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1.
World Neurosurg ; 133: e600-e608, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31568912

RESUMO

BACKGROUND: Evidence is lacking regarding the role of radiologic surveillance for asymptomatic intracranial aneurysms (AIAs) in the elderly (≥65 years). We sought to establish if long-term clinical and radiologic observation is warranted for older patients with AIAs. METHODS: A retrospective cohort of 193 consecutive patients with 255 AIAs were clinically and radiologically observed between January 2011 and January 2019. The primary end points were documented aneurysm growth, subarachnoid hemorrhage, or definitive treatment with microsurgical clipping or endovascular coiling. Baseline patient and aneurysm characteristics were obtained. Univariate and multivariate comparisons were performed. RESULTS: Aneurysm growth was observed in 8 patients (4.2%) at a median follow-up of 58.2 months (interquartile range, 38.4-78.5 months). The median aneurysm size at initial diagnosis was 3.5 mm (interquartile range, 2.2-5 mm). Aneurysms larger than 7 mm selected for surveillance were noted in 37 patients (19.2%). The growth rate was estimated at 0.2 mm per person-year. At the end of the study period, 175 patients (90.7%) were alive, 6 (3.1%) were lost to follow-up, and 12 (6.2%) died of unrelated causes. During the 1025.2 person-years follow-up, no patient had experienced subarachnoid hemorrhage, and none required definitive treatment. The presence of aneurysmal bleb (odds ratio, 6.02; 95% confidence interval, 1.15-31.43; P = 0.033) and multiple intracranial aneurysms (odds ratio, 10.98; 95% confidence interval, 1.27-94.91; P = 0.029) were associated with growth. CONCLUSIONS: AIAs in older patients deemed suitable for conservative management do not require robust follow-up. The current study suggests a potential role for closer surveillance for patients with multiple intracranial aneurysms or aneurysms with bleb morphology.


Assuntos
Aneurisma Intracraniano/patologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Tratamento Conservador , Procedimentos Endovasculares/métodos , Feminino , Seguimentos , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/terapia , Masculino , Estudos Retrospectivos , Fatores de Risco , Hemorragia Subaracnóidea/epidemiologia , Hemorragia Subaracnóidea/etiologia , Tempo
2.
Food Chem ; 303: 125376, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31442900

RESUMO

This study investigated the effects of persistent ultraviolet B (UV-B) irradiation on isoflavone accumulation in soybean sprouts. Three malonyl isoflavones were increased by UV-B. Malonylgenistin specifically accumulated upon UV-B exposure, whereas the other isoflavones were significantly increased under both dark conditions and UV-B exposure. The results of isoflavone accumulation to UV-B irradiation time were observed as following: acetyl glycitin rapidly increased and then gradually decreased; malonyl daidzin and malonyl genistin were highly accumulated within an intermediate period; genistein and daidzin were gradually maximized; daidzin, glycitin, genistein, and malonyl glycitin did not increase; and glycitin, acetyl daidzin, and acetyl genistin exhibited trace amounts. Transcriptional analysis of isoflavonoid biosynthetic genes demonstrated that most metabolic genes were highly activated in response to UV-B 24 and UV-B 36 treatments. In particular, it was found that GmCHS6, GmCHS7, and GmCHS8 genes among the eight known genes encoding chalcone synthase were specifically related to UV-B response.


Assuntos
Regulação da Expressão Gênica de Plantas , Isoflavonas/metabolismo , Soja/efeitos da radiação , Raios Ultravioleta , Aciltransferases/genética , Aciltransferases/metabolismo , Genisteína/metabolismo , Glucosídeos/metabolismo , Cinética , Plântula/genética , Plântula/metabolismo , Plântula/efeitos da radiação , Soja/genética , Soja/metabolismo , Tempo
3.
Food Chem ; 303: 125390, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31450177

RESUMO

Cheddar cheese predicted to develop into different quality classes has been evaluated by time domain Nuclear Magnetic Resonance, Thermogravimetric analysis and quantitative sensory analysis. The water and fat proton signals in the transverse relaxation decay curves have been deconvoluted. Proton transverse relaxation values for both the water and fat fractions decrease and the relative %age of the proton peak area, predominantly from the fat increases over a 450-day ripening period. The thermodynamic free water percentage increases during maturation. Water and fat attributes can distinguish between Cheddar cheese batches after 56 days. Cheese batches which have lower transverse relaxation values for the water and fat proton fractions and a higher relative %age of the proton peak area predominantly from fat at 56 days, mature after 270 days to be more yellow, rubbery and smooth, have a less sour and lingering aftertaste and are also harder to form into a cheese ball.


