Delirium is an acute neuropsychiatric syndrome of multifactorial etiology with a high incidence in people admitted to intensive care units. In addition to reversible impairment of cognitive ...processes, it may be associated with changes in thinking and perception. If, in the past, it was considered an expected complication of severe disease, nowadays, delirium is associated with a poor short-term and long-term prognosis. Knowing that its prevention and early identification can reduce morbidity, mortality, and health costs, it is vital to investigate nursing interventions focused on delirium in critically ill patients. This study aimed to identify nursing interventions in the prevention and management of delirium in critically ill adults. The method used to answer the research question was a scoping review. The literature search was performed in the Medline (via PubMed), CINAHL (via EBSCOhost), Scopus, Web of Science, and JBI databases. The final sample included 15 articles. Several categories of non-pharmacological interventions were identified, addressing the modifiable risk factors that contribute to the development of delirium, and for which nurses have a privileged position in their minimization. No drug agent can, by itself, prevent or treat delirium. However, psychoactive drugs are justified to control hyperactive behaviors through cautious use. Early diagnosis, prevention, or treatment can reduce symptoms and improve the individual’s quality of life. Therefore, nursing professionals must ensure harmonious coordination between non-pharmacological and pharmacological strategies.
Heat-Assisted Extraction (HAE) was used for the optimized production of an extract rich in anthocyanin compounds from
var.
leaves. The optimization was performed using the response surface ...methodology employing a central composite experimental design with five-levels for each of the assessed variables. The independent variables studied were the extraction time (
, 20⁻120 min), temperature (
, 25⁻85 °C), and solvent (
, 0⁻100% of ethanol,
). Anthocyanin compounds were analysed by HPLC-DAD-ESI/MS and the extraction yields were used as response variables. Theoretical models were developed for the obtained experimental data, then the models were validated by a selected number of statistical tests, and finally, those models were used in the prediction and optimization steps. The optimal HAE conditions for the extraction of anthocyanin compounds were:
= 65.37 ± 3.62 min,
= 85.00 ± 1.17 °C and
= 62.50 ± 4.24%, and originated 114.74 ± 0.58 TA mg/g of extract. This study highlighted the red rubin basil leaves as a promising natural matrix to extract pigmented compounds, using green solvents and reduced extraction times. The extract rich in anthocyanins also showed antimicrobial and anti-proliferative properties against four human tumor cell lines, without any toxicity on a primary porcine liver cell line.
Violence against the elderly constitutes an undeniable and serious violation of human rights and affects the physical and psychological integrity of the victim. Is not a new phenomenon, is a ...worldwide problem that has become more pronounce in contemporary societies because of the ageing of the population. World Health Organization
1
defines elder violence as a single or repeated action, or the absence of an appropriate action, arising in the context of a relationship where there is an expectation of trust that causes suffering or harm to an elderly person. Occurs through several behaviours involving psychological, physical, sexual, financial violence, neglect and self-neglect
2
. The purpose of this paper is to demonstrate the work developed by the Victims Information and Assistance Office (GIAV) and by Forensic Psychology Office (GPF) at Egas Moniz Higher Education School about elder abuse.
The sample (n = 14) is derived from the domestic violence risk assessments of GIAV and GPF. We assessed 6 victims: 2 women and 4 man, aged between 64 and 95 years old (M = 76.67, sd = 10.71); and 8 defendants: 6 women and 2 man, aged between 24 and 77 years old (M = 46.13, sd = 15.52). The relationship between victims and defendants are 13 sons/daughters and 1 tenant. Data were collected from lawsuits, semi-structured interviews of the victims and defendants, collateral information and criminal record. All ethical issues have been taken due to the sensitive nature of the involved data involved and the respective informed consentient which contained the purpose of the assesses, the confidentiality limits, and information about the ethics and technician's impartiality was sign by all participants.
