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This study aims to present a combination of methods and propose robust theoretical and conceptual frameworks for solving socio-environmental issues. This proposal included the Problem, Intervention, Context, and Outcome (PICO) framework and Protocol and Reporting result with Search, Appraisal, Synthesis, and Analysis framework, and develop (PSALSAR) method through SODIP steps: (i) Systematic review and meta-analysis defining the study from guiding questions; (ii) Open-source related to software and data; (iii) Data visualization and design information; (iv) Identification of gaps, challenges and trends through automation and lexicometric analysis; and (v) Proposal of theoretical and conceptual frameworks. This proposal defines the steps as support to combine and systematize information necessary to facilitate the production of this type of document using open-access software in the visualization and design of information. All these steps are replicable and essential to propose a conceptual and theoretical framework to contribute to the construction of knowledge in socio-environmental research and to propose solutions by filling in the gaps. In summary, this combination of methods shows:â¢The use of SODIP steps provides robustness and efficiency in carrying out review studies, facilitating the way to propose theoretical or conceptual frameworks.â¢Choosing to use open-source tools is essential for better evaluation and visualization of qualitative and quantitative data in review studies.â¢The combination of methods and data in the systematic review (scientific, political documents. and databases) supports the proposal of robust theoretical and conceptual frameworks.
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The Baby-Friendly Hospital Initiative (BFHI) is a global strategy to encourage health facilities to promote, support, and protect breastfeeding by implementing a package of policies and practices known as the Ten Steps to Successful Breastfeeding. Prior studies have found that implementing the Ten Steps has a positive impact on breastfeeding outcomes. Yet, little is known about the implementation of the Ten Steps in Mexico. The objective of this study was to conduct a systematic review to evaluate the reach, efficacy/effectiveness, adoption, implementation, and maintenance of the Ten Steps in Mexico, using the RE-AIM framework. The systematic literature review included studies published in English or Spanish without date restrictions. Two of the authors coded each of the articles through a harmonized data extraction tool, and group meetings were used to discuss any discrepancies. The reviewed data were managed in the Rayyan platform. The risk of study bias was assessed through the Johanna Briggs Institute critical appraisal checklists. Of the 1,123 articles initially identified, 6 met the review inclusion criteria. None of the articles evaluated the reach and maintenance of the Ten Steps. The articles identified major gaps in the implementation of the Ten Steps. Most of the articles had important limitations in terms of their quality. In Mexico, it is necessary to rethink the BFHI and employ multiple strategies to improve implementation of the Ten Steps, including developing transparent BFHI monitoring mechanisms that produce data on implementation and that are publicly available, as well as investing in implementation research and evaluation to generate strong evidence to support the adoption and efficient maintenance of the Ten Steps in health facilities in Mexico. When properly implemented, BFHI becomes central to promote, protect, and support breastfeeding. Therefore, it is essential for Mexico to position BFHI as a top priority of the country's public policy agenda. Systematic Review Registration: identifier: CRD42021248118.
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Aleitamento Materno , Promoção da Saúde , Feminino , Humanos , México , Hospitais , Política PúblicaRESUMO
Introducción: La Organización Mundial de la Salud diseñó un instrumento para la vigilancia de los factores de riesgo asociados con las enfermedades crónicas, este abarca tres pasos que incluyen los datos personales y comportamentales, antropométricos y bioquímicos. Objetivo: Describir las aplicaciones del Instrumento STEPS (paso 1) para la identificación de factores de riesgo comportamentales asociados a enfermedades no transmisibles en adultos trabajadores, según país y año de publicación. Metodología: Revisión narrativa de estudios originales que utilizaron el STEPS, publicados entre 2015 y 2019 en español, inglés y portugués en las bases de datos PubMed, SciELO y el motor de búsqueda Google Scholar. Resultados: Se revisaron 20 documentos de los cuales 6 fueron de Asia y África, y el año de mayor publicación fue 2017. El consumo nocivo del alcohol, tabaquismo, inactividad física y alimentación no saludable son los riesgos más estudiados. Conclusiones: La utilización del instrumento STEPS en publicaciones es más frecuente en países de África y Asia. Se requiere que su implementación sea sistemática y difundida en otros países, con la finalidad de diseñar e implementar estrategias de salud pública para la prevención, mitigación y tratamiento oportuno de las enfermedades no transmisibles.
