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1.
Braz. j. biol ; 84: e256944, 2024. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1364507

ABSTRACT

In order to ensure the timely and uninterrupted supply of medicinal plant raw materials, the methods of cultivation of plant cell cultures, namely, the production of plant root cultures, are relevant. In this paper, the geroprotective potential of Hedysarum neglectum Ledeb and Panax ginseng C. A. Mey root cultures is studied. They were cultured under in vitro conditions by transforming the rhizome (H. neglectum) and seed seedlings (P. ginseng) with Agrobacterium rhizogenes 15834 Swiss. To identify the geroprotective potential, the antimicrobial disc-diffusion method and the antioxidant activity were analyzed by titration of KMnO4 extracts of plant root cultures. The qualitative and quantitative composition was analyzed using high-performance liquid chromatography, thin-layer chromatography, and gas chromatography with mass spectrometry. In the course of the work, the presence of antimicrobial and antioxidant activity of plant root culture extracts was established. Biologically active substances contained in extracts of Hedysarum neglectum Ledeb root crops and Panax ginseng C. A. Mey are characterized by geroprotective potential, so they can act as a source of natural antioxidants in the functional nutrition of the geroprotective orientation.


Para garantir o abastecimento em tempo e ininterrupto de matérias-primas de plantas medicinais, são relevantes os métodos de cultivo de culturas de células vegetais, nomeadamente a produção de culturas de raízes vegetais. Neste trabalho, foi estudado o potencial geroprotetor de culturas de raízes de Hedysarum neglectum Ledeb e Panax ginseng C. A. Mey. Eles foram cultivados em condições in vitro pela transformação do rizoma (H. neglectum) e mudas de sementes (P. ginseng) com Agrobacterium rhizogenes 15834 Swiss. Para identificar o potencial geroprotetor, o método antimicrobiano de difusão em disco e a atividade antioxidante foram analisados por titulação de extratos de KMnO4 de raízes de plantas. A composição qualitativa e quantitativa foi analisada por cromatografia líquida de alta eficiência, cromatografia em camada delgada e cromatografia gasosa com espectrometria de massa. No decorrer do trabalho, foi constatada a presença de atividade antimicrobiana e antioxidante dos extratos de raízes de plantas. Substâncias biologicamente ativas contidas em extratos de raízes de H. neglectum Ledeb e P. ginseng C. A. Mey são caracterizadas pelo potencial geroprotetor, podendo atuar como fonte de antioxidantes naturais na nutrição funcional da orientação geroprotetora.


Subject(s)
Plants, Medicinal , Plant Roots , Panax , Anti-Infective Agents , Antioxidants
2.
Rev. bras. med. esporte ; 29(spe1): e2022_0187, 2023. tab, graf
Article in English | LILACS | ID: biblio-1394856

ABSTRACT

ABSTRACT Introduction As college basketball continues to develop, more and more college students are joining the sport, and the resulting sports injuries have also gradually increased, affecting the quality of life and academic performance. Objective Analyze the most common sports injuries and offer solutions for the safe practice of college basketball. Methods This article studies, through interviews and literature review, the basketball injuries of college students, analyze the main causes of sports injuries, and presents corresponding countermeasures to promote the safe development of sports education in colleges. Results The main injuries were during training, excessive force, and inadequate preparation. Deficient muscle work is also associated with most of these injuries. Conclusion Basketball is highly competitive and popular on college campuses. It is a sport that can exercise and enrich the extracurricular life of college students, requiring from its practitioners greater attention in the pre-training warm-up phase and parallel muscle strengthening to reduce its major injuries in college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes


RESUMO Introdução Com o desenvolvimento contínuo do basquetebol universitário, cada vez mais estudantes universitários aderem ao esporte e as lesões esportivas resultantes também tem aumentado gradualmente, afetando a qualidade de vida e o desempenho nos estudos. Objetivo Analisar as lesões esportivas mais comuns e oferecer soluções visando a prática segura do basquetebol universitário. Métodos Este artigo estuda por meio de entrevistas e revisão literária as lesões no basquetebol dos estudantes universitários, analisa as principais causas das lesões no esporte e apresenta as contramedidas correspondentes para promover o desenvolvimento seguro do ensino esportivo em faculdades. Resultados As principais lesões encontradas foram durante o treino, excesso de força e preparo inadequado. O trabalho muscular deficitário também está associado a maior parte dessas lesões. Conclusão O basquetebol é um esporte altamente competitivo, muito popular nos campi universitários. É um esporte que pode exercitar e enriquecer a vida extracurricular dos estudantes universitários, requerendo de seus praticantes uma maior atenção na fase de aquecimento pré-treino e fortalecimento muscular paralelo para redução das suas principais lesões em universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción Con el continuo desarrollo del baloncesto universitario, cada vez más estudiantes universitarios se incorporan a este deporte y las lesiones deportivas resultantes también han aumentado gradualmente, afectando a la calidad de vida y al rendimiento en los estudios. Objetivo Analizar las lesiones deportivas más comunes y ofrecer soluciones orientadas a la práctica segura del baloncesto universitario. Métodos Este artículo estudia, mediante entrevistas y revisión de la literatura, las lesiones de baloncesto de los estudiantes universitarios, analiza las principales causas de las lesiones deportivas y presenta las correspondientes contramedidas para promover el desarrollo seguro de la enseñanza deportiva en los colegios. Resultados Las principales lesiones encontradas fueron durante el entrenamiento, la fuerza excesiva y la preparación inadecuada. El trabajo muscular deficiente también está asociado a la mayoría de estas lesiones. Conclusión El baloncesto es un deporte altamente competitivo, muy popular en los campus universitarios. Es un deporte que puede ejercitar y enriquecer la vida extraescolar de los universitarios, requiriendo de sus practicantes una mayor atención en la fase de calentamiento previo al entrenamiento y el fortalecimiento muscular paralelo para reducir sus principales lesiones en los universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Subject(s)
Humans , Athletic Injuries/etiology , Basketball/injuries , Athletic Injuries/therapy , Severity of Illness Index , Interviews as Topic
3.
Int J Hyg Environ Health ; 247: 114044, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36395654

ABSTRACT

BACKGROUND: Safe drinking water is a fundamental human right, yet more than 785 million people do not have access to it. The burden of water management disproportionately falls on women and young girls, and they suffer the health, psychosocial, political, educational, and economic effects. While water conditions and disease outcomes have been widely studied, few studies have summarized the research on drinking water and implications for gender equity and empowerment (GEE). METHODS: A systematic review of primary literature published between 1980 and 2019 was conducted on drinking water exposures and management and the implications for GEE. Ten databases were utilized (EMBASE, PubMed, Web of Science, Cochrane, ProQuest, Campbell, the British Library for Development Studies, SSRN, 3ie International Initiative for Impact Evaluation, and clinicaltrials.gov). Drinking water studies with an all-female cohort or disaggregated findings according to gender were included. RESULTS: A total of 1280 studies were included. GEE outcomes were summarized in five areas: health, psychosocial stress, political power and decision-making, social-educational conditions, and economic and time-use conditions. Water quality exposures and implications for women's health dominated the literature reviewed. Women experienced higher rates of bladder cancer when exposed to arsenic, trihalomethanes, and chlorine in drinking water and higher rates of breast cancer due to arsenic, trichloroethylene, and disinfection byproducts in drinking water, compared to men. Women that were exposed to arsenic experienced higher incidence rates of anemia and adverse pregnancy outcomes compared to those that were not exposed. Water-related skin diseases were associated with increased levels of psychosocial stress and social ostracization among women. Women had fewer decision-making responsibilities, economic independence, and employment opportunities around water compared to men. CONCLUSION: This systematic review confirms the interconnected nature of gender and WaSH outcomes. With growing attention directed towards gender equity and empowerment within WaSH, this analysis provides key insights to inform future research and policy.

