RESUMO
The article exposes the process of design and implementation of a training program for teachers that teach people with Visual Functional Diversity (VFD), taking into account their needs both in training and in the provision of resources in Nicaragua. To verify the effectiveness of the program, a quasi-experimental design was carried out with a non-equivalent pretest and posttest control group. The experimental group received training while the control group did not receive training. The evaluation of the results obtained after the application of the program was carried out through two instruments: an efficacy questionnaire and a satisfaction questionnaire. The results showed significant differences between the experimental and control group after the application of the program (Z = -4,383; p = 0.000) in favor of the experimental group. It is confirmed that the program is effective in training teachers on inclusive education for the visually impaired as the teachers who took part in the training program significantly increased their knowledge in that issue.
Assuntos
Capacitação de Professores , Humanos , Nicarágua , Avaliação de Programas e Projetos de Saúde , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To evaluate the impact of the training strategy of the Escuela de Pacientes (School of Patients) on the use of health services among people with chronic diseases. METHOD: Quantitative design study of pretest and posttest evaluation with a population of 3,350 chronic patients of the Escuela de Pacientes (Andalusia, 2013-2015). A questionnaire adapted from the Stanford University was used. It measured the self-perceived health, number of health visits, and level of trust and communication with health personnel. A descriptive and bivariate study, a correlation study and a pretest/posttest net gain analysis were performed. RESULTS: Participation of 964 patients (28.8% of the population), of which 18.8% were men, mean age 56 years. Training increased trust in Primary Care (PC) and Hospital Care (HC) professionals (0.44 and 0.65 points), medical visits decreased by 25%, and hospital admissions fell by 51% with statistically significant differences by sex and disease. The correlation index between trust in professionals and use of health services was -0.215. CONCLUSION: The training strategy had a positive impact on the use of health services and trust in health professionals, and were identified areas of improvement from which recommendations are established.
Assuntos
Doença Crônica/terapia , Utilização de Instalações e Serviços/estatística & dados numéricos , Educação de Pacientes como Assunto , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Grupo Associado , Instituições Acadêmicas , Autorrelato , EspanhaRESUMO
RESUMEN Objetivo: Evaluar el impacto de la estrategia formativa de la Escuela de Pacientes en el uso de servicios sanitarios entre las personas con enfermedades crónicas. Método: Diseño cuantitativo de evaluación pretest y postest con una población de 3350 pacientes crónicos de la Escuela de Pacientes (Andalucía, 2013-2015). Se empleó un cuestionario adaptado de la Universidad de Stanford, que midió: salud autopercibida, número de visitas médicas y nivel de confianza y comunicación con el personal sanitario. Se realizó estudio descriptivo y bivariante, estudio de correlación y análisis de ganancias netas pretest/postest. Resultados: Participaron 964 pacientes (28,8% de la población): el 18,8% hombres, edad media 56 años. La formación aumentó la confianza en el personal de Atención Primaria (AP) y Atención Hospitalaria (AH) (0,44 y 0,65 puntos), descendieron las visitas médicas en un 25% y los ingresos hospitalarios en un 51%, con diferencias estadísticamente significativas por sexo y enfermedad. El índice de correlación entre confianza con profesionales y uso de servicios sanitarios fue de −0,215. Conclusión: La estrategia formativa tuvo un impacto positivo en el uso de servicios sanitarios y confianza con personal sanitario, detectándose áreas de mejora a partir de las cuales se establecen recomendaciones.
Resumo Objetivo: Avaliar o impacto da formação da Escola de Pacientes entre iguais sobre a utilização de serviços sanitários das pessoas com doenças crónicas. Método: Desenho quantitativo da avaliação pré-teste e pós-teste com uma população de 3.350 pacientes da Escola de Pacientes (Andaluzia, 2013-2015). Foi usado um questionário adaptado da Universidade de Stanford, que mediu: saúde autopercebida, visitas médicas, nível de confiança e comunicação com o pessoal sanitário. A análise estatística incluiu estudo estatístico descritivo e bivariado, estudo de correlação e análise de ganhos líquidos pré-teste/pós-teste. Resultados: Participaram 964 pacientes (28,8% da população do estudo), 18,8% homens, idade média de 56 anos. Depois da formação, a confiança no pessoal de Atenção Primária (AP) e Atenção Hospitalar (AH) aumentou (0,44 e 0,65 pontos, respectivamente), as visitas médicas decresceram em 25% e as entradas hospitalares em 51%, com diferenças estatisticamente significativas por sexo e doença. O índice de correlação entre confiança nos profissionais e utilização de serviços de saúde foi de −0,215. Conclusão: A estratégia formativa teve um impacto positivo na utilização dos serviços de saúde e na confiança no pessoal de saúde, detectando-se áreas de melhoria a partir das quais se estabelecem recomendações.
