RESUMO
OBJECTIVE: End-of-life and anticipatory medications (AMs) have been widely used in various health care settings for people approaching end-of-life. Lack of access to medications at times of need may result in unnecessary hospital admissions and increased patient and family distress in managing palliative care at home. The study aimed to map the use of end-of-life and AM in a cohort of palliative care patients through the use of the Population Level Analysis and Reporting Data Space and to discuss the results through stakeholder consultation of the relevant organizations. METHODS: A retrospective observational cohort study of 799 palliative care patients in 25 Australian general practice health records with a palliative care referral was undertaken over a period of 10 years. This was followed by stakeholders' consultation with palliative care nurse practitioners and general practitioners who have palliative care patients. RESULTS: End-of-life and AM prescribing have been increasing over the recent years. Only a small percentage (13.5%) of palliative care patients received medications through general practice. Stakeholders' consultation on AM prescribing showed that there is confusion about identifying patients needing medications for end-of-life and mixed knowledge about palliative care referral pathways. SIGNIFICANCE OF RESULTS: Improved knowledge and information around referral pathways enabling access to palliative care services for general practice patients and their caregivers are needed. Similarly, the increased utility of screening tools to identify patients with palliative care needs may be useful for health care practitioners to ensure timely care is provided.
Assuntos
Medicina Geral , Assistência Terminal , Austrália , Morte , Humanos , Cuidados Paliativos/métodos , Estudos Retrospectivos , Assistência Terminal/métodosRESUMO
Previously, surfactant-assisted exfoliated graphene oxide (sEGO) formed with the triple-chain surfactant TC14 (sodium 1,4-bis(neopentyloxy)-3-(neopentylcarbonyl)-1,4-dioxobutane-2-sulfonate) was applied in wastewater treatment. The extent of dye-removal and the adsorption capacity of the sEGO formed with this triple-chain surfactant outperformed those of two other systems, namely, the di-chain version of TC14 (AOT14; sodium 1,2-bis-(2,2-dimethyl-propoxycarbonyl)-ethanesulfonate) and the single-chain surfactant sodium n-dodecylsulfate. In the present study, to further optimise the surfactant chemical structure, the sodium ion of TC14 was substituted with 1-butyl-3-methyl-imidazolium (BMIM) generating surfactant ionic liquids (SAILs; 1-butyl-3-imidazolium 1,4-bis(neopentyloxy)-3-(neopentyloxycarbonyl)-1,4-dioxobutane-2-sulfonate), hereafter denoted as BMIM-TC14. This SAIL, together with nanofibrillated kenaf cellulose (NFC), was used to electrochemically exfoliate graphite, yielding BMIM-TC14 sEGO/NFC composites. These highly hydrophobic polymer composites were then used for the removal of methylene blue (MB) from aqueous solution. 1H NMR spectroscopy was used to elucidate the structure of the synthesised SAILs. The morphologies of the resulting nanocomposites were investigated using Raman spectroscopy, field-emission scanning electron microscopy, and high-resolution transmission electron microscopy. Analysis using small-angle neutron scattering was performed to examine the aggregation behaviour of sEGO and custom-made SAILs. Zeta potential, surface tension, and dynamic light-scattering measurements were used to study the aqueous properties and colloidal stability of the suspension. Amongst the surfactants tested, BMIM-TC14 sEGO/NFC exhibited the highest MB adsorption ability, achieving 99% dye removal under optimum conditions. These results highlight the importance of modifying the hydrophilic moieties of amphiphilic compounds to improve the performance of sEGO/NFC composites as effective adsorbents for wastewater treatment.
