.94 (0.17 SE) and 1.1 (0.23 SE) and not statistically different from 1 (p > 0.05); however, the TMFL of D4 was 0.62 (0.11 SE) and statistically less than 1 (p < 0.001). TMFLs of PCB-153 and p,p'-DDE were 5.6 (2.2 SE) and 6.1 (2.8 SE) and statistically greater than 1 (p < 0.001). TMFLs of cVMS in this terrestrial system were similar to those reported in aquatic systems. However, trophic magnification factors derived on a fugacity basis (TMFFs), which recognize differences in body temperature and lipid composition between organisms, were greater than corresponding TMFLs primarily because a temperature-induced thermodynamic biomagnification of hydrophobic chemicals occurs when endothermic organisms consume poikilothermic organisms. Therefore, we recommend that biomagnification studies of food webs including endothermic and poikilothermic organisms incorporate differences in body temperature and tissue composition to accurately characterize the biomagnification potential of chemicals.


Subject(s)
Food Chain , Water Pollutants, Chemical , Bioaccumulation , Body Temperature , Environmental Monitoring , Siloxanes/analysis , Temperature , Water Pollutants, Chemical/analysis
9.
Proc Natl Acad Sci U S A ; 114(50): 13248-13253, 2017 12 12.
Article in English | MEDLINE | ID: mdl-29180438

ABSTRACT

The potential therapeutic effects of agonistic analogs of growth hormone-releasing hormone (GHRH) and their mechanism of action were investigated in diabetic retinopathy (DR). Streptozotocin-induced diabetic rats (STZ-rats) were treated with 15 µg/kg GHRH agonist, MR-409, or GHRH antagonist, MIA-602. At the end of treatment, morphological and biochemical analyses assessed the effects of these compounds on retinal neurovascular injury induced by hyperglycemia. The expression levels of GHRH and its receptor (GHRH-R) measured by qPCR and Western blotting were significantly down-regulated in retinas of STZ-rats and in human diabetic retinas (postmortem) compared with their respective controls. Treatment of STZ-rats with the GHRH agonist, MR-409, prevented retinal morphological alteration induced by hyperglycemia, particularly preserving survival of retinal ganglion cells. The reverse, using the GHRH antagonist, MIA-602, resulted in worsening of retinal morphology and a significant alteration of the outer retinal layer. Explaining these results, we have found that MR-409 exerted antioxidant and anti-inflammatory effects in retinas of the treated rats, as shown by up-regulation of NRF-2-dependent gene expression and down-regulation of proinflammatory cytokines and adhesion molecules. MR-409 also significantly down-regulated the expression of vascular endothelial growth factor while increasing that of pigment epithelium-derived factor in diabetic retinas. These effects correlated with decreased vascular permeability. In summary, our findings suggest a neurovascular protective effect of GHRH analogs during the early stage of diabetic retinopathy through their antioxidant and anti-inflammatory properties.


Subject(s)
Anti-Inflammatory Agents/pharmacology , Diabetic Retinopathy/drug therapy , Growth Hormone-Releasing Hormone/agonists , Sermorelin/analogs & derivatives , Animals , Anti-Inflammatory Agents/therapeutic use , Cell Adhesion Molecules/genetics , Cell Adhesion Molecules/metabolism , Cytokines/genetics , Cytokines/metabolism , Diabetic Retinopathy/metabolism , GA-Binding Protein Transcription Factor/genetics , GA-Binding Protein Transcription Factor/metabolism , Growth Hormone-Releasing Hormone/antagonists & inhibitors , Humans , Male , Rats , Rats, Sprague-Dawley , Retina/drug effects , Retina/metabolism , Sermorelin/pharmacology , Vascular Endothelial Growth Factor A/genetics , Vascular Endothelial Growth Factor A/metabolism
10.
Int J Mol Sci ; 21(15)2020 Jul 29.
Article in English | MEDLINE | ID: mdl-32751103

