Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 421
Filtrar
1.
Int J Drug Policy ; 129: 104465, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38843736

RESUMO

BACKGROUND: During COVID-19, hospitality businesses (e.g. bars, restaurants) were closed/restricted whilst off-sales of alcohol increased, with health consequences. Post-covid, governments face lobbying to support such businesses, but many health services remain under pressure. We appraised 'sweetspot' policy options: those with potential to benefit public services and health, whilst avoiding or minimising negative impact on the hospitality sector. METHODS: We conducted rapid non-systematic evidence reviews using index papers, citation searches and team knowledge to summarise the literature relating to four possible 'sweetspot' policy areas: pricing interventions (9 systematic reviews (SR); 14 papers/reports); regulation of online sales (1 SR; 1 paper); place-shaping (2 SRs; 18 papers/reports); and violence reduction initiatives (9 SRs; 24 papers/reports); and led two expert workshops (n = 11). RESULTS: Interventions that raise the price of cheaper shop-bought alcohol appear promising as 'sweetspot' policies; any impact on hospitality is likely small and potentially positive. Restrictions on online sales such as speed or timing of delivery may reduce harm and diversion of consumption from on-trade to home settings. Place-shaping is not well-supported by evidence and experts were sceptical. Reduced late-night trading hours likely reduce violence; evidence of impact on hospitality is scant. Other violence reduction initiatives may modestly reduce harms whilst supporting hospitality, but require resources to deliver multiple measures simultaneously in partnership. CONCLUSIONS: Available evidence and expert views point to regulation of pricing and online sales as having greatest potential as 'sweetspot' alcohol policies, reducing alcohol harm whilst minimising negative impact on hospitality businesses.

2.
Res Pract Thromb Haemost ; 8(4): 102417, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38859949

RESUMO

Background: The Accelerating COVID-19 Therapeutic Interventions and Vaccines-4c (ACTIV-4c) trial investigated prophylactic apixaban for 30 days following hospitalization for COVID-19. The overall incidence of early postdischarge death or thromboembolism was low, and the trial was closed early. Objectives: To identify a high-risk patient population who might benefit from postdischarge thromboprophylaxis through subgroup analyses stratified by age, race/ethnicity, obesity, D-dimer elevation, World Health Organization score, and modified International Medical Prevention Registry on Venous Thromboembolism score on 30-day composite outcome of all-cause death, arterial thromboembolism (ATE), and venous thromboembolism (VTE). Methods: Cumulative incidences of all-cause death, ATE, and VTE within 30 days were described for each subgroup. Time to death, ATE, or VTE by 30 days was analyzed using Cox proportional hazard models with interaction testing for each subgroup. Results: Among 1217 patients randomized to apixaban or placebo group, 32% were >60 years old. Modified International Medical Prevention Registry on Venous Thromboembolism score was ≥4 in 2% and 2 or 3 with an elevated D-dimer in an additional 9% of participants. The overall incidence of the primary endpoint was 2.13% in the apixaban group and 2.31% in the placebo group. At day 30, similar rates of the primary endpoint occurred within subgroups, except for participants aged >60 years. No benefit of thromboprophylaxis was seen in any subgroup. Conclusion: The combined incidence of 30-day death, ATE, and VTE was low in patients who survived COVID-19 hospitalization, except in patients over age 60 years. Due to the limited number of events, the findings remain inconclusive; nonetheless, the study did not identify a high-risk subgroup that would derive benefits from extended thromboprophylaxis.

3.
bioRxiv ; 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38826457

RESUMO

Protein phosphatase, Mg2+/Mn2+ dependent 1D (PPM1D), is a serine/threonine phosphatase that is recurrently activated in cancer, regulates the DNA damage response (DDR), and suppresses the activation of p53. Consistent with its oncogenic properties, genetic loss or pharmacologic inhibition of PPM1D impairs tumor growth and sensitizes cancer cells to cytotoxic therapies in a wide range of preclinical models. Given the therapeutic potential of targeting PPM1D specifically and the DDR and p53 pathway more generally, we sought to deepen our biological understanding of PPM1D as a drug target and determine how PPM1D inhibition differs from other therapeutic approaches to activate the DDR. We performed a high throughput screen to identify new allosteric inhibitors of PPM1D, then generated and optimized a suite of enzymatic, cell-based, and in vivo pharmacokinetic and pharmacodynamic assays to drive medicinal chemistry efforts and to further interrogate the biology of PPM1D. Importantly, this drug discovery platform can be readily adapted to broadly study the DDR and p53. We identified compounds distinct from previously reported allosteric inhibitors and showed in vivo on-target activity. Our data suggest that the biological effects of inhibiting PPM1D are distinct from inhibitors of the MDM2-p53 interaction and standard cytotoxic chemotherapies. These differences also highlight the potential therapeutic contexts in which targeting PPM1D would be most valuable. Therefore, our studies have identified a series of new PPM1D inhibitors, generated a suite of in vitro and in vivo assays that can be broadly used to interrogate the DDR, and provided important new insights into PPM1D as a drug target.

4.
Arch Sex Behav ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724700

RESUMO

Sexual harm within nightlife settings is a pervasive global concern; however, little is known about the nature of available interventions. The current study aims to review the literature on the nature and effectiveness of nightlife-related sexual harm interventions. A systematic literature search of six databases was conducted to identify records that were published between 1970 and June 2023 and reported approaches that aimed to reduce or prevent nightlife-related sexual harm. Records were included if they theorized, discussed, or evaluated an intervention, prevention or response strategy; however, individual safety strategies were excluded. Results were categorized according to intervention type. Thirty-five peer-reviewed journal articles and 16 gray literature records were identified. The most common nightlife-related sexual harm intervention strategies covered by the literature included targeted policies, laws, and regulations, bystander interventions, and awareness-raising campaigns. Literature in the area is increasing, with the majority of the articles (77.1%) being published in the previous six years; however, there are very few interventions that have been critically evaluated (22.9%). Promising areas for intervention include targeted alcohol regulations (e.g., lockout policies), venue-level policies, and environmental interventions. However, an increase in rigorous evaluative practices is urgently required to ensure future interventions are based on sound theoretical work and empirical evidence.

5.
J Stud Alcohol Drugs ; 2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38775318

RESUMO

OBJECTIVE: With same day online alcohol sales increasing, there is a need to study their regulation. Test purchasing of alcohol home delivery was conducted to measure compliance with regulations for identification checks and unattended deliveries in two Australian jurisdictions (Perth, Western Australia and Geelong, Victoria), which have differing regulations. METHOD: Alcohol orders for same day or rapid (<2 hours) delivery on Friday and Saturday nights were made by research assistants aged 18-24 years in Perth (n=34) and Geelong (n=29). An observation checklist was used to record the delivery interaction, with a specific focus on checking of photo identification at time of delivery and whether deliveries were left unattended. RESULTS: Average time from order to delivery for rapid deliveries was less than one hour in both sites (Perth = 50 minutes; Geelong = 36 minutes). More than 20% of deliveries were made without an identification check in both sites (Perth = 24%; Geelong = 21%). CONCLUSIONS: This pilot study showed alcohol can be delivered to the home within one hour, and not all deliveries include an identification check at point of delivery. These findings indicate a need for policies that empower regulators and police to undertake 'mystery shopper' monitoring to reduce potential harms and improve compliance with alcohol delivery policy.

