Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
1.
Eur J Med Res ; 29(1): 313, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38849950

RESUMO

Alzheimer's disease (AD) is a diverse disease with a complex pathophysiology. The presence of extracellular ß-amyloid deposition as neuritic plaques and intracellular accumulation of hyper-phosphorylated tau as neurofibrillary tangles remain the core neuropathologic criteria for diagnosing Alzheimer's disease. Nonetheless, several recent basic discoveries have revealed significant pathogenic roles for other essential cellular and molecular processes. Previously, there were not so many disease-modifying medications (DMT) available as drug distribution through the blood-brain barrier (BBB) is difficult due to its nature, especially drugs of polypeptides nature and proteins. Recently FDA has approved lecanemab as DMT for its proven efficacy. It is also complicated to deliver drugs for diseases like epilepsy or any brain tumor due to the limitations of the BBB. After the advancements in the drug delivery system, different techniques are used to transport the medication across the BBB. Other methods are used, like enhancement of brain blood vessel fluidity by liposomes, infusion of hyperosmotic solutions, and local intracerebral implants, but these are invasive approaches. Non-invasive approaches include the formulation of nanoparticles and their coating with polymers. This review article emphasizes all the above-mentioned techniques, procedures, and challenges to transporting medicines across the BBB. It summarizes the most recent literature dealing with drug delivery across the BBB.


Assuntos
Doença de Alzheimer , Barreira Hematoencefálica , Sistemas de Liberação de Medicamentos , Humanos , Barreira Hematoencefálica/metabolismo , Barreira Hematoencefálica/efeitos dos fármacos , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/metabolismo , Sistemas de Liberação de Medicamentos/métodos , Animais , Transporte Biológico
2.
BMJ Open ; 14(6): e083152, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38890142

RESUMO

INTRODUCTION: Digital technology is increasingly being adopted within primary healthcare services to improve service delivery and health outcomes; however, the scope for digital innovation within primary care services in rural areas is currently unknown. This systematic review aims to synthesise existing research on the use and integration of digital health technology within primary care services for rural populations across the world. METHODS AND ANALYSIS: A systematic approach to the search strategy will be conducted. Relevant medical and healthcare-focused electronic databases will be searched using key search terms between January 2013 and December 2023. Searches will be conducted using specific inclusion and exclusion criteria. A systematic study selection and data extraction process will be implemented, using standardised templates. Outcomes will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-analyses- Protocol statement guidelines. Quality assessment and risk of bias appraisal will be conducted using the Mixed Methods Appraisal Tool. ETHICS AND DISSEMINATION: Ethical approval will not be required because there is no individual patient data collected or reviewed. The finding of this review will be disseminated through peer-reviewed publications and conference presentations. Outcomes will help to understand existing knowledge and identify gaps in delivering digital healthcare services, while also providing potential future practice and policy recommendations. PROSPERO REGISTRATION NUMBER: CRD42023477233.


Assuntos
Atenção Primária à Saúde , Serviços de Saúde Rural , Revisões Sistemáticas como Assunto , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Humanos , Serviços de Saúde Rural/organização & administração , Serviços de Saúde Rural/normas , Tecnologia Digital , Projetos de Pesquisa , Telemedicina/organização & administração
3.
Blood Transfus ; 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38557323

RESUMO

BACKGROUND: Hematological disorders are often treated with blood transfusions. Many blood group antigens and variants are population-specific, and for patients with rare blood types, extensive donor screening is required to find suitable matches for transfusion. There is a scarcity of knowledge regarding blood group variants in Aboriginal Australian populations, despite a higher need for transfusion due to the higher prevalence of renal diseases and anaemia. MATERIALS AND METHODS: In this study, we applied next-generation sequencing and analysis to 245 samples obtained from Aboriginal Australians from South-East Queensland, to predict antigen phenotypes for 36 blood group systems. RESULTS: We report potential weak antigens in blood group systems RH, FY and JR that have potential clinical implications in transfusion and pregnancy settings. These include partial DIII type 4, weak D type 33, and Del RHD (IVS2-2delA). The rare Rh phenotypes D+ C+ E+ c- e+ and D+ C+ E+ c+ e- were also detected. DISCUSSION: The comprehensive analyses of blood group genetic variant profiles identified in this study will provide insight and an opportunity to improve Aboriginal health by aiding in the identification of appropriate blood products for population-specific transfusion needs.

