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1.
Front Public Health ; 10: 918182, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35844861

RESUMO

Purpose: To review the association between children's behavioral changes during the restriction due to the pandemic of Coronavirus disease (COVID-19) and the development and progression of myopia. Design: A literature review. Method: We looked for relevant studies related to 1) children's behavioral changes from COVID-19 restriction and 2) children's myopia progression during COVID-19 restriction by using the following keywords. They were "Behavior," "Activity," "COVID-19," "Lockdown," "Restriction," and "Children" for the former; "Myopia," "COVID-19," "Lockdown," "Restriction" for the latter. Titles, abstracts and full texts from the retrieved studies were screened and all relevant data were summarized, analyzed, and discussed. Results: Children were less active and more sedentary during COVID-19 restriction. According to five studies from China and six studies, each from Hong Kong, Spain, Israel, South Korea, Turkey and Taiwan included in our review, all countries without myopia preventive intervention supported the association between the lockdown and myopia progression by means of negative SER change ranging from 0.05-0.6 D, more negative SER change (compared post- to pre-lockdown) ranging from 0.71-0.98 D and more negative rate of SER changes (compared post- to pre-lockdown) ranging from 0.05-0.1 D/month. The reported factor that accelerated myopia is an increase in total near work, while increased outdoor activity is a protective factor against myopia progression. Conclusion: The pandemic of COVID-19 provided an unwanted opportunity to assess the effect of the behavioral changes and myopia in the real world. There is sufficient evidence to support the association between an increase in near work from home confinement or a reduction of outdoor activities and worsening of myopia during the COVID-19 lockdown. The findings from this review of data from the real world may help better understanding of myopia development and progression, which may lead to adjustment of behaviors to prevent myopia and its progression in the future.


Assuntos
COVID-19 , Miopia , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Miopia/epidemiologia , Pandemias/prevenção & controle , Fatores Sociais
2.
Epidemics ; 39: 100570, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35569248

RESUMO

Mathematical modeling studies are frequently conducted to guide policy in global health. However, the contribution of mathematical modeling studies to World Health Organization (WHO) guideline recommendations, and the quality of evidence contributed by these studies remains unknown. We conducted a systematic review of the WHO Guidelines Review Committee database to identify guideline recommendations that included evidence from mathematical modeling studies since inception of the Guidelines Review Committee on 1 December, 2007. We included WHO guideline recommendations citing a mathematical modeling study in the primary evidence base. We defined a mathematical model as a framework that predicted epidemiologic, health or economic impact of an intervention or decision in the clinical or public health context. The primary outcome was inclusion of evidence from mathematical modeling studies in a guideline recommendation. We evaluated each unique modeling study across multiple domains of quality. Between 1 December 2007 and 1 April 2019, the WHO Guidelines Review Committee approved 154 guidelines providing 1619 guideline recommendations. Mathematical modeling studies informed 46 WHO guidelines (29.9%) and 101 unique guideline recommendations (6.2%). Modeling evidence addressed topics related to infectious diseases in 38 guidelines (82.6%) and 81 recommendations (80.2%), most commonly for HIV and tuberculosis. Evidence from modeling studies was assessed in the GRADE evidence profile for 12 recommendations (12.9%) and GRADE evidence-to-decision framework for 45 recommendations (44.6%). Modeling-informed recommendations were more likely than other recommendations within the same guidelines to be issued with a "conditional" rather than "strong" strength of recommendation (53.5% versus 37.8%), and the evidence underlying modeling-informed recommendations was more likely to be assessed as very low quality (41.6% versus 24.1%). Upon review of individual modeling studies, we estimated that 33.8% of models performed a calibration, 29.4% of models performed a validation of results, and 20.6% of models reported a change in the study conclusion in the sensitivity analysis. While policy recommendations in WHO guidelines are informed by evidence from modeling studies, the validity of modeling studies included in guidelines development is heterogeneous. Quality assessment is needed to support the evaluation and incorporation of evidence from mathematical modeling studies in guidelines development.


Assuntos
Medicina Baseada em Evidências , Modelos Teóricos , Calibragem , Medicina Baseada em Evidências/métodos , Saúde Pública , Organização Mundial da Saúde
3.
Malar J ; 21(1): 89, 2022 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-35300703

