Zobrazení zdroje stránky Kirkebychristie2228

To review and synthesise the contemporary qualitative evidence, relating to the individual, healthcare professional and system-level barriers and facilitators to injectable therapies in people with type 2 diabetes, and evaluate (using an intersectional approach to explore the diverse perspectives of different identities) whether views have changed with treatment and guideline advancements.<br /><br /> A meta-ethnography approach used. Eight databases searched from the years 2006 (GLP-1 analogues introduced) to February 2021. Study selection (using a pre-defined inclusion criteria), quality appraisal and data extraction, conducted independently by two reviewers.<br /><br /> Screened 7143 abstracts, assessed 93 full-text papers for eligibility and included 42studies-using data from 818 individuals with type 2 diabetes and 160healthcare professionals. Studies covered a diverse range of views from healthcare professionals and individuals, including those relating to older adults and people from ethnic migrant backgrounds, and 10ste diverse views relating to barriers and facilitators that influence engagement with injectable treatments for type 2 diabetes. A model is presented to help patients, health practitioners and policy makers identify barriers and facilitators and understand the complex interplay of physical, psychological and social factors involved when prescribing injectable therapies. Despite advances in injectable treatments and guidelines, findings highlight the many barriers that still exist and show how strongly held culturally-specific health beliefs of people from diverse socio-economic and ethnic backgrounds can become substantial obstacles to treatment.Endoscopy for revealing the orifice of congenital H-type tracheoesophageal fistula (cTEF) is important for diagnostics and therapeutics. To facilitate the identification and catheterization of cTEF, we developed a new modified flexible endoscopy technique using a laryngeal mask with intermittent airflow. A retrospective case series study was conducted from April 2016 to July 2019 at a national regional children's medical center. Twelve infants with cTEF underwent this flexible endoscopy technique. The intermittent positive pressure airflow through laryngeal mask was able to reveal the orifice of cTEF easily in tracheal lumen. Under the visual flexible endoscope, cannulation with a 3-Fr ureteral catheter in fistula was successfully used in all cases. There were no immediate or delayed complications. This case series shows that the flexible endoscopy technique is a safe, easy, and technically efficient approach for diagnosis and cannulation of cTEF.Informal recycling of electronic waste (e-waste) contaminates local environments with metals and other organic compounds. The adverse effects on native earthworm populations are poorly understood. The objective of the present study was to determine metal concentrations in soils from e-waste activity sites in Douala (Cameroon) and assess the effects of these soils on the growth and reproduction of the local earthworm, Alma nilotica. Concentrations of nine metals (arsenic [As], cadmium [Cd], cobalt [Co], chromium [Cr], copper [Cu], mercury [Hg], nickel [Ni], lead [Pb], and zinc [Zn]) were measured in soil samples collected from eight e-waste activity and two non-e-waste sites. Earthworms were then exposed to these soils in the laboratory following test guidelines of the Organisation for Economic Co-operation and Development. Metal concentrations in the e-waste-contaminated soils were significantly higher than in the non-e-waste soils. The e-waste soils were found to have a different soil metal profile (Cu &gt; Pb &gt; Zn &gt; Cr &gt; Ni &gt; Co &gt; As &gt; Cd &gt; Hg) from that of the non-e-waste soils (Zn &gt; Cr &gt; Cu &gt; Pb &gt; Ni &gt; As &gt; Cd &gt; Co &gt; Hg). [https://www.selleckchem.com/products/sodium-2-1h-indol-3-ylacetate.html Sodium 2-(1H-indol-3-yl)acetate ic50] Earthworm growth and reproduction were significantly inhibited in organisms exposed to soils from e-waste sites. Reproduction was particularly affected, with a mean of 8 ± 5.6 offspring/10 worms in the e-waste-exposed worm groups compared with 90.5 ± 0.7 in non-e-waste soil worms. Notably, earthworm growth recovered during depuration in clean soil, indicating the possibility of remediation activities. The results demonstrate that soils at e-waste sites can affect the health of resident worm populations, which may be more sensitive than temperate species. They also highlight the potential of a bioassay-based approach in monitoring risks at e-waste sites. Environ Toxicol Chem 2021;001-11. © 2021 SETAC.<br /><br /> To delineate the trajectories of physical symptoms and psychological distress among patients with a solid metastatic cancer during the last year of life.<br /><br /> We used data of 345 decedents from a prospective cohort of 600 patients with a Stage IV solid cancer. Using group-based trajectory modelling, we assessed (a) demographic (age, gender, education, cancer site) predictors of trajectory membership, (b) shift in trajectories associated with planned and unplanned hospitalizations, emergency room visits and chemotherapy, and (c) the association between trajectory membership and place of death.<br /><br /> We identified three trajectories of physical symptoms-"persistent mild" (56%), "progressive moderate" (36%), and "progressive severe" (8%), and two for psychological distress-"persistent mild" (72%) and "progressive distress" (28%). Females (β=1.40 [SE=0.55], p-value=0.01) and highly educated patients (β=1.46 [SE=0.62], p-value=0.02) were more likely to experience progressive severe symptoms compared to persistent mild symptoms. Older patients were less likely (β=-1.01 [SE=0.33], p-value=0.003), while those with gynecological cancers (β=1.51 [SE=0.65], p-value=0.02) were more likely to experience progressive distress compared to persistent mild distress. Planned and unplanned hospitalizations, emergency room visits, and chemotherapy were associated with a worsening in trajectories. Patients with higher distress were more likely to die in a hospice compared to a hospital.<br /><br /> Interventions to improve physical symptoms and distress can focus on patients at risk of being in worse trajectories and at critical time points in the last year of life-hospitalizations, emergency room visits, and chemotherapy.<br /><br />Interventions to improve physical symptoms and distress can focus on patients at risk of being in worse trajectories and at critical time points in the last year of life-hospitalizations, emergency room visits, and chemotherapy.<br /><br /> To evaluate the prevalence of HSPM worldwide on a child and tooth level and investigate the influence of diagnostic criteria on the prevalence of HSPM.<br /><br /> A comprehensive literature search was performed through MEDLINE/PubMed, Scopus and Web of Science databases. The grey literature was also screened as were the reference lists of included studies. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of HSPM.<br /><br /> The search strategy identified 1,988 articles, 487 were retrieved for full text evaluation and 37 studies were included in the meta-analysis (32 for child and 23 for tooth level prevalence), providing data from 26,805 individuals and 81,107 molars. The prevalence of HSPM was 6.8% (95%CI 4.98 to 8.86%) on a child level and 4.08% on a tooth level (95%CI=2.80 to 5.59%). The diagnostic criteria used did not seem to influence the prevalence results (p&lt;0.05). The majority of the papers (75%) showed low to moderate risk of bias.<br /><br /> There was a broad variation in the prevalence reported that may be attributed to differences in the study population. The present meta-analysis showed a HSPM prevalence worldwide of 6.8% on a child level and 4.1% on a tooth level.<br /><br />There was a broad variation in the prevalence reported that may be attributed to differences in the study population. The present meta-analysis showed a HSPM prevalence worldwide of 6.8% on a child level and 4.1% on a tooth level.<br /><br /> The prevalence of sexual dysfunctions in people with diabetes is still debated and understudied in women. This study examines the prevalence of sexual dysfunction in men and women with type 1 or type 2 diabetes (T1D or T2D) and the associations with clinical and psychological variables.<br /><br /> Adults with diabetes (n=756) completed an online survey including questions on sexual functioning (adapted Short Sexual Functional Scale), general emotional well-being (WHO-5), symptoms of anxiety (GAD-7) and diabetes distress (PAID-20).<br /><br /> One third of participants reported a sexual dysfunction. Men reported erectile dysfunction (T1D 20%; T2D 33%), and orgasmic dysfunction (T1D 22%; T2D 27%). In men, sexual dysfunction was independently associated with, older age (OR=1.05, p=0.022), higher waist circumference (OR=1.04; p&lt;0.001) and longer duration of diabetes (OR=1.04; p=0.007). More men with sexual dysfunction reported diabetes distress (20% vs. 12%, p=0.026). Women reported decreased desire (T1D 22%; T2D 15%) and decreased arousal (T1D 9%; T2D 11%). More women with sexual dysfunction reported diabetes distress (36% vs. 21%, p=0.003), impaired emotional well-being (36% vs. 25%, p=0.036) and anxiety symptoms (20% vs. 11%, p=0.026).<br /><br /> Sexual dysfunctions are common in both men and women with diabetes. In men, sexual dysfunctions were associated with clinical factors. More women with sexual dysfunction reported low emotional well-being and anxiety symptoms compared to women without sexual dysfunction. For both men and women, sexual dysfunctions were associated with diabetes distress.<br /><br />Sexual dysfunctions are common in both men and women with diabetes. In men, sexual dysfunctions were associated with clinical factors. More women with sexual dysfunction reported low emotional well-being and anxiety symptoms compared to women without sexual dysfunction. For both men and women, sexual dysfunctions were associated with diabetes distress.The sediment-water interface of spiked-sediment toxicity tests is a complex exposure system, where multiple uptake pathways exist for benthic organisms. The freely dissolved concentration (Cfree ) in sediment porewater has been proposed as a relevant exposure metric to hydrophobic organic contaminants (HOCs) in this system. However, Cfree has rarely been measured in spiked-sediment toxicity tests. We first developed a direct immersion solid-phase microextraction method for measuring Cfree in overlying water and porewater in a sediment test using polydimethylsiloxane-coated glass fibers, resulting in sensitive and repeatable in situ measurements of HOCs. Then, we measured Cfree and total dissolved concentrations (Cdiss ) in the sediment test systems with the freshwater amphipod Hyalella azteca and thoroughly evaluated the temporal and spatial profiles of four HOCs (phenanthrene, pyrene, benzo[a]pyrene, and chlorpyrifos). Furthermore, we examined the relationship between the measured concentrations and the lethality of H. azteca. We found that the test system was far from an equilibrium state for all four chemicals tested, where Cdiss in overlying water changed over the test duration and a vertical Cfree gradient existed at the sediment-water interface. In porewater Cdiss was larger than Cfree by a factor of 170 to 220 for benzo[a]pyrene because of the strong binding to dissolved organic carbon. Comparison of the median lethal concentrations of chlorpyrifos in the sediment test and those in water-only tests indicates that Cfree in porewater was the most representative indicator for toxicity of this chemical. The method and findings presented in the present study warrant further research on the chemical transport mechanisms and the actual exposure in sediment tests using different chemicals, sediments, and test species. Environ Toxicol Chem 2021;001-11. © 2021 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.