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1.
Trop Med Int Health ; 29(5): 424-433, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38545908

RESUMEN

The spread of antimicrobial resistance (AMR) through multiple reservoirs is a global concern. Wastewater is a critical AMR dissemination source, so this study aimed to assess the persistence of resistance genetic markers in wastewater using a culture-independent approach. Raw and treated wastewater samples (n = 121) from a wastewater treatment plant (WWTP), a human hospital, a veterinary hospital, and a pig farm were monthly collected and concentrated by filtration. DNA was extracted directly from filter membranes, and PCR was used in the qualitative search of 32 antimicrobial resistance genes (ARGs). Selected genes (blaCTX-M, blaKPC, qnrB, and mcr-1) were enumerated by quantitative real-time PCR (qPCR). Twenty-six ARGs were detected in the qualitative ARGs search, while quantitative data showed a low variation of the ARG's relative abundance (RA) throughout the months, especially at the human hospital and the WWTP. At the WWTP, despite significantly reducing the absolute number of gene copies/L after each treatment stage (p < 0.05), slight increases (p > 0.05) in the RAs of genes blaCTX-M, qnrB, and mcr-1 were observed in reused water (tertiary treatment) when compared with secondary effluent. Although the increase is not statistically significant, it is worth noting that there was some level of ARGs concentration after the disinfection process. No significant absolute or relative after-treatment quantification reductions were observed for any ARGs at the veterinary hospital or the pig farm. The spread of ARGs through sewage needs to be continuously addressed, because their release into natural environments may pose potential risks of exposure to resistant bacteria and impact local ecosystems.


Asunto(s)
Aguas Residuales , Aguas Residuales/microbiología , Animales , Humanos , Brasil , Porcinos , Farmacorresistencia Bacteriana/genética , Antibacterianos/farmacología , Genes Bacterianos
2.
Cryobiology ; 115: 104901, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38754687

RESUMEN

While cryopreservation of cauda epididymal sperm (SpCau) allows the preservation of post-mortem bulls' gametes, the process triggers sperm damage. Although improving post-thaw sperm quality, using egg yolk extenders (EY) raises biosafety concerns which forces the use of EY-free extenders (EYFE). Since EYFE are less efficient in preserving post-thaw sperm quality, a strategy for ejaculated sperm (SpEj) frozen with EYFE is to add an Equilibrium Time (ET) step period to the cryopreservation process. However, the ET effect on the quality of SpCau cryopreserved in EYFE remains unknown. Distinct from SpEJ, SpCau physiologically displays cytoplasmic droplets (CDs) in the flagellum that may benefit cell exchange during ET. We hypothesized that using ET in SpCau cryopreserved with EYFE impacts sperm morphofunctional features, CD area, and in vitro fertility ability. Extender nanoparticles were also assessed. Following collection from the cauda epididymis of six Nellore bulls by retrograde flow, SpCau were cryopreserved in EYFE BoviFree® (Minitube, Germany) using three ET protocols: ET0 (no-ET); ET2.5 (2.5 h-ET); and ET5 (5 h-ET). SpCau from ET2.5 and ET5 showed a higher (P ≤ 0.05) percentage of motility and integrity of plasma and acrosome membranes and a smaller (P ≤ 0.05) distal CD area. There are no differences in sperm abnormalities, oxidative stress, capacitation-like events, and in vitro fertility ability. However, a better sperm recovery was found after Percoll® selection for ET2.5 and ET5. Interestingly, the number of nanoparticles in the extender decreased in post-thawed samples. In conclusion, an ET of 2.5 or 5 h is required for an efficient SpCau cryopreservation using an EYFE.


Asunto(s)
Criopreservación , Crioprotectores , Epidídimo , Nanopartículas , Preservación de Semen , Motilidad Espermática , Espermatozoides , Masculino , Animales , Criopreservación/métodos , Criopreservación/veterinaria , Preservación de Semen/métodos , Preservación de Semen/veterinaria , Crioprotectores/farmacología , Espermatozoides/citología , Epidídimo/citología , Bovinos , Nanopartículas/química , Yema de Huevo/química , Análisis de Semen , Citoplasma
3.
Int J Biometeorol ; 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38976066