4.
Food Chem ; 405(Pt B): 134859, 2023 Mar 30.
Article in English | MEDLINE | ID: mdl-36401895

ABSTRACT

Multiple sensor technologies including electronic nose (E-nose), electronic tongue (E-tongue), colorimeter and texture analyzer combined with chemometrics and dada fusion strategies were applied to characterize the flavor quality of traditional Chinese fermented soybean paste. Principal components analysis (PCA) was performed to divide the selected soybean pastes into three clusters which was not completely consistent with geographical regions of selected samples. Support vector machine regression (SVR) outperformed partial least squares regression (PLSR) in quantitatively predicting sensory attributes. Additionally, prediction of overall flavor of soybean paste based on data fusion of multiple sensor information, with a correlation coefficient of prediction (Rp) of 0.9636 based on SVR, was better than prediction of E-nose and E-tongue data fusion (Rp = 0.9267). This study suggested multiple sensor technologies coupled with chemometrics can be a promising tool for flavor assessment and characterization of fermented soybean paste or other food matrixes.

5.
J Hazard Mater ; 444(Pt A): 130403, 2023 02 15.
Article in English | MEDLINE | ID: mdl-36403445

ABSTRACT

Amoxicillin (AMO) is one of the most commonly used antibiotics, and its abuse in animal husbandry or clinical therapy can pose unpredictable hazards to humans. Therefore, it is crucial to develop a real-time and rapid method to accurately determine AMO content. Here, we designed a fluorescent nanoprobe for qualitative and quantitative AMO determination by using as-synthesized green safe materials of nontoxic red carbon dots (RCDs) and blue carbon dots (BCDs). In the presence of AMO, a reaction promoting hydrogen bonding occurred immediately, resulting in an instant increase in the intensity of the blue fluorescence of BCDs, accompanied by a marked color change from red to blue. For practical application, we designed a nontoxic sensing fluorescent handy needle to directly and quantitatively detect AMO in real samples. This portable and easy-to-use device was demonstrated on a smartphone platform based on 3D printing technology, which offers the advantages of simple production, excellent visualization, fast response, and instant quantitative detection. The device requires an extremely short detection time and has a sensitive detection limit of 2.39 nM. The method presented here enables real-time assessment for food safety, as well as on-site detection under field conditions to track various trace substances for timely health checks.


Subject(s)
Amoxicillin , Smartphone , Animals , Humans , Hydrogen Bonding , Coloring Agents , Carbon , Hydrogen
6.
Microelectron Eng ; 267: 111912, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-36406866

ABSTRACT

COVID-19 has spread worldwide and early detection has been the key to controlling its propagation and preventing severe cases. However, diagnostic devices must be developed using different strategies to avoid a shortage of supplies needed for tests' fabrication caused by their large demand in pandemic situations. Furthermore, some tropical and subtropical countries are also facing epidemics of Dengue and Zika, viruses with similar symptoms in early stages and cross-reactivity in serological tests. Herein, we reported a qualitative immunosensor based on capacitive detection of spike proteins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19. The sensor device exhibited a good signal-to-noise ratio (SNR) at 1 kHz frequency, with an absolute value of capacitance variation significantly smaller for Dengue and Zika NS1 proteins (|ΔC| = 1.5 ± 1.0 nF and 1.8 ± 1.0 nF, respectively) than for the spike protein (|ΔC| = 7.0 ± 1.8 nF). Under the optimized conditions, the established biosensor is able to indicate that the sample contains target proteins when |ΔC| > 3.8 nF, as determined by the cut-off value (CO). This immunosensor was developed using interdigitated electrodes which require a measurement system with a simple electrical circuit that can be miniaturized to enable point-of-care detection, offering an alternative for COVID-19 diagnosis, especially in areas where there is also a co-incidence of Zika and Dengue.

7.
Int J Qual Stud Health Well-being ; 18(1): 2143611, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36458742

ABSTRACT

PURPOSE: The purpose of this study was to explore the lived experience of dancing with Parkinson's and Multiple Sclerosis in an inclusive dance group called ReDiscoverMe (RDM). METHODS: Participatory research approaches and interpretative phenomenological analysis were used to make sense of the lived experience captured in interviews and observations. Arthur Frank's conceptual framework on embodied storytelling from his book The Wounded Storyteller was the study's theoretical lens. Themes are both described and represented in images made by an RDM participant. FINDINGS: Dancing in a nonjudgmental environment was described by participants as a way to rediscover themselves while continually adapting to living with chronic illness. We interpreted this experience of rediscovery as an active, recursive process involving three "movements": escaping, expanding, and embracing. Through these movements, participants could rise above the self and illness. CONCLUSIONS: The lived experience of dancing in this group was characterized by transformations of the body, self, and life. Through escaping, expanding, and embracing, participants could more easily embrace the body's contingency, integrate the self and body by becoming dancers, connect with others living with illness, and produce desire through passion. Participants could therefore experience illness as a journey and gain something from the experience.


