104 research outputs found

    A Case Study of Organizational and Curricular Attributes for Interprofessional Education: A Model for Sustainable Curriculum Delivery

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    Background: In health and social care (HASC) professional education, interprofessional competencies are optimally developed by engaging in interprofessional education (IPE) activities that are delivered sustainably along a continuum. Ultimately, active engagement in IPE is meant to prepare future practitioners for interprofessional collaborative practice (IPCP), which leads to improved patient/client and community-oriented outcomes. Methods and Findings: This qualitative case study explores how four Canadian post-secondary institutions deliver IPE within their HASC professional education programmatic structures. Data were collected from institutional websites, publicly available IPE relevant records and documents, and interviews with coordinators and faculty/facilitators of IPE curriculum. Data were inductively analyzed to generate relevant themes, followed by a deductive analysis guided by the five accreditation standards domains identified in the Accreditation of Interprofessional Health Education (AIPHE) projects. Analyses of the data resulted in five attributes: 1) central administrative unit, 2) longitudinal and integrative program, 3) theoretically informed curriculum design, 4) student-centred pedagogy, and 5) patient/client-oriented approach. Conclusions: Using these attributes and guided by AIPHE’s accreditation standards domains, an organizational-curricular model for sustainable IPE is proposed, through which we assert that IPE reinforced through these organizational and curricular supports reflects successful programming, leading to patient/client-oriented outcomes

    Brown shrimp (Crangon crangon) processing remains as ingredient for Litopenaeus vannamei feeds: Biochemical characterisation and digestibility

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    Processing remains of brown shrimp, Crangon crangon, account for up to 60 % of the catch while only the small muscle fraction is used for human consumption. Incorporation into aquafeeds for high-valued species would reduce waste, create by-product value and promote sustainable aquaculture development. A detailed chemical characterisation of the remains from mechanically peeled brown shrimp was made and apparent nutrient digestibility coefficients in Litopenaeus vannamei were investigated. Brown shrimp processing remains (BSPR) contain substantial amounts of key nutrients (521 g⋅kg-1 crude protein, 74 g⋅kg-1 total lipid, 15 MJ⋅kg-1 gross energy) and valuable functional ingredients were detected (cholesterol, astaxanthin). Apparent energy (82 %) and protein (86 %) digestibility coefficients reveal good bioavailability of these nutrients. Dry matter digestibility was lower (64 %) presumably due to the high ash content (244 g⋅kg-1). The amino acid profile meets dietary requirements of penaeid shrimp with high apparent lysine and methionine digestibility coefficients. Analysis of macro- and micro minerals showed reasonable levels of required dietary minerals (phosphorus, magnesium, copper, manganese, selenium, zinc) and apparent copper digestibility was high (93 %). Contamination levels present in BSPR were below European standards acceptable for human consumption. Processing remains of brown shrimp have a high potential as alternative feed ingredient in sustainable diets for L. vannamei in recirculating aquaculture systems

    Clinical, Functional, and Mental Health Outcomes in Kidney Transplant Recipients 3 Months after a Diagnosis of COVID-19

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    Background. Kidney transplant patients are at high risk for coronavirus disease 2019 (COVID-19)-related mortality. However, limited data are available on longer-term clinical, functional, and mental health outcomes in patients who survive COVID-19. Methods. We analyzed data from adult kidney transplant patients in the European Renal Association COVID-19 Database who presented with COVID-19 between February 1, 2020, and January 31, 2021. Results. We included 912 patients with a mean age of 56.7 (±13.7) y. 26.4% were not hospitalized, 57.5% were hospitalized without need for intensive care unit (ICU) admission, and 16.1% were hospitalized and admitted to the ICU. At 3 mo follow-up survival was 82.3% overall, and 98.8%, 84.2%, and 49.0%, respectively, in each group. At 3 mo follow-up biopsy-proven acute rejection, need for renal replacement therapy, and graft failure occurred in the overall group in 0.8%, 2.6%, and 1.8% respectively, and in 2.1%, 10.6%, and 10.6% of ICU-admitted patients, respectively. Of the surviving patients, 83.3% and 94.4% reached their pre-COVID-19 physician-reported functional and mental health status, respectively, within 3 mo. Of patients who had not yet reached their prior functional and mental health status, their treating physicians expected that 79.6% and 80.0%, respectively, still would do so within the coming year. ICU admission was independently associated with a low likelihood to reach prior functional and mental health status. Conclusions. In kidney transplant recipients alive at 3-mo follow-up, clinical, physician-reported functional, and mental health recovery was good for both nonhospitalized and hospitalized patients. Recovery was, however, less favorable for patients who had been admitted to the ICU

