Validity and reliability of a ruler drop test to measure dual-task reaction time, choice reaction time and discrimination reaction time.

BACKGROUND: The aim of this study was to determine the absolute and relative reliability of the Ruler Drop Test (RDT) for assessing dual-task, choice, and discrimination reaction time. In addition, the construct validity of the RDT is examined in comparison to the Deary-Liewald reaction time (DLRT). METHODS: Tests were administered by the same evaluator, one week apart. Intraclass Correlation Coefficient (ICC3.1) was used to measure relative reliability, and the standard error of measurement (SEM) and minimal detectable change (MDC95) were used to measure absolute reliability. Spearman correlation test was used to measure construct validity. RESULTS: The results showed that the relative reliability was good for the choice ruler drop (ICC = 0.81), moderate for the dual-task ruler drop test (ICC = 0.70) and discrimination ruler drop test (ICC = 0.72), and good for simple ruler drop test. However, the simple ruler drop test had poor reliability (ICC = 0.57). The RDT shows construct validity compared to the DLRT. CONCLUSION: We conclude that the RDT is a suitable instrument for measuring dual-task, choice and discrimination reaction time. Future studies should explore the reliability of these measures in other populations.

Marine Bacteroidetes enzymatically digest xylans from terrestrial plants.

Marine Bacteroidetes that degrade polysaccharides contribute to carbon cycling in the ocean. Organic matter, including glycans from terrestrial plants, might enter the oceans through rivers. Whether marine bacteria degrade structurally related glycans from diverse sources including terrestrial plants and marine algae was previously unknown. We show that the marine bacterium Flavimarina sp. Hel_I_48 encodes two polysaccharide utilization loci (PULs) which degrade xylans from terrestrial plants and marine algae. Biochemical experiments revealed activity and specificity of the encoded xylanases and associated enzymes of these PULs. Proteomics indicated that these genomic regions respond to glucuronoxylans and arabinoxylans. Substrate specificities of key enzymes suggest dedicated metabolic pathways for xylan utilization. Some of the xylanases were active on different xylans with the conserved ß-1,4-linked xylose main chain. Enzyme activity was consistent with growth curves showing Flavimarina sp. Hel_I_48 uses structurally different xylans. The observed abundance of related xylan-degrading enzyme repertoires in genomes of other marine Bacteroidetes indicates similar activities are common in the ocean. The here presented data show that certain marine bacteria are genetically and biochemically variable enough to access parts of structurally diverse xylans from terrestrial plants as well as from marine algal sources.

Factors associated with changes in inpatients' smoking pattern during hospitalization and one month after discharge: A cohort study.

INTRODUCTION: Smokers are frequent users of healthcare services. Admissions to hospital can serve as a "teachable moment" for quitting smoking. Clinical guidelines recommend initiating smoking cessation services during hospitalization; however, in Southern European countries less than 5% of inpatients receive a brief intervention for smoking cessation. OBJECTIVES: The aims of this study were (i) to examine rates of smoking abstinence during and after hospitalization; (ii) to measure changes in smoking patterns among persons who continued smoking after discharge; and (iii) to identify predictors of abstinence during hospitalization and after discharge. METHODS: A cohort study of a representative sample of current adult smokers hospitalized in two Spanish and two Portuguese hospitals. We surveyed smokers during hospitalization and recontacted them one month after discharge. We used a 25-item ad hoc questionnaire regarding their smoking pattern, the smoking cessation intervention they have received during hospitalization, and hospital and sociodemographic characteristics. We performed a descriptive analysis using the chi-square test and a multivariate logistic regression to characterize the participant, hospital, and smoking cessation intervention (5As model) characteristics associated with smoking abstinence. RESULTS: Smoking patients from both countries presented high abstinence rates during hospitalization (Spain: 76.4%; Portugal: 70.2%); however, after discharge, their abstinence rates decreased to 55.3% and 46.8%, respectively. In Spain, smokers who tried to quit before hospital admission showed higher abstinence rates, and those who continued smoking reduced a mean of five cigarettes the number of cigarettes per day (p ≤ 0.001). In Portugal, abstinence rates were higher among women (p = 0.030), those not living with a smoker (p = 0.008), those admitted to medical-surgical wards (p = 0.035), who consumed their first cigarette within 60 min after waking (p = 0.006), and those who were trying to quit before hospitalization (p = 0.043). CONCLUSIONS: Half of the smokers admitted into the Spanish hospitals are abstinent one month after discharge or have reduced their cigarettes per day. Nevertheless, success rates could be increased by implementing evidence-based tobacco cessation programs at the organizational-level, including post-discharge active quitting smoking support. CLINICAL RELEVANCE: Three-quarters of the inpatients who smoke remain abstinent during hospitalization and over half achieve to maintain their abstinence or at least reduce their consumption one month after discharge, proving that admission to hospitals is an excellent teachable moment to quit smoking.

