Working with people affected by cancer – Phase 1 of a mixed methods exploration of practitioner perspectives in nutritional therapy

Introduction - Nutritional therapy (NT) is a bioscience-based branch of complementary and alternative medicine (CAM) with National Occupational Standards (NOS) and accredited training courses which include compulsory clinical training. Approximately 900 practitioners are registered with the voluntary regulator, the Complementary and Natural Healthcare Council (CNHC), but the number of unregulated practitioners is unknown. Cancer is a leading cause of death worldwide; nutrition and lifestyle factors may affect recurrence and survival rates. Many cancer patients and survivors seek individualised advice on diet and use of supplements and appropriately skilled nutritional therapy practitioners (NTP) may be well-placed to safely provide this advice. Little is known of NTPs’ perspectives on working with people affected by cancer; this study seeks to explore their views on training, use of evidence and other resources, to support the development of safe evidence-based practice in this important clinical area. Methods – An on-line anonymised questionnaire collected data from participants recruited from all UK registered NTPs. Recruitment was facilitated by the British Association for Applied Nutrition and Nutritional Therapy (BANT). Quantitative data on practitioner characteristics, years in practice, other therapies practiced and work with cancer clients were collected. Qualitative data on types of evidence used, barriers to practice and perceived training and support needs when working with clients with cancer, were collected and analysed. SPSS was used to produce descriptive statistics. Preliminary Results – 274/888 (31%) of registered NTPs participated. 61% respondents had accredited NT qualifications of which 46% were at degree or post-graduate level. 73% (202) participants indicated they also had other higher education qualifications, including 153 (56%) at degree or above. When asked to describe their position on cancer work, 17% respondents (40/238) indicated no interest, and 35% (84/238) respondents already work with cancer clients (cancer practitioners - CP). A further 48% (114/238) respondents expressed interest in starting cancer work, and typically requested specialist training and practice guidelines to support this area of clinical practice. Cancer practitioners (CP) rated searches of peer-reviewed literature as most useful for information to support practice, whereas commercial product information was rated least useful. CPs requested engagement with mainstream medicine, more access to research evidence and professional recognition to facilitate and support work with cancer clients. A need for professional networking, mentorship and/or supervision was noted by CP and non-CP respondents, which is of interest since 81% all participants worked as sole practitioners exclusively or as part of their practice, <1% worked within the NHS. Discussion & Conclusions – This is the first detailed documentation of NTP perspectives on cancer work. A number of areas have been identified for further detailed evidence to be collected using focus groups and interviews, including detailed training needs, communication with mainstream cancer professionals, access to research evidence, and professional recognition. This work will inform and support the development of professional practice guidelines for NT and inform the development of specialist training and other resources.

Anti-MDR and antitumoral action of acetylsalicylic acid on leukaemic cells

ASA (acetylsalicylic acid) is an NSAID (non-steroidal anti-inflammatory drug). ASA has gained attention as a potential chemopreventive and chemotherapeutic agent for several neoplasms. The aim of this study was to analyse the possible antitumoural effects of ASA in two erythroleukaemic cell lines, with or without the MDR (multidrug resistance) phenotype. The mechanism of action of different concentrations of ASA were compared in K562 (non-MDR) and Lucena (MDR) cells by analysing cell viability, apoptosis and necrosis, intracellular ROS (reactive oxygen species) formation and bcl-2, p53 and cox-2 gene expression. ASA inhibited the cellular proliferation or induced toxicity in K562 and Lucena cell lines, irrespective of the MDR phenotype. The ASA treatment provoked death by apoptosis and necrosis in K562 cells and only by necrosis in Lucena cells. ASA also showed antioxidant activity in both cell lines. The bcl-2, p53 and cox-2 genes in both cell lines treated with ASA seem to exhibit different patterns of expression. However, normal lymphocytes treated with the same ASA concentrations were more resistant than tumoral cells. The results of this work show that both cell lines responded to treatment with ASA, demonstrating a possible antitumoral and anti-MDR role for this drug.

