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Exploring the experience of virginity testing by female adolescents in the uThungulu district of Kwazulu-NatalMbulu, Jabulile Favourite 02 1900 (has links)
Text in English / The purpose of the study was to investigate the experience explore the experience of virginity testing of female adolescents in the uThungulu district of KwaZulu-Natal. A qualitative research was conducted to explore and describe the experiences of female adolescents on virginity testing. In-depth phenomenological interviews were conducted on 18 participants during data collection. Proponents of virginity testing believe that virginity testing is a traditional practice that can assist in reducing HIV infection and teenage pregnancy amongst the youth. On the other hand, opponents of virginity testing strongly believe that the practice of virginity testing interferes with human rights and Constitutional prescripts that protect the rights to equity, privacy, bodily integrity and sexual autonomy of young women. The study found that participants had only positive experiences of the practice of virginity testing and none expressed having any negative experiences. The findings also confirmed that virginity testing is being done irrespective of different opinions from different scholars and experts on the subject. Little knowledge about the Children’s Act and the Commission for Rights of Cultural and Linguistic communities was observed. / Health Studies / M.P.H.
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HPV e câncer do colo do útero: um olhar sobre a etiologia infecciosa das doenças crônicas / HPV and cervical cancer: a look at the infectious etiology of chronic diseasesRodrigues, Henrique de Castro January 2010 (has links)
Made available in DSpace on 2011-05-04T12:36:27Z (GMT). No. of bitstreams: 0
Previous issue date: 2010 / O estudo teve por objetivo analisar as questões levantadas na literatura sobre a associação entre o HPV e o câncer do colo uterino e suas implicações para a política de controle da doença. Buscou-se correlacionar esta discussão com antigas polêmicas entre modelos teóricos divergentes sobre etiologia e as medidas de controle por eles prescritas. Trata-se de uma revisão de artigos científicos com abordagem histórica/conceitual acerca das mudanças recentes no conhecimento científico relacionado à etiologia do câncer do colo do útero. A análise do estudo se deu mediante um diálogo entre o discurso produzido pela epidemiologia e pela biologia molecular sobre a gênese do câncer do colo uterino e a reflexão que vem sendo realizada pela Saúde Pública, tendo como eixo temático a crítica ao modelo ainda hegemônico a respeito da etiologia das doenças, focada na especificidade causal e, de acordo com esta, na generalização de intervenções para prevenção e controle. O caso da relação etiológica entre o HPV e o câncer do colo uterino ilustra bem as características e os limites deste modelo, hegemônico desde o final do século XIX. Apesar dos avanços obtidos na compreensão sobre a etiologia das doenças, a lógica das estratégias de controle não tem acompanhado tais avanços. Ainda que as pesquisas sobre a etiologia deste câncer assinalem haver uma complexa rede de interações entre o agente viral e a célula do colo uterino, o modelo hegemônico insiste em privilegiar uma medida específica de intervenção para o controle do câncer, a vacina contra os tipos de HPV de alto-risco. A comprovação do papel de um agente infeccioso na carcinogênese do colo uterino reforça a fragilidade dos limites teóricos que diferenciam os conceitos de doenças transmissíveis e não transmissíveis. Neste contexto, o desenvolvimento da biologia molecular abre novos caminhos e possibilidades de interpretação do fenômeno patológico, aproximando-se da perspectiva daqueles que há muito tempo já buscaram compreendê-lo em uma referência de maior complexidade. A Saúde Pública e a Epidemiologia estiveram na vanguarda de uma postura racional mais ampla sobre a etiologia das doenças, quando aliaram o conhecimento biológico disponível a aspectos sociais e culturais. Os desafios atuais demandam o esforço de integrar a biologia molecular a outros níveis de determinação das doenças, como forma de aprofundar a compreensão dos vínculos complexos entre eles e de buscar alternativas apropriadas de intervenção. / The study aimed to examine the issues raised in the literature on the association between HPV and cervical cancer and its implications for the politics of disease control. We attempted to correlate this discussion with old controversies between different theoretical models about etiology and control measures prescribed by them. This is a review of scientific articles with historical/conceptual approach about recent changes in scientific knowledge related to the etiology of cervical cancer. The study analysis was made by a dialogue between the discourse of the epidemiology and molecular biology about genesis of cervical cancer and the reflection that is being conducted by Public Health, with its central theme the critique of hegemonic still model on the etiology disease, focusing on causal specificity and, according to this, on the generalization of interventions for prevention and control. The case of the etiologic relationship between HPV and cervical cancer illustrates the characteristics and limits of this model, hegemonic since the late nineteenth century. Despite advances in understanding the etiology of diseases, the logic of control strategies has not accompanied these advances. Although research on the etiology of this cancer points that there is a complex network of interactions between the viral agent and the cell of the cervix, the hegemonic model insists on emphasizing a specific measure of intervention for the control of cancer, the vaccine against HPV types high-risk. The evidence of role of an infectious agent in carcinogenesis of the cervix increases the fragility of the theoretical limits that differentiate the concepts of communicable and non-communicable diseases. In this context, the development of molecular biology opens new avenues and possibilities for interpretation of pathological phenomenon, approaching from the perspective of those who long have sought to understand it on a reference of greater complexity. The Public Health and Epidemiology were in the vanguard of rational stance broader on the etiology of disease, when they allied the biological knowledge available with to social and cultural aspects. The current challenges require the effort for integrate the molecular biology with others levels of determine of diseases as a way to deepen understanding of the complex links between them and to seek suitable alternatives for intervention.
