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1.
Proc Natl Acad Sci U S A ; 119(4)2022 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-35058364

RESUMO

While there have been recent improvements in reducing bycatch in many fisheries, bycatch remains a threat for numerous species around the globe. Static spatial and temporal closures are used in many places as a tool to reduce bycatch. However, their effectiveness in achieving this goal is uncertain, particularly for highly mobile species. We evaluated evidence for the effects of temporal, static, and dynamic area closures on the bycatch and target catch of 15 fisheries around the world. Assuming perfect knowledge of where the catch and bycatch occurs and a closure of 30% of the fishing area, we found that dynamic area closures could reduce bycatch by an average of 57% without sacrificing catch of target species, compared to 16% reductions in bycatch achievable by static closures. The degree of bycatch reduction achievable for a certain quantity of target catch was related to the correlation in space and time between target and bycatch species. If the correlation was high, it was harder to find an area to reduce bycatch without sacrificing catch of target species. If the goal of spatial closures is to reduce bycatch, our results suggest that dynamic management provides substantially better outcomes than classic static marine area closures. The use of dynamic ocean management might be difficult to implement and enforce in many regions. Nevertheless, dynamic approaches will be increasingly valuable as climate change drives species and fisheries into new habitats or extended ranges, altering species-fishery interactions and underscoring the need for more responsive and flexible regulatory mechanisms.


Assuntos
Pesqueiros , Conservação dos Recursos Naturais , Ecossistema , Oceanografia
2.
Int J Legal Med ; 138(5): 1947-1954, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38589642

RESUMO

Blow flies (Diptera: Calliphoridae) are generally early colonisers of fresh cadavers, enabling the estimation of a minimum post-mortem interval (minPMI) based on an accurate aging of the oldest immature stages associated with a cadaver. In blow flies, the pupal stage and the subsequent development of the adult take place inside a protective case, the puparium, formed from the hardened and darkened cuticle of the third instar larva. Because the puparium is an opaque structure that shows virtually no external changes, qualitative analyses of the internal tissues can be very informative for determining reliable age-specific morphological markers. Those analyses can be performed using either non-invasive but expensive and not widely accessible techniques, or traditional histological methods, which are invasive as they require the serial sectioning of the sample. Histological methods are often readily available for forensic researchers and practitioners; however, the histological study of blow fly intra-puparial stages has traditionally been hampered by the poor paraffin infiltration of tissues due to the abundance of fat bodies, resulting in usually fragmented sections and the subsequent loss of relevant information. We present here an effective method for the preparation of histological sections of blow fly intra-puparial stages, maximising the paraffin infiltration while enabling the production of clean and entire sections that allow for the use of reliable age-specific morphological markers, thus improving the accuracy of minPMI estimations when access to more costly techniques is not feasible.


Assuntos
Calliphoridae , Entomologia Forense , Mudanças Depois da Morte , Pupa , Animais , Pupa/crescimento & desenvolvimento , Calliphoridae/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Inclusão em Parafina , Humanos , Dípteros
3.
Int J Legal Med ; 138(4): 1769-1779, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38326653

RESUMO

Accurate minimum post-mortem interval (minPMI) estimations often rely on a precise age determination of insect developmental stages, which is significantly influenced by environmental temperature. An optimal preservation of the entomological samples collected at crime scenes is pivotal for a reliable aging of immature insect samples. For blow flies (Diptera: Calliphoridae), the most widely used insect indicators in forensic investigations, an appropriate preservation of tissues is particularly important in the case of puparial samples because aging methods for intra-puparial forms usually depend on morphological analyses; however, although informative soft tissues and structures could be discoloured and/or distorted if they are not properly fixed, there is a lack of studies to assess different methods for the optimal preservation of intra-puparial forms collected in forensic investigations. The present study compares three preservation methods for intra-puparial forms of the blow fly Calliphora vicina Robineau-Desvoidy, 1830: (i) direct immersion into 80% ethanol, (ii) puncturing of the puparium and hot water killing (HWK) prior to preservation in 80% ethanol, and (iii) HWK without puncturing before preservation in 80% ethanol. External and internal morphological analyses of intra-puparial forms of different ages were conducted to assess the quality of preservation. The results indicate that direct immersion in ethanol led to poor preservation, affecting both external and internal tissues. Both methods with HWK resulted in a better preservation, but puncturing resulted, in some cases, in physical damage of the specimens. HWK without puncturing emerged as the optimal preservation method, consistently yielding high preservation scores for both external and internal morphological analyses. These findings have practical implications for forensic practitioners and emphasise the need for updating some published guidelines and protocols in forensic entomology.


