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1.
Dev Psychol ; 2024 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-38934902

RESUMO

Self-regulation (SR; emotion-related, and behavioral), executive function, and theory of mind (ToM) all play an important role in child socioemotional functioning (SEF). However, much remains unknown about the interplay among these abilities when facing various challenging situations. Additionally, the role of these abilities in child SEF has not yet been studied among minority children from an Eastern culture. Thus, we conducted one study with two models to examine the combined contribution of these core abilities, concurrently, to children's SEF during the transition to kindergarten, and longitudinally (about 3 years later) to children's SEF during COVID-19. Overall, 202 kindergarten children (aged 4.9-6.5 years) participated, of which 136 of them in the longitudinal follow-up (aged 8.83-10.6 years). We used behavioral tasks and teacher and maternal reports. Mothers also reported their own distress during the COVID-19 pandemic. During the transition to kindergarten, we found that emotion-related SR was positively related to children's SEF. We also found that emotion-related SR moderated the relation between inhibition and ToM. In the follow-up study, we found that emotion-related SR in kindergarten significantly predicted children's SEF during the COVID-19 crisis, directly and indirectly, through children's SEF in kindergarten and their maternal COVID-related distress. Moreover, emotion-related SR moderated the longitudinal association between children's ToM at kindergarten age and their SEF during the COVID-19 crisis. Our findings highlight the central role that emotion-related SR plays in children's ability to face different challenges. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

2.
Psychol Rep ; : 332941241256623, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38822819

RESUMO

It is well established that parents' own self-regulation is related to adaptive parenting practices (such as warmth and sensitivity) as well as to maladaptive ones (such as laxness and over-reactivity). However, parenting practices are not solely determined by parents' self-regulation. We discuss how broad personality dimensions (drawn from the Big-Five model) relate to temperamental self-regulation (effortful control) and to parenting practices. Considering the limited empirical literature linking these three constructs, we present extant evidence for each of the dyadic connections between these three constructs. We then propose a comprehensive model that includes the plausible moderation/mediation role of different personality dimensions (such as conscientiousness and agreeableness) on the connection between self-regulation and parenting practices. This systematic review summarizes the extant empirical findings from 74 studies, linking effortful control, character and parenting practices. It is the first to systematically review and organize the accumulating knowledge regarding their relations. Based on the reviewed literature, a conceptual framework is proposed for predicting parenting practices, which are, in turn, a crucial concept predicting children's behavioral and cognitive outcomes. In doing so, it provides a theoretical basis for the importance of parental character traits, specifically conscientiousness and agreeableness, as mediators between the parent's effortful control and their actual parenting practices.

3.
J Exp Psychol Hum Percept Perform ; 50(7): 752-768, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38722581

RESUMO

Individuals' reaction time (RT) slopes in tasks of mental rotation have been found to be related to other measures of visual-spatial abilities, and thus are often viewed as a psychometric measure of visual-spatial abilities. The common interpretation of individual RT slopes is as a measure of the speed at which the rotation is carried out. However, electroencephalography studies have found that the process of mental rotation continues after response selection has been carried out, casting doubt on the interpretation of RT slopes as measures of the speed of mental rotation. This study made use of electroencephalography techniques to directly capture individual differences in the speed of mental rotation and assess their association with visual-spatial abilities. We found that individual differences in mental rotation speed are not related to individual differences in RT slopes. Moreover, a computation model supports an alternative explanation by which RT slopes reflect individual differences in differential tolerances for stimulus identification within mental rotation tasks. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Eletroencefalografia , Imaginação , Individualidade , Desempenho Psicomotor , Tempo de Reação , Percepção Espacial , Humanos , Adulto , Percepção Espacial/fisiologia , Adulto Jovem , Masculino , Tempo de Reação/fisiologia , Feminino , Imaginação/fisiologia , Desempenho Psicomotor/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Rotação , Adolescente , Percepção Visual/fisiologia
4.
J Intell ; 12(4)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38667708

