822 resultados para current medical knowledge
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Aim: To review the current knowledge about suicide in cancer patients. Method: We searchedspecialized databases using keywords for articles published in the last two decades (1990-2010),and compiled and reviewed them in order to: indicate the prevalence of suicide in cancer patientsworldwide and in Colombia, differentiating the data by sex and age; establish the types of cancerthat are associated with suicide, identify risk factors for committing or considering suicide andpresent the strategies of professional and psychological intervention directed at cancer patientswith suicidal ideation and suicide attempts. The present article is a review of the information on thesubject. Results: We found that: in cancer patients, the suicide rate is two times higher thanin the general population; depression, suicidal ideation and location of cancer are some of therisk factors for suicide, and there is a lack of published guidelines for professional managementof the suicidal patient with cancer. Conclusion: The need to carry out research on the topic ofsuicide in cancer patients was established.
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Data on the potential health benefits of dietary flavanols and procyanidins, especially in the context of cardiovascular health, are considerable and continue to accumulate. Significant progress has been made in flavanol analytics and the creation of phytonutrient-content food databases, and novel data emanated from epidemiological investigations as well as dietary intervention studies. However, a comprehensive understanding of the pharmacological properties of flavanols and procyanidins, including their precise mechanisms of action in vivo, and a conclusive, consensus-based accreditation of a causal relationship between intake and health benefits in the context of primary and secondary cardiovascular disease prevention is still outstanding. Thus, the objective of this review is to identify and discuss key questions and gaps that will need to be addressed in order to conclusively demonstrate whether or not dietary flavanols and procyanidins have a role in preventing, delaying the onset of, or treating cardiovascular diseases, and thus improving human life expectancy and quality of life.
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The retention of peatland carbon (C) and the ability to continue to draw down and store C from the atmosphere is not only important for the UK terrestrial carbon inventory, but also for a range of ecosystem services, the landscape value and the ecology and hydrology of ~15% of the land area of the UK. Here we review the current state of knowledge on the C balance of UK peatlands using several studies which highlight not only the importance of making good flux measurements, but also the spatial and temporal variability of different flux terms that characterise a landscape affected by a range of natural and anthropogenic processes and threats. Our data emphasise the importance of measuring (or accurately estimating) all components of the peatland C budget. We highlight the role of the aquatic pathway and suggest that fluxes are higher than previously thought. We also compare the contemporary C balance of several UK peatlands with historical rates of C accumulation measured using peat cores, thus providing a long-term context for present-day measurements and their natural year-on-year variability. Contemporary measurements from 2 sites suggest that current accumulation rates (–56 to –72 g C m–2 yr–1) are at the lower end of those seen over the last 150 yr in peat cores (–35 to –209 g C m–2 yr–1). Finally, we highlight significant current gaps in knowledge and identify where levels of uncertainty are high, as well as emphasise the research challenges that need to be addressed if we are to improve the measurement and prediction of change in the peatland C balance over future decades.
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Good information and career guidance about what post-compulsory educational routes are available and where these routes lead is important in ensuring that young people make choices that are most appropriate to their needs and aspirations. Yet the Association of School and College Leaders (2011) express fears that future provision will be inadequate. This paper reports the findings from an on-line survey of 300 secondary school teachers, and follow up telephone interviews with 18 in the South East of England which explored teachers’ experiences of delivering post-compulsory educational and career guidance and their knowledge and confidence in doing so. Results suggest that teachers lack confidence in delivering information, advice and guidance outside their own area of specialism and experience. In particular, teachers knew little in relation to alternative local provision of post-16 education and lacked knowledge of more non-traditional, vocational routes. This paper will therefore raises important policy considerations with respect to supporting teachers’ knowledge, ability and confidence in delivering information in relation to future pathways and career guidance.
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Background: Since their inception, Twitter and related microblogging systems have provided a rich source of information for researchers and have attracted interest in their affordances and use. Since 2009 PubMed has included 123 journal articles on medicine and Twitter, but no overview exists as to how the field uses Twitter in research. // Objective: This paper aims to identify published work relating to Twitter indexed by PubMed, and then to classify it. This classification will provide a framework in which future researchers will be able to position their work, and to provide an understanding of the current reach of research using Twitter in medical disciplines. Limiting the study to papers indexed by PubMed ensures the work provides a reproducible benchmark. // Methods: Papers, indexed by PubMed, on Twitter and related topics were identified and reviewed. The papers were then qualitatively classified based on the paper’s title and abstract to determine their focus. The work that was Twitter focused was studied in detail to determine what data, if any, it was based on, and from this a categorization of the data set size used in the studies was developed. Using open coded content analysis additional important categories were also identified, relating to the primary methodology, domain and aspect. // Results: As of 2012, PubMed comprises more than 21 million citations from biomedical literature, and from these a corpus of 134 potentially Twitter related papers were identified, eleven of which were subsequently found not to be relevant. There were no papers prior to 2009 relating to microblogging, a term first used in 2006. Of the remaining 123 papers which mentioned Twitter, thirty were focussed on Twitter (the others referring to it tangentially). The early Twitter focussed papers introduced the topic and highlighted the potential, not carrying out any form of data analysis. The majority of published papers used analytic techniques to sort through thousands, if not millions, of individual tweets, often depending on automated tools to do so. Our analysis demonstrates that researchers are starting to use knowledge discovery methods and data mining techniques to understand vast quantities of tweets: the study of Twitter is becoming quantitative research. // Conclusions: This work is to the best of our knowledge the first overview study of medical related research based on Twitter and related microblogging. We have used five dimensions to categorise published medical related research on Twitter. This classification provides a framework within which researchers studying development and use of Twitter within medical related research, and those undertaking comparative studies of research relating to Twitter in the area of medicine and beyond, can position and ground their work.
