Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22
Filtrar
Mais filtros

Tipo de documento
Intervalo de ano de publicação
1.
BMC Health Serv Res ; 24(1): 582, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38702763

RESUMO

BACKGROUND: Health professionals in Colombian and many parts of the world, in some cases, work in precarious conditions and intend to migrate to other countries in search of better living conditions for themselves and their families, which results in inadequate distribution worldwide and in the quality of care throughout the health system, which can ultimately influence the quality of life of patients in their health-disease processes. PURPOSE: Describe in depth what quality of life at work is like for the health workforce in adult critical care (ACC). METHODS: This is an investigation of convergent parallel mixed methods approach that are integrated by means of a matrix in terms of convergence, divergence, and complementarity. Two methods are used: a transversal analytical method in which three instruments were applied to 209 participants to study the relationship between Quality of Life at Work, exposure to psychosocial risks, compassion fatigue and the intention to rotate; other than from the experiences narrated by 10 Human Talent in Health explore organizational practices in critical care. RESULTS: The dimension of quality of work life with the greatest dissatisfied was the management of free time (77%), the most compromised psychosocial risk was the pace of work (84%). They have high compassion satisfaction (67%) and there is an intention to migrate to another country (66%). The narrative results in discrimination/harassment as normalized practices and faceless spirituality. The integration of mixed methods shows convergence between the use of the instrument that measures quality of life at work and the narratives of the participants, complementarity with the other instruments, and divergence regarding the intention to rotate to another health institution. CONCLUSION: The positive trend that converges with the two approaches is that of safety at work and well-being achieved through work, embodied in the constant updating of technology and care protocols, experience time, balance between salary and work effort, staffing and supplies, and disconnection with work.


Assuntos
Cuidados Críticos , Satisfação no Emprego , Qualidade de Vida , Humanos , Colômbia , Adulto , Masculino , Feminino , Cuidados Críticos/psicologia , Pessoal de Saúde/psicologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Fadiga de Compaixão/psicologia
2.
Indian J Crit Care Med ; 28(4): 355-363, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38585316

RESUMO

Aim and background: Satisfaction with the quality of work life reflects the inadequate distribution of the workforce in critical care units and is not enough; on many occasions, they work in precarious conditions and with high levels of physical, emotional, spiritual, and social demands, impacting the quality of care. Aim: To identify predictors of the quality of work life of healthcare workers in adult critical care units (ACCU). Materials and methods: Quantitative study, cross-sectional analytical design with stratified two-stage sampling; three instruments were applied to 209 healthcare professionals in adult critical care units in different sites in a region of Colombia, concerning Quality of Life at Work-GOHISALO, Copenhagen Psychosocial Questionnaire-COPSOQ and Professional Quality of Life-ProQoL V. Multiple ordinal logistic regression was performed with exposure variables from the COPSOQ and ProQoL domains; the outcome variables were the dimensions of the Quality of Work Life instrument. Ethical standards for research involving human subjects were ensured. Results: According to the results of the multiple logistic models, quality of work life is predicted by job integration and predictability (OR = 6.93; 95% CI = 3.6-13.9), leisure time management and double presence (OR = 4.5; 95% CI = 1.22-8.79). Both job satisfaction and job security are related to leadership quality (OR=3.82; 95% CI = 2.27-6.55 and OR = 3.18; 95% CI = 1.22-8.79), respectively. Conclusions: The quality of work life of healthcare workers in adult intensive care units is predicted by quantitative demands, double presence, emotional demands, work pace, predictability, vertical trust, and quality of leadership. How to cite this article: Quinones-Rozo LP, Canaval-Erazo GE, Sandoval-Moreno LM. Predictors of Quality of Work Life in Health Care Workers at Adult Critical Care Units: A Cross-sectional Study. Indian J Crit Care Med 2024;28(4):355-363.

