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1.
Sci Total Environ ; 708: 134494, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-31791794

RESUMO

Effective removal of organic contaminants in wastewater effluent poses a challenge to small communities worldwide, particularly in the Arctic due to infrastructure challenges and harsh climates. To understand better the efficacy of current treatment options and risks posed by pharmaceuticals and pesticides on receiving waters in the Arctic, four representative human communities in Nunavut, Canada were evaluated. Per- and polyfluorinated alkyl substances (PFASs) were also investigated in one community. These communities have treatment ranging from primary lagoons, engineered wetlands, and natural lakes. Pharmaceuticals and pesticides were measured using the organic diffusive gradients in thin film (o-DGT) passive sampler in summer 2018. Of the 34 compounds studied, seven pharmaceuticals were found at least once: atenolol, carbamazepine, metoprolol, naproxen, sulfapyridine, sulfamethoxazole, and trimethoprim. With the exception of 5210 ng naproxen/L in Iqaluit, most receiving waters showed negligible amounts of contamination. Iqaluit had the poorest overall system performance while Baker Lake had the best. Measured pharmaceutical concentrations do not appear to pose a significant acute hazard to receiving waters at this time, based on known toxicological endpoints. PFAS concentrations were found to be over 100-fold greater in Cambridge Bay wastewater than previously reported Arctic seawater. Results suggest that wastewater may be an important point source of PFASs in Arctic communities. The o-DGT passive samplers performed well in marine Arctic settings. We recommend further testing of wastewater efficiencies in Arctic communities along with evaluations of seasonal variations.

2.
Acad Med ; 95(3): 401-410, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31348068

RESUMO

PURPOSE: To explore the structural, cultural, and interpersonal issues that may contribute to the inadvertent marginalization of medical students with social science and humanities (SSH) backgrounds. METHOD: Using the hidden curriculum as an analytic construct, the lead author interviewed 14 medical students with SSH backgrounds at the University of Toronto Faculty of Medicine from February to October 2015. The authors analyzed the interview transcripts for common themes around positive and negative cultural, structural, and interpersonal dimensions of the socialization process. RESULTS: Participants reported barriers to applying to medical school: needing to complete prerequisite courses and to do well on an exam geared toward those with a strong science background (the Medical College Admission Test) and lacking an application cohort. Some participants felt they were not ideal candidates for medical school. Participants appreciated how their SSH backgrounds and associated skill sets shaped both their perspectives on patient care and their developing professional identities. However, they perceived that others largely deemed their previous training as irrelevant, and they felt marginalized in medical school by peers, instructors, and the curriculum. These experiences led both to self-censorship, which enabled them to seem to conform to normative behaviors, and to the pursuit of reaffirming elective experiences. CONCLUSIONS: The existing hidden curriculum inadvertently marginalizes SSH medical students; their experiences likely reflect the socialization experiences of other students from underrepresented backgrounds. Curricular and institutional reforms are imperative to shift the hidden curriculum toward one of epistemological inclusion that better supports students from nontraditional backgrounds.

3.
Curr Opin Immunol ; 62: 22-30, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31835066

RESUMO

Since the first animal antimicrobial peptides (AMPs) were discovered in insects, Drosophila melanogaster has emerged as a powerful model for their characterization. Drosophila AMPs have been used extensively to monitor the activity of the Toll and Imd NF-κB pathways, but little was known of their precise functions. In this review, we summarize recent findings on the function of Drosophila AMPs not only for antimicrobial defense, but also in the gut, tumor control, and neurology. The integration of these new studies allows a new framework to be drawn that explains how AMPs can contribute simultaneously to microbe killing whilst also regulating important host cellular functions. These functions require that AMPs target not only negatively charged microbes but also aberrant host cells.

