Family Caregivers' Experiences with Tele-Rehabilitation for Older Adults with Hip Fracture.

BACKGROUND: There is a knowledge gap for implementing tele-rehabilitation (telerehab) after hip fracture. We recently conducted a clinical trial (ClinicalTrials.gov Identifier: NCT02968589) to test a novel online family caregiver-supported rehabilitation program for older adults with hip fracture, called @ctivehip. In this qualitative substudy, our objective was to use semi-structured interviews to explore family caregivers experience with the telerehab program. METHODS: Twenty-one family caregivers were interviewed between three and six months after the older adults completed @ctivehip. One occupational therapist with research and clinical experience, but not involved in the main trial, conducted and transcribed the interviews. We conducted a multi-step content analysis, and two authors completed one coding cycle and two recoding cycles. RESULTS: Family caregivers who enrolled in @ctivehip were satisfied with the program, stated it was manageable to use, and perceived benefits for older adults' functional recovery after hip fracture. They also suggested improvements for the program content, such as more variety with exercises, and increased monitoring by health professionals. CONCLUSIONS: This work extends existing literature and generates research hypotheses for future studies to test telerehab content and program implementation.

The Journey of Recovery: Caregivers' Perspectives From a Hip Fracture Telerehabilitation Clinical Trial.

OBJECTIVE: The objective was to explore family caregivers' perspectives of the recovery process of older adults with hip fracture and describe experiences from caregivers who: (1) used the online intervention, or (2) received home-based care provided by the Andalusian Public Health Care System. METHODS: This was an exploratory secondary study with informal family caregivers who had an older adult family member with hip fracture enrolled in a novel telerehabilitation (telerehab) clinical trial. Forty-four caregivers of older adults with hip fracture were interviewed at 6 to 9 months after their family member's hip fracture. RESULTS: Caregivers shared concerns of family members' survival and recovery; they recounted increased stress and anxiety due to the uncertainty of new tasks associated with providing care and the impact on their lifestyle. Although most caregivers were satisfied with the health care received, they made suggestions for better organization of hospital discharge and requests for home support. The main reasons why caregivers and their family member chose the telerehab program were to enhance recovery after fracture, gain knowledge for managing at home, and because of the convenience of completing the exercises at home. There were more family caregivers in the control group who expressed a high level of stress and anxiety, and they also requested more social and health services compared with caregivers whose family member received telerehab. CONCLUSION: Family caregivers are an essential component of recovery after hip fracture by providing emotional and physical support. However, future clinical interventions should evaluate person-centered interventions to mitigate possible stress and anxiety experienced by family caregivers. IMPACT: Family caregivers' perspectives are necessary in the co-design of management strategies for older adults after hip fracture.

Effect of high hydrostatic pressure challenge on biogenic amines, microbiota, and sensory profile in traditional poultry- and pork-based semidried fermented sausage.

The processing of traditional poultry- and pork-based semidried fermented smoked sausages needs to be modernized to improve product quality and further extend its shelf life. The aim of the present study was to apply different combinations of high pressure (300 to 600 MPa) and time (154 to 1,800 s) on the sausages using an experimental design based on response surface methodology. The chemical, microbial, and sensory characteristics of sausages treated with high-pressure processing (HPP) were investigated. HPP application to semidried fermented sausages resulted in color changes, which could be dependent on the ingredients, formulation, and smoking conditions used. Nevertheless, none of the HPP treatments applied resulted in detectable changes in sensory properties, as tested in a triangle test and confirmed by the analysis of focus groups assessment. Significant differences were detected for lactic acid bacteria (LAB) counts from 344 MPa and 1,530 s onward, with a marked decrease for the combination of 600 MPa and 960 s (P < 0.05). Coagulase-negative staphylococci showed higher tolerance to the increase in pressure than LAB. HPP induced a microbial reduction on Enterobacteriaceae, molds, and yeasts, minimizing the production of the main biogenic amines. However, the polyamines (spermine and spermidine) increased since their metabolic use by microorganisms did not occur. Given the reduction of the main spoilage microbial indicators with no detectable sensory changes observed with the binomial condition of 600 MPa and 960 s, this was chosen as the optimal combination to be further applied. PRACTICAL APPLICATION: The results from sensory analysis revealed that any of the HPP treatments applied resulted in detectable changes in sensory properties, as tested in a triangle test and confirmed by the analysis of the focus groups speeches.

