Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 101
Filtrar
Mais filtros

Base de dados
País/Região como assunto
Tipo de documento
Intervalo de ano de publicação
1.
BMC Nurs ; 23(1): 21, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38183011

RESUMO

BACKGROUND: Postoperative pain control is pivotal for surgical care; it facilitates patient recovery. Although patient-controlled analgesia (PCA) has been available for decades, inadequate pain control remains. Nurses' knowledge of and attitude toward PCA may influence the efficacy on clinic application. PURPOSE: The purpose of this study is to evaluate nurses' knowledge of and attitude toward postoperative PCA and investigate the associated factors. METHODS: This is a cross-sectional study. We enrolled registered nurses from a 2200-bed medical center in northern Taiwan within one year. The participants completed an anonymous self-reported PCA knowledge inventory and PCA attitude inventory. Data were analyzed descriptively and associated were tested using logistic regression. RESULTS: With 303 participants enrolled, we discovered that nurses had limited knowledge of and a negative attitude toward PCA. Under half of the participants know how to set up a bolus dose and lockout intervals. The majority held misconceptions regarding side effect management for opioids. The minority agree to increase the dose when a patient experienced persistent pain or suggested the use of PCA. Surprisingly, participants with a bachelor's or master's degree had lower knowledge scores than those with a junior college degree. Those with 6-10 years of work experience also are lower than those with under 5 years of experience. However, the participants with experience of using PCA for patient care had higher knowledge scores and a more positive attitude. CONCLUSIONS: Although postoperative PCA has been available for decades and education programs are routinely provided, nurses had limited knowledge of and a negative attitude toward PCA. A higher education level and longer work experience were not associated with more knowledge. The current education programs on PCA should be revised to enhance their efficacy in delivering up-to-date knowledge and situation training which may convey supportive attitude toward clinical application of PCA.

2.
BMC Palliat Care ; 22(1): 29, 2023 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-36978057

RESUMO

OBJECTIVES: Compared to aggressive treatment for patients at the end stage of life, hospice care might be more likely to satisfy such patients' need and benefits and improve their dignity and quality of life. Whether the reimbursement policy expansion affect the use of hospice care among various demographics characteristics and health status was unknown. Therefore, the purpose of this study was to explore the impacts of reimbursement policy expansion on hospice care use, and to investigate the effects on people with various demographics characteristics and health status. METHODS: We used the 2001-2017 Taiwan NHI claims data, Death Registry, and Cancer Registry in this study, and we included people who died between 2002 and 2017. The study period was divided into 4 sub-periods. hospice care use and the initiation time of 1st hospice care use were used as dependent variables; demographic characteristics and health status were also collected. RESULTS: There were 2,445,781 people who died in Taiwan during the study period. The results show that the trend of hospice care use increased over time, going steeply upward after the scope of benefits expansion, but the initiation time of 1st hospice care use did not increase after the scope of benefits expansion. The results also show that the effects of expansion varied among patients by demographic characteristics. CONCLUSION: The scope of benefits expansion might induce people's needs in hospice care, but the effects varied by demographic characteristics. Understanding the reasons for the variations in all populations would be the next step for Taiwan's health authorities.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Hospitais para Doentes Terminais , Assistência Terminal , Humanos , Adulto , Qualidade de Vida , Estudos Longitudinais , Taiwan
3.
J Nurs Scholarsh ; 55(6): 1116-1125, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37917036

