We present the novel potential application of imine-based covalent organic frameworks (COFs), formed by the direct Schiff reaction between 1,3,5-tris(4-aminophenyl)benzene and ...1,3,5-benzenetricarbaldehyde building blocks in m-cresol or acetic acid, named RT-COF-1 or RT-COF-1Ac/RT-COF-1AcB. The post-synthetic treatment of RT-COF-1 with LiCl leads to the formation of LiCl@RT-COF-1. The ionic conductivity of this series of polyimine COFs has been characterized at variable temperature and humidity, using electrochemical impedance spectroscopy. LiCl@RT-COF-1 exhibits a conductivity value of 6.45 × 10–3 S cm–1 (at 313 K and 100% relative humidity) which is among the highest values so far reported in proton conduction for COFs. The mechanism of conduction has been determined using 1H and 7Li solid-state nuclear magnetic resonance spectroscopy. Interestingly, these materials, in the presence of controlled amounts of acetic acid and under pressure, show a remarkable processability that gives rise to quasi-transparent and flexible films showing in-plane structural order as confirmed by X-ray crystallography. Finally, we prove that these films are useful for the construction of proton exchange membrane fuel cells (PEMFC) reaching values up to 12.95 mW cm–2 and 53.1 mA cm–2 for maximum power and current density at 323 K, respectively.
Resumen.
En este artículo se presentan los resultados preliminares de una exploración desarrollada para identificar las formas cómo la experiencia de la discapacidad se refleja en la enseñanza de ...profesores universitarios con esta condición. Participaron en este estudio seis profesores con discapacidad, actualmente en ejercicio docente en distintas universidades de Bogotá, Colombia. Los resultados parciales que aquí se presentan corresponden al análisis de los registros videográficos, enfatizando en la definición como gesto docente, de acuerdo a la Teoría de la Acción Didáctica Conjunta y la metodología de la Clínica Didáctica para el análisis de situaciones de enseñanza-aprendizaje. Se encontró que la experiencia de la discapacidad se evidencia de forma clara en los gestos definitorios de los profesores y tiene un papel muy importante en los procesos educativos.
Introduction
Preliminary reports support the hypothesis that sensory issues may be related to atypical defecation habits in children. Clinical practice in this area is limited by the lack of ...validated measures. The toileting habit profile questionnaire was designed to address this gap.
Methods
This study included two phases of validity testing. In phase 1, we used Rasch analysis of existing data to assess item structural validity, directed content analysis of recent literature to determine the extent to which items capture clinical concerns, and expert review to validate the toileting habit profile questionnaire. Based on phase 1 outcomes, we made adjustments to toileting habit profile questionnaire items. In phase 2, we examined the item structural validity of the revised toileting habit profile questionnaire.
Results
Phase 1 resulted in a 17-item questionnaire: 15 items designed to identify habits linked to sensory over-reactivity and two designed to identify sensory under-reactivity and/or poor perception items. The analysis carried out in phase 2 supported the use of the sensory over-reactivity items. Remaining items can be used as clinical observations.
Conclusion
Caregiver report of behaviour using the revised toileting habit profile questionnaire appears to adequately capture challenging defecation behaviours related to sensory over-reactivity. Identifying challenging behaviours related to sensory under-reactivity and/or perception issues using exclusively the revised toileting habit profile questionnaire is not recommended.
