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AIM: To explore the results of fundus screening in 5 307 newborns and the related factors of fundus diseases.METHODS: A total of 5 307 newborns who underwent fundus screening in our ophthalmology department from January to December 2022 were selected. RetCam III system was used for fundus examination, and abnormal fundus conditions were recorded. The influencing factors of retinal hemorrhage in full-term infants and retinopathy of prematurity(ROP)in preterm infants were analyzed.RESULTS: The incidence of ocular abnormalities in newborns was 27.17%, with the highest incidence of retinal hemorrhage(61.23%), followed by retinal exudation(22.95%), ROP and ROP like retinopathy(10.68%). The incidence of morning glory syndrome(0.21%), albino fundus(0.21%), and permanent fetal vasculature(PFV; 0.28%)was lower. The incidence of eye abnormalities in full-term infants was lower than that in preterm infants(26.30% vs 30.08%, P<0.05), and the incidence of retinal hemorrhage and exudation in full-term infants was higher than that in preterm infants(P<0.05). The incidence of ROP and ROP like retinopathy in preterm infants was higher than that in full-term infants(P<0.05). Natural delivery is a risk factor for retinal hemorrhage in full-term infants(P<0.05). Fetal age(32-34, 30-31 wk), birth weight(1 500-2 499, <1 500 g), milk powder feeding, and oxygen inhalation are risk factors for ROP in premature infants(all P<0.05).CONCLUSION: The incidence of eye abnormalities in newborns at our hospital is relatively high, and early detection of eye abnormalities in newborns can be achieved through fundus screening.
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Objective:To identify the influencing factors for community elderly health services provided by general practitioners (GPs) using the social ecological theory, for reference in improving their participation and satisfaction.Methods:According to the social ecological theory, an ecological model for GPs to carry out community elderly health services was constructed from four levels: public policy ecology, community health service ecology, interpersonal relationship ecology, and individual characteristics ecology of general practitioners. A survey questionnaire was designed with six latent variables: public health policy support, public health service and basic medical service supply, doctor-patient relationship, individual participation and individual satisfaction. The questionnaire was distributed to 220 GPs from 11 primary healthcare institutions in Jiangsu province, China, who were randomly selected between October and November 2021. Exploratory and confirmatory analyses of the model were conducted using AMOS 25.0.Results:A total of 207 valid questionnaires were collected, and all the KMO values of the six latent variables were greater than 0.7, while the composite reliability values and average variance extracted values greater than 0.7 and 0.5, respectively. Both the reliability and validity of the data met the analysis requirements. Exploratory analysis revealed that public health policy support had a direct positive effect on both public health service and basic medical service supply (both effect sizes being 0.37). Public health service had a direct positive effect on doctor-patient relationship, individual participation and individual satisfaction (effect sizes being 0.52, 0.22, and 0.31, respectively). The direct effect of basic medical service supply on doctor-patient relationship was not significant (effect size being 0.03), but it had a direct positive effect on public health service (effect size being 0.46). Doctor-patient relationship had a direct positive effect on individual participation (effect size being 0.51), but its direct effect on individual satisfaction was not significant (effect size being 0.06). Individual participation had a direct positive effect on individual satisfaction (effect size being 0.52). Conclusions:By optimizing the public policy ecosystem, community health service ecosystem, and interpersonal relationship ecosystem, the participation and satisfaction of general practitioners can be systematically improved.
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A total of 360 patients with prostate hyperplasia underwent transurethral holmium laser enucleation of the prostate in Department of Urology of Jinhua People′s Hospital from July 2019 to December 2022. Among 360 patients, lower urinary tract symptoms occurred one month after operation in 40 cases with an incidence rate of 11.11%. The age, body mass index (BMI), course of disease, nature of disease, preoperative prostate volume, postoperative prostate volume, preoperative IPSS score, postoperative IPSS score, preoperative maximum urine flow rate, postoperative maximum urine flow rate, preoperative residual urine volume, postoperative residual urine volume, postoperative urinary tract infection, operative time, postoperative catheter retention time were compared between patients with lower urinary tract symptoms (study group) and those without (control group). There were significant differences in the course of disease, preoperative prostate volume, preoperative IPSS score, preoperative maximum urine flow rate, preoperative residual urine volume, postoperative urinary tract infection and postoperative catheter retention time between two groups ( t=28.01, 6.35, 8.79, 17.92, 34.84, 11.45;all P<0.05). Multivariate logistic analysis showed that the course of disease, preoperative prostate volume, preoperative IPSS score, postoperative urinary tract infection, and postoperative catheter retention time were independent risk factors for postoperative lower urinary tract symptoms ( OR=6.964, 3.442, 1.944, 4.836, 4.225, 4.894; all P<0.05); while the preoperative maximum urinary flow rate was the protective factor( OR=0.043, P<0.05). The incidence of postoperative lower urinary tract symptoms in patients undergoing transurethral holmium laser enucleation of prostate is high. Effective protective measures should be taken based on the risk factors to reduce the incidence of postoperative lower urinary tract symptoms and to promote the early recovery of patients.
