Segregation

隔离
  • 文章类型: Journal Article
    预防传染性感染是囊性纤维化(CF)护理的优先事项。这是对CF感染预防和控制干预措施证据的系统回顾的更新。我们的完整协议可以在PROSPERO(CRD42018109999)上找到。我们搜索了包括CF感染预防和控制干预措施的研究和指南。我们纳入了39项研究和7项指南。策略包括:队列或个体隔离,手部卫生,口罩,设备,增强的粘附性或这些的组合。许多研究表明,隔离的传播减少。然而,证据的确定性(使用等级)较低或非常低。大多数指南建议几乎没有证据支持它们,没有更新,因为我们的原始审查。在这方面进行RCT在道德上很困难。基于注册的大规模研究可能是最好的务实方法。感染控制的好处必须与CF患者生活中的入侵相平衡。
    Preventing transmissible infection is a priority in cystic fibrosis (CF) care. This is an update of a systematic review of the evidence for infection prevention and control interventions in CF. Our full protocol can be found on PROSPERO (CRD42018109999). We searched for studies and guidelines which included interventions for infection prevention and control in CF. We included 39 studies and 7 guidelines. Strategies included: cohort or individual segregation, hand hygiene, facemasks, equipment, enhanced adherence or a combination of these. Many studies showed a reduction in transmission with segregation. However, the certainty of evidence (using GRADE) was low or very low. Most guideline recommendations have little evidence to support them, with no updates since our original review. Undertaking RCTs in this area is ethically difficult. Large-scale registry-based studies may be the best pragmatic approach. Benefits of infection control must be balanced against the intrusion in the lives of people with CF.
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  • 文章类型: Journal Article
    尽管在缩小全球性别差距方面取得了重大进展,还有很大的进展,特别是在科学和科学研究领域。许多研究已经解决了这个问题,并确定了导致研究中性别不对称的各种因素。
    这项研究旨在确定过去十年中引用最多的科学研究中存在的性别差距的决定因素,作为消除这些差异的第一步。通过结合Proknow-C知识开发过程和建构主义方法论的系统文献综述。
    结果使我们确定了四个维度来分类科学研究差距的决定因素:学术供应,研究政策,科学生产和研究人员概况及其各自的定量或定性指标。
    作为进一步建模的潜在基础,提供更大的分析和关联深度,以及确定旨在减少研究中性别差距的有针对性的战略。
    UNASSIGNED: Despite significant advancements in closing the global gender gap, there is still much progress to be made, particularly in the field of science and scientific research. Numerous studies have addressed this issue and identified a variety of factors that contribute to gender asymmetries in research.
    UNASSIGNED: This study aimed to identify the determinants of gender gaps in scientific research present in the most cited studies of the past ten years as a first step towards closing these differences. Through a systematic literature review that incorporated the Proknow-C Knowledge Development Process and Constructivism methodology.
    UNASSIGNED: The results lead us to identify four dimensions to classify the determinants of the gaps in scientific research: academic supply, research policies, scientific production and researcher profile with their respective quantitative or qualitative indicators.
    UNASSIGNED: As a potential basis for further modeling that offers greater analytical and correlational depth, as well as the identification of targeted strategies aimed at reducing gender gaps in research.
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  • 文章类型: Journal Article
    本系统综述旨在加深对隔离对老年人认知的复杂影响的理解,并为未来的研究提供指导。
    使用健康的社会决定因素框架进行系统审查,以检查所选文献中隔离与认知之间的关系。
    八篇论文符合入选标准。所有选定的研究都检查了居住在隔离区域对老年人认知的影响,涵盖来自不同种族/族裔群体的老年人。在不同种族/族裔群体的不同方向上发现了隔离与认知之间的关联。效果可以根据种族/种族而变化,教育水平,邻里社会经济地位,或社会背景。
    这篇综述指出了在理解隔离与认知之间关系方面存在的差距。未来的研究应谨慎采取隔离措施,承认不同种族/族裔群体之间不同的隔离经验,并在研究中考虑更多的社会决定因素。
    UNASSIGNED: This systematic review aims to advance the understanding of the complicated effects of segregation on older adults\' cognition and provide guidance for future research.