3.
Ann Fam Med ; (20 Suppl 1)2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36857193

RESUMO

Context: Dementia, characterized by a progressive decline in cognition, affects more than 50 million people globally. In 2020, the 5th Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD5) published up-to-date recommendations to guide the clinical management of persons living with dementia (PLWD) and their caregivers. However, primary care clinicians are not always up-to-date with current evidence as the information might be fragmented. Objective: To provide selected new and updated clinical guidance on the management of patients with dementia that are simple to use in a routine primary care practice. Study design: Recommendations were approved and graded based on the Appraisal of Guidelines for Research and Evaluation (AGREE II collaboration), GRADE, and a Delphi process. Setting: Working groups included experts from different backgrounds (primary care physicians, nurse practitioners and other primary care clinicians, neurologists, psychiatrists and geriatricians, researchers, knowledge translation experts, decisions makers, and PLWD and caregivers' representatives). The experts carried out systematic reviews, which guided the development of new recommendations for dementia care. Recommendations included: We summarize the most relevant CCCDTD5 recommendations for primary care clinicians Results: The relevant recommendations for primary care were focused on: a) risk reduction for the general population (nutrition, exercise, social engagement, education, and medication management), as well as for persons at risk of dementia (evaluation of hearing status and sleep, and cognitive training stimulation); b) screening and diagnosis of dementia, including the role of the informant, screening for patients at risk or with symptoms, use of cognitive tests and neuro-imaging, management of subjective cognitive decline); c) de-prescribing medications for dementia, including aspirin and cognitive enhancers; and d) non-pharmacological interventions for persons with dementia (exercise, cognitive stimulation therapy, psychoeducational interventions for caregivers, case management and dementia-friendly community/organizations). Conclusions: The development of recommendations for ongoing management of dementia is an iterative process as new evidence on interventions for dementia are published. The present recommendations are of importance for dementia care in a primary care setting as the entry point for PLWD into the health system.


Assuntos
Administração de Caso , Demência , Humanos , Canadá , Aspirina , Atenção Primária à Saúde
4.
BMC Health Serv Res ; 22(1): 353, 2022 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-35300660

RESUMO

BACKGROUND: Many primary care sites have implemented models to improve detection, diagnosis, and management of dementia, as per Canadian guidelines. The aim of this study is to describe the responses of clinicians, managers, and staff of sites that have implemented these models when presented with audit results, their insights on the factors that explain their results, their proposed solutions for improvement and how these align to one another. METHODS: One audit and feedback cycle was carried out in eight purposefully sampled sites in Ontario, Canada, that had previously implemented dementia care models. Audit consisted of a) chart review to assess quality of dementia care indicators, b) questionnaire to assess the physicians' knowledge, attitudes and practice toward dementia care, and c) semi-structured interviews to understand barriers and facilitators to implementing these models. Feedback was given to clinicians, managers, and staff in the form of graphic and oral presentations, followed by eight focus groups (one per site). Discussions revolved around: what audit results elicited more discussion from the participants, 2) their insights on the factors that explain their audit results, and 3) solutions they propose to improve dementia care. Deductive content and inductive thematic analyses, grounded in causal pathways models' theory was performed. FINDINGS: The audit and feedback process allowed the 63 participants to discuss many audit results and share their insights on a) organizational factors (lack of human resources, the importance of organized links with community services, clear roles and support from external memory clinics) and b) clinician factors (perceived competency practice and attitudes on dementia care), that could explain their audit results. Participants also provided solutions to improve dementia care in primary care (financial incentives, having clear pathways, adding tools to improve chart documentation, establish training on dementia care, and the possibility of benchmarking with other institutions). Proposed solutions were well aligned with their insights and further nuanced according to contextual details. CONCLUSIONS: This study provides valuable information on solutions proposed by primary care clinicians, managers, and staff to improve dementia care in primary care. The solutions are grounded in clinical experience and will inform ongoing and future dementia strategies.