RESUMEN

Several remote sensing indices have been used to monitor droughts, mainly in semi-arid regions with limited coverage by meteorological stations. The objective of this study was to estimate and monitor agricultural drought conditions in the Jequitinhonha Valley region, located in the Brazilian biomes of the Cerrado and Atlantic Forest, from 2001 to 2021, using vegetation indices and the meteorological drought index from remote sensing data. Linear regression was applied to analyze drought trends and Pearson's correlation coefficient was applied to evaluate the relationship between vegetation indices and climatic conditions in agricultural areas using the Standardized Precipitation Index. The results revealed divergences in the occurrences of regional droughts, predominantly covering mild to moderate drought conditions. Analysis spatial of drought trends revealed a decreasing pattern, indicating an increase in drought in the Middle and Low Jequitinhonha sub-regions. On the other hand, a reduction in drought was observed in the High Jequitinhonha region. Notably, the Vegetation Condition Index demonstrated the most robust correlation with the Standardized Precipitation Index, with R values ​​greater than 0.5 in all subregions of the study area. This index showed a strong association with precipitation, proving its suitability for monitoring agricultural drought in heterogeneous areas and with different climatic attributes. The use of remote sensing technology made it possible to detect regional variations in the spatio-temporal patterns of drought in the Jequitinhonha Valley. This vision helps in the implementation of personalized strategies and public policies, taking into account the particularities of each area, in order to mitigate the negative impacts of drought on agricultural activities in the region.

4.
Int J Biometeorol ; 2024 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-39167210

RESUMEN

The objective of this work was to evaluate the effect of using naturally shaded pastures on scrotal thermoregulatory capacity, testicular echotexture, and sperm morphology of Nelore (Bos indicus) and Canchim (5/8 Bos taurus x 3/8 Bos indicus) bulls in a tropical climate region. Sixty-four adult Nelore and Canchim bulls were used, equally allocated in Full Sun (FS, n = 32) or Crop-Livestock-Forestry (CLF, n = 32) pasture systems. During five consecutive climate seasons, the bulls underwent monthly breeding soundness evaluations and the biometeorological variables in the systems were continuously monitored. Microclimate was significantly different between systems. CLF system had lower BGHI than FS throughout the experimental period. No triple interaction (Season x Breed x Treatment, P > 0.05) was observed for any of the variables. Animals in CLF showed lower body temperature in Summer (FS:39.41 ± 0.05 vs. CLF:39.30 ± 0.05 °C; P = 0.005) and in Autumn (FS:39.54 ± 0.05 vs. CLF:39.35 ± 0.05 °C; P = 0.005). Access to shading did not determine differences in the evolution of scrotal biometry, temperatures, and scrotal thermal gradients (P > 0.05). Regardless of breed, animals in CLF showed greater right testicular volume (FS:247.5 ± 5.7 vs. CLF:259.0 ± 5.7 cm³; P < 0.05), more suitable parenchyma echotexture, and fewer microlithiasis spots in the Spring and Summer. Testosterone concentration was higher in FS (FS:2.6 ± 0.2 vs. CLF:2.1 ± 0.2 ng/mL; P = 0.035). Canchim bulls presented higher total sperm defects during the Autumn and Winter (P = 0.010), but the total defects levels for Canchim and Nelore bulls were in normal range for adult bulls. Thus, the natural shade in CLF system was effective in improving the microclimate of pastures and minimizing adverse environmental effects on some reproductive features of interest in beef cattle.

5.
J Med Virol ; 95(5): e28794, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37212257

RESUMEN

As the coronavirus disease 2019 (COVID-19) outbreak spread, evidence has emerged that gender and race would bear a disproportionate impact on the morbimortality of COVID-19. Here, we conducted a retrospective observational study using the TabNet/Departamento de informática do sistema único de saúde platform of the city of São Paulo. COVID-19 records from March 2020 through December 2021 were included, and we evaluated the temporal trends of confirmed cases and case fatality rate by gender and ethnicity. Statistical analysis was performed using the R-software and BioEstat-software, considering p < 0.05 significant. From March/2020 to December/2021, 1 315 160 COVID-19 confirmed cases were recorded (57.1% females), and 2973 deaths were due to COVID-19. Males presented higher median mortality (0.44% vs. 0.23%; p < 0.05) and intensive care unit (ICU) admission rates (0.34% vs. 0.20%; p < 0.05). Men were also associated with a higher risk of death (risk ratio [RR] = 1.28; p < 0.05) and a higher chance of requiring ICU care (RR = 1.29; p < 0.05). Black ethnicity was associated with a higher risk of death (RR = 1.19; p < 0.05). White patients were more likely to require ICU admission (RR = 1.13; p < 0.05), whereas Browns were associated with a protective effect (RR = 0.86; p < 0.05). Furthermore, men presented a higher chance of death than women across the three major ethnic groups: Whites (RR = 1.33; p < 0.05), Blacks (RR = 1.24; p < 0.05), and Browns (RR = 1.35; p < 0.05). In this study of COVID-19 in São Paulo, men were associated with worse outcomes, including in the three major ethnicities in the population. Blacks exhibited a higher risk of death, Whites were more likely to require intensive care, and Browns were at protection from ICU hospitalization.


