Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 89
Filtrar
1.
Clin Psychol Eur ; 6(2): e11477, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39119052

RESUMO

Background: The transtheoretical conceptualization of the working alliance and the resultant evaluation tools often overestimate the collaboration between therapist and client, while neglecting the negotiation process. The degree to which therapists and clients can negotiate disagreements regarding goals and tasks is an important indicator in establishing and maintaining the alliance. Even though the negotiation concept is not new, there is still a lack of reliable and parsimonious self-report measures of the construct. The purpose of this study was to translate, execute the cultural adaptation and, also, to perform a preliminary psychometric analysis of the Portuguese form of the therapist version of the Alliance Negotiation Scale (ANS-T_Pt). Method: Data were collected online from 100 Portuguese psychologists. Two random sub-samples were used to conduct both exploratory factorial analysis and confirmatory factorial analysis. Convergent validity was assessed through comparison with the Portuguese version of the Working Alliance Inventory. Results: The ANS-T_Pt showed a one-factorial structure, consistent with previous versions, and demonstrated adequate internal consistency. Evidence supporting criterion-related validity was found based on the correlations between ANS-T_Pt and WAI-T scores. The results showed moderate to large associations between the instruments. These results support the usefulness of the scale, construct's relevance and its transtheoretical nature. Conclusion: These results are a step forward for Portuguese therapists' and researchers' ability to evaluate the bond between client and therapist and to compare results from different countries.

2.
J Aging Soc Policy ; : 1-14, 2024 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-39190824

RESUMO

The Human Development Index (HDI) is a proxy for the social and economic level of countries, which is related to the health and well-being of older adults. This study aimed to examine the moderating effect of the HDI on the relationship between frailty and health-related quality of life among European older adults. Participants were 23,972 older adults (53.2% female, M = 74.2 years old, SD = 6.75 years old) from 24 European countries, joining wave 8 (2020) of the Survey of Health, Aging, and Retirement in Europe (SHARE). Multilevel modeling was used to analyze nested data. Significant differences in health-related quality of life among the several European Union countries were observed (intraclass correlation coefficient [ICC] = 0.18, LRT (1) = 5568.07, p < .001). The HDI has been shown to moderate the relationship between frailty and health-related quality of life among older adults, buffering the impact of frailty on the health-related quality of life. Since healthy aging is a priority for the European Union, policies mitigating the impact of HDI on the relationship between frailty and health-related quality of life should be implemented.

3.
Front Public Health ; 12: 1398124, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39045164

RESUMO

Undergraduate medical students who participate in community outreach programs gain a multitude of benefits that impact not only their professional development but also the well-being of the communities they serve. At the Virginia Tech Carilion School of Medicine (VTCSOM), students have the opportunity to volunteer in the "Bodies and Bites" program at the West End Center for Youth, an after-school educational center that serves K-12 children in Roanoke, Virginia. The purpose of Bodies and Bites is to teach elementary school children in 2nd to 5th grade how their bodies work and how to keep them healthy through good nutrition and exercise. All sessions are led by VTCSOM medical students and graduate students from our partnering academic institution, the Fralin Biomedical Research Institute (FBRI). Each week, the children and Health Professions students explore a different topic related to human anatomy and physiology using anatomical models, small group discussions, and hands-on activities. At the end of each session, the participants create a healthy snack related to the day's topic. The overall goal of the present study was to assess the perception of the Bodies and Bites program from the view of our student volunteers, and the 4th and 5th graders who attend the West End Center. Now in its 6th year, Bodies and Bites continues to be popular as a voluntary program among our Health Professions students, and is well received by the West End Center and the elementary school children they serve. Our students and community mutually benefit from this program, with the former having an opportunity to briefly disengage from the rigors of their studies while gaining valuable skills in science communication and inspiring children to pursue fields in Science, Technology, Engineering, Math, and Medicine (STEMM), and the latter having fun while learning about their bodies and discovering ways to improve their health.