Subject(s)
Multiple Sclerosis , Parkinson Disease , Humans , Books , Communication , Emotions
8.
Radiographics ; 43(1): e220119, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36459493

ABSTRACT

MR defecating proctography (MRDP) is a noninvasive examination that can be used for evaluating posterior compartment disorders. MRDP has several advantages over conventional fluoroscopic defecography. These benefits include high-contrast resolution evaluation of the deep pelvic organs, simultaneous multicompartmental assessment that is performed statically and dynamically during defecation, and lack of ionizing radiation. MRDP also provides a highly detailed anatomic evaluation of the pelvic floor supportive structures, including direct assessment of the pelvic floor musculature and indirect assessment of the endopelvic fascia. As the breadth of knowledge regarding anatomic and functional posterior compartment disorders expands, so too does the advancement of noninvasive and surgical treatment options for these conditions. High-quality MRDP examinations, with key anatomic and functional features reported, guide treatment planning. Reporting of MRDP examination findings with use of standardized terminology that emphasizes objective measurements rather than subjective grading aids consistent communication among radiologists, clinicians, and surgeons. Familiarity with commonly encountered posterior compartment pelvic floor pathologic entities that contribute to posterior compartment disorders and awareness of the essential information needed by surgeons are key to providing an optimal multidisciplinary discussion for planning pelvic floor dysfunction treatment. The authors provide an overview of the basic concepts of the MRDP acquisition technique, the anatomic abnormalities of posterior compartment pelvic floor pathologic entities associated with defecatory disorders, and recently developed interdisciplinary MRDP reporting templates and lexicons. In addition, the associated imaging findings that are key for surgical treatment guidance are highlighted. © RSNA, 2022 Online supplemental material is available for this article.

9.
BJOG ; 130(1): 59-67, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36209462

ABSTRACT

OBJECTIVE: To explore the views of women, partners, families, health workers and community leaders of potential investigations to determine the cause(s) of stillbirth, in Malawi, Tanzania and Zambia. DESIGN: Grounded theory. SETTING: Tertiary facilities and community settings in Blantyre, Malawi, Mwanza, Tanzania and Mansa, Zambia. SAMPLE: Purposive and theoretical sampling was used to recruit 124 participants: 33 women, 18 partners, 19 family members, 29 health workers and 25 community leaders, across three countries. METHODS: Semi-structured interviews were conducted using a topic guide for focus. Analysis was completed using constant comparative analysis. Sampling ceased at data saturation. RESULTS: Women wanted to know the cause of stillbirth, but this was tempered by their fear of the implications of this knowledge; in particular, the potential for them to be blamed for the death of their baby. There were also concerns about the potential consequences of denying tradition and culture. Non-invasive investigations were most likely to be accepted on the basis of causing less 'harm' to the baby. Parents' decision-making was influenced by type of investigation, family and cultural influences and financial cost. CONCLUSIONS: Parents want to understand the cause of death, but face emotional, cultural and economic barriers to this. Offering investigations will require these barriers to be addressed, services to be available and a no-blame culture developed to improve outcomes. Community awareness, education and support for parents in making decisions are vital prior to implementing investigations in these settings.

