Short educational programs that involve those thematic information areas might be of special interest for public health systems in low- and middle-income countries due to three reasons. First, most of the population in those countries has a low level of education and limited access to information, which may limit the understanding of aphasia and stroke. The inequities in health care that occur in these countries affect primarily those with lower socioeconomic status(99 Balsa AI, Rossi M, Triunfo P. Horizontal inequity in access to health care in four South American cities. SSRN Electron J. [Internet]. 2009 [cited 2018 Feb 6]. Available from: =1474425 =1474425... ). Second, the high demand imposed on public clinics and hospitals limits the time that health professionals (physicians, speech and language pathologists, nurses) can dedicate properly to patients and families, preventing patients from receiving proper care(1010 Macinko J, Guanais FC, Mullachery P, Jimenez G. Gaps in primary care and health system performance in six Latin American and Caribbean countries. Health Aff. 2016;35(8):1513-21. PMid:27503978. ). Third, not all healthcare services offer speech and language pathologists and there is a discrepancy in the distribution of these professionals across services and throughout demographic regions(1111 Sousa MFS, Nascimento CMB, Sousa FOS, Lima MLLT, Silva VL, Rodrigues M. Evolução da oferta de fonoaudiólogos no SUS e na atenção primária à saúde, no Brasil. Rev CEFAC. 2017;19(2):213-20. -0216201719215816. -021620171... ). Because of this, access to speech and language pathologists is hampered by long waiting lists. In brief, short educational programs about aphasia may be a low-cost and realistic way to mitigate those problems. In this study, we developed a short educational program on aphasia (SEPA) for family caregivers of people with aphasia and verified its effect on caregiver burden and quality of life through a pilot study implemented in a public health setting.
My Life In Brazil - I Like Short Guys From America! - Bruna - December 10 2009
The association between short-acting insulin analogues and a reduction of 7% in total hypoglycemic episodes, 32% in severe hypoglycemia, and 45% in nocturnal hypoglycemia levels is an important finding, as these episodes are particularly associated with lower quality of life and treatment nonadherence [46]. The pursuit of lower HbA1c levels is associated with a higher rate of hypoglycemia episodes [47], which is a well-known barrier to strict glucose control. This may hinder the maintenance of euglycemia over a lifetime, which prevents patients from fully benefitting from glucose control [48]. The benefits mentioned above are most likely determined by the specific pharmacokinetic properties of these analogues; having a very short-acting activity limits the risk of late falls in glucose levels [16]. The lower frequency of nocturnal hypoglycemic episodes observed with short-acting insulin analogues may contribute to the lower frequency of severe hypoglycemia. It is already known that sleep per se is a risk factor for severe hypoglycemia, as symptoms of hypoglycemia might be blunted or absent during sleep [8]. 2ff7e9595c
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