Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 165
Filtrar
1.
Public Health ; 224: 185-194, 2023 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-37820536

RESUMO

OBJECTIVE: The study aimed to identify, appraise and update evidence on the association between cold temperatures (i.e. <18°C) within homes (i.e. dwellings) and health and well-being outcomes. STUDY DESIGN: This study was a systematic review. METHODS: Seven databases (MEDLINE, Embase, Cochrane Database of Systematic Reviews, CINAHL, APA PsycInfo, Applied Social Sciences Index and Abstracts, Coronavirus Research Database) were searched for studies published between 2014 and 2022, which explored the association between cold indoor temperatures and health and well-being outcomes. Studies were limited to those conducted in temperate and colder climates due to the increased risk of morbidity and mortality during winter in those climatic zones. Studies were independently quality assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS: Of 1209 studies, 20 were included for review. Study outcomes included cardiovascular (blood pressure, electrocardiogram abnormalities, blood platelet count), respiratory (chronic obstructive pulmonary disease symptoms, respiratory viral infection), sleep, physical performance and general health. Seventeen studies found exposure to cold indoor temperatures was associated with negative effects on health outcomes studied. Older individuals and those with chronic health problems were found to be more vulnerable to negative health outcomes. CONCLUSION: Evidence suggests that indoor temperatures <18°C are associated with negative health effects. However, the evidence is insufficient to allow clear conclusions regarding outcomes from specific temperature thresholds for different population groups. Significant gaps in the current evidence base are identified, including research on the impacts of cold indoor temperatures on mental health and well-being, studies involving young children, and the long-term health effects of cold indoor temperatures.

2.
Cereb Cortex ; 32(12): 2611-2620, 2022 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34729592

RESUMO

The age- and time-dependent effects of binge drinking on adolescent brain development have not been well characterized even though binge drinking is a health crisis among adolescents. The impact of binge drinking on gray matter volume (GMV) development was examined using 5 waves of longitudinal data from the National Consortium on Alcohol and NeuroDevelopment in Adolescence study. Binge drinkers (n = 166) were compared with non-binge drinkers (n = 82 after matching on potential confounders). Number of binge drinking episodes in the past year was linked to decreased GMVs in bilateral Desikan-Killiany cortical parcellations (26 of 34 with P < 0.05/34) with the strongest effects observed in frontal regions. Interactions of binge drinking episodes and baseline age demonstrated stronger effects in younger participants. Statistical models sensitive to number of binge episodes and their temporal proximity to brain volumes provided the best fits. Consistent with prior research, results of this study highlight the negative effects of binge drinking on the developing brain. Our results present novel findings that cortical GMV decreases were greater in closer proximity to binge drinking episodes in a dose-response manner. This relation suggests a causal effect and raises the possibility that normal growth trajectories may be reinstated with alcohol abstinence.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas , Substância Cinzenta , Adolescente , Consumo de Bebidas Alcoólicas , Encéfalo/diagnóstico por imagem , Etanol/farmacologia , Substância Cinzenta/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética/métodos
3.
Br J Surg ; 108(8): 968-975, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-33829254