Introduction: The World Health Organization designed an instrument for the surveillance of risk factors associated with chronic diseases, it has three steps that include personal and behavioral, anthropometric, and biochemical data. Objective: To describe the applications of the STEPS Instrument (step 1) to identify behavioral risk factors associated with noncommunicable diseases in working adults, according to country and year of publication. Methodology: Narrative review of original studies that used STEPS, published between 2015 and 2019 in Spanish, English and Portuguese in the databases PubMed, SciELO, and the search engine Google Scholar. Results: A total of 20 studies were reviewed, of which 6 were from Asia and Africa, and the year of most significant publication was 2017. The most studied risks are harmful alcohol consumption, smoking, physical inactivity, and unhealthy eating. Conclusions: the use of the STEPS instrument in publications is more frequent in countries of Africa and Asia. Its implementation must be systematic and disseminated in other countries to design and implement public health strategies for the prevention, mitigation, and timely treatment of noncommunicable diseases.
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Humanos , Fatores de Risco , Estilo de Vida Saudável , Doenças não Transmissíveis , Comportamentos Relacionados com a Saúde , Saúde Pública , Inquéritos e QuestionáriosRESUMO
(1) Background: Regular physical activity has multiple benefits. Therefore, school recess is a key tool to provide opportunities for schoolchildren to engage in extracurricular physical activity, have fun, play and interact with their peers. The aim is to provide reference data to quantify the number of steps that children and adolescents perform in a school recess using smart bands according to age range and sex. (2) Method: A descriptive cross-sectional study was carried out in 494 schoolchildren aged 6 to 17 years (292 males and 202 females). Weight, standing height and waist circumference (WC) were evaluated. The body mass index (BMI) was calculated. The quantification of the number of steps during school recess was performed using a smart band. (3) Results: Percentiles were constructed for the number of steps (number of steps/recess). The cut-off points considered were
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BACKGROUND: People who inject drugs living with HIV (PWIDLH) suffer the lowest rates of HIV viral suppression due to episodic injection drug use and poor mental health coupled with poor retention in HIV care. Approximately 44% of PWIDLH along the US-Mexico border are retained in care and only 24% are virally suppressed. This underserved region faces a potential explosion of transmission of HIV due to highly prevalent injection drug use. This protocol describes an optimization trial to promote sustained viral suppression among Spanish-speaking Latinx PWIDLH. METHODS: The multiphase optimization strategy (MOST) is an engineering-inspired framework for designing and building optimized interventions and guides this intervention. The primary aim is to conduct a 24 factorial experiment in which participants are randomized to one of 16 intervention conditions, with each condition comprising a different combination of four behavioral intervention components. The components are peer support for methadone uptake and persistence; behavioral activation therapy for depression; Life-Steps medication adherence counseling; and patient navigation for HIV care. Participants will complete a baseline survey, undergo intervention, and then return for 3-,6-,9-, and 12-month follow-up assessments. The primary outcome is sustained viral suppression, defined as viral loads of < 40 copies per mL at 6-,9-, and 12-month follow-up assessments. Results will yield effect sizes for each component and each additive and interactive combination of components. The research team and partners will make decisions about what constitutes the optimized multi-component intervention by judging the observed effect sizes, interactions, and statistical significance against real-world implementation constraints. The secondary aims are to test mediators and moderators of the component-to-outcome relationship at the 6-month follow-up assessment. DISCUSSION: We are testing well-studied and available intervention components to support PWIDLH to reduce drug use and improve their mental health and engagement in HIV care. The intervention design will allow for a better understanding of how these components work in combination and can be optimized for the setting. TRIAL REGISTRATION: This project was registered at clinicaltrials.gov (NCT05377463) on May 17th, 2022.
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Usuários de Drogas , Infecções por HIV , Humanos , Infecções por HIV/psicologia , Texas , México , Aconselhamento , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Surgical procedures have an inherent feature, which is the sequence of steps. Moreover, studies have shown variability in surgeons' performances, which is valuable to expose residents to different ways to perform a procedure. However, it is unclear how to include the sequence of steps in training programs. METHODS: We conducted a systematic review, including studies reporting explicit teaching of a standard sequence of steps, where assessment considered adherence to a standard sequence, and where faculty or students at any level participated. We searched for articles on PubMed, EMBASE, CINAHL, Web of Science, and Google Scholar databases. RESULTS: We selected nine articles that met the inclusion criteria. The main strategy to teach the sequence was to use videos to demonstrate the procedure. The simulation was the main strategy to assess the learning of the sequence of steps. Non-standardized scoring protocols and written tests with variable validity evidence were the instruments used to assess the learning, and were focused on adherence to a standard sequence and the omission of steps. CONCLUSIONS: Teaching and learning assessment of a standard sequence of steps is scarcely reported in procedural skills training literature. More research is needed to evaluate whether the new strategies to teach and assess the order of steps work. We recommend the use of Surgical Process Models and Surgical Data Science to incorporate the sequence of steps when teaching and assessing procedural skills.
