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1.
J Sex Med ; 21(8): 691-699, 2024 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-38899734

RESUMO

BACKGROUND: While female ejaculation is viewed as a potential enhancer of women's sexual experiences and their relationships with their sexual partners, existing studies to date emphasize the need for further exploration of the squirting phenomenon. AIM: The study sought to explore experiences and perceptions about the phenomenon of squirting in young adult women. METHODS: A descriptive qualitative study was conducted. Semi-structured, in-depth interviews were conducted between December 2022 and March 2023. Seventeen young adult women who experienced squirting were recruited using a convenience and snowball sampling. ATLAS.ti v.9 software was used for a thematic analysis of the interview data. The study adhered to the recommendations for reporting qualitative research (Standards for Reporting Qualitative Research). OUTCOMES: The outcomes included (1) exploring factors influencing initial squirting experiences, (2) insights gained through squirting experiences, (3) communication as the cornerstone in sexual relationships, and (4) resources and sources for knowledge on the squirting phenomenon. RESULTS: After the analysis of the results, the following subthemes emerged: (1) first perceptions on squirting, (2) facilitating factors, (3) physical sensations and psychological aspects in squirting experience, (4) sources of information about squirting and (5) addressing squirting in comprehensive sex education. CLINICAL IMPLICATIONS: Frontline healthcare providers should undergo specific training to address anxiety related to squirting among certain individuals and enhance societal awareness while offering emotional support for diverse sexual response variations. STRENGTHS AND LIMITATIONS: Acknowledging limitations in our study of young women's experiences with squirting, a more diverse sample could provide alternative insights. Despite this, our findings contribute valuable knowledge, suggesting avenues for professional training to promote sexual and reproductive health in a more realistic and sensitive manner. CONCLUSION: This study explored the emotional and psychological effects of squirting on women's sexual experiences, ranging from heightened arousal to feelings of humiliation and embarrassment. It emphasized the importance of a partner's reaction in interpreting the event and the limited understanding of squirting, often influenced by pornography.


Assuntos
Pesquisa Qualitativa , Humanos , Feminino , Adulto Jovem , Adulto , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Entrevistas como Assunto , Educação Sexual/métodos
2.
Artigo em Inglês | MEDLINE | ID: mdl-39028424

RESUMO

The occurrence of preterm birth is correlated with the potential emergence of disabilities in children. Early intervention programs are designed to promote better developmental outcomes. These interventions employ family-centered methodologies, wherein parents are instructed to facilitate neurodevelopment, thereby promoting heightened involvement of the child in their daily activities. The objective of this investigation was to evaluate the efficacy of early family-based interventions on motor, cognitive, and language development. A systematic review and meta-analysis was conducted utilizing the databases PubMed, Medline, PEDro, Scopus, CINAHL Complete, SciELO, and Open Grey. The search terms utilized included NDT (neuro-developmental treatment), Bobath, neurodevelopmental therapy, parents administered, family administered, physical therapy modalities, early intervention (educational), early intervention, premature infant, preterm, and premature. Randomized clinical trials and observational studies written in English or Spanish were taken into consideration. The initial search resulted in 420 articles. After removing duplicates and applying the selection criteria, 12 articles were selected for the systematic review and 5 articles were selected for the meta-analysis. The meta-analysis revealed a significant association between early intervention and enhanced cognitive function (p = 0.01) in this study. Additionally, the meta-analysis indicated improvements resulting from early family-based intervention (p = 0.02) in motor function. Early motor interventions that emphasize parent involvement and education in neurodevelopment show significant outcomes in motor and cognitive areas at 2 years of age in very premature or extremely premature infants. However, inconclusive effects have been found in the language area, which is the least studied domain. Due to the methodological heterogeneity observed, further research is needed to establish conclusive decisions regarding the administration of these interventions and the determination of key evaluation periods.

3.
J Clin Nurs ; 2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38533544

RESUMO

AIM: To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth. BACKGROUND: The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities. METHODS: A cross-sectional study was performed in targeted young individuals (15-29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression. RESULTS: Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth. CONCLUSION: This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue. IMPLICATIONS FOR THE PROFESSION: Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities. REPORTING METHOD: The reporting follows the STROBE checklist. PATIENT CONTRIBUTION: People who were invited to participate voluntarily completed a range of questionnaires.