RESUMO

BACKGROUND: Most current models for predicting survival after resection of colorectal liver metastasis include largest diameter and number of colorectal liver metastases as dichotomous variables, resulting in underestimation of the extent of risk variation and substantial loss of statistical power. The aim of this study was to develop and validate a new prognostic model for patients undergoing liver resection including largest diameter and number of colorectal liver metastases as continuous variables. METHODS: A prognostic model was developed using data from patients who underwent liver resection for colorectal liver metastases at MD Anderson Cancer Center and had RAS mutational data. A Cox proportional hazards model analysis was used to develop a model based on largest colorectal liver metastasis diameter and number of metastases as continuous variables. The model results were shown using contour plots, and validated externally in an international multi-institutional cohort. RESULTS: A total of 810 patients met the inclusion criteria. Largest colorectal liver metastasis diameter (hazard ratio (HR) 1.11, 95 per cent confidence interval 1.06 to 1.16; P < 0.001), number of colorectal liver metastases (HR 1.06, 1.03 to 1.09; P < 0.001), and RAS mutation status (HR 1.76, 1.42 to 2.18; P < 0.001) were significantly associated with overall survival, together with age, primary lymph node metastasis, and prehepatectomy chemotherapy. The model performed well in the external validation cohort, with predicted overall survival values almost lying within 10 per cent of observed values. Wild-type RAS was associated with better overall survival than RAS mutation even when liver resection was performed for larger and/or multiple colorectal liver metastases. CONCLUSION: The contour prognostic model, based on diameter and number of lesions considered as continuous variables along with RAS mutation, predicts overall survival after resection of colorectal liver metastasis.


Assuntos
Neoplasias Colorretais/patologia , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/secundário , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Estados Unidos/epidemiologia
4.
Public Health ; 189: 37-47, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33147524

RESUMO

OBJECTIVES: Adverse childhood experiences (ACEs) have a negative impact on childhood health, but their impact on education outcomes is less well known. We investigated whether or not ACEs were associated with reduced educational attainment at age 7 and 11 years. STUDY DESIGN: The study design used in the study is a population-based electronic cohort study. METHODS: We analysed data from a total population electronic child cohort in Wales, UK. ACEs (exposures) were living with an adult household member with any of (i) serious mental illness, (ii) common mental disorder (CMD), (iii) an alcohol problem; (iv) child victimisation, (v) death of a household member and (vi) low family income. We used multilevel logistic regression to model exposure to these ACEs and not attaining the expected level at statutory education assessments, Key Stage (KS) 1 and KS2 separately, adjusted for known confounders including perinatal, socio-economic and school factors. RESULTS: There were 107,479 and 43,648 children included in the analysis, with follow-up to 6-7 years (KS1) and 10-11 years (KS2), respectively. An increased risk of not attaining the expected level at KS1 was associated with living with adult household members with CMD (adjusted odds ratio [aOR]: 1.13 [95% confidence interval [CI]: 1.09-1.17]) or an alcohol problem (adjusted odds ratio [aOR]: 1.16 [95% confidence interval [CI]: 1.10-1.22]), childhood victimisation (adjusted odds ratio [aOR]: 1.58 [95% confidence interval [CI]: 1.37-1.82]), death of a household member (adjusted odds ratio [aOR]: 1.14 [95% confidence interval [CI]: 1.04-1.25]) and low family income (adjusted odds ratio [aOR]: 1.92 [95% confidence interval [CI]: 1.84-2.01]). Similar results were observed for KS2. Children with multiple adversities had substantially increased odds of not attaining the expected level at each educational assessment. CONCLUSION: The educational potential of many children may not be achieved due to exposure to adversity in childhood. Affected children who come in to contact with services should have relevant information shared between health and care services, and schools to initiate and facilitate a coordinated approach towards providing additional support and help for them to fulfil their educational potential, and subsequent economic and social participation.


Assuntos
Sucesso Acadêmico , Experiências Adversas da Infância/estatística & dados numéricos , Escolaridade , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Vítimas de Crime/estatística & dados numéricos , Feminino , Humanos , Renda/estatística & dados numéricos , Modelos Logísticos , Masculino , Transtornos Mentais/epidemiologia , Razão de Chances , Instituições Acadêmicas , Fatores Socioeconômicos , País de Gales
5.
Pharmacol Res ; 145: 104260, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31059789

RESUMO

Src tyrosine kinase (TK), a redox-sensitive protein overexpressed in dystrophin-deficient muscles, can contribute to damaging signaling by phosphorylation and degradation of ß-dystroglycan (ß-DG). We performed a proof-of-concept preclinical study to validate this hypothesis and the benefit-safety ratio of a pharmacological inhibition of Src-TK in Duchenne muscular dystrophy (DMD). Src-TK inhibitors PP2 and dasatinib were administered for 5 weeks to treadmill-exercised mdx mice. The outcome was evaluated in vivo and ex vivo on functional, histological and biochemical disease-related parameters. Considering the importance to maintain a proper myogenic program, the potential cytotoxic effects of both compounds, as well as their cytoprotection against oxidative stress-induced damage, was also assessed in C2C12 cells. In line with the hypothesis, both compounds restored the level of ß-DG and reduced its phosphorylated form without changing basal expression of genes of interest, corroborating a mechanism at post-translational level. The histological profile of gastrocnemius muscle was slightly improved as well as the level of plasma biomarkers. However, amelioration of in vivo and ex vivo functional parameters was modest, with PP2 being more effective than dasatinib. Both compounds reached appreciable levels in skeletal muscle and liver, supporting proper animal exposure. Dasatinib exerted a greater concentration-dependent cytotoxic effect on C2C12 cells than the more selective PP2, while being less protective against H2O2 cytotoxicity, even though at concentrations higher than those experienced during in vivo treatments. Our results support the interest of Src-TK as drug target in dystrophinopathies, although further studies are necessary to assess the therapeutic potential of inhibitors in DMD.


Assuntos
Dasatinibe , Distrofia Muscular Animal/tratamento farmacológico , Distrofia Muscular de Duchenne/tratamento farmacológico , Inibidores de Proteínas Quinases , Pirimidinas , Quinases da Família src/antagonistas & inibidores , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Dasatinibe/farmacocinética , Dasatinibe/farmacologia , Dasatinibe/uso terapêutico , Distroglicanas/genética , Distroglicanas/metabolismo , Fígado/metabolismo , Masculino , Camundongos Endogâmicos mdx , Fadiga Muscular/efeitos dos fármacos , Força Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/patologia , Músculo Esquelético/fisiologia , Distrofia Muscular Animal/metabolismo , Distrofia Muscular Animal/patologia , Distrofia Muscular Animal/fisiopatologia , Distrofia Muscular de Duchenne/metabolismo , Distrofia Muscular de Duchenne/patologia , Distrofia Muscular de Duchenne/fisiopatologia , Inibidores de Proteínas Quinases/farmacocinética , Inibidores de Proteínas Quinases/farmacologia , Inibidores de Proteínas Quinases/uso terapêutico , Pirimidinas/farmacocinética , Pirimidinas/farmacologia , Pirimidinas/uso terapêutico , Reprodutibilidade dos Testes , Torque
6.
J Public Health (Oxf) ; 41(4): 665-673, 2019 12 20.
Artigo em Inglês | MEDLINE | ID: mdl-30289466

RESUMO

BACKGROUND: Mass unemployment events are not uncommon yet the impact on health is not well recognised. There is a need for a preparedness and response framework, as exists for other events that threaten population health. METHODS: Framework informed by a narrative review of the impact of mass unemployment on health (studies published in English from 1990 to 2016), and qualitative data from 23 semi-structured interviews with individuals connected to historical national and international events, addressing gaps in published literature on lessons learnt from past responses. RESULTS: Economic and employment shock triggered by mass unemployment events have a detrimental impact on workers, families and communities. We present a public health informed response framework which includes (i) identify areas at risk, (ii) develop an early warning system, (iii) mobilise multi-sector action including health and community, (iv) provision of support across employment, finance and health (v) proportionate to need, (vi) extend support to family members and (vii) communities and (viii) evaluate and learn. CONCLUSION: Mass unemployment events have an adverse impact on the health, financial and social circumstances of workers, families, and communities. This is the first framework for action to mitigate and address the detrimental impact of mass unemployment events on population health.


Assuntos
Saúde , Desemprego , Recessão Econômica , Feminino , Humanos , Entrevistas como Assunto , Masculino , Morbidade , Mortalidade
7.
Public Health ; 165: 106-116, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30388488

RESUMO

OBJECTIVES: Educational and employment outcomes are critical elements in determining the life course of individuals, yet through health and other mechanisms, those who suffer adverse childhood experiences (ACEs) may experience barriers to achieve in these domains. This study examines the association between ACEs and poor educational outcomes, before considering the impact of ACEs and education on employment in adulthood. STUDY DESIGN: Retrospective cross-sectional surveys were conducted in England and Wales using a random stratified sampling methodology. METHODS: During face-to-face household interviews (n = 2881), data were collected on demographic factors, ACEs, self-rated childhood affluence, the highest qualification level attained and the current employment status. RESULTS: While respondents with ≥4 ACEs were significantly more likely to have no formal qualifications (adjusted odds ratio [AOR] = 2.18; P < 0.001), among those who did achieve secondary level qualifications, the presence of ACEs did not further impact subsequent likelihood of going on to attain college or higher qualifications. However, results suggest a persisting independent impact of high (≥4) ACEs, which were found to be significantly associated with both current unemployment (AOR = 2.52, P < 0.001) and long-term sickness and disability (AOR = 3.94, P < 0.001). Modelled levels of not being in employment ranged from as little as 3% among those with 0 or 1 ACE and higher qualifications to 62% among those with no qualifications and ≥4 ACEs (adjusted for age, gender and childhood affluence effects). CONCLUSIONS: Compulsory education may play a pivotal role in mitigating the effects of adversity, supporting the case for approaches within schools that build resilience and tackle educational inequalities. However, adults with ACEs should not be overlooked and efforts should be considered to support them in achieving meaningful employment.


Assuntos
Experiências Adversas da Infância/estatística & dados numéricos , Escolaridade , Emprego/estatística & dados numéricos , Adulto , Estudos Transversais , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , País de Gales
8.
Phys Rev Lett ; 121(26): 261801, 2018 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-30636113

RESUMO

We present first evidence that the cosine of the CP-violating weak phase 2ß is positive, and hence exclude trigonometric multifold solutions of the Cabibbo-Kobayashi-Maskawa (CKM) Unitarity Triangle using a time-dependent Dalitz plot analysis of B^{0}→D^{(*)}h^{0} with D→K_{S}^{0}π^{+}π^{-} decays, where h^{0}∈{π^{0},η,ω} denotes a light unflavored and neutral hadron. The measurement is performed combining the final data sets of the BABAR and Belle experiments collected at the ϒ(4S) resonance at the asymmetric-energy B factories PEP-II at SLAC and KEKB at KEK, respectively. The data samples contain (471±3)×10^{6}BB[over ¯] pairs recorded by the BABAR detector and (772±11)×10^{6}BB[over ¯] pairs recorded by the Belle detector. The results of the measurement are sin2ß=0.80±0.14(stat)±0.06(syst)±0.03(model) and cos2ß=0.91±0.22(stat)±0.09(syst)±0.07(model). The result for the direct measurement of the angle ß of the CKM Unitarity Triangle is ß=[22.5±4.4(stat)±1.2(syst)±0.6(model)]°. The measurement assumes no direct CP violation in B^{0}→D^{(*)}h^{0} decays. The quoted model uncertainties are due to the composition of the D^{0}→K_{S}^{0}π^{+}π^{-} decay amplitude model, which is newly established by performing a Dalitz plot amplitude analysis using a high-statistics e^{+}e^{-}→cc[over ¯] data sample. CP violation is observed in B^{0}→D^{(*)}h^{0} decays at the level of 5.1 standard deviations. The significance for cos2ß>0 is 3.7 standard deviations. The trigonometric multifold solution π/2-ß=(68.1±0.7)° is excluded at the level of 7.3 standard deviations. The measurement resolves an ambiguity in the determination of the apex of the CKM Unitarity Triangle.

