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1.
Recurso de Internet en Inglés, Español, Francés, Portugués, Arabe, Ruso, Chino | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-47088

RESUMEN

Organização Mundial da Saúde apresenta dicas para enfrentar consequências psicológicas e mentais do novo coronavírus; doença está gerando estresse na população afetada pelo risco de contaminação, incerteza, isolamento social e desemprego entre outros motivos; guia contempla profissionais de saúde, crianças e idosos, líderes de equipes e pessoas em quarentena.


Asunto(s)
Salud Mental/etnología , Pandemias/prevención & control , Brotes de Enfermedades/prevención & control , Coronavirus , Estrés Psicológico/etiología , Estrés Psicológico/prevención & control , Aislamiento Social/psicología
2.
N C Med J ; 81(2): 126-129, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32132258

RESUMEN

Racial and ethnic disparities in health care occur within broader contexts impacting the youth who present for behavioral health treatment. Clinician bias and clinical uncertainty can influence diagnostic and treatment outcomes. Behavioral health professionals should strive toward effectiveness in the delivery of culturally sensitive interventions to assist in health promotion with youth of color.


Asunto(s)
Disparidades en Atención de Salud/etnología , Trastornos Mentales/diagnóstico , Trastornos Mentales/etnología , Adolescente , Grupos de Población Continentales/psicología , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/psicología , Grupos Étnicos/estadística & datos numéricos , Humanos
3.
Nature ; 579(7798): 310, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32152602
4.
MMWR Morb Mortal Wkly Rep ; 69(11): 286-289, 2020 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-32191684

RESUMEN

Since 1989, the United States has pursued a goal of eliminating tuberculosis (TB) through a strategy of rapidly identifying and treating cases and evaluating exposed contacts to limit secondary cases resulting from recent TB transmission (1). This strategy has been highly effective in reducing U.S. TB incidence (2), but the pace of decline has significantly slowed in recent years (2.2% average annual decline during 2012-2017 compared with 6.7% during 2007-2012) (3). For this report, provisional 2019 data reported to CDC's National Tuberculosis Surveillance System were analyzed to determine TB incidence overall and for selected subpopulations and these results were compared with those from previous years. During 2019, a total of 8,920 new cases were provisionally reported in the United States, representing a 1.1% decrease from 2018.* TB incidence decreased to 2.7 cases per 100,000 persons, a 1.6% decrease from 2018. Non-U.S.-born persons had a TB rate 15.5 times greater than the rate among U.S.-born persons. The U.S. TB case count and rate are the lowest ever reported, but the pace of decline remains slow. In recent years, approximately 80% of U.S. TB cases have been attributed to reactivation of latent TB infection (LTBI) acquired years in the past, often outside the United States (2). An expanded TB elimination strategy for this new decade should leverage existing health care resources, including primary care providers, to identify and treat persons with LTBI, without diverting public health resources from the continued need to limit TB transmission within the United States. Partnerships with health care providers, including private providers, are essential for this strategy's success.


Asunto(s)
Erradicación de la Enfermedad , Vigilancia de la Población , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Adulto , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Metas , Humanos , Incidencia , Tuberculosis/etnología , Estados Unidos/epidemiología
5.
MMWR Morb Mortal Wkly Rep ; 69(11): 290-297, 2020 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-32191688

RESUMEN

Of the 70,237 drug overdose deaths in the United States in 2017, approximately two thirds (47,600) involved an opioid (1). In recent years, increases in opioid-involved overdose deaths have been driven primarily by deaths involving synthetic opioids other than methadone (hereafter referred to as synthetic opioids) (1). CDC analyzed changes in age-adjusted death rates from 2017 to 2018 involving all opioids and opioid subcategories* by demographic characteristics, county urbanization levels, U.S. Census region, and state. During 2018, a total of 67,367 drug overdose deaths occurred in the United States, a 4.1% decline from 2017; 46,802 (69.5%) involved an opioid (2). From 2017 to 2018, deaths involving all opioids, prescription opioids, and heroin decreased 2%, 13.5%, and 4.1%, respectively. However, deaths involving synthetic opioids increased 10%, likely driven by illicitly manufactured fentanyl (IMF), including fentanyl analogs (1,3). Efforts related to all opioids, particularly deaths involving synthetic opioids, should be strengthened to sustain and accelerate declines in opioid-involved deaths. Comprehensive surveillance and prevention measures are critical to reducing opioid-involved deaths, including continued surveillance of evolving drug use and overdose, polysubstance use, and the changing illicit drug market; naloxone distribution and outreach to groups at risk for IMF exposure; linkage to evidence-based treatment for persons with substance use disorders; and continued partnerships with public safety.


Asunto(s)
Analgésicos Opioides/envenenamiento , Sobredosis de Droga/mortalidad , Adolescente , Adulto , Distribución por Edad , Anciano , Niño , Preescolar , Grupos de Población Continentales/estadística & datos numéricos , Sobredosis de Droga/etnología , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Distribución por Sexo , Estados Unidos/epidemiología , Urbanización , Adulto Joven
6.
Public Health Res Pract ; 30(1)2020 Mar 10.
Artículo en Inglés | MEDLINE | ID: mdl-32152618

RESUMEN

OBJECTIVE: The Live Life Well @ School program aims to establish, reinforce and support primary school students (aged 5-11 years) and their families to adopt healthy eating and physical activity behaviours through the implementation of an evidence-based program that focuses on the school curriculum, the school food and physical activity environment, and teacher professional development. This paper examines Live Life Well @ School monitoring data to provide practical insights into program adoption and changes in primary school environments across NSW, particularly in schools characterised as disadvantaged. Type of program: The Live Life Well @ School program provides a universally delivered, state-wide approach to childhood obesity prevention in the primary school setting. The program is a joint initiative between health and education sector agencies. METHODS: The program includes health promotion strategies for primary schools relating to physical activity and nutrition. Adoption of the program is indicated by achievement of evidence-based desirable practices, which are monitored routinely by local health promotion staff using a purpose-built online Population Health Information Management System. Monitoring data are used to provide feedback to schools and identify a staged approach to achieving more desirable practices. Health promotion staff tailor support locally to suit school and community needs, and have additional funding to support socio-economically disadvantaged schools. RESULTS: The program has achieved high reach to schools (82.7%percnt; of the 2570 schools in New South Wales, Australia). Adoption of desirable practices within schools participating in 2017 was 72.9%percnt;. Equitable reach was achieved for schools in areas of socio-economic disadvantage, schools in remote areas and schools with a high propotion of Aboriginal students, who are likely to have higher rates of childhood overweight and obesity. Curriculum-based strategies were more frequently adopted; environmental changes and teacher professional development components were less well adopted. LESSONS LEARNT: The desirable practice approach allows health promotion officers to tailor support by building on school strengths and taking a staged approach to change. Ongoing monitoring of the program provides useful insights that inform quality improvements to the program and implementation process, as well as information on progress towards outcomes. State-wide program targets were adjusted to strengthen impact and focus on desirable practices that were less well achieved. Intentional targeting and tailoring in areas of disadvantage are required to achieve equitable adoption of such a universal health promotion program. Strong relationships at the local level between school champions (teachers and principals) and health promotion staff characterise success.