4.
Medicina (Kaunas) ; 60(3)2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38541205

RESUMO

Background and Objectives: Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by challenges in communication, social interactions, and repetitive behaviors. Although the factors that influence the development of this condition are unknown, certain chemical compounds such as pesticides have been proposed as possible contributors. Due to the lack of an established causal link between pesticide exposure and ASD, this study aimed to evaluate this potential association. Materials and Methods: A case-control study was carried out to ascertain the prevalence and risk associated with ASD in relation to pesticide exposure over a 21-year study period (2000-2021). Results: We included 2821 individuals diagnosed with ASD residing in areas of both high and low pesticide exposure in southern Spain. There was a rise in the ASD prevalence rate in regions with elevated pesticide use when compared to regions with low use [odds ratio (OR): 1.34, 95% confidence interval (CI), (1.24-1.44)]. Notably, men had the highest likelihood, with an OR: 1.42, 95% CI, (1.30-1.55). Furthermore, after performing multiple binary logistic regression adjusted for age, sex, and geographical area, males exhibited a higher likelihood compared to females [OR: 2.41, 95% CI, (2.21-2.62)]. Conclusions: Overall, this research suggests a connection between heightened environmental pesticide exposure due to increased agricultural use and autism.


Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Praguicidas , Masculino , Feminino , Humanos , Praguicidas/toxicidade , Transtorno do Espectro Autista/induzido quimicamente , Transtorno do Espectro Autista/epidemiologia , Estudos de Casos e Controles , Exposição Ambiental/efeitos adversos
5.
J Adv Nurs ; 79(5): 1754-1764, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35668553

RESUMO

AIM: To explore the experiences and perceptions of final-year nursing students in assessing and managing acute pesticide poisoning using a socio-environmental care approach in a primary health care simulation-based scenario. DESIGN: A qualitative descriptive study was conducted using focus groups. METHODS: Twelve focus groups were held, with 114 fourth-year nursing students. The study was carried out from September to November 2021. To grant an in-depth analysis of the collected data, a thematic analysis was used. RESULTS: After our data analysis, three main themes emerged: (i) experiences of an acute pesticide poisoning case in a simulation-based scenario; (ii) environmental health nursing competencies for a culturally competent practice and (iii) social factors in prevention strategies. CONCLUSIONS: Using a socio-environmental care approach with a primary care simulation-based poisoning case can provide a realistic public health clinical experience for local problems and prepare the context for the development of global citizenship values, as well as offer numerous opportunities to facilitate transformative learning, including Sustainable Development Goals (SDGs) into local nursing clinical practice. IMPACT: Nurse managers, policymakers and educators must collaborate together to broaden their reach in teaching the role of the environment and social determinants of health through evidence-based care models, as well as actively contributing to the achievement of the SDGs to promote "glocal" competencies among nursing professionals.


Assuntos
Bacharelado em Enfermagem , Praguicidas , Estudantes de Enfermagem , Humanos , Grupos Focais , Pesquisa Qualitativa , Aprendizagem , Estudantes de Enfermagem/psicologia
6.
J Adv Nurs ; 78(7): 2139-2149, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35112735

RESUMO

AIM: To explore the experiences and perceptions of midwives in the treatment of sex trafficking victims. DESIGN: The study was qualitative with a hermeneutic-phenomenological approach, using semi-structured interviews and focus groups. METHODS: Two focus groups and six interviews were carried out on 14 midwives in primary care, delivery and emergency rooms. Data were collected in three hospitals in Spain in June 2021. ATLAS.ti 9 software was used to conduct a content analysis of the focus group and interview data. RESULTS: The results revealed two primary themes and six subthemes. The two primary themes were (i) sex trafficking: a camouflaged reality on the invisible spectrum, and (ii) a thirst for attention in the aftermath of violence. Representative quotations were used to illustrate both the main themes and the subthemes. CONCLUSIONS: This study provides new insight into midwives' experiences treating sex trafficking victims. Professionals view this type of violence as a silent issue that negatively impacts victims' health and livelihood. However, a number of different factors stand in the way of correctly identifying and treating victims. Therefore, healthcare workers must be provided with practical tools and continuous professional development on this topic. IMPACT: This study indicates the importance of the midwives' key role in identifying and assisting victims of sex. Not only do measures in the healthcare setting, such as on-going specific-related content training or up-to-date protocols, need to be implemented to ensure proper care for those affected by sexual exploitation, but also focusing on suspicious characteristics and reducing obstacles to patient communication will help bring the true situation to light and better respond to patients' priority needs.


