Enhanced clarity and holism: The outcome of implementing the ICF with an acute stroke multidisciplinary team in England

This article is made available through the Brunel Open Access Publishing Fund.Purpose: Although it is recommended that the ICF (International Classification of Functioning, Disability and Health) should be implemented to aid communication within multidisciplinary stroke services, there is no empirical evidence to demonstrate the outcomes of such implementation. Working with one stroke service, this project aimed to address this gap and sought to evaluate the outcomes of implementing an ICF-based clinical tool into practice. Method: Using an action research framework with mixed methods, data were collected from individual interviews, a focus group, questionnaires, email communications, minutes from relevant meetings and field notes. Thematic analysis was undertaken, using immersion and crystallisation, to define overall themes. Descriptive statistics were used to analyse quantitative data. Data from both sources were combined to create key findings. Results: Three findings were determined from the data analysis. The ICF (1) fosters communication within and beyond the multidisciplinary stroke team; (2) promotes holistic thinking; and (3) helps to clarify team roles. Conclusions: The ICF enhanced clarity of communication and team roles within the acute stroke multidisciplinary team as well as with other clinicians, patients and their relatives. In addition, the ICF challenged stroke clinicians to think holistically, thereby appropriately extending their domain of concern beyond their traditional remit. Implications for Rehabilitation: (1) The ICF is a globally accepted framework to describe functioning and is in use in a variety of clinical settings. Yet, the outcomes of using it in clinical practice have yet to be fully explored. (2) This study found that the ICF enhanced clarity of communication and team roles within an acute stroke multidisciplinary team and to others beyond the team, including clinicians, patients and their relatives. (3) Using the ICF also challenged clinicians to think holistically about patient needs following a stroke.The Elizabeth Casson Trus

School Evasion in the Brazilian trends: analyzing the vectors that influence students’ decision to interrupt their formative process

Research data demonstrate that the analyzes built around School Evasion considers, primarily, the quantitative metrics of studentsrsquo; entry and exit and also the monetary losses, especially because it would be incoherent not to take as reference the goals and objectives outlined for education school system. However, analyzing the vectors that influence studentsrsquo; decision to interrupt their formative process, according to purely numerical criteria, would imply in ignoring the function of educational institutions and the real causes/reasons stemming from the social and relational demand of students' passage on educational institutions. For this reason, problematizing some of the recurring issues and incidents generated by certain investigations seems instigating and challenging. If in on the one hand, the attitude of understanding the conceptualization, the investigative tendencies and the characteristics of the studies give rise to certain criticisms that put in check the complexity of the object in question, on the other, it can stimulate the construction of other tendencies, new pathways, other possible ways of overcoming the gaps identified in the studies about School Evasion in Brazil

Xyloglucan and Concanavalin A based dressings in the topical treatment of mice wound healing process

For medical biomaterials, xyloglucan dispersions can form films or gels to be applied as a wound dressing. For this purpose, the structural characterization of xyloglucan dressing (XG) and xyloglucan dressing containing 0.5 mg/mL of concanavalin A (XGL) was performed. The lectin release capacity and stability, cytotoxicity, and pro-wound healing effects were also investigated. XG and XGL films were prepared by mixing 0.5 % (w/v) xyloglucan with 0.3 % (v/v) glycerol. The ConA incorporated in the xyloglucan dressing maintained its biological activity for fourteen days in a controlled-release manner. The films were non-toxic, homogeneous, flexible, and accelerated the wound contraction compared with the control group, promoting less infiltration of inflammatory cells, angiogenesis, remodeling, and early epithelization. The films also alleviate the inflammation phase by reducing the production of pro-inflammatory cytokines (IFN-, TNF-, IL-1, IL-6, and IL-12), especially the XGL film, which promoted the up- and down-regulation of important proteins associated with the wound repair. All these findings suggest that XG and XGL films may represent a good therapeutic approach for wound healing applications.The authors are grateful for the financial support for research grants from the Conselho Nacional de Desenvolvimento Científico e Tecnol ´ogico (CNPq), Coordenaç˜ao de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) and the Fundaç˜ao de Amparo `a Ciˆencia e Tecnologia do Estado de Pernambuco (FACEPE). We are grateful to the Centro de Tecnologias Estrat´egicas do Nordeste (CETENE) and to the Laborat´orio de Imunopatologia Keizo Asami-LIKA at the Universidade Federal de Pernambuco (UFPE) for access to its installation and technical assistance.info:eu-repo/semantics/publishedVersio

Leaf and Root Extracts from Campomanesia adamantium (Myrtaceae) Promote Apoptotic Death of Leukemic Cells via Activation of Intracellular Calcium and Caspase-3

Phytochemical studies are seeking new alternatives to prevent or treat cancer, including different types of leukemias. Campomanesia adamantium, commonly known as guavira or guabiroba, exhibits pharmacological properties including antioxidant, antimicrobial, and antiproliferative activities. Considering the anticancer potential of this plant species, the aim of this study was to evaluate the antileukemic activity and the chemical composition of aqueous extracts from the leaves (AECL) and roots (AECR) of C. adamantium and their possible mechanisms of action. The extracts were analyzed by LC-DAD-MS, and their constituents were identified based on the UV, MS, and MS/MS data. The AECL and AECR showed different chemical compositions, which were identified as main compounds glycosylated flavonols from AECL and ellagic acid and their derivatives from AECR. The cytotoxicity promoted by these extracts were evaluated using human peripheral blood mononuclear cells and Jurkat leukemic cell line. The cell death profile was evaluated using annexin-V-FITC and propidium iodide labeling. Changes in the mitochondrial membrane potential, the activity of caspases, and intracellular calcium levels were assessed. The cell cycle profile was evaluated using propidium iodide. Both extracts caused concentration-dependent cytotoxicity only in Jurkat cells via late apoptosis. This activity was associated with loss of the mitochondrial membrane potential, activation of caspases-9 and -3, changes in intracellular calcium levels, and cell cycle arrest in S-phase. Therefore, the antileukemic activity of the AECL and AECR is mediated by mitochondrial dysfunction and intracellular messengers, which activate the intrinsic apoptotic pathway. Hence, aqueous extracts of the leaves and roots of C. adamantium show therapeutic potential for use in the prevention and treatment of diseases associated the proliferation of tumor cell.Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Mato Grosso do Sul (FUNDECT)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Instituto Nacional de Pesquisa do Pantanal - INPPFundação de Amparo e Desenvolvimento da Pesquisa FadespFed Univ Grande Dourados, Res Grp Biotechnol & Bioprospecting Appl Metab, Dourados, BrazilUniv Fed São Paulo, Dept Biochem, São Paulo, BrazilUniv Braz Cubas, Fac Pharm, Mogi Das Cruzes, BrazilUniv Mogi das Cruzes, Interdisciplinary Ctr Biochem Invest, Mogi Das Cruzes, BrazilUniv Fed São Paulo, Dept Pharmaceut Sci, São Paulo, BrazilUniv Fed Mato Grosso do Sul, Lab Nat Prod & Mass Spectrometry, Campo Grande, MS, BrazilUniv Fed São Paulo, Dept Biochem, São Paulo, BrazilUniv Fed São Paulo, Dept Pharmaceut Sci, São Paulo, BrazilWeb of Scienc

High levels of T lymphocyte activation in Leishmania-HIV-1 co-infected individuals despite low HIV viral load

<p>Abstract</p> <p>Background</p> <p>Concomitant infections may influence HIV progression by causing chronic activation leading to decline in T-cell function. In the Americas, visceral (AVL) and tegumentary leishmaniasis (ATL) have emerged as important opportunistic infections in HIV-AIDS patients and both of those diseases have been implicated as potentially important co-factors in disease progression. We investigated whether leishmaniasis increases lymphocyte activation in HIV-1 co-infected patients. This might contribute to impaired cellular immune function.</p> <p>Methods</p> <p>To address this issue we analyzed CD4⁺T absolute counts and the proportion of CD8⁺T cells expressing CD38 in <it>Leishmania</it>/HIV co-infected patients that recovered after anti-leishmanial therapy.</p> <p>Results</p> <p>We found that, despite clinical remission of leishmaniasis, AVL co-infected patients presented a more severe immunossupression as suggested by CD4⁺T cell counts under 200 cells/mm³, differing from ATL/HIV-AIDS cases that tends to show higher lymphocytes levels (over 350 cells/mm³). Furthermore, five out of nine, AVL/HIV-AIDS presented low CD4⁺T cell counts in spite of low or undetectable viral load. Expression of CD38 on CD8⁺T lymphocytes was significantly higher in AVL or ATL/HIV-AIDS cases compared to HIV/AIDS patients without leishmaniasis or healthy subjects.</p> <p>Conclusions</p> <p><it>Leishmania </it>infection can increase the degree of immune system activation in individuals concomitantly infected with HIV. In addition, AVL/HIV-AIDS patients can present low CD4⁺T cell counts and higher proportion of activated T lymphocytes even when HIV viral load is suppressed under HAART. This fact can cause a misinterpretation of these laboratorial markers in co-infected patients.</p