The impact of portfolios on health professionals' practice: a literature review

Objectives The purpose of this paper is to review the literature on the use of a portfolio and discuss the evidence for the impact of a portfolio on professional practice, in particular pharmacy practice. Method A literature review was performed using databases from health care and education, namely AMED, BEI, CINAHL, Embase, ERIC, IPA, MedLine, PHARM‐LINE, Psycinfo, TIMELIT and ZETOCs, as well as a manual search of relevant journals and documents between 1991 and 2007. The search terms included portfolio, progress files and assessment, and these were linked with pharmacy. Articles were included in the review if they had a focus on the portfolio as a contribution to professional practice. Key findings Portfolios have been used in the education field for over decade. A total of 26 out of 1901 papers were identified which examined portfolios in a post‐registration setting. The majority of these publications were from medicine (12), with education (six), pharmacy (five) and nursing (three) making up a small proportion. Portfolios were seen as (a) a tool for use in feedback, (b) a useful trigger for reflection and (c) a link between academic learning and practice. A similar set of findings were seen in the educational context. In addition, a portfolio (a) requires motivation to record and (b) can change behaviour towards colleagues. Conclusions There is still confusion about the meaning of a professional portfolio in health care professions. It is suggested that portfolios should be classified according to a modified system from the teaching profession. The evidence that portfolios can contribute to practice is limited. This review suggests the need for more studies into the impact of portfolios on professional practice, in particular in a pharmacy context.     

Ex-situ Bioremediation of Crude Oil in Soil, a Comparative Kinetic Analysis

Weathered crude oil (WCO) removals in shoreline sediment samples were monitored for 60 days in bioremediation experimentation. Experimental modeling was carried out using statistical design of experiments. At optimum conditions maximum of 83.13, 78.06 and 69.92% WCO removals were observed for 2, 16 and 30 g/kg initial oil concentrations, respectively. Significant variations in the crude oil degradation pattern were observed with respect to oil, nutrient and microorganism contents. Crude oil bioremediation were successfully described by a first-order kinetic model. The study indicated that the rate of hydrocarbon biodegradation increased with decrease of crude oil concentrations.     

Neonatal and fetal exposure to trans-fatty acids retards early growth and adiposity while adversely affecting glucose in mice

Industrially produced trans-fatty acids (TFAs) consumed in Western diets are incorporated into maternal and fetal tissues and are passed linearly to offspring via breast milk. We hypothesized that TFA exposure in utero and during lactation in infants would promote obesity and poor glycemic control as compared with unmodified fatty acids. We further hypothesized that in utero exposure alone may program for these outcomes in adulthood. To test this hypothesis, we fed female C57/BL6 mice identical Western diets that differed only in cis- or trans-isomers of C18:1 and then aimed to determine whether maternal transfer of TFAs through pregnancy and lactation alters growth, body composition, and glucose metabolism. Mice were unexposed, exposed during pregnancy, during lactation, or throughout pregnancy and lactation to TFA. Body weight and composition (by computed tomography) and glucose metabolism were assessed at weaning and adulthood. Trans-fatty acid exposure through breast milk caused significant early growth retardation (P < .001) and higher fasting glucose (P = .01), but insulin sensitivity was not different. Elevated plasma insulin-like growth factor-1 in mice consuming TFA-enriched milk (P = .02) may contribute to later catch-up growth and leanness and preserved peripheral insulin sensitivity observed in these mice. Mice exposed to TFA in utero underwent rapid early neonatal growth with TFA-free breast milk and had significantly impaired insulin sensitivity (P < .05) and greater abdominal fat (P = .01). We conclude that very early catch-up growth resulted in impaired peripheral insulin sensitivity in this model of diet-related fetal and neonatal programming. Trans-fatty acid surprisingly retarded growth and adiposity while still adversely affecting glucose metabolism.     

The risk of cardiovascular disease in women with a history of miscarriage and/or stillbirth

Abstract

Cardiovascular disease (CVD) remains the main cause of morbidity and mortality in women worldwide. Apart from the well-established risk factors, some adverse pregnancy outcomes have been found to be associated with increased risk of CVD in women. We reviewed the literature on the risk of CVD in women with a history of pregnancy loss (miscarriage and/or stillbirth). Electronic databases including MEDLINE and CINAHL were searched for English language articles published from 2000 to July 2016. Following the application of study inclusion and exclusion criteria, we selected seven studies for review. Women with history of miscarriage and/or stillbirth are more likely to develop coronary heart disease (CHD), but not stroke in their later life compared with women without these conditions. The risk is particularly greater in women with multiple miscarriages or stillbirths. Health professionals should be aware of the risk associated with miscarriage and stillbirth, and use maternal history to identify, refer, closely monitor, and engage these high risk women in healthy lifestyle and risk factor modification programs.     

Primary healthcare and the construction of meanings for oral health: a social constructionist interpretation of discourses by the elderly

Dentistry is nowadays open to new ideas about the constructions of meanings for oral health. This openness tallies with the social production of health and shows the need to contextualize the social, historical and sundry knowledge in the development of oral health for different communities. The scope of this research is to build meanings for oral health with a group of elderly people. With this in mind, we propose an approximation between the discourses of the elderly on oral health and the Social Constructionist discourse. Thus, we interviewed 14 elderly people registered with a Family Health Unit in Ribeir?o Preto in the State of S?o Paulo in the first semester of 2010. This enabled us to identify two Interpretative Repertoires with the use of Discourse Analysis, which showed the relationship between: 1 - Lack of dental information and assistance in childhood; and 2 - Primary Healthcare constructing meaning for oral health. We concluded that Social Constructionism assists epistemologically for the construction of meaning for oral health and that Primary Healthcare is essential for valuing healthcare for the construction of meaning for oral health on the part of the elderly by fostering conditions for self care and healthy attitudes.     

Micro/nanoencapsulation of essential oils and fragrances: Focus on perfumed,antimicrobial, mosquito-repellent and medical textiles

Herbal products have been widely used due to good antimicrobial, fragrance and medical properties. Essential oils and fragrances can be applied on the textile substrates as micro/nanocapsules to prolong lifetime by controlling the release rate. The present review tries to give a general overview on the application of micro/nanoencapsulated essential oils on the textile substrates to achieve aromatherapy textiles. These are divided into four diverse categories as the following: antimicrobial, perfumed, mosquito-repellent and medical textiles. The reports in this field revealed that the encapsulation technique plays an important role in the finishing of plant extracts on the textile substrates. It is also anticipated that aromatherapy textiles have to be developed in the new fields such as multifunctional textiles having wound-healing, antimicrobial and fragrant properties.     

Spotted fever group rickettsiae identified in Dermacentor marginatus and Ixodes ricinus ticks in Algeria

Our study was carried out using Ixodes ricinus ticks collected from cattle from Tizi-Ouzou and Dermacentor marginatus ticks collected from the vegetation of the Blida region, a tourist site, both regions situated in northern Algeria. The results of real-time quantitative PCR (qPCR) specific for a partial sequence of the citrate synthase gene (gltA) indicate that Rickettsia spp. were present in 11/23 (48%) and 4/9 (44%) of the examined ticks from Tizi-Ouzou and Blida, respectively. The sequences of Rickettsia helvetica and Ri. monacensis were found in I. ricinus ticks using gltA primers. In addition, Ri. slovaca was detected based on the sequences of the gltA and the outer membrane protein (OmpA) genes in D. marginatus ticks. DNA sequencing to identify the species revealed for the first time the presence of Ri. helvetica in I. ricinus ticks and Ri. slovaca in D. marginatus ticks from Algeria and confirmed the presence of Ri. monacensis.     

Therapeutic potential of nitric oxide in cancer.

In recent years, several novel approaches have been developed to overcome tumor cell resistance to conventional therapeutics. Such approaches include genetic manipulations, vaccine development and exploitation of the anti-tumor host immune response. The overall development of tumor cell resistance to therapeutics is, in large part, the result of the ability of tumor cells to develop specific mechanisms to overcome cell death or apoptosis. Therefore, the possibility to interfere selectively in the regulation of the apoptotic signaling pathways may result in either the direct induction of cell death and/or sensitization of the cells to cytotoxic stimuli. A novel approach based on modifying gene products that regulate resistance to apoptosis involves nitric oxide (NO). NO is a ubiquitous molecule with diverse cellular effects that depend on the source, concentration, latency, cell type and phenotype. This review describes the role played by NO in cancer including carcinogenesis, pathogenesis, angiogenesis, chemoprevention and as a novel therapeutic to overcome resistance when used alone or as a sensitizing agent used in combination with other therapeutics.     

Human resources and health work: challenges for a research agenda

This article discusses several key concepts for human resources policy in health in the context of Latin America's regional integration efforts. The article focuses on different concepts of integration to emphasize the analytical distinction between regional and conceptual integration. It also presents labor and human resources concepts before discussing, in the final analysis, the challenges that a common research agenda faces in the context of current health sector reforms in Latin America. The conclusion emphasizes the need to develop a technology and research system capable of supporting the agenda for exchange between MERCOSUR member countries.     

Drugs, alcohol and pregnant women--changing characteristics of women engaging with a specialist perinatal outreach addictions service

Pregnant substance misusers present an increased risk to themselves and the unborn child. The aim of this study was to investigate changes in the characteristics of women referred to a specialist perinatal addictions outreach service (1989-1991 versus 2002-2005). A cross-sectional audit of health records was conducted. Information was gathered for each woman who contacted the service (2002-2005). Data were compared to an earlier study in the same locality (1989-1991). A total of 167 pregnant substance-using women were referred between 2002 and 2005, of whom 126 made contact. The mean age was 30.2 years at 20.8 weeks' fetal gestation, with 76% not in addictions treatment, 32% from black or minority ethnic (BME) communities, 49% polysubstance users and 29% homeless. The primary substance used was illicit heroin (38%), followed by cocaine (24%). Compared to 1989-1991, there were significantly more pregnant women presenting at an older age, later gestation, with increased polysubstance use and a higher percentage of women from BME communities. This service was able to access vulnerable substance-abusing women with an altered pattern of substance use compared to over 10 years previously. However, improvements are needed for engaging all referred women and accessing women at an earlier gestation.