Assuntos
Demência , Demência/diagnóstico , Demência/terapia , Retroalimentação , Grupos Focais , Humanos , Ontário , Atenção Primária à Saúde
5.
BMC Fam Pract ; 22(1): 186, 2021 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-34525960

RESUMO

BACKGROUND: Persons living with dementia have various health and social care needs and expectations, some which are not fully met by health providers, including primary care clinicians. The Quebec Alzheimer plan, implemented in 2014, aimed to cover these needs, but there is no research on the effect this plan had on the needs and expectations of persons living with dementia. The objective of this study is to identify persons living with dementia and caregivers' met and unmet needs and to describe their experience. METHODS: This is a sequential mixed methods explanatory design: Phase 1: cross-sectional study to describe the met and unmet health and social care needs of community-dwelling persons living with dementia using Camberwell Assessment of Need of the Elderly and Carers' Assessment for Dementia tools. Phase 2: qualitative descriptive study to explore and understand the experiences of persons living with dementia and caregivers with the use of social and healthcare services, using semi-structured interviews. Data from phase 1 was analyzed with descriptive statistics, and from phase 2, with inductive thematic analysis. Results from phases 1 and 2 were compared, contrasted and interpreted together. RESULTS: The mean total number of needs reported by the patients was 5.03 (4.48 and 0.55 met and unmet needs, respectively). Caregivers had 0.52 met needs (3.16 unmet needs). The main needs for both were memory, physical health, eyesight/hearing/communication, medication, looking after home, money/budgeting. Three categories were mentioned by the participants: Persons living with dementia and caregiver's attitude towards memory decline, their perception of community health services and of the family medicine practice. CONCLUSIONS: Our study confirms the findings of other studies on the most common unmet needs of the patients and caregivers that are met partially or not at all. In addition, the participants were satisfied with access to care, and medical services in primary practices, being confident in their family. Our results indicate persons living with dementia and their caregivers need a contact person, a clear explanation of their dementia diagnosis, a care plan, written information on available services, and support for the caregivers.


Assuntos
Doença de Alzheimer , Demência , Idoso , Doença de Alzheimer/terapia , Cuidadores , Estudos Transversais , Demência/terapia , Humanos , Atenção Primária à Saúde , Quebeque
6.
Reprod Health ; 18(1): 88, 2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33910570

RESUMO

BACKGROUND: Short birth interval is associated with adverse perinatal, maternal, and infant outcomes, although evidence on actionable factors underlying short birth interval remains limited. We explored women and community views on short birth intervals to inform potential solutions to promote a culturally safe child spacing in Northern Uganda. METHODS: Gendered fuzzy cognitive mapping sessions (n = 21), focus group discussions (n = 12), and an administered survey questionnaire (n = 255) generated evidence on short birth intervals. Deliberative dialogues with women, their communities, and service providers suggested locally relevant actions promote culturally safe child spacing. RESULTS: Women, men, and youth have clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice as women are disempowered to exercise child spacing. Women who use contraceptives without their husbands' consent risk losing financial and social assets and are likely to be subject to intra-partner violence. Women were not comfortable with available contraceptive methods and reported experiencing well-recognized side effects. They reported anxiety about the impact of contraception on the health of their future children. This fear was fed by rumors in their communities about the effects of contraceptives on congenital diseases. The women and their communities suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives. CONCLUSIONS: The economic context, gender power dynamics, inequality, gender bias in land tenure and ownership regulations, and the limited contraceptive supply reduce women's capacity to practice child spacing.


The evidence on what increases birth spacing remains limited. This study explored community views on influences on short birth interval to promote a culturally safe child spacing in Northern Uganda. A participatory research process began by collating perspectives of causes of short birth intervals through fuzzy cognitive mapping. Focus group discussions clarified concepts emerging from the fuzzy cognitive mapping exercise. Fieldworkers administered a household survey to quantify reproductive health outcomes. In deliberative dialogue sessions involving women and their communities, shared and discussed these results and suggested potential actions to promote culturally safe child spacing. Women, men, and youth showed clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice, however, as women feel they are unable to exercise child spacing. Women who use contraceptives without their husbands' consent risk losing financial and social resources and are likely to face intra-partner violence. Women were not comfortable with contraceptive methods and reported experiencing side effects. The deliberative dialogues suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives.