ABSTRACT

Retinal ischemia contributes to visual impairment in ischemic retinopathies. A disintegrin and metalloproteinase ADAM17 is implicated in multiple vascular pathologies through its ability to regulate inflammatory signaling via ectodomain shedding. We investigated the role of endothelial ADAM17 in neuronal and vascular degeneration associated with retinal ischemia reperfusion (IR) injury using mice with conditional inactivation of ADAM17 in vascular endothelium. ADAM17Cre-flox and control ADAM17flox mice were subjected to 40 min of pressure-induced retinal ischemia, with the contralateral eye serving as control. Albumin extravasation and retinal leukostasis were evaluated 48 h after reperfusion. Retinal morphometric analysis was conducted 7 days after reperfusion. Degenerate capillaries were assessed by elastase digest and visual function was evaluated by optokinetic test 14 and 7 days following ischemia, respectively. Lack of ADAM17 decreased vascular leakage and reduced retinal thinning and ganglion cell loss in ADAM17Cre-flox mice. Further, ADAM17Cre-flox mice exhibited a remarkable reduction in capillary degeneration following IR. Decrease in neurovascular degeneration in ADAM17Cre-flox mice correlated with decreased activation of caspase-3 and was associated with reduction in oxidative stress and retinal leukostasis. In addition, knockdown of ADAM17 resulted in decreased cleavage of p75NTR, the process known to be associated with retinal cell apoptosis. A decline in visual acuity evidenced by decrease in spatial frequency threshold observed in ADAM17flox mice was partially restored in ADAM17-endothelial deficient mice. The obtained results provide evidence that endothelial ADAM17 is an important contributor to IR-induced neurovascular damage in the retina and suggest that interventions directed at regulating ADAM17 activity can be beneficial for alleviating the consequences of retinal ischemia.


Subject(s)
ADAM17 Protein/genetics , Leukostasis/genetics , Reperfusion Injury/genetics , Retinal Degeneration/genetics , Retinal Ganglion Cells/metabolism , ADAM17 Protein/deficiency , Albumins/metabolism , Animals , Apoptosis/genetics , Capillary Permeability , Caspase 3/genetics , Caspase 3/metabolism , Cell Adhesion , Disease Models, Animal , Endothelium, Vascular/metabolism , Endothelium, Vascular/pathology , Gene Expression Regulation , Leukocytes/metabolism , Leukocytes/pathology , Leukostasis/metabolism , Leukostasis/pathology , Male , Mice , Mice, Inbred C57BL , Mice, Knockout , Oxidative Stress , Receptors, Nerve Growth Factor/genetics , Receptors, Nerve Growth Factor/metabolism , Reperfusion Injury/metabolism , Reperfusion Injury/pathology , Retinal Degeneration/metabolism , Retinal Degeneration/pathology , Retinal Ganglion Cells/pathology
11.
Clin Sci (Lond) ; 133(1): 117-134, 2019 01 15.
Article in English | MEDLINE | ID: mdl-30538149

ABSTRACT

We previously demonstrated in in vitro and ex vivo models that physiological concentrations of unconjugated bilirubin (BR) prevent oxidative stress (OS)-induced hepatocanalicular dysfunction and cholestasis. Here, we aimed to ascertain, in the whole rat, whether a similar cholestatic OS injury can be counteracted by heme oxygenase-1 (HO-1) induction that consequently elevates endogenous BR levels. This was achieved through the administration of hemin, an inducer of HO-1, the rate-limiting step in BR generation. We found that BR peaked between 6 and 8 h after hemin administration. During this time period, HO-1 induction fully prevented the pro-oxidant tert-butylhydroperoxide (tBuOOH)-induced drop in bile flow, and in the biliary excretion of bile salts and glutathione, the two main driving forces of bile flow; this was associated with preservation of the membrane localization of their respective canalicular transporters, bile salt export pump (Bsep) and multidrug resistance-associated protein 2 (Mrp2), which are otherwise endocytosed by OS. HO-1 induction counteracted the oxidation of intracellular proteins and membrane lipids induced by tBuOOH, and fully prevented the increase in the oxidized-to-total glutathione (GSHt) ratio, a sensitive parameter of hepatocellular OS. Compensatory elevations of the activity of the antioxidant enzymes catalase (CAT) and superoxide dismutase (SOD) were also prevented. We conclude that in vivo HO-1 induction protects the liver from acute oxidative injury, thus preventing consequent cholestasis. This reveals an important role for the induction of HO-1 and the consequently elevated levels of BR in preserving biliary secretory function under OS conditions, thus representing a novel therapeutic tool to limit the cholestatic injury that bears an oxidative background.