Assuntos
Calliphoridae , Etanol , Entomologia Forense , Mudanças Depois da Morte , Pupa , Manejo de Espécimes , Animais , Calliphoridae/crescimento & desenvolvimento , Manejo de Espécimes/métodos , Imersão , Preservação Biológica/métodos , Temperatura Alta
4.
Med Vet Entomol ; 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39044406

RESUMO

Blow flies (Diptera: Calliphoridae) are arguably the most important providers of an estimate of minimum post-mortem interval in forensic investigations. They usually undergo a post-feeding dispersal from the body. While previous studies have looked at dispersal of groups of larvae, recording the dispersal activity of individual larvae has not previously been demonstrated. A servosphere was used here to record the speed, directionality and phototaxis of individual post-feeding larvae of two species of blow fly on a smooth plastic surface over time. The servosphere rotates to compensate for the movement of an insect placed at its apex, thereby enabling its unimpeded locomotion in any direction to be studied and behavioural changes to external stimuli recorded. To our knowledge, the servosphere has not previously been used to study apodous insects. The objective of our study was to compare dispersal behaviour of Calliphora vicina Robineau-Desvoidy and Protophormia terraenovae (Robineau-Desvoidy), both common primary colonisers of human and animal cadavers, but showing different post-feeding dispersal strategies. Larvae of C. vicina generally disperse from the body while those of P. terraenovae remain on or close to the body. Our aims were to study (1) changes in dispersal speed over a 1-h period; (2) changes in dispersal speed once a day for 4 days, between the end of feeding and onset of pupariation; and (3) response of dispersing larvae to light. We demonstrated that (1) the movement of three C. vicina larvae tracked for 1 continuous hour on 1 day slowed from an average of 3 to <1.7 mms-1; (2) the average speed of 20 larvae of C. vicina (4.08 mms-1) recorded for 5 min once per day over a 4-day period between onset of dispersal and pupariation was significantly greater than that of P. terraenovae (2.36 mms-1; p < 0.0001), but that speed of both species increased slightly over the 4 days; (3) the responses of larvae of C. vicina to changes in light direction from the four cardinal directions of the compass, showed that they exhibited a strong negative phototactic response within 5 s, turning to move at approximately 180° away from the new light position. While conducted to observe larval calliphorid post-feeding behaviour, the results of this proof of concept study show that apodous insects can be studied on a servosphere to produce both qualitative and quantitative data.

5.
Health Promot Int ; 39(3)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38809234

RESUMO

Globally, oral conditions remain the most prevalent of all non-communicable diseases. Among the broad range of target goals and recommendations for action by the World Health Organization's Global Oral Health Strategy, we call out three specific actions that provide an enabling environment to improve population oral health including: (i) enabling population oral health reform through leadership, (ii) enabling innovative oral health workforce models, (iii) enabling universal health coverage that includes oral health. The aim of the article is to outline how leadership, regulatory approaches and policy in Australia can strengthen health promotion practice and can inform global efforts to tackle the complex wicked problems associated with population oral health. Examples in Australia show that effective leadership, regulatory approaches and well-designed policies can address the growing burden of non-communicable diseases, and are made possible through public health advocacy, collaboration and research.


Assuntos
Política de Saúde , Promoção da Saúde , Liderança , Humanos , Austrália , Saúde Bucal , Cobertura Universal do Seguro de Saúde
6.
Int J Health Plann Manage ; 39(5): 1516-1529, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39039578

RESUMO

BACKGROUND: International oral health policy directions led by the World Health Organisation call for the inclusion of oral health within universal health coverage. The aim of this study is to perform a budget impact analysis of a policy option for a more cost-efficient oral health workforce skill-mix (dentists and oral health therapists) to provide public oral healthcare in Victoria, Australia. METHODS: Two hypothetical standard care pathways were developed. A dynamic population Markov model in TreeAge software, with a time horizon of 6 years. Two scenarios were modelled to determine: (1) base-case scenario: the threshold the dentist workforce could reduce per year, while achieving the same service delivery outputs, and (2) alternative scenario: the potential cost-savings for utilising an optimally cost-efficient oral health workforce skill-mix. RESULTS: The threshold analysis showed a minimum reduction of 13% of the dentist workforce being replaced with oral health therapists can occur without having any impact on the same service delivery outputs. Under the alternative scenario, the potential cost-savings would be AUD$1,425,037 (standard deviation 58,954). CONCLUSIONS: Governments and policy-decision makers should consider strategies in training, attracting, and retaining oral health therapists to achieve an optimally cost-efficient oral health workforce skill-mix when delivering public oral healthcare.