Assuntos
Intervalo entre Nascimentos , Comportamento Contraceptivo , Anticoncepção/estatística & dados numéricos , Adolescente , Adulto , Criança , Pesquisa Participativa Baseada na Comunidade , Feminino , Teoria Fundamentada , Humanos , Masculino , Casamento , Idade Materna , Gravidez , Saúde Reprodutiva , Sexismo , Normas Sociais , Uganda
7.
Sante Publique ; 32(4): 375-380, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33512104

RESUMO

Many countries have answered the call from the World Health Organization, and developed or implemented Alzheimer Plans. Some plans anchored the majority of the care for persons living with dementia in specialized care settings, while others anchored it in primary care. In this article we present the Quebec Alzheimer Plan, which is being implemented in Family Medicine Groups, primary care interdisciplinary clinics, across the Canadian province. The Quebec Alzheimer Plan aims to enable primary healthcare teams of physicians, nurses and/or social workers to provide access to personalized, coordinated assessment and treatment services for people living with dementia and their caregivers. The Quebec Alzheimer Plan enables and empowers primary care clinicians to detect, diagnose, treat and follow-up the vast majority of patients/caregivers. A major strength of the Quebec Alzheimer Plan strategy is the embedded evaluation to inform implementation and its flexibility to allow local adaptations. We are discussing that it is feasible and advantageous to anchor dementia care in an interprofessional primary care setting.


Assuntos
Doença de Alzheimer , Atenção Primária à Saúde , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/terapia , Canadá , Medicina de Família e Comunidade , Humanos , Quebeque
10.
BMC Prim Care ; 25(1): 259, 2024 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-39020277

RESUMO

BACKGROUND: The COVID-19 pandemic changed the healthcare system, leading to the rapid evolution and implementation of telemedicine (TM). TM has the potential to improve the quality of primary health care and increase accessibility for the population. However, its use may represent challenges for older people, as they may have distinct needs from the general population due to age-related changes in perceptual, motor, and cognitive capacities. We, thus, aimed to identify potential facilitators and barriers to TM use in primary care for older adults and develop recommendations accordingly. METHODS: We conducted a qualitative study to explore the challenges associated with TM use among older adults and healthcare professionals (HCPs) in primary care practice. Interviews were conducted with 29 older adults, and three focus groups involving HCPs from four McGill family medicine sites were organized. Employing a hybrid codebook thematic analysis, guided by the Consolidated Framework for Implementation Research (CFIR), we identified facilitators and barriers affecting the optimal use of TM by older adults and HCPs. We synthesized the results from semi-structured interviews and focus groups. These findings were then presented during a deliberative dialogue with eight participants, including family physicians, nurses, a social worker, and a government-level TM expert, to validate our results. The purpose was to gather feedback, identify and refine actionable recommendations. Subsequently, we utilized a thematic analysis using the same codebook to synthesize findings from the deliberative dialogue. RESULTS: Participants agreed that TM contributed to maintaining the continuity of care and was particularly convenient when there was an existing or established patient-physician relationship or for addressing minor health issues. TM was found to be beneficial for people with limited mobility, reducing their exposure to potentially high-risk environments. However, participants expressed concerns about the lack of visual contact, causing essential details to be overlooked. Additionally, issues related to miscommunication due to language or hearing barriers were identified. HCPs perceived that most older adults did not consider phone consultations a medical act. Participants were open to a hybrid approach, combining in-person consultations and TM, based on their specific health conditions. Building upon these results, we formulated seven key recommendations. CONCLUSIONS: Both older adults and HCPs consider TM a good alternative for accessing healthcare services. To improve the effective use of TM, it's crucial to advocate for a hybrid approach that integrates both in-person and virtual methods. This approach should actively encourage and support individuals in becoming familiar with technological tools.


