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1.
Harmful Algae ; 133: 102600, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38485438

RESUMO

Dolichospermum is a cyanobacterial genus commonly associated with toxic blooms in lakes and brackish water bodies worldwide, and is a long-term resident of Lake Stechlin, northeastern Germany. In recent decades, shifts in the phosphorus loading and phytoplankton species composition have seen increased biomass of Dolichospermum during summer blooms from 1998, peaking around 2005, and declining after 2020. Cyanobacteria are known to rapidly adapt to new environments, facilitated by genome adaptation. To investigate the changes in genomic features that may have occurred in Lake Stechlin Dolichospermum during this time of increased phosphorus loading and higher biomass, whole genome sequence analysis was performed on samples of ten akinetes isolated from ten, 1 cm segments of a sediment core, representing a ∼45-year period from 1970 to 2017. Comparison of these genomes with genomes of extant isolates revealed a clade of Dolichospermum that clustered with the ADA-6 genus complex, with remarkable genome stability, without gene gain or loss events in response to recent environmental changes. The genome characteristics indicate that this species is suited to a deep-chlorophyll maximum, including additional light-harvesting and phosphorus scavenging genes. Population SNP analysis revealed two sub-populations that shifted in dominance as the lake transitioned between oligotrophic and eutrophic conditions. Overall, the results show little change within the population, despite diversity between extant populations from different geographic locations and the in-lake changes in phosphorus concentrations.


Assuntos
Cianobactérias , Lagos , Lagos/microbiologia , Cianobactérias/genética , Fitoplâncton , Biomassa , Fósforo
2.
Occup Med (Lond) ; 73(7): 434-438, 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37658781

RESUMO

BACKGROUND: US and Canadian pilots are required to meet medical standards to secure their active flying status, but a subgroup exhibit healthcare avoidance behaviour due to fear of loss of that status. This phenomenon has the potential to impact pilot health, aeromedical screening and aviation safety. No international comparison study of pilot healthcare avoidance currently exists between US and Canadian pilots. AIMS: To compare the rate and subtypes of healthcare avoidance behaviour secondary to fear for loss of flying status between US and Canadian pilots. METHODS: A comparison analysis of data collected during two independent, non-probabilistic, cross-sectional internet surveys including any individual certified to perform flying duties in the USA (US survey) or Canada (Canadian survey). RESULTS: There were 4320 US pilots and 1415 Canadian pilots who completed informed consent and 3765 US pilots and 1405 Canadian pilots were included in the results. There were 56% of US pilots who reported a history of healthcare avoidance behaviour compared to 55% of Canadian pilots (P = 0.578). A multivariable logistic regression that included age, pilot type and gender showed that US pilots were slightly more likely than Canadian pilots to report this behaviour (odds ratio 1.22, 95% confidence interval 1.06-1.4). CONCLUSIONS: Healthcare avoidance behaviour due to fear of loss of flying status has a relatively high prevalence in both US and Canadian pilot populations.

3.
NPJ Parkinsons Dis ; 8(1): 170, 2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36522332

RESUMO

Parkinson disease (PD) is the second most common age-related neurodegenerative condition diagnosed in North America. We recently demonstrated, using multiple epidemiological data sources, that the prevalence of PD diagnoses was greater than previously reported and currently used for clinical, research, and policy decision-making. Prior PD incidence estimates have varied, for unclear reasons. There is a need for improved estimates of PD incidence, not only for care delivery planning and future policy but also for increasing our understanding of disease risk. The objective of this study was thus to investigate the incidence of Parkinson disease across five epidemiological cohorts in North America in a common year, 2012. The cohorts contained data on 6.7 million person-years of adults ages 45 and older, and 9.3 million person-years of adults ages 65 and older. Our estimates of age-sex-adjusted incidence of PD ranged from 108 to 212 per 100,000 among persons ages 65 and older, and from 47 to 77 per 100,00 among persons ages 45 and older. PD incidence increased with age and was higher among males. We also found persistent spatial clustering of incident PD diagnoses in the U.S. PD incidence estimates varied across our data sources, in part due to case ascertainment and diagnosis methods, but also possibly due to the influence of population factors (prevalence of genetic risk factors or protective markers) and geographic location (exposure to environmental toxins). Understanding the source of these variations will be important for health care policy, research, and care planning.

