Self-reported fatigue and associated factors six years after stroke

Several studies have found that fatigue is one of the most commonly reported symptoms after stroke and the most difficult to cope with. The present study aimed to investigate the presence and severity of self-reported fatigue six years after stroke onset and associated factors. The cohort "Life After Stroke Phase I" (n = 349 persons) was invited at six years to report fatigue (Fatigue Severity Scale 7-item version), perceived impact of stroke and global recovery after stroke (Stroke Impact Scale), anxiety and depression (Hospital Anxiety and Depression Scale), life satisfaction (Life Satisfaction Checklist) and participation in everyday social activities (Frenchay Activities Index). At six years 37% of the 102 participants in this cross-sectional study reported fatigue. The results showed that in nearly all SIS domains the odds for post-stroke fatigue were higher in persons with a higher perceived impact. Furthermore, the odds for post-stroke fatigue were higher in those who had experienced a moderate/severe stroke and had signs of depression and anxiety. Fatigue is still present in one-third of persons as long as six years after stroke onset and is perceived to hinder many aspects of functioning in everyday life. There is an urgent need to develop and evaluate interventions to reduce fatigue.

Assessing the Association between Receipt of Antimalarial Drugs and Adverse Pregnancy Outcomes using Pooled Data

Thesis (Ph.D.)--University of Washington, 2016-08

Size-selective mortality and environmental factors affecting early marine growth during early marine life stages of sub-yearling Chinook salmon in Puget Sound, Washington

Thesis (Master's)--University of Washington, 2016-08

Exploring Relationships Between Vector-Borne Diseases and Landscape Architecture: Aedes aegypti, Aedes albopictus and Landscape Architecture

Thesis (Master's)--University of Washington, 2016-06

Supporting people with Autism Spectrum Disorders in leisure time: impact of an University Volunteer Program, and related factors

La participación social tiene efectos positivos en salud mental y física, y puede tomarse como un indicador de calidad de vida. Sin embargo, la participación de personas con discapacidad en su comunidad es aún escasa, especialmente para las personas con autismo. En este trabajo evaluamos el grado de satisfacción con un programa de voluntariado universitario dirigido a personas con autismo para apoyar actividades de ocio y tiempo libre (APUNTATE). Un total de 159 familias de usuarios y 230 voluntarios cumplimentaron un cuestionario de satisfacción que identificó las áreas en las que el programa tenía más impacto. Los resultados mostraron una alta satisfacción general tanto en usuarios como en voluntarios, aunque algunas características personales de los usuarios generaron leves diferencias. Los aspectos más valorados fueron la organización del programa, la formación y tutorización continua que se ofrecía a los voluntarios. Otra característica del programa, ampliamente valorada, fue la capacidad de éste de adaptar los apoyos a las necesidades individuales de usuarios y voluntarios. Este trabajo pone de manifiesto que la universidad pública puede implementar con éxito programas de apoyos para promover la participación social. Estos programas pueden favorecen el desarrollo personal, favorecer el cambio de actitudes hacia las personas con discapacidad y mejorar las perspectivas de empleo de los estudiantes.

Long-term antidepressant use: patient perspectives of benefits and adverse effects

Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment.This study used mixed methods to examine patients’ views and experiences of long-term antidepressant treatment, including benefits and concerns. Data from 180 patients, who were long-term users of antidepressants (3–15 years), were extracted from an anonymous online survey of patients’ experiences of antidepressants in New Zealand. Participants had completed rating scales about the effectiveness of antidepressants, levels of depression before and during antidepressant use, quality of life, and perceived adverse effects. Two open-ended questions allowed participants to comment on personal experiences. The majority (89.4%) reported that antidepressants had improved their depression although 30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects. Some expressed a need for more information about long-term risks and increased information and support to discontinue.

Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015 : a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015 : a systematic analysis for the Global Burden of Disease Study 2015

Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors

SILVEIRA, Inavan Lopes da; MARANHÃO, T. M. O.; AZEVEDO, George Dantas. Metabolic syndrome in postmenopausal women: higher prevalence in the Northeastern Region of Brazil than in other Latin American countries and the influence of obesity and socioeconomic factors. Climacteric (Carnforth), v.10, p.438-439, 2007.

Postoperative Bowel Function and Related Factors in Enhanced Recovery Protocol with Patients Undergoing Hepatectomy

Patients’ bowel dysfunction is a major factor that weakens the results of surgical care as it can cause pain and weaken patients’ rehabilitation. Bowel dysfunction is a common postoperative problem, yet most incidents remain undocumented. The nursing profession has a significant role in enhancing the bowel function postoperatively. However, studies of postoperative bowel function after hepatectomy are scarce and somewhat incongruous. Enhanced recovery protocols are innovative models of care aiming for better outcomes of surgical care. Enhanced recovery protocols can improve gastrointestinal function after surgery, yet patients are also known to be satisfied with their care. The aim was to investigate if postoperative bowel function day varies between patients in terms of age, gender, ASA score, type of surgery, histology, patients’ experienced pain and experienced satisfaction three days after discharge and three months after operation in patients undergoing hepatectomy. The goal was to produce information for basis of scientific research, to give nurses in clinical setting more tools to work with hepatectomy patients undergoing enhanced recovery protocol and to produce information to nurse managers to use in process management of patients undergoing enhanced recovery protocol. The design of this study is descriptive. Data was collected retrospectively from hepatectomy patients (n = 134) undergoing enhanced recovery protocol within the first year of enhanced recovery protocol implementation. The data was based on registers and analyzed statistically. Mean age of patients was 62 years and mean day of discharge was 4. Main (n = 72) histology of the patients was colorectal liver metastases. Mean bowel function day was 3. Most of the patients were very satisfied or satisfied with the care three days after discharge (99%) and three months (90%) after operation. Most of the patients (72%) experienced moderate pain three days after discharge, but three months after operation 47% of the patients did not experience pain and 48% experienced moderate pain. There were no statistically significant differences in bowel function between different age groups, genders, ASA score groups or histologies. Neither were there statistically significant differences in postoperative bowel function in terms of experienced satisfaction or pain. There were statistically significant differences in postoperative bowel function between different types of surgery (p < 0.01). Nurses should take into consideration hepatectomy patients’ type of surgery and pay special attention in supporting major open hepatectomy patients’ postoperative bowel function. Nurses should educate patients undergoing major open hepatectomy about prolonged postoperative bowel function.