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Aprendizagem , Estudantes , Humanos , Docentes , Competência ClínicaRESUMO
RESUMEN Introducción: El trabajo de investigación que se muestra en este artículo, ofrece una respuesta a la carencia de documentos orientadores para el direccionamiento del proceso de enseñanza aprendizaje de los pasos y carreras como elementos técnicos de enlace en los ejercicios competitivos de gimnasia rítmica; lo que a su vez, constituye un apoyo a la aplicación del Programa Integral de Preparación del Deportista (PIPD 2017-2020) y de soporte de capacitación a las entrenadoras encargadas de la preparación de las gimnastas. Objetivo: Ello encaminó el objetivo de la investigación a la elaboración de una guía metodológica en formato multimedia que sirva a las entrenadoras en el proceso de enseñanza de estos elementos contenidos en el PIPD. Materiales y métodos: Los métodos de investigación de nivel teórico utilizados (análisis y síntesis, enfoque de sistema) y los de nivel empírico (la encuesta, la entrevista y el criterio de especialista, el análisis de documentos y la observación de videos). Resultados: Se demuestra la afectación agravada de la enseñanza por los diversos modelos técnicos metodológicos actuantes. Conclusiones: Se concluye planteando que una guía metodológica debe contener la descripción técnica y su metodología de enseñanza, los errores más comunes, elementos de preparación especial para la consecución y las recomendaciones.
RESUMO Introdução: O trabalho de pesquisa mostrado neste artigo, oferece uma resposta à falta de documentos orientadores para a direção do processo de ensino-aprendizagem das etapas e corridas como elementos técnicos de ligação nos exercícios competitivos da ginástica rítmica; o que, por sua vez, constitui um apoio para a aplicação do Programa Integral de Preparação do Atleta (PIPD 2017-2020) e de apoio ao treinamento dos treinadores encarregados da preparação dos ginastas. Objetivo: Isto levou o objetivo da pesquisa à elaboração de um guia metodológico em formato multimídia que serve aos treinadores no processo de ensino destes elementos contidos no PIPD. Materiais e métodos: Os métodos de pesquisa utilizados foram teóricos (análise e síntese, abordagem de sistema) e empíricos (pesquisa, entrevista e critérios especializados, análise de documentos e observação de vídeo). Resultados: A afetação agravada do ensino pelos vários modelos metodológicos de atuação técnica é demonstrada. Conclusões: Conclui-se propondo que um guia metodológico deve conter a descrição técnica e sua metodologia de ensino, os erros mais comuns, elementos de preparação especial para a realização e recomendações.
ABSTRACT Introduction: The research work shown in this article offers a response to the lack of guiding documents for the direction of the teaching-learning process of the steps and runs as technical elements of connection in the competitive exercises of rhythmic gymnastics; which, in turn, constitutes support for the application of the Comprehensive Program for the Preparation of the Athlete (PIPD 2017-2020) and training support for the coaches in charge of preparing the gymnasts. Objective: This directed the objective of the research to the elaboration of a methodological guide in multimedia format that serves the trainers in the process of teaching these elements contained in the PIPD. Materials and methods: The theoretical level research methods used (analysis and synthesis, system approach) and the empirical level (survey, interview and specialist criteria, document analysis and video observation). Results: The aggravated affectation of teaching by the various acting methodological technical models is demonstrated. Conclusions: It is concluded by stating that a methodological guide must contain the technical description and its teaching methodology, the most common errors, elements of special preparation for achievement and recommendations.