5.
Public Health ; 194: 146-148, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33906088

RESUMO

OBJECTIVE: The aim of the study was to investigate the impact of the COVID-19 pandemic and prevention measures on religious practices after death, by ethnic grouping, in an opportunistic/convenience sample of UK adults. METHODS: We distributed a questionnaire online and in hard copy between May 1 and June 18, 2020, via social media, post and face-to-face contact in Leicester, a multi-ethnic city in the UK. RESULTS: From 980 adults providing consent, 665 completed some or all survey items and provided ethnicity data. More than double the proportion of Black and South Asian individuals reported religious practices relating to death, burials or funerals being affected by COVID-19 than White groups. Of the 151 participants reporting practices being impacted, a greater proportion of ethnic minority groups reported restricted access/alteration to eight death-related practices (e.g., funeral attendance) compared with White groups (significantly different for all practices, P < 0.05). CONCLUSION: The initial phase of the COVID-19 pandemic in the UK has negatively impacted on the ability to conduct religious practices after death in all ethnic groups, but the impact appears greater in ethnic minority populations than in White groups. There is a need for further qualitative research on the impact of the COVID-19 pandemic on death and burial practices of minority ethnic groups.


Assuntos
COVID-19/epidemiologia , Etnicidade/estatística & dados numéricos , Rituais Fúnebres , Grupos Minoritários/estatística & dados numéricos , Religião , Adulto , Negro ou Afro-Americano/estatística & dados numéricos , Idoso , Atitude Frente a Morte , COVID-19/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pesquisa Qualitativa , SARS-CoV-2 , Mídias Sociais , Inquéritos e Questionários , Reino Unido , População Branca/estatística & dados numéricos
6.
Eur J Neurol ; 27(3): 484-489, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31571317

RESUMO

BACKGROUND AND PURPOSE: Visual dysfunction is a non-motor symptom of Parkinson disease (PD), but its prevalence is unknown as population-based data on the epidemiology of visual symptoms in PD are lacking. The objective was to determine the prevalence of visual dysfunction in PD. METHODS: This was a cross-sectional analysis of data from adults ≥50 years old in the Survey of Health, Ageing and Retirement in Europe (SHARE), a multinational population-based health survey of adults living in one of 27 European countries and Israel. PD diagnosis was self-reported. Impairment in overall, distance or near eyesight was defined as a score of 4 or 5 on a 1-5 scale. Adjusted logistic regression was used to determine the association between PD and self-reported vision. RESULTS: There were 115 240 age-eligible participants in the SHARE study (mean age 64.3 years, 54% female), of whom 1438 (1.25%) reported a diagnosis of PD. In adjusted logistic regression models, PD was associated with increased odds of impaired overall [odds ratio (OR) 2.67, 95% confidence interval (CI) 1.91-3.72], distance (OR 2.55, 95% CI 2.04-3.19) and near (OR 2.07, 95% CI 1.69-2.55) eyesight. Individuals with PD were also less likely to report having an eye examination within the previous 2 years (OR 0.59, 95% CI 0.38-0.92), but this did not remain statistically significant after adjusting for confounders (OR 0.76, 95% CI 0.47-1.24). CONCLUSIONS: Visual dysfunction is significantly more common in PD than in the general adult population. Visual symptoms are a potentially under-recognized and under-treated source of reduced quality of life in PD patients that require further attention and study.