Assuntos
COVID-19 , Grupos Focais , Atenção Primária à Saúde , Pesquisa Qualitativa , Telemedicina , Humanos , Idoso , COVID-19/epidemiologia , Feminino , Masculino , SARS-CoV-2 , Idoso de 80 Anos ou mais , Pandemias , Entrevistas como Assunto
11.
Can J Aging ; : 1-12, 2023 Oct 19.
Artigo em Inglês | MEDLINE | ID: mdl-37855225

RESUMO

In 2020, the fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD5) published up-to-date recommendations for the clinical management of persons living with dementia (PLWD) and their caregivers. During the CCCDTD5 meetings, a list of recommendations for dementia care was compiled. With the aid of family physicians and the Canadian Consortium on Neurodegeneration in Aging, we selected the most relevant CCCDTD5 recommendations for primary care and tailored and summarized them in the present manuscript to facilitate their reference and use. These recommendations focus on (a) risk reduction, (b) screening and diagnosis, (c) deprescription of dementia medications, and (d) non-pharmacological interventions. The development of recommendations for the ongoing management of dementia is an iterative process as new evidence on interventions for dementia is published. These recommendations are important in the primary care setting as the entry point for PLWD into the health system.

12.
Integr Org Biol ; 4(1): obac036, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36110288

RESUMO

Passive thermoregulation is an important strategy to prevent overheating in thermally challenging environments. Can the diversity of optical properties found in Christmas beetles (Rutelinae) be an advantage to keep cool? We measured changes in temperature of the elytra of 26 species of Christmas beetles, exclusively due to direct radiation from a solar simulator in visible (VIS: 400-700 nm) and near infrared (NIR: 700-1700 nm) wavebands. Then, we evaluated if the optical properties of elytra could predict their steady state temperature and heating rates, while controlling for size. We found that higher absorptivity increases the heating rate and final steady state of the beetle elytra in a biologically significant range (3 to 5°C). There was substantial variation in the absorptivity of Christmas beetle elytra; and this variation was achieved by different combinations of reflectivity and transmissivity in both VIS and NIR. Size was an important factor predicting the change in temperature of the elytra after 5 min (steady state) but not maximum heating rate. Lastly, we show that the presence of the elytra covering the body of the beetle can reduce heating of the body itself. We propose that beetle elytra can act as a semi-insulating layer to enable passive thermoregulation through high reflectivity of elytra, resulting in low absorptivity of solar radiation. Alternatively, if beetle elytra absorb a high proportion of solar radiation, they may reduce heat transfer from the elytra to the body through behavioral or physiological mechanisms.


La termorregulación pasiva es una estrategia para prevenir el calentamiento excesivo en ambientes con altas temperaturas. ¿Será posible que la diversidad en las propiedades ópticas de los élitros, en los escarabajos de Navidad (Rutelinae), sean una ventaja para evitar que su cuerpo se caliente excesivamente? En este trabajo medimos los cambios de temperatura en los élitros de 26 especies de escarabajos de Navidad, expuestos a radiación en el espectro visible (400­700 nm) e infrarrojo cercano (700­1700 nm), siendo ambas regiones del espectro producidas por un simulador solar. Luego, evaluamos si las propiedades ópticas de los élitros pueden predecir su temperatura final y tasa de calentamiento, controlando por la variable de tamaño. Encontramos que una mayor absorción de luz aumenta las tasas de calentamiento y temperatura final de los escarabajos en un rango significativo a nivel biológico. A su vez, esta absorción varía considerablemente entre especies ya que los élitros estudiados poseen diferentes combinaciones de reflectividad y transmisividad en el visible e infrarrojo cercano. El tamaño fue un predictor importante del cambio en la temperatura final de los élitros (°C después de 5 minutos), pero no en la tasa máxima de calentamiento (°C por segundo). Finalmente, demostramos que los élitros contribuyen a reducir la temperatura corporal cuando se cierran cubriendo la parte dorsal del escarabajo. Proponemos que los élitros altamente reflectivos pueden actuar como una capa semi-aislante, que contribuye a la termorregulación pasiva disminuyendo la absorción de luz. Por otro lado, los escarabajos cuyos élitros absorben una gran proporción de la radiación solar, podrían implementar mecanismos fisiológicos o comportamentales adicionales para reducir la transferencia de calor desde los élitros al cuerpo.

13.
Curr Biol ; 31(4): R172-R173, 2021 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-33621499

RESUMO

Amanda M. Franklin and Laura Ospina-Rozo introduce the biology and physics of gloss in nature.


Assuntos
Luz , Animais , Humanos
14.
Trends Ecol Evol ; 36(3): 187-195, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33168152

RESUMO

Signals reliably convey information to a receiver. To be reliable, differences between individuals in signal properties must be consistent and easily perceived and evaluated by receivers. Iridescent objects are often striking and vivid, but their appearance can change dramatically with viewing geometry and illumination. The changeable nature of iridescent surfaces creates a paradox: how can they be reliable signals? We contend that iridescent color patches can be reliable signals only if accompanied by specific adaptations to enhance reliability, such as structures and behaviors that limit perceived hue shift or enhance and control directionality. We highlight the challenges of studying iridescence and key considerations for the evaluation of its adaptive significance.


Assuntos
Iridescência , Iluminação , Cor , Humanos , Reprodutibilidade dos Testes
15.
Med Sci Educ ; 31(3): 1213-1246, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34031640

RESUMO

Knowledge was mapped about how usability has been applied in the evaluation of blended learning programs within health professions education. Across 80 studies, usability was explicitly mentioned once but always indirectly evaluated. A conceptual framework was developed, providing a foundation for future instruments to evaluate usability in this context. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01295-x.

16.
Artigo em Inglês | MEDLINE | ID: mdl-33731319

RESUMO

OBJECTIVES: Describe participatory codesign of interventions to improve access to perinatal care services in Northern Uganda. STUDY DESIGN: Mixed-methods participatory research to codesign increased access to perinatal care. Fuzzy cognitive mapping, focus groups and a household survey identified and documented the extent of obstructions to access. Deliberative dialogue focused stakeholder discussions of this evidence to address the obstacles to access. Most significant change stories explored the participant experience of this process. SETTING: Three parishes in Nwoya district in the Gulu region, Northern Uganda. PARTICIPANTS: Purposively sampled groups of women, men, female youth, male youth, community health workers, traditional midwives and service providers. Each of seven stakeholder categories included 5-8 participants in each of three parishes. RESULTS: Stakeholders identified several obstructions to accessing perinatal care: lack of savings in preparation for childbirth in facility costs, lack of male support and poor service provider attitudes. They suggested joining saving groups, practising saving money and income generation to address the short-term financial shortfall.They recommended increasing spousal awareness of perinatal care and they proposed improving service provider attitudes. Participants described their own improved care-seeking behaviour and patient-provider relationships as short-term gains of the codesign. CONCLUSION: Participatory service improvement is feasible and acceptable in postconflict settings like Northern Uganda. Engaging communities in identifying perinatal service delivery issues and reflecting on local evidence about these issues generate workable community-led solutions and increases trust between community members and service providers.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Assistência Perinatal , Adolescente , Criança , Agentes Comunitários de Saúde , Feminino , Grupos Focais , Humanos , Recém-Nascido , Masculino , Gravidez , Uganda
17.
Data Brief ; 33: 106508, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33294508

RESUMO

The distribution and isotopic composition (δ13C and δD) of lipids are proxies used to determinate paleoenvironmental conditions including precipitation regimes, vegetation changes and sources of organic matter, among others. This data article describes five datasets of distribution (n-alkanes, fatty acids, n-alkanols and sterols) and isotopic composition (n-alkanes and fatty acids) of lipids determined in 50 samples from a gravity core (GeoB16202-2) retrieved on the continental slope off northeastern Brazil. The core site is influenced by the Parnaiba freshwater discharge, the North Brazil Current and by the Intertropical Convergence Zone (ITCZ). Previous work focused on inorganic proxies in this core revealed important clues of climatic conditions during the Heinrich Stadial 1 (HS1). The baseline dataset of molecular and isotopic proxies of the organic matter provided here are additional and/or complimentary evidences to help elucidate past climate change during the Quaternary in the Equatorial Atlantic, where less information is available in comparison to other regions in this ocean.