6.
Int J Drug Policy ; 127: 104426, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38640706

RESUMO

BACKGROUND: During 2017-18, the Northern Territory (NT) introduced a Banned Drinker Register (BDR) and Minimum Unit Price (MUP) NT-wide; Police Auxiliary Liquor Inspectors (PALIs) in three regional towns; and restrictions on daily purchases/opening hours (DPOH) in one regional town. The BDR is an individual-level alcohol ban; MUP is a pricing policy; and PALIs enforce bans on restricted areas at takeaway outlets. This study examines the impact of these policies on adult domestic and family violence (DFV). METHODS: We examined DFV assaults and breaches of violence orders from January 2014 - February 2020 using interrupted time series models for NT, Greater Darwin, Katherine, Tennant Creek, and Alice Springs. To account for increasing numbers of individuals on the BDR we tested two timepoints (Sept 2017, March 2018). FINDINGS: Following DPOH, assaults (78 %) and alcohol-involved assaults (92 %) decreased in Tennant Creek. After PALIs, assaults (79 %) in Tennant Creek, and breaches (39 %) and alcohol-involved breaches (58 %) in Katherine decreased. After MUP, assaults (11 %), alcohol-involved assaults (21 %) and alcohol-involved breaches (21%) decreased NT wide. After MUP/PALIs in Alice Springs, alcohol-involved assaults (33 %), breaches (42 %), and alcohol-involved breaches (57 %) decreased. BDR (Sept 2017) found increases in assaults (44 %) and alcohol-involved assaults (39 %) in Katherine and assaults (10%) and alcohol-involved assaults NT-wide (17 %). There were increases of 21 %-45 % in breaches NT-wide, in Darwin, Katherine, and Alice Springs. Following March 2018 found increases in assaults (33 %) and alcohol-involved assaults (48 %) in Katherine. There were increases - from 20 % to 56 % - in breaches in NT-wide, Katherine, and Alice Springs. CONCLUSION: PALIs and DPOH were associated with some reductions in DFV; the BDR was associated with some increases. The upward trend commences prior to the BDR, so it is also plausible that the BDR had no effect on DFV outcomes. Although MUP was associated with reductions in the NT-wide model, there were no changes in sites without cooccurring PALIs.


Assuntos
Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Violência Doméstica , Polícia , Humanos , Northern Territory/epidemiologia , Consumo de Bebidas Alcoólicas/epidemiologia , Bebidas Alcoólicas/provisão & distribuição , Bebidas Alcoólicas/economia , Adulto , Violência Doméstica/estatística & dados numéricos , Feminino , Comércio/estatística & dados numéricos , Comércio/legislação & jurisprudência , Masculino , Análise de Séries Temporais Interrompida
8.
Drug Alcohol Rev ; 43(2): 529-538, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38231668

RESUMO

INTRODUCTION: In September 2017 the Northern Territory Government of Australia introduced a banned drinker register (BDR) to mitigate the high levels of alcohol-related harm within the Northern Territory. The current study aimed to examine the impact of the Northern Territory BDR on youth (aged <18 years) using police recorded assault data. METHODS: Interrupted time-series models were used to assess monthly trends in assaults and alcohol-related assaults perpetration and victimisation in the regions of Greater Darwin, Alice Springs and Katherine between January 2014 and December 2019. RESULTS: Examining the three regions combined, after the re-introduction of the BDR a significant step decrease in police recorded youth assault perpetration (ß = -1.67) and a significant step increase in police recorded youth assault victimisation (ß = 1.40) was identified. However, no significant effects were identified at the individual region level. DISCUSSION AND CONCLUSIONS: Findings suggest that restricting alcohol consumption in high-risk adults through the BDR had a limited immediate effect in police recorded youth assaults. Individual level or contextual factors may have influenced both immediate and long-term impacts of the BDR, and as such, future policy design needs to support and empower community leaders across the policy development and implementation process. A wider evaluation of the BDR currently underway may provide additional understanding behind the mechanisms that underpin alcohol-related harm in the Northern Territory.


Assuntos
Vítimas de Crime , Violência , Adulto , Humanos , Adolescente , Northern Territory/epidemiologia , Polícia , Consumo de Bebidas Alcoólicas/epidemiologia
9.
J Clin Oncol ; : JCO2301071, 2024 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-38190580

RESUMO

PURPOSE: Clonal hematopoiesis of indeterminate potential (CHIP) is frequent in patients with solid tumors. Prospective data about CHIP prevalence at breast cancer diagnosis and its dynamic evolution under treatment selective pressure are limited. PATIENTS AND METHODS: We performed targeted error-corrected sequencing on 614 samples from 380 patients with breast cancer. We investigated the dynamics of CHIP on prospectively collected paired samples from patients with early breast cancer (eBC) receiving chemotherapy (CT) or endocrine therapy (ET). We assessed the correlation of CHIP with survival in patients with metastatic triple-negative breast cancer (mTNBC). We estimated the risk of progression to treatment-related myeloid neoplasms (t-MN) according to the clonal hematopoiesis risk score (CHRS). In exploratory analyses, we considered clonal hematopoiesis (CH) with variant allele fraction (VAF) ≥0.005. RESULTS: CHIP was identified in 15% of patients before treatment. Few CHIP emerged after treatment, and the risk of developing new mutations was similar for patients receiving CT versus ET (odds ratio [OR], 1.16; P = .820). However, CT increased the risk of developing new CH with VAF ≥0.005 (OR, 3.45; P = .002). Five TP53-mutant CH with VAF ≥0.005 emerged among patients receiving CT. Most patients had low risk of t-MN according to the CHRS score. CHIP did not correlate with survival in mTNBC. CONCLUSION: CHIP is frequent in patients with breast cancer. In this study, CT did not lead to emergence of new CHIP, and most patients had low risk of developing t-MN. This finding is reassuring, given long life expectancy of patients with eBC and the association of CHIP with morbidity and mortality. However, TP53-mutant CH with VAF ≥0.005 emerged with CT, which carries high risk of t-MN. Evolution of these small clones and their clinical significance warrant further investigation.

