A systematic review of the methods used to assess race and racial disparities in uterine fibroid research

Context: Black women are reported to have a higher prevalence of uterine fibroids, and a threefold higher incidence rate and relative risk for clinical uterine fibroid development as compared to women of other races. Uterine fibroid research has reported that black women experience greater uterine fibroid morbidity and disproportionate uterine fibroid disease burden. With increased interest in understanding uterine fibroid development, and race being a critical component of uterine fibroid assessment, it is imperative that the methods used to determine the race of research participants is defined and the operational definition of the use of race as a variable is reported for methodological guidance, and to enable the research community to compare statistical data and replicate studies. ^ Objectives: To systematically review and evaluate the methods used to assess race and racial disparities in uterine fibroid research. ^ Data Sources: Databases searched for this review include: OVID Medline, NML PubMed, Ebscohost Cumulative Index to Nursing and Allied Health Plus with Full Text, and Elsevier Scopus. ^ Review Methods: Articles published in English were retrieved from data sources between January 2011 and March 2011. Broad search terms, uterine fibroids and race, were employed to retrieve a comprehensive list of citations for review screening. The initial database yield included 947 articles, after duplicate extraction 485 articles remained. In addition, 771 bibliographic citations were reviewed to identify additional articles not found through the primary database search, of which 17 new articles were included. In the first screening, 502 titles and abstracts were screened against eligibility questions to determine citations of exclusion and to retrieve full text articles for review. In the second screening, 197 full texted articles were screened against eligibility questions to determine whether or not they met full inclusion/exclusion criteria. ^ Results: 100 articles met inclusion criteria and were used in the results of this systematic review. The evidence suggested that black women have a higher prevalence of uterine fibroids when compared to white women. None of the 14 studies reporting data on prevalence reported an operational definition or conceptual framework for the use of race. There were a limited number of studies reporting on the prevalence of risk factors among racial subgroups. Of the 3 studies, 2 studies reported prevalence of risk factors lower for black women than other races, which was contrary to hypothesis. And, of the three studies reporting on prevalence of risk factors among racial subgroups, none of them reported a conceptual framework for the use of race. ^ Conclusion: In the 100 uterine fibroid studies included in this review over half, 66%, reported a specific objective to assess and recruit study participants based upon their race and/or ethnicity, but most, 51%, failed to report a method of determining the actual race of the participants, and far fewer, 4% (only four South American studies), reported a conceptual framework and/or operational definition of race as a variable. However, most, 95%, of all studies reported race-based health outcomes. The inadequate methodological guidance on the use of race in uterine fibroid studies, purporting to assess race and racial disparities, may be a primary reason that uterine fibroid research continues to report racial disparities, but fails to understand the high prevalence and increased exposures among African-American women. A standardized method of assessing race throughout uterine fibroid research would appear to be helpful in elucidating what race is actually measuring, and the risk of exposures for that measurement. ^

The role of environmental tobacco smoke in the development and exacerbation of asthma among children in developing countries: A systematic review

Environmental tobacco smoke (ETS) is an important indoor air pollutant associated with adverse effects on the respiratory health of the general population, especially people with asthma. ETS consists mainly of sidestream smoke from burning cigarettes and a smaller quantity of mainstream smoke which is exhaled by the smoker. At least one out of every three children is frequently exposed to ETS. ^ This paper reviewed the literature for studies on the role of ETS in the development and exacerbation of asthma among children in developing countries, specifically the low and middle income countries from the year 1980 to the present. The databases searched in this systematic review were: Ovid Medline; PubMed (National Library of Medicine); and Cumulative Index to Nursing and Allied Health (CINAHL) (EBSCOhost). Out of a total of 197 articles initially identified, only four studies (two from China, one from Macedonia and one from Brazil) were rated by two independent raters as being of high quality, and were selected for final abstraction, synthesis and evidence weighting. Results from these four studies suggests that, in developing countries, ETS exposure is associated with childhood asthma, and that asthma prevalence increases with an increase in the amount and duration of exposure to ETS. Similarly, exposure to ETS is associated with persistent cough, current night dry cough, and exacerbation of asthma symptoms. ^ Therefore, as is the case in developed nations, there is suggestive evidence in the literature that ETS exposure plays substantial role in the development and/or exacerbation of asthma among children in developing countries. To decrease the likelihood of new asthma development, enhance asthma control, and reduce the rate of medical service utilization in children exposed to ETS, smoking should be eliminated at home and in public places.^

