• 文章类型: Journal Article
    当不良事件(AE)发生时,对医疗保健专业人员有不同的后果。专业人士的工作环境会影响体验。这项研究旨在探索阿根廷卫生专业人员中第二受害者(SV)的经历。
    一项现象学研究与对医疗保健专业人员的深入访谈一起使用。录音和逐字记录独立分析主题,次主题,和代码。
    分析中出现了三个主要主题:导航体验,环境,和转折点。确定了用于导航体验以描述过程的子主题:接收影响,过渡,并采取行动。
    SV在AE之后经历处理。环境是这种体验的一部分。这是SVs的职业和个人生活的转折点。改善心理安全(PS)环境对于确保SV的安全至关重要。
    UNASSIGNED: When adverse events (AE) occur, there are different consequences for healthcare professionals. The environment in which professionals work can influence the experience. This study aims to explore the experiences of second victims (SV) among health professionals in Argentina.
    UNASSIGNED: A phenomenological study was used with in-depth interviews with healthcare professionals. Audio recordings and verbatim transcriptions were analyzed independently for themes, subthemes, and codes.
    UNASSIGNED: Three main themes emerged from the analysis: navigating the experience, the environment, and the turning point. Subthemes were identified for navigating the experience to describe the process: receiving the impact, transition, and taking action.
    UNASSIGNED: SVs undergo a process after an AE. The environment is part of this experience. It is a turning point in SVs\' professional and personal lives. Improving the psychological safety (PS) environment is essential for ensuring the safety of SVs.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    在阿根廷,戊型肝炎病毒(HEV)基因型3的循环已被描述,产生急性和慢性肝炎的散发性病例。关于儿童HEV感染的信息有限,因此,我们的目标是在该国的儿科人群中调查这种病毒。来自阿根廷儿童(0-18岁)(n=213)的血清样本进行了IgG抗HEV研究,IgM抗HEV和RNA-HEV:202个样本属于到卫生保健中心进行常规检查的个体,和11例病因不明的急性肝炎患者的样本。IgG抗HEV的血清阳性为1.49%(3/202)。一名18岁女性急性肝炎患者的样本检测IgM抗HEV阳性,IgG抗HEV和RNA-HEV阴性,而且IgM抗EBV也呈阳性。HEV患病率较低,并在阿根廷中部儿童中表现出血液循环。
    In Argentina, circulation of hepatitis E virus (HEV) genotype 3 has been described, producing sporadic cases of acute and chronic hepatitis. Limited information is available regarding HEV infection in children, so we aimed to investigate this virus in a pediatric population from the country. Serum samples from Argentine children (0-18 years old) (n = 213) were studied for IgG anti-HEV, IgM anti-HEV and RNA-HEV: 202 samples belonged to individuals attending health-care centers for routine check-ups, and 11 samples from patients with acute hepatitis of unknown etiology. Seropositivity for IgG anti-HEV was 1.49 % (3/202). One sample from an 18-years-old female patient with acute hepatitis tested positive for IgM anti-HEV detection, negative for IgG anti-HEV and RNA-HEV, but also positive for IgM anti-EBV. The HEV prevalence was low and showed circulation among children in central Argentina.
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    文章类型: Journal Article
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  • DOI:
    文章类型: Journal Article
    在人道主义环境中提供基本的性健康和生殖健康服务,包括武装冲突,非常有限,造成可预防的死亡率和发病率,侵犯人权。50%以上的孕产妇死亡发生在人道主义和脆弱环境中。国际人道主义法未能保证所有人获得全面的性健康和生殖健康信息和服务。根据国际人道主义法保证获得性健康和生殖健康服务可以增加获得服务的机会,改善冲突地区平民的健康和福祉。本文件阐述了将关于性健康和生殖健康及权利的国际人权法纳入即将发表的红十字国际委员会《日内瓦第四公约评注》的方式,关于保护平民,确保在武装冲突中提供服务。
    The provision of basic sexual and reproductive health services in humanitarian settings, including armed conflict, is extremely limited, causing preventable mortalities and morbidities and violating human rights. Over 50% of all maternal deaths occur in humanitarian and fragile settings. International humanitarian law falls short in guaranteeing access to the full range of sexual and reproductive health information and services for all persons. Guaranteeing access to sexual and reproductive health services under international humanitarian law can increase access to services, improving the health and well-being of civilians in conflict zones. This paper sets forth ways in which international human rights law on sexual and reproductive health and rights should be incorporated into the forthcoming International Committee of the Red Cross Commentary on Geneva Convention IV, regarding the protection of civilians, to ensure services in the context of armed conflict.