RESUMO

PURPOSE: This study aimed (1) to describe how trends in pediatric palliative care (PPC) utilization changed from 2002 to 2017, and (2) to examine factors predicting PPC utilization among decedent children in Taiwan. DESIGN: This retrospective, correlational study retrieved 2002-2017 data from three national claims databases in Taiwan. METHODS: Children aged 1 through 18 years who died between January 2002 and December 2017 were included. Pediatric palliative care utilization was defined as PPC enrollment and PPC duration, with enrollment described by frequency (n) and percentage (%) and duration described by mean and standard deviation (SD). Logistic regression was used to examine the associations of various demographic characteristics with PPC enrollment; generalized linear regression was used to examine associations of the demographic characteristics with PPC duration. FINDINGS: Across the 16-year study period, PPC enrollment increased sharply (15.49 times), while PPC duration decreased smoothly (by 29.41%). Cause of death was a continuous predictor of both PPC enrollment and PPC duration. The children less likely to be enrolled in PPC services were those aged 1 to 6 years, boys, living in poverty, living in rural areas, and diagnosed with life-threatening noncancer diseases. CONCLUSION: This study used nationwide databases to investigate PPC enrollment and PPC duration among a large sample of deceased children from 2002 to 2017. The findings not only delineate trends and predictors of PPC enrollment and PPC duration but also highlight great progress in PPC as well as the areas still understudied and underserved. This information could help the pediatric healthcare system achieve the core value of family-centered care for children with life-threatening diseases and their families. CLINICAL RELEVANCE: Pediatric palliative care should be widely and continuously implemented in routine pediatric clinical practice to enhance quality of life for children and their families at the end of life.


Assuntos
Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Cuidados Paliativos , Masculino , Humanos , Criança , Qualidade de Vida , Estudos Retrospectivos , Bases de Dados Factuais
4.
J Pediatr Nurs ; 71: e11-e17, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37120387

RESUMO

BACKGROUND: Medical clowning for children has been found to be effective at enhancing parents' psychological well-being during preoperative preparation, but has not been found during cancer treatment. This study aimed to examine whether and how medical clowning influenced the emotions of parents of children undergoing cancer treatment. METHODS: In this quasi-experimental study, 96 parents of children receiving inpatient cancer treatment were recruited, from June 2018 through April 2020. A demographic questionnaire measuring characteristics of parent and dyadic child, Brief Symptom Rating Scale measuring psychological distress of the parent, and Mood Assessment Scale measuring emotional status of parent and child were administered 1 day before a clowning service. The day after the clowning service, the Mood Assessment Scale again collected emotional status for parent and child. Descriptive analysis, bivariate analysis, and structural equation modeling to fit the actor-partner, cross-lagged model were used. FINDINGS: Parents experienced a low degree of psychological distress that called for emotional management. The indirect effect of medical clowning on parents' emotions through children's emotions was significant, as were the direct effect and total effect of medical clowning on parents' emotions. DISCUSSION: Parents experienced psychological distress during their child's inpatient cancer treatment. Medical clowning can directly improve children's emotions and through this pathway indirectly improve their parents' emotions. APPLICATION TO PRACTICE: There is need to monitor psychological distress and provide interventions for parents of children undergoing cancer treatment. Medical clowns should continue to serve parent-child dyads in pediatric oncology practice and become members of multidisciplinary health care teams.


Assuntos
Neoplasias , Pais , Humanos , Pais/psicologia , Emoções , Neoplasias/terapia , Neoplasias/psicologia , Inquéritos e Questionários , Hospitalização , Relações Pais-Filho
5.
J Nurs Scholarsh ; 54(2): 161-168, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34750968