4.
Int J Mol Sci ; 20(21)2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31671625

RESUMO

An obesogenic diet adversely affects the endogenous mammalian circadian clock, altering daily activity and metabolism, and resulting in obesity. We investigated whether an obese pregnancy can alter the molecular clock in the offspring hypothalamus, resulting in changes to their activity and feeding rhythms. Female mice were fed a control (C, 7% kcal fat) or high fat diet (HF, 45% kcal fat) before mating and throughout pregnancy. Male offspring were fed the C or HF diet postweaning, resulting in four offspring groups: C/C, C/HF, HF/C, and HF/HF. Daily activity and food intake were monitored, and at 15 weeks of age were killed at six time-points over 24 h. The clock genes Clock, Bmal1, Per2, and Cry2 in the suprachiasmatic nucleus (SCN) and appetite genes Npy and Pomc in the arcuate nucleus (ARC) were measured. Daily activity and feeding cycles in the HF/C, C/HF, and HF/HF offspring were altered, with increased feeding bouts and activity during the day and increased food intake but reduced activity at night. Gene expression patterns and levels of Clock, Bmal1, Per2, and Cry2 in the SCN and Npy and Pomc in the ARC were altered in HF diet-exposed offspring. The altered expression of hypothalamic molecular clock components and appetite genes, together with changes in activity and feeding rhythms, could be contributing to offspring obesity.

5.
Artigo em Inglês | MEDLINE | ID: mdl-31745735

RESUMO

The impact of initiatives aimed at reducing time in untreated psychosis during early-stage schizophrenia will be unknown for many years. Thus, we simulate the effect of earlier treatment entry and better antipsychotic drug adherence on schizophrenia-related hospitalizations, receipt of disability benefits, competitive employment, and independent/family living over a ten-year horizon. We predict that earlier treatment entry reduces hospitalizations by 12.6-14.4% and benefit receipt by 7.0-8.5%, while increasing independent/family living by 41.5-46% and employment by 42-58%. We predict larger gains if a pro-adherence intervention is also used. Our findings suggest substantial benefits of timely and consistent early schizophrenia care.

6.
Front Immunol ; 10: 2620, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781114

RESUMO

There is a developing interest in how immune genes may function in other physiological roles, and how traditionally non-immune peptides may, in fact, be active in immune contexts. In the absence of infection, the induction of the immune response is costly, and there are well-characterized trade-offs between immune defense and fitness. The agents behind these fitness costs are less understood. Here we implicate antimicrobial peptides (AMPs) as particularly costly effectors of immunity using an evolutionary framework. We describe the independent loss of AMPs in multiple lineages of Diptera (true flies), tying these observations back to life history. We then focus on the intriguing case of the glycine-rich AMP, Diptericin, and find several instances of loss, pseudogenization, and segregating null alleles. We suggest that Diptericin may be a particularly toxic component of the Dipteran immune response lost in flies either with reduced pathogen pressure or other environmental factors. As Diptericins have recently been described to have neurological roles, these findings parallel a developing interest in AMPs as potentially harmful neuropeptides, and AMPs in other roles beyond immunity.

7.
Int J Gynaecol Obstet ; 147(2): 140-146, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31571230

RESUMO

OBJECTIVE: To explore the knowledge of Developmental Origins of Health and Disease (DOHaD) concepts among midwives and obstetricians and to identify barriers and facilitators for clinicians to engage women and their partners before or early in pregnancy on risk factors associated with DOHaD, and thus to embed the concept of DOHaD in routine clinical practice. METHODS: A qualitative study using semi-structured interviews will be conducted in Ghana, India, Pakistan, Brazil, the UK, and USA in collaboration with the International Confederation of Midwives and the International Federation of Obstetricians and Gynecologists. Participants will be contacted via email and telephone interviews will be conducted until data saturation followed by inductive thematic analysis. RESULTS: Findings from this exploratory study will provide new knowledge about the perspectives of midwives and obstetricians on DOHaD and their role in preventing the intergenerational passage of non-communicable disease (NCD) risk and improving preconception care. CONCLUSION: This study will help us understand the current use of DOHaD principles in international maternity care and how this can be improved. Bringing DOHaD to clinical practice will help healthcare practitioners adopt a long-term approach in the prevention of NCDs and childhood obesity and will help women to enter pregnancy in optimum health.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Tocologia/métodos , Obstetrícia/métodos , Cuidado Pré-Concepcional/métodos , Brasil , Feminino , Gana , Humanos , Índia , Tocologia/educação , Obstetrícia/educação , Paquistão , Gravidez , Pesquisa Qualitativa , Melhoria de Qualidade
8.
Int J Gynaecol Obstet ; 147(2): 131-133, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31571231

RESUMO

The activities of the FIGO Pregnancy Obesity and Nutrition Initiative are aimed at reducing all types of malnutrition in women before, during and after pregnancy.