Asunto(s)
COVID-19 , Masculino , Humanos , Femenino , COVID-19/epidemiología , Etnicidad , Brasil/epidemiología , SARS-CoV-2 , Morbilidad , Hospitalización
6.
Ecotoxicology ; 32(4): 525-535, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37119427

RESUMEN

This study evaluates single and joint endocrine disruptor toxicities of thyroid hormone, levothyroxine, and amiodarone in the embryo-larval stages of Danio rerio. Single toxicity experiments were carried out in concentrations based on the environmental concentration and increasing concentrations of 10, 100, and 1000 times the environmental concentration. Joint toxicity experiments evaluated the combined effects of these compounds. Toxic effects were examined during zebrafish embryonic development, and the parameters analyzed were apical sublethal, teratogenicity, mortality endpoints, and morphometry. Thyroid hormone exhibited the highest toxicity. However, the results showed that the environmental concentrations for all 3 compounds had low risk in relation to the parameters studied, such as teratogenic effects and morphometry. The larvae were more affected than embryos, where embryos needed higher concentrations in all experiments, possibly due to the absence of the chorion. The same type of effects were observed in the joint toxicity test, except that a possible antagonistic effect was detected. However, high concentrations showed stronger effects of these toxic compounds on fish development.


Asunto(s)
Amiodarona , Contaminantes Químicos del Agua , Animales , Pez Cebra , Tiroxina , Larva , Amiodarona/toxicidad , Hormonas Tiroideas , Contaminantes Químicos del Agua/toxicidad , Embrión no Mamífero
7.
An Acad Bras Cienc ; 95(suppl 3): e20230181, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38126379

RESUMEN

This work aimed to characterize the variation in the thermal regime of the active layer in a permafrost area on Fildes Peninsula, Antarctica, and relate this variability with meteorological data between 2014 and 2016. The monitoring site was installed to continuously monitor the temperature and moisture of the active layer, radiation flow on the surface, and air temperature. We used data collected to generate the indexes freezing degree-days, thawing degree-days, frost number, n-factor, apparent thermal diffusivity, and active layer thickness. The temperature of the active layer is not homogeneous, varying with depth and position in the transect, with the greatest variations in soil with better drainage and lower moisture content. Among the evaluated factors, air and soil surface temperature are the ones that most influence the thermal gradient of the active layer. We identified that near the surface there is a greater influence of albedo and cloudiness and at -35 cm depth there is a greater influence of net radiation and soil moisture. The average depth of the active layer in 2014 was -44.3 cm and in 2015 -47.7 cm and the frost number index indicates that there was a predominance of continuous permafrost in the transect during the monitoring.


Asunto(s)
Monitoreo del Ambiente , Contaminantes del Suelo , Regiones Antárticas , Suelo , Congelación , Contaminantes del Suelo/análisis
8.
J Clin Nurs ; 32(19-20): 7358-7371, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37477168

RESUMEN

AIMS: To explore stakeholders' perceptions of a facilitator's role in supporting carers when embedding iSupport for Dementia psychoeducation program, in care services. METHODS: A qualitative descriptive study design was applied. Data were collected from workshops and interviews with carers of people living with dementia (PLWD)and with health and social care professionals from two tertiary hospitals and two community aged care organisations across three Australian states between October 2021 and March 2022. A thematic analysis was used to analyse data. The COREQ guideline was followed to report our findings. RESULTS: A total of 30 family carers and 45 health and social care professionals participated in the study. Three main themes and seven subthemes were identified from the data. We described the main themes as (1) the facilitator's role at the time of dementia diagnosis, (2) the facilitator's role throughout the everyday dementia care journey and (3) the facilitator's role during transition moments. CONCLUSIONS: Caring for family members with dementia is demanding and stressful for carers. Embedding a facilitator-enabled iSupport for Dementia program in hospital and community aged care settings has the potential to mitigate sources of stress associated with care recipient factors, carer factors and care service factors, and improve the health and well-being of carers and those for whom they care. RELEVANCE TO CLINICAL PRACTICE: Our findings will inform the establishment of iSupport facilitators appointed by dementia care providers in hospital and community care settings and help determine their roles and responsibilities in delivering the iSupport program. Our findings relate to nurse-led and coordinated dementia care in hospital and community aged care settings. PATIENT OR PUBLIC CONTRIBUTION: This study was co-designed with stakeholders from two aged care organisations and two tertiary hospitals. The study participants were staff employed by these organisations and carers of PLWD who were service users.


Asunto(s)
Cuidadores , Demencia , Humanos , Anciano , Australia , Investigación Cualitativa , Servicios de Salud
9.
J Appl Biomech ; 39(4): 254-263, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-37487581

RESUMEN

The upper body and trunk muscles are crucial to perform soccer kicks. Resistance training targeting these muscles may modify the pattern adopted during kicking. This study aimed to investigate the effect of resistance training of the arm and anterior trunk muscles on instep kicking kinematics. Twenty-six male participants were randomly allocated into a training group or control group. The training group underwent resistance training of arm and trunk muscles and practiced the instep kick for 8 weeks. The control group only practiced kicking during the same period. The trunk, hip, and knee kinematics were assessed during the instep kick before and after the intervention. Kinematics were analyzed according to their data distribution with statistical parametric or nonparametric mapping. The effect of the training on the 1-repetition maximum test was analyzed using a repeated-measures multivariate analysis of variance. The training group showed greater hip extension after the training during the backswing phase (Hedge g effect size of 0.316-0.321) and increased 1-repetition maximum for all exercises. There were no other differences. The present study documented the nonlocal effect of strengthening training in which arm and trunk muscle training resulted in changes in hip kinematics during the backswing phase of the instep kick.


Asunto(s)
Entrenamiento de Fuerza , Fútbol , Humanos , Masculino , Fútbol/fisiología , Fenómenos Biomecánicos , Músculo Esquelético/fisiología , Extremidad Superior
10.
J Sport Rehabil ; 32(6): 635-644, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-37156538

RESUMEN

CONTEXT: Knowing the methods to assess the external load in Paralympic sports can help multidisciplinary teams rely on scientific evidence to better prescribe and monitor the athlete's development, improving sports performance and reducing the risk of injury/illness of Paralympic athletes. OBJECTIVES: This review aimed to systematically explore the current practices of quantifying the external load in Paralympic sports and provide an overview of the methods and techniques used. EVIDENCE ACQUISITION: A search in PubMed, Web of Science, Scopus, and EBSCO was carried out until November 2022. The measures of interest were objective methods for quantifying the external load of training or competition. The inclusion criteria for the studies were as follows: (1) peer-reviewed article; (2) the population were Paralympic athletes; (3) evaluated during training or competition; (4) reported at least one external load measure; and (5) published in English, Portuguese, or Spanish. EVIDENCE SYNTHESIS: Of the 1961 articles found, 22 were included because they met the criteria, and 8 methods were identified to quantify the external load in training or competition in 8 Paralympic sports. The methods varied according to the characteristics of the Paralympic sports. To date, the devices used included an internal radiofrequency-based tracking system (wheelchair rugby) a miniaturized data logger (wheelchair tennis, basketball, and rugby); a linear position transducer (powerlifting and wheelchair basketball); a camera (swimming, goalball, and wheelchair rugby); a global positioning system (wheelchair tennis); heart rate monitors that assess external load variables in set (paracycling and swimming) and an electronic timer (swimming). CONCLUSIONS: Different objective methods were identified to assess the external load in Paralympic sports. However, few studies showed the validity and reliability of these methods. Further studies are needed to compare different methods of external load quantification in other Paralympic sports.


Asunto(s)
Rendimiento Atlético , Baloncesto , Tenis , Humanos , Reproducibilidad de los Resultados , Rendimiento Atlético/fisiología , Natación , Atletas
11.
J Sport Rehabil ; 32(2): 203-214, 2023 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-36150706

RESUMEN

CONTEXT: Sleep serves many important functions for athletes, particularly in the processes of learning, memory, recovery, and cognition. OBJECTIVES: Define the sleep parameters of Paralympic athletes and identify the instruments used to assess and monitor sleep Paralympic athletes. EVIDENCE ACQUISITION: This systematic review was carried out based on the PRISMA guidelines. The survey was conducted in April 2020, the searches were carried out again in September 2021 to check whether there were new scientific publications in the area of sleep and Paralympic sport, searches were performed in the following databases: PubMed, Web of Science, Scopus, SPORTDiscus, Virtual Health Library (BIREME), and SciELO. This systematic review has included studies that investigated at least one of the following sleep parameters: total sleep time, sleep latency, sleep efficiency, number of awakenings, quality of sleep, daytime sleepiness, and chronotype; the participants were comprised of athletes with disabilities. Studies published at any time in English, Portuguese, and Spanish, were included. EVIDENCE SYNTHESIS: Data extraction and study selection were performed by 2 researchers independently, and a third author was consulted as necessary. The search returned a total of 407 studies. Following the screening based on exclusion and inclusion criteria, a total of 13 studies were considered. Paralympic athletes have a low amount (7.06 h) of sleep with poor quality and sleep latency (28.05 min), and 57.2% have daytime sleepiness, with the majority belonging to the indifferent chronotype (53, 5%). Moreover, 11 studies assess sleep using subjective instruments (questionnaires), and 2 studies used an objective instrument (actigraphy). CONCLUSIONS: Sleep disorders are common among Paralympic athletes, poor sleep quality and quantity, and high rates of daytime sleepiness. Subjective methods are most commonly used to assess sleep.