18.
Alzheimers Dement (N Y) ; 6(1): e12086, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33209973

RESUMO

INTRODUCTION: Current pharmacological therapies for dementia have limited efficacy. Thus it is important to provide recommendations on individual and community-based psychosocial and non-pharmacological interventions for persons living with dementia (PLWDs) and their caregivers. METHODS: Phase 1: A systematic review for developing recommendations on psychosocial and non-pharmacological interventions at the individual and community level for PLWDs and their caregivers. Phase 2: Rating of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. Phase 3: Delphi process (>50 dementia experts) for approving recommendations by the 5th Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD5). RESULTS: The CCCDTD5 approved the following recommendations: Exercise (1B) and group cognitive stimulation for PLWDs (2B), psychosocial and psychoeducational interventions for caregivers (2C), development of dementia friendly organization and communities (2C), and case management for PLWDs (2B). DISCUSSION: The CCCDTD5 provides for the first time, evidence-based recommendations on psychosocial and non-pharmacological interventions for PLWDs and their caregivers that can inform evidence-based policies for PLWDs in Canada.

19.
Sci Rep ; 10(1): 10685, 2020 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-32606366

RESUMO

Plant organs including flowers and leaves typically have a variety of different micro-structures present on the epidermal surface. These structures can produce measurable optical effects with viewing angle including shifts in peak reflectance and intensity; however, these different structures can also modulate hydrophobic properties of the surfaces. For some species optical effects have been proposed to act as signals to enhance pollination interactions, whilst the ability to efficiently shed water provides physiological advantages to plants in terms of gas exchange and reducing infections. Currently, little is known about epidermal surface structure of flowering plants in the Southern Hemisphere, and how micro-surface may be related with either hydrophobicity or visual signalling. We measured four Australian native species and two naturalised species using a combination of techniques including SEM imaging, spectral sampling with a goniometer and contact angle measurements. Spectral data were evaluated in relation to published psychophysics results for important pollinators and reveal that potential visual changes, where present, were unlikely to be perceived by relevant pollinators. Nevertheless, hydrophobicity also did not simply explain petal surfaces as similar structures could in some cases result in very different levels of water repellency.


Assuntos
Flores/fisiologia , Iridescência/fisiologia , Magnoliopsida/fisiologia , Austrália , Interações Hidrofóbicas e Hidrofílicas , Pigmentação/fisiologia , Polinização/fisiologia
20.
Hepatología ; 2(2): 372-379, 2021. ilus, tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1396512

RESUMO

La enfermedad inflamatoria intestinal es una patología crónica en la que participa el sistema inmune, que puede acompañarse de manifestaciones extraintestinales en el hígado y vías biliares. El síndrome de Budd-Chiari se ha descrito previamente como una complicación rara de la colitis ulcerativa. Se describe el caso de una paciente joven con antecedente de colitis ulcerativa y trombosis venosa de miembro inferior, en manejo crónico con aminosalicilatos y anticoagulada durante 6 meses, quien debutó con cuadro clínico de ascitis de dos meses de evolución, con líquido ascítico de características hipertensivas, documentación imagenológica y biopsia hepática compatibles con síndrome de Budd-Chiari. Se presenta reporte de caso y revisión breve de la literatura.


Inflammatory bowel disease is a chronic disease involving the immune system, which can be accompanied by extraintestinal manifestations in the liver and biliary tract. Budd-Chiari syndrome has previously been described as a rare complication of ulcerative colitis. We describe the case of a young patient with a history of ulcerative colitis and venous thrombosis of the lower limb, under chronic management with aminosalicylates, and anticoagulation therapy for the past 6 months, who consulted with a 2-month history of ascites, with hypertension-related ascitic fluid, imaging analysis and liver biopsy compatible with Budd-Chiari syndrome. A case report and a brief literature review are presented.


Assuntos
Humanos , Feminino , Adulto , Ascite/etiologia , Colite Ulcerativa/complicações , Síndrome de Budd-Chiari/complicações , Doenças Inflamatórias Intestinais/complicações , Trombose Venosa/complicações , Síndrome de Budd-Chiari/diagnóstico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA