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1.
Int Nurs Rev ; 2024 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-38226681

RESUMO

BACKGROUND: Designing and enhancing resilient occupational health and safety systems is a challenge. This fact makes it clear that occupational health professionals must be able to develop their full range of competencies. From this premise, it is appropriate to define and deepen the strengths and weaknesses of occupational health nursing (OHN), as well as to point out the opportunities and realities that address its performance. SOURCES OF EVIDENCE: In the history of the professionalization of this speciality, different circumstances have conditioned its projection: the absence of its own body of doctrine, the lack of professional recognition, limited autonomy, and the definition of a clear regulatory framework. In addition to an epistemological limitation and the absence of clear leadership. DISCUSSION: In the consolidation of this speciality, there is a limited capacity to implement its own competencies, the invisibility of nursing care, the absence of leadership that incorporates research findings and difficulties in the application of scientific evidence, in addition to the influence of regulatory provisions and the idiosyncrasies of the company. CONCLUSIONS AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: The analysis of classical models with a transformative approach invites a more fluid and coordinated communication between occupational health, occupational risk prevention, primary care and public health, a proposal that induces collaboration and a more holistic approach to care for workers.

2.
Front Cell Dev Biol ; 11: 1256127, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38020883

RESUMO

Introduction: Removal of poorly perfused capillaries by pruning contributes to remodeling the microvasculature to optimize oxygen and nutrient delivery. Blood flow drives this process by promoting the intravascular migration of endothelial cells in developing networks, such as in the yolk sac, zebrafish brain or postnatal mouse retina. Methods: In this study, we have implemented innovative tools to recognize capillary pruning in the complex 3D coronary microvasculature of the postnatal mouse heart. We have also experimentally tested the impact of decreasing pruning on the structure and function of this network by altering blood flow with two different vasodilators: losartan and prazosin. Results: Although both drugs reduced capillary pruning, a combination of experiments based on ex vivo imaging, proteomics, electron microscopy and in vivo functional approaches showed that losartan treatment resulted in an inefficient coronary network, reduced myocardial oxygenation and metabolic changes that delayed the arrest of cardiomyocyte proliferation, in contrast to the effects of prazosin, probably due to its concomitant promotion of capillary expansion. Discussion: Our work demonstrates that capillary pruning contributes to proper maturation and function of the heart and that manipulation of blood flow may be a novel strategy to refine the microvasculature and improve tissue perfusion after damage.

4.
Med Lav ; 114(2): e2023018, 2023 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-37057351

RESUMO

In today's society of uncertainty, we are witnessing a transformation of the economic, social, demographic, digital, ecological, and employment model, which faces unforeseen challenges. These challenges require reflecting beyond their consequences, and new workplace risks call for a debate on solutions beyond traditional ones. In the specific context of companies, the main functions of occupational health nursing are to prevent, promote, protect, and restore workers' health. The integration of research into nursing practice entails the better implementation of scientific advances. Although in the real world of professional nursing practice, there is a discrepancy between the knowledge obtained through research and clinical practice, practicing based on care plans, solid practice guidelines, and scientific evidence is a maxim.


Assuntos
Enfermagem do Trabalho , Saúde Ocupacional , Humanos , Emprego , Local de Trabalho
5.
Obes Surg ; 33(3): 965-968, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36585604

RESUMO

Roux-en-Y gastric bypass (RYGB) is considered the gold standard procedure in patients with obesity and gastroesophageal reflux (GERD), but in patients with preoperative hiatal hernia (HH) or GERD, who are unfit for RYGB, there are no clear guidelines. Ligamentum teres cardiopexy (LTC) has been proposed as an effective alternative. The purpose of this study was to analyze medium-term results of LTC procedure associated with laparoscopic sleeve gastrectomy (LSG) in patients with GERD or HH, according to the absence of pathologic acid reflux in esophageal 24 h pH monitoring test, symptom release, or PPI reduction. Five patients underwent LSG-LTC between March 2018 and October 2019. In one patient, the effectiveness of LTC as an anti-reflux procedure could not be assessed because of conversion to RYGB was required. After a follow-up period of 30 [24-42] months and excessive BMI loss of 62.74 ± 18.18%, GERD recurrence was observed in 75% of patients. The study was discontinued due to unsatisfactory preliminary results with LTC. Our results suggest that LTC might not prevent GERD after LSG in patients with preoperative GERD or HH.