    UNASSIGNED: A systematic review using the Social Determinants of Health framework to examine the relationship between segregation and cognition across the selected literature.
    UNASSIGNED: Eight papers met the criteria for inclusion. All selected studies examined the influence of living in a segregated area on older adults\' cognition, covering older adults from different racial/ethnic groups. The association between segregation and cognition was found in different directions across different racial/ethnic groups. The effects can be varied depending on race/ethnicity, level of education, neighborhood socioeconomic status, or social context.
    UNASSIGNED: This review identified existing gaps in understanding the relationship between segregation and cognition. Future studies should carefully adopt the segregation measures, acknowledge the varying segregation experience among different racial/ethnic groups, and consider more social determinant factors in research.
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  • 文章类型: Journal Article
    随着印度社会和医学对月经卫生的认识不断提高,对卫生巾的需求显着增加。利用高质量和环保的原材料来生产这些垫进一步支持了市场的增长。然而,随着需求和使用的改善,对适当处置技术的需求变得更加相关,因为所有这些垫子都被人体血液污染,这使得它们具有生物危害,并可能对人类健康和环境造成重大损害。一个卫生垫需要大约800年才能自然降解,而卫生垫中的塑料和超吸收聚合物(SAP)是不可生物降解的,可能需要几十年才能降解。废物管理技术,如热解,气化,可以采用资源回收来管理吨卫生废物。目前,卫生废物处理主要集中在填埋,焚化,堆肥,生物危害废物与数吨固体废物混合在一起。一次性卫生垫具有每年约5.3kgCO2当量的高碳足迹。手稿中讨论了用于卫生垫处理的创新解决方案,其中包括将衍生的废纤维素和塑料部分重新用于增值产品。系统讨论了消毒策略的未来方面以及从餐巾纸中回收的废纤维素的增值,以促进循环经济。
    With ever-improving social and medical awareness about menstrual hygiene in India, the demand for sanitary napkins has increased significantly. The utilization of high-quality and environment-friendly raw materials to produce these pads is further supporting the growth of the market. However, with improving demand and usage, the need for proper disposal techniques becomes more relevant, since all of these pads get contaminated with human blood which makes them a biohazard and can cause significant damage to human health and the environment. One sanitary pad takes around 800 years to degrade naturally and the plastic and super absorbent polymers (SAPs) in sanitary pads are non-biodegradable and can take multiple decades to degrade. Waste management technologies such as pyrolysis, gasification, and resource recovery can be adopted to manage tons of sanitary waste. Currently, sanitary waste treatment mainly focuses on landfilling, incineration, and composting, where biohazard wastes are mixed with tons of solid waste. Disposable sanitary pads have a high carbon footprint of about 5.3 kg CO2 equivalent every year. Innovative solutions for sanitary pad disposal are discussed in the manuscript which includes repurposing of derived waste cellulose and plastic fraction into value-added products. Future aspects of disinfection strategies and value addition to waste cellulose recovered from napkins were systematically discussed to promote a circular economy.