Assessment and determination of LC50 of carvacrol and salicylic acid analogues with acaricide activity in larvae and adult ticks of Rhipicephalus (Boophilus) microplus.

Rhipicephalus (Boophilus) microplus is a tick that causes huge economic losses in cattle. The indiscriminate use of acaricides has generated resistance to most compounds present on the market. Carvacrol and salicylic acid have been widely studied for their biological activities and have been evaluated in different strains of Rhipicephalus. In this research the analogues carvacrol and salicylic acid were evaluated in larvae of R. (B.) microplus with data obtained in larval packet test (LPT) and larval immersion test (LIT). A lethal concentration 50 (LC50) was assessed. The most potent compounds were evaluated in the adult ticks since there are no reports of evaluation in the life state of the parasite. From all the tested compounds, the ethyl 2-methoxybenzoate (91.82 ± 1.66%, 0.91 µmol/mL) and ethyl 2,5-dihydroxybenzoate (89.14 ± 1.61%, 2.04 µmol/mL) showed the highest percentage of mortality and the lowest LC50. They were found to be the best candidates for a study in vivo.

Tendencias y pronósticos de la tuberculosis, desafíos en etapa de eliminación en La Habana / Trends and predictions of tuberculosis, and challenges towards tuberculosis eradication in Havana City

Objetivo: describir la variación y tendencia de las notificaciones de casos nuevos de tuberculosis en La Habana desde 1995 hasta 2010, así como su proyección y ocurrencia para los años 2011-2013. Métodos: se realizó un estudio de series temporales, se analizaron los porcentajes de variación total y media anual de las tasas según categoría clínica y bacteriológica, edad, distribución por municipios y coinfección tuberculosis/virus de la inmunodeficiencia humana. Las proyecciones se obtuvieron mediante el alisamiento exponencial con 2 parámetros. Resultados: la tasa de nuevos casos de tuberculosis notificados disminuyó de 16,8 en 1995 hasta 9,5 por 100 000 habitantes en 2010 (43,5 por ciento y 2,9 por ciento de variación total y variación media anual, respectivamente). La tasa descendió en 80 Por ciento de los municipios y en los grupos de edades de 15 a 64 años y con 65 años o más. La Habana Vieja y Centro Habana mantuvieron las tasas más altas durante casi todo el período. La coinfección tuberculosis/virus de la inmunodeficiencia humana se incrementó de 3/369 (0,8 por ciento) hasta 37/202 (18,3 por ciento) en 2010. Se pronostica un ligero incremento para el trienio 2011-2013 (9,5; 10 y 10,5, respectivamente) y un continuo aumento del número de casos con coinfección tuberculosis/virus de la inmunodeficiencia humana. Conclusiones: la tuberculosis muestra una tendencia descendente casi sostenida en La Habana de 1995 a 2010, con una reducción importante en el período. Sin embargo se observa una tendencia creciente de los casos de tuberculosis/virus de la inmunodeficiencia humana/sida que amenaza la posibilidad de la eliminación. Las notificaciones de casos de tuberculosis se ajustan a los valores esperados, ligeramente por encima de lo pronosticado(AU)

