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3.
J Fish Biol ; 90(3): 1090-1097, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27859224

RESUMO

Following the complete eradication of the alien piscivorous perch Perca fluviatilis from a potable reservoir, the abundance of the endemic western minnow Galaxias occidentalis, which was previously undetectable prior to the initial eradication event, increased dramatically. The study reveals the potential of reservoirs to act as ecological refuges and has implications for understanding the relative effects of alien fishes v. habitat alteration on native freshwater fishes.


Assuntos
Cyprinidae/fisiologia , Percas/fisiologia , Animais , Água Doce , Espécies Introduzidas , Densidade Demográfica , Abastecimento de Água
4.
J Fish Biol ; 91(6): 1713-1720, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29023767

RESUMO

Whale sharks Rhincodon typus were monitored via acoustic transmitters at the northern end of Western Australia's Ningaloo Marine Park to establish the extent to which the species inhabits the region beyond the whale-shark ecotourism industry season, which usually extends from March to August in each year. Despite the vast majority (c. 98%) of photographic submissions of R. typus from Ningaloo Reef being between March and August, acoustic detections from the tagged R. typus at Ningaloo were recorded in all months of the year, but do not preclude the occurrence of extended absences. It is concluded that as a species, R. typus occurs year round at Ningaloo, where it generally remains in close proximity to the reef edge, but that some individuals move outside of the detection range of the array for extended periods.


Assuntos
Migração Animal , Comportamento de Retorno ao Território Vital , Tubarões/fisiologia , Acústica , Animais , Recifes de Corais , Indústrias , Fotografação , Estações do Ano , Telemetria/métodos , Austrália Ocidental
5.
Genes Immun ; 17(1): 19-29, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26562079

RESUMO

The outcome of infection with Salmonella Typhimurium in mouse models of human typhoid fever is dependent upon a coordinated complex immune response. A panel of recombinant congenic strains (RCS) derived from reciprocal backcross of A/J and C57BL/6J mice was screened for their susceptibility to Salmonella infection and two susceptibility loci, Ity4 (Immunity to Typhimurium locus 4) and Ity5, were identified. We validated Ity5 in a genetic environment free of the impact of Ity4 using a cross between A/J and 129S6. Using a time-series analysis of genome-wide transcription during infection, comparing A/J with AcB60 mice having a C57BL/6J-derived Ity5 interval, we have identified the differential expression of the positional candidate gene Cd40, Cd40-associated signaling pathways, and the differential expression of numerous genes expressed in neutrophils. CD40 is known to coordinate T cell-dependent B-cell responses and myeloid cell activation. In fact, CD40 signaling is altered in A/J mice as seen by impaired IgM upregulation during infection, decreased Ig class switching, neutropenia, reduced granulocyte recruitment in response to infection and inflammation, and decreased ERK1/2 activity. These results suggest that altered CD40 signaling and granulocyte recruitment in response to infection are responsible for the Ity5-associated Salmonella susceptibility of A/J mice.


Assuntos
Antígenos CD40/imunologia , Proteínas de Transporte de Cátions/genética , Modelos Animais de Doenças , Camundongos , Salmonelose Animal/imunologia , Animais , Proteínas de Transporte de Cátions/imunologia , Cruzamentos Genéticos , Perfilação da Expressão Gênica , Predisposição Genética para Doença , Imunoglobulinas/imunologia , Sistema de Sinalização das MAP Quinases , Camundongos/classificação , Camundongos/genética , Camundongos/imunologia , Camundongos Endogâmicos C57BL , Ativação de Neutrófilo
6.
J Fish Biol ; 86(5): 1658-63, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25943152

RESUMO

A pilot study targeting sawfishes in the southern Pilbara region of Western Australia, which is undergoing a major expansion in human activity, was conducted using gillnets during April and October 2011 in the Ashburton Estuary and adjacent mangrove creeks. Catch per unit effort was greatest in the Ashburton Estuary in October, due to an influx of green sawfish Pristis zijsron pups, and was orders of magnitude higher than previously reported for any Pristidae; the study sites contained P. zijsron up to almost 3 m total length. This study identified the first pupping site for P. zijsron in Western Australia, and the most southerly known nursery area for the species in Australian waters, and is potentially the most important globally.


Assuntos
Ecossistema , Estuários , Rajidae , Animais , Conservação dos Recursos Naturais , Espécies em Perigo de Extinção , Feminino , Masculino , Projetos Piloto , Reprodução , Austrália Ocidental
7.
J Small Anim Pract ; 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38622928

RESUMO

OBJECTIVES: To evaluate the prevalence of bacterial presence in free-catch urine samples preceded by either a standardised prepped ("clean-catch") protocol versus unprepped (non-cleaned) voiding. MATERIALS AND METHODS: The study was a single-centre prospective single-blinded randomised controlled trial. Urine samples were obtained from 100 client-owned dogs presenting for routine evaluation. Dogs were randomly assigned to either the prepped group (preputial or peri-vulvar area cleaned with sterile saline before collection) or the unprepped group (no preliminary cleansing) stratified by sex. Urinalysis and urine culture (blood and MacConkey agar) were performed on all samples. Significant bacterial presence on urine culture was defined as >104 colony forming units (CFU)/mL. RESULTS: There were no statistically significant associations between prepped versus unprepped collection method or sex with a urinalysis positive for bacteriuria. However, on culture, significant bacterial growth was almost five times more likely to be associated with males relative to females (odds ratio 4.59, 95% confidence interval 1.61 to 13.10). The probability of finding a positive culture was not statistically associated with prep method (odds ratio 1.43, 95% confidence interval 0.50 to 4.08). CLINICAL SIGNIFICANCE: For the majority of dogs without clinical signs of urinary tract infection, free-catch urine collection does not result in significant bacteriuria found on analysis or culture. The presence of bacteria found in free-catch samples may be secondary to sample contamination or subclinical bacteriuria. Sample contamination or subclinical bacteriuria may be more prevalent in male dogs.

8.
Child Care Health Dev ; 39(3): 305-24, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-22676438

RESUMO

Children's health policy has highlighted the need to develop self-care programmes. However, there is a lack of evidence on which to base the development of such programmes. This paper reviews the published research on the effectiveness of self-care support interventions for children and young people with asthma, cystic fibrosis and diabetes. A systematic search was conducted of a range of electronic databases, supplemented by searching the reference lists of retrieved papers and published reviews. Retrieved studies were assessed against quality and eligibility criteria by two independent reviewers. The results were narratively synthesized to examine the effectiveness of self-care support interventions on health status, psycho-social well-being, condition-related knowledge, health service use and participant satisfaction. The search strategy identified 4261 papers which were screened against the review inclusion criteria. A total of 194 papers were assessed as being potentially eligible for inclusion with 15 papers being judged as adequate to include in the review. There is strong evidence of the effectiveness of interventions that target children/young people; use e-health or group-based methods; that are delivered in community settings. There is no evidence that interventions that focus on parents alone or are delivered only in hospital settings are effective. While there is some evidence to inform the development of self-care support programmes, there is a need for well-designed trials of interventions that are feasible to transfer into real-life settings and which involve parents and children in their development.


Assuntos
Doença Crônica/terapia , Autocuidado/normas , Adolescente , Asma/psicologia , Asma/terapia , Criança , Doença Crônica/psicologia , Fibrose Cística/psicologia , Fibrose Cística/terapia , Atenção à Saúde/organização & administração , Atenção à Saúde/normas , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 1/terapia , Comportamentos Relacionados com a Saúde , Humanos
9.
J Hum Nutr Diet ; 23(4): 353-9, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20497292

