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Objective: reflecting on the repercussions of social isolation of elderly people during the COVID-19 pandemic according to Wanda Horta’s Theory. Method: theoretical reflection study, developed through the search of articles in periodicals and official documents which deal with the disease, based on Wanda Horta’s Theory of Basic Human Needs. Results: the study reflected on the psychobiological, psychosocial and psycho-spiritual repercussions of the social isolation of elderly people in the context of the pandemic and the performance of nursing professionals. Final considerations: The psychobiological, psychosocial and psycho-spiritual repercussions of social isolation on the elderly person during the pandemic may bring changes to their health situation and interfere with their well-being and quality of life. Health professionals should pay attention to these repercussions, in order to avoid illness and its complications in the life of the elderly person [ABSTRACT FROM AUTHOR]

This article aims to discuss the role of memory and history in economic logic and mediation of organizations in processes of global expansions, from the event of the Itagiba Vapor wreck on the During II World War, with atention to institutionalization and promotion of the Nestlé brand in Brazil. The article begins presenting the historical fact, as an event and the mediatizated uses of this occurrence in favor of institutional action and memory promotion to Nestlé brand in its brazilian expantion. The text ends by highlighting the theoretical and methodological aspects studies on the mediatization of brands in the construction of institutions and organizational memories in cultures, such as possibility of establishing links with the various publics of the organizations in its expansion processes in several consumer markets. [ABSTRACT FROM AUTHOR]

Background: Continuing professional development (CPD) activities are one way that new knowledge can be translated into changes in practice. However, few tools are available for evaluating the extent to which these activities change health professionals’ behavior. We developed a questionnaire called CPD-Reaction for assessing the impact of CPD activities on health professionals’ clinical behavioral intentions. We evaluated its responsiveness to change in behavioral intention and verified its acceptability among stakeholders. Methods and findings: We enrolled 376 health professionals who completed CPD-Reaction before and immediately after attending a CPD activity. We contacted them three months later and asked them to self-report on any behavior change. We compared the mean rankings on each CPD-Reaction construct before and immediately after CPD activities. To estimate its predictive validity, we compared the median behavioral intention score (post-activity) of health professionals reporting a behavior change three months later with the median behavioral intention score of physicians who reported no change. We explored stakeholders’ views on CPD-Reaction in semi-structured interviews. Participants were mostly family physicians (62.2%), with an average of 19 years of clinical practice. Post-activity, we observed an increase in intention-related scores for all constructs (P < 0.001) with the most appreciable for the construct beliefs about capabilities. A total of 313 participants agreed to be contacted at follow up, and of these only 69 (22%) reported back. Of these, 43 (62%) self-reported a behavior change. We observed no statistically significant difference in intention between health professionals who later reported a behavior change and those who reported no change (P = 0.30). Overall, CPD stakeholders found the CPD-Reaction questionnaire of interest and suggested potential solutions to perceived barriers to its implementation. Conclusion: The CPD-Reaction questionnaire seems responsive to change in behavioral intention. Although CPD stakeholders found it interesting, future implementation will require addressing barriers they identified. [ABSTRACT FROM AUTHOR]

l -Glutamate and l -aspartate are the main excitatory amino acids (EAAs) in the Central Nervous System (CNS) and their uptake regulation is critical for the maintenance of the excitatory balance. Excitatory amino acid transporters (EAATs) are widely distributed among central neurons and glial cells. GLAST and GLT1 are expressed in glial cells, whereas excitatory amino acid transporter 3/excitatory amino acid carrier 1 (EAAT3/EAAC1) is neuronal. Different signaling pathways regulate glutamate uptake by modifying the activity and expression of EAATs. In the present work we show that immature postnatal day 3 (PN3) rat retinas challenged by l -glutamate release [ 3 H]- d -Aspartate linked to the reverse transport, with participation of NMDA, but not of non-NMDA receptors. The amount of [ 3 H]- d -Aspartate released by l -glutamate is reduced during retinal development. Moreover, immature retinae at PN3 and PN7, but not PN14, exposed to a single dose of 200 or 500 μM caffeine or the selective A2A receptor (A2AR) antagonist 100 nM ZM241385 decreased [ 3 H]- d -Aspartate uptake. Caffeine also selectively increased total expression of EAAT3 at PN7 and its expression in membrane fractions. However, both EAAT1 and EAAT2 were reduced after caffeine treatment in P2 fraction. Addition of 100 nM DPCPX, an A1 receptor (A1R) antagonist, had no effect on the [ 3 H]- d -Aspartate uptake. [ 3 H]- d -Aspartate release was dependent on both extracellular sodium and D l -TBOA, but not calcium, implying a transporter-mediated mechanism. Our results suggest that in the developing rat retina caffeine modulates [ 3 H]- d -Aspartate uptake by blocking adenosine A2AR. [ABSTRACT FROM AUTHOR]