10.
Drug Alcohol Rev ; 43(2): 407-415, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38048164

RESUMO

INTRODUCTION: Variation in alcohol availability is an important driver of levels of consumption and harm, with recent increases in online alcohol home delivery use expanding availability. There is limited research on the impacts of these changes and the characteristics of consumers who use alcohol home delivery. METHODS: This study presents findings from an online survey (n = 465) of Western Australian adults who had purchased alcohol for home delivery within the past 6 months. Analyses compared high-risk and low-risk drinkers on use of, and exposure to, alcohol home delivery. RESULTS: Compared to low-risk drinkers, high-risk drinkers were significantly more likely to make more frequent online purchases (odds ratio 5.42), utilise same day delivery (odds ratio 2.91) and purchase through specialised online-only retailers (odds ratio 2.69). High-risk drinkers also reported receiving deliveries while intoxicated more often (odds ratio 11.62), and ordering alcohol for delivery to continue a current drinking session (odds ratio 7.47). High-risk drinkers also received advertising for alcohol home delivery more frequently (odds ratio 1.60) than low-risk drinkers. High-risk drinkers also ordered larger quantities of alcohol than low-risk drinkers (M = 49 vs. 32 standard drinks). DISCUSSION AND CONCLUSIONS: Findings from this study indicate that these services are popular with high-risk drinkers and potentially undermine other policy efforts to reduce drinking. Within Australia, stronger legislation (such as mandatory delay between order and delivery) and monitoring (e.g., test purchasing for compliance) are recommended.


Assuntos
Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Adulto , Humanos , Consumo de Bebidas Alcoólicas/epidemiologia , Austrália Ocidental/epidemiologia , Austrália , Risco
11.
Drug Alcohol Rev ; 43(2): 519-528, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38055335

RESUMO

INTRODUCTION: Between 2017 and 2018 three major alcohol policy changes were introduced in the Northern Territory (NT): the Banned Drinker Register, an individual-level ban enforced via ID scanners at takeaway outlets; a Minimum Unit Price on alcohol; and Police Auxiliary Liquor Inspectors, who monitor takeaway outlets to prevent purchase by people who do not have a legal place to consume alcohol. We aimed to: (i) describe alcohol-involved adult sexual assault in the NT; and (ii) estimate the impacts of these alcohol policies on police-recorded adult sexual assault. METHODS: We used victim records for sexual assault where victims were aged 15 years and over. We undertook descriptive analyses for the NT from 2014 to 2020 and used interrupted time series analysis to assess policy impacts across the NT and in Greater Darwin. RESULTS: In 2020, the NT adult victimisation rate was 105 per 100,000. A large minority (40%) of adult sexual assaults involved alcohol. Interrupted time series analyses showed no effect of the Banned Drinker Register or Minimum Unit Price on sexual assault across the NT or in Greater Darwin. DISCUSSION AND CONCLUSIONS: The rate of adult sexual assaults in the NT is extremely high and many involve alcohol. Neither the Banned Drinker Register or Minimum Unit Price were associated with changes in police-recorded adult sexual assault in Greater Darwin or across the NT. Due to small counts, we were unable to assess policy impacts in three of the four main towns, highlighting the challenges of assessing impacts of policies on sexual assault in small population areas.


Assuntos
Vítimas de Crime , Delitos Sexuais , Adulto , Humanos , Polícia , Northern Territory/epidemiologia , Etanol , Política Pública , Delitos Sexuais/prevenção & controle
12.
Cell Stem Cell ; 30(11): 1503-1519.e8, 2023 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-37863054

RESUMO

Somatic mutations accumulate in all cells with age and can confer a selective advantage, leading to clonal expansion over time. In hematopoietic cells, mutations in a subset of genes regulating DNA repair or epigenetics frequently lead to clonal hematopoiesis (CH). Here, we describe the context and mechanisms that lead to enrichment of hematopoietic stem cells (HSCs) with mutations in SRCAP, which encodes a chromatin remodeler that also influences DNA repair. We show that SRCAP mutations confer a selective advantage in human cells and in mice upon treatment with the anthracycline-class chemotherapeutic doxorubicin and bone marrow transplantation. Furthermore, Srcap mutations lead to a lymphoid-biased expansion, driven by loss of SRCAP-regulated H2A.Z deposition and increased DNA repair. Altogether, we demonstrate that SRCAP operates at the intersection of multiple pathways in stem and progenitor cells, offering a new perspective on the functional impact of genetic variants that promote stem cell competition in the hematopoietic system.


Assuntos
Hematopoiese Clonal , Hematopoese , Animais , Humanos , Camundongos , Adenosina Trifosfatases/genética , Adenosina Trifosfatases/metabolismo , Reparo do DNA/genética , Epigênese Genética , Hematopoese/genética , Mutação/genética
13.
Am J Respir Crit Care Med ; 208(11): 1196-1205, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37788444

RESUMO

Rationale: Constantly exposed to the external environment and mutagens such as tobacco smoke, human lungs have one of the highest somatic mutation rates among all human organs. However, the relationship of these mutations to lung disease and function is not known. Objectives: To identify the prevalence and significance of clonal somatic mutations in chronic lung diseases. Methods: We analyzed the clonal somatic mutations from 1,251 samples of normal and diseased noncancerous lung tissue RNA sequencing with paired whole-genome sequencing from the Lung Tissue Research Consortium. We examined the associations of somatic mutations with lung function, disease status, and computationally deconvoluted cell types in two of the most common diseases represented in our dataset, chronic obstructive pulmonary disease (COPD; 29%) and idiopathic pulmonary fibrosis (IPF; 13%). Measurements and Main Results: Clonal somatic mutational burden was associated with reduced lung function in both COPD and IPF. We identified an increased prevalence of clonal somatic mutations in individuals with IPF compared with normal control subjects and individuals with COPD independent of age and smoking status. IPF clonal somatic mutations were enriched in disease-related and airway epithelial-expressed genes such as MUC5B in IPF. Patients who were MUC5B risk variant carriers had increased odds of developing somatic mutations of MUC5B that were explained by increased expression of MUC5B. Conclusions: Our identification of an increased prevalence of clonal somatic mutation in diseased lung that correlates with airway epithelial gene expression and disease severity highlights for the first time the role of somatic mutational processes in lung disease genetics.


Assuntos
Fibrose Pulmonar Idiopática , Doença Pulmonar Obstrutiva Crônica , Humanos , Fibrose Pulmonar Idiopática/genética , Fibrose Pulmonar Idiopática/metabolismo , Pulmão/metabolismo , Mutação/genética , Fenômenos Fisiológicos Respiratórios , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/genética , Doença Pulmonar Obstrutiva Crônica/metabolismo
15.
Blood ; 142(24): 2079-2091, 2023 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-37595362

RESUMO

PPM1D encodes a phosphatase that is recurrently activated across cancer, most notably in therapy-related myeloid neoplasms. However, the function of PPM1D in hematopoiesis and its contribution to tumor cell growth remain incompletely understood. Using conditional mouse models, we uncover a central role for Ppm1d in hematopoiesis and validate its potential as a therapeutic target. We find that Ppm1d regulates the competitive fitness and self-renewal of hematopoietic stem cells (HSCs) with and without exogenous genotoxic stresses. We also show that although Ppm1d activation confers cellular resistance to cytotoxic therapy, it does so to a lesser degree than p53 loss, informing the clonal competition phenotypes often observed in human studies. Notably, loss of Ppm1d sensitizes leukemias to cytotoxic therapies in vitro and in vivo, even in the absence of a Ppm1d mutation. Vulnerability to PPM1D inhibition is observed across many cancer types and dependent on p53 activity. Importantly, organism-wide loss of Ppm1d in adult mice is well tolerated, supporting the tolerability of pharmacologically targeting PPM1D. Our data link PPM1D gain-of-function mutations to the clonal expansion of HSCs, inform human genetic observations, and support the therapeutic targeting of PPM1D in cancer.


