A realist synthesis of educational interventions to improve nutrition care competencies and delivery by doctors and other healthcare professionals

Objective: To determine what, how, for whom, why, and in what circumstances educational interventions to improve the delivery of nutrition care by doctors and other healthcare professionals work?

Design: Realist synthesis following a published protocol and reported following Realist and Meta-narrative Evidence Synthesis: Evolving Standards (RAMESES) guidelines. A multidisciplinary team searched Medline, CINAHL, ERIC, EMBASE, PsyINFO, Sociological Abstracts, Web of Science, Google Scholar, and Science Direct for published and unpublished (grey) literature. The team identified studies with varied designs; appraised their ability to answer the review question; identified relationships between contexts, mechanisms, and outcomes (CMOs); and entered them into a spreadsheet configured for the purpose. The final synthesis identified commonalities across CMO configurations.

Results: Over half of the 46 studies from which we extracted data originated from the US. Interventions that improved the delivery of nutrition care improved skills and attitudes rather than just knowledge; provided opportunities for superiors to model nutrition care; removed barriers to nutrition care in health systems; provided participants with local, practically relevant tools and messages; and incorporated non-traditional, innovative teaching strategies. Operating in contexts where student and qualified healthcare professionals provided nutrition care in both developed and developing countries, these interventions yielded health outcomes by triggering a range of mechanisms, which included: feeling competent; feeling confident and comfortable; having greater self-efficacy; being less inhibited by barriers in healthcare systems; and feeling that nutrition care was accepted and recognised.

Conclusion: These findings show how important it is to move education for nutrition care beyond the simple acquisition of knowledge. They show how educational interventions embedded within systems of healthcare can improve patients’ health by helping health students and professionals to appreciate the importance of delivering nutrition care and feel competent to deliver it.

Enraizamento de mini-estacas de jabuticabeiras, pitangueira, araçazeiro amarelo e sete capoteiro

The most native fruit trees are belonging to Myrtaceae family, which it have as main marketing potential their fruit. Despite the wide acceptance of the fruits of these native fruit cultura, the establishment of commercial orchards is still necessary, because if it prevails extraction in the forest. To start the cultivo in the orchard, the first point is on the mother plant choice, which should provide superior characteristics when compared to other genotypes. Then, it is necessary to choose the method to can produce satisfactory amount of seedlings and preferably without it to lose the mother plant characteristics. For this, it adopts the asexual thechniques, with option for grafting, cuttings and air layering. These techniques when tested with native fruits tree, it proved limiting in theses results, with this, it should to test other it to recommend its use, especially, those fruit native of higher potential as jabuticaba tree, pitanga tree, sete capote tree and araça amarelo tree. The aim of this study was to test the use of asexual propagation through mini-cuttings in these native fruit trees, according to the time of collection, the mini-cutting length and concentration of IBA, as well as, it to relate the results of rooting with tryptophan extracted at certain times. The work was carried out at Universidade Tecnológica Federal do Paraná – Câmpus Dois Vizinhos, Brazil. The samples were collected each two months. The mini-cutting were prepared with 6 or 8 cm, with a pair of leaves reduced to 25% of the original size. The mini-cuttings had their base immersed in liquid solution of indole-butyric acid (IBA) in the concentrations of 0, 3000 and 6000 mg L-1 and then were placed in tubes containing commercial substrate. The experimental design was completely randomized with factorial 2 x 3 x 6 (mini-cutting length x IBA concentration x time of collection), with four replications, it being each plot varied according to the amount of shoots obtained by period time. After 120 days, the rooting and callus formation (%), average number of roots per mini-cutting and the average length of the roots were evaluated. After 60 days of these evaluations, the survival of mini-cuttings rooted after transplant was evaluated. It was evaluated also the production of mini-cuttings of each size in each period time. At the end of the experiment it was evaluated the percentage of survival of mother plantlets. For analysis of tryptophan was used materials branches, leaves and twigs with leaves, taken from the materials used for the production of mini-cutting. It was recommended for hybrid jabuticaba tree the use mini-cutting with eight cm, treated with 6000 mg L-1 of IBA and collected in June. For jabuticaba tree of cabinho and araça amarelo tree the period for propagation by mini-cuttings should be in August, regardless of IBA concentration and length of the mini-cutting. In the jabuticaba tree sabara and sete capote tree is important to obtain more satisfactory results realized the collect in October or December, with the same independence of other levels tested in other factors. However, for sete capote tree should test other techniques to increase the efficiency of propagation. And with pitanga tree recommended to the collection in June, but with 6cm the application of 3000 mg L-1 of IBA and 8 cm with 6000 mg L-1 of IBA.