Assuntos
Tráfico de Pessoas , Tocologia , Enfermeiros Obstétricos , Feminino , Grupos Focais , Humanos , Tocologia/educação , Enfermeiros Obstétricos/educação , Gravidez , Pesquisa Qualitativa
7.
Res Nurs Health ; 45(3): 274-286, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35080033

RESUMO

Aging is a process that includes changes in cognitive and emotional functions, as well as changes in the diversity and integrity of gut microbiota. Probiotic treatments have recently been studied as a potential new therapeutic approach to alleviate a wide range of problems in other populations; however, clinical studies in older adults remain insufficient and limited. Thus, the aim of this project is to evaluate the efficacy of a multispecies probiotic formulation as a therapeutic strategy for attenuating the emotional and cognitive decline associated with aging in adults over the age of 55. This is a double-blind randomized placebo-controlled crossover trial involving at least 32 older adults and comparing two conditions: (a) probiotic, providing a multispecies probiotic for 10 weeks (Lactobacillus rhamnosus and Bifidobacterium lactis); and (b) placebo, receiving a harmless substance (potato starch). Despite the increasing use of probiotics for the treatment of cognitive and emotional problems, no study has yet focused on this group, to the best of our knowledge. Therapeutic strategies of the kind outlined in this protocol will help to shed light on the current state of knowledge about this topic, as well as promote health programs tailored to this population, which would encourage active aging and healthy lifestyles. Not only do we expect improvements in the emotional dimension in terms of anxiety, stress, depression, and sleep quality, we also expect improvements in the cognitive dimension in terms of attention, memory, and decreased impulsivity.


Assuntos
Microbioma Gastrointestinal , Probióticos , Idoso , Cognição , Estudos Cross-Over , Método Duplo-Cego , Promoção da Saúde , Humanos , Probióticos/farmacologia , Probióticos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
J Nurs Manag ; 30(1): 298-309, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34590385

RESUMO

AIM: To synthesize and describe the emotional and psychological implications for healthcare professionals who provided care in a mass casualty incident or disaster. BACKGROUND: The experience of healthcare providers immersed in the actual uncertainty of an ongoing disaster is real, challenging, complex and strongly connected with emotions. Identifying these implications for healthcare professionals is essential for developing strategies to help these professionals deliver high-quality care. EVALUATION: A systematic review was conducted in PubMed, CINAHL, Scopus, Nursing & Allied Health Database and PsycINFO using published data until February 2021 and following the PRISMA guidelines. KEY ISSUES: Nineteen articles were included. Factors associated with negative psychological implications were identified and different strategies have been synthesized to prevent or reduce them when caring for the victims of a disaster. CONCLUSIONS: Feelings of sadness, helplessness, fear and blockage, among others, were identified as common reactions among nurses and other healthcare professionals dealing in mass casualties or disasters. These reactions may lead to post-traumatic disorder, turning professionals into hidden victims. IMPLICATIONS FOR NURSING MANAGEMENT: Organizations, senior charge nurses and other health service managers need to foster resilience and flexibility among their workforce to improve self-care during a disaster, as well as ensure policies to address a lack of emotional preparedness among their personnel. Some strategies to consider include cognitive behavioural therapy, psychoeducation or meditation.


Assuntos
Incidentes com Feridos em Massa , Atenção à Saúde , Emoções , Pessoal de Saúde , Humanos , Sistemas de Apoio Psicossocial
9.
J Nurs Manag ; 30(8): 3874-3884, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35411629

