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1.
Artigo em Inglês | MEDLINE | ID: mdl-38724830

RESUMO

Given the context, the overarching aim is to identify scientific publications on occupational therapy in Psychiatric-Short-Term-Hospitalization-Units. Specific objectives include: (a) Analyzing the historical development of this research area; (b) Synthesizing existing evidence on the nature of documentary sources on occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units; (c) Detailing the volume of scientific literature on occupational therapy in these units; (e) Evaluating available evidence on occupational therapy interventions to improve functionality, quality of life, and recovery in individuals admitted to in Psychiatric-Short-Term-Hospitalization-Units. A scoping review method was employed to conduct a historical mapping of research on in Psychiatric-Short-Term-Hospitalization-Units. The review proceeded in five stages following PRISMA guidelines. After applying selection criteria, the search identified 446 references. Findings are presented under three headings: (a) Historical trends in the scientific literature on occupational therapy and in Psychiatric-Short-Term-Hospitalization-Units; (b) Nature and volume of articles included in the occupational therapy synthesis in Psychiatric Short-Term Hospitalization Units; (c) Data extraction on methodological variables in the research of occupational therapy articles in in Psychiatric-Short-Term-Hospitalization-Units; and (d) Data extraction on research outcome variables of occupational therapy articles in Psychiatric Short-Term Hospitalization Units. The growth of occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units is emphasized, with an increase in qualitative studies. Occupational therapy is underscored as an integral part of care, supporting the diversity and effectiveness of interventions. Common diagnoses include schizophrenia and depressive disorders. Group interventions and the spiritual dimension positively influence the quality of care and meaningful routines for recovery in in Psychiatric-Short-Term-Hospitalization-Units.

2.
J Orthop Traumatol ; 23(1): 49, 2022 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-36242652

RESUMO

BACKGROUND: Robotic surgery (RS) may offer benefits compared with freehand/conventional surgery (FS) in the treatment of patients with spinal disease. The aim of this study was to evaluate the efficacy and safety of RS versus FS in spinal fusion. METHODS: A systematic review and meta-analysis was performed. Data analysis and risk of bias assessment were analysed using REVMAN V5.3. RESULTS: We found 11 randomised clinical trials involving 817 patients (FS: 408, RS: 409). The main diagnosis was degenerative spine disease. SpineAssist, Renaissance (Mazor Robotics), Tianji Robot and TiRobot robots (TINAVI Medical Technologies) were used. Pedicle screw placement within the safety zone (grades A + B according to the Gertzbein and Robbins scale) ranged from 93% to 100% in FS versus 85-100% in RS (relative risk 1.01, 95% CI 1.00-1.03, p = 0.14). Regarding intervention time, the meta-analysis showed a mean difference (MD) of 6.45 min (95% CI -13.59 to 26.49, p = 0.53). Mean hospital stay was MD of -0.36 days (95% CI -1.03 to 0.31, p = 0.30) with no differences between groups. Contradictory results were found regarding fluoroscopy time, although there seems to be a lower radiation dose in RS versus FS (p < 0.05). Regarding safety, the studies included surgical revision frequency. CONCLUSIONS: No conclusive results were found suggesting that there are benefits in using RS over FS for spinal fusion. Further research with adequate patient selection, robot type and quality-of-life variables is needed. LEVEL OF EVIDENCE: level 1.


Assuntos
Parafusos Pediculares , Procedimentos Cirúrgicos Robóticos , Robótica , Doenças da Coluna Vertebral , Fusão Vertebral , Humanos , Vértebras Lombares/cirurgia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Doenças da Coluna Vertebral/cirurgia , Fusão Vertebral/métodos , Coluna Vertebral/cirurgia
3.
BMC Med Educ ; 21(1): 264, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33962600

RESUMO

BACKGROUND: Professional reasoning provides a firm basis for the development of teaching and assessment strategies to support the acquisition of skills by healthcare students. Nevertheless, occupational therapy educators should use diverse methods of learning assessment to examine student learning outcomes more fully with an evaluation that supports the overall complexity of the process, particularly learners' subjective experience. The aim of this article is to identify the range of perspectives among occupational therapy undergraduates regarding terms or concepts that are key for improving their professional reasoning. METHODS: Q-methodology was used to address the aim of the study. A concourse relating to a series of ideas, phrases, terminology, and concepts associated with various studies on professional reasoning in occupational therapy, specifically on students in this field, was generated. The terms that had the clearest evidence, the most relevance or the greatest number of citations in the literature were collected (n = 37). The P-set was assembled by non-probabilistic sampling for convenience. It comprised undergraduate university students in occupational therapy. Factor analysis was conducted using Ken-Q Analysis v.1.0.6, reducing the number of Q-sets to smaller groups of factors representing a common perspective. RESULTS: Through statistical analysis of the Q-sorts of 37 occupational therapy students, 8 default factors were identified. The four factors in accordance with the selection criteria were rotated by varimax rotation to identify variables that could be grouped together. Each viewpoint was interpreted, discussed and liked to different aspects of professional reasoning in occupational therapy. CONCLUSIONS: The observed perceptions were linked to the various aspects of professional reasoning that have been widely discussed in the occupational therapy literature. For most of the students, there was a strong correspondence between the narrative, interactive and conditional aspects of the various components.