Assuntos
Queijo/análise , Gorduras/análise , Manipulação de Alimentos , Água/análise , Espectroscopia de Ressonância Magnética , Paladar , Tempo
4.
Anaesthesia ; 75(1): 131-132, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31794642
5.
Anaesthesia ; 75(1): 129-130, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31794644
7.
Biosci Biotechnol Biochem ; 84(1): 43-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31495297

RESUMO

To date, studies on the application of loop-mediated isothermal amplification (LAMP) in the detection of genetically modified organisms (GMOs) are stably increasing and demonstrates LAMP is a potential and promising method for on spot identification of GMOs. However, little information is known for detection of GM potato events by LAMP. In this report, we developed an optimized and visual LAMP assay with high specificity and sensitivity to rapidly amplify genomic DNA of potato EH92-527-1 within 45 min. The limit of detection of LAMP in our study is 10-fold higher than the conventional PCR. Furthermore, LAMP products can be directly observed via naked eyes by addition of SYBR Green I without gel electrophoresis analysis and PCR-based equipment. Therefore, the LAMP assay developed in this paper provides an efficient, convenient and cost-effective tool for the detection of GM potato EH92-527-1.


Assuntos
DNA de Plantas/genética , Plantas Geneticamente Modificadas/genética , Reação em Cadeia da Polimerase/instrumentação , Reação em Cadeia da Polimerase/métodos , Solanum tuberosum/genética , Sequência de Bases/genética , Percepção de Cores , Primers do DNA/genética , Enzimas de Restrição do DNA/genética , Eletroforese em Gel de Ágar , Corantes Fluorescentes/química , Contaminação de Alimentos/análise , Amplificação de Genes , Limite de Detecção , Compostos Orgânicos/química , Reação em Cadeia da Polimerase/economia , Sensibilidade e Especificidade , Temperatura Ambiente , Tempo
8.
Syst Biol ; 69(1): 1-16, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31058981

RESUMO

Establishing an accurate evolutionary timescale for green plants (Viridiplantae) is essential to understanding their interaction and coevolution with the Earth's climate and the many organisms that rely on green plants. Despite being the focus of numerous studies, the timing of the origin of green plants and the divergence of major clades within this group remain highly controversial. Here, we infer the evolutionary timescale of green plants by analyzing 81 protein-coding genes from 99 chloroplast genomes, using a core set of 21 fossil calibrations. We test the sensitivity of our divergence-time estimates to various components of Bayesian molecular dating, including the tree topology, clock models, clock-partitioning schemes, rate priors, and fossil calibrations. We find that the choice of clock model affects date estimation and that the independent-rates model provides a better fit to the data than the autocorrelated-rates model. Varying the rate prior and tree topology had little impact on age estimates, with far greater differences observed among calibration choices and clock-partitioning schemes. Our analyses yield date estimates ranging from the Paleoproterozoic to Mesoproterozoic for crown-group green plants, and from the Ediacaran to Middle Ordovician for crown-group land plants. We present divergence-time estimates of the major groups of green plants that take into account various sources of uncertainty. Our proposed timeline lays the foundation for further investigations into how green plants shaped the global climate and ecosystems, and how embryophytes became dominant in terrestrial environments.


Assuntos
Evolução Biológica , Classificação/métodos , Fósseis , Viridiplantae/classificação , Genoma de Cloroplastos/genética , Tempo , Viridiplantae/genética
9.
Syst Biol ; 69(1): 38-60, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31062850

RESUMO

Evolutionary relationships have remained unresolved in many well-studied groups, even though advances in next-generation sequencing and analysis, using approaches such as transcriptomics, anchored hybrid enrichment, or ultraconserved elements, have brought systematics to the brink of whole genome phylogenomics. Recently, it has become possible to sequence the entire genomes of numerous nonbiological models in parallel at reasonable cost, particularly with shotgun sequencing. Here, we identify orthologous coding sequences from whole-genome shotgun sequences, which we then use to investigate the relevance and power of phylogenomic relationship inference and time-calibrated tree estimation. We study an iconic group of butterflies-swallowtails of the family Papilionidae-that has remained phylogenetically unresolved, with continued debate about the timing of their diversification. Low-coverage whole genomes were obtained using Illumina shotgun sequencing for all genera. Genome assembly coupled to BLAST-based orthology searches allowed extraction of 6621 orthologous protein-coding genes for 45 Papilionidae species and 16 outgroup species (with 32% missing data after cleaning phases). Supermatrix phylogenomic analyses were performed with both maximum-likelihood (IQ-TREE) and Bayesian mixture models (PhyloBayes) for amino acid sequences, which produced a fully resolved phylogeny providing new insights into controversial relationships. Species tree reconstruction from gene trees was performed with ASTRAL and SuperTriplets and recovered the same phylogeny. We estimated gene site concordant factors to complement traditional node-support measures, which strengthens the robustness of inferred phylogenies. Bayesian estimates of divergence times based on a reduced data set (760 orthologs and 12% missing data) indicate a mid-Cretaceous origin of Papilionoidea around 99.2 Ma (95% credibility interval: 68.6-142.7 Ma) and Papilionidae around 71.4 Ma (49.8-103.6 Ma), with subsequent diversification of modern lineages well after the Cretaceous-Paleogene event. These results show that shotgun sequencing of whole genomes, even when highly fragmented, represents a powerful approach to phylogenomics and molecular dating in a group that has previously been refractory to resolution.


Assuntos
Evolução Biológica , Borboletas/classificação , Borboletas/genética , Genoma de Inseto/genética , Filogenia , Animais , Tempo
10.
J Contemp Dent Pract ; 20(9): 1029-1032, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31797824

RESUMO

AIM: The present study aimed to see the oral health literacy rate among first-time pregnant women across 12 corporate hospital setups in the city of Pune, India. MATERIALS AND METHODS: For the survey, the REALD 30 questionnaires were used to assess the adult literacy rate (with 0 being least score and 30 being the highest score) and the knowledge of the participants related to oral health was assessed using a set of 6 questions. The study was carried out for a period of 1 year from January 2018 to December 2018. The total participants at the end of the study were 2,263. All the women were pregnant for the first time, in their 1st trimester of pregnancy. Written consent was taken from all the participants. Epi Info was used to carry out the statistical analysis. All the p values less than 0.05 was considered to be statistically significant. RESULTS: The mean REALD 30 score was 23.8 ± 8.34. The REALD score was higher for those with a postgraduate degree; this could be due to more number of participants in the group. There were higher percentages of women with correct answers to all the knowledge-based questions. We observed that there was a positive correlation with the REALD total scores and the correct answers provided to the questions on oral health (r = 0.76). There was a positive correlationship between the REALD scores and the oral health knowledge of the participants. CONCLUSION: The educated pregnant women had a high oral health literacy rate. There was a positive correlation of literacy with the REALD 30 score. CLINICAL SIGNIFICANCE: Healthcare providers should focus on clearing the myths and misconceptions that are still prevalent in a small portion of the urban population.


Assuntos
Alfabetização em Saúde , Mulheres , Adulto , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Índia , Saúde Bucal , Gravidez , Inquéritos e Questionários , Tempo
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(10): 1200-1206, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31801710

RESUMO

OBJECTIVE: We propose a strategy for identifying subgroups with the treatment effect from the survival data of a randomized clinical trial based on accelerated failure time (AFT) model. METHODS: We applied adaptive elastic net to the AFT model (designated as the penalized model) and identified the candidate covariates based on covariate-treatment interactions. To classify the patient subgroups, we utilized a likelihood-based change-point algorithm to determine the threshold cutoff point. A two-stage adaptive design was adopted to verify if the treatment effect existed within the identified subgroups. RESULTS: The penalized model with the main effect of the covariates considerably outperformed the univariate model without the main effect for the trial data with a small sample size, a high censoring rate, a small subgroup size, or a sample size that did not exceed the number of covariates; in other scenarios, the latter model showed better performances. Compared with the traditional design, the adaptive design improved the power for detecting the treatment effect where subgroup effect exists with a well-controlled type Ⅰ error. CONCLUSIONS: The penalized AFT model with the main effect of the covariates has advantages in subgroup identification from the survival data of clinical trials. Compared with the traditional design, the two-stage adaptive design has better performance in evaluation of the treatment effect when a subgroup effect exists.