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Objective:To investigate the status quo and influencing factors of health self-management ability of scientific and technological workers in Shanxi Province.Methods:This study was a cross-sectional study. Using the general situation questionnaire and the adult health self-management ability evaluation scale, 467 scientific and technological workers who received physical examination in the First Hospital of Shanxi Medical University from January 2022 to September 2022 were investigated by questionnaire, and their height, weight, body mass index, fasting blood glucose, blood lipids and blood uric acid were collected on the day of physical examination. Multiple linear regression analysis was used to explore the influencing factors of health self-management ability, and Pearson and Spearman correlation analysis was used to analyze the correlation between health self-management ability and examination items.Results:The total score of health self-management ability of 467 scientific and technological workers was (153.7±16.5). The results of multiple linear regression showed that the type of medical insurance, self-assessment of health status, staying up late, and sleep quality were independent influencing factors of health self-management ability ( R2=0.141, adjusted R2=0.120, F=6.771; P<0.001). Health self-management ability was positively correlated with high-density lipoprotein ( r=0.114), behavioral subscale was positively correlated with high-density lipoprotein ( r=0.107), environmental subscale was negatively correlated with uric acid ( r=-0.103), triglyceride ( r=-0.118), and positively correlated with high-density lipoprotein ( r=0.129), and cognitive subscale was negatively correlated with triglyceride ( r=-0.125), all of which were statistically significant ( P<0.05). Conclusions:The ability of health self-management of scientific and technological workers in Shanxi Province belongs to the upper middle level, which is affected by the type of medical insurance, the self-assessment of health status, staying up late, and the quality of sleep. It is suggested that the ability of health self-management of scientific and technological workers can be improved by strengthening their health beliefs, providing a more convenient working environment, reducing the frequency of staying up late, and improving their sleep quality.
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Cataract extraction is often combined with the implantation of intraocular lens (IOL) with the diopter matching the operated eye to restore optimal visual function after surgery.However, there are often errors between the actual refractive power of the operated eye and the predicted value.One of the major causes of postoperative refractive error is the change in IOL position compared with the expected position.In order to improve the accuracy of postoperative refraction prediction, Holladay proposed to introduce the concept of effective lens position (ELP) into the IOL diopter calculation formula.The differences in the parameters and algorithms incorporated in the calculation of ELP lead to differences in the accuracy of IOL calculation formulas.With the application of multi-parameter calculation methods, especially the formula based on the artificial intelligence algorithm, the accuracy of IOL calculation formula has been significantly improved.ELP is also affected by various factors such as differences in ocular anatomy, IOL design and material, and surgical procedures, especially the factors affecting the stability of the capsular bag that increase the difficulty of accurately predicting ELP.Therefore, the changes in postoperative ELP need to be further discussed in order to obtain more accurate postoperative refraction.This article aimed to give a review of the development of calculation formulas and the influencing factors of ELP.
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Premature infants have immature gastrointestinal function and are prone to various comorbidities after birth, which have a great impact on their near and long-term prognosis.Proper nutritional support is the basis of their survival and treatment plan, of which enteral nutrition is the main tool.However, the management of enteral nutrition varies considerably between neonatal facilities worldwide, and the nutritional management of preterm infants varies between physicians.This review summarized and discussed the existing literature on enteral nutrition in preterm infants, to provide a review of the current status of enteral nutrition support in preterm infants in China and abroad and the factors that currently influence the time to achieve adequate enteral nutrition, aiming to provide a reference for improving clinical practice protocols.
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Objective:To systematically review the prevalence, influencing factors of financial toxicity and coping strategies in cancer patients.Methods:The studies on financial toxicity among cancer patients were searched in PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, WangFang Data, CNKI, Sinomed, VIP from inception to June 2022. Stata14.0 software was used to analyze the prevalence of financial toxicity and coping strategies with a single group meta-analysis. Descriptive analysis was used to analyze the influencing factors.Results:A total of 25 papers including 2 939 cancer patients were included. Meta-analysis results showed that the prevalence of financial toxicity in cancer patients was 47% (95% CI 39%-55%). The influencing factors of financial toxicity included sociodemographic factors, disease related factors, medical insurance related factors and psychological factors. Conclusions:The high incidence of financial toxicity in cancer patients is associated with a variety of factors. Health care professionals should pay attention to early screening of cancer patients, dynamically collect relevant data such as patient expenditure items, continuously assess patients' economic status, and make relevant preventive efforts.