RESUMO
The degradation and mechanical properties of potential polymeric materials used for green manufacturing are significant determinants. In this study, cellulose nanofibre was prepared from Schizostachyum brachycladum bamboo and used as reinforcement in the PLA/chitosan matrix using melt extrusion and compression moulding method. The cellulose nanofibre(CNF) was isolated using supercritical carbon dioxide and high-pressure homogenisation. The isolated CNF was characterised with transmission electron microscopy (TEM), FT-IR, zeta potential and particle size analysis. The mechanical, physical, and degradation properties of the resulting biocomposite were studied with moisture content, density, thickness swelling, tensile, flexural, scanning electron microscopy, thermogravimetry, and biodegradability analysis. The TEM, FT-IR, and particle size results showed successful isolation of cellulose nanofibre using this method. The result showed that the physical, mechanical, and degradation properties of PLA/chitosan/CNF biocomposite were significantly enhanced with cellulose nanofibre. The density, thickness swelling, and moisture content increased with the addition of CNF. Also, tensile strength and modulus; flexural strength and modulus increased; while the elongation reduced. The carbon residue from the thermal degradation and the glass transition temperature of the PLA/chitosan/CNF biocomposite was observed to increase with the addition of CNF. The result showed that the biocomposite has potential for green and sustainable industrial application.
Assuntos
Materiais Biocompatíveis/química , Celulose/química , Quitosana/química , Nanocompostos/química , Nanofibras/química , Poliésteres/química , Sasa/química , Algoritmos , Fenômenos Químicos , Modelos Teóricos , Nanocompostos/ultraestrutura , Nanofibras/ultraestrutura , Tamanho da Partícula , TermogravimetriaRESUMO
Studies evaluating the occurrence of enteropathogenic bacteria in urban rats (Rattus spp.) are scarce worldwide, specifically in the urban environments of tropical countries. This study aims to estimate the prevalence of diarrhoeagenic Escherichia coli (DEC) and Salmonella spp. with zoonotic potential in urban slum environments. We trapped rats between April and June 2018 in Salvador, Brazil. We collected rectal swabs from Rattus spp., and cultured for E. coli and Salmonella spp., and screened E. coli isolates by polymerase chain reaction to identify pathotypes. E. coli were found in 70% of Rattus norvegicus and were found in four Rattus rattus. DEC were isolated in 31.3% of the 67 brown rats (R. norvegicus). The pathotypes detected more frequently were shiga toxin E. coli in 11.9%, followed by atypical enteropathogenic E. coli in 10.4% and enteroinvasive E. coli in 4.5%. From the five black rats (R. rattus), two presented DEC. Salmonella enterica was found in only one (1.4%) of 67 R. norvegicus. Our findings indicate that both R. norvegicus and R. rattus are host of DEC and, at lower prevalence, S. enterica, highlighting the importance of rodents as potential sources of pathogenic agents for humans.
Assuntos
Escherichia coli Enteropatogênica/isolamento & purificação , Infecções por Escherichia coli/veterinária , Doenças dos Roedores/microbiologia , Salmonelose Animal/epidemiologia , Salmonella/isolamento & purificação , Zoonoses , Animais , Brasil/epidemiologia , Diarreia/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Masculino , Áreas de Pobreza , Prevalência , Ratos , Reto/microbiologia , Doenças dos Roedores/epidemiologia , Salmonella/patogenicidade , Salmonelose Animal/microbiologia , População Urbana , Zoonoses/epidemiologia , Zoonoses/microbiologiaRESUMO
BACKGROUND: Medication-related adverse events, or adverse drug reactions (ADRs) are harmful events caused by medication. ADRs could have profound effects on the patients' quality of life, as well as creating an increased burden on the healthcare system. ADRs are one of the rising causes of morbidity and mortality internationally, and will continue to be a significant public health issue with the increased complexity in medication, to treat various diseases in an aging society. This scoping review aims to provide a detailed map of the most common adverse drug reactions experienced in primary healthcare setting, the drug classes that are most commonly associated with different levels/types of adverse drug reactions, causes of ADRs, their prevalence and consequences of experiencing ADRs. METHODS: We systematically reviewed electronic databases Ovid MEDLINE, Embase, CINAHL Plus, Cochrane Central Register of Controlled Trials, PsycINFO and Scopus. In addition, the National Patient Safety Foundation Bibliography and the Agency for Health Care Research and Quality and Patient Safety Net Bibliography were searched. Studies published from 1990 onwards until December 7, 2018 were included as the incidence of reporting drug reactions were not prevalent before 1990. We only include studies published in English. RESULTS: The final search yielded a total of 19 citations for inclusion published over a 15-year period that primarily focused on investigating the different types of adverse drug reactions in primary healthcare. The most causes of adverse events were related to drug related and allergies. Idiosyncratic adverse reactions were not very commonly reported. The most common adverse drug reactions reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with adverse events. CONCLUSION: This scoping review identified that the most causes of ADRs were drug related and due to allergies. Idiosyncratic adverse reactions were not very commonly reported in the literature. This is mainly because it is hard to predict and these reactions are not associated with drug doses or routes of administration. The most common ADRs reported in the studies included in this review were those that are associated with the central nervous system, gastrointestinal system and cardiovascular system. Several classes of medications were reported to be associated with ADRs.
Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Atenção Primária à Saúde , HumanosRESUMO
OBJECTIVE: The objective of this study is to map the existent research undertaken in Australia into broad thematic areas and identify the characteristics of the studies and areas of future research in the literature. METHODS: A scoping review methodology was employed to map the current areas of research undertaken in Australia since January 2000 until the end of December 2018 according to years of publications, types of studies, populations studied, research themes, and areas of focus. RESULTS: Our review identified 1,405 Australian palliative care research publications between January 2000 and December 2018. Nearly 40% of the studies were quantitative (39%) and a third were qualitative studies (31%). The remainder of the studies were reviews, mixed methods, quality improvement projects, and others. One-third (30%) of the research was done with carers' participants followed by nurses (22%) and doctors and physicians (18%). The most frequently reported diagnosis in the studies was cancer with 42% of the publication total. The most frequently explored theme was physical symptoms (such as pain, breathlessness, nausea, delirium, and dyspnea) with a total of 16% of all articles followed by communication (15%). There was a large gap to the next most frequently explored theme with service delivery (9%) and coordination of care (8%). Assessment of patients (7%), end-of-life decision-making (6%), and rural/regional (6%) all produced a similar number of publications. Very few studies addressed topics such as quality of life, E-Health, after-hours care, spirituality, and health economics. Moreover, there were only 15 (1%) studies focused on the last days of life. SIGNIFICANCE OF THE RESULTS: The current review presented a comprehensive search of the literature across almost two decades in Australia in the palliative care setting. It has covered a breadth of research topics and highlighted urgent areas for further research.
Assuntos
Cuidados Paliativos/classificação , Pesquisa/classificação , Austrália , Humanos , Cuidados Paliativos/estatística & dados numéricos , Pesquisa/estatística & dados numéricosRESUMO
This work presents the development, validation and application of three simple and direct analytical methods for determination of posaconazole (PSZ) in its pure form and in suspension dosage form. Method I is based on high performance thin layer chromatography (HPTLC) where effective separation of PSZ and the internal standard (itraconazole) was achieved using Merck HPTLC plates (20×10cm aluminium plates with 250µm layer thickness precoated with silicagel 60 F254) and a mobile phase composed of acetone and chloroform (1:2, by volume), followed by densitometric measurement of the drugs' spots at 262nm. Method II involves measurement of the native fluorescence of PSZ in 0.1M H2SO4 at excitation and emission wavelengths of 260 and 365nm, respectively. Method III depends on the voltammetric analysis of PSZ. A well-defined cathodic wave was obtained for PSZ in Britton-Robinson buffer pH 6.5 using the differential-pulse mode at the hanging mercury drop electrode (HMDE). The developed methods were validated according to the International Conference on Harmonization (ICH) guidelines regarding linearity, ranges, accuracy, precision, robustness and limits of detection and quantification. The proposed methods showed good linearity over the concentration ranges 5-50, 0.05-0.3, 0.005-0.05µg/mL PSZ for methods I, II, and III respectively. Intra and inter-day precision were verified by the RSD% values which were less than 2%. The proposed methods were successfully applied for the quantification of PSZ in suspension dosage form with no observable interferences. Assay methods were favorably compared with those obtained by previously reported HPLC method.
Assuntos
Antifúngicos/análise , Triazóis/análise , Cromatografia Líquida de Alta Pressão , Cromatografia em Camada Fina , Formas de Dosagem , Técnicas Eletroquímicas , Indicadores e Reagentes , Padrões de Referência , Solventes , Espectrometria de Fluorescência , SuspensõesRESUMO
BACKGROUND: Hand ischemia following trauma in children is rare, and the natural history after upper extremity arterial bypass in children is unknown. We hypothesize children with brachial artery repair are at long-term risk of developing aneurysmal degeneration or thrombosis, thus necessitating annual duplex ultrasonography and physical examination. METHODS: A retrospective review of children who had brachial artery repair (bypass or vein patch) for hand ischemia secondary to trauma at a level I trauma pediatric hospital was performed. Telephone interviews were conducted to assess the presence of arm/hand symptoms (pain, weakness, fatigue, sensory function, limb length discrepancy). RESULTS: Between 2003 and 2016, 16 children (12 males), mean age 8 years (3-13 years) underwent brachial artery repair (12 bypass with vein, 4 vein patch). Mechanism of injury included 11 supracondylar fractures and 5 lacerations. All patients were seen at 2 weeks with a duplex ultrasound. Thirteen patients were lost to follow-up. The 3 patients with follow-up had patent bypasses, but one patient 6 years out from the repair had aneurysmal degeneration of the vein graft. Seven patients were never seen again. Phone interviews were conducted for the remaining 6 patients and 2 complained of arm fatigue and intermittent hand pain. Only one patient reported that the pediatrician checked pulses in the affected extremity. CONCLUSIONS: Eighty percentage of children had no further follow-up after the postoperative visit. Asymptomatic aneurysmal degeneration of the vein graft was noted 6 years following repair in one patient, and 2 patients had unevaluated hand complaints. These patients are at risk for late complications and are unlikely to return for routine follow-up. The importance of graft surveillance must be more clearly emphasized at time of initial surgery.
Assuntos
Artéria Braquial/diagnóstico por imagem , Traumatismos da Mão/diagnóstico por imagem , Isquemia/diagnóstico por imagem , Ultrassonografia Doppler Dupla , Lesões do Sistema Vascular/diagnóstico por imagem , Adolescente , Fatores Etários , Aneurisma/diagnóstico por imagem , Aneurisma/etiologia , Artéria Braquial/lesões , Artéria Braquial/fisiopatologia , Artéria Braquial/cirurgia , Criança , Pré-Escolar , Feminino , Traumatismos da Mão/fisiopatologia , Traumatismos da Mão/cirurgia , Humanos , Isquemia/fisiopatologia , Isquemia/cirurgia , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Veia Safena/transplante , Fatores de Tempo , Resultado do Tratamento , Enxerto Vascular/efeitos adversos , Enxerto Vascular/métodos , Grau de Desobstrução Vascular , Lesões do Sistema Vascular/fisiopatologia , Lesões do Sistema Vascular/cirurgiaRESUMO
OBJECTIVES: According to clinical and comissioning guidelines for chronic rhinosinusitis (CRS), patients being referred to secondary care should have failed primary medical treatment with nasal douching (ND) and intranasal corticosteroids (INCS). The study objectives were to identify the rate of specific medical therapy in CRS patients and establish any differences in medication use, for both CRS and associated medical conditions, between CRS phenotypes. DESIGN AND SETTING: Case-control study in a secondary care setting. METHODS: Participant-reported study-specific questionnaire capturing free text data on current medication use at the time of study entry. Qualitative interviews with 21 participants also explored their experience of CRS and its management. PARTICPANTS: Patients both without (CRSsNPs) and with polyps (CRSwNPs). MAIN OUTCOME MEASURES: Reported use of CRS-related and non-related medications. RESULTS: Within a total of 1243 CRS participants, current INCS usage was low (18% in CRSwNPs, 12% in CRSsNPs); ND was being performed by only 1% of all participants. Bronchodilators and inhaled corticosteroids use was significantly higher in CRSwNPs participants (P < .0001). Antidepressant use was significantly higher in CRSsNPs (14% vs 7%, P < .0002). There were no significant regional variations in rates of INCS use, nor any significant influence of social deprivation. CONCLUSIONS: The current use of baseline medical therapy in CRS appears to be very low, representing a combination of poor patient compliance, possible ineffectiveness of treatment and a lack of familiarity with current guidelines amongst general practitioners and some ENT specialists. Work is needed to disseminate guidelines to all practitioners involved and reduce unnecessary burden on existing healthcare resources for this common condition by ensuring timely referral and definitive management.
