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1.
J Emerg Manag ; 22(7): 71-85, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38573731

RESUMO

Flooding events are the most common natural hazard globally, resulting in vast destruction and loss of life. An effective flood emergency response is necessary to lessen the negative impacts of flood disasters. However, disaster management and response efforts face a complex scenario. Simultaneously, regular citizens attempt to navigate the various sources of information being distributed and determine their best course of action. One thing is evident across all disaster scenarios: having accurate information and clear communication between citizens and rescue personnel is critical. This research aims to identify the diverse needs of two groups, rescue operators and citizens, during flood disaster events by investigating the sources and types of information they rely on and information that would improve their responses in the future. This information can improve the design and implementation of existing and future spatial decision support systems (SDSSs) during flooding events. This research identifies information characteristics crucial for rescue operators and everyday citizens' response and possible evacuation to flooding events by qualitatively coding survey responses from rescue responders and the public. The results show that including local input in SDSS development is crucial for improving higher-resolution flood risk quantification models. Doing so democratizes data collection and analysis, creates transparency and trust between people and governments, and leads to transformative solutions for the broader scientific community.


Assuntos
Planejamento em Desastres , Desastres , Humanos , Inundações , Comunicação , Coleta de Dados
2.
Sports Med Open ; 10(1): 40, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38625433

RESUMO

BACKGROUND: Esports is competitive video gaming, performed within teams or individually, across multiple genres. Players are required to be sedentary for extended periods and require a high-level of cognitive skills for successful competitive performance. There are conflicting findings within the physical activity research in the esports industry. The aim of this research is to explore self-reported physical activity through accelerometer-assessed physical activity, to gain a better insight into the physical activity behaviours of international e'athletes. METHOD: Participants (n = 796) across multiple popular esports games, holding any in-game rank, competing at any level, were recruited. The survey consisted of demographic details, esports experience, the International Physical Activity Questionnaire-Long Form (IPAQ-LF), and Behavioural Regulations towards Exercise Questionnaire (BREQ-3). Within a convenience sample, local intervarsity e'athletes (n = 18) were recruited to wear a wrist-worn accelerometer to measure physical activity for 7-days and then complete the survey. Results from the accelerometers were compared to the survey results to explore physical activity reporting within this population. RESULTS: When comparing IPAQ-LF to accelerometer data, players significantly over-report moderate-to-vigorous physical activity and weekly MET-min- 1 (p = .018, r = .63 and p ≤ .001, r = .92). The BREQ-3 showed that e'athletes categorised as high physical activity displayed significantly higher levels of intrinsic motivation, when compared to players categorised as low and moderate physical activity. CONCLUSIONS: E'athletes significantly over report physical activity time when measured through the IPAQ-LF, suggesting previous surveys may overestimate physical activity and further research is needed. Given the exponential growth of the industry and the level of physical inactivity, esports may contribute to global physical inactivity levels.

3.
Subst Use Misuse ; 59(5): 699-706, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38170177

RESUMO

BACKGROUND: Nicotine and tobacco product (NTP) and cannabis use are common in adolescence/young adulthood and increase risk for negative psychosocial outcomes. This study investigated associations among adolescent/young adults' initial experiences with NTPs, lifetime frequency of substance use, substance-related problems, and mental health symptoms. METHOD: Adolescents and young adults enrolled in a study on NTP and cannabis use were asked at what age they initiated the use of NTPs and were assigned to groups based on which product or substance(s) they reported using at the earliest age. Participants who reported use of NTPs (in isolation, without cannabis) first (N = 78, "NTP-only"), simultaneous use of NTPs and cannabis first (e.g., blunt or bowl; N = 25, "Simult-only"), use of both NTPs in isolation and simultaneous use at the same age (N = 48, "NTP + Simult"), and no NTP use (N = 53, "NTP-naïve") were compared on substance use, substance-related problems, and mental health symptoms. RESULTS: Groups differed on lifetime frequency of NTP, simultaneous, and cannabis use, with NTP users reporting more substance use episodes and substance-related problems than the NTP-naïve group. The lifetime frequency of cannabis use did not differ across NTP use groups. NTP use was associated with increased anxiety and depression, with no significant differences between groups. CONCLUSIONS: Adolescents and young adults who use nicotine may be at increased risk for greater nicotine use and mental health consequences, but initiating NTP use simultaneously with cannabis may not increase the risk of negative outcomes above and beyond nicotine initiation. Prospective longitudinal research is needed to establish temporal associations between first-used NTP/cannabis products and relevant outcomes.


