The present study employed a quantitative, non-experimental, multivariate correlational research design to test a hypothesized model examining associative paths of influence between ecological factors and weight status of urban, African-American adolescent females. Anthropometric and self-report survey data of 182 urban, African- American adolescent females were collected during after-school programs, health and physical education classes, and community events in an urban area in northeast Florida. Descriptive analyses were conducted to characterize the study participants based upon their age, study setting, and weight status. A scale reliability analysis was conducted to assess the internal consistency reliability of the sample data using selected measures within the context of the study’s specific population and subsequently guided the structural equation model (SEM) analyses. The SEM path analysis was used to develop two measurement models to control for observed error variance for variables demonstrating poor internal consistency reliability (diet behaviors and nutrition selfefficacy) and a final structural model to test the associative paths of influence between latent (diet behaviors and nutrition self-efficacy) and manifest variables (teacher social support and friend social support) on weight status. The results of the path analysis indicated that both teacher social support and friend social support demonstrated a positive, indirect influence on child weight status through nutrition self-efficacy and diet behaviors following two different and specific paths of influence. Diet behaviors, in turn, demonstrated a positive, direct effect on child weight status. These findings provide clear implications for educational leaders that call for the integration of health behavior change theory into traditional education and leadership practice and actively addressing the childhood obesity epidemic in the school environment by implementing health behavior change strategies at various ecological environmental levels.

O infarto do miocárdio (IM) é a doença cardiovascular que mais causa morte e invalidez em todo o mundo. O uso de animais experimentais tem auxiliado a compreender melhor a fisiopatologia e as formas de tratamento do IM. Sabendo que as dislipidemias estão associadas com o IM e que o treinamento físico pode ser prescrito para prevenção e tratamento de doenças cardiovasculares, no presente trabalho, investigamos os efeitos de dois tipos de treinamentos físicos em um modelo experimental de dislipidemia e isquemia miocárdica. Camundongos selvagens (WT) e knockout para o receptor LDL (LDL-/-) foram divididos em oito grupos: a) LDLr-/- sedentário (LDL-S); b) LDLr-/- infartado sedentário (LDL-IM-S); c) LDLr-/- infartado submetido a treinamento contínuo (LDL-IM-C); d) LDLr-/- infartado submetido a treinamento intervalado (LDL-IM-I); e) WT sedentário (WT-S); f) WT infartado sedentário (WT-IM-S); g) WT infartado submetido a treinamento contínuo (WT-IM-C); h) WT infartado submetido a treinamento intervalado (WT-IM-I). Após 60 dias da ligadura da artéria coronária descendente, o treino contínuo constou de corrida a 60% do máximo e o intervalado de 8 tiros de 4min a 80% do máximo e recuperação de 4min a 40% do máximo. Nos animais WT infartados, ambos os treinamentos aumentaram a tolerância ao esforço e provocaram diminuição do balanço simpatovagal e aumento do índice alfa em magnitudes semelhantes. O treinamento intervalado reduziu o número de fibras do tipo II em relação aos grupos WT-S e WT-IM-C, bem como reduziu a quantidade de fibras do tipo II-X em relação aos WT-S. A área de secção transversa das fibras do tipo I foi maior no grupo WT-IM-I do que no WT-IM-S e WT-S. A razão capilar/fibra foi maior nos animais do grupo WT-I do que no WT-S. A fração de ejeção e a fração de encurtamento foi menor no grupo LDL-IM-I em relação aos demais, mas sem diferenças entre os grupos WT-S, WT-IM-C e WT-IM-I. Nos animais LDL-/-, o LDL foi maior e o VLDL menor no grupo LDL-IM-C em relação aos demais. O HDLtg(%) foi superior no LDL-C em relação ao LDL-S. O HDLc (mg e %) do LDL-IM-I foi maior que o do grupo LDL-IM-C, sendo que o HDLc (mg) do LDL-IM-I foi, ainda maior do que o grupo LDL-S. O triglicérides total foi menor no grupo LDL-IM-C do que no LDL-S. Somente o grupo LDL-IM-I diminuiu a FC de repouso em relação ao grupo LDL-IM-S. A PA diastólica foi menor no grupo LDL-IM-S em relação ao LDL-S, enquanto que o grupo LDL-IM-I apresentou PA diastólica maior do que o grupo LDL-IM-C. A variância do intervalo de pulso foi maior no grupo LDL-S somente em relação ao grupo LDL-IM-I. Em conjunto nossos resultados demonstraram que os animais LDL possuem diferenças funcionais e fisiológicas importantes em relação ao WT, especialmente na morfologia muscular, na hemodinâmica e no controle autonômico. Que o IM acarretou prejuízos em ambas as linhagens investigadas e que os dois tipos de TF atenuaram semelhantemente esses prejuízos em grande parte das variáveis analisadas / Myocardial infarction (MI) is a major cause of death and disability worldwide. The use of experimental animals has supported to better understand the pathophysiology and treatment forms of myocardial infarction (MI). Knowing that the dyslipidemia associated with IM and that physical training can be prescribed for prevention and treatment of cardiovascular diseases, the present study investigated the effects of two types of physical training on an experimental model of dyslipidemia and myocardial ischemia. Wild mice (WT) and LDL receptor knockout (LDL-/- ) were divided into eight groups: a) LDLr-/- sedentary (LDL-S), b) LDLr-/- myocardium infarction sedentary (LDL-MI-S), c) LDLr-/- myocardium infarction submitted to continuous training (LDL-MI-C), d) LDLr-/- myocardium infarction submitted to interval training (LDLMI- I), e) sedentary WT (WT-S); f) WT myocardium infarction sedentary (WT-MI-S); g) WT myocardium infarction submitted to continuous training (WT-MI-C), h) WT myocardium infarction submitted to interval training (WT-IM-I). After 60 days of descending coronary artery ligation, the continuous training consisted of running at 60% of maximum, while the interval training consisted of eight sprints of 4 min at 80% of maximum and a 4 min recovery at 40% of maximum. In infarcted WT animals, both training programs increased exercise tolerance and promoted decrease of sympathetic-vagal balance and increase of alpha index in similar magnitudes. Nevertheless, the interval training reduced the number of type II fibers in infarcted WT animals compared to WT-S and WT-MI-C groups, as well as reduced the amount of fiber type II-X compared to WT-S. The cross-sectional area of the fiber type I was higher in the WTMI- I animals than in WT-MI-S and S-WT groups. The reason capillary/fiber was higher in group WT-I than in the WT-S. Ejection fraction and shortening fraction were lower in LDL-MII compared to the others, but with no differences among the WT-S, WT-IMI-C and WT-MI-I groups. About the LDL-/- animals, the LDL was higher and VLDL was lower in the group LDL-MI-C in relation to the others. The HDLtg (%) was higher in LDL-C compared to LDL-S. The HDLc (mg and %) of LDL-MI-I was higher than the LDL-MI-C group, and the HDLc (mg) of LDL-MI-I was even higher than LDL-S group. The total triglycerides was lower in LDL- MIC than in LDL-S animals. Only in LDL-MI-I group the resting HR was decreased in comparison to LDL-MI-S. The diastolic blood pressure was lower in LDL-MI-S in relation to LDL-S, while the LDL-MI-I group presented a higher diastolic BP than the LDL-MI-C group. The pulse interval variance was greater in LDL-S than in LDL-MI-I only. In conclusion, our results demonstrate that LDL animals have important functional and physiological differences compared to WT, especially in relation to muscle morphology, hemodynamic and autonomic cardiovascular control. Furthermore, MI leads to damage in both investigated strains and the two types of physical training attenuate similarly the impairment of most of the analyzed variables

