RESUMO
Letter to the editor.
Carta al editor.
Assuntos
Consumo de Bebidas Alcoólicas/terapia , Qualidade de Vida , Estudos Clínicos como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Resultado do TratamentoRESUMO
Meat production and consumption are sources of animal cruelty, responsible for several environmental problems and human health diseases, and contribute to social inequality. Vegetarianism and veganism (VEG) are two alternatives that align with calls for a transition to more ethical, sustainable, and healthier lifestyles. Following the PRISMA guidelines, we conducted a systematic literature review of 307 quantitative studies on VEG (from 1978 to 2023), collected from the Web of Science in the categories of psychology, behavioral science, social science, and consumer behavior. For a holistic view of the literature and to capture its multiple angles, we articulated our objectives by responding to the variables of "WHEN," "WHERE," "WHO," "WHAT," "WHY," "WHICH," and "HOW" (6W1H) regarding the VEG research. Our review highlighted that quantitative research on VEG has experienced exponential growth with an unbalanced geographical focus, accompanied by an increasing richness but also great complexity in the understating of the VEG phenomenon. The systematic literature review found different approaches from which the authors studied VEG while identifying methodological limitations. Additionally, our research provided a systematic view of factors studied on VEG and the variables associated with VEG-related behavior change. Accordingly, this study contributes to the literature in the field of VEG by mapping the most recent trends and gaps in research, clarifying existing findings, and suggesting directions for future research.
RESUMO
INTRODUCTION: Community pharmacists (CP) are among the health professionals with closest contact to the general population. They play a key role in delivering public health programs. The aim of this study was to analyse the attitudes, knowledge, preparedness and ability to screen and advise on alcohol of CP in Catalonia and their perceptions about the provision of alcohol screening and brief interventions (SBI) in community pharmacies. METHODS: This is an observational, cross-sectional study. An online survey on attitudes, knowledge and behaviours was sent to all registered CP in Catalonia, and bivariate and multivariate statistical analyses were conducted. RESULTS: The response rate was 7.96% (639/8027), more than two-thirds of respondents were 41 years of age or older and 79.9% were female. Results showed that CP readiness to offer advice on alcohol problems was higher than their preparedness to screen (37.5% vs. 31.8%, respectively). They also showed that having received 1 h or more of training on alcohol and drug-related health promotion and prevention during the last 5 years increased CP perception of role security and therapeutic commitment related to alcohol. DISCUSSION AND CONCLUSION: This study showed that involving CP in the provision of alcohol SBIs may be feasible in Catalonia. Furthermore, this and previous research show an association between CP training in alcohol or drugs and preparedness to screen and advise on alcohol use. Consequently, promoting alcohol-related training programs to enhance CP skills is recommended to support successful implementation of alcohol SBI in community pharmacy settings.
Assuntos
Serviços Comunitários de Farmácia , Intervenção em Crise , Humanos , Feminino , Masculino , Farmacêuticos , Espanha , Atitude do Pessoal de Saúde , Etanol , Papel ProfissionalRESUMO
BACKGROUND: Brief interventions (BI) for risky drinkers in primary healthcare have been demonstrated to be cost-effective but they are still poorly implemented. Digital BI seems to be a complementary strategy to overcome some barriers to implementation but there is a scarcity of studies in clinical environments. We present the results of a randomized controlled non-inferiority trial which tests the non-inferiority of facilitated access to a digital intervention (experimental condition) for risky drinkers against a face-to-face BI (control condition) provided by primary healthcare professionals. METHOD: In a non-inferiority randomized controlled trial, unselected primary healthcare patients (≥ 18 years old) were given a brief introduction and asked to log on to the study website to fill in the 3-item version of the Alcohol Use Disorders Identification Test. Positively screened patients (4+ for women and 5+ for men) received further online assessment (AUDIT, socio-demographic characteristics and EQ-5D-5L) and were automatically randomized to either face-to-face or digital BI (1:1). The primary outcome was the proportion of patients classified as risky drinkers by the digitally administered AUDIT at month 3. A multiple imputation approach for the missing data was performed. RESULTS: Of the 4499 patients approached by 115 healthcare professionals, 1521 completed the AUDIT-C. Of the 368 positively screened patients, 320 agreed to participate and were randomized to either intervention. At month 3, there were more risky drinkers in the experimental group (59.8%) than in the control group (52%), which was similar to the distribution at baseline and less than the pre-specified margin of 10%. The difference was not significant when accounting for possible confounders. CONCLUSION: Digital BI was not inferior to face-to-face BI, in line with previous findings and the a priori hypothesis. However, the low power of the final sample, due to the low recruitment and loss to follow-up, limits the interpretation of the findings. New approaches in this field are required to ensure the effective implementation of digital interventions in actual practice.