Effects of Multimodal Exercise With Augmented Reality on Cognition in Community-Dwelling Older Adults.

OBJECTIVES: This study aims to investigate the effects of an exercise intervention using multimodal exercise with augmented reality and multimodal exercise-only on cognitive function in older adults living in a community dwelling. DESIGN: Quasi-experimental research study. SETTING AND PARTICIPANTS: In this control study, 78 participants were divided into 2 experimental groups (with sessions 3 times a week for 12 weeks) and a control group (CG). METHODS: EG1 participated in a multimodal exercise-only intervention program, EG2 participated in a multimodal exercise program with augmented reality exergames, and CG continued its usual activities. Participants were assessed at baseline and postintervention after 12 weeks. RESULTS: Comparison between baseline and postintervention at 12 weeks showed significant improvements in executive functions, verbal fluency, choice reaction time, and dual task in EG1, whereas there were improvements in general cognition, executive functions, verbal fluency, discrimination reaction time, and depression in EG2 (P ≤ .05). The clinical effect sizes of the interventions were large for overall cognition, executive functions, and reaction time on single- and dual-task reaction time in EG1 and for overall cognition, executive functions, and verbal fluency in EG2. CONCLUSION AND IMPLICATIONS: The intervention programs showed significant improvements in several cognitive domains. The multimodal exercise-only showed improvements in more variables than the multimodal exercise with augmented reality, but the augmented reality group showed greater changes between baseline and postintervention.

Muscle weakness in critically ill patients: Effects of a systematized rehabilitation nursing program.

OBJECTIVE: Intensive care unit-acquired muscle weakness (ICUAW) in critically ill patients is frequent and associated with negative outcomes. Early rehabilitation is a strategy to improve outcomes. The aim was to assess the effects of a rehabilitation nursing programme at discharge from intensive care unit. METHODS: Quasi-experimental study with the comparison between two groups: one enrolled in a systematized nursing rehabilitation program and the other with usual nursing rehabilitation care. A non-probabilistic sample, sequential, of 42 critically ill ventilated patients, 21 patients in the control group and 21 patients the intervention group (June 2017 to June 2019), in three intensive care units of one large Portuguese teaching hospital. Mann-Whitney test was performed to compare Medical Research Council Sum Score (MRC-SS) values between groups. RESULTS: Patients undergoing the rehabilitation program had a decrease in ICUAW (at ICU discharge mean MRC-SS = 38 vs. mean MRC-SS = 42.7, p = 0.043, U = 152,5). There was a decrease in severe muscle weakness (9.5% vs. 28.6%) and significant muscle weakness (42.9% vs. 52.4%) and an increase without muscle weakness (47,6% vs. 19%). CONCLUSIONS: The systematic rehabilitation nursing program can improve muscle strength and reduce functional disability at the time of discharge from intensive care.

Translation, Cultural Adaptation, and Reliability of the 15D Portuguese Version: A Generic Health-Related Quality of Life (HRQoL) Instrument.

(1) Background: Purpose: The assessment of quality of life is essential to the human condition and can be measured through questionnaires. This study aims to translate and culturally adapt the 15D questionnaire to assess the population's quality of life, as well as explore its relative reliability and internal consistency; (2) Methods: The translation and cultural adaptation of the 15D questionnaire was carried out independently, considering two translations. The synthesis version was applied to eight subjects, distributed by gender. Cognitive interviews were conducted to observe clarity, acceptability, and familiarity with the version of the questionnaire. The final version of the questionnaire, in Portuguese, was again translated into the official language by two translators who had never had contact with the questionnaire. To assess the test-retest reliability and internal consistency of the 15D questionnaire, 43 participants were interviewed; (3) Results: Participants indicated that they had some doubts about dimensions, breathing, and discomfort and symptoms; however, as there were no suggestions for change, the questionnaire had no changes. Items were clear and understandable. Internal consistency was observed using Cronbach's alpha, with values between 0.76 and 0.98. The test-retest reliability values were between 0.77 and 0.97; and (4) Conclusions: The Portuguese version of the 15D questionnaire was proved to be equivalent to the English version and to be reliable for the Portuguese population. This instrument is easy to access and apply.

