Burden indicators, coping strategies and depressive symptoms among older people caring for other seniors

Orientador: Samila Sathler Tavares BatistoniDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Objetivo: O presente estudo identificou associações entre variáveis sociodemográficas, estressores de natureza objetiva e subjetiva, estratégias de enfrentamento e a presença de sintomatologia depressiva em idosos que cuidam informalmente de outros idosos no contexto domiciliar. Material e Métodos: Trata-se de uma pesquisa de corte transversal, descritiva e correlacional, fruto da análise parcial dos dados provenientes do banco de dados do Estudo intitulado "Bem-estar psicológico de idosos que cuidam de outros idosos no contexto da família". Foi composta uma amostra de conveniência de 121 cuidadores idosos entrevistados a partir de um protocolo para levantamento das variáveis: idade, gênero, estado conjugal, renda, escolaridade, tempo em que é cuidador, grau de parentesco com o alvo de cuidado e as estratégias de enfrentamento, sobrecarga e sintomatologia depressiva. Resultados: A amostra foi predominantemente composta por mulheres (73%), por idosos com média etária de 70,5 anos (DP=7,20 ), por cônjuges (62%) e tempo médio em que exercem o cuidado de 5,34 anos (DP=6,27). A análise de conglomerados identificou a composição de três grupos distintos a partir do vínculo com o idoso alvo de cuidado, da faixa de renda e do tempo em que exercem o papel de cuidador. Examinou-se a composição fatorial do Inventário de Enfrentamento da Califórnia e identificada a pontuação média dos idosos nos fatores encontrados. Para a amostra total, houve menor uso de estratégias disfuncionais e maior tendência em utilizar-se de estratégias de autoproteção (ou de controle secundário compensatório) e de estratégias de controle secundário seletivo. Examinou-se também a composição fatorial da Zarit Burden Interview e identificou-se estabilidade na ordenação dos domínios explicativos do construto de sobrecarga quando investigado entre idosos cuidadores. Identificou-se uma prevalência de sintomatologia depressiva de 24%. Análise de regressão multivariada associações de depressão com sexo feminino, idade de 80 anos e mais, grau de instrução intermediário (5 a 8 anos de escolaridade) e sobrecarga moderada medida pela Zarit Burden Interview. Conclusões: Os resultados apontam para as necessidades em se considerar as especificidades do cuidador idoso, sua exposição ao estressor crônico de cuidar e a maneira de como isso afeta o curso de vida, adicionada aos desafios ao processo de envelhecimento pessoalAbstract: Objective: This study identified associations between sociodemographic variables, objective nature and subjective stressors, coping strategies and the presence of depressive symptoms in elderly people who informally care for other seniors in the home context. Material and Methods: This is a descriptive and correlational, analysis of data from the study database entitled "Psychological well-being of older people caring for other seniors in the context of family." A convenience sample of 121 elderly caregivers interviewed from a protocol to survey the variables comprised age, gender, marital status, income, education, time spend as a caregiver, relationship with the care and sets out the strategies coping, burden and depressive symptoms. Results: The sample was predominantly composed of women (73%), for the elderly with a main age of 70.5 years (SD = 7.20), by spouses (62%) and average time in which they require care to 5.34 (SD = 6.27). The analysis identified the composition of three distinct groups from the link with the elderly as a target of care, the income level and the time in which they require the role of caregiver. It examined the factorial composition of the Coping Inventory California and identified the average score of the elderly in the found factors to the total sample, there was less use of dysfunctional strategies and more likely to be used for self-protection strategies (or compensatory secondary control) and selective secondary control strategies. It also examined the factor composition of the Zarit Burden Interview and identified stability in the ordering of explanatory areas of overload construct when we inquired among elderly caregivers. It identified a prevalence of depressive symptoms of 24%. Multivariate regression analysis of associations with depression female, age 80 years and older, intermediate level of education (5-8 years of schooling) and moderate overload measured by the Zarit Burden Interview. Conclusions: The results point to the need of considering the specifics of elderly caregivers, their exposure to chronic stressor of care and the manner of how it affects the course of life, added to the challenges of personal aging processMestradoGerontologiaMestra em Gerontologi