Assuntos
Doença de Parkinson/epidemiologia , Autorrelato , Transtornos da Visão/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Comorbidade , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Aposentadoria
7.
Chemosphere ; 241: 124980, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31600620

RESUMO

Azoxystrobin and pyraclostrobin are broad spectrum strobilurin fungicides that have been measured in the aquatic environment. Strobilurins inhibit mitochondrial respiration by binding to the mitochondrial respiratory complex III. The goal of this study was to investigate mitochondrial dysfunction and oxidative stress in the developing zebrafish from exposure to azoxystrobin and pyraclostrobin. Exposure studies were performed where zebrafish embryos were exposed to azoxystrobin and pyraclostrobin at 0.1, 10, 100 µg/L from 4 hpf to 48 hpf to measure mitochondrial dysfunction and oxidative stress mRNA transcripts, and 5 dpf to measure movement, growth, oxygen consumption, enzymatic activities, and mRNA transcripts. Results from this study indicated that there was a significant reduction in both basal and maximal respiration at 48 hpf in zebrafish exposed to 100 µg/L of pyraclostrobin. There was no difference in oxidative stress or apoptotic mRNA transcripts at 48 hpf, indicating that the two strobilurins were acting first on mitochondrial function and not directly through oxidative stress. At 5 dpf, standard body length was significantly reduced with exposure to pyraclostrobin and azoxystrobin exposure as compared to the control. These reductions in apical endpoints corresponded with increases in oxidative stress and apoptotic mRNA transcripts in treatment groups at 5 dpf indicating that strobilurins' exposure followed the adverse outcome pathway for mito-toxicants. Our results indicate that strobilurins can decrease mitochondrial function, which in turn lead to diminished growth and movement.


Assuntos
Estrobilurinas/farmacologia , Peixe-Zebra/crescimento & desenvolvimento , Animais , Embrião não Mamífero/metabolismo , Desenvolvimento Embrionário , Fungicidas Industriais/toxicidade , Larva/efeitos dos fármacos , Mitocôndrias/metabolismo , Estresse Oxidativo , Pirimidinas/farmacologia , Poluentes Químicos da Água/toxicidade , Peixe-Zebra/metabolismo
8.
Vet J ; 248: 42-47, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31113561

RESUMO

Enterococci have been increasing in prevalence in foal sepsis over the past three decades. There are no published studies in the peer-reviewed literature documenting common sites of infection, antimicrobial susceptibility, or outcome specifically associated with enterococcal infections in foals. Our objectives were to evaluate the sites of origin, antimicrobial susceptibility, and survival outcome to discharge in foals with enterococcal infections compared with foals with sepsis of another bacterial etiology. Seventy-five foals 0-30 days of age with cultures positive for Enterococcus and 170 control foals 0-30 days of age with cultures positive for other bacteria were included. Enterococcus was 2.67 times (95% confidence interval [CI], 1.49-4.80; P = 0.0012) more likely to be isolated from the lower urogenital tract of foals than were other bacteria. Enterococci were less likely to be isolated from blood cultures than other bacteria, with an odds ratio (OR) of 0.17 (95% CI 0.09-0.35; P < 0.0001). For Enterococcus isolates, 48% (n = 29/61) had a multiple antimicrobial resistance (MAR) index of ≥30% and 46% (n = 28/61) had a multiple drug resistance (MDR) index of ≥30%. Foals with enterococcal infections were less likely to survive to discharge (49.9% vs. 63.5%; P = 0.03). Enterococcus is commonly isolated from the lower urogenital tract of foals, is often multidrug resistant, and foals with enterococcal infections were less likely to survive. Multidrug resistance is common among enterococcal isolates, and therefore antimicrobial susceptibility testing of cultured isolates is warranted.


Assuntos
Antibacterianos/farmacologia , Enterococcus/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/veterinária , Doenças dos Cavalos/tratamento farmacológico , Animais , Animais Recém-Nascidos , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Resistência a Múltiplos Medicamentos , Enterococcus/isolamento & purificação , Feminino , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Doenças dos Cavalos/microbiologia , Cavalos , Masculino , Testes de Sensibilidade Microbiana/veterinária , Estudos Retrospectivos
9.
Environ Toxicol Chem ; 38(7): 1455-1466, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30919521

RESUMO

Azole fungicides have entered the aquatic environment through agricultural and residential runoff. In the present study, we compared the off-target toxicity of tebuconazole, propiconazole, and myclobutanil using embryo-larval zebrafish as a model. The aim of the present study was to investigate the relative toxicity of tebuconazole, propiconazole, and myclobutanil using multiple-level endpoints such as behavioral endpoints and enzymatic and molecular biomarkers associated with their mode of action. Zebrafish embryos were exposed to azoles at environmentally relevant and high concentrations, 0.3, 1.0, and 1000 µg/L, starting at 5 h postfertilization (hpf) up to 48 hpf, as well as 5 d postfertilization (dpf). Relative mRNA expressions of cytochrome P450 family 51 lanosterol-14α-demethylase, glutathione S-transferase, caspase 9, phosphoprotein p53, and BCL2-associated X protein were measured to assess toxicity attributable to fungicides at the mRNA level, whereas caspase 3/7 (apoptosis) and 3,4-methylene​dioxy​amphetamine (lipid peroxidation) levels were measured at the enzymatic level. Furthermore, mitochondrial dysfunction was measure through the Mito Stress test using the Seahorse XFe24 at 48 hpf. In addition, light to dark movement behavior was monitored at 5 dpf using Danio Vision® to understand adverse effects at the organismal level. There was no significant difference in the light to dark behavior with exposure to azoles compared to controls. The molecular biomarkers indicated that propiconazole and myclobutanil induced lipid peroxidation, oxidative stress, and potentially apoptosis at environmentally relevant concentrations (0.3 and 1 µg/L). The results from the mitochondrial respiration assay indicated a slight decrease in spare respiratory capacity with an acute exposure (48 hpf) to all 3 azoles at 1000 µg/L. Based on the present results, propiconazole and myclobutanil are acutely toxic compared to tebuconazole in aquatic organisms at environmentally relevant concentrations. Environ Toxicol Chem 2019;38:1455-1466. © 2019 SETAC.


Assuntos
Apoptose/efeitos dos fármacos , Fungicidas Industriais/toxicidade , Peroxidação de Lipídeos/efeitos dos fármacos , Peixe-Zebra/metabolismo , Animais , Azóis/química , Expressão Gênica/efeitos dos fármacos , Larva/efeitos dos fármacos , Larva/metabolismo , Nitrilas/toxicidade , Esterol 14-Desmetilase/genética , Esterol 14-Desmetilase/metabolismo , Triazóis/toxicidade , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Peixe-Zebra/crescimento & desenvolvimento , Proteína X Associada a bcl-2/genética , Proteína X Associada a bcl-2/metabolismo
10.
Nutr Metab Cardiovasc Dis ; 29(4): 325-333, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30777308

RESUMO

AIMS: To evaluate theory-based psychological approaches that have been effective in promoting behavior change in interventions promoting a Mediterranean style diet (MD) for the reduction of cardiovascular disease (CVD) risk. DATA SYNTHESIS: A systematic review of primary research articles using PRISMA recommendations was conducted. References were retrieved using keyword searches from MEDLINE via PUBMED and included studies targeted participants at high risk for CVD. Two hundred and ninety one studies were reviewed; however, only six met the inclusionary criteria. Three articles describe the same intervention; therefore, only four were included. Included studies incorporated social cognitive theory, social learning theory, goal-system theory, social ecological theory, selfdetermination theory, and the transtheoretical model of behavior change. Overall, studies were nutrition interventions in clinical settings with participants at high risk for or with CVD. CONCLUSIONS: Results from use of the social cognitive theory and self-determination theory in increasing MD adherence for the reduction of CVD risk and events are encouraging. However, we encourage future long-term interventions focusing on dietary behavior change to provide not only an in-depth description of the psychological methodologies used but also how these methodologies were implemented in order ascertain the most effective theory for promoting dietary behavior change towards patterns of a MD.


