Ceras utilizadas como agentes estructurantes para organogeles de alimentos – Revisión:

Lipids are key ingredients in the human diet. Because of the manipulation and modification of lipids in the food industry, the amount of trans and saturated fat has been substantially increasing in industrialized products. At the same time, the number of studies demonstrating the harmful effects of these foods on human health has increased. Organogels arise as a promising alternative for replacing trans and saturated fat in processed foods. Among the main challenges of preparing an organogel is the difficulty of finding compatible and viable structuring agents in the food industry. Waxes have been studied for this purpose and are one of the most promising organogelators. This article brings a bibliographical review on the recent studies regarding the use of waxes as structuring agents for edible vegetable oils.Los lípidos son ingredientes clave en la dieta humana. Debido a la manipulación y modificación de estos lípidos en la industria alimentaria, la cantidad de grasas trans y las saturadas ha aumentado sustancialmente en los productos industrializados. Al mismo tiempo, ha aumentado la cantidad de estudios que demuestran los efectos nocivos de estos alimentos en la salud humana. Los organogeles surgen como una alternativa prometedora para reemplazar las grasas trans y las saturadas en los alimentos procesados. Entre los principales desafíos de preparar un organogel está la dificultad de encontrar agentes estructurantes compatibles y viables en la industria alimentaria. Las ceras se han estudiado para este propósito y son uno de los organogeladores más prometedores. Este artículo presenta una revisión bibliográfica de los estudios recientes sobre el uso de ceras como agentes estructurantes para aceites vegetales comestibles

How people-centred health systems can reach the grassroots: experiences implementing community-level quality improvement in rural Tanzania and Uganda

Background Quality improvement (QI) methods engage stakeholders in identifying problems, creating strategies called change ideas to address those problems, testing those change ideas and scaling them up where successful. These methods have rarely been used at the community level in low-income country settings. Here we share experiences from rural Tanzania and Uganda, where QI was applied as part of the Expanded Quality Management Using Information Power (EQUIP) intervention with the aim of improving maternal and newborn health. Village volunteers were taught how to generate change ideas to improve health-seeking behaviours and home-based maternal and newborn care practices. Interaction was encouraged between communities and health staff. Aim To describe experiences implementing EQUIP’s QI approach at the community level. Methods A mixed methods process evaluation of community-level QI was conducted in Tanzania and a feasibility study in Uganda. We outlined how village volunteers were trained in and applied QI techniques and examined the interaction between village volunteers and health facilities, and in Tanzania, the interaction with the wider community also. Results Village volunteers had the capacity to learn and apply QI techniques to address local maternal and neonatal health problems. Data collection and presentation was a persistent challenge for village volunteers, overcome through intensive continuous mentoring and coaching. Village volunteers complemented health facility staff, particularly to reinforce behaviour change on health facility delivery and birth preparedness. There was some evidence of changing social norms around maternal and newborn health, which EQUIP helped to reinforce. Conclusions Community-level QI is a participatory research approach that engaged volunteers in Tanzania and Uganda, putting them in a central position within local health systems to increase health-seeking behaviours and improve preventative maternal and newborn health practices

Decision-making process in the selection of home hemodialysis treatment by adult patients with end-stage renal disease in the United Kingdom: a systematic literature review

Introduction: In the UK, the number of people diagnosed with renal disease is on the increase. As a result, there will be more people in need of renal replacement therapy (RRT). Despite the mounting evidence showing that home hemodialysis (HHD) treatment is clinical and cost-effective as well as amendable to suit patients' lifestyle, the number of patients choosing this dialysis modality is low. The aim of this study is to explore factors influencing decision-making process in the selection of HHD treatment for adult patients with end-stage renal disease in the UK. Methods: A systematic literature review methodology was utilized to review, critique, and synthesize the literature on the low uptake of HHD among adult patients. Systematic searches involving the databases Google Scholar, EMBASE, MEDLINE, PsycINFO, and CINAHL were carried out for articles published from 2008 to 2021. A search was conducted from June 1 through December 23, 2020. Eight articles met the study inclusion criteria. We followed preferred Reporting Items for Systematic Reviews and Meta-analyses in designing the research and reporting. Results: This systematic review revealed that patient information needs, dialysis education, training and support, and patient decision-making preference were the major factors influencing decision-making of adult patients. Conclusion: Deciding over which dialysis modality to choose can be challenging for many adult patients. Dialysis education, training, and support should not stop at the predialysis stage but should continue during treatment

To test or not: occurrence of sickle cell trait and assessment of the awareness toward its screening among patients attending Magale Health Center IV, Namisindwa District, Eastern Uganda

Keneth Mandu,1 Sharifu K Tusuubira,1,2 Bashir Mwambi,1 Fred Webbo,3 Christine Atuhairwe,4 Ivan Mugisha Taremwa1 1Institute of Allied Health Sciences, Clarke International University, Kampala, Uganda; 2Uganda Sickle Cell Rescue Foundation, Kampala, Uganda; 3Lancet Laboratories, Kampala, Uganda; 4Institute of Public Health and Management, Clarke International University, Kampala, Uganda Purpose: To evaluate the occurrence of sickle cell trait (SCT), assess patient awareness and evaluate the performance of a sickle cell hemoglobin-S (dithionate-qualitative solubility) point-of-care test among patients seeking care at Magale Health Center IV, Namisindwa District, Eastern Uganda. Materials and methods: We conducted a cross sectional study, in which we consecutively enrolled participants aged ≥18 years at Magale Health Center IV. Four milliliters of EDTA blood were collected by venipuncture and screened for SCT using solubility testing, and confirmed with hemoglobin (Hb) electrophoresis at Central Public Health Laboratory (CPHL), Kampala, Uganda. A structured questionnaire was used to assess participants’ awareness of SCT. Data were presented as proportion, and measurements of diagnostic test performance were calculated. Results: We enrolled 242 participants, of these 58.7% (N = 142) were females. Their mean age was 26.4 years (range 18–49). Of the 242 participants, 11, who represent 4.5% (95% CI: 3.3–5.9), tested positive. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid sickle cell test were 63.64%, 100%, 100% and 98.30%, respectively. There was knowledge gap regarding sickle cell awareness. Conclusion: The occurrence of SCT was high, and the point-of-care test showed a high diagnostic reliability. The risk of SCT is associated with genetic predisposition as indicated by Hb electrophoresis. Community sensitization is key to avert the associated risk of Hb defects. Keywords: sickle cell trait, point-of-care testing, Ugand

A intersubjetividade no contexto da família de pessoas com fibrose cística

Trata-se de uma investigação qualitativa, com aproximação fenomenológica, que objetivou desvelar os processos intersubjetivos no contexto da família de pessoas com Fibrose Cística (FC). Desenvolveu-se entrevista com 14 famílias com portadores de FC, cadastrados na Associação Paranaense de Assistência à Mucoviscidose (AAMPR), residentes nas regiões Norte e Noroeste do estado do Paraná (PR), Brasil. Das suas falas foram apreendidas unidades de significado, agrupadas em três categorias: Família, portador de FC e o outro; Aspectos religiosos na vivência da FC na família; Portador de FC na vida escolar, afetiva e profissional. Os resultados evidenciaram que a experiência das famílias compartilhada com o outro foi crucial para o enfrentamento da doença. Conhecer os processos intersubjetivos que perpassam o âmago da família de pessoas acometidas pela FC possibilita um novo modo de atuar em Enfermagem