RESUMO

PURPOSE: To examine the effectiveness of one-time medical clowning on improving short-term positive emotions among hospitalized children undergoing cancer treatment, and to analyze whether age moderates this effect. DESIGN: In this quasi-experimental research study, we recruited a pooled sample of 96 children who were undergoing cancer treatment in pediatric oncology/hematology wards at three university-affiliated medical centers in Taiwan from June 2018 through April 2020. METHODS: Children's demographic characteristics, symptom distress, quality of life, and pretest emotional status were collected at T1. At T2, we collected only posttest emotional status. We adapted generalized estimating equation models to evaluate the effectiveness of medical clowning on enhancing positive emotions. FINDINGS: Changes in the probabilities of positive emotion were significantly different across groups (51.84% for the experimental group, 15.76% for the control group; Δ = 36.08, p = 0.001), and the change was more than two times larger for the experimental group (effect ratio = 3.28, p < 0.05) than for the control group. When evaluating the moderating effect of age on the intervention, none of the coefficients reached the significant (p < 0.05) levels, suggesting that age may not moderate the intervention effect. CONCLUSION: This study demonstrates the core value of medical clowning in child-friendly health care. Our findings clearly support the benefit of the one-time medical clowning program on enhancing short-term emotional well-being across age groups of children. Medical clowning programs should be strongly encouraged and supported in pediatric oncology wards. CLINICAL RELEVANCE: Medical clowning programs should be widely and continuously implemented in pediatric oncology wards as a routine clinical practice for enhancing emotional well-being among children receiving cancer treatment. Nurses need to be aware of medical clowning's equal effectiveness across age groups, not only or better for younger children.


Assuntos
Criança Hospitalizada , Neoplasias , Criança , Criança Hospitalizada/psicologia , Emoções , Humanos , Neoplasias/terapia , Qualidade de Vida , Taiwan
6.
J Formos Med Assoc ; 121(9): 1773-1785, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35094911

RESUMO

BACKGROUND/PURPOSE: The increasing prevalence of overweight and obese children and adolescents has been recognized as a public health threat worldwide. This study aimed to assess the effect of a stepwise lifestyle intervention in children and adolescents. METHODS: We developed a multidisciplinary clinic aimed at providing lifestyle interventions for obese children and adolescents. The program comprised three stages with stepwise goals: knowledge building (the first 4 weeks), habit consolidation (5-12 weeks), and self-monitoring (13-20 weeks). RESULTS: Of the 63 participants (age 11.6 ± 3.2 years) who entered the first stage of the program, 48, 22, and 15 completed the first, second and third stages (4, 12, and 20 weeks), respectively. In the first stage, significant improvement was noted in body weight, body mass index (BMI), BMI z-score, and waist circumference. Improvements in physical fitness performance were observed at 4 weeks in 3/5 items and at 12 weeks in 4/5 items. The decreases in body weight, BMI and BMI z-score were most prominent in the first two stages. In the third stage, participants maintained a stable body weight. In the 15 subjects who completed the whole program, BMI decreased from 29.3 ± 6.9 to 27.8 ± 6.1 (P = 0.001), and BMI z-score decreased from 3.06 ± 0.96 to 2.69 ± 0.91(P = 0.001). CONCLUSION: We developed a feasible multidisciplinary program based on knowledge education and individualized training. BMI and physical fitness scores can be used as early indicators of lifestyle change for obese children and adolescents.


Assuntos
Sobrepeso , Obesidade Infantil , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Humanos , Estilo de Vida
7.
J Pediatr Nurs ; 64: e102-e108, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34996681

RESUMO

PURPOSE: To examine the association between sleep pattern regularity and measures of weight and length in infants. DESIGN AND METHODS: This was a prospective observational study conducted in a university-affiliated children's hospital in northern Taiwan. A total of 316 healthy infants recruited during their 6-month well-child checkups had their weight and recumbent length measured, and wore an actigraph on the ankle for a week. Based on average weekday, weekend, and all-week sleep durations, infants were categorized into 3 groups: regular sleep, weekend catch-up sleep, and weekend sleep curtailment. General linear model analyses were performed with the 3 sleep regularity groups as the primary predictor variable of interest and infant anthropometry as the dependent variable. RESULTS: At risk of overweight, overweight, and obese was present in a total of 62 (19.6%) infants. In both unadjusted and adjusted models, infants in the weekend catch-up sleep group (30.4%) and those in the weekend sleep curtailment group (34.5%) had significantly higher weight-to-length ratios, body mass index, weight-for-age z-scores, and weight velocity of 6-month increments z-scores when compared with infants in the regular sleep group (35.1%, all p < 0.05). CONCLUSIONS: Differences in weekday-weekend sleep exist as early as in the first 6 months of life, and both catch-up sleep and sleep curtailment over the weekend is associated with higher measures of weight and length in infants. PRACTICE IMPLICATIONS: Sleep assessments in well-child checkups should include not only global assessments of average sleep duration but also address sleep patterns and their regularity.