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Avaliação do impacto à saúde causado pela queima prévia de palha de cana-de-açúcar no Estado de São Paulo / Evaluation of the health impact caused by the pre-harvest burning of sugarcane straw in the State of São PauloMaria Leticia de Souza Paraiso 12 December 2013 (has links)
O etanol de cana-de-açúcar se consolida como combustível renovável, o que promove nova expansão da cultura da cana-de-açúcar no Brasil e, principalmente, no Estado de São Paulo. Como a queima prévia controlada da palha de cana-de-açúcar ainda é considerada uma prática agrícola necessária para a viabilização econômica da colheita, em mais de 70% dos municípios do Estado de São Paulo a população é obrigada a conviver com essa poluição. Para estudar a distribuição desse fator de risco e sua relação com a saúde, realizei um estudo epidemiológico ecológico nos 645 municípios de São Paulo. Usei um modelo Bayesiano de regressão multivariada relacionando os efeitos na saúde com a exposição à queima prévia da palha de cana-de-açúcar, sendo controlados os efeitos das variações socioeconômicas (saneamento, educação e renda) e climáticas (temperatura máxima, umidade mínima e precipitação), através da inserção das mesmas no modelo. O efeito sobre a saúde foi medido por meio da Razão de Mortalidade e Morbidade Padronizada (RMP) dos desfechos: óbitos por doenças respiratórias nas faixas etárias acima de 65 anos e internações por doença respiratória, nas faixas etárias menores de 5 anos e acima de 65 anos de cada um dos municípios. Usei como medida de exposição à queima prévia dados obtidos no INPE: percentual da área de cana colhida com queima (PMQ), níveis médios de Aerossol e Focos de queima, testadas separadamente. Para resolver a autocorrelação entre os dados, estes foram considerados conforme sua disposição espacial, através da construção de uma matriz de vizinhança dos 645 municípios do Estado. Utilizei o método de simulação de Monte Carlo via Cadeias de Markov (MCMC) para \'suavizar\' as estimativas da RMP. A análise demonstrou que existe associação entre a queima prévia da palha de cana-de-açúcar e a ocorrência de doenças respiratórias, porque o aumento nos focos de queima (Focos) esteve associado significativamente com o aumento das internações por doenças respiratórias, na faixa etária de menores de cinco anos. Os resultados mostraram que a queima prévia da palha da cana-de-açúcar oferece efetivamente risco à saúde da população e, adicionados aos mapas coropléticos gerados, oferecem subsídios para a vigilância epidemiológica e contribuem para o estabelecimento de políticas públicas para controle da poluição do ar, que contemplem além dos grandes centros urbanos, os pequenos municípios. A eliminação desse fator de risco deve fazer parte das medidas primordiais de prevenção à saúde a serem adotadas no Estado / Ethanol from sugarcane is consolidated as a renewable fuel which promotes further expansion of the culture of sugarcane in Brazil and especially in the State of São Paulo. As the controlled pre-harvest burning of sugarcane straw is still considered an agricultural practice necessary for the economic viability of this crop in more than 70% of municipalities in the State of São Paulo the population is forced to live with this pollution. To study the distribution of this risk factor and its relationship with the health of the population, I conducted an ecological study in the 645 municipalities of São Paulo. I used a Bayesian multivariate regression model relating the health effects and the exposure to previous straw burning of sugarcane, controlling the effects of socioeconomic factors (sanitation, education and income) and climate (maximum temperature, minimum humidity and precipitation) by the insertion of these variables in the model. The effect on health was measured by Standardized Mortality and Morbidity Ratio (SMR) of the outcomes: deaths from respiratory diseases in the age group above 65 years old and admissions for respiratory disease in children less than 5 years old and above 