Assuntos
Algoritmos , Projetos de Pesquisa , Tamanho da Amostra , Humanos , Funções Verossimilhança , Ensaios Clínicos Controlados Aleatórios como Assunto , Tempo
12.
J Adhes Dent ; 21(6): 487-495, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31802064

RESUMO

PURPOSE: This meta-analysis investigated the influence of different acid etching times on the retention rate of pit-and-fissure sealants based on clinical trials with a minimum duration of two years. MATERIALS AND METHODS: A literature search was carried out in electronic databases along with hand searching to identify clinical trials that evaluated pit-and-fissure sealants in permanent molars. From 1280 identified abstracts, 195 studies were selected for full-text analysis, and 28 studies with 36 test groups were included in this meta-analysis. Test groups with etching times of 15 (n = 3), 20 (n = 2), 30 (n = 10), 40 (n = 1) and 60 s (n = 20) were found. Incidence rates of pit-and-fissure sealant losses were modelled using negative binomial regression. RESULTS: The regression analysis did not reveal a significant influence of etching time on the survival of pit-and-fissure sealants based on the identified and included clinical trials. CONCLUSIONS: Due to the limited number of clinical data for 15 and 20 s, conclusions regarding very short acid etching times were not possible. On the basis of regression analysis, a minimum of 30-s acid etching might be sufficient prior to fissure sealing.


Assuntos
Cárie Dentária , Humanos , Dente Molar , Selantes de Fossas e Fissuras , Tempo
13.
Adv Exp Med Biol ; 1203: 133-148, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31811633

RESUMO

The noncoding elements of an mRNA influence multiple aspects of its fate. For example, 3'-UTRs serve as physical and sequence-based information hubs that direct the time, place, and level of translation of the protein encoded in cis, but often also have additional roles in trans. Understanding the information content of 3'-UTRs has been a challenge. Bioinformatic searches for motifs, such as those that encode the polyadenylation signal or microRNA seed regions, are simple enough, but rarely do these inferred positions in genomes correlate well with the actual sites chosen by the relevant nanomachines in living cells. This is almost certainly due to three-dimensional complexity of RNA, the physical states of which are recognized by RNA-binding proteins that serve to read and interpret the information content. Here, we follow the 3'-UTR-mediated posttranscriptional metabolism of mRNA in the germline of the nematode worm Caenorhabditis elegans. While many areas still require the clarification only detailed fundamental research can provide, this model system can serve as a basis of 3'-mediated regulatory control for elaboration in more complex metazoan systems.


Assuntos
Regiões 3' não Traduzidas , Regulação da Expressão Gênica , RNA Mensageiro , Regiões 3' não Traduzidas/genética , Motivos de Aminoácidos , Animais , Caenorhabditis elegans , Poliadenilação , Processamento Pós-Transcricional do RNA , RNA Mensageiro/metabolismo , Tempo
15.
Environ Monit Assess ; 192(1): 14, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31811395

RESUMO

The potential influence of short-period (May-June 2012) dredging activities (for the installation of a submarine gas pipeline) on physical properties of the marine environment of two shallow-water sites in the Aliveri and Varnavas areas of South Euboean Gulf (Greece) has been evaluated. During the dredging operation in Varnavas, the induced dredge plume traveled up to ~ 750 m from the shoreline, featured by light attenuation coefficient (cp) maxima of 4.01-4.61 m-1 and suspended particulate matter (SPM) concentrations up to 6.01 mg L-1. After dredging the previous parameters reduced to the ambient seawater condition, ~ 0.45 m-1 and < 2.8 mg L-1 on average, respectively. Likewise in Aliveri, the dredging-associated sediment plume drifted offshore up to ~ 400 m from the shoreline, characterized by cp maxima of 2.11-4.86 m-1 and SPM concentrations up to 13.07 mg L-1. After the completion of the excavation and trenching activities, the cp and SPM values were restored to the pre-disturbance condition, ~ 0.6 m-1 and < 2.2 mg L-1 on average, respectively. The migration of the dredge plume in both dredging sites was accomplished through the formation of intermediate and benthic nepheloid layers, whose development and evolution were governed by seawater stratification and flow regime. The dredging-derived SPM levels appeared to increase within a distance of no more than 300 m from the shoreline (near-field zone). Based on data from the literature, this SPM enhancement together with the deposition of a post-dredging residual mud veneer in the near-field zone could deteriorate local marine biota, but in a reversible way.


