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Artigo em Inglês | MEDLINE | ID: mdl-31614615


Patients with chronic mental illness are highly vulnerable to chronic respiratory problems. We examined the influence of mental disability on respiratory infection-related utilization risk in individuals with and without mental disabilities. A population-based, retrospective cohort design and two-part model were used to analyze respiratory infection-related utilization in individuals with MDs (MD group) and a matched reference group. The respiratory infection-related utilization rate in one year was lower in the MD group (53.8%) than in the reference group (56.6%). The odds ratios (ORs) were significantly higher among individuals with profound MDs (aOR = 1.10; 95% CI 1.07-1.14) and those with a history of dental cavities (aOR = 1.16; 95% CI: 1.13-1.19) or periodontal disease (aOR = 1.22; 95% CI: 1.19-1.26) after controlling for covariables. The average number of visits was higher in the MD group (5.3) than in the reference group (4.0). The respiratory infection-related utilization rate and average number of visits were significantly higher in the mild, moderate and severe disabled groups with a history of periodontal disease, respectively, than that of the reference group. In conclusion, healthcare authorities must develop an incentive program to prevent respiratory infections among individuals with MDs.

Deficiência Intelectual/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Doenças Periodontais/epidemiologia , Infecções Respiratórias/epidemiologia , Adulto , Idoso , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoas com Deficiência Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Razão de Chances , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
Angew Chem Int Ed Engl ; 53(17): 4450-5, 2014 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-24644091


Banded spherulites are formed by crystallization of a chiral polymer that is end-capped with chromophore. Induced circular dichroism (ICD) of the chromophore can be found in the crystallized chiral polymers, giving exclusive optical response of the ICD. The ICD signals are presumed to be driven by the lamellar twisting in the crystalline spherulites, and the exclusive optical activity is attributed to the chirality transfer from molecular level to macroscopic level. To verify the suggested mechanism, the sense of the lamellar twisting in the crystalline spherulite is determined using PLM for the comparison with the ICD signals of the chromophore in the electron circular dichroism spectrum. The conformational chirality of the chiral polymer is determined by the vibrational circular dichroism spectrum. On the basis of the chiroptical results, evolution of homochirality from helical polymer chains (conformational chirality) to lamellar twisting in the banded spherulite (hierachical chirality) is suggested.