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1.
J Exp Biol ; 227(3)2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38344873

RESUMO

Gut symbionts influence the physiology and behavior of their host, but the extent to which these effects scale to social behaviors is an emerging area of research. The use of the western honeybee (Apis mellifera) as a model enables researchers to investigate the gut microbiome and behavior at several levels of social organization. Insight into gut microbial effects at the societal level is critical for our understanding of how involved microbial symbionts are in host biology. In this Commentary, we discuss recent findings in honeybee gut microbiome research and synthesize these with knowledge of the physiology and behavior of other model organisms to hypothesize how host-microbe interactions at the individual level could shape societal dynamics and evolution.


Assuntos
Microbioma Gastrointestinal , Abelhas , Animais , Comportamento Social
2.
Econ Hum Biol ; 47: 101155, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35944452

RESUMO

We hypothesize that the impact of antibiotics is moderated by a population's inherent (genetic) resistance to infectious disease. Using the introduction of sulfa drugs in 1937, we show that US states that are more genetically susceptible to infectious disease saw larger declines in their bacterial mortality rates following the introduction of sulfa drugs in 1937. This suggests area-level genetic endowments of disease resistance and the discovery of medical technologies have acted as substitutes in determining levels of health across the US. We also document immediate effects of sulfa drug exposure to the age of the workforce and cumulative effects on educational attainment for cohorts exposed to sulfa drugs in early life.


Assuntos
Antibacterianos , Resistência à Doença , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico
3.
J Clin Microbiol ; 60(7): e0042122, 2022 07 20.
Artigo em Inglês | MEDLINE | ID: mdl-35758702

RESUMO

Tongue dorsum swabs have shown promise as alternatives to sputum for detecting Mycobacterium tuberculosis (MTB) in patients with pulmonary tuberculosis (TB). Some of the most encouraging results have come from studies that used manual quantitative PCR (qPCR) to analyze swabs. Studies using the automated Cepheid Xpert MTB/RIF Ultra qPCR test (Xpert Ultra) have exhibited less sensitivity with tongue swabs, possibly because Xpert Ultra is optimized for testing sputum, not tongue swab samples. Using two new sample preprocessing methods that demonstrated good sensitivity in preliminary experiments, we assessed diagnostic accuracy and semi-quantitative signals of Xpert Ultra performed on tongue swabs collected from 183 adults with presumed TB in Kampala, Uganda. Relative to a sputum Xpert Ultra reference standard, the sensitivity of tongue swab Xpert Ultra was 77.8% (95% confidence interval [CI] 64.4-88.0) and specificity was 100.0% (95% CI, 97.2-100.0). When compared to a microbiological reference standard (MRS) incorporating both sputum Xpert Ultra and sputum mycobacterial culture, sensitivity was 72.4% (95% CI, 59.1-83.3) and specificity remained the same. Semi-quantitative Xpert Ultra results were generally lower with tongue swabs than with sputum, and cycle threshold values were higher. None of the eight sputum Xpert Ultra "trace" or "very low" results were detected using tongue swabs. Tongue swabs should be considered when sputum cannot be collected for Xpert Ultra testing, or in certain mass-screening settings. Further optimization of tongue swab analysis is needed to achieve parity with sputum-based molecular testing for TB.


Assuntos
Mycobacterium tuberculosis , Tuberculose , Adulto , Humanos , Mycobacterium tuberculosis/genética , Rifampina , Sensibilidade e Especificidade , Escarro/microbiologia , Tuberculose/diagnóstico , Tuberculose/microbiologia , Uganda
4.
Trends Microbiol ; 30(10): 930-939, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35393166

RESUMO

Multicellular organisms harbor populations of microbial symbionts; some of these symbionts can be dispersed through the feeding activities of consumers. Studies of consumer-mediated microbiota dispersal generally focus on pathogenic microorganisms; the dispersal of beneficial microorganisms has received less attention, especially in the context of 'antagonistic' trophic interactions (e.g., herbivory, parasitism, predation). Yet, this 'trophic transmission' of beneficial symbionts has significant implications for microbiota assembly and resource species (e.g., prey) health. For example, trophic transmission of microorganisms could assist with environmental acclimatization and help resource species to suppress other consumers or competitors. Here, we highlight model systems and approaches that have revealed these potential 'silver-linings' of antagonism as well as opportunities and challenges for future research.