Subject(s)
Antioxidants/pharmacology , Cholestasis/prevention & control , Heme Oxygenase (Decyclizing)/biosynthesis , Hemin/pharmacology , Liver/drug effects , Oxidative Stress , Animals , Bile/metabolism , Bilirubin/metabolism , Catalase/metabolism , Cholestasis/chemically induced , Cholestasis/enzymology , Cholestasis/pathology , Disease Models, Animal , Enzyme Induction , Glutathione/metabolism , Liver/enzymology , Liver/pathology , Male , Rats, Wistar , Superoxide Dismutase/metabolism , tert-Butylhydroperoxide
12.
Ecotoxicol Environ Saf ; 186: 109736, 2019 Dec 30.
Article in English | MEDLINE | ID: mdl-31654909

ABSTRACT

Overwintering canvasbacks were collected in the Lake St. Clair region of the Great Lakes in the winter of 2008/09 and livers were analyzed for organochlorines, mercury (Hg), and selenium (Se). We found dramatic increases in hepatic concentrations of Hg, Se, sum PCBs, p,p'-DDE, and other organochlorines in canvasbacks in which concentrations in February were greater than concentrations in November when overwintering ducks arrived in the study area. Increases in contaminant burdens were generally greatest between December and January which also coincided with the period when ducks from Lake St. Clair (LSC) moved following freeze-up of the Lake to forage on the St. Clair River (SCR), an area of known historic contamination, and upstream of LSC. Body condition estimated using body metrics and measured using lipid reserves (after controlling for body size) increased in LSC ducks but subsequently decreased in SCR ducks. This rapid loss of body condition through loss of lipid reserves was one factor likely driving the dramatic increase in contaminant burdens and particularly for organochlorines which were inversely related to body condition in SCR ducks. Increased exposure due to foraging in closer proximity to contaminant sources and changes in diet associated with the movement of ducks may have also contributed to temporal trends. Concentrations overall were below those associated with toxicity with the exception of Se for which 30% of ducks exceeded the Se threshold that is considered elevated and one duck exceeded the threshold associated with possible toxicity. Fitness consequences of reduced lipid reserves include reduced survival, delayed migration, reduced breeding propensity, and transfer of contaminant burdens to eggs. Food availability, ice cover, and movements of canvasbacks are additional factors influencing contaminant accumulation and lipid reserves in waterfowl utilizing this important wintering location.


Subject(s)
Ducks/physiology , Lakes , Water Pollutants, Chemical/metabolism , Animals , Body Burden , Ducks/metabolism , Environmental Monitoring , Lipid Metabolism , Liver/metabolism , Seasons , Water Pollutants, Chemical/toxicity
13.
Rev Panam Salud Publica ; 43: e41, 2019.
Article in Spanish | MEDLINE | ID: mdl-31093265

ABSTRACT

OBJECTIVE: Evaluate the impact of the Adult Respiratory Diseases (ERA) Program and the General System of Explicit Health Guarantees (GES) on mortality from community-acquired pneumonia (CAP) in persons aged ≥65 years in Chile. METHODS: In this ecological study, annual and quarterly mortality rates from CAP were calculated in persons aged 65 to 79 years and ≥80 years from 1990 to 2014. Information was gathered from the databases of Chile's Department of Health Statistics and Information and its National Statistics Institute. The ERA Program (implemented in 2001) and the inclusion of CAP in the GES (starting in 2005) were evaluated as interventions. Data were analyzed using the interrupted time-series method, following the Prais-Winsten model, with a 5% significance level. RESULTS: The analysis showed that after the ERA Program began, significant reductions in CAP mortality were observed in the two age groups studied, whereas after CAP was added to the GES program, no statistically significant changes were found in those rates. CONCLUSIONS: Implementation of the ERA Program helped to reduce CAP mortality in persons aged ≥65 years in Chile, whereas inclusion of CAP in the GES program did not.


OBJETIVO: Avaliar o efeito do Programa Enfermidades Respiratorias del Adulto (doenças respiratórias do adulto, ERA) e do Régimen General de Garantías Explícitas en Salud (regime geral de garantias explícitas em Saúde, GES) na mortalidade por pneumonia adquirida na comunidade (PAC) em indivíduos acima de 65 anos no Chile. MÉTODOS: Estudo ecológico em que foram calculadas as taxas anuais e trimestrais de mortalidade por PAC em indivíduos de 65 a 79 anos e acima de 80 anos no período entre 1990 e 2014. Os dados foram obtidos dos bancos de dados do Departamento de Estatística e Informação em Saúde e do Instituto Nacional de Estatística do Chile. As intervenções avaliadas foram o Programa ERA (implantado em 2001) e a inclusão da PAC no GES (a partir de 2005). Os dados foram analisados com o método de séries temporais interrompidas segundo o modelo de Prais-Winsten. O nível de significância foi de 5%. RESULTADOS: A análise demonstrou que, após a implantação do Programa ERA, houve uma redução significativa na taxa de mortalidade por PAC nas duas faixas etárias consideradas. Por outro lado, a inclusão da PAC no GES não teve efeito estatisticamente significativo na taxa de mortalidade. CONCLUSÕES: A implantação do Programa ERA contribuiu para reduzir a taxa de mortalidade por PAC em indivíduos acima de 65 anos no Chile, porém o mesmo não ocorreu com a inclusão da PAC no GES.

14.
Environ Sci Technol ; 52(10): 5571-5580, 2018 05 15.
Article in English | MEDLINE | ID: mdl-29660979

ABSTRACT

Perfluoroalkyl acids (PFAAs) were determined in European starling ( Sturnus vulgaris) eggs collected between 2009 and 2014 from industrial, rural/agricultural, and landfill locations within five urban centers across Canada. Within each urban center, perfluoroalkyl sulfonic acid (PFSA) concentrations were generally greater in starling eggs collected from urban/industrial locations and PFSAs and perfluoroalkyl carboxylic acids (PFCAs) were generally greater at landfills compared to rural and remote locations. However, the relative importance of urban/industrial versus landfill locations as potential sources was chemical- and location-specific. PFSA concentrations in eggs collected from nonlandfills were positively correlated with human population. Despite the 2000 to 2002 phase-out of perfluorooctanesulfonic acid (PFOS) and its C8 precursors, leaching from consumer products during use likely continues to be a major source to the environment. In comparison, the concentrations of most PFCAs in eggs were not related to population, which supports the hypothesis that atmospheric transport and degradation of precursor chemicals are influencing their spatial trends. PFAA concentrations in eggs from landfills were not correlated with the quantity of waste received by a given landfill. The variability in PFAAs between landfills may be due to the specific composition of waste items.


Subject(s)
Alkanesulfonic Acids , Fluorocarbons , Starlings , Water Pollutants, Chemical , Animals , Canada , Eggs , Environmental Monitoring , Humans , Waste Disposal Facilities
15.
Environ Sci Technol ; 52(3): 1280-1289, 2018 02 06.
Article in English | MEDLINE | ID: mdl-29286648

ABSTRACT

Substituted diphenylamine antioxidants (SDPAs) and benzotriazole UV stabilizers (BZT-UVs) are industrial additives of emerging environmental concern. However, the bioaccumulation, biomagnification, and spatial distribution of these contaminants in the Great Lakes of North America are unknown. The present study addresses these knowledge gaps by reporting SDPAs and BZT-UVs in herring gull (Larus argentatus) eggs, lake trout (Salvelinus namaycush), and their food web in the Great Lakes for the first time. Herring gull eggs showed much higher detection frequency and concentrations of target SDPAs and 2-(2H-benzotriazol-2-yl)-4,6-di-tert-pentylphenol (UV328) than that of the whole body fish homogenate. For herring gull eggs, the samples from upper Great Lakes contained significantly greater levels of SDPAs than those eggs from lower lakes, possibly due to the differences in terrestrial food in diet. Interestingly, the predominant SDPAs in herring gull eggs were dinonyl- (C9C9) and monononyl-diphenylamine (C9) which were previously shown to be less bioaccumulative than other SDPAs in fish. In contrast, dioctyl-diphenylamine (C8C8) was the major SDPA in lake trout, and biodilution of C8C8 was observed in a Lake Superior lake trout food web. Such variations in herring gull eggs and fish indicate the differences in accumulation and elimination pathways of SDPAs and BZT-UVs and require further elucidation of these mechanisms.


Subject(s)
Charadriiformes , Water Pollutants, Chemical , Animals , Antioxidants , Aquatic Organisms , Diphenylamine , Environmental Monitoring , Great Lakes Region , Lakes , North America , Triazoles
16.
Ecotoxicology ; 27(5): 539-555, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29623614

ABSTRACT

The concept of the Anthropocene, that humans are now re-engineering global ecosystems, is in part evidenced by the pervasive pollution by persistent organic pollutants (POPs). Certain POPs are hormone mimics and can disrupt endocrine and hence reproductive processes, shown mainly by laboratory studies with model species. There are, in contrast, fewer confirmations of such disruption from eco-epidemiological studies of wild mammals. Here we used the American mink (Neovison vison) as a sentinel species for such a study. Over the period 1998-2006, 161 mink carcasses were obtained from commercial trappers in the Canadian provinces of British Columbia and Ontario. Mink were aged, sexed, measured, and body condition assessed. Livers were analyzed either individually or pooled for organochlorine (OC) pesticides, polychlorinated biphenyls (PCBs), and subsets for polybrominated diphenyl ethers (PBDEs). We primarily addressed whether contaminants affected male reproductive development by measuring baculum size and assessing the influences of age and body condition. We also considered the influence of spatial variation on relative exposure and size of baculum. Statistical models separated by age class revealed that significant relationships between baculum length or mass and juvenile mink were mostly positive, whereas for adults and first year mink they were mostly negative. A significant negative relationship for adult mink was determined between DDE and both baculum length and mass. For juvenile mink we found significant positive relationships between ∑PCBs, DDE and ∑PBDEs with baculum length. Our results provide some indication of negative effects of halogenated contaminants on male reproductive development in wild mink, and the most likely candidate chemical is the confirmed anti-androgenic compound, DDE, rather than PCBs or other compounds.


Subject(s)
Environmental Exposure , Environmental Pollutants/adverse effects , Mink/metabolism , Reproduction/drug effects , Age Factors , Animals , Body Composition/drug effects , British Columbia , Environmental Monitoring , Halogenated Diphenyl Ethers/adverse effects , Hydrocarbons, Chlorinated/adverse effects , Male , Ontario , Organ Size/drug effects , Pesticides/adverse effects , Polychlorinated Biphenyls/adverse effects
18.
J Relig Health ; 57(5): 1980-1995, 2018 Oct.
Article in English | MEDLINE | ID: mdl-29860644

ABSTRACT

This study examined how having a relationship with God served as a protective factor between racial stigma beliefs and psychological well-being. A church sample of African American adolescent girls (N = 117, Mage= 15) completed measures on racial stigma, psychological well-being, and reports on having a relationship with God. After controlling for adolescent age, family income, and church attendance, positive racial beliefs and having a relationship with God were associated with a healthier psychological well-being. Findings also revealed that having a relationship with God and internalizing healthier racial beliefs were associated with a healthier psychological well-being, whereas reporting higher levels of having a relationship with God served as a protective factor for African American girls when internalizing moderate levels of racial stigma. Overall, results suggest that having a relationship with God can serve as a coping mechanism and promote a healthier psychological well-being for African American adolescent girls.


Subject(s)
Adaptation, Psychological , Black or African American/psychology , Mental Health , Racism/psychology , Religion , Social Stigma , Spirituality , Adolescent , Adult , Child , Female , Humans , Protective Factors , Young Adult
19.
Environ Sci Technol ; 51(17): 9836-9845, 2017 Sep 05.
Article in English | MEDLINE | ID: mdl-28771368

