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1.
Soc Psychiatry Psychiatr Epidemiol ; 59(2): 211-232, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37420003

RESUMO

PURPOSE: Suicide and self-harm by pesticide self-poisoning is common in low- and middle-income countries (LMICs). Alcohol is an important risk factor for self-harm; however, little is known about its role in pesticide self-poisoning. This scoping review explores the role that alcohol plays in pesticide self-harm and suicide. METHODS: The review followed the Joanna Briggs Institute scoping review guidance. Searches were undertaken in 14 databases, Google Scholar, and relevant websites. Articles were included if they focussed on pesticide self-harm and/or suicide and involvement of alcohol. RESULTS: Following screening of 1281 articles, 52 were included. Almost half were case reports (n = 24) and 16 focussed on Sri Lanka. Just over half described the acute impact of alcohol (n = 286), followed by acute and chronic alcohol use (n = 9), chronic use, (n = 4,) and only two articles addressed harm to others. One systematic review/meta-analysis showed increased risk of intubation and death in patients with co-ingested alcohol and pesticides. Most individuals who consumed alcohol before self-harming with pesticides were men, but alcohol use among this group also led to pesticide self-harm among family members. Individual interventions were recognised as reducing or moderating alcohol use, but no study discussed population-level alcohol interventions as a strategy for pesticide suicide and self-harm prevention. CONCLUSION: Research on alcohol's role in pesticide self-harm and suicide is limited. Future studies are needed to: further assess the toxicological effects of combined alcohol and pesticide ingestion, explore harm to others from alcohol including pesticide self-harm, and to integrate efforts to prevent harmful alcohol use and self-harm.


Assuntos
Praguicidas , Comportamento Autodestrutivo , Suicídio , Masculino , Humanos , Feminino , Comportamento Autodestrutivo/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Fatores de Risco , Etanol
2.
BMC Public Health ; 23(1): 1362, 2023 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-37455312

RESUMO

BACKGROUND: Medication adherence is a crucial component of the pharmacological treatment of smoking. Previous interventions targeted to improve adherence to smoking cessation medications (SCMs) were designed using pragmatic approaches. This study aims to develop a comprehensive intervention strategy to improve adherence to SCMs using the Behaviour Change Wheel (BCW) and a modified Delphi method. METHODS: Recommendations for the design of intervention strategies were based on the BCW guide and six studies conducted by the research team. Factors related to healthcare providers and consumers (person making a quit attempt) that showed associations with adherence were mapped into the Capability, Opportunity, Motivation, Behaviour (COM-B) model, and corresponding intervention functions and policy categories. Interventions were then represented using the Behaviour Change Technique Taxonomy. Finally, a modified Delphi study using 17 experts was conducted to evaluate the nominated strategies using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects, and Equity (APEASE) criteria. RESULTS: Following a stepped approach, an adherence support wheel was designed to guide implementation strategies and programmes. Thirteen intervention strategies were selected. The selected interventions include providing detailed instructions on how to use SCMs; establishing realistic expectations from SCMs; and providing training for healthcare providers regarding comprehensive smoking cessation care with specifics on the provision of adherence support. CONCLUSION: The BCW guide and a modified Delphi were applied successfully to design interventions tailored to improve adherence to SCMs. Improving adherence to SCMs requires a comprehensive intervention approach involving various stakeholders. Future research is needed to assess the effectiveness of the nominated intervention strategies.


Assuntos
Abandono do Hábito de Fumar , Humanos , Abandono do Hábito de Fumar/métodos , Técnica Delphi , Fumar , Terapia Comportamental , Motivação
3.
Int J Equity Health ; 21(1): 127, 2022 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076199

RESUMO

Alcohol is the leading cause of healthy years lost. There is significant variation in alcohol consumption patterns and harms in Australia, with those residing in the Northern Territory (NT), particularly First Nations Australians, experiencing higher alcohol-attributable harms than other Australians. Community leadership in the planning and implementation of health, including alcohol, policy is important to health outcomes for First Nations Australians. Self-determination, a cornerstone of the structural and social determinants of health, is necessary in the development of alcohol-related policy. However, there is a paucity of published literature regarding Indigenous Peoples self-determination in alcohol policy development. This study aims to identify the extent to which First Nations Australians experience self-determination in relation to current alcohol policy in Alice Springs/Mbantua (Northern Territory, Australia).Semi-structured qualitative yarns with First Nations Australian community members (n = 21) were undertaken. A framework of elements needed for self-determination in health and alcohol policy were applied to interview transcripts to assess the degree of self-determination in current alcohol policy in Alice Springs/Mbantua. Of the 36 elements, 33% were not mentioned in the interviews at all, 20% were mentioned as being present, and 75% were absent. This analysis identified issues of policy implementation, need for First Nations Australian leadership, and representation.Alcohol policy for First Nations Australians in the NT is nuanced and complicated. A conscious approach is needed to recognise and implement the right to self-determination, which must be led and defined by First Nations Australians.First Nations Australians' experiences of current alcohol policy in Central Australia: evidence of self-determination?