Assuntos
Doenças Cardiovasculares/dietoterapia , Terapia Cognitivo-Comportamental , Dieta Saudável , Dieta Mediterrânea , Educação de Pacientes como Assunto/métodos , Idoso , Doenças Cardiovasculares/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Cooperação do Paciente , Autonomia Pessoal , Fatores de Proteção , Fatores de Risco , Comportamento de Redução do Risco , Resultado do Tratamento
11.
NPJ Parkinsons Dis ; 4: 21, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30003140

RESUMO

Estimates of the prevalence of Parkinson's disease in North America have varied widely and many estimates are based on small numbers of cases and from small regional subpopulations. We sought to estimate the prevalence of Parkinson's disease in North America by combining data from a multi-study sampling strategy in diverse geographic regions and/or data sources. Five separate cohort studies in California (2), Minnesota (1), Hawaii USA (1), and Ontario, Canada (1) estimated the prevalence of PD from health-care records (3), active ascertainment through facilities, large group, and neurology practices (1), and longitudinal follow-up of a population cohort (1). US Medicare program data provided complementary estimates for the corresponding regions. Using our age- and sex-specific meta-estimates from California, Minnesota, and Ontario and the US population structure from 2010, we estimate the overall prevalence of PD among those aged ≥45 years to be 572 per 100,000 (95% confidence interval 537-614) that there were 680,000 individuals in the US aged ≥45 years with PD in 2010 and that that number will rise to approximately 930,000 in 2020 and 1,238,000 in 2030 based on the US Census Bureau population projections. Regional variations in prevalence were also observed in both the project results and the Medicare-based calculations with which they were compared. The estimates generated by the Hawaiian study were lower across age categories. These estimates can guide health-care planning but should be considered minimum estimates. Some heterogeneity exists that remains to be understood.

12.
Eur J Dent Educ ; 22(4): e661-e668, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29877053

RESUMO

INTRODUCTION: Oral Medicine focuses on care for patients with chronic, recurrent and medically related disorders of the orofacial region that are distinct from diseases of the periodontal and tooth tissues, with an emphasis on non-surgical management. At present, there are no shared outcomes for Oral Medicine to define the standards to be achieved before new graduates become registered dentists engaged with ongoing professional development. CURRICULUM: We present a consensus undergraduate curriculum in Oral Medicine agreed by representatives from 18 Dental Schools in the United Kingdom and Republic of Ireland. The scope of Oral Medicine practice includes conditions involving the oral mucosa, salivary glands, neurological system or musculoskeletal tissues that are not directly attributable to dental (tooth and periodontium) pathology. Account is taken of the priorities for practice and learning opportunities needed to support development of relevance to independent clinical practice. The outcomes triangulate with the requirements set out by the respective regulatory bodies in the UK and Republic of Ireland prior to first registration and are consistent with the framework for European undergraduate dental education and greater harmonisation of dental education. CONCLUSIONS: This curriculum will act as a foundation for an increasingly shared approach between centres with respect to the outcomes to be achieved in Oral Medicine. The curriculum may also be of interest to others, such as those responsible for the training of dental hygienists and dental therapists. It provides a platform for future collective developments with the overarching goal of raising the quality of patient care.


Assuntos
Currículo , Educação em Odontologia , Medicina Bucal/educação , Estudantes de Odontologia , Educação em Odontologia/normas , Avaliação Educacional , Humanos , Irlanda , Mucosa Bucal , Sistema Musculoesquelético , Sistema Nervoso , Medicina Bucal/normas , Qualidade da Assistência à Saúde , Glândulas Salivares , Reino Unido
13.
Eur J Dent Educ ; 22(3): e588-e593, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29667358

RESUMO

In March 2017, a group of teachers of human disease/clinical medical science (HD/CMSD) representing the majority of schools from around the UK and Republic of Ireland met to discuss the current state of teaching of human disease and also to discuss how the delivery of this theme might evolve to inform improved healthcare. This study outlines how the original teaching in medicine and surgery to dental undergraduate students has developed into the theme of HD/CMSD reflecting changing needs as well as guidance from the regulators, and how different dental schools have developed their approaches to reach their current state. Each school was also asked to share a strengths, weakness, opportunities and threats (SWOT) analysis of their programme and to outline how they thought their HD/CMSD programme may develop. The school representatives who coordinate the delivery and assessment of HD/CMSD in the undergraduate curriculum have extensive insight in this area and are well-placed to shape the HD/CMSD development for the future.


