HEALTH-RELATED QUALITY OF LIFE AND FUNCTIONAL HEALTH STATUS QUESTIONNAIRES IN OROPHARYNGEAL DYSPHAGIA

Background: Oropharyngeal dysphagia negatively affects the quality of life of patients. It may lead to malnutrition, dehydration, aspiration pneumonia and death, especially in older people. Dysphagia and its level of severity have to be assessed accurately and in a timely fashion, because only early intervention can prevent the onset of complications. There are numerous self-administered questionnaires to monitor both the severity of dysphagia and the effectiveness of therapeutic approaches. The objective of this article is to conduct a literature review and to illustrate the characteristics of various self-assessment questionnaires for oropharyngeal dysphagia. Methods: A search of observational studies of adult populations with dysphagia, published from 1990 to June 2014, was performed in the electronic database Pubmed. Results: A total of 23 self-assessment questionnaires, on Health-related Quality of Life and Functional Health status, were identified. Fourteen questionnaires were excluded from the analysis for the following reasons: the questionnaire was written in a language other than English or Italian (n=3); the questionnaire was specific for caregivers (n=1); the questionnaires were not specific for oropharyngeal dysphagia (n=10). Nine questionnaires, validated in adult populations, were examined. Only two self-assessment questionnaires on quality of life - DHI (Dysphagia Handicap Index) and SWAL-QOL (Swallowing Quality Of Life) - were correctly validated; other questionnaires had methodological errors. Conclusions: A specific self-assessment questionnaire for older adults was not found. Almost all of the currently available questionnaires need to be improved methodologically. Furthermore, new questionnaires specifically for older people should be developed

Bone mineral density in patients on home parenteral nutrition: a follow-up study.

Home artificial nutrition

Home parenteral nutrition provision modalities for chronic intestinal failure in adult patients:An international survey

Background & aims: The safety and effectiveness of a home parenteral nutrition (HPN) program depends both on the expertise and the management approach of the HPN center. We aimed to evaluate both the approaches of different international HPN-centers in their provision of HPN and the types of intravenous supplementation (IVS)-admixtures prescribed to patients with chronic intestinal failure (CIF). Methods: In March 2015, 65 centers from 22 countries enrolled 3239 patients (benign disease 90.1%, malignant disease 9.9%), recording the patient, CIF and HPN characteristics in a structured database. The HPN-provider was categorized as health care system local pharmacy (LP) or independent home care company (HCC). The IVS-admixture was categorized as fluids and electrolytes alone (FE) or parenteral nutrition, either commercially premixed (PA) or customized to the individual patient (CA), alone or plus extra FE (PAFE or CAFE). Doctors of HPN centers were responsible for the IVS prescriptions. Results: HCC (66%) was the most common HPN provider, with no difference noted between benign-CIF and malignant-CIF. LP was the main modality in 11 countries; HCC prevailed in 4 European countries: Israel, USA, South America and Oceania (p < 0.001). IVS-admixture comprised: FE 10%, PA 17%, PAFE 17%, CA 38%, CAFE 18%. PA and PAFE prevailed in malignant-CIF while CA and CAFE use was greater in benign-CIF (p < 0.001). PA + PAFE prevailed in those countries where LP was the main HPN-provider and CA + CAFE prevailed where the main HPN-provider was HCC (p < 0.001). Conclusions: This is the first study to demonstrate that HPN provision and the IVS-admixture differ greatly among countries, among HPN centers and between benign-CIF and cancer-CIF. As both HPN provider and IVS-admixture types may play a role in the safety and effectiveness of HPN therapy, criteria to homogenize HPN programs are needed so that patients can have equal access to optimal CIF care

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P &lt; .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Un modelo de consumo de largo plazo para Venezuela (1968-1996).

