3,727 research outputs found
Reflections of Researchers Involved in the Evaluation of Pedagogical Technological Innovations in a University Setting
It is widely assumed that developments in information and communication technologies are fundamentally transforming and improving higher education. As a part of an ongoing evaluation of technology-supported pedagogy in one university, our three-year research project was designed, on the one hand, to determine if and how selected technologies were beneficial for learning and, on the other hand, to offer professional development for faculty members. In this paper, we reflect on our participation in a pedagogy and technology (referred to as PedTech) pilot project, describe some of the relationships that developed between ourselves as researchers and evaluators and our faculty collaborators, and share what we have learned from this experience. We suggest that a scholarship of teaching approach to evaluating innovations in teaching and learning is one way to support institution-wide adoption.Présumons que les développements dans les technologies de l'information et de la communication transforment et améliorent l'éducation postsecondaire. Par une évaluation continue de technologies pédagogiques dans une université, notre projet de recherche avait deux objectifs de base. Le premier objectif était de déterminer si les technologies choisies amélioreraient l'apprentissage. Le deuxième était d'offrir le développement professionnel aux professeurs ciblés. Dans cet article, nous réfléchissons sur notre participation dans ce projet pilote de nature techno-pédagogique. Nous décrivons les relations développées entre nous, les chercheurs-évaluateurs, et les professeurs collaborateurs, pour partager les leçons et les pratiques de réussite. Nous croyons qu'une approche institutionnelle d'évaluation des technologies pédagogiques innovatrices est un moyen d'étendre cette application
Qualidade de vida e sobrecarga dos cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica em oxigenoterapia
OBJECTIVE: to assess the quality of life and burden of caregivers to Chronic Obstructive Pulmonary Disease patients on Long-Term Oxygen Therapy and to investigate the factors influencing this burden. METHOD: this is an analytical, cross-sectional study of 80 persons with Chronic Obstructive Pulmonary Disease on Long-Term Oxygen Therapy who used the specialized outpatient center of the Federal University of São Paulo, and their carers. The following instruments were used: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS) and the Katz Index, along with socio-demographic and clinical variables. RESULTS: the most compromised scores on the carers' quality of life questionnaire were for Vitality and Mental Health. On the Caregiver Burden Scale, the domain which created the greatest burden for carers was the Environment. With the exception of Emotional Involvement, all the domains of quality of life were affected negatively by the domains of caregiver burden. CONCLUSION: it was shown that carers' quality of life was compromised and that they were overburdened with care tasks, confirming that assisting persons with Chronic Obstructive Pulmonary Disease is an important element in carers' quality of life.OBJETIVO: evaluar la calidad de vida y la sobrecarga de cuidados experimentada por cuidadores de portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar Prolongada e investigar los factores que influencian esa sobrecarga. MÉTODO: se trata de estudio transversal analítico, con 80 portadores de la Enfermedad Pulmonar Obstructiva Crónica en uso de Oxigenoterapia Domiciliar en el ambulatorio especializado de la Universidad Federal de Sao Paulo y de sus respectivos cuidadores, aplicando los instrumentos: Medical Outcomes Studies 36 (SF-36), Caregiver Burden Scale (CBS), índice de Katz y variables sociodemográficas y clínicas. RESULTADOS: los puntajes del cuestionario de calidad de vida de los cuidadores más comprometidos fueron la Vitalidad y la Salud Mental. El Ambiente fue el dominio del Caregiver Burden Scale que generó mayor sobrecarga de cuidados. Con excepción del Envolvimiento Emocional, todos los dominios de calidad de vida fueron influenciados de forma negativa por los dominios de sobrecarga de cuidados. CONCLUSIÓN: se demostró que la calidad de vida y la sobrecarga de cuidados, de los cuidadores, estaban comprometidos, confirmando que cuidar a los portadores de Enfermedad Pulmonar Obstructiva Crónica, es un importante interviniente en la calidad de vida del cuidador.OBJETIVO: avaliar a qualidade de vida e a sobrecarga de cuidados, vivenciada por cuidadores de portadores de Doença Pulmonar Obstrutiva Crônica, em uso de Oxigenoterapia Domiciliar Prolongada, e investigar os fatores que influenciam essa sobrecarga. MÉTODO: trata-se de estudo transversal analítico, com 80 portadores de Doença Pulmonar Obstrutiva Crônica em uso de Oxigenoterapia Domiciliar do ambulatório especializado da Universidade Federal de São Paulo e seus respectivos cuidadores, aplicando-se os instrumentos: Medical Outcomes Studies 36, Caregiver Burden Scale, índice de Katz e variáveis sociodemográficas e clínicas. RESULTADOS: os escores do questionário de qualidade de vida dos cuidadores mais comprometidos foram vitalidade e saúde mental. O ambiente foi o domínio do Caregiver Burden Scale que gerou maior sobrecarga de cuidados. Com exceção do envolvimento emocional, todos os domínios de qualidade de vida foram influenciados de forma negativa pelos domínios de sobrecarga de cuidados. CONCLUSÃO: demonstrou-se comprometimento da qualidade de vida e sobrecarga de cuidados dos cuidadores, confirmando que assistir portadores de Doença Pulmonar Obstrutiva Crônica é um importante interveniente na qualidade de vida do cuidador
Retinal pigment epithelium degeneration caused by aggregation of PRPF31 and the role of HSP70 family of proteins
Background
Mutations in pre-mRNA splicing factor PRPF31 can lead to retinitis pigmentosa (RP). Although the exact disease mechanism remains unknown, it has been hypothesized that haploinsufficiency might be involved in the pathophysiology of the disease.
Methods
In this study, we have analyzed a mouse model containing the p.A216P mutation in Prpf31 gene.
Results
We found that mutant Prpf31 protein produces cytoplasmic aggregates in the retinal pigment epithelium and decreasing the protein levels of this splicing factor in the nucleus. Additionally, normal protein was recruited in insoluble aggregates when the mutant protein was overexpressed in vitro. In response to protein aggregation, Hspa4l is overexpressed. This member of the HSP70 family of chaperones might contribute to the correct folding and solubilization of the mutant protein, allowing its translocation to the nucleus.
Conclusions
Our data suggests that a mechanism haploinsufficiency and dominant-negative is involved in retinal degeneration due to mutations in PRPF31. HSP70 over-expression might be a new therapeutic target for the treatment of retinal degeneration due to PRPF31 mutations.This project has been financed through a) The ISCIII (Miguel Servet-I, 2015), co-financed by the European Regional Development Fund (ERDF), No CP15/00071. b) The European Union’s Horizon 2020 research and innovation program, under grant agreement No 634479. c) Regional Ministry of Economy, Innovation and Science of the Junta de Andalucía, No P09-CTS-04967.info:eu-repo/semantics/publishedVersio
Influence that sociodemographic variables, clinical characteristics, and level of dependence have on quality of life in COPD patients on long-term home oxygen therapy
OBJECTIVE: To evaluate and correlate the quality of life (QoL) of COPD patients on long-term home oxygen therapy (LTOT) with their sociodemographic/clinical characteristics and level of dependence. METHODS: This was a cross-sectional analytical study involving COPD patients on LTOT followed at the Oxygen Therapy Outpatient Clinic of the Federal University of São Paulo Hospital São Paulo, in the city of São Paulo, Brazil. Sociodemographic, clinical, and biochemical data were collected. We assessed QoL and level of dependence using the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) and the Katz index, respectively. Multiple linear regression models were constructed in order to determine the influence of these variables on QoL. RESULTS: We included 80 patients in the study. The mean age was 69.6 ± 9.1 years, and 51.3% were female. The lowest SF-36 scores were for the physical functioning and role-physical domains. All sociodemographic characteristics (except gender) were found to correlate significantly with the SF-36 domains mental health, vitality, role-physical, and social functioning. We also found that body mass index, PaO2, post-bronchodilator FEV1, hemoglobin, and Katz index correlated significantly with the physical functioning, mental health, role-physical, and bodily pain domains. In addition, oxygen flows were found to correlate negatively with the physical functioning, mental health, vitality, and role-emotional domains. CONCLUSIONS: Low scores for SF-36 domains, as well as the variables that negatively influence them, should be considered and analyzed during the development and implementation of strategies for improving the QoL of COPD patients on LTOT.OBJETIVO: Avaliar e correlacionar a qualidade de vida (QV) de pacientes com DPOC em uso de oxigenoterapia domiciliar prolongada (ODP) com suas características sociodemográficas/clínicas e o nível de dependência. MÉTODOS: Estudo transversal analítico com portadores de DPOC em ODP acompanhados no Ambulatório de Oxigenoterapia do Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), em São Paulo (SP). Os pacientes foram avaliados quanto aos dados sociodemográficos, clínicos e laboratoriais. A qualidade de vida e o nível de dependência foram avaliados pelo Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) e índice de Katz, respectivamente. Modelos de regressão linear múltipla foram construídos para verificar a influência dessas variáveis na QV. RESULTADOS: A média de idade dos 80 pacientes incluídos foi 69,6 ± 9,1 anos, e 51,3% eram do sexo feminino. Os escores dos domínios do SF-36 mais baixos foram capacidade funcional e função física. Correlações significantes foram encontradas entre características sociodemográficas (exceto gênero) e os domínios saúde mental, vitalidade, função física e aspectos sociais, assim como entre várias características clínicas/laboratoriais (índice de massa corpórea, PaO2, VEF1 pós-broncodilatador, hemoglobina e índice de Katz) e os domínios capacidade funcional, saúde mental, função física e dor corporal. Houve correlações negativas entre os fluxos de oxigênio e os domínios capacidade funcional, saúde mental, vitalidade e função emocional. CONCLUSÕES: Os baixos escores nos domínios do SF-36 e as variáveis que os influenciam negativamente devem ser considerados e analisados na elaboração e implementação de estratégias para a melhoria da QV de portadores de DPOC em ODP.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de EnfermagemUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Hospital São PauloUNIFESP, Escola Paulista de Enfermagem (EPE)UNIFESP, EPM, Hospital São PauloSciEL
Barreiras ao acesso das pessoas com deficiência aos serviços de saúde: uma revisão de escopo
OBJETIVO Analisar as evidências científicas relativas às barreiras para o acesso de pessoas com deficiência aos serviços de saúde. MÉTODOS Realizou-se uma revisão de escopo estabelecendo-se a perguntanorteadora: “Quais são as principais barreiras que as pessoas com deficiência enfrentam no acesso a serviços de saúde?” O levantamento dos artigos foi realizado em julho de 2019, em seis bases de dados de literatura científica. Dos 1.155 documentos identificados nas buscas, após seleção por título e resumo, foram lidas na íntegra 170 publicações e, após leitura, 96 artigos foram incluídos e categorizados conforme referencial teórico. RESULTADOS As principais barreiras indicadas pelos usuários do serviço foram: comunicação falha entre profissionais e paciente/cuidador; limitações financeiras; questões atitudinais/comportamentais; oferta de serviços escassa; barreiras organizacionais e de transporte. As principais barreiras apresentadas pelos prestadores de serviços foram: falta de treinamento/capacitação aos profissionais; falha do sistema de saúde; barreiras físicas; falta de recursos/tecnologia e barreiras de idioma. CONCLUSÕES Ficou evidente que as pessoas com deficiência enfrentam diversas barreiras ao tentarem acesso aos serviços de saúde de que necessitam e que usuários e profissionais de saúde têm visões distintas e complementares sobre as dificuldades.OBJECTIVE To analyze the scientific evidence regarding barriers to the access of people with disabilities to health services. METHODS A scoping review was carried out from the main question: “What are the main barriers that people with disabilities face in accessing health services?” The articles were surveyed in July 2019 in six scientific literature databases. Of the 1,155 documents identified in the searches, after selection by title and abstract, 170 publications were read in full and, thus, 96 articles were included and categorized according to the theoretical framework. RESULTS The main barriers indicated by the users of the service were: communication failure between professionals and patient/caregiver; financial limitations; attitudinal/behavioral issues; scarce service provision; organizational and transport barriers. The main barriers presented by service providers were: lack of training to professionals; failure of the health system; physical barriers; lack of resources/technology; and language barriers. CONCLUSIONS It was evident that people with disabilities face several barriers when trying to access the health services they need and that users and health professionals have distinct and complementary views on difficulties
Survival in Patients with Primary Parotid Gland Carcinoma after Surgery—Results of a Single-Centre Study
This study aims to analyse a single-centre cohort series of patients who underwent parotidectomy for primary malignant parotid tumours. A retrospective chart review of 64 consecutive patients treated from November 2010 to March 2022 was performed. Outcomes were analysed by Kaplan-Meier curves. Sixty-four patients with a primary parotid malignancy were included in the study, with one bilateral case in this cohort. Patients were classified as stage I–II in 39 cases and stage III–IV in 26 cases. The five-year overall survival (OS), disease-specific survival (DSS), local relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 78.4%, 89%, 92.5%, and 87.1%, respectively. Univariate analysis showed that high-risk histology, stage IV disease, lymphovascular invasion, perineural invasion, node metastasis, skin involvement, facial nerve involvement, and positive or close margins were risk factors associated with poorer outcomes. At present, the best evidence suggests that radical surgery should be the standard approach, and adjuvant therapy, in terms of radiotherapy/chemoradiotherapy, is recommended in patients with risk factors
A atuação médica nos cuidados paliativos de pacientes terminais internados em unidade de terapia intensiva
The aim was to discuss medical performance in palliative care in the Intensive Unit environment. This is a bibliographical review prepared and written in an integrative manner. Palliative care is not new to medical practice. In the intensive environment, this care is routinely ignored or poorly implemented. The intensive care doctor must be prepared to face practical, ethical, and cultural dilemmas. In addition to indicating the interruption of treatments and providing clear and precise information to patients and family members. The professional must also be able to recommend palliative extubation, and interruption of dialysis and manage the main symptoms presented by terminal patients, such as pain, dyspnea, nausea, and vomiting. However, what is clear is that most professionals are not capable of performing palliative care in an intensive environment. In this sense, this study seeks to discuss palliative practices in the care of terminally ill patients admitted to an Intensive Care Unit based on evidence and experiences from large centers.Objetivou-se dissertar sobre a atuação médica nos cuidados paliativos no ambiente de Unidade Intensiva. Trata-se de uma revisão bibliográfica elaborada e redigida de maneira integrativa. Os cuidados paliativos não são uma novidade na prática médica. No ambiente intensivo, esses cuidados são rotineiramente ignorados ou implantados de forma deficitária. O médico no cuidado intensivo deve estar preparado para encarar dilemas práticos, éticos e culturais. Além de ser apto a indicar a interrupção de tratamentos e ser capaz de passar informações claras e precisas aos pacientes e familiares. O profissional deve também estar apto a indicar extubação paliativa, interrupção da diálise e a manejar os principais sintomas apresentados por pacientes terminais, como a dor, a dispneia, a náuseas e o vômito. Porém, o que se percebe é que a maioria dos profissionais não são capazes de realizar cuidados paliativos no ambiente intensivo. Neste sentido, este estudo busca discutir práticas paliativas no cuidado do paciente terminal internado em Unidade de Terapia Intensiva a partir de evidências e experiências de grandes centros
Haemolymph removal by Varroa mite destabilizes the dynamical interaction between immune effectors and virus in bees, as predicted by Volterra's model
The association between the deformed wing virus and the parasitic mite Varroa destructor has been identified as a major cause of worldwide honeybee colony losses. The mite acts as a vector of the viral pathogen and can trigger its replication in infected bees. However, the mechanistic details underlying this tripartite interaction are still poorly defined, and, particularly, the causes of viral proliferation in mite-infested bees. Here, we develop and test a novel hypothesis that mite feeding destabilizes viral immune control through the removal of both virus and immune effectors, triggering uncontrolled viral replication. Our hypothesis is grounded on the predator-prey theory developed by Volterra, which predicts prey proliferation when both predators and preys are constantly removed from the system. Consistent with this hypothesis, we show that the experimental removal of increasing volumes of haemolymph from individual bees results in increasing viral densities. By contrast, we do not find consistent support for alternative proposed mechanisms of viral expansion via mite immune suppression or within-host viral evolution. Our results suggest that haemolymph removal plays an important role in the enhanced pathogen virulence observed in the presence of feeding Varroa mites. Overall, these results provide a new model for the mechanisms driving pathogen-parasite interactions in bees, which ultimately underpin honeybee health decline and colony losses
Síndrome do pânico na área da psicologia: uma revisão
The aim was to carry out research regarding panic disorder (PD) and its association with anxiety attacks and other factors, related to the increased occurrence of disorders that are associated with stress today. Integrative bibliographic review, in which the selection was made in an integrative and systematic way, for analysis and writing. The diagnosis of PD is essentially clinical and, advantageously, it is made early so that treatment can be started as soon as possible. Through bibliographic research, three types of treatment for PD were identified: psychopharmacological, psychotherapeutic, and combined, which combines the two isolated types. Therefore, when comparing the isolated treatments with the associated treatment between them, it was observed that the combined treatment demonstrated greater effectiveness. This literary review sought to characterize panic disorder and its attacks, in addition to demonstrating the effectiveness of treatment for a better patient prognosis. In this sense, non-pharmacological treatment associated with pharmacological treatment demonstrated greater benefits when compared to its isolated types of clinical management.Objetivou-se realizar uma pesquisa a respeito do Transtorno do Pânico (TP) e sua associação com crises de ansiedade e outros fatores, relacionados ao aumento da ocorrência de transtornos que possuem associação com o estresse na sociedade atual. Revisão bibliográfica integrativa, na qual a seleção foi feita de maneira integrativa e sistemática, para análise e escrita. O diagnóstico do TP é essencialmente clínico e é vantajoso que ele seja feito de forma precoce, para que o tratamento seja iniciado o mais brevemente possível. Através das pesquisas bibliográficas foram identificados três tipos de tratamento para o TP: o psicofarmacológico, o psicoterapêutico e o combinado, que associa os dois tipos isolados. Dessa forma, ao se comparar os tratamentos isolados com o tratamento associado entre eles, foi observado que o tratamento combinado demonstrou uma maior eficácia. Essa revisão literária buscou caracterizar o transtorno do pânico e seus ataques, além de demonstrar a eficácia do tratamento para o melhor prognóstico do paciente. Nesse sentido, o tratamento não farmacológico associado ao farmacológico demonstrou maiores benefícios, quando comparado a seus tipos isolados de manejo clínico
Malformação de Chiari: relato de experiência
The aim was to produce an experience report about a patient with several disorders related to Chiari syndrome type I, also addressing other findings found in her. The patient described in the case was previously diagnosed with Arnold-Chiari Malformation type I, which is characterized by the existence of an ectopia of the cerebellar tonsils, which are located underneath the foramen magnum. Such a patient meets all clinical, laboratory, and imaging criteria for this pathology. Type I Chiari Malformation is the projection of the cerebellar tonsils towards the foramen magnum. This projection compresses the brain stem and spinal cord; Therefore, the cranial nerves are affected. It is worth mentioning that there is partial or total obstruction of the cerebral aqueduct. It is concluded that Chiari I, as it affects the cerebellum and adjacent structures, brings general symptoms, which makes diagnosis difficult. Efforts must be aimed at improving effective surgical techniques that reduce complications and sequelae for the patient.Objetivou-se produzir um relato de experiência sobre uma paciente com vários acometimentos referentes a síndrome de Chiari tipo I, sendo abordado também outros achados encontrados na mesma. A paciente descrita no caso foi previamente diagnosticada com a Malformação de Arnold-Chiari tipo I, a qual se caracteriza pela existência de uma ectopia das amígdalas cerebelares, que se situam por debaixo do forame magno. Tal paciente tem todos os critérios clínicos, laboratoriais e de imagem para esta patologia. A Malformação de Chiari tipo I é a projeção das amígdalas cerebelares, em direção ao forame magno. Essa projeção comprime o tronco encefálico e a medula espinhal; portanto há o acometimento dos nervos cranianos. Vale ressaltar, que há obstrução parcial ou total do aqueduto cerebral. Conclui-se, que o Chiari I, por acometer o cerebelo e estruturas adjacentes, traz sintomas generalistas o que dificulta diagnóstico. Os esforços devem se destinar ao aperfeiçoamento de técnicas cirúrgicas eficazes que diminua as complicações e sequelas ao paciente
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