Background: Participant recruitment in clinical trials is often challenging. Building partnerships with healthcare organizations during proposal development facilitates access to the community and may influence its subsequent organization participation and participant recruitment. We aimed to assess how pre-engaging directors of homecare organizations influenced organization participation in a subsequent trial. Findings: Repeated cross-sectional study prior to a cluster randomized controlled trial involving 33 eligible Health and Social Services Centres (HSSCs). During proposal development, we asked eligible HSSC directors in a randomized order about their willingness to participate in our trial, if funded. In the pre-engagement phase, 23 directors were contacted until we met sample size requirements (n ≥ 16); 19 of whom wrote letters of intent. Once funded, we contacted all 33 eligible HSSC directors in a randomized order to enroll them. Of the 19 directors who provided letters of intent, 15 agreed to participate (79 %); of the four who did not provide letters, one agreed to participate (25 %); and of the ten who had not been approached in the pre-engagement phase, two agreed to participate (20 %). Fisher exact tests indicated that providing letters of intent was associated with subsequent participation (p = 0.003). Conclusions: Given that significantly more HSSCs directors who signed letters of intent followed through with study participation, pre-engagement with trial sites during proposal development appears to improve recruitment. [ABSTRACT FROM AUTHOR]

The brewing industry can be considered one of the most important productive activities of the 21st Century. Despite being consumed for thousands of years, it is only in the last 150 years that its production and consumption have become the most widespread among alcoholic beverages. Currently, its consumption may has been globalized and the participation of Brazil in this internationalized market has drawn the attention of the major companies operating in the sector. This article seeks to show the recent but consistent importance of the brewing industry in Brazil and its challenges in the context of regulation, consumption, and media convergence. [ABSTRACT FROM AUTHOR]

Oil cakes have excellent nutritional value and offer considerable potential for use in biotechnological processes that employ solidstate fermentation (SSF) for the production of high value products. This work evaluates the feasibility of using canola cake as a substrate for protease production by a selected strain of Aspergillus oryzae cultivated under SSF. The influences of the following process parameters were considered: initial substrate moisture content, incubation temperature, inoculum size, and pH of the buffer used for protease extraction and activity analysis. Maximum protease activity was obtained after cultivating Aspergillus oryzae CCBP 001 at 20ºC, using an inoculum size of 107 spores/g in canola cake medium moistened with 40mL of water to 100 g of cake. Cultivation and extraction under selected conditions increased protease activity 5.8-fold, compared to the initial conditions. Zymogram analysis of the enzymatic extract showed that the protease molecular weights varied between 31 and 200 kDa. The concentrated protease extract induced clotting of casein in 5 min. The results demonstrate the potential application of canola cake for protease production under SSF and contribute to the technological advances needed to increase the efficiency of processes designed to add value to agroindustrial wastes. [ABSTRACT FROM AUTHOR]

Individual spinal motor neuron identities are specified in large part by the intrinsic repertoire of transcription factors expressed by undifferentiated progenitors and maturing neurons. It is shown here that the transcription factor AML1 /Runx1 (Runx1) is expressed in selected spinal motor neuron subtypes after the onset of differentiation and is both necessary and sufficient to suppress interneuron-specific developmental programs and promote maintenance of motor neuron characteristics. These findings show an important role for Runx1 during the consolidation of selected spinal motor neuron identities. Moreover, they suggest a requirement for a persistent suppression of interneuron genes within maturing motor neurons. [ABSTRACT FROM AUTHOR]

Cellular prion protein (PrPc) has a pivotal role in prion diseases. PrPc is a specific receptor for laminin (LN) γ1 peptide and several lines of evidence indicate that it is also involved in neural plasticity. Here we investigated whether the interaction between PrPc and LN plays a role in rat memory formation. We found that post-training intrahippocampal infusion of PrPc-derived peptides that contain the LN binding site ( and ) or of anti-PrPc or anti-LN antibodies that inhibit PrPc–LN interaction impaired inhibitory avoidance memory retention. The amnesic effect of anti-PrPc antibodies and peptide was reversed by co-infusion of a LN γ1 chain-derived peptide containing the PrPc-binding site, suggesting that PrPc–LN interaction is indeed crucial for memory consolidation. In addition, peptide and anti-PrPc or anti-LN antibodies also inhibited the activation of hippocampal cAMP-dependent protein kinase A (PKA) and extracellular regulated kinase (ERK1/2), two kinases that mediate the up-regulation of signaling pathways needed for consolidation of inhibitory avoidance memory. Our findings show that, through its interaction with LN, hippocampal PrPc plays a critical role in memory processing and suggest that this role is mediated by activation of both PKA and ERK1/2 signaling pathways. [ABSTRACT FROM AUTHOR]

To test for a role for the cellular prion protein (PrPc) in cell death, we used a PrPc-binding peptide. Retinal explants from neonatal rats or mice were kept in vitro for 24 h, and anisomycin (ANI) was used to induce apoptosis. [ABSTRACT FROM AUTHOR]

Purpose: The recognition of the Brazilian Sign Language (Libras) as the official language of the Brazilian deaf, in 2002, reaffirms the linguistic and cultural particularities of the deaf population. Therefore, there is a lack of a validated instrument for assessing the Quality of Life of deaf people using Libras. With authorization from the World Health Organization (WHO), a version of the WHOQOL-Bref in Libras was developed, called WHOQOL-Bref/Libras. However, its psychometric properties have not been examined as yet. Therefore, the purpose of this work is to perform the psychometric validation of the WHOQOL-Bref/Libras. Methods: WHOQOL-Bref/Libras and a sociodemographic questionnaire were applied to 311 deaf people from the five Brazilian regions. To assess temporal stability, the questionnaire was readministered to 52 deaf people, over an interval of 2 weeks. Results: WHOQOL-Bref/Libras demonstrated satisfactory psychometric values for reliability, discriminant and construct validity, temporal stability, and internal consistency. Cronbach's alpha coefficient showed satisfactory values for each of the WHOQOL-Bref domains: Physical health (0.641), Psychological (0.705), Environment (0.710), and Overall-Bref domains (0.873). The WHOQOL-Bref/Libras is the appropriate option to assess the quality of life of deaf people who communicate through Libras. Conclusion: WHOQOL-Bref/Libras had a satisfactory psychometric performance; therefore, it is a valid option that will provide autonomous participation for the deaf in quality of life investigations. [ABSTRACT FROM AUTHOR]

Cashew nuts kernels (CN) are known for their composition of unsaturated fatty acids, considered “healthy fats.” Agro-industrial residues, such as cupuaçu seed (CS), have great potential for use as raw material in the elaboration of products, as they have a good nutritional composition. This study aimed to elaborate CN pastes with powdered CS (cream similar to peanut butter), and their chemical, microbiological, and sensory characterization. Three formulations were prepared: (A) CN and CS in similar proportions, (B) the highest concentration in the proportion of CS, and (C) the highest CS concentration in the CN ratio. Some differences were observed in the total soluble solids and ash concentration related to the higher amount of CN added. The result revealed that sample B had the best result in terms of sensory properties for the following parameters: aroma, flavor, texture, and appearance. In addition, this sample also showed greater purchase intention. In its composition, paste B has a higher amount of CN (67.5%) and about 20% of CS. CN and CS proved to be the best raw materials for making the paste. [ABSTRACT FROM AUTHOR]

In this present study, we describe the chemical composition, larvicidal and molluscicidal activity of essential oil distilled from Alpinia zerumbet leaves against third-stage larvae of Ae.aegypti and the snail Biomphalaria glabrata, respectively. For this, we distilled the oil by hydrodistillation, identified its components by gas chromatography coupled to mass spectrometry and gas chromatography with flame ionization detection and calculated the lethal concentration of larvicidal and molluscicidal activity using the probit method. From these analyses, we showed that the oil is predominantly composed of monoterpenes, in which p-cymene (34.12%), 1,8-cineole (25.67%) and terpinen-4-ol (21.01%) stood out. In addition, we also proved that the oil has larvicidal and molluscicidal activity with lethal concentrations respectively of 43.74 and 36.52 µg/mL. Therefore, we conclude that the oil is active and has the potential to replace synthetic larvicides and molluscicides. [ABSTRACT FROM AUTHOR]

Policy-makers worldwide are increasingly interested in scaling up evidence-based interventions (EBIs) to larger populations, and implementation scientists are developing frameworks and methodologies for achieving this. But scaling-up does not always produce the desired results. Why not? We aimed to enhance awareness of the various pitfalls to be anticipated when planning scale-up. In lower- and middle-income countries (LMICs), the scale-up of health programs to prevent or respond to outbreaks of communicable diseases has been occurring for many decades. In high-income countries, there is new interest in the scaling up of interventions that address communicable and non-communicable diseases alike. We scanned the literature worldwide on problems encountered when implementing scale-up plans revealed a number of potential pitfalls that we discuss in this paper. We identified and discussed the following six major pitfalls of scaling-up EBIs: 1) the cost-effectiveness estimation pitfall, i.e. accurate cost-effectiveness estimates about real-world implementation are almost impossible, making predictions of economies of scale unreliable; 2) the health inequities pitfall, i.e. some people will necessarily be left out and therefore not benefit from the scaled-up EBIs; 3) the scaled-up harm pitfall, i.e. the harms as well as the benefits may be amplified by the scaling-up; 4) the ethical pitfall, i.e. informed consent may be a challenge on a grander scale; 5) the top-down pitfall, i.e. the needs, preferences and culture of end-users may be forgotten when scale-up is directed from above; and 6) the contextual pitfall, i.e. it may not be possible to adapt the EBIs to every context. If its pitfalls are addressed head on, scaling-up may be a powerful process for translating research data into practical improvements in healthcare in both LMICs and high-income countries, ensuring that more people benefit from EBIs. [ABSTRACT FROM AUTHOR]

Background: Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached. Methods: Affiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement. Results: Consensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (κ = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases. Conclusion: Expert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions. [ABSTRACT FROM AUTHOR]

Background: Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached.Methods: Affiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement.Results: Consensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (κ = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases.Conclusion: Expert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions. [ABSTRACT FROM AUTHOR]

Introduction: Despite the lack of randomised evidence, there is a current trend towards omitting axillary surgery in cases of positive sentinel lymph node (SLN) following neoadjuvant chemotherapy (NACT). This study evaluated practice patterns of Brazilian breast surgeons when managing positive SLN following NACT. Methods: This was a nationwide electronic survey of breast surgeons affiliated with the Brazilian Society of Mastology. Management approaches for positive SLN after NACT (axillary dissection (AD), regional nodal irradiation (RNI) or no additional treatment) were evaluated as a function of residual disease volume in the SLN (macro-metastasis, micrometastasis or isolated tumour cells (ITC)). Results: Survey response rate was 49%, with 799/1,627 questionnaires returned. Most respondents were <50 years old (61%), lived in southeastern Brazil (50%), in a major city (67%), worked in an academic institute (80%) and were board-certified (80%). AD recommendation rate decreased according to residual nodal disease volume: 91% of respondents recommended AD for cases of macro-metastasis, 64% for micrometastasis and 38% for ITC (p < 0.00001). Furthermore, 35% would recommend no additional surgery for micro-metastasis, while 27% would recommend no treatment at all for ITC (p < 0.00001). Not working in an academic institute was associated with RNI for micro-metastasis (p = 0.02), but not for macro-metastasis or ITC. Being board-certified did not affect axillary management. Conclusion: Most respondents would recommend AD and/or RNI in residual nodal disease following NACT irrespective of disease volume. Nevertheless, a trend towards surgical de-escalation was found with low-volume disease (micro-metastasis and ITC). Ongoing randomised trials will clarify the impact of this trend. [ABSTRACT FROM AUTHOR]

