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One of the main health-related worries for older adults is becoming dependent. Even healthy older adults may worry about becoming dependent, generating guilt feelings due to the anticipation of future needs that others must solve. The guilt associated with self-perception as a burden has not been studied in older adults, and there is no instrument available to measure these feelings.
To adapt the Self-Perceived Burden Scale (SPBS; Cousineau et al., 2003) for the assessment of feelings of guilt for perceiving oneself as a burden for the family in older adults without explicit functional or cognitive impairment.
Participants were 298 older adults living independently in the community. Participants completed the assessment protocol, which included measures of guilt associated with self-perception as a burden, depressive and anxious symptomatology, self-perceived burden, and sociodemographic information.
Results from exploratory, parallel and confirmatory factor analyses suggest that the scale, named Guilt associated with Self-Perception as a Burden Scale (G-SPBS), has a unidimensional structure, explaining 57.04% of the variance of guilt. Good reliability was found (Cronbach’s alpha = .94). The results revealed significant (p < .01) positive associations with depressive and anxious symptomatology.
These findings suggest that the G-SPBS shows good psychometric properties which endorse its use with healthy community older adults. Also, guilt associated with perceiving oneself as a burden seems to be a relevant variable that can contribute to improving our understanding of psychological distress in older adults.
The need to achieve a uniform distribution of concentrated solar flux in the photovoltaic, thermal or any other receivers is a common problem; therefore, the optical characterization of the concentration system is necessary to determinate the physical characteristics of the receptors. In this work, a parabolic dish concentrator of 1.65x1.65 m2, developed by research from the University of Arizona, is optically characterized under normal operating conditions, also known as environmental conditions that refer to non-controlled conditions as solar radiation, environmental temperature and wind velocity that could affect slightly, by thermal and mechanical efforts, the distribution profiles of the concentrated solar radiation. The set used for the evaluation consisted of the parabolic mirror and Chilled Lambertian Flat Surface installed in the focal point on the optical axis of the mirror. The evaluation was divided into two parts: a theoretical part that consist on using ray tracing simulation and an experimental part that corresponds to image analysis. The used methodology in this work has been stablish in many researches, so this is a reliable method. The global optical error was 2.3 mrad under normal operating conditions.
This article describes a project intended to promote access to electroacoustic music for children and teenagers aged 6 to 15 years in a socially and educationally disadvantaged rural community in Michoacán, Mexico. It explores an educational model of teaching, learning and creation of electroacoustic music through the use of music technology and pedagogy based on constructivism and Paulo Freire’s ideas on education as a practice of freedom. It provides a pedagogical reflection on the processes of learning and appreciation of this new music. The project includes the use of an interactive music system – implemented in MaxMSP using a mobile phone OSC app to control space and its interaction with timbre, pitch and duration – as an aid in the classroom and its implementation in an educational programme with a social impact. The research covered in this article could be taken into account to deliver new music education in rural communities with similar socioeconomic circumstances.
Objectives: How brain damage after stroke is related to specific clinical manifestation and recovery is incompletely understood. We studied cognitive reserve (CR) in stroke patients by two types of measurements: (i) objectively verifiable static proxies (i.e., education, occupational attainment), and (ii) subjective, dynamic proxies based on patient testimony in response to a questionnaire. We hypothesized that one or both of these types of CR measurements might correlate positively with patient cognitive performance during the post-acute and chronic phases of recovery. Method: Thirty-four stroke patients underwent neuropsychological assessment at 2, 6 and 24 months after stroke onset. In chronic stage at 24+ months, self-rating assessments of cognitive performance in daily life and social integration were obtained. CR before and after stroke was estimated using static proxies and dynamic proxies were obtained using the Cognitive Reserve Scale (CRS-Pre-stroke, CRS-Post-stroke). Results: CRS-Pre-stroke and CRS-Post-stroke showed significant mean differences. Dynamic proxies showed positive correlation with self-assessment of attention, metacognition, and functional ability in chronic stage. In contrast, significant correlations between static proxies and cognitive recovery were not found. Conclusions: Dynamic proxies of CR were positively correlated with patients’ perception of their functional abilities in daily life. To best guide cognitive prognosis and treatment, we propose that dynamic proxies of CR should be included in neuropsychological assessments of patients with brain damage.
Emergency physicians play a frontline role in hospital disaster responses and require appropriate training.
The aim of the current study was to pilot and compare the effectiveness of two emergency preparedness teaching interventions: the first employing traditional lecture-based instruction (LEC) and the second utilizing interactive simulation/game-based teaching (SIM).
A two-group randomized pre- and post-test design was implemented into the didactic curriculum of the Emergency Medicine (EM) Residency Training Program at the San Lucas Episcopal Hospital in Ponce, Puerto Rico. Residents (n=23) completed either a LEC (control) or SIM teaching module (single day, one to two hours) focusing on emergency preparedness concepts, disaster-related clinical decision-making, and physician responsibilities during hospital disaster protocols. Knowledge-based multiple-choice exams and scenario-based competency exams were administered at three different time points: one-week pre-intervention, immediately post-training, and two-weeks post-training. Test scores were compared between groups at each time point using the Mann-Whitney U test.
Following the teaching interventions, no significant differences were found between the LEC group versus the SIM group in knowledge-based exam performance (LEC 81.1%[9.4] vs. SIM 74.9%[12.1]; U=42.50, p=0.15) and scenario-based exam performance (LEC 80.0%[9.7] vs. SIM 80.2%[9.2]; U=62.00, p=0.83), suggesting both teaching methods were similarly effective. Indeed, knowledge-based exam scores improved two-fold and scenario-based exam scores improved by over 50% immediately following training relative to baseline exam scores. Two-weeks post-training, a significant decrease in scenario-based exam performance was found in the LEC group relative to the SIM group (LEC 63.1%[11.6] vs. SIM 75.4%[11.5]; U=91.50, p=0.036), suggesting residents who train with simulations show greater retention of scenario-based concepts compared to those who train with lecture-based training alone.
The current study highlights the potential dual value of incorporating simulation training in EM emergency preparedness curriculums in improving both knowledge and concept retention of physician disaster responsibilities.
The rate coefficients, k(T= 11.7 – 64.4 K), for the gas-phase reaction between OH radicals and acetone, CH3C(O) CH3, have been measured using the pulsed CRESU (French acronym for Reaction Kinetics in a Uniform Supersonic Flow) technique, the most suitable one to cool down gases below the freezing point without gas condensation. The experimental k(T) was found to increase as temperature was lowered and is several orders of magnitude higher for low temperature than k(300 K). No pressure dependence of k(20 K) and k(64 K) was observed, while k(50 K) at the largest gas density is twice higher than the average values found at lower gas densities. The obtained values of k(11.7 K) and k(21.1 K) were 2.45’10-10 and 1.39’10-10 cm3 molecule-1 s-1, respectively.
Trichomonas vaginalis induces cellular damage to the host cells (cytotoxicity) through the proteolytic activity of multiple proteinases of the cysteine type (CPs). Some CPs are modulated by environmental factors such as iron, zinc, polyamines, etc. Thus, the goal of this study was to assess the effect of glucose on T. vaginalis cytotoxicity, proteolytic activity and the particular role of TvCP2 (TVAG_057000) during cellular damage. Cytotoxicity assays showed that glucose-restriction (GR) promotes the highest HeLa cell monolayers destruction (~95%) by trichomonads compared to those grown under high glucose (~44%) condition. Zymography and Western blot using different primary antibodies showed that GR increased the proteolytic activity, amount and secretion of certain CPs, including TvCP2. We further characterized the effect of glucose on TvCP2. TvCP2 increases in GR, localized in vesicles close to the plasma membrane and on the surface of T. vaginalis. Furthermore, pretreatment of GR-trichomonads with an anti-TvCP2r polyclonal antibody specifically reduced the levels of cytotoxicity and apoptosis induction to HeLa cells in a concentration-dependent manner. In conclusion, our data show that GR, as a nutritional stress condition, promotes trichomonal cytotoxicity to the host cells, increases trichomonad proteolytic activity and amount of CPs, such as TvCP2 involved in cellular damage.
In recent years, modified graphene has been used in various biomedical applications due to its excellent properties that allow the development of devices capable of detecting macromolecules within the human organism, also for biomolecular analysis, discovery of biomarkers, bioimaging and target delivery. These applications involve interactions between enzymes, proteins, peptides, DNA, RNA, etc. and modified graphene, therefore the study and the theoretical and experimental investigation of these interactions is essential for the development of nanobio-technology. For example, many applications based on using modified graphene to detect macromolecules require studying the changes in the properties of doped graphene when interacting with macromolecules. In this work, DFT and molecular dynamics methods were used to obtain results of the changes in energy density of states of graphene doped with iron when it is made to interact with coenzyme A. Besides, we presented a study of molecular dynamics in order to determine the quantum factors that guide the interaction graphene-coenzyme A. The system was studied in aqueous medium which it was simulated by the dielectric constant of water. The results confirm that the methodology presented in this work can be used to theoretically detect various macromolecules.
Boring sponges are an important component of bioeroder assemblages in tropical coral reefs. They are considered as a potential threat for coral reef health, and the increase of dead corals is expected to promote their abundance. The relationship between the availability of dead coral substrata and the development of boring sponge assemblages was evaluated during El Niño 2015–16 at five reefs from Zihuatanejo, Guerrero, Mexico. Environment and substrate quality were assessed. Overall, environment conditions remained normal in relation to previous studies in the area. Only water temperature showed unusually high records at all sites and coincided with bleaching and mortality of corals, possibly caused by the effects of the El Niño event. Abundance of boring sponges in dead corals and coral rubble was lower than during previous studies. Although sponge abundance was not directly related to cover of both dead corals and coral rubble, cover of dead corals showed a high correlation with the variation in the structure of sponge assemblages across sites. Cliona vermifera dominated sponge assemblages at all sites, and its abundance was high under conditions of high cover of live corals and low cover of bleached corals. Since overall sponge abundance responded in a similar way, these results suggest that boring sponge assemblages dominated by C. vermifera are enhanced by conditions favourable for corals. Our results imply that El Niño events in the Mexican Pacific are not likely to cause immediate population outbreaks of boring sponges.
To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017.
This prospective, pre–post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate.
During the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34–0.6; P<.001).
Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina.
Grounded in self-determination theory, the aim of this study was to develop a scale with adequate psychometric properties to assess motivation for teaching and to explain some outcomes of secondary education teachers at work. The sample comprised 584 secondary education teachers. Analyses supported the five-factor model (intrinsic motivation, identified regulation, introjected regulation, external regulation and amotivation) and indicated the presence of a continuum of self-determination. Evidence of reliability was provided by Cronbach’s alpha, composite reliability and average variance extracted. Multigroup confirmatory factor analyses supported the partial invariance (configural and metric) of the scale in different sub-samples, in terms of gender and type of school. Concurrent validity was analyzed by a structural equation modeling that explained 71% of the work dedication variance and 69% of the boredom at work variance. Work dedication was positively predicted by intrinsic motivation (ß = .56, p < .001) and external regulation (ß = .29, p < .001) and negatively predicted by introjected regulation (ß = –.22, p < .001) and amotivation (ß = –.49, p < .001). Boredom at work was negatively predicted by intrinsic motivation (ß = –.28, p < .005) and positively predicted by amotivation (ß = .68, p < .001). The Motivation for Teaching Scale in Secondary Education (Spanish acronym EME-ES, Escala de Motivación por la Enseñanza en Educación Secundaria) is discussed as a valid and reliable instrument. This is the first specific scale in the work context of secondary teachers that has integrated the five-factor structure together with their dedication and boredom at work.
Stereo-electroencephalography (SEEG) has been shown to be a valuable tool for the anatomo-electroclinic definition of the epileptogenic zone (EZ) in some patients with medically refractory epilepsy considered for surgery. In Spain, many of those patients are not offered this diagnostic procedure. The objective of our health technology assessment (HTA) report was to evaluate the effectiveness, safety and cost-effectiveness of SEEG to define the EZ in patients with refractory epilepsy considered for surgery compared to no SEEG intervention (i.e. remaining with further antiepileptic drugs).
We undertook a systematic review with meta-analyses on the effectiveness and safety of SEEG. A cost-effectiveness analysis was conducted using a Markov model which simulates the costs and health outcomes of individuals for a lifetime horizon from the perspective of the Spanish National Health Service (NHS). The effectiveness measure was quality-adjusted life years (QALYs). We ran extensive sensitivity analyses, including a probabilistic sensitivity analysis.
The EZ was found in 92 percent of patients who underwent SEEG, 72 percent were eligible for epilepsy surgery and 33 percent were free of seizures after surgery (47 percent of those who received surgery). Any complications related to insertion and monitoring of SEEG and the subsequent intervention occurred in 1.3 percent of patients. In the base case analysis, SEEG led to higher QALYs and healthcare costs with an estimated incremental cost-effectiveness ratio of EUR 10,368 (USD 12,217) per QALY. The sensitivity analyses showed that the results of the study were robust.
SEEG is a cost-effective technology in patients with refractory epilepsy considered for surgery when compared to no SEEG intervention.
The crystal structure of karibibite, Fe33+(As3+O2)4(As23+O5)(OH), from the Urucum mine (Minas Gerais, Brazil), was solved and refined from electron diffraction tomography data [R1 = 18.8% for F > 4σ(F)] and further confirmed by synchrotron X-ray diffraction and density functional theory (DFT) calculations. The mineral is orthorhombic, space group Pnma and unit-cell parameters (synchrotron X-ray diffraction) are a = 7.2558(3), b = 27.992(1), c = 6.5243 (3) Å, V = 1325.10(8) Å3, Z = 4. The crystal structure of karibibbite consists of bands of Fe3+O6 octahedra running along a framed by two chains of AsO3 trigonal pyramids at each side, and along c by As2O5 dimers above and below. Each band is composed of ribbons of three edge-sharing Fe3+O6 octahedra, apex-connected with other ribbons in order to form a kinked band running along a. The atoms As(2) and As(3), each showing trigonal pyramidal coordination by O, share the O(4) atom to form a dimer. In turn, dimers are connected by the O(3) atoms, defining a zig-zag chain of overall (As3+O2)n-n stoichiometry. Each ribbon of (Fe3+O6) octahedra is flanked on both edges by the (As3+O2)n-n chains. The simultaneous presence of arsenite chains and dimers is previously unknown in compounds with As3+. The lone-electron pairs (4s2) of the As(2) and As(3) atoms project into the interlayer located at y = 0 and y = ½, yielding probable weak interactions with the O atoms of the facing (AsO2) chain.
The DFT calculations show that the Fe atoms have maximum spin polarization, consistent with the Fe3+ state.