65 years old of each of the municipalities. I used as a measure of exposure to the pre-harvest burning data obtained at INPE: percent of sugarcane area harvest with burning (PMQ), levels of Aerosol and Spotlights of burning, tested separately. To solve the autocorrelation in the data these were considered as their spatial arrangement, by building a neighborhood matrix of the 645 municipalities in the state. I used the Markov Chain-Monte Carlo simulation method (MCMC) to \'soften\' the estimates of the SMR. The analysis showed that there is an association between previous straw burning of sugarcane and respiratory diseases, because the increase in outbreaks of burning (Spotlights) was significantly associated with increased hospital admissions for respiratory diseases in children aged under five years old. The results show that the previous straw burning of sugarcane effectively offers health risk to the population and added to the choropleth maps generated provide valuable information for epidemiological surveillance and contribute to the establishment of public policies for the control of air pollution, which should contemplate beyond the major urban centers, the small towns. The elimination of this risk factor should be part of a primordial prevention measure to be taken in the state
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Evaluation of fracture resistance of three post and core systems in endodontically treated teeth under loading to failure; and marginal gap measurement before and after cyclic loadingSaad, Amir N., 1979- January 2009 (has links)
Indiana University-Purdue University Indianapolis (IUPUI) / The purpose of this study was to evaluate the fracture resistance of three post and core systems in endodontically treated teeth by loading to failure, and to measure marginal gaps before and after cyclic loading.
Sixty extracted canines were assigned to three groups. The groups tested were:
1) Single cast post and core (Group CP).
2) Prefabricated metal post and composite resin core (Group MR).
3) Glass fiber post and composite resin core (Group FR).
All teeth were obturated and prepared to receive a post and core with a coping.
Thirty teeth (10 from each group) were loaded to failure, and the other 30 teeth were fatigue-loaded. The marginal gaps on the facial and lingual surface of the fatigue-loaded group were measured before and after cyclic loading.
There were two hypotheses for this study. The first was that the FR group would have less marginal gap opening on the lingual surface than the other groups.
The second was that the CP group would have a higher load at failure than the other groups.
Group CP was found to have a significantly smaller pre-loading marginal gap than group FR (p = 0.0265) and group MR (p = 0.0273), while groups FR and MR did not have a significantly different pre-loading marginal gaps (p = 0.86). Group FR had significantly less change in marginal gap than group MR (p = 0.0013). Groups CP and MR did not have significantly different changes in marginal gap (p = 0.09). Groups CP and FR did not have significantly different changes in marginal gap (p = 0.11).
The three post types did not have significantly different maximum loads to failure (p= 0.49), moments of inertia at cervical area (p = 0.75), or moments of inertia at fracture site (p=0.12).
There was no significant difference between groups CP, FR, and MR in the load-to-failure test. Group CP demonstrated the highest load-to-failure values; however, the highest load-to-failure mean was for group MR. All fractures observed in this study were catastrophic. Group FR demonstrated better stress distribution and caused no early fractures in the fatigue-loading group.
All groups demonstrated significant marginal gap changes on the lingual surface after fatigue loading; however, group FR demonstrated <45 μm marginal gap opening. In group FR, the reduced marginal gap opening was attributed to the use of Panavia 21 with the proper surface treatments to bond to the tooth structure, the resin composite, and the metal coping.