Phase Angle as a Predictor for Physical Function in Institutionalized Independent Older Adults.

The aim of this study was to investigate the relationship between phase angle (PhA) and physical function in institutionalized, independent older adults. Physical function was evaluated using the Senior Fitness Test Battery. PhA was measured by electrical bioimpedance at 50 khz, and body composition parameters were also registered. Results showed that PhA significantly correlated with all physical fitness tests, except for arm curls. Regarding the results of the multivariate analysis, three models were created: Model 1, formed by a dependent variable "PhA" and two predictor variables "8 ft up-and-go" and "6 min walk"; Model 2, formed by a dependent variable "PhA" and three predictor variables "8 ft up-and-go", "6 min walk" and "30-s chair stand"; and Model 3, formed by a dependent variable "PhA" and four predictor variables "8 ft up-and-go", "6 min walk", "30-s chair stand" and "arm curl". Results showed that predictor variables had a significant influence on the PhA for all three models (Model 1: p = 0.001, 12.5%; Model 2: p = 0.002, 12.9%; and Model 3: p = 0.005, 13.1%). For women, Model 1 showed a significant influence of predictor variables on the PhA (p = 0.030, 9.3%). The results for men in Models 1, 2 and 3 showed significant influences on the PhA (p = 0.002, 31.2%; p = 0.006, 31.6%; and p = 0.016, 31.6%; respectively). This study confirmed previous studies regarding to the relationship between PhA and physical function. It also indicates that PhA could be an excellent predictor of physical function.

Acute Effects of Augmented Reality Exergames versus Cycle Ergometer on Reaction Time, Visual Attention, and Verbal Fluency in Community Older Adults.

BACKGROUND: This study aims to investigate the acute effects of an augmented reality session and a cycle ergometer session compared to no exercise on the reaction times, cognitive flexibility, and verbal fluency of older adults. METHODS: Each participant did a familiarization with cognitive tests and the following three sessions: cycle ergometer, no exercise (control group), and augmented reality exergame (Portable Exergame Platform for Elderly) sessions. The participants were randomized in a within-group design into one of six possible combinations. Each moment had a 30 min duration, and after the session, the participants performed a Trail Making Test, a verbal fluency test, and a Deary-Liewald reaction time task. The data were analyzed with a one-way ANOVA with a Bonferroni adjustment. RESULTS: The analysis between the no exercise, cycle ergometer, and augmented reality sessions showed no significant differences in the cognitive measurements. CONCLUSIONS: One session of the cycle ergometer exercise or the augmented reality exergames does not acutely improve the reaction times, cognitive flexibility, or verbal fluency in the elderly.

Can Physical Activity Make Up for the Self-Care Disability Effects of Too Much Sitting? A Moderation Analysis in Octogenarians Residing in Living Care Facilities.

BACKGROUND AND PURPOSE: Physical activity can delay the progression of self-care disability in older adults residing in living care facilities. Nonetheless, older adults residing in living care facilities spend most of their time sedentary and do not meet the physical activity recommendation, which may result in increasing self-care disability in this population group. In this study, we aimed to determine whether the association between sedentary time and self-care disability was moderated by moderate-to-vigorous physical activity (MVPA) in older adults residing in living care facilities. METHODS: Sedentary time and MVPA were both measured with accelerometers. Self-care disability was assessed with the Barthel Index. A multivariate regression model was used to ascertain the effects of the interaction between sedentary time and MVPA on the self-care disability of participants. The Johnson-Neyman technique was then used to estimate the exact MVPA threshold at which the effect of sedentary time on self-care disability became nonsignificant. RESULTS: We found a significant effect of sedentary time on self-care disability (standardized ß=-1.66; 95% CI -1.77 to -1.54, P = .013). Results indicated that MVPA moderates the relationship between self-care disability status and sedentary time (standardized ß= 1.14; 95% CI 1.13 to 1.14, P = .032). The Johnson-Neyman technique determined that 51 min/day of MVPA would offset the negative effects of sedentary time on self-care disability. CONCLUSIONS: Our results suggest physical therapists should focus on reducing sedentary time alongside physical activity to prevent the progression to dependency in octogenarians residing in living care facilities.