Assuntos
Derivação Gástrica , Refluxo Gastroesofágico , Hérnia Hiatal , Laparoscopia , Obesidade Mórbida , Ligamentos Redondos , Humanos , Obesidade Mórbida/cirurgia , Refluxo Gastroesofágico/prevenção & controle , Refluxo Gastroesofágico/cirurgia , Refluxo Gastroesofágico/complicações , Hérnia Hiatal/complicações , Derivação Gástrica/métodos , Gastrectomia/métodos , Ligamentos Redondos/cirurgia , Laparoscopia/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
6.
J Abdom Wall Surg ; 2: 11123, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38312419

RESUMO

Incisions performed for hepato-pancreatic-biliary (HPB) surgery are diverse, and can be a challenge both to perform correctly as well as to be properly closed. The anatomy of the region overlaps muscular layers and has a rich vascular and nervous supply. These structures are fundamental for the correct functionality of the abdominal wall. When performing certain types of incisions, damage to the muscular or neurovascular component of the abdominal wall, as well as an inadequate closure technique may influence in the development of long-term complications as incisional hernias (IH) or bulging. Considering that both may impair quality of life and that are complex to repair, prevention becomes essential during these procedures. With the currently available evidence, there is no clear recommendation on which is the better incision or what is the best method of closure. Despite the lack of sufficient data, the following review aims to correlate the anatomical knowledge learned from posterior component separation with the incisions performed in hepato-pancreatic-biliary (HPB) surgery and their consequences on incisional hernia formation. Overall, there is data that suggests some key points to perform these incisions: avoid vertical components and very lateral extensions, subcostal should be incised at least 2 cm from costal margin, multilayered suturing using small bites technique and consider the use of a prophylactic mesh in high-risk patients. Nevertheless, the lack of evidence prevents from the possibility of making any strong recommendations.

7.
Arch Prev Riesgos Labor ; 25(3): 237-241, 2022 07 15.
Artigo em Espanhol | MEDLINE | ID: mdl-36265105

RESUMO

Scientific and professional and societies constitute an element of social transformation. The nursing associative trend has run parallel to the social reality of the profession and its historical evolution. The late incorporation is conditioned by a delay in the conception of the discipline as a scientific profession with its own body of knowledge. Among others, the purpose of an association in this field is to promote updating in the professional skills of its members, identify the demands of its affiliated, provoke an open debate, promote collaborative research, favor the generation of knowledge and transfer that academic content to society. The text proposes a panoramic view of this polyhedral reality in which professional and scientific societies of this nursing discipline find themselves.


Las sociedades científicas y profesionales constituyen un elemento de transformación social. La tendencia asociativa enfermera ha discurrido paralela a la realidad social de la profesión y su evolución histórica. La incorporación tardía viene condicionada por un retraso en la concepción de la disciplina como una profesión científica con un cuerpo de conocimientos propio. Entre otros, la finalidad de una asociación en este ámbito es promover la actualización en las competencias profesionales de los integrantes, identificar las demandas de sus miembros, provocar un debate abierto, promover la investigación colaborativa, favorecer la generación de conocimiento y trasladar ese contenido académico a la sociedad. En el texto se propone una visión panorámica de esta realidad poliédrica en la que se encuentran las sociedades profesionales y científicas de esta disciplina enfermera.


Assuntos
Enfermagem do Trabalho , Humanos , Conhecimento
9.
PLoS One ; 16(7): e0254057, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34214126

RESUMO

Discovering low-dimensional structure in real-world networks requires a suitable null model that defines the absence of meaningful structure. Here we introduce a spectral approach for detecting a network's low-dimensional structure, and the nodes that participate in it, using any null model. We use generative models to estimate the expected eigenvalue distribution under a specified null model, and then detect where the data network's eigenspectra exceed the estimated bounds. On synthetic networks, this spectral estimation approach cleanly detects transitions between random and community structure, recovers the number and membership of communities, and removes noise nodes. On real networks spectral estimation finds either a significant fraction of noise nodes or no departure from a null model, in stark contrast to traditional community detection methods. Across all analyses, we find the choice of null model can strongly alter conclusions about the presence of network structure. Our spectral estimation approach is therefore a promising basis for detecting low-dimensional structure in real-world networks, or lack thereof.