Assuntos
Anatomia , Humanos , Criança , Virginia , Anatomia/educação , Faculdades de Medicina , Feminino , Masculino , Fisiologia/educação , Estudantes de Medicina/estatística & dados numéricos
4.
Res Psychother ; 27(1)2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38695608

RESUMO

In 1988, Bowlby posited that the emotional availability of psychotherapists in establishing a secure base environment is influenced by their personal relational history. Despite the acknowledged influence of the therapist's attachment on therapeutic processes and outcomes, the therapist's role as a secure base figure has received insufficient attention. This study delves into the connection between psychotherapists' attachment organization and their self-perceived roles as secure base figures within clinical contexts. Additionally, we explore the mediating role of emotion regulation processes in this context. The dataset comprises self-reports from 384 psychotherapists with diverse theoretical orientations. Our analysis reveals both direct and indirect effects of psychotherapists' attachment on the provision of a secure base. Emotion regulation, specifically through the dimension of clarity, emerges as a significant mediator in this relationship. This study offers a distinctive contribution to deepening our understanding of the relational dynamics inherent to psychotherapeutic practice. It sheds light on the nuanced relation between attachment and emotion regulation, influencing the psychotherapist's role as a secure base figure in psychotherapy. The discussion of the results additionally emphasizes key implications for clinical practice and therapists' training.

5.
Pain ; 165(2): 412-422, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37768722

RESUMO

ABSTRACT: Interoception is critical to health regulation and is often disrupted in individuals with chronic pain (ICPs). Interoceptive sensibility (IS)-the self-reported experience and relationship toward internal states-includes skills such as sensing, interpreting, and using bodily information for self-regulation. Current studies on IS and chronic pain (CP) adjustment are scarce, and how the interplay between different IS skills shapes CP adjustment remains unclear. This cross-sectional study aimed to identify profiles of IS skills among ICPs and examined their associations with pain outcomes and psychological and behavioral risk or protective processes. Individuals with chronic musculoskeletal pain (n = 173; 84.4% women) completed the Multidimensional Assessment of Interoceptive Awareness (MAIA), measures of CP adjustment (depression, anxiety, vitality, pain severity, interference, and physical function), psychological (self-efficacy, catastrophizing, and kinesiophobia), and behavioral processes (activity patterns). A cluster analysis identified 3 IS skills profiles: (1) high IS skills (n = 68), with the highest levels of attention regulation toward bodily sensations, body trust, listening for insight, and self-regulation; (2) low IS skills (n = 29), who distracted less and worried more about bodily sensations, and presented lower-body trust; and (3) mixed IS skills (n = 71), despite good body trust, attention regulation, and low worrying, showed lower awareness of body-mind connections. Interoceptive sensibility skills profiles differed in depression, vitality (fatigue), and psychological or behavioral processes, such as pain-related self-efficacy, catastrophizing, kinesiophobia, and activity pacing. These findings contribute to integrating body-mind connections more explicitly into current theoretical CP models and developing tailored interventions targeting specific IS skills to improve CP adjustment.


Assuntos
Dor Crônica , Humanos , Feminino , Masculino , Estudos Transversais , Atenção , Ansiedade/psicologia , Catastrofização , Conscientização/fisiologia
6.
Br J Psychol ; 115(2): 324-344, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38049953

RESUMO

Although the perception of justice is a core need of all individuals, the adaptive value of belief in a just world (BJW)-in everyday life and when facing severe distress-has been typically investigated in separate studies. In this article, we tested, in only one study, the possibility that BJW can be a personal resource and a coping resource. We analysed data from the European Social Survey comprised of random representative samples of 27 European countries (N = 24,776 participants). We considered distressing circumstances both at an individual level (health impairment and financial difficulty) and at a macroeconomic contextual level. The results showed that for people both facing and not facing financial or health-related distress, BJW was positively associated with well-being, supporting BJW as a personal resource. Furthermore, we found that the decrease of well-being of people facing distress, both at an individual level and at a contextual level, compared to people not facing distress, was lower for individuals with higher BJW than for individuals with lower BJW, supporting BJW as a coping resource.