Assuntos
Política de Saúde , Vitória , Humanos , Saúde Bucal , Eficiência Organizacional , Odontólogos , Cadeias de Markov , Análise Custo-Benefício
7.
Med Vet Entomol ; 37(4): 859-864, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37141311

RESUMO

Oestrid flies (Diptera: Oestridae) are obligate parasites of mammals during their larval stage and show anatomical adaptations for the infestation of host tissues. Unlike the species that parasitize domestic mammals, those oestrid species that infest wild mammal hosts remain poorly known. With the use of x-ray micro-computed tomography, we describe for the first time the anatomy of the digestive and excretory systems of the second and third larval instars of Pharyngomyia picta (Meigen), a parasite of cervids that, like other species within the subfamily Oestrinae, causes nasopharyngeal myiasis. Both larval instars of P. picta show a pair of remarkably large salivary glands arranged in a characteristic 'glandular band', a convoluted and thickly uniform midgut and a greatly enlarged distal region of the anterior pair of Malpighian tubules. These anatomical features also have been described in other species within the subfamily Oestrinae, whereas they differ from the observations in other oestrid subfamilies. We discuss the potential functional significance of the anatomy of the digestive and excretory systems of Oestrinae larvae as specific adaptations to parasitize the nasopharyngeal cavities of mammal hosts.


Assuntos
Cervos , Dípteros , Miíase , Animais , Dípteros/anatomia & histologia , Larva , Microtomografia por Raio-X , Miíase/parasitologia , Miíase/veterinária , Cervos/parasitologia
8.
Med Vet Entomol ; 37(1): 14-26, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36156281

RESUMO

The enigmatic larvae of the Old World genus Passeromyia Rodhain & Villeneuve, 1915 (Diptera: Muscidae) inhabit the nests of birds as saprophages or as haematophagous agents of myiasis among nestlings. Using light microscopy, confocal laser scanning microscopy and scanning electron microscopy, we provide the first morphological descriptions of the first, second and third instar of P. longicornis (Macquart, 1851) (Diptera: Muscidae), the first and third instar of P. indecora (Walker, 1858) (Diptera: Muscidae), and we revise the larval morphology of P. heterochaeta (Villenueve, 1915) (Diptera: Muscidae) and P. steini Pont, 1970 (Diptera: Muscidae). We provide a key to the third instar of examined species (excluding P. steini and P. veitchi Bezzi, 1928 (Diptera: Muscidae)). Examination of the cephaloskeleton revealed paired rod-like sclerites, named 'rami', between the lateral arms of the intermediate sclerite in the second and third instar larva. We reveal parastomal bars fused apically with the intermediate sclerite, the absence of which has so far been considered as apomorphic for second and third instar muscid larvae. Examination of additional material suggests that modified parastomal bars are not exclusive features of Passeromyia but occur widespread in the Muscidae, and rami may occur widespread in the Cyclorrhapha.


Assuntos
Dípteros , Muscidae , Miíase , Animais , Larva/anatomia & histologia , Muscidae/anatomia & histologia , Microscopia Eletrônica de Varredura/veterinária , Miíase/parasitologia , Miíase/veterinária , Aves
9.
Med Vet Entomol ; 37(4): 767-781, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37477152

RESUMO

In medical, veterinary and forensic entomology, the ease and affordability of image data acquisition have resulted in whole-image analysis becoming an invaluable approach for species identification. Krawtchouk moment invariants are a classical mathematical transformation that can extract local features from an image, thus allowing subtle species-specific biological variations to be accentuated for subsequent analyses. We extracted Krawtchouk moment invariant features from binarised wing images of 759 male fly specimens from the Calliphoridae, Sarcophagidae and Muscidae families (13 species and a species variant). Subsequently, we trained the Generalized, Unbiased, Interaction Detection and Estimation random forests classifier using linear discriminants derived from these features and inferred the species identity of specimens from the test samples. Fivefold cross-validation results show a 98.56 ± 0.38% (standard error) mean identification accuracy at the family level and a 91.04 ± 1.33% mean identification accuracy at the species level. The mean F1-score of 0.89 ± 0.02 reflects good balance of precision and recall properties of the model. The present study consolidates findings from previous small pilot studies of the usefulness of wing venation patterns for inferring species identities. Thus, the stage is set for the development of a mature data analytic ecosystem for routine computer image-based identification of fly species that are of medical, veterinary and forensic importance.