Assuntos
Terapia Ocupacional , Competência Clínica , Humanos , Terapia Ocupacional/educação , Percepção , Resolução de Problemas , Estudantes
4.
Healthcare (Basel) ; 11(4)2023 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-36833164

RESUMO

(1) Background: This study examines the nature of the rarely studied factors of the professional identity from an occupational therapist's perspective. (2) Methods: Q-methodology was applied to identify the different perspectives. Participants were selected through a non-probability sampling procedure in the whole Spanish territory. Different assessment tools were considered, in order to develop an ad hoc tool which had 40 statements classified into four categories. A factor analysis was performed by applying Ken-Q analysis v.1.0. (3) Results: Thirty-seven occupational therapists participated in the study. Their diverse approaches revealed different perspectives that influence the professional identity of occupational therapists: professional identity, due to referents, a grey field on professional identity, reaffirming a common professional identity, the role of education and mentors on professional identity and the outcome of ongoing training, in order to develop the abovementioned identity. (4) Conclusions: Once the different aspects of the professional identity have been understood, future educational initiatives can be designed to adapt curricula to the professional scene.

5.
J Intell ; 11(3)2023 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-36976141

RESUMO

Pedagogical practices contribute to enhancing professional intelligence which is an indicator of maturity and development of professional identity. The research guiding question was: What are the pedagogical practices involved in occupational therapy students' professional identity formation? A scoping review using a six-stage methodological framework was used to capture a variety of evidence describing how professional identity has been conceptualised and integrated into the occupational therapy curriculum while noticing a link to professional intelligence. Databases included were: Ovid MEDLINE, CINAHL, PsycINFO, ProQuest ERIC, Scopus, Web of Science, CSIC, Dialnet, PubMed, Pubmed Central, OTDBASE and Scielo. Qualitative content analysis was used to categorise learning outcomes into five components of professional identity that were associated with the pedagogical practices identified in the studies. n = 58 peer-reviewed journal articles were recorded. The articles were classified as intervention studies (n = 31; 53.4%), reviews (n = 12; 20.7%) and theoretical articles (n = 15; 25.9%). To ensure the feasibility of collecting and reporting results, we narrowed the focus to n = 31 intervention studies that provided information on pedagogical practices and learning outcomes on professional identity forging in students. This scoping review illustrates the variety of contexts in which students learn, the multiple dimensions of identity establishment, and the variety of pedagogical practices. These findings can be used to adapt and design focused formative curricula that support the development of professional identity.

6.
Viruses ; 15(11)2023 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-38005918

RESUMO

BACKGROUND: Acute hepatitis B infection is associated with severe liver disease and chronic sequelae in some cases. The purpose of this review was to determine the efficacy of nucleoside analogues (NA) (lamivudine versus entecavir) compared to placebo or no intervention for treating acute primary HBV infection. METHODS: A meta-analysis for drug intervention was performed, following a fixed-effect model. Randomized controlled trials (RCTs) and quasi-randomized studies that evaluated the outcomes of NA in acute hepatitis B infection were included. The following outcomes were considered: virological cure (PCR negative), elimination of acute infection (seroconversion of HBsAg), mortality, and serious adverse events. RESULTS: Five trials with 627 adult participants with severe acute hepatitis B defined by biochemical and serologic parameters were included. Virological cure did not favor any intervention: OR 0.96, 95% CI 0.54 to 1.7 (p = 0.90), I2 = 58%. Seroconversion of HBsAg to negative favored placebo/standard-of-care compared to lamivudine: OR 0.54, 95% CI 0.33 to 0.9 (p = 0.02), I2 = 31%. The only trial that compared entecavir and lamivudine favored entecavir over lamivudine (OR: 3.64, 95% CI 1.31-10.13; 90 participants). Adverse events were mild. CONCLUSION: There is insufficient evidence that NA obtain superior efficacy compared with placebo/standard-of-care in patients with acute viral hepatitis, based on low quality evidence.


Assuntos
Hepatite B Crônica , Hepatite B , Adulto , Humanos , Lamivudina/uso terapêutico , Antivirais/farmacologia , Antígenos de Superfície da Hepatite B , Hepatite B/complicações , Vírus da Hepatite B/genética , Resultado do Tratamento , DNA Viral
7.
Arch Biochem Biophys ; 526(1): 44-53, 2012 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-22809892

RESUMO

The phosphotransferase system (PTS) is involved in the use of carbon sources in bacteria. It is formed by two general proteins: enzyme I (EI) and the histidine phosphocarrier (HPr), and various sugar-specific permeases. EI is formed by two domains, with the N-terminal domain (EIN) being responsible for the binding to HPr. In low-G+C Gram-positive bacteria, HPr becomes phosphorylated not only by phosphoenolpyruvate (PEP) at the active-site histidine, but also by ATP at a serine. In this work, we have characterized: (i) the stability and binding affinities between the active-site-histidine phosphorylated species of HPr and the EIN from Streptomyces coelicolor; and (ii) the stability and binding affinities of the species involving the phosphorylation at the regulatory serine of HPr(sc). Our results show that the phosphorylated active-site species of both proteins are less stable than the unphosphorylated counterparts. Conversely, the Hpr-S47D, which mimics phosphorylation at the regulatory serine, is more stable than wild-type HPr(sc) due to helical N-capping effects, as suggested by the modeled structure of the protein. Binding among the phosphorylated and unphosphorylated species is always entropically driven, but the affinity and the enthalpy vary widely.