The incidence of postoperative nausea and vomiting (PONV) is unknown in neuraxial anesthesia for orthopedic surgery. The effect on PONV of adding gabapentin to an evidence-based antiemetic regimen as part of an opioid-sparing analgesic protocol is also unknown in this population. A retrospective analysis of all adults undergoing hip and knee arthroplasty and receiving neuraxial anesthesia in 2017 was conducted. The overall incidence of PONV was assessed. Additionally, PONV incidence was assessed for all combinations of gabapentin, dexamethasone, and/or ondansetron (in addition to propofol infusion) and compared with propofol alone. The PONV risk ratios were estimated, adjusting for age and PONV risk score. The overall incidence of PONV was 14.0%. The addition of gabapentin to propofol was associated with reduced PONV (multivariable risk ratio [mRR], 0.6; 95% CI, 0.4-1.0) vs propofol alone. Dexamethasone with propofol was associated with reduced PONV (mRR 0.6; 95% CI, 0.4-1.1) vs propofol alone, although not statistically significant. The addition of both gabapentin and dexamethasone to propofol was associated with stronger reduction in PONV (mRR 0.3; 95% CI, 0.1-0.7) vs propofol alone. Adding ondansetron to propofol showed little benefit. Gabapentin and dexamethasone are effective in reducing PONV in patients undergoing knee and hip arthroplasty with neuraxial anesthesia.

Although guidelines indicate when patients are eligible for antihypertensives and statins, little is known about whether general practitioners (GPs) follow this guidance. To determine the factors influencing GPs decisions to prescribe cardiovascular prevention drugs. DESIGN OF STUDY: Secondary analysis of data collected on patients whose cardiovascular risk factors were measured as part of a controlled study comparing nurse-led risk assessment (four practices) with GP-led risk assessment (two practices). SETTING: Six general practices in the West Midlands, England. PATIENTS: Five hundred patients: 297 assessed by the project nurse, 203 assessed by their GP. MEASUREMENTS: Cardiovascular risk factor data and whether statins or antihypertensives were prescribed. Multivariable logistic regression models investigated the relationship between prescription of preventive treatments and cardiovascular risk factors. RESULTS: Among patients assessed by their GP, statin prescribing was significantly associated only with a total cholesterol concentration >/= 7 mmol/L and antihypertensive prescribing only with blood pressure >/= 160/100 mm Hg. Patients prescribed an antihypertensive by their GP were five times more likely to be prescribed a statin. Among patients assessed by the project nurse, statin prescribing was significantly associated with age, sex, and all major cardiovascular risk factors. Antihypertensive prescribing was associated with blood pressures >/= 140/90 mm Hg and with 10-year cardiovascular risk. LIMITATIONS: Generalizability is limited, as this is a small analysis in the context of a specific cardiovascular prevention program. CONCLUSIONS: GP prescribing of preventive treatments appears to be largely determined by elevation of a single risk factor. When patients were assessed by the project nurse, prescribing was much more consistent with established guidelines.

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.

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.

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%).

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%).

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.

No description available.