Prevalence of orofacial clefts and social factors in Brazil

RODRIGUES, Katamara et al. Prevalence of orofacial clefts and social factors in Brazil. Brazilian oral research, v.23, n. 1, p. 38-42, 2009.Disponivel em: . Acesso em: 04 out. 2010.

DYNAMICS OF THE SHORT TERM AND LONG TERM AVIAN DISTRIBUTIONS IN NORTH AMERICA - THE ROLES OF VEGETATION HEIGHT HETEROGENEITY AND CLIMATIC FACTORS

Understanding how biodiversity spatially distribute over both the short term and long term, and what factors are affecting the distribution, are critical for modeling the spatial pattern of biodiversity as well as for promoting effective conservation planning and practices. This dissertation aims to examine factors that influence short-term and long-term avian distribution from the geographical sciences perspective. The research develops landscape level habitat metrics to characterize forest height heterogeneity and examines their efficacies in modelling avian richness at the continental scale. Two types of novel vegetation-height-structured habitat metrics are created based on second order texture algorithms and the concepts of patch-based habitat metrics. I correlate the height-structured metrics with the richness of different forest guilds, and also examine their efficacies in multivariate richness models. The results suggest that height heterogeneity, beyond canopy height alone, supplements habitat characterization and richness models of two forest bird guilds. The metrics and models derived in this study demonstrate practical examples of utilizing three-dimensional vegetation data for improved characterization of spatial patterns in species richness. The second and the third projects focus on analyzing centroids of avian distributions, and testing hypotheses regarding the direction and speed of these shifts. I first showcase the usefulness of centroids analysis for characterizing the distribution changes of a few case study species. Applying the centroid method on 57 permanent resident bird species, I show that multi-directional distribution shifts occurred in large number of studied species. I also demonstrate, plain birds are not shifting their distribution faster than mountain birds, contrary to the prediction based on climate change velocity hypothesis. By modelling the abundance change rate at regional level, I show that extreme climate events and precipitation measures associate closely with some of the long-term distribution shifts. This dissertation improves our understanding on bird habitat characterization for species richness modelling, and expands our knowledge on how avian populations shifted their ranges in North America responding to changing environments in the past four decades. The results provide an important scientific foundation for more accurate predictive species distribution modeling in future.

Association between physical activity and cardiorespiratory factors in adolescents: a cross-sectional exploratory study

Background: Currently, under half of the adolescents reach recommended daily levels of physical activity (PA). It is known that higher levels of PA lead to higher levels of cardiorespiratory fitness (CRF) and therefore, a health-related CRF criterion value could contribute to identify the target population for primary cardiovascular disease prevention. Therefore, the aim of this study was to explore the relation between PA levels and CRF factors in healthy adolescents. Methods: A cross-sectional exploratory study with healthy adolescents aged 12-18 years old was conducted. Socio-demographic and body composition data were collected using a questionnaire. PA level was scored with the Physical Activity Index (PAI) and CRF assessment included lung function (LF) measured with spirometry and exercise tolerance measured with Incremental Shuttle Walking Test (ISWT). According to PAI scores the sample was divided in two groups: 1 (sedentary, low and moderately active); 2 (vigorously active (VA)). Descriptive statistics were applied to characterise the sample. Independent sample t-tests assessed differences between groups and simple logistic regressions identified the predictors of being VA. Results: The study included 115 adolescents (14.63±1.70 years old; 56.52% female). Adolescents presented a normal body mass index=21.19±3.14 Kg.m-2) and LF (forced expiratory volume in the first second (FEV1)=105.58±12.73% of the predicted). Significant differences were found between groups in height (G1–163.44±8.01; G2–167±8.65; p=0.024), LF (FEV1/ forced vital capacity (FVC); G1–97.58±10.66; G2–94.04±8.04; p=0.049), ISWT distance (G1– 1089.81±214.04; G2–1173.60±191.86; p=0.038); heart rate (HR) at rest (G1– 84.61±13.68; G2–79.23±13.81; p=0.038), HR at the end of the best ISWT (G1– 124.71±37.57; G2–133.54±33.61; p=0.041) and percentage of the maximal HR achieved during ISWT (G1–63.09±19.03; G2–67.53±17.08; p=0.043). Simple logistic regressions showed that height (OR–1.054; 95%CI 1.006-1.104), ISWT distance (OR–1.002; 95%CI 1.000-1.004) and HR at rest (OR–0.971; 95%CI 0.945-0.999) were predictors of being VA. Conclusions: Results suggest that more physically active adolescents have a better CRF profile. The findings suggest that PA is important to adolescents’ health status and it should be encouraged since childhood. Clinical practice will benefit from the use of PAI, ISWT and HR findings, allowing physiotherapists to use it for prescribing exercise.