ABSTRACT

Volatile methylsiloxanes (VMSs) and organophosphate esters (OPEs) are two suites of chemicals that are of environmental concern as organic contaminants, but little is known about the exposure of wildlife to these contaminants, particularly in birds, in terrestrial and aquatic ecosystems. The present study investigates the spatial distributions of nine cyclic and linear VMSs and 17 OPEs in the eggs of European starlings (Sturnus vulgaris) and three congeneric gull species (i.e., herring gull (Larus argentatus), glaucous-winged gull (L. glaucescens), and California gull (L. californicus)) from nesting sites across Canada. ∑VMS concentrations for all bird eggs were dominated by decamethylcyclopentasiloxane (D5), dodecamethylcyclohexasiloxane (D6), and octamethylcyclotetrasiloxane (D4). With European starlings, birds breeding adjacent to landfill sites had eggs containing significantly greater ∑VMS concentrations (median: 178 ng g-1 wet weight (ww)) compared with those from the urban industrial (20 ng g-1 ww) and rural sites (1.3 ng g-1 ww), indicating that the landfills are important sources of VMSs to Canadian terrestrial environments. In gull eggs, the median ∑VMS concentrations were up to 254 ng g-1 ww and suggested greater detection frequencies and levels of VMSs in aquatic- versus terrestrial-feeding birds in Canada. In contrast, the detection frequency of OPEs in all European starling and gull eggs was lower than 16%. This suggested that low dietary exposure or rapid metabolism of accumulated OPEs occurs in aquatic feeding birds and may warrant further investigation for the elucidation of the reasons for these differences.


Subject(s)
Charadriiformes , Eggs , Environmental Pollutants/analysis , Organophosphates/analysis , Siloxanes/analysis , Starlings , Animals , Canada , Environmental Monitoring , Esters
20.
J Allergy Clin Immunol ; 137(2): 500-506.e4, 2016 Feb.
Article in English | MEDLINE | ID: mdl-26260969

ABSTRACT

BACKGROUND: There is evolving evidence that vitamin D insufficiency may contribute to food allergy, but findings vary between populations. Lower vitamin D-binding protein (DBP) levels increase the biological availability of serum vitamin D. Genetic polymorphisms explain almost 80% of the variation in binding protein levels. OBJECTIVE: We sought to investigate whether polymorphisms that lower the DBP could compensate for adverse effects of low serum vitamin D on food allergy risk. METHODS: From a population-based cohort study (n = 5276) we investigated the association between serum 25-hydroxyvitamin D3 (25[OH]D3) levels and food allergy at age 1 year (338 challenge-proven food-allergic and 269 control participants) and age 2 years (55 participants with persistent and 50 participants with resolved food allergy). 25(OH)D3 levels were measured using liquid chromatography-tandem mass spectrometry and adjusted for season of blood draw. Analyses were stratified by genotype at rs7041 as a proxy marker of DBP levels (low, the GT/TT genotype; high, the GG genotype). RESULTS: Low serum 25(OH)D3 level (≤50 nM/L) at age 1 years was associated with food allergy, particularly among infants with the GG genotype (odds ratio [OR], 6.0; 95% CI, 0.9-38.9) but not in those with GT/TT genotypes (OR, 0.7; 95% CI, 0.2-2.0; P interaction = .014). Maternal antenatal vitamin D supplementation was associated with less food allergy, particularly in infants with the GT/TT genotype (OR, 0.10; 95% CI, 0.03-0.41). Persistent vitamin D insufficiency increased the likelihood of persistent food allergy (OR, 12.6; 95% CI, 1.5-106.6), particularly in those with the GG genotype. CONCLUSIONS: Polymorphisms associated with lower DBP level attenuated the association between low serum 25(OH)D3 level and food allergy, consistent with greater vitamin D bioavailability in those with a lower DBP level. This increases the biological plausibility of a role for vitamin D in the development of food allergy.


Subject(s)
Calcifediol/blood , Food Hypersensitivity/blood , Food Hypersensitivity/genetics , Genetic Association Studies , Polymorphism, Single Nucleotide , Vitamin D-Binding Protein/genetics , Adolescent , Adult , Alleles , Child , Child, Preschool , Cohort Studies , Dietary Supplements , Female , Follow-Up Studies , Food Hypersensitivity/epidemiology , Genotype , Humans , Infant , Male , Odds Ratio , Population Surveillance , Risk , Seasons , Young Adult
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