10.
J Pediatr Hematol Oncol Nurs ; 40(1): 17-23, 2023.
Article in English | MEDLINE | ID: mdl-36221984

ABSTRACT

Background: Oral chemotherapy nonadherence is a challenge in clinical oncology. During therapy for acute lymphoblastic leukemia (ALL), poor adherence to 6-mercaptopurine (6MP) increases relapse risk. Clinically significant nonadherence is reported in 30% of children treated for ALL on Children's Oncology Group (COG) trials. Whether nonadherence rates vary across regimens with different treatment schedules and modes of administration is unknown. Methods: We conducted an exploratory, cross-sectional survey study on parents of children (1-18 years) receiving continuation therapy on, or as per Dana-Farber Cancer Institute (DFCI) ALL Consortium Protocol 11-001. Treatment required weekly visits to the clinic and 14 days of oral 6MP every 3 weeks. Survey assessed self-reported sociodemographics, medication-taking, chemotherapy comprehension, and 6MP adherence; adherence survey items were developed from published surveys. Patients were grouped as nonadherent if they endorsed missing one 6MP dose during the last cycle, or more than one dose during prior cycles, for nonmedical reasons. Results: Sixty-two families completed the surveys, all of whom had evaluable adherence data. In total, 25% of patients met the study definition of nonadherence. Twenty-three percent reported that it was "not easy" to follow administration guidelines around the dairy intake and 57% requested more teaching and educational resources. Conclusion: Self-reported nonadherence to oral 6MP in the DFCI ALL Consortium is high, with rates similar to those observed in the COG. This suggests that the additional contact during weekly infusions on the DFCI is insufficient to address barriers affecting oral chemotherapy adherence.

11.
J Pediatr Hematol Oncol Nurs ; 40(1): 5-16, 2023.
Article in English | MEDLINE | ID: mdl-36221958

ABSTRACT

Background. Medication adherence is challenging after pediatric hematopoietic stem cell transplant (HCT), particularly after hospital discharge. Post-HCT medication adherence is important to manage morbidity and mortality risk. Designing interventions that are effective and acceptable to caregivers is key to improving post-HCT medication adherence. This study aimed to characterize caregiver preferences about medication adherence support from their child's medical team. Methods. Twenty-nine caregivers of children who received an HCT completed semi-structured qualitative interviews about their experience with, and recommendations for improving, medication adherence support provided by the medical team. Twenty-two caregivers also completed a card sort task to clarify the content of received support and caregiver recommendations for future HCT families. Results. Thematic analysis revealed eight themes grouped into two categories: Communication Is Key and Practical Medication Adherence Support. Caregivers emphasized the importance of communication in helping them manage their child's outpatient medications and provided suggestions to further strengthen communication. The types of practical medication adherence support used varied across caregivers highlighting the importance of tailoring adherence support to each family's needs. Caregivers also identified all the domains as potentially helpful for other families. Discussion. Findings suggest that caregivers prefer that efforts to improve outpatient medication adherence post-HCT prioritize the medical team initiating frequent, clear, and open communication about medications, and provide educational materials on adherence (e.g., handouts). Results also indicate that practical medication adherence supports should be offered based on family preferences but that families may particularly appreciate tips about addressing medication challenges based on other caregivers' lived experience.

12.
Biotechnol Bioeng ; 120(1): 154-168, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36225098

ABSTRACT

Constructing predictive models to simulate complex bioprocess dynamics, particularly time-varying (i.e., parameters varying over time) and history-dependent (i.e., current kinetics dependent on historical culture conditions) behavior, has been a longstanding research challenge. Current advances in hybrid modeling offer a solution to this by integrating kinetic models with data-driven techniques. This article proposes a novel two-step framework: first (i) speculate and combine several possible kinetic model structures sourced from process and phenomenological knowledge, then (ii) identify the most likely kinetic model structure and its parameter values using model-free Reinforcement Learning (RL). Specifically, Step 1 collates feasible history-dependent model structures, then Step 2 uses RL to simultaneously identify the correct model structure and the time-varying parameter trajectories. To demonstrate the performance of this framework, a range of in-silico case studies were carried out. The results show that the proposed framework can efficiently construct high-fidelity models to quantify both time-varying and history-dependent kinetic behaviors while minimizing the risks of over-parametrization and over-fitting. Finally, the primary advantages of the proposed framework and its limitation were thoroughly discussed in comparison to other existing hybrid modeling and model structure identification techniques, highlighting the potential of this framework for general bioprocess modeling.