Assuntos
Monitoramento Ambiental , Sedimentos Geológicos/química , Material Particulado/análise , Água do Mar/química , Grécia , Mar Mediterrâneo , Indústria de Petróleo e Gás/normas , Navios , Tempo , Poluentes Químicos da Água/análise
16.
Crit Care ; 23(1): 377, 2019 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775837

RESUMO

BACKGROUND: African children hospitalised with severe febrile illness have a high risk of mortality. The Fluid Expansion As Supportive Therapy (FEAST) trial (ISCRTN 69856593) demonstrated increased mortality risk associated with fluid boluses, but the temporal relationship to bolus therapy and underlying mechanism remains unclear. METHODS: In a post hoc retrospective analysis, flexible parametric models were used to compare change in mortality risk post-randomisation in children allocated to bolus therapy with 20-40 ml/kg 5% albumin or 0.9% saline over 1-2 h or no bolus (control, 4 ml/kg/hour maintenance), overall and for different terminal clinical events (cardiogenic, neurological, respiratory, or unknown/other). RESULTS: Two thousand ninety-seven and 1041 children were randomised to bolus vs no bolus, of whom 254 (12%) and 91 (9%) respectively died within 28 days. Median (IQR) bolus fluid in the bolus groups received by 4 h was 20 (20, 40) ml/kg and was the same at 8 h; total fluids received in bolus groups at 4 h and 8 h were 38 (28, 43) ml/kg and 40 (30, 50) ml/kg, respectively. Total fluid volumes received in the control group by 4 h and 8 h were median (IQR) 10 (6, 15) ml/kg and 10 (10, 26) ml/kg, respectively. Mortality risk was greatest 30 min post-randomisation in both groups, declining sharply to 4 h and then more slowly to 28 days. Maximum mortality risk was similar in bolus and no bolus groups; however, the risk declined more slowly in the bolus group, with significantly higher mortality risk compared to the no bolus group from 1.6 to 101 h (4 days) post-randomisation. The delay in decline in mortality risk in the bolus groups was most pronounced for cardiogenic modes of death. CONCLUSIONS: The increased risk from bolus therapy was not due to a mechanism occurring immediately after bolus administration. Excess mortality risk in the bolus group resulted from slower decrease in mortality risk over the ensuing 4 days. Thus, administration of modest bolus volumes appeared to prevent mortality risk declining at the same rate that it would have done without a bolus, rather than harm associated with bolus resulting from a concurrent increased risk of death peri-bolus administration. TRIAL REGISTRATION: ISRCTN69856593. Date of registration 15 December 2008.


Assuntos
Hidratação , Criança , Humanos , Ressuscitação , Estudos Retrospectivos , Tempo
18.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(11): 1183-1187, 2019 Nov 06.
Artigo em Chinês | MEDLINE | ID: mdl-31683411

RESUMO

Lead-time bias and length bias were common systematic errors in observational screening studies, which might be a common cause of overstating or distorting the true screening effects. One of key concerns in observational screening studies was how to estimate the screening effects based on the consideration of these two biases. This paper illustrated how to identify and correct the lead-time bias using the tumor volume doubling time and the non-homogeneous Poisson process, and how to correct the length bias using a weighted method. The application conditions of each method were also discussed to present several useful toolboxes to correct the lead-time bias and length bias appropriately and evaluate the effectiveness of the cancer screening program accurately.


Assuntos
Viés , Detecção Precoce de Câncer , Programas de Rastreamento/métodos , Neoplasias/diagnóstico , Humanos , Tempo
20.
Lancet Psychiatry ; 6(11): 915-925, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31601530

RESUMO

BACKGROUND: Housing First is increasingly implemented for homeless adults with mental illness in large urban centres, but little is known about its long-term effectiveness. The At Home/Chez Soi randomised controlled trial done in five cities in Canada showed that Housing First improved housing stability and other select health outcomes. We extended the At Home/Chez Soi trial at the Toronto site to evaluate the long-term effects of the Housing First intervention on housing and health outcomes of homeless adults with mental illness over 6 years. METHODS: The At Home/Chez Soi Toronto study was a randomised, controlled trial done in Toronto (ON, Canada). Here, we present the results of an extension study done at the same site. Participants were homeless adults (aged ≥18 years) with a serious mental disorder with or without co-occurring substance use disorder. In phase 1, participants were stratified by level of need for mental health support services (high vs moderate), and randomly assigned (1:1) using adaptive randomisation procedures to Housing First with assertive community treatment (HF-ACT), Housing First with intensive case management (HF-ICM), or to treatment as usual (TAU). Participants with moderate support needs were further stratified by ethnoracial status. Considering the nature of the Housing First intervention, study participants and study personnel were not masked to group assignment. Phase 1 participants could choose to enrol in the extension study (phase 2). The primary outcome was the rate of days stably housed per year analysed in the modified intention-to-treat population, which included all randomly assigned participants who had at least one assessment for the primary outcome. Participants contributed data to the study up to the point of their last interview. Multilevel multiple imputation was used to handle missing data. The trial was registered with ISRCTN, ISRCTN42520374. FINDINGS: Between Oct 1, 2009, and March 31, 2013, 575 individuals participated in phase 1 of the Toronto Site At Home/Chez Soi study (197 [34%] participants with high support needs and 378 [66%] with moderate support needs). Of the 378 participants with moderate support needs, 204 were randomly assigned to receive the HF intervention with ICM or with ethnoracial-specific ICM services (HF-ER-ICM; HF-ICM or HF-ER-ICM groups) and 174 were randomly assigned to TAU. Of the 197 participants with high support needs, 97 were randomly assigned to receive the HF intervention with ACT (HF-ACT treatment group) and 100 were randomly assigned to TAU group. Between Jan 1, 2014, and March 31, 2017, 414 (81%) of 575 phase 1 participants participated in the extended phase 2 study. The median duration of follow-up was 5·4 years (IQR 2·1-5·9). Among phase 2 participants, 141 had high support needs (79 participants in the HF-ACT group; 62 participants in the TAU group), and 273 had moderate support needs (160 participants in the HF-ICM or HF-ER-ICM group; 113 participants in the TAU group). 187 high support needs participants (93 participants in the HF-ACT group, 94 participants in the TAU group), and 361 moderate support needs participants (201 participants in the HF-ICM or HF-ER-ICM group, 160 participants in the TAU group) were included in the modified intention-to-treat analysis for the primary outcome. The number of days spent stably housed was significantly higher among participants in the HF-ACT and HR-ICM or HF-ER-ICM groups than participants in the TAU groups at all timepoints. For participants with moderate support needs, the rate ratio (RR) of days stably housed in the Housing First group, compared with TAU, was 2·40 (95% CI 2·03-2·83) in year 1, which decreased to 1·13 (1·01-1·26) in year 6. The RR of days stably housed for participants with high support needs, compared with TAU, was 3·02 (2·43-3·75) in year 1 and 1·42 (1·19-1·69) in year 6. In year 6, high support needs participants in the Housing First group spent 85·51% of days stably housed compared with 60·33% for the TAU group, and moderate needs participants in the Housing First group spent 88·16% of days stably housed compared with 78·22% for the TAU group. INTERPRETATION: Rent supplements and mental health support services had an enduring positive effect on housing stability for homeless adults with mental illness in a large, resource-rich urban centre, with a larger impact on individuals with high support needs than moderate support needs. FUNDING: Mental Health Commission of Canada, Ontario Ministry of Health and Long-Term Care, and the Canadian Institute of Health Research.


Assuntos
Serviços Comunitários de Saúde Mental/métodos , Pessoas em Situação de Rua/psicologia , Pessoas em Situação de Rua/estatística & dados numéricos , Transtornos Mentais/terapia , Avaliação de Programas e Projetos de Saúde/métodos , Habitação Popular/estatística & dados numéricos , Adulto , Feminino , Seguimentos , Humanos , Masculino , Transtornos Mentais/psicologia , Ontário , Tempo , População Urbana/estatística & dados numéricos
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