[Skills perceived by general practitioners for providing care to immigrant patients]. / Aptitudes percibidas por el médico de familia en la atención a pacientes inmigrantes.

OBJECTIVE: To identify the skills perceived by general practitioners for providing competent care to immigrants MATERIAL AND METHODS: Observational, descriptive and cross-sectional study with data collection using a 21-item questionnaire completed electronically by the general practitioners and validated by the National Validation Commission of SEMERGEN. It was structured with closed-ended, multiple-choice test questions, including variables related to the doctor and variables related to the immigrant patient. The level of professional competence was assessed using a 1 to 10 Likert scale. RESULTS: A total 610 family physicians with a mean age of 47.5±12.3 years responded and 64.1% were women. Of these, 112 (18.4%) were residents. The response rate was 4.9%. A large majority (72.6%) had not taken part in continuing education courses on caring for immigrants in the last 5years. Participants reported difficulties in the clinic: 73% of the cases with the language, 38.7% with the allotted time, and 32.3% due to knowledge of the culture. Most (96.9%) of patients attended the clinic due to a common illness. The cause in 14.4% was related to the migratory process (infectious disease acquired in the country of origin), and in 26.4% with the health conditions in the host country (lack of stable housing, overcrowding, and conditions of work). The perceived level of competence was 6.2±1.9. CONCLUSIONS: The competence perceived by general practitioners in providing care to immigrants is moderate. The most important barriers for these professionals are ignorance of the language, lack of time allocated for consultation, and ignorance of the patient's culture.

Biodegradation kinetics of BTE-OX and MTBE by a diesel-grown biomass.

The biodegradation kinetics of BTE-oX and MTBE, mixed all together in the presence of diesel-grown bioaugmented bacterial populations as high as 885 mg/L VSS, was evaluated. The effect of soil in aqueous samples and the effect of Tergitol NP-10 on substrate biodegradation rates were also evaluated. Biodegradation kinetics was evaluated for 54 h, every 6 h. All BTE-oX chemicals followed a first-order two-phase biodegradation kinetic model, whereas MTBE followed a zero-order removal kinetic model in all samples. BTE-oX removal rates were much higher than those of MTBE in all samples. The presence of soil in aqueous samples retarded BTE-oX and MTBE removal rates. The addition of Tergitol NP-10 to aqueous samples containing soil had a positive effect on substrate removal rate in all samples. Substrate percent removals ranged between 64.8-98.9% for benzene, toluene and ethylbenzene. O-xylene and MTBE percent removals ranged between 18.7-40.8% and 7.2-10.3%, respectively.