ABSTRACT Objective: To evaluate the impact of the training strategy of the Escuela de Pacientes (School of Patients) on the use of health services among people with chronic diseases. Method: Quantitative design study of pretest and posttest evaluation with a population of 3,350 chronic patients of the Escuela de Pacientes (Andalusia, 2013-2015). A questionnaire adapted from the Stanford University was used. It measured the self-perceived health, number of health visits, and level of trust and communication with health personnel. A descriptive and bivariate study, a correlation study and a pretest/posttest net gain analysis were performed. Results: Participation of 964 patients (28.8% of the population), of which 18.8% were men, mean age 56 years. Training increased trust in Primary Care (PC) and Hospital Care (HC) professionals (0.44 and 0.65 points), medical visits decreased by 25%, and hospital admissions fell by 51% with statistically significant differences by sex and disease. The correlation index between trust in professionals and use of health services was −0.215. Conclusion: The training strategy had a positive impact on the use of health services and trust in health professionals, and were identified areas of improvement from which recommendations are established.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Participação do Paciente , Autocuidado , Educação em Saúde , Doença Crônica , Fibromialgia , Diabetes Mellitus , Serviços de Saúde , Insuficiência CardíacaRESUMO
UNLABELLED: Background and rationale for the study. Hyperglycemia after graft reperfusion is a consistent finding in liver transplantation (LT) that remains poorly studied. We aim to describe its appearance in LT recipients of different types of grafts and its relation to the graft function. MATERIAL & METHODS: 436 LT recipients of donors after brain death (DBD), donors after cardiac death (DCD), and familial amyloidotic polyneuropathy (FAP) donors were reviewed. Serum glucose was measured at baseline, during the anhepatic phase, after graft reperfusion, and at the end of surgery. Early graft dysfunction (EAD) was assessed by Olthoff criteria. Caspase-3, IFN-γ, IL1ß, and IL6 gene expression were measured in liver biopsy. RESULTS: The highest increase in glucose levels after reperfusion was observed in FAP LT recipients and the lowest in DCD LT recipients. Glucose level during the anhepatic phase was the only modifiable predictive variable of hyperglycemia after reperfusion. No relation was found between hyperglycemia after reperfusion and EAD. However, recipients with the highest glucose levels after reperfusion tended to achieve the best glucose control at the end of surgery and those who were unable to control the glucose value after reperfusion showed EAD more frequently. The highest levels of caspase-3 were found in recipients with the lowest glucose values after reperfusion. In conclusion, glucose levels increased after graft reperfusion to a different extent according to the donor type. Contrary to general belief, transient hyperglycemia after reperfusion does not appear to impact negatively on the liver graft function and could even be suggested as a marker of graft quality.
Assuntos
Glicemia/metabolismo , Hiperglicemia/etiologia , Transplante de Fígado/efeitos adversos , Doadores de Tecidos , Adulto , Idoso , Neuropatias Amiloides Familiares , Biomarcadores/sangue , Biópsia , Morte Encefálica , Causas de Morte , Feminino , Humanos , Hiperglicemia/sangue , Hiperglicemia/diagnóstico , Testes de Função Hepática , Transplante de Fígado/métodos , Masculino , Pessoa de Meia-Idade , Disfunção Primária do Enxerto/etiologia , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
This study aimed to assess the capacity of saponite modified with n-hexadecyltrimethylammonium bromide (CTAB) and/or 3-aminopropyltriethoxysilane (APTS) to adsorb and remove caffeine from aqueous solutions. Powder X-ray diffraction (PXRD) revealed increased basal spacing in the modified saponites. Small-angle X-ray scattering (SAXS) confirmed the PXRD results; it also showed how the different clay layers were stacked and provided information on the swelling of natural saponite and of the saponites functionalized with CTAB and/or APTS. Thermal analyses, infrared spectroscopy, scanning electron microscopy, element chemical analysis, and textural analyses confirmed functionalization of the natural saponite. The maximum adsorption capacity at equilibrium was 80.54 mg/g, indicating that the saponite modified with 3-aminopropyltriethoxysilane constitutes an efficient and suitable caffeine adsorbent.
Assuntos
Silicatos de Alumínio/química , Cafeína/isolamento & purificação , Compostos Orgânicos/química , Purificação da Água/métodos , Difração de Raios X/métodos , Adsorção , Cafeína/química , Nanopartículas/química , Nanopartículas/ultraestrutura , Tamanho da Partícula , Espalhamento a Baixo Ângulo , Poluentes Químicos da Água/isolamento & purificaçãoRESUMO
A lo largo de las tres últimas décadas, muchos países de Latinoamérica y el Caribe (LAC) han reconocido la salud como un derecho humano y han actuado de acuerdo a ese reconocimiento. En consecuencia las exigencias a los sistemas de salud han aumentado de forma sostenida con el objetivo de responder mejor a la prestación de servicios. De ahí que se hayan promovido y puesto en marcha políticas y programas encaminados a lograr la cobertura universal de salud(1). En este contexto las políticas de Recursos Humanos han adquirido, si cabe, una mayor relevancia.