RESUMO

BACKGROUND: The zoonotic malaria parasite Plasmodium knowlesi has emerged across Southeast Asia and is now the main cause of malaria in humans in Malaysia. A critical priority for P. knowlesi surveillance and control is understanding whether transmission is entirely zoonotic or is also occurring through human-mosquito-human transmission. METHODS: A systematic literature review was performed to evaluate existing evidence which refutes or supports the occurrence of sustained human-mosquito-human transmission of P. knowlesi. Possible evidence categories and study types which would support or refute non-zoonotic transmission were identified and ranked. A literature search was conducted on Medline, EMBASE and Web of Science using a broad search strategy to identify any possible published literature. Results were synthesized using the Synthesis Without Meta-analysis (SWiM) framework, using vote counting to combine the evidence within specific categories. RESULTS: Of an initial 7,299 studies screened, 131 studies were included within this review: 87 studies of P. knowlesi prevalence in humans, 14 studies in non-human primates, 13 studies in mosquitoes, and 29 studies with direct evidence refuting or supporting non-zoonotic transmission. Overall, the evidence showed that human-mosquito-human transmission is biologically possible, but there is limited evidence of widespread occurrence in endemic areas. Specific areas of research were identified that require further attention, notably quantitative analyses of potential transmission dynamics, epidemiological and entomological surveys, and ecological studies into the sylvatic cycle of the disease. CONCLUSION: There are key questions about P. knowlesi that remain within the areas of research that require more attention. These questions have significant implications for malaria elimination and eradication programs. This paper considers limited but varied research and provides a methodological framework for assessing the likelihood of different transmission patterns for emerging zoonotic diseases.


Assuntos
Culicidae , Malária , Plasmodium knowlesi , Animais , Ásia Sudeste/epidemiologia , Humanos , Malária/epidemiologia , Zoonoses/epidemiologia
4.
Rev. Ciênc. Plur ; 8(2): e25243, mar. 2022. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1368175

RESUMO

Introdução:As doenças do aparelho respiratório se configuram como o segundo principal motivo de internações hospitalares no Brasil entre 2013 e 2017. Objetivo:Analisar a morbimortalidade de doenças do aparelho respiratório da população brasileira, segundo faixa etária,no período compreendido entre os anos de 2015 a 2019. Metodologia:Trata-se de um estudo do tipo ecológico, retrospectivo, realizado sobre o território brasileiro. Os dados foram coletados a partir do Departamento de Informática do Sistema Único de Saúde, nas seções de Morbidade Hospitalar, de Mortalidade e População Residente. Foram analisados os dados entre 2015 a 2019 e de todas as faixas etárias. Resultados:Ao investigar a mortalidade por doenças do sistema respiratório entre os anos de 2015 e 2019, as cinco causas mais frequentes foram: influenza e pneumonia; doenças crônicas das vias aéreas inferiores; outras doenças do aparelho respiratório; outras doenças respiratórias que afetam principalmente interstício; doenças pulmonares devidas a agentes externos, nessa ordem. Enquanto as cinco causas de morbidades mais frequentes foram: pneumonia; outras doenças do aparelho respiratório; bronquite, enfisema e outras doenças pulmonares obstrutivas crônicas; asma; bronquite aguda e bronquiolite aguda. Conclusões:Verificou-se que a pneumonia, influenza, doenças respiratórias do trato inferior e outras doenças crônicas respiratórias foram as mais prevalentes entre a população respectivamente. Dentre o público mais acometido, foi possível constatar que o público infantil e a população idosa foram os mais atingidos tanto na mortalidade quanto na morbidade (AU).


Introduction:Introduction: Respiratory diseases are the second main reason for hospital admissions in Brazil between 2013 and 2017. Objective:To analyze the morbidity and mortality of respiratory diseases of the Brazilian population, according to age group, in the period from 2015 to 2019. Methodology:This is an ecological, retrospective study conducted on the Brazilian territory. Data were collected from the Informatics Department of the Unified Health System, in the Sections of Hospital Morbidity, Mortality and Resident Population. Data were analyzed between 2015 and 2019 and all age groups. Results:When investigating mortality from respiratory system diseases between 2015 and 2019, the five most frequent causes were: influenza and pneumonia; chronic diseases of the lower airways; other diseases of the respiratory system; other respiratory diseases that mainly affect interstitium; diseases due to external agents, in that order. Conclusions:It was found that pneumonia, influenza, respiratory diseases of the lower tract and other chronic respiratory diseases were the most prevalent among the population, respectively. Among the most affected public, it was possible to observe that the child's public and the elderly population were the most affected in both mortality and morbidity (AU).