Lipid oxidation kinetics of ozone-processed shrimp during iced storage using peroxide value measurements

In this research, in situ generated ozone exposure/wash cycles of 1, 3, and 5 min applied to shrimp samples either before (BIS) or during iced storage (DIS) has been used to study the lipid oxidation kinetics using the peroxide values (PV). The induction period (IP) as well as PV at end of the IP (PVIP) have been obtained. The rate constants (k) as well as half-lives (t1/2) of hydroperoxides formation for different oxidation stages were calculated. The results showed that both IP and PVIP were lower with BIS (IP between 4.35±0.09 and 5.08±0.23 days; PVIP between 2.92±0.06 and 3.40±0.18 mEq kg−1) compared with DIS (IP between 5.92±0.12 and 6.14±0.09 days; PVIP between 4.49±0.17 and 4.56±0.10 mEq kg−1). The k value for DIS seemed to be the greater compared to BIS. In addition, whilst decreases and increases in t1/2 were found at propagation, respectively, for BIS and DIS, decreases and increases were only found at the induction of oxidation stage(s) for BIS. Further, the PV of ozone-processed samples would fit first order lipid oxidation kinetics independent of duration of ozone exposures. For the first time, PV measurements and fundamental kinetic principles have been used to describe how increasing ozone exposures positively affects the different oxidation stages responsible for the formation of hydroperoxides in ozone-processed shrimp.

Produção de biomassa e composição química de adubos verdes cultivados no Vale do Ribeira

The contribution of green manure to soil improvement and crop production depends primarily on biomass production and its chemical composition, which vary depending on the species, region and growing season. The aim of this research was to evaluate the chemical composition of biomass produced by green manures in Vale do Ribeira, São Paulo, Brazil. In order to develop this research, was carried an experiment in Pariquera-Acu, in 2006/2007, in completely randomized blocks design with four treatments (three green manure and spontaneous vegetation) and five replications. At 30, 60, 90 and 120 after sowing samples were collected in 1m(2) of the shoots and determined fresh and dry, and chemical composition biomass. Sunhemp, pigeon pea and mucuna produced, in decreasing order, the largest quantities of biomass and were more efficient than the spontaneous vegetation. The biomass produced by green manure had higher quality than that produced by spontaneous vegetation. Sunhemp and pigeon pea have a higher proportion of dry matter in stems which have low N, high C/N and L/N ratio, variables indicating slow decomposition of residues. The analysis of dry matter partitioned to better indication of the chemical composition of the residues and the prevision of the availability of nutrients in the soil.

Resistência do solo à penetração e ao cisalhamento em diversos usos do solo em áreas de preservação permanente

The soil resistance to penetration and shear can be used as indicators of soil compaction and to indicate the susceptibility of a soil to erosion. The objective of this study was to quantify and compare the impact provided by different land uses in a haplic cambissol in areas of permanent preservation, from the soil resistance to penetration and shear. The experimental area was located in an area of permanent preservation, the sub-basin of the Ribeira Iguape River - SP, with different land uses: banana cultivation - CBAN, degraded pasture - PDEG, silvopastoral system - MPIS and native forest - MNAT. The test for resistance to penetration was accomplished with a digital penetrometer compaction of manual effort, to a depth of 40 cm. The soil shear strength was determined by Vane Test at a depth between 0 and 5 cm. The degraded pasture was similar to native forest, with less resistance to penetration. The banana cultivation and silvopastoral system were the land uses with the highest resistance to penetration, bringing serious risk of erosion in areas of permanent preservation. The soil under native forest had lower shear strength. The cultivation of bananas, degraded pasture and silvopastoral system were the land uses with higher shear strength of soil, indicating that the use of these soils in areas of permanent preservation is promoting the same compression.

Minerals and vitamin B9 in dried plants vs. infusions: assessing absorption dynamics of minerals by membrane dialysis tandem in vitro digestion

Vitamins and mineral elements are among the most important phytochemicals due to their important role in the maintenance of human health. Despite these components had already been studied in different plant species, their full characterization in several wild species is still scarce. In addition, the knowledge regarding the in vivo effects of phytochemicals, particularly their bioaccessibility, is still scarce. Accordingly, a membrane dialysis process was used to simulate gastrointestinal conditions in order to assess the potential bioaccessibility of mineral elements in different preparations of Achillea millefolium (yarrow), Laurus nobilis (laurel) and Taraxacum sect. Ruderalia (dandelion). The retention/passage dynamics was evaluated using a cellulose membrane with 34 mm pore. Dandelion showed the highest levels of all studied mineral elements (except zinc) independently of the used formulations (dried plant or infusion), but yarrow was the only species yielding minerals after the dialysis step, either in dried form, or as infusion. In fact, the ability of each evaluated element to cross the dialysis membrane showed significant differences, being also highly dependent on the plant species. Regarding the potential use of these plants as complementary vitamin B9 sources, the detected values were much lower in the infusions, most likely due to the thermolability effect.

