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Varga, Somogy. "Epistemic Authority, Philosophical Explication, and the Bio-Statistical Theory of Disease." Erkenntnis 85, no. 4 (August 29, 2018): 937–56. http://dx.doi.org/10.1007/s10670-018-0058-9.
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Stepanova, Elena S. "Linguocognitive Specifics of the Disease Myth." RUDN Journal of Language Studies, Semiotics and Semantics 12, no. 1 (December 15, 2021): 153–64. http://dx.doi.org/10.22363/2313-2299-2021-12-1-153-164.
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The article deals with the question of cancer myth representation in the popular science medical discourse. This study is carried out according to the linguocultural approach to the study of the cancer myth, which is based on the reconsideration of linguocultural phenomena. Myths about diseases are of linguistic and cultural significance and they are passed down from generation to generation. Those of phenomena that are incomprehensible and frightening are considered to cause additional associations. Cancer diseases refer to such linguocultural phenomena. Myths about diseases reflect the results of this or that form of reconsideration or experience of some phenomena by a particular linguocultural society. The work provides the definitions of the notions myth and disease. The methodology of the study is based on the research by foreign and Russian scientists in the field of study of the notions of myth and disease as semiotic systems. The popular science medical survey The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee served as a research background. It analyses the way the disease myth actualizes in the popular science medical discourse. It shows a mythological plot (or mythological information) to get actualized in a particular situation by means of reference, and the way it contributes to the explication of a particular disease myth. Neither the subject of the message nor the plot of the myth is of importance for the reader, only the influence of the myth on the patients representations of disorder and his emotional state and on the society as a whole makes sense. The study helps conclude that mythological information representing the disease myth is nationally and socially marked, and is characterized by a particular conceptual presentation and is expressed by different linguistic means.
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Gheorghe, Dorin Nicolae, Darian Rusu, Elena Herascu, Dora Maria Popescu, Petra Surlin, and Ion Rogoveanu. "Evaluation of Liver Chemistry Tests and Clinical Parameters in Patients with Periodontal Disease and Chronic Hepatitis C." Revista de Chimie 68, no. 6 (July 15, 2017): 1252–54. http://dx.doi.org/10.37358/rc.17.6.5651.
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The concept of periodontal medicine has been created by taking into consideration the strong connection between the development of the periodontal disease and other general conditions. The presence in blood, saliva and gingival fluid of certain inflammatory markers that are common for the two conditions � periodontitis and chronic hepatitis C, that can generate the appearance of the periodontal inflammation, can be an explication for the probable interconnection of the two conditions. The purpose of this pilot study is to investigate whether chronic hepatitis C can be a worsening factor for the development of the periodontal disease, by setting correlations between the periodontal pathology and some metabolic markers of both hepatitis C and periodontitis patients in comparison to periodontitis-only ones. Positive correlations would justify the expansion of the study for a larger group of patients and the dosage of inflammatory markers for biologic fluids such as blood, saliva and gingival fluid.
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Borisova, O., G. Kopeyko, V. Gusev, E. Gedevani, and T. Vladimirova. "Value-meaning formations in mentally ill patients with a religious worldview." European Psychiatry 64, S1 (April 2021): S685—S686. http://dx.doi.org/10.1192/j.eurpsy.2021.1816.
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IntroductionIt is necessary to consider the religious worldview and spiritual needs of patients with mental illness in the course of psychotherapy and rehabilitation.ObjectivesThe explication of value-meaning formations (VMF) in mental patients with a religious worldview.MethodsG. Kelly’s methodology of personal constructs (Method of Triads, Hinkle’s laddering technique, the assessment repertory grid by F.Fransella&D.Bannister) and statistical analyses were applied.Results1. The structure of the value-meaning formations (VMF) of patients with religious worldview was characterized by its integrity, which is prerequisite for coping. 2. Opposite, patients with absence of religious belief had substantial destruction of integrity and plurality of relationships between VMF. 3. The content of the VMF of mental patients with religious worldview and healthy believers had similarities. 4. In the content of VMF meta-values were: 1. active aspiration to God and the realization of own existence; 2. material well-being in the earthly world; 3. “unselfish” ability to get along without causing harm; 4. feeling of inner confidence.ConclusionsMental disease affects VMF of believers and unbelievers in different way. In unbelievers, the structure of VMF in the course of disease significantly changes. In believers, the disease does not destroy the basis of VMF and allows to keep safe the key elements. The stability of VMF in the believers may be explained by the meaningfulness of life. The concepts of “health” and “disease” are included in the worldview of believers, in the general context of their spiritual, psychic and physical life.DisclosureNo significant relationships.
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Reece, Albert Stuart, and Gary Kenneth Hulse. "Novel Insights into Potential Cannabis-Related Cancerogenesis from Recent Key Whole Epigenome Screen of Cannabis Dependence and Withdrawal: Epidemiological Commentary and Explication of Schrott et al." Genes 14, no. 1 (December 22, 2022): 32. http://dx.doi.org/10.3390/genes14010032.
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Whilst the cannabis-cancer link has been traditionally described as controversial recent whole nation and whole continent studies have demonstrated that well documented laboratory-based multimodal cannabinoid genotoxicity is indeed reflected in numerous cancer types in larger epidemiological series. A recent longitudinal human sperm epigenome-wide DNA methylation screen in both cannabis dependence and cannabis withdrawal has revealed remarkable insights into the manner in which widespread perturbations of DNA methylation may lead to cancerogenic changes in both the exposed and subsequent generations as a result of both cannabis exposure and withdrawal. These results therefore powerfully strengthen and further robustify the causal nature of the relationship between cannabinoid exposure and cancerous outcomes well beyond the previously published extensive mechanistic literature on cannabinoid genotoxicity. The reported epigenomic results are strongly hypothesis generating and call powerfully for further work to investigate oncogenic mechanisms in many tissues, organs and preclinical models. These epigenomic results provide an extraordinarily close predictive account for the epidemiologically observed pattern of cannabis-related malignant disease and indicate that malignant and multigenerational cannabinoid epigenotoxicity is potentially a significant and major public health concern.
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Goyal, Prerna, and Shibba Takkar Chhabra. "Impact of COVID-19 on Cardio-obstetric Risk Indicators: Future Directions." Indian Journal of Cardiovascular Disease in Women WINCARS 5, no. 03 (September 2020): 209–15. http://dx.doi.org/10.1055/s-0040-1716815.
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AbstractCardiovascular illness is one the foremost causes of death in females. The goal of preventive medicine is to identify and target high-risk females belonging to the younger age group in order to prevent future onset of cardiovascular pathologies. Certain obstetric complications like idiopathic preterm birth, preeclampsia (PE), gestational diabetes and abruptio placentae mark their presence in the checklist of risk indicators for cardiovascular diseases (CVD) among the female population. Previous severe acute respiratory syndrome-1 (SARS-1) infections recorded a significant impact on maternal and fetal outcomes. In this article, we aim to focus on the incidence of cardiovascular risk indicators with the incessant novel Coronavirus disease-19 (COVID-19) pandemic in pregnant women and to provide recommendations for venous thromboembolism (VTE) prophylaxis in infected females. As the disease is novel and gradually unfolding to clinicians globally, the data and the publications are also evolving. Studies on COVID-19 in pregnancy has shown an increase in the number of preterm births, and PE with some reports on vertical transmission, but no significant increase in miscarriage, still births and teratogenicity. Preterm births appear more likely to be iatrogenic rather than idiopathic, owing to severity of infection or maternal/fetal safety. Causal association of virus with PE needs further analysis by large population studies, as both have common overlapping clinical and laboratory parameters. Direct placental involvement by virus leading on to PE or infection itself simulating PE needs further explication. Assessment of placental function, histopathological examination, and measurement of antiangiogenic factors are some of the suggested measures to differentiate further. Peripartum cardiomyopathy in COVID-19 positive pregnant females has not yet been actively explored, particularly in cases of clinical deterioration. Practical utilization of handheld point-of-care echocardiography machines stand in need for diagnosing myocardial dysfunction in this pandemic. COVID-19 infection and pregnancy together may impart a greater thromboembolism risk due to their inherent hypercoagulable states. All pregnant females with COVID-19 infection are candidates for VTE prophylaxis, both antepartum and postpartum depending on the severity of illness.
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CHAMOUX, A., C. PLOTTON, and X. GOCKO. "Modèles explicatifs des patients souffrant de Lyme chronique." EXERCER 31, no. 163 (May 1, 2020): 196–201. http://dx.doi.org/10.56746/exercer.2020.163.196.
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Contexte : L’existence du « Lyme chronique » est l’objet de controverses scientifiques depuis plus de 10 ans. Dans le cas du Lyme chronique, la maladie du malade-illness diffère de la maladie du médecin-disease. Un modèle explicatif sous-tend illness et disease. Il regroupe « l’étiologie, le moment et le mode d’apparition des symptômes, la physiopathologie, l’évolution du trouble et le traitement ». Les différences de modèles explicatifs compliquent les soins. Objectif : Recueillir les modèles explicatifs de patients pensant souffrir de maladie de Lyme chronique et des « Lyme doctors » afin de faciliter la mise en place de réseaux sémantiques support du soin. Méthode : Étude qualitative par entretiens semi-dirigés auprès de patients présentant des symptômes persistants après une borréliose de Lyme avec un guide d’entretien fondé sur la médecine narrative. Les entretiens ouverts pour les « Lymes doctors » ont recherché les interactions entre leurs modèles explicatifs et ceux des patients. Résultats : Borrelia burgdorferi (Bb) est perçue comme une bactérie intelligente, véritable poison, capable de se cacher et de s’enkyster. Le phénomène d’attribution exogène est autonome et souvent en conflit avec les médecins. Des études de faible niveau de preuve ont recherché la persistance de Bb après un traitement antibiotique conforme aux recommandations. La persistance de traces de la bactérie n’est pas le témoin de l’infection. Conclusion : Établir des ponts entre les modèles explicatifs des patients et des médecins demande de réfuter les théories sans fondement scientifique et de reconnaître la souffrance.
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Shishkova, Alexandra M., Viktor V. Bocharov, Anastasia M. Tverdokhlebova, Yulia S. Chernaya, Aleksandr Ja Vuks, Vladimir A. Mikhailov, and Natalia A. Sivakova. "Interrelationship of psychological distress, basic beliefs and perceptions of family relationships in informal caregivers of children and adults with epilepsy." Pediatrician (St. Petersburg) 13, no. 4 (November 27, 2022): 115–27. http://dx.doi.org/10.17816/ped134115-127.
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BACKGROUND: Relatives caring for an epilepsy patient play a significant role in the care system and maintaining the well-being of the chronically ill and often suffer from significant stress.