Zarit Burden Interview Psychometric Indicators Applied In Older People Caregivers Of Other Elderly

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)To derive psychometric indicators of construct validity and internal consistence of the Zarit Burden Interview scale for caregivers, describing associations of the scale with metrics related to care demands, coping strategies and depression in aged caregivers. Method: crosscutting descriptive and correlational study. The convenience sample was composed by a hundred and twenty one senior caregivers (Avg= 70.5 +/- 7.2 years, 73% women). They answered a questionnaire to check the physical and cognitive demands of care, the Zarit Burden Interview (ZBI), the California Inventory of Coping Strategies and the Geriatric Depression Scale (GDS-15). Results: ZBI showed good internal consistency and also for the three factors emerging from factor analysis, explaining 44% of variability. ZBI is positively related with objective care demands (p < 0.001), depression (p = 0.006) and use of dysfunctional coping strategies (p = 0.0007). Conclusion: ZBI is of interest to be applied to aged caregivers and the association of higher degrees of burden, dysfunctional coping and depression show a vulnerability scenario that may affect to older people taking care of other elderly.24Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES), BrazilCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Colon adenocarcinoma diagnosis in human samples by multicontrast nonlinear optical microscopy of hematoxylin and eosin stained histological sections

Combined multimodal nonlinear optical (NLO) microscopies were used to detect and quantify morphological changes associated with stroma and epithelial transformation in colon cancer. Our findings provide complementary information about tissue microstructure, displaying distinctive patterns between normal and malignant human colon. Additionally, we have demonstrated the usefulness of using fixed tissues for the disease diagnostic and prognostic. The present work provides a framework for using NLO techniques as a clinical diagnostic tool for human colon cancer. NLO metrics could be applied to other disorders, which are characterized by abnormal cell proliferation and collagen assembly.Fil: Adur, Javier Fernando. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; Argentina. National Institute of Science and Technology on Photonics Applied to Cell Biology; Brasil. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Transferencia de Entre Ríos. Universidad Nacional de Entre Ríos. Centro de Investigaciones y Transferencia de Entre Ríos; ArgentinaFil: Bianchi, Mariana. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Pelegati, Vitor B.. National Institute of Science and Technology on Photonics Applied to Cell Biology; BrasilFil: Viale, Silvia. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; ArgentinaFil: Izaguirre, María Fernanda. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; ArgentinaFil: Carvalho, Hernandes Faustino. Universidade Estadual de Campinas; BrasilFil: Cesar, Carlos L.. Universidade Estadual de Campinas; BrasilFil: Casco, Victor Hugo. Universidad Nacional de Entre Ríos. Facultad de Ingeniería; Argentin

Saliency-driven system models for cell analysis with deep learning.

Background and objectivesSaliency refers to the visual perception quality that makes objects in a scene to stand out from others and attract attention. While computational saliency models can simulate the expert's visual attention, there is little evidence about how these models perform when used to predict the cytopathologist's eye fixations. Saliency models may be the key to instrumenting fast object detection on large Pap smear slides under real noisy conditions, artifacts, and cell occlusions. This paper describes how our computational schemes retrieve regions of interest (ROI) of clinical relevance using visual attention models. We also compare the performance of different computed saliency models as part of cell screening tasks, aiming to design a computer-aided diagnosis systems that supports cytopathologists.MethodWe record eye fixation maps from cytopathologists at work, and compare with 13 different saliency prediction algorithms, including deep learning. We develop cell-specific convolutional neural networks (CNN) to investigate the impact of bottom-up and top-down factors on saliency prediction from real routine exams. By combining the eye tracking data from pathologists with computed saliency models, we assess algorithms reliability in identifying clinically relevant cells.ResultsThe proposed cell-specific CNN model outperforms all other saliency prediction methods, particularly regarding the number of false positives. Our algorithm also detects the most clinically relevant cells, which are among the three top salient regions, with accuracy above 98% for all diseases, except carcinoma (87%). Bottom-up methods performed satisfactorily, with saliency maps that enabled ROI detection above 75% for carcinoma and 86% for other pathologies.ConclusionsROIs extraction using our saliency prediction methods enabled ranking the most relevant clinical areas within the image, a viable data reduction strategy to guide automatic analyses of Pap smear slides. Top-down factors for saliency prediction on cell images increases the accuracy of the estimated maps while bottom-up algorithms proved to be useful for predicting the cytopathologist's eye fixations depending on parameters, such as the number of false positive and negative. Our contributions are: comparison among 13 state-of-the-art saliency models to cytopathologists' visual attention and deliver a method that the associate the most conspicuous regions to clinically relevant cells

Endothelin system in intestinal villi: A possible role of endothelin-2/vasoactive intestinal contractor in the maintenance of intestinal architecture

The endothelin system consists of three ligands (ET-1, ET-2 and ET-3) and at least two receptors (ETA and ETB). In mice ET-2 counterpart is a peptide originally called " vasoactive intestinal contractor" (VIC) for this reason, this peptide is frequently named ET-2/VIC. In intestinal villi, fibroblasts-like cells express endothelin's receptors and response to ET-1 and ET-3 peptides, changing their cellular shape. Several functions have been attributed to these peptides in the " architecture" maintenance of intestinal villi acting over sub-epithelial fibroblasts. Despite this, ET-2/VIC has not been analyzed in depth. In this work we show the intestine gene expression and immunolocalization of ET-1, ET-2 and the ETA and ETB receptors from duodenum to rectus and in the villus-crypt axis in mice, allowing a complete analysis of their functions. While ET-1 is expressed uniformly, ET-2 had a particular distribution, being higher at the bottom of the villi of duodenum, ileum and jejunum and reverting this pattern in the crypts of colon and rectus, where the higher expression was at the top. We postulated that ET-2 would act in a cooperative manner with ET-1, giving to the villus the straight enough to withstand mechanical stress.Fil: Bianchi, Mariana. Universidad Nacional de Entre Ríos. Facultad de Ingeniería. Departamento de Biología. Laboratorio de Microscopía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Adur, Javier Fernando. Universidad Nacional de Entre Ríos. Facultad de Ingeniería. Departamento de Biología. Laboratorio de Microscopía; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Takizawa, Satoshi. Institute for Biological Resources and Functions; JapónFil: Saida, Kaname. Soka University; Japón. Institute for Biological Resources and Functions; JapónFil: Casco, Victor Hugo. Universidad Nacional de Entre Ríos. Facultad de Ingeniería. Departamento de Biología. Laboratorio de Microscopía; Argentin

Use of Electrodiagnostics in the Diagnosis and Follow-Up of Brachial Plexus Syndrome in a Calf

Electrodiagnostic testing by using electromyography (EMG) and nerve conduction studies (NCS) is essential in the evaluation of patients with traumatic brachial plexus injury as it facilitates the localization of the lesion and the prognosis. In this case report, we present a long-term electrodiag- nostic follow-up of a 5-day-old female Holstein calf with brachial plexus syndrome. Electrodiagnostic studies were carried out at 2 weeks, 5 weeks, 7 months and 12 months after admission. Initially, EMG confirmed the damage to the brachial plexus, potentially indicating a condition of neurotmesis or axonotmesis. However, motor NCS and the repeated electrodiagnostic follow-up, along with the evolution of the clinical signs, allowed a more favorable diagnosis of axonotmesis to be made. In fact, EMG showed a slow but gradual reduction and finally the disappearance of spontaneous pathological activity, while motor NCS revealed an increase in the amplitude and areas of the compound muscle action potentials. The animal was deemed fully recovered 12 months after admission. To the authors’ knowledge, this is the first report on the use of motor NCS in bovine medicine and it demonstrates that electrodiagnostics represent a useful and practical tool for the evaluation and prognosis of brachial plexus injury cases in cattle