Objectives: to describe the variation and the trend of new tuberculosis case reports in Havana from 1995 to 2010, as well as their projection and occurrence for 2011-2013. Methods: a time series study was conducted, and the annual total and mean variation percentages of rates by clinical and bacteriological categories, age, municipal distribution and TB/HIV co-infection were analyzed. Estimation of projections by using two-parameter exponential smoothing techniques was made. Results: the rate of new reported TB cases decreased from 16.8 in 1995 to 9.5 per 100 000 inhabitants in 2010 (43.5 percent and 2.9 percent of annual total variation and mean variation respectively). The rate declined by 80 percent in the municipalities and in 15-64 and ³ 65 years age groups. Habana Vieja and Centro Habana municipalities kept the highest rates throughout the whole period. TB/HIV coinfection notification increased from 3 out of 369 (0.8 %) cases in 1995 to 37 out of 202 (18.3 %) cases in 2010. A slight increase was estimated for the 2011-2013 period (9.5; 10.0; 10.5 per 100 000 population respectively) in addition to continuous rise of the number of cases with TB/HIV co-infection. Conclusions: the TB trend showed a steady decline in Havana from 1995 to 2010, with substantial reduction in the study period, except for TB/HIV co-infection in which the number of cases increases. The TB case report rates are within the expected values, although slightly above the predictions(AU)

Tendencias y pronósticos de la tuberculosis, desafíos en etapa de eliminación en La Habana / Trends and predictions of tuberculosis, and challenges towards tuberculosis eradication in Havana City

Objetivo: describir la variación y tendencia de las notificaciones de casos nuevos de tuberculosis en La Habana desde 1995 hasta 2010, así como su proyección y ocurrencia para los años 2011-2013. Métodos: se realizó un estudio de series temporales, se analizaron los porcentajes de variación total y media anual de las tasas según categoría clínica y bacteriológica, edad, distribución por municipios y coinfección tuberculosis/virus de la inmunodeficiencia humana. Las proyecciones se obtuvieron mediante el alisamiento exponencial con 2 parámetros. Resultados: la tasa de nuevos casos de tuberculosis notificados disminuyó de 16,8 en 1995 hasta 9,5 por 100 000 habitantes en 2010 (43,5 % y 2,9 % de variación total y variación media anual, respectivamente). La tasa descendió en 80 % de los municipios y en los grupos de edades de 15 a 64 años y con 65 años o más. La Habana Vieja y Centro Habana mantuvieron las tasas más altas durante casi todo el período. La coinfección tuberculosis/virus de la inmunodeficiencia humana se incrementó de 3/369 (0,8 %) hasta 37/202 (18,3 %) en 2010. Se pronostica un ligero incremento para el trienio 2011-2013 (9,5; 10 y 10,5, respectivamente) y un continuo aumento del número de casos con coinfección tuberculosis/virus de la inmunodeficiencia humana. Conclusiones: la tuberculosis muestra una tendencia descendente casi sostenida en La Habana de 1995 a 2010, con una reducción importante en el período. Sin embargo se observa una tendencia creciente de los casos de tuberculosis/virus de la inmunodeficiencia humana/sida que amenaza la posibilidad de la eliminación. Las notificaciones de casos de tuberculosis se ajustan a los valores esperados, ligeramente por encima de lo pronosticado.

Objectives: to describe the variation and the trend of new tuberculosis case reports in Havana from 1995 to 2010, as well as their projection and occurrence for 2011-2013. Methods: a time series study was conducted, and the annual total and mean variation percentages of rates by clinical and bacteriological categories, age, municipal distribution and TB/HIV co-infection were analyzed. Estimation of projections by using two-parameter exponential smoothing techniques was made. Results: the rate of new reported TB cases decreased from 16.8 in 1995 to 9.5 per 100 000 inhabitants in 2010 (43.5 % and 2.9 % of annual total variation and mean variation respectively). The rate declined by 80 % in the municipalities and in 15-64 and ³ 65 years age groups. Habana Vieja and Centro Habana municipalities kept the highest rates throughout the whole period. TB/HIV coinfection notification increased from 3 out of 369 (0.8 %) cases in 1995 to 37 out of 202 (18.3 %) cases in 2010. A slight increase was estimated for the 2011-2013 period (9.5; 10.0; 10.5 per 100 000 population respectively) in addition to continuous rise of the number of cases with TB/HIV co-infection. Conclusions: the TB trend showed a steady decline in Havana from 1995 to 2010, with substantial reduction in the study period, except for TB/HIV co-infection in which the number of cases increases. The TB case report rates are within the expected values, although slightly above the predictions.