Assuntos
Proteínas de Bactérias/química , Proteínas de Bactérias/metabolismo , Domínio Catalítico , Sistema Fosfotransferase de Açúcar do Fosfoenolpiruvato/química , Sistema Fosfotransferase de Açúcar do Fosfoenolpiruvato/metabolismo , Fosfoproteínas/química , Fosfoproteínas/metabolismo , Streptomyces coelicolor/enzimologia , Proteínas de Bactérias/genética , Estabilidade Enzimática , Ligação de Hidrogênio , Mutagênese Sítio-Dirigida , Mutação , Sistema Fosfotransferase de Açúcar do Fosfoenolpiruvato/genética , Fosfoproteínas/genética , Fosforilação , Serina/metabolismo , Termodinâmica
8.
Spine (Phila Pa 1976) ; 47(8): 615-623, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-34468435

RESUMO

STUDY DESIGN: Quasi-experimental intervention study. OBJECTIVE: To assess the effect of a clinical safety and quality improvement plan for patients undergoing spinal fusion surgery on the incidence of surgical site infection (SSI). SUMMARY OF BACKGROUND DATA: In recent years, infection surveillance and control programs based on care bundles have been included in surgical protocols. These have proven to be essential tools for the prevention and control of SSI, providing indicators for improvement and allowing the characterization of related risk factors. METHODS: A quasi-experimental study was carried out with analysis before and after the introduction of a preventive care bundle (clinical safety and quality improvement plan). Patients who underwent spinal fusion surgery were included. The incidence of SSI up to 90 days after surgery (maximum incubation period) was assessed. The effect of the intervention was evaluated with the adjusted odds ratio (oR) using a logistic regression model. RESULTS: A total of 1554 patients were included, 690 in the period 2007 to 2011 (before) and 864 during 2012 to 2018 (after). SSI incidence decreased from 4.2% to 1.9% after the plan (OR: 0.43; 95% confidence interval: 0.23-0.80; P  = 0.006). There was also an improvement in the adequacy of antibiotic prophylaxis, preoperative preparation, and hair removal procedure after the introduction of the care bundle. CONCLUSION: After implementation of the care bundle, the incidence of SSI in spine fusion surgery decreased significantly. Multivariate analysis showed that the care bundle was an independent protective factor. The implementation of these measures should be reinforced on the routine medical practice to reduce the SSI incidence.Level of Evidence: 3.


Assuntos
Pacotes de Assistência ao Paciente , Infecção da Ferida Cirúrgica , Antibioticoprofilaxia , Humanos , Incidência , Controle de Infecções/métodos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle
9.
Maturitas ; 166: 65-85, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36081216

RESUMO

This project aims to develop eligibility criteria for menopausal hormone therapy (MHT). The tool should be similar to those already established for contraception A consortium of scientific societies coordinated by the Spanish Menopause Society met to formulate recommendations for the use of MHT by women with medical conditions based on the best available evidence. The project was developed in two phases. As a first step, we conducted 14 systematic reviews and 32 metanalyses on the safety of MHT (in nine areas: age, time of menopause onset, treatment duration, women with thrombotic risk, women with a personal history of cardiovascular disease, women with metabolic syndrome, women with gastrointestinal diseases, survivors of breast cancer or of other cancers, and women who smoke) and on the most relevant pharmacological interactions with MHT. These systematic reviews and metanalyses helped inform a structured process in which a panel of experts defined the eligibility criteria according to a specific framework, which facilitated the discussion and development process. To unify the proposal, the following eligibility criteria have been defined in accordance with the WHO international nomenclature for the different alternatives for MHT (category 1, no restriction on the use of MHT; category 2, the benefits outweigh the risks; category 3, the risks generally outweigh the benefits; category 4, MHT should not be used). Quality was classified as high, moderate, low or very low, based on several factors (including risk of bias, inaccuracy, inconsistency, lack of directionality and publication bias). When no direct evidence was identified, but plausibility, clinical experience or indirect evidence were available, "Expert opinion" was categorized. For the first time, a set of eligibility criteria, based on clinical evidence and developed according to the most rigorous methodological tools, has been defined. This will provide health professionals with a powerful decision-making tool that can be used to manage menopausal symptoms.