Assuntos
Programas de Rastreamento/métodos , Obesidade/prevenção & controle , Fenômenos Fisiológicos da Nutrição Pré-Natal , Feminino , Humanos , Gravidez
9.
Int J Gynaecol Obstet ; 147(2): 134-139, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31571233

RESUMO

OBJECTIVE: To develop a Core Outcome Set (COS) for pregnancy nutrition research that is relevant to varied stakeholders and resource settings. METHODS: This study has three distinct phases. The first phase involves generating a list of outcomes for consideration for the COS. This includes a systematic review of studies evaluating nutrition during pregnancy where all outcomes reported in relevant literature will be extracted. Qualitative interviews with currently or previously pregnant women will also be conducted. This step will supplement the findings of the systematic review by identifying additional outcomes of importance to this stakeholder group. In the second phase of the study, healthcare professionals, researchers, and mothers from various international resource settings will be invited to participate in a two-round modified Delphi survey. The aim of the survey is to gain consensus on which outcomes are most important to include in the COS. Finally, a face-face consensus meeting will be held with a select group of participants to finalize the COS. CONCLUSION: This COS will support standardization of outcome reporting in pregnancy nutrition research and ensure that selected outcomes are considered important by a variety of stakeholders. This will enhance the evidence behind nutrition interventions in pregnancy to improve outcomes for pregnant women.


Assuntos
Consenso , Fenômenos Fisiológicos da Nutrição Pré-Natal , Técnica Delfos , Feminino , Humanos , Gravidez , Resultado da Gravidez , Pesquisa Qualitativa , Revisão Sistemática como Assunto , Adulto Jovem
10.
Environ Toxicol Chem ; 38(12): 2621-2628, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31553481

RESUMO

The main petroleum product transported through pipelines in Canada is diluted bitumen (dilbit), a semiliquid form of heavy crude oil mixed with natural gas condensates to facilitate transport. The weathering, fate, behavior, and environmental effects of dilbit are crucial to consider when responding to a spill; however, few environmental studies on dilbit have been completed. We report on 11-d-long experimental spills of dilbit (Cold Lake Winter Blend) in outdoor microcosms meant to simulate a low-energy aquatic system containing natural lake water and sediments treated with low (1:8000 oil:water) and high (1:800 oil:water) volumes of dilbit. In the first 24 h of the experiment, volatile hydrocarbons quickly evaporated from the dilbit, resulting in increased dilbit density and viscosity. These changes in dilbit's physical and chemical properties ultimately led to its submergence after 8 d. We also detected rapid accumulation of polycyclic aromatic compounds in the water column of the treated microcosms following the spills. The present study provides new information on the environmental fate and behavior of dilbit in a freshwater environment that will be critical to environmental risk assessments of proposed pipeline projects. In particular, the study demonstrates the propensity for dilbit to sink under ambient environmental conditions in freshwaters typical of many boreal lakes. Environ Toxicol Chem 2019;38:2621-2628. © 2019 SETAC.

11.
Sci Total Environ ; 685: 1221-1239, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31390712

RESUMO

Improving the quality of pesticide toxicity studies is a shared goal in ecotoxicology and a priority for risk assessors. Using the herbicide atrazine and testing on primary producers as a case study, we developed and applied a transparent scoring system for assessing the quality of peer-reviewed studies. The exercise also highlights where data gaps exist for planning future work. We determined that, while a large number of studies (147) present experimental data fitting basic inclusion criteria, only a small proportion provide sufficient information on the test substance, test organism, and test results to be considered of sufficient quality (i.e., a minimum score of >8 out of 16, meaning no critical study weaknesses identified) that would allow recommendation for their use in decision-making. Optimal studies for use in first tier risk assessment were further identified for each taxonomic group as the highest-scoring study scoring >8, that also used the technical grade active ingredient, reported an EC50 for a population-level endpoint (e.g. cell density, dry weight), and an exposure period in line with standard tests (≤96-h for algae, ≤14-d for macrophytes). Ultimately, 22 freshwater studies (four periphyton, ten macrophytes, and eight phytoplankton) achieved scores >8. Only one study with marine phytoplankton scored >8, and no studies met the risk assessment inclusion criteria for marine/estuarine periphyton or macrophytes. This indicates a potential research need with respect to toxicity data for salt-water species. Finally, registrant studies were evaluated, and in many cases, were the most appropriate for risk assessment, with the greatest scores observed for their respective species relative to those reported in the peer-reviewed literature. This exercise highlights the importance of defining and identifying well-performed toxicity tests, illuminating knowledge gaps, and reporting high quality data in support of the risk assessment process outside of the standard regulatory framework.