Asunto(s)
Trastornos de Somnolencia Excesiva , Paratletas , Trastornos del Inicio y del Mantenimiento del Sueño , Deportes , Humanos , Sueño , Atletas
12.
Biol Reprod ; 106(1): 213-226, 2022 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-34725678

RESUMEN

Holding at room temperature is the first step in most boar semen cryopreservation protocols. It is well accepted that a holding time (HT) of 24 h increases sperm cryotolerance. However, the effect of HT on ejaculates with different freezability is not entirely clear. The aim of this study was to understand how HT influences spermatic and seminal plasma metabolite profiles of boar ejaculates and how these possible changes affect freezability. A total of 27 ejaculates were collected and extended to 1:1 (v: v) with BTS and split into two aliquots. The first aliquot was cryopreserved without HT (0 h), and the second was held at 17°C for 24 h before cryopreservation. Spermatozoa and seminal plasma were collected by centrifugation at two times, before HT (0 h) and after HT (24 h), and subsequently frozen until metabolite extraction and UPLC-MS analysis. After thawing, the semen samples were evaluated for kinetics, membrane integrity, mitochondrial potential, membrane lipid peroxidation, and fluidity. The ejaculates were then allocated into two phenotypes (good ejaculate freezers [GEF] and poor ejaculate freezers [PEF]) based on the percent reduction in sperm quality (%RSQ) as determined by the difference in total motility and membrane integrity between raw and post-thaw samples cryopreserved after 24 h of HT. The metabolic profile of the seminal plasma did not seem to influence ejaculate freezability, but that of the spermatozoa were markedly different between GEF and PEF. We identified a number of metabolic markers in the sperm cells (including inosine, hypoxanthine, creatine, ADP, niacinamide, spermine, and 2-methylbutyrylcarnitine) that were directly related to the improvement of ejaculate freezability during HT; these were components of metabolic pathways associated with energy production. Furthermore, PEF showed an upregulation in the arginine and proline as well as the glutathione metabolism pathways. These findings help to better understand the effect of HT on boar sperm freezability and propose prospective metabolic markers that may predict freezability; this has implications in both basic and applied sciences.


Asunto(s)
Criopreservación/veterinaria , Metaboloma/fisiología , Preservación de Semen/veterinaria , Espermatozoides/metabolismo , Sus scrofa , Factores de Tiempo , Animales , Criopreservación/métodos , Masculino , Fenotipo , Semen/química , Semen/metabolismo , Análisis de Semen/veterinaria , Preservación de Semen/métodos , Temperatura
13.
Age Ageing ; 51(4)2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-35460410

RESUMEN

OBJECTIVE: To assess the effectiveness of a pharmacist-led intervention using validated tools to reduce medicine-induced deterioration and adverse reactions. DESIGN AND SETTING: Multicenter, open-label parallel randomised controlled trial involving 39 Australian aged-care facilities. PARTICIPANTS: Residents on ≥4 medicines or ≥1 anticholinergic or sedative medicine. INTERVENTION: Pharmacist-led intervention using validated tools to detect signs and symptoms of medicine-induced deterioration which occurred every 8 weeks over 12 months. COMPARATOR: Usual care (Residential Medication Management Review) provided by accredited pharmacists. OUTCOMES: Primary outcome was change in Frailty Index at 12 months. Secondary outcomes included changes in cognition, 24-hour movement behaviour by accelerometry, grip strength, weight, adverse events and quality of life. RESULTS: 248 persons (median age 87 years) completed the study; 120 in the interventionand, 128 in control arms. In total 575 pharmacist, sessions were undertaken in the intervention arm. There was no statistically significant difference for change in frailty between groups (mean difference: 0.009, 95% CI: -0.028, 0.009, P = 0.320). A significant difference for cognition was observed, with a mean difference of 1.36 point change at 12 months (95% CI: 0.01, 2.72, P = 0.048). Changes in 24-hour movement behaviour, grip strength, adverse events and quality of life were not significantly different between groups. Point estimates favoured the intervention arm at 12 months for frailty, 24-hour movement behaviour and grip strength. CONCLUSIONS: The use of validated tools by pharmacists to detect signs of medicine-induced deterioration is a model of practice that requires further research, with promising results from this trial, particularly with regards to improved cognition.


Asunto(s)
Fragilidad , Farmacéuticos , Anciano , Anciano de 80 o más Años , Australia , Análisis Costo-Beneficio , Fragilidad/diagnóstico , Humanos , Casas de Salud , Calidad de Vida
14.
BMC Health Serv Res ; 22(1): 762, 2022 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-35689281

RESUMEN

BACKGROUND: The majority of people with dementia are cared for by their family members. However, family carers are often unprepared for their caring roles, receiving less education and support compared with professional carers. The consequences are their reduced mental and physical health and wellbeing, and that of care recipients. This study protocol introduces the 'Partnership in iSupport program' that includes five interventional components: managing transitions, managing dementia progression, psychoeducation, carer support group and feedback on services. This health services research is built on family carer and dementia care service provider partnerships. The aims of the study are to evaluate the effectiveness, cost-effectiveness and family carers' experiences in the program. METHODS: A multicentre randomised controlled trial will be conducted with family carers of people living with dementia from two tertiary hospitals and two community aged care providers across three Australian states. The estimated sample size is 185 family carers. They will be randomly assigned to either the intervention group or the usual care group. Outcomes are measurable improvements in quality of life for carers and people with dementia, caregiving self-efficacy, social support, dementia related symptoms, and health service use for carers and their care recipients. Data will be collected at three time points: baseline, 6 months and 12 months post-initiation of the intervention. DISCUSSION: This is the first large randomised controlled trial of a complex intervention on health and social care services with carers of people living with dementia in real-world practice across hospital and community aged care settings in three Australian states to ascertain the effectiveness, cost-effectiveness and carers' experiences of the innovative program. We expect that this study will address gaps in supporting dementia carers in health and social care systems while generating new knowledge of the mechanisms of change in the systems. Findings will strengthen proactive health management for both people living with dementia and their carers by embedding, scaling up and sustaining the 'Partnership in iSupport program' in the health and social care systems. TRIAL REGISTRATION: The Australian New Zealand Clinical Trials Registry (ANZCTR). ACTRN12622000199718 . Registered February 4th, 2022.


Asunto(s)
Cuidadores , Demencia , Anciano , Australia , Demencia/terapia , Familia , Humanos , Estudios Multicéntricos como Asunto , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto
15.
J Med Internet Res ; 24(1): e33873, 2022 01 10.
Artículo en Inglés | MEDLINE | ID: mdl-35006086

RESUMEN

BACKGROUND: Digital technologies can enable rapid targeted delivery of audit and feedback interventions at scale. Few studies have evaluated how mode of delivery affects clinical professional behavior change and none have assessed the feasibility of such an initiative at a national scale. OBJECTIVE: The aim of this study was to develop and evaluate the effect of audit and feedback by digital versus postal (letter) mode of delivery on primary care physician behavior. METHODS: This study was developed as part of the Veterans' Medicines Advice and Therapeutics Education Services (MATES) program, an intervention funded by the Australian Government Department of Veterans' Affairs that provides targeted education and patient-specific audit with feedback to Australian general practitioners, as well as educational material to veterans and other health professionals. We performed a cluster randomized controlled trial of a multifaceted intervention to reduce inappropriate gabapentinoid prescription, comparing digital and postal mode of delivery. All veteran patients targeted also received an educational intervention (postal delivery). Efficacy was measured using a linear mixed-effects model as the average number of gabapentinoid prescriptions standardized by defined daily dose (individual level), and number of veterans visiting a psychologist in the 6 and 12 months following the intervention. RESULTS: The trial involved 2552 general practitioners in Australia and took place in March 2020. Both intervention groups had a significant reduction in total gabapentinoid prescription by the end of the study period (digital: mean reduction of 11.2%, P=.004; postal: mean reduction of 11.2%, P=.001). We found no difference between digital and postal mode of delivery in reduction of gabapentinoid prescriptions at 12 months (digital: -0.058, postal: -0.058, P=.98). Digital delivery increased initiations to psychologists at 12 months (digital: 3.8%, postal: 2.0%, P=.02). CONCLUSIONS: Our digitally delivered professional behavior change intervention was feasible, had comparable effectiveness to the postal intervention with regard to changes in medicine use, and had increased effectiveness with regard to referrals to a psychologist. Given the logistical benefits of digital delivery in nationwide programs, the results encourage exploration of this mode in future interventions.


