902 resultados para Active Life Expectancy
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International audience
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International audience
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International audience
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Background: The evidence base on end-of-life care in acute stroke is limited, particularly with regard to recognising dying and related decision-making. There is also limited evidence to support the use of end-of-life care pathways (standardised care plans) for patients who are dying after stroke. Aim: This study aimed to explore the clinical decision-making involved in placing patients on an end-of-life care pathway, evaluate predictors of care pathway use, and investigate the role of families in decision-making. The study also aimed to examine experiences of end-of-life care pathway use for stroke patients, their relatives and the multi-disciplinary health care team. Methods: A mixed methods design was adopted. Data were collected in four Scottish acute stroke units. Case-notes were identified prospectively from 100 consecutive stroke deaths and reviewed. Multivariate analysis was performed on case-note data. Semi-structured interviews were conducted with 17 relatives of stroke decedents and 23 healthcare professionals, using a modified grounded theory approach to collect and analyse data. The VOICES survey tool was also administered to the bereaved relatives and data were analysed using descriptive statistics and thematic analysis of free-text responses. Results: Relatives often played an important role in influencing aspects of end-of-life care, including decisions to use an end-of-life care pathway. Some relatives experienced enduring distress with their perceived responsibility for care decisions. Relatives felt unprepared for and were distressed by prolonged dying processes, which were often associated with severe dysphagia. Pro-active information-giving by staff was reported as supportive by relatives. Healthcare professionals generally avoided discussing place of care with families. Decisions to use an end-of-life care pathway were not predicted by patients’ demographic characteristics; decisions were generally made in consultation with families and the extended health care team, and were made within regular working hours. Conclusion: Distressing stroke-related issues were more prominent in participants’ accounts than concerns with the end-of-life care pathway used. Relatives sometimes perceived themselves as responsible for important clinical decisions. Witnessing prolonged dying processes was difficult for healthcare professionals and families, particularly in relation to the management of persistent major swallowing difficulties.
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Buckler sorrel (Rumex induratus Boiss. & Reut.) is an underutilized leafy vegetable with peculiar sensory properties and potential as a gourmet food. In the food industry, different packaging methods have been used for shelf-life extension, but it is important to know how the quality of minimally processed vegetable is affected by these treatments. Recently, nitrogen and argon have been used for food packaging. Nitrogen is low soluble in water and other food constituents and does not support the growth of aerobic microbes. In turn, argon is biochemically active and appears to interfere with enzymatic oxygen receptor sites. In this study, modified atmospheres enriched with nitrogen and argon were evaluated for shelf-life extension of buckler sorrel leaves. Wild samples were gathered in Bragança, Portugal, considering local consumers’ sites and criteria. Healthy and undamaged leaves were selected, rinsed in tap water, and a portion was immediately analyzed (non-stored control). The remaining fresh material was packaged in polyethylene bags under nitrogen- and argon-enriched atmospheres and a conventional control atmosphere (air). All packaged samples were stored at 4 ºC for 12 days and then analyzed. The headspace gas composition was monitored during storage. Different quality attributes were evaluated, including visual (colour), nutritional (macronutrients, individual sugars and fatty acids) and bioactive (hydrophilic and lipophilic molecules and antioxidant properties) parameters. Different statistical tools were used; the one-way analysis of variance (ANO VA) was applied for analyse the differences among treatments and a linear discriminant analysis (LDA ) was used to evaluate the effects on the overall postharvest quality. The argon-enriched atmosphere better prevent the samples yellowing. The proximate composition did not change significantly during storage. Samples in control atmosphere revealed higher protein and ash contents and lower levels of lipids. The non-stored control samples presented the higher amounts of fructose, glucose and trehalose. The storage time increased the palmitic acid levels and decreased the content in α-linolenic and linoleic acids. The γ- e δ-tocopherols were higher after the 12 days of cold storage. Probably, the synthesis of these lipophilic compounds was a plant strategy to fight against the abiotic stress induced by storage. Higher levels of total phenolics and flavonoids and increased reducing power and β-carotene bleaching inhibition capacity were also found in the stored control samples. Once again, this result may be attributed to the intrinsic plant-protection mechanisms. Overall, the argon atmosphere was more suitable for quality preservation and shelf-life extension of buckler sorrel.