For patients with metastatic colorectal cancer (mCRC) that have failed a first-line oxaliplatin-based regimen, the preferred treatment option is an irinotecan-based regimen. This prospective, ...observational, noncomparative, post-authorization safety study (OZONE) evaluated the safety and effectiveness of aflibercept plus fluorouracil, leucovorin, and irinotecan (FOLFIRI) in patients with mCRC treated in daily practice after failure of an oxaliplatin-based regimen. Patients were grouped by age, renal impairment, hepatic impairment, race, number, and type of prior anticancer therapy. Of 766 treated patients enrolled, 59.5% were male, 94.8% had an Eastern Cooperative Oncology Group performance status of 0-1, all received previous chemotherapy (97.8% including oxaliplatin), and 58.6% had prior exposure to bevacizumab. At least one grade ≥ 3 treatment-emergent adverse event (TEAE) was reported in 68.3% of patients. Neutropenia, hypertension, diarrhea, and asthenia were the most frequently occurring grade ≥ 3 TEAEs. Antivascular endothelial growth factor class events were infrequent. Subgroup analyses did not reveal major differences in the safety profile according to age, renal and hepatic status, race, or prior anticancer therapy. For the total population, median overall survival was 12.5 months, median progression-free survival was 6.1 months, and overall response rate was 16.3%. Aflibercept in combination with FOLFIRI is a safe and efficacious regimen administered in current clinical practice to patients with mCRC previously treated with oxaliplatin. The study results, conducted in real-world clinical practice with a less selected patient population, are aligned with the VELOUR (NCT00561470) trial and no new safety issues were identified.
This study aimed to analyze the psychological affectation of health professionals (HPs) of Spanish Emergency Medical Services (EMSs) according to the cumulative incidence (CI) of COVID-19 cases in ...the regions in which they worked. A cross-sectional descriptive study was designed, including all HPs working in any EMS of the Spanish geography between 1 February 2021 and 30 April 2021. Their level of stress, anxiety and depression (DASS-21) and the perception of self-efficacy (G-SES) were the study's main results. A 2-factor analysis of covariance was used to determine if the CI regions of COVID-19 cases determined the psychological impact on each of the studied variables. A total of 1710 HPs were included. A third presented psychological impairment classified as severe. The interaction of CI regions with the studied variables did not influence their levels of stress, anxiety, depression or self-efficacy. Women, younger HPs or those with less EMS work experience, emergency medical technicians (EMT), workers who had to modify their working conditions or those who lived with minors or dependents suffered a greater impact from the COVID-19 pandemic in certain regions. These HPs have shown high levels of stress, anxiety, depression and medium levels of self-efficacy, with similar data in the different geographical areas. Psychological support is essential to mitigate their suffering and teach them to react to adverse events.
Sensory over-reactivity may be related to atypical defecation habits in children with constipation. The Toileting Habit Profile Questionnaire-Revised (THPQ-R) is designed to identify ...defecation-related sensory issues. This study examined the discriminative and concurrent validity of the THPQ-R. Differentiating between children with and without constipation was used to establish discriminative validity. The relationship between scores on the THPQ-R and on the defecation scale of the Virginia Encopresis-Constipation Apperception Test (VECAT-S) was examined to establish concurrent validity. The difference in THPQ-R scores was statistically significant. There was a strong positive correlation between the over-reactivity section of the THPQ-R and VECAT-S scores. Results support using the THPQ-R to identify atypical defecation behaviors.
PurposeThe aim of this paper is to share the details of a multidisciplinary approach, which includes occupational therapy, and to review the factors that should be considered in the evaluation and ...treatment of children with autism spectrum disorders (ASD) who are excessively selective in their food choices. Issues in this area are complex and often related to several complementary domains (medical, nutritional, psychosocial, sensorimotor, etc.). However, feeding disorders are frequently assessed and treated from a single discipline and important issues are missed or confounded.Design/methodology/approachA team of experienced clinicians in the field of paediatric feeding disorders gathered the knowledge and experience they acquired from working with individuals with ASD as well as with individuals with other neurodevelopmental diagnosis. A review of current literature in paediatric feeding disorders was used to document and explicate the multifactorial nature of feeding disorders in children with ASD and justify the need for a multidisciplinary approach to issues in this area.FindingsFeeding disorders in children with ASD are linked to multiple sensory, motor, behavioural, nutritional and gastrointestinal comorbidities. A multidisciplinary approach is needed and increasingly recommended. However, multidisciplinary teams, specialised in the care of children with ASD and feeding issues, continue to be difficult to locate and access for families. The authors sought to highlight the signs of feeding problems in children with ASD from different domains and share a model of a multidisciplinary approach that can lead to more successful interventions.Originality/valueThe detailed description of the domains linked to feeding issues and the clinical descriptions provided throughout the paper create a roadmap for other clinicians aiming to set up similar teams.