Assuntos
Rinite/terapia , Atenção Secundária à Saúde , Sinusite/terapia , Administração Intranasal , Adolescente , Corticosteroides/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Estudos de Casos e Controles , Doença Crônica , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Rinite/epidemiologia , Sinusite/epidemiologia , Irrigação Terapêutica , Reino Unido/epidemiologia , Adulto JovemRESUMO
BACKGROUND AND AIMS: High-density lipoprotein (HDL) cholesterol efflux capacity in adults may be a measure of the atheroprotective property of HDL. Little however, is known about HDL cholesterol efflux capacity in childhood. We aimed to investigate the relationship between HDL cholesterol efflux capacity and childhood anthropometrics in a longitudinal study. METHODS AND RESULTS: Seventy-five children (mean age = 9.4 ± 0.4 years) were followed from birth until the age of 9 years. HDL cholesterol efflux capacity was determined at age 9 by incubating serum-derived HDL-supernatants with 3H-cholesterol labeled J774 macrophages and percentage efflux determined. Mothers provided dietary information by completing food frequency questionnaires in early pregnancy and then 5 years later on behalf of themselves and their children. Pearson's correlations and multiple regression analyses were conducted to confirm independent associations with HDL efflux. There was a negative correlation between HDL cholesterol efflux capacity and waist circumference at age 5 (r = -0.3, p = 0.01) and age 9 (r = -0.24, p = 0.04) and BMI at age 5 (r = -0.45, p = 0.01) and age 9 (r = -0.19, p = 0.1). Multiple regression analysis showed that BMI at age 5 remained significantly associated with reduced HDL cholesterol efflux capacity (r = -0.45, p < 0.001). HDL-C was negatively correlated with energy-adjusted fat intake (r = -0.24, p = 0.04) and positively correlated with energy-adjusted protein (r = 0.24, p = 0.04) and starch (r = 0.29, p = 0.01) intakes during pregnancy. HDL-C was not significantly correlated with children dietary intake at age 5. There were no significant correlations between maternal or children dietary intake and HDL cholesterol efflux capacity. CONCLUSIONS: This novel analysis shows that efflux capacity is negatively associated with adiposity in early childhood independent of HDL-C.
Assuntos
Adiposidade , Fenômenos Fisiológicos da Nutrição Infantil , HDL-Colesterol/sangue , Dieta , Macrófagos/metabolismo , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Efeitos Tardios da Exposição Pré-Natal , Fatores Etários , Biomarcadores/sangue , Índice de Massa Corporal , Linhagem Celular , Criança , Pré-Escolar , Dieta/efeitos adversos , Registros de Dieta , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Exposição Materna/efeitos adversos , Avaliação Nutricional , Gravidez , Análise de Regressão , Inquéritos e Questionários , Fatores de TempoRESUMO
Arthroscopy of the foot and ankle is a common orthopedic procedure with low complication rates. Arterial injuries from these procedures are an even more rare subset of the complications. Hemophilia A is a genetic disorder of aberrant coagulation, which leads to increased risk of bleeding even after minor trauma. We present the second case of anterior tibial artery pseudoaneurysm formation secondary to ankle arthroscopy in a hemophiliac patient and suggest that these individuals are at higher risk for developing complications associated with arterial injury. Furthermore, potential risk factors include port placement, anatomic variation of the vessels, and nature of the arthroscopic procedure. We recommend steps to prevent complications in hemophiliac patients.