Assuntos
Dano ao DNA , Proteína Supressora de Tumor p53 , Adulto , Humanos , Animais , Camundongos , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Proteína Fosfatase 2C , Mutação , Monoéster Fosfórico Hidrolases/genética , Ciclo Celular
16.
Sci Adv ; 9(33): eadh0150, 2023 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-37585538

RESUMO

Recurring slow slip along near-trench megathrust faults occurs at many subduction zones, but for unknown reasons, this process is not universal. Fluid overpressures are implicated in encouraging slow slip; however, links between slow slip, fluid content, and hydrogeology remain poorly known in natural systems. Three-dimensional seismic imaging and ocean drilling at the Hikurangi margin reveal a widespread and previously unknown fluid reservoir within the extensively hydrated (up to 47 vol % H2O) volcanic upper crust of the subducting Hikurangi Plateau large igneous province. This ~1.5 km thick volcaniclastic upper crust readily dewaters with subduction but retains half of its fluid content upon reaching regions with well-characterized slow slip. We suggest that volcaniclastic-rich upper crust at volcanic plateaus and seamounts is a major source of water that contributes to the fluid budget in subduction zones and may drive fluid overpressures along the megathrust that give rise to frequent shallow slow slip.

17.
Mol Cell ; 83(15): 2753-2767.e10, 2023 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-37478846

RESUMO

Nuclear hormone receptors (NRs) are ligand-binding transcription factors that are widely targeted therapeutically. Agonist binding triggers NR activation and subsequent degradation by unknown ligand-dependent ubiquitin ligase machinery. NR degradation is critical for therapeutic efficacy in malignancies that are driven by retinoic acid and estrogen receptors. Here, we demonstrate the ubiquitin ligase UBR5 drives degradation of multiple agonist-bound NRs, including the retinoic acid receptor alpha (RARA), retinoid x receptor alpha (RXRA), glucocorticoid, estrogen, liver-X, progesterone, and vitamin D receptors. We present the high-resolution cryo-EMstructure of full-length human UBR5 and a negative stain model representing its interaction with RARA/RXRA. Agonist ligands induce sequential, mutually exclusive recruitment of nuclear coactivators (NCOAs) and UBR5 to chromatin to regulate transcriptional networks. Other pharmacological ligands such as selective estrogen receptor degraders (SERDs) degrade their receptors through differential recruitment of UBR5 or RNF111. We establish the UBR5 transcriptional regulatory hub as a common mediator and regulator of NR-induced transcription.


Assuntos
Cromatina , Fatores de Transcrição , Humanos , Ligantes , Cromatina/genética , Fatores de Transcrição/metabolismo , Receptores Citoplasmáticos e Nucleares/genética , Ubiquitinas , Ubiquitina-Proteína Ligases/genética
18.
Clin Psychol Rev ; 104: 102285, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37499317

RESUMO

There is an increasing focus on evaluating the effectiveness of Relationship Education (RE) programs on reducing relationship aggression. Nevertheless, there has been little by way of a systematic quantitative synthesis of research to date. The primary aim of this research was to conduct a meta-analysis into the effects of RE programs on relationship aggression and provide a comprehensive assessment as to the moderating effects of various methodological characteristics of studies. A secondary aim was to determine whether RE programs reduce negative aspects of relationship functioning that are known to exacerbate relationship aggression. Thirty-one studies (n = 25,527) were included comprising of pre-post comparison studies and control trials. Overall, RE programs were significantly associated with reductions in relationship aggression (d = 0.11, p = .001). Pre-post studies yielded a significantly larger effect size (d = 0.28, p < .001) than RCT studies (d = 0.05, p = .10). Subgroup analysis revealed that participants who reported moderate to severe relationship aggression upon RE program entry demonstrated large reductions in physical (d = 0.66, p = .01) and psychological (d = 0.85, p < .001) aggression compared to those who reported minimal to low relationship aggression on entry (physical aggression d = 0.07, p = .009; psychological aggression d = -0.04; p = .17). Amongst participants who reported moderate to severe relationship aggression, RE programs were also found to reduce controlling behavior (d = 0.20, p < .01) and conflict behavior (d = 0.40, p < .001). Findings demonstrate the emerging efficacy of RE programs for reducing relationship aggression and conflict behavior, particularly in those with a history of moderate to severe levels of relationship aggression.