Systematic literature review on internet-based interventions to prevent HIV transmission

Objective. To perform a systematic review of the internet based HIV prevention interventions.^ Data Source. Data resources including Ovid Medline, CINAHL (EBSCOhost and Psycinfo) were searched for the relevant articles. Study Selection: Studies were selected if the entire article was in English, Randomized control trial performed after 1998 till current, internet based aimed towards HIV/AIDS prevention. ^ Data Extraction. Each relevant article was coded using a code sheet which consisted of background information, study characteristics, study population information, program details, intervention and results. Data Synthesis: Total of seven relevant articles were coded and the information obtained was incorporated into the evidence tables for comparison.^ Conclusion. Overall the internet based HIV prevention studies have been very successful in recruiting large number of people but has not been able to show effective results due to high attrition. More research needs to be done in the area.^

Spectral Biomimetic Technique for Wood Classification Inspired by Human Echolocation

Los Clics palatales son sonidos interesantes para la ecolocalización humana pero tambien pueden utilizarse para determinar propiedades de la madera como para poder identificar tres especies diferentes de madera. Los resultados muestran que la ecolocalización humana tiene un enorme potencial.

Factors influencing metal price selection in mining feasibility studies

The mineral price assigned in mining project design is critical to determining the economic feasibility of a project. Nevertheless, although it is not difficult to find literature about market metal prices, it is much more complicated to achieve a specific methodology for calculating the value or which justifications are appropriate to include. This study presents an analysis of various methods for selecting metal prices and investigates the mechanisms and motives underlying price selections. The results describe various attitudes adopted by the designers of mining investment projects, and how the price can be determined not just by means of forecasting but also by consideration of other relevant parameters.

El discurso psicosocial en el Fuero de Familia Español

Los equipos psicosociales de la administración de justicia desde 1982 asesoran a los jueces en materia de conflictos familiares. El estudio que se presenta informa cómo se ha elaborado el discurso de este colectivo, y parte de la noción de discurso de Michel Foucault, desde su visión problemática.Luego recoge, a través de entrevistas y grupos de discusión, las opiniones de los trabajadores sociales y psicólogos de Madrid y Barcelona sobre la gestión del discurso. El estudio plantea un supuesto inicial sobre un menor protagonismo de los trabajadores sociales en la creación del relato que corresponde a una práctica común y busca una explicación y una descripción de lo sucedido. El trabajo que se presenta forma parte de una investigación académica básica y exploratoria de tipo cualitativo, basada en el principio fundamental de obtener los discursos principales para la resolución de los objetivos planteados como nuevas alternativas técnicas del trabajo psicosocial en los juzgados de familia y las tareas que desarrollarán los equipos psicosociales con las familias. Como conclusiones cabe resaltar que los trabajadores sociales forenses ven el futuro con optimismo, valoran su propia intervención en la ayuda a los jueces y creen que habría que impulsar una actuación profesional más propia. Los psicólogos y trabajadores sociales forenses entienden que hay un problema de falta de discurso psicosocial, por lo que es necesaria una mayor implicación en producir investigación en el área del discurso psicosocial. Aunque al evaluar la aportación de los trabajadores sociales la realidad resulta más pobre.