Assuntos
Dípteros , Muscidae , Sarcofagídeos , Animais , Masculino , Calliphoridae , Entomologia
10.
Health Expect ; 26(3): 1159-1169, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36786161

RESUMO

INTRODUCTION: There is a growing understanding of the benefits of patient and public involvement (PPI), and its evaluation, in research. An online version of the CUBE PPI evaluation framework has been developed. We sought to use the CUBE to evaluate the value of early PPI with two small healthcare companies during product development. METHODS: Contributors were recruited online and had lived experience of either type 1 diabetes or obesity. Two 1-h sessions were run with a company developing a smartphone application to manage diabetes (DEE-EM): one with young people (YP; n = 5) and one with parents (n = 7). Two 1-h sessions were run with a company developing a weight-loss product, both with adults (n = 7 in each session). Sessions were facilitated by an independent University researcher and attended by company representatives, who presented their product. One facilitator led the evaluation of the session by giving a demonstration of the CUBE and asking simple questions in the YP session. RESULTS: A high proportion of contributors completed the CUBE (80.5% DEE-EM; 93% Oxford Medical Products). Responses were positive to all four CUBE dimensions (in italics). Contributors felt there were diverse ways to contribute to the sessions, and that they had a strong voice to add to the discussion. Balance was achieved regarding whose concerns (public or company) led the agenda, and contributors felt that both companies would make changes based on the discussion. The supportive attitude of both companies resulted in most contributors feeling comfortable participating in PPI sessions with the industry, while recognising the profit-making aspect of their work. CONCLUSIONS: PPI with small healthcare companies is both feasible and worthwhile. The CUBE framework facilitated the evaluation of the interaction between experts in different knowledge spaces. We provide recommendations for future projects, including considerations of who should participate and the level of implicit endorsement of the product that participation implies. PATIENT OR PUBLIC CONTRIBUTION: People with lived experience of type 1 diabetes or obesity were invited to contribute to one of four PPI sessions, which they then evaluated. One contributor agreed to contribute to the analysis of the evaluation data and interpretation and preparation of the manuscript.


Assuntos
Diabetes Mellitus Tipo 1 , Adulto , Humanos , Adolescente , Diabetes Mellitus Tipo 1/terapia , Participação do Paciente , Pesquisadores
11.
Health Promot Int ; 38(4)2023 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-37555701

RESUMO

Dental caries, a non-communicable disease, is one of the most prevalent diseases globally and share common modifiable risk factors with obesity such as excess sugar intake. However, prioritization by governments to improve population oral health has been limited and is typically excluded from the discourse of public health policy development. Therefore, interventions that target dental caries can have other co-benefits including obesity prevention. In Victoria, Australia, local government authorities have a regulatory requirement to develop their Municipal Health and Wellbeing Plans. The aim of this paper is to identify whether prioritization for oral health by local government authorities in Victoria has changed through the subsequent renewal of the Victorian Public Health and Wellbeing Plans 2011-2015 and 2019-2023. Three desktop audits for all publicly available Municipal Health and Wellbeing Plans by local government authorities in Victoria were conducted between 2014 and 2022. Key terms related to oral health was searched within these policy documents and categorized into six indicators: (i) included oral health as a priority, (ii) linked healthy eating and oral health, (iii) supported the Achievement Program, (iv) included the Smiles 4 Miles program, (v) advocated for fluoridated drinking water, and (vi) included other strategies related to oral health. Overall, there was statistically significant reduction in five of the six indicators, with the exception for prioritization of other strategies related to oral health such as targeting excess sugar intake and smoking. A multi-sectoral approach, that includes oral health would be advantageous to address the growing burden of non-communicable diseases.