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The two-step protocol (2 S) is currently used for boar semen cryopreservation. In this method, the cryoprotectant penetrant agents (CPAs) are added at 5 °C to reduce the toxicity of CPAs. An alternative is the one-step protocol (1 S), which is easier, cheaper, and reduces the necessity of equipment, but could increase the toxicity of CPAs. Currently, there are no studies that compared both protocols for boar semen cryopreservation. This experiment aimed to study the effect of cryopreservation protocol (1 S vs 2 S) on boar spermatozoa. In the one-step protocol, after centrifugation, the spermatozoa pellet was resuspended at 17 °C in the extender containing CPAs to achieve a concentration of 1 × 109 spermatozoa/mL and then submitted to cryopreservation. For the two-step protocol, the sperm pellet was resuspended in fraction A at 17 °C to achieve a concentration of 1.5 × 109 spermatozoa/ mL, and then allowed to cool to 5º C before fraction B with CPA was added to the sample to achieve a final concentration of 1 × 109 spermatozoa/mL and followed by freezing. The cryopreservation protocol did not impact total motility at 5 °C (1 S: 78.5 % vs 2 S: 79 %, p > 0.05). After thawing, the two-step protocol improved (p < 0.05) total (1 S: 18.2 % vs 2 S: 29.5 %) and progressive motility (1 S: 9 % vs 2 S: 15%). Further, the 2 S protocol increased (p < 0.05) the percentage of rapid spermatozoa (1 S: 8.7 % vs 2 S: 14.6 %) and spermatozoa with intact plasma and acrosomal membrane (IAIP) (1 S: 40.5 % vs 2 S: 61.5 %), and increased (p < 0.05) live sperm cells with high mitochondrial potential (MHIP) (1 S: 42.9 % vs 2 S: 60 %). The boar semen cryopreservation method (TRT) did not (p > 0.05) alter membrane lipid disorder, lipid peroxidation, and superoxide anion. Thus, the best method for boar semen cryopreservation is the two-step protocol.
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Análise do Sêmen , Preservação do Sêmen , Suínos , Masculino , Animais , Análise do Sêmen/veterinária , Preservação do Sêmen/veterinária , Preservação do Sêmen/métodos , Sêmen , Criopreservação/veterinária , Criopreservação/métodos , Espermatozoides , Crioprotetores/farmacologia , Motilidade dos EspermatozoidesRESUMO
La formación de la cultura ambiental en el profesor de Educación Física resulta ser un factor de importancia en la preparación integral de este profesional. El objetivo de este estudio se centra en: proponer un sistema de talleres metodológicos orientados a la apropiación de la cultura ambiental del profesor de la disciplina Educación Física en la Universidad de Oriente de Santiago de Cuba. La investigación posee un enfoque mixto de tipo explicativa. Se aplicaron métodos teóricos y empíricos, técnicas e instrumentos que permitieron acopiar la información necesaria para el estudio. Se efectuó un diagnóstico a 15 profesores de la disciplina Educación Física en la Universidad de Oriente. Sus resultados expresaron las insuficiencias en la cultura ambiental del profesor de la disciplina Educación Física. En el procesamiento de los datos, se utilizó la estadística de contraste: prueba W de Kendall y prueba de T-Student, con un nivel de significación establecido en 0.05. La concordancia de los criterios emitidos por los especialistas consultados y la diferencia de los resultados entre el pretest y postest y con el grupo control, ambos con una significación de 0.00, permitió valorar de factible y funcional la propuesta.
A conformação da cultura ambiental no professor de Educação Física é um importante fator para a preparação integral deste profissional. O objetivo deste estudo é: propor um sistema de oficinas metodológicas orientadas para a apropriação da cultura ambiental do professor de Educação Física na Universidade de Oriente, em Santiago de Cuba. A pesquisa tem uma abordagem explicativa mista. Métodos, técnicas e instrumentos teóricos e empíricos foram utilizados para coletar as informações necessárias para o estudo. Foi realizado uma diagnose em 15 professores de educação física na Universidade de Oriente. Os resultados revelaram as deficiências na cultura ambiental dos professores de Educação Física. No processamento dos dados, foram usadas estatísticas de contraste: teste W de Kendall e teste T de Student, com um nível de significância fixado em 0,05. A coincidência dos critérios formulados pelos especialistas consultados e a diferença de desempenho entre o pré-teste e o pós-teste e com o grupo de controle, ambos com um significado de 0,00, nos permitiu avaliar a proposta como viável e funcional.