Isolamento e caracterização biológica e bioquímica de um activador do factor x da coagulação presente no veneno da serpente Bothrops erythromelas

Dissertação de Mestrado Integrado em Medicina Veterinária

Bioecology of Spodoptera frugiperda (Smith, 1757) in different cover crops.

The objective of this work was to evaluate the biological variables of Spodoptera frugiperda on species of cover crops. The experiments were conducted in laboratory and greenhouse using the following species: sunflower (Helianthus annuus), sun hemp (Crotalaria juncea), brachiaria (Urochloa decumbens e Urochloa ruziziensis), millet (Pennisetum americanum), black oat (Avena stringosa), white lupin (Lupinus albus), forage turnip (Rafanus sativus) and maize (Zea mays). In laboratory the S. frugiperda larval survival varied from 57%, on L. albus, to 93% on H. annuus and the survival of the pre-imaginal phase varied from 45% on U. decumbens to 81.6% on Z. mays. On C. juncea the larval biomass was lower and the development period of the young and larval stage was higher. The adaptation index was less on C. juncea in greenhouse and laboratory. In greenhouse the larval survival at 14 days was similar for all plants and at 21 days was the lowest on C. juncea. There was less accumulation of biomass at 14 days on C. juncea and at 21 days on C. juncea and A. stringosa. Regarding damage, C. juncea presented less susceptibility to Spodoptera frugiperda attack, which together with the other evaluated parameters, indicated this plant as the most appropriate for soil cover before cultivation of maize.

Revisión del uso de los medicamentos biosimilares vs. biológicos: implicaciones para la salud en Colombia.

Este documento tiene como objetivo describir las implicaciones para la salud con el uso de medicamentos biosimilares en comparación con los medicamentos biológicos en Colombia. Así mismo, describir el contexto normativo acerca del uso de medicamentos biosimilares, las recomendaciones y lineamientos sobre seguridad y efectividad del uso de medicamentos Biosimilares y Biológicos, partiendo de sus diferencias biomoleculares. Para esto, se desarrolló una revisión documental electrónica y manual de la literatura en bases de datos, revistas y libros limitada a términos MeSH. La selección de los artículos incluyo documentos completos publicados en revistas indexadas de los últimos 10 años, en español e inglés; la información recolectada se organizó para la construcción del presente documento. Concluyendo, se encontró que las patentes de muchos medicamentos biológicos han vencido o están próximas a caducar y varios biosimilares están desarrollándose y comercializándose incluso en países sin regulaciones estrictas. Los biosimilares nunca podrán ser iguales al original por su complejidad molecular, por ello debemos integrarlos a los sistemas de farmacovigilancia mejorando trazabilidad e identificando su origen mientras se establecen denominaciones comunes distinguibles. La evidencia actual sugiere que la regulación de medicamentos biosimilares debe ser evaluada y armonizada en todo el mundo.

Caracterización sociodemográfica de las enfermedades huérfanas en Colombia

Las enfermedades huérfanas en Colombia, se definen como aquellas crónicamente debilitantes, que amenazan la vida, de baja prevalencia (menor 1/5000) y alta complejidad. Se estima que a nivel mundial existen entre 6000 a 8000 enfermedades raras diferentes(1). Varios países a nivel mundial individual o colectivamente, en los últimos años han creado políticas e incentivos para la investigación y protección de los pacientes con enfermedades raras. Sin embargo, a pesar del creciente número de publicaciones; la información sobre su etiología, fisiología, historia natural y datos epidemiológicos persiste escasa o ausente. Los registros de pacientes, son una valiosa herramienta para la caracterización de las enfermedades, su manejo y desenlaces con o sin tratamiento. Permiten mejorar políticas de salud pública y cuidado del paciente, contribuyendo a mejorar desenlaces sociales, económicos y de calidad de vida. En Colombia, bajo el decreto 1954 de 2012 y las resoluciones 3681 de 2013 y 0430 de 2013 se creó el fundamento legal para la creación de un registro nacional de enfermedades huérfanas. El presente estudio busca determinar la caracterización socio-demográfica y la prevalencia de las enfermedades huérfanas en Colombia en el periodo 2013. Métodos: Se realizó un estudio observacional de corte transversal de fuente secundaria sobre pacientes con enfermedades huérfanas en el territorio nacional; basándose en el registro nacional de enfermedades huérfanas obtenido por el Ministerio de Salud y Protección Social en el periodo 2013 bajo la normativa del decreto 1954 de 2012 y las resoluciones 3681 de 2013 y 0430 de 2013. Las bases de datos obtenidas fueron re-categorizadas en Excel versión 15.17 para la extracción de datos y su análisis estadístico posterior, fue realizado en el paquete estadístico para las ciencias sociales (SPSS v.20, Chicago, IL). Resultados: Se encontraron un total de 13173 pacientes con enfermedades huérfanas para el 2013. De estos, el 53.96% (7132) eran de género femenino y el 46.03% (6083) masculino; la mediana de la edad fue de 28 años con un rango inter-cuartil de 39 años, el 9% de los pacientes presentaron discapacidad. El registro contenía un total de 653 enfermedades huérfanas; el 34% del total de las enfermedades listadas en nuestro país (2). Las patologías más frecuentes fueron el Déficit Congénito del Factor VIII, Miastenia Grave, Enfermedad de Von Willebrand, Estatura Baja por Anomalía de Hormona de Crecimiento y Displasia Broncopulmonar. Discusión: Se estimó que aproximadamente 3.3 millones de colombianos debían tener una enfermedad huérfana para el 2013. El registro nacional logró recolectar datos de 13173 (0.4%). Este bajo número de pacientes, marca un importante sub-registro que se debe al uso de los códigos CIE-10, desconocimiento del personal de salud frente a las enfermedades huérfanas y clasificación errónea de los pacientes. Se encontraron un total de 653 enfermedades, un 34% de las enfermedades reportadas en el listado nacional de enfermedades huérfanas (2) y un 7% del total de enfermedades reportadas en ORPHANET para el periodo 2013 (3). Conclusiones: La recolección de datos y la sensibilización sobre las enfermedades huérfanas al personal de salud, es una estrategia de vital importancia para el diagnóstico temprano, medidas específicas de control e intervenciones de los pacientes. El identificar apropiadamente a los pacientes con este tipo de patologías, permite su ingreso en el registro y por ende mejora el sub-registro de datos. Sin embargo, cabe aclarar que el panorama ideal sería, el uso de un sistema de recolección diferente al CIE-10 y que abarque en mayor medida la totalidad de las enfermedades huérfanas.

Breed comparison for heat adaptation in rams using multivariate analysis.

2016

Robustness of germination analysis methods for Copaifera langsdorffii Desf. (Fabaceae) seeds.

2016

Fertilizers with coated urea in upland rice production and nitrogen apparent recovery.

Urea is the most used N fertilizer for upland rice, however, a great percentage of N loss can occur with the use of this fertilizer. The use of products that provide reduction of N loss for urea fertilizers can contribute to increase N use efficiency. The objective of this study was to determine the effect of N rates applied in the form of coated urea in the content and accumulation of N in dry biomass, apparent recovery of nitrogen and grain yield of upland rice. The experimental design was a randomized complete blocks arranged in a 4 x 3 + 1 factorial scheme. The treatments consisted of four sources of N fertilizer [1. Common urea; 2. Polymer-coated urea for slow release of N (PCU); 3. urea with the urease inhibitor N-(n-Butyl) thiophosphoric triamide (NBPT); and 4. urea coated with copper sulfate and boric acid as urease inhibitors (UCCB)], with three fertilization rates (30, 60 and 90 kg ha-1 of N). In addition, we included a control treatment without N application. Coated urea did not provide increases in rice grain yield in relation to common urea. The increasing amount of N resulted in significant increases in rice grain yield (from 3217 to 5548 kg ha-1, 2010/11, and from 3392 to 4560 kg ha-1, 2011/12). The apparent nitrogen recovery rate decreased with the increase in N applied doses.

Current Situaion of Eurhizococcus brasiliensis (Hemiptera: Margarodidae) in Brazil.

2016

Impact assessment of the production and utilization of entomopathogens and its effects on public policies.

2008