Assuntos
Neoplasias da Mama , Terapia de Reposição de Estrogênios , Menopausa , Feminino , Humanos , Neoplasias da Mama/induzido quimicamente , Terapia de Reposição de Estrogênios/efeitos adversos , Pessoal de Saúde , Sociedades Científicas
10.
Appl Environ Microbiol ; 77(16): 5761-9, 2011 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-21705545

RESUMO

Formamidases (EC 3.5.1.49) are poorly characterized proteins. In spite of this scarce knowledge, ammonia has been described as playing a central role in the pathogenesis of human pathogens such as Helicobacter pylori, for which formamidase has been shown to participate in the nitrogen metabolic pathway. Sequence analysis has revealed that at least two different groups of formamidases are classified as EC 3.5.1.49: on the one hand, the derivatives of the FmdA-AmdA superfamily, which are the best studied to date, and on the other hand, the derivatives of Helicobacter pylori AmiF. Here we present the cloning, purification, and characterization of a recombinant formamidase from Bacillus cereus CECT 5050T (BceAmiF), the second member of the AmiF subfamily to be characterized, showing new features of the enzyme further supporting its relationship with aliphatic amidases. We also present homology modeling-based mutational studies confirming the importance of the Glu140 and Tyr191 residues in the enzymatic activities of the AmiF family. Moreover, we can conclude that a second glutamate residue is critical in several members of the nitrilase superfamily, meaning that what has consistently been identified as a C-E-K triad is in fact a C-E-E-K tetrad.


Assuntos
Amidoidrolases/química , Aminoidrolases/metabolismo , Bacillus cereus/enzimologia , Proteínas de Bactérias/química , Amidoidrolases/genética , Bacillus cereus/genética , Proteínas de Bactérias/genética , Sequência de Bases , Catálise , Cromatografia em Gel , Cromatografia Líquida de Alta Pressão , Dicroísmo Circular/métodos , Clonagem Molecular , Ativação Enzimática , Ensaios Enzimáticos , Escherichia coli/química , Escherichia coli/genética , Ácido Glutâmico/química , Dados de Sequência Molecular , Mutagênese Sítio-Dirigida , Mutação , Filogenia , Estrutura Secundária de Proteína , Proteínas Recombinantes/química , Alinhamento de Sequência , Homologia de Sequência de Aminoácidos , Especificidade por Substrato
11.
Artigo em Inglês | MEDLINE | ID: mdl-33803688

RESUMO

BACKGROUND: This review aims to evaluate the level of scientific evidence for the effectiveness of Community Occupational Therapy interventions. METHODS: A systematic review was used to analyze and synthesize the studies collected. The databases of Cochrane, OTseeker, OTCATS, Web of Science, Scielo and Scopus were used in order to collect articles published between 2007 and 2020. PRISMA recommendations were followed. RESULTS: A total of 12 articles comprised part of the study (7 randomized controlled studies, 4 systematic reviews and 1 meta-analysis). The main areas of practice were geriatric gerontology (22.1%) and mental health (19.7%), which were statistically significant (χ2; p < 0.005) compared to the rest. Regarding the studies analyzed, all of them had scores of >7 on the PEDro and AMSTAR scales. CONCLUSIONS: Research on Community Occupational Therapy constitutes a consolidated line of research but the objectives and areas of research were limited. Descriptive qualitative methodology predominated and studies on the effectiveness of Community Occupational Therapy interventions showed a medium-low level of evidence.


Assuntos
Terapia Ocupacional , Idoso , Humanos , Saúde Mental , Ensaios Clínicos Controlados Aleatórios como Assunto , Descanso
12.
J Struct Biol ; 169(2): 200-8, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19895890

RESUMO

The recombinant dihydropyrimidinase from Sinorhizobium meliloti CECT4114 (SmelDhp) has been characterised and its crystal structure elucidated at 1.85A. The global architecture of the protein is reminiscent of that of the amidohydrolase superfamily, consisting of two domains; an (alpha/beta)(8) TIM-like barrel domain, where the catalytic centre is located, and a smaller beta-sheet sandwich domain of unknown function. The c-terminal tails of each subunit extend toward another monomer in a swapping-like manner, creating a hydrogen bond network which suggests its implication in protein oligomerisation. Mutational and structural evidence suggest the involvement of a conserved tyrosine in the reaction mechanism of the enzyme. SmelDhp presents both hydantoinase and dihydropyrimidinase activities, with higher affinity for the natural six-membered ring substrates. For the five-membered ring substrates, affinity was greater for those with aliphatic and apolar groups in the 5th carbon atom, with the highest rates of hydrolysis for d-5-methyl and d-5-ethyl hydantoin (k(cat)/K(m)=2736+/-380 and 944+/-52M(-1)s(-1), respectively). The optimal conditions for the enzyme activity were found to be 60 degrees C of temperature at pH 8.0. SmelDhp retains 95% of its activity after 6-hour preincubation at 60 degrees C. This is the first dihydropyrimidinase used for the hydrolytic opening of non-natural 6-monosubstituted dihydrouracils, which may be exploited for the production of beta-amino acids.