RESUMO

BACKGROUND: Education plays a key role in the development of self-management skills for people with type 2 diabetes, although there is limited evidence for the use of video education. AIMS: To develop a video-based lifestyle education programme for people newly diagnosed with type 2 diabetes and to evaluate changes in knowledge, biomedical indices and quality of life. METHODS: Forty-two newly diagnosed type 2 diabetic subjects were recruited and randomly allocated to either a video education or control group. Data were collected at baseline and 6 months after the intervention. Subjects (43% male) had a mean (SD) age of 60.8 (9.6) years, weight 89.5 (15.5) kg, BMI 31.3 (5.1) kg m(2), glycated haemoglobin (A1c) 7.4 (1.7)%, total cholesterol 4.7 (1.2) mmol L(-1), high-density lipoprotein cholesterol 1.15 (0.34) mmol L(-1), triglycerides 1.8 (1.0) mmol L(-1), low-density lipoprotein cholesterol 2.8 (1.0) mmol L(-1), pedometer reading 5721 (3446) steps per day. There were 63.7% correct answers given to the ADKnowl questionnaire and the WHO-5 Well-Being score was 65.8%. RESULTS: At 6 months, the intervention group showed increased knowledge compared to controls (74.3% versus 56.4% correct answers, P < or = 0.0001). Although there were no significant differences in changes over 6 months between the two groups, the intervention group showed improvements in A1c (-0.7%, P = 0.024), total cholesterol (-0.5 mmol L(-1), P = 0.017), low-density lipoprotein cholesterol (-0.5, P = 0.018) and increased physical activity measured by pedometer (1266 steps per day, P = 0.043) from baseline, with no significant changes in the control group. CONCLUSIONS: A brief video intervention increased diabetes knowledge amongst those newly diagnosed with type 2 diabetes and may comprise an effective way of directing education to such individuals.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Promoção da Saúde/métodos , Estilo de Vida , Educação de Pacientes como Assunto/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Gravação de Videoteipe , Diabetes Mellitus Tipo 2/sangue , Exercício Físico , Feminino , Seguimentos , Hemoglobinas Glicadas/análise , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Inquéritos e Questionários , Caminhada
10.
J Fish Biol ; 76(7): 1770-85, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20557630

RESUMO

In this study, 1429 fishes of 18 different species (12 native and six exotic) were sampled from 29 localities to compare the levels of parasitism between native and exotic fish species and to examine the relationship between environmental degradation and parasite diversity. Forty-four putative species of parasites were found and most of these appear to be native parasites, which have not previously been described. Two parasite species, Lernaea cyprinacea and Ligula intestinalis, are probably introduced. Both were found on or in a range of native fish species, where they may cause severe disease. Levels of parasitism and parasite diversity were significantly greater in native fishes than in exotic species, and this may contribute to an enhanced demographic performance and competitive ability in invading exotics. Levels of parasitism and parasite diversity in native fishes were negatively related to habitat disturbance, in particular to a suite of factors that indicate increased human use of the river and surrounding environment. This was due principally to the absence in more disturbed habitats of a number of species of endoparasites with complex life cycles, involving transmission between different host species.


Assuntos
Biodiversidade , Peixes/classificação , Peixes/parasitologia , Parasitos/classificação , Animais , Doenças dos Peixes/parasitologia , Parasitos/isolamento & purificação , Rios/parasitologia , Austrália Ocidental
11.
J Anat ; 215(2): 212-20, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19486204

RESUMO

This study elucidates the structure of the anal sphincter complex (ASC) and correlates the individual layers, namely the external anal sphincter (EAS), conjoint longitudinal muscle (CLM) and internal anal sphincter (IAS), with their ultrasonographic images. Eighteen male cadavers, with an average age of 72 years (range 62-82 years), were used in this study. Multiple methods were used including gross dissection, coronal and axial sheet plastination, different histological staining techniques and endoanal sonography. The EAS was a continuous layer but with different relations, an upper part (corresponding to the deep and superficial parts in the traditional description) and a lower (subcutaneous) part that was located distal to the IAS, and was the only muscle encircling the anal orifice below the IAS. The CLM was a fibro-fatty-muscular layer occupying the intersphincteric space and was continuous superiorly with the longitudinal muscle layer of the rectum. In its middle and lower parts it consisted of collagen and elastic fibres with fatty tissue filling the spaces between the fibrous septa. The IAS was a markedly thickened extension of the terminal circular smooth muscle layer of the rectum and it terminated proximal to the lower part of the EAS. On endoanal sonography, the EAS appeared as an irregular hyperechoic band; CLM was poorly represented by a thin irregular hyperechoic line and IAS was represented by a hypoechoic band. Data on the measurements of the thickness of the ASC layers are presented and vary between dissection and sonographic imaging. The layers of the ASC were precisely identified in situ, in sections, in isolated dissected specimens and the same structures were correlated with their sonographic appearance. The results of the measurements of ASC components in this study on male cadavers were variable, suggesting that these should be used with caution in diagnostic and management settings.