AIM: The aim of the study was to reveal the relationship of psychological distress, basic beliefs and perceptions of family relationships in relatives taking care of children and adults with epilepsy.
MATERIALS AND METHODS: The study involved 62 relatives caring for patients with epilepsy, 44 relatives of children (mean [SD] age, 34,64 6,73 years) and 18 relatives of adults (mean [SD] age, 48,72 10,99 years). The Symptom Checklist-90-Revised (SCL-90-R), the World Assumption Scale and the Family Environment Scale was used as an assessment tools. Also semi-structured interview for assessing socio-demographic and clinical characteristics was applied.
RESULTS: The results of the study revealed significant similarities of the studied groups both in the explication of the psychopathological symptoms and in perception of their own personality, the surrounding world and intra-family interaction. Informal caregivers of such patients demonstrates significant variability and severity of psychopathological symptoms. And their perception of themselves and the surrounding world is characterized by the faade tendencies that act as psychological protection that prevents the catastrophizing of the subjective assessment of the situation associated with the chronic disease of a loved one.
CONCLUSIONS: The study demonstrated the need to develop specialized psychotherapeutic interventions aimed at reducing the level of psychological distress in informal caregivers of patients with epilepsy. During the development and carrying out of such interventions, it is important to take into account the subjective assessment of caregivers available life situation, as well as his/her personal values and attitudes that largely determine the severity of psychopathological symptoms.
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Palmer, Nynikka R., Janet K. Shim, Celia P. Kaplan, Dean Schillinger, Sarah D. Blaschko, Benjamin N. Breyer, and Rena J. Pasick. "Ethnographic investigation of patient–provider communication among African American men newly diagnosed with prostate cancer: a study protocol." BMJ Open 10, no. 8 (August 2020): e035032. http://dx.doi.org/10.1136/bmjopen-2019-035032.
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IntroductionIn the USA, African American men bear a disproportionate burden of prostate cancer (PCa) compared with all other groups, having a higher incidence and mortality, poorer quality of life and higher dissatisfaction with care. They are also less likely to receive guideline-concordant treatment (eg, undertreatment of aggressive disease). Inadequate patient–provider communication contributes to suboptimal care, which can be exacerbated by patients’ limited health literacy, providers’ lack of communication skills and time constraints in low-resource, safety net settings. This study is designed to examine the communication experiences of African American patients with PCa as they undertake treatment decision-making.Methods and analysisUsing an ethnographic approach, we will follow 25 African American men newly diagnosed with PCa at two public hospitals, from diagnosis through treatment decision. Data sources include: (1) audio-recorded clinic observations during urology, radiation oncology, medical oncology and primary care visits, (2) field notes from clinic observations, (3) patient surveys after clinic visits, (4) two in-depth patient interviews, (5) a provider survey, and (6) in-depth interviews with providers. We will explore patients’ understanding of their diagnoses and treatment options, sources of support in decision-making, patient–provider communication and treatment decision-making processes. Audio-recorded observations and interviews will be transcribed verbatim. An iterative process of coding and team discussions will be used to thematically analyse patients’ experiences and providers’ perspectives, and to refine codes and identify key themes. Descriptive statistics will summarise survey data.Ethics and disseminationTo our knowledge, this is the first study to examine in-depth patient–provider communication among African American patients with PCa. For a population as marginalised as African American men, an ethnographic approach allows for explication of complex sociocultural and contextual influences on healthcare processes and outcomes. Study findings will inform the development of interventions and initiatives that promote patient-centred communication, shared decision-making and guideline-concordant care. This study was approved by the University of California San Francisco and the Alameda Health System Institutional Review Boards.
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Merzlova, N. B., I. A. Serova, and A. Yu Yagodina. "Medical and sociological explication of the problem of infectious diseases prophylaxis among pregnant women." Health Risk Analysis, no. 4 (April 2016): 128–34. http://dx.doi.org/10.21668/health.risk/2016.4.14.
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Merzlova, N. B., Serova, and A. Yu Yagodina. "Medical and sociological explication of the problem of infectious diseases prophylaxis among pregnant women." Health Risk Analysis, no. 4 (April 2016): 128–34. http://dx.doi.org/10.21668/health.risk/2016.4.14.eng.
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Timmer, Richard T., and Robert B. Gunn. "The Molecular Basis for Na-Dependent Phosphate Transport in Human Erythrocytes and K562 Cells." Journal of General Physiology 116, no. 3 (August 14, 2000): 363–78. http://dx.doi.org/10.1085/jgp.116.3.363.
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The kinetics of sodium-stimulated phosphate flux and phosphate-stimulated sodium flux in human red cells have been previously described (Shoemaker, D.G., C.A. Bender, and R.B. Gunn. 1988. J. Gen. Physiol. 92:449–474). However, despite the identification of multiple isoforms in three gene families (Timmer, R.T., and R.B. Gunn. 1998. Am. J. Physiol. Cell Physiol. 274:C757–C769), the molecular basis for the sodium-phosphate cotransporter in erythrocytes is unknown. Most cells express multiple isoforms, thus disallowing explication of isoform-specific kinetics and function. We have found that erythrocyte membranes express one dominant isoform, hBNP-1, to which the kinetics can thus be ascribed. In addition, because the erythrocyte Na-PO4 cotransporter can also mediate Li-PO4 cotransport, it has been suggested that this transporter functions as the erythrocyte Na–Li exchanger whose activity is systematically altered in patients with bipolar disease and patients with essential hypertension. To determine the molecular basis for the sodium-phosphate cotransporter, we reasoned that if the kinetics of phosphate transport in a nucleated erythroid-like cell paralleled those of the Na-activated pathway in anucleated erythrocytes and yet were distinct from those known for other Na-PO4 cotransporters, then the expressed genes may be the same in both cell types. In this study, we show that the kinetics of sodium phosphate cotransport were similar in anuclear human erythrocytes and K562 cells, a human erythroleukemic cell line. Although the erythrocyte fluxes were 750-fold smaller, the half-activation concentrations for phosphate and sodium and the relative cation specificities for activation of 32PO4 influx were similar. Na-activation curves for both cell types showed cooperativity consistent with the reported stoichiometry of more than one Na cotransported per PO4. In K562 cells, external lithium activation of phosphate influx was also cooperative. Inhibition by arsenate, KI = 2.6–2.7 mM, and relative inhibition by amiloride, amiloride analogs, phosphonoformate, and phloretin were similar. These characteristics were different from those reported for hNaPi-3 and hPiT-1 in other systems. PCR analysis of sodium-phosphate cotransporter isoforms in K562 cells demonstrated the presence of mRNAs for hPiT-1, hPiT-2, and hBNP-1. The mRNAs for hNaPi-10 and hNaPi-3, the other two known isoforms, were absent. Western analysis of erythrocytes and K562 cells with isoform-specific antibodies detected the presence of only hBNP-1, an isoform expressed in brain neurons and glia. The similarities in the kinetics and the expression of only hBNP-1 protein in the two cell types is strong evidence that hBNP-1 is the erythrocyte and K562 cell sodium-phosphate cotransporter.
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Anaele, Agaptus. "Explicating Transformative Participation and Contributions of Black Youth in Heart Disease Campaign." ATHENS JOURNAL OF HEALTH & MEDICAL SCIENCES 6, no. 2 (July 1, 2019): 91–108. http://dx.doi.org/10.30958/ajhms.6-2-3.
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Muindu, Japheth Peter. "From Limbo to Continuity Existential Analysis of Joseph Situma’s The Mysterious Killer." International Journal of Linguistics, Literature and Translation 3, no. 9 (September 30, 2020): 246–49. http://dx.doi.org/10.32996/ijllt.2020.3.9.25.
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The paper is an explication of the stoicism and the resilience of the diseased characters in Joseph Situma’s The Mysterious Killer which is framed within Sartrean existential epistemology with a focus on his concept of authenticity. For Sartre, authentic existence is related to pursuance of transcendent goals, honesty and courage. Human beings, Sartre opines, impose values in their lives in moments of forlornness. This concept is germane to analyzing the existential necessity of the diseased characters in the selected text to transcend the limbo of their existence as HIV/AIDS patients.
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Mpofu, Bhekimpilo, and Musawenkosi Khanyile. "Transitional trajectories of academic progress for low-status students at a University in South Africa." Higher Education, Skills and Work-Based Learning 10, no. 1 (November 27, 2019): 275–92. http://dx.doi.org/10.1108/heswbl-05-2019-0066.
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Purpose The purpose of this paper is to explore the perceptions of university undergraduate students who originate from disadvantaged South African schools. The perceptions probed are those that relate to their material circumstances, learning and teaching environment and academic progress. Design/methodology/approach The paper draws on a theoretical framework that underscores the primacy of the environment blended with transition theory to explain environmental influences on disadvantaged students’ academic progression at university. Data were gathered through detailed face-to-face interviews with eight participants and from the open-ended section of a questionnaire administered to 41 students from which the 8 students were drawn. Findings The findings demonstrate that disadvantaged students require both physical and socio-psychological support in order to succeed at university. Research limitations/implications A university in South Africa and the students from low quintile schools provide the case study for the explication of the findings of this study. Ethical issues such as seeking the informed consent of the participants to access their academic records weighed against the potency or robustness of the results of this study, because few of the participants allowed this researcher to access their results. Thus, this study focussed on potentially sensitive areas such as the academic records of students and poverty. As such it was extremely difficult to persuade disadvantaged students to participate in this study. Practical implications The study is thus useful for the school system, families and higher education institutions in the quest to provide the much-needed socio-psychological or “empathetic infrastructure” that acts as the cytoplasm for disadvantaged students’ academic progress at university. Social implications By invoking the primacy of the environment under the rubrics of epigenetics, this study also sought to contribute to the debate around the human genome – a grand ambitious global scientific project launched in the late 1980s to generate a catalogue of all the genes present in humans. However, this was a smokescreen because there are simply not enough genes to account for the complexity of the human life or human disease. By invoking the theory of transition, this study sought to fathom how to promote a favourable teaching and learning environment for poor students at university in a holistic manner. Originality/value This study utilised an empirically supported definition of disadvantage: that of students coming from no fee schools, as classified by the Department of Education based on Household Expenditure statistics of 2002 using the quintile system. The quintile system is based on average measures of income, unemployment rates and educational levels. To date, there is no published research utilising the school quintile system to define disadvantaged students in higher education in South Africa. This paper, which investigates such a sample from a university, is therefore ground-breaking and novel.
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Gillaizeau, Florence, Etienne Dantan, Magali Giral, and Yohann Foucher. "A multistate additive relative survival semi-Markov model." Statistical Methods in Medical Research 26, no. 4 (June 7, 2015): 1700–1711. http://dx.doi.org/10.1177/0962280215586456.