Assuntos
Cannabis , Sistemas Eletrônicos de Liberação de Nicotina , Alucinógenos , Fumar Maconha , Transtornos Relacionados ao Uso de Substâncias , Tabagismo , Adulto Jovem , Humanos , Adolescente , Adulto , Nicotina/efeitos adversos , Fumar Maconha/psicologia , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Tabagismo/psicologia , Produtos do Tabaco
4.
HIV Med ; 25(3): 332-342, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38012059

RESUMO

BACKGROUND: The transition between inpatient and outpatient care for hospitalized people with HIV represents an opportunity for linkage and re-engagement in care. We evaluated whether attendance at a post-hospitalization visit ('discharge clinic') within 1-2 weeks of discharge would reduce readmissions and improve retention in care (RIC) among people with HIV in San Diego, California, USA. METHODS: This was a retrospective cohort study of people with HIV hospitalized between June 2020 and November 2021. Our primary outcome was 30-day readmissions among people with HIV who did or did not attend a discharge clinic visit. Secondary outcomes included the effect of discharge clinic attendance on RIC, along with the impact of attendance at any HIV clinic visit within 30 days of discharge on readmissions and RIC. RESULTS: We evaluated 114 people with HIV, of whom 77 (67.5%) and 90 (78.9%) attended a discharge clinic visit or any HIV clinic visit within 30 days of discharge, respectively. Active substance use disorder (SUD) was associated with failing to attend a discharge clinic visit (odds ratio 0.31; 95% confidence interval 0.13-0.77). We observed no significant differences in readmissions between people with HIV who did or did not attend a discharge clinic visit; however, the former had significantly higher 6-month RIC (79.2% vs. 35.1%, p < 0.001). People with HIV attending any HIV clinic visit within 30 days of discharge had significantly fewer 30-day readmissions (8.9% vs. 29.2%, p = 0.02) and better 6-month RIC (75.6% vs. 25%, p < 0.001) than those who did not attend. CONCLUSION: Early hospital follow-up care was associated with a reduction in readmissions among people with HIV. Active SUD was a significant barrier to linkage to outpatient follow-up and RIC.


Assuntos
Infecções por HIV , Retenção nos Cuidados , Humanos , Readmissão do Paciente , Alta do Paciente , Seguimentos , Estudos Retrospectivos , Hospitais
5.
Brain Imaging Behav ; 18(1): 34-43, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37851272

RESUMO

Nicotine and tobacco product (NTP) use remains prevalent in adolescence/young adulthood. The effects of NTPs on markers of brain health during this vulnerable neurodevelopmental period remain largely unknown. This report investigates associations between NTP use and gray matter cerebral blood flow (CBF) in adolescents/young adults. Adolescent/young adult (16-22 years-old) nicotine users (NTP; N = 99; 40 women) and non-users (non-NTP; N = 95; 56 women) underwent neuroimaging sessions including anatomical and optimized pseudo-continuous arterial spin labeling scans. Groups were compared on whole-brain gray matter CBF estimates and their relation to age and sex at birth. Follow-up analyses assessed correlations between identified CBF clusters and NTP recency and dependence measures. Controlling for age and sex, the NTP vs. non-NTP contrast revealed a single cluster that survived thresholding which included portions of bilateral precuneus (voxel-wise alpha < 0.001, cluster-wise alpha < 0.05; ≥7 contiguous voxels). An interaction between NTP group contrast and age was observed in two clusters including regions of the left posterior cingulate (PCC)/lingual gyrus and right anterior cingulate cortex (ACC): non-NTP exhibited positive correlations between CBF and age in these clusters, whereas NTP exhibited negative correlations between CBF and age. Lower CBF from these three clusters correlated with urine cotinine (rs=-0.21 - - 0.16; ps < 0.04) and nicotine dependence severity (rs=-0.16 - - 0.13; ps < 0.07). This is the first investigation of gray matter CBF in adolescent/young adult users of NTPs. The results are consistent with literature on adults showing age- and nicotine-related declines in CBF and identify the precuneus/PCC and ACC as potential key regions subserving the development of nicotine dependence.


