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    دورية أكاديمية

    الوصف: The Internet offers increased availability and accessibility of medicinal pharmaceuticals including those containing opioids, sedatives and gamma-aminobutyric acid (GABA) drugs through both legal and illegal routes. Sourcing concerns have been further heightened due to the current severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic which reduced face-to-face access for non-COVID-19 related health conditions and to drug treatment services. This study is the second of a two stage study comprising interviews with three key stakeholders who were policy makers, health care professionals or police, and three individuals who sourced medicinal products online (ISOs). An in-depth case study approach was adopted. Thematic analysis of in-depth case narratives revealed the following key themes; Motivations, initiation, and making the move online; Process of sourcing online; Supply issues and COVID-19; Perception of control; Quality of medications; and Public health recommendations. Motivations for purchasing online are complex and methods to divert and control the supply of medicinal pharmaceuticals are equally complex and difficult to navigate. Novel routes to access now include Telegram, a cross-platform messaging service with enhance encryption and privacy. Whilst stakeholders and ISOs had similar views on the prevalence and ease of access to medication, there were also some substantial differences primarily in terms of perceptions of risk. This study highlights the need for enhanced pharmacovigilance of non-regulated online vendors and the imperatives of continued health messaging around the potential self-directed use of these controlled drugs and the dangers of using websites purporting to be regulated pharmacies.

    وصف الملف: text

    العلاقة: https://researchonline.ljmu.ac.uk/id/eprint/18387/1/1-s2.0-S2667118222000162-main.pdfTest; Hillis, A, Germain, J, Whitfield, M, Halsall, D, McVeigh, J, Abbasi, Y and Van Hout, MC (2022) Internet sourcing and unsafe use of controlled medicines (opioids, sedatives and GABA drugs) in the UK: An in-depth case study of consumer dynamics during COVID-19. Emerging Trends in Drugs, Addictions, and Health, 3. ISSN 2667-1182

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    المصدر: Journal of the American Nutrition Association; Nov/Dec2023, Vol. 42 Issue 8, p727-736, 10p

    مستخلص: The aim of this systematic review was to examine the characteristics of Paleolithic diet (PD) interventions designed for adult patients with autoimmune thyroid disease (AITD) in order to determine if diet elements have the potential to successfully reduce thyroid antibodies (Ab) such as thyroglobulin (Tg), thyroid peroxidase (TPO), and thyroid stimulating hormone receptor (TSHR), and improve thyroid hormones (thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH)) or resolve AITD pathogenesis. Randomized controlled trials (RCTs) with an adult population of 18 years and older, diagnosed with Hashimoto's thyroiditis (HT) or Graves' disease (GD) (Basedow's), who were placed on a diet of Paleolithic or ancestral nature, and achieved reduction of AITD Abs, improvement of thyroid hormones, and, or resolution of AITD were searched. Various electronic databases were used. Bias was assessed using critical appraisal tools from the Scottish Intercollegiate Guidelines Network (SIGN) and Joanna Briggs Institute (JBI). Studies were excluded according to exclusion criteria and results analyzed. One randomized controlled trial (RCT), a pilot study, and six case studies were found. In total, eight AITD studies focusing on Paleolithic or ancestral interventions were located. In highlight, females were the predominant gender. Case studies solely focused on AITD with protocols ranging from 8–60 weeks. All studies showed clinical improvements, one had significant improvement, two showed AITD resolution. After structured evaluation of nutritional interventions utilizing the PD on the effects of AITD, it was concluded foods of ancestral nature along with the addition of specific supplements, food components, exercise and mindfulness meditation, and exclusion of modern day foods have a considerable impact on thyroid Ab and hormones. The relevant studies suggest while this dietary protocol can be useful in clinical practice, larger-scale studies need to be conducted. There are currently no dietary interventions recommended for the treatment of autoimmune thyroid disease. The Paleo diet has been documented to improve AITD antibodies and thyroid hormones in both Hashimoto's thyroiditis and Graves' disease. The Paleo diet can provide a natural source of nutrients similar to supplemental nutrients that have shown positive results on AITD. The paleo diet provides specific macronutrient percentages that may be beneficial in reducing AITD antibodies, while improving thyroid hormones. Methylation supplementation may be useful in AITD cases. [ABSTRACT FROM AUTHOR]

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