Assuntos
Sobrepeso , Sono , Antropometria , Índice de Massa Corporal , Humanos , Lactente , Obesidade
8.
Int J Mol Sci ; 23(23)2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36498853

RESUMO

Sphingosine kinase 1 (SPHK1) and the sphingosine-1-phosphate (S1P) signaling pathway have been shown to play a role in pulmonary arterial hypertension (PAH). S1P is an important stimulus for pulmonary artery smooth muscle cell (PASMC) proliferation and pulmonary vascular remodeling. We aimed to examine the specific roles of SPHK1 in PASMCs during pulmonary hypertension (PH) progression. We generated smooth muscle cell-specific, Sphk1-deficient (Sphk1f/f TaglnCre+) mice and isolated Sphk1-deficient PASMCs from SPHK1 knockout mice. We demonstrated that Sphk1f/f TaglnCre+ mice are protected from hypoxia or hypoxia/Sugen-mediated PH, and pulmonary vascular remodeling and that Sphk1-deficient PASMCs are less proliferative compared with ones isolated from wild-type (WT) siblings. S1P or hypoxia activated yes-associated protein 1 (YAP1) signaling by enhancing its translocation to the nucleus, which was dependent on SPHK1 enzymatic activity. Further, verteporfin, a pharmacologic YAP1 inhibitor, attenuated the S1P-mediated proliferation of hPASMCs, hypoxia-mediated PH, and pulmonary vascular remodeling in mice and hypoxia/Sugen-mediated severe PH in rats. Smooth muscle cell-specific SPHK1 plays an essential role in PH via YAP1 signaling, and YAP1 inhibition may have therapeutic potential in treating PH.


Assuntos
Hipertensão Pulmonar , Fosfotransferases (Aceptor do Grupo Álcool) , Proteínas de Sinalização YAP , Animais , Camundongos , Ratos , Proliferação de Células , Células Cultivadas , Hipertensão Pulmonar/metabolismo , Hipóxia/complicações , Hipóxia/metabolismo , Miócitos de Músculo Liso/metabolismo , Artéria Pulmonar/metabolismo , Transdução de Sinais , Esfingosina/metabolismo , Remodelação Vascular , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Proteínas de Sinalização YAP/metabolismo
9.
BMC Neurol ; 21(1): 484, 2021 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-34893030

RESUMO

BACKGROUND: Brain Magnetic Resonance Imaging (MRI) examination of cerebral small vessel disease (CSVD) may help screen vascular cognitive impairment. A recently estimated CSVD score system was suggested to capture the overall CSVD burden. The study aimed to detect the association between systemic evaluation score of cerebral vascular imaging parameters with cognitive functions. METHODS: This was a cross-sectional study in community settings. From October 2017 to September 2018, elder (≧60) residents were recruited through on-site visit in 6 communities from Shanghai, China. The participants underwent brain MRI, carotid ultrasound, laboratory tests of blood and urine samples. Cognitive function was evaluated using Mini-Mental State Examination (MMSE). MRI score of CSVD was calculated according to the 2012 standard for the evaluation of statistical changes in imaging. RESULTS: Total 171 subjects completed survey and examinations. There were 55 participants diagnosed with cognitive impairment, with a total percentage of 32.2%. Participants with and without cognitive impairment showed significant differences in age, BMI and education level. Cognitive impaired participant had more disease history/comorbidity of hypertension and chronic renal insufficiency, higher level of creatinine, as well as lower level of full blood count (FBC) and alanine aminotransferase (ALT). A significant difference was detected in CSVD score between participants with and without cognitive impairment. Results of linear regression analysis showed significant negative correlations between MMSE score and both left and right carotid artery peak systolic velocity (PSV), however the CSVD score was only borderline (P = 0.0566) positively correlated with MMSE. Multivariate linear correlation analysis including all collected risk factor data showed that left carotid artery PSV score was among the independent negative correlated factors of MMSE. Multivariate binary logistic analysis showed that age, education and history of hypertension were the only statistically associated factors of cognitive impairment. CONCLUSIONS: The current study identified high prevalence of cognitive impairment in a Chinese community. In addition, correlations between cerebral vascular disease imaging status and cognitive functions were confirmed although the sample size limited the possibility of screening cognitive impairment with imaging technique.


