Medical System Choice: Information That Affects the Selection of Healthcare Provider in Australia?

Many complementary and alternative medical practices (CAM) are readily assessable in Australia alongside Allopathic practitioners. Although CAM practices are prevalent, little is known about how patients seek and use information when deciding which system to consult. We report some preliminary findings of a longitudinal study, designed to solicit factors that influence the Australian public when selecting from diverse medical systems. Fifty-four general public participants, willing to provide their confidential and anonymous opinion were included. The magnitudes of importance, critical in influencing factors, were screened. Results indicated a medical system was selected for its effectiveness, safety, credentials and care (p<0.001). Consultation time, convenience, cost, empowerment and rapport were less important factors (p<0.001) influencing selection of a medical system. The level of choices by participants [χ2 (1, N=54) = 53.445, p<0.001] follow similar trends found for those in conventional medical systems. This contrasts with findings in other locations, where cost and time were major contributing factors when selecting medical systems

Endoplasmic reticulum stress and Nrf2 repression in circulating cells of type 2 diabetic patients without the recommended glycemic goals

Endoplasmic reticulum (ER) stress plays a role in the pathogenesis of type 2 diabetes mellitus (T2DM), with activation of the unfolded protein response (UPR) and ER apoptosis in \u3b2-cells. The aim of the study is investigating the role of the prolonged glycemic, inflammatory, and oxidative impairment as possible UPR and ER apoptosis inductors in triggering the ER stress response and the protective nuclear erythroid-related factor 2 (Nrf2)/antioxidant-related element (ARE) activation in peripheral blood mononuclear cells (PBMC) of T2DM patients without glycemic target. Oxidative stress markers (oxidation product of phospholipid 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine [oxPAPC], and malondialdehyde [MDA]), the UPR and ER apoptosis, the activation of the pro-inflammatory nuclear factor-kappa B (NF-kB) with its inhibitory protein inhibitor-kB\u3b1, and the expression of the protective Nrf2 and heme oxygenase-1 (HO-1) were evaluated in PBMC of 15 T2DM patients and 15 healthy controls (C). OxPAPC concentrations (in PBMC and plasma), MDA levels (in plasma), the expressions of the glucose-regulated protein 78 kDa (or BiP) as representative of UPR, and of the CCAAT/enhancer-binding protein homologous protein as representative of ER apoptosis were significantly higher (p < 0.01) in T2DM with respect to C. IkB\u3b1 expression was significantly lower (p < 0.01) in T2DM as well as Nrf2 and HO-1. In vitro experiments demonstrated that hyperglycemic conditions, if prolonged, were NF-kB inductors, without a corresponding Nrf2/ARE response. In PBMC of T2DM without glycemic target achievement, there is an activation of the UPR and of the ER apoptosis, which may be related to the chronic exposure to hyperglycemia, to the augmented inflammation, and to the augmented oxidative stress, without a corresponding Nrf2/ARE defense activation

Phenylketonuria, congenital hypothyroidism and haemoglobinopathies: public health issues for a Brazilian newborn screening program

In this study, the frequency of detected congenital hypothyroidism, phenylketonuria and haemoglobinopathies in the State of Rio de Janeiro's (Brazil) Newborn Screening Program (NBSP) was analyzed between the years of 2005 and 2007. There were two Newborn Screening Reference Centers (named NSRC A and B) with programmatic differences. In 2007, overall detection coverage reached 80.7%. The increase in the incidence of congenital hypothyroidism (1:1,030 in 2007) was attributed to the reduction of neonatal TSH value limits over time. The incidence discrepancy of phenylketonuria between NSRC A (1:28,427) and B (1:16,522) might be partially explained by the small number of cases. The incidence of sickle cell disease and its traits were uniformly high (1:1,288 and 1:21, respectively). This was coherent with the ethnic composition of the population. The differences in laboratory methods and critical values, in addition to other programmatic issues, may explain the variances in the results and limited analysis of the role of biological and environmental determinants in the occurrence of these diseases.Neste estudo, foi analisada a frequência de detecção do hipotireoidismo congênito, fenilcetonúria e hemoglobinopatias no Programa de Triagem Neonatal do Estado do Rio de Janeiro, Brasil, entre 2005 e 2007. Havia dois Serviços de Referência em Triagem Neonatal (designados SRTN A e B) com diferenças programáticas. Em 2007, a cobertura alcançou 80,7%. O aumento na incidência do hipotireoidismo congênito (1:1.030 em 2007) foi atribuído à redução no valor de corte do TSH ao longo do tempo. As incidências discrepantes da fenilcetonúria entre os modelos (SRTN A - 1:28.427; SR-TN B - 1:16.522) podem ser parcialmente explicadas pelo pequeno número de casos. A incidência da doença falciforme e do traço falcêmico foi uniformemente elevada (1:1.288 e 1:21, respectivamente), sendo coerente com a composição étnica da população. As diferenças nos métodos laboratoriais e valores críticos, além de outras questões programáticas, podem explicar a variabilidade nos resultados e limitar a análise do papel dos determinantes biológicos e ambientais sobre a ocorrência das doenças

Evidence of exposure to SARS-CoV-2 in cats and dogs from households in Italy

SARS-CoV-2 emerged from animals and is now easily transmitted between people. Sporadic detection of natural cases in animals alongside successful experimental infections of pets, such as cats, ferrets and dogs, raises questions about the susceptibility of animals under natural conditions of pet ownership. Here, we report a large-scale study to assess SARS-CoV-2 infection in 919 companion animals living in northern Italy, sampled at a time of frequent human infection. No animals tested PCR positive. However, 3.3% of dogs and 5.8% of cats had measurable SARS-CoV-2 neutralizing antibody titers, with dogs from COVID-19 positive households being significantly more likely to test positive than those from COVID-19 negative households. Understanding risk factors associated with this and their potential to infect other species requires urgent investigation