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Medical researchers are often interested to investigate the relationship between explicative variables and times-to-events such as disease progression or death. Such multiple times-to-events can be studied using multistate models. For chronic diseases, it may be relevant to consider semi-Markov multistate models because the transition intensities between two clinical states more likely depend on the time already spent in the current state than on the chronological time. When the cause of death for a patient is unavailable or not totally attributable to the disease, it is not possible to specifically study the associations with the excess mortality related to the disease. Relative survival analysis allows an estimate of the net survival in the hypothetical situation where the disease would be the only possible cause of death. In this paper, we propose a semi-Markov additive relative survival (SMRS) model that combines the multistate and the relative survival approaches. The usefulness of the SMRS model is illustrated by two applications with data from a French cohort of kidney transplant recipients. Using simulated data, we also highlight the effectiveness of the SMRS model: the results tend to those obtained if the different causes of death are known.
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Conley, Terri D., and Jennifer L. Piemonte. "Monogamy as Public Policy for STD Prevention: In Theory and in Practice." Policy Insights from the Behavioral and Brain Sciences 7, no. 2 (October 2020): 181–89. http://dx.doi.org/10.1177/2372732220943228.
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Monogamy is current public policy for preventing sexually transmitted diseases (STDs). To evaluate whether monogamy is serving its intended purposes, the Centers for Disease Control’s (CDC’s) definition of monogamy is considered. This definition does not convey to the public the fact that monogamy must be practiced very strictly to be effective and implies that serial monogamy is a safe practice. Benefits and drawbacks of employing (different versions of) monogamy to reduce STD transmission are considered. Although certain forms of monogamy are efficacious in reducing STDs, these versions of monogamy have not been adopted by the public and widely practiced forms of monogamy are not effective in practice. Finally, this review considers whether the public policy of monogamy helps society achieve its sexual health goals, explicating strengths and weaknesses of monogamy advice versus other tactics that might be utilized to curb STDs.
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Goddard, Cliff, and Anna Wierzbicka. "Semantics in the time of coronavirus: “Virus”, “bacteria”, “germs”, “disease” and related concepts." Russian Journal of Linguistics 25, no. 1 (December 15, 2021): 7–23. http://dx.doi.org/10.22363/2687-0088-2021-25-1-7-23.
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This study proposes Natural Semantic Metalanguage semantic explications for the English words virus (in two senses), bacteria, germs, and for the related words sick, ill, and disease. We concentrate on their nave or folk meanings (Apresjan 1992) in everyday English, as opposed to scientific or semi-scientific meanings. In this way, the paper makes a start on uncovering the folk epidemiology embedded in the English lexicon. The semantics of words like virus, bacteria and germs is not, however, a purely academic matter. It is also a matter of effective health education and health communication. To reach people at a time of an epidemic, explanations need to connect with ordinary peoples ways of thinking and speaking. This paper argues that the simple and cross-translatable words of NSM, and minimal languages based on it, can be effective tools not only for linguistic semantics but also for education and communication everywhere - at the local school and in the world at large.
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Jan, VAN LUNZEN, J. SCHMITZ, H. SCHMITZ, and H. DIETRICH. "NUCLEOSIDE ANALOGUES SUPPRESS VIRAL EXPLICATION IN PATIENTS WITH HIGH VIRUS LOAD IN VITRO BUT INTERFERE WITH T-CELL BLASTOCRNESIS IN EARLIER STAGES OF HIV-INFECTION." AIDS 8, Supplement 4 (November 1994): S29. http://dx.doi.org/10.1097/00002030-199411004-00112.
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Guo, Rongjie, Qi Liang, Yun He, Chenchen Wang, Jiaxuan Jiang, Taige Chen, Di Zhang, and Kai Hu. "Mesenchymal Stromal Cells-Derived Extracellular Vesicles Regulate Dendritic Cell Functions in Dry Eye Disease." Cells 12, no. 1 (December 22, 2022): 33. http://dx.doi.org/10.3390/cells12010033.
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We explored the therapeutic efficacy of Mesenchymal stromal cells-derived extracellular vesicles (MSC-EVs) and its inhibition of the functions of dendritic cells (DCs) in dry eye disease (DED). MSC-EVs were isolated from the culture supernatants of mesenchymal stromal cells (MSCs) and characterized. In vitro, human corneal epithelial cells (HCECs) were cultured in hyperosmotic medium to simulate the DED hyperosmotic environment and treated with MSC-EVs. Cell viability was assessed, and the expression of inflammatory cytokines was quantified. Next, we induced DED in female C57BL/6 mice and divided the mice into groups treated with either MSC-EVs or phosphate buffer solution (PBS) eye drops. Disease severity was assessed; mRNA expression of inflammatory cytokines was analyzed by RT-PCR; and Th17 cells were detected by flow cytometry. Lastly, we evaluated DCs by immunofluorescence and flow cytometric analysis to assess its amounts and maturation. MSC-EVs showed protective effects on HCECs under hyperosmotic stress in vitro, suppressing the expression of inflammatory cytokines. In vivo, mice topically treated with MSC-Evs presented reduced DED disease severity compared to PBS-treated mice. MSC-Evs downregulated the expression of inflammatory cytokines, including TNF-α, IL-6, and IL-1β, as well as the frequency of Th17 cells. Further investigation showed that MSC-EVs suppressed the increase of amounts and the maturation of DCs in DED. Changes of morphological characters of DCs were also inhibited by MSC-EVs. Our study revealed that MSC-EVs suppressed ocular surface inflammation by inhibiting DCs activation-mediated Th17 immune responses, explicating the therapeutic potential of MSC-EVs in DED and other ocular surface diseases.
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Adham, M., D. F. Mirza, F. Chapuis, A. D. Mayer, S. R. Bramhall, C. Coldham, J. Baulieux, and J. Buckels. "Results of vascular resections during pancreatectomy from two European centres: an analysis of survival and disease-free survival explicative factors." HPB 8, no. 6 (December 2006): 465–73. http://dx.doi.org/10.1080/13651820600839944.
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Ramírez-Cendrero, Juan M., and Eszter Wirth. "Empresas públicas, fondos soberanos y enfermedad holandesa: El caso de Noruega / Public enterprises, sovereign wealth funds and Dutch disease: The case of Norway." Revista Brasileira de Planejamento e Desenvolvimento 6, no. 2 (April 1, 2017): 180. http://dx.doi.org/10.3895/rbpd.v6n2.5768.
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Noruega es un caso de economía con abundante dotación de recursos naturales que ha escapado a la maldición de los recursos naturales y no sufre los efectos de la enfermedad holandesa. De entre todos los factores explicativos del caso noruego, se estudian fundamentalmente dos: el Fondo Gubernamental de Pensiones y la actuación de las empresas públicas, como Statoil. A partir de estos aspectos, pueden extraerse lecciones para los desafíos que enfrentan las economías subdesarrolladas ricas en hidrocarburos (como Bolivia). Particularmente, la capacidad para identificar restricciones estructurales (productivas o institucionales) de las economías subdesarrolladas, o la importancia de la persistente búsqueda de objetivos de transformación productiva a largo plazo, son aspectos esenciales para lograr un uso inteligente de los recursos naturales.
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Lemos, Mariantonia. "La teoría de la alóstasis como mecanismo explicativo entre los apegos inseguros y la vulnerabilidad a enfermedades crónicas." Anales de Psicología 31, no. 2 (April 25, 2015): 452. http://dx.doi.org/10.6018/analesps.31.2.176361.
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The attachment bond has been proven to be a vulnerability factor for chronic diseases. This article seeks to clarify this relationship by the theory of allostasis. Allostasis theory refers to the regulation of complex physiological processes by systemic response in the body maintaining physiological stability when a person is confronted by challenges. The insecure attachments confront children from his first years with stressful events, by failing to provide security, fundamental purpose of attachment. In this way insecure attachments could impact the calibration of the stress system in the early age and would be factors that increases the allostatic load by a larger number of stressful life events compare to people with secure attachment, a cognitive appraisal of threat that leads to the development of hypervigilance and the impact on stress regulation systems in the body.
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Monterde Fuertes, Alberto. "Disease mongering y la epidemia de la depresión: una revisión histórica del desarrollo del tratamiento psiquiátrico de la depresión y su relación con el proceso de promoción de enfermedades." Eikasía Revista de Filosofía, no. 107 (June 1, 2022): 57–92. http://dx.doi.org/10.57027/eikasia.107.297.
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Desde mediados del siglo XX ha aumentado progresivamente la incidencia y prevalencia de la depresión y se ha llegado a considerar que existe una epidemia de depresión. Los autores que han analizado esta idea consideran que la evidencia no avala tales extremos, pero señalan diferentes factores explicativos propios del desarrollo histórico de la psiquiatría, de su situación interna y de su relación con la sociedad. Tales explicaciones guardan similitud con las características propias de un proceso de disease mongering que se define por ampliar las fronteras de la enfermedad para expandir los mercados. Mostraré como una revisión del desarrollo histórico de la psiquiatría, en relación con estas posibles hipótesis explicativas, permite afirmar que ciertas actitudes o situaciones han podido fomentar un proceso de disease mongering asociado a intereses privados y valores de los agentes relevantes en el desarrollo de la psiquiatría en cuestiones como: creación de un método diagnóstico, innovación farmacológica y regulación de nuevos fármacos. Sin embargo, debido a limitaciones conceptuales o epistémicas, no se puede realizar una afirmación más fuerte.
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Borgoni, Riccardo, Paola Del Bianco, Nicola Salvati, Timo Schmid, and Nikos Tzavidis. "Modelling the distribution of health-related quality of life of advanced melanoma patients in a longitudinal multi-centre clinical trial using M-quantile random effects regression." Statistical Methods in Medical Research 27, no. 2 (March 17, 2016): 549–63. http://dx.doi.org/10.1177/0962280216636651.
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Health-related quality of life assessment is important in the clinical evaluation of patients with metastatic disease that may offer useful information in understanding the clinical effectiveness of a treatment. To assess if a set of explicative variables impacts on the health-related quality of life, regression models are routinely adopted. However, the interest of researchers may be focussed on modelling other parts (e.g. quantiles) of this conditional distribution. In this paper, we present an approach based on quantile and M-quantile regression to achieve this goal. We applied the methodologies to a prospective, randomized, multi-centre clinical trial. In order to take into account the hierarchical nature of the data we extended the M-quantile regression model to a three-level random effects specification and estimated it by maximum likelihood.