Assuntos
Cárie Dentária , Saúde Bucal , Humanos , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Vitória , Política de Saúde , Política Pública , Obesidade/prevenção & controle , Governo Local , Açúcares
12.
J Nurs Scholarsh ; 54(2): 202-212, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34750961

RESUMO

OBJECTIVES: To (1) compare the probability of cigarette smoking cessation for pregnant women with and without past-year mental illness by the trimester of pregnancy; and (2) examine the association between the receipt of past-year mental health treatment and prenatal cigarette smoking cessation among pregnant lifetime-smokers with mental illness. METHODS: We conducted secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2008-2014. The NSDUH included 2019 pregnant lifetime smokers aged 18-44 years, 528 of whom had a mental illness. We used multiple logistic regression to model the probability of prenatal cigarette smoking cessation. RESULTS: Pregnant lifetime-smokers with mental illness had a lower rate of cigarette smoking cessation than women without mental illness (47.9% vs. 61.7%, p = 0.001). Compared to pregnant women without mental illness, pregnant women with mental illness had a significantly lower odds of smoking cessation in the first trimester (Adjusted Odds Ratio [AOR]: 0.34, 95% Confidence Interval [CI]: 0.18-0.66), but not in the second (AOR: 0.87, 95% CI: 0.46-1.63) and third trimesters (AOR: 0.94, 95% CI: 0.51-1.72). The likelihood of quitting smoking did not differ significantly for pregnant lifetime-smokers with mental illness who received and did not receive mental health treatment (AOR: 1.69, 95% CI: 0.87-3.28). CONCLUSION: Pregnant lifetime-smokers with mental illness are less likely to quit smoking than those without mental illness; overall, pregnant women tended to quit smoking as they progressed in their pregnancy. The receipt of mental health treatment was not associated with quitting smoking. Mental health care providers need to screen for cigarette use among pregnant women and strengthen smoking cessation efforts. CLINICAL RELEVANCE: Pregnancy presents a unique opportunity for mental health care providers to screen for cigarette use in women with mental illness and support their smoking cessation efforts.


Assuntos
Transtornos Mentais , Abandono do Hábito de Fumar , Produtos do Tabaco , Adolescente , Adulto , Feminino , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Saúde Mental , Gravidez , Gestantes , Adulto Jovem
13.
Women Health ; 61(10): 1007-1015, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34802393

RESUMO

This study compared and contrasted perceived barriers to mental health and substance use treatment among pregnant and non-pregnant women from 2008-2010 to 2011-2014. A trend study was conducted using secondary data from the National Survey on Drug Use and Health 2008-2014 from a propensity score-matched sample of pregnant (n = 5,520) and nonpregnant women (n = 11,040) aged 18 to 44 years. The most frequently perceived barriers to mental health treatment among all women ranked similarly in 2008-2010 compared to 2011-2014: cost (45.2% vs. 50.6%), opposition to treatment (41.9% vs. 41.4%), and stigma (28.2% vs. 24.7%). The rank order of barriers to substance use treatment in 2008-2010 among all women was cost (38.7%), stigma (18.2%), and time/transportation limitations (17%), whereas in 2011-2014, stigma ranked first (35.5%), followed by cost (25.9%) and time/transportation limitations (22.2%). In 2011-2014, the women were significantly more likely than women in 2008-2010 to report not knowing where to go (8.2% vs. .9%, p = .003) and a lack of substance use treatment programs (17.7% vs. 3.0%, p = .014). Perceived barriers to mental health treatment did not change overtime; however, there was a decrease in reported availability of substance use treatment programs between 2008-2010 and 2011-2014.


Assuntos
Saúde Mental , Transtornos Relacionados ao Uso de Substâncias , Feminino , Humanos , Gravidez , Psicoterapia , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/terapia
14.
Int J Legal Med ; 134(2): 793-810, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31209558

RESUMO

Most studies of decomposition in forensic entomology and taphonomy have used non-human cadavers. Following the recommendation of using domestic pig cadavers as analogues for humans in forensic entomology in the 1980s, pigs became the most frequently used model cadavers in forensic sciences. They have shaped our understanding of how large vertebrate cadavers decompose in, for example, various environments, seasons and after various ante- or postmortem cadaver modifications. They have also been used to demonstrate the feasibility of several new or well-established forensic techniques. The advent of outdoor human taphonomy facilities enabled experimental comparisons of decomposition between pig and human cadavers. Recent comparisons challenged the pig-as-analogue claim in entomology and taphonomy research. In this review, we discuss in a broad methodological context the advantages and disadvantages of pig and human cadavers for forensic research and rebut the critique of pigs as analogues for humans. We conclude that experiments using human cadaver analogues (i.e. pig carcasses) are easier to replicate and more practical for controlling confounding factors than studies based solely on humans and, therefore, are likely to remain our primary epistemic source of forensic knowledge for the immediate future. We supplement these considerations with new guidelines for model cadaver choice in forensic science research.