9.
Phys Rev Lett ; 115(12): 121604, 2015 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-26430984

RESUMO

We report a measurement of the time-dependent CP asymmetry of B[over ¯]^{0}→D_{CP}^{(*)}h^{0} decays, where the light neutral hadron h^{0} is a π^{0}, η, or ω meson, and the neutral D meson is reconstructed in the CP eigenstates K^{+}K^{-}, K_{S}^{0}π^{0}, or K_{S}^{0}ω. The measurement is performed combining the final data samples collected at the ϒ(4S) resonance by the BABAR and Belle experiments at the asymmetric-energy B factories PEP-II at SLAC and KEKB at KEK, respectively. The data samples contain (471±3)×10^{6} BB[over ¯] pairs recorded by the BABAR detector and (772±11)×10^{6} BB[over ¯] pairs recorded by the Belle detector. We measure the CP asymmetry parameters -η_{f}S=+0.66±0.10(stat)±0.06(syst) and C=-0.02±0.07(stat)±0.03(syst). These results correspond to the first observation of CP violation in B[over ¯]^{0}→D_{CP}^{(*)}h^{0} decays. The hypothesis of no mixing-induced CP violation is excluded in these decays at the level of 5.4 standard deviations.

10.
J Public Health (Oxf) ; 37(3): 445-54, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25174044

RESUMO

BACKGROUND: ACE (adverse childhood experience) studies typically examine the links between childhood stressors and adult health harming behaviours. Using an enhanced ACE survey methodology, we examine impacts of ACEs on non-communicable diseases and incorporate a proxy measure of premature mortality in England. METHODS: A nationally representative survey was undertaken (n = 3885, aged 18-69, April-July 2013). Socio-demographically controlled proportional hazards analyses examined the associations between the number of ACE categories (<18 years; e.g. child abuse and family dysfunction such as domestic violence) and cancer, diabetes, stroke, respiratory, liver/digestive and cardiovascular disease. Sibling (n = 6983) mortality was similarly analysed as a measure of premature mortality. RESULTS: Of the total, 46.4% of respondents reported ≥1 and 8.3% ≥4 ACEs. Disease development was strongly associated with increased ACEs (e.g. hazard ratios, HR, 0 versus ≥4 ACEs; cancer, 2.38 (1.48-3.83); diabetes, 2.99 (1.90-4.72); stroke, 5.79 (2.43-13.80, all P < 0.001). Individuals with ≥4 ACEs (versus no ACEs) had a 2.76 times higher rate of developing any disease before age 70 years. Adjusted HR for mortality was strongly linked to ACEs (≥4 versus 0 ACEs; HR, 1.97 (1.39-2.79), P < 0.001). CONCLUSIONS: Radically different life-course trajectories are associated with exposure to increased ACEs. Interventions to prevent ACEs are available but rarely implemented at scale. Treating the resulting health costs across the life course is unsustainable.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/estatística & dados numéricos , Efeitos Psicossociais da Doença , Adolescente , Adulto , Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Idoso , Inglaterra/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Modelos de Riscos Proporcionais , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
11.
Int J Drug Policy ; 25(2): 204-11, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24332457