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Ibrahim, Nurul ‘Izzah, Syed Fairus, and Isa Naina Mohamed. "The Effects and Potential Mechanism of Oil Palm Phenolics in Cardiovascular Health: A Review on Current Evidence." Nutrients 12, no. 7 (July 10, 2020): 2055. http://dx.doi.org/10.3390/nu12072055.
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Cardiovascular disease (CVD) is globally known as the number one cause of death with hyperlipidemia as a strong risk factor for CVD. The initiation of drug treatment will be recommended if lifestyle modification fails. However, medicines currently used for improving cholesterol and low-density lipoprotein cholesterols (LDL-C) levels have been associated with various side effects. Thus, alternative treatment with fewer or no side effects needs to be explored. A potential agent, oil palm phenolics (OPP) recovered from the aqueous waste of oil palm milling process contains numerous water-soluble phenolic compounds. It has been postulated that OPP has shown cardioprotective effects via several mechanisms such as cholesterol biosynthesis pathway, antioxidant and anti-inflammatory properties. This review aims to summarize the current evidence explicating the actions of OPP in cardiovascular health and the mechanisms that maybe involved for the cardioprotective effects.
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Wysong, Earl. "Conflicting Agendas, Interests, and Actors in Disease Prevention Policy-Making: Business, Labor, and the High Risk Act." International Journal of Health Services 23, no. 2 (April 1993): 301–22. http://dx.doi.org/10.2190/bt1m-49qr-k3we-4qbd.
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During 1985–1988, the U.S. Congress considered and nearly passed the controversial “High Risk Act.” This article analyzes the case in terms of a class-dialectic perspective that views contradictory class interests, the political economy context, intraclass divisions, and institutional biases favoring dominant class interests as important, underlying factors in shaping the character, course, and outcome of the policy-making process. These concepts are used as the basis for explicating the political conflicts surrounding the legislation, the course of its consideration by the Congress, and its ultimate defeat. The sharp labor-business conflicts over the bills are shown to be closely tied to the legislation's potential effects upon their class-based economic and ideological/political interests. The course of Congressional consideration of the legislation is demonstrated as strongly influenced by contextual factors and intraclass divisions, especially those within the business community. Finally, indirect and direct institutional biases favoring business interests are shown to be particularly relevant to the legislation's defeat. In conclusion, the author develops a series of lessons regarding the disease prevention policy-making process which illustrate how the political dynamics and outcomes associated with episodes of occupational health policy reform may be interpreted through a class-dialectic perspective focusing upon class interests, divisions, and struggle.
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Mpeta, Kolentino N., Ntebogang D. Moroke, and Lesego Gabaitiri. "Explicating factors that explain condom use intention among in-school adolescents in Botswana: a structural equation modelling approach." SAHARA-J: Journal of Social Aspects of HIV/AIDS 18, no. 1 (January 1, 2021): 156–69. http://dx.doi.org/10.1080/17290376.2021.2002714.
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Greenstein, Robert J., and Sheldon T. Brown. "A data-based hypothesis explicating the observations that “Smoking is associated with risk for developing inflammatory bowel disease including late onset ulcerative colitis: a prospective study”." Scandinavian Journal of Gastroenterology 53, no. 4 (February 15, 2018): 505. http://dx.doi.org/10.1080/00365521.2018.1440003.
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Reece, Albert Stuart, and Gary Kenneth Hulse. "Clinical Epigenomic Explanation of the Epidemiology of Cannabinoid Genotoxicity Manifesting as Transgenerational Teratogenesis, Cancerogenesis and Aging Acceleration." International Journal of Environmental Research and Public Health 20, no. 4 (February 14, 2023): 3360. http://dx.doi.org/10.3390/ijerph20043360.
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As global interest in the therapeutic potential of cannabis and its’ derivatives for the management of selected diseases increases, it is increasingly imperative that the toxic profile of cannabinoids be thoroughly understood in order to correctly assess the balance between the therapeutic risks and benefits. Modern studies across a number of jurisdictions, including Canada, Australia, the US and Europe have confirmed that some of the most worrying and severe historical reports of both congenital anomalies and cancer induction following cannabis exposure actually underestimate the multisystem thousand megabase-scale transgenerational genetic damage. These findings from teratogenic and carcinogenic literature are supported by recent data showing the accelerated patterns of chronic disease and the advanced DNA methylation epigenomic clock age in cannabis exposed patients. Together, the increased multisystem carcinogenesis, teratogenesis and accelerated aging point strongly to cannabinoid-related genotoxicity being much more clinically significant than it is widely supposed and, thus, of very considerable public health and multigenerational impact. Recently reported longitudinal epigenome-wide association studies elegantly explain many of these observed effects with considerable methodological sophistication, including multiple pathways for the inhibition of the normal chromosomal segregation and DNA repair, the inhibition of the basic epigenetic machinery for DNA methylation and the demethylation and telomerase acceleration of the epigenomic promoter hypermethylation characterizing aging. For cancer, 810 hits were also noted. The types of malignancy which were observed have all been documented epidemiologically. Detailed epigenomic explications of the brain, heart, face, uronephrological, gastrointestinal and limb development were provided, which amply explained the observed teratological patterns, including the inhibition of the key morphogenic gradients. Hence, these major epigenomic insights constituted a powerful new series of arguments which advanced both our understanding of the downstream sequalae of multisystem multigenerational cannabinoid genotoxicity and also, since mechanisms are key to the causal argument, inveighed strongly in favor of the causal nature of the relationship. In this introductory conceptual overview, we present the various aspects of this novel synthetic paradigmatic framework. Such concepts suggest and, indeed, indicate numerous fields for further investigation and basic science research to advance the exploration of many important issues in biology, clinical medicine and population health. Given this, it is imperative we correctly appraise the risk–benefit ratio for each potential cannabis application, considering the potency, severity of disease, stage of human development and duration of use.
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Rigamonti, Ivo E., Valeria Trivellone, Mauro Jermini, Daniele Fuog, and Johann Baumgärtner. "Multiannual infestation patterns of grapevine plant inhabitingScaphoideus titanus(Hemiptera: Cicadellidae) leafhoppers." Canadian Entomologist 146, no. 1 (September 13, 2013): 67–79. http://dx.doi.org/10.4039/tce.2013.51.
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AbstractThe Nearctic leafhopperScaphoideus titanusBall (Hemiptera: Cicadellidae) was accidentally introduced in Europe, where it became the vector of the ‘Candidatus Phytoplasma vitis’ phytoplasma causing the ‘Flavescence dorée’ disease of grapevine plants. A time-varying distributed delay model, simulating the successive occurrences of egg hatching, nymph presence, and adult emergence, is extended here to represent multi-generation infestation patterns of grapevine plants inhabited by eggs, nymphs, and adults. The model extension includes intrinsic mortality, mortality caused by plant dormancy, and low temperatures, development of diapausing and post-diapausing eggs, fecundity rates, and adult longevity. Field observations and published data were used to estimate parameters. The model was validated with five years canopy infestation data from five vineyards not subjected to insecticide treatments and found to have satisfactory explicative and predictive qualities. The model output is most sensitive to a 10% variation in the upper threshold and in the shape parameters of the survivorship function and least sensitive to a 10% variation in the shape parameters of the development function and the survivorship level. Recommendations are made to take into account other factors than temperature and plant phenology and include a wider geographical area in further model development.
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Torres-Macho, Juan, Pablo Ryan, Jorge Valencia, Mario Pérez-Butragueño, Eva Jiménez, Mario Fontán-Vela, Elsa Izquierdo-García, et al. "The PANDEMYC Score. An Easily Applicable and Interpretable Model for Predicting Mortality Associated With COVID-19." Journal of Clinical Medicine 9, no. 10 (September 23, 2020): 3066. http://dx.doi.org/10.3390/jcm9103066.
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This study aimed to build an easily applicable prognostic model based on routine clinical, radiological, and laboratory data available at admission, to predict mortality in coronavirus 19 disease (COVID-19) hospitalized patients. Methods: We retrospectively collected clinical information from 1968 patients admitted to a hospital. We built a predictive score based on a logistic regression model in which explicative variables were discretized using classification trees that facilitated the identification of the optimal sections in order to predict inpatient mortality in patients admitted with COVID-19. These sections were translated into a score indicating the probability of a patient’s death, thus making the results easy to interpret. Results. Median age was 67 years, 1104 patients (56.4%) were male, and 325 (16.5%) died during hospitalization. Our final model identified nine key features: age, oxygen saturation, smoking, serum creatinine, lymphocytes, hemoglobin, platelets, C-reactive protein, and sodium at admission. The discrimination of the model was excellent in the training, validation, and test samples (AUC: 0.865, 0.808, and 0.883, respectively). We constructed a prognostic scale to determine the probability of death associated with each score. Conclusions: We designed an easily applicable predictive model for early identification of patients at high risk of death due to COVID-19 during hospitalization.
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Zamora Sánchez, Felix Dario, Maite Nicole Pinela Torres, and Jazmín Elena Castro Jalca. "Filtrado glomerular como indicador de la función y daño renal: estudio comparativo entre ecuaciones." MQRInvestigar 6, no. 3 (August 13, 2022): 736–63. http://dx.doi.org/10.56048/mqr20225.6.3.2022.736-763.
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La alteración en la función renal es considerada una anomalía estructural que puede seridentificada al analizar los datos de una muestra de orina, sangre y el filtrado glomerular. Enla actualidad existen numerosas fórmulas que utilizan datos como creatinina sérica, edad,sexo y otras variables que han permitido clasificar de manera más efectiva los estadios deenfermedad renal. El objetivo principal de la investigación fue argumentar información sobreFiltrado glomerular como indicador de la función y daño renal: Estudio comparativo entreecuaciones. El diseño metodológico de la investigación fue de tipo narrativa documental,exploratoria de nivel explicativo donde se tomó información de artículos e investigacionesen inglés y español, de revistas indexadas y bases de datos científicas como; Googleacadémico, RefSeek, Pudmed, Dialnet, Scielo, Science Research, Redalyc y Springer Link,sitios web científicos, para el desarrollo teorico y de resultados de la investigación. Losresultados demostraron que existe un predominio en la región de Sur América eninvestigaciones que aplicaron ecuaciones estadísticas para evaluar el filtrado glomerular, lasecuaciones más empleadas son la Modification of Diet in Renal Disease, Chronic KidneyDisease Epidemiology Collaboration y la de Cockcroft-Gault. La amplia gama de ecuacionespara estimar el filtrado glomerular convierte a este método en un indicador confiable almomento de realizar la estimación del filtrado glomerular en diversos grupos poblacionales.