Physical properties of Physalis peruviana L

Physalis (Physalis peruviana L.), also known as cape gooseberry or ground-cherry, plays an important role in nutrition as an excellent base for dietetic products. Highly valued for its unique flavour, texture and colour, recent research has shown that physalis fruit is rich in many beneficial compounds. In this study, the diameter and mass of physalis fruits were measured, which can be used to calculate other biometric characteristics of the fruit, such as: surface area, volume or density. Other physical properties were measured, namely the colour coordinates, by means of a Chroma meter, whilst the textural parameters firmness and elasticity were measured with a texturometer. The following values were calculated for the physalis fruits analysed in the present work: 1.69 cm for average diameter; 8.98 cm2 for surface area, 2.51 cm3 for volume; 2.77 g for mass was, and 1.10 g/cm3 for density. The colour coordinates were 56.72 for lightness, 16.69 for redness, and 58.11 for yellowness. Skin firmness and elasticity were evaluated for texture attributes, and their average values were 2.40 N and 2.94 mm, respectively. The results of this work are in accordance

Sistematic, population genetics, propagation and conservation of Prunus azorica (Rosaceae)

Tese de Doutoramento, Biologia (Ecologia Vegetal), 25 de Junho de 2013, Universidade dos Açores.

A biochemical analysis into the co-translational folding of a G protein-coupled receptor; GPR35

The folding and targeting of membrane proteins poses a major challenge to the cell, as they must remain insertion competent while their highly hydrophobic transmembrane (TM) domains are transferred from the ribosome, through the aqueous cytosol and into the lipid bilayer. The biogenesis of a mature membrane protein takes place through the insertion and integration into the lipid bilayer. A number of TM proteins have been shown to gain some degree of secondary structure within the ribosome tunnel and to retain this conformation throughout maturation. Although studies into the folding and targeting of a number of membrane proteins have been carried out to date, there is little information on one of the largest class of eukaryotic membrane proteins; the G-protein-coupled receptors (GPCRs). This project studies the early folding events of the human ortholog of GPR35. To analyse the structure of the 1st TM domain, intermediates were generated and assessed by the biochemical method of pegylation (PEG-MAL). A structurally-similar microbial opsin (Bacterioopsin) was also used to investigate the differences in the early protein folding within eukaryotic and prokaryotic translation systems. Results showed that neither the 1st TM domain of GPR35 nor Bacterioopsin were capable of compacting in the ribosome tunnel before their N-terminus reached the ribosome exit point. The results for this assay remained consistent whether the proteins were translated in a eukaryotic or prokaryotic translation system. To examine the communication mechanism between the ribosome, the nascent chain and the protein targeting pathway, crosslinking experiments were carried out using the homobifunctional lysine cross-linker BS3. Specifically, the data generated here show that the nascent chain of GPR35 reaches the ribosomal protein uL23 in an extended conformation and interacts with the SRP protein as it exits the ribosome tunnel. This confirms the role of SRP in the co-translational targeting of GPR35. Using these methods insights into the early folding of GPCRs has been obtained. Further experiments using site-directed mutagenesis to reduce hydrophobicity in the 1st TM domain of GPR35, highlighted the mechanisms by which GPCRs are targeted to the endoplasmic reticulum. Confirming that hydrophobicity within the signal anchor sequence is essential of SRP-dependent targeting. Following the successful interaction of the nascent GPR35 and SRP, GPR35 is successfully targeted to ER membranes, shown here as dog pancreas microsomes (DPMs). Glycosylation of the GPR35 N-terminus was used to determine nascent chain structure as it is inserted into the ER membrane. These glycosylation experiments confirm that TM1 has obtained its compacted state whilst residing in the translocon. Finally, a site-specific cross-linking approach using the homobifunctional cysteine cross-linker, BMH, was used to study the lateral integration of GPR35 into the ER. Cross-linking of GPR35 TM1 and TM2 could be detected adjacent to a protein of ~45kDa, believed to be Sec61α. The loss of this adduct, as the nascent chain extends, showed the lateral movement of GPR35 TM1 from the translocon was dependent on the subsequent synthesis of TM2.

Erosive potential of sugar-free hard candies dissolved in water and artificial saliva

Aim: To compare the acidity of sugar-free hard candies dissolved in water and artificial saliva. Methods: Sugar-free Flopi Florestal hard candies (grape, strawberry, cherry, orange, ginger, lemon balm, fennel) were selected and grouped in 2 groups: G-1 (candies dissolved in distilled water) and G-2 (candies dissolved in artificial saliva). Candies were triturated with a porcelain pestle, yielding two samples of 20 g. Samples were dissolved in 120 mL distilled water (G-1) and 120 mL artificial saliva (20 mM NaHCO3, 3 mM NaH2PO4.H2O and 1 mM CaCl2.2H2O) (G-2), obtaining three samples of 30 mL for each of the flavors and groups. pH was measured using potentiometer and combined glass electrode. Titratable acidity was evaluated by adding 100 μL 1M NaOH aliquots until reaching pH 5.5. For statistical analysis, analysis of variance (ANOVA) was used. Means were compared by the Tukey test at 5% significance level (p<0.05) Results: All flavors of G-1 showed pH values below 5.5. Comparison of groups in the same flavor showed a significant increase in pH in flavors of G-2. Comparison of the titratable acidity between G-1 and G-2, showed that fruit flavors were significantly different from each other, with reduced acidity in G-2. Conclusions: All evaluated candies are acid, and dilution in artificial saliva raised their pH and lowered their titratable acidity, reducing their erosive potential.

Use of alternative wood chips from new botanical species. Their impact on phenolic composition and sensory properties of a white wine from Encruzado grape variety

Mestrado Vinifera Euromaster - Instituto Superior de Agronomia - UL

En/titled: The space where writing, editing and teaching intersect

Editing a literary magazine offers us a cultural space where our ideas and aesthetics can be expressed collectively and therefore be heard more effectively. This informs and frames our own writing by increasing our confidence in our own unusual voices. The sense of belonging Brand creates further breaks down the isolation of the writing life. The internationalism of Brand reinforces our own cultural identities as non-English writers. However, acting as a facilitator of others’ creativity can sometimes dissipate or even deplete creative energy. Editing and teaching can take over your writing to the point of annihilation. Further, in terms of external perceptions, you run the risk of disappearing as a writer. We shall look at how this can happen and explore ways that we can prevent it e.g. keeping the boundaries firm and clear.

Identificação de Meloidogyne spp. em áreas de aceroleira no Submédio do Vale do São Francisco.

O objetivo deste trabalho foi identificar as espécies de Meloidogyne em áreas de aceroleiras no polo de irrigação Petrolina-Juazeiro.

Melhoramento genetico da aceroleira.

Origem, Dispersão; Aspectos botânicos: florescimento e frutificação; Situação da aceroleira no Brasil: ações de melhoramento genético.

Fruit juice label: what matters to the consumer?

2014

Caracterización de las condiciones de salud y de trabajo y su relación con lesiones cutáneas en los orfebres artesanales de Mompox Bolivar-Colombia 2015

INTRODUCCIÓN Las alteraciones de la salud relacionadas con el trabajo (enfermedades y accidentes), pueden prevenirse desde las actividades bien enfocadas del Sistema de Gestión de Seguridad y Salud en el Trabajo (SGSST), realizando la identificación y control de los agentes causales en el ambiente de trabajo y la vigilancia de la salud de la población trabajadora. El proyecto desarrollado va dirigido a un grupo específico de artesanos orfebres en la ciudad de Mompox, Bolivar, en la que esta labor artesanal se centra en el arte de la filigrana, transmitido generacionalmente desde antaño En esta ciudad los artesanos orfebres, aunque corresponden a un sector informal de la economía, se encuentran agremiados principalmente en tres asociaciones ubicadas en la cabecera municipal. En el desempeño de sus labores, estos profesionales del arte de la filigrana manipulan agentes químicos como el ácido nítrico, el ácido sulfúrico, la plata y el mercurio, los cuales se utilizan en las diferentes etapas del proceso que incluye técnicas propias de esta labor. Teniendo en cuenta que la información disponible en la literatura científica describe principalmente los efectos de agentes químicos en otros oficios diferentes a la población orfebre y conociendo que la exposición a estas sustancias químicas puede generar variados efectos en el organismo, el interés de este proyecto se centra específicamente en las alteraciones cutáneas posiblemente relacionadas con las condiciones de trabajo de esta población del sector informal. MATERIALES Y METODOS La presente investigación es un estudio de corte trasversal, el cual realizó una selección por conveniencia de 114 trabajadores de orfebres Momposinos con el fin de identificar la relación de las condiciones de trabajo con la presencia de alteraciones cutáneas de los trabajadores que laboran en la orfebrería artesanal en la ciudad de Mompox, departamento de Bolívar, en el año 2015, de tal manera que dejando a consideración la descripción de los hallazgos encontrados, se posibiliten futuras y precisas investigaciones e intervenciones en este colectivo de trabajadores. Los instrumentos empleados para la recolección de la información y para el cumplimento de los objetivos fueron la encuesta Nacional de Condiciones de Trabajo del Instituto Nacional de Seguridad e Higiene en el trabajo de España (INSHT) que permite recolectar información sobre la caracterización de la población a nivel sociodemográfico y ocupacional, y para la determinación de patologías dermatológicas relacionadas con el trabajo se utilizó el Cuestionario NOSQ-2002 Nórdico- Enfermedades Cutáneas de origen Laboral, en su versión validada en español. Se describieron las variables categóricas con porcentajes y las continuas (cuantitativas) con medidas de tendencia central y dispersión La asociación entre los hallazgos de exposición ocupacional y los síntomas y signos en piel, fue estimada mediante riesgos relativos. RESULTADOS El 75,4% del total de la población correspondió al género masculino y el 67,5% reportó realizar sus labores como trabajadores independientes. Respecto a la identificación de condiciones de salud, la percepción por parte de los orfebres fue positiva, reportando muy buena salud en el 34% de los mismos. El 8% de la población manifestó alteraciones dermatológicas tipo eczema en los últimos seis meses y el 11% las presentó principalmente en manos. Respecto de la iniciación del eczema, el 97% de los trabajadores reportó que se iniciaba al contacto con sustancias químicas y el 98,7% manifestó que se encontraban realizando la labor de orfebrería cuando inició el eczema. La lesión prevalente fue mancha roja sin edema (8%), seguida de ronchas o manchas y ampollas pequeñas (3%) y de piel seca con escamas (2%). CONCLUSIONES Los resultados de la presente investigación mostraron la prevalencia de alteraciones cutáneas principalmente en las manos, tipo eczema (manchas rojas) o prurito (picor). Se recomienda la disminución de los tiempos de exposición, adecuación de jornadas y tiempos de descanso, sistemas de protección personal adecuados y la implementación de un programa de educación y participación para el control integral del riesgo.

Fungos associados às podridões pós-colheita em acerola.

A aceroleira é uma das principais culturas produzidas no Submédio do Vale do São Francisco, sendo importante fonte de renda na região. O fruto é rico em vitamina C e muito utilizado na indústria de sucos. As podridões resultantes da atividade de patógenos ocasionam graves perdas na pós-colheita de acerolas. Desta forma, o objetivo deste trabalho foi isolar e identificar os fungos associados às podridões em acerola em diferentes cultivares e estádios de maturação. Os frutos foram coletadas das cultivares Flor Branca e Junco, em quatro estádios de maturação (0%, 1-25%, 25-75% e 75%-100% de coloração vermelha da casca). Posteriormente, os mesmos foram colocados em câmara úmida por 48 horas, em temperatura de 25o C e avaliados quanto à incidência de fungos causadores de podridões pós-colheita. Os fungos Aspergillus e Mucor predominaram com 96% e 100% para as cultivares Junco e Flor Branca, respectivamente. Alguns fungos só se desenvolvem quando os frutos atingem 75% de maturação, tais como Alternaria, Fusarium e Lasiodiplodia. Aspergillus e Mucor são encontrados independentemente do estádio de maturação do fruto.

Sensory analysis of specialty coffee from different environmental conditions in the region of Matas de Minas, Minas Gerais, Brazil.

Specialty coffees can be differentiated in various ways, including the environmental conditions in which they are produced and the sensory composition of the drink. This study aimed to evaluate the effect of altitude, slope exposure and fruit color on the sensory attributes of cafes of the region of Matas de Minas. Sampling points were georeferenced in four altitude ranges (< 700 m; 700 < x> 825 m, 825 < x < 950 m and > 950 m) of the coffee crop; two fruit colors of var. Catuaí (yellowand red); and two slope exposures (North-facing and South-facing). Coffee fruit at the cherry stage were processed andsubmitted to sensory analysis. The sensory attributes evaluated were overall perception, clean cup, balance, aftertaste, sweetness, acidity , body and flavor, which made up the final score. The scores were examined by ANOVA and means werecompared by the Tukey test (p < 0.05). From the sensory standpoint, coffee fruits of both colors are similar, as well as the cof fees from both slope exposures when these factors were analyzed separately . However , at higher altitudes, Y ellow Catuaí produces coffees with better sensory quality . Similarly , coffees from North-facing slopes, at higher altitudes produce better quality cup. The altitude is the main factor that interferes with coffee quality in the area. All factors together contribute tothe final quality of the beverage produced in the region of Matas de Minas.

Effects of the orientation of the mountainside, altitude and varieties on the quality of the coffee beverage from the "Matas de Minas" region, brazilian Southeast.

Based upon qualitative parameters experiments, this study aims to investigate how the elements of the environment, where the coffee is produced, contribute to the final quality of the product. For the analyses, it was used approximately one kilogram of coffee cherry samples collected in 14municipalities previously chosen on the East side of the Minas Gerais State, Brazil. The coffee cherry samples were collected and analyzed for each of the two varieties in four levels of altitude for each exposure side of the mountain in relation to the Sun. The quality of the coffee was evaluated through the analysis of its physical characteristics and sensory analysis, popularly known as "Test of drink or Cupping" carried out by three tasters that belonging to the group of Q -Graders, according to the rules of national and international competitions of the Brazilian Association of Special Coffees (BSCA). Were performed analysis by means descriptive statistics, analysis of variance and multivariate analysis, all of them aiming to study the individual sensor y characteristics of quality of the coffee beverage from the ?Matas de Minas? region. Path coefficient analysis also was carried out for the partition of the phenotypic correlation coefficients into measures of direct and indirect effects, in order to determine the individual sensory characteristics that playeda major role in the beverage final score. The results demonstrat e that it is not possible to concl usively establish the differences among coffees evaluated with basis on varieties and environmental factors previously cited. It can be concluded that it is not recommended to associate the quality of coffee only to a specific factor whether from the environment or being it a specific of the culture of coffee. However, the cafes that were evaluated had intrinsic quality, which were derived from the specific characteristics of the ?Matas de Minas? region where they were grown.