Assuntos
Doenças de Pequenos Vasos Cerebrais , Disfunção Cognitiva , Idoso , Doenças de Pequenos Vasos Cerebrais/complicações , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Doenças de Pequenos Vasos Cerebrais/epidemiologia , China/epidemiologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/epidemiologia , Estudos Transversais , Humanos , Testes de Estado Mental e Demência
10.
BMC Neurol ; 21(1): 95, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33648444

RESUMO

BACKGROUND: Screening for cognitive impairment (CI) is often hampered by lack of consensus as to which screening instrument to use. The aim is to assess the consistence and applicability of different CI screening tools. METHOD: In a cross-sectional study from October 2017 to September 2018 in 7 communities in Shanghai, China, elder (≧60) residential volunteers with no history of major cardiovascular diseases, cancers and other comorbidities known to affect cognitive functions were recruited. The participants underwent tests with 7 cognitive function screening instruments. Multivariate linear regressions were performed to test correlations between demographic characteristics, including gender, age, education, and marital status, with cognitive test scores. Mini-Mental State Examination (MMSE) score adjusted according to the correlation coefficients was used to detect CI with a cutoff of 24. Other cognitive function scores were compared between participants with and without CI. In addition, Pearson's correlation test was used to detect association between different test scores. RESULTS: 172 participants with relatively low education levels were included. Age and education showed significant association with cognitive test scores. Using adjusted MMSE, 39.6% of participants were identified with CI, while the percentage was 87.2% when adjusted Montreal Cognitive Assessment (MoCA) with cutoff of 26 was used. Analysis of "abnormal" test scores showed that MMSE had the highest percentage of valid data (98.8%). MoCA and Isaacs test of Verbal Fluency (VF) score had correlation with most the other scores, while MMSE only significantly associated with VF and MoCA. CONCLUSIONS: MMSE may still present the most applicable tools for quick screen of cognitive functions, especially when environmental conditions may interfere with participants' attention.


Assuntos
Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Idoso , Idoso de 80 Anos ou mais , China , Estudos Transversais , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade
11.
IEEE Trans Instrum Meas ; 70: 4503012, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35582003

RESUMO

Methods to recover high-quality computed tomography (CT) images in low-dose cases will be of great benefit. To reach this goal, sparse-data subsampling is one of the common strategies to reduce radiation dose, which is attracting interest among the researchers in the CT community. Since analytic image reconstruction algorithms may lead to severe image artifacts, the iterative algorithms have been developed for reconstructing images from sparsely sampled projection data. In this study, we first develop a tensor gradient L0-norm minimization (TGLM) for low-dose CT imaging. Then, the TGLM model is optimized by using the split-Bregman method. The Coronavirus Disease 2019 (COVID-19) has been sweeping the globe, and CT imaging has been deployed for detection and assessing the severity of the disease. Finally, we first apply our proposed TGLM method for COVID-19 to achieve low-dose scan by incorporating the 3-D spatial information. Two COVID-19 patients (64 years old female and 56 years old man) were scanned by the [Formula: see text]CT 528 system, and the acquired projections were retrieved to validate and evaluate the performance of the TGLM.