RESUMO

AIM: The aim of this study is to explore the experiences and perceptions of final-year nursing students on the acceptability and feasibility of using a chatbot for clinical decision-making and patient safety. BACKGROUND: The effective and inclusive use of new technologies such as conversational agents or chatbots could support nurses in increasing evidence-based care and decreasing low-quality services. METHODS: A descriptive qualitative study was used through focus group interviews. The data analysis was conducted using a thematic analysis. RESULTS: This study included 114 participants. After our data analysis, two main themes emerged: (i) experiences in the use of a chatbot service for clinical decision-making and and (ii) integrating conversational agents into the organizational safety culture. CONCLUSIONS: The findings of our study provide preliminary support for the acceptability and feasibility of adopting SafeBot, a chatbot for clinical decision-making and patient safety. Our results revealed substantial recommendations for refining navigation, layout and content, as well as useful insights to support its acceptance in real nursing practice. IMPLICATIONS FOR NURSING MANAGEMENT: Leaders and managers may well see artificial intelligence-based conversational agents like SafeBot as a potential solution in modern nursing practice for effective problem-solving resolution, innovative staffing and nursing care delivery models at the bedside and criteria for measuring and ensure quality and patient safety.


Assuntos
Estudantes de Enfermagem , Humanos , Inteligência Artificial , Resolução de Problemas , Pesquisa Qualitativa , Atenção à Saúde
10.
J Nurs Manag ; 30(6): 1540-1548, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34595793

RESUMO

AIM: To explore nursing students' perceptions of the identification and medical care of sex trafficking victims and how to improve the care provided based on the identified barriers. BACKGROUND: Despite the fact that more than 87% of sex trafficking victims establish contact with health professionals, their lack of awareness and training hinders their ability to assist victims properly. METHODS: A descriptive qualitative study was carried out using 11 focus groups of nursing students after a simulated case of sex trafficking victim. The analysis of results was conducted through content analysis. RESULTS: A total of 110 fourth-year nursing students participated in this study. After performing the data analysis, three main categories emerged: (i) making a health issue visible, (ii) identifying sex trafficking victims: resources based on evidence-based practice, and (iii) educational resources on sex trafficking in nursing degree. CONCLUSIONS: Our results show that through clinical simulation, integrating content regarding the medical care of vulnerable groups can be useful for developing the skills necessary to provide effective care from a trauma-informed approach. IMPLICATIONS FOR NURSING MANAGEMENT: Health institutions, senior charge nurses, and other health service managers should be aware of the current need for sex trafficking training, structural-level changes, and updated evidence-based guidelines and protocols with other service providers and law enforcement to provide high-quality care.


Assuntos
Bacharelado em Enfermagem , Tráfico de Pessoas , Estudantes de Enfermagem , Bacharelado em Enfermagem/métodos , Grupos Focais , Pessoal de Saúde , Tráfico de Pessoas/prevenção & controle , Humanos , Pesquisa Qualitativa
11.
J Clin Nurs ; 2021 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-33969561

RESUMO

AIMS AND OBJECTIVES: The aim of review was to describe and synthesise the evidence on the use of tourniquets to control haemorrhages, summarising both civilian and military use. BACKGROUND: Trauma-related haemorrhage constitutes one of the most preventable deaths among injured patients, particularly in multi-casualty incidents and disasters. In this context, safe instruments such as tourniquets are essential to help healthcare professionals to minimise loss of life and maximise patient recovery. DESIGN AND METHODS: An integrative review was conducted in Medline, Nursing & Allied Health Premium, and Health & Medical Collection, using published data until March 2021 and following the PRISMA guidelines. RESULTS: A total of 25 articles were included. Evidence has been synthesised to understand the use of different types of tourniquets, environment of application, indication for their placement and potential complications associated with tourniquet placement. CONCLUSIONS: Commercial tourniquets such as Combat Application Tourniquet or Emergency Tourniquet models are a valuable and safe instrument for haemorrhage control in both military and civilian out-of-hospital care settings. Nurses, as part of emergency teams, and other professionals should be aware that there is a possibility of adverse complications, but they are directly proportional to the time of tourniquet placement and generally temporary. In addition, national and international guidelines ensure the need for all civilian emergency services to be equipped with these devices, as well as for the training of healthcare professionals and first responders in their use. RELEVANCE TO CLINICAL PRACTICE: Despite the lack of complications in the use of tourniquets in these cases, their use has been a matter of debate for decades. In this sense, this review yields up-to-date guidelines in the use of tourniquets, their recommendations and their significance among professionals to manage complicated situations.

