502 research outputs found
Perspectives of healthcare providers on the nutritional management of patients on haemodialysis in Australia: An interview study
Get PDFObjective To describe the perspectives of healthcare providers on the nutritional management of patients on haemodialysis, which may inform strategies for improving patient-centred nutritional care. Design Face-to-face semistructured interviews were conducted until data saturation, and thematic analysis based on principles of grounded theory. Setting 21 haemodialysis centres across Australia. Participants 42 haemodialysis clinicians (nephrologists and nephrology trainees (15), nurses (12) and dietitians (15)) were purposively sampled to obtain a range of demographic characteristics and clinical experiences. Results Six themes were identified: responding to changing clinical status (individualising strategies to patient needs, prioritising acute events, adapting guidelines), integrating patient circumstances (assimilating life priorities, access and affordability), delineating specialty roles in collaborative structures (shared and cohesive care, pivotal role of dietary expertise, facilitating access to nutritional care, perpetuating conflicting advice and patient confusion, devaluing nutritional specialty), empowerment for behaviour change (enabling comprehension of complexities, building autonomy and ownership, developing self-efficacy through engagement, tailoring self-management strategies), initiating and sustaining motivation (encountering motivational hurdles, empathy for confronting life changes, fostering non-judgemental relationships, emphasising symptomatic and tangible benefits, harnessing support networks), and organisational and staffing barriers (staffing shortfalls, readdressing system inefficiencies). Conclusions Organisational support with collaborative multidisciplinary teams and individualised patient care were seen as necessary for developing positive patient-clinician relationships, delivering consistent nutrition advice, and building and sustaining patient motivation to enable change in dietary behaviour. Improving service delivery and developing and delivering targeted, multifaceted self-management interventions may enhance current nutritional management of patients on haemodialysis
The Evolution of ADHD: A Disorder of Communication?
Get PDFAttention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychiatric condition. Many believe that the central disability is impaired inhibition, which leads to reduced abilities in social skills, self-control, organization and time management. The behaviors identified by clinicians as problematic-inattention, hyperactivity and impulsivity-have been incorporated into several evolutionary models as selectively adaptive cognitive skills for surviving the challenges of a variable Pleistocene environment. We propose that the disabilities exhibited by individuals with ADHD are maladaptive, and we concur with Barkley that there is a central impairment in the behavioral inhibition system. The underlying neural anatomy and physiology support the possibility that neurotransmitter pathology may have an impact on other interlinked systems (including language), and may also account for the frequent comorbidity of aggression, anxiety, depression, and learning disabilities (many of which are language-related). Language skills compete with other cognitive activities for the attentional system, and thus the evolution of language could not in fact be independent of the evolution of attention. If language represents the ultimate expression of the attentional system, and some individuals with ADHD are seriously impaired in the coordination of interlinked neural systems (including language), then ADHD fits Jerome Wakefield\u27s definition of harmful dysfunction, and communication impairments should be investigated more thoroughly by clinicians
eHealth interventions for people with chronic kidney disease
Get PDFThis is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to look at the benefits and harms of using eHealth interventions in the CKD population
"Ventaja competitiva como factor de éxito clave en la inserción de los países latinoamericanos al comercio internacional"
Get PDFDesde mitad del siglo XX se ha venido observando en el mundo la tendencia
económica de las economías de dejar de ser cerradas y abrirse al comercio
internacional. Al principio el grado y tipo de apertura iba de acuerdo a las ventajas
absolutas y comparativas. El surgimiento de lo que se conoce como ventaja competitiva
cambió el panorama del comercio internacional.
El concepto de ventaja competitiva viene del termino de competitividad, al cual se da
una aproximación, sobre todo a nivel empresarial, puesto que desde el desarrollo a
nivel micro, se encuentra la clave para que los países puedan tener un crecimiento. Se
analiza el desarrollo del concepto de Ventaja Competitiva en América Latina, en qué
sectores de la economía se observa, de qué manera, y se compara la efectividad de
utilizar estas ventajas competitivas para la región, en relación con otras partes del
mundo. Adicionalmente, se revisan los resultados obtenidos por los países de
Latinoamérica en Competitividad, haciendo énfasis en dos aspectos importantes que se
tienen en cuenta al momento de medirla, como el uso de tecnologías y de capital
humano capacitado, que han sido de gran importancia para el desarrollo de muchos de
los países industrializados, y cómo a partir de estos se pueden generar políticas que
creen un crecimiento sostenible para los países.Incluye bibliografí
Interventions for improving health literacy in people with chronic kidney disease
Get PDFThis is the protocol for a review and there is no abstract. The objectives are as follows: This review aims to look at the benefits and harms of interventions for improving health literacy in patients with CKD
Maternal developmental history alters transfer of circadian clock genes to offspring in Japanese quail (Coturnix japonica)
Get PDFFunding: This work was supported by the UKRI Biotechnology and Biological Sciences Research Council (BBSRC) Eastbio Doctoral Training Programme grant number BB/M010996/1.Maternal signals shape embryonic development, and in turn post-natal phenotypes. RNA deposition is one such method of maternal signalling and circadian rhythms are one trait thought to be maternally inherited, through this mechanism. These maternal circadian gene transcripts aid development of a functioning circadian system. There is increasing evidence that maternal signals can be modified, depending on prevailing environmental conditions to optimise offspring fitness. However, currently, it is unknown if maternal circadian gene transcripts, and consequently early embryonic gene transcription, are altered by maternal developmental conditions. Here, using avian mothers who experienced either pre-natal corticosterone exposure, and/or post-natal stress as juveniles we were able to determine the effects of the timing of stress on downstream circadian RNA deposition in offspring. We demonstrated that maternal developmental history does indeed affect transfer of offspring circadian genes, but the timing of stress was important. Avian mothers who experienced stress during the first 2 weeks of post-natal life increased maternally deposited transcript levels of two core circadian clock genes, BMAL1 and PER2. These differences in transcript levels were transient and disappeared at the point of embryonic genome transcription. Pre-natal maternal stress alone was found to elicit delayed changes in circadian gene expression. After activation of the embryonic genome, both BMAL1 and PER2 expression were significantly decreased. If both pre-natal and post-natal stress occurred, then initial maternal transcript levels of BMAL1 were significantly increased. Taken together, these results suggest that developmental stress differentially produces persistent transgenerational effects on offspring circadian genes.Publisher PDFPeer reviewe
How has HRM evolved in a post-disaster situation?
Get PDFThe post-disaster period following the Christchurch 2011 seismic disaster resulted in a variety of changes for HR practitioners. A multiple-case study analysis surrounding post-disaster experiences of 11 HR practitioners showed that the focus of HR practitioners evolved from immediate employee welfare, to creative retentive practices, to ensuring employee wellbeing. There also became an increasing awareness of the importance of employee-focused HRM, resulting in a changed outlook for some practitioners. The post-disaster period provided a potential learning experience for practitioners, along with an opportunity for practitioners to introduce new initiatives. As a result, some participants felt HRM gained increasing legitimacy within their organisations. Throughout the period, both employees and HR practitioners adapted to the ‘new normal’ at varying rates, influencing their ability to perform at work. The study brings awareness of the need for HR practitioners to utilise a more employee- centred style of HRM in both normal and post-disaster environments
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