Assuntos
Falso Aneurisma/etiologia , Articulação do Tornozelo/cirurgia , Artroscopia/efeitos adversos , Hemofilia A/complicações , Artérias da Tíbia/lesões , Lesões do Sistema Vascular/etiologia , Adulto , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/fisiopatologia , Falso Aneurisma/cirurgia , Hemofilia A/diagnóstico , Humanos , Ligadura , Masculino , Fatores de Risco , Trombectomia , Artérias da Tíbia/diagnóstico por imagem , Artérias da Tíbia/fisiopatologia , Artérias da Tíbia/cirurgia , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/fisiopatologia , Lesões do Sistema Vascular/cirurgiaRESUMO
Lemierre's syndrome is a rare life-threatening condition characterized by internal jugular vein thrombosis and is typically associated with a gram-negative infection with septic metastasis secondary to a retropharyngeal abscess that involves the vasculature of the head and neck. We report a case of Lemierre's syndrome in an 18-year-old female adolescent who developed an internal carotid artery occlusion and ipsilateral external carotid artery (ECA) mycotic aneurysm complicated by fulminant pseudomonal sepsis. The patient was managed with open ligation of the ECA with essentially complete recovery.
Assuntos
Aneurisma Infectado/microbiologia , Doenças das Artérias Carótidas/microbiologia , Artéria Carótida Externa/microbiologia , Artéria Carótida Interna/microbiologia , Estenose das Carótidas/microbiologia , Fusobacterium necrophorum/isolamento & purificação , Síndrome de Lemierre/microbiologia , Adolescente , Aneurisma Infectado/diagnóstico por imagem , Aneurisma Infectado/terapia , Antibacterianos/uso terapêutico , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/terapia , Artéria Carótida Externa/diagnóstico por imagem , Artéria Carótida Externa/cirurgia , Artéria Carótida Interna/diagnóstico por imagem , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/terapia , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Síndrome de Lemierre/complicações , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/terapia , Ligadura , Choque Séptico/microbiologia , Resultado do Tratamento , Procedimentos Cirúrgicos VascularesRESUMO
The sorption of radium 226 ((226)Ra) on different clay materials (bentonite, illite and a mixture of bentonite-illite) was studied. Clay materials are used in the construction of disposal pits for technically enhanced naturally occurring radioactive materials (TENORM) wastes (i.e., contaminated soil and sludge) generated by the oil and gas industry operations. Experimental conditions (pH, clay materials quantity, and activity concentrations of (226)Ra) were changed in order to determine the optimal state for adsorption of (226)Ra. The results showed that the concentration of adsorbed (226)Ra on clay materials increased with time to reach an equilibrium state after approximately 5 h. More than 95 % of the radium was adsorbed. The mixture of bentonite-illite (1/9) exhibited the greatest adsorption of radium under all experimental conditions.
Assuntos
Silicatos de Alumínio/química , Modelos Químicos , Rádio (Elemento)/química , Poluentes Radioativos da Água/química , Absorção Fisico-Química , Adsorção , Bentonita/química , Argila , Minerais/química , Esgotos , Poluentes Radioativos da Água/análiseRESUMO
OBJECTIVE: To date, there are few data on pharmacy-specific placement programs and their impact on students' work after graduation. The present study evaluated an innovative rural pharmacy placement program targeted at influencing students to work and live in rural areas after graduation. A secondary aim of the study was to explore the students' intentions to come back and practice in rural areas as a result of their involvement in the rural pharmacy program. METHODS: A questionnaire was distributed, by hand, to a total of 58 third and fourth (final) year pharmacy students undertaking their rural placement in the Gippsland region, in rural Victoria in 2011 and 2012. RESULTS: Fifty-seven responses were returned (response rate = 98%). Students stated that understanding pharmacy practice from a rural perspective, visits to rural health professionals and sites and the attitude of their preceptors were essential to their satisfaction with their rural placements. A significant number of students (72%) intend to seek employment in rural areas if opportunities arise as a result of their increased rural awareness. The key components for a successful rural placement program were described by the surveyed students as social awareness, recognising job opportunities and interprofessional learning. CONCLUSION: The evaluation of the rural placement program revealed that students valued their visits to rural sites and their interaction with other rural health professionals the most.