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Embryo implantation is one of the most critical steps in the reproductive process. The failure of embryo implantation to continue development is one of the important reasons leading to infertility. The success of embryo implantation depends on the high receptivity of endometrium and the embryo with implantation ability. Autophagy is a process in which cytoplasm， organelles， and inclusions are absorbed by double-membrane vesicles and transported to lysosomes for degradation and recycling， which is a way to maintain the homeostasis. A large amount of evidence have shown that autophagy plays an important role in all aspects of embryo implantation. Based on this， this paper explored the relationship between autophagy and endometrial receptivity and embryo implantation ability. According to the latest research progress， this paper combed 5 mechanisms （promotion of decidualization of endometrial stromal cells， promotion of apoptosis， regulation of hormone levels， coordination of inflammation， and promotion of ovulation） of 14 kinds of Chinese medicine monomers， including emodin， catalpol， paeoniflorin， resveratrol， folic acid， zearalenone， curcumin， wogonin， quercetin， chrysin， berberine， apigenin， phisetine， and kaempferol， in regulating different links of autophagy intervention in embryo implantation. This paper is expected to provide references and ideas for future Chinese medicine monomers to improve the success rate of embryo implantation.
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Objective: To investigate the clinicopathological characteristics of superior mediastinal lymph node metastases (sMLNM) in medullary thyroid carcinoma (MTC). Methods: This retrospective analysis enrolled the patients who were treated for sMLNM of MTC in our hospital from May 2012 to January 2021. All patients were suspected of sMLNM due to preoperative imaging. According to the pathological results, the patients were divided into two groups named sMLNM group and the negative superior-mediastinal-lymph-node group. We collected and analyzed the clinical features, pathological features, pre- and post-operative calcitonin (Ctn), and carcinoembryonic antigen (CEA) levels of the two groups. Logistic regression analysis was used to analyze risk factors, and receiver operation characteristic (ROC) curves were drawn to determine the optimal cut-off values of preoperative Ctn and preoperative CEA for predicting sMLNM. Results: Among the 94 patients, 69 cases were in the sMLNM group and 25 cases were in the non-SMLNM group. Preoperative Ctn level (P=0.003), preoperative CEA level (P=0.010), distant metastasis (P=0.022), extracapsular lymph node invasion (P=0.013), the number of central lymph node metastases (P=0.002) were related to sMLNM, but the multivariate analysis did not find any independent risk factors. The optimal threshold for predicting sMLNM by pre-operative Ctn is 1500 pg/ml and AUC is 0.759 (95% CI: 0.646, 0.872). The sensitivity, specificity, positive predictive value, and negative predictive value of diagnosis are 61.2%, 77.3%, 89.1%, 39.5%, respectively. In patients who underwent mediastinal lymph node dissection through transsternal approach, the metastatic possibility of different levels from high to low were level 2R (82.3%, 28/34), level 2L (58.8%, 20/34), level 4R (58.8%, 20/34), level 3 (23.5%, 8/34), level 4L (11.8%, 4/34). Postoperative complications occurred in 41 cases (43.6%), and there was no perioperative death in all cases. 14.8% (12/81) of the patients achieved biochemical complete response (Ctn≤12 pg/ml) one month after surgery, 5 of these patients were in sMLNM group. Conclusions: For patients who have highly suspicious sMLNM through imaging, combining with preoperative Ctn diagnosis can improve the accuracy of diagnosis, especially for patients with preoperative Ctn over 1 500 pg/ml. The superior mediastinal lymph node dissection for the primary sternotomy should include at least the superior mediastinal levels 2-4 to avoid residual lesions. The strategy of surgery needs to be cautiously performed. Although the probability of biochemical cure in sMLNM cases is low, nearly 40% of patients can still benefit from the operation at the biochemical level.
Subject(s)
Humans , Carcinoembryonic Antigen , Lymphatic Metastasis/pathology , Retrospective Studies , Lymph Nodes/pathology , Thyroid Neoplasms/pathology , Carcinoma, Neuroendocrine/pathology , Lymph Node Excision/methodsABSTRACT
ObjectiveTo investigate the risk factors of anemia in HIV-infected patients receiving highly active antiretroviral therapy （HAART） in the Pudong New Area. MethodsA retrospective cohort study was conducted among HIV-infected patients who started HAART from 2005 to 2020 in Pudong New Area. Cox proportional hazards model was used to analyze the risk factors of anemia， moderate or severe anemia， and chronic anemia. The piecewise linear mixed-effect model was used to analyze the association between initial HAART classes and hemoglobin change in the follow-up. ResultsA total of 2 403 HIV-infected patients were included in the analysis. Among them， there were 357 cases of new onset anemia， 86 cases of chronic anemia and 102 cases of moderate or severe anemia， with the incidence density of 4.41/100 person years， 0.89/100 person years and 0.96/100 person years respectively. Multifactorial Cox regression analysis results showed that female， age >45 years， baseline CD4+ T lymphocyte count （CD4） <200 cells‧μL-1， opportunistic infections， glomerular filtration rate （eGFR） <60 mL‧min-1‧（1.73 m2）-1， and zidovudine （AZT） or protease inhibitor （PIs） based regimens were associated factors for the development of anemia. Female， age >45 years， CD4 <200 cells‧μL-1， opportunistic infections， and AZT-based regimens were associated with the development of chronic anemia. Mild anemia at baseline and AZT-based regimens were associated with the development of moderate or severe anemia. Linear mixed-effects model showed that the use of AZT （-7.87 g‧L-1， 95%CI： -9.42 to -6.32） or PIs （-3.43 g‧L-1， 95%CI： -5.57 to -1.30） was associated with lower Hb at follow-up. ConclusionInitial use of AZT and PIs is associated with progression to anemia and a lower follow-up hemoglobin level. Increased hemoglobin monitoring in users of AZT and PIs may be beneficial， especially during the first 6 months after initiation of HAART.