Assuntos
Análise Espectral , Algoritmos , Animais , Encéfalo/metabolismo , Regulação da Expressão Gênica , Camundongos , Modelos Teóricos
10.
Arch Prev Riesgos Labor ; 24(2): 88-97, 2021 04 15.
Artigo em Espanhol | MEDLINE | ID: mdl-34015205

RESUMO

Occupational health nursing has a unique opportunity to identify the needs of the working population within the scope of its competences. In the different possible future of work scenarios, factors related to globalization, demographic changes, the massive use of tech - nology, the digitization of a significant number of processes, the multidisciplinary nature of the approach to worker care and some approaches close to public health, are driving a new approach to occupational health and safety, while eliciting an ethical debate. In this social, professional and occupational reality, interventions by this nursing subspecialty will need to be based on comprehensive, safe, collaborative, coordinated, quality care, focused on people and based on the best available scientific evidence.


La enfermería del trabajo se encuentra en una posición privilegiada para identificar las ne - cesidades de la población laboral en el ámbito de sus competencias. En los distintos esce - narios posibles del futuro de la actividad laboral, los factores relacionados con la globaliza - ción, los cambios demográficos, la utilización masiva de la tecnología, la digitalización de un número significado de procesos, el carácter multidisciplinar del abordaje de la atención al trabajador y unos planteamientos próximos a la salud pública, determinan un nuevo en - foque de la seguridad y salud ocupacional y suscitan un debate ético. En esta realidad socioprofesional y laboral, la intervención de esta disciplina enfermera tendrá un sustrato de actuación basado en una atención integral, segura, colaborativa, coordinada, de calidad, centrada en las personas y basada en la mejor evidencia científica disponible.


Assuntos
Enfermagem do Trabalho , Saúde Ocupacional , Previsões , Humanos , Saúde Pública
11.
Front Immunol ; 12: 637152, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33833758

RESUMO

After a year of evolution of the SARS-CoV-2 epidemic, there is still no specific effective treatment for the disease. Although the majority of infected people experience mild disease, some patients develop a serious disease, especially when other pathologies concur. For this reason, it would be very convenient to find pharmacological and immunological mechanisms that help control SARS-CoV-2 infection. Since the COVID-19 and BCoV viruses are very close phylogenetically, different studies demonstrate the existence of cross-immunity as they retain shared epitopes in their structure. As a possible control measure against COVID-19, we propose the use of cow's milk immune to BCoV. Thus, the antigenic recognition of some highly conserved structures of viral proteins, particularly M and S2, by anti-BCoV antibodies present in milk would cause a total or partial inactivation of SARS-COV-2 (acting as a particular vaccine) and be addressed more easily by GALT's highly specialized antigen-presenting cells, thus helping the specific immune response.


Assuntos
Anticorpos Antivirais/imunologia , COVID-19/imunologia , Coronavirus Bovino/imunologia , SARS-CoV-2/imunologia , Animais , Bovinos
12.
Eur J Trauma Emerg Surg ; 47(3): 683-692, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33742223

RESUMO

PURPOSE: To analyse acute cholecystitis (AC) management during the first pandemic outbreak after the recommendations given by the surgical societies estimating: morbidity, length of hospital stay, mortality and hospital-acquired SARS-CoV-2 infection rate. METHODS: Multicentre-combined (retrospective-prospective) cohort study with AC patients in the Community of Madrid between 1st March and 30th May 2020. 257 AC patients were involved in 16 public hospital. Multivariant binomial logistic regression (MBLR) was applied to mortality. RESULTS: Of COVID-19 patients, 30 were diagnosed at admission and 12 patients were diagnosed during de admission or 30 days after discharge. In non-COVID-19 patients, antibiotic therapy was received in 61.3% of grade I AC and 40.6% of grade II AC. 52.4% of grade III AC were treated with percutaneous drainage (PD). Median hospital stay was 5 [3-8] days, which was higher in the non-surgical treatment group with 7.51 days (p < 0.001) and a 3.25% of mortality rate (p < 0.21). 93.3% of patients with SARS-CoV-2 infection at admission were treated with non-surgical treatment (p = 0.03), median hospital stay was 11.0 [7.5-27.5] days (p < 0.001) with a 7.5% of mortality rate (p > 0.05). In patients with hospital-acquired SARS-CoV-2 infection, 91.7% of grade I-II AC were treated with non-surgical treatment (p = 0.037), with a median hospital stay of 16 [4-21] days and a 18.2% mortality rate (p > 0.05). Hospital-acquired infection risk when hospital stay is > 7 days is OR 4.7, CI 95% (1.3-16.6), p = 0.009. COVID-19 mortality rate was 11.9%, AC severity adjusted OR 5.64 (CI 95% 1.417-22.64). In MBLR analysis, age (OR 1.15, CI 95% 1.02-1.31), SARS-CoV-2 infection (OR 14.49, CI 95% 1.33-157.81), conservative treatment failure (OR 8.2, CI 95% 1.34-50.49) and AC severity were associated with an increased odd of mortality. CONCLUSION: In our population, during COVID-19 pandemic, there was an increase of non-surgical treatment which was accompanied by an increase of conservative treatment failure, morbidity and hospital stay length which may have led to an increased risk hospital-acquired SARS-CoV-2 infection. Age, SARS-CoV-2 infection, AC severity and conservative treatment failure were mortality risk factors.