Introducción: Las enfermedades respiratorias son la segunda razón principal de los ingresos hospitalarios en Brasil entre 2013 y 2017. Objetivo: Analizar la morbilidad y mortalidad de las enfermedades respiratorias de la población brasileña, según el grupo de edad, en el período comprendido entre 2015 y 2019.Metodología: Se trata de un estudio ecológico y retrospectivo realizado en territorio brasileño. Los datos fueron recogidos del Departamento de Informática del Sistema Unificado de Salud, en las Secciones de Morbilidad Hospitalaria, Mortalidad y Población Residente. Los datos se analizaron entre 2015 y 2019 y todos los grupos de edad. Resultados: Al investigar la mortalidad por enfermedades del sistema respiratorio entre 2015 y 2019, las cinco causas más frecuentes fueron: gripe y neumonía; enfermedades crónicas de las vías respiratorias inferiores; otras enfermedades del sistema respiratorio; otras enfermedades respiratorias que afectan principalmente al intersticio; enfermedades debidas a agentes externos, en ese orden.Mientras que las cinco causas más frecuentes de morbilidad fueron: neumonía; otras enfermedades del sistema respiratorio; bronquitis, enfisema y otras enfermedades pulmonares obstructivas crónicas; asma; bronquiolitis aguda y bronquiolitis aguda. While the five most frequent causes of morbidities were: pneumonia; other diseases of the respiratory system; bronchitis, emphysema and other chronic obstructive pulmonary diseases; asthma; acute bronchitis and acute bronchiolitis. Conclusiones: Se encontróque la neumonía, la influenza, las enfermedades respiratorias de las vías inferiores y otras enfermedades respiratorias crónicas eran las más prevalentes entre la población, respectivamente. Entre el público más afectado, se pudo observar que el público del niño y la población de edad avanzada eran los más afectados tanto en la mortalidad como en la morbilidad (AU).


Assuntos
Humanos , Masculino , Feminino , Sistema Respiratório/anatomia & histologia , Doenças Respiratórias/patologia , Brasil/epidemiologia , Indicadores de Morbimortalidade , Estudos Retrospectivos , Interpretação Estatística de Dados , Estudos Ecológicos , Grupos Etários
5.
Official Document;363ODD363.
Não convencional em Inglês | PAHO-IRIS | ID: phr-55782

RESUMO

The Program Budget of the Pan American Health Organization 2022–2023 is the second to be developed and implemented under the Strategic Plan of the Pan American Health Organization 2020–2025. It sets out the corporate results and targets for the Pan American Health Organization (PAHO) for the next two years. It presents the budget that the Pan American Sanitary Bureau will require in order to deliver on these biennial results and support Member States in improving health outcomes while contributing to the achievement of health targets set out in existing regional and global frameworks. The results framework of the Program Budget responds to the main strategic mandates for the period: the Thirteenth General Programme of Work of the World Health Organization (WHO), the WHO Programme Budget 2022–2023, the Sustainable Health Agenda for the Americas 2018–2030, and the PAHO Strategic Plan 2020–2025. Its implementation will also contribute to progress toward the Sustainable Development Goals. Moreover, this is the first Program Budget to be developed during the COVID-19 period, and many aspects of it have been shaped by the consequences and lessons learned from the protracted emergency.


Assuntos
Planejamento Estratégico , Administração Financeira , Orçamentos , Análise de Impacto Orçamentário de Avanços Terapêuticos , Administração Financeira , Organização Pan-Americana da Saúde , Desenvolvimento Sustentável , Prestação de Contas Financeiras em Saúde , Medição de Risco , Serviços de Saúde , Doenças Transmissíveis , Doenças não Transmissíveis , Saúde Mental , Qualidade da Assistência à Saúde , Cooperação Técnica , América , COVID-19
6.
Global Health ; 18(1): 1, 2022 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-34980187

RESUMO

BACKGROUND: Climate change is expected to alter the global footprint of many infectious diseases, particularly vector-borne diseases such as malaria and dengue. Knowledge of the range and geographical context of expected climate change impacts on disease transmission and spread, combined with knowledge of effective adaptation strategies and responses, can help to identify gaps and best practices to mitigate future health impacts. To investigate the types of evidence for impacts of climate change on two major mosquito-borne diseases of global health importance, malaria and dengue, and to identify the range of relevant policy responses and adaptation strategies that have been devised, we performed a scoping review of published review literature. Three electronic databases (PubMed, Scopus and Epistemonikos) were systematically searched for relevant published reviews. Inclusion criteria were: reviews with a systematic search, from 2007 to 2020, in English or French, that addressed climate change impacts and/or adaptation strategies related to malaria and/or dengue. Data extracted included: characteristics of the article, type of review, disease(s) of focus, geographic focus, and nature of the evidence. The evidence was summarized to identify and compare regional evidence for climate change impacts and adaptation measures. RESULTS: A total of 32 reviews met the inclusion criteria. Evidence for the impacts of climate change (including climate variability) on dengue was greatest in the Southeast Asian region, while evidence for the impacts of climate change on malaria was greatest in the African region, particularly in highland areas. Few reviews explicitly addressed the implementation of adaptation strategies to address climate change-driven disease transmission, however suggested strategies included enhanced surveillance, early warning systems, predictive models and enhanced vector control. CONCLUSIONS: There is strong evidence for the impacts of climate change, including climate variability, on the transmission and future spread of malaria and dengue, two of the most globally important vector-borne diseases. Further efforts are needed to develop multi-sectoral climate change adaptation strategies to enhance the capacity and resilience of health systems and communities, especially in regions with predicted climatic suitability for future emergence and re-emergence of malaria and dengue. This scoping review may serve as a useful precursor to inform future systematic reviews of the primary literature.