The results demonstrated physical and psychological abuse (in all cases), followed by economical abuse (n = 13, 92.9%) and social abuse (n = 3, 21.4%). It is possible to identify several victims' risk factors, namely gender (female victims - n = 11, 78.6%), physical problems/limitations (n = 11, 78.6%), age above 75 years old (n = 8, 57.1%) and previous abuse (n = 6, 42.9%). The most relevant offender's risk factors are financial problems (n = 12, 85.7%), deficit in the coping skills (n = 12, 85.7%), others blame (n = 10, 71.4%), history of violence against others (n = 8, 57.1%), aggressiveness (n = 8, 57.1%), criminal history (n = 6, 42.9%), victim of domestic violence in the past (n = 8, 35.7%) and perpetrator of domestic violence in the past (n = 5, 35.7%). Finally external/relational factors are: offender's dependence (n = 11, 78.6%), cohabitation (n = 11, 78.6%), history of conflicts between victim and offender (n = 10, 71.4%), poor emotional attachment or low family cohesion (n = 10, 71.4%), social isolation or lack of social support (n = 8, 57.1%), intergenerational transmission of violence (n = 7, 50%), inability in the performance of caregiver tasks (n = 5, 35.7%) and inexperience as caregiver (n = 5, 35.7%).
Portugal it's one of the top five European Countries with higher percentage (39%) of elderly mistreated
3
, however, elder abuse is still the hidden face of domestic violence. The data show several risk factors for elder abuse. These results demonstrated the urgency about elder abuse risk assessment in criminal justice system and the need of a good articulation between Forensic Psychology and Law in order to demystify the hidden face of elder abuse.
Rumo a um conceito de inovação no turismo Aires, Jussara Danielle Martins; Costa, Carlos Manuel Martins da; Brandão, Ana Filipa Fernandes Aguiar
Revista Brasileira de Pesquisa em Turismo,
08/2022, Letnik:
16
Journal Article
Recenzirano
Odprti dostop
Partindo do pressuposto que definiçõ es constituem o ponto de partida essencial de base metodoló gica para apreender e avaliar fenômemos, este artigo teórico-empírico se propõe a discutir a ...evolução do conceito de inovação na literatura e associá-la às dinâmicas de empresas de turismo, representadas pelas concepções de seus gestores. Para alcançar o nosso propósito, primeiro elaboramos um quadro conceitual da inovação, a partir de uma revisão da literatura. Depois, definimos o turismo e as atividades empresariais, que o compõem (com base na Conta Satélite do Turismo - CST). Com vista a confrontar essas informações, realizamos 35 entrevistas semiestruturadas (gravadas) com diretores de empresas turísticas na Cidade do Natal - Brasil. O acompanhamento prévio e posterior das empresas ocorreu de 2019 a 2022. O conteúdo das entrevistas foi transcito e processado com o apoio dos softwares Iramuteq e SPSS 25. Nuvens de palavras e tabelas de frequências foram criadas. Constatamos que o conceito de inovaçã o no turismo, não diferente de outros setores, está atrelado à ideia de renovaçã o, melhorias significativas, reconfiguraçõ es (físicas, relacionais ou virtuais), interaçõ es pessoais e organizacionais, conhecimento adquirido, partilhado ou imitado, percepçõ es e estraté gias isoladas ou em conjunto, soluções de problemas, agregaçã o de valor e satisfação de necessidades de consumidores (potenciais ou reais).
The trial process is usually stressful for victims. Testifying in criminal court must cope potentially traumatising effects and implies recalling and evoking a crime. Such act tends to be a ...revictimization
1-3
. Several studies have shown that re-traumatization of victims in criminal justice process has serious problems
3
.The article 271 of the Portuguese Code of Criminal Procedure allows the prosecutors and the inquiring judge to record the victim's testimony and use it during the future trial. This procedure, called future memory statements, prevents the victim to be exposed months or years later to the memories of a traumatic event
2
. Even this procedure has a traumatic outcome due to the normal anxiety felt by victims. To minimise this it is necessary to inform and prepare the victims for this diligence, explaining the court procedures. Prepare the vulnerable victim for future memory statements aims to avoid an emotional trauma event towards the criminal justice system. The purpose of this paper is to demonstrate the work developed by the Victims Information and Assistance Office (GIAV), and its role as technical advisor to the Public Prosecutor's Office, specifically about victim's attendance.
GIAV was established in partnership with Egas Moniz Higher Education School and it is located at the Combat Unit against Domestic Violence, 7
th
Section of the Lisbon Public Prosecutor's Office. Data was collected between March 2013 and May 2015 from future memory statements protocol that comprises three phases: Pre-inquiry stage (1 or 2 days before inquiry), inquiry stage (trial hearing) and post-inquiry stage (after trial hearing)
1
,
2
. A total of 144 statements for future memory were performed by GIAV. All ethical issues have been taken due to the sensitive nature of the involved data involved and the respective informed consentient, the confidentiality limits, and information about the ethics and technician's impartiality.
The type of crime of vulnerable victims is mostly child sexual abuse (n = 55, 39.5%), child abuse and neglect (n = 42, 29.9%) and domestic violence (n = 26, 18.8%). The other type of crime are sexual harassment (n = 7, 4.9%), intimate partner violence (n = 4, 2.1%), and exposure to violence (n = 2, 1.4%), rape (n = 2, 1.4%) and others (e.g. threats and sexual coercion, crimes against freedom). We evaluate 98 female victims and 42 male victims, aged between 4 and 79 years old (M = 14.06, SD = 11.32).The relationship between victims and defendants are: 55 sons and daughters, 49 others situations, mostly more than one defendant (like parent and stepfather, grandmother and uncle), 16 stepchild, 6 ex-girlfriend and others (neighbour, grandchild, unknow).
It can be seen that the statements for future memory diligence is properly present in the current reality, and it can be concluded that the use of a structured protocol allows to benefit the quantity and quality of information, promoting, within what is a particularly vulnerable victim experience, making it very effective. At the same time, it allows the articulation between law, criminal justice system and forensic psychology, allowing an effective management of the process, praising the superior interest of the victim as well as emotional stability. Victim's statements are crucial to our criminal justice system and give us a better understand of the experience of testifying and how we can reduce re-traumatization and revictimization of victims.
The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering ...their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self‐care profile; experience of the nursing staff in the cannulation technique and nurse‐to‐patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision‐making on the “ideal” cannulation technique for each patient.
Tuberculosis (TB) is a transmissible disease listed as one of the 10 leading causes of death worldwide (10 million infected in 2019). A swift and precise diagnosis is essential to forestall its ...transmission, for which the discovery of effective diagnostic biomarkers is crucial. In this study, we aimed to discover molecular biomarkers for the early diagnosis of tuberculosis. Two independent cohorts comprising 29 and 34 subjects were assayed by proteomics, and 49 were included for metabolomic analysis. All subjects were arranged into three experimental groups—healthy controls (controls), latent TB infection (LTBI), and TB patients. LC-MS/MS blood serum protein and metabolite levels were submitted to univariate, multivariate, and ROC analysis. From the 149 proteins quantified in the discovery set, 25 were found to be differentially abundant between controls and TB patients. The AUC, specificity, and sensitivity, determined by ROC statistical analysis of the model composed of four of these proteins considering both proteomic sets, were 0.96, 93%, and 91%, respectively. The five metabolites (9-methyluric acid, indole-3-lactic acid, trans-3-indoleacrylic acid, hexanoylglycine, and N-acetyl-L-leucine) that better discriminate the control and TB patient groups (VIP > 1.75) from a total of 92 metabolites quantified in both ionization modes were submitted to ROC analysis. An AUC = 1 was determined, with all samples being correctly assigned to the respective experimental group. An integrated ROC analysis enrolling one protein and four metabolites was also performed for the common control and TB patients in the proteomic and metabolomic groups. This combined signature correctly assigned the 12 controls and 12 patients used only for prediction (AUC = 1, specificity = 100%, and sensitivity = 100%). This multiomics approach revealed a biomarker signature for tuberculosis diagnosis that could be potentially used for developing a point-of-care diagnosis clinical test.
Aural hematoma is defined by the accumulation of serosanguineous fluid within the ear pinna in small animals, typically stemming from traumatic incidents. Inadequate treatment may lead to recurring ...episodes and structural deformities in the patient's ear. In veterinary clinical practice, this condition exhibits a high incidence among dogs, but is relatively rare in cats. Conventional treatments employed for the physiological and aesthetic restoration of the affected area are typically invasive and often entail significant costs. Therefore, this article aims to present a case study involving a 15-year-old female mixed-breed feline diagnosed with an aural hematoma. The patient had previously undergone various forms of conventional treatment, none of which proved successful. Thus, a complementary treatment approach utilizing oral homeopathy was selected, as it represented the sole available option at that particular juncture. The homeopathic medicines were selected according to the law of similars. The treatment consisted of the following medications: Arsenicum album 30CH; Bellis perennis 30CH and Rhus Toxicodendron 30CH. After 20 days of treatment, the animal exhibited an ear pinna devoid of fluid accumulation and recurrence. The ear pinna was in excellent condition, except for the presence of scars along the ear, resulting in a residual deformation. Hence, homeopathic therapy holds significant promise as a therapeutic modality for managing aural hematomas in cats, obviating the necessity for invasive procedures. Under this perspective, this article represents one of the initial reports documenting such a treatment approach in feline cases.
El hematoma auditivo se define por la acumulación de líquido serosanguinolento dentro del pabellón auricular en animales pequeños, generalmente como resultado de incidentes traumáticos. Un tratamiento inadecuado puede provocar episodios recurrentes y deformidades estructurales en el oído del paciente. En la práctica clínica veterinaria, esta afección presenta una alta incidencia entre los perros, pero es relativamente rara en los gatos. Los tratamientos convencionales empleados para la restauración fisiológica y estética de la zona afectada suelen ser invasivos y a menudo conllevan costes importantes. Por ello, este artículo tiene como objetivo presentar un estudio de caso que involucra a una felina mestiza hembra de 15 años diagnosticada con un hematoma auditivo. El paciente había sido sometido previamente a diversos tratamientos convencionales, ninguno de los cuales tuvo éxito. Por lo tanto, se seleccionó un enfoque de tratamiento complementario que utilizaba la homeopatía oral, ya que representaba la única opción disponible en ese momento particular. Los medicamentos homeopáticos fueron seleccionados según la ley de similitudes. El régimen de tratamiento consistió en los siguientes medicamentos: Arsenicum album 30CH, Bellis perennis 30CH y Rhus toxicodendron 30CH. Después de 20 días de tratamiento, el animal presentaba un pabellón auricular sin acumulación de líquido ni recurrencia. El pabellón auricular se encontraba en excelentes condiciones, salvo por la presencia de cicatrices a lo largo de la oreja, lo que provocaba una deformación residual. Por lo tanto, la terapia homeopática es muy prometedora como modalidad terapéutica para el tratamiento de los hematomas auditivos en gatos, evitando la necesidad de procedimientos invasivos. Bajo esta perspectiva, este artículo representa uno de los informes iniciales que documentan dicho enfoque de tratamiento en casos felinos.
O hematoma aural é definido pelo acúmulo de líquido serossanguinolento no pavilhão auricular de pequenos animais, geralmente decorrente de incidentes traumáticos. O tratamento inadequado pode levar a episódios recorrentes e deformidades estruturais na orelha do paciente. Na prática clínica veterinária, esta condição apresenta alta incidência em cães, mas é, relativamente, rara em gatos. Os tratamentos convencionais empregados para a restauração fisiológica e estética da área afetada são invasivos e muitas vezes acarretam custos significativos. Portanto, este artigo tem como objetivo apresentar um estudo de caso envolvendo um felino, fêmea, sem raça definida, de 15 anos de idade, com diagnóstico de hematoma aural. O paciente já havia sido submetido a várias formas de tratamento convencional, nenhuma das quais teve sucesso. Assim, foi selecionada uma abordagem complementar utilizando homeopatia oral, por representar a única opção disponível, naquele momento específico. Os medicamentos homeopáticos foram selecionados de acordo com a lei dos semelhantes. O regime de tratamento consistiu nos seguintes medicamentos: Arsenicum album 30CH, Bellis perennis 30CH e Rhus toxicodendron 30CH. Após 20 dias de tratamento, o animal apresentou pavilhão auricular desprovido de acúmulo de líquido e recidiva. O pavilhão auricular encontrava-se em excelente estado, exceto pela presença de cicatrizes ao longo da orelha, resultando em deformação residual. Consequentemente, a terapia homeopática é uma importante ferramenta terapêutica o manejo de otohematoma em gatos, evitando a necessidade de procedimentos invasivos. Sob esta perspectiva, este artigo representa um dos primeiros relatos que documentam tal abordagem de tratamento em gatos.
Introduction: In our everyday life we see a large number of faces that share a set of basic elements, making it necessary to distinguish those that we already know from those we know for the first ...time. This is particularly important in crimes where victims need to identify their offenders, making facial recognition an important theme in Forensic Psychology
1
. Over the time, there are more and more studies that attach greater importance to the face, which is increasingly considered an important aspect for human interaction since it provides a large amount of information that should be analyzed efficiently
2
. It is known that we have more difficulties in recognizing a face from a different race of our own, and this variable has been designated as race bias, cross race effect, other race bias and own race bias.