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  • 文章类型: Journal Article
    钩端螺旋体病是最常见的人畜共患感染之一,是兽医学和公共卫生方面的主要问题。然而,这种疾病在世界范围内被低估和诊断不足,尤其是马。马的临床钩端螺旋体病主要与复发性葡萄膜炎(ERU)有关,最近被更深入地研究,和生殖障碍,对其流行病学的了解仍然相对较少。为了提高我们对马钩端螺旋体病引起的流产的理解,并确定致病菌株,进行了血清学研究,随后对获得的分离物进行了分子表征。使用显微镜凝集试验(MAT),从流产的母马和胎儿液(如果有)的血清样本进行了针对钩端螺旋体的抗体测试。此外,从肾脏培养物中分离细菌。97份母马血清样本中,21人(21.64%)检测呈阳性,Grippotyphosa和Pomona是最常见的血清群。与来自同一地理区域的健康马群相比,流产母马的血清阳性率明显更高,以及明显的季节性变化。在任何胎儿液体中均未检测到钩端螺旋体抗体,但39例中有1例(2.56%)成功隔离。通过多位点序列分型(MLST)和核心基因组多位点序列分型(cgMLST)进行基因分型,将获得的分离株鉴定为克氏钩端螺旋体,波莫纳血清群,serovarMozdok.进一步监测和分子分型导致马流产的钩端螺旋体菌株对于了解钩端螺旋体病对欧洲马生殖健康的患病率和影响是非常宝贵的。
    Leptospirosis is one of the most common zoonotic infections and a major problem in terms of both veterinary medicine and public health. However, the disease is under-recognised and under-diagnosed worldwide, particularly in horses. Clinical leptospirosis in horses is mainly associated with recurrent uveitis (ERU), which has recently been studied more intensively, and reproductive disorders, the epidemiology of which is still relatively poorly understood. To enhance our comprehension of abortions caused by leptospirosis in horses and to identify the causative strains, a serological study was carried out with subsequent molecular characterisation of the isolate obtained. Using the microscopic agglutination test (MAT), serum samples from mares that aborted and foetal fluids (when available) were tested for antibodies against Leptospira spp. Furthermore, bacteria isolation from kidney cultures was conducted. Of 97 mare serum samples, 21 (21.64%) tested positive, with Grippotyphosa and Pomona being the most frequently detected serogroups. A significantly higher seroprevalence was found in aborting mares compared to the healthy horse population from the same geographical area, as well as a pronounced seasonal variation. Leptospiral antibodies were not detected in any of the foetal fluids, but isolation was successful in 1 case out of 39 (2.56%). Genotyping by multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) identified the obtained isolate as Leptospira kirschneri, serogroup Pomona, serovar Mozdok. Further surveillance and molecular typing of Leptospira strains causing abortion in horses would be invaluable in understanding the prevalence and impact of leptospirosis on equine reproductive health in Europe.
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  • 文章类型: Journal Article
    背景:复发性妊娠丢失是指在妊娠24周之前两次或更多次妊娠的自发死亡。在几乎一半的复发性流产病例中,原因仍然未知,因为没有可靠的预后方法,早期诊断,或治疗。最近的研究已经检测到某些miRNA在生殖系统病理中的差异表达。方法:本综述的目的是关注microRNA及其与特发性复发性流产的关系,并将miRNA表达与复发性流产相关联,并检查其作为生物标志物的潜在作用。截至2024年1月31日,搜索Pubmed/Medline和Scopus数据库,其中包含与复发性妊娠丢失和miRNA相关的术语。结果:总的来说,选择了21项研究进行审查。总共鉴定了75种不同的miRNA,显示统计学上显著的差异表达。大约40个miRNAs表达增加,如miR-520、miR-184和miR-100-5p,21减少,比如let-7c,根据研究,14种表达增加或减少,例如miR-21。结论:miRNA表达失调与复发性流产密切相关。外周血中循环的miRNAs,miR-100-5p和let-7c,可能被用作生物标志物,并在未来建立有价值的非侵入性预后和诊断工具。
    Background: Recurrent pregnancy loss refers to the spontaneous demise of two or more pregnancies before the 24 weeks of gestation. In almost half of the cases of recurrent miscarriages, the causes remain unknown since there is no reliable way of prognosis, early diagnosis, or treatment. Recent research has detected differential expression of certain miRNAs in reproductive system pathologies. Methods: The aim of the present review is to focus on microRNAs and their relationship with idiopathic recurrent miscarriages and to correlate miRNA expression with recurrent miscarriage and examine their potential role as biomarkers. Pubmed/Medline and Scopus databases were searched up to 31st January 2024 with terms related to recurrent pregnancy loss and miRNAs. Results: In total, 21 studies were selected for the review. A total of 75 different miRNAs were identified, showing a statistically significant differential expression. Around 40 miRNAs had increased expression, such as miR-520, miR-184 and miR-100-5p, 21 decreased, such as let-7c, and 14 had either increased or decreased expression depending on the study, such as miR-21. Conclusions: The dysregulation of miRNA expression is strongly associated with recurrent miscarriages. The circulating in the peripheral blood miRNAs, miR-100-5p and let-7c, might be utilized as biomarkers and establish a valuable non-invasive prognostic and diagnostic tool in the future.
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  • 文章类型: Journal Article
    美国最高法院多布斯诉杰克逊妇女卫生组织的决定允许各州加强对堕胎的限制,引发计划生育诊所的关闭,并导致人们对紧急避孕药(EC)的合法性感到困惑。
    评估多布斯决定与在多布斯之后颁布了最严格的堕胎政策的州中口服和紧急避孕药之间的关联。
    这项队列研究使用了来自IQVIA国家处方审核PayerTrak的美国育龄妇女(15-49岁)的避孕药具填充数据和来自Guttmacher研究所的数据对每个州的堕胎限制的变化进行分类。差异差异分析比较了限制最严格的州(在Dobbs之后实施了全面的堕胎禁令)和比较州(在Dobbs决定之前(2021年3月至2021年11月)和之后(2022年7月至2023年10月)保持中等水平的堕胎限制)的每日口服避孕药(OCP)和EC的每月填充率变化。
    州级堕胎限制。
    每10万名育龄妇女每月填写OCP和EC。
    在2021年3月至2023年10月之间,美国零售药店发放了1.428亿张OCP处方和904269张EC处方。在多布斯之前,在最严格和比较的状态之间,OCP和EC的月填充率趋势相似。在多布斯的决定之后,成为限制性最强的州的OCP填充量额外下降了4.1%,每100000个填充量减少了285.9个(95%CI,-495.8至-6.8;P=.04)。与OCPs相比,在Dobbs之后的第一年(2022年7月至2023年6月),两组州的EC填充量都有所增加。然而,多布斯(2023年7月至2023年10月)之后的1年,限制性最强的州紧急避孕药的填充量额外减少了65%,每100000个国家的填充量减少了13.2个(95%CI,-27.2~-4.1;P=.01).
    在这项针对美国药店处方的队列研究中,Dobbs的决定与口服避孕药的下降有关,尤其是EC,在制定最严格的堕胎政策的州。鉴于OCPs和ECs在预防怀孕和需要堕胎方面的重要作用,可能需要努力改善获取,尤其是在合法堕胎不再是一种选择的州。
    UNASSIGNED: The US Supreme Court Dobbs v Jackson Women\'s Health Organization decision allowed states to strengthen restrictions on abortion access, triggering the closure of family planning clinics and leading to confusion about the legality of emergency contraceptives (ECs).
    UNASSIGNED: To evaluate the association between the Dobbs decision and fills for oral and emergency contraceptives in states that enacted the most restrictive abortion policies after Dobbs.
    UNASSIGNED: This cohort study used data on contraceptive fills for women of reproductive age (15-49 years) in the US from IQVIA\'s National Prescription Audit PayerTrak and data from the Guttmacher Institute were used to categorize changes in abortion restrictions in each state. A difference-in-differences analysis compared changes in monthly fill rates for daily oral contraceptive pills (OCPs) and ECs in states that became most restrictive (implemented a full abortion ban after Dobbs) and comparison states (kept a medium level of abortion restrictions after Dobbs) before (March 2021 to November 2021) and after (July 2022 to October 2023) the Dobbs decision.
    UNASSIGNED: State-level abortion restrictions.
    UNASSIGNED: Monthly fills of OCPs and ECs per 100 000 women of reproductive age.
    UNASSIGNED: Between March 2021 and October 2023, 142.8 million prescriptions for OCPs and 904 269 prescriptions for ECs were dispensed at US retail pharmacies. Before Dobbs, trends in monthly fill rates were similar for OCPs and ECs between the most restrictive and comparison states. After the Dobbs decision, states that became the most restrictive experienced an additional 4.1% decline in OCP fills with 285.9 fewer fills per 100 000 (95% CI, -495.8 to -6.8; P = .04). In contrast to OCPs, fills for ECs increased during the first year after Dobbs (July 2022 to June 2023) in both groups of states. However, 1 year after Dobbs (July 2023 to October 2023), the most restrictive states experienced an additional 65% decrease in emergency contraceptive fills with 13.2 fewer fills per 100 000 (95% CI, -27.2 to -4.1; P = .01).