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Archaeal replicative DNA polymerase D (PolD) constitute an atypical class of DNA polymerases made of a proofreading exonuclease subunit (DP1) and a larger polymerase catalytic subunit (DP2), both with unknown structures. We have determined the crystal structures of Pyrococcus abyssi DP1 and DP2 at 2.5 and 2.2 angstrom resolution, respectively, revealing a catalytic core strikingly different from all other known DNA polymerases (DNAPs). Rather, the PolD DP2 catalytic core has the same 'double-psi beta-barrel' architecture seen in the RNA polymerase (RNAP) superfamily, which includes multi-subunit transcriptases of all domains of life, homodimeric RNA-silencing pathway RNAPs and atypical viral RNAPs. This finding bridges together, in non-viral world, DNA transcription and DNA replication within the same protein superfamily. This study documents further the complex evolutionary history of the DNA replication apparatus in different domains of life and proposes a classification of all extant DNAPs.
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O presente relatório diz respeito às atividades realizadas no âmbito de um estágio no Health Club Virgin Active Oeiras (VAO), com incidência sobre a importância da avaliação da aptidão física aos utentes. Este estágio decorreu ao longo do 2º ano de Mestrado em Exercício e Saúde da Faculdade de Motricidade Humana. Para além de uma descrição e reflexão sobre os métodos e procedimentos adotados no decorrer do estágio, este relatório tem como objetivo principal explorar questões relacionadas com a metodologia de avaliação física aos utentes neste clube de saúde, com vista à sua otimização. Perante isto, foram estudados os meios disponíveis para a operacionalização de um protocolo de avaliação que englobasse todas as componentes da aptidão física segundo as recomendações atuais, incluindo a vertente cardiorrespiratória que não era usualmente avaliada no clube. De forma a atingir os objetivos pretendidos, o processo de sensibilização da direção do Clube foi realizado através da avaliação da aptidão cardiorrespiratória a 100 utentes iniciantes. Esta abordagem mostrou que 47% dos utentes iniciantes possuía uma aptidão cardiorrespiratória abaixo do razoável. Uma vez que esta análise era limitada, tendo em conta a elevada população que frequenta o clube, foram ainda abordados 150 utentes não iniciantes, através de uma campanha denominada “coração saudável”, na qual constou incluiu um “vale” para a realização de uma avaliação da aptidão cardiorrespiratória e um questionário. Este questionário refletiu que aproximadamente 70% dos utentes nunca tinha sido sujeito a uma prova de esforço já tendo frequentado outros clubes de saúde. Outras abordagens aos utentes foram realizadas durante este processo, nomeadamente, a promoção de atividades de cariz cardiorrespiratório e a disponibilização e instrução quanto ao uso do cardio-frequêncimetro. Este relatório refletiu a necessidade de um clube de saúde diferenciar-se não só pelas infraestruturas e atividades oferecidas, mas também pela informação e educação dos utentes relativamente à aptidão física relacionada com a saúde e ao impacto do exercício físico na qualidade de vida de quem o pratica.
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The aim of this study was to analyze the quality of life of faculty and staff of the Presbítero Benjamín Núñez Campus of Universidad Nacional (UNA, Costa Rica) as well as to assess the influence of two factors, sense of coherence and physical exercise, in the quality of life of the subjects. A group of 37 faculty members and 30 staff members participated in the study. The SF-36 Questionnaire, the Sense of Coherence Scale, and a survey to measure physical exercise habits were used. In general, results showed a relatively good quality of life and similar scores were found in the Sense of Coherence Scale. Additionally, significant connections were found between certain factors related to sense of coherence and quality of life. Data confirmed that persons who practice physical exercise have a better quality of life than those who are not physically active. It was concluded that, although quality of life and sense of coherence were relatively good, new proposals must be designed and implemented to improve both aspects. In this sense, physical exercise proved to be one of the pillars in the development of innovative proposals aimed at bettering health in university employees, all of this within the “Healthy Universities” concept.
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Prostate cancer, the leading cause of cancer in men, has positive survival rates and constitutes a challenge to men with its side effects. Studies have addressed the bivaritate relationships between prostate cancer treatment side effects masculinity, partner relationship, and quality of life (QOL). However, few studies have highlighted the relationships among prostate cancer treatment side effects (i.e., sexual dysfunction, urinary incontinence), masculinity, and relationship with the partner together on QOL in men. Most studies were conducted with predominately Caucasian sample of men. Miami is a unique multiethnic setting that hosts Cuban, Columbian, Venezuelan, Haitian, other Latin American and Caribbean communities that were not represented in previous literature. The purpose of this study was to examine relative contributions of age, ethnicity, sexual dysfunction, urinary incontinence, masculinity, and perception of the relationship with the partner on the quality of life in men diagnosed with prostate cancer. Data were collected using self administered questionnaires measuring demographic variables, sexual and urinary functioning (UCLA PCI), masculinity (CMNI), partner relationship (DAS), and QOL (SF-36). A total of 117 partnered heterosexual men diagnosed with prostate cancer were recruited from four urology clinics in Miami, Florida. Men were 67.47 (SD = 8.42) years old and identified themselves to be of Hispanic origin (54.3 %, n = 63). Findings demonstrated that there was a significant moderate negative relationship between urinary and sexual functioning of men. There was a significant strong negative association between men’s perceived relationship with partner and masculinity. There was a weak negative relationship between the partner relationship and QOL. Hierarchal multiple regression showed that the partner relationship (β = -.25, t (91) = -2.28, p = .03) significantly contributed overall to QOL. These findings highlight the importance of the relationship satisfaction in the QOL of men with prostate cancer. Nursing interventions to enhance QOL for these men should consider strengthening the relationship and involving the female partner as an active participant.
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No funding agencies or grants indicated in the publication.
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The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
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This thesis investigates how ways of being in different ontologies emerge from material and embodied practice. This general concern is explored through the particular case study of Scotland in the period of the witch trials (the 16th and 17th centuries C.E.). The field of early modern Scottish witchcraft studies has been active and dynamic over the past 15 years but its prioritisation of what people said over what they did leaves a clear gap for a situated and relational approach focusing upon materiality. Such an approach requires a move away from the Cartesian dichotomies of modern ontology to recognise past beliefs as real to those who experienced them, coconstitutive of embodiment and of the material worlds people inhabited. In theory, method and practice, this demands a different way of exploring past worlds to avoid flattening strange data. To this end, the study incorporates narratives and ‘disruptions’ – unique engagements with Contemporary Art which facilitate understanding by enabling the temporary suspension of disbelief. The methodology is iterative, tacking between material and written sources in order to better understand the heterogeneous assemblages of early modern (counter-) witchcraft. Previously separate areas of discourse are (re-)constituted into alternative ontic categories of newly-parallel materials. New interpretations of things, places, bodies and personhoods emerge, raising questions about early modern experiences of the world. Three thematic chapters explore different sets of collaborative agencies as they entwine into new things, co-fabricating a very different world. Moving between witch trial accounts, healing wells, infant burial grounds, animals, discipline artefacts and charms, the boundaries of all prove highly permeable. People, cloth and place bleed into one another through contact; trees and water emerge as powerful agents of magical-place-making; and people and animals meet to become single, hybrid-persons spread over two bodies. Life and death consistently emerge as protracted processes with the capacity to overlap and occur simultaneously in problematic ways. The research presented in this thesis establishes a new way of looking at the nature of Being as experienced by early modern Scots. This provides a foundation for further studies, which can draw in other materials not explored here such as communion wares and metal charms. Comparison with other early modern Western societies may also prove fruitful. Furthermore, the methodology may be suitable for application to other interdisciplinary projects incorporating historical and material evidence.
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While much of the study of molecular biology inevitably focuses on the parts of the genome that contain active genes, there are also non-coding regions that nonetheless play an essential role in maintaining genome integrity. One such region are telomeres, which cap the ends of all eukaryotic chromosomes and play an important role in chromosome protection. Telomere loss occurs at each cell division as a result of the ‘end replication problem’ and a relatively short telomere length is indicative of poor biological state. Thus far, the majority of studies on the dynamics and role of telomeres have been biased towards certain taxa. Research to date has mostly focussed on humans, other mammals and birds. There has been far less research on the telomere dynamics of ectotherms. It is important that we do so, especially since ectothermic vertebrates do not seem to down-regulate telomerase expression in the same way as endotherms, suggesting that their telomere dynamics may be less predictable in the later life stages. The main objective of this thesis was therefore to investigate how life history and environmental effects may influence telomere dynamics in Atlantic salmon Salmo salar. I carried out carefully designed experiments, both in the laboratory and in the wild, using a longitudinal approach where possible, in order to address a number of specific questions that are connected to this central theme. In chapter 2, I demonstrate that there can be significant links between parental life history and offspring telomere dynamics. Maternal life history traits, in particular egg size, were most strongly related to offspring telomere length at the embryonic stages. Paternal life history traits, such as early life growth rate, had a greater association with offspring telomere dynamics in the later stages of development. In chapter 3, using a wild Atlantic salmon population, I found that most individuals experienced a reduction in telomere length during the migratory phase of their life cycle; however the relative rate of telomere loss was dependent on sex, with males experiencing a relatively greater loss. Unexpectedly, I also found that juvenile salmon that had the shortest telomeres at the time of outward migration, had the greatest probability of surviving through to the return migration. In chapter 4, again using a wild system involving experimental manipulations of juvenile Atlantic salmon in Scottish streams, I found that telomere length in juvenile fish was influenced by parental traits and by direct environmental effects. Faster-growing fish had shorter telomeres and there was a greater cost (in terms of reduced telomere length) if the growth occurred in a harsher environment. I also found a positive association between offspring telomere length and the growth history of their fathers (but not mothers), represented by the number of years that fathers had spent at sea. Chapter 5 explored the hypotheses that oxidative DNA damage, catalase (CAT) antioxidant activity and cell proliferation rate are underlying mechanisms linking incubation temperature and telomere dynamics in salmon embryos. No evidence was found for any such effects, but telomere lengths in salmon embryos were found to be significantly affected by the temperature of the water in which they were living. There is also evidence that telomere length significantly increases during embryonic development. In summary, this thesis has shown that a complex mix of environmental and parental effects appear to influence telomere dynamics in Atlantic salmon, with parental effects especially evident during early life stages. It also demonstrated that telomeres lengthen through the embryo stages of development before reducing once the fry begin feeding, indicating that the patterns of telomere loss commonly found in endotherms may differ in ectotherms. Reasons for this variation in telomere dynamics are presented in the final Discussion chapter of the thesis.
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Nel settore alimentare viene utilizzata un’elevata quantità di materie plastiche per conservare i prodotti e facilitarne la distribuzione. L’utilizzo di questi polimeri ha un costo ambientale piuttosto elevato, per questo trovare surrogati ecosostenibili diventa sempre più importante. In questa tesi abbiamo testato l’efficacia del confezionamento di un prodotto altamente deperibile, quale carne di pollo, con un biofilm a base di chitosano. Il chitosano è polisaccaride largamente presente in natura, dotato di caratteristiche chimico-fisiche che permettono l’ottenimento di un film con proprietà meccaniche e di barriera simili ai polimeri tradizionali, oltre a possedere attività antibatterica. Abbiamo realizzato film contenenti chitosano e altri biocomposti, quali montmorillonite, nanoparticelle di ossido di zinco e olio essenziale di rosmarino, per un totale di 6 film con diversa composizione. Tramite analisi microbiologiche e chimico-fisiche abbiamo confrontato l’efficacia dei diversi film prodotti rispetto ad un controllo (carne conservata in un contenitore asettico). Le analisi sono state svolte in doppio, a 0, 3, 7, 10, 15 giorni di conservazione ad una temperatura di 4°C. In diversi film abbiamo ottenuto una riduzione significativa rispetto al controllo (p<0,05) della conta totale dei microrganismi mesofili aerobici (TMAM) e delle Enterobacteriaceae. La rilevazione del pH e dell’acidità titolabile ha fornito risultati in linea a quelli microbiologici. I campioni nel biofilm hanno spesso subito una variazione significativa (p<0,05) dell’umidità rispetto al controllo, a causa dell’elevata permeabilità al vapore acqueo. L’analisi dei TBARS non ha spesso riportato differenze significative rispetto al controllo (p>0,05), e quando presenti, è perché il campione era più ossidato del controllo (p<0,05). Invece, è stato ottenuto un miglioramento significativo (p<0,05) dello Hue angle tra i film e il controllo. I risultati ottenuti forniscono le basi per studi aggiuntivi.