RESUMO

This study aimed to investigate two specific behavioral manifestations of the executive attention systems in preschoolers and kindergarteners, beyond the unique contribution of intelligence. We tested post-error slowing [RT¯Post-error trial-RT¯Not post-error trial] as a marker of reactive control and delayed disinhibition as a novel marker for proactive control. One hundred and eighty preschool- and kindergarten-aged children, as well as their mothers (final sample: 155 children and 174 mothers), performed an adapted task based on Go/NoGo and Stroop-like paradigms-the emotional day-night task. The children showed reliable post-error slowing and delayed disinhibition (mean size effects of 238.18 ms and 58.31 ms, respectively), while the adult size effects were 40-50% smaller. The post-error slowing effect was present for both sexes in all the tested ages, while the delayed disinhibition effect was present only for girls. Both effects showed large individual differences that became smaller in adulthood. Our findings emphasize the earlier maturation of reactive control compared to proactive control, and the earlier maturation of proactive cognitive control in girls compared to boys.

5.
Prehosp Emerg Care ; 28(1): 186-191, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37216642

RESUMO

Background: Heart failure is a leading cause of hospitalization with a high readmission rate. Mobile integrated health care (MIH) programs have expanded the role of emergency medical services to provide community-based care to patients with chronic disease, such as heart failure. However, there is little data published on the outcomes of MIH programs.Objective: This study evaluated the effect of a rural MIH program on emergency department and inpatient utilization for patients with congestive heart failure.Methods: A retrospective propensity score matched case-control study patients was performed for patients who participated in the MIH program associated with a single rural Pennsylvania health system between April 2014 and June 2020. Cases and controls were matched based on demographics and comorbidities. Pre- and post-intervention utilization were examined at 30, 90, and 180 days from the index encounters within the treatment groups, and then compared to the change in utilization among controls.Results: 1237 patients were analyzed. The change in all-cause ED utilization among cases was significantly better than the change in ED utilization among controls at 30 (Δ = -3.6%; 95% CI: -6.1%, -1.1%) and 90 days (Δ = -3.5%; 95% CI: -6.7%, -0.2%). There was no significant change in all-cause inpatient utilization at 30, 90, or 180 days. Limiting to CHF-only encounters also showed no significant change in utilization between cases and controls at any of the time intervals.Conclusion: Analysis of this MIH program demonstrates efficacy in delivering community-based care to reduce all-cause ED utilization. Prospective studies should be conducted to better assess the effects on inpatient utilization, cost data, and patient satisfaction to evaluate the effectiveness of such programs more holistically.


Assuntos
Serviços Médicos de Emergência , Insuficiência Cardíaca , Humanos , Estudos Retrospectivos , Estudos Prospectivos , Estudos de Casos e Controles , Hospitalização , Serviço Hospitalar de Emergência , Insuficiência Cardíaca/terapia , Hospitais
6.
JPEN J Parenter Enteral Nutr ; 48(1): 120-127, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37904600

RESUMO

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) tube placement is the most common enteral access for long-term feeding. The aim of our study is to assess the feasibility and safety of immediate PEG tube use after initial placement. METHODS: We conducted a single-center retrospective cohort study between August 2006 and August 2016. Prior to August 2011, tube feedings were delayed for ≥4 h after initial PEG placement, compared with immediate use (<1 h) after August 2011. Primary outcomes were complication rates within 30 days of placement. Secondary outcomes were impact of morbidity, mortality, length of stay, and need for repeat PEG placement. RESULTS: Our study included 1296 patients during the 10-year period, of which 704 underwent delayed use and 592 underwent immediate use (744 inpatient and 552 outpatient). There were no significant differences between the delayed-use and immediate-use PEG with regard to complications (3.4% vs 4.4%; P = 0.76). Subgroup analysis also reflected no significant differences in complications between inpatient and outpatient groups. For inpatients, there were no substantial differences in inpatient mortality (3.9% vs 3.3%; P = 0.70), mortality within 30 days of discharge (13.8% vs 13.1%; P = 0.15), readmissions (38.2% vs 34.3%; P = 0.23), repeat PEG placement (0.7% vs 1.5%; P = 0.46), and length of stay (13.3 vs 13.9 days; P = 0.99). CONCLUSION: Patients who received immediate enteral nutrition after PEG tube placement did not have any increased complications, morbidity, or mortality; and it is just as safe when compared with patients who received delayed feeding.