Assuntos
Medicina Clínica/tendências , Currículo/tendências , Educação em Odontologia/tendências , Educação de Graduação em Medicina/tendências , Faculdades de Odontologia/tendências , Estudantes de Odontologia , Docentes de Odontologia , Humanos , Irlanda , Reino Unido
14.
Eur J Cancer Care (Engl) ; 27(2): e12820, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29337398

RESUMO

Clinical trials of adjuvant endocrine therapy in women with early breast cancer have consistently reported that genitourinary symptoms are common. However, little is known about women's experiences of genitourinary symptoms, their views about the symptoms and how they impact on their lives. The aim of this study was to explore knowledge, attitudes and experiences of genitourinary symptoms among women receiving adjuvant endocrine therapy for early breast cancer. Thirty-two semi-structured interviews were conducted and subjected to a rigorous qualitative analysis. Genitourinary symptoms were commonly reported to negatively impact on personal, social and physical activities, were often attributed to anxiety and stress and were a source of embarrassment. Women also commented on the limited information available or provided regarding the potential genitourinary adverse effects of adjuvant endocrine therapy. There was a general lack of awareness that their symptoms could be associated with or exacerbated by adjuvant endocrine therapy. Women indicated a preference to receive information and advice about potential management options from either their general practitioner or specialist. These findings underscore the importance of improving communication and increasing awareness among both clinicians and patients about the potential impact of adjuvant endocrine therapy on genitourinary symptoms.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/psicologia , Doenças Urogenitais Femininas/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Idoso , Ansiedade/etiologia , Atitude Frente a Saúde , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante , Feminino , Comportamento de Busca de Ajuda , Humanos , Acontecimentos que Mudam a Vida , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Autorrelato , Disfunções Sexuais Fisiológicas/etiologia , Incontinência Urinária/psicologia
15.
Eur J Pain ; 21(5): 815-826, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-27977068

RESUMO

BACKGROUND: Individual patient data (IPD) meta-analysis of existing randomized controlled trials (RCTs) is a promising approach to achieving sufficient statistical power to identify sub-groups. We created a repository of IPD from multiple low back pain (LBP) RCTs to facilitate a study of treatment moderators. Due to sparse heterogeneous data, the repository needed to be robust and flexible to accommodate millions of data points prior to any subsequent analysis. METHODS: We systematically identified RCTs of therapist delivered intervention for inclusion to the repository. Some were obtained through project publicity. We requested both individual items and aggregate scores of all baseline characteristics and outcomes for all available time points. The repository is made up of a hybrid database: entity-attribute-value and relational database which is capable of storing sparse heterogeneous datasets. We developed a bespoke software program to extract, transform and upload the shared data. RESULTS: There were 20 datasets with more than 3 million data points from 9328 participants. All trials collected covariates and outcomes data at baseline and follow-ups. The bespoke standardized repository is flexible to accommodate millions of data points without compromising data integrity. Data are easily retrieved for analysis using standard statistical programs. CONCLUSIONS: The bespoke hybrid repository is complex to implement and to query but its flexibility in supporting datasets with varying sets of responses and outcomes with different data types is a worthy trade off. The large standardized LBP dataset is also an important resource useable by other LBP researchers. SIGNIFICANCE: A flexible adaptive database for pain studies that can easily be expanded for future researchers to map, transform and upload their data in a safe and secure environment. The data are standardized and harmonized which will facilitate future requests from other researchers for secondary analyses.


Assuntos
Bases de Dados Factuais , Dor Lombar/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Pessoal de Saúde , Humanos , Resultado do Tratamento
16.
Clin Genet ; 92(2): 121-133, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27643459

RESUMO

Evidence suggests that a significant proportion of individuals referred to cancer genetic counselling (GC) do not attend, and thus may not be engaged in adequate cancer risk management. We aimed to review the literature to better understand barriers to accessing GC and how they may be overcome. We conducted a systematic literature search for articles examining factors influencing cancer GC uptake as well as motivators and barriers to GC attendance. Factors were categorised as sociodemographic, psychosocial or clinical. The literature search identified 1413 citations, 35 of which met the inclusion criteria. GC uptake ranged from 19% to 88%. With the exceptions of education level, socioeconomic status, cancer-specific distress, personal cancer diagnosis and actual and perceived risk of cancer, support was lacking for most sociodemographic, clinical and psychosocial factors as predictors of GC uptake. Cost and logistical barriers, emotional concerns, family concerns and low perceived personal relevance were reported as important considerations for those declining GC. We conclude that there is poor understanding of GC and a lack of decision support among those referred to GC. Research into ways of providing education and support to referred individuals will be important as the scope and availability of GC and genetic testing broaden.


Assuntos
Aconselhamento Genético/psicologia , Predisposição Genética para Doença , Neoplasias/genética , Neoplasias/psicologia , Humanos , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Classe Social
17.
J Fluoresc ; 26(6): 2033-2040, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27524379

RESUMO

Copper(I) complexes of the formula [Cu(L)(PPh3)2]X (1-4) (X = Cl(1), ClO4(2), BF4(3) and PF6(4)) [where L = N-(2-{[(2E)-2-(4-nitrobenzylidenyl)hydrazinyl]carbonyl}phenyl)benzamide; PPh3 = triphenylphosphine] have been prepared by the condensation of N-[2-(hydrazinocarbonyl)phenyl]benzamide with 4-nitrobenzaldehyde followed by the reaction with CuCl, [Cu(MeCN)4]ClO4, [Cu(MeCN)4]BF4 and [Cu(MeCN)4]PF6 in presence of triphenylphosphine as a coligand. Complexes 1-4 were then characterized by elemental analyses, FTIR, UV-visible and 1H NMR spectroscopy. Mononuclear copper(I) complexes 1-4 were formed with L in its keto form by involvement of azomethine nitrogen and the carbonyl oxygen along with two PPh3 groups. A single crystal X-ray diffraction study of the representative complex [(Cu(L)(PPh3)2]CIO4 (2) reveals a distorted tetrahedral geometry around Cu(I). Crystal data of (2): space group = C2/c, a = 42.8596 (9) Å, b = 14.6207 (3) Å, c = 36.4643 (7) Å, V = 20,653.7 (7) Å3, Z = 16. Complexes 1-4 exhibit quasireversible redox behaviour corresponding to a Cu(I)/Cu(II) couple. All complexes show blue-green emission as a result of fluorescence from an intra-ligand charge transition (ILCT), ligand to ligand charge transfer transition (LLCT) or mixture of both. Significant increase in size of the counter anion shows marked effect on quantum efficiency and lifetime of the complexes in solution.

18.
Diabetes Res Clin Pract ; 120: 73-80, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27522562

RESUMO

AIMS: People of South Asian origin experience higher rates of diabetes and complications of diabetes compared to white Europeans. Therefore, it is important to identify those with undiagnosed diabetes and those at high risk of developing diabetes, in order to intervene with lifestyle intervention to reduce risk and prevent complications. We conducted a study to assess the feasibility of delivering a faith centre based pathway for screening and referral to group education for high risk individuals to increase screening uptake and reduce diabetes risk. METHODS: Opportunistic screening and early intervention strategy for people at risk of diabetes and cardiovascular disease in local faith centres. The screening consisted of a diabetes risk assessment tool and a near patient test for HbA1c. Participants found to be at high risk of diabetes (HbA1c 6-6.4%/42-46mmol/mol) were offered a 'Walking Away from Diabetes' group educational intervention aimed at increasing exercise levels and reducing diabetes risk. RESULTS: 252 participants were screened during four screening events. 202 participants (80.2%) gave consent for their data to be included in the analysis. 72.4% of participants were found to have a high diabetes risk score. 32 participants (15.8%) had a HbA1c result (6-6.4%/42-46mmol/mol). Eight participants (4.0%) had a (HbA1c ⩾6.5%/⩾47mmol/mol). Of those eligible for the diabetes prevention education programme, 18 participants (56.3%) attended. CONCLUSIONS: This study confirms that screening followed by group education within faith centre settings is feasible and acceptable to participants. The strategies chosen were effective in achieving a high screening yield and high uptake of group education.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Intervenção Educacional Precoce , Programas de Rastreamento , Educação de Pacientes como Assunto , Adulto , Idoso , Povo Asiático , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/psicologia , Exercício Físico , Estudos de Viabilidade , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Religião , Medição de Risco
19.
Diabetes Res Clin Pract ; 118: 12-20, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27485852