13.
Clin Imaging ; 93: 86-92, 2023 Jan.
Article in English | MEDLINE | ID: mdl-36417792

ABSTRACT

PURPOSE: This study aims to evaluate qualitative and quantitative imaging metrics along with clinical features affecting overall survival in glioblastomas and to classify them into high survival and low survival groups based on 12, 19, and 24 months thresholds using machine learning. METHODS: The cohort consisted of 98 adult glioblastomas. A standard brain tumor magnetic resonance (MR) imaging protocol, was performed on a 3T MR scanner. Visually Accessible REMBRANDT Images (VASARI) features were assessed. A Kaplan-Meier survival analysis followed by a log-rank test and multivariate Cox regression analysis were used to investigate the effects of VASARI features along with the age, gender, the extent of resection, pre- and post-KPS, ki67 and P53 mutation status on overall survival. Supervised machine learning algorithms were employed to predict the survival of glioblastoma patients based on 12, 19, and 24 months thresholds. RESULTS: Tumor location (p<0.001), the proportion of non-enhancing component (p=0.0482), and proportion of necrosis (p=0.02) were significantly associated with overall survival based on Kaplan-Meier analysis. Multivariate Cox regression analysis revealed that increases in proportion of non-enhancing component (p=0.040) and proportion of necrosis (p=0.039) were significantly associated with overall survival. Machine-learning models were successful in differentiating patients living longer than 12 months with 96.40% accuracy (sensitivity=97.22%, specificity=95.55%). The classification accuracies based on 19 and 24 months survival thresholds were 70.87% (sensitivity=83.02%, specificity=60.11%) and 74.66% (sensitivity=67.58%, specificity=82.08%), respectively. CONCLUSION: Employing clinical and VASARI features together resulted in a successful classification of glioblastomas that would have a longer overall survival.


Subject(s)
Brain Neoplasms , Glioblastoma , Adult , Humans , Glioblastoma/diagnostic imaging , Brain Neoplasms/diagnostic imaging , Necrosis , Machine Learning , Algorithms
14.
Int J Qual Stud Health Well-being ; 18(1): 2149097, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36419342

ABSTRACT

PURPOSE: This research examines the implementation of the Icelandic Prevention Model (IPM) in Canada to identify opportunities revealed by the COVID-19 pandemic to re-design our social eco-system to promote wellbeing. This paper has two objectives: 1) to provide a conceptual review of research that applies the bioecological model to youth substance use prevention with a focus on the concepts of time and physical space use and 2) to describe a case study that examines the implementation of the IPM in Canada within the context of the COVID-19 pandemic. METHOD: Study data were collected through semi-structured qualitative interviews with key stakeholders involved in implementing the IPM. RESULTS: Findings are organized within three over-arching themes derived from a thematic analysis: 1) Issues that influence time and space use patterns and youth substance use, 2) Family and community cohesion and influences on developmental context and time use and 3) Opportunities presented by the pandemic that can promote youth wellbeing. CONCLUSION: We apply the findings to research on the IPM as well as the pandemic to examine opportunities that may support primary prevention and overall youth wellbeing. We use the concepts of time and space as a foundation to discuss implications for policy and practice going forward.


Subject(s)
COVID-19 , Substance-Related Disorders , Adolescent , Humans , COVID-19/prevention & control , Iceland , Pandemics/prevention & control , Policy
15.
Can J Psychiatry ; 68(1): 43-53, 2023 Jan.
Article in English | MEDLINE | ID: mdl-35854421

ABSTRACT

OBJECTIVE: Throughout the COVID-19 pandemic, there have been concerns about the mental health of health care workers (HCW). Although numerous studies have investigated the level of distress among HCW, few studies have explored programs to improve their mental well-being. In this paper, we describe the implementation and evaluation of a program to support the mental health of HCW at University Health Network (UHN), Canada's largest healthcare network. METHODS: Using a quality improvement approach, we conducted a needs assessment and then created and evaluated a modified stepped-care model to address HCW mental health during the pandemic. This included: online resources focused on psychoeducation and self-management, access to online support and psychotherapeutic groups, and self-referral for individual care from a psychologist or psychiatrist. We used ongoing mixed-methods evaluation, combining quantitative and qualitative analysis, to improve program quality. RESULTS: The program is ongoing, running continuously throughout the pandemic. We present data up to November 30, 2021. There were over 12,000 hits to the UHN's COVID mental health intranet web page, which included self-management resources and information on group support. One hundred and sixty-six people self-referred for individual psychological or psychiatric care. The mean wait time from referral to initial appointment was 5.4 days, with an average of seven appointments for each service user. The majority had moderate to severe symptoms of depression and anxiety at referral, with over 20% expressing thoughts of self-harm or suicide. Post-care user feedback, collected through self-report surveys and semistructured interviews, indicated that the program is effective and valued. CONCLUSIONS: Development of a high-quality internal mental health support for HCW program is feasible, effective, and highly valued. By using early and frequent feedback from multiple perspectives and stakeholders to address demand and implement changes responsively, the program was adjusted to meet HCW mental health needs as the pandemic evolved.