RESUMO

BACKGROUND: Many developed countries are facing a major challenge to improve identification of individuals acutely and chronically infected with hepatitis C virus (HCV) infection. We explored the views and experiences of people who inject drugs (PWID) in relation to HCV testing, and diagnosis through a review and synthesis of qualitative research. METHODS: Based on the thematic synthesis of qualitative research. Searches were conducted in 14 databases and supplemented by reference checking, hand searching of selected journals, and searches of relevant websites. Studies of any qualitative design that examined the views and experiences of, and attitudes towards, HCV testing and diagnosis among PWID or practitioners involved in their care were included. Key themes and sub-themes were systematically coded according to the meaning and content of the findings of each study which proceeded to the preparation of a narrative account of the synthesis. RESULTS: 28 qualitative studies were identified. We identified a number of overarching descriptive themes in the literature, finding overall that PWID hold complex and differing views and experiences of testing and diagnosis. Three major themes emerged: missed opportunities for the provision of information and knowledge; shifting priorities between HCV testing and other needs; and testing as unexpected and routine. Evidence of missed opportunities for the provision of knowledge and information about HCV were clear, contributing to delays in seeking testing and providing a context to poor experiences of diagnosis. Influenced by the nature of their personal circumstances, perceptions of the risk associated with HCV and the prioritisation of other needs acted both to encourage and discourage the uptake of HCV testing. Undergoing HCV testing as part of routine health assessment, and an unawareness of being testing was common. An unexpected positive diagnosis exacerbated anxiety and confusion. CONCLUSION: This review has identified that there are modifiable factors that affect the uptake of HCV testing and experiences of HCV diagnosis among PWID. Intervention development should focus on addressing these factors. There is a need for further research that engages PWID from a diverse range of populations to identify interventions, strategies and approaches that they consider valuable.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hepatite C/complicações , Hepatite C/diagnóstico , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/psicologia , Técnicas e Procedimentos Diagnósticos/psicologia , Hepatite C/psicologia , Humanos , Pesquisa Qualitativa
12.
Public Health ; 127(10): 908-15, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23906607

RESUMO

OBJECTIVES: There is an established relationship between nightlife, substance use and violence. This study investigated this relationship when people are on holiday, and explored the differences in experiences between physical and verbal violence. STUDY DESIGN: A survey of young tourists at seven airport departure areas in Southern European resorts. METHODS: Questionnaires from 6502 British and German tourists were analysed exploring demographics, violence (verbal and physical), substance use, and reasons for resort and venue selection. RESULTS: Over two-thirds of respondents reported being drunk on their holiday, 12.4% had been involved in arguments and 2.9% had been involved in fights. Logistic regression highlighted more violence amongst visitors to Mallorca [arguments: adjusted odds ratio (AOR) 2.7; fights: AOR 2.0] compared with those visiting Portugal, males (arguments: AOR 1.3; fights: AOR 1.7), those who had used illicit drugs (arguments: AOR 1.5; fights: AOR 2.9), those who had been in fights at home in the last 12 months (arguments: AOR 2.2; fights AOR 2.9), and those who had frequently been drunk abroad (arguments: AOR 2.4; fights: AOR 2.5). Those aged 16-19 years, visiting Italy or Crete, who were drunk for fewer than half of the days of their stay, and who chose bars because they were frequented by drunk people were more likely to report having an argument. Fights were associated with cannabis use and were negatively associated with choosing bars with a friendly atmosphere. Economic status or frequency of visiting bars had no relationship with arguments or fights. CONCLUSIONS: Understanding and addressing the variables involved in violence when holidaying abroad is critical in targeting appropriate health promotion and harm reduction measures.


Assuntos
Férias e Feriados , Meio Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Viagem/psicologia , Violência/estatística & dados numéricos , Adolescente , Adulto , Intoxicação Alcoólica/epidemiologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Drogas Ilícitas , Masculino , Razão de Chances , Fatores de Risco , Inquéritos e Questionários , Viagem/estatística & dados numéricos , Comportamento Verbal , Adulto Jovem
13.
AIDS Care ; 23(5): 542-9, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21287419

RESUMO

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.


Assuntos
Serviços de Saúde Comunitária/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Síndrome da Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , Negro ou Afro-Americano , Análise de Variância , Criança , Pré-Escolar , Inglaterra/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/etnologia , Homossexualidade Masculina , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Vigilância da População , Migrantes/estatística & dados numéricos , Adulto Jovem
14.
Phys Rev Lett ; 105(11): 112301, 2010 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-20867566

RESUMO

Because of their long lifetimes, the ω and ϕ mesons are the ideal candidates for the study of possible modifications of the in-medium meson-nucleon interaction through their absorption inside the nucleus. During the E01-112 experiment at the Thomas Jefferson National Accelerator Facility, the mesons were photoproduced from 2H, C, Ti, Fe, and Pb targets. This Letter reports the first measurement of the ratio of nuclear transparencies for the e+e- channel. The ratios indicate larger in-medium widths compared with what have been reported in other reaction channels. The absorption of the ω meson is stronger than that reported by the CBELSA-TAPS experiment and cannot be explained by recent theoretical models.

15.
Br J Pharmacol ; 160(7): 1652-61, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20649569

RESUMO

BACKGROUND AND PURPOSE: ClC-K kidney Cl(-) channels are important for renal and inner ear transepithelial Cl(-) transport, and are potentially interesting pharmacological targets. They are modulated by niflumic acid (NFA), a non-steroidal anti-inflammatory drug, in a biphasic way: NFA activates ClC-Ka at low concentrations, but blocks the channel above approximately 1 mM. We attempted to identify the amino acids involved in the activation of ClC-Ka by NFA. EXPERIMENTAL APPROACH: We used site-directed mutagenesis and two-electrode voltage clamp analysis of wild-type and mutant channels expressed in Xenopus oocytes. Guided by the crystal structure of a bacterial CLC homolog, we screened 97 ClC-Ka mutations for alterations of NFA effects. KEY RESULTS: Mutations of five residues significantly reduced the potentiating effect of NFA. Two of these (G167A and F213A) drastically altered general gating properties and are unlikely to be involved in NFA binding. The three remaining mutants (L155A, G345S and A349E) severely impaired or abolished NFA potentiation. CONCLUSIONS AND IMPLICATIONS: The three key residues identified (L155, G345, A349) are localized in two different protein regions that, based on the crystal structure of bacterial CLC homologs, are expected to be exposed to the extracellular side of the channel, relatively close to each other, and are thus good candidates for being part of the potentiating NFA binding site. Alternatively, the protein region identified mediates conformational changes following NFA binding. Our results are an important step towards the development of ClC-Ka activators for treating Bartter syndrome types III and IV with residual channel activity.


Assuntos
Anti-Inflamatórios não Esteroides/farmacologia , Canais de Cloreto/metabolismo , Ativação do Canal Iônico/efeitos dos fármacos , Rim/metabolismo , Ácido Niflúmico/farmacologia , Sequência de Aminoácidos , Animais , Sítios de Ligação , Canais de Cloreto/antagonistas & inibidores , Canais de Cloreto/genética , Relação Dose-Resposta a Droga , Humanos , Rim/efeitos dos fármacos , Modelos Moleculares , Dados de Sequência Molecular , Mutagênese Sítio-Dirigida , Oócitos/metabolismo , Técnicas de Patch-Clamp , Alinhamento de Sequência , Transfecção , Xenopus
16.
Phys Rev Lett ; 105(26): 262302, 2010 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-21231649

RESUMO

The electric form factor of the neutron was determined from studies of the reaction 3He(e,e'n)pp in quasielastic kinematics in Hall A at Jefferson Lab. Longitudinally polarized electrons were scattered off a polarized target in which the nuclear polarization was oriented perpendicular to the momentum transfer. The scattered electrons were detected in a magnetic spectrometer in coincidence with neutrons that were registered in a large-solid-angle detector. More than doubling the Q2 range over which it is known, we find G(E)(n)=0.0236±0.0017(stat)±0.0026(syst), 0.0208±0.0024±0.0019, and 0.0147±0.0020±0.0014 for Q(2)=1.72, 2.48, and 3.41 GeV2, respectively.