Asunto(s)
Médicos Generales , Salud Pública , Australia , Humanos , Prescripción Inadecuada , Prescripciones
16.
Lasers Med Sci ; 37(9): 3713-3722, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36274079

RESUMEN

The aim of this study was to evaluate the time course of the effects of far-infrared emitting fabric (FIR) on neuromuscular performance of knee extensor over 120 h and to investigate whether the use of FIR affects semen. This is a crossover, randomized, double-blind, and placebo-controlled trial split into neuromuscular and fertility assessments. Four (28.8 ± 4.7 years old) and six (29 ± 3.9 years old) healthy, resistance-trained males completed all neuromuscular and fertility assessments, respectively. In neuromuscular assessments, for five consecutive days, the participants underwent neuromuscular tests in an isokinetic dynamometer (maximal isometric voluntary contraction (MVC) and fatigue test) every 24 h in both conditions (FIR and Placebo). In fertility assessments, participants performed three semen collections: Baseline, FIR, and Placebo. FIR and Placebo collections were performed after five consecutive days of use of the pants. Conventional parameters and sperm DNA fragmentation were evaluated. In the FIR condition, the participants showed significant differences in total work at 96 h (p < 0.001; Cohen's d = 3.73), 120 h (p = 0.01; Cohen's d = 2.65), and pre-MVC at 120 h (p = 0.02; Cohen's d = 2.15) when compared to Placebo. FIR did not significantly (p > 0.05) affect the conventional semen parameters or sperm DNA fragmentation compared to Baseline or Placebo. FIR improved the knee extensor neuromuscular performance of healthy resistance-trained individuals, with 112.4 ± 7.8 h accumulated, and did not affect their seminal parameters (conventional or sperm DNA fragmentation), with 113.1 ± 10.2 h accumulated.


Asunto(s)
Ejercicio Físico , Músculo Esquelético , Masculino , Humanos , Adulto Joven , Adulto , Proyectos Piloto , Semen , Fatiga Muscular , Fertilidad , Contracción Muscular
17.
J Therm Biol ; 105: 103188, 2022 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35393043

RESUMEN

The aim of the study was to compare the levels and relative responses of C-Reactive Protein (CRP) and Skin Temperature (Tsk) of the lower limbs (LLs) of elite soccer players following three consecutive games with short intervals (< 4 days). Eleven male professional athletes (age, 29.26 ± 4.52 years) from an Brazil elite team were evaluated, with measurements obtained before (Baseline), and at Post-Games times (24, 48 and 72h). CRP and Tsk levels at 24 h and 48 h Post-Games times were higher than Baseline levels (CRP, p < 0.001, d > 0.9; Tsk, p < 0.04, d > 0.58), additionally, the levels of these variables (CRP vs. Tsk) showed positive correlations (p < 0.05, rs = 0.60-0.88). The relative responses these variables were evaluated (Δ%CRP; Δ%Tsk). The 48h responses of Game 3 are respectively higher than 48 h responses of games 1 and 2, in Δ%CRP (p < 0.03; G3 vs. G1, r = 0.66; G3 vs. G2, r = 0.88) and in Δ%Tsk (p < 0.003; G3 vs. G1, r = 0.88; G3 vs. G2, r = 0.88). The 48 h Post-Game time seems to represent valuable contributions to understanding the development regarding the magnitude and duration of inflammatory processes associated with recovery. Additionally, the positive correlations that were verified allow an increase in the robustness of the analysis of the load of consecutive games through CRP and Tsk of the LLs. Then, these results indicate a physiological stress and a probable cumulative effect of the game loads due to short intervals (< 4 days), which is reinforced by the verified outcome of the Total Distance covered (G3 < G2, p = 0.003; r = 0.88). These findings can contribute to better load control and greater robustness of injury prevention programs.