4.
Molecules ; 28(17)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37687232

RESUMO

Fruits, vegetables, and other food items contain phytochemicals or secondary metabolites which may be considered non-essential nutrients but have medicinal importance. These dietary phytochemicals exhibit chemopreventive and therapeutic effects against numerous diseases. Polyphenols are secondary metabolites found in vegetables, fruits, and grains. These compounds exhibit several health benefits such as immune modulators, vasodilators, and antioxidants. This review focuses on recent studies on using dietary polyphenols to treat cardiovascular disorders, atherosclerosis, and vascular endothelium deficits. We focus on exploring the safety of highly effective polyphenols to ensure their maximum impact on cardiac abnormalities and discuss recent epidemiological evidence and intervention trials related to these properties. Kaempferol, quercetin, and resveratrol prevent oxidative stress by regulating proteins that induce oxidation in heart tissues. In addition, polyphenols modulate the tone of the endothelium of vessels by releasing nitric oxide (NO) and reducing low-density lipoprotein (LDL) oxidation to prevent atherosclerosis. In cardiomyocytes, polyphenols suppress the expression of inflammatory markers and inhibit the production of inflammation markers to exert an anti-inflammatory response. Consequently, heart diseases such as strokes, hypertension, heart failure, and ischemic heart disease could be prevented by dietary polyphenols.


Assuntos
Aterosclerose , Insuficiência Cardíaca , Polifenóis/farmacologia , Polifenóis/uso terapêutico , Verduras , Endotélio Vascular
5.
Hum Resour Health ; 21(1): 31, 2023 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-37081430

RESUMO

BACKGROUND: Inadequate distribution of the medical workforce in rural regions remains a key global challenge. Evidence of the importance of postgraduation (after medical school) rural immersion time and subsequent rural practice, particularly after accounting for other key factors, remains limited. This study investigated the combined impact of three key training pathway factors: (1) rural background, (2) medical school rural immersion, and (3) postgraduation rural immersion, and duration time of each immersion factor on working rurally. METHODS: Data from a cross-sectional national survey and a single university survey of Australian doctors who graduated between 2000 to 2018, were utilised. Key pathway factors were similarly measured. Postgraduation rural training time was both broad (first 10 years after medical school, national study) and specific (prevocational period, single university). This was firstly tested as the dependent variable (stage 1), then matched against rural practice (stage 2) amongst consultant doctors (national study, n = 1651) or vocational training doctors with consultants (single university, n = 478). RESULTS: Stage 1 modelling found rural background, > 1 year medical school rural training, being rural bonded, male and later choosing general practice were associated with spending a higher proportion (> 40%) of their postgraduation training time in a rural location. Stage 2 modelling revealed the dominant impact of postgraduation rural time on subsequent rural work for both General Practitioners (GPs) (OR 45, 95% CI 24 to 84) and other specialists (OR 11, 95% CI 5-22) based on the national dataset. Similar trends for both GPs (OR 3.8, 95% CI 1.6-9.1) and other specialists (OR 2.8, 95% CI 1.3-6.4) were observed based on prevocational time only (single university). CONCLUSIONS: This study provides new evidence of the importance of postgraduation rural training time on subsequent rural practice, after accounting for key factors across the entire training pathway. It highlights that developing rural doctors aligns with two distinct career periods; stage 1-up to completing medical school; stage 2-after medical school. This evidence supports the need for strengthened rural training pathways after medical school, given its strong association with longer-term decisions to work rurally.