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  • 文章类型: Systematic Review
    种族居住隔离被认为是种族健康差异的根本原因,住房歧视是住宅隔离的关键驱动因素。尽管有这种联系,与人口健康文献中的隔离相比,住房中的种族歧视研究要少得多。因此,除了与隔离的联系外,我们对住房歧视与健康的联系知之甚少。此外,我们需要了解不同类型的住房歧视对健康的影响有何不同。这篇综述旨在评估人口健康文献在概念化方面的状况,测量,以及住房歧视对健康的影响。我们使用PRISMA指南进行范围审查,并提供了2022年1月1日之前发表的符合我们纳入标准的32篇文章的数据。近一半的条款没有明确界定住房歧视。此外,在各个研究中,住房歧视的运作方式存在很大差异。与使用行政数据进行住房歧视暴露的研究相比,使用调查数据的研究更有可能报告与健康结局的不利关联.综合和比较这些研究的结果有助于将方法学方法与本研究联系起来。我们的审查有助于为有关种族主义如何影响人口健康的辩论提供信息。鉴于种族歧视的性质随着时间和地点的变化而变化,我们讨论了人口健康研究人员如何研究各种形式的住房歧视。
    Racial residential segregation is considered a fundamental cause of racial health disparities, with housing discrimination as a critical driver of residential segregation. Despite this link, racial discrimination in housing is far less studied than segregation in the population health literature. As a result, we know little about how discrimination in housing is linked to health beyond its connection to segregation. Furthermore, we need to understand how health impacts differ across different types of housing discrimination. This review aims to assess the state of the population health literature on the conceptualization, measurement, and health implications of housing discrimination. We used PRISMA guidelines for scoping reviews and presented the data on 32 articles that met our inclusion criteria published before January 1, 2022. Nearly half of the articles do not define housing discrimination explicitly. Additionally, there is considerable variation in how housing discrimination is operationalized across studies. Compared to studies using administrative data for housing discrimination exposures, studies using survey data were more likely to report a detrimental association with health outcomes. Synthesizing and comparing the results of these studies helps bridge methodological approaches to this research. Our review helps inform the debate on how racism impacts population health. Given the changing nature of racial discrimination over time and place, we discuss how population health researchers can approach studying various forms of housing discrimination.
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  • 文章类型: Journal Article
    各个医院和医疗机构产生的废物,包括工业的浪费,可以归类为生物医学废物(宝马)。这种类型的废物的成分是各种传染性和有害物质。然后识别这些废物,隔离,科学地对待。医疗保健专业人员不可避免地需要对宝马及其管理有足够的知识和适当的态度。产生的宝马可以是固体或液体废物,包括传染性或潜在传染性材料,比如医疗,研究,或实验室废物。宝马管理不当很有可能会导致医护人员感染,参观这些设施的病人,以及周围环境和社区。宝马也可以分为一般,病态,放射性,化学,传染性,夏普,制药,或加压废物。印度有完善的规则来正确处理和管理宝马。生物医学废物管理规则,2016(BMWM规则,2016年)规定,每个医疗机构应采取一切必要步骤,以确保宝马的处理不会对人类和环境健康产生任何不利影响。这份文件包含六个时间表,包括宝马的类别,容器的颜色编码和类型,和宝马容器或袋子的标签,它应该是不可洗的和可见的。宝马集装箱的运输标签,处理和处置的标准,而焚化炉和高压灭菌器等废物处理设施的时间表也包括在附表中。印度制定的新规则旨在改善种族隔离,交通运输,处置方法,和宝马的治疗。这种适当的管理旨在减少环境污染,因为,如果管理不当,宝马可以引起空气,水,土地污染。在金融和基础设施发展方面,政府提供的集体团队合作是有效处置宝马的非常重要的要求。虔诚的医护人员和设施也很重要。Further,对宝马进行适当和持续的监控是至关重要的。因此,制定环保的方法以及正确的宝马处置计划和协议对于实现绿色和清洁环境的目标非常重要。这篇评论文章的目的是提供系统的基于证据的信息以及对宝马的全面研究。
    The waste generated in various hospitals and healthcare facilities, including the waste of industries, can be grouped under biomedical waste (BMW). The constituents of this type of waste are various infectious and hazardous materials. This waste is then identified, segregated, and treated scientifically. There is an inevitable need for healthcare professionals to have adequate knowledge and a proper attitude towards BMW and its management. BMW generated can either be solid or liquid waste comprising infectious or potentially infectious materials, such as medical, research, or laboratory waste. There is a high possibility that inappropriate management of BMW can cause infections to healthcare workers, the patients visiting the facilities, and the surrounding environment and community. BMW can also be classified into general, pathological, radioactive, chemical, infectious, sharps, pharmaceuticals, or pressurized wastes. India has well-established rules for the proper handling and management of BMW. Biomedical Waste Management Rules, 2016 (BMWM Rules, 2016) specify that every healthcare facility shall take all necessary steps to ensure that BMW is handled without any adverse effect on human and environmental health. This document contains six schedules, including the category of BMW, the color coding and type of containers, and labels for BMW containers or bags, which should be non-washable and visible. A label for the transportation of BMW containers, the standard for treatment and disposal, and the schedule for waste treatment facilities such as incinerators and autoclaves are included in the schedule. The new rules established in India are meant to improve the segregation, transportation, disposal methods, and treatment of BMW. This proper management is intended to decrease environmental pollution because, if not managed properly, BMW can cause air, water, and land pollution. Collective teamwork with committed government support in finance and infrastructure development is a very important requirement for the effective disposal of BMW. Devoted healthcare workers and facilities are also significant. Further, the proper and continuous monitoring of BMW is a vital necessity. Therefore, developing environmentally friendly methods and the right plan and protocols for the disposal of BMW is very important to achieve a goal of a green and clean environment. The aim of this review article is to provide systematic evidence-based information along with a comprehensive study of BMW in an organized manner.