Assuntos
Gastrostomia , Intubação Gastrointestinal , Humanos , Gastrostomia/efeitos adversos , Estudos Retrospectivos , Intubação Gastrointestinal/efeitos adversos , Nutrição Enteral/efeitos adversos , Alta do Paciente
7.
Arch Pathol Lab Med ; 148(2): 155-167, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37134236

RESUMO

CONTEXT.­: Health care providers were surveyed to determine their ability to correctly decipher laboratory test names and their preferences for laboratory test names and result displays. OBJECTIVE.­: To confirm principles for laboratory test nomenclature and display and to compare and contrast the abilities and preferences of different provider groups for laboratory test names. DESIGN.­: Health care providers across different specialties and perspectives completed a survey of 38 questions, which included participant demographics, real-life examples of poorly named laboratory orders that they were asked to decipher, an assessment of vitamin D test name knowledge, their preferences for ideal names for tests, and their preferred display for test results. Participants were grouped and compared by profession, level of training, and the presence or absence of specialization in informatics and/or laboratory medicine. RESULTS.­: Participants struggled with poorly named tests, especially with less commonly ordered tests. Participants' knowledge of vitamin D analyte names was poor and consistent with prior published studies. The most commonly selected ideal names correlated positively with the percentage of the authors' previously developed naming rules (R = 0.54, P < .001). There was strong consensus across groups for the best result display. CONCLUSIONS.­: Poorly named laboratory tests are a significant source of provider confusion, and tests that are named according to the authors' naming rules as outlined in this article have the potential to improve test ordering and correct interpretation of results. Consensus among provider groups indicates that a single yet clear naming strategy for laboratory tests is achievable.


Assuntos
Nomes , Humanos , Inquéritos e Questionários , Laboratórios , Vitamina D
8.
Cureus ; 15(10): e46424, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37927687

RESUMO

Introduction To assess the trends for liver biopsy (LB) indications, technique, and histopathologic diagnosis, we retrospectively evaluated liver biopsies in two one-year periods, separated by a decade. Methods A pathology database query was performed for all parenchymal LB in patients over 18 years (11/2017 to 10/2018) and compared to those performed over a one-year period, a decade ago. We identified 427 parenchymal liver biopsies in the recent group and 166 in the decade-old group. Results Elevated liver enzymes are the most common indication for LB. Non-alcoholic fatty liver disease (NAFLD) has become the most common diagnosis compared to 10 years ago, when it was viral hepatitis. Routes of LB were significantly different between the two groups, endoscopic ultrasound-guided liver biopsy (EUS-LB) (80.3% vs 0; p<0.0001), computed tomography-guided (0 vs 42.8%, p<0.0001), percutaneous by gastroenterologists (0% vs 29.5%, p<0.0001), and transjugular-LB (15.1% vs 17.6%, p<0.0001). The adequacy of the tissue for pathological diagnosis was similar, and there was no difference in adverse events. Conclusion At our institution, practice patterns have changed significantly for liver biopsy. There has been an increase in liver biopsy volume, and EUS guidance has become the most common approach for liver biopsy.

9.
Cortex ; 167: 25-40, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37517356

RESUMO

Increased intrasubject variability of reaction time (RT) refers to inconsistency in an individual's speed of responding to a task. This increased variability has been suggested as a fundamental feature of attention deficit hyperactivity disorder (ADHD), however, its neural sources are still unclear. In this study, we aimed to examine whether such inconsistency at the behavioral level would be accompanied by inconsistency at the neural level; and whether different types of neural and behavioral variability would be related to ADHD symptomatology. We recorded electroencephalogram (EEG) data from 62 adolescents, who were part of a prospective longitudinal study on the development of ADHD. We examined trial-by-trial neural variability in response to visual stimuli in two cognitive tasks. Adolescents with high ADHD symptomatology exhibited an increased neural variability before the presentation of the stimulus, but when presented with a visual stimulus, this variability decreased to a level that was similar to that exhibited by participants with low ADHD symptomatology. In contrast with our prediction, neural variability was unrelated to the magnitude of behavioral variability. Our findings suggest that adolescents with higher symptoms are characterized by increased neural variability before the stimulation, which might reflect a difficulty in alertness to the forthcoming stimulus; but this increased neural variability does not seem to account for their RT variability.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Eletroencefalografia , Estudos Longitudinais , Estudos Prospectivos , Tempo de Reação/fisiologia
10.
J Exp Child Psychol ; 233: 105697, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37224705