Assuntos
Amidoidrolases/química , Modelos Moleculares , Conformação Proteica , Sinorhizobium meliloti/enzimologia , Amidoidrolases/genética , Sequência de Aminoácidos , Sequência de Bases , Evolução Molecular , Dados de Sequência Molecular , Ligação Proteica , Alinhamento de Sequência , Análise de Sequência de DNA , Especificidade por Substrato
13.
Appl Microbiol Biotechnol ; 85(3): 441-58, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19830420

RESUMO

Enzymatic kinetic resolution is a widely used biotechnological tool for the production of enantiomerically pure/enriched compounds. This technique takes advantage of the enantioselectivity or enantiospecificity of an enzyme for one of the enantiomers of a racemic substrate to isolate the desired isomer. N-Carbamoyl-D- and L-amino acid amidohydrolases (D- and L-carbamoylases) are model enzymes for this procedure due to their strict enantiospecificity. Carbamoylase-based kinetic resolution of amino acids has been applied for the last three decades, allowing the production of optically pure D- or L-amino acids. Furthermore, this enzyme has become crucial in the industrially used multienzymatic system known as "Hydantoinase Process," where the kinetic resolution produced by coupling an enantioselective hydantoinase and the enantiospecific carbamoylase is enhanced by the enzymatic/chemical dynamic kinetic resolution of the low-rate hydrolyzed substrate. This review outlines the properties of D- and L-carbamoylases, emphasizing their biochemical/structural characteristics and their biotechnological applications. It also pinpoints new applications for the exploitation of carbamoylases over the forthcoming years.


Assuntos
Amidoidrolases/metabolismo , Aminoácidos/metabolismo , Amidoidrolases/química , Sequência de Aminoácidos , Biotecnologia/métodos , Cinética , Modelos Moleculares , Dados de Sequência Molecular , Estrutura Terciária de Proteína , Homologia de Sequência , Estereoisomerismo , Especificidade por Substrato
14.
Chem Biodivers ; 7(6): 1531-48, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20564568

RESUMO

Interest in D-amino acids has increased in recent decades with the development of new analytical methods highlighting their presence in all kingdoms of life. Their involvement in physiological functions, and the presence of metabolic routes for their synthesis and degradation have been shown. Furthermore, D-amino acids are gaining considerable importance in the pharmaceutical industry. The immense amount of information scattered throughout the literature makes it difficult to achieve a general overview of their applications. This review summarizes the state-of-the-art on D-amino acid applications and occurrence, providing both established and neophyte researchers with a comprehensive introduction to this topic.


Assuntos
Aminoácidos/metabolismo , Aminoácidos/química , Antibacterianos/química , Enzimas/metabolismo
15.
Occup Ther Int ; 2020: 6934579, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32934612

RESUMO

BACKGROUND/AIM: One way to facilitate occupational therapy undergraduate students transferring their academic skills of data gathering and analysis to professional settings is to ensure they can competently use diagnostic reasoning. Nevertheless, there are several obvious gaps in empirical evidence related to the learning and development of this style of reasoning in occupational therapy undergraduates. The most important are related to promoting higher-order thinking and the use of information to solve problems in the context of professional practice. This study analyses undergraduates' diagnostic reasoning and its changes during their education. MATERIALS AND METHODS: This multicentre study was conducted with a descriptive observational design. The study took place at the University of Coruña (Spain), University of Castilla-La Mancha (Spain), and University of el Valle (Colombia). The sample was n = 247. For data collection, a clinical case was specifically designed. IBM SPSS Statistics (v19) and EPIDAT 3.1 were used for the data analysis. RESULTS: Participants identified and categorized occupational performance problems. However, they had difficulties when identifying and categorizing the occupational performance components (specifically, the symptoms and signs of the disease presented in the study case). They presented limitations to analyse and synthesize the information collected to develop an explanation of the occupational problems and their causes. CONCLUSIONS: Undergraduate students' ability to analyse and synthesize information during data collection is poorly organized, so it makes the problem formulation difficult. This study contributes to the knowledge of undergraduates' diagnostic reasoning features, specifically the undergraduate students' capacities and limits to process information during the occupational assessment.


Assuntos
Competência Clínica , Tomada de Decisão Clínica/métodos , Educação Baseada em Competências/organização & administração , Terapia Ocupacional/educação , Estudantes de Ciências da Saúde/psicologia , Adulto , Currículo , Feminino , Humanos , Masculino , Resolução de Problemas , Espanha , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto Jovem
16.
Am J Infect Control ; 48(12): 1437-1444, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32464296

RESUMO

BACKGROUND: The increased demand for hip arthroplasty means a growing number of postsurgical complications. This study aims to assess the risk of surgical site infection (SSI) in a teaching hospital; develop regional, national and international external comparisons; and evaluate SSI-related risk factors, particularly according to the timing of surgery (urgent/unplanned or elective). METHODS: Prospective cohort study from January 2008 to December 2018. Patients were followed up to 90 days after surgery. Primary endpoint was SSI incidence according to the Centers for Disease Control and Prevention criteria. Multivariate analysis was conducted to find independently associated SSI risk factors. The association between risk factors and SSI incidence was assessed by reference to odds ratio (OR). Analyses were also performed among urgent/unplanned and elective patients to identify whether SSI risk factors differed between groups. RESULTS: The study population (n = 1,808) has an overall SSI rate of 3.0% (95% confidence interval [CI]: 2.4-3.9). Timing of surgery caused an effect modification, so surgery duration> 75th percentile (OR: 3.8; 95% CI: 1.5-9.8) and inadequate preparation (OR: 3.3; 95% CI: 1.1-10.0) were independent risk factors in the urgent/unplanned group; National Healthcare Safety Network risk index≥ 2 (OR: 6.3; 95% CI: 0.1-19.2) and transfusion (OR: 3.6; 95% CI: 1.1-11.9) in the elective group. CONCLUSIONS: Hospital infection surveillance systems allow identifying risk factors susceptible to change. Characterization of factors that caused an effect modification is key to identify areas of quality improvement, including reducing operating times, preventing perioperative blood transfusion, or improving patient preparation before surgery.