    Sex differences in COVID-19 mortality risk in patients on kidney function replacement therapy

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    © 2022, The Author(s).In the general population with COVID-19, the male sex is an established risk factor for mortality, in part due to a more robust immune response to COVID-19 in women. Because patients on kidney function replacement therapy (KFRT) have an impaired immune response, especially kidney transplant recipients due to their use of immunosuppressants, we examined whether the male sex is still a risk factor for mortality among patients on KFRT with COVID-19. From the European Renal Association COVID-19 Database (ERACODA), we examined patients on KFRT with COVID-19 who presented between February 1st, 2020, and April 30th, 2021. 1204 kidney transplant recipients (male 62.0%, mean age 56.4 years) and 3206 dialysis patients (male 61.8%, mean age 67.7 years) were examined. Three-month mortality in kidney transplant recipients was 16.9% in males and 18.6% in females (p = 0.31) and in dialysis patients 27.1% in males and 21.9% in females (p = 0.001). The adjusted HR for the risk of 3-month mortality in males (vs females) was 0.89 (95% CI 65, 1.23, p = 0.49) in kidney transplant recipients and 1.33 (95% CI 1.13, 1.56, p = 0.001) in dialysis patients (pinteraction = 0.02). In a fully adjusted model, the aHR for the risk of 3-month mortality in kidney transplant recipients (vs. dialysis patients) was 1.39 (95% CI 1.02, 1.89, p = 0.04) in males and 2.04 (95% CI 1.40, 2.97, p < 0.001) in females (pinteraction = 0.02). In patients on KFRT with COVID-19, the male sex is not a risk factor for mortality among kidney transplant recipients but remains a risk factor among dialysis patients. The use of immunosuppressants in kidney transplant recipients, among other factors, may have narrowed the difference in the immune response to COVID-19 between men and women, and therefore reduced the sex difference in COVID-19 mortality risk

    Three reasons why parental burnout is more prevalent in individualistic countries: A 36-country study

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    Abstract Purpose The prevalence of parental burnout, a condition that has severe consequences for both parents and children, varies dramatically across countries and is highest in Western countries characterized by high individualism. Method In this study, we examined the mediators of the relationship between individualism measured at the country level and parental burnout measured at the individual level in 36 countries (16,059 parents). Results The results revealed three mediating mechanisms, that is, self-discrepancies between socially prescribed and actual parental selves, high agency and self-directed socialization goals, and low parental task sharing, by which individualism leads to an increased risk of burnout among parents. Conclusion The results confirm that the three mediators under consideration are all involved, and that mediation was higher for self-discrepancies between socially prescribed and actual parental selves, then parental task sharing, and lastly self-directed socialization goals. The results provide some important indications of how to prevent parental burnout at the societal level in Western countries.</jats:p

    Gender Equality and Maternal Burnout : A 40-Country Study

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    In Western countries, recent decades have witnessed a revolution toward gender equality. Inequalities have been greatly reduced in areas such as education or employment. Because inequalities lead to distress, this development has largely benefited women. One notable exception is the realm of parenting, which has remained rife with inequalities even in the most egalitarian countries. We hypothesized that experiencing inequality in parenting when one holds egalitarian values and raising a child in a country characterized by a high level of gender equality in other areas, increases mothers’ psychological distress in the specific area of parenting. Multilevel modeling analyses computed among 11,538 mothers from 40 countries confirmed this prediction: high egalitarian values at the individual level and high gender equality at the societal level are associated with higher burnout levels in mothers. The associations hold beyond differences in sociodemographic characteristics at the individual level and beyond economic disparities at the societal level. These findings show the importance of egalitarian values and gender equality and their paradoxical effect when inequalities are still present in specific areas as parenting. This study reveals the crucial need to act not only at the micro level but also at the macro level to promote gender equality in parenting and prevent parental burnout.peerReviewe