The formation of environmental culture in the Physical Education teacher turns out to be an important factor in the comprehensive preparation of this professional. The objective of this study is focused on: proposing a system of methodological workshops aimed at the appropriation of the environmental culture of the professor of the Physical Education discipline at the Universidad de Oriente de Santiago de Cuba. The research has a mixed explanatory approach. Theoretical and empirical methods, techniques and instruments were applied that made it possible to collect the necessary information for the study. A diagnosis was made to 15 professors of the Physical Education discipline at the Universidad de Oriente. Their results expressed the insufficiencies in the environmental culture of the professor of the Physical Education discipline. In data processing, the contrast statistic was used: Kendall's W test and Student's T test, with a level of significance set at 0.05. The concordance of the criteria issued by the specialists consulted and the difference in the results between the pre-test and post-test and with the control group, both with a significance of 0.00, allowed the proposal to be assessed as feasible and functional.
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Research is very competitive but vital in medical training at all levels and disciplines. Given the evidence-based practice, people are reinforced to adopt a constant change attitude and critically appraise all the literature to make the best medical decisions. Nonetheless, the motivation to generate new knowledge and scientific research is relegated to small groups due to multiple factors. Such as the lack of research education from early stages in medical training, the absence of early results, and the lack of mentors willing to sponsor a person who wants to begin this way. This mini review would like to highlight the importance of pursuing a medical research career; therefore, we recommend beginning in the long run.
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Pesquisa Biomédica , Mentores , HumanosRESUMO
Rethinking IDH-wildtype glioblastoma through its unique features can help researchers find innovative and effective treatments. It is currently emerging that, after decades of therapeutic impasse, some traditional concepts regarding IDH-wildtype glioblastoma need to be supplemented and updated to overcome therapeutic resistance. Indeed, multiple clinical aspects and recent indirect and direct experimental data are providing evidence that the supratentorial brain parenchyma becomes entirely and quiescently micro-infiltrated long before primary tumor bulk growth. Furthermore, they are indicating that the known micro-infiltration that occurs during the IDH-wildtype glioblastoma growth and evolution is not at the origin of distant relapses. It follows that the ubiquitous supratentorial brain parenchyma micro-infiltration as a source for the development of widespread distant recurrences is actually due to the silent stage that precedes tumor growth rather than to the latter. All this implies that, in addition to the heterogeneity of the primary bulk, there is a second crucial cause of therapeutic resistance that has never hitherto been identified and challenged. In this regard, the ancestral founder cancer stem cell (CSC) appears as the key cell that can link the two causes of resistance.
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Neoplasias Encefálicas , Glioblastoma , Neoplasias Encefálicas/classificação , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/terapia , Glioblastoma/classificação , Glioblastoma/diagnóstico , Glioblastoma/genética , Glioblastoma/terapia , Humanos , Isocitrato Desidrogenase/genética , Recidiva Local de Neoplasia , Segunda Neoplasia PrimáriaRESUMO
The aim of this study was to develop methodologies to obtain fish protein concentrates from tambacu filleting residues, characterize their physical-chemical composition and evaluate their sensory profile. Concentrates were prepared by one of three methodologies: cooking of the raw material and subsequent drying (FPC1); cooking, drying, lipid removal with ethanol at 70 °C and final drying (FPC2); and three washing steps of the raw material with ethanol at 70 °C and drying (FPC3). FPC2 had a lower final yield (15.5%) and chroma a* (1.77) and chroma b* values (14.12) but higher moisture (5.22%) and protein content (80.39%) and luminosity (74.97), in addition to having the weakest fish taste compared to FPC1 and FPC3. FPC1 had the strongest odour, darkest colour, and strongest fish taste compared to FPC2 and FPC3. Ash, pH values, and water activity were not different between the concentrates. It is concluded that the methodology where lipid removal steps are carried out after cooking and drying (FPC2) is more effective for the removal of lipids and deodorization of tambacu protein concentrate.(AU)
Este trabalho teve por objetivo desenvolver metodologias para a obtenção de concentrados proteicos de pescado a partir de aparas da filetagem de tambacu, caracterizando sua composição físico-química e perfil sensorial. Foram utilizadas três metodologias: cozimento da matéria-prima e posterior secagem (CP1), cozimento, secagem, deslipidificação com etanol a 70°C e secagem final (CP2) e três lavagens da matéria-prima com etanol a 70°C e secagem (CP3). O CP2 apresentou o menor rendimento final (15,5%), porém maior teor de umidade (5,22%), proteína (80,39%) e luminosidade (74,97), além de menores médias para croma a* (1,77), croma b * (14,12), além de sabor de peixe mais fraco comparado aos CP1 e CP3. O CP1 apresentou odor mais forte, cor mais escura e o sabor de peixe mais forte em relação ao CP2 e CP3. Os valores de pH e atividade de água não foram diferentes entre os concentrados. Conclui-se que a metodologia de deslipidificação após o cozimento e secagem (CP2) é mais eficaz para a remoção dos lipídeos e desodorização do concentrado proteico de tambacu.(AU)
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Animais , Sensação , Characidae , Conservação de Alimentos/métodos , Alimentos para Praticantes de Atividade FísicaRESUMO
BACKGROUND: Step quantification is a good way to characterize the mobility and functional status of individuals with some functional disorder. Therefore, a validation study may lead to the feasibility of devices to stimulate an increase in the number of steps and physical activity level of individuals with Parkinson's Disease (PD). AIM: To investigate the validity of mHealth devices to estimate the number of steps in individuals with PD and compare the estimate with a standard criterion measure. METHOD: An observational study in a university laboratory with 34 individuals with idiopathic PD. The number of steps was measured using mHealth devices (Google Fit, Health, STEPZ, Pacer, and Fitbit INC®), and compared against a criterionstandard measure during the Two-Minute Walk Test using habitual speed. RESULTS: Our sample was 82% men with a Hoehn and Yahr mean of 2.3 ± 1.3 and mean walking speed of 1.2 ± 0.2 m/s. Positive and statistically significant associations were found between Google Fit (r = 0.92; p < 0.01), STEPZ (r = 0.91; p < 0.01), Pacer (r = 0.77; p < 0.01), Health (r = 0.54; p < 0.01), and Fitbit Inc® (r = 0.82; p < 0.01) with the criterion-standard measure. CONCLUSIONS: GoogleFit, STEPZ, Fitbit Inc.®, Pacer, and Health are valid instruments to measure the number of steps over a given period of time with moderate to high correlation with the criterion-standard in individuals with PD. This result shows that technology such as smartphone applications and activity monitor can be used to assess the number of steps in individuals with PD, and allows the possibility of using this technology for assessment and intervention purposes.
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Aplicativos Móveis , Doença de Parkinson , Telemedicina , Feminino , Humanos , Masculino , Teste de Caminhada , Caminhada , Velocidade de CaminhadaRESUMO
This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.
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Hispânico ou Latino , Meios de Transporte , Adulto , Exercício Físico , Feminino , Humanos , América Latina , Masculino , Estado NutricionalRESUMO
Abstract Background: The Baby Friendly Hospital Initiative has proven to be effective to increase exclusive and prolonged breastfeeding. Material and methods: Longitudinal study, in two hospitals of second level, in the period from 2015 to 2018. A percentage above 85% in each step was considered acceptable. The statistical analysis was descriptive using student's t test to compare the mean between the two hospitals and ANOVA to compare the mean throughout time in SPSS v.25. Results: Steps 1 and 7 were different between the hospitals with p = 0.010 and p = 0.023, respectively. In the follow-up, General Zone Hospital No. 5 kept steps 1, 2, 3, 7, 8, and 9 above 85%, while those who did not were steps 4, 5, 6, and 10, p = 0.37. Steps of General Hospital No. 15 that remained over 85% were 1, 3, 7, and 9; those that oscillated over time with a <85% rating were steps 2, 4, 5, 6, 8, and 10, p = 0.003. Conclusion: Monitoring child-friendly hospitals allow us to observe areas of opportunity to strengthen training for both clinical and non-clinical staff, pregnant women, the general population, and to improve exclusive and prolonged breastfeeding.
Resumen Introducción: La Iniciativa Hospital Amigo del Niño y la Niña ha probado ser efectiva para mejorar la lactancia materna exclusiva y prolongada. Material y métodos: Estudio longitudinal, en dos hospitales de segundo nivel, en el periodo de 2015 a 2018. Un porcentaje superior al 85% en cada paso se consideró aceptable. El análisis estadístico fue descriptivo, utilizando la prueba t de Student para comparar las medias entre los dos hospitales y el análisis de la varianza para compararlas a lo largo del tiempo empleando el programa SPSS v.25. Resultados: Los pasos 1 y 7 variaron entre los hospitales (con p = 0.010 y p = 0.023, respectivamente). En el seguimiento, el Hospital General de Zona (HGZ) 5 mantuvo los pasos 1, 2, 3, 7, 8 y 9 por encima del 85%, y < 85% los pasos 4, 5, 6 y 10 (p = 0.37). Las medidas del HGZ 15 que se mantuvieron > 85% fueron 1, 3, 7 y 9; aquellos que oscilaron a lo largo del tiempo con una calificación < 85% fueron los pasos 2, 4, 5, 6, 8 y 10 (p = 0.003). Conclusión: Estos seguimientos permiten observar áreas de oportunidad para reforzar la capacitación al personal clínico y no clínico como a las mujeres embarazadas, a la población en general y para mejorar la lactancia materna exclusiva y prolongada.
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In fermented milks inoculated with two thermophilic strains (Lactobacillus bulgaricus and Streptococcus thermophilus), guabiroba pulp (Campomanesia xanthocarpa O. Berg) was added in different concentrations: 5% (I5 sample) and 10% (I10 sample), compared to a control sample, with no pulp addition. In these fermented milks, Bifidobacterium BB-12 was added and the samples were submitted to a progressive gastrointestinal simulation in vitro. The cells count was performed, including the survival rates for all the progressive steps of the simulated digestion. Total phenolic content (TPC) and antioxidant activity analysis by FRAP (Ferric Reducing Antioxidant Power) and DPPH (2,2-diphenyl-1-picrylhydrazyl) were performed in all the gastrointestinal steps. Before and during the entire gastrointestinal tract, the Bifidobacterium BB-12 count was 8-9 log CFU g-1, above the recommended for a probiotic product, with a highlight in intestinal colon steps. The I10 sample showed the highest viable cell count, the highest total phenolic content and antioxidant activity throughout the entire gastric steps (p < 0.05). The fermented milk proved to be an effective matrix for the probiotic stability and incorporation of guabiroba components. Bioactive compounds present in the guabiroba pulp may have occasioned a prebiotic and protective effect on Bifidobacterium BB-12 after gastric conditions. The possible bioconversion of these compounds in more active forms can contribute to the absorption in epithelial cells, enhancing fermented milks with guabiroba pulp as important sources of dietary accessible bioactive compounds.
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Myrtaceae , Probióticos , Animais , Fermentação , Leite , Streptococcus thermophilusRESUMO
Asthma is a disease characterized by reversible bronchoconstriction, but some subjects develop fixed airflow obstruction (FAO). Subjects with FAO present more asthma symptoms and may have increased sedentary behavior; however, the effect of FAO on aerobic fitness and physical activity levels (PAL) remains poorly understood. AIM: To compare adolescents with asthma and FAO and adolescents with asthma without FAO in terms of aerobic fitness, PAL, muscle strength, and health-related quality of life (HRQoL). METHODS: This cross-sectional study included adolescents with asthma, both sexes, and aged 12-18 years. They were divided into two groups: FAO and non-FAO groups. The adolescents were diagnosed with asthma according to the Global Initiative for Asthma guidelines and underwent optimal pharmacological treatment for at least 12 months. FAO was diagnosed when the forced expiratory volume in the first second/forced vital capacity ratio was below the lower limit of the normal range after optimal treatment. Aerobic fitness, PAL, peripheral and respiratory muscle strength, and HRQoL were evaluated. RESULTS: No significant differences were observed between FAO and non-FAO groups regarding the peak oxygen uptake (34.6 ± 8.5 vs. 36.0 ± 8.4 mLO2 /min/kg), sedentary time (578 ± 126 vs. 563 ± 90 min/day), upper limb muscle strength (29.1 ± 5.9 vs. 28.1 ± 5.7 kilograms of force [kgf]), lower limb muscle strength (42.8 ± 8.6 vs. 47.6 ± 9.6 kgf), or HRQoL (5.1 ± 1.3 vs. 4.7 ± 1.4 score; p > .05). However, the FAO group exhibited a higher maximal expiratory pressure than the non-FAO group (111.5 ± 15.5 vs. 101.5 ± 15.0 cmH2 O, respectively). CONCLUSION: Our results suggest that FAO does not impair aerobic fitness, PAL, peripheral muscle strength, or HRQoL in adolescents with asthma. Furthermore, adolescents with asthma were physically deconditioned.
Assuntos
Asma/fisiopatologia , Aptidão Física , Qualidade de Vida , Adolescente , Asma/tratamento farmacológico , Asma/epidemiologia , Criança , Estudos Transversais , Exercício Físico , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Força Muscular , Doença Pulmonar Obstrutiva Crônica , Testes de Função Respiratória , Capacidade VitalRESUMO
BACKGROUND: Total knee arthroplasty (TKA) is commonly performed with proprietary, manual instrumentation provided by the surgical implant manufacturer. Registry studies and meta-analysis, with few outliers, have consistently shown similar functional outcomes and implant survival after TKA regardless of implant manufacturer, implant design, or surgical technique. We hypothesized that process mapping could identify areas for improvement in TKA instrumentation. METHODS: Seventeen TKA implant systems from 10 companies representing over 90% of all TKAs performed in the United States were evaluated. Instrumentation required for femoral, tibial, and patellar preparation was compared. The number of steps including surgical technician assembly steps, instrument handoffs, and surgeon steps were tabulated based off application of a standardized surgical flow, adjusted for manufacturer-recommended steps during completion of a TKA operation. RESULTS: Cruciate-retaining (CR) knee instrumentation in studied systems required 158-225 discrete steps and posterior-stabilized (PS) knees required 181-230 steps. With the fewest steps for femoral, tibial, and patellar instrumentation, CR and PS knee systems could be improved to 145 and 163 steps, respectively. The Arthrex iBalance and the Biomet Vanguard Microplasty required fewest steps among CR systems; the OrthoDevelopment Balanced and the Corin Unity required fewest steps among PS systems. CONCLUSIONS: Process mapping identified potential areas for improved instrumentation in all studied systems, suggesting the possibility to reduce operative steps broadly across the TKA industry. Patient outcomes were not evaluated by system. Future implant system design changes may do well to reduce unnecessary steps and instrumentation.
Assuntos
Artroplastia do Joelho , Prótese do Joelho , Osteoartrite do Joelho , Ligamento Cruzado Posterior , Humanos , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Patela/cirurgia , Ligamento Cruzado Posterior/cirurgiaRESUMO
The coffee processing wastewater (CPWW) requires treatment before being disposed of in the environment or reused due to its high organic and inorganic composition and a low pH. The indigenous microbiota from CPWW is highly diverse and could be selected as inoculums in treatment waste plants. Considering the physico-chemical characteristics of wastewater coffee, we elaborate on steps to select the microbial consortium that showed positive impact via decreasing the pollutant parameters of this effluent. The effectiveness was confirmed using wastewater from different origins with different chemical characteristics. A bacterial consortium composed by Serratia marcescens CCMA 1010 and CCMA 1012, Corynebacterium flavescens CCMA 1006, and Acetobacter indonesiensis CCMA 1002 was selected as the inoculums-based phenotypic assays. The mixed inoculum showed a highly active population (11.18 log CFU mL-1), promoting an 85% decrease in biochemical oxygen demand and a 60% decrease in chemical oxygen demand. There was also an 80% reduction in phosphorus and nitrogen. The final pH changed from 6.0 to 7.5. Additionally, the eco-toxicity using Daphnia similis was reduced by more than 59%. The microbial inoculum was efficient in the biological treatment in CPWWs, demonstrating the efficiency and robustness of the selected strains, independent of the physico-chemical characteristics of wastewater.
Assuntos
Águas Residuárias , Poluentes Químicos da Água , Acetobacter , Animais , Análise da Demanda Biológica de Oxigênio , Café , Corynebacterium , Eliminação de Resíduos LíquidosRESUMO
Increasing physical activity (PA) is a complex and challenging task in patients with chronic obstructive pulmonary disease (COPD). However, some questions are raised regarding the evaluation of PA in these patients: Have all aspects of PA evaluation in patients with COPD already been explored in the scientific literature and clinical practice? What is the clinical importance of assessing PA inequality? PA inequality is defined as the Gini coefficient (Ginicoef) of the PA distribution of a population and is already shown to have implications for public health in the general population. It is a simple tool that might allow a better understanding of PA disparities among different COPD populations, although to our knowledge there is no previous investigation of PA inequality in patients with COPD using the Ginicoef. In this perspective study we have provided examples of the Ginicoef use in different scenarios. Future studies might try to apply it in order to identify subpopulations with higher PA inequality, and perhaps are therefore more prone to benefit most from interventions specifically tailored to promote PA. In summary, we propose the quantification of PA inequality with the Ginicoef as a tool that might allow us to see PA even more comprehensively than we already do, expanding our perspective on PA in patients with COPD.