16.
Dev Med Child Neurol ; 65(1): 16-23, 2023 Jan.
Article in English | MEDLINE | ID: mdl-35869593

ABSTRACT

Self-determination is a human right that people with profound intellectual and multiple disabilities (PIMD) risk not being granted. Exploration of such topics and research in general has traditionally not included people with PIMD as sources of knowledge; rather, the perspective of others has been sought. Ethnographic methods highlighting descriptions of lived experience have been argued as a way of including such individuals, producing knowledge building on the person's perspective. Exploring the human right to be self-determined through ethnographic approaches can bring novel ways of understanding the concept, both about how to listen and learn from such experiences, and about implications for understanding self-determination. All people have the potential for self-determination, by being understood through embodied communication in caring relationships. By fostering relations with people with PIMD in sensitive, ethical ways, and addressing their profound dependency, their self-determination can be realized. WHAT THIS PAPER ADDS: Attentive engagement with people with lived experience of profound intellectual and multiple disabilities can inform both researchers and clinicians on self-determination. Through real-life descriptions, self-determination is demonstrated to move beyond independence and choice-making.

17.
Nicotine Tob Res ; 25(1): 19-27, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-35894290

ABSTRACT

INTRODUCTION: Poly-tobacco use (PTU), or the concomitant use of two or more nicotine and tobacco products, are a growing public health concern. Adults reporting increased psychological distress (PD) experience profound nicotine and tobacco health-related disparities. Sexual minority (SM) adults report more PTU and higher levels of PD than heterosexuals, yet little is known about patterns of nicotine and tobacco use and its relationship to PD in SM populations. AIMS AND METHODS: The purpose of this study was to investigate sexual identity differences in PD and PTU. Data were drawn from the 2016-2018 National Health Interview Survey (N = 83 017), an annual cross-sectional survey of a nationally representative sample of U.S. adults. PD was assessed using the Kessler Psychological Distress Scale (K6). We fit sex-stratified, weighted, adjusted logistic models to compare PTU and PD by sexual identity. RESULTS: PTU was more prevalent in adults with higher K6 scores. Female adults and SM adults had significantly higher K6 scores and were significantly more likely to experience serious PD when compared to their male and heterosexual counterparts. CONCLUSIONS: The current study provides a snapshot of trends in PTU in relation to PD, gender, and sexual identity. Findings suggest higher rates of both PD and PTU in SM adults. Further research examining the mechanisms underlying this disparity is critical to the development of effective intervention and prevention strategies. IMPLICATIONS: Little is known about sex and sexual identity differences in the relations between patterns of tobacco product use and PD. This study is the first to examine the effect of gender and sexual identity on both PD and PTU. SMs reported higher rates of PD and were more likely to be poly-tobacco users. As new ways of engaging nicotine/tobacco continue to proliferate, health risks will endure especially for marginalized populations. An increased understanding of the psychological and social correlates of PTU in SMs is warranted.