Assuntos
Agressão , Relações Interpessoais , Humanos , Agressão/psicologia
19.
Matern Child Health J ; 27(10): 1742-1753, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37418097

RESUMO

OBJECTIVES: The World Health Organization has adopted two main strategies to improve the quality of maternal health: increasing the number of deliveries by skilled birth attendants and increasing access to emergency obstetric care. Despite increased access to care, there continue to be high rates of maternal morbidity and mortality in part due to quality of care. This study aims to identify and summarize existing frameworks for measuring quality of maternal care at a facility-level. METHODS: PubMed, Health Systems Evidence, Embase, Global Health, OVID Healthstar, OVID Medline, PsycINFO, and Web of Science were searched for frameworks, tools, theories, or components of frameworks relevant to maternal quality of care in facility-level settings. Title/abstract and full-text screening were completed by two independent reviewers and conflicts resolved through consensus or a third reviewer. RESULTS: An initial search resulted in 3182 studies. Fifty-four studies were included in the qualitative analysis. A best fit framework analysis was done using the updated Hulton framework as the conceptual framework. A facility-based maternal quality of care framework is proposed including the following components, separated into provision and experience of care: (1) human resources; (2) infrastructure; (3) equipment, supplies and medicine; (4) evidence and information; (5) referral and networks of care; (6) cultural competence; (7) clinical practice; (8) financing; (9) leadership and governance; (10) cognition; and 11) respect, dignity, equity, and emotional support.


Despite increased institutional access to care, there continue to be high rates of maternal morbidity and mortality in some low- and middle-income countries. This is in part due to the quality of maternal care once care has been accessed. Several frameworks have been proposed for understanding the complexities surrounding quality of care in maternal health but there has not been a single framework consistently used in the literature for facility-based quality of maternal care. This paper identifies and summarizes existing frameworks and tools, and uses a best fit framework analysis to propose a comprehensive framework for assessing facility-based maternal quality of care.


Assuntos
Serviços de Saúde Materna , Gravidez , Feminino , Humanos , Qualidade da Assistência à Saúde
20.
J Epidemiol Glob Health ; 13(3): 504-516, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37351780

RESUMO

OBJECTIVE: To investigate the medium-term impacts of the COVID-19 pandemic on violence-related offences in Australia, and whether there was evidence of a 'dual pandemic' of family violence in addition to COVID-19. METHODS: Autoregressive Integrated Moving Average time series were conducted to analyse publicly available violent crime statistics data from January 2017 to November 2021. Population rates of homicide, sexual, domestic and non-domestic assault were assessed across each Australian state and territory, with the effects of COVID-19 being modelled using the average monthly World Health Organization COVID-19 stringency rating for each jurisdiction. FINDINGS: All jurisdictions in Australia showed increasing or stable domestic assault trends over the past decade, which were not significantly impacted by COVID-19, nor by the subsequent lockdowns. Non-domestic assaults demonstrated a significant, negative relationship with the stringency index for each jurisdiction, except Western Australia. There was no significant change in the rates of homicide or sexual assault across Australia in relation to COVID-19. CONCLUSION: Overall, there was no evidence of a 'dual pandemic' in Australia, and whilst domestic assaults continue to increase across the country, non-domestic assaults showed a notable but brief decline. However, these have returned to levels at least as high as pre-COVID-19 and some states show a continuing upward trend. The findings also suggest that alcohol availability may have played a role in continuing high violence numbers. Given the ongoing increasing and high levels of family violence in Australia, revised conceptual frameworks and interventions are indicated.


Assuntos
COVID-19 , Violência Doméstica , Humanos , Austrália/epidemiologia , Pandemias , COVID-19/epidemiologia , Controle de Doenças Transmissíveis
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...