Assuntos
Clínicos Gerais , Serviços de Saúde Rural , Estudantes de Medicina , Humanos , Masculino , Austrália , Estudos Transversais , Escolha da Profissão , Área de Atuação Profissional , Recursos Humanos
6.
BMJ Open ; 13(1): e068704, 2023 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-36707116

RESUMO

OBJECTIVES: To investigate the effects of extended short-term medical training placements in small rural and remote communities on postgraduate work location. DESIGN AND SETTING: Cohort study of medical graduates of The University of Queensland, Australia. PARTICIPANTS: Graduating medical students from 2012 to 2021 who undertook a minimum of 6 weeks training in a small rural or remote location. Some participants additionally undertook either or both an extended short-term (12-week) placement in a small rural or remote location and a long-term (1 or 2 years) placement in a large regional centre. PRIMARY OUTCOME MEASURE: Work location was collected from the Australian Health Practitioner Regulation Agency in 2022, classified as either rural, regional or metropolitan and measured in association with rural placement type(s). RESULTS: From 2806 eligible graduates, those participating in extended small rural placements (n=106, 3.8%) were associated with practising rurally or regionally postgraduation (42.5% vs 19.9%; OR: 2.2, 95% CI: 1.1 to 4.6), for both those of rural origin (50% vs 30%; OR: 4.9, 95% CI: 2.6 to 9.2) or metropolitan origin (36% vs 17%; OR: 2.8, 95% CI: 1.7 to 4.8). Those undertaking both an extended small rural placement and 2 years regional training were most likely to be practising in a rural or regional location (61% vs 16%; OR: 8.6, 95% CI: 4.5 to 16.3). Extended small rural placements were associated with practising in smaller rural or remote locations in later years (15% vs 6%, OR: 2.7, 95% CI: 1.3 to 5.3). CONCLUSION: This work location outcome evidence supports investment in rural medical training that is both located in smaller rural and remote settings and enables extended exposure with rural generalists. The evaluated 12-week programme positively related to rural workforce outcomes when applied alone. Outcomes greatly strengthened when the 12-week programme was combined with a 2-year regional centre training programme, compared with either alone. These effects were independent of rural origin.


Assuntos
Serviços de Saúde Rural , Estudantes de Medicina , Humanos , Estudos de Coortes , Austrália , Área de Atuação Profissional , Recursos Humanos , Escolha da Profissão
7.
Aust J Rural Health ; 30(6): 870-875, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35834238

RESUMO

Note: We respectfully refer to Aboriginal and Torres Strait Islander people as Indigenous in this study. OBJECTIVE: To design and develop an Indigenous specific suicide intervention skills program that focuses on education and intervention training as an effective suicide prevention strategy. METHOD: Using a co-designed wrap-around framework, we developed a program in collaboration with >90 communities, stakeholders and service providers across Australia to understand knowledge, awareness and sense of connectedness between at-risk groups and health services or support groups. RESULTS: The I-ASIST training provides participants with the necessary skills and knowledge to apply a suicide intervention model. The framework behind the intervention model provides caregivers the awareness to recognise when someone may be at risk of suicide. It then gives them the skills to connect with a person at risk of suicide and to understand and clarify that risk, steps to keep that person safe for a specific period and then provide them with the resources or links required for further help. The program enables the development of knowledge through interactive strategies through cultural recognition and empowerment of participants. Based on a social-enterprise model, I-ASIST has been translated into a certified program supported by LivingWorks Australia. CONCLUSION: Based on a strengths-based and self-determination model of co-design, this grass roots innovative framework creates suicide safer communities.


Assuntos
Serviços de Saúde do Indígena , Suicídio , Humanos , Prevenção do Suicídio , Austrália
8.
Curr Med Res Opin ; 38(7): 1219-1228, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35410562

RESUMO

BACKGROUND: The role of personalized treatment approaches, including those based on genetic testing, are increasingly enabling informed decision-making to improve health outcomes. Research involving Indigenous Australians has been lagging behind, although this population experiences a higher prevalence of chronic disease and mental health disorders. METHODS: Using community-based participatory research principles, this study purposefully interviewed participants with a diagnosed common mental disorder and a comorbid chronic disease condition. This was an inductive thematic analysis on semi-structured interviews with consenting participants (n = 48). Common themes and analytical domains were identified that provided a semantic understanding shared by participants. RESULTS: Five emerging themes were identified, primarily focusing on: (1) The perceptions and understanding of genetics research; (2) culturally appropriate conduct of genetics research; (3) the role of indigenous-led genetics research; (4) future prospects of genetics research; and (5) the importance of genetics research for patients with mental and physical health comorbidities. CONCLUSION: Indigenous Australians are under-represented in pharmacogenomics research despite well-documented epidemiological research demonstrating that Indigenous people globally experience greater risk of developing certain chronic diseases and more severe disease progression. Positive outcomes from this study highlight the importance of not only involving Indigenous participants, but providing leadership and governance opportunities for future genetics research.


Assuntos
Transtornos Mentais , Havaiano Nativo ou Outro Ilhéu do Pacífico , Austrália/epidemiologia , Doença Crônica , Comorbidade , Humanos , Transtornos Mentais/epidemiologia , Transtornos Mentais/genética , Havaiano Nativo ou Outro Ilhéu do Pacífico/genética
9.
Aust N Z J Public Health ; 45(4): 330-337, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34097328

RESUMO

OBJECTIVE: To generate outcomes for the development of a culturally appropriate mental health treatment model for Indigenous Australians with depression. METHODS: Three focus group sessions and two semi-structured interviews were undertaken over six months across regional and rural locations in South West Queensland. Data were transcribed verbatim and coded using manual thematic analyses. Transcripts were thematically analysed and substantiated. Findings were presented back to participants for authenticity and verification. RESULTS: Three focus group discussions (n=24), and two interviews with Elders (n=2) were conducted, from which six themes were generated. The most common themes from the focus groups included Indigenous autonomy, wellbeing and identity. The three most common themes from the Elder interviews included culture retention and connection to Country, cultural spiritual beliefs embedded in the mental health system, and autonomy over funding decisions. CONCLUSIONS: A treatment model for depression must include concepts of Indigenous autonomy, identity and wellbeing. Further, treatment approaches need to incorporate Indigenous social and emotional wellbeing concepts alongside clinical treatment approaches. Implications for public health: Any systematic approach to address the social and cultural wellbeing of Indigenous peoples must have a community-led design and delivery.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Atenção à Saúde/organização & administração , Serviços de Saúde do Indígena/organização & administração , Saúde Mental/estatística & dados numéricos , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Determinantes Sociais da Saúde/etnologia , Adulto , Idoso , Austrália , Atenção à Saúde/métodos , Feminino , Grupos Focais , Humanos , Povos Indígenas , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
10.
BMJ Open ; 11(4): e040875, 2021 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-33879480

RESUMO

OBJECTIVE: Trauma is reported by 70% of the global population and 4% of those exposed develop post-traumatic stress disorder (PTSD), but data from Indigenous populations are limited. We aimed to determine the prevalence, types and age of occurrence of traumatic events among community-living Indigenous Australians and associations with PTSD. DESIGN: Lifetime trauma and PTSD were quantified among a broadly representative sample of 544 Indigenous participants using a diagnostic clinical interview. Logistic regression examined predictors of PTSD. SETTING: Metropolitan, regional and remote areas of Southern Queensland and Northern New South Wales. PARTICIPANTS: Indigenous Australians 18 years and older. OUTCOME MEASURES: Prevalence of traumatic life events and risk of PTSD. RESULTS: 64.9% of participants (standardised prevalence 62.6%) reported lifetime trauma, with more than one trauma category in 62.3%. Females reported 2.3 times more sexual violence, otherwise no gender differences existed. The prevalence of four common trauma categories were 1.7-3.0 times higher than in the Australian population; physical violence being the highest relative risk. Although overall childhood trauma was not increased, sexual or physical violence before age 15 was twice more common than in the Australian population.The standardised prevalence of 12-month PTSD was 13.3% (95% CI 10.4 to 16.1), 16.1% (95% CI 12.2 to 19.9) in females and 8.2% (95% CI 5.3 to 11.1) in males, three times the Australian rates. In multiple regression analysis, independent predictors of PTSD were female gender (OR 2.1), rural residence (OR 3.0), trauma under age 10 (OR 2.2), sexual (without physical) violence (OR 2.5), physical (without sexual) violence (OR 2.3), and both sexual and physical violence (OR 5.0). CONCLUSION: Indigenous Australians are more likely to experience potentially harmful traumas and develop PTSD than other Australians. Mitigation of trauma among Indigenous Australians, particularly childhood exposure and sexual or physical violence, is essential to reduce their high burden of PTSD.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Adolescente , Adulto , Austrália/epidemiologia , Estudos Transversais , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , New South Wales , Grupos Populacionais , Prevalência , Queensland/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto Jovem
11.
Soc Sci Med ; 258: 113015, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32559573

RESUMO

RATIONALE: Suicide prevention training in Aboriginal and Torres Strait Islander communities is a national health priority in Australia. OBJECTIVE: This paper describes a qualitative study to increase understanding of how a mobile application (app) could be used to support suicide prevention gatekeepers in Indigenous communities. We respectfully use the term Indigenous to refer to Australian peoples of Aboriginal and/or Torres Strait Islander descent. METHOD: Two participatory design workshops were held with 12 participants who were either Indigenous health workers or community members. The workshops first explored what knowledge, skills, and support suicide prevention gatekeepers in Indigenous communities may require, as well as how technology, specifically mobile apps, could be used to support these needs. RESULTS: Qualitative analysis identified four themes related to perceptions of who gatekeepers are, their role requirements, technology and supporting resources, as well as broader community issues. Participants thought training programs should target key, accessible, and respected people from diverse, designated, and emergent groups in Indigenous communities to act as gatekeepers, but requested an alternative, more culturally appropriate term to 'gatekeeper' (e.g., responder). Training should prepare gatekeepers for multifaceted suicide prevention roles, including the identification and management of at-risk Indigenous persons, the provision of psychoeducation and ongoing support, as well as facilitate integrated care in collaboration with community services. A combination of multiple support resources was recommended, including multi-platform options in the technology (e.g., mobile applications, social media) and physical domains (e.g., wallet cards, regular meetings). Recommended app features included culturally appropriate refresher content on suicide intervention, training recall, integrated care, how to access gatekeeper peer support, and debriefing. Broader community concerns on gatekeeper support needs were also considered.


Assuntos
Serviços de Saúde do Indígena , Aplicativos Móveis , Prevenção do Suicídio , Austrália , Humanos , Havaiano Nativo ou Outro Ilhéu do Pacífico , Pesquisa Qualitativa
13.
BJPsych Open ; 6(3): e33, 2020 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-32249727

RESUMO

BACKGROUND: A four- to seven-fold increase in the prevalence of current mood, anxiety, substance use and any mental disorders in Indigenous adults compared with non-Indigenous Australians has been reported. A lifetime prevalence of major depressive disorder was 23.9%. High rates of comorbid mental disorders indicated a transdiagnostic approach to treatment might be most appropriate. The effectiveness of psychological treatment for Indigenous Australians and adjunct Indigenous spiritual and cultural healing has not previously been evaluated in controlled clinical trials. AIMS: This project aims to develop, deliver and evaluate the effectiveness of an Indigenous model of mental healthcare (IMMHC). Trial registration: ANZCTR Registration Number: ACTRN12618001746224 and World Health Organization Universal Trial Number: U1111-1222-5849. METHOD: The IMMHC will be based on transdiagnostic cognitive-behaviour therapy co-designed with the Indigenous community to ensure it is socially and culturally appropriate for Indigenous Australians. The IMMHC will be evaluated in a randomised controlled trial with 110 Indigenous adults diagnosed with a current diagnosis of depression. The primary outcome will be the severity of depression symptoms as determined by changes in Beck Depression Inventory-II score at 6 months post-intervention. Secondary outcomes include anxiety, substance use disorder and quality of life. Outcomes will be assessed at baseline, 6 months post-intervention and 12 months post-intervention. RESULTS: The study design adheres to the Consolidated Standards of Reporting Trials (CONSORT) statement recommendations and CONSORT extensions for pilot trials. We followed the Standard Protocol Items for Randomised Trials statement recommendations in writing the trial protocol. CONCLUSIONS: This study will likely benefit participants, as well as collaborating Aboriginal Medical Services and health organisations. The transdiagnostic IMMHC has the potential to have a substantial impact on health services delivery in the Indigenous health sector.

14.
Gerontologist ; 60(3): 513-524, 2020 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-30500896

RESUMO

BACKGROUND AND OBJECTIVES: Traditional Elders are integral to the social structure of Australian Indigenous communities. Due to progressive loss of traditional way of life, however, the role of Elders has been eroding. This study aims to develop a conceptual model of the role of Elders in an Australian Indigenous community, with the goal of attaining strategies to strengthen the role of Elders. RESEARCH DESIGN AND METHODS: The study, conducted in a regional Indigenous community in Australia, adopted a community-based participatory approach. Design and focus of the project were informed by a community forum (Yarning Circle). One-on-one semistructured interviews and focus groups with community members were conducted by Indigenous researchers. Group concept mapping (GCM) was applied to elicit major themes in qualitative data, from the point of view of community members, and to derive a conceptual model of the role of Elders. RESULTS: Fifty members of the Indigenous community took part in interviews and focus groups. The participants' median age was 45 years (range 18-76 years); 31 (62%) were female. An additional 24 Indigenous community members took part in the data sorting task of GCM. GCM identified seven major aspects of the role of Elders, including Community relations, Passing down the knowledge, Dealing with racism and oppression, Building a better resourced community, Intergenerational connectedness, Safeguarding our identity, and Caring for our youth. DISCUSSION AND IMPLICATIONS: Elders fulfill many important roles in contemporary Indigenous communities. Our results can be used to assist the community to codesign a program to increase community wellbeing.


Assuntos
Relações Comunidade-Instituição/normas , Povos Indígenas/psicologia , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Adolescente , Adulto , Idoso , Austrália , Pesquisa Participativa Baseada na Comunidade , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Relação entre Gerações , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Racismo/psicologia , Adulto Jovem
15.
Australas Psychiatry ; 27(4): 362-365, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31165642

RESUMO

OBJECTIVE: This study determined the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people. METHODS: De-identified qualitative feedback from participants and psychologists regarding the cultural appropriateness of the SCID-I for Indigenous people using open-ended anonymous questionnaires was gathered. Aboriginal Medial Service staff and Indigenous Support Workers participated in a focus group. RESULTS: A total of 95.6% of participants felt comfortable during the 498 questionnaires completed. Psychologists also provided qualitative feedback for 502 (92.3%) interviews, of whom 40.4% established a good rapport with participants. Of the participants, 77.7% understood the SCID-I questions well, while 72.5% did not require any cultural allowances to reach a clinical diagnosis. CONCLUSION: When administered by a culturally safe trained psychologist, SCID-I is well tolerated in this group.


Assuntos
Competência Cultural , Entrevista Psicológica/métodos , Entrevista Psicológica/normas , Transtornos Mentais/diagnóstico , Havaiano Nativo ou Outro Ilhéu do Pacífico/estatística & dados numéricos , Austrália/etnologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Retroalimentação , Serviços de Saúde do Indígena/organização & administração , Humanos , Transtornos Mentais/etnologia , Reprodutibilidade dos Testes , Inquéritos e Questionários
16.
BMJ Open ; 8(6): e020196, 2018 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-29961007

RESUMO

OBJECTIVE: To determine, using face-to-face diagnostic interviews, the prevalence of common mental disorders (CMD) in a cohort of adult Indigenous Australians, the cultural acceptability of the interviews, the rates of comorbid CMD and concordance with psychiatrists' diagnoses. DESIGN: Cross-sectional study July 2014-November 2016. Psychologists conducted Structured Clinical Interviews for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision Axis I Disorders (SCID-I) (n=544). Psychiatrists interviewed a subsample (n=78). SETTING: Four Aboriginal Medical Services and the general community located in urban, regional and remote areas of Southern Queensland and two Aboriginal Reserves located in New South Wales. PARTICIPANTS: Indigenous Australian adults. OUTCOME MEASURES: Cultural acceptability of SCID-I interviews, standardised rates of CMD, comorbid CMD and concordance with psychiatrist diagnoses. RESULTS: Participants reported that the SCID-I interviews were generally culturally acceptable. Standardised rates (95% CI) of current mood, anxiety, substance use and any mental disorder were 16.2% (12.2% to 20.2%), 29.2% (24.2% to 34.1%), 12.4% (8.8% to 16.1%) and 42.2% (38.8% to 47.7%), respectively-6.7-fold, 3.8-fold, 6.9-fold and 4.2-fold higher, respectively, than those of the Australian population. Differences between this Indigenous cohort and the Australian population were less marked for 12-month (2.4-fold) and lifetime prevalence (1.3-fold). Comorbid mental disorder was threefold to fourfold higher. In subgroups living on traditional lands in Indigenous reserves and in remote areas, the rate was half that of those living in mainstream communities. Moderate-to-good concordance with psychiatrist diagnoses was found. CONCLUSIONS: The prevalence of current CMD in this Indigenous population is substantially higher than previous estimates. The lower relative rates of non-current disorders are consistent with underdiagnosis of previous events. The lower rates among Reserve and remote area residents point to the importance of Indigenous peoples' connection to their traditional lands and culture, and a potentially important protective factor. A larger study with random sampling is required to determine the population prevalence of CMD in Indigenous Australians.


Assuntos
Transtornos Mentais/etnologia , Havaiano Nativo ou Outro Ilhéu do Pacífico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales/etnologia , Prevalência , Queensland/etnologia , População Rural , Adulto Jovem
17.
MedEdPublish (2016) ; 7: 219, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-38074611

RESUMO

This article was migrated. The article was marked as recommended. Introduction: Medical students undertake extensive training yet often feel they lack the practical non-medical skills required for successful transition to internship. While research provides evidence for student perceptions and experiences regarding internship, there is little information regarding how students can be 'taught' work-readiness through learning non-medical skills. Methods: By reducing cognitive load when structured using a flipped classroom method, active learning resources may provide an effective approach to prepare medical students to be work-ready interns. Using a blended instructional method, the University of Queensland's Rural Clinical School (UQRCS) integrated face-to-face and online learning, to develop an Intern Preparedness program. Discussion: The Intern Preparedness program promotes student interaction in a range of active learning tasks to improve learning and engagement in a difficult and often neglected area of professional training. The program focused on providing knowledge and skills to increase competency in non-medical skills including time management on the ward, patient-focused prioritisation of tasks, and clinical conversations with the healthcare team. Conclusion: This program has become an integral part of the student learning experiences at the UQRCS as it continues to elevate student preparedness for internship. The program has become a fundamentally important aspect of improving cognitive skills such as critical thinking and reasoning, as well as soft skills, which are all essential for successful transitions to internship. A very high uptake and completion of program activities provided further incentive for program developers to continue its improvements over time.

18.
BMC Psychiatry ; 17(1): 219, 2017 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-28610603

RESUMO

BACKGROUND: Little is known of the appropriateness of existing gatekeeper suicide prevention programs for Indigenous communities. Despite the high rates of Indigenous suicide in Australia, especially among Indigenous youth, it is unclear how effective existing suicide prevention programs are in providing appropriate management of Indigenous people at risk of suicide. METHODS: In-depth, semi-structured interviews and focus groups were conducted with Indigenous communities in rural and regional areas of Southern Queensland. Thematic analysis was performed on the gathered information. RESULTS: Existing programs were time-intensive and included content irrelevant to Indigenous people. There was inconsistency in the content and delivery of gatekeeper training. Programs were also not sustainable for rural and regional Indigenous communities. CONCLUSIONS: Appropriate programs should be practical, relevant, and sustainable across all Indigenous communities, with a focus on the social, emotional, cultural and spiritual underpinnings of community wellbeing. Programs need to be developed in thorough consultation with Indigenous communities. Indigenous-led suicide intervention training programs are needed to mitigate the increasing rates of suicide experienced by Indigenous peoples living in rural and remote locations.


Assuntos
Serviços Comunitários de Saúde Mental , Encaminhamento e Consulta , Prevenção do Suicídio , Grupos Focais , Humanos , Entrevistas como Assunto , Havaiano Nativo ou Outro Ilhéu do Pacífico , Avaliação de Programas e Projetos de Saúde , Queensland , Suicídio/etnologia
19.
Oxid Med Cell Longev ; 2017: 8158315, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28303171

RESUMO

Over the past few years, considerable attention has been focused on carrageenan based bionanocomposites due to their multifaceted properties like biodegradability, biocompatibility, and nontoxicity. Moreover, these composites can be tailored according to the desired purpose by using different nanofillers. The role of ferromagnetic nanoparticles in drug delivery is also discussed here in detail. Moreover, this article also presents a short review of recent research on the different types of the carrageenan based bionanocomposites and applications.


Assuntos
Carragenina/química , Sistemas de Liberação de Medicamentos/métodos , Imãs/química , Nanocompostos/química , Nanopartículas/química , Liberação Controlada de Fármacos
20.
Acta Pol Pharm ; 74(2): 379-383, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29624242

RESUMO

A simple, efficient, accurate and selective HPLC method has been developed and validated successfully for the estimation of 5-fluorouracil in rabbit plasma. The drug was eluted by using Supelco C18 column (1.5 cm x 4.6 mm, 5 µm) with a mobile phase consisting of methanol and water (20: 80, v/v) by adjusting pH at 3.2, using perchloric acid solution. The retention time was found to be 4.107 with a flow rate of I mL/min. Multiple validation parameters evaluated with high accuracy indicating that the current method sufficiently qualifies the recommended criteria. Regression value obtained from linearity curve was R² = 0.999 and percentage recovery obtained was ranged from 96.6 to 102.5%. A fine response in short run time with perfect resolution made the method highly suitable for pharmacokinetic studies.


Assuntos
Antimetabólitos Antineoplásicos/sangue , Cromatografia Líquida de Alta Pressão , Cromatografia de Fase Reversa , Monitoramento de Medicamentos/métodos , Fluoruracila/sangue , Animais , Antimetabólitos Antineoplásicos/farmacocinética , Soluções Tampão , Calibragem , Cromatografia Líquida de Alta Pressão/normas , Cromatografia de Fase Reversa/normas , Fluoruracila/farmacocinética , Concentração de Íons de Hidrogênio , Limite de Detecção , Modelos Lineares , Metanol/química , Percloratos/química , Coelhos , Padrões de Referência , Reprodutibilidade dos Testes , Solventes/química , Água/química
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...