Assuntos
Artroplastia de Quadril , Infecção da Ferida Cirúrgica , Artroplastia de Quadril/efeitos adversos , Seguimentos , Humanos , Estudos Prospectivos , Fatores de Risco , Infecção da Ferida Cirúrgica/epidemiologia
17.
Appl Environ Microbiol ; 75(2): 514-20, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19011069

RESUMO

An N-carbamoyl-beta-alanine amidohydrolase of industrial interest from Agrobacterium tumefaciens C58 (beta car(At)) has been characterized. Beta car(At) is most active at 30 degrees C and pH 8.0 with N-carbamoyl-beta-alanine as a substrate. The purified enzyme is completely inactivated by the metal-chelating agent 8-hydroxyquinoline-5-sulfonic acid (HQSA), and activity is restored by the addition of divalent metal ions, such as Mn(2+), Ni(2+), and Co(2+). The native enzyme is a homodimer with a molecular mass of 90 kDa from pH 5.5 to 9.0. The enzyme has a broad substrate spectrum and hydrolyzes nonsubstituted N-carbamoyl-alpha-, -beta-, -gamma-, and -delta-amino acids, with the greatest catalytic efficiency for N-carbamoyl-beta-alanine. Beta car(At) also recognizes substrate analogues substituted with sulfonic and phosphonic acid groups to produce the beta-amino acids taurine and ciliatine, respectively. Beta car(At) is able to produce monosubstituted beta(2)- and beta(3)-amino acids, showing better catalytic efficiency (k(cat)/K(m)) for the production of the former. For both types of monosubstituted substrates, the enzyme hydrolyzes N-carbamoyl-beta-amino acids with a short aliphatic side chain better than those with aromatic rings. These properties make beta car(At) an outstanding candidate for application in the biotechnology industry.


Assuntos
Agrobacterium tumefaciens/enzimologia , Amidoidrolases/metabolismo , Aminoácidos/metabolismo , Proteínas de Bactérias/metabolismo , Agrobacterium tumefaciens/genética , Amidoidrolases/química , Amidoidrolases/genética , Amidoidrolases/isolamento & purificação , Proteínas de Bactérias/isolamento & purificação , Cátions Bivalentes/farmacologia , Quelantes/farmacologia , DNA Bacteriano/química , DNA Bacteriano/genética , Dimerização , Ativadores de Enzimas/farmacologia , Inibidores Enzimáticos/farmacologia , Concentração de Íons de Hidrogênio , Cinética , Metais/farmacologia , Modelos Moleculares , Dados de Sequência Molecular , Peso Molecular , Oxiquinolina/análogos & derivados , Oxiquinolina/farmacologia , Estrutura Terciária de Proteína , Análise de Sequência de DNA , Especificidade por Substrato , Temperatura , beta-Alanina/análogos & derivados , beta-Alanina/metabolismo
18.
Arch Esp Urol ; 72(10): 985-991, 2019 12.
Artigo em Espanhol | MEDLINE | ID: mdl-31797800

RESUMO

OBJECTIVES: To assess the adherence to the antibiotic prophylaxis protocol in patients undergoing prostate surgery and evaluate the effect of antibiotic prophylaxis on surgical site infections (SSI). MATERIAL AND METHODS: A prospective cohort study was carried out between January 2009 and September 2016. The global compliance with the antibiotic prophylaxis protocol was evaluated studying the items: time of onset, route of administration, antibiotic prescribed, duration and dose. Percentages of adequacy are described. The incidence of infection was calculated after 30 days of follow-up. Relationship between the adequacy to the protocol and the surgical site infection are described with the relative risk. RESULTS: A total of 595 patients were studied. The global adequacy was 93.8%. The leading cause of inadequacy was the time of onset 3%. The incidence of surgical site infection was 1%. No relationship between the inadequacy of antibiotic prophylaxis and surgical site infection (RR=1.1%; 95%CI: 1.0-1.2) was found. No relationship between the procedure (laparoscopic or open surgery) and surgical site infection (RR=0.4%; 95%CI: 0.1-1.9) was found. CONCLUSIONS: The adequacy of antibiotic prophylaxis was high. The incidence of surgical site infection was low and compliance of antibiotic prophylaxis contributes to diminish surgical site infection incidence.