12.
Opt Express ; 28(17): 25180-25193, 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32907045

RESUMO

Ring artifacts usually appear in photon counting computed tomography (PCCT) images, which may compromise image quality and cause non-uniformity bias. This study proposed a fast ring artifacts removal method by exploring the correlation from projections with different views for PCCT. This method has three advantages. First, our method only employ mean projection of current scan to correct projections without additional scans. Second, our method can correct the inconsistency of all detector pixels simultaneously without locating the inconsistent response pixels. Third, it can preserve reconstructed image details well without extra computational cost. Both numerical and preclinical experiments demonstrate the proposed method can suppress the ring artifacts very well than the competitors.

13.
Opt Express ; 27(4): 5264-5279, 2019 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-30876127

RESUMO

Dynamic computed tomography (CT) is usually employed to image motion objects, such as beating heart, coronary artery and cerebral perfusion, etc. Recently, to further improve the temporal resolution for aperiodic industrial process imaging, the swinging multi-source CT (SMCT) systems and the corresponding swinging multi-source prior image constrained compressed sensing (SM-PICCS) method were developed. Since the SM-PICCS uses the L1-norm of image gradient, the edge structures in the reconstructed images are blurred and motion artifacts are still present. Inspired by the advantages in terms of image edge preservation and fine structure recovering, the L0-norm of image gradient is incorporated into the prior image constrained compressed sensing, leading to an L0-PICCS Algorithm 1Table 1The parameters of L0-PICCS (δ1,δ2,λ1*,λ2*) for numerical simulation.Sourceswδ1(10-2)δ2(10-2)λ1*(10-2)λ2*(10-8)Noise-free510522.001.525522.001.55035002.00471014.33332.00500025522.00500050222.005000Noise51062002.505002554502.501.55054502.901.571027.385.91.5810000258.285.91.5850050522.001.5. The experimental results confirm that the L0-PICCS outperforms the SM-PICCS in both visual inspection and quantitative analysis.

14.
Eur J Cancer Care (Engl) ; 28(4): e13045, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30993778

RESUMO

The objective of this study was to examine whether physical activity self-efficacy mediated the adverse effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. A secondary data analysis approach was used to analyse a pooled sample of 97 adolescents who were undergoing cancer treatment in paediatric oncology/haematology wards and ambulatory settings in northern Taiwan. Mediation analysis was performed to examine the mediation relationship among physical activity self-efficacy, symptom distress and exercise involvement. The total effect (path c) (p < 0.001), the indirect effect (paths a and b) (p < 0.05 and p < 0.01) and the direct effect (path c') (p < 0.001) were significant. The bootstrapping test was significant (95% CI: -0.356 to -0.016), indicating that physical activity self-efficacy partially mediated the adverse effect of symptom distress on exercise involvement after adjusting for age, gender and cancer diagnosis. Physical activity self-efficacy partially mediates the relationship between symptom distress and exercise involvement for adolescents undergoing cancer treatment. There is an imperative need for healthcare professionals to design interventions to enhance these adolescents' physical activity self-efficacy, increase their exercise involvement and thus improve their quality of life.


Assuntos
Exercício Físico/psicologia , Neoplasias/terapia , Autoeficácia , Estresse Psicológico/psicologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Neoplasias/psicologia , Taiwan , Adulto Jovem
15.
Eur J Cancer Care (Engl) ; 28(1): e12891, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30015996