18.
Nicotine Tob Res ; 25(1): 159-163, 2023 Jan 01.
Article in English | MEDLINE | ID: mdl-35896127

ABSTRACT

INTRODUCTION: Flavored electronic nicotine delivery systems (ENDS) and tobacco products are associated with the initiation and progression of tobacco use. With recent restrictions around flavored products, it is critical to measure both the product and the flavor being used. The Tobacco Centers of Regulatory Science (TCORS) Flavored Tobacco Products Measurement Subcommittee (FTPMS) was established to develop core measures to assess flavored tobacco and ENDS product usage, facilitate data harmonization, replicability, and comparisons across studies. AIMS AND METHODS: The FTPMS used a mixed-method approach to inform the development of recommended measures (first use, current use, reasons for use) to assess tobacco and ENDS product flavors. This included reviewing existing surveys, identifying priority areas, developing new measures, cognitive testing, and finalization of recommended measures. RESULTS: Recommended measures were selected from national surveys (e.g. PATH study) and survey items used in TCORS studies to evaluate first use, current use, and reasons for use of tobacco and ENDS products. Response options were expanded for questions about specific flavors and adapted to allow for assessments relevant to recent federal policies. Supplemental measures were developed for researchers conducting more in-depth research around flavored products. CONCLUSIONS: Using an expert consensus process supplemented with cognitive testing, the FTPMS developed recommendations for core and supplemental measures for flavored tobacco and ENDS products. Harmonizing data on these factors for flavored tobacco and ENDS products are critical for researchers and may provide actionable evidence to federal, state, and local regulators and policymakers, as well as support evaluations of policies restricting flavors in these products. IMPLICATIONS: The development of core measures to assess first use, current use, and reasons for use of flavored tobacco and ENDS products will facilitate data harmonization, replicability, and comparisons across studies conducted in different samples or across communities with varying levels of regulation for these products. Use of these standardized measures will allow for a greater understanding of the role of flavors and helps to build a more robust evidence base to inform regulatory decisions to reduce tobacco and ENDS use at the population level.

19.
Int J Qual Stud Health Well-being ; 18(1): 2152220, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36451523

ABSTRACT

BACKGROUND: The first-person experiences of people diagnosed with borderline personality disorder (BPD) is an important area of research. It can support clinical and ethical practice, and nuance and expand on insights offered by diagnostic and treatment-oriented research approaches. In this study, we aimed to develop knowledge about how persons who were recently diagnosed with BPD experience being in relationships with themselves and others. METHODS: We conducted in-depth life-world interviews with 12 women recently diagnosed with BPD. The interviews focused on their lived experiences of relationships to self and others. All participants gave their informed consents to participate. We analysed the data with a structured approach to reflexive thematic analysis, conducted as a team-based approach. RESULTS: We extracted an overarching theme, "Reaching for firm holdings", that is the most abstract interpretation of participants' experiences. The five subordinate themes ("Captive of emotions", "Keeping undeservedness at bay", "Distrusting oneself", "Dependence as stability" and "The uncertainty of reaching out") are specific constituents of the overarching theme, and provide detail and variations across individual accounts. CONCLUSIONS: The results suggest that the experience of relationship to self and others of people recently diagnosed with BPD entails feeling insecure, unsafe and frightened. We report five themes that describe ways participants seek to cope with this situation. The results indicate that their experiences encompass turning to others, or to objects, for feelings of safety. As such, the experience of relationship to self and others in the context of receiving a BPD diagnosis seemed to entail finding and evolving strategies to protect a vulnerable self. Self-harm, suicide attempts and addiction all seemed to be ways of handling and tolerating chaotic and frightful emotions. One major limitation of our study is that only people who identified as female were recruited to participate in the study.


Subject(s)
Borderline Personality Disorder , Self-Injurious Behavior , Female , Humans , Qualitative Research , Emotions , Fear
20.
J Interpers Violence ; 38(1-2): NP288-NP310, 2023 Jan.
Article in English | MEDLINE | ID: mdl-35350920

ABSTRACT

African American women survivors of intimate partner violence disproportionately experience homicide due, in part, to the racism and racial discrimination they experience during their help-seeking process. Yet, existing scholarship neglects to examine how this multiply-marginalized population of women navigate sociocultural barriers to obtain crisis services and supports from the domestic violence service provision system. Fundamental to developing culturally-salient interventions is more fully understanding their help-seeking behavior. We conducted 30 in-depth, semi-structured interviews with women who self-identified as African American. Constructivist grounded theory methodology was employed. Sensitizing concepts from the Transtheoretical Model of Change and Intersectionality theories, along with Agency framework were conceptually bound. The Theory of Help-Seeking Behavior emerged from the data. This nascent theory provides practitioners and researchers with a theoretical model to examine African American women's nuanced help-seeking efforts.


Subject(s)
Domestic Violence , Help-Seeking Behavior , Intimate Partner Violence , Female , Humans , African Americans , Survivors
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