Assuntos
Canal Anal/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Canal Anal/diagnóstico por imagem , Dissecação/métodos , Endossonografia/métodos , Resinas Epóxi , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/anatomia & histologia , Inclusão em Plástico
12.
Mol Cell Biol ; 5(9): 2231-7, 1985 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-3016523

RESUMO

The 3T3-TNR9 cell line is a variant of Swiss 3T3 cells which does not respond mitogenically to tumor promoters, but does respond mitogenically to epidermal growth factor, fibroblast growth factor, and serum. To elucidate differences between tumor promoters and polypeptide mitogens in the pathway(s) of mitogenesis which might be responsible for the nonresponsiveness of the 3T3-TNR9 cells, we have examined in these cells the early protein phosphorylation events known to be associated with mitogenesis in the parental 3T3 cells. We find that the 3T3-TNR9 cells display levels of tetradecanoyl phorbol acetate binding and of a calcium- and phospholipid-dependent protein kinase activity which are at least the equal of those seen in the parental 3T3 cells, implicating some postreceptor event in the nonmitogenic phenotype. In addition, we find that phosphorylation of the epidermal growth factor receptor and of 80-kDa and 22-kDa proteins, as well as the tyrosine phosphorylation of a 42-kDa protein, all proceed normally in the nonmitogenic variant, even though these phosphorylations must depend on the activation of different kinases. Thus, all these early phosphorylation reactions are intact in the 3T3-TNR9 cells. Although these phosphorylations may be necessary, they clearly are insufficient to trigger mitogenesis.


Assuntos
Fibroblastos/metabolismo , Forbóis/farmacologia , Fosfoproteínas/biossíntese , Acetato de Tetradecanoilforbol/farmacologia , Animais , Carcinógenos/farmacologia , Divisão Celular/efeitos dos fármacos , Linhagem Celular , Fator de Crescimento Epidérmico/farmacologia , Receptores ErbB , Fibroblastos/efeitos dos fármacos , Camundongos , Mitógenos/farmacologia , Fosforilação , Protamina Quinase/metabolismo , Proteínas Quinases/metabolismo , Proteínas Tirosina Quinases/metabolismo , Proteínas/metabolismo , Receptores de Superfície Celular/metabolismo
13.
Eye (Lond) ; 31(2): 258-272, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27935597

RESUMO

In recent years, manufacturers and distributors have promoted commercially available intraocular lenses (IOLs) with transmittance properties that filter visible short-wavelength (blue) light on the basis of a putative photoprotective effect. Systematic literature review. Out of 21 studies reporting on outcomes following implantation of blue-light-filtering IOLs (involving 8914 patients and 12 919 study eyes undergoing cataract surgery), the primary outcome was vision, sleep pattern, and photoprotection in 9 (42.9%), 9 (42.9%), and 3 (14.2%) respectively, and, of these, only 7 (33.3%) can be classed as high as level 2b (individual cohort study/low-quality randomized controlled trials), all other studies being classed as level 3b or lower. Of the level 2b studies, only one (14.3%) found in favor of blue-light-filtering IOLs vs ultraviolet (UV)-only filtering IOLs on the basis of an association between better post-operative contrast sensitivity (CS) at select frequencies with the former; however, that study did not measure or report CS preoperatively in either group, and the finding may simply reflect better preoperative CS in the eyes scheduled to be implanted with the blue-light-filtering IOL; moreover, that study failed to measure macular pigment, a natural preceptoral filter of blue-light, augmentation of which is now known to improve CS. In terms of photoprotection, there is no level 2b (or higher) evidence in support of blue filtering IOLs vs UV-only filtering IOLs. On the basis of currently available evidence, one cannot advocate for the use of blue-light-filtering IOLs over UV-only filtering IOLs.