Replacing Sedentary Behavior With Physical Activity of Different Intensities: Implications for Physical Function, Muscle Function, and Disability in Octogenarians Living in Long-Term Care Facilities.

BACKGROUND: We investigated the associations of replacing sedentary behavior (SB) with physical activity of different intensities on the physical function of octogenarians living in long-term care facilities. METHODS: This pooled study recruited 427 older adults aged 80 years and older (69.1% female; body mass index: 27.53). For 345 participants who provided valid data, we assessed device-measured time spent in SB, light-intensity physical activity (LIPA), and moderate to vigorous physical activity (MVPA). We assessed lower limb physical function, strength, mobility, and disability. We used compositional data analysis to investigate the associations of replacing SB with physical activity on the outcomes. RESULTS: Reallocation of SB to LIPA and MVPA was associated with a higher number of 30-second Chair Stand cycles (LIPA: +0.21, MVPA: +1.81; P < .001), greater peak force (LIPA: +11.96 N, MVPA: +27.68 N; P < .001), peak power (LIPA: +35.82 W, MVPA: +92.73 W; P < .001), peak velocity (LIPA: +0.03 m/s, MVPA: +0.12 m/s; P < .001), higher levels of grip strength (LIPA: +0.68 kg, MVPA: +2.49 kg; P < .001), and less time in the Time Up and Go (LIPA: -7.63 s, MVPA: -12.43 s; P < .001). CONCLUSIONS: Replacing SB with LIPA or MVPA is associated with physical function and disability of older adults living in long-term care facilities.

Intrauterine growth restriction and its impact on intestinal morphophysiology throughout postnatal development in pigs.

Intrauterine growth restriction (IUGR) compromises fetal development, leading to low birth weight, and predisposes to gastrointestinal disorders. Pigs that suffered IUGR present poor postnatal development, resulting in great economic losses to the industry. The small intestine may be involved with impaired development, but studies investigating this issue are still limited. Thus, the present study aimed to investigate small intestine morphofunctional alterations in IUGR pigs throughout the production phases (birth to 150 days). IUGR pigs presented lower body weight from birth to the finishing phase (P < 0.05). Although histomorphometrical parameters were not affected during the pre-weaning period, their commitment was observed specifically in the duodenum of the IUGR group at older ages (P < 0.05). The most detrimental effects on the small intestine, such as deeper duodenum crypts' depth, lower villus height:crypt depth ratio and absorptive area, increased apoptosis and lower proliferation of the duodenum epithelium were noticed at 70 days of age (P < 0.05). Additionally, IUGR pigs presented the lowest chymotrypsin and amylase activities at 70 and 150 days of age, respectively (P < 0.05). These findings may contribute to the elucidation of morphofunctional disorders of the small intestine in IUGR pigs throughout the different production phases, suggesting that poor postnatal development may be due to intestinal damage.

Test-retest reliability of the functional reach test and the hand grip strength test in older adults using nursing home services.

OBJECTIVE: This study aimed to determine the absolute and relative test-retest reliability of the functional reach test (FRT) and the handgrip strength test (HGST) in older adults using nursing homes. METHODS: Participants (≥ 65 years old), living in nursing homes or using their day care services, were distributed into a group without cognitive impairment (GWCI, n = 43) and a group with mild cognitive impairment (GCI; n = 22). A 1-week test-retest was performed for the FRT and the HGST. Relative reliability was measured by the intraclass correlation coefficient (ICC3.1), and absolute reliability by the standard error of measurement (SEM), minimal detectable change (MDC95), and Bland-Altman plots. RESULTS: The ICC showed high reliability for the FRT (GWCI, ICC = 0.83; GCI, ICC = 0.87) and the HGST (ICC ≥ 0.95 in both hands and participant groups). The absolute reliability was good: FRT, SEM = 2.96/2.29, MDC95 = 8.20/6.35 for the GWCI and the GCI, respectively; HGST dominant hand SEM = 1.26/0.82, MDC95 = 3.50/2.29, and HGST non-dominant hand SEM = 1.05/0.80, MDC95 = 2.90/2.21, for the GWCI and the GCI, respectively. Bland-Altman showed that there was not a systematic bias for the tests in both groups. DISCUSSION: Findings show that the FRT and the HGST are reliable, have acceptable measurement error, and may be used for research and clinical purposes to assess functional balance and strength of the hands in older adults using nursing homes.

Psychometric properties of a computerized and hand-reaction time tests in older adults using long-term facilities with and without mild cognitive impairment.

The aim of this study was to determine the absolute and relative reliability and validity of two reaction time (RT) tests in older adults using long-term facility: the ruler drop test (RDT, a simple RT) and the Deary-Liewald RT task (DLRT, simple and four-choice RT). Participants (≥65 years old) using long-term facilities were distributed into a group without cognitive impairment (GWCI, n = 41), and a group with mild cognitive impairment (GCI, n = 32). The tests were administered one week apart, by the same evaluator. Relative reliability was measured by the Intraclass Correlation Coefficient (ICC3.1), absolute reliability by the standard error of measurement (SEM) and minimal detectable change (MDC95) and convergent validity by the Pearson correlation. The results showed that the relative reliability was good for the RDT (GWCI, ICC = 0.84; GCI, ICC = 0.80) and moderate for the Deary Liewald RT simple (DLRT-S) (GWCI, ICC = 0.61; GCI, ICC = 0.65). The relative reliability of the Deary Liewald RT choice (DLRT-C) was good (ICC = 0.89) for the GWCI and excellent (ICC = 0.93) for the GCI. However, the DLRT-C had low feasibility in the GCI, as most participants were unable to complete the test. Measurement precision was acceptable for the RDT and DLRT-C (GWCI) and for the DLRT-C (GCI). There were no significant associations between the RDT and DLRT scores. We conclude that the RDT could be more suitable than the DLRT-S for assessing simple RT in older adults. Future studies should explore if fewer than the four stimulus-response alternatives used in the DLRT-C could be more appropriate for assessing choice RT in older adults with cognitive impairment.

"a felicidade é uma coisa que os olhos transmitem". percepções sobre conexões sociais em pessoas idosas praticantes de exercícios físicos / "happines is a thing that the eyes transmit." perceptions about social connections in older people who practice physical exercises / "la felicida es una cosa que transmiten los ojos." percepciones sobre conexiones sociales en ancianos que practican ejercicios físicos

Resumo O objetivo deste estudo foi verificar as percepções das pessoas idosas sobre as características que contribuíram para as conexões sociais em um programa de exercícios físicos sistematizados. Para isso, utilizou-se da abordagem qualitativa e foram entrevistados 18 participantes após um programa de 16 semanas de treino. Foi realizada uma entrevista presencial, a partir de um roteiro com questões semiestruturadas. Os dados foram analisados pelo método de Análise Temática. Foram identificados quatro temas gerais: a) motivação extrínseca, b) características do grupo, c) características pessoais, e d)características profissionais. Além disso, foram identificados alguns atributos, como ter pessoas conhecidas nos programas, estar em grupo de participantes com idades próximas, estar aberto ao diálogo e ter profissionais com características socioafetivas como comunicação, empatia, entre outros, que podem influenciar na percepção de conexões sociais durante o exercício físico, potencializando seus benefícios e contribuindo para uma vida mais ativa.

Abstract The aim of this study was to verify the older people's perceptions about the characteristics that contributed to the social connections in a systematic physical exercises program. For this, a qualitative method was used, and 18 participants were interviewed after a 16-week training program. A face-to-face interview was carried out, based on a script with semi-structured questions. The data was analyzed using the Thematic Analysis method. Four general themes were identified: a) extrinsic motivation, b) group characteristics, c) personal characteristics, and d) professional characteristics. Furthermore, some attributes were identified, such as identify familiar people in the programs, belong in a group of participants with similar age, be open to dialogue and have professionals with socio-affective characteristics such as communication, empathy, among others, which can influence the perception of social connections during physical exercise, enhancing its benefits and contributing to a physically active life.

Resumen El objetivo de este estudio fue verificar las percepciones de las personas mayores sobre las características que contribuyen a las conexiones sociales en un programa sistematizado de ejercicio físico. Para eso, se utilizó un enfoque cualitativo y se entrevistó a 18 participantes después de un programa de entrenamiento físico de 16 semanas. Se realizó una entrevista cara a cara, basada en un guion con preguntas semiestructuradas. Los datos fueron analizados mediante el método de Análisis Temático. Se identificaron cuatro temas generales: a) motivación extrínseca, b) características grupales, c) características personales y d) características profesionales. Además, se identificaron algunos atributos como tener personas conocidas en los programas, estar en un grupo de participantes de edades cercanas, estar abiertos al diálogo y contar con profesionales con características socioafectivas como comunicación, empatía, entre otras, que pueden influyen en la percepción de las conexiones sociales durante el ejercicio físico, potenciando sus beneficios y contribuyendo a una vida más activa.

Physical activity and physical fitness of nursing home residents with cognitive impairment: A pilot study.

Physical activity and physical fitness are important for health, functional mobility and performance of everyday activities. To date, little attention has been given to physical activity and physical fitness among nursing home residents with cognitive impairment. Therefore, the main aim of this study was to examine physical activity behavior and physical fitness of institutionalized older adults with cognitive impairment and to investigate their interrelations. Forty-eight older adults with cognitive impairment (83.9±7.7years; 72.9% women) and 22 without cognitive impairment (82.2±8.8years; 54.5% women) participated. Physical activity was objectively assessed with accelerometers and physical fitness components (muscular strength, flexibility, balance, body composition and reaction time) were evaluated with physical fitness field tests. Nursing home residents with cognitive impairment spent only ~1min per day in moderate physical activity and ~89min in light physical activity. In average they accumulated 863 (±599) steps per day and spent 87.2% of the accelerometer wear time in sedentary behavior. Participants' physical fitness components were markedly low and according to the cut-offs used for interpreting the results a great number of nursing home residents had an increased risk of associated health problems, functional impairment and of falling. The performance in some physical fitness tests was positively associated with physical activity. Participants without cognitive impairment had higher levels of physical activity and physical fitness than their counterparts with cognitive impairment. These results indicate that nursing home residents, especially those with cognitive impairment, have low levels of physical activity, spent a high proportion of daytime in sedentary behavior and have low physical fitness. Nursing homes should implement health promotion strategies targeting physical activity and physical fitness of their residents.

[Statins in chronic renal disease]. / Estatinas na doença renal crônica.

Hypertriglyceridemia and low HDL-c are common features in patients with chronic renal failure. Cardiovascular mortality is substantially increased in the presence of chronic renal disease (10-20 times higher). There is evidence from clinical trials with statins suggesting their protective role in the progression of renal disease. In addition, reduced rates of non-fatal myocardial infarction and cardiac mortality were seen after renal transplant in patients receiving fluvastatin. However, a recent study with atorvastatin failed to demonstrate reduction in cardiovascular morbidity and mortality among diabetic patients on hemodialysis therapy. Ongoing trials will define the precise role of statins in this subset of patients.

A visita domiciliária na transição hospital-domicílio à pessoa com doença mental: uma revisão integrativa da literatura / The home visit in the hospital-domicile transition of the person with a mental disorder: an integrative review of the literature / La visita a domicilio em la transición hospital-domicilio a la persona com enfermedad mental: una revisión integrativa de la literatura

CONTEXTO: A mudança de um paradigma hospitalocêntrico para um de raiz comunitária vem sendo desde há vários anos contemplada como prioritário. No entanto, continua a existir uma escassa resposta de estruturas necessárias de apoio às pessoas com doença mental e seus cuidadores. O processo de vivência da transição hospital-domicílio pode expor a pessoa a um risco potencial de desenvolver um processo de adaptação desajustado, pelo que a visita domiciliária pode ser um recurso interessante, na medida em que promove a acessibilidade e a aceitabilidade, podendo influenciar positivamente o envolvimento das pessoas e dos seus cuidadores no tratamento destas patologias. OBJETIVO: Identificar os benefícios da visita domiciliária às pessoas com doença mental na continuidade de cuidados hospital-domicílio. MÉTODO: Realizou-se uma revisão integrativa da literatura, recorrendo-se a pesquisa nas bases de dados EBSCO e B-ON e no RCAAP, tendo resultado em cinco artigos compreendidos no horizonte temporal 2013-2018. RESULTADOS: A visita domiciliária permite manter o contacto da pessoa com doença mental e os cuidados de saúde, assegura a continuidade de cuidados, demonstrando ter benefícios quer a nível da sintomatologia, da funcionalidade ou da qualidade e vida das pessoas e das suas famílias, reduzindo o desperdício de recursos consumidos durante os reinternamentos por causa das recaídas, além de promover igualmente a sua inserção na comunidade. CONCLUSÕES: A visita domiciliária deve ser explorada no que concerne aos cuidados a pessoas com doença mental, por ser um recurso que pode diminuir algumas das barreiras identificadas na continuidade de cuidados pós-hospitalar e pelos benefícios que acarreta.

