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1.
Lancet ; 402(10410): 1382-1392, 2023 10 14.
Article in English | MEDLINE | ID: mdl-37838443

ABSTRACT

The future of work is rapidly changing, with higher flexibility of the labour market and increasing informal employment in many countries worldwide. There is also an increased pressure to extend working careers until older age. We introduce the concept of working life expectancy as a useful metric, capturing the expected numer of years in paid employment across the working age individuals, in particular among different groups. We describe factors that determine working life expectancy. Macro-level factors focus on the socioeconomic and political context that influences labour force participation, primarily policies and legislation in specific countries. At the meso level, employment contracts and working conditions are important. The micro level shows that individual characteristics, such as education, gender, and age, influence working careers. There are three important groups with a disadvantaged position in the labour market-workers with chronic diseases, workers with impairing disabilities, and workers aged 50 years or more. Within each of these disadvantaged groups, macro-level, meso-level, and micro-level factors that influence entering and exiting paid employment are discussed. To assure that paid employment is available for everyone of working age and that work contributes to better health, specific challenges need to be addressed at the macro, meso, and micro levels. To reach inclusive labour force participation, national policies, company practices, and workplace improvements need to be aligned to ensure safe and healthy workplaces that contribute to the health and wellbeing of workers and their communities.


Subject(s)
Employment , Workplace , Humans , Occupations , Health Status , Educational Status
2.
Brain Behav ; 13(2): e2891, 2023 02.
Article in English | MEDLINE | ID: mdl-36706022

ABSTRACT

OBJECTIVE: The aim of this study is to compare a portable ultrasound (US) device and a traditional US for performing transcranial ultrasonography (CCT) in patients with Parkinson's disease (PD). METHODS: This is a cross-sectional, observational, and analytical study. The study recruited a total of 129 individuals from two public hospitals in the city of Rio de Janeiro in a prospective and non-randomized manner between September 2019 and July 2021 as follows: group A with 31 patients with PD, group B with 65 patients with PD, and group C with 64 healthy individuals. Group A was used to collect data to establish the agreement analysis of the TCS measurements between the two devices. Groups B and C provided data for constructing the receiver operating characteristic curve for the handheld US. The subjects underwent the assessment of the transtemporal bone window (TW) quality, the mesencephalon area, the size of the third ventricle, and the substantia nigra (SN) hyperechogenicity area. RESULTS: There was a good agreement between the methods regarding the quality of the TW-Kappa concordance coefficient of 100% for the right TW and 83% for the left, the midbrain area-intraclass correlation coefficient (ICC) of 69%, the SN area ICC = 90% for the right SN and 93% for the left and the size of the third ventricle ICC = 96%. The cutoff point for the SN echogenic area in the handheld US was 0.20 cm2 . CONCLUSIONS: The handheld US is a viable imaging method for performing TCS because it shows good agreement with the measurements performed with traditional equipment, and the measurement of SN echogenic area for PD diagnosis presents good sensitivity and specificity.


Subject(s)
Parkinson Disease , Humans , Parkinson Disease/diagnostic imaging , Cross-Sectional Studies , Prospective Studies , Ultrasonography, Doppler, Transcranial/methods , Brazil , Substantia Nigra/diagnostic imaging , Ultrasonography
3.
Saudi J Anaesth ; 14(2): 231-234, 2020.
Article in English | MEDLINE | ID: mdl-32317882

ABSTRACT

The epidural block is an anesthetic procedure that can have possible complications upon insertion or removal. Epidural catheter retention is a rare complication; its etiology may come from lateral migration with kinking of the catheter or from involvement with bone, ligamentous, muscular, vascular structures, or nerve roots. Up until today, there is not a standard approach to this complication; however, there are some recommendations for the management of retained epidural catheters. Here, we describe a case report of epidural catheter retention, in which we followed the published recommendations. Although computed tomography scanning may be the best option to visualize the anatomical position of the distal extremity of an epidural catheter, with this case report we intend to reinforce the fundamental contribution of the contrast radiograph in the successful catheter removal. Posteriorly, a protocol for clinical orientation of epidural catheter retention was developed in our institution.

4.
Free Radic Res ; 50(11): 1257-1264, 2016.
Article in English | MEDLINE | ID: mdl-27607739

ABSTRACT

The clinical implications of the nitrate-nitrite-nitric oxide pathway have been extensively studied in recent years. However, the physiological impact of bioactive nitrogen oxides produced from dietary nitrate has remained largely elusive. Here, we report a hitherto unrecognized nitrite-dependent nitrating pathway that targets tight junction proteins in the stomach. Inorganic nitrate, nitrite or saliva obtained after the consumption of lettuce were administered by oral gavage to Wistar rats. The enterosalivary circulation of nitrate was allowed to occur for 4 h after which the animals were euthanized and the stomach collected. Nitrated occludin was detected by immunoprecipitation in the gastric epithelium upon inorganic nitrite administration (p < .05) but was not observed in the case of inorganic nitrate or human saliva administration. This observation, along with differences in •NO production rates from inorganic and salivary nitrite under simulated gastric conditions, suggests that competing reactions at acidic pH determine the production of nitrating agents (•NO2) or other, more stable, oxides. Accordingly, it is shown in vitro that salivary nitrite yields higher steady state concentrations of •NO (0.37 ± 0.01 µM) than sodium nitrite (0.12 ± 0.03 µM). Dietary-dependent reactions involving the production of nitrogen oxides should be further investigated as, in the context of occludin nitration, the consumption of green leafy vegetables (with high nitrate content), if able to modulate gut barrier function, may have important implications in the context of leaky gut disorders.


Subject(s)
Nitrates/metabolism , Nitrites/metabolism , Occludin/metabolism , Adult , Animals , Healthy Volunteers , Humans , Male , Rats , Rats, Wistar
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