RESUMO

Family caregivers face multiple challenges when caring for patients with oral cancer at home. Understanding the difficulties they face may assist health professionals to better organise and provide support for family caregivers of oral cancer patients. The aim of this study was to describe the caregivers' primary tasks and the difficulties they encounter when caring for a family member with oral cancer. This qualitative study included a purposeful sample of 22 primary family caregivers ranging in age from 25 to 71 years old. The researchers used face-to-face, semi-structured and tape-recorded interviews to collect data and employed qualitative content analysis to elicit caregiving-related themes. Six task-related themes and associated challenges were identified. These included managing the patient's nutritional issues, investigating and making decisions about patient care, managing sudden and unpredictable changes in the patient's condition, managing emotional distress, adjusting their attitudes towards patient care, and seeking resources. Family caregivers handle such essential tasks when they care for patients in home settings and they face specific challenges related to them. This study identified several challenges related to each task. From the outset, healthcare providers should actively offer caregiving information and strategies. Health professionals can incorporate strategies for supporting caregivers' ability to carry out these tasks into their treatment model and can help caregivers manage difficulties that can impede them from doing so.


Assuntos
Atitude Frente a Saúde , Cuidadores/psicologia , Tomada de Decisões , Neoplasias Bucais/enfermagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/enfermagem , Estresse Psicológico/psicologia , Adulto , Idoso , Família/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Taiwan
16.
Hu Li Za Zhi ; 66(1): 27-37, 2019 Feb.
Artigo em Zh | MEDLINE | ID: mdl-30648243

RESUMO

BACKGROUND: Children suffering from adrenoleukodystrophy (ALD) requires life-long care. Little is known about the care needs of parents of ALD children at different stages of their disease. PURPOSE: The purpose of this study was to understand the long-term care experiences and care needs of parents caring for their ALD children. METHODS: A descriptive qualitative study with 7 in-depth interviews was conducted with parents. RESULTS: The results of these care experiences were distinguished into three phases: "pathogenesis to diagnosis", "rapid deterioration of physiological functions", and "bedridden until the death". The long-term care experiences revealed five themes, including "chaos and helplessness to seek medical attention then being forced to accept", "self-accusation and guilt", "strengthening parents' toughness", "seizing the moment and facing the future", and "accompanying children through life without pain". Within the three phases, the care needs comprised the three themes of "integrating resources and providing immediate care", "obtaining information and support regarding ALD rapidly", and "establishing individualized long-term care". CONCLUSIONS / IMPLICATIONS FOR PRACTICE: This study revealed the long-term care experiences and care needs of the parents of ALD children. Providing individualized care, nursing instruction, and telephone consultation as well as connecting case managers with the hospice-care team will help facilitate and meet the care needs of these parents.


Assuntos
Adrenoleucodistrofia/terapia , Necessidades e Demandas de Serviços de Saúde , Relações Pais-Filho , Pais/psicologia , Criança , Humanos , Assistência de Longa Duração/psicologia , Pesquisa Qualitativa
17.
BMC Genomics ; 19(1): 343, 2018 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-29743016

RESUMO

BACKGROUND: Euryale ferox Salisb., an annual aquatic plant, is the only species in the genus Euryale in the Nymphaeaceae. Seeds of E. ferox are a nutritious food and also used in traditional Chinese medicine (Qian Shi in Mandarin). The molecular events that occurred during seed development in E. ferox have not yet been characterized. In this study, we performed transcriptomic analysis of four developmental stages (T1, T2, T3, and T4) in E. ferox seeds with three biological replicates per developmental stage to understand the physiological and biochemical processes during E. ferox seeds development. RESULTS: 313,844,425 clean reads were assembled into 160,107 transcripts and 85,006 unigenes with N50 lengths of 2052 bp and 1399 bp, respectively. The unigenes were annotated using five public databases (NR, COG, Swiss-Prot, KEGG, and GO). In the KEGG database, all of the unigenes were assigned to 127 pathways, of which phenylpropanoid biosynthesis was associated with the synthesis of secondary metabolites during E. ferox seed growth and development. Phenylalanine ammonia-lyase (PAL) as the first key enzyme catalyzed the conversion of phenylalanine to trans-cinnamic acid, then was related to the synthesis of flavonoids, lignins and alkaloid. The expression of PAL1 reached its peak at T3 stage, followed by a slight decrease at T4 stage. Cytochrome P450 (P450), encoded by CYP84A1 (which also called ferulate-5-hydroxylase (F5H) in Arabidopsis), was mainly involved in the biosynthesis of lignins. CONCLUSIONS: Our study provides a transcriptomic analysis to better understand the morphological changes and the accumulation of medicinal components during E. ferox seed development. The increasing expression of PAL and P450 encoded genes in phenylpropanoid biosynthesis may promote the maturation of E. ferox seed including size, color, hardness and accumulation of medicinal components.


