Identifying longitudinal sustainable hierarchies in activities of daily living

© 2017 Elsevier B.V. Activities of daily living serve as an indicator of progression in disability and rehabilitation. It is know that some of the measurement scales used show hierarchical properties indicating that activities of daily living are lost and gained in a consistent pattern. Few studies have investigated the extent to which these patterns are sustained across time and across a range of disability. The study aimed to investigate the hierarchical properties of the activity of daily living items in the ValGraf functional ability scale, to establish if there is a hierarchy of items in the scale and to study the sustainability of the hierarchy over time. Secondary analysis of a retrospective database from 13,113 people over 65 years in 105 nursing homes in northern Italy, between 2008 and 2013 was conducted. Data were gathered 6-monthly and analysed using Mokken scaling to identify a hierarchy of items in the scale and if this was sustainable over time. A sustainable hierarchy of items was observed running in difficulty from urinary incontinence to feeding. The hierarchical structure of the activities of daily living observed in the present study is stable over time meaning that changes in total score for these items can be compared meaningfully across time

Adipose Tissue-Derived Stem Cells and the Importance of Animal Model Standardization for Pre-Clinical Trials

ABSTRACTStem cells are undifferentiated cells and can self-renew and differentiate into various cell types, besides having immuno-modulating properties and paracrine effects in response to tissue injury, and may therefore treat injuries and diseases or even replace damaged or lost cells. Adipose tissue is an attractive source of adult stem cells, since the human body has a large reserve that is obtained in large amounts by minimally invasive methods. Interest in these cells has been increasing steadily due to their properties and possible applications in regenerative medicine and cell therapy. A large part of these investigations are focused on cardiovascular diseases, which are a leading cause of morbidity and mortality worldwide. Although in recent years treatments have advanced in cardiology, the development of new therapies to recover the damaged tissue still remains one of the main goals of cardiac research. However, to achieve effective results, in vivo and in vitro animal models for preclinical studies and consequently for application in humans must be standardized. The development of preclinical models in large animals requires the use of well-characterized animal cell lines, similar to human cells, and the use of the porcine model represents a great advantage for preclinical translational research

Una experiencia desde equipo técnico : tensiones y apuesta en torno a procesos de autonomía en personas discapacitadas

Nos proponemos en este trabajo tensionar los conceptos de discapacidad, sujeto y educación desde las miradas interdisciplinarias de un equipo que trabaja en una institución de escolaridad especial. Las concepciones epistemológicas que subyacen a las prácticas en la educación especial, como en otros campos, generan acciones y efectos de viejas y nuevas teorías. Revisamos estos supuestos y la naturalización de las prácticas y de las perspectivas. Como equipo hacemos referencia a la necesidad de un proceso permanente de construcción del rol, que permita pensarnos, interactuar, interrogarnos y discutir las diferentes intervenciones institucionales y comunitarias. Así, la conformación interdisciplinaria del equipo nos permite beneficiarnos con una mirada crítica hacia la diversidad y conformar una multiplicidad de observaciones sobre el objeto, lo que implica un capital simbólico muy importante. En éste trabajo es nuestro interés reflexionar acerca de las prácticas interprofesionales en los ámbitos donde se desarrollan los procesos educativos, tendientes a generar procesos de subjetivación y de construcción de ciudadanía posibilitando instancias de autonomía en los alumnos.We propose in this work to tense the concepts of disability, subject(person) and education from the interdisciplinary looks of an (team) that is employed at an institution of special education. The epistemological conceptions that sublie to the practices in the special education, (as,like) in other fields, generate actions (shares) and effects of old and new theories. We check these suppositions and the naturalization of the practices and of the perspectives. Since (team) we refer to the need of a permanent process of construction of the role, which allows us to think, to interact, to interrogate and to discuss the different institutional and community interventions. We seek to share how the interdisciplinary conformation of the team allows us to benefit us with a critical look towards the diversity and this way to shape a multiplicity of observations on the object, which implies the symbolic very important capital. In this one work is our interest to think brings over of the interprofessional practices in the areas where there develop the educational processes, tending to generate processes of subjectivation and of construction of citizenship making instances of autonomy possible in the pupils.Fil: Ramírez, Carolina.Fil: Della Giustina, Cecilia.Fil: Doce, Gisela.Fil: Lipschitz , Aaron.Fil: Sieber, Liliana.Fil: Zuttion, Betina.Fil: Zubarán, Soledad

High feeding dependence prevalence in residents living in Italian nursing homes requires new policies: findings from a regionally based cross-sectional study

Objectives: An increased amount of functional dependence has been reported among residents living in nursing homes. Among others, feeding dependence is one of the most complex needs to satisfy: behind the attempt to personalise meals with individual preferences and clinical regimens, all residents require help at the same moment and for long periods of time, three or more times a day. With the intent of debating policy implications, the aims of this study were to advance the knowledge in the field of feeding dependence prevalence and predictors in Italy, a country where life expectancy is among the highest in the World.Method: A large retrospective regionally-based study approaching all nursing homes (n=105) was performed in 2014; all residents (n=10,900) were eligible and those with a completed assessment recorded in the regional database and aged > 65 years (n=8,875) were included. Results: 1,839 residents (20.7%) were in total need of help in feeding on a daily basis. At the multilevel analysis, predictors were moderate/severe dementia (OR 4.044, CI 95% 3.213–5.090); dysphagia (OR 4.003 CI 95% 3.155–5.079); pressure sores (OR 2.317 CI 95% 1.803–2.978); unintentional weigh loss (OR 2.197 CI 95% 1.493–3.233); unsociability (OR 1.561 CI 95% 1.060–2.299); and clinical instability (OR 1.363 CI 95% 1.109–1.677). Conclusions: The feeding dependence prevalence emerged seem to be unique compared to that documented at the international levels. Modifiable and unmodifiable predictors found require new policies regarding workforce skills-mix and shifts schedules; as well as alliances with families, associations and communities’ stakeholders. According to the complexity of the resident profile emerged, staff education and training is also recommended

Inactive Residents Living in Nursing Homes and Associated Predictors: Findings From a Regional-Based, Italian Retrospective Study.

Objectives: It has been amply reported that nursing home (NH) residents are largely inactive, a condition that may further increase functional decline, behavioral disorders, and risk of death. To date, studies have mainly focused on individual characteristics that may decrease residents' involvement in activities. Therefore, the aim of this study is to describe the prevalence of inactive NH residents in an Italian context, identifying predictors of inactivity at the individual and NH levels. Design: Retrospective regional-based study performed in 2014. Setting: All NHs (n = 105) located in the Friuli Venezia Giulia Region, northeastern region of Italy. Participants: A total of 8875 residents with at least 1 nursing assessment and living in an NH for at least 1 year. Measurements: The dependent variable was inactivity in the last week, defined as the resident not being involved in any socially or individually based, or meaningful recreational (eg, gardening) activities. The independent variables were set at individual and NH levels. Aiming at identifying predictors of inactivity, a hierarchical generalized linear (mixed-effects) model incorporating both fixed-effect parameters and random effects, was performed. Results: A total of 4042 (45.6%) residents were inactive during the week before the evaluation. At the resident level, those with severe cognitive impairment [odds (OR) 4.462, 95% confidence interval (CI) 3.880-5.132], unsociable behavior (OR 2.961, 95% CI 2.522-3.473), night restlessness (OR 1.605, 95% CI 1.395-1.853), lack of cooperation in daily care (OR 1.408, 95% CI 1.199-1.643), pressure sores (OR 1.314, 95% CI 1.065-1.622), depressive disorders (OR 1.242, 95% CI 1.089-1.416), and clinical instability (OR 1.110, 95% CI 1.037-1.188) reported an increased risk of being inactive. At the NH level, for each additional hour of care offered by professional educators, there was 1% less likelihood of inactive residents (OR .964, 95% .933-.996). Conclusions: Approximately one-half of the residents in this study living in Italian NHs are inactive. Inactivity is significantly associated with the presence of severe cognitive impairment, behavioral disorders (eg, unsociability, night restlessness, and lack of cooperation in daily care), pressure sores, depressive symptoms, and clinical instability. Moreover, receiving care from professional educators whose aim in their training program and professional mission is to improve individual and social engagement, decreased the likelihood of resident inactivity. \ua9 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine

Pre-Procedural Statin Use Is Associated with Improved Long-Term Survival and Reduced Major Cardiovascular Events in Patients Undergoing Carotid Artery Stenting: A Retrospective Study

Carotid artery stenting (CAS) is a minimal invasive procedure used to resolve carotid occlusion that can be affected by peri-procedural complications. Statin use before CAS has shown to reduce peri-procedural risk and improve survival, though time-dependent cofactors that influence mortality has not been considered. The aim of this study was to evaluate long-term survival of patients who undergo CAS considering new occurred major adverse cardiovascular event (MACE) as time-dependent cofactor. In this study, 171 high cardiovascular risk patients (age 72 \ub1 8 years, 125 males) were enrolled after CAS procedure and were followed for a median of 8.4 years. Death occurred in 44% of patients with a mean time to death of 69 \ub1 39 months and MACE in 34% with a mean time of 35 \ub1 42 months. In patients who used or not statins at baseline, death occurred in 33% and 65%, respectively (p < 0.001). Survival analysis showed that statin use reduced risk of death (hazard ratio HR 0.36, 95% confidence interval CI 0.23\u207b0.58, p < 0.0001). Including MACE as time-dependent variable did not change beneficial effects of statins. Additionally, statin use was associated with a protective effect on MACE (HR 0.48, 95% CI 0.27\u207b0.85, p = 0.012); particularly, the prevalence of stroke was reduced by 59% (p = 0.018). In multivariate analysis, effects of statins were independent of demographic and anthropometric variables, prevalence of cardiovascular risk factors, renal function, antiplatelet use, and MACE occurrence. In conclusion, use of statins before CAS procedure is associated with increased long-term survival and reduced MACE occurrence. This evidence supports the hypothesis that statin use before CAS might be beneficial in high risk patients

SCHOOL NETWORK

O projeto School Network trata-se de um site com o objetivo de trazer melhorias para instituições de ensino,proporcionando isto com ajuda de nossos usuários. Ele funcionará como uma rede social, que pode ser usada pordiscentes, docentes e servidores das instituições brasileiras como um local para fonte de inspiração e feedbacksobre seus trabalhos, atividades e projetos feitos pelos próprios usuários da plataforma. O School Network, alémde ajudar com ideias e proporcionar feedbacks, também poderá ser usado para organização de discentes edocentes no quesito escolar, permitindo a criação de calendários, cujo estes serão privados ou compartilhados,dependendo da escolha do usuário Ainda que seja um site aberto para todos os públicos e sem restrição de idade,o School Network terá um modo para discentes do fundamental, para que não haja problemas com conteúdosimpróprios e também contará com modos diferentes para docentes e servidores, para que assim possaproporcionar um melhor atendimento às necessidades de cada. As atividades do School Network serão separadaspor áreas de conhecimentos, tornando-se mais fácil para o usuário encontrar o que deseja, também terá umaseção exclusiva para as melhorias escolares, para ajudar em ideias físicas novas, como eventos presenciais,alimentação dos alunos, construções que atendam as necessidades dos alunos, etc. O projeto também apresentaráchat, para que os usuários possam esclarecer dúvidas entre si, além de possibilitar a conversa e ocompartilhamento de conteúdo. Para ser possível a utilização do nosso site, será facil e rápido, somente seránecessário um login, que será feito através de um cadastro onde precisará ser informado o nome, a idade, email,senha, o modo e de acordo com estas escolhas algumas informações específicas de modo, como série,instituição, disciplinas, etc. Com o tempo também gostaríamos de expandir o projeto para fora do Brasil,disponibilizando o site em outras línguas e com atualizações que visam as demandas de cada país em que seinstalar

Conversaciones para construir mundos no excluyentes. Feminismos y discapacidad en perspectiva interseccional

Esta reseña recupera algunas pistas y derivas del PID 5128 “Feminismos y estudios críticos en discapacidad. Diálogos subalternos e interseccionalidad” desarrollado entre 2019 y 2021 por nuestro equipo de investigación/extensión y docencia de la Facultad de Trabajo Social de la UNER. Este PID es el 5º proyecto de investigación en una línea de producción que se inscribe en los estudios críticos en discapacidad latinoamericanos, campo al cual aportamos y del cual nos nutrimos desde hace más de 20 años[1]. Es continuidad de un equipo y de una línea de investigación/activismo consolidada en la UNER que articuló dos campos: el de los estudios y activismos feministas en su heterogeneidad con los estudios críticos en discapacidad en su diversificación y en esos cruces identificar y relevar confluencias, convergencias, divergencias y/o bifurcaciones. Son recientes y germinales los diálogos y más las alianzas entre campos que lidian con rémoras de reduccionismos esencialistas y capacitismos en ambos casos. Lo Feminista funciona como epistemología, como un punto de vista que posibilita rehuir y destruir, y fisurar la matriz normo heteropatriarcal capacitista que constituye la base de la producción de discapacidad como categoría de exclusión e identidad devaluada. Abordar la discapacidad como producto de un modo de cristalización de la ideología de la normalidad, posibilita visibilizar las articulaciones entre perspectivas que permiten tejer en esos diálogos, las alianzas imperativas para la transformación radical de órdenes capacitistas, racistas y patriarcales intrínsecamente injustos y excluyentes.  Incluimos reflexiones en torno experiencias de trabajo activista y de producción con mujeres sordas y ciegas nucleadas en organizaciones de la región y además del estado del debate ampliado las nuevas formas de articulación que nos dan los feminismos locos. Nos propusimos construir en conjunto a las organizaciones discas, distintas pistas (aunque no respuestas) interrogantes teórico políticos confluyendo en diferentes espacios de trabajo compartido en el marco de la investigación/extensión en contexto pandémico. [1] El primer proyecto de extensión se presentó en la Convocatoria UNER de 1999 y el primer PID en la Convocatoria 2003. ARK/CAICYT: http://id.caicyt.gov.ar/ark:/s22504559/t05j04wz