[Evaluation of a coding guide on social determinants of health in primary care consultations: A mixed study]. / Evaluación de una guía de codificación de determinantes sociales de la salud en las consultas de atención primaria: Estudio mixto.

OBJECTIVE: To evaluate a coding guide for social determinants of health in primary care consultations as an effective tool in the professional's daily workflow. DESIGN: Mixed sequential explanatory study. Formed by a quantitative part (experimental) and a qualitative part (descriptive-evaluative). LOCATION: All the primary care teams of the Central Catalonia Management (32 teams). PARTICIPANTS AND SETTING: All nursing, social work and medical professionals working in the 32 primary care teams of the Catalan Institute of Health in Central Catalonia from February 2023 to July 2023. METHODS: A social determinants of health coding guide was developed. This guide was created in a multidisciplinary and multicenter manner. Purposive sampling. Quantitatively, the number of diagnoses recorded by the experimental group versus the control group was counted. Qualitatively, a thematic analysis was carried out from a socio-constructivist perspective. RESULTS: The results were significant and satisfactory. Using a quantitative methodology, the effectiveness of the use of the guide was assessed. A significant increase in the use of the social determinants was observed in the intervention group vs. the control group, with a percentage of post-intervention use of 19.53% in the control group and 32.26% in the intervention group (P < .001). The number of diagnoses recorded increased from 312 to 1322 in the intervention group, while it remained the same in the control group. The main factors identified through qualitative methodology that may explain the effectiveness of the guideline were: 1) the effectiveness of the guideline among primary care professionals, 2) the appropriateness of the guideline by assessing its usefulness and practicality, 3) feasibility and 4) specific contributions to the improvement of the guideline. CONCLUSIONS: The social determinants of health coding guide is effective, appropriate and can be implemented in the workflow of primary health care professionals for good recording of the social determinants of health.

TRAUMATIC (FOREIGN BODY) PERICARDITIS IN A TOCO TOUCAN (RAMPHASTOS TOCO).

An approximately 10-yr-old, captive-born female toco toucan ( Ramphastos toco ) was presented due to an acute onset of depression and apathy. On visual and physical examination, it showed an abnormal posture and dehydration, respectively. Serum biochemistry revealed hyperuricemia (39.4 mg/dl) and elevated glutamic oxaloacetic transaminase (GOT; 1,050 U/L). Radiographs demonstrated an enlargement of the cardiac silhouette. The bird died 7 days after presentation, despite treatment with enrofloxacin, allopurinol, a preparation of hepatorenal protectors, and complex B vitamins with dextrose. Necropsy revealed severe fibrinohemorrhagic pericarditis with a 15 mm long and 2.5 mm diameter, rigid foreign body in the pericardial exudate. Microscopically, this foreign body was of vegetal origin.

Bilateral Renal Tubular Neoplasm in a Channel-billed Toucan (Ramphastos vitellinus).

An adult male channel-billed toucan (Ramphastos vitellinus) was presented with a history of weakness, dyspnea, and severe dilatation of the coelomic cavity, which was caused by accumulation of serohemorrhagic fluid. Radiographs revealed increased radiodensity and thickness of the descending aorta and a pectoral mass, and blood test results revealed anemia, hypocalcemia, hypoproteinemia, and hyperuricemia. On ultrasound examination, a hyperechoic enlarged soft tissue mass was found in the caudodorsal region of the coelom. The bird did not respond to supportive care and died. Postmortem examination revealed severe, bilateral nephromegaly due to multifocal to coalescing renal tubular adenomas (adenomatosis), which was complicated with renal gout and soft tissue mineralization. Relevant concurrent diseases included hepatic hemochromatosis, subcutaneous cestodiasis with cellulitis, and systemic amyloidosis. There are few documented cases of neoplasms in ramphastid birds and to our knowledge, this is the first report of a renal neoplasm in a channel-billed toucan.

De la razón coriial a la compasión: la ética con los animales / Frm cordial reasson to compassion: ethics with animals / Da razão corial para à compaixão: a ética com os animais

Este artículo discute la siguiente tesis: la ética (responsabilidad consigo mismo, con los animales, con el entorno) se basa en la compasión, progresivamente dilucidada por sucesivos estados mentales de segundo orden. Así, este estudio pone su centro en la investigación ética, sobre todo cuando se entrelaza o se entreteje esta en relación con los animales. La tesis que sostenemos es que ética, en rigor, solo hay cuando hay imputabilidad, responsabilidad. Una y otra son esferas de lo humano e implican estados mentales de segundo orden (EM2). Solo mediante estos la persona puede dar cuenta de sí misma y de los otros.

This paper discusses the fundamental thesis: Ethics (responsibility with itself, with animals, with the environment) is based on compassion, progressively become to successive second-order Mental States. Thus, this study puts on center of ethical research, especially when it is interlaced or is interweaving in relation to animals. The thesis that we hold is that ethics, strictly speaking, only when there is accountability, responsibility. One and the other are the human sphere and involve Mental States of second order (EM2). Only through this person can give an account of himself and others.

O presente artigo discute a seguinte tese: a ética (responsabilidade para si mesmo, para os animais, para o meio ambiente) é baseada na compaixão, progressivamente elucidado por sucessivos estados mentais de segunda ordem. Assim, este estudo é centrado na pesquisa ética, especialmente quando está entrelaçada ou entretecida esta em relação com os animais. A tese que argumentamos é que ética, na verdade, somente há quando há imputabilidade, responsabilidade. Uma e outra são áreas do humano e envolvem estados mentais de segunda ordem (EM2). Só através destes a pessoa pode dar-se conta de si mesma e dos outros.