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Donnarumma, Marianna, Davide Fattore, Vincenzo Greco, Maria Ferrillo, Maria Vastarella, Paolo Chiodini, and Gabriella Fabbrocini. "How to Increase Adherence and Compliance in Acne Treatment? A Combined Strategy of SMS and Visual Instruction Leaflet." Dermatology 235, no. 6 (2019): 463–70. http://dx.doi.org/10.1159/000502575.
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Introduction: Acne is a common skin disease with important psychosocial impact. Often inadequate compliance affects the efficacy of the therapy. Because of emerging use of mobile and electronic health technology, the recent literature evaluated the helpfulness of the tools in medication adherence. The first goal of our study was to evaluate the adherence to therapy with topical adapalene 0.3%/benzoyl peroxide (A-BPO) 2.5% in different groups of patients who received explicative information supported by different strategies. The second goal was to evaluate the patient’s quality of life and skin parameters. Materials and Methods: We enrolled 126 subjects with mild to severe acne vulgaris. They were randomized into 3 groups of 42 patients each and applied daily topical A-BPO (0.3%, 2.5%) for 12 weeks. The first group (G1) was trained on the gel application by an explicative leaflet. The second group (G2) received the same instructions as group 1 and a daily SMS to remind them of the application of the product. The third group (G3) only received standard instructions. Evaluations were performed at the beginning of treatment (T0) and after 12 weeks (T1): assessment of acne severity using the Investigator’s Global Assessment (IGA) Scale for Acne Severity, quality of life by the Cardiff Acne Disability Index (CADI) and the Patient-Doctor Relationship Depth-of-Relationship Scale (PDRDS), skin pH, grade of hydration and adherence to treatment with a 7-day recall calendar were also measured. Results: After 12 weeks of therapy, we observed a reduction in IGA in all groups confirming the clinical efficacy of the product. In the multiple comparison analysis of IGA score reduction, a significant difference was found in G2 versus G1 and G2 versus G3, while the G1 versus G3 comparison was not statistically significant. However, the leaflet group (G1) showed better results compared to the no-leaflet group (G3). Supporting these data, we observed that adherence days correlated positively with the improvement of the single parameters. Moreover, we observed that SMS and leaflet groups had a greater improvement in quality of life evaluated by CADI and PDRDS scores. Conclusions: According to our data, this experimental setup based on text message service and leaflet service is inexpensive and easy to use. Physicians could consider using these items in their practice to enhance patient adherence and satisfaction as well as treatment outcome.
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Guevara-Valtier, Carlos Milton, Ana Victoria Ramírez-Rodríguez, Velia Margarita Cárdenas-Villarreal, Tirso Duran-Badillo, Juana Mercedes Gutiérrez-Valverde, and Ana Belen Sánchez-Garcia. "Perception of Cardiovascular Risk and Use of Technologies in Health in Adults with Obesity." Enfermería Global 18, no. 3 (June 8, 2019): 246–69. http://dx.doi.org/10.6018/eglobal.18.3.336891.
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En este articulo se determinó la relación entre la Percepción del riesgo de enfermedad cardiovascular con el Nivel de uso de Tecnologías de la Información y Comunicación (TIC´s), así como el efecto explicativo del nivel de uso de las TIC´s y antecedentes para enfermedad cardiovascular en la Percepción del riesgo de enfermedad cardiovascular en adultos con obesidad. Este estudio es pertinente dado que la relación entre las variables propuestas, así como la relación de las TIC´s y otras variables sobre la percepción de riesgo de enfermedad cardiaca y cerebral aún no es del todo clara. Se realizó un estudio descriptivo-analítico realizado en una muestra de 260 adultos con obesidad. Se usaron los cuestionarios Percepción del Riesgo de enfermedad cardiovascular y Uso de TICS en pacientes atendidos en un centro de salud, se respetaron las normas éticas y se utilizó estadística descriptiva e inferencial. Se encontró relación entre la Percepción del riesgo de enfermedad cardiovascular y el uso de las TIC´s (rs =0,142, p=0,022). El Nivel de uso de TICS y antecedentes personales/familiares para el desarrollo de enfermedad cardiovascular fue un 14,3% en la percepción del riesgo de enfermedad cardiovascular. Se concluyó que la percepción del riesgo de enfermedad cardiovascular se relaciona con el Nivel de uso de Tecnologías de la información y comunicación en salud y es explicada en parte por el Nivel de uso de tecnologías de la información y comunicación y antecedentes de salud. Objective: This paper determined the relationship between the perception of risk of a cardiovascular disease with the level of use of Information and Communication Technology or ICT, as well as the explanatory effect of these ICTs and the history of cardiovascular disease in the perception of risk of cardiovascular disease in adults with obesity.Methods: This study is relevant since the relationship between the proposed variables, and the relationship of the ICTs and other variables about the risk perception of heart and brain disease is not very clear yet. An analytical-descriptive research was made on a sample of 260 obese adults. Questionnaires of risk perception of a cardiovascular disease and use of ICT in patients who receive care in a health center were used; ethical standards were observed and descriptive statistics and statistical inference were applied.Results: A relationship between risk perception of a cardiovascular disease and the use of ICTs was found (rs=0,142, p=0,022). The level of use of ICTs and personal/family history of disease for the development of a cardiovascular disease explain a 14,3% in the perception of risk of the disease.Conclusions: It was concluded that the perception of risk of cardiovascular disease was related to the level of use of Information and Communication Technologies regarding health, and it is partially explained by the level of use of the ICTs and health history.
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Savadogo, Madi, Abdoul-Fataf Soré, Laibané Dieudonné Dahourou, Walter Ossebi, Alima Hadjia Banyala Combari, Rianatou Bada Alambedji, and Zékiba Tarnagda. "Assessing factors associated with owner's individual decision to vaccinate their dogs against rabies: A house-to-house survey in Ouagadougou, Burkina Faso." Veterinary World 14, no. 4 (April 27, 2021): 1014–19. http://dx.doi.org/10.14202/vetworld.2021.1014-1019.
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Background and Aim: In rabies endemic area, dog vaccination is an effective way of controlling the disease in animals and humans if a minimum of 70% vaccination coverage is reached. This study aimed to identify dog demographics and household characteristics associated with dogs' vaccination against rabies in Ouagadougou, Burkina Faso. Materials and Methods: A questionnaire was used to collect data from respondents with regard to their dogs' demographics and their household characteristics. Chi-square test and Fisher's exact test were performed to assess the association between explicative variables and the dogs' vaccination status. Results: Overall, as per the findings of this study, it was determined that out of 424 dogs, 57.8% were reportedly vaccinated. The vaccination status was significantly associated with most of the household variables (e.g., gender of the respondent, age, level of education, main means of transportation, participation in a vaccination campaign, knowledge on rabies, and knowledge on dog vaccination) and the dogs' variables (breed of dog, dog origin, purpose for keeping, confinement status, and perceived behavior) (p<0.05). Moreover, only religion, type of housing, knowledge of rabies transmission modes, and dog sex were not significantly associated with vaccination status (p>0.05). Conclusion: Our study generated informative data showing that animal health workers could develop effective rabies vaccination strategy planning by examining owned dog demographics and their husbandry practices in households.
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Filippov, A. V., A. D. Donika, and A. M. Ostrovsky. "UNDERSTANDING OUTCOMES OF THE PANDEMIC: SAFETY ETHICS." Bioethics 27, no. 1 (May 19, 2021): 32–35. http://dx.doi.org/10.19163/2070-1586-2021-1(27)-32-35.
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Summing up the interim results in the fight against the COVID-19 pandemic determines a multidisciplinary approach to studying the problem of security for all spheres of society. The analysis of the priority of scientific publications carried out on the platform of the information resource CyberLeninka showed that the main interest of researchers is medical and information security. Takin g into account the tendency for legal norms to lag behind ethical ones, and the specifics of the legal support of these spheres of social life, a working hypothesis was developed based on the assumption that the explication of ethical challenges during the COVID-19 pandemic will determine the strategy of social policy in these priority areas. Quantitative and qualitative sociological methods (content analysis, case study, survey) were used in the work. Fragments of sociological research carried out in collaboration based on the Volgograd and Gomel State Medical Universities are used. The results obtained demonstrate ethical deformations in the medical and, in g eneral, in the social sphere. In the context of the pandemic, the problem of the vulnerability of socially unprotected groups has become more acute. The basic moral tenets of the ethics of care are violated in relation to patients with severe concomitant diseases and patients with limited mobility. The extreme conditions which the national health care system found itself began to be perceived in the professional group of medical specialists as "extenuating circumstances" allowing, in conditions of survival, to neglect not only medical ethics, but also the law. These tendencies are reflected in the minds of future doctors, which requires strengthening the positions of the humanitarian block of disciplines in the curricula of professional education. The tendencies noted have an international nature, which determines the possible implementation of the approaches developed in the process of international collaboration into the practice of humanitarian national professional education.
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Akram, Harith, Sarah Miller, Susie Lagrata, Marwan Hariz, John Ashburner, Tim Behrens, Manjit Matharu, and Ludvic Zrinzo. "Optimal deep brain stimulation site and target connectivity for chronic cluster headache." Neurology 89, no. 20 (October 13, 2017): 2083–91. http://dx.doi.org/10.1212/wnl.0000000000004646.
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Objective:To investigate the mechanism of action of deep brain stimulation for refractory chronic cluster headache and the optimal target within the ventral tegmental area.Methods:Seven patients with refractory chronic cluster headache underwent high spatial and angular resolution diffusion MRI preoperatively. MRI-guided and MRI-verified electrode implantation was performed unilaterally in 5 patients and bilaterally in 2. Volumes of tissue activation were generated around active lead contacts with a finite-element model. Twelve months after surgery, voxel-based morphometry was used to identify voxels associated with higher reduction in headache load. Probabilistic tractography was used to identify the brain connectivity of the activation volumes in responders, defined as patients with a reduction of ≥30% in headache load.Results:There was no surgical morbidity. Average follow-up was 34 ± 14 months. Patients showed reductions of 76 ± 33% in headache load, 46 ± 41% in attack severity, 58 ± 41% in headache frequency, and 51 ± 46% in attack duration at the last follow-up. Six patients responded to treatment. Greatest reduction in headache load was associated with activation in an area cantered at 6 mm lateral, 2 mm posterior, and 1 mm inferior to the midcommissural point of the third ventricle. Average responders' activation volume lay on the trigeminohypothalamic tract, connecting the trigeminal system and other brainstem nuclei associated with nociception and pain modulation with the hypothalamus, and the prefrontal and mesial temporal areas.Conclusions:We identify the optimal stimulation site and structural connectivity of the deep brain stimulation target for cluster headache, explicating possible mechanisms of action and disease pathophysiology.
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Saraiva, L., L. Brites, A. R. Cunha, H. Assunção, A. R. Prata, M. Luis, F. Costa, et al. "AB0223 PHYSICIAN’S GLOBAL ASSESSMENT OF DISEASE ACTIVITY IN RHEUMATOID ARTHRITIS IS A RELIABLE AND RESPONSIVE TOOL IN CLINICAL practice." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1411.1–1412. http://dx.doi.org/10.1136/annrheumdis-2020-eular.2606.
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Background:Physician’s global assessment of disease activity (PhGA) is highly influential upon treatment decisions taken by rheumatologists, surpassing the impact of DAS28. [1, 2]. However, data regarding its psychometric properties are scarce.Objectives:To evaluate the reliability and responsiveness of PhGA.Methods:We included two consecutive visits of RA patients followed in a Tertiary Rheumatology Department. Socio-demographic (age and gender) and clinical data were collected including tender (TJ28) and swollen (SJC28) joints in 28 count, C-Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), Disease activity Score (DAS28-3v-CRP, DAS28-3v-ESR, DAS28-4v-CRP, DAS28-4v-ESR), PhGA and Patient Global Assessment of disease Activity (PGA) through a Visual Analogic Scale (VAS) 0-100mm. Changes (Δ) between the two visits were calculated. Only patients without missing data were included. Correlations between ΔPhGA and change of other variables were assessed using Pearson’s correlations. Reliability was evaluated through Intraclass Correlation Coefficient (ICC) between two consecutive appointments in a subgroup of patients with stable disease activity (Δ DAS28-4vESR [-0.6 to 0.6]. An ICC above 0.8 was considered indicative of excellent reliability. Sensitivity to change was assessed in the subgroup of patients who improved their disease activity at least 0.6 on DAS28-4V-ESR, through Standardized Response Mean (SRM). The respective intervals of confidence were obtained through bootstrapping procedures. SRM above 0.8 were considered large. Independent factors associated with ΔPhGA were identified through multivariate linear regression analysis. p<0.05 was considered statistically significantResults:121 RA patients (84.3% female and 64.0±12.6 years) were included. Δ PhGA was weakly correlated with ΔCRP (r=0.23), Δ PGA (r=0.31) and Δ pain (r=0.37). Moderate to strong correlations were observed with Δ DAS28-3V-ESR (r=0.55), Δ SJC28 (r=0.56), Δ DAS28-3V-CRP (r=0.58), Δ DAS28-3V-CRP (r=0.60), Δ TJ28 (r=0.62) and Δ DAS28-4V-CRP (r=0.63). ICC between two consecutive visits was 0.7, [95%CI:0.47-0.83] and SRM was -1.01 [95%CI:-1.26-(-0.73)]. In the multivariate regression analysis, ΔSJC28 (β=4.01; 95% CI:3.07 to 4.96) and Δ Pain (β=0.18; 95%CI: 0.07 to 0.28) remained as independent factors associated with ΔPhGA (R2:0.49, p<0.01)Conclusion:In this study, PhGA showed a high reliability and sensitivity to change regarding disease activity, in clinical practice. Changes in SJC had the strongest association with change in PhGA scoring, but Δ Pain was also significantly correlated (graph 1).Figure 1.Graph 1 – Explicative model to variations on PhGAReferences:[1]Choy T et al. Rheum (Oxford, England). 2014;53(3):482-90.[2]Rohekar G et al. Jour Rheum. 2009;36(10):2178.Disclosure of Interests:LILIANA SARAIVA: None declared, Luisa Brites: None declared, Ana Rita Cunha: None declared, Helena Assunção: None declared, Ana Rita Prata: None declared, Mariana Luis: None declared, Flavio Costa: None declared, Pedro Freitas: None declared, Marlene Sousa: None declared, José Antonio P. da Silva Grant/research support from: Pfizer, Abbvie, Consultant of: Pfizer, AbbVie, Roche, Lilly, Novartis, Catia Duarte: None declared
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Caldas, Mikaela Lopes de, and Francisco Das Chagas Cardoso Filho. "Desempenho e Importância da Atenção Básica na Prevenção e Controle da Tuberculose: Revisão de Literatura." Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde 23, no. 2 (December 9, 2019): 80. http://dx.doi.org/10.17921/1415-6938.2019v23n2p80-83.
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A tuberculose (TB) é uma doença infecciosa e transmissível, causada pelo Mycobacterium tuberculosis. A detecção de casos figura entre as principais medidas de controle da tuberculose, embora grandes avanços tenham ocorrido no que se relaciona ao diagnóstico, tratamento e prevenção da doença, a mesma ainda requer atenção especial, por parte dos profissionais da saúde (equipe multiprofissional) e da sociedade como um todo. A Atenção Básica se caracteriza como ferramenta primordial na suspeição e na detecção dos casos de tuberculose na comunidade. O objetivo geral do presente trabalho é identificar produções científicas que avaliem o desempenho da Atenção Básica no controle da tuberculose. Os objetivos específicos foram: ressaltar a importância da Atenção Básica na detecção dos casos suspeitos; expor a relevância da Atenção Básica como fator indispensável no controle da tuberculose. Caracteriza-se como uma pesquisa bibliográfica explicativa e explorativa, realizada no recorte histórico de 1998 a 2011, período esse definidor para a implementação de medidas de controle da tuberculose. Encontraram-se 29 referências, das quais 19 obedeciam aos critérios de inclusão. Portanto, a Atenção Básica caracterizada como principal porta de entrada ao acesso à saúde, proporciona a aproximação do cidadão às medidas de controle da tuberculose, assim como promove a educação em saúde, que visa a prevenção dos agravos e proporcionam autonomia e autoconhecimento que são indispensáveis para a manutenção da saúde frente às doenças preveníveis como a tuberculose, porém que se configuram como problemas de saúde pública. Palavras-chave: Tuberculose. Atenção Básica. Controle. AbstractTuberculosis (TB) is an infectious and communicable disease caused by mycobacterium tuberculosis. The case detection is one of the main control measures of tuberculosis, although major advances have occurred regarding the diagnosis, treatment and prevention of the disease, the same still requires special attention on the part of health professionals (multidisciplinary team) and society as a whole. The primary care is characterized as a primary tool in suspicion and detection of tuberculosis cases in the community. The overall objective of this study is to identify scientific production to assess the performance of primary health care in tuberculosis control. The specific objectives were to highlight the importance of primary care in the detection of suspected cases; expose the relevance of primary health care as an essential factor in tuberculosis control. It is characterized as an explanatory and exploratory literature survey, conducted in historical period from 1998 to 2011, a period defined for the implementation of tb control measures. It was found 29 references, 19 of which obeyed the inclusion criteria. Therefore, the primary care characterized as the main gateway to access to health, provides the citizen’s approach to tuberculosis control measures and promotes health education aimed at prevention of injuries and provides autonomy and self-knowledge that are essential for maintenance health against preventable diseases such as tuberculosis, but which are seen as the main public health problems. Keywords: Tuberculosis. Primary Care. Control.
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Zannou, Olivier M., Achille S. Ouedraogo, Abel S. Biguezoton, Emmanuel Abatih, Marco Coral-Almeida, Souaïbou Farougou, Kouassi Patrick Yao, Laetitia Lempereur, and Claude Saegerman. "Models for Studying the Distribution of Ticks and Tick-Borne Diseases in Animals: A Systematic Review and a Meta-Analysis with a Focus on Africa." Pathogens 10, no. 7 (July 14, 2021): 893. http://dx.doi.org/10.3390/pathogens10070893.
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Ticks and tick-borne diseases (TTBD) are constraints to the development of livestock and induce potential human health problems. The worldwide distribution of ticks is not homogenous. Some places are ecologically suitable for ticks but they are not introduced in these areas yet. The absence or low density of hosts is a factor affecting the dissemination of the parasite. To understand the process of introduction and spread of TTBD in different areas, and forecast their presence, scientists developed different models (e.g., predictive models and explicative models). This study aimed to identify models developed by researchers to analyze the TTBD distribution and to assess the performance of these various models with a meta-analysis. A literature search was implemented with PRISMA protocol in two online databases (Scopus and PubMed). The selected articles were classified according to country, type of models and the objective of the modeling. Sensitivity, specificity and accuracy available data of these models were used to evaluate their performance using a meta-analysis. One hundred studies were identified in which seven tick genera were modeled, with Ixodes the most frequently modeled. Additionally, 13 genera of tick-borne pathogens were also modeled, with Borrelia the most frequently modeled. Twenty-three different models were identified and the most frequently used are the generalized linear model representing 26.67% and the maximum entropy model representing 24.17%. A focus on TTBD modeling in Africa showed that, respectively, genus Rhipicephalus and Theileria parva were the most modeled. A meta-analysis on the quality of 20 models revealed that maximum entropy, linear discriminant analysis, and the ecological niche factor analysis models had, respectively, the highest sensitivity, specificity, and area under the curve effect size among all the selected models. Modeling TTBD is highly relevant for predicting their distribution and preventing their adverse effect on animal and human health and the economy. Related results of such analyses are useful to build prevention and/or control programs by veterinary and public health authorities.
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Muñoz Martínez, Rubén. "ATENCIÓN MÉDICA, ADHERENCIA TERAPÉUTICA AL TRATAMIENTO ANTIRRETROVIRAL Y DISCRIMINACIÓN." Revista Pueblos y fronteras digital 9, no. 17 (June 1, 2014): 95. http://dx.doi.org/10.22201/cimsur.18704115e.2014.17.65.
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En este texto se abordan algunas de las problemáticas en el acceso, por parte de los usuarios, a los cuidados en prevención/atención/control del VIH-sida del consultorio médico del Servicio de Atención Integral (SAI), perteneciente a una clínica de la Secretaría de Salud en San Cristóbal de Las Casas (Chiapas). En particular aquellas vinculadas con la discriminación, y concretamente la relacionada con la orientación sexual y el itinerario socio/cultural del usuario del SAI, en la relación médico-paciente-institución. Para ello analizo las representaciones sociales de los médicos del consultorio con respecto a las prácticas sexuales (y preventivas de VIH-sida) y a los modelos explicativos del trinomio salud/enfermedad/atención de los sujetos y colectivos destinatarios, y las praxis de cuidados en dicho consultorio.
HEALTH CARE, ADHERENCE TO ANTIRETROVIRAL THERAPY AND DISCRIMINATION.
Some issues in healh care for people living with HIV-aids, from an anthropological perspective
This text addresses some problems regarding access by users to HIV-AIDS prevention/care/control services at the medical office of Servicio de Atención Integral (SAI by its acronym in Spanish), pertaining to a Mexican Health Department clinic in San Cristóbal de Las Casas, Chiapas. It specifically focuses on discrimination-related issues, concretely regarding the user’s sexual orientation and socio-cultural trajectory through SAI, as well as the doctor-patient-institution relationship. The representations of the clinic’s doctors regarding sexual and HIV-AIDS preventive practices as well as the explicatory models of the health/disease/care triad of the subjects and collective recipients, and the clinic’s health care praxis are analyzed
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Jerome, J. Terrence Jose, Francisco Mercier, Chaitanya S. Mudgal, Joan Arenas-Prat, Gustavo Vinagre, Chul Ki Goorens, Ignacio J. Rivera-Chavarría, et al. "Perspectives and Consensus among International Orthopaedic Surgeons during Initial and Mid-lockdown Phases of Coronavirus Disease." Journal of Hand and Microsurgery 12, no. 03 (July 6, 2020): 135–62. http://dx.doi.org/10.1055/s-0040-1713964.
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AbstractWith a lot of uncertainty, unclear, and frequently changing management protocols, COVID-19 has significantly impacted the orthopaedic surgical practice during this pandemic crisis. Surgeons around the world needed closed introspection, contemplation, and prospective consensual recommendations for safe surgical practice and prevention of viral contamination. One hundred orthopaedic surgeons from 50 countries were sent a Google online form with a questionnaire explicating protocols for admission, surgeries, discharge, follow-up, relevant information affecting their surgical practices, difficulties faced, and many more important issues that happened during and after the lockdown. Ten surgeons critically construed and interpreted the data to form rationale guidelines and recommendations. Of the total, hand and microsurgery surgeons (52%), trauma surgeons (32%), joint replacement surgeons (20%), and arthroscopy surgeons (14%) actively participated in the survey. Surgeons from national public health care/government college hospitals (44%) and private/semiprivate practitioners (54%) were involved in the study. Countries had lockdown started as early as January 3, 2020 with the implementation of partial or complete lifting of lockdown in few countries while writing this article. Surgeons (58%) did not stop their surgical practice or clinics but preferred only emergency cases during the lockdown. Most of the surgeons (49%) had three-fourths reduction in their total patients turn-up and the remaining cases were managed by conservative (54%) methods. There was a 50 to 75% reduction in the number of surgeries. Surgeons did perform emergency procedures without COVID-19 tests but preferred reverse transcription polymerase chain reaction (RT-PCR; 77%) and computed tomography (CT) scan chest (12%) tests for all elective surgical cases. Open fracture and emergency procedures (60%) and distal radius (55%) fractures were the most commonly performed surgeries. Surgeons preferred full personal protection equipment kits (69%) with a respirator (N95/FFP3), but in the case of unavailability, they used surgical masks and normal gowns. Regional/local anesthesia (70%) remained their choice for surgery to prevent the aerosolized risk of contaminations. Essential surgical follow-up with limited persons and visits was encouraged by 70% of the surgeons, whereas teleconsultation and telerehabilitation by 30% of the surgeons. Despite the protective equipment, one-third of the surgeons were afraid of getting infected and 56% feared of infecting their near and dear ones. Orthopaedic surgeons in private practice did face 50 to 75% financial loss and have to furlough 25% staff and 50% paramedical persons. Orthopaedics meetings were cancelled, and virtual meetings have become the preferred mode of sharing the knowledge and experiences avoiding human contacts. Staying at home, reading, and writing manuscripts became more interesting and an interesting lifestyle change is seen among the surgeons. Unanimously and without any doubt all accepted the fact that COVID-19 pandemic has reached an unprecedented level where personal hygiene, hand washing, social distancing, and safe surgical practices are the viable antidotes, and they have all slowly integrated these practices into their lives. Strict adherence to local authority recommendations and guidelines, uniform and standardized norms for admission, inpatient, and discharge, mandatory RT-PCR tests before surgery and in selective cases with CT scan chest, optimizing and regularizing the surgeries, avoiding and delaying nonemergency surgeries and follow-up protocols, use of teleconsultations cautiously, and working in close association with the World Health Organization and national health care systems will provide a conducive and safe working environment for orthopaedic surgeons and their fraternity and also will prevent the resurgence of COVID-19.
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Yagodina, A., I. Serova, U. Maslov, and S. Korotin. "How to minimize infectious health risks for elderly people (based on focus group data)." Health Risk Analysis, no. 1 (March 2022): 81–92. http://dx.doi.org/10.21668/health.risk/2022.1.08.
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This literature review focuses on practices aimed at mitigating infectious health risks for elderly people in acute care inpatient hospitals with multiple specializations. We revealed a necessity to create medical information centers; common reference centers for PCR diagnostics, sequencing, plasmid analysis, and MULDI-TOF; as well as to provide support and further development of bacteriological and hygienic service in medical and preventive organizations. Our review also dwells on theoretical solutions to issues related to minimizing infection risks in nursing homes and prospective approaches to providing infectious safety at home. A focus group was organized on May 20, 2021 at the E.A. Wagner’s Perm State Medical University of the RF Public Healthcare Ministry with its aim being to implement theoretical approaches into practices of minimizing infectious health risks for elderly people in Perm region within the “aging in place” paradigm. The sociological explication made it possible to fix the regional agenda on minimizing infectious heath risks for elderly people as per three basic directions: by improving living conditions, by improving care provided for elderly people at home, and by making elderly people’s lives more active as a way to support their immunity. All the discussion participants unanimously agreed both on assigning the primary role to the strengthened immunity as a way to minimize infectious health risks and on obvious absence of any drugs which would be able to resolve the issue. Experts believe adherence to conventional recommendations on how to improve elderly people’s immunity to be fundamental for infection risk mitigation. We should remember that some elderly people live in improper housing which should be renovated and adapted to basic needs of an elderly person. It is also important to develop the city environment taking into account elderly people’s habits and needs (they should be provided with a special place in the yard where they can communicate with each other, play board games or do physical exercises). Financial support should be given to “Inpatient hospital at home” program and to developing tools used to promptly minimize infection risks, for example, telemedicine which allows detecting certain alerting symptoms typical for communicable diseases (fever, complaining about cough and running nose, pains in the lumbar spine, decreased diuresis etc.)
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Díaz Benavides, Jhon Jairo. "La paradoja de los niños y las niñas saludables que “no comen”. Una investigación sociológica sobre la crianza en Bogotá." Revista Colombiana de Sociología 39, no. 1 (March 21, 2016): 243–59. http://dx.doi.org/10.15446/rcs.v39n1.56349.
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<p>Este artículo es el producto de una investigación cualitativa realizada en Bogotá durante el periodo comprendido entre agosto del 2013 y marzo del 2015, para la que se sometieron a análisis treinta entrevistas semiestructuradas, realizadas tanto a pediatras como a acudientes de niños y niñas menores de seis años de edad que fueron llevados a consulta médica por la preocupación de que “no comen”, pero que luego del respectivo examen médico fueron considerados saludables. La paradoja resulta de la dificultad para explicar y entender que ciertos niños y niñas que durante sus primeros años no comen, según los papás o acudientes, resulten sin ningún criterio médico que pueda ser considerado como una enfermedad. Enmarcado en el modelo de análisis en el que illness, disease y sickness son tres formas diferentes pero complementarias de entender la enfermedad, se encontró en el “no comer” un problema sociológico en el que el sistema explicativo de creencias, pautas y prácticas de crianza por parte de los padres o cuidadores durante el proceso socialización primaria de los pequeños involucrados marca el inicio y el desarrollo de un conflicto en el momento de la alimentación que termina siendo motivo de consulta pediátrica. De la misma manera que se da en otros aspectos de la crianza, en la alimentación se da una negociación entre las diversas características biológicas y culturales involucradas, que pueden resultar francamente problemáticas, ocasionando choques insospechados entre los adultos y los infantes durante su proceso de socialización. Finalmente, se encontraron indicios consistentes con la sospecha de que el no comer de los niños y las niñas es una manifestación problemática de la forma como actualmente se conciben en la sociedad tanto la infancia —por medio del discurso de los derechos— como el rol de los padres, quienes se terminan encontrando en una franca crisis de sentido.</p>
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Benzi, Margherita. "Defining Metabolic Syndrome: Which Kind of Causality, if any, is Required?" Disputatio 9, no. 47 (December 1, 2017): 553–80. http://dx.doi.org/10.1515/disp-2017-0018.
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Abstract The definition of metabolic syndrome (MetS) has been, and still is, extremely controversial. My purpose is not to give a solution to the associated debate but to argue that the controversy is at least partially due to the different ‘causal content’ of the various definitions: their theoretical validity and practical utility can be evaluated by reconstructing or making explicit the underlying causal structure. I will therefore propose to distinguish the alternative definitions according to the kinds of causal content they carry: (1) definitions grounded on associations, (2) definitions presupposing a causal model built upon statistical associations, and (3) definitions grounded on underlying mechanisms. I suggest that analysing definitions according to their causal content can be helpful in evaluating alternative definitions of some diseases. I want to show how the controversy over MetS suggests a distinction among three kinds of definitions based on how explicitly they characterise the syndrome in causal terms, and on the type of causality involved. I will call ‘type 1 definitions’ those definitions that are purely associative; ‘type 2 definitions’ the definitions based on statistical associations, plus generic medical and causal knowledge; and ‘type 3 definitions’ the definitions based on (hypotheses about) mechanisms. These kinds of definitions, although different, can be related to each other. A definition with more specific causal content may be useful in the evaluation of definitions characterised by a lower degree of causal specificity. Moreover, the identification of the type of causality involved is of help to constitute a good criterion for choosing among different definitions of a pathological entity. In section (1) I introduce the controversy about MetS, in section (2) I propose some remarks about medical definitions and their ‘causal import’, and in section (3) I suggest that the different attitudes towards the definition of MetS are relevant to evaluate their explicative power.
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Rynkiewich, Katharina, David Schwartz, Sarah Y. Won, Mikhail Heber, Kavya Timmireddy, and Bradley Stoner. "1091. An Ethnographic Approach to Interrogating Antimicrobial Stewardship at US Teaching Hospitals." Open Forum Infectious Diseases 6, Supplement_2 (October 2019): S388. http://dx.doi.org/10.1093/ofid/ofz360.955.