Assuntos
Microbiota , Comportamento Predatório , Animais , Modelos Biológicos , Simbiose
5.
In. Faculty of Medical Sciences, The University of the West Indies. 23rd Annual Student Research Day. Port of Sapin, Faculty of Medical Sciences,The University of the West Indies, October 14, 2021. .
Não convencional em Inglês | MedCarib | ID: biblio-1337732

RESUMO

The COVID-19 pandemic caused a sudden halt in normal day-today movements & interactions across the world. Restrictive measures were implemented to lessen the spread of the virus, however, it altered social interactions. In times of stress, persons usually turn to social support for comfort. However, this pandemic has forced individuals to be isolated. Although the physical health of individuals has been addressed somewhat, their mental health has not been prioritized. Young adults in relationships were either isolated with or away from their partner, while single young adults were generally without a stable companion. With the impacts discovered from this research, new measures can be adopted in society & health facilities to mediate the harmful effects this pandemic caused & will cause on the mental health of young adults with respect to dating and relationships.


Assuntos
Humanos , Adulto , Trinidad e Tobago , COVID-19 , Saúde Mental , Pandemias
7.
S Afr J Sports Med ; 32(1): v32i1a8415, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-36818976

RESUMO

Background: The International Study of Movement Behaviours in the Early Years, SUNRISE, was initiated to assess the extent to which young children meet movement behaviour guidelines (physical activity, sedentary behaviour, screen time, sleep). Objective: The South African SUNRISE pilot study assessed movement behaviours in preschool children from two low-income settings, and associations between these movement behaviours, adiposity, motor skills and executive function (EF). Methods: Preschool child/parent pairs (n = 89) were recruited from preschools in urban Soweto and rural Sweetwaters. Height and weight were measured to assess adiposity. Physical activity was assessed using accelerometers while sedentary behaviour, screen time and sleep were assessed via parent report. Fine and gross motor development were measured using the Ages and Stages Questionnaire-3, and EF was assessed using the Early Years Toolbox. Results: The proportion of children meeting the physical activity guideline was 84%, 66% met the sleep guideline, 48% met the screen time guideline, and 26% met all three guidelines. Rural children were more active, but spent more time on screens compared to urban children. Most children were on track for gross (96%) and fine motor (73%) development, and mean EF scores were in the expected range for all EF measures. EF was negatively associated with screen time, and gross motor skills were positively associated with physical activity. Conclusion: The South African SUNRISE study contributes to the growing literature on 24-hour movement behaviours in SA preschool children, and highlights that these behaviours require attention in this age group.

8.
J Sci Med Sport ; 23(1): 69-74, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31526664

RESUMO

OBJECTIVES: This study profiled the 24h neuromuscular, endocrine and mood responses to a single versus a double training day in soccer players. DESIGN: Repeated measures. METHODS: Twelve semi-professional soccer players performed small-sided-games (SSG's; 4 vs 4+goalkeepers; 6×7-min, 2-min inter-set recovery) with neuromuscular (peak-power output, PPO; jump height, JH), endocrine (salivary testosterone, cortisol), and mood measures collected before (pre) and after (0h, +24h). The following week, the same SSG protocol was performed with an additional lower body strength training session (back-squat, Romanian deadlift, barbell hip thrust; 4×4 repetitions, 4-min inter-set recovery; 85% 1 rep-max) added at 2h after the SSG's. RESULTS: Between-trial comparisons revealed possible to likely small impairments in PPO (2.5±2.2Wkg-1; 90% Confidence Limits: ±2.2Wkg-1), JH (-1.3; ±2.0cm) and mood (4.6; ±6.1AU) in response to the double versus single sessions at +24h. Likely to very likely small favourable responses occurred following the single session for testosterone (-15.2; ±6.1pgml-1), cortisol (0.072; ±0.034ugdl-1) and testosterone/cortisol ratio (-96.6; ±36.7AU) at +24h compared to the double session trial. CONCLUSIONS: These data highlight that performance of two training sessions within a day resulted in possible to very likely small impairments of neuromuscular performance, mood score and endocrine markers at +24h relative to a single training session day. A strategy of alternating high intensity explosive training days containing multiple sessions with days emphasising submaximal technical/tactical activities may be beneficial for those responsible for the design and delivery of soccer training programs.


