992 resultados para Developments of HCR in the Indian Scenario
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BACKGROUND: The assessment of Health Related Quality of Life (HRQL) is important in people with dementia as it could influence their care and support plan. Many studies on dementia do not specifically set out to measure dementia-specific HRQL but do include related items. The aim of this study is to explore the distribution of HRQL by functional and socio-demographic variables in a population-based setting. METHODS: Domains of DEMQOL's conceptual framework were mapped in the Cambridge City over 75's Cohort (CC75C) Study. HRQL was estimated in 110 participants aged 80+ years with a confirmed diagnosis of dementia with mild/moderate severity. Acceptability (missing values and normality of the total score), internal consistency (Cronbach's alpha), convergent, discriminant and known group differences validity (Spearman correlations, Wilcoxon Mann-Whitney and Kruskal-Wallis tests) were assessed. The distribution of HRQL by socio-demographic and functional descriptors was explored. RESULTS: The HRQL score ranged from 0 to 16 and showed an internal consistency Alpha of 0.74. Validity of the instrument was found to be acceptable. Men had higher HRQL than women. Marital status had a greater effect on HRQL for men than it did for women. The HRQL of those with good self-reported health was higher than those with fair/poor self-reported health. HRQL was not associated with dementia severity. CONCLUSIONS: To our knowledge this is the first study to examine the distribution of dementia-specific HRQL in a population sample of the very old. We have mapped an existing conceptual framework of dementia specific HRQL onto an existing study and demonstrated the feasibility of this approach. Findings in this study suggest that whereas there is big emphasis in dementia severity, characteristics such as gender should be taken into account when assessing and implementing programmes to improve HRQL.
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Background: Intraocular pressure (IOP) is the pressure inside the eye that helps to maintain the integrity and the suitable form of the ocular globe. Precise and accurate measures of IOP are needed for the diagnosis as well as follow-up of glaucoma. In daily clinical practice, Goldmann applanation tonometer (GAT) and Non-contact tonometer (NCT) are the most common devices for measuring IOP. A close agreement between these methods has been showed, particularly in normotensive patients and a poor agreement, especially when IOP levels are above the normal range. Ophthalmologists have noticed a poor agreement between NCT and GAT, observing that by using NCT and after comparing with GAT, there is an overestimation of IOP readings, and particularly it occurs when the eyes are tearful. Previous studies investigate the effect of tears in Non-contact tonometer readings by the instillation of artificial tears, concluding in one of the studies that the variation was less than 1mmHg and not clinically significant, in contrast with another study which the increases were sadistically significant. Tear menisci are a thin strip of tear fluid located between the bulbar conjunctiva and the eyelid margins. We think that the overestimation of IOP readings using NCT could be due to the presence of a higher volume of tear in the lower tear meniscus which might cause an optical interference in the optoelectronic applanation monitoring system of this deviceObjectives: To research the influence of a certain volume of fluid in the lower tear meniscus on IOP measurements using the NCT in healthy eyes. Moreover, to investigate the agreement between IOP readings obtained by NCT and GAT in the presence and absence of this volume of fluidMethods: The study design will be transversal for diagnostic tests of repeated measures. We will study patients with no ocular pathology and IOP<21mmHg. It will consist in the measurement of IOP using NCT before and after the instillation of COLIRCUSÍ FLUOTEST, used as a volume of fluid in the lower tear meniscus, to observe if there will be differences using the paired t-test. Moreover, we will take IOP measures by GAT in order to know the agreement between these methods after and before the application of these eyedrops, using the ICC (intraclass correlation coefficient) and the Bland-Altmann method
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BACKGROUND: Population aging is closely related to high prevalence of chronic conditions in developed countries. In this context, health care policies aim to increase life span cost-effectively while maintaining quality of life and functional ability. There is still, however, a need for further understanding of how chronic conditions affect these health aspects. The aim of this paper is to assess the individual and combined impact of chronic physical and mental conditions on quality of life and disability in Spain, and secondly to show gender trends. METHODS: Cross-sectional data were collected from the COURAGE study. A total of 3,625 participants over 50 years old from Spain were included. Crude and adjusted multiple linear regressions were conducted to detect associations between individual chronic conditions and disability, and between chronic conditions and quality of life. Separate models were used to assess the influence of the number of diseases on the same variables. Additional analogous regressions were performed for males and females. RESULTS: All chronic conditions except hypertension were statistically associated with poor results in quality of life and disability. Depression, anxiety and stroke were found to have the greatest impact on outcomes. The number of chronic conditions was associated with substantially lower quality of life [β for 4+ diseases: -18.10 (-20.95,-15.25)] and greater disability [β for 4+ diseases: 27.64 (24.99,30.29]. In general, women suffered from higher rates of multimorbidity and poorer results in quality of life and disability. CONCLUSIONS: Chronic conditions impact greatly on quality of life and disability in the older Spanish population, especially when co-occurring diseases are added. Multimorbidity considerations should be a priority in the development of future health policies focused on quality of life and disability. Further studies would benefit from an expanded selection of diseases. Policies should also deal with gender idiosyncrasy in certain cases.
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BACKGROUND: This study examined potential predictors of remission among patients treated for major depressive disorder (MDD) in a naturalistic clinical setting, mostly in the Middle East, East Asia, and Mexico. METHODS: Data for this post hoc analysis were taken from a 6-month prospective, noninterventional, observational study that involved 1,549 MDD patients without sexual dysfunction at baseline in 12 countries worldwide. Depression severity was measured using the Clinical Global Impression of Severity and the 16-item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16). Depression-related pain was measured using the pain-related items of the Somatic Symptom Inventory. Remission was defined as a QIDS-SR16 score ≤5. Generalized estimating equation regression models were used to examine baseline factors associated with remission during follow-up. RESULTS: Being from East Asia (odds ratio [OR] 0.48 versus Mexico; P<0.001), a higher level of depression severity at baseline (OR 0.77, P=0.003, for Clinical Global Impression of Severity; OR 0.92, P<0.001, for QIDS-SR16), more previous MDD episodes (OR 0.92, P=0.007), previous treatments/therapies for depression (OR 0.78, P=0.030), and having any significant psychiatric and medical comorbidity at baseline (OR 0.60, P<0.001) were negatively associated with remission, whereas being male (OR 1.29, P=0.026) and treatment with duloxetine (OR 2.38 versus selective serotonin reuptake inhibitors, P<0.001) were positively associated with remission. However, the association between Somatic Symptom Inventory pain scores and remission no longer appeared to be significant in this multiple regression (P=0.580), (P=0.008 in descriptive statistics), although it remained significant in a subgroup of patients treated with selective serotonin reuptake inhibitors (OR 0.97, P=0.023), but not in those treated with duloxetine (P=0.182). CONCLUSION: These findings are largely consistent with previous reports from the USA and Europe. They also highlight the potential mediating role of treatment with duloxetine on the negative relationship between depression-related pain and outcomes of depression.
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BACKGROUND: There is a need for short, specific instruments that assess quality of life (QOL) adequately in the older adult population. The aims of the present study were to obtain evidence on the validity of the inferences that could be drawn from an instrument to measure QOL in the aging population (people 50+ years old), and to test its psychometric properties. METHODS: The instrument, WHOQOL-AGE, comprised 13 positive items, assessed on a five-point rating scale, and was administered to nationally representative samples (n = 9987) from Finland, Poland, and Spain. Cronbach's alpha was employed to assess internal consistency reliability, whereas the validity of the questionnaire was assessed by means of factor analysis, graded response model, Pearson's correlation coefficient and unpaired t-test. Normative values were calculated across countries and for different age groups. RESULTS: The satisfactory goodness-of-fit indices confirmed that the factorial structure of WHOQOL-AGE comprises two first-order factors. Cronbach's alpha was 0.88 for factor 1, and 0.84 for factor 2. Evidence supporting a global score was found with a second-order factor model, according to the goodness-of-fit indices: CFI = 0.93, TLI = 0.91, RMSEA = 0.073. Convergent validity was estimated at r = 0.75 and adequate discriminant validity was also found. Significant differences were found between healthy individuals (74.19 ± 13.21) and individuals with at least one chronic condition (64.29 ± 16.29), supporting adequate known-groups validity. CONCLUSIONS: WHOQOL-AGE has shown good psychometric properties in Finland, Poland, and Spain. Therefore, considerable support is provided to using the WHOQOL-AGE to measure QOL in older adults in these countries, and to compare the QOL of older and younger adults.
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This study describes a simple, fast and reproducible method using RP-HPLC-UV, in a gradient system, for quantification of reserpine in Rauvolfia sellowii stem bark. The analysis were carried out on a C18 column; mobile phase was water and acetonitrile, and separations were carried out in 10 min, flow rate of 1.0 mL min-1, 25 ºC and 268 nm. The validation data showed that the method was specific, accurate, precise and robust. Results were linear over a range of 0.625-40.0 μg mL-1, and the mean recovery was 95.1%. The amount of reserpine found in the dried stem bark was 0.01% (m/m).
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Hydrogels have been prepared by free-radical solution copolymerization of acrylamide and sodium acrylate (NaAc), with molar ratio ranging from 25/75 to 80/20, respectively, using methylene bisacrylamide as the crosslinking agent. A FTIR spectroscopy procedure to determine the acrylate/acrylamide ratio in these hydrogels was proposed based on absorbance at 1410 cm-1 (nCOO-) and 2940 cm-1 (nCH and nCH2). A straight line with a good linear correlation coefficient (0.998) was obtained by plotting the acrylate content (Ac%) versus relative absorbance (Arel = A1410/A2940). Results were confirmed by the amount of sodium cation released in acid medium determined by atomic absorption spectrometry.
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This article describes the isolation and identification of flavonoids in the hydroethanolic extract of the aerial parts from Tonina fluviatilis and evaluation of their antiradical activity. A method based on HPLC-DAD was developed and validated for detecting and quantifying flavonoids in hydroethanolic extracts. The flavonoids identified and quantified in the extract were 6,7-dimethoxyquercetin-3-O-β-D-glucopyranoside (1), 6-hydroxy-7-methoxyquercetin-3-O-β-D-glucopyranoside (2), and 6-methoxyquercetin-3-O-β-D-glucopyranoside (3). The developed method presented good validation parameters, showing that the results obtained are consistent and can be used in ensuring the quantification of these constituents in the extracts. Compounds 2 and 3 showed strong antiradical activity when compared with the positive controls (quercetin and gallic acid).
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An improved method based on reverse flow injection is proposed for determining sulfate concentration in the wet-process of phosphoric acid (WPA). The effect of reagent composition, flow rate, temperature, acid concentration, length of the reaction coil, and linear response range on the flow system is discussed in detail. Optimal conditions are established for determining sulfate in the WPA samples. Baseline drift is avoided by a periodic washing step with EDTA in an alkaline medium. A linear response is observed within a range of 20 - 360 mg L-1, given by the equation A = 0.0020C (mg L-1) + 0.0300, R² = 0.9991. The detection limit of the proposed method for sulfate analysis is 3 mg L-1, and the relative standard deviation (n = 12) of sulfate absorbance peak is less than 1.60%. This method has a rate of up to 29 samples per hour, and the results compare well with those obtained with gravimetric method.
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Atmospheric pollutants can have serious impacts on the preservation of São Paulo's tangible cultural heritage. The purpose of this paper is to report the results of a monitoring campaign focussed on particulate matter (PM) that was conducted in three of the most important museums of the São Paulo megacity (Brazil): the Museu de Arqueologia e Etnologia (MAE-USP), the Museu Paulista (MP-USP), and the Pinacoteca do Estado de São Paulo (PE). These museums exhibit indoor PM and black carbon (BC) concentrations consistent with their urban locations and their specific methods for managing the indoor environment.
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No presente trabalho, o autor trata da formação de campo petrolífero que se teria formado às expensas de organismos planctónicos, misturados com areia das dunas, material esse que teria sido transportado pelo vento. Refere-se, assim, o autor, ao campo petrolífero de "Wilmington", situado na Ilha Terminal, ao sul de Los Angeles, California. Esse campo, que já fora descrito, em 1943, por GILLULY & GRANT, faz parte do Mioceno e do Plioceno inferior, achando-se separado dos schistos Jurássicos metamórficos, por uma discordância localizada a 6.000 pés de profundidade. O conjunto das camadas petrolíferas alcança espessura de 1 .500 pés, sendo cada uma delas separada das outras por estratos do "siltstone" (siltito). O tamanho dos grãos, nos dois tipos de rochas, é o de depósitos eólicos, mas, ao contrário do que acontece em depósitos sub-aéreos, esses grãos são angulosos ou sub-angulosos. De acordo com MCNAUGHTON , esses depósitos se teriam formado em profundidade crescente, de 200 a 5.000 pés; esse fato, relacionado com as dimensões dos grãos, leva a crer que o material tenha sido transportado pelo vento. A sedimentação deu-se longe da costa, de maneira muito lenta, provavelmente em consequência de tempestades de excepcional intensidade. O petróleo teria sido produzido por organismos planctónicos que se teriam misturado com areia das dunas, sendo a velocidade da sedimentação desta, muito menor. Os cálculos indicam que foram armazenados somente 23% dos hidrocarbonetos que caíram sobre a areia de sedimentação, sob a forma de organismos mortos. M. V.
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The present study investigates the spatial and spectral discrimination potential for grassland patches in the inner Turku Archipelago using Landsat Thematic Mapper satellite imagery. The spatial discrimination potential was computed through overlay analysis using official grassland parcel data and a hypothetical 30 m resolution satellite image capturing the site. It found that Landsat TM imagery’s ability to retrieve pure or near-pure pixels (90% purity or more) from grassland patches smaller than 1 hectare was limited to 13% success, compared to 52% success when upscaling the resolution to 10 x 10 m pixel size. Additionally, the perimeter/area patch metric is proposed as a predictor for the suitability of the spatial resolution of input imagery. Regression analysis showed that there is a strong negative correlation between a patch’s perimeter/area ratio and its pure pixel potential. The study goes on to characterise the spectral response and discrimination potential for the five main grassland types occurring in the study area: recreational grassland, traditional pasture, modern pasture, fodder production grassland and overgrown grassland. This was done through the construction of spectral response curves, a coincident spectral plot and a contingency matrix as well as by calculating the transformed divergence for the spectral signatures, all based on training samples from the TM imagery. Substantial differences in spectral discrimination potential between imagery from the beginning of the growing season and the middle of summer were found. This is because the spectral responses for these five grassland types converge as the peak of the growing season draws nearer. Recreational grassland shows a consistent discrimination advantage over other grassland types, whereas modern pasture is most easily confused. Traditional pasture land, perhaps the most biologically valuable grassland type, can be spectrally discriminated from other grassland types with satisfactory success rates provided early growing season imagery is used.