RESUMO
BACKGROUND: There is evidence that exposure to passive smoking in general, and in babies in particular, is an important cause of morbimortality. Passive smoking is related to an increased risk of pediatric diseases such as sudden death syndrome, acute respiratory diseases, worsening of asthma, acute-chronic middle ear disease and slowing of lung growth.The objective of this article is to describe the BIBE study protocol. The BIBE study aims to determine the effectiveness of a brief intervention within the context of Primary Care, directed to mothers and fathers that smoke, in order to reduce the exposure of babies to passive smoking (ETS). METHODS/DESIGN: Cluster randomized field trial (control and intervention group), multicentric and open. SUBJECT: Fathers and/or mothers who are smokers and their babies (under 18 months) that attend pediatric services in Primary Care in Catalonia.The measurements will be taken at three points in time, in each of the fathers and/or mothers who respond to a questionnaire regarding their baby's clinical background and characteristics of the baby's exposure, together with variables related to the parents' tobacco consumption. A hair sample of the baby will be taken at the beginning of the study and at six months after the initial visit (biological determination of nicotine). The intervention group will apply a brief intervention in passive smoking after specific training and the control group will apply the habitual care. DISCUSSION: Exposure to ETS is an avoidable factor related to infant morbimortality. Interventions to reduce exposure to ETS in babies are potentially beneficial for their health.The BIBE study evaluates an intervention to reduce exposure to ETS that takes advantage of pediatric visits. Interventions in the form of advice, conducted by pediatric professionals, are an excellent opportunity for prevention and protection of infants against the harmful effects of ETS. TRIAL REGISTRATION: Clinical Trials.gov Identifier: NCT00788996.
Assuntos
Bem-Estar do Lactente , Poluição por Fumaça de Tabaco/prevenção & controle , Feminino , Humanos , Lactente , Masculino , Educação de Pacientes como Assunto , Atenção Primária à Saúde , Espanha , Inquéritos e QuestionáriosRESUMO
Digital brief interventions have emerged as an instrument to improve the implementation of Screening, Brief Intervention and Referral to Treatment programs for risky drinkers. However, trials in Catalonia have been unsuccessful. This study was aimed at researching professionals' perceptions regarding the usefulness of digital brief interventions in overcoming traditional barriers of face-to-face Screening, Brief Intervention and Referral to Treatment and new barriers posed by the use of digital brief interventions. Professionals who participated in the Effectiveness of primary care based Facilitated Access to alcohol Reduction website (EFAR)digital brief intervention clinical trial were surveyed on April 2017 on the following areas: (1) satisfaction, (2) usefulness, (3) perceived ability of digital interventions on overcoming traditional barriers and (4) perceived new barriers of digital interventions. Sixty-eight professionals completed the survey. Univariate and multivariate analyses were performed using the level of professional engagement with the project as the dependent variable, barriers as independent variables and socio-demographic characteristics as covariables. Of all professionals, 79.4 percent were satisfied with their participation in the project, but only 26.5 percent perceived the website as useful. Low engagement was associated with the perceived lack of feedback (0.22; 95% confidence interval: 0.05 -0.88), perception that it was difficult to use among the elderly(0.22; 95 confidence interval: 0.05 -0.091) and among low socioeconomic population (0.14; 95% confidence interval: 0.03 -0.64). The majority of the participants indicated that digital brief intervention for risky drinkers succeeded in overcoming most of the traditional barriers. However, new barriers emerged as difficulties for implementing digital brief interventions in the Catalan Primary Health Care System. Usefulness perception is a key factor, which must be addressed in any proposed intervention in primary care.