Assuntos
Antibacterianos/uso terapêutico , COVID-19 , Colecistectomia/estatística & dados numéricos , Colecistite Aguda , Tratamento Conservador , Infecção Hospitalar , Controle de Infecções , COVID-19/diagnóstico , COVID-19/mortalidade , COVID-19/prevenção & controle , Colecistite Aguda/diagnóstico , Colecistite Aguda/epidemiologia , Colecistite Aguda/terapia , Estudos de Coortes , Comorbidade , Tratamento Conservador/métodos , Tratamento Conservador/estatística & dados numéricos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/virologia , Drenagem/métodos , Drenagem/estatística & dados numéricos , Feminino , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Medição de Risco , SARS-CoV-2 , Espanha/epidemiologia
14.
Appl Environ Microbiol ; 86(12)2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32276971

RESUMO

Bacillus thuringiensis (Bt) is the most widely used active ingredient for biological insecticides. The composition of δ-endotoxins (Cry and Cyt proteins) in the parasporal crystal determines the toxicity profile of each Bt strain. However, a reliable method for their identification and quantification has not been available, due to the high sequence identity of the genes that encode the δ-endotoxins and the toxins themselves. Here, we have developed an accurate and reproducible mass spectrometry-based method (liquid chromatography-tandem mass spectrometry-multiple reaction monitoring [LC-MS/MS-MRM]) using isotopically labeled proteotypic peptides for each protein in a particular mixture to determine the relative proportion of each δ-endotoxin within the crystal. To validate the method, artificial mixtures containing Cry1Aa, Cry2Aa, and Cry6Aa were analyzed. Determination of the relative abundance of proteins (in molarity) with our method was in good agreement with the expected values. This method was then applied to the most common commercial Bt-based products, DiPel DF, XenTari GD, VectoBac 12S, and Novodor, in which between three and six δ-endotoxins were identified and quantified in each product. This novel approach is of great value for the characterization of Bt-based products, not only providing information on host range, but also for monitoring industrial crystal production and quality control and product registration for Bt-based insecticides.IMPORTANCEBacillus thuringiensis (Bt)-based biological insecticides are used extensively to control insect pests and vectors of human diseases. Bt-based products provide greater specificity and biosafety than broad-spectrum synthetic insecticides. The biological activity of this bacterium resides in spores and crystals comprising complex mixtures of toxic proteins. We developed and validated a fast, accurate, and reproducible method for quantitative determination of the crystal components of Bt-based products. This method will find clear applications in the improvement of various aspects of the industrial production process of Bt. An important aspect of the production of Bt-based insecticides is its quality control. By specifically quantifying the relative proportion of each of the toxins that make up the crystal, our method represents the most consistent and repeatable evaluation procedure in the quality control of different batches produced in successive fermentations. This method can also contribute to the design of specific culture media and fermentation conditions that optimize Bt crystal composition across a range of Bt strains that target different pestiferous insects. Quantitative information on crystal composition should also prove valuable to phytosanitary product registration authorities that oversee the safety and efficacy of crop protection products.