Assuntos
Perfilação da Expressão Gênica/métodos , Regulação da Expressão Gênica de Plantas , Nymphaeaceae/genética , Proteínas de Plantas/genética , Sementes/genética , Transcriptoma , Biologia Computacional , Sequenciamento de Nucleotídeos em Larga Escala , Anotação de Sequência Molecular , Nymphaeaceae/crescimento & desenvolvimento , Sementes/crescimento & desenvolvimento
19.
Methods ; 128: 105-118, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-28624539

RESUMO

Second harmonic (SH) microscopy has proven to be a powerful imaging modality over the past years due to its intrinsic advantages as a multiphoton process with endogenous contrast specificity, which allows pinhole-less optical sectioning, non-invasive observation, deep tissue penetration, and the possibility of easier signal detection at visible wavelengths. Depending on the relative orientation between the polarization of the incoming light and the second-order susceptibility of non-centrosymmetric structures, SH microscopy provides the unique capacity to probe the absolute molecular structure of a broad variety of biological tissues without the necessity for additional labeling. In addition, SH microscopy, when working with polarimetry, provides clear and in-depth insights on the details of molecular orientation and structural symmetry. In this review, the working principles of the polarization resolving techniques and the corresponding implements of SH microscopy are elucidated, with focus on Stokes vector based polarimetry. An overview of the advancements on SH anisotropy measurements are also presented. Specifically, the recent progresses on the following three topics in polarization resolved SH microscopy will be elucidated, which include Stokes vector resolving for imaging molecular structure and orientation, 3-D structural chirality by SH circular dichroism, and correlation with fluorescence lifetime imaging (FLIM) for in vivo wound healing diagnosis. The potentials and challenges for future researches in exploring complex biological tissues are also discussed.


Assuntos
Dicroísmo Circular/métodos , Imageamento Tridimensional/métodos , Microscopia de Geração do Segundo Harmônico/métodos , Animais , Colágeno/química , Humanos , Microscopia de Polarização/métodos
20.
Inverse Probl ; 34(10)2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30906099

RESUMO

Spectral computed tomography (CT) reconstructs the same scanned object from projections of multiple narrow energy windows, and it can be used for material identification and decomposition. However, the multi-energy projection dataset has a lower signal-noise-ratio (SNR), resulting in poor reconstructed image quality. To address this thorny problem, we develop a spectral CT reconstruction method, namely spatial-spectral cube matching frame (SSCMF). This method is inspired by the following three facts: i) human body usually consists of two or three basic materials implying that the reconstructed spectral images have a strong sparsity; ii) the same basic material component in a single channel image has similar intensity and structures in local regions. Different material components within the same energy channel share similar structural information; iii) multi-energy projection datasets are collected from the subject by using different narrow energy windows, which means images reconstructed from different energy-channels share similar structures. To explore those information, we first establish a tensor cube matching frame (CMF) for a BM4D denoising procedure. Then, as a new regularizer, the CMF is introduced into a basic spectral CT reconstruction model, generating the SSCMF method. Because the SSCMF model contains an L0-norm minimization of 4D transform coefficients, an effective strategy is employed for optimization. Both numerical simulations and realistic preclinical mouse studies are performed. The results show that the SSCMF method outperforms the state-of-the-art algorithms, including the simultaneous algebraic reconstruction technique, total variation minimization, total variation plus low rank, and tensor dictionary learning.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA