366 research outputs found

    Development of a self-scan to evaluate and improve person-centered care in nursing homes:A Delphi study

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    Background and objective: Person centered care (PCC) has become the gold standard for providing care in nursing homes (NHs). Therefore, it is important for healthcare professionals in NHs to learn PCC-skills and to be supported to learn about- and improve the quality of PCC they provide. At this moment an instrument to support healthcare professionals in NHs to monitor and evaluate PCC is limited. The aim of the study was to develop a self-evaluation tool that provides healthcare professionals in NHs insight into the extent to which they provide PCC to residents, so that they can learn and further improve their current ways of working in a person-centered way. Methods: A three-round Delphi study with an expert panel (n = 25) in the domains of PCC, quality of NH care and education of caring staff. Findings were validated by residents and relatives during semi-structured interviews. Thematic analysis and descriptive statistics were used to analyze the data. Results: In the first round the experts did not provide measuring instruments, but we identified 18 key aspects of PCC. In the second round, three clusters were identified, and a scale was added, to enable assessment. In the third round, we deduplicated, restructured and used more clear language. This led to 14 key aspects of PCC, 24 measures, grouped into five clusters: knowing the resident, establishing relationship, a respectful approach, making decisions jointly and personal development. The result is a PCC self-scan for healthcare professionals in NHs. Residents and relatives, agreed with all aspects and stated that no aspects were missing. Conclusions: In this study we developed an accessible self-report learning tool for healthcare professionals that makes it possible to evaluate and improve their PCC-skills and improve the quality of PCC in NHs

    How do practically trained (student) caregivers in nursing homes learn?:A scoping review

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    Background and objective: Practically trained (student) caregivers (further: caregivers) make up the majority of care staff in nursing homes (NHs). To keep up with the fast-changing healthcare environment and ensure a high quality of care, it is important to know how to stimulate continuous work-based learning (WBL) among this group. The purpose of the study was to systematically study the scientific literature published to date on (1) how caregivers learn in NHs and (2) what facilitates or impedes their learning. Methods: A scoping review was carried out, systematically searching six scientific databases. A total of 35 studies published from January 2009 to February 2021 were included. Study characteristics, learning mechanisms, facilitators, and barriers to learning were extracted and synthesized. Results: None of the studies specifically focused on how caregivers learn. Yet, we identified various learning mechanisms, and found that learning by theory or supervision was most frequently engaged in. Most learning mechanisms used among the groups in the included studies were planned and formal and developed and initiated by others out of the context. Three main themes were identified among the facilitators and barriers of WBL: individual learning, collective learning, and resources for learning. An interdependency between (sub)themes was found. Conclusions: The way caregivers in NHs learn is understudied. Moreover, both their informal learning and the support they receive to be(come) active learners has been overlooked. As WBL provides caregivers with opportunities to learn within a real-life setting, we suggest more research on informal learning mechanisms

    Tumor markers in finding recurrent disease in colorectal cancer: a diagnostic review

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    Aim: In the search for evidence-based follow-up of patients after resection for colorectal cancer, numerous tumor markers have been proposed. This review has evaluated these markers and comments on the diagnostic accuracy in finding recurrent disease in relation to Carcino-Embryonic Antigen (CEA). Methods: A comprehensive literature review (1985-2010) was performed by two independent reviewers. Sensitivity and specificity of markers mentioned in the articles were checked by recalculation. A validated quality score system was used to estimate study quality. Results: Seventeen studies focusing on eight different markers were included. Three markers were shown to have comparable or better accuracy than CEA: TPA, CA 242 and CA 72-4 in at least one study. These three markers, from four independent studies, showed a tumor marker sensitivity of > 60% in combination with an outperformance of CEA in follow-up. These results were not confirmed by six other studies investigating the same markers. Conclusion: This review revealed three tumor markers other than CEA that have been shown to adequately indicate recurrences in colorectal cancer. However, comparability of studies was difficult. Therefore a prospective study of these markers seems necessary to investigate their real value, and to overcome design and inclusion biases

    L-DOPA Treatment Selectively Restores Spine Density in Dopamine Receptor D2–Expressing Projection Neurons in Dyskinetic Mice

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    L-3,4-dihydroxyphenylalanine (L-DOPA)–induced dyskinesia is an incapacitating complication of L-DOPA therapy that affects most patients with Parkinson’s disease. Previous work indicating that molecular sensitization to dopamine receptor D1 (D1R) stimulation is involved in dyskinesias prompted us to perform electrophysiological recordings of striatal projection “medium spiny neurons” (MSN). Wild-type and bacterial artificial chromosome transgenic mice (D1R and D2R) mice were lesioned with 6-hydroxydopamine and then treated with L-DOPA. Functional, molecular, and structural changes were assessed in corticostriatal slices. Individual MSNs injected with Lucifer-Yellow were detected by immunohistochemistry for three-dimensional reconstructions. Both D1R-MSNs and D2R-MSNs showed diminished spine density in totally denervated striatal regions in parkinsonian mice. Chronic L-DOPA treatment, which induced dyskinesia and aberrant FosB expression, restored spine density in D2R-MSNs but not in D1R- MSNs. In basal conditions, MSNs are more excitable in parkinsonian than in sham mice, and excitability decreases toward normal values after L-DOPA treatment. Despite this normalization of basal excitability, in dyskinetic mice, the selective D1R agonist SKF38393 increased the number of evoked action potentials in MSNs, compared with sham animals. Conclusions: Chronic L-DOPA induces abnormal spine re-growth exclusively in D2R-MSNs and robust supersensitization to D1R- activated excitability in denervated striatal MSNs. These changes might constitute the anatomical and electrophysiological substrates of dyskinesia.This work was supported by grants from the Spanish Ministries de Economía y Competitividad and Sanidad y Política Social, ISCIII: BFU2010-20664, PNSD, RedRTA (RD06/0001/1011), CIBERNED ref.CB06/05/0055, and Comunidad de Madrid ref. S2011/BMD-2336 to RM; Spanish Ministries de Ciencia e Innovación (MICINN) PIU081067 to JMS Fondo Nacional para la Investigación Científica y Tecnológ- ica, Argentina, PICT 2008-2205/PICT 2011-521, Consejo Nacional de Investigaciones Científicas y Tecnológicas, Argentina, PIP 2009-77, and Universidad de Buenos Aires, UBACYT M562, to MGM

    Reprogramming human A375 amelanotic melanoma cells by catalase overexpression: Reversion or promotion of malignancy by inducing melanogenesis or metastasis

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    Advanced melanoma is the most aggressive form of skin cancer. It is highlymetastatic and dysfunctional in melanogenesis; two processes that are induced byH2O2. This work presents a melanoma cell model with low levels of H2O2 inducedby catalase overexpression to study differentiation/dedifferentiation processes.Three clones (A7, C10 and G10) of human A375 amelanotic melanoma cells withquite distinct phenotypes were obtained. These clones faced H2O2 scavenging by two main strategies. One developed by clone G10 where ROS increased. This resulted in G10 migration and metastasis associated with the increased of cofilin-1 and CAP1. The other strategy was observed in clone A7 and C10, where ROS levels were maintained reversing malignant features. Particularly, C10 was not tumorigenic, while A7 reversed the amelanotic phenotype by increasing melanin content and melanocytic differentiation markers. These clones allowed the study of potential differentiation and migration markers and its association with ROS levels in vitro and in vivo, providing a new melanoma model with different degree of malignancy.Fil: Bracalente, María Candelaria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Comisión Nacional de Energía Atómica. Gerencia de Área de Investigación y Aplicaciones no Nucleares. Gerencia de Desarrollo Tecnológico y Proyectos Especiales. Departamento de Micro y Nanotecnología; ArgentinaFil: Salguero, Noelia. Comisión Nacional de Energía Atómica. Gerencia de Área de Investigación y Aplicaciones no Nucleares. Gerencia de Desarrollo Tecnológico y Proyectos Especiales. Departamento de Micro y Nanotecnología; ArgentinaFil: Notcovich, Cintia Karina. Comisión Nacional de Energía Atómica. Gerencia de Área de Investigación y Aplicaciones no Nucleares. Gerencia de Desarrollo Tecnológico y Proyectos Especiales. Departamento de Micro y Nanotecnología; ArgentinaFil: Muller, Carolina. Universidade Federal do Rio Grande do Sul; BrasilFil: Da Motta, Leonardo L.. Universidade Federal do Rio Grande do Sul; BrasilFil: Klamt, Fabio. Universidade Federal do Rio Grande do Sul; BrasilFil: Ibañez, Irene Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Comisión Nacional de Energía Atómica. Gerencia de Área de Investigación y Aplicaciones no Nucleares. Gerencia de Desarrollo Tecnológico y Proyectos Especiales. Departamento de Micro y Nanotecnología; ArgentinaFil: Duran, Hebe Alicia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de San Martín. Escuela de Ciencia y Tecnología; Argentina. Comisión Nacional de Energía Atómica. Gerencia de Área de Investigación y Aplicaciones no Nucleares. Gerencia de Desarrollo Tecnológico y Proyectos Especiales. Departamento de Micro y Nanotecnología; Argentin

    Obsessive compulsive disorder- prevalence in Xhosaspeaking schizophrenia patients

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    Obsessive compulsive disorder (OCD) has been reported in up to 31% of  schizophrenia sufferers. This study evaluated the presence of OCD in a  Xhosa-speaking schizophrenia group. Xhosa patients (N = 509, including 100  sibships) with schizophrenia were recruited from hospital and community settings. The patients underwent a structured clinical interview for the presence  of lifetime co-morbid schizo-phrenia and OCD. Only 3 patients (0.5%) fulfilled criteria for OCD. No concordance for OCD was noted in the  sibship group. Our findings differ from those in other parts of the world, and if replicated, might suggest unique protective environmental or genetic factors  for OCD in certain ethnic groups

    Tumor cell load and heterogeneity estimation from diffusion-weighted MRI calibrated with histological data: an example from lung cancer

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    Producción CientíficaDiffusion-weighted magnetic resonance imaging (DWI) is a key non-invasive imaging technique for cancer diagnosis and tumor treatment assessment, reflecting Brownian movement of water molecules in tissues. Since densely packed cells restrict molecule mobility, tumor tissues produce usually higher signal (a.k.a. less attenuated signal) on isotropic maps compared with normal tissues. However, no general quantitative relation between DWI data and the cell density has been established. In order to link low-resolution clinical cross-sectional data with high-resolution histological information, we developed an image processing and analysis chain, which was used to study the correlation between the diffusion coefficient (D value) estimated from DWI and tumor cellularity from serial histological slides of a resected non-small cell lung cancer tumor. Color deconvolution followed by cell nuclei segmentation was performed on digitized histological images to determine local and cell-type specific 2d (two-dimensional) densities. From these, the 3d cell density was inferred by a model-based sampling technique, which is necessary for the calculation of local and global 3d tumor cell count. Next, DWI sequence information was overlaid with high-resolution CT data and the resected histology using prominent anatomical hallmarks for co-registration of histology tissue blocks and non-invasive imaging modalities' data. The integration of cell numbers information and DWI data derived from different tumor areas revealed a clear negative correlation between cell density and D value. Importantly, spatial tumor cell density can be calculated based on DWI data. In summary, our results demonstrate that tumor cell count and heterogeneity can be predicted from DWI data, which may open new opportunities for personalized diagnosis and therapy optimization

    In-vitro study of hierarchical structures: Anodic oxidation and alkaline treatments onto highly rough titanium cold spray coatings for biomedical applications

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    Hierarchical structures were obtained applying two different nanotexturing surface treatments onto highly rough commercial pure titanium coatings by cold spray: (i) anodic oxidation and (ii) alkaline treatments. An extended surface characterization in terms of topography, composition, and wettability has been performed to understand how those parameters affect to cell response. Primary human osteoblasts extracted from knee were seeded onto the as-sprayed titanium surface before and after the nanotexturing treatments. Cell viability was tested by using MTS and LIVE/DEAD assays, as well as osteoblasts differentiation by alkaline phosphatase (ALP) quantification at 3 and 10 days of cell culture. The combination of micro-/nano-roughness results in a significantly increase of cell proliferation, as well as cell differentiation after 10 days of cell culture in comparison with the non-treated coatings
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