Assuntos
Autonomia Pessoal , Política Pública , Humanos , Northern Territory , Formulação de Políticas
4.
Health Res Policy Syst ; 20(1): 12, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35062976

RESUMO

BACKGROUND: Recognition of the role of structural, cultural, political and social determinants of health is increasing. A key principle of each of these is self-determination, and according to the United Nations (2007), this is a right of Indigenous Peoples. For First Nations Australians, opportunities to exercise this right appear to be limited. This paper explores First Nations Australian communities' responses to reducing alcohol-related harms and improving the health and well-being of their communities, with a focus on understanding perceptions and experiences of their self-determination. It is noted that while including First Nations Australians in policies is not in and of itself self-determination, recognition of this right in the processes of developing health and alcohol policies is a critical element. This study aims to identify expert opinion on what is needed for First Nations Australians' self-determination in the development of health- and alcohol-related policy. METHODS: This study used the Delphi technique to translate an expert panel's opinions into group consensus. Perspectives were sought from First Nations Australians (n = 9) and non-Indigenous Peoples (n = 11) with experience in developing, evaluating and/or advocating for alcohol interventions led by First Nations Australians. Using a web-based survey, this study employed three survey rounds to identify and then gain consensus regarding the elements required for First Nations Australians' self-determination in policy development. RESULTS: Twenty panellists (n = 9 First Nations Australian) participated in at least one of the three surveys. Following the qualitative round 1 survey, six main themes, 60 subthemes and six examples of policy were identified for ranking in round 2. In round 2, consensus was reached with 67% of elements (n = 40/60). Elements that did not reach consensus were repeated in round 3, with additional elements (n = 5). Overall, consensus was reached on two thirds of elements (66%, n = 43/65). CONCLUSIONS: Self-determination is complex, with different meaning in each context. Despite some evidence of self-determination, systemic change in many areas is needed, including in government. This study has identified a starting point, with the identification of elements and structural changes necessary to facilitate First Nations Australian community-led policy development approaches, which are vital to ensuring self-determination.


Assuntos
Havaiano Nativo ou Outro Ilhéu do Pacífico , Política Pública , Austrália , Técnica Delphi , Humanos , Autonomia Pessoal
5.
Anaesthesia ; 76(6): 832-836, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33150618

RESUMO

Interventions from randomised controlled trials can only be replicated if they are reported in sufficient detail. The results of trials can only be confidently interpreted if the delivery of the intervention was systematic and the protocol adhered to. We systematically reviewed trials of anaesthetic interventions published in 12 journals from January 2016 to September 2019. We assessed the detail with which interventions were reported, using the Consolidated Standards of Reporting Trials statement for non-pharmacological treatments. We analysed 162 interventions reported by 78 trials in 18,675 participants. Detail sufficiently precise to replicate the intervention was reported for 111 (69%) interventions. Intervention standardisation was reported for 135 (83%) out of the 162 interventions, and protocol adherence was reported for 20 (12%) interventions. Sixty (77%) out of the 78 trials reported the administrative context in which interventions were delivered and 36 (46%) trials detailed the expertise of the practitioners. We conclude that bespoke reporting tools should be developed for anaesthetic interventions and interventions in other areas such as critical care.


Assuntos
Anestesia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Relatório de Pesquisa/normas , Humanos
6.
Med J Malaysia ; 76(2): 251-253, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33742639

RESUMO

Melioidosis is endemic in the State of Sabah, Malaysia. We report a case of a 34-year-old man with one-week history of fever and cough, three days history of diarrhoea and vomiting, which was associated with a loss of appetite and loss of weight for one-month. Clinically, he had hepatosplenomegaly and crepitation over his right lower zone of lung. Chest radiograph showed right lower lobe consolidation. Ultrasound abdomen showed liver and splenic abscesses. Ultrasound guided drainage of splenic abscess yielded Burkholderia pseudomallei. Magnetic resonance imaging (MRI) lumbosacral confirmed right sacral intraosseous abscess after he developed back pain a week later. He received 6 weeks of intravenous antibiotics and oral co-trimoxazole, followed by 6 months oral co-trimoxazole and had full recovery.


Assuntos
Burkholderia pseudomallei , Melioidose , Esplenopatias , Abscesso/diagnóstico por imagem , Abscesso/tratamento farmacológico , Abscesso/etiologia , Adulto , Antibacterianos/uso terapêutico , Humanos , Masculino , Melioidose/diagnóstico por imagem , Melioidose/tratamento farmacológico , Esplenopatias/diagnóstico por imagem , Esplenopatias/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol
7.
Eur J Neurol ; 27(2): 258-264, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31446637

RESUMO

BACKGROUND AND PURPOSE: High uric acid (UA) levels have been shown to exert a neuroprotective effect in Parkinson's disease (PD) by inhibiting oxidative stress in the nigrostriatal pathway. However, the association between striatal dopamine activity and UA level has not been clarified. METHODS: A total of 213 patients with early PD were enrolled. All patients underwent positron emission tomography using 18 F-N-(3-fluoropropyl)-2beta-carbon ethoxy-3beta-(4-iodophenyl) nortropane and a venous blood test for quantification of serum UA. All patients were stratified into either the lower UA group or the higher UA group using the median UA level. After normalizing the positron emission tomography images, differences in the regional standardized uptake value ratios (SUVRs) were analyzed with a volume-of-interest template. All tested SUVRs were also compared after categorizing patients by gender. RESULTS: The UA affected dopamine transporter SUVRs in different ways by gender. In female patients, the higher UA level group showed a smaller reduction in dopamine transporter uptake in the posterior putamen, whereas there was no such association observed in male patients. CONCLUSIONS: Higher UA levels were correlated with higher dopamine transporter uptake in the putamen in female patients with early PD. This finding suggests that UA has a neuroprotective effect, as demonstrated by the relatively preserved striatal dopamine activity in women.


Assuntos
Corpo Estriado/metabolismo , Dopamina/metabolismo , Doença de Parkinson/metabolismo , Ácido Úrico/metabolismo , Idoso , Idoso de 80 Anos ou mais , Corpo Estriado/diagnóstico por imagem , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuroprotetores , Doença de Parkinson/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Putamen/metabolismo , Caracteres Sexuais , Ácido Úrico/sangue
8.
BMC Med Res Methodol ; 20(1): 183, 2020 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-32631364

RESUMO

BACKGROUND: Population estimates of alcohol consumption vary widely among samples of Aboriginal and Torres Strait Islander (Indigenous) Australians. Some of this difference may relate to non-representative sampling. In some communities, household surveys are not appropriate and phone surveys not feasible. Here we describe activities undertaken to implement a representative sampling strategy in an urban Aboriginal setting. We also assess our likely success. METHODS: We used a quota-based convenience sample, stratified by age, gender and socioeconomic status to recruit Indigenous Australian adults (aged 16+) in an urban location in South Australia. Between July and October 2019, trained research staff (n = 7/10, Aboriginal) recruited community members to complete a tablet computer-based survey on drinking. Recruitment occurred from local services, community events and public spaces. The sampling frame and recruitment approach were documented, including contacts between research staff and services, and then analysed. To assess representativeness of the sample, demographic features were compared to the 2016 Australian Bureau of Statistics Census of Population and Housing. RESULTS: Thirty-two services assisted with data collection. Many contacts (1217) were made by the research team to recruit organisations to the study (emails: n = 610; phone calls: n = 539; texts n = 33; meetings: n = 34, and one Facebook message). Surveys were completed by 706 individuals - equating to more than one third of the local population (37.9%). Of these, half were women (52.5%), and the average age was 37.8 years. Sample characteristics were comparable with the 2016 Census in relation to gender, age, weekly individual income, Indigenous language spoken at home and educational attainment. CONCLUSION: Elements key to recruitment included: 1) stratified sampling with multi-site, service-based recruitment, as well as data collection events in public spaces; 2) local services' involvement in developing and refining the sampling strategy; and 3) expertise and local relationships of local Aboriginal research assistants, including health professionals from the local Aboriginal health and drug and alcohol services. This strategy was able to reach a range of individuals, including those usually excluded from alcohol surveys (i.e. with no fixed address). Carefully pre-planned stratified convenience sampling organised in collaboration with local Aboriginal health staff was central to the approach taken.


