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1.
J Adv Nurs ; 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38895960

RESUMO

BACKGROUND: Climate change has serious consequences for the morbidity and mortality of older adults. OBJECTIVE: To identify the effects of climate change on older people's health. METHODS: A scoping review was conducted following the Joanna Briggs Institute guidelines and the PRISMA-ScR checklist. Quantitative research and reports from organizations describing the effects of climate change on older people were selected. RESULTS: Sixty-three full-text documents were selected. Heat and air pollution were the two factors that had the most negative effects on cardiovascular and respiratory morbidity and mortality in older people. Mental health and cognitive function were also affected. CONCLUSIONS: Climate change affects several health problems in older individuals, especially high temperatures and air pollution. Nursing professionals must have the necessary skills to respond to the climate risks in older adults. More instruments are required to determine nursing competencies on climate change and the health of this population group. PATIENT OF PUBLIC CONTRIBUTION: No patient or public contribution.

2.
Death Stud ; 48(2): 140-149, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36975846

RESUMO

Perinatal loss is a traumatic and stressful experience with a significant emotional toll on the physical and psychological wellbeing of the healthcare professionals. We included 216 healthcare professionals working in an obstetrics-gynecology service or neonatal intensive care unit in a cross-sectional study and aimed to analyze the possible association between the healthcare professionals' level of professional quality of life, their coping with death competence, and their personal and work-related characteristics. Compassion fatigue and burnout did not correlate significantly with healthcare professionals' personal and work-related characteristics. Formal training was strongly associated with high levels of compassion satisfaction and coping with death competence. A low level of coping with death competence was found in women and in younger healthcare professionals, those who are single, and with little professional experience. Self-care activities and hospital support systems can be effective resources in coping with death.


Assuntos
Esgotamento Profissional , Qualidade de Vida , Recém-Nascido , Humanos , Feminino , Estudos Transversais , Esgotamento Profissional/psicologia , Capacidades de Enfrentamento , Empatia , Atenção à Saúde , Inquéritos e Questionários
3.
Aten Primaria ; 56(4): 102773, 2024 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-38043175

RESUMO

OBJECTIVE: To analyse predictor variables of contraceptive method use in young people. DESIGN: Systematic review. DATA SOURCES: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. STUDY SELECTION: An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. DATA EXTRACTION: Information was extracted on the selected study population, contraceptive method studied and predictor variables identified. RESULTS: Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with women having higher knowledge of hormonal contraceptive options and more positive attitudes. CONCLUSION: Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.


Assuntos
Anticoncepção , Anticoncepcionais , Humanos , Masculino , Feminino , Adolescente , Anticoncepção/métodos , Preservativos , Conhecimentos, Atitudes e Prática em Saúde
4.
Pediatr Res ; 94(5): 1784-1788, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37340099

RESUMO

BACKGROUND: Baby-led weaning (BLW) is an alternative method to spoon-feeding to introduce solid foods. This study aimed to describe and understand the experiences and opinions of pediatricians and pediatric nurse specialists of the implementation of the BLW approach. METHODS: An interpretive descriptive qualitative research was carried out. A focus group with 7 participants and 13 face-to-face interviews were conducted between February and May 2022 (17 females and 3 males). All were audio-recorded, transcribed, and analyzed with the supported by Atlas.Ti qualitative data analysis software. RESULTS: From the data, two themes developed: (1) BLW as an ideal method of introducing solid food, with the subthemes: "a natural method of introducing complementary feeding" and "BLW is a safe method"; (2) Perceived barriers to the uptake of the BLW method, with the subthemes: "a lack of BLW training prevents the best practice" and "the influence of family and social context on parents." CONCLUSIONS: Healthcare professionals perceive BLW to be a safe and natural weaning approach. The lack of training of healthcare professionals and the influence of family social context on parents may limit the implementation of BLW. IMPACT: Baby-led weaning is perceived by healthcare professionals as a safe complementary feeding method that promotes chewing, improves growth, and the development of fine motor skills. However, lack of training of healthcare professionals and the family social context of the parents hinders the uptake of baby-led weaning. The views of the family and parents' social context about baby-led weaning may restrict their willingness to use the method. Family education delivered by healthcare professionals may avoid risks and allay parental anxieties about safety.


Assuntos
Comportamento Alimentar , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Lactente , Feminino , Criança , Humanos , Desmame , Pesquisa Qualitativa , Atenção à Saúde , Alimentos Infantis
5.
J Electrocardiol ; 79: 108-111, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37031631

RESUMO

A patient admitted for non-ST-elevation acute coronary syndrome showed an episode of ST-segment elevation on the monitor. These alterations were due to an artifact produced by the administration of a saline bolus through an infusion pump that disappeared at the end of the bolus. Our findings highlight that the interpretation of the electrocardiogram requires careful analysis and correlation with the clinical situation and with other physiological parameters.


Assuntos
Síndrome Coronariana Aguda , Eletrocardiografia , Humanos , Artefatos , Arritmias Cardíacas , Síndrome Coronariana Aguda/diagnóstico , Bombas de Infusão
6.
BMC Med Educ ; 23(1): 283, 2023 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-37101260

RESUMO

BACKGROUND: Living safely sexuality and without risk to one's health is an international priority. The youth age group has specific characteristics that make it a particularly vulnerable group for adverse consequences such as unwanted pregnancies or sexually transmitted infections. Health professionals are an important group to address this issue; however, to achieve a good result, sufficient knowledge is required to solve all the issues. This study aimed to assess the level of knowledge of young university students studying a nursing or a medical degree. METHODS: A descriptive cross-sectional study of young medical and nursing students was conducted. The selection of participants was made by convenience. The Sexuality and Contraceptive Knowledge Instrument scale was used to measure knowledge level. A bivariate analysis was conducted using the Mann-Whitney U test or the Kruskal-Wallis H test, depending on the number of categories of the independent variable. Finally, a multivariate analysis was conducted using a multiple linear regression model, establishing the level of knowledge as the dependent variable and all variables that obtained statistical significance in the bivariate analysis as predictors. Data collection was carried out from October 2020 to March 2021. RESULTS: The sample comprised 657 health university students. Participants had a good level of knowledge, with 77.9% answering 50% of the questions correctly. Before training, 34.15% of the participants did not pass 50% of the questions asked. This percentage decreased to 12.87% after receiving sexuality training during their university degrees. The main training gaps were found for the items on hormonal contraceptive methods. The bivariate analysis showed that female participants had significantly higher knowledge scores, as did those who had used a hormonal contraceptive method during the most recent intercourse or were aware of family planning centers. These variables maintained their significant effect at the multivariate level, obtaining two models with good explanatory power for participants of both university degrees. CONCLUSION: The general level of knowledge of the healthcare students was high and sufficient after receiving training during the university degree (87.13% of the participants obtain more than 50% of items correct). The main training gap was found for items on hormonal contraceptive methods, which should be emphasized in future training programs.


Assuntos
Estudantes de Medicina , Gravidez , Adolescente , Humanos , Feminino , Universidades , Estudos Transversais , Anticoncepção , Comportamento Sexual , Sexualidade , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde
7.
J Clin Nurs ; 32(11-12): 2547-2558, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35312126

RESUMO

AIMS AND OBJECTIVES: This study aimed to describe and understand the lived experiences and opinions of sub-Saharan women living in Spain in relation to female genital mutilation. BACKGROUND: Female genital mutilation is a bloody procedure with serious consequences for the health of women and girls. Understanding mutilated women's lived experiences plays a crucial role in the management of health consequences and could help healthcare professionals to provide assistance to these women. DESIGN: A descriptive phenomenological study was carried out. The COREQ checklist was followed as guidance to write the manuscript. METHODS: A total of 12 in-depth interviews were conducted. Interviews were recorded, transcribed and analysed using ATLAS.ti 9.0. RESULTS: Two themes with four subthemes were identified from the data analysis: 1) 'The traumatic experience of female circumcision' with the subthemes 'Female mutilation is a physical and psychological torture procedure' and 'recognising and coping with negative emotions'; 2) 'The fight for the eradication of female genital mutilation' which contains the subthemes 'the need for a real sociocultural change at the origin' and '"I want to be the last": Personal development leads to sociocultural change'. CONCLUSIONS: Female genital mutilation was experienced by women as a very aggressive and traumatic event. It causes considerable negative emotions that last over time. Although there is a tendency to reject the practice, in women's countries of origin, there is social pressure for girls to be mutilated. RELEVANCE TO CLINICAL PRACTICE: Caring for women who have suffered from female genital mutilation requires awareness of the traumatic experience they underwent when they were girls. Healthcare professionals play a crucial role in eradicating female genital mutilation. Apart from education, preventive measures may include specific recommendations when girls are travelling to the country of origin and participatory action research.