RESUMO

The current study examined the relations between children's cognitive and emotion abilities with their likelihood to tell a lie for personal gain in a tempting situation. These relations were examined using behavioral tasks and questionnaires. A total of 202 Israel Arab Muslim kindergarten children participated in this study. Our results showed that behavioral self-regulation was positively associated with children's likelihood to tell a lie for personal gain. Children with higher behavioral self-regulation actually tended to lie more for their own gain, suggesting that the likelihood to tell a lie might be related to children's ability to mobilize and integrate their cognitive abilities to self-regulate their behavior. In addition, through exploratory analysis, we found a positive relation between theory of mind and children's likelihood to tell a lie, which was moderated by inhibition. Specifically, only among children with low inhibition was there a positive correlation between their theory of mind and the likelihood to lie. Moreover, age and gender were related to children's lie-telling; older children tended more to lie for their own gain, and this likelihood was higher for boys than for girls.


Assuntos
Comportamento Infantil , Enganação , Criança , Masculino , Feminino , Humanos , Adolescente , Comportamento Infantil/psicologia , Inibição Psicológica , Inquéritos e Questionários
11.
Dermatopathology (Basel) ; 10(2): 136-141, 2023 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-37092531

RESUMO

Fungal folliculitis (including tinea capitis and Majocchi granuloma) has a wide range of clinical presentations, and biopsy may be obtained to distinguish this from other conditions with similar presentations. The study aims to evaluate the proportion of hairs infected in biopsies of fungal folliculitis. Copath records were searched for diagnoses of fungal folliculitis, tinea capitis and Majocchi granuloma between 1 January 2000 and 31 December 2020. Confirmed cases were pulled and reviewed by a dermatopathologist to count the total number of hairs on the sample and the total infected. Of 72 included cases, the median number of hair follicles per biopsy was 3 (IQR 1,4), and the median proportion of hairs infected was 54.2% (IQR 33.3%, 100.0%). Nineteen (26.4%) had only one hair included in the biopsy which was also an infected hair (100% of hairs were infected). The percentage of total hair follicles infected differed significantly depending upon location (p = 0.0443), with a smaller percentage of infected hairs in biopsies of tinea capitis. Clinicians should be cautious when using biopsy for diagnosis of fungal folliculitis, specifically, when there are few hairs in the specimen. Failure to capture infected hairs leads to false negative diagnoses.

12.
PeerJ ; 11: e15211, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37065687

RESUMO

Background: Parenting practices are crucial to children's development and are important predictors of children's conduct problems. The aim of the current study was to test the mediating role of mothers' character traits on the relationship between their temperamental self-regulation and their parenting practices, and on their children's conduct problems. Method: A representative sample of 387 Israeli mothers of kindergarten children was recruited online. They completed questionnaires about their own effortful control (adult temperament questionnaire; ATQ), character traits (temperament and character inventory-revised (TCI-R), big five inventory (BFI)), and parenting practices (coping with children's negative emotions scale; CCNES), as well as conduct problems of their children (strengths and difficulties questionnaire; SDQ). Structural equation models were fitted, testing for direct and indirect connections, once with character traits drawn from the TCI and once with BFI traits. Results: In both analyses, the first model presented a significant direct effect between mothers' effortful control and children's conduct problems. When including mother's parenting and character (based on the TCI or on the BFI) in the model, the direct path became insignificant and significant mediation effects were found; specifically, the indirect path through the parenting practices, as well as the mediated mediation path through the parenting practices and character. Moreover, mediation effects were found between mothers' effortful control and parenting practices through some character traits. The selected models showed a good fit (e.g., NFI = 0.985; CFI = 0.997; RMSEA = 0.038). Discussion: Our findings emphasize the importance of the mother's mature personality characteristics, the mother's actual parental practices, and the crucial value of this path for predicting child behavior outcomes.


