Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 33
Filtrar
1.
Animals (Basel) ; 13(15)2023 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-37570339

RESUMO

(1) Background: When a human or animal is recovering from general anesthesia, their medical team uses several behavioral and physiological parameters to assess their emergence from the unconscious state to complete wakefulness. However, the return of auditory and acoustic behaviors indicative of the complete return of consciousness in humans can be difficult to assess in a completely aquatic non-human mammal. Dolphins produce sound using the nasal system while using both passive auditory and active biological sonar (echolocation) to navigate and interrogate their environment. The sounds generated by dolphins, such as whistles and clicks, however, can be difficult to hear when the animal is submerged. (2) Methods: We implemented a system to audibly and visually (i.e., using spectrograms) monitor the underwater acoustic behavior of dolphins recovering from anesthesia. (3) Results: Eleven of the twelve recorded dolphins began echolocating within 92 min (Mean = 00:43:41 HH:MM:SS) following spontaneous respirations. In all cases, the dolphins echolocated prior to whistling (Mean = 04:57:47). The return of echolocation was significantly correlated to the return of the righting reflex (Mean = 1:13:44), a commonly used behavioral indicator of dolphin emergence. (4) Conclusions: We suggest that acoustic monitoring for the onset of click production may be a useful supplement to the established medical and behavioral biomarkers of restoring consciousness following anesthesia in bottlenose dolphins.

2.
Contemp Clin Trials Commun ; 35: 101169, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37638227

RESUMO

Background: Sexual and gender minority (SGM) older adults and their care partners, compared to the general population, face unique vulnerabilities that exacerbate living with dementia, including elevated disparities in comorbidities, social isolation, and structural inequities, such as discrimination and lack of access to supports. Methods: This paper describes the virtual adaptation process of the first-ever randomized controlled clinical trial intervention, Aging with Pride: Innovations in Dementia Empowerment and Action (IDEA), that was designed for SGM older adults living with dementia and their care partners and built upon the foundation of RDAD and NHAS. Results: The virtual adaptation of IDEA was guided by the goals of accessibility, quality, ease of delivery, sustainability, and cultural relevance. The implementation required the development of a HIPPA-compliant online virtual platform, coach and participant virtual training, and modification of necessary intervention elements and materials, as needed. Based on the preliminary findings, the participants and intervention coaches responded well to the virtual adaptation of IDEA. When comparing to in-person delivery, the virtual delivery decreased attrition among both intervention participants and coaches. Discussion: The virtual adaptation of the IDEA intervention resulted in preliminary, unexpected, yet potentially important benefits, including the ability to expand the reach of the intervention and decreased attrition. Virtual interventions are an emerging field for people living with dementia and their care partners and additional systematic research is needed to fully assess the benefits and limitations as well as to evaluate if specific subgroups are better served by differing delivery modalities.

3.
Animals (Basel) ; 13(13)2023 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-37443922

RESUMO

Research evaluating marine mammal welfare and opportunities for advancements in the care of species housed in a professional facility have rapidly increased in the past decade. While topics, such as comfortable housing, adequate social opportunities, stimulating enrichment, and a high standard of medical care, have continued to receive attention from managers and scientists, there is a lack of established acoustic consideration for monitoring the welfare of these animals. Marine mammals rely on sound production and reception for navigation and communication. Regulations governing anthropogenic sound production in our oceans have been put in place by many countries around the world, largely based on the results of research with managed and trained animals, due to the potential negative impacts that unrestricted noise can have on marine mammals. However, there has not been an established best practice for the acoustic welfare monitoring of marine mammals in professional care. By monitoring animal hearing and vocal behavior, a more holistic view of animal welfare can be achieved through the early detection of anthropogenic sound sources, the acoustic behavior of the animals, and even the features of the calls. In this review, the practice of monitoring cetacean acoustic welfare through behavioral hearing tests and auditory evoked potentials (AEPs), passive acoustic monitoring, such as the Welfare Acoustic Monitoring System (WAMS), as well as ideas for using advanced technologies for utilizing vocal biomarkers of health are introduced and reviewed as opportunities for integration into marine mammal welfare plans.