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Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis of clinical pathways is a promising strategy to improve medical quality effectively. However, the clinical pathway knowledge has not been fully integrated into treatment process and thus cannot provide comprehensive support to the actual work practice. Therefore this paper proposes a knowledgebased clinical pathway management method which contributes to make use of clinical knowledge to support and optimize medical practice. We have developed a knowledgebased clinical pathway management system to demonstrate how the clinical pathway knowledge comprehensively supports the treatment process. The experiences from the use of this system show that the treatment quality can be effectively improved by the extracted and classified clinical pathway knowledge, seamless integration of patient-specific clinical pathway recommendations with medical tasks and the evaluating pathway deviations for optimization.
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Rhizoremediation is a bioremediation technique whereby enhanced microbial degradation of organic contaminants occurs within the plant root zone (rhizosphere). It is considered an effective and affordable ‘green technology’ for remediating soils contaminated with petroleum hydrocarbons (PHCs). This paper critically reviews the potential role of root exuded compounds in rhizoremediation, with emphasis on commonly exuded low molecular weight aliphatic organic acid anions (carboxylates). The extent to which remediation is achieved shows wide disparity among plant species. Therefore, plant selection is crucial for the advancement and widespread adoption of this technology. Root exudation is speculated to be one of the predominant factors leading to microbial changes in the rhizosphere and thus the potential driver behind enhanced petroleum biodegradation. Carboxylates can form a significant component of the root exudate mixture and are hypothesised to enhance petroleum biodegradation by: i) providing an easily degradable energy source; ii) increasing phosphorus supply; and/or iii) enhancing the contaminant bioavailability. These differing hypotheses, which are not mutually exclusive, require further investigation to progress our understanding of plant–microbe interactions with the aim to improve plant species selection and the efficacy of rhizoremediation.
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Objectives. This study aimed to investigate the knowledge, attitudes and perceptionstowards contraceptive use and counselling among medical students in Maharashtra, India. Setting. Considerable global maternal mortality and morbidity could be avoided through theuse of effective contraception. In India, contraception services are frequently unavailable or there are obstacles to obtaining modern, reversible contraceptives. Participants. A cross-sectional descriptive study using a self-administered questionnaire was conducted among 1996 medical students in their fifth year of study at 27 medical colleges in the state of Maharashtra, India. Descriptive and analytical statistics interpreted the survey instrument and significant results were presented with 95% CI. Results. Respondents expressed a desire to provide contraceptive services. A few studentshad experienced training in abortion care. There were misconceptions about moderncontraceptive methods and the impact of sex education. Attitudes towards contraceptionwere mainly positive, premarital counselling was supported and the influence of traditional values and negative provider attitudes on services was recognised. Gender, area of upbringing and type of medical college did not change the results. Conclusions. Despite mostly positive attitudes towards modern contraceptives, sex education and family planning counselling, medical students in Maharashtra have misconceptions about modern methods of contraception. Preservice and in-service training in contraceptive counselling should be implemented in order to increase women's access to evidence-based maternal healthcare services.
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At present, gene transfection insufficient efficiency is a major drawback of non-viral gene therapy. The 2 main types of delivery systems deployed in gene therapy are based on viral or non-viral gene carriers. Several non-viral modalities can transfer foreign genetic material into the human body. To do so, polycation-based gene delivery methods must achieve sufficient efficiency in the transportation of therapeutic genes across various extracellular and intracellular barriers. These barriers include interactions with blood components, vascular endothelial cells and uptake by the reticuloendothelial system. Furthermore, the degradation of therapeutic DNA by serum nucleases is a potential obstacle for functional delivery to target cells. Cationic polymers constitute one of the most promising approaches to the use of viral vectors for gene therapy. A better understanding of the mechanisms by which DNA can escape from endosomes and traffic to enter the nucleus has triggered new strategies of synthesis and has revitalized research into new polycation-based systems. The objective of this review is to address the state of the art in gene therapy with synthetic and natural polycations and the latest advances to improve gene transfer efficiency in cells.
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A high prevalence of dental trauma exists and its effects on function and esthetics deserve the attention of general dentists. The aim of this study was to assess the level of general dental practitioners' (GDPs) knowledge about guidelines for dental avulsion and its prevention using a questionnaire. The 21-item questionnaire was distributed among 264 GDPs and the survey was realized between August-November 2006. The data obtained were statistically analyzed using descriptive analysis and Pearson's Chi-square test to determine associations between knowledge regarding emergency treatment and dentists from public or private dental schools and years of experience. The results showed that the participants exhibited appropriate knowledge concerning procedures in cases of tooth avulsion and its prevention. The number of correct answers was low in relation to recommended treatment at the site of injury. Storage medium, preparation of the alveolus and splint time for receiving the avulsed tooth received a high number of correct answers. One statistically significant association between years of experience and recommended treatment at the site of the injury in the case an avulsed tooth (KH2 = 9.384, P = 0.009). In conclusion, this survey showed appropriate knowledge of dental avulsion management and its prevention among the surveyed dentists. The findings also showed that communication between dentists and the population is deficient, especially concerning practitioners of high risk and contact sports.
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Bacterial cellulose (BC) has established to be a remarkably versatile biomaterial and can be used in wide variety of applied scientific endeavours, especially for medical devices. In fact, biomedical devices recently have gained a significant amount of attention because of an increased interest in tissue-engineered products for both wound care and the regeneration of damaged or diseased organs. Due to its unique nanostructure and properties, microbial cellulose is a natural candidate for numerous medical and tissue-engineered applications. Hydrophilic bacterial cellulose fibers of an average diameter of 50 nm are produced by the bacterium Acetobacter xylinum, using a fermentation process. The microbial cellulose fiber has a high degree of crystallinity. Using direct nanomechanical measurement, determined that these fibers are very strong and when used in combination with other biocompatible materials, produce nanocomposites particularly suitable for use in human and veterinary medicine. Moreover, the nanostructure and morphological similarities with collagen make BC attractive for cell immobilization and cell support. The architecture of BC materials can be engineered over length scales ranging from nano to macro by controlling the biofabrication process. The chapter describes the fundamentals, purification and morphological investigation of bacterial cellulose. This chapter deals with the modification of microbial cellulose and how to increase the compatibility between cellulosic surfaces and a variety of plastic materials. Furthermore, provides deep knowledge of fascinating current and future applications of bacterial cellulose and their nanocomposites especially in the medical field, materials with properties closely mimic that of biological organs and tissues were described. © Springer-Verlag Berlin Heidelberg 2013.
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Abstract Background The Atlantic rainforest ecosystem, where bromeliads are abundant, provides an excellent environment for Kerteszia species, because these anophelines use the axils of those plants as larval habitat. Anopheles (K.) cruzii and Anopheles (K.) bellator are considered the primary vectors of malaria in the Atlantic forest. Although the incidence of malaria has declined in some areas of the Atlantic forest, autochthonous cases are still registered every year, with Anopheles cruzii being considered to be a primary vector of both human and simian Plasmodium. Methods Recent publications that addressed ecological aspects that are important for understanding the involvement of Kerteszia species in the epidemiology of malaria in the Atlantic rainforest in the Neotropical Region were analysed. Conclusion The current state of knowledge about Kerteszia species in relation to the Atlantic rainforest ecosystem was discussed. Emphasis was placed on ecological characteristics related to epidemiological aspects of this group of mosquitoes. The main objective was to investigate biological aspects of the species that should be given priority in future studies.
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Abstract Background Educational computer games are examples of computer-assisted learning objects, representing an educational strategy of growing interest. Given the changes in the digital world over the last decades, students of the current generation expect technology to be used in advancing their learning requiring a need to change traditional passive learning methodologies to an active multisensory experimental learning methodology. The objective of this study was to compare a computer game-based learning method with a traditional learning method, regarding learning gains and knowledge retention, as means of teaching head and neck Anatomy and Physiology to Speech-Language and Hearing pathology undergraduate students. Methods Students were randomized to participate to one of the learning methods and the data analyst was blinded to which method of learning the students had received. Students’ prior knowledge (i.e. before undergoing the learning method), short-term knowledge retention and long-term knowledge retention (i.e. six months after undergoing the learning method) were assessed with a multiple choice questionnaire. Students’ performance was compared considering the three moments of assessment for both for the mean total score and for separated mean scores for Anatomy questions and for Physiology questions. Results Students that received the game-based method performed better in the pos-test assessment only when considering the Anatomy questions section. Students that received the traditional lecture performed better in both post-test and long-term post-test when considering the Anatomy and Physiology questions. Conclusions The game-based learning method is comparable to the traditional learning method in general and in short-term gains, while the traditional lecture still seems to be more effective to improve students’ short and long-term knowledge retention.