RESUMO
Whereas several quantitative studies have measured the impact of complications after cosmetic procedures on patients' lives, little qualitative research is available. To address this gap, we interviewed 20 patients attending a special filler complication consultation hour in the Netherlands. We conducted a reflexive thematic analysis, which resulted in three main themes: (1) complications: a patient's journey; (2) complications: the impact of procedures gone wrong; and (3) complications: a filler-free future? Throughout the interviews, the multifaceted impact of the complications was illustrated, which ultimately also demonstrated participants' negotiation of (negative) experiences with complications after cosmetic procedures within a neoliberal, consumerist environment. Within this context, particular discourses were advanced as others were obscured and/or rejected. Most significantly, issues of stigmatization and shame were tangible throughout the interviews as participants felt they (must) accept responsibility for the consequences of their own consumerist decision to undergo cosmetic procedures. Moreover, the participants' decision to undergo further cosmetic procedures after their complication illustrate the normality, or even normativity, of contemporary beauty practices. A final note regards some important implications for the industry in relation to providing adequate complication care.
Assuntos
Emoções , Pacientes , Humanos , Países Baixos , Pesquisa Qualitativa , Avaliação de Resultados da Assistência ao PacienteRESUMO
Fusarium poae is commonly detected in field surveys of Fusarium head blight (FHB) of cereal crops and can produce a range of trichothecene mycotoxins. Although experimentally validated reports of F. poae strains producing T-2/HT-2 trichothecenes are rare, F. poae is frequently generalized in the literature as a producer of T-2/HT-2 toxins due to a single study from 2004 in which T-2/HT-2 toxins were detected at low levels from six out of forty-nine F. poae strains examined. To validate/substantiate the observations reported from the 2004 study, the producing strains were acquired and phylogenetically confirmed to be correctly assigned as F. poae; however, no evidence of T-2/HT-2 toxin production was observed from axenic cultures. Moreover, no evidence for a TRI16 ortholog, encoding a key acyltransferase shown to be necessary for T-2 toxin production in other Fusarium species, was observed in any of the de novo assembled genomes of the F. poae strains. Our findings corroborate multiple field-based and in vitro studies on FHB-associated Fusarium populations which also do not support the production of T-2/HT-2 toxins with F. poae and therefore conclude that F. poae should not be generalized as a T-2/HT-2 toxin producing species of Fusarium.
Assuntos
Fusarium , Micotoxinas , Toxina T-2/análogos & derivados , Fusarium/genética , Micotoxinas/análise , Grão Comestível/químicaRESUMO
OBJECTIVES: To determine whether integrated maternity care is associated with reduced preterm births (PTB) and fewer small-for-gestational-age infants (SGA), and whether its implementation leads to a reduction of secondary care consultations. DESIGN: Retrospective study. SETTING: Integrated maternity care organisation in the southwestern region of the Netherlands. PARTICIPANTS: All singleton pregnancies (≥24 weeks) within integrated maternity care organisation Annature between 2015 and 2020. INTERVENTION: Implementation of a shared maternity record in primary and secondary care. METHODS: Data of 20 818 women were derived from patient records and from the Netherlands Perinatal Registry. Intervention was the introduction of integrated maternity care in January 2018. Through multivariate logistic regression and segmented regression analysis we assessed the combined prevalence of SGA and PTB (SGA-PTB) before (2015-2017), and after the intervention (2018-2020). Regional rates were contrasted with nationwide rates (n=782 176). MAIN OUTCOME MEASURES: SGA-PTB prevalence and mean number of secondary care consultations per pregnancy. RESULTS: SGA-PTB prevalence declined from 618/3443 (17.9%) in 2015 to 560/3501 (16.0%) in 2017 to 507/3459 (14.7%) in 2020 (p<0.005). Mean number of secondary care consultations declined from six per pregnancy in 2015 to three in 2020. Logistic regression demonstrated a significant decline in odds of SGA-PTB (OR 0.83 (95% CI 0.77 to 0.89)) between 2015-2017 and 2018-2020 adjusted for changes in sociodemographic characteristics over time. A statistically significant average monthly 7.3% (p=0.05) reduction in SGA-PTB prevalence and 12.4% (p<0.005) mean monthly reduction in secondary care consultations were demonstrated for 2015-2017. Immediately after the intervention, mean monthly prevalence of SGA-PTB dropped non-significantly to 14.7%. Between 2018 and 2020 a significant 15.2% (p<0.005) reduction in secondary care consultations was shown. CONCLUSION: Our results suggest that implementation of integrated maternity care was associated with reduced PTBs and/or low birth weight, and fewer secondary care consultations. These encouraging findings were observed in a less favourable sociodemographic profile and should be confirmed in other regions with sufficiently large populations, and the possibility to test individual components of integrated maternity care.