4.
Contemp Clin Trials ; 128: 107143, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36893987

RESUMO

BACKGROUND: Heightened risks of cognitive impairment, disability, and barriers to care among sexual and gender minority (SGM) older adults are well documented. To date, culturally responsive evidence-based dementia interventions for this population do not exist. OBJECTIVE: This study describes the design of the first randomized controlled trial (RCT) testing a culturally responsive cognitive behavioral and empowerment intervention, Innovations in Dementia Empowerment and Action (IDEA), developed to address the unique needs of SGM older adults living with dementia and care partners. METHODS: IDEA is a culturally enhanced version of Reducing Disability in Alzheimer's Disease (RDAD), an efficacious, non-pharmaceutical intervention for people with dementia and care partners. We utilized a staggered multiple baseline design with the goal to enroll 150 dyads randomized into two arms of 75 dyads each, enhanced IDEA and standard RDAD. RESULTS: IDEA was adapted using findings from the longitudinal National Health, Aging, and Sexuality/Gender study, which identified modifiable factors for SGM older adults, including SGM-specific discrimination and stigma, health behaviors, and support networks. The adapted intervention employed the original RDAD strategies and enhanced them with culturally responsive empowerment practices designed to cultivate engagement, efficacy, and support mobilization. Outcomes include adherence to physical activity, reduction in perceived stress and stigma, and increased physical functioning, efficacy, social support, engagement, and resource use. CONCLUSION: IDEA addresses contemporary issues for underserved populations living with dementia and their care partners. Our findings will have important implications for marginalized communities by integrating and evaluating the importance of cultural responsiveness in dementia and caregiving interventions.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Minorias Sexuais e de Gênero , Humanos , Idoso , Cuidadores/psicologia , Doença de Alzheimer/psicologia , Identidade de Gênero
5.
Behav Processes ; 200: 104690, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35709885

RESUMO

Bottlenose dolphins have individually distinct signature whistles that are characterized by a stereotyped frequency-time contour. Signature whistles are commonly exchanged with short time delays between calls. Dolphin whistles are produced by pressurized nasal sacs that increase and then decrease in pressure over emission. This study found that the relative amplitude modulation pattern over time exhibited the same fade-in and then fade-out pattern in the signature whistles of eight bottlenose dolphins at the Navy in San Diego, CA. Both the initial and final five percent of the whistle's duration also had significantly lower mean relative amplitude than the center five percent. The current analyses of the amplitude-time relationship was then integrated to a previously reported model of the negative relationship between relative log amplitude and log peak frequency. This produced a more robust model for accounting for the predictable aspects of the more broadly non-stereotyped amplitude modulations of signature whistles. Whether dolphins can intentionally manipulate these amplitude features or they are simple by-products of the sound production system, and further whether they are perceived and utilized by receivers, is an exciting area for continued research.


Assuntos
Golfinho Nariz-de-Garrafa , Vocalização Animal , Animais , Som , Espectrografia do Som
6.
Behav Processes ; 194: 104561, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34838900

RESUMO

Bottlenose dolphin signature whistles are characterized by distinctive frequency modulation over time. The stable frequency contours of these whistles broadcast individual identity information. Little is known however, about whether or not the amplitude contour is also stereotyped. Here, we examined the relative amplitude-time contour of signature whistle emissions from eight bottlenose dolphins (Tursiops truncatus) in the U.S. Navy Marine Mammal Program (MMP) in San Diego, CA. The results suggested that unlike the stable frequency-time contour, the amplitude-time contour of signature whistles were largely non-stereotyped, characterized by large variability across multiple whistle emissions. Relative amplitude was negatively related to log peak frequency, with more energy focused in the lower frequency bands. This trend was consistent over all eight dolphins despite having quite different signature whistle contours. This relationship led to the amplitude contours being slightly more stereotyped within than between dolphins. We propose that amplitude across signature whistle emissions may serve as an avenue for encoding additional communicative information. We encourage future studies to incorporate analyses of amplitude contours in addition to frequency contours of signature whistles in order to begin to understand what role it may play in the dolphin communication system.