Hydrolysis of ibuprofen nitrile and ibuprofen amide and deracemisation of ibuprofen using Nocardia corallina B-276.

A novel application of whole cells of Nocardia corallina B-276 for the deracemisation of ibuprofen is reported. This microorganism successfully hydrolysed ibuprofen nitrile to ibuprofen amide, and ibuprofen amide to ibuprofen, using a suspension of cells in a potassium phosphate buffer solution (0.1 M, pH = 7.0). These results can be explained by the presence of NHase and amidase enzymes, but the reactions are not enantioselective and low ee values were obtained. However, (R)-ibuprofen was isolated with > 99% ee by a deracemisation process catalysed by N. corallina B-276. This is the first report of this kind of catalysis with this microorganism.

[Trends and predictions of tuberculosis, and challenges towards tuberculosis eradication in Havana City]. / Tendencias y pronósticos de la tuberculosis, desafíos en etapa de eliminación en la Habana.

OBJECTIVES: To describe the variation and the trend of new tuberculosis case reports in Havana from 1995 to 2010, as well as their projection and occurrence for 2011-2013. METHODS: A time series study was conducted, and the annual total and mean variation percentages of rates by clinical and bacteriological categories, age, municipal distribution and TB/HIV co-infection were analyzed. Estimation of projections by using two-parameter exponential smoothing techniques was made. RESULTS: The rate of new reported TB cases decreased from 16.8 in 1995 to 9.5 per 100 000 inhabitants in 2010 (43.5% and 2.9% of annual total variation and mean variation respectively). The rate declined by 80% in the municipalities and in 15-64 and > or = 65 years age groups. Habana Vieja and Centro Habana municipalities kept the highest rates throughout the whole period. TB/HIV coinfection notification increased from 3 out of 369 (0.8%) cases in 1995 to 37 out of 202 (18.3%) cases in 2010. A slight increase was estimated for the 2011-2013 period (9.5; 10.0; 10.5 per 100 000 population respectively) in addition to continuous rise of the number of cases with TB/HIV co-infection. CONCLUSIONS: The TB trend showed a steady decline in Havana from 1995 to 2010, with substantial reduction in the study period, except for TB/HIV co-infection in which the number of cases increases. The TB case report rates are within the expected values, although slightly above the predictions.

Hydroxynitrile lyases from prunus seeds in the preparation of cyanohydrins.

The hydroxynitrile lyase (HNL) activity of nine defatted Prunus seeds was compared for catalyzing the addition of HCN to aromatic, heteroaromatic and α,ß-unsaturated aldehydes. Although the conversion and enantiomeric excess (ee) of the corresponding cyanohydrins were both influenced by the HNL source and the chemical structure of the aldehyde, Prunus HNLs were all suitable for the enantioselective preparation of cyanohydrins.

Biocatalytic oxidative kinetic resolution of (±)-4-(chlorophenyl)phenylmethanol by Nocardia corallina B-276

Chiral diarylmethanols are versatile building blocks for the preparation of biologically active substances, but they are difficult to obtain in enantiopure form. We used Nocardia corallina B-276 for the oxidative kinetic resolution of (+/-)-4-(chlorophenyl)phenylmethanol, 1. Two experimental methods were used: 1) Suspension of cells in a phosphate buffer solution and 2) Cells in the culture media, in a 3-L bioreactor. After 36 hrs using the first method, the ketone/alcohol ratio was 56/44 and the unoxidized alcohol had an enantiomeric ratio of 93/7, predominating the R-alcohol.

Valoración de los métodos de estudio en alumnos de 1er año de Medicina y Licenciatura en Enfermería en la Facultad de Ciencias Médicas de Matanzas / Assessment of study methods to first -year students of Medicine and College-Degree Nursing Careers at Matanzas Medical Science Faculty

El presente trabajo realizó una valoración de los métodos de estudio en los alumnos de primer año de las carreras de Medicina y Licenciatura en Enfermería del curso 2000-2001, teniendo en cuenta los aspectos higiénicos, de disciplina y organización, de los métodos propiamente dichos y la autovaloración que poseen los estudiantes.Se utilizó una muestra de 50 estudiantes de Medicina y 20 de Licenciatura en Enfermería, seleccionada por el método aleatorio simple, a los cuales se les aplicó una encuesta con veinte preguntas dirigidas a estos fines. Se tabularon los datos, se confeccionaron las tablas, reflejando los resultados en frecuencias absolutas y relativas, las cuales fueron analizadas por la prueba estadística de diferencia de proporciones. Los resultados muestran que en ambas carreras los métodos de estudios son deficientes y que las diferencias entre Medicina y Licenciatura no son significativas...(AU)

Valoración de los métodos de estudio en alumnos de 1er año de Medicina y Licenciatura en Enfermería en la Facultad de Ciencias Médicas de Matanzas / Assessment of study methods to first -year students of Medicine and College-Degree Nursing Careers at Matanzas Medical Science Faculty

El presente trabajo realizó una valoración de los métodos de estudio en los alumnos de primer año de las carreras de Medicina y Licenciatura en Enfermería del curso 2000-2001, teniendo en cuenta los aspectos higiénicos, de disciplina y organización, de los métodos propiamente dichos y la autovaloración que poseen los estudiantes.Se utilizó una muestra de 50 estudiantes de Medicina y 20 de Licenciatura en Enfermería, seleccionada por el método aleatorio simple, a los cuales se les aplicó una encuesta con veinte preguntas dirigidas a estos fines. Se tabularon los datos, se confeccionaron las tablas, reflejando los resultados en frecuencias absolutas y relativas, las cuales fueron analizadas por la prueba estadística de diferencia de proporciones. Los resultados muestran que en ambas carreras los métodos de estudios son deficientes y que las diferencias entre Medicina y Licenciatura no son significativas...

Pancreatitis por Clostridium perfringens con retroneumoperitoneo extenso / Pancreatitis caused by Clostridium perfringens infection with extensive retropneumoperitoneum

Presentamos un caso de pancreatitis enfisematosa primaria debida a infección por Clostridium Perfringens (CP), (también llamada gangrena gaseosa pancreática espontánea), en un varón de 66 años de edad, diabético y con antecedentes de pancreatitis recidivante. Es destacable la escasa focalidad del proceso, que se manifiesta radiológicamente con un extenso retroneumoperitoneo (RNP) y diseminación de el gas hacia la raíz del mesenterio y los espacios pélvicos extraperitoneales. Esta gran difusión está propiciada por las toxinas del propio Clostridium y por las enzimas pancreáticas liberadas, dando un cuadro de evolución fulminante con una mortalidad temprana y elevada en todos los casos revisados. El diagnóstico precoz de esta entidad es fundamental para instaurar un tratamiento enérgico médico y quirúrgico urgente. La diabetes es un factor de riesgo conocido para la infección por gérmenes anaerobios y entre ellos el CP, como es el caso de la colecistitis enfisematosa. Un páncreas o conducto pancreático patológico, facilita la aparición de infecciones, ya que aclara mal los gérmenes que a él acceden desde el duodeno. La gangrena gaseosa secundaria a sobreinfección de necrosis o colecciones pancreáticas es rara y la espontánea o primaria es excepcional (AU)