Asunto(s)
Rendimiento Atlético , Fútbol , Adulto , Rendimiento Atlético/fisiología , Biomarcadores , Brasil , Proteína C-Reactiva , Humanos , Extremidad Inferior , Masculino , Temperatura Cutánea , Fútbol/fisiología , Adulto Joven
18.
J Strength Cond Res ; 36(7): 1770-1780, 2022 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-34932279

RESUMEN

ABSTRACT: Martins-Costa, HC, Lacerda, LT, Diniz, RCR, Lima, FV, Andrade, AGP, Peixoto, GH, Gomes, MC, Lanza, MB, Bemben, MG, and Chagas, MH. Equalization of training protocols by time under tension determines the magnitude of changes in strength and muscular hypertrophy. J Strength Cond Res 36(7): 1770-1780, 2022-The aim of this study was to investigate the effects of 2 training protocols equalized by tension (TUT) on maximal strength (1 repetition maximum [RM]), regional cross-sectional areas (proximal, middle, and distal), and total cross-sectional areas (sum of the regional cross-sectional areas) of the pectoralis major and triceps brachii muscles. Thirty-eight men untrained in resistance training participated in the study and were allocated under 3 conditions: Protocol 3s (n = 11; 12 repetitions; 3s repetition duration), Protocol 6s (n = 11; 6 repetitions; 6s repetition duration), and Control (n = 11; no training). Training protocols (10 weeks; bench press exercise) were equated for TUT (36 seconds per set), number of sets (3-4), intensity (50-55% of 1RM), and rest between sets (3 minutes). Analysis of variance was used to examine a percentage change in variables of interest across the 3 groups with an alpha level of 0.05 used to establish statistical significance. Protocols 3s and 6s showed no differences in the increase of total and regional muscle cross-sectional areas. There were no differences in regional hypertrophy of the pectoralis major muscle. In the triceps brachii muscle, the increase in distal cross-sectional area was greater when compared with the middle and proximal regions. Both experimental groups had similar increases in the 1RM test. In conclusion, training protocols with the same TUT promote similar strength gains and muscle hypertrophy. Moreover, considering that the protocols used different numbers of repetitions, the results indicate that training volumes cannot be considered separately from TUT when evaluating neuromuscular adaptations.


Asunto(s)
Fuerza Muscular , Entrenamiento de Fuerza , Brazo , Humanos , Hipertrofia , Masculino , Músculo Esquelético/fisiología , Entrenamiento de Fuerza/métodos
19.
Fish Physiol Biochem ; 48(6): 1449-1462, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36480096

RESUMEN

The objective of this work was to develop a food additive for the sex reversal of Nile tilapia (Oreochromis niloticus) based on a simple oil in water (O/W) nanoemulsion with testosterone propionate for incorporation into commercial feed. Oil screening and evaluation of the organoleptic and physicochemical characteristics were carried out to determine the best formulation. A palatability test was also performed. Sex reversal test was assayed using 5 experimental groups: negative control - macerated feed without hormone; free testosterone - macerated feed with 60 mg/kg of testosterone propionate diluted in ethanol; and macerated feed with testosterone propionate nanoemulsion at a concentration of 30, 60, and 90 mg/kg. Stable nanoemulsions (size 76-210 nm) with testosterone propionate were produced. All nanoemulsion-added feed was palatable to tilapia. We obtained sex reversal values of ≈65, 75, and 72% in the groups of 30, 60, and 90 mg/kg, respectively. We can conclude that the nanoemulsion showed promising results; it is capable of inducing sex reversal in tilapia, is suitable as a commercial product, and has the potential to promote safety for rural staff and reduce the environmental impact of hormones.


Asunto(s)
Cíclidos , Propionato de Testosterona , Tilapia , Animales , Testosterona , Alimentación Animal
20.
Curr Psychol ; : 1-12, 2022 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-35291222

RESUMEN

Text messaging is the primary form of technology-mediated interpersonal contact and the most carried out activity on cell phones. Despite its advantages, text messaging is not exempt from risks. The present paper aimed to validate and expand the psychometric properties of the Self-perception of Text-message Dependency Scale (STDS) in a Brazilian sample of adult internet users. In this cross-sectional study, we recruited a convenience sample of Brazilian internet users aged 18 and over. A total of 1,642 (M age = 38.6, SD = 13.5; 73% female) participants completed the STDS, the Mobile Phone Problem Usage Scale-27 (MPPUS), and the Problematic Internet Use Questionnaire - Short form - 9 questionnaires (PIUQ-SF-9). Multigroup confirmatory factor analysis showed measurement invariance for gender and age. Internal consistency was high when accessed by both McDonalds' Omega and Cronbach's alpha. Network Analysis provided insights into the core symptoms of problematic text messaging. Convergent validity of the STDS was demonstrated by the subscale's correlation with MPPUS and PIUQ-SF-9. Due to its expanded psychometric properties and brevity, the STDS can be used in more comprehensive investigations about other excessive technology-related behaviors, such as problematic smartphone and internet use, allowing a better understanding of the mechanisms involved in problematic technology use. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-02957-8.

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