    UNASSIGNED: In this cohort study of prescriptions filled at US pharmacies, the Dobbs decision was associated with declines in oral contraceptives, particularly ECs, in states enacting the most restrictive abortion policies. Given the important role of OCPs and ECs in preventing pregnancy and the need for abortion, efforts to improve access may be needed, especially in states where legal abortion is no longer an option.
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  • 文章类型: English Abstract
    Information on how economic fluctuations affect educational inequalities in homicides in Latin America is scarce. This study aimed to: (a) analyze the temporal variations of educational inequalities related to homicide mortality and (b) compare these inequalities between years of economic growth and recession in southern South America cities from 2000 to 2019. Data from seven urban areas in three countries in the Southern Cone of South America were used: Mendoza and Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro, and São Paulo (Brazil); and Santiago (Chile). Poisson models were estimated by using age, sex, city of residence, year of economic growth or recession, and schooling level as explanatory variables. Results showed significant differences in the temporal evolution of homicide rates in the seven cities, although populations with a low schooling level always showed the most vulnerability. The four Brazilian cities, analyzed together, showed greater educational inequalities related to homicides in years of economic recession when compared to those of economic growth. On the one hand, the indiscriminate use of force by the State against criminal groups seems to increase social inequality in homicide mortality. On the other hand, criminal fragmentation and economic crisis can exacerbate these inequalities by increasing territorial disputes between criminal groups.
    Se sabe poco sobre cómo las fluctuaciones económicas afectan las desigualdades educativas en homicidios en países latinoamericanos. Los objetivos de este estudio fueron (a) analizar las variaciones temporales de las desigualdades relativas educacionales de la mortalidad por homicidio, y (b) comparar estas desigualdades entre años de crecimiento económico y años de recesión en ciudades del sur sudamericano durante el período 2000-2019. Se utilizaron datos de siete áreas urbanas, en tres países del Cono Sur Sudamericano: Mendoza y Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro y São Paulo (Brasil); y Santiago (Chile). Se estimaron modelos de Poisson, utilizando como variables explicativas la edad, sexo, año, ciudad de residencia, año de expansión o recesión económica y nivel educativo. Encontramos diferencias marcadas en la evolución temporal de las tasas de homicidio entre las siete ciudades, aunque siempre las poblaciones de nivel educativo bajo fueron las más vulnerables. Las cuatro ciudades de Brasil, analizadas en conjunto, tuvieron desigualdades educativas relativas de homicidios mayores en años de recesión económica, con respecto a años de crecimiento económico. Por un lado, el uso de la fuerza indiscriminado por parte del Estado enfocado hacia grupos criminales parece haber llevado a una creciente desigualdad social de la mortalidad por homicidio. Por el otro, en un contexto de fragmentación criminal y crisis económica se podrían agravar estas desigualdades a través de mayores disputas territoriales entre grupos criminales.
    São escassas as informações sobre como as flutuações econômicas afetam as desigualdades educacionais em homicídios na América Latina. Os objetivos deste estudo foram: (a) analisar as variações temporais das desigualdades educacionais relacionadas à mortalidade por homicídio, e (b) comparar essas desigualdades entre os anos de crescimento econômico e os anos de recessão nas cidades do sul da América do Sul no período de 2000 a 2019. Foram utilizados dados de sete áreas urbanas, em três países do Cone Sul da América do Sul: Mendoza e Rosário (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro e São Paulo (Brasil); e Santiago (Chile). Os modelos de Poisson foram estimados utilizando como variáveis explicativas a idade, sexo, ano, cidade de residência, ano de expansão ou recessão econômica e nível de escolaridade. Os resultados mostraram diferenças significativas na evolução temporal das taxas de homicídio entre as sete cidades, apesar de que as populações com baixo nível de escolaridade sempre foram as mais vulneráveis. As quatro cidades brasileiras, analisadas em conjunto, apresentaram maiores desigualdades educacionais relacionadas a homicídios em anos de recessão econômica em relação aos anos de crescimento econômico. Por um lado, o uso indiscriminado da força pelo Estado contra grupos criminosos parece ter levado ao aumento da desigualdade social na mortalidade por homicídio. Por outro lado, em um contexto de fragmentação criminal e crise econômica, essas desigualdades podem ser exacerbadas pelo aumento das disputas territoriais entre grupos criminosos.
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  • 文章类型: Journal Article
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