Assuntos
Circuncisão Feminina , Feminino , Humanos , Masculino , Relações Interpessoais , Escolaridade , África Subsaariana , Espanha
8.
J Clin Nurs ; 32(17-18): 6634-6647, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37029475

RESUMO

AIM AND OBJECTIVES: The aim of this study was to describe and understand how heterosexual women with Turner Syndrome experience sexuality. BACKGROUND: Turner Syndrome is a genetic condition that is the result of one of the X chromosomes missing or partially missing, and it affects women of all ages. Turner Syndrome may lead to psychological, relational and sex life disorders. DESIGN: This is a qualitative study, and the COREQ checklist was employed to report on the current study. METHODS: The study was conducted in a region of southern Spain. Convenience and snowball sampling were used to recruit 18 women, aged 22-51 years, who had been diagnosed with Turner Syndrome. Participants' experiences were explored through semi-structured interviews between January and May 2021. Thematic analysis was used for data analysis. RESULTS: Three main themes and eight sub-themes emerge from the data analysis: (1) Sexuality linked to corporeality, with the sub-themes: 'Discovering that your body is different', 'Social stigma limits one's sex life' and 'Fear of penetration surpresses sexual desire'. (2) Adapting one's sexuality to Turner Syndrome, with the sub-themes: 'Feeling like a woman' and 'Suffering from and adapting to comorbidities'. (3) When infertility overshadows sexuality, with the sub-themes: 'Prolonging childhood by ignoring sexuality', 'Fertility treatment: always a possibility' and 'Lack of specialised professional knowledge'. CONCLUSION: Heterosexual women with Turner Syndrome suffer from sexual problems, delayed diagnosis and treatment, and lack of information. Unawareness and relational problems may also lead to scarce and late sexual relations, jealousy and a fear of being left. The women with Turner Syndrome refer to little self-exploration or masturbation as well as a fear of penetration. RELEVANCE TO CLINICAL PRACTICE: Understanding the experiences of sexuality in heterosexual women with Turner Syndrome is a challenge for clinical nurses, who could provide quality care to these women in contextualised services.


Assuntos
Disfunções Sexuais Fisiológicas , Síndrome de Turner , Humanos , Feminino , Criança , Heterossexualidade , Sexualidade/psicologia , Comportamento Sexual , Pesquisa Qualitativa
9.
BMC Nurs ; 22(1): 266, 2023 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-37568137

RESUMO

BACKGROUND: Chronic ultimorbidity is the most frequent and serious health problem in older adults. Home visiting programmes could be a strategy with potential benefits. However, there are no scoping reviews to date that examine the effects of home visiting programmes on community-dwelling older adults with chronic multimorbidity. OBJECTIVE: To examine the effects of home visiting programmes on community-dwelling older adults with chronic multimorbidity. METHODS: A scoping review was carried out following PRISMA-ScR reporting guidelines. The search was conducted in six databases (PubMed/Medline, Cochrane, CINAHL, Web of Science, Scopus and EMBASE) between October 2021 and April 2022. RESULTS: Four RCTs with 560 patients were included. The visits were carried out by nurses, nursing students, volunteers, and other healthcare professionals. The interventions varied in the number of visits, frequency, duration of follow-up, and whether or not they were combined with other strategies such as telephone calls. Discrepancies were found in the effects of the interventions on quality of life, self-efficacy, self-rated health, and use and cost of health and social services. CONCLUSION: This review shows that home visiting programmes could have potential benefits for older adults with chronic multimorbidity. However, its results have been inconclusive. There is a need for high quality studies involving a larger number of patients, in which home visits are the main intervention.

10.
Nurs Res ; 71(2): 111-118, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34670253

RESUMO

BACKGROUND: The COVID-19 pandemic has provoked several changes in home care. Understanding home care nurses' experiences during the COVID-19 pandemic plays an essential role in home care management. OBJECTIVE: This study aimed to explore and articulate the experience of home care nurses during the COVID-19 pandemic in Spain. DESIGN: A qualitative study using hermeneutic phenomenology was carried out. Twenty home care nurses were interviewed by teleconference between January and March 2021. Interviews were audio-recorded, transcribed verbatim, and analyzed using qualitative data analysis software. RESULTS: Three main themes with five subthemes emerged from the data analysis: (a) "The effect of COVID-19 pandemic on home care," with the subtheme "the reorganization of home care nurses' competencies"; (b) "The role of telehealth in home care," which included the subthemes "home care nurses' satisfaction with telehealth" and "barriers to implement telehealth in home care"; and (c) "Effects of the pandemic on home care nurses' lives," including the subthemes "working in a pandemic is emotionally draining" and "the continuing fear of infecting others." DISCUSSION: The findings from this study demonstrate the profound effect that home care has experienced during the COVID-19 pandemic. Home care nurses' competencies were modified to care for and diagnose COVID-19 patients. Face-to-face home care was replaced by telehealth. All home care nurses experienced physical and psychological symptoms and the fear of infecting others.


Assuntos
COVID-19 , Serviços de Assistência Domiciliar , Enfermeiras e Enfermeiros , COVID-19/epidemiologia , Humanos , Pandemias , Pesquisa Qualitativa , SARS-CoV-2
11.
Appl Nurs Res ; 66: 151603, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35840275

RESUMO

BACKGROUND AND AIM: Healthcare professionals have played a fundamental role in managing and controlling the COVID-19 health crisis. They are exposed to high levels of suffering, trauma, uncertainty, and powerlessness in the workplace. The objective of this study was to explore and understand experiences of suffering among primary care and hospital care nurses during the COVID-19 health crisis. DESIGN: This is a descriptive qualitative study. Between March and April 2021, 19 in-depth interviews were carried out with nurses at health and social care facilities and hospitals in southern Spain. ATLAS.ti 9.0 software was used for discourse analysis. RESULTS: Nurses reported that they had experienced suffering during their work in the pandemic. The main causes suggested were direct contact with patients' suffering and organisational difficulties. The repercussions are in emotional dimension and physical deterioration and social isolation. CONCLUSION AND IMPLICATIONS: Given the circumstances, programmes to promote healthy, compassion-based behaviours and changes to the way in which professionals' suffering is handled must be implemented by healthcare facility managers. Nursing leaders should consider the management of suffering as a matter of the first order, both from the ethical point of view and the business profitability and make compassionate leadership.


Assuntos
COVID-19 , Atitude do Pessoal de Saúde , Empatia , Humanos , Pandemias , Pesquisa Qualitativa
12.
BMC Nurs ; 21(1): 245, 2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36057567

RESUMO

BACKGROUND: Mainstreaming sustainable healthcare into the curricula of health professions is a key action to raise awareness and change attitudes. Therefore, the present study aimed to assess the contribution of scenario-based learning and augmented reality to the environmental awareness and attitudes toward climate change and sustainability among undergraduate nursing students. METHODS: This study was designed as a time-series analysis. Undergraduate nursing students in their 3 years were introduced to sustainability and climate change in the context of healthcare through scenario-based learning sessions. Questionnaires were used to collect data on participants' attitudes towards sustainability and climate change, the usefulness of the educational sessions and the extent to which students changed their clinical practice. A data summary, related sample Friedman and Wilcoxon signed-rank tests were used to test for differences in survey scores. RESULTS: Attitudes and environmental awareness toward climate change and sustainability increased significantly as students received the learning sessions over the 3 years. After their first clinical training period, students already showed a high awareness of unsustainable practices in their working environment; however, they still struggled to apply sustainability and address unsustainable practices in healthcare settings. Most students felt that the scenarios helped them to make links between climate change, resources, and health. CONCLUSIONS: The scenario-based learning and augmented reality increase environmental awareness and attitudes toward climate change and sustainability among nursing students. Students are very aware of unsustainable practices in their work environment, but more work needs to be done on the application of sustainability principles to nursing practice.

13.
J Nurs Manag ; 30(1): 135-143, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34498335

RESUMO

AIM: To describe nurses and ward managers' experiences with nursing leadership in the implementation of evidence-based practice. BACKGROUND: The implementation of evidence-based practice requires to identify the most suitable styles of nursing leadership for the successful application. DESIGN: A qualitative descriptive study. METHODS: The study was carried out with 57 nurses (clinical nurses and ward managers) in eight focus groups from five public hospitals. Template analysis, using the Promoting Action on Research Implementation in Health Services framework, was used. The Consolidated Criteria for Reporting Qualitative Research guide was followed in planning and reporting this research. RESULTS: Three types of nursing leadership were identified: traditional leadership, medium leadership and transformational leadership. Traditional leadership was the most frequent, with a predominance of bureaucratic tasks for ward managers, so implementation of evidence-based practice is difficult. CONCLUSION: Nurses do not feel empowered and they perceive the changes as an imposition. In the absence of strong leadership for evidence-based practice, a natural leader emerges. IMPLICATIONS FOR NURSING MANAGEMENT: Clinical nurses demand more empowerment for decision-making, and ward managers need clarity of roles. To create an environment favourable to evidence-based practice, it is necessary consider the role of the transformational leader.


Assuntos
Liderança , Enfermeiros Administradores , Prática Clínica Baseada em Evidências , Hospitais Públicos , Humanos , Pesquisa Qualitativa
14.
Int Nurs Rev ; 69(1): 69-79, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34628657

RESUMO

AIM: The aim of our study is to describe and understand the experiences of nurses providing emergency care to undocumented migrants who arrive in Spain in small boats. BACKGROUND: Spain receives thousands of undocumented migrants every year who arrive by sea. Provision of appropriate emergency care to undocumented migrants is a public health problem. INTRODUCTION: Nurses, along with other health care providers, such as doctors or cultural mediators, make up the Spanish Red Cross Emergency Response Team. Nurses, in particular, are associated with all phases of emergency care to undocumented migrants who arrive in small boats, offering first aid as well as clinical and humanitarian care. METHODS: Qualitative descriptive study. Seventeen nurses from the Spanish Red Cross Emergency Response Team participated in face-to-face interviews. Thematic analysis was used to analyse the qualitative data. FINDINGS: Three main themes emerged: (i) guaranteeing comprehensive emergency care, (ii) the nurse, the key member of the multidisciplinary care team for undocumented migrants and (iii) 'making a difference', volunteering as a nurse's role. CONCLUSIONS: Nurses try to guarantee comprehensive care provision for undocumented migrants, even though they face stigma, ethical concerns or an impossibility to prescribe pharmacological treatments. Personalised care, more time and protocols, better training and the incorporation of debriefing are elements that are required to improve the emergency care given to undocumented migrants. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Institutions must develop policies to support provsion of emergency care to undocumented migrants. A public health issue cannot depend upon volunteer healthcare providers. Governments must guarantee funding, training and established care teams. Understanding nurses' experiences could increase awareness of the problem, reduce stigma and improve the comprehensive emergency care provided to undocumented migrants.


Assuntos
Serviços Médicos de Emergência , Enfermeiras e Enfermeiros , Migrantes , Acessibilidade aos Serviços de Saúde , Humanos , Pesquisa Qualitativa , Navios
15.
Mar Drugs ; 19(11)2021 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-34822487

RESUMO

Green extraction was applied to Argentinean shortfin squid (Illex argentinus) viscera, consisting of a wet pressing method including a drying step, mechanic pressing, centrifugation of the resulting slurry, and oil collection. To maximise the oil yield and ω3 fatty acid content and to minimise the oil damage degree, a response surface methodology (RSM) design was developed focused on the drying temperature (45-85 °C) and time (30-90 min). In general, an increase of the drying time and temperature provided an increase in the lipid yield recovery from the viscera. The strongest drying conditions showed a higher recovery than 50% when compared with the traditional chemical method. The docosahexaenoic and eicosapentaenoic acid contents in the extracted oil revealed scarce dependence on drying conditions, showing valuable ranges (149.2-166.5 and 88.7-102.4 g·kg-1 oil, respectively). Furthermore, the values of free fatty acids, peroxides, conjugated dienes, and ω3/ω6 ratio did not show extensive differences by comparing oils obtained from the different drying conditions. Contrary, a polyene index (PI) decrease was detected with increasing drying time and temperature. The RSM analysis indicated that optimised drying time (41.3 min) and temperature (85 °C) conditions would lead to 74.73 g·kg-1 (oil yield), 1.87 (PI), and 6.72 (peroxide value) scores, with a 0.67 desirability value.


Assuntos
Decapodiformes , Ácidos Graxos Ômega-3/química , Animais , Organismos Aquáticos , Química Verde , Vísceras/química
16.
Mar Drugs ; 19(10)2021 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-34677454

RESUMO

Omega-3 polyunsaturated fatty acids are associated with a lower risk of cardiometabolic diseases. However, docosahexaenoic acid (DHA) is easily oxidized, leading to cellular damage. The present study examined the effects of an increased concentration of DHA in fish oil (80% of total fatty acids) on cardiometabolic risk factors and oxidative stress compared to coconut oil, soybean oil, and fish oil containing eicosapentaenoic acid (EPA) and DHA in a balanced ratio. Forty healthy male Sprague-Dawley rats were supplemented with corresponding oil for 10 weeks. Supplementation with the fish oil containing 80% DHA decreased plasma fat, plasma total cholesterol and muscle fat compared to the coconut oil and the soybean oil. Increasing concentrations of DHA induced incorporation of DHA and EPA in cell membranes and tissues along with a decrease in ω-6 arachidonic acid. The increase in DHA promoted lipid peroxidation, protein carbonylation and antioxidant response. Taken together, the increased concentration of DHA in fish oil reduced fat accumulation compared to the coconut oil and the soybean oil. This benefit was accompanied by high lipid peroxidation and subsequent protein carbonylation in plasma and in liver. In our healthy framework, the slightly higher carbonylation found after receiving fish oil containing 80% DHA might be a protecting mechanism, which fit with the general improvement of antioxidant defense observed in those rats.


Assuntos
Ácidos Docosa-Hexaenoicos/farmacologia , Óleos de Peixe/farmacologia , Administração Oral , Animais , Organismos Aquáticos , Fatores de Risco Cardiometabólico , Ácidos Docosa-Hexaenoicos/administração & dosagem , Óleos de Peixe/administração & dosagem , Masculino , Modelos Animais , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley
17.
J Adv Nurs ; 77(7): 3132-3141, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33755231

RESUMO

AIMS: To understand how the social patterns about death influence end-of-life care from the perspective of healthcare professionals. DESIGN: A qualitative study according to the theory of Glaser and Strauss. METHODS: A purposeful sample of 47 participants with different roles (nurses, physicians and clinical psychologists) were involved in four focus groups and 17 interviews in 2017-2019. Responses were audio-recorded, transcribed verbatim and analysed using computer-assisted qualitative data. RESULTS: A core category 'the theory of social patterns about death' emerged, which is explained by three categories: the culture of concealment and stubbornness towards death, the effort and internal work to make death a part of existence, and the influence of the social patterns of coping with death on end-of life care and healthcare professionals. Our results suggest that social coping with death is affected by a network of concealment and obstinacy towards death. CONCLUSION: Recognizing death as part of life and thinking about death itself are social coping strategies. Although healthcare professionals occupy a privileged place in this process, the culture of concealment of death influences end-of-life care. IMPACT: The social process that leads to the loneliness of the dying in our days has been theorized. However, social acceptance of death also influences healthcare professionals' attitudes towards death. Thus, healthcare professionals' own attitudes may affect the end-of-life care given to dying individuals and their families. The social patterns of death may contribute to the healthcare professionals' negative attitudes towards death. The concept of dignified death has been linked to the notion of humanization of healthcare. Death should be approached from a more naturalistic perspective by healthcare professionals, healthcare and academic institutions.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Assistência Terminal , Atitude do Pessoal de Saúde , Humanos , Distância Psicológica , Pesquisa Qualitativa
18.
Int J Mol Sci ; 22(18)2021 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-34576003

RESUMO

Noncommunicable diseases (NCD) and age-associated diseases (AAD) are some of the gravest health concerns worldwide, accounting for up to 70% of total deaths globally. NCD and AAD, such as diabetes, obesity, cardiovascular disease, and cancer, are associated with low-grade chronic inflammation and poor dietary habits. Modulation of the inflammatory status through dietary components is a very appellative approach to fight these diseases and is supported by increasing evidence of natural and dietary components with strong anti-inflammatory activities. The consumption of bioactive lipids has a positive impact on preventing chronic inflammation and consequently NCD and AAD. Thus, new sources of bioactive lipids have been sought out. Microalgae are rich sources of bioactive lipids such as omega-6 and -3 polyunsaturated fatty acids (PUFA) and polar lipids with associated anti-inflammatory activity. PUFAs are enzymatically and non-enzymatically catalyzed to oxylipins and have a significant role in anti and pro-resolving inflammatory responses. Therefore, a large and rapidly growing body of research has been conducted in vivo and in vitro, investigating the potential anti-inflammatory activities of microalgae lipids. This review sought to summarize and critically analyze recent evidence of the anti-inflammatory potential of microalgae lipids and their possible use to prevent or mitigate chronic inflammation.


Assuntos
Envelhecimento/efeitos dos fármacos , Misturas Complexas/uso terapêutico , Ácidos Graxos Ômega-3/uso terapêutico , Ácidos Graxos Ômega-6/uso terapêutico , Microalgas/química , Doenças não Transmissíveis/tratamento farmacológico , Misturas Complexas/química , Ácidos Graxos Ômega-3/química , Ácidos Graxos Ômega-6/química , Humanos , Inflamação/tratamento farmacológico
19.
Molecules ; 26(9)2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33922113

RESUMO

Polyphenols and omega-3 polyunsaturated fatty acids from fish oils, i.e., eicosapentaenoic and docosahexaenoic acids, are well-recognized nutraceuticals, and their single antioxidant and anti-inflammatory properties have been demonstrated in several studies found in the literature. It has been reported that the combination of these nutraceuticals can lead to three-fold increases in glutathione peroxidase activity, two-fold increases in plasma antioxidant capacity, decreases of 50-100% in lipid peroxidation, protein carbonylation, and urinary 8-isoprotanes, as well as 50-200% attenuation of common inflammation biomarkers, among other effects, as compared to their individual capacities. Therefore, the adequate combination of those bioactive food compounds and their single properties should offer a powerful tool for the design of successfully nutritional interventions for the prevention and palliation of a plethora of human metabolic diseases, frequently diet-induced, whose etiology and progression are characterized by redox homeostasis disturbances and a low-grade of chronic inflammation. However, the certain mechanisms behind their biological activities, in vivo interaction (both between them and other food compounds), and their optimal doses and consumption are not well-known yet. Therefore, we review here the recent evidence accumulated during the last decade about the cooperative action between polyphenols and fish oils against diet-related metabolic alterations, focusing on the mechanisms and pathways described and the effects reported. The final objective is to provide useful information for strategies for personalized nutrition based on these nutraceuticals.


Assuntos
Suplementos Nutricionais , Óleos de Peixe/farmacologia , Polifenóis/química , Polifenóis/farmacologia , Animais , Ácidos Docosa-Hexaenoicos/farmacologia , Avaliação Pré-Clínica de Medicamentos , Metabolismo Energético , Ácidos Graxos Ômega-3 , Óleos de Peixe/química , Humanos , Peroxidação de Lipídeos/efeitos dos fármacos , Doenças Metabólicas/etiologia , Doenças Metabólicas/metabolismo , Doenças Neurodegenerativas/etiologia , Doenças Neurodegenerativas/metabolismo , Estresse Oxidativo/efeitos dos fármacos
20.
Mar Drugs ; 18(6)2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32560216

RESUMO

Diacylglycerols (DAG) and ceramides have been suggested as early predictors of insulin resistance. This study was aimed to examine the combined effects of fish oil (FO) and grape seed extract (GSE) on hepatic endogenous antioxidants, DAG and ceramides in diet-induced early stages of insulin resistance. Thirty-five rats were fed one of the following diets: (1) a standard diet (STD group), (2) a high-fat high-sucrose diet (HFHS group), (3) an HFHS diet enriched with FO (FO group), (4) an HFHS diet enriched with GSE (GSE group) or (5) an HFHS diet enriched with FO and GSE (FO + GSE group). In the liver, endogenous antioxidants were measured using spectrophotometric and fluorometric techniques, and non-targeted lipidomics was conducted for the assessment of DAG and ceramides. After 24 weeks, the FO + GSE group showed increased glutathione peroxidase activity, as well as monounsaturated fatty acid and polyunsaturated fatty acid-containing DAG, and long-chain fatty acid-containing ceramides abundances compared to the STD group. The FO and GSE combination induced similar activation of the antioxidant system and bioactive lipid accumulation in the liver than the HFHS diet without supplementation. In addition, the FO and GSE combination increased the abundances of polyunsaturated fatty acid-containing DAG in the liver.


Assuntos
Antioxidantes/administração & dosagem , Suplementos Nutricionais , Óleos de Peixe/administração & dosagem , Extrato de Sementes de Uva/administração & dosagem , Resistência à Insulina , Fígado/efeitos dos fármacos , Animais , Ceramidas/análise , Ceramidas/metabolismo , Dieta Hiperlipídica/efeitos adversos , Diglicerídeos/análise , Diglicerídeos/metabolismo , Modelos Animais de Doenças , Ácidos Graxos Insaturados , Feminino , Humanos , Metabolismo dos Lipídeos/efeitos dos fármacos , Lipidômica , Fígado/metabolismo , Ratos
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