Asunto(s)
Curriculum , Promoción de la Salud , Obesidad Pediátrica/prevención & control , Servicios de Salud Escolar , Niño , Femenino , Humanos , Masculino , Nueva Gales del Sur , Grupo de Ascendencia Oceánica , Obesidad Pediátrica/etnología , Evaluación de Programas y Proyectos de Salud
8.
Medicine (Baltimore) ; 99(12): e19562, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195965

RESUMEN

It has been established that prediabetes can causes significant comorbidities, particularly in the elderly. The deterioration of glucose metabolism are generally considered to be results of the impairment of the 4 factors: first, second insulin secretion (FPIS, SPIS, respectively), glucose effectiveness (GE), and insulin resistance. In this study, we enrolled older women to investigate their relationships with prediabetes.Five thousand four hundred eighty-two nonobese, nondiabetic women were included. They were divided into normal glucose tolerance and prediabetes groups. Receiver operating characteristic curve was performed to investigate the effects on whether to have prediabetes for each factors. Two models were built: Model 1: FPIS + SPIS, and Model 2: model 1 + GE. The area under the receiver operating characteristic (aROC) curve was used to determine the predictive power of these models.The aROC curve of GE was significantly higher than the diagonal line followed by SPIS and FPIS accordingly. The aROC curve of Model 1 (0.611) was not different from GE. However, Model 2 improved significantly up to 0.663. Based on this model, an equation was built (-0.003 × GE - 212.6 × SPIS - 17.9 × insulin resistance + 4.8). If the calculated value is equal or higher than 0 (≥0), then the subject has higher chance to have prediabetes (sensitivity = 0.607, specificity = 0.635).Among the 4 factors, GE is the most important contributor for prediabetes in older women. By building a model composed of FPIS, SPIS, and GE, the aROC curve increased significantly. The equation built from this model could predict prediabetes precisely.


Asunto(s)
Grupo de Ascendencia Continental Asiática/etnología , Glucosa/metabolismo , Resistencia a la Insulina/fisiología , Secreción de Insulina/fisiología , Estado Prediabético/epidemiología , Anciano , Índice de Masa Corporal , Estudios Transversales , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Prueba de Tolerancia a la Glucosa/métodos , Humanos , Persona de Mediana Edad , Estado Prediabético/fisiopatología , Prevalencia , Sensibilidad y Especificidad , Taiwán/epidemiología
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(3): 278-282, 2020 Mar 06.
Artículo en Chino | MEDLINE | ID: mdl-32187932

RESUMEN

Objective: To explore the association of dietary pattern and type 2 diabetes mellitus (T2DM) risk. Methods: In 2013, 3 747 participants from 87 coalmine branches of a large coal mine group in Datong City, Shanxi Province were selected by using a two-stage cluster stratified sampling method. Data on demographic characteristics, smoking, drinking, and family history of diabetes were collected by using a self-made questionnaire, and the International Physical Activity Questionnaire was used to assess the level of physical activity. Physical, glucose and lipid metabolism indicators were measured and subjects were divided into high-risk groups and low-risk groups of T2DM according to the T2DM risk score. Dietary data were collected by using Semi-quantitative Food Frequency Questionnaire, and dietary patterns were derived by using the exploratory factor analysis and cluster analysis. The unconditional logistic regression model was used to assess the association of dietary patterns and T2DM risk. Results: The age of the subjects was(41.48±8.62) years old, and 2 843 of them were males (84.31%). A total of 1 819 subjects were in the high-risk group and 1 553 in the low-risk group. Four dietary patterns, healthy diet, high-salt diet, meats diet, and carbohydrate-rich diet, were identified in this study. The unconditional logistic regression analysis showed that compared with the healthy diet pattern, after the adjustment of demographic characteristics, smoking, and drinking, the OR (95%CI) of T2DM risk in high-salt diet, carbohydrate-rich diet and meats diet patterns was 1.54 (1.26-1.88), 1.80 (1.43-2.28) and 1.20 (0.99-1.46), respectively. Conclusion: High-salt diet and carbohydrate-rich diet were positively associated with T2DM risk, whereas there was no association of meats diet and T2DM risk.


