33 research outputs found
SaĂşde bucal para pacientes com necessidades especiais: pesquisa avaliativa de Centros de Especialidades OdontolĂłgicas
ABSTRACT - The Dental Specialties Centers (CEOs) were created within
the context of the National Oral Health Policy, and the main
function of these establishments is to serve as units of reference
in secondary oral health care in the Brazilian national
health system (SUS), and they must offer at least the services
of stomatology, specialized periodontology, minor oral surgery,
endodontics, and attendance to patients with special
needs. The aim of this study was to evaluate the quality of
the CEOs in the mountain region of the Rio de Janeiro State,
Brazil, in the perspective of the patients with special needs
care or their companion’s satisfaction. Data were collected
from 159 users by using a standardized self-applied individual
semi-structured questionnaire. The results indicated a
positive evaluation in most of the dimensions, except the
accessibility dimension. Significant differences (p < 0.05)
were observed between the services of the following dimensions
of quality: accessibility, resoluteness, technical-scientific
quality, efficiency, efficacy, and acceptability. The analysis
of qualitative data, through the discourse of the collective
subject technique (DCS) and social representations, showed
five central ideas about users’ satisfaction and dissatisfaction
with CEOs services (humanized health care, resoluteness of
the service, professional competence, infrastructure and organization
of the service, access to the services). In conclusion,
most patients with special needs care and their companions
were satisfied with specialized dental centers (SDC)
services, although there were significant differences among
SDCs services in relation to individuals’ satisfaction.RESUMO - Os Centros de Especialidades Odontológicas (CEOs) foram
criados dentro do contexto da PolĂtica Nacional de SaĂşde
Bucal e a principal função desses estabelecimentos é servir
como unidades de referĂŞncia em atenção secundária Ă
saúde bucal no SUS, devendo oferecer pelo menos os serviços
de estomatologia, periodontia especializada, cirurgia
oral menor, endodontia e atendimento a pacientes com
necessidades especiais. O objetivo deste estudo foi avaliar
a qualidade dos Centros de Especialidades OdontolĂłgicas
da regiĂŁo serrana do Estado do Rio de Janeiro,
Brasil, por meio da satisfação dos pacientes com necessidades
especiais ou de seus acompanhantes. Os dados
foram coletados de 159 usuários utilizando um questionário
semiestruturado individual auto-aplicado padronizado.
Os resultados indicaram uma avaliação positiva na
maioria das dimensões, exceto na acessibilidade. Diferenças
significativas (p < 0.05) foram observadas entre os
serviços nas seguintes dimensões de qualidade: acessibilidade,
resolutividade, qualidade tĂ©cnico-cientĂfica, eficiĂŞncia,
eficácia e aceitabilidade. A análise dos dados
qualitativos, por meio da técnica do Discurso do Sujeito
Coletivo (DSC) e das representações sociais, apresentou
cinco ideias centrais sobre a satisfação e insatisfação dos
usuários com os serviços dos CEOs (cuidado humanizado,
resolutividade do serviço, competência profissional, infraestrutura
e organização do serviço, acesso aos serviços).
Em conclusĂŁo, a maioria dos pacientes com necessidades
especiais e seus acompanhantes estavam satisfeitos
com os serviços dos CEOs, embora houvesse diferenças
significativas entre os serviços dos CEOs em relação à satisfação
dos indivĂduos.info:eu-repo/semantics/publishedVersio
Does ADHD worsen inhibitory control in preschool children born very premature and/or with very low birth weight?