Assuntos
Projetos de Pesquisa , Justiça Social , Humanos , Inquéritos e Questionários , Adaptação Psicológica
7.
J Curr Glaucoma Pract ; 17(1): 30-36, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37228310

RESUMO

Aim: This study evaluates the safety and efficacy of micropulse transscleral cyclophotocoagulation (MPTSCPC) in glaucoma patients, with standard parameters, over a 24-month period. Methods: Retrospective analysis of 61 eyes undergoing MPTSCPC from January 2018 to December 2020 was carried out. Patients received 160 seconds of laser, with settings of 2000 mW/cm2 and a duty cycle of 31.3%. Results: A total of 61 eyes were included, arranged in an age distribution of 73.9 ± 10.8 years. The most frequent diagnosis was primary open-angle glaucoma (POAG), with a mean best-corrected visual acuity (BCVA) of 5/10 in the Snellen Visual chart. Around 37.7% of the eyes had undergone at least one glaucoma filtration surgery prior to MPTSCPC. The mean pretreatment intraocular pressure (IOP) was 24.9 ± 8.6 mm Hg. Except for the contrast at 24 months, at every other follow-up visit, there was a significant reduction (p ≤ 0.001) in IOP and in the number of topical drugs required to control IOP, from four (baseline) to three, with oral acetazolamide suspension in most cases. The total success rate (absolute and clinical successes combined) was 81.9% after 1 year of the treatment. There was no drop in visual acuity or cases of serious complications. There is a positive and significant correlation between prior glaucoma surgery and the need for reinterventions (p = 0.028). Conclusions: Micropulse transscleral cyclophotocoagulation (MPTSCPC) is an effective and safe procedure for reducing IOP within a broad spectrum of glaucoma patients. Additional studies are needed to confirm the current indications, widen their scope, and determine the optimal treatment settings on an individual basis. How to cite this article: Basto RC, Almeida J, Roque JN, et al. Clinical Outcomes of Micropulse Transscleral Cyclophotocoagulation: 2 Years of Experience in Portuguese Eyes. J Curr Glaucoma Pract 2023;17(1):30-36.

8.
Proc Natl Acad Sci U S A ; 120(11): e2216286120, 2023 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-36897974

RESUMO

Unlike most higher plants, unicellular algae can acclimate to changes in irradiance on time scales of hours to a few days. The process involves an enigmatic signaling pathway originating in the plastid that leads to coordinated changes in plastid and nuclear gene expression. To deepen our understanding of this process, we conducted functional studies to examine how the model diatom, Phaeodactylum tricornutum, acclimates to low light and sought to identify the molecules responsible for the phenomenon. We show that two transformants with altered expression of two putative signal transduction molecules, a light-specific soluble kinase and a plastid transmembrane protein, that appears to be regulated by a long noncoding natural antisense transcript, arising from the opposite strand, are physiologically incapable of photoacclimation. Based on these results, we propose a working model of the retrograde feedback in the signaling and regulation of photoacclimation in a marine diatom.


Assuntos
Diatomáceas , Diatomáceas/metabolismo , Transdução de Sinal Luminoso , Transdução de Sinais
9.
Sci Rep ; 13(1): 2440, 2023 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-36765079

RESUMO

Long non-coding (lnc)RNAs have been shown to have central roles in stress responses, cell identity and developmental processes in multicellular organisms as well as in unicellular fungi. Previous works have shown the occurrence of lncRNAs in diatoms, namely in Phaeodactylum tricornutum, many of which being expressed under specific stress conditions. Interestingly, P. tricornutum is the only known diatom that has a demonstrated morphological plasticity, occurring in three distinct morphotypes: fusiform, triradiate and oval. Although the morphotypes are interchangeable, the fusiform is the dominant one while both the triradiate and the oval forms are less common, the latter often being associated with stress conditions such as low salinity and solid culture media, amongst others. Nonetheless, the molecular basis underpinning morphotype identity in P. tricornutum remains elusive. Using twelve previously published transcriptomic datasets originating from the three morphotypes of P. tricornutum, we sought to investigate the expression patterns of lncRNAs (lincRNAs and NATs) in these distinct morphotypes, using pairwise comparisons, in order to explore the putative involvement of these noncoding molecules in morphotype identity. We found that differentially expressed lncRNAs cluster according to morphotype, indicating that lncRNAs are not randomly expressed, but rather seem to provide a specific (noncoding) transcriptomic signature of the morphotype. We also present evidence to suggest that the major differences in DE genes (both noncoding and coding) between the stress related oval morphotype and the most common fusiform morphotype could be due, to a large extent, to the hyposaline culture conditions rather than to the morphotype itself. However, several lncRNAs associated to each one of the three morphotypes were identified, which could have a potential role in morphotype (or cell) identity in P. tricornutum, similar to what has been found in both animals and plant development.