ArtículosLa filosofía del régimen prezjiminista: el nuevo ideal nacional.Cartay, RafaelLa apertura petrolera en Venezuela dentro del capitalismo rentístico.Domingo, Carlos; Fargier, María; Mora, C., Jesús Alberto; Rojas Salazar, Andrés José y Tonella, GiorgioEl ingreso como variable estimada.Garnica Olmos, ElsyLeyes de Newton y dinámica migratoria.Ramos Ojeda, OswaldoLas políticas de ajuste estructural (PAE) en Venezuela: rezago social y alternativas para combatir la pobreza.Padrón, AlejandroUn modelo de consumo de largo plazo para Venezuela (1968-1996).Ramoni P., Josefa y Orlandoni M., GiampaoloVenezuela entre el G-3 y el MERCOSUR.Toro G., Luis [email protected]@ula.veNivel analíticosemestra

The relationship between academic research and preferment: the case of a Venezuelan university

A nivel nacional, los sueldos de los profesores universitarios en Venezuela son establecidos por el gobierno a partir de un sistema de cinco categorías, cada una de las cuales tiene sus propios requisitos en cuanto a antigüedad y trabajos de investigación. Generalmente, los profesores muestran un cierto retraso en sus ascensos, probablemente debido a la poca atención prestada a la investigación, al predominio de la labor docente y a la falta de incentivos monetarios. A fin de promover la investigación, las universidades ofrecen ingresos no-salariales. Este estudio aplica métodos de estimación en dos etapas para analizar la relación entre investigación y ascenso, utilizando datos de una universidad venezolana. Los resultados indican que la probabilidad de retardo en ascenso reduce los ingresos nosalariales que los profesores pueden percibir, mientras que el nivel de educación incrementa la probabilidad de realizar investigación así como los ingresos de los profesores, a la vez que reducen la probabilidad de retardo.129-144semestralNationwide wages at public universities in Venezuela are established by government based on a five-category system, whose requirements include research and tenure. Generally, professors show delay in promotion, probably due to neglecting research, prevalence of lecturing and lack of monetary incentives. In order to promote research, universities are offering a non-wage income. This paper uses two-step estimation methods to analyze the relationship between research and preferment, using data from one Venezuelan university. Results indicate that the probability of delay reduces the extra income; education increases the probability of researching and the non-wage income, while reducing the probability of delay

La demanda de dinero en Venezuela: un análisis de cointegración (1968-1996).

ArtículosEstrategias globalizadoras tendencia histórica del capitalismo.Añez Hérnandez, Carmen; Boscán, Roberto y Useche, María CristinaLa industria turística busca nuevos horizontes.Cabeza R., María AlejandraStratified/PCA: Un método de procesamiento de datos y variables para la construcción de modelos de redes neuronales.Colmenares L., Gerardo A.Modelo de programación lineal de la producción, integrado en un sistema computarizado de producción, inventario y ventas industrial.Ponsot B., Ernesto y Márquez, VictorLa demanda de dinero en Venezuela: un análisis de cointegración (1968-1996).Ramoni P., Josefa y Orlandoni M., GiampaoloDiversosÍndice acumulado Revista Economía.Directorio de Institutos de Investigación y Centros de Investigación de la Facultad de Ciencias Económicas y Sociales de la Universidad de Los Andes.Directorio de Centros de Postgrado de la Facultad de Ciencias Económicas y Sociales de la Universidad de Los Andes.103 [email protected]@ula.veNivel analíticosemestra

La ULA evalúa impacto de proyectos de inversión pública

La evaluación de impacto es fundamental para garantizar el éxito de la inversión pública, la cual requiere medidas para mitigar los impactos negativos, impulsar los positivos, introducir los correctivos necesarios y decidir acerca de su [email protected]@ula.veanua

Sustentabilidad global, comercio internacional y política ambiental.

ArtículosEl rendimiento estudiantil: una metodología para su medición.Garnica Olmos, ElsyPrecios y monedas en la Mérida del último cuarto del siglo XVI.González Raposo, María del Salvador y Contreras Dávila, MilagrosAspectos teóricos de la deuda externa.Graterol Guevara, AdelisEl gasto público y la acumulación del capital en la agricultura venezolana.Gutiérrez, AlejandroEl uso indebido de la teoría de la renta como legitimación del estado rentista.Maldonado V., Fabio E.Modelos de crecimiento de poblaciones biológicas: un enfoque de dinámica de sistemas.Orlandoni M., GiampaoloSustentabilidad global, comercio internacional y política ambiental.Perazzi, Ramoni y Orlandoni, GianpaoloEl liberalismo económico: una ficción histórica (una respuesta a la concepción estatista de acción democrática).Rivas Aguilar, RamónSimulación de cambios estructurales y análisis de escenarios.Terán V., Oswaldo R. y Domingo, CarlosDistribución del índice de acuerdos en diagnósticos a, vía bootstrap.Torres Rivas, [email protected]@ula.veNivel analíticosemestra