Introduction: Despite the lack of randomised evidence, there is a current trend towards omitting axillary surgery in cases of positive sentinel lymph node (SLN) following neoadjuvant chemotherapy (NACT). This study evaluated practice patterns of Brazilian breast surgeons when managing positive SLN following NACT. Methods: This was a nationwide electronic survey of breast surgeons affiliated with the Brazilian Society of Mastology. Management approaches for positive SLN after NACT (axillary dissection (AD), regional nodal irradiation (RNI) or no additional treatment) were evaluated as a function of residual disease volume in the SLN (macro-metastasis, micrometastasis or isolated tumour cells (ITC)). Results: Survey response rate was 49%, with 799/1,627 questionnaires returned. Most respondents were <50 years old (61%), lived in southeastern Brazil (50%), in a major city (67%), worked in an academic institute (80%) and were board-certified (80%). AD recommendation rate decreased according to residual nodal disease volume: 91% of respondents recommended AD for cases of macro-metastasis, 64% for micrometastasis and 38% for ITC (p < 0.00001). Furthermore, 35% would recommend no additional surgery for micro-metastasis, while 27% would recommend no treatment at all for ITC (p < 0.00001). Not working in an academic institute was associated with RNI for micro-metastasis (p = 0.02), but not for macro-metastasis or ITC. Being board-certified did not affect axillary management. Conclusion: Most respondents would recommend AD and/or RNI in residual nodal disease following NACT irrespective of disease volume. Nevertheless, a trend towards surgical de-escalation was found with low-volume disease (micro-metastasis and ITC). Ongoing randomised trials will clarify the impact of this trend. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify the impact of oral disease on the quality of life of morbid obese and normal weight individuals. Cohort was composed of 100 morbid-obese and 50 normal-weight subjects. Dental caries, community periodontal index, gingival bleeding on probing (BOP), calculus, probing pocket depth, clinical attachment level, dental wear, stimulated salivary flow, and salivary pH were used to evaluate oral diseases. Socioeconomic and the oral impacts on daily performances (OIDP) questionnaires showed the quality of life in both groups. Unpaired Student, Fisher’s Exact, Chi-Square, Mann-Whitney, and Multiple Regression tests were used (p<0.05). Obese showed lower socio-economic level than control group, but no differences were found considering OIDP. No significant differences were observed between groups considering the number of absent teeth, bruxism, difficult mastication, calculus, initial caries lesion, and caries. However, saliva flow was low, and the salivary pH was changed in the obese group. Enamel wear was lower and dentine wear was higher in obese. More BOP, insertion loss, and periodontal pocket, especially the deeper ones, were found in obese subjects. The regression model showed gender, smoking, salivary pH, socio-economic level, periodontal pocket, and periodontal insertion loss significantly associated to obesity. However, both OIDP and BOP did not show significant contribution to the model. The quality of life of morbid obese was more negatively influenced by oral disease and socio-economic factors than in normal weight subjects. [ABSTRACT FROM AUTHOR]

Background and Objectives Informal caregivers are rarely as involved as they want to be in the housing decisions of cognitively impaired older adults. Lack of awareness of available options and their benefits and risks may lead to decisions that do not reflect older adults' preferences, and to guilt and regret. We assessed the effect of training home care teams in interprofessional shared decision-making (SDM) on the proportion of caregivers who report being active in this decision. Research Design and Methods In a two-arm pragmatic cluster randomized trial with home care teams working in health centers in the Province of Quebec, we randomized health centers to receive training in interprofessional SDM (intervention) or not (control). Eligible caregivers had made a housing decision for a cognitively impaired adult aged 65 years or older who was receiving services from a home care team. The primary outcome was the proportion of caregivers reporting an active role in decision making. We performed intention-to-treat multilevel analysis. Results We consecutively enrolled a random group of 16 health centers and recruited 309 caregivers, among whom 296 were included in the analysis. In the intervention arm, the proportion of caregivers reporting an active role in decision making increased by 12% (95% CI −2% to 27%; p =.10). After removal of an influential cluster outlier, the proportion increased to 18% (95% CI: 7%–29%; p <.01). Discussion and Implications Training home care teams in interprofessional SDM increased caregiver involvement in health-related housing decisions for cognitively impaired older adults. [ABSTRACT FROM AUTHOR]

Background: DOLCE (Improving Decision making On Location of Care with the frail Elderly and their caregivers) was a post-intervention clustered randomised trial (cRT) to assess the effect of training home care teams on interprofessional shared decision-making (IP-SDM). Alongside the cRT, we sought to monitor healthcare providers' level of behavioural intention to engage in an IP-SDM approach and to identify factors associated with this intention.Methods: We conducted two cross-sectional surveys in the province of Quebec, Canada, one each at cRT entry and exit. Healthcare providers (e.g. nurses, occupational therapists and social workers) in the 16 participating intervention and control sites self-completed an identical paper-based questionnaire at entry and exit. Informed by the Integrated model for explaining healthcare professionals' clinical behaviour by Godin et al. (2008), we assessed their behavioural intention to engage in IP-SDM to support older adults and caregivers of older adults with cognitive impairment to make health-related housing decisions. We also assessed psychosocial variables underlying their behavioural intention and collected sociodemographic data. We used descriptive statistics and linear mixed models to account for clustering.Results: Between 2014 and 2016, 271 healthcare providers participated at study entry and 171 at exit. At entry, median intention level was 6 in a range of 1 (low) to 7 (high) (Interquartile range (IQR): 5-6.5) and factors associated with intention were social influence (β = 0.27, P <  0.0001), beliefs about one's capabilities (β = 0.43, P <  0.0001), moral norm (β = 0.31, P <  0.0001) and beliefs about consequences (β = 0.21, P <  0.0001). At exit, median intention level was 5.5 (IQR: 4.5-6.5). Factors associated with intention were the same but did not include moral norm. However, at exit new factors were kept in the model: working in rehabilitation (β = - 0.39, P = 0.018) and working as a technician (β = - 0.41, P = 0.069) (compared to as a social worker).Conclusion: Intention levels were high but decreased from entry to exit. Factors associated with intention also changed from study entry to study exit. These findings may be explained by the major restructuring of the health and social care system that took place during the 2 years of the study, leading to rapid staff turnover and organisational disturbance in home care teams. Future research should give more attention to contextual factors and design implementation interventions to withstand the disruption of system- and organisational-level disturbances.Trial Registration: Clinicaltrials.gov (NCT02244359). Registered on September 19th, 2014. [ABSTRACT FROM AUTHOR]

Training in shared decision-making (SDM) often focuses solely on dyadic relationships between one healthcare provider and one patient. However, many healthcare decisions often involve two or more health professionals. These decisions warrant utilizing an interprofessional shared decision-making (IP-SDM) approach which enables patients and their caregivers to face difficult decisions around care together. Most existing SDM training programs fall short when building interprofessional (IP) competencies and require an approach that integrates IP with SDM. This short report discusses the creation and trial implementation of three enhanced education tools (a video, role-play exercise with decision aid, and an IP observation aid) for an IP-SDM workshop focused on helping homecare teams collaborate with seniors and their caregivers throughout the decision-making process. We developed and implemented these tools in eight study sites of a larger randomized control trial to test the training workshop for homecare teams. The workshop and tools helped participants overcome interprofessional challenges in their work. Participants evaluated the tools and workshop, which offered guidance to better translate teachable IP collaboration competencies within SDM. [ABSTRACT FROM AUTHOR]

We determined the chemical composition and explored the hypothesis that the essential oil of the fruits of Pimenta dioica inhibits the mycelial development of fungi Fusarium oxysporum f. sp. lycopersici, F. oxysporum f. sp. passiflorae, F. subglutinans f. sp. ananas, F. oxysporum f. sp. vasinfectum e F. oxysporum f. sp. Cubense. To do this, we extracted the oil by hydrodistillation, identified its components by gas chromatography coupled to mass spectrometry (GC-MS) and determined the fungal activity against five special forms of Fusarium species. The results showed that the oil had 76.88% of eugenol and inhibited the mycelial development of fungi up to 97.78% in an average of 7.2 days. Therefore, oil is a potential natural fungicide. [ABSTRACT FROM AUTHOR]

In this present study, we determined the chemical composition and we tested the toxicity and the molluscicidal activity of the essential oil extracted from the barks of Citrus sinensis (L.) Osbeck. For this, the essential oil was extracted quantitatively by hydrodistillation. Then, quantifications of its components were performed by gas chromatography coupled to mass spectrometry (CG-MS) and the toxicity and molluscicidal activity were tested, respectively, against Artemia salina and snails Biomphalaria glabrata. The results showed that the oil contains 81.50% of D-limonene (main constituent) and 0.06% of citronellal (minor component) and it has lethal activity (LC50) of 100.08 mg.L-1 and a toxicity, with LC50 of 321.84 mg.L -1 at a 95% confidence level. Therefore, the oil is active against the snail Biomphalaria glabrata and non-toxic to other living bein. [ABSTRACT FROM AUTHOR]

In this present work, it was tested the linalool pattern and the essential oil extracted from the Aniba duckei Kostermans (rosewood) branches against the fungi Colletotrichum gloesporioides and Fusarium oxysporum. To do this, we extracted the essential oil by hydrodistillation and identified and quantified the components by gas chromatography coupled to mass spectrometry (GC/MS). We obtained and isolated the fungi by the routine plating method from hose and okra plants, respectively. The results of the chromatographic analysis showed that the oil had 93.60 % linalool and 3.03 % cis-linalool oxide. The essential oil and the standard inhibited mycelial growth by 100% at concentrations of 0.4 and 0.2% respectively. Therefore, the essential oil and the linalool pattern have antifungal action against the fungi demonstrated. [ABSTRACT FROM AUTHOR]

This work evaluated the molluscicidal activity of the essential oil of the Zingiber officinale Roscoe rhizomes in with of the Biomphalaria glabrata species. The essential oil was isolated quantitatively by hydrodistillation and the oil was characterized analytically by gas chromatography coupled to mass spectrometry and the LC50 of the oil was calculated from the methods of Reed-Muench & Pizzi, respectively. From this, 18 components were identified, the main ones being A-zingiberene, geranial and nerolidol. The essential oil obtained LC50 of 56.23 mg.L-1 and mortality of the snails in the concentration of 75 mg.L-1 in 72 hours. It was concluded that this essential oil has molluscicidal activity. [ABSTRACT FROM AUTHOR]

Background: In 2013, the Canadian Institutes of Health Research funded 12 community-based primary health care research teams to develop evidence-based innovations. We aimed to explore the scalability of these innovations. Methods: In this cross-sectional study, we invited the 12 teams to rate their evidence-based innovations for scalability. Based on a systematic review, we developed a self-administered questionnaire with 16 scalability assessment criteria grouped into 5 dimensions (theory, impact, coverage, setting and cost). Teams completed a questionnaire for each of their innovations. We analyzed the data using simple frequency counts and hierarchical cluster analysis. We calculated the mean number and standard deviation (SD) of innovations that met criteria within each dimension that included more than 1 criterion. The analysis unit was the innovation. Results: The 11 responding teams evaluated 33 evidence-based innovations (median 3, range 1–8 per team). The innovations focused on access to care and chronic disease prevention and management, and varied from health interventions to methodological innovations. Most of the innovations were health interventions (n = 21), followed by analytical methods (n = 4), conceptual frameworks (n = 4), measures (n = 3) and strategies to build research capacity (n = 1). Most (29) met criteria in the theory dimension, followed by impact (mean 22.3 [SD 5.6] innovations per dimension), setting (mean 21.7 [SD 8.5]), cost (mean 17.5 [SD 2.1]) and coverage (mean 14.0 [SD 4.1]). On average, the innovations met 10 of the 16 criteria. Adoption was the least assessed criterion (n = 9). Most (20) of the innovations were highly ranked for scalability. Interpretation: Scalability varied among innovations, which suggests that readiness for scale up was suboptimal for some innovations. Coverage remained largely unaddressed; further investigation of this critical dimension is necessary. [ABSTRACT FROM AUTHOR]

Background: Little is known about the decision-making experiences of seniors and informal caregivers facing decisions about seniors’ housing decisions when objective decision making measures are used. Objectives: To report on seniors’ and caregivers’ experiences of housing decisions. Design: A cross-sectional study with a quantitative approach supplemented by qualitative data. Setting: Sixteen health jurisdictions providing home care services, Quebec province, Canada. Participants: Two separate samples of seniors aged ≥ 65 years and informal caregivers of cognitively impaired seniors who had made a decision about housing. Measurements: Information on preferred choice and actual choice about housing, role assumed in the decision, decisional conflict and decision regret was obtained through closed-ended questionnaires. Research assistants paraphrased participants’ narratives about their decision-making experiences and made other observations in standardized logbooks. Results: Thirty-one seniors (median age: 85.5 years) and 48 caregivers (median age: 65.1 years) were recruited. Both seniors and caregivers preferred that the senior stay at home (64.5% and 71.7% respectively). Staying home was the actual choice for only 32.2% of participating seniors and 36.2% of the seniors cared for by the participating caregivers. Overall, 93% seniors and 71% caregivers reported taking an active or collaborative role in the decision-making process. The median decisional conflict score was 23/100 for seniors and 30/100 for caregivers. The median decision regret score was the same for both (10/100). Qualitative analysis revealed that the housing decision was influenced by factors such as seniors’ health and safety concerns and caregivers’ burden of care. Some caregivers felt sad and guilty when the decision did not match the senior’s preference. Conclusion: The actual housing decision made for seniors frequently did not match their preferred housing option. Advanced care planning regarding housing and better decision support are needed for these difficult decisions. [ABSTRACT FROM AUTHOR]

Background: Most older adults wish to stay at home during their late life years, but physical disabilities and cognitive impairment may force them to face a housing decision. However, they lack relevant information to make informed value-based housing decisions. Consequently, we sought to identify the sets of factors influencing the housing decision-making of older adults. Methods: We performed a systematic literature search for studies evaluating any factors influencing the housing decisions among older adults over 65 years old without cognitive disabilities. Primary research from any study design reported after 1990 in a peer-reviewed journal, a book chapter or an evaluated doctoral thesis and written in English, French or Spanish were eligible. We extracted the main study characteristics, the participant characteristics and any factors reported as associated with the housing decision. We conducted a qualitative thematic analysis from the perspective of the meaning and experience of home. Results: The search resulted in 660 titles (after duplicate removal) from which 86 studies were kept for analysis. One study out of five reported exclusively on frail older adults (n = 17) and two on adults over 75 years old. Overall, a total of 88 factors were identified, of which 71 seem to have an influence on the housing decision-making of older adults, although the influence of 19 of them remains uncertain due to discrepancies between research methodologies. No conclusion was made regarding 12 additional factors due to lack of evidence. Conclusion: A wealth of factors were found to influence housing decisions among older adults. However, very few of them have been studied extensively. Our results highlight the importance of interdisciplinary teamwork to study the influence of a broader range of factors as a whole. These results will help older adults make the best possible housing decision based on their unique situation and values. [ABSTRACT FROM AUTHOR]

Contexte/problématique : Lors d'un forum d'échanges, un groupe de décideurs en développement professionnel continu (DPC) et des chercheurs en transfert de connaissances ont identiié le besoin de disposer de méthodes d'évaluation eficaces pour évaluer l'impact des activités de DPC sur la pratique clinique. Objectifs/questions : Présenter les résultats initiaux du développement d'un instrument de mesure fondé sur la théorie, iable et valide, pour évaluer l'impact d'activités de DPC sur la pratique clinique. Méthodes : Premièrement, nous avons identiié, par une approche systématique, les instruments de mesure existants pour évaluer les intentions et/ou les comportements chez les professionnels de la santé. Pour ce faire, nous avons utilisé la revue de Godin et collab. (2008). Par la suite, nous avons identiié les caractéristiques des outils retenus et de leurs items. Les items répertoriés ont été intégrés dans les 8 construits d'un modèle théorique fondé sur les théories sociocognitives. Les items les plus pertinents ont ensuite été sélectionnés selon un processus interactif avec un comité d'experts multidisciplinaire. Les items retenus ont été soumis à une étude e-Delphi qui a permis de produire un instrument de mesure générique. Résultats : Nous avons identiié 47 instruments de mesure éligibles qui comprenaient 1 218 items. Ces items ont été reclassés dans les 8 construits du modèle théorique. Suite au processus interactif avec le comité d'experts, 61 items ont été sélectionnés. L'étude e-Delphi a par la suite permis de créer un instrument générique de 40 items. Discussion/conclusion : Notre inventaire a fourni la base pour le développement d'un nouvel instrument de mesure fondé sur la théorie, pour évaluer l'impact d'activités de DPC sur la pratique clinique. Cet outil pourra répondre aux besoins des organisateurs et décideurs en DPC de disposer de méthodes d'évaluation eficaces. Des validations sont nécessaires pour optimiser l'instrument de mesure pour mieux répondre aux besoins des utilisateurs. [ABSTRACT FROM AUTHOR]

Background: One of the toughest decisions faced by elderly people is whether to stay at home or move to a care facility. This study seeks to evaluate the impact of training interprofessional home-care teams in shared decision making combined with a decision aid on the proportion of elderly people who report being active in the decision-making process regarding whether to stay at home or move to a care facility. Methods/Design: We propose a multicenter cluster randomized trial conducted with home-care interprofessional teams in the Province of Quebec with 2 data collection phases: before and after the intervention. Units of randomization will be centers for primary healthcare and social services. We will enroll 16 of these and ask each to provide one home-care interprofessional team involved in decisions and care planning with eligible clients. Clients will be included if they i) are aged =65; ii) are receiving care from the participating home-care interprofessional team; iii) have faced the decision about staying at home or moving to a care facility in the past 3 to 6 months; iv) are able to read, understand and write French or English; and v) are able to give informed consent. If clients are unable to provide informed consent, their primary caregiver who was involved in the decision-making process will be eligible to participate. The intervention arm will receive training in shared decision making and use of a decision aid. The control arm will receive 'usual care'. The primary outcome of interest is the assumed role in the decisionmaking process as assessed in clients or caregivers with a modified version of the Control Preferences Scale. Multilevel modeling will be used to take the hierarchical structure of the data into account. The study has obtained full ethical approval. The trial will comply with CONSORT guidelines adapted for cluster randomized trials. Discussion: Home care is a rapidly growing sector and this study will lay the foundations of a national strategy to ensure that IP home-care teams provide the highest quality of care for seriously ill elderly people and support for their families. [ABSTRACT FROM AUTHOR]

Background: Decision-makers in organizations providing continuing professional development (CPD) have identified the need for routine assessment of its impact on practice. We sought to develop a theory-based instrument for evaluating the impact of CPD activities on health professionals' clinical behavioral intentions. Methods and Findings: Our multipronged study had four phases. 1) We systematically reviewed the literature for instruments that used socio-cognitive theories to assess healthcare professionals' clinically-oriented behavioral intentions and/or behaviors; we extracted items relating to the theoretical constructs of an integrated model of healthcare professionals' behaviors and removed duplicates. 2) A committee of researchers and CPD decision-makers selected a pool of items relevant to CPD. 3) An international group of experts (n = 70) reached consensus on the most relevant items using electronic Delphi surveys. 4) We created a preliminary instrument with the items found most relevant and assessed its factorial validity, internal consistency and reliability (weighted kappa) over a two-week period among 138 physicians attending a CPD activity. Out of 72 potentially relevant instruments, 47 were analyzed. Of the 1218 items extracted from these, 16% were discarded as improperly phrased and 70% discarded as duplicates. Mapping the remaining items onto the constructs of the integrated model of healthcare professionals' behaviors yielded a minimum of 18 and a maximum of 275 items per construct. The partnership committee retained 61 items covering all seven constructs. Two iterations of the Delphi process produced consensus on a provisional 40-item questionnaire. Exploratory factorial analysis following test-retest resulted in a 12-item questionnaire. Cronbach's coefficients for the constructs varied from 0.77 to 0.85. Conclusion: A 12-item theory-based instrument for assessing the impact of CPD activities on health professionals' clinical behavioral intentions showed adequate validity and reliability. Further studies could assess its responsiveness to behavior change following CPD activities and its capacity to predict health professionals' clinical performance. [ABSTRACT FROM AUTHOR]