Assuntos
Comunicação Interdisciplinar , Área de Atuação Profissional , Serviços de Saúde Rural , Estudantes de Farmácia , Feminino , Humanos , Intenção , Masculino , Inquéritos e Questionários , Vitória , Adulto JovemRESUMO
BACKGROUND: Hepatitis B virus (HBV) is considered the most important cross-infection hazard in developing countries. Patients infected with hepatitis virus could encounter difficulties in obtaining dental care. The aim of this study was to investigate the willingness of Saudi dental professionals to treat hepatitis B virus infected patients. MATERIALS AND METHODS: This cross-sectional survey was carried out by distributing 300 questionnaires to Saudi dentists working in 40 government and private dental centers in Riyadh, Saudi Arabia. The questionnaire included questions related to age, sex, vaccination against HBV, screening for HBV antibody levels, willingness to treat hepatitis B infected patients, and the reasons behind any refusal. A t-test was used to compare the results and a P < 0.05 was considered significant. RESULTS: Of the 300 distributed questionnaires, 274 were collected giving a response rate of 91%. The respondents were 212 males (77.4%) and 62 (22.6%) females. Only 10.2% of the Saudi dentists were willing to treat HB infected patients. The other dentists (89.8%) were unwilling to provide dental care for HB infected patients. Although 94.5% of the surveyed dentists were vaccinated against HBV, the main reason behind the refusal to treat HB infected patients (92.3%) was the risk of cross infection. CONCLUSION: High percentages of Saudi dentists are unwilling to treat HBV-infected patients due to their apprehension about risk of cross infection. Many of the Saudi dentists do not screen for HBV antibody levels. All vaccinated dentists should carefully monitor their antibody levels to evaluate the need for booster doses. There is a need for educational programs to change the attitude of dentists toward treating HBV-infected patients. The strict adoption of cross infection preventive protocols by dentists will reduce the risk of transmitting infectious diseases in dental clinics as identification of blood-borne infections is not always possible.
Assuntos
Atitude do Pessoal de Saúde , Odontólogos , Hepatite B/transmissão , Transmissão de Doença Infecciosa do Paciente para o Profissional , Recusa em Tratar , Adulto , Estudos Transversais , Feminino , Hepatite B/imunologia , Anticorpos Anti-Hepatite B , Vírus da Hepatite B , Humanos , Masculino , Pessoa de Meia-Idade , Arábia Saudita , Inquéritos e Questionários , VacinaçãoRESUMO
Multifunctional and sustainable packaging biofilms felicitous to changeable conditions are in large demand as substitutes to petroleum-derived synthetic films. Macroalgae with noticeable film-formation, abundant, low-cost, and edible properties is a promising bioresource for sustainable and eco-friendly packaging materials. However, the poor hydrophobicity and mechanical properties of sustainable macroalgae biofilms seriously impede their practical applications. Herein, lignin nanoparticles (LNPs) produced by a sustainable approach from black liquor of coconut fiber waste were incorporated in the macroalgae matrix to improve the water tolerance and mechanical characteristics of the biofilms. The effect of different LNPs loadings on the performance of biofilms, such as physical, morphological, surface roughness, structural, water resistance, mechanical, and thermal behaviors, were systematically evaluated and found to be considerably improved. Biofilm with 6 % LNPs presented the optimum enhancement in most ultimate performances. The optimized biofilm exhibited great hydrophobic features with a water contact angle of over 100° and high enhancement in the tensile strength of >60 %. This study proposes a facile and sustainable approach for designing and developing LNPs-macroalgae biofilms with excellent and multifunctional properties for sustainable high-performance packaging materials.
Assuntos
Nanopartículas , Alga Marinha , Lignina , Cocos , Biofilmes , ÁguaRESUMO
Background: Mechanical thrombectomy is a time-sensitive treatment, with rapid initiation and reduced delays being associated with better patient outcomes. Several systematic reviews reported on various interventions to address delays. Hence, we performed an umbrella review of systematic reviews to summarise the current evidence. Methods: Medline, Embase, Cochrane Library and JBI were searched for published systematic reviews. Systematic Reviews that detailed outcomes related to time-to-thrombectomy or functional independence were included. Methodological quality was assessed using the JBI critical appraisal tool by two independent reviewers. Results: A total of 17 systematic reviews were included in the review. These were all assessed as high-quality reviews. A total of 13 reviews reported on functional outcomes, and 12 reviews reported on time-to-thrombectomy outcomes. Various interventions were identified as beneficial. The most frequently reported beneficial interventions that improved functional and time-related outcomes included: direct-to-angio-suite and using a mothership model (compared to drip-and-ship). Only a few studies investigated other strategies including other pre-hospital and teamwork strategies. Conclusion: Overall, there were various strategies that can be used to reduce delays in the delivery of mechanical thrombectomy with different effectiveness. The mothership model appears to be superior to the drip-and-ship model in reducing delays and improving functional outcomes. Additionally, the direct-to-angiosuite approach appears to be beneficial, but further research is required for broader implementation of this approach and to determine which groups of patients would benefit the most.
RESUMO
Due to growing environmental concerns for better waste management, this study proposes developing a composite aerogel using cellulose nanofibers (CNF) and spent coffee grounds (SCG) through an eco-friendly method for efficient methylene blue (MB) adsorption. Adding SCG to the CNF aerogel altered the physical properties: it increases the volume (4.14 cm3 to 5.25 cm3) and density (0.018 to 0.022 g/cm3) but decrease the water adsorption capacity (2064 % to 1635 %). FTIR spectrum showed distinct functional groups in both all aerogels, showing hydroxyl, glyosidic bonds, and aromatic compounds. Additionally, SCG improved thermal stability of the aerogels. In term of adsorption efficacy, CNF-SCG40% aerogel as exceptionally well. According to Langmuir isotherm models, the adsorption of MB happened in a monolayer, with CNF-SCG40% showing a maximum adsorption capacity of 113.64 mg/g, surpassing CNF aerogel (58.82 mg/g). The study identified that the pseudo-second-order model effectively depicted the adsorption process, indicating a chemical-like interaction. This investigation successfully produced a single-use composite aerogel composed of CNF and SCG using an eco-friendly approach, efficiently adsorbing MB. By utilizing cost-effective materials and eco-friendly methods, this approach offers a sustainable solution for waste management, contributes to an eco-friendly industrial environment, and reduces production expenses and management costs.
Assuntos
Celulose , Café , Adsorção , Meio Ambiente , Radical Hidroxila , Azul de MetilenoRESUMO
This study investigates the potential of utilizing green chemically treated spent coffee grounds (SCGs) as micro biofiller reinforcement in Poly-3-hydroxybutyrate-co-3-hydroxyvalerate (PHBV) biopolymer composites. The aim is to assess the impact of varying SCG concentrations (1 %, 3 %, 5 %, and 7 %) on the functional, thermal, mechanical properties and biodegradability of the resulting composites with a PHBV matrix. The samples were produced through melt compounding using a twin-screw extruder and compression molding. The findings indicate successful dispersion and distribution of SCGs microfiller into PHBV. Chemical treatment of SCG microfiller enhanced the interfacial bonding between the SCG and PHBV, evidenced by higher water contact angles of the biopolymer composites. Field Emission Scanning Electron Microscopy (FE-SEM) confirmed the successful interaction of treated SCG microfiller, contributing to enhanced mechanical characteristics. A two-way ANOVA was conducted for statistical analysis. Mass losses observed after burying the materials in natural soil indicated that the composites degraded faster than the pure PHBV polymer suggesting that both composites are biodegradable, particularly at high levels of spent coffee grounds (SCG). Despite the possibility of agglomeration at higher concentrations, SCG incorporation resulted in improved functional properties, positioning the green biopolymer composite as a promising material for sustainable packaging and diverse applications.