Assuntos
Poder Familiar , Comportamento Problema , Feminino , Adulto , Humanos , Criança , Poder Familiar/psicologia , Mães/psicologia , Temperamento/fisiologia , Comportamento Infantil/psicologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-36948591

RESUMO

BACKGROUND AND OBJECTIVES: Anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) is the most common form of autoimmune encephalitis in children and adults. Although our understanding of the disease mechanisms has progressed, little is known about estimating patient outcomes. Therefore, the NEOS (anti-NMDAR Encephalitis One-Year Functional Status) score was introduced as a tool to predict disease progression in NMDARE. Developed in a mixed-age cohort, it currently remains unclear whether NEOS can be optimized for pediatric NMDARE. METHODS: This retrospective observational study aimed to validate NEOS in a large pediatric-only cohort of 59 patients (median age of 8 years). We reconstructed the original score, adapted it, evaluated additional variables, and assessed its predictive power (median follow-up of 20 months). Generalized linear regression models were used to examine predictability of binary outcomes based on the modified Rankin Scale (mRS). In addition, neuropsychological test results were investigated as alternative cognitive outcome. RESULTS: The NEOS score reliably predicted poor clinical outcome (mRS ≥3) in children in the first year after diagnosis (p = 0.0014) and beyond (p = 0.036, 16 months after diagnosis). A score adapted to the pediatric cohort by adjusting the cutoffs of the 5 NEOS components did not improve predictive power. In addition to these 5 variables, further patient characteristics such as the "Herpes simplex virus encephalitis (HSE) status" and "age at disease onset" influenced predictability and could potentially be useful to define risk groups. NEOS also predicted cognitive outcome with higher scores associated with deficits of executive function (p = 0.048) and memory (p = 0.043). DISCUSSION: Our data support the applicability of the NEOS score in children with NMDARE. Although not yet validated in prospective studies, NEOS also predicted cognitive impairment in our cohort. Consequently, the score could help identify patients at risk of poor overall clinical outcome and poor cognitive outcome and thus aid in selecting not only optimized initial therapies for these patients but also cognitive rehabilitation to improve long-term outcomes.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato , Encefalite por Herpes Simples , Adulto , Criança , Humanos , Encefalite Antirreceptor de N-Metil-D-Aspartato/tratamento farmacológico , Estudos de Coortes , Estudos Retrospectivos , Estudos Prospectivos , Encefalite por Herpes Simples/complicações , Receptores de N-Metil-D-Aspartato
14.
Radiother Oncol ; 184: 109314, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-35905780

RESUMO

BACKGROUND AND PURPOSE: Stereotactic radiosurgery (SRS) after maximal safe resection is an accepted treatment strategy for patients with cerebral metastatic disease. Despite its high conformality profile, the incidence of radionecrosis (RN) remains high. SRS delivered pre-operatively could be associated with a reduced incidence of RN. We sought to evaluate whether neoadjuvant SRS could reduce radiotherapy doses in a cohort of patients treated with post-operative SRS. METHODS: A cohort of 47 brain metastases (BM) treated at 2 academic institutions was retrospectively analyzed. Subjects underwent surgical extirpation of BMs and subsequent SRS to surgical bed. Post-operative volumetric and dosimetric data was collected from records or recreations of delivered plans; pre-operative data were derived from hypothetical radiotherapy courses and compared using Wilcoxon signed-rank tests. RESULTS: Higher planned tumor volume post-operatively (median[IQR] 12.28 [6.54, 18.69]cc vs 10.20 [4.53, 21.70]cc respectively, p = 0.4150) was observed. The median prescribed radiotherapy dose (DRx) was 16 Gy pre-operatively and 24 Gy post-operatively (p < 0.0001). Further investigations revealed improved pre-operative conformity index (1.23[1.20, 1.29] vs 1.29[1.23, 1.39], p = 0.0098) and gradient index (2.72[2.59, 2.98] vs 2.94[2.69, 3.47], p = 0.0004). A significant difference was found in normal brain tissue exposed to 10 Gy (12.97[6.78, 25.54]cc vs 32.13[19.42, 48.40]cc, p < 0.0001), 12 Gy (9.31[4.56, 17.43]cc vs 23.80[14.74, 36.56]cc, p < 0.0001), and 14 Gy (5.62[3.23, 11.61]cc vs 17.47[9.00, 28.31]cc, p < 0.0001), favoring pre-operative SRS. CONCLUSIONS: Neoadjuvant SRS is associated reduced DRx, better conformality profile and decreased radiation to normal tissue. These findings could support the use of neoadjuvant SRS for the treatment of BMs.