Assuntos
Diatomáceas , RNA Longo não Codificante , Animais , Diatomáceas/metabolismo , RNA Longo não Codificante/genética , RNA Longo não Codificante/metabolismo , Perfilação da Expressão Gênica , Transcriptoma , Meios de Cultura/metabolismo
10.
Curr Psychol ; : 1-19, 2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36684465

RESUMO

Based on social cognitive, reasoned action, and basic needs theories, this study examines whether co-rumination with others about the job search mediates the positive relation between state negative affect and job search intentions. In addition, we looked at how this positive indirect effect interacts with the social support received from different sources (such as friends, family, and significant others) at the beginning and six months after the initial job search process. Using a sample of 87 graduates (job seekers) from a Portuguese masters program, we used multilevel modeling to test this moderated mediation. Ages ranged from 22 to 53 years old (M = 29.45; SD = 7.60). Data were collected using measures to assess negative affect, co-rumination, perceived social support, and job search intentions. We found an indirect effect of state negative affect on job search intentions; when job seekers perceive higher levels of social support from significant others at the beginning of the job search, the positive, mediating role of co-rumination in this relationship is increased. Further, for a sub-sample of six-month job seekers, this positive indirect effect increased when there was also an increased perception of social support from family. Discussion focuses on implications for theory and practice and the role of co-rumination for unemployed people during job search.

11.
J Pain ; 24(4): 582-592, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36372361

RESUMO

Assessing family supportive responses to pain behaviors is paramount, as these may help or hinder chronic pain (CP) adjustment. Current self-report measures of pain-specific family supportive dynamics are scarce, covering a limited range of responses. To address this gap, this paper aimed at the psychometric validation of a (revised) novel measure - the Informal Social Support for Autonomy and Dependence in Pain Inventory (ISSADI-PAIN). Three-hundred and three adults participated in this study (53.3% women; Mage = 49.31), 53.5% with current CP, 20.1% with acute pain (AP) in the previous week and 26.4% with no current pain. All participants completed the revised ISSADI-PAIN. Participants reporting AP/CP in the previous week also filled out measures of pain coping/outcomes. Exploratory and confirmatory factor analyzes supported a 3-factor structure: Perceived Promotion of Dependence (PPD; 5 items; α = .82), Perceived Promotion of Autonomy-Emotional (PPA-Emot; 3 items; α = .78), PPA-instrumental (PPA-Inst; 3 items; α = .82). Higher PPD was associated with higher AP disability and less wellness-focused coping; higher PPA-Emot was associated with more wellness-focused CP coping; PPA-Inst was associated with better/worse AP/CP outcomes and more frequent use of wellness-focused CP coping. Men with AP reported more PPD than women. The revised ISSADI-PAIN is an innovative, valid, and reliable measure of relevant functions of pain-related social support, which may influence pain persistence and adaptation. PERSPECTIVE: This article presents a novel self-report measure (ISSADI-PAIN) that assesses family support for functional autonomy and dependence in pain contexts. This measure may contribute to further research on the complexities of family supportive dynamics surrounding individuals with AP/CP, clarifying their role on pain persistence and adaptation processes.


Assuntos
Dor Aguda , Dor Crônica , Masculino , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Psicometria , Inquéritos e Questionários , Dor Crônica/psicologia , Apoio Familiar , Apoio Social , Adaptação Psicológica
12.
Molecules ; 27(15)2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35956930

RESUMO

A sequential design strategy was applied to optimize the secretion of pectinases by a Saccharomyces cerevisiae strain, from Brazilian sugarcane liquor vat, on passion fruit residue flour (PFRF), through solid-state fermentation (SSF). A factorial design was performed to determine the influence variables and two rotational central composite designs were executed. The validated experimental result was of 7.1 U mL-1 using 50% PFRF (w/w), pH 5, 30 °C for 24 h, under static SSF. Polygalacturonase, pectin methyl esterase, pectin-lyase and pectate-lyase activities were 3.5; 0.08; 3.1 and 0.8 U mL-1, respectively. Shotgun proteomics analysis of the crude extract enabled the identification of two pectin-lyases, one pectate-lyase and a glucosidase. The crude enzymatic extract maintained at least 80% of its original activity at pH values and temperatures ranging from 2 to 8 and 30 to 80 °C, respectively, over 60 min incubation. Results revealed that PFRF might be a cost-effective and eco-friendly substrate to produce pectinases. Statistical optimization led to fermentation conditions wherein pectin active proteins predominated. To the extent of our knowledge, this is the first study reporting the synthesis of pectate lyase by S. cerevisiae.