BACKGROUND: Changing the hospital-centered to a community-based care paradigm has been seen as a priority for a long time. However, there still is a limited response from all the organizations needed to help and support patients with Mental Illnesses and their caretakers. The hospital-home transition and how the patients cope with it might lead to maladjusted adaptation mechanisms. As such, home visits are an important tool that promote accessibility and acceptability, positively influencing patients’ and their caretakers’ involvment in the treatment of the underlying disease. AIM: To understand the benefits that home visits can have in promoting the continuity of hospital-home care for the patients with mental illness. METHODS: An integrative literature review was conducted using the EBSCO and B-ON databases and RCAAP, resulting in five articles included in the 2013-2018 time horizon. RESULTS: The home visit allows the person with mental illness to maintain contact with the health care system, ensures continuity of care, demonstrating benefits in terms of symptoms, functionality or quality of life and life of individuals and their families, reducing the waste of resources consumed during readmissions due to relapses, and also promoting their integration into the community. CONCLUSIONS: Home visits should be explored with regard to the care of people with mental illness, as this is a resource that can reduce some of the barriers identified in the continuity of post-hospital care and the benefits it brings.

CONTEXTO: El cambio de un paradigma centrado en el hospital a uno basado en la comunidad ha sido considerado una prioridad durante varios años. Todavía hay poca respuesta de las estructuras de apoyo necesarias para las personas con enfermedades mentales y sus cuidadores. El proceso de experimentar la transición entre el hospital y el domicilio puede exponer a la persona a un riesgo potencial de desarrollar un proceso de adaptación inapropiado, por lo que la visita a domicilio puede ser un recurso interesante, ya que promueve la accesibilidad, la aceptabilidad y la participación de las personas y sus cuidadores en el tratamiento de estas patologías. OBJETIVO: Identificar los beneficios de las visitas domiciliarias a personas con enfermedades mentales en la continuidad de la atención hospitalaria domiciliaria. METODOLOGÍA: Se llevó a cabo una revisión integrativa de la literatura utilizando las bases de datos de EBSCO y B-ON y RCAAP, lo que resultó en la inclusión de cinco artículos en el horizonte temporal 2013-2018. RESULTADOS: La visita domiciliaria asegura la continuidad de la atención, demuestra beneficios en términos de síntomas, funcionalidad o calidad de vida de las personas y sus familias, reduce el derroche de recursos consumidos, y también promueve su integración en la comunidad. CONCLUSIONES: Se deben explorar las visitas domiciliarias en relación con la atención de las personas con enfermedades mentales, ya que se trata de un recurso que puede reducir algunas de las barreras identificadas en la continuidad de la atención poshospitalaria y los beneficios que aporta.

Affinity analysis and application of dipeptides derived from l-tyrosine in plasmid purification.

The developments in the use of plasmid DNA (pDNA) in gene therapy and vaccines have motivated the search and improvement of optimized purification processes. In this context, dipeptides l-tyrosine-l-tyrosine and l-tyrosine-l-arginine are synthetized to explore their application as affinity ligands for supercoiled (sc) plasmid DNA (pDNA) purification. The synthesis is based on the protection of N-Boc-l-tyrosine, followed by condensation with l-tyrosine or l-arginine methyl esters in the presence of dicyclohexylcarbodiimide (DCC), which after hydrolysis and acidification give the afforded dipeptides. The supports are then obtained by coupling l-tyrosine, l-tyrosine-l-tyrosine and l-tyrosine-l-arginine to epoxy-activated Sepharose and are characterized by high resolution magic angle spinning (HR-MAS) NMR and Fourier transform infrared spectroscopy (FTIR). Surface plasmon resonance (SPR) biosensor is used to establish the promising ligand to be used in the chromatographic experiments and ascertain experimental conditions. Sc isoform showed the highest affinity to the dipeptides, followed by linear (ln) pDNA, being the open circular (oc) the one that promoted the lowest affinity to l-tyrosine-l-arginine. Saturation transfer difference (STD)-NMR experiments show that the interaction is mainly hydrophobic with the majority of the 5'-mononucleotides, except for 5'-GMP with l-tyrosine-l-arginine Sepharose that is mainly electrostatic. The support l-tyrosine Sepharose used in chromatographic experiments promotes the separation of native pVAX1-LacZ and pcDNA3-FLAG-p53 samples (oc+sc) by decreasing the salt concentration. The results suggest that it is possible to purify different plasmids with the l-tyrosine Sepharose, with slight adjustments in the gradient conditions.

Cardiovascular effects of successful renal transplantation: a 1-year sequential study of left ventricular morphology and function, and 24-hour blood pressure profile.

BACKGROUND: Cardiovascular disease is the leading cause of death in renal transplant recipients. The purpose of this study was to determine the effects of a successful renal transplantation on left ventricular morphology and function and on the 24-hr blood pressure profile. METHODS: Twenty-four patients with end-stage renal disease were prospectively studied by ambulatory blood pressure monitoring and echocardiography before and at 3, 6, and 12 months after renal transplantation. Patients were also analyzed according to their renal function after transplantation. RESULTS: We observed a significant drop in the mean values of daytime and nocturnal systolic blood pressure and in the 24-hr systolic pressure load at 12 months after transplantation. The most frequent echocardiographic finding was left ventricular hypertrophy (LVH), for which the incidence decreased from 75% before transplantation to 52.1% at 12 months after transplantation (P = 0.125). There was a significant decrease in left ventricular dilatation, and systolic dysfunction normalized in all patients after 12 months. The variables that best independently predicted the decrease in LVH were serum creatinine levels and the 24-hr systolic pressure load as registered by ambulatory blood pressure monitoring at 12 months after transplantation. We observed significant decreases in left ventricular mass and left ventricular mass index in the group of patients who had adequate renal function, as compared with no changes in patients who did not. CONCLUSIONS: Correction of the uremic state by renal transplantation leads to complete resolution of systolic dysfunction, regression of LVH, and improvement of left ventricular dilatation. In fact the reduction of LVH was dependent on adequate renal function and on a decrease in the systolic pressure levels.

Keep on Going: Apoio à escolha estratégica do estágio curricular / Keep On Going: Support for the strategic choice of the curriculum internship / Keep on Going: Apoyo a la elección estratégica en las prácticas curriculares

No presente artigo é apresentado e descrito um projeto de intervenção no domínio da psicologia vocacional designado Keep-on-Going. A intervenção em causa visa apoiar jovens na fase final do processo formativo, na escolha estratégica do contexto de estágio curricular. Tem como base teórica o Modelo de Exploração Reconstrutiva do Investimento Vocacional, e estrutura-se em seis momentos-chave num total de 10 sessões com duas a três horas cada. Participaram na 1.ª edição cinco estudantes (do sexo feminino) do 1.º ano do Mestrado em Psicologia da Educação. Os resultados da avaliação contínua apontam para valores médios de seis numa escala de 1 a 7, em termos da qualidade geral do projeto. Na avaliação de follow-up as dimensões "Evolução na capacidade de escolher" e "Utilidade do projeto", são as mais pontuadas confirmando que a participação no projeto se revelou uma experiência de valor para as estudantes.

This article presents and describes an intervention project in the field of vocational psychology named Keep-on-Going. This intervention aims to support young people in the final stage of the training process, in the strategic choice of the context of curricular internship. Its theoretical basis is the Reconstructive Exploitation Model of Vocational Investment, and it is structured into six key moments in a total of 10 sessions with two to three hours each. Five female students participated in the first edition of the 1st year of the Master's in Educational Psychology. The results of the continuous evaluation point to average values ​​of six on a scale of 1 to 7, in terms of the overall quality of the project. In the follow-up assessment, the dimensions "Evolution in the ability to choose" and "Project usefulness" are the highest scores confirming that participation in the project has proved to be a valuable experience for the students.

En el presente artículo se presenta y describe un proyecto de intervención en el ámbito de la psicología vocacional designado Keep-on-Going. La intervención en cuestión pretende apoyar a los jóvenes en la fase final del proceso formativo para la elección estratégica del contexto de la práctica curricular. Se tiene como base teórica el Modelo de Exploración Reconstructiva de la Inversión Vocacional, y se estructura en seis momentos clave en un total de 10 sesiones de dos a tres horas cada una. Participaron en la primera edición cinco estudiantes (sexo femenino) del primer año de la Maestría en Psicología de la Educación. Los resultados de la evaluación continua apuntan valores medios de seis en una escala de 1 a 7, en términos de la calidad general del proyecto. En la evaluación de seguimiento, las dimensiones "Evolución en la capacidad de escoger" y "Utilidad del proyecto" son las más puntuadas, confirmando que la participación en el proyecto constituyó una experiencia de valor para las estudiantes.