17.
Sex Transm Infect ; 85(6): 477-82, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19826066

RESUMO

OBJECTIVES: To explore sexual behaviour and risk-taking among British backpackers in Australia and to investigate the influence of substance use and social settings on sexual behaviour abroad. METHODS: A cross-sectional design was used. The questionnaire gathered information on sexual and substance use behaviour in the 12 months prior to leaving the UK and during backpackers' stays in Australia. A total of 1008 backpackers, recruited in hostels in Sydney and Cairns, were included in the study. RESULTS: In total, 73.2% had sex during their stay in Australia, including 68.9% of those who arrived without a partner. Across all backpackers, mean number of sexual partners increased from 0.3 per 4-week period in the UK in the 12 months prior to the trip to 1.0 per 4-week period spent in Australia. Over a third (39.7%) had multiple partners in Australia, increasing to 45.7% in those arriving single. Of those arriving single and having sex, 40.9% reported inconsistent condom use and 24.0% had unprotected sex with multiple partners. Number of sexual partners in the UK, length of stay in Australia at time of interview, planned length of stay, frequent visits to bars/clubs, high frequency of alcohol intake and use of illicit substances in Australia were indicators for risky sexual behaviour. CONCLUSIONS: Backpackers are at high risk of sexually transmitted infections and other negative sexual health outcomes. Multi-agency sexual health promotion strategies that address the relationship between sex, drugs and alcohol should be targeted at backpackers prior to, and during, their travels.


Assuntos
Assunção de Riscos , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Férias e Feriados , Humanos , Masculino , New South Wales/epidemiologia , Queensland/epidemiologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Meio Social , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Inquéritos e Questionários , Viagem , Reino Unido/etnologia , Adulto Jovem
18.
Phys Rev Lett ; 103(1): 012301, 2009 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-19659138

RESUMO

We report a measurement of the differential cross section for the gamman-->pi- p process from the CLAS detector at Jefferson Laboratory in Hall B for photon energies between 1.0 and 3.5 GeV and pion center-of-mass (c.m.) angles (thetac.m.) between 50 degrees and 115 degrees. We confirm a previous indication of a broad enhancement around a c.m. energy ([sqrt]s) of 2.1 GeV at thetac.m.=90 degrees in the scaled differential cross section s7dsigma/dt and a rapid falloff in a center-of-mass energy region of about 400 MeV following the enhancement. Our data show an angular dependence of this enhancement as the suggested scaling region is approached for thetac.m. from 70 degrees to 105 degrees.

19.
Accid Anal Prev ; 41(4): 703-9, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19540958

RESUMO

INTRODUCTION: Riding with a drunk and/or a drugged driver (RDD) is a risk behaviour that has received very little attention in spite of its potential dangers. Young people involved in the recreational nightlife context are especially at risk. METHOD: 1363 regular users of recreational nightlife from nine European countries (mean age: 21.75; 51.5% women) filled out a self-administered and anonymous questionnaire (in 2006). RESULTS: 37.2% had practised RDD during the previous month. RDD is related to drunkenness and use of drugs, personality factors such as impulsivity, preferring to use a private car to get to nightlife venues, living in a southern European country and being unemployed. No significant influence was found for age, gender, educational level or socioeconomic status. DISCUSSION: It is important to raise awareness about the high prevalence of RDD. This lack of awareness can be related to its social acceptance among young people. The use of private cars for going to nightlife venues should be discouraged.


Assuntos
Acidentes de Trânsito , Intoxicação Alcoólica , Condução de Veículo , Tomada de Decisões , Assunção de Riscos , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Internacionalidade , Modelos Logísticos , Masculino , Razão de Chances , Prevalência , Testes Psicológicos , Psicometria , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
20.
Phys Rev Lett ; 102(19): 192001, 2009 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-19518944

RESUMO

The neutron elastic magnetic form factor was extracted from quasielastic electron scattering on deuterium over the range Q;{2}=1.0-4.8 GeV2 with the CLAS detector at Jefferson Lab. High precision was achieved with a ratio technique and a simultaneous in situ calibration of the neutron detection efficiency. Neutrons were detected with electromagnetic calorimeters and time-of-flight scintillators at two beam energies. The dipole parametrization gives a good description of the data.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...