OBJETIVO: El objetivo de este trabajo ha sido evaluar la adecuación de la profilaxis antibiótica y su relación con la incidencia de infección de sitio quirúrgico (ISQ) en pacientes sometidos a cirugía de próstata.MATERIAL Y MÉTODOS: Estudio de cohortes prospectivo, realizado de enero de 2009 a septiembre de 2016. Se evaluó la adecuación global al protocolo de profilaxis antibiótica y de cada apartado de la profilaxis (inicio, vía de administración, antibiótico de elección, duración y dosis). Se describieron los porcentajes de adecuación. Se calculó la incidencia de infección tras un periodo máximo de 30 días de incubación. Se evaluó la adecuación entre adecuación de la profilaxis e ISQ mediante el riesgo relativo (RR). RESULTADOS: Se incluyeron 595 pacientes en el estudio. La adecuación global fue del 93,8%. La mayor causa de incumplimiento fue el inicio de la profilaxis con un 3,0%. La incidencia de infección de sitio quirúrgico fue del 1,0%. No se encontró relación entre la inadecuación de la profilaxis antibiótica y la infección de sitio quirúrgico (RR=1,01; IC95%: 1,00-1,02). No se encontró relación en el riesgo de infección entre la cirugía laparoscópica y la cirugía abierta (RR=0,37; IC95%: 0,08-1,98). CONCLUSIONES: La adecuación de la profilaxis antibiótica fue alta. La incidencia de infección de sitio quirúrgico fue baja y la adecuada cumplimentación de la profilaxis antibiótica en la cirugía de próstata permite reducir la incidencia de infección de sitio quirúrgico.

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Cad. Bras. Ter. Ocup ; 31: e3443, 2023. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS, Index Psi Periódicos Técnico-Científicos | ID: biblio-1430052

RESUMO

Resumen Introducción Los beneficios de la autoría múltiple son indudables, pero en ocasiones el número de autores es desproporcionadamente mayor que el contenido intelectual. Objetivo Conocer la autoría media en el ámbito terapia ocupacional y valorar sus posibles determinantes. Método Se incluyeron 19 revistas de la disciplina. Seleccionamos artículos de investigación y revisiones sistemáticas. Resultados Encontramos una media de 3,5 autores, con un aumento de 0,9 (R2=0,86) de 2011 a 2020. El número de autorías múltiples es mayor que de autorías individuales. Los tres posibles determinantes del aumento de la autoría parecen ser: (a) la visibilidad (las revistas open access/charge aumentan el número de autorías en 40,2%); (b) el factor de impacto (las revistas JCR [Journal Citation Report] aumentan en 15,7% frente a los otros); y (c) los cuartiles (las revistas ESCI [Emerging Sources Citation Index] aparecen en el panorama de las publicaciones y las SSCI/SCI [Social Science Citation Index/ Science Citation Index]experimentan su mayor subida de 10.5% en los Q1 [Primero Cuartil]). Conclusión Este estudio aporta por primera vez una información completa y contrastada, donde se muestra la autoría media de los artículos de terapia ocupacional y los determinantes que influyen.


Resumo Introdução Os benefícios da autoria múltipla são indiscutíveis, mas às vezes o número de autores é desproporcionalmente maior que o conteúdo intelectual. Objetivo Conhecer a média de autoria no campo da terapia ocupacional e avaliar seus possíveis determinantes. Método Foram incluídos 19 periódicos da área. Selecionamos artigos de pesquisa e revisões sistemáticas. Resultados Encontramos uma média de 3,5 autores com aumento de 0,9 (R2=0,86) de 2011 a 2020. O número de autorias múltiplas é maior que o de autorias individuais. Os três possíveis determinantes do aumento da autoria parecem ser a: (a) visibilidade (os periódicos de acesso aberto/cobrança aumentam o número de autorias em 40,2%); (b) o fator de impacto (os periódicos JCR [Journal Citation Report] aumentam 15,7% em relação ao demais) e (c) os quartis, //periódicos ESCI [Emerging Sources Citation Index] aparecem no cenário editorial e SSCI/SCI [Social Science Citation Index/ Science Citation Index]experimentam seu maior aumento de 10,5% no primeiro quartil [Q1]). Conclusão Este estudo fornece pela primeira vez informações confiáveis ​​e contrastadas, mostrando a autoria média de artigos de terapia ocupacional e os determinantes que a influenciam.


Abstract Introduction The benefits of multiple authorship are undoubted, but sometimes the number of authors is disproportionately greater than the intellectual content. Objective To know the average authorship in the occupational therapy field and assess its possible determinants. Method 19 journals of the discipline were included. We select research articles and systematic reviews. Results We found an average of 3.5 authors, with an increase of 0.9 (R2=0.86) from 2011 to 2020. The number of multiple authorships is greater than individual authorships. The three possible determinants of the increase in authorship seem to be: (a) visibility (open access/charge journals increase the number of authorships by 40.2%); (b) the impact factor (JCR [Journal Citation Report] journals increase by 15.7% compared to others) and (c) quartiles (ESCI Emerging Sources Citation Index] journals appear in the publishing landscape and SSCI/SCI [Social Science Citation Index/ Science Citation Index]experience their biggest rise of 10.5% in Q1 [First Quartile]). Conclusion This study provides complete and contrasted information for the first time, showing the average authorship of occupational therapy articles and the determinants that influence it.