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  • 文章类型: Review
    脱发智力障碍综合征4(APMR4)是一种非常罕见的常染色体隐性疾病,由21号染色体上存在的LSS基因突变引起。该综合征具有临床异质性,主要表现为不同程度的智力残疾(ID)和先天性脱发,也是。先前已报告了8个家庭,其中13个病例。在这里,我们提供了一份关于一个埃及家庭的报告,该家庭有两个受影响的兄弟姐妹和一个受影响的胎儿,他们在产前被诊断。全外显子组测序(WES)揭示了与受检患者相关的羊毛甾醇合酶基因(LSS)中的一种新的致病性错义变体(c.1609G>T;p.Val537Leu)。通过Sanger测序确认检测到的变体。分离分析证实父母是杂合的。除了新的表型特征外,我们的患者还表现出典型的疾病临床表现,包括一些畸形相,如额叶和双侧大耳,以及手指和腕关节的双侧过伸性,身材矮小,脐疝,和牙齿矿化缺陷。这项研究是埃及的第一项研究,也是迄今为止第9个分子证明的家族。目的是扩大该综合征的临床和突变谱。此外,该报告暗示了产前检查和适当遗传咨询的重要性,以帮助父母根据自己的信念做出自己的决定。
    Alopecia intellectual disability syndromes 4 (APMR4) is a very rare autosomal recessive condition caused by a mutation in the LSS gene present on chromosome 21. This syndrome has a clinical heterogeneity mainly exhibited with variable degrees of intellectual disability (ID) and congenital alopecia, as well. Eight families with 13 cases have been previously reported. Herein, we provide a report on an Egyptian family with two affected siblings and one affected fetus who was diagnosed prenatally. Whole-exome sequencing (WES) revealed a novel pathogenic missense variant (c.1609G > T; p.Val537Leu) in the lanosterol synthase gene (LSS) related to the examined patients. The detected variant was confirmed by Sanger sequencing. Segregation analyses confirmed that the parents were heterozygous. Our patient was presented with typical clinical manifestations of the disease in addition to new phenotypic features which included some dysmorphic facies as frontal bossing and bilateral large ears, as well as bilateral hyperextensibility of the fingers and wrist joints, short stature, umbilical hernia, and teeth mineralization defect. This study is the first study in Egypt and the 9th molecularly proven family to date. The aim is to expand the clinical and mutational spectrum of the syndrome. Moreover, the report gives a hint on the importance of prenatal testing and the proper genetic counseling to help the parents to take their own decision based on their beliefs.
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  • 文章类型: Journal Article
    在大萧条和相关的房屋丧失抵押品赎回权之后,联邦政府建立了新的机构,以促进获得负担得起的住房抵押贷款,包括房主贷款公司(HOLC)和联邦住房管理局(FHA)。HOLC和FHA指导了广泛的邻里评估,以确定投资风险,被称为“红线”,“其中考虑到了居民的种族。由此导致了种族隔离,撤资,以及在房屋所有权和财富积累机会方面的种族不平等。最近的研究检查了历史上的重新划分与随后的健康和健康相关结果的环境决定因素之间的关联。在这次范围审查中,我们评估当前证据的范围,研究的结果范围,和关键研究特点,检查红线之间的关系的方向和强度,邻里环境,和健康以及不同的方法论方法。总的来说,研究几乎普遍报告了重新修订和健康相关结果之间关联的证据,尽管研究设计的异质性排除了结果的直接比较。我们批判性地考虑关于HOLC因果关系的证据,并为修订与当今健康之间的关系提供一个概念框架。最后,我们指出了未来研究的关键方向,以提高和扩大对修订的持久影响的理解,并将研究结果转化为公共卫生和规划实践。
    Following the Great Depression and related home foreclosures, the federal government established new agencies to facilitate access to affordable home mortgages, including the Home Owners\' Loan Corporation (HOLC) and Federal Housing Administration (FHA). HOLC and FHA directed widespread neighborhood appraisals to determine investment risk, referred to as \"redlining,\" which took into account residents\' race. Redlining thereby contributed to segregation, disinvestment, and racial inequities in opportunities for homeownership and wealth accumulation. Recent research examines associations between historical redlining and subsequent environmental determinants of health and health-related outcomes. In this scoping review, we assess the extent of the current body of evidence, the range of outcomes studied, and key study characteristics, examining the direction and strength of the relationship between redlining, neighborhood environments, and health as well as different methodological approaches. Overall, studies nearly universally report evidence of an association between redlining and health-relevant outcomes, although heterogeneity in study design precludes direct comparison of results. We critically consider evidence regarding HOLC\'s causality and offer a conceptual framework for the relationship between redlining and present-day health. Finally, we point to key directions for future research to improve and broaden understanding of redlining\'s enduring impact and translate findings into public health and planning practice.
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  • 文章类型: Systematic Review
    目的:系统回顾和荟萃分析在惩教环境中暴露于单独监禁的囚犯的心理影响和死亡率。
    方法:PubMed,PsycINFO,WebofScience,和GoogleScholar使用描述单独监禁的关键词以及心理或死亡率结果的关键词进行搜索。系统审查的合格病例对照研究符合单独监禁的操作定义,并评估了暴露于这种监禁后的结果。使用随机效应模型对提供统计数据的研究进行了进一步的荟萃分析,这些研究允许计算症状量表或死亡率比值比的标准化平均差异。
    结果:系统评价确定了13项纳入研究,样本共382,440名囚犯(23%曾接受单独监禁)。更高质量的证据表明,单独监禁与不良心理影响的增加有关,自我伤害,和死亡率,尤其是自杀。对五项研究(n=4,517)的荟萃分析显示,一般心理症状学的标准化平均差为0.45,在排除异常值时增加到0.51。观察到情绪的轻度至中度显着影响,精神病患者,特别是敌意症状。此外,两项死亡率研究的荟萃分析(n=243,050)显示,任何或非自然原因对死亡率产生中等影响的趋势(即,自杀,凶杀案,用药过量,和事故)。
    结论:分析表明,单独监禁与囚犯的心理恶化有关。这种影响似乎超出了一般监禁或先前精神疾病的存在。因此,单独监禁可能对囚犯造成重大伤害。尽管如此,需要进一步的研究表明暴露于SC会增加释放后死亡的风险.最后,讨论了可以减轻相关心理伤害的单独监禁的附加治疗和替代方法。
    OBJECTIVE: To systematically review and meta-analyze the psychological effects and mortality rate in inmates having been exposed to solitary confinement in correctional settings.
    METHODS: PubMed, PsycINFO, Web of Science, and Google Scholar were searched using keywords describing solitary confinement in combination with keywords for psychological or mortality outcomes. Eligible case-control studies for the systematic review met an operational definition for solitary confinement and evaluated outcomes after exposure to such confinement. Studies presenting statistical data which allowed to compute standardized mean differences for symptom scales or odds ratio for mortality were further meta-analyzed using random-effects models.