RESUMO

AIMS: To assess the opportunistic use in primary care of a computer risk score versus a self-assessment risk score for undiagnosed type 2 diabetes. METHODS: We conducted a randomised controlled trial in 11 primary care practices in the UK. 577 patients aged 40-75years with no current diagnosis of type 2 diabetes were recruited to a computer based risk score (Leicester Practice Computer Risk Score (LPCRS)) or a patient self-assessment score (Leicester Self-Assessment Score (LSAS)). RESULTS: The rate of self-referral blood tests was significantly higher for the LPCRS compared to the LSAS, 118.98 (95% CI: 102.85, 137.64) per 1000 high-risk patient years of follow-up compared to 92.14 (95% CI: 78.25, 108.49), p=0.022. Combined rate of diagnosis of type 2 diabetes and those at risk of developing the disease (i.e. impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)) was similar between the two arms, 15.12 (95% CI: 9.11, 25.08) per 1000 high-risk patient years for LPCRS compared to 14.72 (95% CI: 9.59, 22.57) for the LSAS, p=0.699. For the base case scenario the cost per new case of type 2 diabetes diagnosed was lower for the LPCRS compared to the LSAS, £168 (95% Credible Interval (CrI): 76, 364), and £352 (95% CrI: 109, 1148), respectively. CONCLUSIONS: Compared to a self-assessment risk score, a computer based risk score resulted in greater attendance to an initial blood test and is potentially more cost-effective.


Assuntos
Diabetes Mellitus Tipo 2/diagnóstico , Diagnóstico Precoce , Hiperglicemia/diagnóstico , Medição de Risco/métodos , Adulto , Idoso , Análise Custo-Benefício , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/economia , Feminino , Intolerância à Glucose/diagnóstico , Humanos , Hiperglicemia/sangue , Hiperglicemia/economia , Incidência , Masculino , Pessoa de Meia-Idade , Reino Unido/epidemiologia
20.
Methods Cell Biol ; 136: 221-41, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27473912

RESUMO

The zebrafish (Danio rerio) is an important animal model to study cell biology in vivo. Benefits of the zebrafish include a fully annotated reference genome, an easily manipulable genome (for example, by morpholino oligonucleotide or CRISPR-Cas9), and transparent embryos for noninvasive, real-time microscopy using fluorescent transgenic lines. Zebrafish have orthologues of most human septins, and studies using larvae were used to investigate the role of septins in vertebrate development. The zebrafish larva is also an established model to study the cell biology of infection and has recently been used to visualize septin assembly during bacterial infection in vivo. Here, we describe protocols for the study of septins in zebrafish, with emphasis on techniques used to investigate the role of septins in host defense against bacterial infection.


Assuntos
Infecções Bacterianas/genética , Desenvolvimento Embrionário/genética , Septinas/genética , Peixe-Zebra/genética , Animais , Animais Geneticamente Modificados , Bactérias/genética , Bactérias/patogenicidade , Infecções Bacterianas/microbiologia , Modelos Animais de Doenças , Embrião não Mamífero/microbiologia , Interações Hospedeiro-Patógeno/genética , Humanos , Larva/genética , Larva/crescimento & desenvolvimento , Larva/microbiologia , Morfolinos/genética , Peixe-Zebra/crescimento & desenvolvimento , Peixe-Zebra/microbiologia
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