RESUMEN
Care provision for children with anorexia nervosa is provided by outpatient care teams in hospitals, but the way these teams are organized differs per hospital and hampers the continuity of care. The aim of this study is to explore the organization and continuity of care for children with anorexia nervosa in the Netherlands by using a modular perspective.We conducted a qualitative, exploratory case study and took the healthcare provision for children with anorexia nervosa, provided by outpatient care teams, as our case. We conducted nine interviews with healthcare professionals involved in outpatient care teams from six hospitals. A thematic analysis was used to analyze the data.The modular perspective offered insights into the work practices and working methods of outpatient care teams. We were able to identify modules (i.e. the separate consultations with the various professionals), and components (i.e. elements of these consultations). In addition, communication mechanisms (interfaces) were identified to facilitate information flow and coordination among healthcare professionals. Our modular perspective revealed gaps and overlap in outpatient care provision, consequently providing opportunities to deal with unnecessary duplications and blind spots. Conclusion: A modular perspective can be applied to explore the organization of outpatient care provision for children with anorexia nervosa. We specifically highlight gaps and overlap in healthcare provision, which in turn leads to recommendations on how to support the three essential parts of continuity of care: informational continuity, relational continuity, and management continuity. What is Known: ⢠Care provision for children with anorexia nervosa requires a network of health care professionals from different organizations, as a result the organization and provision of care faces challenges. What is New: ⢠Modular care provision sheds light on the complexity and organization of outpatient care provision and supports the three dimensions of continuity of care as experienced by children with anorexia nervosa and their parents/caregivers.
Asunto(s)
Atención Ambulatoria , Anorexia Nerviosa , Continuidad de la Atención al Paciente , Investigación Cualitativa , Humanos , Anorexia Nerviosa/terapia , Continuidad de la Atención al Paciente/organización & administración , Países Bajos , Niño , Atención Ambulatoria/organización & administración , Grupo de Atención al Paciente/organización & administración , Femenino , Adolescente , MasculinoRESUMEN
The impact of solution stoichiometry on the nucleation and growth of BaSO4 was studied by measuring solution transmittance and subsequent fitting to a crystallization model. Our results show that a large excess of either Ba2+ or SO42- ions inhibits both the nucleation and growth of BaSO4. However, for a small excess of Ba2+, the growth is enhanced. The dependence of nucleation and growth rates on supersaturation and solution stoichiometry was captured by a semiempirical rate model. Hence, the solution stoichiometry is a highly relevant parameter while studying all aspects of BaSO4 crystallization, and it could be worthwhile to examine other minerals similarly.
RESUMEN
Maternal anxiety symptoms in the perinatal period might have long-term health effects on both the mother and the developing child. Valerian is a phytotherapeutic agent that is widely used for the treatment of anxiety. This study investigated the effects of valerian treatment in postpartum rats on maternal care, toxicity, and milk composition. Postnatal development, memory, and anxiety behavior in the offspring were also assessed. Postpartum Wistar rats received the valerian (500, 1000, or 2000 mg·kg-1·day-1) by oral gavage. Clinical and biochemical toxicity was evaluated with commercial kits. Maternal behavior was observed daily. Milk composition was analyzed by colorimetric methods. Physical and neuromotor tests were used to analyze postnatal development. Anxiolytic activity was assessed by the elevated plus maze, and memory was evaluated by the step-down inhibitory avoidance task. Maternal toxicity and care behavior were not altered by the treatment, while only the highest dose promoted a significant increase of lactose, and the doses 1000 and 2000 mg·kg-1·day-1 promoted a reduction of protein contents in milk. Postnatal development was similar in all offspring. Adult offspring did not display altered anxiety behavior, while long-term memory was impaired in the female adult offspring by maternal treatment with 1000 mg·kg-1·day-1. These results suggested that high doses of valerian had significant effects on important maternal milk components and can cause long-term alterations of offspring memory; thus, treatment with high doses of valerian is not safe for breastfeeding Wistar rat mothers.
Asunto(s)
Humanos , Animales , Embarazo , Ratas , Efectos Tardíos de la Exposición Prenatal , Valeriana , Ratas Wistar , Periodo Posparto , Memoria a Largo Plazo , Leche HumanaRESUMEN
O hipérico (Hypericum perforatum) é utilizado no tratamento alternativo da depressão, enfermidade que tem atingido mulheres, tanto no pós-parto quanto durante a gestação. Existem poucas informações sobre estudos experimentais quanto à toxicidade reprodutiva do hipérico. O presente trabalho tem por objetivo avaliar seu potencial embriotóxico. Ratas Wistar prenhes foram tratadas com 36 ou 360 mg/kg de extrato seco de Jarsin, por gavagem nos dias 5 e 7 pós-inseminação. Animais do grupo controle receberam 0,5 mL de água destilada pela mesma via e dias. Após eutanásia no 15(0) dia, as seguintes variáveis foram analisadas: peso corporal materno e fetal, consumo de ração, sinais clínicos de toxicidade, peso de ovários e placentas, número de corpos lúteos, de reabsorções, de fetos vivos e de fetos mortos e proporção de implantação e de reabsorção. Não foram observadas diferenças significativas em nenhuma dessas variáveis, levando a concluir que no modelo experimental utilizado, o Hypericum perforatum não parece apresentar toxicidade para a mãe, não interfere na implantação do blastocisto e nem parece ser tóxico para o embrião.
Hypericum perforatum is used as an alternative treatment of depression, which is a disease that has been affecting women during post-partum or gestation. There is little information in experimental studies regarding the reproductive toxicity of hiperic. The present paper aims at assessing Hypericum perforatum's embryotoxic potential. Pregnant Wistar rats were treated with 36 or 360 mg/kg body weight of Jarsin dried extract, via oral gavage on days 5 and 7 post-insemination. Animals from the control group received 0.5 mL of distilled water through the same via and days. The animals were killed on the 15th day and the following variables were analyzed: maternal and fetal body weight, food intake, clinical signs of toxicity, weight of ovaries and placenta, number of corpora lutea, resorptions, live and dead fetuses, and the proportion of implantation and resorption. No significant differences were observed in any of these variables, leading to the conclusion that in the experimental model used, Hypericum perforatum does not seem to be toxic to the mother, does not interfere with blastocyst implantation nor does it seem to be toxic to the embryo.
RESUMEN
A oxcarbazepina é uma droga antiepiléptica de alta eficácia e poucos efeitos colaterais, mas pouco estudada quanto a seus efeitos durante a gestaçäo humana e animal. OBJETIVO: Verificar se a administraçäo de oxcarbazepine em ratas, nos quatro primeiros dias após a inseminaçäo, altera a viabilidade ou o desenvolvimento do pré-embriäo. MÉTODOS: Ratas Wistar foram tratadas com 20 ou 200 mg de oxcarbazepina/ Kg de peso corporal, via gástrica, nos dias 1, 2, 3, ou 4 a partir da inseminaçäo ou, consecutivamente, do 1º ao 4º. Os pré-embriões foram coletados no quinto dia, visando verificar a quantidade e o desenvolvimento até a fase de blastocisto expandido. O peso corporal materno e sinais como pelos eriçados e alteraçäo de atividade locomotora foram anotados para verificar indícios de toxicidade materna. Número de corpos lúteos e peso de ovários foram anotados com vistas à capacidade reprodutiva do animal. RESULTADOS: Näo ocorreram perdas de pesos corporais maternos e nenhuma alteraçäo física indicativa de desconforto para as ratas. Peso de ovários e número de corpos lúteos näo diferiram entre tratados e controles. O número médio de pré-embrioes por mäes, o índice de perdas embrionárias, a proporçäo de blastocistos expandidos com relaçäo ao total de pré-embriões e a média de blastocistos expandidos/mäe, näo diferiram entre tratados e controles. CONCLUSÇO: A oxcarbazepina administrada em ratas, seguindo o esquema terapêutico mencionado, näo apresentou efeito tóxico sobre a mäe e näo alterou o desenvolvimento do pré-embriäo
Asunto(s)
Animales , Ratas , Femenino , Preñez , Carbamazepina/farmacología , Desarrollo Fetal/efectos de los fármacos , Anticonvulsivantes/farmacología , Peso Corporal , Estudios de Casos y Controles , Cuerpo LúteoRESUMEN
Lapachol is a naphtoquinone with therapeutic potential against enterovirus, Chagas disease and is also used as an antimalarial and antiinflamatory agent. In order to study teratogenic potential of Lapachol, pregnant Wistar rats were treated with 0.5 ml of distilled water (control group); 0.5 ml of hydroalcoholic solution (vehicle group) and 10 mg of Lapachol in 0.5 ml of hydroalcoholic solution (treated group) by oral gavage from the 8th to the 12th day of pregnancy. The following variables were observed: maternal body weight on days 1, 6, l5 and 21 and food intake on days 2, 6, 15 and 21 of pregnancy. The number of live and dead fetuses and the sites of resorptions were counted. The ovaries were weighed and the corpora lutea were counted. Data were analyzed by ANOVA-one way, Dunnett test and the chi square test. Significance level test alpha = 0.05. Results have shown that mothers were unaffected but there were a 99.2 percent of fetus mortality, indicative of a strong abortifacient effect of Lapachol in rats