Assuntos
Poligalacturonase , Saccharomyces cerevisiae , Fermentação , Concentração de Íons de Hidrogênio , Pectinas/metabolismo , Poligalacturonase/metabolismo , Proteômica , Saccharomyces cerevisiae/metabolismo
13.
BMC Nephrol ; 23(1): 218, 2022 06 21.
Artigo em Inglês | MEDLINE | ID: mdl-35729492

RESUMO

BACKGROUND: The vascular access preservation and the maintenance of a complication-free fistula remains an Achilles' heel of hemodialysis in chronic kidney patients due to its substantial contribution to the morbidity and mortality. Systematic studies in the area of examining cannulation practices, achieving complication-free cannulation, and strategies to improve fistula survival are needed. For this reason, we consider it essential to create and investigate new methodologies for approaching fistula in patients on regular HD. The Multiple Single Cannulation Technique (MuST) is based on the association between the rope-ladder (RL) using the arteriovenous vessel through progressive rotation, and the buttonhole (BH) since there are three specific cannulation sites for each cannulation day during the week. The MuST is simple to implement and seems to be a very promising technique in terms of patient safety. Previous studies already showed an arteriovenous fistula survival similar to RL but significantly higher than BH. METHODS: This MuST study is a multicenter, prospective, non-blind, parallel-group, randomized controlled trial with the intervention group submitted to MuST and a control group undergoing the rope-ladder, up to 100 subjects for each group. Patients will be randomized 1:1 to one of two cannulation technique (CT), and the follow-up period of this study will be 12 months. Primary outcome is to evaluate the arteriovenous fistula survival rate at 12 months determined by the percentage of fistulas in use from the beginning of the study to the date of the first clinical intervention by angioplasty or vascular surgery, to maintain or restore patency (unassisted patency). Secondary outcome is to evaluate arteriovenous fistula survival rate at 12 month determined by the percentage of fistulas in use from the study start to the date of access abandonment due to dysfunction, patient abandonment, or death, treatment change modality or study end. We will also evaluate the assisted primary patency and include the following secondary outcomes associated with the cannulation technique: Infection, Hematoma, Aneurysm development, and pain. DISCUSSION: The study will investigate whether fistula survival can be improved when using cannulation by MuST compared to the RL. MuST study will provide important information on fistula survival when cannulated by MuST but also information related to its use in fistulas previously cannulated by other CTs. TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT05081648 registered on 18 October 2021.


Assuntos
Fístula Arteriovenosa , Derivação Arteriovenosa Cirúrgica , Derivação Arteriovenosa Cirúrgica/métodos , Cateterismo/métodos , Humanos , Estudos Multicêntricos como Assunto , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Diálise Renal/métodos , Resultado do Tratamento , Grau de Desobstrução Vascular
14.
Child Adolesc Social Work J ; : 1-13, 2022 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-35095182

RESUMO

The conditions imposed by the Covid-19 outbreaks forced residential care (RC) facilities to experience new challenges and to adopt new practices. The aim of the current study is to analyze how RC facilities have experienced and managed confinement during the 1st wave of the pandemic. A thematic analysis of 20 semi-structured interviews were conducted with professionals responsible for managing crisis in RC facilities. The main implications of the confinement measures on RC dynamics and relations were organized in three major themes: Chaos, novelty and organization; reinventing normalization and deconfinement. The pandemic exposes the structural weaknesses of RC, namely mobility of human resources, scarcity of supportive networks, and fragilities in providing comprehensive and integrative care. These factors need to be considered when addressing risk/vulnerability and discussing best practices and policies on child/youth welfare domain. Future studies should explore representations of important key actors as youth, families and other professionals from youth care.

15.
J Photochem Photobiol ; 10: 100108, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35039805

RESUMO

The importance of two related factors _ latitude and solar ultraviolet radiation _ has been insufficiently recognized as determining the spread of pandemic Sars-CoV-2 outbreaks across the globe. In this study we provide evidence of the impact of latitude and investigate how daily RT-PCR diagnosed infections and deaths are quantitively correlated with the UV component of solar light. Here, we present regression analyses using daily national numbers from Austria and from Portugal with daily ultraviolet indexes of two selected locations in these territories, obtained from a satellite source. These countries, have similar surfaces areas and population size but Austria's mean latitude is 9° up-north. The equations derived from regression analyses of those two variables are comparable for both countries, fit best the fall (2nd) pandemic wave and can be a useful non-R(t) (ratio of transmission at a particular time) dependent predictive tool. Similar equations were derived for deaths that follow infections within a few weeks delay. Strong correlations depend on the size of the region/country from which infections are collected, the robustness of screening practices, ideally kept through weekends and holidays. Besides the forecasting usefulness of such correlations, these findings also suggest that covid-19 transmission co-exists with a Sars-Cov-2 specific UV-induced immunosuppression response. While in 2020, intensity of pandemic spring and fall waves reflect a solar UV-light modulation, we relate exceptional low temperature and humidity with additional waves, as the winter 2020/2021 3rd wave, felt in the western European countries. This work may help understanding this Pandemic phenomenon and dealing with similar catastrophes in the future.

16.
Child Abuse Negl ; 130(Pt 1): 105370, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-34756741

RESUMO

BACKGROUND: Children and youth residential care institutions were forced to introduce adaptations to their regular functioning in order to respond to the COVID-19 pandemic challenges. OBJECTIVE: The purpose of this study was to examine the effects of the lockdown on the adolescents' psychological adjustment and whether adolescents' perceived cohesion mitigated the increase of adolescents' psychological adjustment problems. PARTICIPANTS: Participants were 243 adolescents aged 12 to 18 years, living in 21 different residential care institutions. RESULTS: The results suggested a moderating role of cohesion on the stability of adolescents' emotional distress across time. Lower levels of cohesion were related with higher emotional distress stability across time. On the contrary, as cohesion increased, the association between adolescents' emotional distress at T0 and T1 decreased. DISCUSSION: Results are discussed considering the mechanisms raised by the institutions to respond to the COVID-19 pandemic and minimize the negative effects on the psychological adjustment of adolescents living in residential care.


Assuntos
COVID-19 , Angústia Psicológica , Adolescente , COVID-19/epidemiologia , Criança , Controle de Doenças Transmissíveis , Ajustamento Emocional , Humanos , Pandemias
17.
Hemodial Int ; 26(1): 4-12, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34231332

RESUMO

INTRODUCTION: Despite the impact needling has had on vascular access survival and patient outcome, there is no universal or standardized method proposed for proper cannulation. Rigorous studies are needed, examining cannulation practices, and challenges to achieving complication-free cannulation. METHODS: This randomized, open-label trial was conducted at 18 dialysis units owned by a large private dialysis provider operating in Portugal. Eligible patients were adults on chronic hemodialysis, with a new arteriovenous fistula (AVF); cannulated for at least 4 weeks complication-free. Patients were randomly assigned in a 1:1 ratio to one of three cannulation techniques (CT): Multiple Single cannulation Technique (MuST), rope-ladder (RLC), and buttonhole (BHC). The primary endpoint was AVF primary patency at 1 year. FINDINGS: One hundred seventy-two patients were enrolled between March 2014 and March 2017. Fifty-nine patients were allocated to MuST, 56 to RLC, and 57 to BHC. MuST and RLC were associated with a better AVF primary patency than BHC. Primary patency at 12 months was 76.3% in MuST, 59.6% in BHC, and 76.8% in RLC group. Mean AVF survival times were 10.5 months (95% CI = 9.6, 11.3) in the MuST group, 10.4 months (95% CI = 9.5, 11.2) in RLC, and 9.5 months (95% CI = 8.6, 10.4) in BHC. BHC was a significant risk predictor for AVF survival with 2.13 times more events than the other two CT (HR 2.13; 95% CI = 1.07, 4.21; p = 0.03). DISCUSSION: MuST was easy to implement without a diagram and there is no need to use blunt needles. This study showed MuST was efficacious and safe in maintaining the longevity of AVF in dialysis patients.