Assuntos
Afeto , Desempenho Atlético/fisiologia , Hidrocortisona/análise , Futebol/fisiologia , Testosterona/análise , Atletas , Fadiga , Humanos , Masculino , Condicionamento Físico Humano , Saliva/química , Carga de Trabalho , Adulto Jovem
9.
Nat Med ; 25(9): 1370-1376, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31406349

RESUMO

The MORDOR I trial1, conducted in Niger, Malawi and Tanzania, demonstrated that mass azithromycin distribution to preschool children reduced childhood mortality1. However, the large but simple trial design precluded determination of the mechanisms involved. Here we examined the gut microbiome of preschool children from 30 Nigerien communities randomized to either biannual azithromycin or placebo. Gut microbiome γ-diversity was not significantly altered (P = 0.08), but the relative abundances of two Campylobacter species, along with another 33 gut bacteria, were significantly reduced in children treated with azithromycin at the 24-month follow-up. Metagenomic analysis revealed functional differences in gut bacteria between treatment groups. Resistome analysis showed an increase in macrolide resistance gene expression in gut microbiota in communities treated with azithromycin (P = 0.004). These results suggest that prolonged mass azithromycin distribution to reduce childhood mortality reduces certain gut bacteria, including known pathogens, while selecting for antibiotic resistance.


Assuntos
Azitromicina/administração & dosagem , Infecções por Campylobacter/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Metagenômica , Campylobacter/efeitos dos fármacos , Campylobacter/patogenicidade , Infecções por Campylobacter/genética , Infecções por Campylobacter/mortalidade , Criança , Mortalidade da Criança , Pré-Escolar , Farmacorresistência Bacteriana/efeitos dos fármacos , Farmacorresistência Bacteriana/genética , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Humanos , Macrolídeos/administração & dosagem , Masculino , Nigéria/epidemiologia , Análise de Sequência de RNA
11.
Demography ; 56(5): 1855-1874, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31359286

RESUMO

A large literature has documented links between harmful early-life exposures and later-life health and socioeconomic deficits. These studies, however, have typically been unable to examine the possibility that these shocks are transmitted to the next generation. Our study uses representative survey data from the United States to trace the impacts of in utero exposure to the 1918 influenza pandemic on the outcomes of the children and grandchildren of those affected. We find evidence of multigenerational effects on educational, economic, and health outcomes.


Assuntos
Escolaridade , Nível de Saúde , Renda/estatística & dados numéricos , Influenza Pandêmica, 1918-1919/estatística & dados numéricos , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Pesos e Medidas Corporais , Feminino , História do Século XX , Humanos , Renda/história , Influenza Pandêmica, 1918-1919/história , Estudos Longitudinais , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/história , Fatores Socioeconômicos , Estados Unidos
12.
Obes Sci Pract ; 5(1): 3-14, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30820327

RESUMO

OBJECTIVE: Lifestyle interventions remain the cornerstone for obesity treatment. Commercial programs offer one weight loss approach, yet the efficacy of few such programs have been rigorously investigated. The purpose of this study was to evaluate the efficacy of two commercial weight-loss programs, both utilizing pre-portioned meal replacements (MRs) and different levels of behavioural support, compared to a self-directed control diet in adults with overweight and obesity. METHODS: In this 16-week study, participants were randomized to the low-calorie OPTAVIA® 5&1 Plan® with telephone coaching (OPT), the reduced-calorie Medifast® 4&2&1 self-guided plan (MED), or a self-directed, reduced-calorie control diet. Differences in weight, body composition (DXA) and body circumferences, all measured monthly, were assessed by analysis of covariance with sex and baseline measures as covariates. RESULTS: Of 198 participants randomized (80.8% female, BMI 34.2 kg/m2, 45.7 years), 92.3% completed the study. The OPT and MED groups had significantly greater reductions in body weight (-5.7% and - 5.0%, respectively, p < 0.0001), fat and abdominal fat mass (p < 0.0001) and waist and hip circumferences (p ≤ 0.003) than control at 16 weeks. Weight change was correlated with MR usage and completion of coaching support calls. CONCLUSIONS: Both structured commercial programs were more efficacious than a self-directed, reduced-calorie diet for weight loss and other anthropometric measures. Evidence-based commercial programs can be an important tool to help adults with overweight and obesity lose clinically relevant amounts of weight.