Assuntos
Serviços de Saúde do Indígena , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Austrália/epidemiologia , Feminino , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico , Austrália do Sul
9.
BMC Fam Pract ; 21(1): 33, 2020 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-32054450

RESUMO

BACKGROUND: Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. The Continuing Quality Improvement (CQI) process is designed to enable services to detect barriers, then devise and implement changes, resulting in service improvements. METHODS: We conducted a systematic review of literature reporting on strategies to improve implementation of screening and interventions for unhealthy alcohol use in primary care (MEDLINE EMBASE, PsycINFO, CINAHL, the Australian Indigenous Health InfoNet). Additional inclusion criteria were: (1) pragmatic setting; (2) reporting original data; (3) quantitative outcomes related to provision of service or change in practice. We investigate the extent to which the three essential elements of CQI are being used (data-guided activities, considering local conditions; iterative development). We compare characteristics of programs that include these three elements with those that do not. We describe the types, organizational levels (e.g. health service, practice, clinician), duration of strategies, and their outcomes. RESULTS: Fifty-six papers representing 45 projects were included. Of these, 24 papers were randomized controlled trials, 12 controlled studies and 20 before/after and other designs. Most reported on strategies for improving implementation of screening and brief intervention. Only six addressed relapse prevention pharmacotherapies. Only five reported on patient outcomes and none showed significant improvement. The three essential CQI elements were clearly identifiable in 12 reports. More studies with three essential CQI elements had implementation and follow-up durations above the median; utilised multifaceted designs; targeted both practice and health system levels; improved screening and brief intervention than studies without the CQI elements. CONCLUSION: Utilizing CQI methods in implementation research would appear to be well-suited to drive improvements in service delivery for unhealthy alcohol use. However, the body of literature describing such studies is still small. More well-designed research, including hybrid studies of both implementation and patient outcomes, will be needed to draw clearer conclusions on the optimal approach for implementing screening and treatment for unhealthy alcohol use. (PROSPERO registration ID: CRD42018110475).


Assuntos
Alcoolismo/diagnóstico , Alcoolismo/terapia , Atenção Primária à Saúde , Melhoria de Qualidade , Gestão da Qualidade Total , Consumo de Bebidas Alcoólicas , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Transtornos Relacionados ao Uso de Álcool/terapia , Humanos , Ciência da Implementação , Programas de Rastreamento
10.
Nano Lett ; 19(2): 1112-1117, 2019 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-30698977

RESUMO

In pursuit of the elusive mechanism of high- T C superconductors (HTSC), spectroscopic imaging scanning tunneling microscopy (SI-STM) is an indispensable tool for surveying local properties of HTSC. Since a conventional STM utilizes metal tips, which allow the examination of only quasiparticles and not superconducting (SC) pairs, Josephson tunneling using STM has been demonstrated by many authors in the past. An atomically resolved scanning Josephson tunneling microscopy (SJTM), however, was realized only recently on Bi2Sr2CaCu2O8+ x (Bi-2212) below 50 mK and on the Pb(110) surface at 20 mK. Here we report the atomically resolved SJTM on Bi2Sr2CaCu2O8+ x at 4.2 K using Bi-2212 tips created in situ. The I- V characteristics show clear zero bias conductance peaks following Ambegaokar-Baratoff (AB) theory. A gap map was produced for the first time using an atomically resolved Josephson critical current map I C( r) and AB theory. Surprisingly, we found that this new gap map is anticorrelated to the gap map produced by a conventional method relying on the coherence peaks. Quasiparticle resonance due to a single isolated zinc atom impurity was also observed by SJTM, indicating that atomically resolved SJTM was achieved at 4.2 K. Our result provides a starting point for realizing SJTM at even higher temperatures, rendering possible investigation of the existence of SC pairs in HTSC above the T C.