Assuntos
Bacillus thuringiensis/química , Proteínas de Bactérias/isolamento & purificação , Cromatografia Líquida/métodos , Endotoxinas/isolamento & purificação , Proteínas Hemolisinas/isolamento & purificação , Inseticidas/isolamento & purificação , Proteômica/métodos , Espectrometria de Massas em Tandem/métodos , Toxinas de Bacillus thuringiensis , Proteínas de Bactérias/química , Endotoxinas/química , Proteínas Hemolisinas/química , Inseticidas/química , Proteoma/química
15.
Comp Cytogenet ; 14(1): 157-182, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32206208

RESUMO

A cytogenetic analysis of sixteen taxa of the genus Aeschynomene Linnaeus, 1753, which includes species belonging to both subgenera Aeschynomene (Léonard, 1954) and Ochopodium (Vogel, 1838) J. Léonard, 1954, was performed. All studied species had the same chromosome number (2n = 20) but exhibited karyotype diversity originating in different combinations of metacentric, submetacentric and subtelocentric chromosomes, chromosome size and number of SAT chromosomes. The plasticity of the genomes included the observation in a taxon belonging to the subgenus Aeschynomene of an isolated spherical structure similar in appearance to the extra chromosomal circular DNA observed in other plant genera. By superimposing the karyotypes in a recent phylogenetic tree, a correspondence between morphology, phylogeny and cytogenetic characteristics of the taxa included in the subgenus Aeschynomene is observed. Unlike subgenus Aeschynomene, the species of Ochopodium exhibit notable karyotype heterogeneity. However the limited cytogenetic information recorded prevents us from supporting the proposal of their taxonomic separation and raise it to the genus category. It is shown that karyotype information is useful in the taxonomic delimitation of Aeschynomene and that the diversity in the diploid level preceded the hybridization/polyploidization demonstrated in the genus. The systematic implications of our results and their value can be extended to other Dalbergieae genera as knowledge about the chromosomal structure and its evolution increases.

16.
Toxins (Basel) ; 12(2)2020 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-32033215

RESUMO

The bacterium Bacillus thuringiensis produces insecticidal Vip3 proteins during the vegetative growth phase with activity against several lepidopteran pests. To date, three different Vip3 protein families have been identified based on sequence identity: Vip3A, Vip3B, and Vip3C. In this study, we report the construction of chimeras by exchanging domains between Vip3Aa and Vip3Ca, two proteins with marked specificity differences against lepidopteran pests. We found that some domain combinations made proteins insoluble or prone to degradation by trypsin as most abundant insect gut protease. The soluble and trypsin-stable chimeras, along with the parental proteins Vip3Aa and Vip3Ca, were tested against lepidopteran pests from different continents: Spodopteraexigua, Spodopteralittoralis, Spodopterafrugiperda,Helicoverpaarmigera, Mamestrabrassicae, Anticarsiagemmatalis, and Ostriniafurnacalis. The exchange of the Nt domain (188 N-terminal amino acids) had little effect on the stability and toxicity (equal or slightly lower) of the resulting chimeric protein against all insects except for S.frugiperda, for which the chimera with the Nt domain from Vip3Aa and the rest of the protein from Vip3Ca showed a significant increase in toxicity compared to the parental Vip3Ca. Chimeras with the C-terminal domain from Vip3Aa (from amino acid 510 of Vip3Aa to the Ct) with the central domain of Vip3Ca (amino acids 189-509 based on the Vip3Aa sequence) made proteins that could not be solubilized. Finally, the chimera including the Ct domain of Vip3Ca and the Nt and central domain from Vip3Aa was unstable. Importantly, an insect species tolerant to Vip3Aa but susceptible to Vip3Ca, such as Ostriniafurnacalis, was also susceptible to chimeras maintaining the Ct domain from Vip3Ca, in agreement with the hypothesis that the Ct region of the protein is the one conferring specificity to Vip3 proteins.


Assuntos
Proteínas de Bactérias , Inseticidas , Controle Biológico de Vetores , Animais , África , Ásia , Proteínas de Bactérias/química , Proteínas de Bactérias/genética , Proteínas de Bactérias/toxicidade , Europa (Continente) , Insetos/efeitos dos fármacos , Inseticidas/toxicidade , Dose Letal Mediana , América do Norte , Domínios Proteicos , Estabilidade Proteica , América do Sul
17.
Arch Prev Riesgos Labor ; 23(1): 34-51, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-31991076