Assuntos
Entomologia Forense/métodos , Ciências Forenses/tendências , Modelos Animais , Projetos de Pesquisa/tendências , Suínos , Animais , Cadáver , História do Século XIX , História do Século XX , História do Século XXI , Humanos
15.
Subst Use Misuse ; 55(14): 2321-2331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32900265

RESUMO

BACKGROUND: High-risk alcohol use on college campuses is a significant public health concern, especially among students in fraternities and sororities. Alcohol harm-reduction programs that include protective behavioral strategies (PBSs) provide a promising approach to curb drinking among students, yet results have been inconsistent among high-risk drinkers. Purpose: To evaluate the impact of a harm-reduction, peer-led training program called "Voice of Reason" (VOR) on alcohol knowledge and behaviors among students in Greek chapters. Methods: We conducted two studies with students directly trained in VOR (Study 1: N = 118; Study 2: N = 53) and with students in affiliated Greek chapters (Study 1: N = 1363; Study 2: N = 1446). Study 1 included 13 chapters and Study 2 included 15 chapters. Results: Results of analyses across both studies showed that among those directly trained in VOR, there were pre-post increases in alcohol knowledge, medical amnesty law awareness, talking with friends about PBS, use of PBS, and intentions to use PBS, as well as pre-post decreases in drinking and driving and riding with drinking drivers. In addition, VOR had an impact on students in affiliated chapters, indicating an increase in medical amnesty law awareness and a decrease in the number of drinks consumed on a typical day. Conclusions: Overall, results provide some early evidence of VOR impact, while also demonstrating the challenge of changing normative drinking behaviors among high-risk college students. Ongoing research is needed to assess the effectiveness of VOR, especially after successive implementations with the same chapters.


Assuntos
Consumo de Álcool na Faculdade , Alcoolismo/prevenção & controle , Fraternidades e Irmandades Universitárias/organização & administração , Redução do Dano , Grupo Associado , Estudantes/estatística & dados numéricos , Adolescente , Consumo de Álcool na Faculdade/psicologia , Alcoolismo/psicologia , Feminino , Humanos , Masculino , Estudantes/psicologia , Universidades , Adulto Jovem
16.
Rural Remote Health ; 19(4): 5322, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31607139

RESUMO

INTRODUCTION: Recent evidence indicates that the oral health for children in Timor-Leste is deteriorating, with 40% of school children experiencing toothache during 2014. Timorese have easy access to sugar, poor food security and lack of water fluoridation, all of which exacerbate the risk of dental caries. A lack of quality epidemiological data is available to confirm anecdotal information of high caries rates in rural and remote Timor-Leste. Such data are required to inform oral health issues and health policy at both the local and national levels. This study investigated the caries status and potential risk factors among primary school children in the rural Aileu municipality of Timor-Leste. The objectives of this study were to determine caries prevalence and experience, the status (active/arrested) of existing caries lesions and associations between dental caries and potential risk factors, among primary school children in the Aileu municipality, Timor-Leste. METHODS: This study analysed secondary data. De-identified data for this analysis were obtained from North Richmond Community Health (NRCH), Melbourne, Australia. North Richmond Community Health (NRCH) has been working with the Friends of Aileu (a government-to-government partnership between an Australian local government area and the municipality of Aileu) to improve the oral health of school children in the municipality of Aileu. NRCH conducts an outreach school-based oral health promotion program, called Kose Nehan, at six primary schools in the Aileu municipality. Caries was diagnosed using the International Caries Detection and Assessment System (ICDAS) and reported using the decayed, missing and filled teeth (DMFT/dmft) index. Examiners were trained and calibrated. A brief interviewer-administered questionnaire was used to capture information on child oral hygiene and diet behaviours. For the analysis, dental caries was defined as 'any caries lesions' (ICDAS caries codes 1-6). Descriptive and inferential analyses were conducted using STATA 14. Multivariable logistic regression analysis predicting the odds of dental caries (yes/no) was used to determine independent associations between the exposures and the outcome. RESULTS: Data were analysed for 685 children. In the primary dentition, the overall prevalence of caries was 64% and the mean dmft score was 2.74 (standard deviation (SD) 3.08). In the permanent dentition, the overall prevalence was 53% and the mean DMFT score was 1.74 (SD 2.46). Overall, approximately 84% of caries lesions were identified as being active. The multivariable regression analysis did not identify independent predictors of caries. CONCLUSION: Dental caries was highly prevalent among this population and urgent action is required to reduce the population burden of this disease. Malnutrition, which was not measured for this study, is highly prevalent among children in Timor-Leste and could explain the high caries rates in this population. The effect of malnutrition on dental caries and vice-versa needs further investigation. Programs and policies are urgently needed for oral health promotion and also the prevention and management of dental caries in Timorese children. These strategies should also address the urgent need for emergency dental services aimed at pain relief, first aid for oral infections and restorations, given the high prevalence of advanced disease in this child population.