12.
BMC Med Inform Decis Mak ; 19(1): 180, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31488135

RESUMO

BACKGROUND: The Grog Survey App is a visual and interactive tablet computer-based survey application. It has been shown to be an accurate and acceptable tool to help Indigenous Australians describe what they drink. METHODS: The Grog Survey App was used to enquire into patterns of drinking in a stratified sample of Indigenous Australians in urban and remote/regional sites during testing of the App. The App asked about the last four drinking occasions in the past 12 months, including preferred alcohol types and containers; and symptoms of alcohol dependence, based on ICD-11 descriptions. Drinking patterns are presented here using medians and interquartile ranges, and the thresholds set out by the Australian National and Health and Medical Research Council guidelines. Patterns of consumption are compared by gender and remoteness, using Wilcoxon rank-sum test to compare medians. Logistic regressions tested whether alcohol types and drinking containers varied by remoteness. RESULTS: In this stratified sample most people either consumed nothing (21.7%), or consumed quantities which placed them at short- (95.6%) or long-term risk (47.8%) of harms. Drinkers in remote areas were more likely to drink beer, but less likely to drink pre-mixed spirits. 'Stubbies' and other beer glasses were popular in urban areas, compared with 'slabs' (cases of beer) in remote/regional areas. The use of improvised containers (i.e. empty juice bottles) did not vary by remoteness. Nearly one in six (15%) current drinkers reported experiencing at least two symptoms of alcohol dependence at least monthly. Average drinks per day was the consumption measure most highly correlated with each dependence symptom (r = 0.34-0.38). CONCLUSIONS: The App was able to capture a wide range of preferred alcohol types and containers, and demonstrate a diversity in how alcohol is consumed. This detail was captured in a relative brief survey delivered using an interactive and appealing tablet computer-based application.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Havaiano Nativo ou Outro Ilhéu do Pacífico , Autorrelato , Software , Adulto , Austrália , Computadores de Mão , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Projetos de Pesquisa
13.
BMC Med Inform Decis Mak ; 18(1): 8, 2018 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-29334962

RESUMO

BACKGROUND: The challenges of assessing alcohol consumption can be greater in Indigenous communities where there may be culturally distinct approaches to communication, sharing of drinking containers and episodic patterns of drinking. This paper discusses the processes used to develop a tablet computer-based application ('App') to collect a detailed assessment of drinking patterns in Indigenous Australians. The key features of the resulting App are described. METHODS: An iterative consultation process was used (instead of one-off focus groups), with Indigenous cultural experts and clinical experts. Regular (weekly or more) advice was sought over a 12-month period from Indigenous community leaders and from a range of Indigenous and non-Indigenous health professionals and researchers. RESULTS: The underpinning principles, selected survey items, and key technical features of the App are described. Features include culturally appropriate questioning style and gender-specific voice and images; community-recognised events used as reference points to 'anchor' time periods; 'translation' to colloquial English and (for audio) to traditional language; interactive visual approaches to estimate quantity of drinking; images of specific brands of alcohol, rather than abstract description of alcohol type (e.g. 'spirits'); images of make-shift drinking containers; option to estimate consumption based on the individual's share of what the group drank. CONCLUSIONS: With any survey platform, helping participants to accurately reflect on and report their drinking presents a challenge. The availability of interactive, tablet-based technologies enables potential bridging of differences in culture and lifestyle and enhanced reporting.


Assuntos
Consumo de Bebidas Alcoólicas , Aplicativos Móveis , Havaiano Nativo ou Outro Ilhéu do Pacífico , Autorrelato , Consumo de Bebidas Alcoólicas/etnologia , Austrália/etnologia , Computadores de Mão , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico/etnologia , Design de Software
14.
BMC Med Inform Decis Mak ; 18(1): 26, 2018 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-29720186

RESUMO

After publication of the original article [1] it was noted that the name of author, Peter Jack, was erroneously typeset in both the PDF and online formats of the manuscript as Peter Jack GradDipIndigH.

16.
Eur J Neurol ; 24(2): 349-356, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27888574

RESUMO

BACKGROUND AND PURPOSE: Reduction of metaiodobenzylguanidine (MIBG) uptake has been observed in almost all patients with Parkinson's disease (PD), associated with hyposmia, orthostatic hypotension and rapid eye movement sleep behavioral disorder (RBD). In contrast, a subgroup of patients with PD with normal MIBG uptake have been reported to have milder disease and preserved cognition compared with those with lower MIBG. The aim of this study was to investigate whether non-motor manifestations of PD differ between patients with normal and abnormal myocardial MIBG uptake. METHODS: Among 160 de-novo cases of PD, 44 had normal MIBG uptake. Twelve candidate non-motor features were evaluated using questionnaires and laboratory tests. RESULTS: Patients with decreased MIBG uptake had more constipation, RBD, cognitive impairment, hyposmia and orthostatic hypotension than did those with normal MIBG uptake. On linear regression analysis, orthostatic hypotension, olfactory function and probable RBD were significantly associated with MIBG uptake in PD. The principal component analysis showed that the group with normal MIBG was not associated with non-motor impairments. CONCLUSIONS: These results suggest that patients with PD with normal MIBG scans have a relatively low disease burden compared with those with abnormal MIBG. Fewer synuclein pathologies in the myocardia and sympathetic ganglia in PD with preserved MIBG uptake might be associated with lower threshold patterns of Braak synuclein pathology for non-motor manifestations compared with PD with decreased MIBG.


