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1.
J Neurosci ; 42(21): 4342-4359, 2022 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-35437275

RESUMO

How do people limit awareness of unwanted memories? When such memories intrude, a control process engages the right DLPFC (rDLPFC) to inhibit hippocampal activity and stop retrieval. It remains unknown how the need for control is detected, and whether control operates proactively to prevent unwelcome memories from being retrieved, or responds reactively, to counteract intrusions. We hypothesized that dorsal ACC (dACC) detects the emergence of an unwanted trace in awareness and transmits the need for inhibitory control to rDLPFC. During a memory suppression task, we measured in humans (both sexes) trial-by-trial variations in the theta power and N2 amplitude of dACC, two EEG markers that are thought to reflect the need for control. With simultaneous EEG-fMRI recordings, we tracked interactions among dACC, rDLPFC, and hippocampus during suppression. We found a clear role of dACC in detecting the need for memory control and upregulating prefrontal inhibition. Importantly, we identified distinct early (300-450 ms) and late (500-700 ms) dACC contributions, suggesting both proactive control before recollection and reactive control in response to intrusions. Stronger early activity was associated with reduced hippocampal activity and diminished BOLD signal in dACC and rDLPFC, suggesting that preempting retrieval reduced overall control demands. In the later window, dACC activity was larger, and effective connectivity analyses revealed robust communication from dACC to rDLPFC and from rDLPFC to hippocampus, which are tied to successful forgetting. Together, our findings support a model in which dACC detects the emergence of unwanted content, triggering top-down inhibitory control, and in which rDLPFC countermands intruding thoughts that penetrate awareness.SIGNIFICANCE STATEMENT Preventing unwanted memories from coming to mind is an adaptive ability of humans. This ability relies on inhibitory control processes in the prefrontal cortex to modulate hippocampal retrieval processes. How and when reminders to unwelcome memories come to trigger prefrontal control mechanisms remains unknown. Here we acquired neuroimaging data with both high spatial and temporal resolution as participants suppressed specific memories. We found that the anterior cingulate cortex detects the need for memory control, responding both proactively to early warning signals about unwelcome content and reactively to intrusive thoughts themselves. When unwanted traces emerge in awareness, anterior cingulate communicates with prefrontal cortex and triggers top-down inhibitory control over the hippocampus through specific neural oscillatory networks.


Assuntos
Giro do Cíngulo , Rememoração Mental , Feminino , Giro do Cíngulo/fisiologia , Hipocampo/fisiologia , Humanos , Inibição Psicológica , Imageamento por Ressonância Magnética , Masculino , Rememoração Mental/fisiologia , Córtex Pré-Frontal/fisiologia
2.
Eur J Pediatr ; 182(5): 2421-2432, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36914778

RESUMO

Most studies, aimed at determining the incidence and transmission of SARS-CoV-2 in children and teenagers, have been developed in school settings. Our study conducted surveillance and inferred attack rates focusing on the practice of sports. Prospective and observational study of those attending the sports facilities of Fútbol Club Barcelona (FCB), in Barcelona, Spain, throughout the 2020-2021 season. Participants were young players (from five different sports) and adult workers, who belonged to stable teams (shared routines and were involved in same quarantine rules). Biweekly health questionnaires and SARS-CoV-2 screening were conducted. From the 234 participants included, 70 (30%) both lived and trained in the FCB facilities (Recruitment Pathway 1;RP1) and 164 (70%) lived at their own household and just came to the facilities to train (RP2). During the study, 38 positive cases were identified; none had severe symptoms or needed hospitalization. The overall weekly incidence in the cohorts did not differ compared to the one expected in the community, except for 2 weeks when an outbreak occurred. The attack rate (AR) was three times higher for the participants from RP1, in comparison to those from RP2 (p < 0.01). A Basketball team showed a significant higher AR.  Conclusion: Physical activities in stable teams are not related to an increased risk of transmission of SARS-CoV-2, since there were the same observed cases than expected in the community. The risk is higher in indoor sports (Basketball vs. Football), and in closed cohort living settings (RP1 vs. RP2). The fulfilment of preventive measures is essential. What is Known: • Despite the low numerical impact caused in paediatric hospitalizations during COVID-19 pandemic, the social impact has been maximum. • The transmission potential in children and teenagers is limited, and it had been widely demonstrated in school settings. What is New: • Group physical activities in children and teenagers are not also related to an increased risk of transmission of SARS-CoV-2, when preventive measures, such as washing hands, and screening protocols are applied. • Routine and semi-professional sports activities seem safe environments to promote during this pandemic.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , Adolescente , Adulto Jovem , Criança , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Estudos Prospectivos , Quarentena
3.
Hum Brain Mapp ; 40(4): 1353-1375, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30378210

RESUMO

The hippocampus, a hub of activity for a variety of important cognitive processes, is a target of increasing interest for researchers and clinicians. Magnetoencephalography (MEG) is an attractive technique for imaging spectro-temporal aspects of function, for example, neural oscillations and network timing, especially in shallow cortical structures. However, the decrease in MEG signal-to-noise ratio as a function of source depth implies that the utility of MEG for investigations of deeper brain structures, including the hippocampus, is less clear. To determine whether MEG can be used to detect and localize activity from the hippocampus, we executed a systematic review of the existing literature and found successful detection of oscillatory neural activity originating in the hippocampus with MEG. Prerequisites are the use of established experimental paradigms, adequate coregistration, forward modeling, analysis methods, optimization of signal-to-noise ratios, and protocol trial designs that maximize contrast for hippocampal activity while minimizing those from other brain regions. While localizing activity to specific sub-structures within the hippocampus has not been achieved, we provide recommendations for improving the reliability of such endeavors.


Assuntos
Mapeamento Encefálico/métodos , Hipocampo/fisiologia , Magnetoencefalografia/métodos , Humanos
4.
Clin Psychol Psychother ; 24(6): 1377-1383, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28804935

RESUMO

OBJECTIVE: To evaluate whether therapeutic mechanisms assumed to explain the effect of cognitive behavioural therapy (CBT) concerning temporomandibular symptoms are confirmed by structural equation modelling. METHOD: Patients were randomly assigned to either an experimental group receiving CBT (N = 41) or a standard therapy control group (N = 31). Subjects were assessed before and after intervention using mediator variables hypothesized according to the CBT model, as well as outcome variables and other socio-demographic and clinical measures. RESULTS: The results confirm that the effect of treatment on pain intensity was partially mediated by distress, catastrophizing, perceived control, distraction, and mental self-control. The self-medication frequency was partially mediated by distraction. Pain interference was partially mediated by distress, distraction, and mental self-control. Reduction in the number of painful points on palpation was partially explained by distress, although in this case, there was a significant direct effect of treatment not mediated by other variables. CONCLUSIONS: The results could set the principles for the development of more efficient and effective cognitive behavioural interventions for chronic pain.


Assuntos
Dor Crônica/etiologia , Dor Crônica/terapia , Terapia Cognitivo-Comportamental/métodos , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/psicologia , Adolescente , Adulto , Idoso , Dor Crônica/psicologia , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
5.
Neuroimage ; 142: 533-543, 2016 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-27521743

RESUMO

Human hippocampal theta oscillations play a key role in accurate spatial coding. Associative encoding involves similar hippocampal networks but, paradoxically, is also characterized by theta power decreases. Here, we investigated how theta activity relates to associative encoding of place contexts resulting in accurate navigation. Using MEG, we found that slow-theta (2-5Hz) power negatively correlated with subsequent spatial accuracy for virtual contextual locations in posterior hippocampus and other cortical structures involved in spatial cognition. A rare opportunity to simultaneously record MEG and intracranial EEG in an epilepsy patient provided crucial insights: during power decreases, slow-theta in right anterior hippocampus and left inferior frontal gyrus phase-led the left temporal cortex and predicted spatial accuracy. Our findings indicate that decreased slow-theta activity reflects local and long-range neural mechanisms that encode accurate spatial contexts, and strengthens the view that local suppression of low-frequency activity is essential for more efficient processing of detailed information.


Assuntos
Eletrocorticografia/métodos , Hipocampo/fisiologia , Magnetoencefalografia/métodos , Rememoração Mental/fisiologia , Córtex Pré-Frontal/fisiologia , Navegação Espacial/fisiologia , Lobo Temporal/fisiologia , Ritmo Teta/fisiologia , Adulto , Epilepsia/fisiopatologia , Feminino , Humanos , Masculino , Adulto Jovem
6.
Artigo em Inglês | MEDLINE | ID: mdl-38342426

RESUMO

INTRODUCTION: The enlarged vestibular aqueduct (EVA) is the most frequent malformation of the inner ear associated with sensorineural hearing loss (5-15%). It exists when the diameter in imaging tests is greater than 1.5 mm at its midpoint. The association between hearing loss and EVA has been described in a syndromic and non-syndromic manner. It can appear as a familial or isolated form and the audiological profile is highly variable. The gene responsible for sensorineural hearing loss associated with EVA is located in the same region described for Pendred syndrome, where the SCL26A4 gene is located. OBJECTIVE: To describe a series of children diagnosed with EVA in order to study their clinical and audiological characteristics, as well as the associated genetic and vestibular alterations. METHOD: Retrospective study of data collection of children diagnosed with EVA, from April 2014 to February 2023. RESULTS: Of the 17 cases, 12 were male and 5 were female. 5 of them were unilateral and 12 bilateral. In 5 cases, a cranial traumatism triggered the hearing loss. Genetic alterations were detected in 3 cases: 2 mutations in the SCL26A4 gene and 1 mutation in the MCT1 gene. 13 patients (76.5%) were rehabilitated with hearing aids and 9 of them required cochlear implantation. DISCUSSION: The clinical importance of AVD lies in the fact that it is a frequent finding in the context of postneonatal hearing loss. It is convenient to have a high suspicion to diagnose it with imaging tests, to monitor its evolution, and to rehabilitate early.


Assuntos
Perda Auditiva Neurossensorial , Aqueduto Vestibular , Humanos , Aqueduto Vestibular/anormalidades , Aqueduto Vestibular/diagnóstico por imagem , Masculino , Feminino , Estudos Retrospectivos , Perda Auditiva Neurossensorial/genética , Perda Auditiva Neurossensorial/etiologia , Lactente , Pré-Escolar , Criança , Transportadores de Sulfato/genética , Surdez/genética , Surdez/etiologia , Adolescente , Mutação
7.
J Cogn Neurosci ; 25(8): 1343-57, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23469886

RESUMO

Different cortical dynamics of alpha oscillations (8-13 Hz) have been associated with increased working memory load, which have been mostly interpreted as a neural correlate of functional inhibition. This study aims at determining whether different manifestations of load-dependent amplitude and phase dynamics in the alpha band can coexist over different cortical regions. To address this question, we increased information load by manipulating the number and spatial configuration of domino spots. Time-frequency analysis of EEG source activity revealed (i) load-independent increases of both alpha power and interregional alpha-phase synchrony within task-irrelevant, posterior cortical regions and (ii) load-dependent decreases of alpha power over areas of the left pFC and bilateral posterior parietal cortex (PPC) preceded in time by load-dependent decreases of alpha-phase synchrony between the left pFC and the left PPC. The former results support the role of alpha oscillations in inhibiting irrelevant sensorimotor processing, whereas the latter likely reflect release of parietal task-relevant areas from top-down inhibition with load increase. This interpretation found further support in a significant latency shift of 15 msec from pFC to the PPC. Together, these results suggest that amplitude and phase alpha dynamics in both local and long-range cortical networks reflect different neural mechanisms of top-down control that might be crucial in mediating the different working memory processes.


Assuntos
Ritmo alfa/fisiologia , Mapeamento Encefálico , Córtex Cerebral/fisiologia , Sincronização Cortical/fisiologia , Memória de Curto Prazo/fisiologia , Adolescente , Adulto , Eletroencefalografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Memória/fisiologia , Rede Nervosa/fisiologia , Estimulação Luminosa , Tempo de Reação/fisiologia , Percepção Espacial/fisiologia , Fatores de Tempo , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-37149133

RESUMO

OBJECTIVE: To determine the percentage of children with permanent bilateral postnatal hearing loss in order to study its incidence, related risk factors, diagnosis and treatment. METHODS: Retrospective study to collect data on children diagnosed with hearing loss outside the neonatal period in the Hearing Loss Unit of the Hospital Universitario Central de Asturias, from April 2014 to April 2021. RESULTS: 52 cases met the inclusion criteria. The detection rate of congenital hearing loss in the neonatal screening programme in the same study period was 1.5 children per thousand newborns per year, adding postnatal hearing loss results in a rate of infant bilateral hearing loss of 2.7 children per thousand (55.5% and 44.4% respectively). Thirty-five children presented risk factors for hearing loss, of which 23 were at retrocochlear risk. The mean age at referral was 91.9 (18-185) months. Hearing aid fitting was indicated in 44 cases (84.6%). Cochlear implantation was indicated in eight cases (15.4%). DISCUSSION: Although congenital hearing loss accounts for the majority of childhood deafness, postnatal hearing loss has a significant incidence. This may be mainly due to: (1) that hearing impairment may arise in the first years of life, (2) that mild hearing loss as well as hearing loss in severe frequencies are undetectable by neonatal screening in some cases, (3) that some children may have false negative results. CONCLUSION: postnatal hearing loss requires identification of risk factors and long-term follow-up of children with hearing loss, as it needs to be detected and treated early.


Assuntos
Surdez , Perda Auditiva Neurossensorial , Perda Auditiva , Lactente , Criança , Recém-Nascido , Humanos , Estudos Retrospectivos , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Bilateral/diagnóstico , Perda Auditiva Bilateral/epidemiologia , Perda Auditiva Bilateral/etiologia , Audição
9.
Artigo em Inglês | MEDLINE | ID: mdl-37117143

RESUMO

INTRODUCTION: Despite the decrease of hepatitis C in Spanish prisons in the last years, it still remains a reservoir for infection. The aim of this work is to analyze the characteristics of these patients and the response to antiviral treatment over the last 18 years. METHODS: Retrospective observational study in inmates of Araba penitentiary center diagnosed with HCV infection between 2002 and 2020. A descriptive analysis of patient characteristics and the response to the three antiviral treatment modalities was performed: peg-interferon and ribavirin, peg-interferon, ribavirin and a first-generation protease inhibitor and different combinations of direct-acting antivirals. RESULTS: A total of 248 antiviral treatments were prescribed. Treatment response rate up to 2015 was 65% and 93,7% after that year. Interferon non-responders were the main cause of non-response to treatment in periods 1 and 2 (40%-50%). Conversely, in period 3 viral breakthrough (67%) was the main culprit. CONCLUSION: After 18 years, active hepatitis C infection in prison inmates has resolved with treatment according to clinical criteria. Therefore, the stay in prison may represent an opportunity to reduce the reservoir of the disease in the community, together with continued health care for those released from prison.

10.
Biochemistry ; 51(1): 1-3, 2012 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-22191472

RESUMO

HopPmaL is a member of the HopAB family of type III effectors present in the phytopathogen Pseudomonas syringae. Using both X-ray crystallography and solution nuclear magnetic resonance, we demonstrate that HopPmaL contains two structurally homologous yet functionally distinct domains. The N-terminal domain corresponds to the previously described Pto-binding domain, while the previously uncharacterised C-terminal domain spans residues 308-385. While structurally similar, these domains do not share significant sequence similarity and most importantly demonstrate significant differences in key residues involved in host protein recognition, suggesting that each of them targets a different host protein.


Assuntos
Proteínas de Bactérias/química , Pseudomonas syringae/química , Pseudomonas syringae/patogenicidade , Proteínas de Bactérias/fisiologia , Sequência Conservada , Cristalografia por Raios X , Interações Hidrofóbicas e Hidrofílicas , Solanum lycopersicum/microbiologia , Família Multigênica , Fragmentos de Peptídeos/química , Fragmentos de Peptídeos/fisiologia , Doenças das Plantas/microbiologia , Proteínas de Plantas/química , Ligação Proteica , Dobramento de Proteína , Proteínas Serina-Treonina Quinases/química , Estrutura Terciária de Proteína , Alinhamento de Sequência
11.
Neuroimage ; 61(4): 1235-48, 2012 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-22450299

RESUMO

Growing evidence suggests that age-related deficits in associative memory are alleviated when the to-be-associated items are semantically related. Here we investigate whether this beneficial effect of semantic relatedness is paralleled by spatio-temporal changes in cortical EEG dynamics during incidental encoding. Young and older adults were presented with faces at a particular spatial location preceded by a biographical cue that was either semantically related or unrelated. As expected, automatic encoding of face-location associations benefited from semantic relatedness in the two groups of age. This effect correlated with increased power of theta oscillations over medial and anterior lateral regions of the prefrontal cortex (PFC) and lateral regions of the posterior parietal cortex (PPC) in both groups. But better-performing elders also showed increased brain-behavior correlation in the theta band over the right inferior frontal gyrus (IFG) as compared to young adults. Semantic relatedness was, however, insufficient to fully eliminate age-related differences in associative memory. In line with this finding, poorer-performing elders relative to young adults showed significant reductions of theta power in the left IFG that were further predictive of behavioral impairment in the recognition task. All together, these results suggest that older adults benefit less than young adults from executive processes during encoding mainly due to neural inefficiency over regions of the left ventrolateral prefrontal cortex (VLPFC). But this associative deficit may be partially compensated for by engaging preexistent semantic knowledge, which likely leads to an efficient recruitment of attentional and integration processes supported by the left PPC and left anterior PFC respectively, together with neural compensatory mechanisms governed by the right VLPFC.


Assuntos
Envelhecimento/fisiologia , Encéfalo/fisiopatologia , Transtornos da Memória/fisiopatologia , Memória/fisiologia , Semântica , Idoso , Potenciais Evocados/fisiologia , Feminino , Humanos , Masculino , Transtornos da Memória/etiologia , Pessoa de Meia-Idade , Estimulação Luminosa , Reconhecimento Psicológico/fisiologia , Processamento de Sinais Assistido por Computador , Ritmo Teta , Adulto Jovem
12.
Int J Mol Sci ; 13(6): 7354-7364, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22837698

RESUMO

CV_2116 is a small hypothetical protein of 82 amino acids from the Gram-negative coccobacillus Chromobacterium violaceum. A PSI-BLAST search using the CV_2116 sequence as a query identified only one hit (E = 2e(-07)) corresponding to a hypothetical protein OR16_04617 from Cupriavidus basilensis OR16, which failed to provide insight into the function of CV_2116. The CV_2116 gene was cloned into the p15TvLic expression plasmid, transformed into E. coli, and (13)C- and (15)N-labeled NMR samples of CV_2116 were overexpressed in E. coli and purified for structure determination using NMR spectroscopy. The resulting high-quality solution NMR structure of CV_2116 revealed a novel α + ß fold containing two anti-parallel ß-sheets in the N-terminal two-thirds of the protein and one α-helix in the C-terminal third of the protein. CV_2116 does not belong to any known protein sequence family and a Dali search indicated that no similar structures exist in the protein data bank. Although no function of CV_2116 could be derived from either sequence or structural similarity searches, the neighboring genes of CV_2116 encode various proteins annotated as similar to bacteriophage tail assembly proteins. Interestingly, C. violaceum exhibits an extensive network of bacteriophage tail-like structures that likely result from lateral gene transfer by incorporation of viral DNA into its genome (prophages) due to bacteriophage infection. Indeed, C. violaceum has been shown to contain four prophage elements and CV_2116 resides in the fourth of these elements. Analysis of the putative operon in which CV_2116 resides indicates that CV_2116 might be a component of the bacteriophage tail-like assembly that occurs in C. violaceum.


Assuntos
Chromobacterium , Prófagos/química , Proteínas Virais/química , Chromobacterium/química , Chromobacterium/virologia , Bases de Dados de Proteínas , Ressonância Magnética Nuclear Biomolecular , Estrutura Secundária de Proteína , Estrutura Terciária de Proteína
13.
J Cogn Neurosci ; 23(1): 75-90, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19925185

RESUMO

Growing evidence suggests that theta oscillations play a crucial role in episodic encoding. The present study evaluates whether changes in electroencephalographic theta source dynamics mediate the positive influence of semantic congruence on incidental associative learning. Here we show that memory for episodic associations (face-location) is more accurate when studied under semantically congruent contexts. However, only participants showing RT priming effect in a conceptual priming test (priming group) also gave faster responses when recollecting source information of semantically congruent faces as compared with semantically incongruent faces. This improved episodic retrieval was positively correlated with increases in theta power during the study phase mainly in the bilateral parahippocampal gyrus, left superior temporal gyrus, and left lateral posterior parietal lobe. Reconstructed signals from the estimated sources showed higher theta power for congruent than incongruent faces and also for the priming than the nonpriming group. These results are in agreement with the attention to memory model. Besides directing top-down attention to goal-relevant semantic information during encoding, the dorsal parietal lobe may also be involved in redirecting attention to bottom-up-driven memories thanks to connections between the medial-temporal and the left ventral parietal lobe. The latter function can either facilitate or interfere with encoding of face-location associations depending on whether they are preceded by semantically congruent or incongruent contexts, respectively, because only in the former condition retrieved representations related to the cue and the face are both coherent with the person identity and are both associated with the same location.


Assuntos
Aprendizagem por Associação/fisiologia , Córtex Cerebral/fisiologia , Memória/fisiologia , Semântica , Ritmo Teta/fisiologia , Mapeamento Encefálico , Formação de Conceito/fisiologia , Discriminação Psicológica/fisiologia , Eletroencefalografia/métodos , Feminino , Lateralidade Funcional/fisiologia , Humanos , Masculino , Reconhecimento Visual de Modelos/fisiologia , Estimulação Luminosa/métodos , Tempo de Reação/fisiologia , Análise de Regressão , Percepção Espacial/fisiologia , Fatores de Tempo , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-34886070

RESUMO

INTRODUCTION: Engagement and co-production in healthcare research and innovation are crucial for delivering person-centred interventions in underserved communities, but the knowledge of effective strategies to target this population is still vague, limiting the provision of person-centred care. Our research aimed to identify essential knowledge to foster engagement and co-production. MATERIALS AND METHODS: A meta-synthesis research design was used to compile existing qualitative research papers on health communication, engagement, and empowerment in vulnerable groups in high-income countries (HICs) from 2008 to 2018. A total of 23 papers were selected and analysed. RESULTS: 'Design and recruitment' and 'engagement and co-production' thematic areas are presented considering the factors related to researcher-communities attunement and the strategical plans for conducting research. The insights are discussed in light of the literature. Long-term alliances, sustainable structures, and strengthened bonds are critical factors for producing real long-term change, empowering persons and communities, and paving the way to person-centred care. CONCLUSIONS: The enhancement of the recruitment, involvement, and empowerment of traditionally disengaged communities and individuals depends on the awareness and analysis of social determinants, power differentials and specific tactics, and the capacity of researchers and individuals to apply all these principles in real-world practice.


Assuntos
Pesquisa sobre Serviços de Saúde , Autocuidado , Humanos , Assistência Centrada no Paciente , Pesquisa Qualitativa , Pesquisadores
16.
Rev Enferm ; 32(3): 204-8, 2009 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-19462603

RESUMO

Coaching is an adult learning method which is supported by psychological, pedagogical, philosophical bases as well as managerial aspects. Powerful questions and action plans are its essential tools. By means of a narration, the authors want to transmit the basic principles of Coaching plus its applications and benefits.


Assuntos
Liderança , Enfermagem , Educação de Pós-Graduação em Enfermagem
17.
Artigo em Inglês | MEDLINE | ID: mdl-31200434

RESUMO

This study analyses the effectiveness and cost-effectiveness of a group-based multicomponent physical exercise programme aimed at reducing the risk of falling and frailty in community-dwelling older adults. This is a pretest-posttest non-equivalent control group design, with an intervention group and a comparison group. Participants were evaluated at baseline and after 9 months. The effectiveness analyses showed significant reduction in the risk of falling (-45.5%; p = 0.000) and frailty (-31%; p = 0.000) after the intervention for the participants in the physical exercise programme. Moreover, these participants showed an improvement in limitations in activities of daily living, self-care ability and the use of health resources, physical performance, balance and body mass index. The cost-effectiveness analyses showed that the intervention was cost-saving and more effective than usual care scenario. A novel group-based multicomponent physical exercise programme showed to be more effective and cost-effective than usual care for older adults suffering from risk of falling and frailty.


Assuntos
Acidentes por Quedas/prevenção & controle , Terapia por Exercício/economia , Fragilidade/prevenção & controle , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Análise Custo-Benefício , Exercício Físico , Feminino , Humanos , Vida Independente , Masculino , Equilíbrio Postural , Autocuidado
18.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30086890

RESUMO

INTRODUCTION AND OBJECTIVES: Inadequate auditory feedback in prelingually deaf children alters the articulation of consonants and vowels. The purpose of this investigation was to compare vowel production in Spanish-speaking deaf children with cochlear implantation, and with hearing-aids with normal-hearing children by means of acoustic analysis of formant frequencies and vowel space. METHODS: A total of 56 prelingually deaf children (25 with cochlear implants and 31 wearing hearing-aids) and 47 normal-hearing children participated. The first 2 formants (F1 and F2) of the five Spanish vowels were measured using Praat software. One-way analysis of variance (ANOVA) and post hoc Scheffé test were applied to analyze the differences between the 3 groups. The surface area of the vowel space was also calculated. RESULTS: The mean value of F1 in all vowels was not significantly different between the 3 groups. For vowels /i/, /o/ and /u/, the mean value of F2 was significantly different between the 2 groups of deaf children and their normal-hearing peers. CONCLUSION: Both prelingually hearing-impaired groups tended toward subtle deviations in the articulation of vowels that could be analyzed using an objective acoustic analysis programme.


Assuntos
Transtornos da Articulação/etiologia , Implantes Cocleares , Auxiliares de Audição , Perda Auditiva/complicações , Pessoas com Deficiência Auditiva , Fonética , Transtornos da Articulação/fisiopatologia , Criança , Pré-Escolar , Retroalimentação Sensorial , Feminino , Perda Auditiva/fisiopatologia , Perda Auditiva/reabilitação , Humanos , Masculino , Acústica da Fala , Medida da Produção da Fala , Qualidade da Voz
19.
Artigo em Inglês | MEDLINE | ID: mdl-31885661

RESUMO

BACKGROUND: Breech presentation at the time of delivery is 3.8-4%. Fetuses that maintain a noncephalic presentation beyond 32 weeks will have a lower probability of spontaneous version before labor. Given the increasing interest in exploring the use of complementary medicine during pregnancy and childbirth, the moxibustion technique, a type of traditional Chinese medicine, could be another option to try turning a breech baby into a cephalic presentation. OBJECTIVES: To review the evidence from systematic reviews (SR) on the efficacy and safety of acupuncture and moxibustion in pregnant women with noncephalic presentation. MAIN RESULTS: Our SR synthesizes the results from five clinical trials on pregnant women with a singleton noncephalic presentation. There is evidence that moxibustion reduces the number of noncephalic presentations at the time of birth compared with no treatment. The adverse effects that acupuncture and moxibustion can cause seem to be irrelevant. Most SRs agree that there are no adverse effects directly related to acupuncture and moxibustion. CONCLUSIONS: Even though the results obtained are positive and the five reviews conclude that moxibustion reduces the number of noncephalic presentations at birth (alone or combined with postural techniques or acupuncture), there is considerable heterogeneity between them. Better methodologically designed studies are required in the future to reaffirm this conclusion.

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