Reflexões sobre avaliação de políticas de saúde no Brasil

O presente texto tem como objetivo trazer contribuições para o debate sobre a avaliação de políticas públicas, especificamente no que concerne ao setor saúde no Brasil. Busca-se apresentar e tematizar algumas das questões fundamentais que perpassam esse campo de estudo, mediante o levantamento ou revisão bibliográfica sobre avaliação de políticas no setor saúde numa conceituada e reconhecida base de dados, o SciELO. Foram selecionados 66 artigos com os descritores "Avaliação em Saúde" e "Avaliação de Programas e Projetos de Saúde", de publicações brasileiras indexadas na área da saúde coletiva, desde o ano de 1994 até o ano de 2009. O artigo explora aspectos da produção acadêmica numa tipologia estabelecida e em correlação com as possibilidades de desenvolvimento do tema da avaliação de políticas, articulado a intervenções voltadas para o enfrentamento eficaz, eficiente e efetivo de agravos da população

A peculiar morphological alteration of canine neutrophils

Background: Multiple thin nuclear projections in canine blood neutrophils, here named “hairy”, have been anecdotally observed during routine hematology. A similar alteration has been described in people with hypercortisolism. Objective: To determine the analytical aspects of hairy neutrophils (HN) and their possible association with suspected hypercortisolism. Methods: Intra-observer repeatability and effects of stains were evaluated on both Hemacolor-stained smears (HSS) and May Grünwald-Giemsa-stained smears (MSS). Inter-observer repeatability was evaluated by two independent operators on HSS. The frequency of HNs and the possible association with suspected hypercortisolism was assessed on 223 HSS from dogs with normal (N=106) or high alkaline phosphatase (ALP) activity (N=117). Cohen’s K, Wilcoxon signed rank, and Spearman tests were performed to respectively evaluate concordance, differences between stains, operators or “ALP groups”, and correlations. Results: HNs were more visible on HSS, that provided higher counts than MSS, although without statistical significance. Intra-observer coefficient of variations ranged from 8 to 10% with higher values at low HN counts. Inter-operator concordance was good (k: 0.73). Results of the operators were significantly different (P=0.015) but correlated (p&lt;0.001, r=0.625). HNs were detected on 74/223 cases (33.2%). The HN count was higher in dogs with high (58.2%) than in dogs with normal ALP (43.4%; P=&lt;0.001) and in dogs with very high (3 X URL) (67.6%) than in dogs with high-normal ALP (48.1%, P=0.007). Conclusions: HN can be found in dogs, especially in HSS. Finding HN should prompt to measure ALP activity and, if high, to investigate the possible presence of hypercortisolism

Exploring the Potential of Geographical Indications for Green Innovation in EU regions

The Geographical Indications’ (GIs) policy tool of the European Union (EU) has achieved increasing success since its introduction in 1992. Moreover, the EU has implemented, through the Green Deal, an ambitious plan to become climate-neutral by 2050. In this scenario, the adoption of green technologies could be useful to reduce carbon emissions, mitigate and adapt the effects of climate change. Therefore, the aim of this study is to investigate if GIs play a role in the implementation of green innovation at regional level. By using fixed effects regression model, we test this relationship for 245 NUTS2 EU-27 regions over the period of 1996-2017. Preliminary results seem to be consistent with the neo-Schumpeterian distance-to-the-frontier model, suggesting that market competition is linked to sustainable innovative activities, and that GIs have a positive effect on green innovation in agriculture, with regions furthest away from the technological frontier innovating more

Passive acquisition of anti-Staphylococcus aureus antibodies by newborns via transplacental transfer and breastfeeding, regardless of maternal colonization

OBJECTIVE: To investigate the transmission of anti-Staphylococcus aureus (Sa) IgG, IgG1 and IgG2 via placental transfer and the transfer of IgA via the colostrum according to maternal Sa carrier status at delivery. METHODS: We evaluated anti-Sa IgG, IgG1 and IgG2 in maternal and cord sera and IgA in colostrum from a case (n=49, Sa+) and a control group (n=98, Sa-). RESULTS: Of the 250 parturients analyzed for this study, 49 were nasally colonized with S. aureus (prevalence of 19.6%). Ninety-eight non-colonized subjects were selected for the control group. The anti-Sa IgG, IgG1 and IgG2 levels and the IgG avidity indexes in the maternal and cord sera did not differ between the groups, with a low transfer ratio of anti-Sa IgG to the newborns in both groups. The anti-Sa IgG2 titers were significantly higher than the IgG1 titers in the maternal and cord sera. Inversely, the transfer ratios were higher for anti-Sa IgG1 compared with IgG2; however, no differences between the groups were detected. The Sa-specific IgA levels and avidity indexes in the colostrum were equivalent between groups. CONCLUSIONS: Maternal Sa nasal colonization at delivery is not associated with higher antibody levels in the mother or newborns. The high titers of anti-Sa IgG2 found in the cord serum indicate a greater reactivity with non-protein antigens, which may further contribute to the susceptibility to staphylococcal infections at birth. The presence of IgA in the colostrum with avidity to S. aureus reinforces the importance of breastfeeding shortly after birth