This paper aims at a better understanding of race effects in face recognition from the 80's until today as it is still an understudied but relevant subject to Forensic Psychology.
Materials and methods: For this study we included articles that focused on the effect of race on face recognition. To that end, studies were included from the 80's until 2018, written in Portuguese, English and Spanish. Quantitative studies were included. Finally, the research was limited to articles published in peer-reviewed journals/journals limited to full-text articles. The articles were selected by reading the title and the respective abstract.
The included articles are available in full text in the EBSCOhost Web, B-On and SAGE Journals databases. The articles were found by combining the following descriptors: "other race bias"; "own race bias" and "eyewitness AND cross-race identifications".
After applying the inclusion criteria, a total of 510 articles were found (already with the duplicates removed). Of the total number of articles 497 articles were excluded. These were excluded for the following reasons: they were not available for reading (n = 257); are not quantitative studies (n = 113); do not report the effect of race on face recognition (n = 77); were not relevant to forensic psychology (n = 50).
Results: In this review, 13 empirical articles were included, most of them being carried out between 2004 and 2016, reinforcing the importance given to this issue today. The absence of studies between 1990 and 2004 could be due to a possible lack of interest in the subject during this time. Most studies are distributed across Europe (n = 7) and North America (n = 5) and only one in Asia (Zhou, Pu, Young, & Tse, 2014). The total number of participants is 1493, with the lowest being 40 participants (Brigham, Maass, & Martinez, 1983, Yan, Andrews, Jenkins & Young, 2016) and the largest being 304 participants (Lawson & Dysart, 2014). Only five studies used an experimental method (38%) while the others used quantitative methods (62%).
After analysing the articles chosen, it was possible to underline some results. In the 80's, it was believed there was no bias in facial recognition when it came to race
3
, thus it was pointed out that own-race effect is no more common than the cross-race identifications
4
. However, in the 90's it started to be implied that there was a better memory to identify own race faces than other races, which meant that other race bias would increase when the contact with other races would decrease
4
. In the new millennium, a greater number of variables, as well as the use of different methodologies and facial recognition technique begins to emerge. In a showup, observing an innocent person of the same race of the perpetrator suspect increased the identification of false lineups
5
. Young people have a better accuracy when discriminating their own race from other races, which is not influenced by interracial contact, unlike what happens with elderly
6
. Also, Caucasian people were found to make more mistakes in identifications, comparing to other races, and it's more common to mistake identity and expressions of Caucasian than Asian faces
7
. Facial expressions began to be given more relevance in the last few years
7
.
Discussion and conclusions: There are significant differences in how individuals of different races look at the same face and determine recognition points differing from each other. Some faces are better recognized than others, creating practical implications in white witnesses which will lead to a greater probability of identifying a non-familiar black face than an unfamiliar face white and thereby increasing the likelihood of "false positive" results when the lineups are shown
5
. There is still no significant methodology evolution to test the effect of race in facial recognition, being the most used one the grey-scale photography line up.
This study aims at identifying molecular biomarkers differentiating responders and non-responders to treatment with Tumor Necrosis Factor inhibitors (TNFi) among patients with axial spondyloarthritis ...(axSpA). Whole blood mRNA and plasma proteins were measured in a cohort of biologic-naïve axSpA patients (
= 35), pre and post (14 weeks) TNFi treatment with adalimumab. Differential expression analysis was used to identify the most enriched pathways and in predictive models to distinguish responses to TNFi. A treatment-associated signature suggests a reduction in inflammatory activity. We found transcripts and proteins robustly differentially expressed between baseline and week 14 in responders. C-reactive protein (CRP) and Haptoglobin (HP) proteins showed strong and early decrease in the plasma of axSpA patients, while a cluster of apolipoproteins (APOD, APOA2, APOA1) showed increased expression at week 14. Responders to TNFi treatment present higher levels of markers of innate immunity at baseline, and lower levels of adaptive immunity markers, particularly B-cells. A logistic regression model incorporating ASDAS-CRP, gender, and
, the top differentially expressed gene at baseline, enabled an accurate prediction of response to adalimumab in our cohort (AUC = 0.97). In conclusion, innate and adaptive immune cell type composition at baseline may be a major contributor to response to adalimumab in axSpA patients. A model including clinical and gene expression variables should also be considered.
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