Assuntos
Intervenção em Crise , Pessoal de Saúde , Atenção Primária à Saúde , Intervenção em Crise/métodos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Percepção , Projetos Piloto , Atenção Primária à Saúde/métodos , Encaminhamento e ConsultaRESUMO
INTRODUCTION: Early identification (EI) and brief interventions (BIs) for risky drinkers are effective tools in primary care. Lack of time in daily practice has been identified as one of the main barriers to implementation of BI. There is growing evidence that facilitated access by primary healthcare professionals (PHCPs) to a web-based BI can be a time-saving alternative to standard face-to-face BIs, but there is as yet no evidence about the effectiveness of this approach relative to conventional BI. The main aim of this study is to test non-inferiority of facilitation to a web-based BI for risky drinkers delivered by PHCP against face-to-face BI. METHOD AND ANALYSIS: A randomised controlled non-inferiority trial comparing both interventions will be performed in primary care health centres in Catalonia, Spain. Unselected adult patients attending participating centres will be given a leaflet inviting them to log on to a website to complete the Alcohol Use Disorders Identification Test (AUDIT-C) alcohol screening questionnaire. Participants with positive results will be requested online to complete a trial module including consent, baseline assessment and randomisation to either face-to-face BI by the practitioner or BI via the alcohol reduction website. Follow-up assessment of risky drinking will be undertaken online at 3 months and 1 year using the full AUDIT and D5-EQD5 scale. Proportions of risky drinkers in each group will be calculated and non-inferiority assessed against a specified margin of 10%. Assuming reduction of 30% of risky drinkers receiving standard intervention, 1000 patients will be required to give 90% power to reject the null hypothesis. ETHICS AND DISSEMINATION: The protocol was approved by the Ethics Commmittee of IDIAP Jordi Gol i Gurina P14/028. The findings of the trial will be disseminated through peer-reviewed journals, national and international conference presentations. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT02082990.
Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/diagnóstico , Internet , Atenção Primária à Saúde/organização & administração , Adulto , Protocolos Clínicos , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Espanha , Adulto JovemRESUMO
En la práctica clínica con niños, adolescentes y adultos con discapacidad será necesario retomar el rumbo que orienta la ética del psicoanálisis en lo concerniente a la dirección de la cura. Si bien puede parecer una obviedad hacer referencia a esto, no obstante es importante remarcarlo ya que es un rumbo que suele olvidarse cuando se trabaja con esta población de pacientes.Esto significa tomar la senda trazada por Freud cuando sostiene que el psicoanálisis se basa en la cura a través de la palabra, sin perder de vista que en el orden simbólico nada es absoluto debido a que ninguna palabra puede cerrarse en una significación que lo defina todo, ni siquiera, podemos agregar, cuando existe algo tan contundente como real como una discapacidad. Rescatar para la escucha de los pacientes con un compromiso orgánico este rumbo será fundamental dado que a través de él es como se podrá favorecer la dialectización de lo que la discapacidad tiende a transformar en signo y a eclipsar al sujeto detrás de ella.
Assuntos
Humanos , Pessoas com Deficiência Auditiva/psicologia , Surdez/psicologia , Terapia Psicanalítica/ética , Psicanálise/éticaRESUMO
La medicina tradicional es la suma completa de conocimientos, técnicas y prácticas fundamentadas en las teorías, creencias y experiencias propias de diferentes culturas, que se utilizan para prevenir, diagnosticar, mejorar o tratar trastornos físicos o mentales que ha sido adoptada por un sinnúmero de poblaciones; sin embargo son escasos los datos resultantes de ensayos científicos destinados a evaluar la seguridad y eficacia de los productos y las prácticas de la medicina tradicional, es por ello que nos planteamos lo siguiente: ¿Tendrán las 5 especies vegetales actividad antimicrobiana?. El presente trabajo evalúa la actividad antimicrobiana de 5 especies vegetales colectadas en la ciudad de León a través del método MTT (Bromuro de 3-(4,5-dimetiltiazol-2-yl)-2,5 difeniltetrazolio).
Assuntos
Medicina Tradicional , Plantas Medicinais/química , Produtos com Ação Antimicrobiana , NicaráguaRESUMO
Se presentan 2 casos de lipomas broncopulmonares observados en un período de 14 años, en la revisación de un total de 381 enfermos portadores de tumores. Un caso correspondió a un lipoma endobronquial que requirió para su curación una pleuroneumonectomía por las complicaciones del parénquima postobstrucción; el otro se trataba de un lipoma periférico en el que se realizó sólo una resección atípica conservadora. Ambos evolucionaron favorablemente. Se concluye en la necesidad del diagnóstico temprano para evitar resecciones mayores. Se menciona el uso de la laseroterapia por vía endoscópica para el tratamiento de los tumores benignos endobronquiales
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Neoplasias Brônquicas/cirurgia , Lipoma/cirurgia , Neoplasias Pulmonares/cirurgiaRESUMO
Análisis descriptivo de la situación poblacional del Correccional visto desde su estructura institucional y organizacional desde julio-diciembre 1995. Aborda antecedentes de la creación de penitenciarias y orígen del sistema en el Paraguay. Presenta el marco juríco además de sus normas y procedimientos