Efectos del té verde en el estado nutricional del ejercicio físico; revisión sistemática

Objetivo: evaluar el efecto del té verde o sus sucedáneos en el estado nutricional de los sujetos que realizan ejercicio físico. Metodología: las palabras clave son: “green tea” AND “exercise”, en cuatro bases de datos documentales: Pubmed, EBSCOHOST, OvidSP y Proquest. Criterios de inclusión (enero de 2010 y diciembre de 2014): edad adulta de la muestra (18-65 años, OMS); consumo de una cantidad cuantificada de té verde o sucedáneos, junto con la realización de ejercicio físico medible en intensidad. Resultados: de 260 artículos, se incluyeron el 5%. En el 69% se trata de estudios con un entrenamiento diseñado, y en el 92% se ha incluido un test de ejercicio para valorar parámetros. El 77% oscilan entre 20-40 años; las muestras varían entre 9 y 36 individuos. El 69% son de larga duración. El GTE ha sido el sucedáneo más utilizado (38%). El 92% de los ensayos han obtenido algún tipo de mejora (en el 92% fue significativa). Conclusiones: se recomienda aumentar las investigaciones sobre la clasificación de los ejercicios. Las mejoras significativas en el estado nutricional de los sujetos por la ingesta del té verde o sucedáneos son: IMC, peso, IGC, MM, INM, OM y MR. El GTE ha sido el que mayores resultados satisfactorios ha proporcionado. No existe homogeneidad en los resultados significativos. Se necesitan realizar nuevos ensayos clínicos. Las diferencias entre los ensayos clínicos revisados reflejan que las mejoras encontradas en el estado nutricional de los sujetos que realizan actividad física deben ser avaladas con nuevas investigaciones. Esto ayudará a crear evidencia en este tipo de aspectos.

Time-limited home-care reablement services for maintaining and improving the functional independence of older adults

Background: Reablement, also known as restorative care, is one possible approach to home-care services for older adults at risk of functional decline. Unlike traditional home-care services, reablement is frequently time-limited (usually six to 12 weeks) and aims to maximise independence by offering an intensive multidisciplinary, person-centred and goal-directed intervention. Objectives:Objectives To assess the effects of time-limited home-care reablement services (up to 12 weeks) for maintaining and improving the functional independence of older adults (aged 65 years or more) when compared to usual home-care or wait-list control group. Search methods:We searched the following databases with no language restrictions during April to June 2015: the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (OvidSP); Embase (OvidSP); PsycINFO (OvidSP); ERIC; Sociological Abstracts; ProQuest Dissertations and Theses; CINAHL (EBSCOhost); SIGLE (OpenGrey); AgeLine and Social Care Online. We also searched the reference lists of relevant studies and reviews as well as contacting authors in the field.Selection criteria:We included randomised controlled trials (RCTs), cluster randomised or quasi-randomised trials of time-limited reablement services for older adults (aged 65 years or more) delivered in their home; and incorporated a usual home-care or wait-list control group. Data collection and analysis:Two authors independently assessed studies for inclusion, extracted data, assessed the risk of bias of individual studies and considered quality of the evidence using GRADE. We contacted study authors for additional information where needed.Main results:Two studies, comparing reablement with usual home-care services with 811 participants, met our eligibility criteria for inclusion; we also identified three potentially eligible studies, but findings were not yet available. One included study was conducted in Western Australia with 750 participants (mean age 82.29 years). The second study was conducted in Norway (61 participants; mean age 79 years). We are very uncertain as to the effects of reablement compared with usual care as the evidence was of very low quality for all of the outcomes reported. The main findings were as follows. Functional status: very low quality evidence suggested that reablement may be slightly more effective than usual care in improving function at nine to 12 months (lower scores reflect greater independence; standardised mean difference (SMD) -0.30; 95% confidence interval (CI) -0.53 to -0.06; 2 studies with 249 participants). Adverse events: reablement may make little or no difference to mortality at 12 months’ follow-up (RR 0.97; 95% CI 0.74 to 1.29; 2 studies with 811 participants) or rates of unplanned hospital admission at 24 months (RR 0.94; 95% CI 0.85 to 1.03; 1 study with 750 participants). The very low quality evidence also means we are uncertain whether reablement may influence quality of life (SMD -0.23; 95% CI -0.48 to 0.02; 2 trials with 249 participants) or living arrangements (RR 0.92, 95% CI 0.62 to 1.34; 1 study with 750 participants) at time points up to 12 months. People receiving reablement may be slightly less likely to have been approved for a higher level of personal care than people receiving usual care over the 24 months’ follow-up (RR 0.87; 95% CI 0.77 to 0.98; 1 trial, 750 participants). Similarly, although there may be a small reduction in total aggregated home and healthcare costs over the 24-month follow-up (reablement: AUD 19,888; usual care: AUD 22,757; 1 trial with 750 participants), we are uncertain about the size and importance of these effects as the results were based on very low quality evidence. Neither study reported user satisfaction with the serviceAuthors’ conclusions:There is considerable uncertainty regarding the effects of reablement as the evidence was of very low quality according to our GRADE ratings. Therefore, the effectiveness of reablement services cannot be supported or refuted until more robust evidence becomes available. There is an urgent need for high quality trials across different health and social care systems due to the increasingly high profile of reablement services in policy and practice in several countries. 

The sexual health knowledge of people with intellectual disabilities: A review.

There is a growing recognition that people with disabilities have the same sexual needs and rights as people without disabilities. However, less attention is paid to the sexuality of people diagnosed with intellectual disabilities. This narrative review summarises what is currently known about the level of sexual health knowledge of people with intellectual disabilities. A literature review was conducted of the published literature using Google Scholar, PubMed, PsychInfo, EBSCOhost, and Science Direct. Forty eight articles were identified that addressed the question about the level of sexual health knowledge of people with intellectual disabilities. Overall, studies demonstrate that people with intellectual disabilities are highly variable in levels of sexual knowledge, but on average have a range of deficits in knowledge compared to non-disabled individuals. More tailored education and support in accessing formal and informal sources of information are needed.

Trazer a biblioteca no bolso: os serviços para dispositivos móveis nas bibliotecas académicas

Introdução – Os serviços de comunicação móvel para tablets, smartphones, e-book readers desenvolveram-se de forma extremamente rápida nos últimos anos assumindo-se como uma rede de aprendizagem privilegiada para os estudantes. Em 2012, 55% dos estudantes do ensino superior possuíam um smarthphone, 62% dispunham de um ipod e 21% tinham de um tablet. 67% usavam-nos em contexto académico. Objetivo – Apresentar de forma sucinta a resposta das bibliotecas de ensino superior ao crescimento da utilização dos dispositivos móveis e como é que os parceiros das bibliotecas, em especial os editores, estão a potenciar essa utilização. Métodos – A partir de uma seleção e análise de bibliografia sobre a temática realizou-se uma pesquisa na internet, nos sites de bibliotecas de ensino superior e nas páginas dos editores que permitisse aferir evidências. Resultados – Identificaram-se cinco serviços e 23 recursos. Discussão – Um primeiro serviço prende-se com a adaptação dos conteúdos dos websites das bibliotecas de forma a serem lidos por qualquer tipo de dispositivos. Outro serviço identificado foi a disponibilização do catálogo da biblioteca online tornando-o acessível aos dispositivos móveis, permitindo a pesquisa e a localização de informação, a reserva ou a renovação de documentos. Identificou-se o desenvolvimento de algumas coleções especificamente para os dispositivos móveis. Constatou-se a utilização de códigos QR para divulgar normas de funcionamento da biblioteca, recursos, o mapa, o contacto do serviço de referência e para geolocalização. Por fim verificou-se a utilização de SMS para informar os utilizadores sobre reservas, prazos de empréstimo, entre outras informações. O recurso mais comum na maioria dos sites analisados foi a disponibilização de uma versão do website para dispositivos móveis de que são exemplos a Cambridge Journals Online mobile, o EBSCOhost mobile, o SpringerLink, a OVIDToday, o UpToDate, a PubChase e a BrowZine. Com o objetivo de tornar os seus produtos acessíveis on-the go, oferecem inúmeras possibilidades, nomeadamente de pesquisa, de acesso a textos integrais, de elaboração de listas de interesse personalizadas, de leitura offline, entre outras que podemos encontrar na aplicação da EBSCOhost mobile, na JAMA Network, na OVIDToday, no portal de Periódicos CAPES ou na plataforma Ebrary da ProQuest. Em ferramentas como a UpToDate ou os aplicativos da Elsevier e da Micromedex é disponibilizada informação baseada na evidência e recomendações que podem ser aplicadas em consulta. Os gestores de referências bibliográficas como o Mendeley e o Zotero também acompanharam esta tendência e desenvolveram aplicações para dispositivos móveis. Para além disso funcionam de forma integrada com outras aplicações como a Browzine e a Pubchase. Conclusão – O recurso às tecnologias móveis é uma forma das bibliotecas manterem canais de comunicação com os utilizadores, mas embora existam muitas vantagens no uso das tecnologias móveis a implementação destes serviços implica um esforço financeiro e humano que nem todas as bibliotecas serão capazes de cumprir. Encontrar a forma de gerir este processo é o desafio que se impõe no futuro.

Ferulates and lignin structural composition in cork

The structure of lignin and suberin, and ferulic acid (FA) content in cork from Quercus suber L. were studied. Extractive-free cork (Cork), suberin, desuberized cork (Cork(sap)), and milled-cork lignins (MCL) from Cork and Cork(sap) were isolated. Suberin composition was determined by GC-MS/FID, whereas the polymers structure in Cork, Corksap, and MCL was studied by Py-TMAH and 2D-HSQC-NMR. Suberin contained 94.4% of aliphatics and 3.2% of phenolics, with 90% of omega-hydroxyacids and alpha,omega-diacids. FA represented 2.7% of the suberin monomers, overwhelmingly esterified to the cork matrix. Py-TMAH revealed significant FA amounts in all samples, with about 3% and 6% in cork and cork lignins, respectively. Py-TMAH and 2D-HSQC-NMR demonstrated that cork lignin is a G-lignin (>96% G units), with a structure dominated by beta-O-4' alkyl-aryl ether linkages (80% and 77% of all linkages in MCL and MCLsap, respectively), followed by phenylcoumarans (18% and 20% in MCL and MCLsap, respectively), and smaller amounts of resinols (ca. 2%) and dibenzodioxocins (1%). HSQC also revealed that cork lignin is heavily acylated (ca. 50%) exclusively at the side-chain gamma-position. Ferulates possibly have an important function in the chemical assembly of cork cell walls with a cross-linking role between suberin, lignin and carbohydrates.

Instrumentos para evaluación del riesgo de caídas en los ancianos residentes en la comunidad

Las caídas y el riesgo de caer aumentan con la edad y con el grado de fragilidad asociado al envejecimiento, siendo este el motivo por el cual el riesgo de caídas es un fenómeno de interés para los enfermeros. En Portugal, la Dirección General de Salud recomienda la realización de pruebas de evaluación de la movilidad, la capacidad física y funcional. Objetivo: Identificar los instrumentos utilizados para evaluar el riesgo de caída en el anciano residente en la comunidad. Método: Revisión sistemática de la literatura, cumpliendo las recomendaciones del Joanna Briggs Institute a través de la utilización del método PICo y de las recomendaciones PRISMA. El método PICo ayudó a definir los criterios de inclusión: Muestra (P) - los ancianos; Área de Interés (I) - instrumentos y pruebas que permiten evaluar el riesgo de caídas, y Contexto (Co) - vivir en la comunidad. La consulta bibliográfica fue realizada a través de las bases de datos: EBSCOHost®, CINAHL Complete y MEDLINE Complete, y utilizando los términos; fall, community dwelling, fall risk factors y tools escale. Resultados: Fueron seleccionados 24 estudios, en los que se identificaron seis escalas que evaluaban el riesgo de caídas, tres el miedo de caer y siete que evaluaban factores de riesgo predictivos del riesgo de caída, en ancianos que residen en la comunidad. Conclusiones: Los resultados destacan el número de instrumentos disponibles y la importancia de la utilización práctica por parte de los enfermeros de instrumentos válidos, fidedignos y sensibles, de modo de obtener diagnósticos precisos.

Beneficios da intervenção do enfermeiro de reabilitação na promoção da contingência urinária após AVC

Relatório de Estagio apresentado para obtenção do grau de Mestre na especialidade de Enfermagem de Reabilitação

Beneficios da intervenção do enfermeiro de reabilitação na promoção da contingência urinária após AVC

Relatório de Estagio apresentado para obtenção do grau de Mestre na especialidade de Enfermagem de Reabilitação