RESUMO

OBJECTIVE: To evaluate the importance and degree of development of the professional competences of occupational health nursing specialists in Spain described in Public Order SAS/1348/2009 in the areas of prevention, clinical care services, legal expertise, management, teaching and research. METHODOLOGY: This cross-sectional, descriptive study surveyed occupational health nurse members of specific and/or relevant multidisciplinary professional societies at the autonomous community or state levels in Spain. A questionnaire, designed by an expert panel and centered on approved professional competencies was administered in 2014. Descriptive statistics summarized the sociodemographic profile of respondents. Bivariate analysis, followed by multivariate linear regression analysis, was used to measure associations between specific independent variables and both the perceived importance and degree of development of each competency. RESULTS: In the descriptive analysis of perceived importance, there are three competencies that stand out: manage a registration system that ensures the confidentiality of the data; increase the health level of the worker through health promotion and risk prevention, and identify real or potential occupational health problems. Regarding highest degree of development, the following stand out: management of a confidentiality registration system; provide urgent and emergency care in the workplace and identify real or potential occupational health problems. DISCUSSION: Type of occupational health service, the economic sector to which the company belonged and years of professional experience were associated with both the importance and degree of development of each of the competencies.


OBJETIVO: Evaluar la importancia y el grado de desarrollo de las competencias profesionales de los/as Enfermeros/as del Trabajo descritas en la Orden SAS/1348/2009 en las áreas preventiva, asistencial, legal y pericial, gestión, docencia e investigación. METODOLOGÍA: Investigación de carácter observacional, descriptivo y transversal que utilizó como población a estudio los especialistas en Enfermería del Trabajo vinculados a sociedades profesionales específicas y/o multidisciplinares. La recogida de datos se realizó en 2014 mediante un cuestionario diseñado por un panel de expertos. El análisis descriptivo incluyó el perfil sociodemográfico del colectivo, el análisis bivariado determinó la importancia y el grado de desarrollo de cada competencia según las variables independientes definidas, y finalmente el modelo de regresión lineal múltiple explica los factores determinantes. RESULTADOS: En el análisis descriptivo de competencias en cuanto a la importancia atribuida, tres son las competencias que destacan: gestionar un sistema de registro que asegure la confidencialidad de los datos; incrementar el nivel de salud del trabajador mediante la promoción y prevención de riesgos e identificar problemas de salud laboral reales o potenciales. En cuanto al mayor grado de desarrollo resaltan las siguientes: gestión de un sistema de registro de confidencialidad; prestar atención de urgencia y emergencia en el centro de trabajo e identificar problemas de salud laboral reales o potenciales. DISCUSIÓN: La adscripción a cada modalidad de servicio de prevención, el sector económico de la empresa y los años de experiencia profesional, resultan determinantes en la importancia y el grado de desarrollo de cada una de sus competencias.


Assuntos
Competência Clínica , Enfermagem do Trabalho , Saúde Ocupacional , Estudos Transversais , Humanos , Enfermagem do Trabalho/normas , Espanha , Inquéritos e Questionários , Local de Trabalho
18.
BMC Med ; 17(1): 211, 2019 11 27.
Artigo em Inglês | MEDLINE | ID: mdl-31771585

RESUMO

BACKGROUND: Outcomes of processes questioning a physician's ability to practise -e.g. disciplinary or regulatory- may strongly impact their career and provided care. However, it is unclear what factors relate systematically to such outcomes. METHODS: In this cross-sectional study, we investigate this via multivariate, step-wise, statistical modelling of all 1049 physicians referred for regulatory adjudication at the UK medical tribunal, from June 2012 to May 2017, within a population of 310,659. In order of increasing seriousness, outcomes were: no impairment (of ability to practise), impairment, suspension (of right to practise), or erasure (its loss). This gave adjusted odds ratios (OR) for: age, race, sex, whether physicians first qualified domestically or internationally, area of practice (e.g. GP, specialist), source of initial referral, allegation type, whether physicians attended their outcome hearing, and whether they were legally represented for it. RESULTS: There was no systematic association between the seriousness of outcomes and the age, race, sex, domestic/international qualification, or the area of practice of physicians (ORs p≥0.05), except for specialists who tended to receive outcomes milder than suspension or erasure. Crucially, an apparent relationship of outcomes to age (Kruskal-Wallis, p=0.009) or domestic/international qualification (χ2,p=0.014) disappeared once controlling for hearing attendance (ORs p≥0.05). Both non-attendance and lack of legal representation were consistently related to more serious outcomes (ORs [95% confidence intervals], 5.28 [3.89, 7.18] and 1.87 [1.34, 2.60], respectively, p<0.001). CONCLUSIONS: All else equal, personal characteristics or first qualification place were unrelated to the seriousness of regulatory outcomes in the UK. Instead, engagement (attendance and legal representation), allegation type, and referral source were importantly associated to outcomes. All this may generalize to other countries and professions.


Assuntos
Competência Clínica/legislação & jurisprudência , Competência Clínica/normas , Médicos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Médicos/psicologia , Prática Profissional/legislação & jurisprudência , Prática Profissional/normas , Fatores Sexuais
19.
Pestic Biochem Physiol ; 157: 1-12, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31153457

RESUMO

The use of neurotoxic chemical insecticides has led to consequences against the environment, insect resistances and side-effects on non-target organisms. In this context, we developed a novel strategy to optimize insecticide efficacy while reducing doses. It is based on nanoencapsulation of a pyrethroid insecticide, deltamethrin, used as synergistic agent, combined with a non-encapsulated oxadiazine (indoxacarb). In this case, the synergistic agent is used to increase insecticide efficacy by activation of calcium-dependant intracellular signaling pathways involved in the regulation of the membrane target of insecticides. In contrast to permethrin (pyrethroid type I), we report that deltamethrin (pyrethroid type II) produces an increase in intracellular calcium concentration in insect neurons through the reverse Na/Ca exchanger. The resulting intracellular calcium rise rendered voltage-gated sodium channels more sensitive to lower concentration of the indoxacarb metabolite DCJW. Based on these findings, in vivo studies were performed on the cockroach Periplaneta americana and mortality rates were measured at 24 h, 48 h and 72 h after treatments. Comparative studies of the toxicity between indoxacarb alone and indoxacarb combined with deltamethrin or nanoencapsulated deltamethrin (LNC-deltamethrin), indicated that LNC-deltamethrin potentiated the effect of indoxacarb. We also demonstrated that nanoencapsulation protected deltamethrin from esterase-induced enzymatic degradation and led to optimize indoxacarb efficacy while reducing doses. Moreover, our results clearly showed the benefit of using LNC-deltamethrin rather than piperonyl butoxide and deltamethrin in combination commonly used in formulation. This innovative strategy offers promise for increasing insecticide efficacy while reducing both doses and side effects on non-target organisms.


Assuntos
Cálcio/metabolismo , Inseticidas/química , Inseticidas/farmacologia , Nanocápsulas/química , Nitrilas/química , Nitrilas/farmacologia , Oxazinas/química , Oxazinas/farmacologia , Piretrinas/química , Piretrinas/farmacologia , Animais , Células Cultivadas , Baratas , Masculino , Estrutura Molecular , Periplaneta/efeitos dos fármacos , Trocador de Sódio e Cálcio/metabolismo
20.
PLoS One ; 14(2): e0210545, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30730908

RESUMO

Quantitative laboratory bioassay methods are required to evaluate the toxicity of novel insecticidal compounds for pest control and to determine the presence of resistance traits. We used a radioactive tracer based on 32P-ATP to estimate the volume of a droplet ingested by two dipteran pests: Ceratitis capitata (Tephritidae) and Drosophila suzukii (Drosophilidae). Using blue food dye it was possible to distinguish between individuals that ingested the solution from those that did not. The average volume ingested by C. capitata adults was 1.968 µl. Females ingested a ~20% greater volume of solution than males. Adults of D. suzukii ingested an average of 0.879 µl and females ingested ~30% greater volume than males. The droplet feeding method was validated using the naturally-derived insecticide spinosad as the active ingredient (a.i.). For C. capitata, the concentration-mortality response did not differ between the sexes or among three different batches of insects. Lethal dose values were calculated based on mean ingested volumes. For C. capitata LD50 values were 1.462 and 1.502 ng a.i./insect for males and females, respectively, equivalent to 0.274 and 0.271 ng a.i./mg for males and females, respectively, when sex-specific variation in body weight was considered. Using the same process for D. suzukii, the LD50 value was estimated at 2.927 ng a.i./insect, or 1.994 ng a.i./mg based on a mean body weight of 1.67 mg for both sexes together. We conclude that this technique could be readily employed for determination of the resistance status and dose-mortality responses of insecticidal compounds in many species of pestiferous Diptera.


Assuntos
Ceratitis capitata/efeitos dos fármacos , Drosophila/efeitos dos fármacos , Inseticidas/toxicidade , Macrolídeos/toxicidade , Animais , Ceratitis capitata/fisiologia , Drosophila/fisiologia , Combinação de Medicamentos , Feminino , Controle de Insetos , Dose Letal Mediana , Masculino
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