PURPOSE: Adequate sensory perception and reactivity to the sensory stimuli associated with defecation is key to successful stool toileting. Preliminary reports suggests that some of the difficulties ...that many children with functional defecation disorders (FDD) experience with toileting routines could be related to issues in sensory reactivity. The Toileting Habit Profile Questionnaire-Revised (THPQ-R) is a tool that measures sensory reactivity in relation to defecation related sensations. This study investigated the relationship between sensory reactivity and FDD, and further evaluated the validity of the THPQ-R. DESIGN: This investigation adopted a descriptive survey methodology in which participants were invited to complete two different online questionnaires. Participants were caregivers of children with and without FDD and aged 3 to 6 years old. Children with a diagnosis of ASD or ADHD were also included because of the reported higher prevalence of FDD in children with these diagnoses. Parents of children with organic causes of defecation issues were excluded. Apart from parents of children with a diagnosis of ASD or ADHD, parents with children who qualified for their school's special needs program or who had been referred to early intervention programs were excluded to insure that FDD was not confounded by other diagnoses. Participants whose children had not yet initiated toilet training were also excluded. Parents were recruited through parent support groups of all types and through social media. Pediatric gastroenterologists and occupational therapists from both public and private clinics were also contacted for recruitment. Snowball recruitment was permitted. Recruitment was aimed at several English and Spanish speaking countries. METHOD: Parents of three to six-year-old children with and without FDD completed two questionnaires; the THPQ-R and the Short Sensory Profile (SSP). A web-based survey tool (QualtricsR) was used for data collection. On both questionnaires, low scores indicate more concerns. Between group comparisons (comparison group and FDD/STR group) on the THPQ-R and SSP were conducted using the student-t test. Differences were considered statistically significant at p <.05. A Pearson correlation coefficient was calculated to analyze the relationships between the SSP scores and the THPQ-R scores. In order to use parametric statistical tests, THPQ-R and SSP raw scores, based on ordinal scaling, were transformed to linear measurements expressed in log odds probability units (logits) using Rasch computations.Considering that, the purpose of the study is to develop a better understanding of the relationship between defecation behaviors and sensory hyper-reactivity, our analysis was based on a subset of relevant items from the THPQ-R and the SSP. RESULTS: Children with FDD showed higher level of sensory hyper-reactivity. The difference was statistically significant (p < .0005). There was a positive correlation between THPQ-R and sensory hyper-reactivity scores on the SSP (r.sub.274 = .485, p < .0005). Further, higher levels of sensory hyper-reactivity were associated with a higher frequency of challenging defecation behaviors and difficulties with toileting routines (THPQ-R). CONCLUSION: Health practitioners do not usually consider sensory hyper-reactivity as a possible factor contributing to the difficulties that children with FDD may have with participation in healthy, age appropriate toileting routines. Our results indicate that routine screening for sensory hyper-reactivity may be an important practice element when working with children with FDD. In addition, the present study adds support to the validity of the THPQ-R in identifying challenging toileting behaviors potentially linked to sensory hyper-reactivity.
This research examines the mental health inequalities between employed and unemployed individuals among the fluctuations over the business cycle. To analyze whether a recession affects self-evaluated ...mental health and consequently increases the demand for mental health care, I exploit the sudden increase of the unemployment rate in Spain during the period 2007–2009. First, I analyze the impairment of self-evaluated mental health as a consequence of the Great Recession and if it prevails during the economic recovery. In addition, I estimate if the effect on self-reported mental health is reflected in demand for mental health care. The results from an event study design show that the economic downturn increases the differences between employed and unemployed individuals in self-evaluated mental health. However, and despite the continuous improvement in unemployment, the mental health gap remained unchanged between 2014 and 2017, which could imply the persistence of some lasting impacts of the Great Recession on mental health. Nonetheless, I find a reduction in the differences of using drugs related to mental health during the period 2011–2012, when I estimate the largest inequalities in self-evaluated mental health.
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