Assuntos
Coração/diagnóstico por imagem , Doença de Parkinson/diagnóstico por imagem , 3-Iodobenzilguanidina/metabolismo , Idoso , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Constipação Intestinal/etiologia , Efeitos Psicossociais da Doença , Feminino , Humanos , Hipotensão Ortostática/etiologia , Hipotensão Ortostática/fisiopatologia , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/etiologia , Transtornos do Olfato/fisiopatologia , Doença de Parkinson/complicações , Tomografia por Emissão de Pósitrons , Transtorno do Comportamento do Sono REM/etiologia , Compostos Radiofarmacêuticos/metabolismo
17.
Community Dent Health ; 34(2): 88-92, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28573838

RESUMO

OBJECTIVE: To investigate the relationship between mental health risk factors and Korean adolescents' oral health. BASIC RESEARCH DESIGN: Cross-sectional study was based on the 9th Korea Youth Risk Behavior Web-based Survey (2013). PARTICIPANTS: Data were selected for 66,951 adolescents (33,777 males and 33,174 females; aged 13-18 years) out of 72,435 participants were analysed, after excluding cases with missing values. MAIN OUTCOME MEASURES: Oral health (experience of one or more of six oral symptoms), demographic characteristics (seven factors), and mental health risk (five factors). METHOD: Logistic regression analysis determined the effects of mental health risk factors on subjects' oral symptoms after adjustment for general characteristics. RESULTS: The adjusted odds ratio (AOR) was 1.52 (95%CI 1.50,1.54) for sleep satisfaction self-described as "not sufficient at all" and AOR 2.64 (95%CI 2.59,2.69) for those reporting very high stress levels. The AOR was 1.26 times (95%CI 1.24,1.27) higher for those using the internet on weekends for non-study purposes for ⟩6 hours than those using it for one hour. The AOR for experiencing oral symptoms was 1.44 times (95%CI 1.41,1.47) higher for those who had experienced school violence than for those who had not. CONCLUSIONS: Mental health risk factors were associated with oral symptoms. These results should inform the development of school health policies and comprehensive adolescent health promotion programs in Korea.


Assuntos
Saúde Mental , Doenças da Boca/epidemiologia , Saúde Bucal , Adolescente , Comportamento do Adolescente , Feminino , Inquéritos Epidemiológicos , Humanos , Internet , Masculino , República da Coreia , Fatores de Risco
18.
Community Dent Health ; 34(3): 183-189, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28872814

RESUMO

OBJECTIVE: This study aimed to investigate excessive Internet use's (EIU's) association with oral health behaviors among Korean adolescents. BASIC RESEARCH DESIGN: This cross-sectional study was based on the 11th Korea Youth Risk Behavior Web-based Survey (2015). PARTICIPANTS: 68,043 school students aged 13-18 years (35,204 boys and 32,839 girls). Data on, 45,271 (23,354 males and 21,917 females using the Internet on weekdays) and 49,324 (27,448 males and 21,876 females using the Internet on weekends) were analyzed after excluding questionnaires with missing values. MAIN OUTCOME MEASURES: The key variables were oral health behaviors (tooth-brushing frequency and tooth brushing after lunch at school, and preventive oral health behaviors), EIU (hours of Internet use on weekdays and weekends, excluding use for academic purposes). RESULTS: Compared to the general groups, the odds ratio (OR) for less tooth-brushing was 4.04 (95%CI=2.990-5.459) and 3.55-fold higher (95% CI=2.703-4.659) in the high-risk groups for weekday and weekend EIU, respectively. For post-lunch tooth-brushing, compared to the general groups, the OR for less tooth-brushing was 1.7-fold higher in the high-risk groups for EIU during weekdays and weekends. The OR for no preventive behavior was significantly higher in the high-risk groups than in the potential-risk and general groups. CONCLUSIONS: Policies moderating adolescents' EIU may enable appropriate oral health behaviors.


Assuntos
Comportamentos Relacionados com a Saúde , Internet , Saúde Bucal , Adolescente , Comportamento do Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , República da Coreia , Inquéritos e Questionários
19.
Ann Oncol ; 27(5): 828-33, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26823524

RESUMO

BACKGROUND: We aimed to develop a prediction model to identify long-term survivors after developing distant metastasis from breast cancer. PATIENTS AND METHODS: From the institution's database, we collected data of 547 patients who developed distant metastasis during their follow-ups. We developed a model that predicts the post-metastasis overall survival (PMOS) based on the clinicopathologic factors of the primary tumors and the characteristics of the distant metastasis. For validation, the survival data of 254 patients from four independent institutions were used. RESULTS: The median duration of the PMOS was 31.0 months. The characteristics of the initial primary tumor, such as tumor stage, hormone receptor status, and Ki-67 expression level, and the characteristics of the distant metastasis presentation including the duration of disease-free interval, the site of metastasis, and the presence of metastasis-related symptoms were independent prognostic factors determining the PMOS. The association between tumor stage and the PMOS was only seen in tumors with early relapses. The PMOS score, which was developed based on the above six factors, successfully identified patients with superior survival after metastasis. The median PMOS for patients with a PMOS score of <2 and for patients with a PMOS score of >5 were 71.0 and 12 months, respectively. The clinical significance of the PMOS score was further validated using independent multicenter datasets. CONCLUSIONS: We have developed a novel prediction model that can classify breast cancer patients with distant metastasis according to their survival after metastasis. Our model can be a valuable tool to identify long-term survivors who can be potential candidates for more intensive multidisciplinary approaches. Furthermore, our model can provide a more reliable survival information for both physicians and patients during their informed decision-making process.


Assuntos
Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer , Prognóstico , Adulto , Idoso , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Receptor alfa de Estrogênio/genética , Feminino , Humanos , Antígeno Ki-67/genética , Metástase Linfática/genética , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Receptores de Progesterona/genética
20.
J Viral Hepat ; 23(5): 358-65, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26864153

RESUMO

In Korea, patients with chronic hepatitis C virus (HCV) infection are typically treated with pegylated interferon-alpha plus ribavirin, but interferons are contraindicated in many patients and are often poorly tolerated, particularly by the elderly and those with advanced liver disease. No interferon-free treatment regimens are approved in Korea. Sofosbuvir is an oral nucleotide analog inhibitor of the HCV nonstructural 5B RNA polymerase. It is approved in the USA, European Union and Japan for treating a number of HCV genotypes, including genotype 2. Genotype 2 has a seroprevalence of 38-46% in Korea. This single-arm, phase 3b study (NCT02021643) examined the efficacy and safety of sofosbuvir plus ribavirin (12-week duration) in chronic genotype 2 HCV-infected treatment-naive and treatment-experienced Korean patients with and without cirrhosis. The proportion of patients with sustained virologic response 12 weeks after treatment discontinuation (SVR12) was 97% (125/129), with 96% (101/105) of treatment-naive and 100% (24/24) of treatment-experienced patients achieving SVR12. Two patients experienced virologic failure (n = 1, on-treatment failure; n = 1, relapse). No patient discontinued study treatment due to an adverse event (AE). The most common treatment-emergent AEs were headache (18%, 23/129) and pruritus (15%, 19/129). Few patients had grade 3 AEs (5%, 6/129) or grade 3 laboratory abnormalities (12%, 15/129). No grade 4 AE was reported. These data suggest that 12 weeks of treatment with the all-oral, interferon-free regimen of sofosbuvir plus ribavirin is effective and well tolerated in Korean patients with chronic genotype 2 HCV infection.


Assuntos
Antivirais/uso terapêutico , Genótipo , Hepacivirus/isolamento & purificação , Hepatite C Crônica/tratamento farmacológico , Ribavirina/uso terapêutico , Sofosbuvir/uso terapêutico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antivirais/efeitos adversos , Povo Asiático , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Hepacivirus/classificação , Hepacivirus/genética , Humanos , Masculino , Pessoa de Meia-Idade , Ribavirina/efeitos adversos , Sofosbuvir/efeitos adversos , Resultado do Tratamento , Carga Viral , Adulto Jovem
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