Background: Long-term exposure to infrasound and low frequency noise (ILFN <500 Hz, including infrasound) can lead to the development of vibroacoustic disease (VAD). VAD is a systemic pathology characterized by the abnormal growth of extracellular matrices in the absence of inflammatory processes, namely of collagen and elastin, both of which are abundant in the basement membrane zone of the vocal folds. ILFN-exposed workers include pilots, cabin crewmembers, restaurant workers, ship machinists and, in previous studies, even though they did not present vocal symptoms, ILFN-exposed workers had significant different voice acoustic patterns (perturbation and temporal measures) when compared with normative population. Study Aims: The present study investigates the effects of age and years of occupational ILFN-exposure on voice acoustic parameters of 37 cabin crewmembers: 12 males and 25 females. Specifically, the goals of this study are to: 1) Verify if acoustic parameters change over the age and years of ILFN-exposure and 2) Determine if there is any interaction between age and years of ILFN-exposure on voice acoustic parameters of crewmembers. Materials and Methods: Spoken phonatory tasks were recorded with a C420III PP AKG head-worn microphone and a DA-P1 Tascam DAT. Acoustic analyses were performed using KayPENTAX Computer Speech Lab and Multi-Dimensional Voice Program. Acoustic parameters included speaking fundamental frequency, perturbation measures (jitter, shimmer and harmonic-to-noise ratio), temporal measures (maximum phonation time and s/z ratio) and voice tremor frequency. Results: One-way ANOVA analysis revealed that as the number of ILFN-exposure years increased male cabin crewmembers presented significant different shimmer values of /i/ as well as tremor frequency of /u/. Females presented significantly different jitter % of /i, a, o/ (p <0.05). Lastly, Two-way ANOVA analysis revealed that for females, there was a significant interaction between age and occupational ILFN-exposure for voice acoustic parameters, namely for jitter's mean for /a, o/ and shimmer's (%) mean for /a, i/ (p <0.05). Discussion and Conclusion: These perturbation measure patterns may be indicative of histological changes within the vocal folds as a result of ILFN-exposure. The results of this study suggest that voice acoustic analysis may be an important tool for confirming ILFN-induced health effects. [ABSTRACT FROM AUTHOR]

Abstract: Cellular prion protein (PrPC) is a cell surface glycoprotein that interacts with several ligands such as laminin, NCAM (Neural-Cell Adhesion Molecule) and the stress-inducible protein 1 (STI1). PrPC association with these proteins in neurons mediates adhesion, differentiation and protection against programmed cell death. Herein, we used an aversively motivated learning paradigm in rats to investigate whether STI1 interaction with PrPC affects short-term memory (STM) formation and long-term memory (LTM) consolidation. Blockage of PrPC-STI1 interaction with intra-hippocampal infusion of antibodies against PrPC or STI1 immediately after training impaired both STM and LTM. Furthermore, infusion of PrPC peptide 106–126, which competes for PrPC-STI1 interaction, also inhibited both forms of memory. Remarkably, STI1 peptide 230–245, which includes the PrPC binding site, had a potent enhancing effect on memory performance, which could be blocked by co-treatment with the competitive PrPC peptide 106–126. Taken together, these results demonstrate that PrPC-STI1 interaction modulates both STM and LTM and suggests a potential use of ST11 peptide 230–245 as a pharmacological agent. [Copyright &y& Elsevier]

Prions are composed of an isoform of a normal sialoglycoprotein called PrPc, whose physiological role has been under investigation, with focus on the screening for ligands. Our group described a membrane 66 kDa PrPc-binding prot [ABSTRACT FROM AUTHOR]

Background: One of the toughest decisions faced by elderly people is whether to stay at home or move to a care facility. This study seeks to evaluate the impact of training interprofessional home-care teams in shared decision making combined with a decision aid on the proportion of elderly people who report being active in the decision-making process regarding whether to stay at home or move to a care facility.Methods/design: We propose a multicenter cluster randomized trial conducted with home-care interprofessional teams in the Province of Quebec with 2 data collection phases: before and after the intervention. Units of randomization will be centers for primary healthcare and social services. We will enroll 16 of these and ask each to provide one home-care interprofessional team involved in decisions and care planning with eligible clients. Clients will be included if they i) are aged ≥65; ii) are receiving care from the participating home-care interprofessional team; iii) have faced the decision about staying at home or moving to a care facility in the past 3 to 6 months; iv) are able to read, understand and write French or English; and v) are able to give informed consent. If clients are unable to provide informed consent, their primary caregiver who was involved in the decision-making process will be eligible to participate. The intervention arm will receive training in shared decision making and use of a decision aid. The control arm will receive 'usual care'. The primary outcome of interest is the assumed role in the decision-making process as assessed in clients or caregivers with a modified version of the Control Preferences Scale. Multilevel modeling will be used to take the hierarchical structure of the data into account. The study has obtained full ethical approval. The trial will comply with CONSORT guidelines adapted for cluster randomized trials.Discussion: Home care is a rapidly growing sector and this study will lay the foundations of a national strategy to ensure that IP home-care teams provide the highest quality of care for seriously ill elderly people and support for their families.Trial Registration: ClinicalTrials.gov NCT02244359 (registered 18 September 2014). [ABSTRACT FROM AUTHOR]