12.
J Nurs Manag ; 29(2): 258-267, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32881134

RESUMO

AIM: To explore the experiences and perceptions of recent nursing graduates working in emergency departments during the COVID-19 outbreak. BACKGROUND: Overcrowding in emergency departments has been one of the most prominent issues arising in these units for more than 20 years. However, it has become even more problematic due to the novelty of the coronavirus pandemic, which has forced hospitals to recruit larger numbers of beginner nursing staff as the number of quarantined health professionals increases. METHODS: Sixteen semi-structured interviews were conducted in Spanish emergency departments, which were analysed and synthesized using content analysis. RESULTS: Three major themes emerged from the data analysis: (a) Fears and concerns, (b) Organisational issues and (c) Support for novice nurses. CONCLUSIONS: Our findings may help to understand how shadowing periods as a learning programme for nurses, continuing professional development, evidence-based apps and better planning are needed to ensure both novice nurses' confidence in emergency departments and expert emergency room nurses' ability to cope with complications in critical situations. IMPLICATIONS FOR NURSING MANAGEMENT: Training periods that include shadowing expert emergency room nurses, along with evidence-based technology, provide an opportunity to support novice nurses' transition into the workplace. These measures would provide a safety net and would increase novice nurses' confidence as well as high-quality care.


Assuntos
COVID-19/enfermagem , Enfermagem em Emergência/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Recursos Humanos de Enfermagem Hospitalar/psicologia , Adulto , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Pesquisa Qualitativa , Espanha/epidemiologia , Adulto Jovem
13.
J Nurs Manag ; 29(1): 75-84, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32969544

RESUMO

AIM: To know the perspectives of nursing students in trans patients' care and their access to health services and how to improve the quality of care in trans patients, related to the barriers identified by nursing students. BACKGROUND: Lesbian, gay, bisexual, transgender, queer and plus (LGBTQ+) find barriers related to the health care access, including stigma, discrimination and lack of education. In addition, to the transphobia reported in some health care providers. METHODS: A descriptive qualitative study was performed through 12 focus group interviews in nursing students. Data analysis was based on content analysis. RESULTS: 124 first-year nursing students participated. The qualitative analysis resulted in three major themes: (a) Exposing an invisible reality, (b) Interprofessional communication: a starting point to arise awareness and (c) Care with pride as a link between individuality and professionalism. CONCLUSIONS: Our findings suggest that both LGBTQ+ content and institutional resources are the cornerstone for nursing students and professionals' practice in order to develop and provide a well-informed and high-quality care delivery to these patients. IMPLICATIONS FOR NURSING MANAGEMENT: Policymakers, senior charge nurses and other managers should be aware of the structural-level changes identified and ongoing mentoring needed to guarantee trans patients' privacy and safety.


Assuntos
Minorias Sexuais e de Gênero , Estudantes de Enfermagem , Feminino , Grupos Focais , Identidade de Gênero , Humanos , Percepção
14.
Pharmacol Res ; 159: 104928, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32504837

RESUMO

Opioid drugs are widely used to treat chronic pain, but their misuse can lead to tolerance, dependence, and addiction and have created a significant public health problem. In addition, food-derived opioid peptides, known as exorphins, like gluten exorphins have been shown to have harmful effects in certain pathologies like celiac disease, for example. Several studies support the involvement of the opioid system in the development of disorders such as autism spectrum syndrome. Moreover, bidirectional communication between the intestine and brain has been shown to be altered in various neurodegenerative diseases including Alzheimer´s and Parkinson´s. The presence of opioid receptors in both the digestive tract and the central nervous system (CNS) suggests that opioid drugs and exorphins may modulate the gut-brain axis. Morphine, for example, has shown a dysbiotic effect on the bacterial microbiota in addition to inducing an increase in intestinal permeability facilitating bacterial translocation. Furthermore, certain components of bacteria can modify the expression of opioid receptors at the central level increasing sensitivity to pain. Strategies based on use of probiotics have resulted in improvements in symptoms of autism and Parkinson´s disease. In this manuscript, we review the role of the opioid system in disorders and CNS pathologies and the involvement of the gut-brain axis.


Assuntos
Analgésicos Opioides/efeitos adversos , Bactérias/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Microbioma Gastrointestinal/efeitos dos fármacos , Intestinos/microbiologia , Morfina/efeitos adversos , Peptídeos/efeitos adversos , Receptores Opioides/efeitos dos fármacos , Animais , Bactérias/metabolismo , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Exposição Dietética/efeitos adversos , Disbiose , Humanos , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/microbiologia , Doenças Neurodegenerativas/fisiopatologia , Doenças Neurodegenerativas/terapia , Probióticos/uso terapêutico , Receptores Opioides/metabolismo , Transdução de Sinais
15.
Am J Otolaryngol ; 41(4): 102557, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497952

RESUMO

PURPOSE: To evaluate the prophylactic, protocolized, and standardized use of a Montgomery tube in preventing pharyngocutaneous fistulas after total laryngectomy and neck dissection. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral centre. SUBJECT AND METHODS: A Montgomery salivary bypass tube was placed in 44 patients undergoing total laryngectomy and neck dissection, observing the percentage of fistula appearance and the time of start of deglutition. Comparison was made with a group of 28 patients prior to the implantation of the protocol in whom the tube was not used. RESULTS: There was a statistically significant decrease in the percentage of fistulas and an earlier onset of deglutition in the salivary bypass tube patients compared to those in whom the tube had not been used. CONCLUSION: Prophylactic and standardized use of the Montgomery salivary bypass tube in patients undergoing total laryngectomy and neck dissection might decrease the incidence of pharyngocutaneous fistula and improve the course of one that is already established.


Assuntos
Fístula Cutânea/prevenção & controle , Drenagem/instrumentação , Fístula/prevenção & controle , Intubação/instrumentação , Neoplasias Laríngeas/cirurgia , Laringectomia/efeitos adversos , Doenças Faríngeas/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Saliva , Idoso , Estudos de Coortes , Fístula Cutânea/etiologia , Deglutição , Feminino , Fístula/etiologia , Humanos , Neoplasias Laríngeas/fisiopatologia , Laringectomia/métodos , Masculino , Pessoa de Meia-Idade , Esvaziamento Cervical , Doenças Faríngeas/etiologia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos
16.
Med Teach ; 42(4): 403-410, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31738615

RESUMO

Purpose: Gamification or learning using game elements is a process that seeks to capture students' interest. One of the most popular games in recent years is the Escape Room, but the study of its use in education and with health professionals is still limited. The aim of this study was to find out the perceptions and experiences of final year nursing students in an Objective Structured Clinical Examination (OSCE) by means of an Escape Room.Methods: In January 2019, 9 focus groups (FG) were held, with a total of 95 final year nursing students. We applied a qualitative content analysis approach and ATLAS.ti version 8 was used for data analysis.Results: The data revealed 3 main themes and 8 sub-themes. The three main themes, which were mapped to the conceptual framework, were student learning outcomes, emotional impact on students and conclusions on the serious games experience. Both the main themes and the sub-themes were illustrated using representative quotes from the participants.Conclusions: These results can help to apply these methodologies, such as the Escape Room, alongside other pre-existing ones, complementing the way in which students are assessed and the development of important nursing skills, such as teamwork and communication.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Grupos Focais , Humanos , Aprendizagem , Pesquisa Qualitativa , Inquéritos e Questionários
17.
Behav Pharmacol ; 30(2 and 3-Spec Issue): 187-200, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30844962

RESUMO

Stress is a nonspecific response of the body to any demand imposed upon it, disrupting the body homoeostasis and manifested with symptoms such as anxiety, depression or even headache. These responses are quite frequent in the present competitive world. The aim of this review is to explore the effect of stress on gut microbiota. First, we summarize evidence of where the microbiota composition has changed as a response to a stressful situation, and thereby the effect of the stress response. Likewise, we review different interventions that can modulate microbiota and could modulate the stress according to the underlying mechanisms whereby the gut-brain axis influences stress. Finally, we review both preclinical and clinical studies that provide evidence of the effect of gut modulation on stress. In conclusion, the influence of stress on gut microbiota and gut microbiota on stress modulation is clear for different stressors, but although the preclinical evidence is so extensive, the clinical evidence is more limited. A better understanding of the mechanism underlying stress modulation through the microbiota may open new avenues for the design of therapeutics that could boost the pursued clinical benefits. These new designs should not only focus on stress but also on stress-related disorders such as anxiety and depression, in both healthy individuals and different populations.


Assuntos
Microbioma Gastrointestinal/fisiologia , Estresse Fisiológico/fisiologia , Estresse Psicológico/metabolismo , Ansiedade , Transtornos de Ansiedade/metabolismo , Encéfalo/metabolismo , Depressão , Transtorno Depressivo/metabolismo , Humanos , Estresse Psicológico/microbiologia
18.
Nature ; 493(7431): 191-4, 2013 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-23283173

RESUMO

The formation of gaseous giant planets is thought to occur in the first few million years after stellar birth. Models predict that the process produces a deep gap in the dust component (shallower in the gas). Infrared observations of the disk around the young star HD 142527 (at a distance of about 140 parsecs from Earth) found an inner disk about 10 astronomical units (AU) in radius (1 AU is the Earth-Sun distance), surrounded by a particularly large gap and a disrupted outer disk beyond 140 AU. This disruption is indicative of a perturbing planetary-mass body at about 90 AU. Radio observations indicate that the bulk mass is molecular and lies in the outer disk, whose continuum emission has a horseshoe morphology. The high stellar accretion rate would deplete the inner disk in less than one year, and to sustain the observed accretion matter must therefore flow from the outer disk and cross the gap. In dynamical models, the putative protoplanets channel outer-disk material into gap-crossing bridges that feed stellar accretion through the inner disk. Here we report observations of diffuse CO gas inside the gap, with denser HCO(+) gas along gap-crossing filaments. The estimated flow rate of the gas is in the range of 7 × 10(-9) to 2 × 10(-7) solar masses per year, which is sufficient to maintain accretion onto the star at the present rate.

19.
Behav Pharmacol ; 29(2 and 3-Spec Issue): 103-119, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29521671

RESUMO

In recent years, interest in the relationship between gut microbiota and disease states has grown considerably. Indeed, several strategies have been employed to modify the microbiome through the administration of different diets, by the administration of antibiotics or probiotics, or even by transplantation of feces. In the present manuscript, we focus specifically on the potential application of probiotics, which seem to be a safe strategy, in the management of digestive, pain, and emotional disorders. We present evidence from animal models and human studies, notwithstanding that translation to clinic still deserves further investigation. The microbiome influences gut functions as well as neurological activity by a variety of mechanisms, which are also discussed. The design and performance of larger trials is urgently needed to verify whether these new strategies might be useful not only for the treatment of disorders affecting the gastrointestinal tract but also in the management of emotional and pain disorders not directly related to the gut.


Assuntos
Microbioma Gastrointestinal/fisiologia , Probióticos/farmacologia , Probióticos/uso terapêutico , Animais , Sistema Digestório/efeitos dos fármacos , Emoções/efeitos dos fármacos , Microbioma Gastrointestinal/efeitos dos fármacos , Humanos , Dor/dietoterapia , Dor/tratamento farmacológico
20.
Behav Pharmacol ; 29(7): 654-663, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30179883

RESUMO

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired communication and social interactions, and repetitive behavioural patterns. These patterns are believed to be dysfunctional symptoms in executive processing, which impact other cognitive functions such as attention or cognitive flexibility. In recent years, several studies have shown that certain intestinal bacteria may play a role in shaping cognitive networks encompassing emotional and social domains. A microbiota-gut-brain axis is known to exist, establishing several mechanisms by which microbiota may modulate brain development, function and behaviour, including immune, endocrine and neural pathways. As the aetiology of ASD is largely unknown, some studies have shown that intestinal bacteria may be involved in its pathogenesis. The aim of this review was to focus on the role of the gut-brain axis in ASD and, specifically, on its role in executive functions. First, we summarize the relationship between the gastrointestinal and cognitive symptoms of ASD patients. In addition, we highlight the evidence that supports and emphasizes the involvement of gut microbiota, and the putative underlying mechanisms in this population. Finally, we present evidence from preclinical and clinical studies on the modulation of microbiota and their effects on cognitive symptoms, specifically in relation to executive function. In conclusion, manipulation of microbiota could be a positive intervention to improve ASD symptoms. However, more research evaluating the role of microbiota in the cognitive symptoms ASD is needed.


Assuntos
Transtorno do Espectro Autista/complicações , Encéfalo/fisiopatologia , Transtornos Cognitivos/etiologia , Função Executiva/fisiologia , Microbioma Gastrointestinal/fisiologia , Trato Gastrointestinal/microbiologia , Animais , Encéfalo/microbiologia , Transtornos Cognitivos/microbiologia , Humanos
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