Assuntos
Dengue , Malária , Animais , Mudança Climática , Dengue/epidemiologia , Previsões , Humanos , Malária/epidemiologia
7.
Epigenetics ; 17(7): 759-785, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34384035

RESUMO

DNA methylation (DNAm) is one of the most studied epigenetic modifications. DNAm has emerged as a key biological mechanism and biomarkers to test associations between environmental exposure and outcomes in epidemiological studies. Although previous studies have focused on associations between DNAm and either exposure/outcomes, it is useful to test for mediation of the association between exposure and outcome by DNAm. The purpose of this scoping review is to introduce the methodological essence of statistical mediation analysis and to examine emerging epidemiological research applying mediation analyses. We conducted this scoping review for published peer-reviewed journals on this topic using online databases (PubMed, Scopus, Cochrane, and CINAHL) ending in December 2020. We extracted a total of 219 articles by initial screening. After reviewing titles, abstracts, and full texts, a total of 69 articles were eligible for this review. The breakdown of studies assigned to each category was 13 for smoking (18.8%), 8 for dietary intake and famine (11.6%), 6 for other lifestyle factors (8.7%), 8 for clinical endpoints (11.6%), 22 for environmental chemical exposures (31.9%), 2 for socioeconomic status (SES) (2.9%), and 10 for genetic factors and race (14.5%). In this review, we provide an exposure-wide summary for the mediation analysis using DNAm levels. However, we found heterogenous methods and interpretations in mediation analysis with typical issues such as different cell compositions and tissue-specificity. Further accumulation of evidence with diverse exposures, populations and with rigorous methodology will be expected to provide further insight in the role of DNAm in disease susceptibility.


Assuntos
Metilação de DNA , Análise de Mediação , Doença Crônica , Epigênese Genética , Humanos , Fumar
8.
Int Health ; 14(2): 132-141, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-34415026

RESUMO

Stem cell tourism is an emerging area of medical tourism activity. Frustrated by the slow translation of stem cell research into clinical practice, patients with debilitating conditions often seek therapeutic options that are not appropriately regulated. This review summarises recent developments in the field of stem cell tourism and provides clinicians with the information necessary to provide basic pretravel health advice to stem cell tourists. PubMed and Scopus databases were consulted for relevant publications, using combinations of the terms 'stem cell', 'tourism', 'regenerative medicine', 'international', 'travel medicine' and 'environmental health'. The leading countries in the international stem cell tourism market are the USA, China, India, Thailand and Mexico. As the majority of clinics offering stem cell therapies are based in low- and-middle-income countries, stem cell tourists place themselves at risk of receiving an unproven treatment, coupled with the risk of travel-related illnesses. These clinics do not generally provide even basic travel health information on their websites. In addition to often being ineffective, stem cell therapies are associated with complications such as infection, rejection and tumorigenesis. Physicians, researchers, regulatory bodies, advocacy groups and medical educators are encouraged to work together to improve patient and physician education and address current legislative deficiencies.


Assuntos
Turismo Médico , Turismo , Humanos , Células-Tronco , Viagem , Doença Relacionada a Viagens
9.
Eur J Clin Nutr ; 76(5): 637-646, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34545213

RESUMO

Unhealthy population diets contribute to the burden of non-communicable diseases. Policies targeting food environments (FE policies) may improve population diets. This review of systematic reviews aims to summarise recent evidence of the effectiveness of FE policies in improving diets. We searched PubMed for systematic reviews published from January 2010 onwards. Eligible FE policies included: nutrition and food labelling, provision of foods in public institutions or specific settings, price, marketing, nutrition quality and portion size, and availability of foods in retail and food service establishments. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) instrument was used to assess review quality. Reviews of critically low quality were excluded. Results were narratively reported in text and tables. The search identified 1102 records after removing duplicates. Following screening and quality assessment we included 12 systematic reviews. Two reviews focused on nutrition and food labelling, two on provision of foods in school settings, four on price, none on marketing policies, three on nutrition quality and portion size and one on the availability of foods in retail and food service establishments. Pricing policies (tax/subsidy) appear effective in altering intake and purchase of targeted foods and beverages. FE policies targeting the availability of foods in retail and food establishments, food provision in school settings, product reformulation and the size of portions/packages or items of tableware also appear effective. Overall, policies targeting food environments appear effective in improving population diets. However, there is a need for further high-quality evidence.


Assuntos
Dieta , Política Nutricional , Alimentos , Rotulagem de Alimentos , Humanos , Revisões Sistemáticas como Assunto
10.
Braz J Microbiol ; 53(1): 231-244, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34825345

RESUMO

Sporotrichosis is a cosmopolitan subcutaneous mycosis caused by Sporothrix species. Recently, this mycosis has gained notoriety due to the appearance of new endemic areas, recognition of new pathogenic species, changes in epidemiology, occurrence of outbreaks, and increasing numbers of cases. The purpose of this study is to analyze the peculiarities of sporotrichosis cases in Brazil since its first report in the country until 2020. In this work, ecological, epidemiological, clinical, and laboratorial characteristics were compiled. A systematic review of human sporotrichosis diagnosed in Brazil and published up to December 2020 was performed on PubMed/MEDLINE, SciELO, Web of Science, and LILACS databases. Furthermore, animal sporotrichosis and environmental isolation of Sporothrix spp. in Brazil were also evaluated. The study included 230 papers, resulting in 10,400 human patients. Their ages ranged from 5 months to 92 years old and 55.98% were female. The lymphocutaneous form was predominant (56.14%), but systemic involvement was also notably reported (14.34%), especially in the lungs. Besides, hypersensitivity manifestations (4.55%) were described. Most patients had the diagnosis confirmed by isolation of Sporothrix spp., mainly from skin samples. Sporothrix brasiliensis was the major agent identified. HIV infection, cardiovascular diseases, and diabetes were the most common comorbidities. Cure rate was 85.83%. Concerning animal sporotrichosis, 8538 cases were reported, mostly in cats (90.77%). Moreover, 13 Sporothrix spp. environmental strains were reported. This review highlights the burden of the emergent zoonotic sporotrichosis in Brazil, reinforcing the importance of "One Health" based actions to help controlling this disease.


Assuntos
Doenças do Gato , Infecções por HIV , Sporothrix , Esporotricose , Animais , Brasil/epidemiologia , Doenças do Gato/epidemiologia , Gatos , Surtos de Doenças/veterinária , Infecções por HIV/epidemiologia , Humanos , Filogenia , Sporothrix/genética , Esporotricose/microbiologia
11.
FEMS Microbiol Rev ; 46(1)2022 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-34468735

RESUMO

Understanding the interactions of ecosystems, humans and pathogens is important for disease risk estimation. This is particularly true for neglected and newly emerging diseases where modes and efficiencies of transmission leading to epidemics are not well understood. Using a model for other emerging diseases, the neglected tropical skin disease Buruli ulcer (BU), we systematically review the literature on transmission of the etiologic agent, Mycobacterium ulcerans (MU), within a One Health/EcoHealth framework and against Hill's nine criteria and Koch's postulates for making strong inference in disease systems. Using this strong inference approach, we advocate a null hypothesis for MU transmission and other understudied disease systems. The null should be tested against alternative vector or host roles in pathogen transmission to better inform disease management. We propose a re-evaluation of what is necessary to identify and confirm hosts, reservoirs and vectors associated with environmental pathogen replication, dispersal and transmission; critically review alternative environmental sources of MU that may be important for transmission, including invertebrate and vertebrate species, plants and biofilms on aquatic substrates; and conclude with placing BU within the context of other neglected and emerging infectious diseases with intricate ecological relationships that lead to disease in humans, wildlife and domestic animals.


Assuntos
Úlcera de Buruli , Mycobacterium ulcerans , Animais , Ecossistema , Humanos , Plantas
12.
Environ Pollut ; 293: 118584, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34843856

RESUMO

Emergency responses to the COVID-19 pandemic led to major changes in travel behaviours and economic activities in 2020. Machine learning provides a reliable approach for assessing the contribution of these changes to air quality. This study investigates impacts of health protection measures upon air pollution and traffic emissions and estimates health and economic impacts arising from these changes during two national 'lockdown' periods in Oxford, UK. Air quality improvements were most marked during the first lockdown with reductions in observed NO2 concentrations of 38% (SD ± 24.0%) at roadside and 17% (SD ± 5.4%) at urban background locations. Observed changes in PM2.5, PM10 and O3 concentrations were not significant during first or second lockdown. Deweathering and detrending analyses revealed a 22% (SD ± 4.4%) reduction in roadside NO2 and 2% (SD ± 7.1%) at urban background with no significant changes in the second lockdown. Deweathered-detrended PM2.5 and O3 concentration changes were not significant, but PM10 increased in the second lockdown only. City centre traffic volume reduced by 69% and 38% in the first and second lockdown periods. Buses and passenger cars were the major contributors to NO2 emissions, with relative reductions of 56% and 77% respectively during the first lockdown, and less pronounced changes in the second lockdown. While car and bus NO2 emissions decreased during both lockdown periods, the overall contribution from buses increased relative to cars in the second lockdown. Sustained NO2 emissions reduction consistent with the first lockdown could prevent 48 lost life-years among the city population, with economic benefits of up to £2.5 million. Our findings highlight the critical importance of decoupling emissions changes from meteorological influences to avoid overestimation of lockdown impacts and indicate targeted emissions control measures will be the most effective strategy for achieving air quality and public health benefits in this setting.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar/prevenção & controle , Controle de Doenças Transmissíveis , Monitoramento Ambiental , Humanos , Pandemias , Material Particulado/análise , Saúde Pública , SARS-CoV-2 , Reino Unido
13.
Trans R Soc Trop Med Hyg ; 116(2): 108-116, 2022 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34134133

RESUMO

BACKGROUND: We analysed the spatial distribution and the socio-economic and environmental factors (SEFs) associated with Schistosoma mansoni infection in the state of Alagoas, an important tourist area in northeastern Brazil. METHODS: We conducted an ecological time-series study (2007-2016) on schistosomiasis cases and SEFs. We evaluated the temporal trends of schistosomiasis cases (annual percentage change [APC]) and their correlation with SEFs. Spatial analysis maps were built using QGIS and TerraView software. RESULTS: We observed that 4.9% of the municipalities had a high prevalence of S. mansoni infection and were located mainly in the coastal strip of Alagoas state. The positivity rate for schistosomiasis decreased during the period (8.1% in 2007 to 4.9% in 2016; APC=-5.71). There was a reduction in the number of tests performed (APC=-5.05). There was a negative correlation between S. mansoni infection and the municipal human development index (ρ=-0.34) and schooling rate (ρ=-0.24). The main species of snail was Biomphalaria glabrata (94.79%), but Biomphalaria straminea showed a higher percentage of S. mansoni detection (10.11%). Lastly, Biomphalaria tenagophila specimens were identified for the first time in Alagoas (n=28). CONCLUSIONS: Despite a reduction in the number of cases, intestinal schistosomiasis still represents a serious public health concern in Alagoas. It urgently requires planning and improvements in diagnosis, prevention programs and the state's socio-economic indicators.


Assuntos
Biomphalaria , Esquistossomose mansoni , Esquistossomose , Animais , Brasil/epidemiologia , Vetores de Doenças , Humanos , Schistosoma mansoni , Esquistossomose mansoni/diagnóstico , Esquistossomose mansoni/epidemiologia , Fatores Socioeconômicos
14.
Occup Environ Med ; 79(1): 63-71, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34035182

RESUMO

OBJECTIVES: Employees in non-healthcare occupations may be in several ways exposed to infectious agents. Improved knowledge about the risks is needed to identify opportunities to prevent work-related infectious diseases. The objective of the current study was to provide an updated overview of the published evidence on the exposure to pathogens among non-healthcare workers. Because of the recent SARS-CoV-2 outbreaks, we also aimed to gain more evidence about exposure to several respiratory tract pathogens. METHODS: Eligible studies were identified in MEDLINE, Embase and Cochrane between 2009 and 8 December 2020. The protocol was registered with International Prospective Register of Systematic Reviews (CRD42019107265). An additional quality assessment was applied according to the Equator network guidelines. RESULTS: The systematic literature search yielded 4620 papers of which 270 met the selection and quality criteria. Infectious disease risks were described in 37 occupational groups; 18 of them were not mentioned before. Armed forces (n=36 pathogens), livestock farm labourers (n=31), livestock/dairy producers (n=26), abattoir workers (n=22); animal carers and forestry workers (both n=16) seemed to have the highest risk. In total, 111 pathogen exposures were found. Many of these occupational groups (81.1%) were exposed to respiratory tract pathogens. CONCLUSION: Many of these respiratory tract pathogens were readily transmitted where employees congregate (workplace risk factors), while worker risk factors seemed to be of increasing importance. By analysing existing knowledge of these risk factors, identifying new risks and susceptible risk groups, this review aimed to raise awareness of the issue and provide reliable information to establish more effective preventive measures.


Assuntos
Transmissão de Doença Infecciosa , Doenças Profissionais/epidemiologia , Exposição Ocupacional , Recursos Humanos , Local de Trabalho , Saúde Global , Humanos , Fatores de Risco
15.
Nurs Open ; 9(3): 1575-1588, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34021729

RESUMO

AIM: This review aimed to elucidate research trends in global nursing in international literature. DESIGN: A scoping literature review of the PRISMA was used to guide the review. METHODS: PubMed was used to search for English articles published in academic journals between 2016-2018. The search keywords were "global/international/world nursing." We used thematic synthesis to analyse and interpret the data and generated topics for global nursing literature. RESULTS: In total, 133 articles were analysed. Six topics emerged: (a) conceptualization of global nursing, (b) environmental health, (c) infectious diseases, (d) security efforts, (e) global shortage of nursing personnel and (f) diversification of study abroad programmes. The results of this review reflect today's serious international health, labour and global environmental issues. Based on these latest global nursing topics, it is necessary to develop new strategies, nursing models and environment-related theories to create and maintain a healthy environment.


Assuntos
Saúde Global , Publicações , Saúde Ambiental
16.
Stem Cell Rev Rep ; 18(3): 902-932, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34110587

RESUMO

Extracellular vesicle (EV)-based therapy was hypothesized as a promising regenerative approach which has led to intensive research of EVs in various pathologies. In this study, we performed a comprehensive systematic review of the current experimental evidence regarding the protective properties of EVs in chronic kidney disease (CKD). We evaluated the EV-based experiments, EV characteristics, and effector molecules with their involvement in CKD pathways. Including all animal records with available creatinine or urea data, we performed a stratified univariable meta-analysis to assess the determinants of EV-based therapy effectiveness. We identified 35 interventional studies that assessed nephroprotective role of EVs and catalogued them according to their involvement in CKD mechanism. Systematic assessment of these studies suggested that EVs had consistently improved glomerulosclerosis, interstitial fibrosis, and cell damage, among different CKD models. Moreover, EV-based therapy reduced the progression of renal decline in CKD. The stratified analyses showed that the disease model, administered dose, and time of therapeutic intervention were potential predictors of therapeutic efficacy. Together, EV therapy is a promising approach for CKD progression in experimental studies. Further standardisation of EV-methods, continuous improvement of the study quality, and better understanding of the determinants of EV effectiveness will facilitate preclinical research, and may help development of clinical trials in people with CKD.


Assuntos
Vesículas Extracelulares , Células-Tronco Mesenquimais , Insuficiência Renal Crônica , Animais , Vesículas Extracelulares/metabolismo , Humanos , Rim , Células-Tronco Mesenquimais/metabolismo , Modelos Teóricos , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Insuficiência Renal Crônica/terapia
17.
Environ Sci Pollut Res Int ; 29(6): 8452-8463, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34490561

RESUMO

The COVID-19 pandemic has created unprecedented human health crisis in recent global history with rippling social and economic effects. The outbreak in India has resulted in emergency lockdown in the country for more than 2 months, and that caused decline in the catch, demand, and supply of fish. It has severely altered the life and livelihoods of the floodplain wetland fishers. These floodplain wetlands play a key role in socio-economic development of stakeholders, by generating employment and livelihood in the studied regions. In the present study, a systematic assessment was conducted to identify the impact of lockdown on floodplain wetland fisheries in India with the aim to evaluate the impact of the COVID-19 lockdown on wetland fishing, fisheries production, income, and food access. We conducted a rapid telephonic survey covering176 wetland fishers in 3 states to document the early impacts of the pandemic and policy responses on floodplain wetland fisher households. The majority of fishers report negative impacts on production, sales, and incomes. Fishers of three Indian states Bihar, West Bengal, and Assam lost 20, 25, and 9 fishing days, respectively. About 70, 60, and 55 % fishers of floodplain wetlands of the three states admitted that lockdown made them partially jobless. Fish harvest during March to May was 32, 44, and 20 % lower than the previous years in Bihar, West Bengal, and Assam. The fishers of Bihar, West Bengal, and Assam lost income of INR 10000/-, 12500/-, and 4500/- due to lockdown. The analysis also showed that 25% of fishers each responded moderate to severe psychological impact and anxiety symptoms due to COVID-19. Demand supply gap during the lockdown led to the in 20-40 % increase in farm gate price of fishes at the wetland level. The present study is the first of its kind in India to systematically assess the impact and discusses several magnitudes on floodplain wetland fisher livelihood, income, and food access and suggests strategies and decision support.


Assuntos
COVID-19 , Pesqueiros , Animais , Controle de Doenças Transmissíveis , Humanos , Caça , Pandemias , SARS-CoV-2 , Áreas Alagadas
18.
Disabil Rehabil ; 44(7): 1007-1022, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-32686963

RESUMO

PURPOSE: Chronic physical conditions often negatively affect work participation. The objective of this systematic review is to investigate the effectiveness and characteristics of vocational rehabilitation interventions for people with a chronic physical condition. METHODS: Searches in five databases up to April 2020 identified 30 studies meeting our inclusion criteria. Two reviewers independently assessed and extracted data. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) framework was used to evaluate quality of evidence for three outcome measures related to work participation. RESULTS: All vocational rehabilitation interventions consisted of multiple components, but their characteristics varied widely. Analysis of 22 trials yielded a moderate positive effect with moderate certainty of interventions on work status; analysis of five trials with low risk of bias showed a large positive effect with moderate certainty (risk ratio 1.33 and 1.57, respectively). In addition, in eight studies we found a moderate to small positive effect with low certainty on work attitude (standardized mean difference = 0.59 or 0.38, respectively). We found no effect on work productivity in nine studies. CONCLUSION: The systematic review of the literature showed positive effects of vocational rehabilitation interventions on work status and on work attitude; we found no effect on work productivity.Implications for rehabilitationIn rehabilitation, addressing work participation of persons with a chronic physical condition using targeted interventions is beneficial to improve or sustain work participation, irrespective of the intervention characteristics and diagnosis.Interventions that include multiple components and offer individual support, whether or not combined with group sessions, are likely to be more effective in improving work participation in persons with a chronic physical condition.The overview of vocational interventions in this systematic review may assist healthcare professionals in making informed decisions as to which intervention to provide.Vocational rehabilitation, as well as studies on work participation in chronic disease, should include a long follow-up period to explore if work participation is sustainable and contributes to health and wellbeing.


Assuntos
Avaliação de Resultados em Cuidados de Saúde , Reabilitação Vocacional , Adulto , Viés , Doença Crônica , Pessoal de Saúde , Humanos
19.
Sci Total Environ ; 816: 151654, 2022 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-34785217

RESUMO

A rich body of literature indicates that environmental factors interact with the human microbiome and influence its composition and functions contributing to the pathogenesis of diseases in distal sites of the body. This systematic review examines the scientific evidence on the effect of environmental toxicants, air pollutants and endocrine disruptors (EDCs), on compositional and diversity of human microbiota. Articles from PubMed, Embase, WoS and Google Scholar where included if they focused on human populations or the SHIME® model, and assessed the effects of air pollutants and EDCs on human microbiome. Non-human studies, not written in English and not displaying original research were excluded. The Newcastle-Ottawa Scale was used to assess the quality of individual studies. Results were extracted and presented in tables. 31 studies were selected, including 24 related to air pollutants, 5 related to EDCs, and 2 related to EDC using the SHIME® model. 19 studies focussed on the respiratory system (19), gut (8), skin (2), vaginal (1) and mammary (1) microbiomes. No sufficient number of studies are available to observe a consistent trend for most of the microbiota, except for streptococcus and veillionellales for which 9 out of 10, and 3 out of 4 studies suggest an increase of abundance with exposure to air pollution. A limitation of the evidence reviewed is the scarcity of existing studies assessing microbiomes from individual systems. Growing evidence suggests that exposure to environmental contaminants could change the diversity and abundance of resident microbiota, e.g. in the upper and lower respiratory, gastrointestinal, and female reproductive system. Microbial dysbiosis might lead to colonization of pathogens and outgrowth of pathobionts facilitating infectious diseases. It also might prime metabolic dysfunctions disrupting the production of beneficial metabolites. Further studies should elucidate the role of environmental pollutants in the development of dysbiosis and dysregulation of microbiota-related immunological processes.


Assuntos
Poluição do Ar , Disruptores Endócrinos , Microbioma Gastrointestinal , Microbiota , Poluição do Ar/estatística & dados numéricos , Disbiose , Disruptores Endócrinos/toxicidade , Feminino , Humanos
20.
Environ Pollut ; 293: 118544, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34801622

RESUMO

It is enlightening to determine the discrepancies and potential reasons for the degree of impact from the COVID-19 control measures on air quality as well as the associated health and economic impacts. Analysis of air quality, socio-economic factors, and meteorological data from 447 cities in 46 countries indicated that the COVID-19 control measures had significant impacts on the PM2.5 (particulate matter with an aerodynamic diameter less than 2.5 µm) concentrations in 20 (reduced PM2.5 concentrations of -7.4-29.1 µg m-3) of the selected 46 countries. In these 20 countries, the robustly distinguished changes in the PM2.5 concentrations caused by the control measures differed between the developed (95% confidence interval (CI): -2.7-5.5 µg m-3) and developing countries (95% CI: 8.3-23.2 µg m-3). As a result, the COVID-19 lockdown reduced death and hospital admissions change from the decreased PM2.5 concentrations by 7909 and 82,025 cases in the 12 developing countries, and by 78 and 1214 cases in the eight developed countries. The COVID-19 lockdown reduced the economic cost from the PM2.5 related health burden by 54.0 million dollars in the 12 developing countries and by 8.3 million dollars in the eight developed countries. The disparity was related to the different chemical compositions of PM2.5. In particular, the concentrations of primary PM2.5 (e.g., BC) in cities of developing countries were 3-45 times higher than those in developed countries, so the mass concentration of PM2.5 was more sensitive to the reduced local emissions in developing countries during the COVID-19 control period. The mass fractions of secondary PM2.5 in developed countries were generally higher than those in developing countries. As a result, these countries were more sensitive to the secondary atmospheric processing that may have been enhanced due to reduced local emissions.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , COVID-19 , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Cidades , Controle de Doenças Transmissíveis , Países em Desenvolvimento , Monitoramento Ambiental , Humanos , Material Particulado/análise , SARS-CoV-2
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