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Validação da versão em português da entrevista telefônica para avaliação do estado cognitivo - modificada (TICS-M) em pacientes acometidos por acidente vascular cerebral / Validation of the portuguese version of the telephone interview for cognitive status - modified (tics-m) among post-stroke patientsBaccaro, Alessandra Fernandes 04 June 2014 (has links)
Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indivíduos acometidos por AVC, foi realizada tradução para o Português do Brasil e adaptação transcultural da versão original da TICS-M em uma amostra de 30 sujeitos não clínicos. Após esta fase, um subgrupo de 61 pacientes com AVC, participantes do Estudo da Mortalidade e Morbidade do AVC (EMMA) que ocorre no Hospital Universitário da Universidade de São Paulo, foram convidados a participar da validação da TICS-M, seis meses após o evento agudo. A TICS-M foi aplicada em três momentos: avaliação inicial (entrevista presencial), uma e duas semanas após a primeira avaliação. Na avaliação inicial, além da TICS-M, questionários adicionais foram aplicados para avaliar a cognição: MoCA (Montreal Cognitive Assessment), MEEM (Mini Exame do Estado Mental); e para a depressão, HDRS (Hamilton Depression Rating Scale). Todos os questionários foram aplicados por duas entrevistadoras treinadas para o estudo. A confiabilidade intra-observador da TICS-M foi testada através dos coeficientes de Pearson, Intraclasse e alfa de Cronbach. As características internas do TICS-M também foram avaliadas através de uma análise exploratória utilizando o método Análise de Componentes Principais. A validade discriminatória do instrumento para rastreamento de demência pós-AVC foi avaliada em comparação a MEEM pela análise da área sob a curva (AUC) determinada pela curva ROC. Foram calculadas sensibilidade e especificidade para o ponto de corte ideal para rastrear demência. Resultados: De maneira geral, a TICS-M traduzida para o português apresentou um bom entendimento dos itens na mostra de indivíduos não clínicos. Foi observada uma frequência de 23% sugestiva de demência pós-AVC. O nível de escolaridade esteve positivamente associado ao estado demencial rastreado pelo MEEM. O estado depressivo assim como outras características de base não se associou à demência sugerida pelo MEEM. A confiabilidade teste-reteste intra-observador revelou taxas quase totais nos três momentos avaliados (Pearson Coeficiente > 0,85, Coeficientes de Correlação Intraclasse > 0,85 e Coeficiente alfa de Cronbach: 0,96). A análise fatorial determinou três domínios: memória de trabalho e atenção; memória recente e de evocação e orientação. A área sob a curva (AUC) determinada para a TICS-M em comparação com MEEM foi de 0,89 (intervalo de confiança 95%: 0,80-0,98). O ponto de corte sugerido para TICS-M foi de 14 pontos (escala de 0-39 pontos) para rastrear demência com sensibilidade de 91,5% e especificidade de 71,4%. Resultados semelhantes foram observadas com o MoCA. Conclusão: A versão brasileira da TICS-M sugere ser um instrumento de pesquisa útil e confiável para rastrear demência em pacientes pós-AVC / Introduction: Stroke is one most important cause of neuropsychological disorders. An initial cognitive assessment performed by telephone resulting in an early diagnosis of cognitive impairment and dementia, reducing costs and time. Objective: To examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status Assessment (TICS-M) for assessment of dementia in post-stroke patients. Methods: Prior to validation of TICS-M in post-stroke patients, translation was performed for the Brazilian-Portuguese and cross-cultural adaptation of the original version of TICS-M in a non-clinical sample of 30 subjects. After this phase, 61 stroke patients enrolled in the Stroke Mortality and Morbidity Study (The EMMA study) that occurs at the University Hospital of the University of São Paulo, were invited to participate in this sub-study to validate the TICS-M six months after the acute event. The TICS-M was applied in three moments: first evaluation (personal interview), one and two weeks after of the first evaluation. At the first evaluation, beyond the TICS-M, additional questionnaires were applied to assess cognition: MoCA (Montreal Cognitive Assessment), MMSE (Mini-Mental Status Examination), and for depression, HDRS (Hamilton Depression Rating Scale). All questionnaires were administered by two trained interviewers for the study. Reliability of the TICS-M was tested by intra-observer rates using Pearson, Intraclass and Cronbach´s alpha coefficients. The internal characteristics of TICS-M were also evaluated by an exploratory analysis using Principal Component Analysis. The discrimination validity of the instrument to assess dementia was evaluated by comparison to the MMSE analysis of the area under the curve (AUC) determined by the ROC curve. Sensitivity and specificity for the ideal cutoff to assess dementia were calculated. Results: In general, the TICS-M translated into Portuguese version showed a good understanding of the items in non-clinical individuals. A frequency of 23% suggestive of post-stroke dementia was observed. The level of education was positively associated with dementia status assessed by MMSE. The depressive status, as well as, other baseline characteristics was not associated with dementia suggested by MMSE. Test-retest reliability intra-observer revealed almost total rates in the three evaluation moments (Pearson coefficient > 0.85, Intraclass Correlation Coefficient > 0.85 and Cronbach\'s alpha coefficient: 0.96). The factorial analysis determined three domains: working memory and attention, recent and recall memory and orientation. The area under the curve (AUC) determined by TICS-M compared to MMSE was 0.89 (95% confidence interval: 0.80-0.98). The cutoff suggested for TICS-M was equal or greater than 14 points (range 0-39 points) to assess dementia (91.5% sensitivity, 71.4 % specificity). Similar results were observed with the MoCA. Conclusion: The Brazilian version of TICSM suggests being a useful and reliable research instrument to evaluate dementia in poststroke patients in epidemiological studies
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"Prática de medicina baseada em evidências em um centro de tratamento intensivo pediátrico" / The practice of evidence-based medicine in a pediatric intensive care unitCarlos Augusto Cardim de Oliveira 17 December 2003 (has links)
Objetivos: Estimar a concordância entre as práticas e as evidências disponíveis em uma unidade de terapia intensiva pediátrica. Métodos: Estudo retrospectivo de todos os pacientes internados durante 2001. As práticas foram classificadas em adequadas ou não-adequadas de acordo com recomendações. Esperava-se para as práticas recomendadas 90% de concordância, para as contra-indicadas, discordância de até 10% e para aquelas onde havia incertezas, 50%. Resultados: Foram selecionadas 114 publicações e avaliadas 253/275 internações (92%). O uso foi considerado apropriado para albumina em 47,6% (IC 95% 39% 55%); dopamina <3mg/kg/min 87,9% (83% 92%); sedação e analgesia 88,6% (87% 90%); transfusões de concentrado de hemácias 95,2% (92% 97%); profiliaxia de úlcera de estresse 89,7% (88% 91%). / Objectives: Estimate the concordance between the practices and the evidence available in a pediatric intensive care unit. Methods: Retrospective study of all admitted patients during 2001. The practices were classified as adequate or non-adequate according to recommendations. It was expected 90% concordance for the recommended practices, while for non-adequate practices, discordance until 10% and for those where there was doubt, 50%. Results: 114 publications were selected and 253/275 admissions (92%) were evaluated. Use was considered appropriate for albumin in 47.6% (IC 95% 39% 55%); dopamine <3mg/kg/min 87.9% (83% 92%); sedation and analgesia 88.6% (87% 90%); red blood cell transfusions 95.2% (92% 97%); stress ulcer prophylaxis 89.7% (88% 91%).
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"Prática de medicina baseada em evidências em um centro de tratamento intensivo pediátrico" / The practice of evidence-based medicine in a pediatric intensive care unitOliveira, Carlos Augusto Cardim de 17 December 2003 (has links)
Objetivos: Estimar a concordância entre as práticas e as evidências disponíveis em uma unidade de terapia intensiva pediátrica. Métodos: Estudo retrospectivo de todos os pacientes internados durante 2001. As práticas foram classificadas em adequadas ou não-adequadas de acordo com recomendações. Esperava-se para as práticas recomendadas 90% de concordância, para as contra-indicadas, discordância de até 10% e para aquelas onde havia incertezas, 50%. Resultados: Foram selecionadas 114 publicações e avaliadas 253/275 internações (92%). O uso foi considerado apropriado para albumina em 47,6% (IC 95% 39% 55%); dopamina <3mg/kg/min 87,9% (83% 92%); sedação e analgesia 88,6% (87% 90%); transfusões de concentrado de hemácias 95,2% (92% 97%); profiliaxia de úlcera de estresse 89,7% (88% 91%). / Objectives: Estimate the concordance between the practices and the evidence available in a pediatric intensive care unit. Methods: Retrospective study of all admitted patients during 2001. The practices were classified as adequate or non-adequate according to recommendations. It was expected 90% concordance for the recommended practices, while for non-adequate practices, discordance until 10% and for those where there was doubt, 50%. Results: 114 publications were selected and 253/275 admissions (92%) were evaluated. Use was considered appropriate for albumin in 47.6% (IC 95% 39% 55%); dopamine <3mg/kg/min 87.9% (83% 92%); sedation and analgesia 88.6% (87% 90%); red blood cell transfusions 95.2% (92% 97%); stress ulcer prophylaxis 89.7% (88% 91%).
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Validação da versão em português da entrevista telefônica para avaliação do estado cognitivo - modificada (TICS-M) em pacientes acometidos por acidente vascular cerebral / Validation of the portuguese version of the telephone interview for cognitive status - modified (tics-m) among post-stroke patientsAlessandra Fernandes Baccaro 04 June 2014 (has links)
Introdução: O AVC (acidente vascular cerebral) é uma das mais importantes causas de alterações neuropsicológicas. Uma avaliação cognitiva inicial realizada por telefone implicaria em um diagnóstico mais precoce de prejuízo cognitivo e demência, reduzindo custos e tempo. Objetivo: Examinar as propriedades psicométricas da versão brasileira da Entrevista Telefônica para Avaliação do Estado Cognitivo - Modificada (TICS-M) em pacientes pós-AVC. Métodos: Previamente à validação da TICS-M em indivíduos acometidos por AVC, foi realizada tradução para o Português do Brasil e adaptação transcultural da versão original da TICS-M em uma amostra de 30 sujeitos não clínicos. Após esta fase, um subgrupo de 61 pacientes com AVC, participantes do Estudo da Mortalidade e Morbidade do AVC (EMMA) que ocorre no Hospital Universitário da Universidade de São Paulo, foram convidados a participar da validação da TICS-M, seis meses após o evento agudo. A TICS-M foi aplicada em três momentos: avaliação inicial (entrevista presencial), uma e duas semanas após a primeira avaliação. Na avaliação inicial, além da TICS-M, questionários adicionais foram aplicados para avaliar a cognição: MoCA (Montreal Cognitive Assessment), MEEM (Mini Exame do Estado Mental); e para a depressão, HDRS (Hamilton Depression Rating Scale). Todos os questionários foram aplicados por duas entrevistadoras treinadas para o estudo. A confiabilidade intra-observador da TICS-M foi testada através dos coeficientes de Pearson, Intraclasse e alfa de Cronbach. As características internas do TICS-M também foram avaliadas através de uma análise exploratória utilizando o método Análise de Componentes Principais. A validade discriminatória do instrumento para rastreamento de demência pós-AVC foi avaliada em comparação a MEEM pela análise da área sob a curva (AUC) determinada pela curva ROC. Foram calculadas sensibilidade e especificidade para o ponto de corte ideal para rastrear demência. Resultados: De maneira geral, a TICS-M traduzida para o português apresentou um bom entendimento dos itens na mostra de indivíduos não clínicos. Foi observada uma frequência de 23% sugestiva de demência pós-AVC. O nível de escolaridade esteve positivamente associado ao estado demencial rastreado pelo MEEM. O estado depressivo assim como outras características de base não se associou à demência sugerida pelo MEEM. A confiabilidade teste-reteste intra-observador revelou taxas quase totais nos três momentos avaliados (Pearson Coeficiente > 0,85, Coeficientes de Correlação Intraclasse > 0,85 e Coeficiente alfa de Cronbach: 0,96). A análise fatorial determinou três domínios: memória de trabalho e atenção; memória recente e de evocação e orientação. A área sob a curva (AUC) determinada para a TICS-M em comparação com MEEM foi de 0,89 (intervalo de confiança 95%: 0,80-0,98). O ponto de corte sugerido para TICS-M foi de 14 pontos (escala de 0-39 pontos) para rastrear demência com sensibilidade de 91,5% e especificidade de 71,4%. Resultados semelhantes foram observadas com o MoCA. Conclusão: A versão brasileira da TICS-M sugere ser um instrumento de pesquisa útil e confiável para rastrear demência em pacientes pós-AVC / Introduction: Stroke is one most important cause of neuropsychological disorders. An initial cognitive assessment performed by telephone resulting in an early diagnosis of cognitive impairment and dementia, reducing costs and time. Objective: To examine the psychometric properties of the Brazilian version of the Modified Telephone Interview for Cognitive Status Assessment (TICS-M) for assessment of dementia in post-stroke patients. Methods: Prior to validation of TICS-M in post-stroke patients, translation was performed for the Brazilian-Portuguese and cross-cultural adaptation of the original version of TICS-M in a non-clinical sample of 30 subjects. After this phase, 61 stroke patients enrolled in the Stroke Mortality and Morbidity Study (The EMMA study) that occurs at the University Hospital of the University of São Paulo, were invited to participate in this sub-study to validate the TICS-M six months after the acute event. The TICS-M was applied in three moments: first evaluation (personal interview), one and two weeks after of the first evaluation. At the first evaluation, beyond the TICS-M, additional questionnaires were applied to assess cognition: MoCA (Montreal Cognitive Assessment), MMSE (Mini-Mental Status Examination), and for depression, HDRS (Hamilton Depression Rating Scale). All questionnaires were administered by two trained interviewers for the study. Reliability of the TICS-M was tested by intra-observer rates using Pearson, Intraclass and Cronbach´s alpha coefficients. The internal characteristics of TICS-M were also evaluated by an exploratory analysis using Principal Component Analysis. The discrimination validity of the instrument to assess dementia was evaluated by comparison to the MMSE analysis of the area under the curve (AUC) determined by the ROC curve. Sensitivity and specificity for the ideal cutoff to assess dementia were calculated. Results: In general, the TICS-M translated into Portuguese version showed a good understanding of the items in non-clinical individuals. A frequency of 23% suggestive of post-stroke dementia was observed. The level of education was positively associated with dementia status assessed by MMSE. The depressive status, as well as, other baseline characteristics was not associated with dementia suggested by MMSE. Test-retest reliability intra-observer revealed almost total rates in the three evaluation moments (Pearson coefficient > 0.85, Intraclass Correlation Coefficient > 0.85 and Cronbach\'s alpha coefficient: 0.96). The factorial analysis determined three domains: working memory and attention, recent and recall memory and orientation. The area under the curve (AUC) determined by TICS-M compared to MMSE was 0.89 (95% confidence interval: 0.80-0.98). The cutoff suggested for TICS-M was equal or greater than 14 points (range 0-39 points) to assess dementia (91.5% sensitivity, 71.4 % specificity). Similar results were observed with the MoCA. Conclusion: The Brazilian version of TICSM suggests being a useful and reliable research instrument to evaluate dementia in poststroke patients in epidemiological studies
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Comparing Immune Responses to Inactivated Vaccines Against SARS-CoV-2 Between People Living With HIV and HIV-Negative Individuals: A Cross-Sectional Study in ChinaHuang, Xiaojie, Yan, Ying, Su, Bin, Xiao, Dong, Yu, Maohe, Jin, Xia, Duan, Junyi, Zhang, Xiangjun, Zheng, Shimin, Fang, Yuan, Zhang, Tong, Tang, Weiming, Wang, Lunan, Wang, Zixin, Xu, Junjie 28 January 2022 (has links)
This study compared the immunogenicity of inactivated SARS-CoV-2 vaccines between people living with HIV (PLWH) and HIV-negative individuals. We recruited 120 PLWH and 53 HIV-negative individuals aged 18-59 years who had received an inactivated SARS-CoV-2 vaccine in two Chinese cities between April and June 2021. Blood samples were tested for immunogenicity of the inactivated SARS-CoV-2 vaccines. The prevalence and severity of adverse events associated with SARS-CoV-2 vaccines were similar between PLWH and HIV-negative individuals. The seropositivity of neutralizing activity against authentic SARS-CoV-2, of the total amount of antibody (total antibody) and of S-IgG were 71.3%, 81.9%, and 92.6%, respectively, among fully vaccinated PLWH. Among all participants, PLWH had lower neutralizing activity, total antibody, S-IgG, and T-cell-specific immune response levels, compared to HIV-negative individuals, after controlling for types of vaccine, time interval between first and second dose, time after receiving the second dose, and sociodemographic factors. PLWH with a longer interval since HIV diagnosis, who received their second dose 15-28 days prior to study commencement, and who had an interval of ≥21 days between first and second dose had higher neutralizing activity levels. The immunogenicity of the inactivated SARS-CoV-2 vaccines was lower among PLWH as compared to HIV-negative individuals. Vaccination guideline specific for PLWH should be developed.
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570 |
Chemoprevention for Colorectal CancerKrishnan, K, Ruffin, M T., Brenner, D E. 01 March 2000 (has links)
No description available.
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