Assuntos
Fístula Arteriovenosa , Derivação Arteriovenosa Cirúrgica , Adulto , Derivação Arteriovenosa Cirúrgica/métodos , Cateterismo/métodos , Humanos , Diálise Renal/métodos
18.
Med Sci Educ ; 31(2): 745-751, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34457923

RESUMO

INTRODUCTION: Conceptions of learning and teaching refer to what faculty think about teaching effectiveness. Approaches to teaching refer to the methods they use to teach. Both conceptions and approaches range from student-centered/learning-focused (active learner engagement) to teaching-centered/content-focused (passive learner engagement). This study explored how faculty teaching experience influenced faculty conceptions and their approaches to teaching. The authors hypothesized that more experienced educators appreciate and apply active learning approaches. METHODS: The authors used a cross-sectional survey to collect anonymous data from the Basic Science faculty at Virginia Tech Carilion School of Medicine (VTCSOM). The survey included the Conceptions of Learning and Teaching scale (COLT; Jacobs et al. 2012) and demographic information. They assessed instrument reliability with Cronbach's alpha and examined relationships between variables with correlation and chi-square and group differences with ANOVA. RESULTS: Thirty-eight percent (50/130) of faculty responded to the survey. COLT scores for student-centered (4.06 ± 0.41) were significantly higher (p < 0.001) than teacher-centered (3.12 ± 0.6). Teacher-centered scores were lower (p < 0.05) for younger (30-39, 2.65 ± 0.48) than older faculty (50-59, 3.57 ± 0.71) and were negatively correlated with using multiple teaching methods (p = 0.022). However, 83% (39/50) reported using both traditional lectures and active approaches. DISCUSSION: Faculty conceptions about teaching showed appreciation for active learning, but a tendency to use traditional teaching methods interspersed with student-centered ones. Teaching experience was not related to faculty conceptions but was related to their teaching approaches. The amount of time dedicated to teaching was related to the appreciation of active learning, and young teachers were more student-oriented. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01264-4.

19.
Int J Adv Manuf Technol ; 116(7-8): 2161-2181, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34248244

RESUMO

To track industry 4.0 status, readiness models are used to analyze the state of industry 4.0 technologies' implementation, allowing the quantification and qualification of its readiness level considering different dimensions. Not all companies are adopting these new technologies with the same ease and with the same pace. There are companies unable to blend the industry 4.0 with their business models, leading to a lack of a correct self-assessment on understanding the reached readiness level. Into this purpose, it is important to understand how companies are facing the digital transformation challenges, what is their perception about the enabling technologies towards the industry 4.0, assess the industry 4.0' readiness so far, and what are their perception of the barriers to the adoption of these technologies. This paper aims to assess the industry 4.0' readiness level of companies and discuss the perception of companies about the barriers on the adoption of industry 4.0 with the reached readiness level of companies. New barriers are also brought for discussion on academic community. To this end, empirical data was collected on a sample of 15 companies belonging to an important industrial cluster located in Portugal.

20.
Vet Rec Open ; 8(1): e5, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33981439

RESUMO

BACKGROUND: Referral of cases is becoming more and more frequent in companion animal practice. The Infectious Diseases Isolation Unit (IDIU) admits first opinion, second opinion and referred patients with a confirmed infectious disease (ID) or a clinically suspected ID that is awaiting laboratory diagnosis. The primary aims of this study were to describe the annual number and characteristics of patients referred to the IDIU and identify the most frequent IDs in referred dogs and cats. A secondary aim was to investigate possible differences in the length of the hospitalisation and the clinical outcome among referred cases and those admitted to the IDIU after first and second opinion appointments. METHODS: A retrospective study was carried out on patients hospitalised at the unit over 5 years from 9th October 2013 to 31st December 2018. RESULTS: The study population consisted of 365 dogs and 515 cats to give a total of 880 patients hospitalised at the IDIU from October 2013 to December 2018. Among the 96 referred dogs, parvovirosis (37.7%) and leptospirosis (31.1%) were the most frequent IDs. Feline upper respiratory tract infection (38.2%) and feline leukaemia virus infections (36.4%) were the main causes in the 80 referred cats. Worrying noncompliance rates of dog (51.0%) and cat (52.5%) vaccination schedules were identified. The analysis of the length of hospitalisation in the three groups of patients was not statistically different. In both animal species there were statistically significant higher clinical discharge rates on the first opinion patients' group in comparison to referred patients and the second opinion group. CONCLUSIONS: Parvovirosis and leptospirosis in dogs and upper respiratory disease and feline leukaemia virus infection in cats were the most common diagnoses for patients admitted to the IDIU, reinforcing the need for accurate vaccination. Discharge rates results pinpoint the need for timely accurate reference.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA