39 research outputs found
Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: A qualitative pilot study
Background: Virtual communities of practice (vCoPs) facilitate online learning via the exchange of experiences and knowledge between interested participants. Compared to other communities, vCoPs need to overcome technological structures and specific barriers. Our objective was to pilot the acceptability and feasibility of a vCoP aimed at improving the attitudes of primary care professionals to the empowerment of patients with chronic conditions. Methods: We used a qualitative approach based on 2 focus groups: one composed of 6 general practitioners and the other of 6 practice nurses. Discussion guidelines on the topics to be investigated were provided to the moderator. Sessions were audio-recorded and transcribed verbatim. Thematic analysis was performed using the ATLAS-ti software. Results: The available operating systems and browsers and the lack of suitable spaces and time were reported as the main difficulties with the vCoP. The vCoP was perceived to be a flexible learning mode that provided up-to-date resources applicable to routine practice and offered a space for the exchange of experiences and approaches. Conclusions: The results from this pilot study show that the vCoP was considered useful for learning how to empower patients. However, while vCoPs have the potential to facilitate learning and as shown create professional awareness regarding patient empowerment, attention needs to be paid to technological and access issues and the time demands on professionals. We collected relevant inputs to improve the features, content and educational methods to be included in further vCoP implementation. Trial registration: ClinicalTrials.gov, NCT02757781. Registered on 25 April 2016.This study was financed by Instituto de Salud Carlos III and Cofinanced by Fondo
Europeo de Desarrollo Regional (FEDER). Ministerio de Economía
y Competitividad. Gobierno de España. (PI15/00164, PI15/00586, PI15/00566
Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU
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Evaluación de un programa de Programa de Intervención Nutricional en pacientes con enfermedad renal crónica avanzada (ERCA)
Introducción y Objetivos: La Enfermedad Renal Crónica
Avanzada (ERCA) se asocia a una elevada prevalencia de
malnutrición. La práctica habitual en estos pacientes va
dirigida a reducir la ingesta proteica, recomendación que
podría favorecer esta situación. Por ello, el objetivo de este
estudio fue evaluar el efecto de un programa de intervención
nutricional (PIN) sobre la función renal y el estado
nutricional en pacientes con ERCA.
Pacientes y Métodos: Se diseñó un estudio longitudinal
y prospectivo con 93 pacientes (53,7% hombres, 66 ±
17años) que participaron en un PIN durante 6 meses con
visitas mensuales. Al inicio y al final de la intervención se
evaluaron: estado nutricional en función de los criterios
de Chang, datos antropométricos, dietéticos y bioquímicos
(albúmina, prealbúmina, aclaramiento de creatinina,
fósforo y potasio séricos, Colesterol-total, LDL, HDL, triglicéridos
y PCR).
Resultados: Tras el PIN la ingesta calórica disminuyó
en los normonutridos (1833 ± 318 vs 1571 ± 219 kcal p <
0,001) y se mantuvo en los malnutridos. Se redujo significativamente
la ingesta proteica (69,9 ± 16,6 vs 54,9 ± 11 g
p < 0,001), potasio (2938 ± 949 vs 2377 ± 743 mg, p <
0,0001) y fósforo (1180 ± 304 vs 946,6 ± 211 mg, p <
0,0001). Un 16,5% requirió suplementación. El porcentaje
de pacientes que presentaba malnutrición según criterios
de Chan disminuyó tras el PIN (41,7 % (27,8% leve,
10,10% moderada y 3,8% grave) vs 16,8% (8% leve, 5%
moderada y 3,8% grave)). Tras el PIN incrementó significativamente
el aclaramiento de creatinina (17,8 ± 5,2 vs
19,4 ± 6,9 ml/min, p < 0,01), albúmina (3,3 ± 0,5 g/dL vs
3,5 ± 0,4 g/dL, p < 0,05) y disminuyó el potasio sérico (4,8
± 0,6 vs 4,5 ± 0,5 mmol/L, p < 0,05), Colesterol Total
(179,8 ± 44,3 vs 170,0 ± 15,1 mg/dL, p < 0,05), LDL colesterol
(113,2 ± 37,0 vs 108,3 ± 27,3 mg/dL, p < 0.01) y triglicéridos
(141,9 ± 60,8 vs 129,9 ± 52,7 mg/dL, p < 0,05
Introducción y Objetivos: La Enfermedad Renal Crónica
Avanzada (ERCA) se asocia a una elevada prevalencia de
malnutrición. La práctica habitual en estos pacientes va
dirigida a reducir la ingesta proteica, recomendación que
podría favorecer esta situación. Por ello, el objetivo de este
estudio fue evaluar el efecto de un programa de intervención
nutricional (PIN) sobre la función renal y el estado
nutricional en pacientes con ERCA.
Pacientes y Métodos: Se diseñó un estudio longitudinal
y prospectivo con 93 pacientes (53,7% hombres, 66 ±
17años) que participaron en un PIN durante 6 meses con
visitas mensuales. Al inicio y al final de la intervención se
evaluaron: estado nutricional en función de los criterios
de Chang, datos antropométricos, dietéticos y bioquímicos
(albúmina, prealbúmina, aclaramiento de creatinina,
fósforo y potasio séricos, Colesterol-total, LDL, HDL, triglicéridos
y PCR).
Resultados: Tras el PIN la ingesta calórica disminuyó
en los normonutridos (1833 ± 318 vs 1571 ± 219 kcal p <
0,001) y se mantuvo en los malnutridos. Se redujo significativamente
la ingesta proteica (69,9 ± 16,6 vs 54,9 ± 11 g
p < 0,001), potasio (2938 ± 949 vs 2377 ± 743 mg, p <
0,0001) y fósforo (1180 ± 304 vs 946,6 ± 211 mg, p <
0,0001). Un 16,5% requirió suplementación. El porcentaje
de pacientes que presentaba malnutrición según criterios
de Chan disminuyó tras el PIN (41,7 % (27,8% leve,
10,10% moderada y 3,8% grave) vs 16,8% (8% leve, 5%
moderada y 3,8% grave)). Tras el PIN incrementó significativamente
el aclaramiento de creatinina (17,8 ± 5,2 vs
19,4 ± 6,9 ml/min, p < 0,01), albúmina (3,3 ± 0,5 g/dL vs
3,5 ± 0,4 g/dL, p < 0,05) y disminuyó el potasio sérico (4,8
± 0,6 vs 4,5 ± 0,5 mmol/L, p < 0,05), Colesterol Total
(179,8 ± 44,3 vs 170,0 ± 15,1 mg/dL, p < 0,05), LDL colesterol
(113,2 ± 37,0 vs 108,3 ± 27,3 mg/dL, p < 0.01) y triglicéridos
(141,9 ± 60,8 vs 129,9 ± 52,7 mg/dL, p < 0,05Introduction and Objectives: Advanced Chronic Kidney
Disease (ACKD) is associated with high prevalence of
malnutrition. The habitual continuous dietary restrictions
used in clinical practice. increased the malnutrition
risk. The aim of this study was to evaluate the effects of a
Nutritional intervention Program (NIP) on renal function
and nutritional status in patients with ACKD.
Patients and Methods: 93 patients, (53.7% men, 66 ± 17
years) were included in a prospective longitudinal study.
The patients recived a NIP during 6 months with mensual
visits. At baseline and six months the outcome assessed
were: nutritional status by Chang criteria, anthropometric,
dietetic and biochemical parameters (albumin,
prealbumin, creatinine clearance, serum phosphorus,
potassium, total-Cholesterol, LDL, HDL, triglycerides,
and PCR).
Results: After intervention, caloric intake decreased in
nourished patients (1833 ± 318 vs 1571 ± 219 kcal p =
.001). and it was constant in malnourished patients. The
intake of protein (69,9 ± 16,6 vs 54,9 ± 11 g p < 0.001),
potassium (2938 ± 949 vs 2377 ± 743 mg p < 0.001) and
phosphorus (1180 ± 304 vs 946,6 ± 211 mg p < 0.001) significantly
decreased. 16.5% patients required supplementation.
A total of 41.7% of patients were malnourished at
baseline (27.8% mild, 10.10% moderate and 3.8%
severe), and 16.8% at the end (8% mild, 5% moderate
and 3.8% severe) by Chang criteria. At the end of NIP,
patients significantly increased creatinine clearance (17,8
± 5,2 vs 19,4 ± 6,9 ml/min, p < 0,01), albumin (3,3 ± 0,5 vs.
3,5 ± 0,4 g/dL, p < 0,05), and decreased serum potassium
(4,8 ± 0,6 vs 4,5 ± 0,5 mmol/L, p < 0,05), total cholesterol
(179,8 ± 44,3 vs 170,0 ± 15,1 mg/dL, p < 0,05), LDL (113,2
± 37,0 vs 108,3 ± 27,3 mg/dL, p < 0.01) and tryglicerides
(141.9 ± 60.8 vs 129.9 ± 52.7 mg/dL, p < 0.05).
Conclusions: The study reflected a NIP usefulness in
the nutritional status and renal function improvements
within an interdisciplinary framework during ACKD
consultation
Precipitation of particles using combined high turbulence extraction assisted by ultrasound and supercritical antisolvent fractionation
High Turbulence Extraction Assisted by Ultrasound combined with Supercritical Antisolvent Fractionation (SAF) was done to intensify the recovery of bixin and phenolic compounds from semi-defatted annatto seeds. Annatto seeds are extensively used due to its colorant properties and bioactive potential in human health. Modifications were performed in the SAF experimental apparatus in order to prevent losses of product. Results show that supercritical fractionation resulted in particle yields between 72.2–80.5%, 20–50% phenolics, and 66% bixin.3549CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP302423/2015-088882.305824/2013-012015/13299-