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Objective: To explore the influencing factors of abnormal pulmonary function in dust-exposed workers and establish the risk prediction model of abnormal pulmonary function. Methods: In April 2021, a total of 4255 dust exposed workers from 47 enterprises in 2020 were included in the study. logistic regression was used to analyze the influencing factors of abnormal pulmonary function in dust-exposed workers, and the corresponding nomogram prediction model was established. The model was evaluated by ROC curve, Calibrationpolt and decision analysis curve. Results: logistic regression analysis showed that age (OR=1.03, 95%CI=1.02~1.05, P<0.001) , physical examination type (OR=4.52, 95%CI=1.69~12.10, P=0.003) , dust type (Comparison with coal dust, Cement dust, OR=3.45, 95%CI=1.45~8.18, P=0.005, Silica dust (OR=2.25, 95%CI=1.01~5.03, P=0.049) , blood pressure (OR=1.63, 95%CI=1.22~2.18, P=0.001) , creatinine (OR=0.08, 95%CI=0.05~0.12, P<0.001) , daily exposure time (OR=1.06, 95%CI=1.10~1.12, P=0.034) and total dust concentration (OR=1.29, 95%CI=1.08~1.54, P=0.005) were the influencing factors of abnormal pulmonary function. The area under the ROC curve of risk prediction nomogram model was 0.764. The results of decision analysis curve showed that the nomogram model had reference value in the prevention and intervention of abnormal pulmonary function when the threshold probability exceeded 0.05. Conclusion: The accuracy ofthe nomogram model constructed by logistic regression werewell in predicting the risk of abnormal lung function of dust-exposed workers.
Subject(s)
Humans , Dust/analysis , Lung , Nomograms , Risk Factors , ROC CurveABSTRACT
OBJECTIVE@#Taking artificial hip joint test as the object, integrating ISO/IEC 17025 and GLP, and establishing a new set of management requirements for test influence factors.@*METHODS@#The requirements of ISO/IEC 17025 and GLP regulations for influencing factors were compared and analyzed, the similarities and differences were found, and the two were integrated to formulate new management requirements for each influencing factor.@*RESULTS@#From the personnel, equipment, materials, methods, reports, filing and other factors, a set of management requirements in line with ISO/IEC 17025 and GLP was formulated, so that the laboratory can provide the objective, real and accurate test data for medical equipment manufacturers and regulatory authorities.@*CONCLUSIONS@#It can improve the test quality of the laboratory and ensure the authenticity and reliability of the test data and conclusions.
Subject(s)
Reproducibility of Results , Laboratories , Hip JointABSTRACT
The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.
Estudos sobre assembleias de peixes em riachos enfatizam o papel dos filtros ambientais associados ao padrão de colonização das assembleias, por outro lado, quando a assembleia está sujeita aos efeitos antropogênicos, as variáveis ambientais associadas à qualidade ambiental assumem maior importância. Dessa forma, o objetivo deste estudo foi analisar a riqueza e a composição de peixes de riachos amostrados em diferentes níveis de urbanização, buscando evidenciar se o efeito reflete diretamente na estrutura das assembleias. As amostragens foram realizadas em 31 locais distribuídos em três microbacias na bacia Rio Ivinhema, Alto Rio Paraná, no período de 2003 a 2011. Com base nas variáveis ambientais, físico-químicos da água e análise do uso e ocupação do solo as microbacias foram classificadas em diferentes níveis de urbanização (baixo, médio e alto). Foram amostrados um total 4.320 indivíduos, dos quais foram registradas 57 espécies de peixes. Os locais amostrados com influência média da urbanização apresentaram maior riqueza de espécies, entretanto, os locais amostrados com alta influência da urbanização apresentaram menor riqueza de espécies. Dessa forma, constatamos que a urbanização influencia diretamente na integridade ambiental, que pode levar a homogeneização das assembleias de riachos.
Subject(s)
Animals , Soil Analysis , River Basins/analysis , Fishes/classification , Fishes/growth & development , Environmental Pollution/analysis , Urbanization , Land Use , Water/analysis , Water/chemistryABSTRACT
Abstract The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.