Assuntos
Cárie Dentária/epidemiologia , População Rural , Fatores Etários , Criança , Feminino , Humanos , Masculino , Saúde Bucal/estatística & dados numéricos , Higiene Bucal/métodos , Fatores de Risco , Serviços de Saúde Escolar , Fatores Sexuais , Timor-Leste/epidemiologia
17.
Acta Derm Venereol ; 98(3): 324-328, 2018 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-29182791

RESUMO

Atopic dermatitis (AD) is a chronic, itchy, inflammatory skin disorder that may worsen due to stress and anxiety. Tachykinins have been suggested to be involved in the inflammation in AD, as well as pruritus. Aprepitant is a NK-1 receptor antagonist. This open randomized trial evaluated the effect of aprepitant added to topical treatment in adult patients with moderate-severe AD. The treatment group (n = 19) received 80 mg/day aprepitant for 7 days as a supplement to standardized topical treatment with a moderately strong steroid and a moisturizer. The control group (n = 20) received topical treatment alone. Patients were monitored for the extent of the disease (using SCORing of Atopic Dermatitis; SCORAD), pruritus, and scratching movements. In both the aprepitant-treated and the control groups there was a decrease in SCORAD, pruritus and scratching movements. However, there was no significant additional improvement in any of these parameters in the aprepitant-treated group compared with the control group.


Assuntos
Antipruriginosos/administração & dosagem , Dermatite Atópica/tratamento farmacológico , Morfolinas/administração & dosagem , Antagonistas dos Receptores de Neurocinina-1/administração & dosagem , Prurido/tratamento farmacológico , Pele/efeitos dos fármacos , Substância P/antagonistas & inibidores , Administração Cutânea , Adulto , Antipruriginosos/efeitos adversos , Aprepitanto , Dermatite Atópica/diagnóstico , Dermatite Atópica/metabolismo , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morfolinas/efeitos adversos , Antagonistas dos Receptores de Neurocinina-1/efeitos adversos , Prurido/diagnóstico , Prurido/metabolismo , Índice de Gravidade de Doença , Pele/metabolismo , Pele/patologia , Substância P/metabolismo , Suécia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
18.
Subst Abus ; 39(3): 280-285, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29452065

RESUMO

BACKGROUND: Prescription drug-related overdose deaths have increased dramatically in recent years. Women in the justice system experience high rates of drug use, victimization, trauma symptoms, and other health problems and would appear to be at high risk for nonmedical use of prescription drugs (NMUPD). This study will be among the first to describe prevalence and correlates of NMUPD among this population. METHODS: This cross-sectional study collected data from 406 victimized women on probation and parole between 2010 and 2012. In a multiple logistic regression model, we differentiated women who reported past-year NMUPD from those who did not using demographic, health, other drug use, substance use treatment, and trauma symptom severity variables. RESULTS: Past-year NMUPD was reported by 26.8% (n = 109) of the overall sample. Women reporting NMUPD were significantly younger and more likely to be white. Past-year use of alcohol (adjusted odds ratio [AOR]: 3.3; 95% confidence interval [CI]: 1.8-6.1), marijuana (AOR: 3.6; 95% CI: 1.8-7.0), methamphetamines (AOR: 6.1; 95% CI: 1.7-21.3), and heroin (AOR: 8.4; 95% CI: 2.0-35.2) were significantly associated with NMUPD. Additionally, each unit increase in the measure assessing bodily pain was associated with a 40% increase (AOR: 1.4; 95% CI: 1.1-1.7) in the odds of NMUPD. Finally, meeting diagnostic criteria for posttraumatic stress disorder almost doubled (AOR: 1.9; 95% CI: 1.1-3.4) the odds of reporting past-year NMUPD. CONCLUSIONS: Victimized women on probation and parole report high rates of NMUPD, and this behavior intersects with other complex social, behavioral, psychological, and physical needs. The authors recommend increased access to trauma-informed correctional care among women in the justice system.