Assuntos
Golfinho Nariz-de-Garrafa , Vocalização Animal , Animais , Espectrografia do Som
7.
Conserv Physiol ; 9(1): coab007, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33833867

RESUMO

Changes in species composition and biomass of Arctic benthic communities are predicted to occur in response to environmental changes associated with oceanic warming and sea-ice loss. Such changes will likely impact ecosystem function, including flows of energy and organic material through the Arctic marine food web. Oxygen consumption rates can be used to quantify differences in metabolic demand among species and estimate the effects of shifting community structure on benthic carbon consumption. Closed-system respirometry using non-invasive oxygen optodes was conducted onboard the R/V Sikuliaq in June 2017 and 2018 on six dominant species of benthic macrofauna from the northern Bering and southern Chukchi Sea shelves, including five bivalve species (Macoma sp., Serripes groenlandicus, Astarte sp., Hiatella arctica and Nuculana pernula) and one amphipod species (Ampelisca macrocephala). Results revealed species-specific respiration rates with high metabolic demand for S. groenlandicus and A. macrocephala compared to that of the other species. For a hypothetical 0.1-g ash-free dry mass individual, the standard metabolic rate of S. groenlandicus would be 4.3 times higher than that of Astarte sp. Overall, carbon demand ranged from 8 to 475 µg C individual-1 day-1 for the species and sizes of individuals measured. The allometric scaling of respiration rate with biomass also varied among species. The scaling coefficient was similar for H. arctica, A. macrocephala and Astarte sp., while it was high for S. groenlandicus and low for Macoma sp. These results suggest that observed shifts in spatial distribution of the dominant macrofaunal taxa across this region will impact carbon demand of the benthic community. Hence, ecosystem models seeking to incorporate benthic system functionality may need to differentiate between communities that exhibit different oxygen demands.

9.
PLoS One ; 15(5): e0233658, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32442214

RESUMO

Most commonly, animal communication systems are driven by shared call repertoires, with some individual distinctiveness encoded as a byproduct of voice cues. We provide evidence that bottlenose dolphins produce both individually distinctive whistles, and a shared whistle type. A stereotyped whistle contour (termed the group whistle) is shared by five bottlenose dolphins that have lived, worked, and traveled together for at least 21 years. These five dolphins are members of a group of eight dolphins that work as a specialized team for the Navy Marine Mammal Program. Each dolphin is routinely recorded during periods when an individual is isolated from the others in above ground pools as part of their routine training. Each of the eight dolphins has an individually distinctive signature whistle. In addition, at least five of these dolphins share a distinct non-signature whistle type. This shared whistle contour was produced an average of 22.4% +/- 9.0% of the time during periods in which individuals were isolated. During these isolations the signature whistle was produced an average of 42.9% +/- 11.9% of the time. This is consistent with decades of signature whistle research. A group of 10 naïve observers rated the similarity of the different whistle contours. The observers rated the group whistle contour produced by all five dolphins as highly similar (P < 0.01). Their ratings further showed that the signature whistles of the five dolphins were very different (P < 0.01). These findings were further supported by discriminant function analyses. That said, the shared whistle contours still exhibited individual differences which may allow conspecifics to identify the producer even when a whistle contour is shared among multiple dolphins. This is the first in-depth analysis of a non-signature whistle type shared among multiple conspecifics.


Assuntos
Golfinho Nariz-de-Garrafa/psicologia , Vocalização Animal , Animais , Feminino , Individualidade , Masculino , Comportamento Social , Espectrografia do Som/métodos , Estereotipagem
10.
Ann Pharmacother ; 54(2): 97-104, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31416330

RESUMO

Background: Evidence regarding the use of antipsychotics and associated venous thromboembolism (VTE) risk is inconclusive. Studies finding a relationship lack in-depth analysis; thus, the VTE risk among those treated with antipsychotic remains largely unknown. Objectives: The primary objective of this investigation was to compare the incidence of antipsychotic use in patients who developed a VTE versus those who did not. Methods: Data were collected via retrospective chart review from an ambulatory care clinic between January 2012 and August 2017. All active clinic patients within the study period were included unless they met the following criteria: age <18 years, pregnancy within the study period, and/or current or historical malignancy. The odds ratio (OR) of developing a VTE was determined using multivariate regression analysis controlling for age, gender, obesity, and smoking. Secondary end points were reviewed for participants who were exposed to an antipsychotic and subsequently developed a VTE within the study period. Results: A total of 7079 patients were included in the analysis, of whom 314 developed a VTE. Of these, 45 were exposed to an antipsychotic prior to VTE development. Nearly 25% of patients receiving an antipsychotic did not have a primary psychiatric diagnosis. Results suggest that antipsychotic use was significantly associated with increased risk of VTE development (OR = 1.481 [95% CI = 1.067 to 2.055]). Conclusion and Relevance: The results of this study suggest an association between antipsychotic use and VTE development. This association should be considered when prescribing antipsychotics and treating patients who develop a VTE after antipsychotic exposure.


Assuntos
Assistência Ambulatorial , Antipsicóticos/efeitos adversos , Uso de Medicamentos/estatística & dados numéricos , Tromboembolia Venosa/epidemiologia , Adulto , Antipsicóticos/administração & dosagem , Antipsicóticos/uso terapêutico , Registros Eletrônicos de Saúde , Feminino , Humanos , Incidência , Masculino , Transtornos Mentais , Análise Multivariada , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Estados Unidos , Tromboembolia Venosa/induzido quimicamente
11.
Am J Obstet Gynecol ; 221(2): 86-94, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30790565

RESUMO

Endometriosis, a systemic disease that is often painful and chronic, affects ∼10% of reproductive-age women. The disease can have a negative impact on a patient's physical and emotional well-being, quality of life, and productivity. Endometriosis also places significant economic and social burden on patients, their families, and society as a whole. Despite its high prevalence and cost, endometriosis remains underfunded and underresearched, greatly limiting our understanding of the disease and slowing much-needed innovation in diagnostic and treatment options. Due in part to the societal normalization of women's pain and stigma around menstrual issues, there is also a lack of disease awareness among patients, health care providers, and the public. The Society for Women's Health Research convened an interdisciplinary group of expert researchers, clinicians, and patients for a roundtable meeting to review the current state of the science on endometriosis and identify areas of need to improve a woman's diagnosis, treatment, and access to quality care. Comprehensive and interdisciplinary approaches to disease management and increased education and disease awareness for patients, health care providers, and the public are needed to remove stigma, increase timely and accurate diagnosis and treatment, and allow for new advancements.


Assuntos
Endometriose/diagnóstico , Anti-Inflamatórios não Esteroides/uso terapêutico , Biomarcadores/sangue , Contraceptivos Hormonais/uso terapêutico , Diagnóstico Tardio , Denervação , Erros de Diagnóstico , Endometriose/terapia , Antagonistas de Estrogênios/uso terapêutico , Feminino , Humanos , Histerectomia , Laparoscopia , Imageamento por Ressonância Magnética , Dor Pélvica/etiologia , Modalidades de Fisioterapia , Guias de Prática Clínica como Assunto , Progestinas/uso terapêutico , Estigma Social , Ultrassonografia
12.
Nat Methods ; 15(5): 330-338, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29638227

RESUMO

A key component of efforts to address the reproducibility crisis in biomedical research is the development of rigorously validated and renewable protein-affinity reagents. As part of the US National Institutes of Health (NIH) Protein Capture Reagents Program (PCRP), we have generated a collection of 1,406 highly validated immunoprecipitation- and/or immunoblotting-grade mouse monoclonal antibodies (mAbs) to 737 human transcription factors, using an integrated production and validation pipeline. We used HuProt human protein microarrays as a primary validation tool to identify mAbs with high specificity for their cognate targets. We further validated PCRP mAbs by means of multiple experimental applications, including immunoprecipitation, immunoblotting, chromatin immunoprecipitation followed by sequencing (ChIP-seq), and immunohistochemistry. We also conducted a meta-analysis that identified critical variables that contribute to the generation of high-quality mAbs. All validation data, protocols, and links to PCRP mAb suppliers are available at http://proteincapture.org.


Assuntos
Anticorpos Monoclonais/imunologia , Análise Serial de Proteínas/métodos , Fatores de Transcrição/metabolismo , Animais , Clonagem Molecular , Bases de Dados Factuais , Feminino , Células HeLa , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Reprodutibilidade dos Testes
13.
J Thromb Thrombolysis ; 45(4): 512-515, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29556958

RESUMO

Patients with sickle cell disease (SCD) experience initial and recurrent venous thromboembolism (VTE) more commonly and at a younger age than the general population, and it confers a higher mortality for patients with SCD. However, limited evidence is available to guide anticoagulant use for VTE treatment in this population. The primary objective of this study is to characterize the effectiveness and safety of direct oral anticoagulants (DOAC) and warfarin for VTE treatment among patients with SCD. This single-center retrospective study includes adult patients with SCD who were diagnosed with VTE. Data was obtained from review of electronic health records for the 6 months after VTE diagnosis. Among the 22 patients treated initially with a DOAC, 6 (27%) developed recurrent VTE, none experienced major bleeding, and 3 (14%) experienced clinically relevant non-major bleeding (CRNMB). Similarly, of 15 patients initially treated with warfarin, 3 (20%) developed a recurrent VTE, 1 (7%) experienced major bleeding, and 2 (13%) experienced CRNMB. Twelve patients received more than one oral anticoagulant during the study period, most commonly due to a recurrent VTE, concern for non-adherence, or subtherapeutic INR. Overall, the incidence of VTE recurrence and bleeding events were similar between groups, but occurred at a higher rate than those found in major clinical trials of anticoagulant agents. Prescribers should continue to individualize therapeutic decision-making regarding oral anticoagulant therapy for VTE treatment for individuals with SCD based on patient-specific factors and anticipated ability to adhere to the drug regimen or required monitoring.


Assuntos
Anemia Falciforme/tratamento farmacológico , Anticoagulantes/uso terapêutico , Tromboembolia Venosa/tratamento farmacológico , Adulto , Anemia Falciforme/complicações , Anticoagulantes/efeitos adversos , Hemorragia/induzido quimicamente , Humanos , Adesão à Medicação , Medicina de Precisão/métodos , Estudos Retrospectivos , Resultado do Tratamento , Tromboembolia Venosa/complicações , Varfarina/efeitos adversos , Varfarina/uso terapêutico
14.
MAbs ; 10(4): 539-546, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29485921

RESUMO

Monoclonal antibodies are commonly assumed to be monospecific, but anecdotal studies have reported genetic diversity in antibody heavy chain and light chain genes found within individual hybridomas. As the prevalence of such diversity has never been explored, we analyzed 185 random hybridomas, in a large multicenter dataset. The hybridomas analyzed were not biased towards those with cloning difficulties or known to have additional chains. Of the hybridomas we evaluated, 126 (68.1%) contained no additional productive chains, while the remaining 59 (31.9%) contained one or more additional productive heavy or light chains. The expression of additional chains degraded properties of the antibodies, including specificity, binding signal and/or signal-to-noise ratio, as determined by enzyme-linked immunosorbent assay and immunohistochemistry. The most abundant mRNA transcripts found in a hybridoma cell line did not necessarily encode the antibody chains providing the correct specificity. Consequently, when cloning antibody genes, functional validation of all possible VH and VL combinations is required to identify those with the highest affinity and lowest cross-reactivity. These findings, reflecting the current state of hybridomas used in research, reiterate the importance of using sequence-defined recombinant antibodies for research or diagnostic use.


Assuntos
Anticorpos Monoclonais/imunologia , Especificidade de Anticorpos/imunologia , Hibridomas/imunologia , Animais , Anticorpos Monoclonais/genética , Especificidade de Anticorpos/genética , Genes de Cadeia Pesada de Imunoglobulina/genética , Genes de Cadeia Pesada de Imunoglobulina/imunologia , Genes de Cadeia Leve de Imunoglobulina/genética , Genes de Cadeia Leve de Imunoglobulina/imunologia , Humanos
15.
Spine (Phila Pa 1976) ; 42(20): 1529-1537, 2017 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-28306638

RESUMO

STUDY DESIGN: Institutional review board-approved research using human annulus cells cocultured with F11 nerve cells. OBJECTIVE: To perform functional, kinetic assays of neurite dynamics and media neurotrophin measurements to test whether proinflammatory cytokines influence annulus cells' signaling cues for neurite growth/repulsion. SUMMARY OF BACKGROUND DATA: Nerves grow in response to signaling molecules called neurotrophins, which disc cells produce (e.g., brain-derived neurotrophic factor [BDNF], glial cell line-derived neurotrophic factor [GDNF], and neurotrophin 3 [NT3]) and which influence neuron survival, differentiation, and migration. How proinflammatory cytokines influence disc signaling cues for neurite growth/repulsion is poorly understood. METHODS: Studies used our previous model of 4-day human annulus cell-F11 nerve cell coculture to assess effects of added proinflammatory cytokines interleukin 1 beta (IL-1ß; 10 pmol/L) or tumor necrosis factor alpha (TNF-α) (10 pmol/L). Annulus cells were cultured from 6 Thompson grade I, 9 grade II, 8 grade III, 11 grade IV, and 7 grade V discs. Neurite lengths were measured following control conditions or with added IL-1ß or TNF-α, and conditioned media assayed with RayBiotech Growth Factor Arrays. Standard statistical methods used analysis of variance and Spearman correlation coefficient testing associations of neurite length with neurotrophin levels. RESULTS: IL-1-ß or TNF-α significantly increased neurite lengths (P < 0.001) and BDNF, NT3, and GDNF media levels (P ≤ 0.01) versus controls. Significant positive correlations were present between media neurotrophin levels for BDNF, NT3, and GDNF and neurite lengths under control conditions, following addition of IL-1ß, and following addition of TNF-α. Novel data showed production of the neurotrophin amphiregulin. CONCLUSION: In vitro data supported the hypothesis that nerve-disc cell interactions may be influenced by the heightened proinflammatory milieu present in degenerating discs, leading to increased nerve migration. Data may have direct clinical relevance/implications for nerve ingrowth and pain in the outer annulus (where disc cell numbers are high), and in regions where nerves penetrate into the disc via annular tears. LEVEL OF EVIDENCE: N/A.


Assuntos
Anel Fibroso/metabolismo , Interleucina-1beta/farmacologia , Neuritos/metabolismo , Transdução de Sinais/fisiologia , Fator de Necrose Tumoral alfa/farmacologia , Adolescente , Adulto , Idoso , Anel Fibroso/efeitos dos fármacos , Células Cultivadas , Criança , Pré-Escolar , Técnicas de Cocultura , Sinais (Psicologia) , Citocinas/metabolismo , Citocinas/farmacologia , Feminino , Humanos , Lactente , Recém-Nascido , Mediadores da Inflamação/metabolismo , Interleucina-1beta/metabolismo , Disco Intervertebral/efeitos dos fármacos , Disco Intervertebral/metabolismo , Masculino , Pessoa de Meia-Idade , Fatores de Crescimento Neural/metabolismo , Neuritos/efeitos dos fármacos , Neurotrofina 3 , Estudos Prospectivos , Transdução de Sinais/efeitos dos fármacos , Fator de Necrose Tumoral alfa/metabolismo , Adulto Jovem
16.
PLoS One ; 12(1): e0170603, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28141807

RESUMO

BACKGROUND: Recent research has challenged the stereotype that eating disorders are largely limited to young, White, upper-class females. This study investigated the association between indicators of socioeconomic status and eating disorder features. METHODS AND FINDINGS: Data were merged from cross-sectional general population surveys of adults in South Australia in 2008 (n = 3034) and 2009 (n = 3007) to give a total sample of 6041 participants. Multivariate logistic regressions were employed to test associations between indicators of socioeconomic status (household income, educational level, employment status, indigenous status and urbanicity) and current eating disorder features (objective binge eating, subjective binge eating, purging, strict dieting and overvaluation of weight/shape). Eating disorder features occurred at similar rates across all levels of income, education, indigenous status, and urbanicity (p > 0.05). However, compared to working full-time, not working due to disability was associated with an increased risk of objective binge eating (odds ratio (OR) = 2.30, p < 0.01) and purging (OR = 4.13, p < 0.05), engagement in home-duties with an increased risk of overvaluation of weight/shape (OR = 1.39, p < 0.05), and unemployment with an increased risk of objective binge eating (OR = 2.02, p < 0.05) and subjective binge eating (OR = 2.80, p < 0.05). Furthermore, participants with a trade or certificate qualification were at a significantly increased risk of reporting strict dieting compared to participants without a tertiary qualification (OR = 1.58, p <0.01). Limitations included the small numbers of indigenous participants (n = 115) and participants who reported purging (n = 54), exclusion of excessive exercise (which is associated with eating disorders, particularly in males), and the conduct of interviews by laypersons. CONCLUSIONS: Overall, symptoms of eating disorders are distributed equally across levels of socioeconomic status. This study highlights the need for universal access to specialised services, to train healthcare workers in the detection and diagnosis of eating disorders in diverse subgroups, and to combat barriers to help-seeking experienced by people who do not conform to the demographic stereotype of an eating disorder. The increased prevalence of various eating disorder features in those who are not working could be addressed by providing support to help sufferers join the workforce, or engage in meaningful social or community activities to improve resilience against the development of eating disorders.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Fatores Socioeconômicos , Cidades , Demografia , Escolaridade , Emprego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Relatório de Pesquisa , Austrália do Sul/epidemiologia
18.
J Asthma ; 53(6): 607-17, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27116362

RESUMO

OBJECTIVE: The goal of this report is to review available modalities for assessing and managing acute asthma exacerbations in pediatric patients, including some that are not included in current expert panel guidelines. While it is not our purpose to provide a comprehensive review of the National Asthma Education and Prevention Program (NAEPP) guidelines, we review NAEPP-recommended treatments to provide the full range of treatments available for managing exacerbations with an emphasis on the continuum of care between the ER and ICU. DATA SOURCES: We searched PubMed using the following search terms in different combinations: asthma, children, pediatric, exacerbation, epidemiology, pathophysiology, guidelines, treatment, management, oxygen, albuterol, ß2-agonist, anticholinergic, theophylline, corticosteroid, magnesium, heliox, BiPAP, ventilation, mechanical ventilation, non-invasive mechanical ventilation and respiratory failure. We attempted to weigh the evidence using the hierarchy in which meta-analyses of randomized controlled trials (RCTs) provide the strongest evidence, followed by individual RCTs, followed by observational studies. We also reviewed the NAEPP and Global Initiative for Asthma expert panel guidelines. RESULTS AND CONCLUSIONS: Asthma is the most common chronic disease of childhood, and acute exacerbations are a significant burden to patients and to public health. Optimal assessment and management of exacerbations, including appropriate escalation of interventions, are essential to minimize morbidity and prevent mortality. While inhaled albuterol and systemic corticosteroids are the mainstay of exacerbation management, escalation may include interventions discussed in this review.