Resumo Estudos sobre assembleias de peixes em riachos enfatizam o papel dos filtros ambientais associados ao padrão de colonização das assembleias, por outro lado, quando a assembleia está sujeita aos efeitos antropogênicos, as variáveis ambientais associadas à qualidade ambiental assumem maior importância. Dessa forma, o objetivo deste estudo foi analisar a riqueza e a composição de peixes de riachos amostrados em diferentes níveis de urbanização, buscando evidenciar se o efeito reflete diretamente na estrutura das assembleias. As amostragens foram realizadas em 31 locais distribuídos em três microbacias na bacia Rio Ivinhema, Alto Rio Paraná, no período de 2003 a 2011. Com base nas variáveis ambientais, físico-químicos da água e análise do uso e ocupação do solo as microbacias foram classificadas em diferentes níveis de urbanização (baixo, médio e alto). Foram amostrados um total 4.320 indivíduos, dos quais foram registradas 57 espécies de peixes. Os locais amostrados com influência média da urbanização apresentaram maior riqueza de espécies, entretanto, os locais amostrados com alta influência da urbanização apresentaram menor riqueza de espécies. Dessa forma, constatamos que a urbanização influencia diretamente na integridade ambiental, que pode levar a homogeneização das assembleias de riachos.
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ABSTRACT OBJECTIVE This study aimed to measure the proportion of Uber use instead of drinking and driving in ten Brazilian capitals, in 2019. METHODS A cross-sectional survey was developed in ten Brazilian capitals. Data were collected in agglomeration points (AP) and sobriety checkpoints (SC). Based on responses to a standardized questionnaire, the proportion of drivers who used Uber instead of drinking and driving was measured for total sample of each methodology and stratified by municipality, age group, gender, education level, and type of vehicle. Fisher's exact test was used to make comparisons between the strata. RESULTS A total of 8,864 drivers were interviewed. The most used means of transport to replace driving after drinking alcohol was the Uber system (AP: 54.6%; 95%CI: 51.2-58.0. SC: 58.6%; 95%CI: 55.2-61.9). Most of these users were aged from 18 to 29 years, women, with at least one higher education degree. According to the AP methodology, the highest magnitude of this indicator was found in Vitória (ES) (71.0%; 95%CI: 63.5-77.5), whereas the lowest was observed in Teresina (PI) (33.1%; 95%CI: 22.7-45.5). According to the SC methodology, the highest magnitude of the indicator was also found in Vitória (ES) (78.3%; 95%CI: 68.8-85.5), whereas the lowest was observed in Boa Vista (RR) (36.6%; 95%CI: 26.8-47.7). CONCLUSION In Brazilian capitals, the study showed higher proportions of Uber use instead of drinking and driving. This type of scientific evidence on factors associated with road traffic injuries presents the potential to guide public health interventions.
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Humans , Male , Female , Automobile Driving , Automobiles , Motorcycles , Alcohol Drinking/epidemiology , Driving Under the Influence , Brazil/epidemiology , Accidents, Traffic , Cross-Sectional StudiesABSTRACT
ABSTRACT: The birth of a child with a disability brings implications, changes in the environment and family dynamics. The family goes through a process of overcoming until the child acceptance with disability and the establishment of a suitable family environment that includes and meets his/her needs. Trisomy 21 (T21) is the most frequent genetic anomaly among those diagnosed. This study aimed to identify the perception of a sibling group of people with T21 regarding their family and social relationships. The sample consisted of 18 adolescents aged between 11 and 16 years, siblings of people with T21, and 17 guardians. Data collection occurred through semi-structured interviews conducted by video calls, with an average duration of 10 to 15 minutes. The interviews were recorded, transcribed and analyzed qualitatively based on the creation of thematic nuclei and categories. The results reinforce the importance of family relationships as a security factor and acceptance of the siblings' needs.
RESUMO: O nascimento de uma criança com deficiência traz implicações, mudanças no ambiente e na dinâmica familiar como um todo. A família passa por um processo de superação até a aceitação da criança com deficiência e a instalação de um ambiente familiar propício que a inclua e atenda às suas necessidades. A trissomia 21 (T21) é a anomalia genética mais frequente dentre as diagnosticadas. Este estudo teve como objetivo conhecer a percepção de um grupo de irmãos de pessoas com T21 quanto às suas relações familiares e sociais. A amostra foi composta por 18 adolescentes com idades entre 11 e 16 anos, irmãos de pessoas com T21 e 17 responsáveis. A coleta de dados ocorreu por meio de entrevista semiestruturada realizadas por meio de chamada de vídeo, com duração média de dez a 15 minutos. As entrevistas foram gravadas, transcritas e analisadas qualitativamente a partir da criação de núcleos temáticos e categorias. Os resultados reforçam a importância das relações familiares como um fator segurança e acolhimento das necessidades dos irmãos.
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Abstract The colonization pattern of fish assemblages in streams is often studied in the context of environmental filters. On the other hand, when fish assemblages are subjected to anthropogenic effects, variables associated with environmental quality assume more importance. Therefore, this work evaluated the richness and composition of fish from streams sampled at different urbanization levels, aiming to determine any direct effects on the structure of fish assemblages. To accomplish this, samples were collected from 2003 to 2011 at 31 sites distributed among 3 microbasins in the Rio Ivinhema Basin, Alto Rio Paraná. Based on environmental variables, physicochemical of the water and analysis of the use and occupation of the soil, the microbasins were classified into different urbanization levels (low, medium and high). A total of 4,320 individuals were sampled, out of which 57 fish species were recorded. Sampled sites with medium urbanization level presented higher richness compared to sampled sites with high urbanization level which presented lower richness. Species richness in these sites was explained mainly by water temperature and water velocity. Results confirmed that urbanization does directly affect environmental integrity, which, in turn, can lead to the homogenization of stream assemblages.
Resumo Estudos sobre assembleias de peixes em riachos enfatizam o papel dos filtros ambientais associados ao padrão de colonização das assembleias, por outro lado, quando a assembleia está sujeita aos efeitos antropogênicos, as variáveis ambientais associadas à qualidade ambiental assumem maior importância. Dessa forma, o objetivo deste estudo foi analisar a riqueza e a composição de peixes de riachos amostrados em diferentes níveis de urbanização, buscando evidenciar se o efeito reflete diretamente na estrutura das assembleias. As amostragens foram realizadas em 31 locais distribuídos em três microbacias na bacia Rio Ivinhema, Alto Rio Paraná, no período de 2003 a 2011. Com base nas variáveis ambientais, físico-químicos da água e análise do uso e ocupação do solo as microbacias foram classificadas em diferentes níveis de urbanização (baixo, médio e alto). Foram amostrados um total 4.320 indivíduos, dos quais foram registradas 57 espécies de peixes. Os locais amostrados com influência média da urbanização apresentaram maior riqueza de espécies, entretanto, os locais amostrados com alta influência da urbanização apresentaram menor riqueza de espécies. Dessa forma, constatamos que a urbanização influencia diretamente na integridade ambiental, que pode levar a homogeneização das assembleias de riachos.
Subject(s)
Humans , Animals , Urbanization , Rivers , Soil , Brazil , Ecosystem , FishesABSTRACT
Abstract: Background: It is challenging to make informed decision in genetic counseling. Shared decision-making provides a chance in balancing the information and preferences between counselors and counselees. However, the status and prescriptions of shared decision-making have not been extensively studied in genetic counseling. Aim: To develop an up-to-date literature review of the shared decision-making in genetic counseling, identify knowledge gaps, and provide inspiration and suggestions for the development and practice of genetic counseling. Methods: "Genetic Counseling" and "Shared decision-making" were used to search in PubMed, Web of Science, Embase, Wanfang, CNKI and CBM databases. The search deadline was March 26, 2021. Results: A total of 22 articles were included, and four themes were identified: how people involved in genetic counseling, different stakeholders involved in SDM, multiple facilitators and barriers to SDM and the effectiveness of SDM in genetic counseling. Conclusion: Each participant needs to recognize their boundaries and make the best effort to involve in the shared decision-making. In the future, multinational studies should be considered for bringing shared decision-making to the global scale and well-designed studies are required to explore the long-term impact of shared decision-making in genetic counseling.
Resumen: Antecedentes: Es un reto tomar una decisión informada en el asesoramiento genético. La toma de decisiones compartida ofrece una oportunidad para equilibrar la información y las preferencias entre los asesores y los pacientes. Sin embargo, el estado y las prescripciones de la toma de decisiones compartida no se han estudiado ampliamente en el asesoramiento genético. Objetivo: Desarrollar una revisión bibliográfica actualizada de la toma de decisiones compartida en el asesoramiento genético, identificar las lagunas de conocimiento y proporcionar inspiración y sugerencias para el desarrollo y la práctica del asesoramiento genético. Métodos: "Genetic Counseling" y "Shared decision-making" se utilizaron para buscar en las bases de datos PubMed, Web of Science, Embase, Wanfang, CNKI y CBM. La fecha límite de búsqueda fue el 26 de marzo de 2021. Resultados: Se incluyó un total de 22 artículos y se identificó cuatro temas: cómo se involucran las personas en el asesoramiento genético, las diferentes partes interesadas involucradas en la GDS, los múltiples facilitadores y barreras para la GDS y la efectividad de la GDS en el asesoramiento genético. Conclusión: Cada participante necesita reconocer sus límites y hacer el mejor esfuerzo para involucrarse en la toma de decisiones compartida. En el futuro, se debe considerar la realización de estudios multinacionales para llevar la toma de decisiones compartida a la escala global y se requieren estudios bien diseñados para explorar el impacto a largo plazo de la toma de decisiones compartida en el asesoramiento genético.
Resumo Antecedentes: Tomar uma decisão informada em aconselhamento genético é um desafio. A tomada de decisão compartilhada (SDM) fornece uma oportunidade para contrabalançar a informação e preferências entre conselheiros e aconselhados. Entretanto, o status e prescrições da tomada de decisão compartilhada não têm sido extensivamente estudados em aconselhamento genético. Objetivo: Desenvolver uma revisão de literatura atualizada sobre a tomada de decisão compartilhada em aconselhamento genético, identificar lacunas no conhecimento e fornecer inspiração e sugestões para o desenvolvimento e prática do aconselhamento genético. Métodos: "Genetic Counseling" e "Shared decision-making" foram usados para pesquisar nos bancos de dados PubMed, Web of Science, Embase, Wanfang, CNKI e CBM. A data limite para a pesquisa foi 26 de março de 2021. Resultados: Um total de 22 artigos foram incluídos e quatro temas foram identificados: como pessoas se envolveram em aconselhamento genético, diferentes interessados envolvidos em SDM, facilitadores e barreiras múltiplas à SDM e efetividade da SDM em aconselhamento genético. Conclusão: Cada participante necessita reconhecer seus limites e fazer os melhores esforços para se envolver em tomada de decisão compartilhada. No futuro, estudos multinacionais devem ser considerados para trazer a tomada de decisão compartilhada a uma escala global e estudos bem desenhados são requeridos para explorar o impacto a longo prazo da tomada de decisão compartilhada em aconselhamento genético.
Subject(s)
Humans , Decision Making, Shared , Genetic CounselingABSTRACT
RESUMEN Introducción: La competencia en matemáticas se encuentra relacionada con el desarrollo de habilidades básicas para el procesamiento numérico (simbólico y no simbólico) desde etapas tempranas del desarrollo y antes de la escolarización formal. Existe evidencia a favor de que el ambiente del hogar proporciona experiencias que facilitan la adquisición de habilidades específicas relacionadas con las matemáticas. Objetivo: Identificar actividades y estilos de relación presentes en el marco familiar que son buenos predictores del procesamiento numérico y el rendimiento aritmético de niños preescolares cubanos. Método: Entre septiembre y noviembre de 2019 se evaluaron 82 preescolares cubanos y sus padres a través de un estudio no experimental de tipo transeccional, con un carácter descriptivo-correlacional. Los instrumentos utilizados fueron el Numeracy Screener y Cuestionario para Padres, ambos adaptados al contexto cubano en el Centro de Neurociencias de Cuba. Resultados: El desarrollo de habilidades específicas para el procesamiento numérico básico, en formato simbólico y no simbólico, predijo de forma significativa el rendimiento matemático en la muestra estudiada. Se confirmó que la presencia en el marco familiar de estilos de relación y actividades que incluyen contenido numérico y cuantitativo, favorece el desarrollo de habilidades para el procesamiento numérico en los niños preescolares. Conclusiones: Entre los factores más significativos se encontraron: escolaridad de los padres, sus experiencias y actitudes hacia las matemáticas y la frecuencia con que comparten prácticas formales numéricas con sus hijos en el hogar.
ABSTRACT Introduction: Competence in mathematics is related to the development of basic skills for number processing (symbolic and non-symbolic) from early stages of development and before formal schooling. There is evidence that the home environment provides experiences that facilitate the acquisition of specific math-related skills. Objective: To identify activities and relationship styles present in the family setting that are good predictors of numerical processing and arithmetic performance in Cuban preschool children. Method: Between September and November 2019, 82 Cuban preschoolers and their parents were evaluated through a non-experimental transactional study, with a descriptive-correlational nature. The instruments used were the Numeracy Screener and Parent Questionnaire, both adapted to the Cuban context at the Centro de Neurociencias de Cuba. Results: The development of specific skills for basic numerical processing, in symbolic and non-symbolic format, significantly predicted mathematical performance in the sample studied. It was confirmed that the presence in the family of relationship styles and activities that include numerical and quantitative content favors the development of numerical processing skills in preschool children. Conclusions: Among the most significant factors found were: parental education, their experiences and attitudes towards mathematics and the frequency with which they share formal numerical practices with their children at home.
RESUMO Introdução: A competência em matemática está relacionada ao desenvolvimento de habilidades básicas para processamento de números (simbólicos e não simbólicos) desde as fases iniciais do desenvolvimento e antes da escolarização formal. Há evidências de que o ambiente domiciliar proporciona experiências que facilitam a aquisição de habilidades específicas relacionadas à matemática. Objetivo: Identificar atividades e estilos de relacionamento presentes no ambiente familiar que sejam bons preditores de processamento numérico e desempenho aritmético em crianças pré-escolares cubanas. Método: Entre setembro e novembro de 2019, 82 pré-escolares cubanos e seus pais foram avaliados por meio de um estudo transacional não experimental, de natureza descritivo-correlacional. Os instrumentos utilizados foram o Numeracy Screener e o Parent Questionnaire, ambos adaptados ao contexto cubano no Centro de Neurociencias de Cuba. Resultados: O desenvolvimento de habilidades específicas para processamento numérico básico, em formato simbólico e não simbólico, predisse significativamente o desempenho matemático na amostra estudada. Confirmou-se que a presença na família de estilos de relacionamento e atividades que incluem conteúdos numéricos e quantitativos favorece o desenvolvimento de habilidades de processamento numérico em crianças pré-escolares. Conclusiones: Entre os fatores mais significativos foram encontrados: a educação dos pais, suas experiências e atitudes em relação à matemática e a frequência com que compartilham práticas numéricas formais com seus filhos em casa.
ABSTRACT
Abstract One research line in criminal behavior studies 2D:4D ratio as predictor of aggression and violent behavior has been established, given that there are sexually dimorphic behaviors associated with the influence of testosterone on brain organization. However, results have been mixed. The aim of this study was to explore the differences in the 2D:4D ratio among offending and non-offending Colombian men in four groups (N = 139). A comparative study was conducted with three groups of offenders sentenced in a Colombian penitentiary: (1) sexual offenders against children (n = 34), (2) sexual offenders against adult women (n = 31), and (3) non-sexual violent offenders (n = 26); as well as one group (4) men with no criminal record (n = 48). The 2D:4D ratio was measured using the hand scanning technique and three digital measurements were analyzed with the Autometric software: right hand ratio, left hand ratio, and difference between the right and left hand ratios (Dr - Iz). Although, in all groups, right-digit ratio was lower that left-digit ratio (negative Dr-l ratio) and, in non-offending men this difference was not significant, no strong significant differences were found between groups in any measure of 2D:4D ratio used (right hand, left hand or Dr−l). The results support the idea that these associations are too weak to consider them predictors of sexual or non-sexual criminal behavior. The risk factors determining sexual or non-sexual criminal behavior, seems to go beyond intra-uterine effects and involve complex interactions between heritability, epigenetics, and pre-natal and post-natal life events.
Resumen Una de las líneas de investigación de la conducta criminal estudia la relación 2D:4D como predictor de agresión y comportamiento violento, dada la conexión de este marcador biológico con la influencia de la testosterona en la organización del cerebro y los comportamientos sexualmente dimórficos más prevalentes en hombres. Los resultados han sido mixtos y, en general, se han encontrado tamaños de efecto débiles, aunque significativos, en la relación entre proporción 2D:4D y el comportamiento agresivo, con escasos estudios comparativos y con muestras forenses. El objetivo de este estudio fue explorar las diferencias en la relación 2D:4D entre hombres colombianos (N = 139) con y sin delitos en cuatro grupos. Para ello, .e realizó un estudio comparativo con tres grupos de delincuentes condenados en una cárcel de Colombia: (1) agresores sexuales de menores (n = 34); (2) agresores sexuales de mujeres adultas (n = 31); (3) delincuentes violentos no sexuales (n = 26), y uno de (4) hombres sin antecedentes delictivos (n = 48). Se midió la proporción 2D:4D usando la técnica de escaneo de las manos y se analizaron tres medidas digitales con el software Autometric: proporción de la mano derecha, mano izquierda y diferencia entre la proporción de las manos derecha e izquierda (Dr - Iz). Se encontraron diferencias significativas entre la diferencia de la proporción Dr-Iz en todos los grupos, en la que la 2D:4D de la mano derecha fue menor que la de la mano izquierda en todos los grupos. Sólo en los hombres sin antecedentes delictivos esta diferencia no fue significativa. Para evaluar las diferencias grupales en las relaciones 2D:4D, se ajustaron modelos tipo a ANOVA unidireccional con un solo grupo como predictor, seguidos de contrastes de Helmert para comparar las diferencias entre todos los grupos. El grupo predijo sólo la diferencia de las proporciones Dr - Iz, pero no las proporciones de la mano derecha o izquierda por separado. El grupo de hombres sin antecedentes delictivos, mostró una proporción 2D:4D de la mano izquierda significativamente menor (masculinizada) y una menor diferencia (más cercana a cero) entre las proporciones Dr-Iz comparado con los grupos de delincuentes. Sin embargo, los contrastes con cada grupo, mostraron que la diferencia sólo fue significativa con el grupo de delincuentes violentos no sexuales, pero no con los grupos de agresores sexuales. Se concluyó que no hubo diferencias significativas importantes y concluyentes entre los grupos en ninguna medida de la proporción 2D:4D utilizada (mano derecha, mano izquierda o Dr − Iz). Estos resultados respaldan la idea de que estas asociaciones son demasiado débiles para considerarlas predictores de conductas criminales sexuales o no sexuales. Los factores de riesgo que determinan el comportamiento delictivo sexual o no sexual parecen ir más allá de los efectos intrauterinos reflejados por el biomarcador 2D:4D y, posiblemente, involucrar interacciones complejas entre heredabilidad, epigenética y eventos de la vida prenatal y postnatal. Si la relación 2D:4D es un marcador indirecto válido y confiable de androgenización prenatal, no es algo que se pueda discutir con los datos aquí obtenidos. Sin embargo, si tiene más que un simple efecto detectado por casualidad en el comportamiento delictivo, esto también debería explorarse más a fondo no sólo en la mano derecha, como la mayoría de la investigación disponible lo ha hecho, sino en la mano izquierda y en la diferencia entre las proporciones 2D:4D Dr-Iz, para evaluar si su poder explicativo se mantiene bajo como hasta ahora o incluso inexistente.