    RESULTS: Systematic review identified 13 studies for inclusion, with a total sample of 382,440 inmates (23% having been exposed to solitary confinement). Higher quality evidence showed solitary confinement was associated with an increase in adverse psychological effects, self-harm, and mortality, especially by suicide. Meta-analysis of five studies (n = 4,517) showed a standardized mean difference of 0.45 for general psychological symptomatology, which increased to 0.51 upon outlier exclusion. Small to moderate significant effects were observed for mood, psychotic, and hostility symptoms specifically. In addition, meta-analysis of two mortality studies (n = 243,050) showed a trend for a moderate effect for mortality by any or unnatural causes (i.e., suicide, homicide, overdose, and accidents).
    CONCLUSIONS: Analyses showed that solitary confinement is associated with the psychological deterioration of inmates. This effect appears to be beyond that of general incarceration or presence of prior mental illness. Thus, solitary confinement may pose significant harm for inmates. Still, further studies are required to show that exposure to SC can increase risk of post-release death. Finally, add-on treatments and alternatives to solitary confinement that could alleviate the associated psychological harm are discussed.
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  • 文章类型: Journal Article
    鉴于受害的经济和医疗后果,被释放的囚犯的累犯与沉重的社会负担有关。在被监禁的北美人中,大约7%被单独监禁(SC)。研究表明,SC可以导致心理恶化和争议,它可以有效减少机构不当行为或累犯。这项荟萃分析旨在阐明SC对再犯的影响,我们假设在SC之后会增加。使用PubMed进行了荟萃分析,PsycINFO,WebofScience,和GoogleScholar数据库从成立到2019年12月。如果他们符合SC的操作定义,则包括对惩教场所中成年囚犯的研究,测量累犯,并包括一般囚犯人群的对照组。随机效应模型用于评估SC对多种类型的累犯的影响。在2,713条确定的记录中,12符合纳入标准(n=194,078)。SC与任何累犯之间存在中度关联(比值比[OR]=1.67,95%置信区间[1.41,1.97]),在对照研究中持续存在(OR=1.41)。这种关联在包括暴力在内的累犯类型中重复(OR=1.41),再逮捕(OR=1.37),和轮回(OR=1.67)。此外,最近接触SC增加了累犯风险(OR=2.02),并且在SC和累犯的天数之间发现了剂量反应关系。总体数据库呈现高度异质性,但没有发表偏倚。调查结果表明,SC与未来的犯罪/暴力之间存在小到中等的联系。考虑到SC之后与反社会行为相关的社会成本,应在强有力的研究设计中实施和严格评估促进囚犯成功重返社会的心理健康和社会心理规划。
    Recidivism among released inmates is associated with a substantial societal burden given the financial and medical consequences of victimization. Among incarcerated North Americans, approximately 7% are housed in solitary confinement (SC). Studies show SC can lead to psychological deterioration and dispute it can effectively reduce institutional misconduct or recidivism. This meta-analysis aims to clarify the impact of SC on postrelease recidivism, which we hypothesized would increase following SC. A meta-analysis was conducted using PubMed, PsycINFO, Web of Science, and Google Scholar databases from inception until December 2019. Studies on adult inmates in correctional settings were included if they met an operational definition of SC, measured recidivism, and included a comparison group in general inmate population. Random-effect models were used to assess the impact of SC on multiple types of recidivism. Of the 2,713 identified records, 12 met inclusion criteria (n = 194,078). A moderate association was found between SC and any recidivism (odds ratio [OR] = 1.67, 95% confidence interval [1.41, 1.97]), which persisted in controlled studies (OR = 1.41). This association was replicated across types of recidivism comprising violence (OR = 1.41), rearrests (OR = 1.37), and reincarceration (OR = 1.67). Moreover, a more recent exposure to SC increased recidivism risk (OR = 2.02), and a dose-response relationship was found between days in SC and recidivism. The overall database presented high heterogeneity but no publication bias. Findings show a small to moderate association between SC and future crime/violence. Considering the societal costs associated with antisocial behaviors following SC, mental health and psychosocial programming facilitating inmates\' successful reentry into society should be implemented and rigorously evaluated in strong research design.
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