Assuntos
Medicina Baseada em Evidências/normas , Implante de Lente Intraocular , Lentes Intraoculares , Proteção Radiológica/métodos , Sensibilidades de Contraste/efeitos da radiação , Filtração/instrumentação , Humanos , Pigmentos da Retina/fisiologia , Espalhamento de Radiação
14.
J Nutr Health Aging ; 21(3): 254-261, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28244563

RESUMO

OBJECTIVE: To investigate non-dietary correlates and determinants of plasma lutein (L) and zeaxanthin (Z) concentrations in The Irish Longitudinal Study on Ageing (TILDA) sample. DESIGN: Cross-sectional study. SETTING: Community dwelling adults in the Republic of Ireland (ROI). PARTICIPANTS: 3,681 participants aged 50 years and older. MEASUREMENTS: TILDA is a nationally representative prospective cohort study of community dwelling adults aged 50 years and over in the ROI. Demographic and health variables were collected during a face-to-face interview carried out in the home (n=8175), and a substantial proportion of these (n=5035; 62%) also attended a study visit in a health assessment centre. Blood samples collected at baseline (wave 1, the subject of the current study), were analysed for plasma concentrations of L and Z by reversed-phase high performance liquid chromatography, and macular pigment (MP) optical density was also measured (using customized heterochromatic flicker photometry). RESULTS: After excluding participants with eye disease, data from 3,681 participants were available for analysis. For this group of participants, plasma L and Z were inversely and significantly associated with body mass index (BMI), and were positively and significantly associated with MP, total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) (p<0.001, for all). Plasma L and Z were significantly lower in males, current smokers, participants reporting less physical exercise, and participants reporting lower levels of education (p<0.05, for all). Plasma L was significantly higher in participants reporting a family history of age-related macular degeneration (AMD) (p=0.001), and in the group of ≥75 years old (p<0.05). For each of these variables, the significant associations remained after controlling for other potential confounding variables. CONCLUSION: The findings of this large study indicate that plasma concentrations of L and Z were lower in association with indicators of a poor lifestyle (high BMI, tobacco use, and less physical exercise) and in association with lower education, indicating that modifying lifestyle in a positive way is likely to be reflected in higher concentrations of plasma carotenoids, with consequential and putative health benefits.


Assuntos
Carotenoides/sangue , Nível de Saúde , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Luteína/sangue , Zeaxantinas/sangue , Idoso , Envelhecimento , Índice de Massa Corporal , Colesterol/sangue , Estudos de Coortes , Estudos Transversais , Exercício Físico , Olho/metabolismo , Feminino , Humanos , Irlanda , Estudos Longitudinais , Degeneração Macular/sangue , Pigmento Macular/análise , Masculino , Pessoa de Meia-Idade , Fotometria , Estudos Prospectivos , Características de Residência , Inquéritos e Questionários
15.
J Vet Intern Med ; 31(4): 994-999, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28617995

RESUMO

BACKGROUND: N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations may be increased in cats with various cardiac disorders. The point-of-care (POC) ELISA assay uses the same biologic reagents as the quantitative NT-proBNP ELISA. Previous studies have evaluated the sensitivity and specificity of the POC ELISA in cats with cardiac disease. OBJECTIVES: To prospectively evaluate the diagnostic utility of the POC ELISA in a select population of cats. ANIMALS: Thirty-eight client-owned cats presented to the University of Florida Cardiology Service for cardiac evaluation. Fifteen apparently healthy cats recruited as part of another study. METHODS: Physical examination and echocardiography were performed in all cats. The POC ELISA was assessed visually as either positive or negative by a reader blinded to the echocardiographic findings, and results were analyzed relative to quantitative assay results. RESULTS: Twenty-six cats were diagnosed with underlying cardiac disease, and 27 cats were considered free of cardiac disease. Cats with cardiac disease included: 21 with hypertrophic cardiomyopathy, 2 with unclassified cardiomyopathy, 2 with restrictive cardiomyopathy, and 1 with 3rd degree atrioventricular (AV) block. The POC ELISA differentiated cats with cardiac disease with a sensitivity of 65.4% and specificity of 100%. CONCLUSIONS AND CLINICAL IMPORTANCE: The POC NT-proBNP ELISA performed moderately well in a selected population of cats. A negative test result cannot exclude the presence of underlying cardiac disease, and a positive test result indicates that cardiac disease likely is present, but further diagnostic investigation would be indicated for a definitive diagnosis.