Assuntos
Corticosteroides/uso terapêutico , Antiasmáticos/uso terapêutico , Asma/terapia , Broncodilatadores/uso terapêutico , Serviço Hospitalar de Emergência/organização & administração , Oxigênio/uso terapêutico , Doença Aguda , Corticosteroides/administração & dosagem , Antiasmáticos/administração & dosagem , Asma/fisiopatologia , Gasometria , Broncodilatadores/administração & dosagem , Criança , Doença Crônica , Vias de Administração de Medicamentos , Quimioterapia Combinada , Hélio/uso terapêutico , Humanos , Guias de Prática Clínica como Assunto , Respiração Artificial/métodos , Insuficiência Respiratória
19.
Chest ; 150(1): 131-8, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26923626

RESUMO

BACKGROUND: Chest radiography (CXR) is the test of choice for diagnosing pneumonia. Lung ultrasonography (LUS) has been shown to be accurate for diagnosing pneumonia in children and may be an alternative to CXR. Our objective was to determine the feasibility and safety of substituting LUS for CXR when evaluating children suspected of having pneumonia. METHODS: We conducted a randomized control trial comparing LUS with CXR in 191 children from birth to 21 years of age suspected of having pneumonia in an ED. Patients in the investigational arm underwent LUS. If there was clinical uncertainty after ultrasonography, physicians had the option to perform CXR. Patients in the control arm underwent sequential imaging with CXR followed by LUS. The primary outcome was the rate of CXR reduction; secondary outcomes were missed pneumonia, subsequent unscheduled health-care visits, and adverse events between the investigational and control arms. RESULTS: There was a 38.8% reduction (95% CI, 30.0%-48.9%) in CXR among investigational subjects compared with no reduction (95% CI, 0.0%-3.6%) in the control group. Novice and experienced physician-sonologists achieved 30.0% and 60.6% reduction in CXR use, respectively. There were no cases of missed pneumonia among all study participants (investigational arm, 0.0%: 95% CI, 0.0%-2.9%; control arm, 0.0%: 95% CI, 0.0%-3.0%), or differences in adverse events, or subsequent unscheduled health-care visits between arms. CONCLUSIONS: It may be feasible and safe to substitute LUS for CXR when evaluating children suspected of having pneumonia with no missed cases of pneumonia or increase in rates of adverse events. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01654887; URL: www.clinicaltrials.gov.


Assuntos
Pulmão/diagnóstico por imagem , Pneumonia/diagnóstico , Radiografia Torácica/métodos , Ultrassonografia/métodos , Adolescente , Pré-Escolar , Estudos de Viabilidade , Humanos , Recém-Nascido , Segurança do Paciente , Reprodutibilidade dos Testes , Adulto Jovem
20.
Anim Cogn ; 19(4): 789-97, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27022973

RESUMO

Although many species have proven capable of cooperating to achieve common goals, the role of communication in cooperation has received relatively little attention. Analysis of communication between partners is vital in determining whether actions are truly cooperative rather than serendipitous or learned via trial and error (Chalmeau and Gallo in Behav Process 35:101-111, 1996a. doi: 10.1016/0376-6357(95)00049-6 , Primates 37:39-47, 1996b. doi: 10.1007/BF02382918 ). Wild cetaceans often produce sounds during cooperative foraging, playing, and mating, but the role of these sounds in cooperative events is largely unknown. Here, we investigated acoustic communication between two male bottlenose dolphins while they cooperatively opened a container (Kuczaj et al. in Anim Cogn 18:543-550, 2015b. doi: 10.1007/s10071-014-0822-4 ). Analyses of whistles, burst pulses, and bi-phonations that occurred during four contexts (i.e., no container, no animals interacting with container, one animal interacting with container, and two animals interacting with container) revealed that overall sound production rate significantly increased during container interactions. Sound production rates were also significantly higher during cooperative successes than solo successes, suggesting that the coordination of efforts rather than the apparatus itself was responsible for the phonation increase. The most common sound type during cooperative successes was burst pulse signals, similar to past recordings of cooperative events in bottlenose dolphins (Bastian in Animal sonar systems. Laboratoire de Physiologie Acoustique, Jouy-en Josas, pp 803-873, 1967; Connor and Smolker 1996).


Assuntos
Golfinho Nariz-de-Garrafa , Comportamento Social , Vocalização Animal , Acústica , Animais , Comportamento Animal , Masculino
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...