Assuntos
Atrazina/toxicidade , Herbicidas/toxicidade , Poluentes Químicos da Água/toxicidade , Ecotoxicologia , Água Doce , Fitoplâncton , Testes de Toxicidade
12.
BMJ Open ; 9(7): e026998, 2019 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-31362961

RESUMO

OBJECTIVES: To investigate socioeconomic inequalities, using maternal educational attainment, maternal and partner employment status, and lone motherhood indicators, in the risk of small-for-gestational-age (SGA) births, their time trend, potential mediation by maternal smoking and body mass index, and effect modification by parity. DESIGN: Population-based birth cohort using routine antenatal healthcare data. SETTING: Babies born at University Hospital Southampton, UK, between 2004 and 2016. PARTICIPANTS: 65 909 singleton live births born to mothers aged ≥18 years between 24-week and 42-week gestation. MAIN OUTCOME MEASURES: SGA (birth weight <10th percentile for others born at the same number of completed weeks compared with 2013/2014 within England and Wales). RESULTS: Babies born to mothers educated up to secondary school level (adjusted OR (aOR) 1.32, 99% CI 1.19 to 1.47), who were unemployed (aOR 1.27, 99% CI 1.16 to 1.38) or with unemployed partners (aOR 1.27, 99% CI 1.13 to 1.43), were at greater risk of being SGA. There was no statistically significant change in the magnitude of this risk difference by these indicators over time between 2004 and 2016, as estimated by linear interactions with year of birth. Babies born to lone mothers were not at higher risk compared with partnered mothers after adjusting for maternal smoking (aOR 1.05, 99% CI 0.93 to 1.20). The inverse association between maternal educational attainment and SGA risk appeared greater in multiparous (aOR 1.40, 99% CI 1.10 to 1.77) compared with primiparous women (aOR 1.28, 99% CI 1.12 to 1.47), and the reverse was true for maternal and partner's unemployment where the association was stronger in primiparous women. CONCLUSIONS: Socioeconomic inequalities in SGA risk by educational attainment and employment status are not narrowing over time, with differences in association strength by parity. The greater SGA risk in lone mothers was potentially explained by maternal smoking. Preventive interventions should target socially disadvantaged women, including preconception and postpartum smoking cessation to reduce SGA risk.

13.
Trends Ecol Evol ; 34(10): 883-885, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31422891

RESUMO

Niche-constructing organisms actively modify their environments with adaptive consequences, sustaining a new equilibrium. Modern humans are instead niche modifiers, continually changing their environments irrespective of adaptive pressures. The nature, scale, and speed of such modifications have potential ill effects that need to be addressed with multilevel societal initiatives.


Assuntos
Evolução Biológica , Evolução Cultural , Humanos
14.
Obes Rev ; 20 Suppl 1: 5-17, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31419048

RESUMO

Evidence for the effect of preconception and periconceptional risk factors on childhood outcomes such as obesity and other non-communicable diseases (NCDs) in later life is growing. Issues such as maternal malnutrition need to be addressed before pregnancy, to prevent a transgenerational passage of risk of NCDs. The aim of this review was to evidence for preconception interventions to prevent obesity and other risk factors for NCDs in children. A search for systematic reviews of interventions in the preconception period published between 2006 and 2018 was conducted on academic databases. Fifteen reviews were included, two of the reviews also included pregnant women. None of the reviews directly reported on obesity or NCD outcomes in children. Results suggest that exercise- and diet-based interventions significantly reduced maternal weight postpartum, weight gain during pregnancy, and improved prevention and control of gestational diabetes. Balanced protein energy supplementation during and before pregnancy was associated with an increase in mean birth weight and reduction of low birth weight babies. There is a dearth of evidence for preconception programmes that follow up on childhood outcomes related to a risk of NCDs. Nevertheless, results suggest that women who received preconception interventions were more likely to have improved pregnancy-related and behavioural outcomes.

15.
Lancet ; 393(10187): 2262-2271, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31162084

RESUMO

There is growing interest in preconception health as a crucial period for influencing not only pregnancy outcomes, but also future maternal and child health, and prevention of long-term medical conditions. Successive national and international policy documents emphasise the need to improve preconception health, but resources and action have not followed through with these goals. We argue for a dual intervention strategy at both the public health level (eg, by improving the food environment) and at the individual level (eg, by better identification of those planning a pregnancy who would benefit from support to optimise health before conception) in order to raise awareness of preconception health and to normalise the notion of planning and preparing for pregnancy. Existing strategies that target common risks factors, such as obesity and smoking, should recognise the preconception period as one that offers special opportunity for intervention, based on evidence from life-course epidemiology, developmental (embryo) programming around the time of conception, and maternal motivation. To describe and monitor preconception health in England, we propose an annual report card using metrics from multiple routine data sources. Such a report card should serve to hold governments and other relevant agencies to account for delivering interventions to improve preconception health.


Assuntos
Cuidado Pré-Concepcional/organização & administração , Desenvolvimento de Programas , Indicadores de Qualidade em Assistência à Saúde , Inglaterra/epidemiologia , Feminino , Política de Saúde/economia , Humanos , Cuidado Pré-Concepcional/economia , Gravidez , Complicações na Gravidez/prevenção & controle , Resultado da Gravidez/epidemiologia
17.
Glob Health Action ; 12(1): 1603491, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31062667

RESUMO

During the past decades innovative research has shown that exposure to harmful events during pregnancy and early infancy ('the first 1000 days') has an impact on health at subsequent stages of the life course and even across generations. Recently it has been shown that even the pre-conception period is of outmost importance, and other scholars have made the case that the 1000 days should be extended to a period of 8000 days post-conception. The present contribution aims to bridge further the gap between research evidence and public health policy by applying a holistic 'full-cycle' perspective. Thus, a conceptual framework is suggested for guiding public health prioritization, including the variables of 'impact on the next generation', 'plasticity' and 'available interventions with documented impact'. This framework could guide decision makers in selecting at which stages of the life course to invest (and not), and furthermore it points to some pertinent research priorities.


Assuntos
Promoção da Saúde/métodos , Estilo de Vida Saudável , Cuidado do Lactente/métodos , Pais/educação , Cuidado Pré-Natal/métodos , Saúde Pública/métodos , Política Pública , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez
19.
Cell Rep ; 27(4): 1050-1061.e3, 2019 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-31018123

RESUMO

The melanization response is an important defense mechanism in arthropods. This reaction is mediated by phenoloxidases (POs), which are activated by complex extracellular serine protease (SP) cascades. Here, we investigate the role of SPs in the melanization response using compound mutants in D. melanogaster and discover phenotypes previously concealed in single-mutant analyses. We find that two SPs, Hayan and Sp7, activate the melanization response in different manners: Hayan is required for blackening wound sites, whereas Sp7 regulates an alternate melanization reaction responsible for the clearance of Staphylococcus aureus. We present evidence that Sp7 is regulated by SPs activating the Toll NF-κB pathway, namely ModSP and Grass. Additionally, we reveal a role for the combined action of Hayan and Psh in propagating Toll signaling downstream of pattern recognition receptors activating either Toll signaling or the melanization response.

20.
Acta Paediatr ; 108(10): 1747-1756, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30964948

RESUMO

Cardiovascular disease (CVD) is foremost among the non-communicable diseases (NCDs) which account for 71% of deaths globally each year. CVD is also prominent among the pre-existing conditions still accounting for nearly 25% of maternal deaths and is linked to gestational diabetes and pre-eclampsia. Markers of CVD risk have been reported even in young children, related to prenatal factors such as mother's diet or body composition. The underlying mechanisms include epigenetic changes which can alter the trajectory of risk across the life course. Preventive interventions need to commence before conception, to reduce transmission of CVD risk by promoting healthy behaviours in prospective parents, as well as in pregnancy, and postpartum through breastfeeding and healthy complementary feeding. Surprisingly, these opportunities are not emphasised in the 2018 United Nations Political Declaration on NCDs. NCDs such as CVD have communicable risk components transmitted across generations by socio-economic as well as biological factors, although the former can also become embodied in the offspring by epigenetic mechanisms. The inheritance of CVD risk, and social inequalities in such risk, thus raises wider questions about responsibility for the health of future generations at societal as well as individual levels.

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