Assuntos
Neoplasias Encefálicas , Lesões por Radiação , Radiocirurgia , Neoplasias Supratentoriais , Humanos , Estudos Retrospectivos , Radiocirurgia/efeitos adversos , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/patologia , Encéfalo/patologia , Lesões por Radiação/etiologia , Resultado do Tratamento
15.
Perspect Psychol Sci ; 18(3): 664-674, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36269781

RESUMO

Contemporary conceptualizations on infant cognitive development focus on predictive processes; the basic idea is that the brain continuously creates predictions about what is expected and that the divergence between predicted and actual perceived data yields a prediction error. This prediction error updates the model from which the predictions are generated and therefore is a basic mechanism for learning and adaptation to the dynamics of the ever-changing environment. In this article, we review the types of available empirical evidence supporting the idea that predictive processes can be found in infancy, especially emphasizing the contribution of electrophysiology as a potential method for testing the similarity of the brain mechanisms for processing prediction errors in infants to those of adults. In infants, as with older children, adolescents, and adults, predictions involve synchronization bursts of middle-central theta reflecting brain activity in the anterior cingulate cortex. We discuss how early in development such brain mechanisms develop and open questions that still remain to be empirically investigated.


Assuntos
Encéfalo , Aprendizagem , Adulto , Adolescente , Criança , Humanos , Lactente , Aprendizagem/fisiologia , Encéfalo/fisiologia , Cognição
16.
Clin Nutr ; 41(12): 2833-2842, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36402010

RESUMO

BACKGROUND & AIMS: Studies demonstrate that caloric restriction in the first seven days in the ICU is safe. The amount of protein that should be delivered, however, is still unclear with clinical trials suggesting mixed results. Despite some capacity to customize the delivery of protein using supplemental modules, protein delivered is best determined by the concentration of protein contained in enteral formula (EF) ordered. This fact provides an opportunity to explore the potential clinical effects of protein delivery and lower carbohydrate intake on clinical outcomes compared with conventional enteral formulas. METHODS: Retrospective analysis of clinical outcomes according to the amount of protein delivered in critically ill patients admitted to intensive care units at Geisinger Health System. RESULTS: 2000 encounters (1899 patients) in patients on enteral nutrition were divided into three groups receiving EF with either ≤20% protein (standard formula - SF), 21-25% protein (high protein - HP) or > 25% protein (VHP). Protein intake increased up to day 7 (p < 0.0001). Patients on VHP received more protein than other groups (p < 0.0001). Multivariable regression analysis showed no evidence of harm. In fact, we observed increased mortality with SF and HP formulas at 30-days post-discharge when compared to patients on VHP even when the effects of other variables (including age, BMI, sex, primary diagnosis, diabetes, history of dialysis, ICU days kept NPO) were taken into consideration. CONCLUSIONS: Increasing protein intake while reducing carbohydrate intake appears to be safe. Further research aimed at defining a causative effect of increasing protein delivery while reducing carbohydrate load on outcomes is warranted.