Assuntos
Doenças do Gato/diagnóstico , Ensaio de Imunoadsorção Enzimática/veterinária , Cardiopatias/veterinária , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Animais , Bloqueio Atrioventricular/sangue , Bloqueio Atrioventricular/diagnóstico , Bloqueio Atrioventricular/veterinária , Cardiomiopatias/sangue , Cardiomiopatias/diagnóstico , Cardiomiopatias/veterinária , Cardiomiopatia Hipertrófica/sangue , Cardiomiopatia Hipertrófica/diagnóstico , Cardiomiopatia Hipertrófica/veterinária , Estudos de Casos e Controles , Doenças do Gato/sangue , Gatos , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Cardiopatias/sangue , Cardiopatias/diagnóstico , Masculino , Sistemas Automatizados de Assistência Junto ao Leito , Sensibilidade e Especificidade
16.
Cancer Res ; 45(2): 879-85, 1985 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-3871353

RESUMO

Human anti-murine immunoglobulin responses were assessed in serum from three groups of patients receiving murine monoclonal antibody therapy. Each of the three patient groups responded differently. Chronic lymphocytic leukemia patients demonstrated little or no preexisting murine immunoglobulin G-reactive antiglobulin prior to treatment, while the cutaneous T-cell lymphoma and melanoma patients demonstrated preexisting antiglobulin levels in the same range as those demonstrated in healthy controls. None of 11 chronic lymphocytic leukemia patients receiving the T101 monoclonal antibody demonstrated an antiglobulin response, whereas all four of the cutaneous T-cell lymphoma patients receiving the same antibody developed increased levels of antiglobulins. Three of nine malignant melanoma patients receiving the 9.2.27 monoclonal antibody showed an increase in antiglobulin titers. In patients developing antiglobulin responses, the response was rapid, typically being detectable within 2 weeks. The antiglobulins were primarily immunoglobulin G and, with the exception of a single melanoma patient in whom the response appeared to have a substantial 9.2.27-specific component (i.e., antiidiotype), were cross-reactive with most murine immunoglobulin G preparations tested. This pattern of results suggested that the antiglobulin was a secondary immune reaction with elevation of the levels of preexisting antiglobulin which was cross-reactive with the mouse antibody administered. While the presence of serum antiglobulin would be expected to present major complications to monoclonal antibody therapy, no clinical toxicity related to antiglobulin responses was observed in these patients, and no inhibition of antibody localization on tumor cells was seen.


Assuntos
Anticorpos Anti-Idiotípicos/análise , Anticorpos Monoclonais/uso terapêutico , Imunoglobulinas/imunologia , Leucemia Linfoide/imunologia , Linfoma/imunologia , Especificidade de Anticorpos , Ensaio de Imunoadsorção Enzimática , Humanos , Imunização Passiva , Leucemia Linfoide/terapia , Linfoma/terapia , Linfócitos T
17.
J Psychiatr Ment Health Nurs ; 23(1): 12-21, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26634415

RESUMO

BACKGROUND: Service users wish to be involved in care planning but typically feel marginalized in this process. Qualitative explorations of the barriers and enablers of user involvement in mental health care planning are limited. QUESTION: How is user involvement in care planning conceptualized by service users and how can meaningful involvement be instilled in the care planning process? METHODS: In 2013, we conducted five focus groups (n = 27) and 23 individual interviews with current or recent adult users of secondary care mental health services (n = 27) in England. Eight users participated in both. Data were analysed using Framework Analysis. Results Ten themes emerged from the data: these themes encompassed procedural elements (connection; contribution; currency; care consolidation; and consequence), service user characteristics (capacity and confidence) and professional enablers (consultation; choice; and clarity of expression). Procedural elements were discussed most frequently in service user discourse. DISCUSSION: The process of care planning, centred on the user-clinician relationship, is key to user involvement. IMPLICATIONS FOR PRACTICE: Users describe a common model of meaningful involvement in care planning. Their requests, summarized through a 10C framework of care planning involvement, provide clear direction for improving service users satisfaction with care planning and enhancing the culture of services.


Assuntos
Serviços de Saúde Mental , Planejamento de Assistência ao Paciente , Participação do Paciente , Relações Profissional-Paciente , Pesquisa Qualitativa , Adulto , Humanos
18.
Eye (Lond) ; 30(8): 1063-71, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27197868

RESUMO

PurposeTo identify the strongest variable(s) linked with the number of ranibizumab injections and outcomes in AURA, and to identify ways to improve outcomes using this association.MethodsAURA was a large observational study that monitored visual acuity over a 2-year period in patients with neovascular age-related macular degeneration (AMD) who received ranibizumab injections. Baseline characteristics, resource use, and outcomes were analyzed using an instrumental variable approach and regression analysis.ResultsData were analyzed from 2227 patients enrolled in AURA. Optical coherence tomography (OCT) and ophthalmoscopy were the most common diagnostic tests used, and this combination was the strongest instrumental variable. Use of OCT and ophthalmoscopy affected the number of injections given and resulted in an increase in visual acuity gains from baseline of 17.6 letters in year 1 and 2.5 letters in year 2. Regression models using the instrumental variable (OCT and ophthalmoscopy combined) showed that ≥5.1 (95% CI: 3.3-11.4) ranibizumab injections were needed to maintain visual acuity from baseline to year 1 and ≥8.3 (95% CI: 5.3-18.8) injections were needed to maintain visual acuity from year 1 to year 2. To gain ≥15 letters, ≥7.9 (95% CI: 5.1-17.5) ranibizumab injections would be needed in year 1 and ≥16.1 (95% CI: 10.3-36.4) injections would be needed over 2 years.ConclusionsThese findings highlight the role that regular monitoring plays in guiding neovascular AMD therapy and they showed that the number of ranibizumab injections needed to maintain visual acuity is higher than that administered in AURA.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Ranibizumab/administração & dosagem , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia , Degeneração Macular Exsudativa/tratamento farmacológico , Degeneração Macular Exsudativa/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Feminino , Humanos , Injeções Intravítreas , Masculino , Oftalmoscopia , Ranibizumab/uso terapêutico , Estudos Retrospectivos , Tomografia de Coerência Óptica
20.
Br J Ophthalmol ; 89(6): 670-2, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15923498

RESUMO

AIM: To establish long term outcomes and incidence of complications following refractive lens exchange (RLE) for the correction of high myopia. METHODS: Operative and postoperative records of 62 cases of small incision phacoemulsification RLE performed in 37 patients over an 11 year period, by a single surgeon, were reviewed. In addition, patients were recalled for a follow up examination, which included dilated retinal examination with scleral indentation. RESULTS: Two cases (3.2%) of retinal detachment occurred at intervals of 2 months and 5 months following uncomplicated RLE procedures. A posterior chamber intraocular lens was inserted in 46 eyes (74%). YAG laser posterior capsulotomy was performed in 38 of 62 eyes (61%) and did not represent a risk for retinal detachment. CONCLUSION: Refractive lens exchange results in rapid and predictable improvement in unaided vision in patients with high myopia. However, the risks of sight threatening complications inherent in any intraocular procedure underlie the need for appropriate patient selection.


Assuntos
Implante de Lente Intraocular/métodos , Miopia/cirurgia , Facoemulsificação , Adulto , Feminino , Seguimentos , Humanos , Implante de Lente Intraocular/efeitos adversos , Lentes Intraoculares , Masculino , Pessoa de Meia-Idade , Miopia/complicações , Miopia/fisiopatologia , Refração Ocular , Degeneração Retiniana/etiologia , Descolamento Retiniano/etiologia , Resultado do Tratamento , Acuidade Visual
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