Assuntos
Substância Cinzenta , Tabagismo , Recém-Nascido , Adulto Jovem , Humanos , Adolescente , Feminino , Adulto , Substância Cinzenta/diagnóstico por imagem , Nicotina , Imageamento por Ressonância Magnética/métodos , Tabagismo/diagnóstico por imagem , Encéfalo/fisiologia , Circulação Cerebrovascular/fisiologia
6.
JCO Clin Cancer Inform ; 7: e2300061, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37851942

RESUMO

PURPOSE: To explore medications and their administration patterns in real-world patients with breast cancer. METHODS: A retrospective study was performed using TriNetX, a federated network of deidentified, Health Insurance Portability and Accountability Act-compliant data from 21 health care organizations across North America. Patients diagnosed with breast cancer between January 1, 2013, and May 31, 2022, were included. We investigated a rule-based and unsupervised learning algorithm to extract medications and their administration patterns. To group similar administration patterns, we used three features in k-means clustering: total number of administrations, median number of days between administrations, and standard deviation of the days between administrations. We explored the first three lines of therapy for patients classified into six groups on the basis of their stage at diagnosis (early as stages I-III v late as stage IV) and the sensitivity of the tumor's receptors to targeted therapies: hormone receptor-positive/human epidermal growth factor 2-negative (HR+/ERBB2-), ERBB2-positive (ERBB2+/HR±), or triple-negative (TN; HR-/ERBB2-). To add credence to the derived regimens, we compared them to the National Comprehensive Cancer Network (NCCN): Breast Cancer (version 2.2023) recommendations. RESULTS: In early-stage HR+/ERBB2- and TN groups, the most common regimens were (1) cyclophosphamide and docetaxel, administered once every 3 weeks for three to six cycles and (2) cyclophosphamide and doxorubicin, administered once every 2 weeks for four cycles, followed by paclitaxel administered once every week for 12 cycles. In the early-stage ERBB2+/HR± group, most patients were administered carboplatin and docetaxel with or without pertuzumab and with trastuzumab (for six or more cycles). Medications most commonly administered in our data set (7,798 patients) agreed with recommendations from the NCCN in terms of medications (regimens), number of administrations (cycles), and days between administrations (cycle length). CONCLUSION: Although there is a general agreement with the NCCN Guidelines, real-world medication data exhibit variability in the medications and their administration patterns.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/etiologia , Docetaxel/uso terapêutico , Estudos Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Ciclofosfamida
7.
JAMIA Open ; 6(2): ooad035, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37193038

RESUMO

Objective: This article describes a scalable, performant, sustainable global network of electronic health record data for biomedical and clinical research. Materials and Methods: TriNetX has created a technology platform characterized by a conservative security and governance model that facilitates collaboration and cooperation between industry participants, such as pharmaceutical companies and contract research organizations, and academic and community-based healthcare organizations (HCOs). HCOs participate on the network in return for access to a suite of analytics capabilities, large networks of de-identified data, and more sponsored trial opportunities. Industry participants provide the financial resources to support, expand, and improve the technology platform in return for access to network data, which provides increased efficiencies in clinical trial design and deployment. Results: TriNetX is a growing global network, expanding from 55 HCOs and 7 countries in 2017 to over 220 HCOs and 30 countries in 2022. Over 19 000 sponsored clinical trial opportunities have been initiated through the TriNetX network. There have been over 350 peer-reviewed scientific publications based on the network's data. Conclusions: The continued growth of the TriNetX network and its yield of clinical trial collaborations and published studies indicates that this academic-industry structure is a safe, proven, sustainable path for building and maintaining research-centric data networks.

8.
mBio ; 14(1): e0332522, 2023 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-36625598

RESUMO

Streptococcus pneumoniae colonizes the human nasopharynx and causes several diseases. Pneumococcal vaccines target the polysaccharide capsule and prevent most serious disease, but there has been an increase in the prevalence of nonencapsulated S. pneumoniae (NESp). Previously, it was thought that a capsule was necessary to cause invasive disease. NESp strains expressing the oligopeptide transporters AliC and AliD have been isolated from patients with invasive disease. The AliC and AliD oligopeptide transporters regulate the expression of several genes, including choline binding protein AC (CbpAC) (a homolog of PspA), which aids in reducing C3b deposition. It is hypothesized that by altering CbpAC expression, AliC and AliD provide protection from classical complement-mediated clearance by reducing C-reactive protein (CRP) binding. Our study demonstrates that AliC and AliD regulate CbpAC expression in NESp and that AliD found in certain serotypes of encapsulated strains regulates PspA expression. C3b deposition was increased in the NESp ΔaliD and encapsulated mutants in comparison to the wild type. NESp strains expressing AliC and AliD have a significant decrease in C1q and CRP deposition in comparison to the ΔaliC ΔaliD mutant. The complement protein C1q is required for NESp clearance in a murine model and increases opsonophagocytosis. By regulating CbpAC expression, NESp inhibits CRP binding to the bacterial surface and blocks classical complement activation, leading to greater systemic survival and virulence. Due to the increase in the prevalence of NESp, it is important to gain a better understanding of NESp virulence mechanisms that aid in establishing disease and persistence within a host by avoiding clearance by the immune system. IMPORTANCE Streptococcus pneumoniae (pneumococcus) can cause a range of diseases. Although there is a robust pneumococcal vaccination program that reduces invasive pneumococcal disease by targeting various polysaccharide capsules, there has been an increase in the isolation of nonvaccine serotypes and nonencapsulated S. pneumoniae (NESp) strains. While most studies of pneumococcal pathogenesis have focused on encapsulated strains, there is little understanding of how NESp causes disease. NESp lacks a protective capsule but contains novel genes, such as aliC and aliD, which have been shown to regulate the expression of numerous genes and to be required for NESp virulence and immune evasion. Furthermore, NESp strains have high transformation efficiencies and harbor resistance to multiple drugs. This could be deleterious to current treatment strategies employed for pneumococcal disease as NESp can be a reservoir of drug resistance genes. Therefore, deciphering how NESp survives within a host and facilitates disease is a necessity that will allow the fabrication of improved, broad-spectrum treatments and preventatives against pneumococcal disease. Our study provides a better understanding of NESp virulence mechanisms during host-pathogen interactions through the examination of genes directly regulated by the NESp proteins AliC and AliD.


Assuntos
Infecções Pneumocócicas , Streptococcus pneumoniae , Animais , Humanos , Camundongos , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Proteínas de Transporte/genética , Proteínas de Transporte/metabolismo , Colina/metabolismo , Complemento C1q , Darbepoetina alfa/metabolismo , Proteínas de Membrana Transportadoras/metabolismo , Infecções Pneumocócicas/microbiologia
9.
Environ Geochem Health ; 45(2): 333-342, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35246781

RESUMO

Residents and advocacy groups began voicing concerns over the environmental quality located in the neighborhoods of Kashmere Gardens, Fifth Ward, and Denver Harbor in Houston, TX, following the confirmation of a cancer cluster in 2019 and another in 2021. These neighborhoods are in close proximity to a railyard and former wood treatment plant known to have utilized coal tar creosote and contain polycyclic aromatic hydrocarbons (PAHs). This research took core soil samples in September and October 2020 from 46 sites to assess for the presence and concentration of the U.S. Environmental Protection Agency's (USEPA) 7 Carcinogenic PAHs. Results showed the cumulative concentration of these PAHs in each sample was variable with a range of 13,767 ng/g to 328 ng/g and a mean of 2,517.2 ng/g ± 3122. A regional soil screening evaluation revealed that 40 of the 46 soil samples were in excess of the USEPAs most conservative screening levels of 1.0 × 10-6 increased cancer risk, but none exceeding levels considered actionable for remediation. This study is a fundamental first step for quantifying the environmental pollutants in this minority-majority community. Findings revealed a low risk of cancer risk based on current PAH concentrations alone but cannot assess contributions from other contaminants or from past, possibly higher, levels of contamination. Further research is needed to identify the potential casual pathways of the observed cancer cluster and to explore possible remediation needs.


Assuntos
Neoplasias , Hidrocarbonetos Policíclicos Aromáticos , Poluentes do Solo , Humanos , Solo , Carvão Mineral/análise , Poluentes do Solo/toxicidade , Poluentes do Solo/análise , Monitoramento Ambiental/métodos , Hidrocarbonetos Policíclicos Aromáticos/toxicidade , Hidrocarbonetos Policíclicos Aromáticos/análise , Texas/epidemiologia , Justiça Ambiental , Neoplasias/induzido quimicamente , Neoplasias/epidemiologia , Medição de Risco , China
10.
Int J Behav Nutr Phys Act ; 19(1): 113, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050778

RESUMO

BACKGROUND: Food literacy is theorised to improve diet quality, nutrition behaviours, social connectedness and food security. The definition and conceptualisation by Vidgen & Gallegos, consisting of 11 theoretical components within the four domains of planning and managing, selecting, preparing and eating, is currently the most highly cited framework. However, a valid and reliable questionnaire is needed to comprehensively measure this conceptualisation. Therefore, this study draws on existing item pools to develop a comprehensive food literacy questionnaire using item response theory. METHODS: Five hundred Australian adults were recruited in Study 1 to refine a food literacy item pool using principal component analysis (PCA) and item response theory (IRT) which involved detailed item analysis on targeting, responsiveness, validity and reliability. Another 500 participants were recruited in Study 2 to replicate item analysis on validity and reliability on the refined item pool, and 250 of these participants re-completed the food literacy questionnaire to determine its test-retest reliability. RESULTS: The PCA saw the 171-item pool reduced to 100-items across 19 statistical components of food literacy. After the thresholds of 26 items were combined, responses to the food literacy questionnaire had ordered thresholds (targeting), acceptable item locations (< -0.01 to + 1.53) and appropriateness of the measurement model (n = 92% expected responses) (responsiveness), met outfit mean-squares MSQ (0.48-1.42) (validity) and had high person, item separation (> 0.99) and test-retest (ICC 2,1 0.55-0.88) scores (reliability). CONCLUSIONS: We developed a 100-item food literacy questionnaire, the IFLQ-19 to comprehensively address the Vidgen & Gallegos theoretical domains and components with good targeting, responsiveness, reliability and validity in a diverse sample of Australian adults.


Assuntos
Alimentos , Letramento em Saúde , Adulto , Austrália , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
11.
Public Health Nutr ; 25(11): 3235-3239, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35942634

RESUMO

Our dominant food system is a primary driver of worsening human and planetary health. Held in March 2022, the Public Health Association of Australia's Food Futures Conference was an opportunity for people working across the food system to connect and advocate for a comprehensive, intersectoral, whole-of-society food and nutrition policy in Australia to attenuate these issues. Conference themes included food systems for local and global good; ecological nutrition; social mobilisation for planetary and public good; food sovereignty and food equity. Students and young professionals are integral in transforming food systems, yet they are under-represented in the academic workforce, across publishing, scientific societies and conference plenaries. A satellite event was held to platform initiatives from early career researchers (ECR) in areas integral for improving planetary and public good. The research topics discussed in this commentary reflect sub-themes of the conference under investigation by ECR: food systems governance and regulation; local food policies; commercial determinants of health; sustainable healthy diets; and food equity and sovereignty.


Assuntos
Política Nutricional , Saúde Pública , Austrália , Humanos
12.
Bull Hist Med ; 96(2): 182-210, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35912618

RESUMO

While nineteenth-century regular physicians were expected to project a circumscribed affect in the exercise of their duties, they were not always successful in maintaining this performance. Archival sources, particularly the manuscript casebook for private practice, reveal the slippage between the performance of appropriate affect and the felt, interior emotions of the physician. This essay frames the casebook as an affective genre, building on Gianna Pomata's concept of epistemic genre. I argue that the nineteenth-century casebook, particularly when compared with the published case narrative, can reveal the disjunction or slippage between the expected performance of affect-that which Osler and others wished to prescribe for medical practitioners-and the felt reality or interiority of the physician. This article proposes the concept of affective genre and then explores its utility through close analysis of the casebook of a single practitioner, Andrew Bowles Holder, and selected examples from the casebooks of his contemporaries.


Assuntos
Médicos , Humanos
13.
Brain Sci ; 12(7)2022 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-35884696

RESUMO

Nicotine and tobacco product (NTP) use has escalated, largely due to the advent of e-cigarettes. The NTP administration method (i.e., combustible cigarette, e-cigarette) may be an important differentiator. We assessed young adult substance use history, nicotine attitudes, mental health, and neurocognition by the NTP use method. Emerging adults (16-22 year olds) were divided into combustible NTP users (Combustible+ = 79, had used any combustible NTP in the last 6 months), non-combustible users (E-Cig = 43, had used non-combustible NTP, in the past 6 months), and NTP Naïve (n = 79; had not used NTP in the past 6 months) based on past 6-month NTP use patterns. Participants completed self-report and objective neurocognition measures. Analysis of covariance assessed mental health and neurocognition by group, controlling for confounds and correcting for multiple comparisons. Nicotine groups reported more favorable attitudes toward combustible cigarette and e-cigarette use, with taste as the primary reason for e-cigarette use. Combustible+ reported more nicotine dependence and craving. Substance use differed by group, with Combustible+ using the most NTP, alcohol, and cannabis. Nicotine groups reported higher depression and stress symptoms; male Combustible+ reported higher depression symptoms than other same-gender groups. Groups did not differ on neurocognition, though cannabis use was associated with inaccurate emotional Stroop responses. Overall, research suggests that young adult combustible users are likely qualitatively different from non-combustible users. Understanding the unique characteristics related to NTP product use will help guide intervention and prevention development.

14.
Methods Mol Biol ; 2425: 57-83, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35188628

RESUMO

Drug toxicity, as well as therapeutic activity, is contingent upon the parent drug, or a derivative thereof, reaching the relevant site of action in the body, at sufficient concentration, over a given period of time. Thus, the potential to truly elicit an effect is governed by both the intrinsic activity/toxicity of the drug (or its transformation products) and its pharmacokinetic profile. As the pharmaceutical industry has become increasingly aware of the role of pharmacokinetics in determining drug activity and toxicity, the range of software, both freely available and commercial, to predict relevant properties has proliferated. Such tools can be considered on three different levels, applicable at different stages within the drug development process and providing increasing detail and relevance of information. Level (i) is the prediction of fundamental physicochemical properties that can be used to screen vast virtual libraries of potential candidates. Level (ii), predicting the individual absorption, distribution, metabolism, and excretion (ADME) characteristics of potential drugs, can also be applied to many compounds simultaneously. Level (iii), predicting the concentration-time profile of a drug in blood or specific tissues/organs for individuals or a population, is the most sophisticated level of prediction, applied to fewer candidates. In this chapter, in silico tools for predicting ADME-relevant properties, across these three levels, and the applications of this information, are described using exemplar, freely available resources. Further resources are signposted but not all are considered in detail as the purpose here is more to provide an introduction to the capabilities and practicalities of the tools, rather than to provide an exhaustive review of all the tools available.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Preparações Farmacêuticas , Simulação por Computador , Indústria Farmacêutica , Humanos , Modelos Biológicos , Farmacocinética , Software
15.
Med Humanit ; 48(4): 421-430, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34759026

RESUMO

Literary and medical historical scholars have long explored the work of physician-writers and the cross-pollination of literature and medicine. However, few scholars have considered how these interactions have shaped medical manuscripts and the echoes they contain of the emotional contours of the medical encounter. This essay uses the papers of Southern physician Andrew Bowles Holder (1860-1896) to explore how the emotions of the physician were managed at the bedside and in the aftermath of medical encounters through recourse to literary thinking. Holder, like many 19th-century physicians, was an avid reader with an interest in literary endeavours, and his manuscripts reveal the influences of literature on his work as a physician. This article frames the bedside as a theatre of emotions, in which Holder's performance and management of his emotions was key to his professional identity. His literary interests thus provided him with two tools: first, literature provided him with models for how to respond to and record different kinds of medical encounters, particularly deaths, near-death experiences and childbirth; second, his mode of keeping these records, which included the production of poetry as well as medical prose, served as a technology of coping, further allowing him to manage his emotions by exorcising them on the page.


Assuntos
Médicos , Redação , Masculino , Humanos , Emoções
16.
Disaster Med Public Health Prep ; 16(3): 1064-1072, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-33845933

RESUMO

OBJECTIVE: Hurricane evacuation is one of the strategies employed by emergency management and other agencies to reduce morbidity and mortality associated with hurricanes. However, factors associated with residents' evacuation decision-making have been inconsistent. In this study, we conducted a statistical meta-analysis to identify factors associated with hurricane evacuation as well as moderators of the evacuation decision. METHODS: A systematic literature search identified 36 studies published between 1999 and 2018. Pooled estimates were calculated using random-effects models, and heterogeneity across studies was checked using both Q and I2 statistics. Meta-regression methods were used to identify moderators. Publication bias was assessed using both visual (funnel plots) and statistical methods. RESULTS: Mobile home residence, perception of risk, female sex, and Hispanic ethnicity were statistically associated with hurricane evacuation, while geographic region modified the relationship between Hispanic race and evacuation. CONCLUSIONS: Agencies responsible for preparedness may utilize these findings to identify specific population sub-groups for hurricane evacuation communication and other interventions. Future studies should consider statistical interactions and explore opportunities for research translation to emergency officials.


Assuntos
Tempestades Ciclônicas , Planejamento em Desastres , Feminino , Humanos , Projetos de Pesquisa
17.
Public Health Nutr ; : 1-11, 2021 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-34743775

RESUMO

OBJECTIVE: Food literacy is the knowledge, skills and behaviours needed to meet food needs and determine intake and is conceptualised as eleven components under four domains of planning and managing, selecting, preparing, and eating. Previous measures of food literacy vary in their adherence to the conceptualisation and ability to capture totality of eating. This study aimed to determine items for inclusion and exclusion in a food literacy item pool and capture the general public's interpretation of everyday food literacy practices. DESIGN: Beginning with an item pool from previous studies, cognitive interviews were conducted using think-aloud and verbal probing methods. Data were first analysed for applicability, clarity, ambiguity and logic, then for emergent themes to ensure items captured the totality of the participant's eating. SETTING: Australia. PARTICIPANTS: Australian residents over 18 years of age recruited via Facebook residential groups (n 20). RESULTS: Of the original 116 items, 11 items had limited applicability; 13 items had unclear references; 32 items had lexical problems and 11 items had logical problems. In total, 29 items were deleted, 31 retained and 56 revised. Thematic analysis revealed participants limited their responses to consider only conventional practices such as grocery shopping, cooking and planned meals rather than the totality of their eating. An additional eighty-four items were developed to address eating out, incidental eating occasions and inconsistencies between participants assumed correct knowledge and that of public health guidelines. This resulted in a refined 171-item pool. CONCLUSIONS: This study progresses the development towards a comprehensive, validated food literacy questionnaire.

18.
Altern Lab Anim ; 49(5): 197-208, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34836462

RESUMO

Across multiple sectors, including food, cosmetics and pharmaceutical industries, there is a need to predict the potential effects of xenobiotics. These effects are determined by the intrinsic ability of the substance, or its derivatives, to interact with the biological system, and its concentration-time profile at the target site. Physiologically-based kinetic (PBK) models can predict organ-level concentration-time profiles, however, the models are time and resource intensive to generate de novo. Read-across is an approach used to reduce or replace animal testing, wherein information from a data-rich chemical is used to make predictions for a data-poor chemical. The recent increase in published PBK models presents the opportunity to use a read-across approach for PBK modelling, that is, to use PBK model information from one chemical to inform the development or evaluation of a PBK model for a similar chemical. Essential to this process, is identifying the chemicals for which a PBK model already exists. Herein, the results of a systematic review of existing PBK models, compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) format, are presented. Model information, including species, sex, life-stage, route of administration, software platform used and the availability of model equations, was captured for 7541 PBK models. Chemical information (identifiers and physico-chemical properties) has also been recorded for 1150 unique chemicals associated with these models. This PBK model data set has been made readily accessible, as a Microsoft Excel® spreadsheet, providing a valuable resource for those developing, using or evaluating PBK models in industry, academia and the regulatory sectors.


Assuntos
Modelos Biológicos , Software , Animais , Cinética , Medição de Risco
19.
Infection ; 49(6): 1203-1211, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34368941

RESUMO

PURPOSE: Overlapping clinical features of cutaneous leishmaniasis (CL) with ulcers caused by fungi and mycobacteria necessitate confirmatory diagnostic testing. We evaluated a handheld battery-operated device for detection of CL and common fungal and mycobacterial causes of ulcers. METHODS: We validated Palm PCR™ for detection of common ulcerative skin pathogens using ATCC® reference and clinical strains of Leishmania, mycobacteria, and fungi in the lab and field. Amplified products were Sanger sequenced. Performance characteristics were calculated using conventional PCR as a reference standard. RESULTS: Palm PCR™ detected 100% of ATCC® strains of Leishmania, fungi, and mycobacteria, with sensitivity and specificity of 90% and 91.7%, respectively. In the field, the sensitivity for detection of Leishmania in patients with suspected CL was 100%. In 61% of CL patients, co-colonization with genera such as Malassezia, Aspergillus, Candida, and Cladosporium was detected. In 50% of CL patients with an inflammatory (secondarily infected) phenotype, detected fungal species had known associations with human cutaneous disease. CONCLUSIONS: Palm PCR™ performs comparably to conventional PCR for detection of Leishmania, fungi, and mycobacteria. This work has implications for the diagnostic approach to tropical ulcers, and has the potential to improve field detection of ulcerative pathogens in resource constrained areas.


Assuntos
Leishmania , Leishmaniose Cutânea , Mycobacterium , Fungos , Humanos , Leishmania/genética , Leishmaniose Cutânea/diagnóstico , Peru , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade , Úlcera
20.
Nutrients ; 13(6)2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34200872

RESUMO

(1) Background: The term 'food literacy' has gained momentum globally; however, a lack of clarity around its definition has resulted in inconsistencies in use of the term. Therefore, the objective was to conduct a systematic scoping review to describe the use, reach, application and definitions of the term 'food literacy' over time. (2) Methods: A search was conducted using the PRISMA-ScR guidelines in seven research databases without any date limitations up to 31 December 2019, searching simply for use of the term 'food literacy'. (3) Results: Five hundred and forty-nine studies were included. The term 'food literacy' was used once in 243 articles (44%) and mentioned by researchers working in 41 countries. Original research was the most common article type (n = 429, 78%). Food literacy was published across 72 In Cites disciplines, with 456 (83%) articles from the last 5 years. In articles about food literacy (n = 82, 15%), review articles were twice as prevalent compared to the total number of articles (n = 10, 12% vs. n = 32, 6%). Fifty-one different definitions of food literacy were cited. (4) Conclusions: 'Food literacy' has been used frequently and broadly across differing article types and disciplines in academic literature internationally. However, agreement on a standardised definition of food literacy endorsed by a peak international agency is needed in order to progress the field.


Assuntos
Consenso , Alimentos , Educação em Saúde , Internacionalidade , Humanos , Publicações , Fatores de Tempo
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