Assuntos
Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Populações Vulneráveis/estatística & dados numéricos , Adulto , Vítimas de Crime , Estudos Transversais , Feminino , Humanos , Kentucky/epidemiologia , Dor/epidemiologia , Prevalência , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto Jovem
19.
Int J Legal Med ; 131(3): 855-866, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27924407

RESUMO

The Muscidae is one of the main dipteran families recognized as important for medico-legal purposes. Although an association of adult flies with decomposing human and animal bodies is documented for about 200 taxa worldwide, cadavers and carrion represents a breeding habitat for considerably fewer species. Species that do colonize dead human bodies can do so under diverse environmental conditions and, under certain circumstances, Muscidae may be the only colonizers of a body. Because of difficulties in identification, many studies have identified immature and/or adult muscids only to the genus or family level. This lack of detailed species-level identifications hinders detailed investigation of their medico-legal usefulness in carrion succession-oriented experiments. Identification to species level of third instars of Muscidae of forensic importance and the utility of larval morphological characters for taxonomic purposes were subjected to an in-depth revision. A combination of characters allowing for the discrimination of third instar muscids from other forensically important dipterans is proposed. An identification key for third instar larvae, which covers the full set of cadaver-colonising species of Muscidae from the western Palaearctic (Europe, North Africa, Middle East), is provided. This key will facilitate more detailed and species-specific knowledge of the occurrence of Muscidae in forensic entomology experiments and real cases. The carrion-visiting Muscidae worldwide are catalogued, and those species breeding in animal carrion and dead human bodies are briefly discussed with regard to their forensic importance.


Assuntos
Restos Mortais , Comportamento Alimentar , Larva/crescimento & desenvolvimento , Muscidae/crescimento & desenvolvimento , Mudanças Depois da Morte , Animais , Entomologia , Ciências Forenses , Humanos , Microscopia Eletrônica de Varredura
20.
Int J Legal Med ; 131(5): 1429-1448, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28474172

RESUMO

Minimum post-mortem interval (minPMI) estimates often rely on the use of developmental data from blow flies (Diptera: Calliphoridae), which are generally the first colonisers of cadavers and, therefore, exemplar forensic indicators. Developmental data of the intra-puparial period are of particular importance, as it can account for more than half of the developmental duration of the blow fly life cycle. During this period, the insect undergoes metamorphosis inside the opaque, barrel-shaped puparium, formed by the hardening and darkening of the third instar larval cuticle, which shows virtually no external changes until adult emergence. Regrettably, estimates based on the intra-puparial period are severely limited due to the lack of reliable, non-destructive ageing methods and are frequently based solely on qualitative developmental markers. In this study, we use non-destructive micro-computed tomography (micro-CT) for (i) performing qualitative and quantitative analyses of the morphological changes taking place during the intra-puparial period of two forensically relevant blow fly species, Calliphora vicina and Lucilia sericata, and (ii) developing a novel and reliable method for estimating insect age in forensic practice. We show that micro-CT provides age-diagnostic qualitative characters for most 10% time intervals of the total intra-puparial period, which can be used over a range of temperatures and with a resolution comparable to more invasive and time-consuming traditional imaging techniques. Moreover, micro-CT can be used to yield a quantitative measure of the development of selected organ systems to be used in combination with qualitative markers. Our results confirm micro-CT as an emerging, powerful tool in medico-legal investigations.


Assuntos
Dípteros/crescimento & desenvolvimento , Pupa/crescimento & desenvolvimento , Microtomografia por Raio-X , Animais , Análise Discriminante , Comportamento Alimentar , Humanos , Imageamento Tridimensional , Mudanças Depois da Morte
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