Asunto(s)
Diabetes Mellitus Tipo 2/etiología , Dieta/efectos adversos , Adulto , Estudios Transversales , Diabetes Mellitus Tipo 2/etnología , Encuestas sobre Dietas , Carbohidratos de la Dieta , Azúcares de la Dieta , Femenino , Humanos , Modelos Logísticos , Masculino , Carne , Persona de Mediana Edad , Factores de Riesgo , Cloruro de Sodio Dietético
11.
Medicine (Baltimore) ; 99(11): e19433, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176070

RESUMEN

BACKGROUND: Number of studies have been performed to evaluate the relationship between the cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) gene variant rs5742909 polymorphism and cervical cancer risk, but the sample size was small and the results were conflicting. This meta-analysis was conducted to comprehensively evaluate the overall association. METHODS: PubMed, Web of Science, Embase, China Biology Medical Literature database, China National Knowledge Infrastructure, WanFang, and Weipu databases were searched before July 31, 2018. The strength of associations was assessed using odds ratios (ORs) and 95% confidence intervals (CIs). All of the statistical analyses were conducted using Review Manager 5.3 and Stata 14.0. RESULTS: Eleven studies involved 3899 cases and 4608 controls. Overall, significant association was observed between the CTLA-4 gene variant rs5742909 polymorphism and cervical cancer (T vs C: OR = 1.40, 95% CI = 1.12-1.76; TT vs CC: OR = 2.22, 95% CI = 1.13-4.37; TT vs CT+CC: OR = 1.96, 95% CI = 1.03-3.74; TT+CT vs CC: OR = 1.47, 95% CI = 1.14-1.90). In subgroup analysis by ethnic group, a statistically significant association was observed in Asians (T vs C: OR = 1.56, 95% CI = 1.22-1.99), but not in Caucasians (T vs C: OR = 1.19, 95% CI = 0.87-1.62). The sensitivity analysis confirmed the reliability and stability of the meta-analysis. CONCLUSION: our meta-analysis supports that the CTLA-4 gene variant rs5742909 polymorphism might contribute to individual susceptibility to cervical cancer in Asians.


Asunto(s)
Grupo de Ascendencia Continental Asiática/genética , Antígeno CTLA-4/genética , Predisposición Genética a la Enfermedad/etnología , Polimorfismo de Nucleótido Simple , Neoplasias del Cuello Uterino/etnología , Neoplasias del Cuello Uterino/genética , Femenino , Humanos
13.
Medicine (Baltimore) ; 99(11): e19244, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32176048

RESUMEN

A mutation in the epithelial morphogen gene ectodysplasin-A1 (EDA1) is responsible for the disorder X-linked hypohidrotic ectodermal dysplasia (XLHED), the most common form of ectodermal dysplasia. XLHED is characterized by impaired development of hair, eccrine sweat glands, and teeth. This study aimed to identify potentially pathogenic mutations in four Chinese XLHED families.Genomic DNA was extracted from the peripheral blood and sequenced. Sanger sequencing was used to carry out mutational analysis of the EDA1 gene, and the three-dimensional structure of the novel mutant residues in the EDA trimer was determined. Transcriptional activity of NF-κB was tested by Dual luciferin assay.We identified a novel EDA1 mutation (c.1046C>T) and detected 3 other previously-reported mutations (c.146T>A; c.457C>T; c.467G>A). Our findings demonstrated that novel mutation c.1046C>T (p.A349 V) resulted in XLHED. The novel mutation could cause volume repulsion in the protein due to enlargement of the amino acid side chain. Dual luciferase assay revealed that transcriptional NF-κB activation induced by XLHED EDA1 protein was significantly reduced compared with wild-type EDA1.These results extend the spectrum of EDA1 mutations in XLHED patients and suggest a functional role of the novel mutation in XLHED.


Asunto(s)
Displasia Ectodermal Anhidrótica Tipo 1/etnología , Displasia Ectodermal Anhidrótica Tipo 1/genética , Ectodisplasinas/genética , Predisposición Genética a la Enfermedad , Luciferasas/genética , Mutación Missense/genética , Preescolar , China , Displasia Ectodermal Anhidrótica Tipo 1/fisiopatología , Femenino , Humanos , Masculino , Linaje , Reacción en Cadena de la Polimerasa/métodos
14.
Nephrol Nurs J ; 47(1): 53-65, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32083437

RESUMEN

Understanding African-American families' experiences with treatment for kidney failure is necessary for informing the delivery of family-centered care and the design of appropriate interventions. This qualitative study explored treatment-related questions, concerns, and family impacts among African-American family members of patients with pre-kidney failure and kidney failure. Thirty-five family members participated in focus groups stratified by patients' treatment experiences (pre-kidney failure, in-center hemodialysis, peritoneal dialysis, awaiting living-donor kidney transplantation, or post-transplantation). Family members raised questions and concerns about the psychological, lifestyle, and practical aspects of treatment. Similarly, discussions about family impacts emphasized psychosocial effects, lifestyle consequences, and the provision and receipt of support. Efforts to address these questions, concerns, and perceived family impacts through additional research, early and tailored education, and supportive interventions are needed.


Asunto(s)
Afroamericanos/psicología , Actitud Frente a la Salud/etnología , Familia/etnología , Insuficiencia Renal/etnología , Insuficiencia Renal/terapia , Familia/psicología , Humanos
16.
Z Psychosom Med Psychother ; 66(1): 20-31, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32066348

RESUMEN

Objectives: Intercultural opening of the health care system is supposed to optimize health services for migrants. It is part of the National Integration Plan and promoted by medical societies in Germany. This study examines its state of implementation at hospitals and rehabilitation centres for psychosomatic medicine and psychotherapy in Bavaria. Methods: A written survey was conducted using a modified version of the questionnaire for the implementation of intercultural opening in the mental health care system IKÖ-P (Penka et al. 2012a). Results: Altogether 18 institutions responded. Migrants were underrepresented among patients and employees excluding physicians. Specialized psychotherapeutic interventions for migrants were rarely available, but frequently used when offered. Conclusions: Intercultural opening was poorly implemented in a structural level. Due to the low response-rate of 21.7 % the survey is not representative. Participation of institutions interested in intercultural opening could have led to biased results. To provide adequate psychosomatic medical care for migrants, intercultural opening should be further developed.


Asunto(s)
Competencia Cultural/organización & administración , Hospitales , Trastornos Psicofisiológicos/terapia , Medicina Psicosomática/organización & administración , Psicoterapia/organización & administración , Centros de Rehabilitación/organización & administración , Alemania , Humanos , Trastornos Psicofisiológicos/etnología , Migrantes/psicología
17.
Am Surg ; 86(1): 8-14, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-32077410

RESUMEN

Studies demonstrate a significant variation in decision-making regarding withdrawal of life-sustaining treatment (WLST) practices for patients with severe traumatic brain injury (TBI). We investigated risk factors associated with WLST in severe TBI. We hypothesized age ≥65 years would be an independent risk factor. In addition, we compared survivors with patients who died in hospital after WLST to identify potential factors associated with in-hospital mortality. The Trauma Quality Improvement Program (2010-2016) was queried for patients with severe TBI of the head. Patients were compared by age (age < 65 and age ≥ 65 years) and survival after WLST (survivors versus non-survivors) at hospitalization discharge. A multivariable logistic regression model was used for analysis. From 1,403,466 trauma admissions, 328,588 (23.4%) patients had severe TBI. Age ≥ 65 years was associated with increased WLST (odds ratio: 1.76, confidence interval: 1.59-1.94, P < 0.001), whereas nonwhite race was associated with decreased WLST (odds ratio: 0.60, confidence interval: 0.55-0.65, P < 0.001). Compared with non-survivors of WLST, survivors were older (74 vs 61 years, P < 0.001) and more likely to have comorbidities such as hypertension (57% vs 38.5%, P < 0.001). Age ≥ 65 years was an independent risk factor for WLST, and nonwhite race was associated with decreased WLST. Patients surviving until discharge after WLST decision were older (≥74 years) and had multiple comorbidities.


Asunto(s)
Lesiones Traumáticas del Encéfalo/terapia , Privación de Tratamiento , Adulto , Factores de Edad , Anciano , Lesiones Traumáticas del Encéfalo/etnología , Lesiones Traumáticas del Encéfalo/mortalidad , Toma de Decisiones , Mortalidad Hospitalaria , Humanos , Puntaje de Gravedad del Traumatismo , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
19.
MMWR Morb Mortal Wkly Rep ; 69(6): 161-165, 2020 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-32053581

RESUMEN

Diabetes is one of the most common chronic diseases among persons aged <20 years (1). Onset of diabetes in childhood and adolescence is associated with numerous complications, including diabetic kidney disease, retinopathy, and peripheral neuropathy, and has a substantial impact on public health resources (2,3). From 2002 to 2012, type 1 and type 2 diabetes incidence increased 1.4% and 7.1%, respectively, among U.S. youths (4). To assess recent trends in incidence of diabetes in youths (defined for this report as persons aged <20 years), researchers analyzed 2002-2015 data from the SEARCH for Diabetes in Youth Study (SEARCH), a U.S. population-based registry study with clinical sites located in five states. The incidence of both type 1 and type 2 diabetes in U.S. youths continued to rise at constant rates throughout this period. Among all youths, the incidence of type 1 diabetes increased from 19.5 per 100,000 in 2002-2003 to 22.3 in 2014-2015 (annual percent change [APC] = 1.9%). Among persons aged 10-19 years, type 2 diabetes incidence increased from 9.0 per 100,000 in 2002-2003 to 13.8 in 2014-2015 (APC = 4.8%). For both type 1 and type 2 diabetes, the rates of increase were generally higher among racial/ethnic minority populations than those among whites. These findings highlight the need for continued surveillance for diabetes among youths to monitor overall and group-specific trends, identify factors driving these trends, and inform health care planning.


Asunto(s)
Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Adolescente , Niño , Preescolar , Diabetes Mellitus Tipo 1/etnología , Diabetes Mellitus Tipo 2/etnología , Femenino , Humanos , Incidencia , Indios Norteamericanos/estadística & datos numéricos , Lactante , Recién Nacido , Masculino , Estados Unidos/epidemiología , Adulto Joven
20.
Medicine (Baltimore) ; 99(3): e18824, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011493

RESUMEN

This study aims to investigate the clinical characteristics and outcomes of carotid body tumors in Chinese patients in the last decade. A systematic search was conducted without limits and included studies published between January 2006 and December 2016 according to PubMed, the Chinese Science Citation Database, the China Science Periodical Database and the China National Knowledge Infrastructure. Relevant synonyms for the search terms "paraganglioma" and "carotid body tumor" were applied, and the clinical data were evaluated and analyzed. There were 1810 cases of CBTs reported in the last decade, of which females accounted for 60.22%, and the mean age was 40.60 years, with most cases being sporadic (98.51%). Surgical resection was performed in 1791 cases: vessel repair occurred in 38.88% of the cases, carotid ligation occurred in 1.42% of the cases, and 1.05% of the patients refused treatment. Some patients underwent selective embolization, and the results showed that embolization could decrease procedure time and blood loss (P < .01). Stroke and death occurred in 1.95% and 0.39% of patients, respectively. Malignant CBTs accounted for 4.30% of cases, and the metastatic sites involved were local metastasis (46.88%), lung (31.25%), bone (21.88%), liver (12.50%), and brain (9.38%). The overall survival rate was 98.87% 36 months after the procedure, and the survival rate of metastatic cases was 56.25% 6 months after recurrence; however, only 21.88% of metastatic cases received radiotherapy. The CBTs of Chinese patients showed some clinical features that were different from those of Western patients.


Asunto(s)
Tumor del Cuerpo Carotídeo/etnología , Tumor del Cuerpo Carotídeo/cirugía , China/epidemiología , Humanos
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