13.
J Sci Med Sport ; 21(10): 1095-1099, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29789267

RESUMO

OBJECTIVES: The effects of vascular occlusion on recovery of physiological and neuromuscular markers over 24h, and hormonal reactivity to subsequent exercise were investigated. DESIGN: Counterbalanced, randomised, crossover. METHODS: Academy rugby players (n=24) completed six 50-m sprints (5-min inter-set recovery) before occlusion cuff application (thighs) and intermittent inflation to 171-266mmHg (Recovery) or 15mmHg (Con) for 12-min (two sets, 3-min repetitions, 3-min non-occluded reperfusion). Countermovement jumps, blood (lactate, creatine kinase), saliva (testosterone, cortisol), and perceptual (soreness, recovery) responses were measured before (baseline) and after (post, +2h, +24h) sprinting. Saliva was sampled after a 30-min resistance exercise session performed 24h after sprinting. RESULTS: Although sprinting (total: 40.0±2.8s, p=0.238; average: 6.7±0.5s, p=0.674) influenced creatine kinase (p<0.001, +457.1±327.3µL-1, at 24h), lactate (p<0.001, 6.8±2.3mmolL-1, post), testosterone (p<0.001, -55.9±63.2pgmL-1, at 2h) and cortisol (p<0.001, -0.3±0.3µgdL-1, at 2h) concentrations, countermovement jump power output (p<0.001, -409.6±310.1W; -5.4±3.4cm, post), perceived recovery (p<0.001, -3.0±2.3, post), and muscle soreness (p<0.001; 1.5±1.1, at 24h), vascular occlusion had no effect (all p>0.05) on recovery. In response to subsequent exercise performed 24h after vascular occlusion, testosterone increased pre-to-post-exercise (Recovery: p=0.031, 21.6±44.9pgmL-1; Con: p=0.178, 10.6±36.6pgmL-1) however Δtestosterone was not significantly different (p=0.109) between conditions. CONCLUSIONS: Vascular occlusion had no effect on physiological or neuromuscular markers 2h or 24h after sprinting or in response to a physical stress test.


Assuntos
Extremidade Inferior , Corrida/fisiologia , Torniquetes , Atletas , Constrição , Creatina Quinase/sangue , Estudos Cross-Over , Teste de Esforço , Futebol Americano , Humanos , Hidrocortisona/análise , Ácido Láctico/sangue , Masculino , Mialgia , Saliva , Testosterona/análise , Adulto Jovem
14.
Epidemiol Infect ; 146(9): 1138-1150, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29785893

RESUMO

Vaccination is increasingly being recognised as a potential tool to supplement 'stamping out' for controlling foot-and-mouth disease (FMD) outbreaks in non-endemic countries. Infectious disease simulation models provide the opportunity to determine how vaccination might be used in the face of an FMD outbreak. Previously, consistent relative benefits of specific vaccination strategies across different FMD simulation modelling platforms have been demonstrated, using a UK FMD outbreak scenario. We extended this work to assess the relative effectiveness of selected vaccination strategies in five countries: Australia, New Zealand, the USA, the UK and Canada. A comparable, but not identical, FMD outbreak scenario was developed for each country with initial seeding of Pan Asia type O FMD virus into an area with a relatively high density of livestock farms. A series of vaccination strategies (in addition to stamping out (SO)) were selected to evaluate key areas of interest from a disease response perspective, including timing of vaccination, species considerations (e.g. vaccination of only those farms with cattle), risk area vaccination and resources available for vaccination. The study found that vaccination used with SO was effective in reducing epidemic size and duration in a severe outbreak situation. Early vaccination and unconstrained resources for vaccination consistently outperformed other strategies. Vaccination of only those farms with cattle produced comparable results, with some countries demonstrating that this could be as effective as all species vaccination. Restriction of vaccination to higher risk areas was less effective than other strategies. This study demonstrates consistency in the relative effectiveness of selected vaccination strategies under different outbreak start up conditions conditional on the assumption that each of the simulation models provide a realistic estimation of FMD virus spread. Preferred outbreak management approaches must however balance the principles identified in this study, working to clearly defined outbreak management objectives, while having a good understanding of logistic requirements and the socio-economic implications of different control measures.


Assuntos
Simulação por Computador , Surtos de Doenças/veterinária , Febre Aftosa/prevenção & controle , Modelos Biológicos , Vacinação/veterinária , Animais , Austrália/epidemiologia , Canadá/epidemiologia , Bovinos , Surtos de Doenças/prevenção & controle , Febre Aftosa/epidemiologia , Febre Aftosa/transmissão , Modelos Lineares , Análise Multivariada , Nova Zelândia/epidemiologia , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
15.
Int J Tuberc Lung Dis ; 22(4): 437-443, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29562993

RESUMO

BACKGROUND: Performance measurement assists tuberculosis (TB) programmes in understanding areas of strength and weakness, and planning for improvements. Canada currently does not have a national comprehensive system for the measurement and analysis of TB programme performance. OBJECTIVE: To analyse the performance of a Canadian provincial TB programme using measures and targets based on those published by the US Centers for Disease Prevention and Control for 2015. DESIGN: Using provincial surveillance data from the Canadian province of Manitoba, we analysed key programme performance outcome measures (treatment completion, early detection, human immunodeficiency virus [HIV] testing, paediatric TB, retreatment, and contact elicitation and assessment) for people diagnosed with TB between 2008 and 2010. RESULTS: Significant outcome variation was found between Indigenous and non-Indigenous populations as well as within populations. The reporting rate of HIV testing was low. High rates of paediatric TB among Indigenous populations, particularly in rural areas, were found. Significantly better performance in HIV testing and reporting as well as in contact investigation was found for rural compared with urban Indigenous populations. Foreign-born persons had the lowest contact assessment rate. CONCLUSION: This study of TB programme performance in Manitoba demonstrates the viability of the approach in the Canadian context, and could help to identify key areas for TB programme improvement.


Assuntos
Emigrantes e Imigrantes/estatística & dados numéricos , Grupos Populacionais/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Tuberculose/epidemiologia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Infecções por HIV/epidemiologia , Acessibilidade aos Serviços de Saúde , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Manitoba/epidemiologia , Pessoa de Meia-Idade , Análise Multivariada , Guias de Prática Clínica como Assunto , Saúde Pública , Análise de Regressão , Adulto Jovem
16.
Mucosal Immunol ; 11(3): 681-692, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29346347

RESUMO

Antibody responses induced at mucosal and nonmucosal sites demonstrate a significant level of autonomy. Here, we demonstrate a key role for mucosal interferon regulatory factor-4 (IRF4)-dependent CD103+CD11b+ (DP), classical dendritic cells (cDCs) in the induction of T-dependent immunoglobulin G (IgG) and immunoglobulin A (IgA) responses in the mesenteric lymph node (MLN) following systemic immunization with soluble flagellin (sFliC). In contrast, IRF8-dependent CD103+CD11b- (SP) are not required for these responses. The lack of this response correlated with a complete absence of sFliC-specific plasma cells in the MLN, small intestinal lamina propria, and surprisingly also the bone marrow (BM). Many sFliC-specific plasma cells accumulating in the BM of immunized wild-type mice expressed α4ß7+, suggesting a mucosal origin. Collectively, these results suggest that mucosal DP cDC contribute to the generation of the sFliC-specific plasma cell pool in the BM and thus serve as a bridge linking the mucosal and systemic immune system.


Assuntos
Células Dendríticas/imunologia , Fatores Reguladores de Interferon/metabolismo , Linfonodos/imunologia , Mucosa/imunologia , Plasmócitos/imunologia , Animais , Antígenos CD/metabolismo , Antígeno CD11b/metabolismo , Células Cultivadas , Flagelina/imunologia , Imunidade Humoral , Imunoglobulina A/metabolismo , Switching de Imunoglobulina , Imunoglobulina G/metabolismo , Cadeias alfa de Integrinas/metabolismo , Integrina alfa4/metabolismo , Cadeias beta de Integrinas/metabolismo , Fatores Reguladores de Interferon/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout
18.
Scand J Med Sci Sports ; 28(4): 1345-1353, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29266410

RESUMO

This study investigated salivary testosterone (sal-T) variation across the menstrual cycle in female athletes, at different competitive levels, and its association with motivation and neuromuscular power. Six elite and 16 non-elite female athletes were monitored on days 7 (D7), 14 (D14), and 21 (D21) across 3 menstrual cycles for basal sal-T concentrations and self-appraised motivation to train and compete. Two further measures were taken on D7, D14, and D21 across 2 menstrual cycles: (1) the sal-T response (delta change) to a physical stress test and (2) peak power (PP) response to a 6-second cycle sprint following a post-activation potentiation (PAP) stimulus. Basal sal-T concentrations increased by 17 ± 27% from D7 to D14 before decreasing by -25 ± 43% on D21 (P < .05), but this result was biased by elite females with higher sal-T (>102%) who showed larger menstrual changes. Motivation, sal-T reactivity to stress, and the PP responses to a PAP stimulus also varied by testing day (P < .05), in parallel with basal sal-T and in favor of the elite group. Furthermore, stronger within-subject relationships (P < .001) between basal sal-T and motivation emerged in the elites (r = .70-.75) vs the non-elite group (r = .41-.50). In conclusion, menstrual cycle changes in sal-T were more obvious in high-performing female athletes with higher sal-T concentrations. This was accompanied by greater training motivation, a more pronounced sal-T response to a physical stressor and greater neuromuscular power in the elite group. These results support observations that female athletes with higher T are more represented at elite levels of performance.


Assuntos
Ciclo Menstrual , Motivação , Força Muscular , Saliva/química , Testosterona/análise , Atletas , Feminino , Humanos , Estudos Longitudinais , Músculo Esquelético/fisiologia , Estresse Fisiológico , Adulto Jovem
19.
Addict Sci Clin Pract ; 12(1): 22, 2017 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-28950912

RESUMO

BACKGROUND: Alcohol consumption has been associated with poor antiretroviral therapy (ART) adherence but less is known about its relationship to HIV viral suppression, or whether certain drinking patterns have a stronger association than others. The objectives of this study were to determine the association of different patterns of alcohol consumption to HIV viral suppression and ART adherence, and to determine whether any associations of alcohol with HIV viral suppression were mediated by poor ART adherence. METHODS: This observational study used baseline data from 619 HIV+ participants, recruited across 8 clinical and community settings across Florida as part of the Florida Cohort from 2014 to 2016. Alcohol consumption was measured by self-report, and grouped into four categories: heavy drinking (>7/week for women or >14 drinks/week for men); binge, but not heavy drinking (≥4 or >5 drinks/occasion for women and men, respectively), low level drinking (neither heavy nor binge), and abstinence. Serum HIV RNA measurements were obtained from statewide HIV surveillance data, and durable viral suppression was defined as achieving HIV viral suppression (<200 copies/ml) at every assessment in the past 12 months. RESULTS: The majority of the 619 participants were male (63%) and aged 45 or greater (65%). The proportion of participants with heavy, binge, low-level drinking and abstinence was 9, 25, 37 and 30%, respectively. Optimal ART adherence (≥95%) was reported by 68%, and 60% achieved durable viral suppression. In multivariable analysis controlling for demographic factors, drug use, and homelessness, heavy drinking (compared to abstinence) was associated with increased odds of failing to achieve durable viral suppression (OR 2.16, 95% CI 1.08-4.32) whereas binge drinking alone was not significantly associated with this outcome (OR 1.04, 95% CI 0.64-1.70). Both heavy drinking and binge drinking were significantly associated with suboptimal ART adherence. Mediation analyses suggested that only a small proportion of the relationship between heavy drinking and suboptimal viral suppression was due to poor ART adherence. CONCLUSIONS: Exceeding weekly recommended levels of alcohol consumption (heavy drinking) was significantly associated with poor HIV viral suppression and ART non-adherence, while binge drinking was associated with suboptimal ART adherence in this sample. Clinicians should attempt to address heavy drinking in their patients with HIV.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Infecções por HIV/tratamento farmacológico , Comportamentos Relacionados com a Saúde , Adesão à Medicação/estatística & dados numéricos , Resposta Viral Sustentada , Adulto , Fármacos Anti-HIV/administração & dosagem , Feminino , Florida , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Fatores Socioeconômicos
20.
Glob Health Action ; 10(1): 1301085, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28524803

RESUMO

Early life is important for later health outcomes, yet there are few studies which adequately address all of the potential early life insults that may affect later life health and growth trajectories. This is particularly evident in low- to middle-income countries such as South Africa, where women of childbearing age are particularly vulnerable to high levels of physical inactivity, malnutrition, and obesity. Pregnancy may therefore be an opportune time to change behaviours and improve maternal and offspring health outcomes, and decrease the inter-generational transfer of risk. We show clear evidence that physical activity and nutrition are important target areas for intervention during pregnancy and in the early years of life, yet that current literature in Africa, and specifically South Africa, is limited. We have outlined the available literature concerning the impact of maternal and early life nutrition and physical activity on the health status of South African children, and have provided some recommendations for future research and policy.


Assuntos
Exercício Físico , Fenômenos Fisiológicos da Nutrição do Lactente , Desnutrição/prevenção & controle , Fenômenos Fisiológicos da Nutrição Materna , Atividade Motora , Estado Nutricional , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , África do Sul
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