Assuntos
Assistência ao Convalescente , Nutrição Enteral , Humanos , Estudos Retrospectivos , Alta do Paciente , Diálise Renal , Carboidratos
18.
Front Psychiatry ; 13: 927411, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935437

RESUMO

Although the evidence for the genetic basis of attention-deficit/hyperactivity disorder (ADHD) is strong, environmental factors, such as the quality of parenting or the home environment, may moderate such genetic liability. The plausible negative effect of a low-quality home environment and negative parenting on child outcomes is well-established; however, the positive effect of a high-quality environment and positive parenting remained largely uninvestigated. Due to the presence of genetic, temperamental, or physiological factors, children who were traditionally considered at-risk for ADHD may be more sensitive to aspects of their environment compared to children who are not at such risk. Therefore, they would be more affected by their environmental experience, either for good or bad. Under supportive environmental conditions, such at-risk individuals might actually outperform their non-vulnerable peers, suggesting that these individual factors might be considered susceptibility factors rather than risk factors. Little is known regarding the positive effect of the environment in the ADHD literature, but it has been demonstrated in cognitive functions that are closely associated with ADHD, such as executive functions (EF). We review this literature and examine the extant empirical support for sensitivity to aspects of the home environment and parenting in the case of ADHD and EF. Moreover, we review factors that could help identify the specific aspects of the home environment and parenting that these children might be more susceptible to. Such knowledge could be valuable when designing preventive interventions and identifying those children that are especially sensitive and could benefit from such interventions. Recommendations for future studies are discussed as well.

19.
Nutrients ; 14(9)2022 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-35565852

RESUMO

Fetal alcohol spectrum disorders (FASDs) are lifelong disabilities and the leading preventable cause of developmental disabilities. Antenatal care providers may influence pregnant women's dietary practices and their awareness of the risks of alcohol consumption during pregnancy. This study aimed to assess nutritionists' self-reported knowledge about the risks of drinking alcohol during pregnancy, professional practices in this respect, and self-perceived competence to assess and guide women about alcohol consumption during pregnancy in Israel. A sample of 526 professional nutritionists completed an anonymous online questionnaire. Results showed significant differences between the nutritionists' knowledge and professional practices scores. About 349 (66.3%) of the sample agreed (to any degree) that they did not have enough knowledge to guide pregnant women regarding drinking alcohol. The number of years of experience, combined with self-perceived competence and the mean knowledge score, explained 18% of the variance in professional practices. Nutritionists and other health professionals may have a crucial role in preventing FASD and should prioritize appropriate screening for prenatal alcohol use. Eliminating alcohol consumption at any point in pregnancy would reduce the risk for FASDs.


Assuntos
Transtornos do Espectro Alcoólico Fetal , Nutricionistas , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Etanol , Feminino , Transtornos do Espectro Alcoólico Fetal/epidemiologia , Transtornos do Espectro Alcoólico Fetal/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Israel/epidemiologia , Gravidez , Inquéritos e Questionários
20.
Gastroenterology Res ; 15(1): 13-18, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35369679

RESUMO

Background: Coronavirus disease 2019 (COVID-19) patients are at higher risk of acute gastrointestinal bleeding (AGIB) due to higher use of steroids, mechanical ventilation, and use of anticoagulation. We performed this study to compare outcomes of AGIB in COVID-19-positive patients and those without COVID-19 and AGIB. Methods: This was a case-control study including patients admitted from March 2020 to February 2021 with the diagnosis of AGIB. Patients were divided into two groups: COVID-19-positive and non-COVID-19 patients. Our primary outcomes were in-hospital or 30 days mortality and length of stay. Secondary outcomes were the rate of rebleeding, the need for intensive care unit (ICU) level of care, and the need for blood transfusion. Results: Eighteen COVID-19-positive patients and 54 matched non-COVID-19 patients were included. The COVID-19-positive patients less frequently had endoscopies performed (33.3% vs. 74.1%, P = 0.0059) and had greater steroid use (83.3% vs. 14.8%, P < 0.0001) compared to non-COVID-19 patients. ICU stays were more likely in the COVID-positive patients (odds ratio (OR): 20.41; 95% confidence interval (CI): 2.59 - 160.69; P = 0.004) as was longer hospital length of stay (OR: 1.08; 95% CI: 1.03 - 1.13; P = 0.002). Mortality, readmission within 30 days, need for blood transfusion, and having rebleeding during the admission did not differ for COVID-19 and non-COVID-19 patients. Conclusion: COVID-19 patients with AGIB are more likely to require ICU admission and had a longer length of stay. Despite the significantly lower rate of endoscopic procedures performed in patients with COVID-19, need for blood transfusion, mortality and rebleeding were not significantly different.

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