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Cad. Bras. Ter. Ocup ; 31: e3381, 2023. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS, Index Psi Periódicos Técnico-Científicos | ID: biblio-1420982

RESUMO

Resumen Objetivo analizar el desarrollo histórico, la naturaleza y el volumen de la literatura científica de la Investigación sobre Educación Interprofesional en terapia ocupacional, así como los tipos de intervenciones que se desarrollan. Método Se utilizó un scoping review con un marco metodológico de cuatro etapas para capturar la evidencia que describe cómo las Investigación sobre Educación Interprofesional y la identidad profesional ha sido conceptualizada e integradas en la terapia ocupacional. Las bases de datos incluidas fueron MEDLINE, EMBASE, PubMed, Pubmed Central, ERIC, PsychInfo, Cinahl, Ciberindex, Dialnet, Scopus, Web of Science, Cochrane y Scielo. Como criterios de inclusión los artículos debían describir conceptos relacionados con la terapia ocupacional y otras disciplinas, identidad profesional y la educación interprofesional en estudiantes y/o profesionales. Del listado final se analizaron las variables: información demográfica, objetivo/propósito del estudio, detalles metodológicos, tipos de intervenciones realizadas y resultados/hallazgos principales. Resultados 18 artículos cumplieron los criterios y 16 se tuvieron en cuenta para la síntesis cualitativa. Predomina la investigación universitaria (92,3%). El 75% de la muestra de las investigaciones se concentra en estudiantes. La investigación mixta representa el 50% del estudio. Las intervenciones más numerosas en Investigación sobre Educación Interprofesional son prácticas en el aula (62,5%) frente a prácticas de campo (37,5%). Conclusión este estudio muestra la fortaleza de las prácticas ligadas a la educación interprofesional y su vínculo para desarrollar la identidad profesional. La formación de colaboración interprofesional en comparación con la educación clínica tradicional, aumenta la identidad profesional a través de la autoeficacia percibida de los estudiantes.


Resumo Objetivo analisar o desenvolvimento histórico, a natureza e o volume da produção científica sobre pesquisa em educação interprofissional em terapia ocupacional, bem como os tipos de intervenções que são desenvolvidas. Método Uma revisão de escopo com uma estrutura metodológica de quatro estágios foi usada para capturar evidências que descrevem como a pesquisa em educação interprofissional e a identidade profissional foram conceituadas e integradas à terapia ocupacional. As bases de dados incluídas foram MEDLINE, EMBASE, PubMed, Pubmed Central, ERIC, PsychInfo, Cinahl, Ciberindex, Dialnet, Scopus, Web of Science, Cochrane e Scielo. Como critérios de inclusão, os artigos deveriam descrever conceitos relacionados à terapia ocupacional e outras disciplinas, identidade profissional e educação interprofissional em estudantes e/ou profissionais. Da lista final, foram analisadas as variáveis: informações demográficas, objetivo/finalidade do estudo, detalhes metodológicos, tipos de intervenções realizadas e principais resultados/achados. Resultados 18 artigos atenderam aos critérios e 16 foram considerados para a síntese qualitativa. Predomina a pesquisa universitária (92,3%). 75% da amostra da pesquisa se concentra nos alunos. A pesquisa mista representa 50% do estudo. As intervenções mais numerosas na Pesquisa em Educação Interprofissional são as práticas de sala de aula (62,5%) em oposição às práticas de campo (37,5%). Conclusão este estudo mostra a força das práticas vinculadas à educação interprofissional e seu vínculo com o desenvolvimento da identidade profissional. O treinamento interprofissional colaborativo, em comparação com a educação clínica tradicional, aumenta a identidade profissional por meio da autoeficácia percebida pelos alunos.


Abstract Objective To analyze the historical development, nature, and volume of scientific literature on Interprofessional Education Research in occupational therapy, as well as the types of interventions carried out. Method A scoping review was used with a four-stage methodological framework to capture evidence describing how Interprofessional Education Research and professional identity has been conceptualized and integrated into occupational therapy. The databases included were MEDLINE, EMBASE, PubMed, Pubmed Central, ERIC, PsychInfo, Cinahl, Ciberindex, Dialnet, Scopus, Web of Science, Cochrane, and Scielo. As inclusion criteria, articles had to describe concepts related to occupational therapy and other disciplines, professional identity, and interprofessional education in students and/or professionals. From the final list, the following variables were analyzed: demographic information, study objective/purpose, methodological details, types of interventions carried out, and main results/findings. Results 18 articles met the criteria and 16 were considered for qualitative synthesis. University research predominated (92.3%). 75% of the research sample focuses on students. Mixed research represents 50% of the study. The most numerous interventions in Interprofessional Education Research are in-class practices (62.5%) versus field practices (37.5%). Conclusion This study shows the strength of practices linked to interprofessional education and their link to developing professional identity. Interprofessional collaboration training compared to traditional clinical education increases professional identity through perceived self-efficacy of students.

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