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Abstract Background Hospital antimicrobial stewardship programs (ASPs) deploy variably evidence-based interventions aimed at improving antimicrobial use and reducing antimicrobial resistance. Little is known about how ASPs are perceived by hospital clinicians or how such data might inform ASP improvement. We conducted an ethnographic study of hospital ASPs and infectious diseases (ID), surgical intensive care unit (SICU) and medical intensive care unit (MICU) practitioners to identify how ASPs are understood and integrated into everyday practice by hospital staff. Methods A medical anthropologist performed direct observation of patient care and semi-structured interviews with ID (N = 29), SICU (N = 10), and MICU (N = 19) practitioners at two affiliated teaching hospitals in Chicago, IL, between July 2017 and September 2018, accruing >576 hours of direct observations and 48 hours of semi-structured interview data. Data collection and analysis centered on explicating the understandings and interpretations of ASPs present in diverse practice groups. Transcriptions of the data were analyzed using thematic coding aided by MAXQDA qualitative analysis software. Results Understandings and interpretations of ASPs varied greatly between the practice groups. ID practitioners commonly focused on “changing prescribing behavior” and “restricting inappropriate usage,” while MICU and SICU practitioners more often emphasized “following guidelines” and maintaining clinical “balance.” Additionally, direct observation data demonstrate that MICU and SICU practitioners are bounded by social and institutional determinants of antimicrobial prescribing (Table 1) that affect the pursuit of “appropriate antimicrobial use.” Conclusion Ethnographic interrogation found that practice groups understand and integrate ASPs differently according to everyday encounters with the social and institutional determinants of antimicrobial prescribing. ASP effectiveness might be enhanced by adopting a more mindful approach to accounting for and addressing the distinct understandings and interpretations of ASPs among diverse practice groups operating within the same institution. Disclosures All authors: No reported disclosures.
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Sánchez Peña, Sara, María del Mar Pastor Bravo, Miguel Ángel Cánovas Tomás, Pilar Almansa-Martínez, Caridad Peñalver Guillen, and Ismael Jiménez-Ruiz. "Factores relacionados con la adherencia al tratamiento antirretroviral en mujeres con VIH: Un estudio mixto con diseño secuencial." Enfermería Global 20, no. 2 (April 1, 2021): 1–34. http://dx.doi.org/10.6018/eglobal.437711.
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Introducción: El VIH/Sida afecta cada vez a más mujeres. La adherencia al tratamiento antirretroviral es decisiva en la calidad de vida de las personas infectadas. Objetivos: El objetivo del estudio es determinar el grado de adherencia manifestada en un grupo de mujeres con VIH/Sida, con TAR e identificar los factores y circunstancias que influyen en su adherencia.Metodología: Se ha realizado un estudio con diseño mixto secuencial explicativo. Los sujetos de estudio son 86 mujeres diagnosticadas con VIH/Sida en tratamiento con TARGA. Resultados: Se recogieron datos cualitativos de 18 de ellas. El 59,3% de las participantes son no adherentes. Los factores determinantes de la no adherencia son el grado académico, edad, ingresos, así como factores personales, interpersonales como el apoyo sociofamiliar, estigma percibido y autoestigma y factores relativos a la enfermedad y tratamiento. Conclusión: Los cuidados de enfermería deben abordar con enfoque de género aquellos factores psicosociales e individuales del proceso de adherencia. Background: HIV/AIDS is affecting more and more women. Adherence to antiretroviral treatment (ART) is decisive for those infected to achieve quality of life. Purpose: The aim of the present study is to determine the degree of adherence displayed by a group of women with HIV/AIDS and to identify those factors and circumstances which might influence their adherence to ART. Method: A sequential mixed model research design was applied. The subjects studied consisted of 86 women diagnosed with HIV/AIDS and treated with ART. Findings and discussion: Qualitative data were collected from 18 of these women. 59.3% of participants were non-adherents. The determining factors for non-adherence were level of education, age, income, as well as personal and/or interpersonal factors such as socio-familial support, perceived stigma, self-stigma and factors related to disease and treatment. Nursing care should take a gender-focused approach towards those psychological and personal factors inherent in the adherence process.
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Ayón Lucio, Carlos Alberto, Teresa Véliz Castro, Teresa Ayón Lucio Ayón Lucio, and Nereida Valero Cedeño. "PREVALENCIA E INMUNIDAD AL VIRUS DENGUE Y FACTORES DE RIESGOS EN LATINOAMÉRICA." Enfermería Investiga 8, no. 1 (January 3, 2023): 69–75. http://dx.doi.org/10.31243/ei.uta.v8i1.1892.2023.
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Introducción: El dengue es una enfermedad viral, considerada uno de los mayores retos por el creciente problema en la salud pública de representación endémo-epidémico, transmitido por mosquitos del género Aedes aegypti. Objetivo: Describir la prevalencia e inmunidad al virus dengue y los factores de riesgos en Latinoamérica. Métodos: El estudio fue de diseño documental, de tipo descriptivo, nivel explicativo, en el cual se analizaron un total de 20 artículos con información referente a las variables de estudio correspondiente a los últimos 10 años. Utilizando bases de datos como Medline, Scielo, Cochrane Library, Elsevier, Redalyc y Google Académico. Resultados: Los países con más afectación con la prevalencia del virus fueron Brasil y Republica Dominicana, en Estados Unidos se midió el impacto y eficacia de la vacuna de dengue para generar inmunidad en personas de 2 a 16 años, dando los siguientes resultados de 35.000 inoculados hasta el año 3 después de la primera dosis, la protección de la vacuna tuvo una eficacia de un 65%. Conclusiones: El dengue es una enfermedad que afecta de manera crítica al ser humano causada por un virus, transmitido por mosquitos, afecta de 50 a 100 millones de personas y que causa una alta mortalidad anualmente, sobre todo en regiones tropicales y subtropicales del planeta.
Palabras clave: Aedes aegypti, virus del dengue, epidemiologia, incidencia, mortalidad.
ABSTRACT
Introduction: Dengue is a viral disease, considered one of the greatest challenges due to the growing public health problem of endemic-epidemic representation, transmitted by mosquitoes of the Aedes aegypti genus. Objective: to describe the prevalence and immunity to the dengue virus and the risk factors in Latin America. Methods: The study was of a documentary design of the type of study is descriptive, explanatory level, a total of 30 articles were analyzed from which information was extracted regarding the study variables corresponding to the last 10 years. Results: The countries most affected by the prevalence of the virus were Brazil and the Dominican Republic. In the United States, the impact and efficacy of the dengue vaccine was measured to generate immunity in people aged 2 to 16 years, giving the following results of 35,000 inoculated up to year 3 after the first dose, the protection of the vaccine was 65% effective. Conclusion: Dengue is a disease that critically affects humans caused by a virus transmitted by mosquitoes, affects 50 to 100 million people and causes about 25.000 deaths annually, especially in tropical and subtropical regions of the planet.
Keywords: Aedes aegypti, dengue virus, epidemiology, incidence, mortality
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Zayas García, Antonio, Paloma Gil-Olarte Márquez, Cristina Guerrero Rodríguez, and Rocío Guil Bozal. "RESILIENCIA Y ANSIEDAD EN MADRES DE MENORES QUE PADECEN DIABETES TIPO 1." International Journal of Developmental and Educational Psychology. Revista INFAD de Psicología. 3, no. 1 (November 4, 2017): 131. http://dx.doi.org/10.17060/ijodaep.2017.n1.v3.982.
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Abstract.RESILIENCE AND ANXIETY IN MOTHERS OF CHILDREN WITH TYPE 1 DIABETES Type 1 diabetes is one of the most common chronic diseases in childhood and adolescence according to the American Diabetes Association (2009). This disease requires complex treatment, which involves a constant attention from children’s caretakers, especially their mothers (Garcia- Campayo, Sanz-Carrillo, & Tazon-Ansola, 2009). This attention implies an overload for the mother that involves a risk for the mother’s wellbeing. Type-1-diabetes children (T1DC) increase anxiety simptoms among their mothers. Hence, this work aims to know the level of both state/trait anxiety and resilience of mothers with T1DC; and the predictive relationship between resilience and anxiety of mother’s T1DC. A sample of 54 mothers with mean age 42,40 (SD=5,1), of T1DC from the Association of Diabetics of Jerez (ADIJE, Spain) filled the State Trait Anxiety Inventory (STAI) (Spielberger, Gorsuch, & Lushene, 1970, 1982) and the Wagnild and Young Resilience Scale (1988). Outcomes showed that the participants presented medium-high levels of state anxiety and high trait anxiety. Mother’s T1DC scored moderate levels of resilience. Regarding the relationship between resilience and anxiety, Equanimity predicted a negative relationship to state anxiety levels, Confidence was negative related to trait anxiety levels. This work suggests that promoting resilience in mothers with T1DC can help to manage the anxiety symptoms among mothers. However, it is necessary to increase studies that include psychosocial variables that may would be involved in the anxiety regulation abilities of mothers with T1DC.Keywords: childhood diabetes, informal caregivers, anxiety, and resilience.Resumen.La diabetes tipo 1 es una de las enfermedades crónicas más comunes en la infancia y la adolescencia según la American Diabetes Association (2009). Requiere un tratamiento complejo que implica la atención constante por parte de los cuidadores principales, que suelen ser las madres (Garcia-Campayo, Sanz-Carrillo, & Tazon-Ansola, 2009). Esto a su vez supone una sobrecarga que determina el bienestar psicológico de estas cuidadoras, siendo muy frecuente la manifestación de sintomatología ansiosa. Nuestros objetivos con el presente trabajo es conocer el nivel de ansiedad estado/rasgo en este colectivo, estudiar sus niveles de resiliencia y analizar la relación y la posible capacidad explicativa y/o predictiva que la resiliencia pueda tener sobre los niveles de ansiedad en estas madres. Para llevar a cabo este trabajo se ha seleccionado un total de 54 madres de niños que padecen la enfermedad, con una media de edad de 42,40 años (DT=5,1), de la Asociación de Diabéticos de Jerez (ADIJE). Para la evaluación de las variables se ha administrado el State Trait Anxiety Inventory (STAI) (Spielberger, Gorsuch, & Lushene, 1970, 1982) y la Escala de Resiliencia de Wagnild y Young (1988). Los resultados arrojan niveles medios-altos de ansiedad estado y altos de ansiedad rasgo en las madres. Asimismo, muestran niveles moderados de resiliencia. Respecto a la relación entre la resiliencia y la ansiedad se ha hallado que la dimensión Ecuanimidad de la variable Resiliencia tiene una capacidad predictiva en los niveles de ansiedad estado, y la dimensión Confianza en sí mismo presenta una capacidad predictiva en los niveles de ansiedad rasgo. Concluimos con la importancia de fomentar la resiliencia en madres de menores con diabetes tipo 1 al fin de prevenir la sintomatología ansiosa, así como consideramos necesario continuar estudiando en profundidad las variables psicosociales que puedan evitar la aparición de cuadros psicopatológicos en esta población.Palabras claves: diabetes infantil, cuidadores informales, ansiedad y resiliencia.