Introduction: Deficits in executive functioning, especially in inhibitory control, are present in children born very premature and/or with very low birth weight (VP/VLBW) and in children with attention-deficit/ hyperactivity disorder (ADHD). Objective: To evaluate whether ADHD imposes additional inhibitory control (IC) deficits in preschoolers born VP/VLBW. Methods: 79 VP/VLBW (4 to 7 years) children were assessed for ADHD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children – Present and Lifetime Version (K-SADS-PL). IC was measured with Conners’ Kiddie Continuous Performance Test (K-CPT 2) and the Behavior Rating Inventory of Executive Function – Preschool Version (BRIEF-P). Results: No significant differences were found between ADHD (n = 24) and non-ADHD children (n = 55) for any of the measures (p = 0.062 to p = 0.903). Both groups had deficits in most K-CPT 2 scores compared to normative samples, indicating poor IC and inconsistent reaction times. Conclusions: ADHD does not aggravate IC deficits in VP/VLBW children. Either neuropsychological tasks and parent reports of executive functions (EFs) may not be sensitive enough to differentiate VP/VLBW preschoolers with and without ADHD, or these children’s EFs are already so impaired that there is not much room for additional impairments imposed by ADHD
Nursing reception in the admission of chronic renal patient for hemodialitic treatment / Acolhimento do enfermeiro na admissĂŁo do paciente renal crĂ´nico para tratamento hemodialitico
Objetivos: analisar de que forma ocorre o acolhimento do paciente renal crĂ´nico para o tratamento hemodialitico pelo enfermeiro na admissĂŁo em uma clĂnica de Hemodiálise. MĂ©todo: Estudo descritivo exploratĂłrio de abordagem qualitativa, realizada nos meses de setembro e outubro de 2018. Os participantes do estudo foram 16 enfermeiros que atuavam há pelo menos seis meses na área de hemodiálise, e excluĂdos os que nĂŁo realizam assistĂŞncia direta ao paciente. Resultados: As falas evidenciam que os enfermeiros executam procedimentos burocráticos rotineiros na admissĂŁo, identificam as necessidades de cuidado relacionados principalmente ao acesso, orientam para o autocuidado e que tem muitos pacientes sob sua supervisĂŁo dificultando a realização de uma assistĂŞncia completa. ConclusĂŁo: o ato de acolher Ă© executado, na busca da construção do vĂnculo profissional-paciente, orientando ao auto cuidado, mostrando formas de adaptação ao novo tratamento e o seu reflexo na qualidade de vida do paciente
Nursing reception in the admission of chronic renal patient for hemodialitic treatment / Acolhimento do enfermeiro na admissĂŁo do paciente renal crĂ´nico para tratamento hemodialitico
Objetivos: analisar de que forma ocorre o acolhimento do paciente renal crĂ´nico para o tratamento hemodialitico pelo enfermeiro na admissĂŁo em uma clĂnica de Hemodiálise. MĂ©todo: Estudo descritivo exploratĂłrio de abordagem qualitativa, realizada nos meses de setembro e outubro de 2018. Os participantes do estudo foram 16 enfermeiros que atuavam há pelo menos seis meses na área de hemodiálise, e excluĂdos os que nĂŁo realizam assistĂŞncia direta ao paciente. Resultados: As falas evidenciam que os enfermeiros executam procedimentos burocráticos rotineiros na admissĂŁo, identificam as necessidades de cuidado relacionados principalmente ao acesso, orientam para o autocuidado e que tem muitos pacientes sob sua supervisĂŁo dificultando a realização de uma assistĂŞncia completa. ConclusĂŁo: o ato de acolher Ă© executado, na busca da construção do vĂnculo profissional-paciente, orientando ao auto cuidado, mostrando formas de adaptação ao novo tratamento e o seu reflexo na qualidade de vida do paciente
Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial
Background
Recent open-label trials show that psychedelics, such as ayahuasca, hold promise as fast-onset antidepressants in treatment-resistant depression.
Methods
To test the antidepressant effects of ayahuasca, we conducted a parallel-arm, double-blind randomized placebo-controlled trial in 29 patients with treatment-resistant depression. Patients received a single dose of either ayahuasca or placebo. We assessed changes in depression severity with the Montgomery-Ă…sberg Depression Rating Scale (MADRS) and the Hamilton Depression Rating scale at baseline, and at 1 (D1), 2 (D2), and 7 (D7) days after dosing.
Results
We observed significant antidepressant effects of ayahuasca when compared with placebo at all-time points. MADRS scores were significantly lower in the ayahuasca group compared with placebo at D1 and D2 (p = 0.04), and at D7 (p < 0.0001). Between-group effect sizes increased from D1 to D7 (D1: Cohen's d = 0.84; D2: Cohen's d = 0.84; D7: Cohen's d = 1.49). Response rates were high for both groups at D1 and D2, and significantly higher in the ayahuasca group at D7 (64% v. 27%; p = 0.04). Remission rate showed a trend toward significance at D7 (36% v. 7%, p = 0.054).
Conclusions
To our knowledge, this is the first controlled trial to test a psychedelic substance in treatment-resistant depression. Overall, this study brings new evidence supporting the safety and therapeutic value of ayahuasca, dosed within an appropriate setting, to help treat depression. This study is registered at http://clinicaltrials.gov (NCT02914769)
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4
While the increasing availability of global databases on ecological communities has advanced our knowledge
of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In
the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of
Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus
crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced
environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian
Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by
2050. This means that unless we take immediate action, we will not be able to establish their current status,
much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio
Pervasive gaps in Amazonian ecological research
Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost