Gestão e liderança na percepção de enfermeiros: um caminhar à luz da burocracia profissional / Gestión y liderazgo en la percepción de los enfermeros: un paseo a la luz de la burocracia profesional / Management and leadership in the nurses' perception: A walk in the light of professional burocracy

Resumo Objetivo analisar os estilos e fatores intervenientes na gestão e liderança de enfermeiros em três países, Brasil, Portugal e Espanha, à luz da Burocracia Profissional. Método estudo exploratório e descritivo de abordagem qualitativa realizado em três hospitais universitários localizados em diferentes países: Brasil, Espanha e Portugal. Participaram da pesquisa 30 enfermeiros. Os dados foram coletados por meio de um roteiro de coleta de dados com questões sociodemográficas e entrevistas analisadas com auxílio do software WebQda. Resultados diferentes percepções sobre os elementos integradores da participação foram reveladas nos três países, destacando-se a comunicação em diversas óticas. Verificou-se algumas convergências em relação ao trabalho em equipe, sendo a confiança o elemento que impulsiona e motiva a equipe. Sinaliza-se para uma relação participativa no desenvolvimento do trabalho. Conclusão e implicações para a prática foi possível identificar, nos três países, a importância da comunicação no processo de gestão, bem como dos estilos de gestão e de liderança, como elementos que oportunizam a atuação da equipe. Também foi evidenciada a presença de fatores intervenientes de relevância, tais como escuta, clima organizacional, relação interpessoal, transparência no trabalho e delegação de funções, os quais envolvem a burocracia profissional em que o conhecimento do enfermeiro possibilita o exercício de suas habilidades de forma horizontalizada e participativa.

Resumen Objetivo analizar los estilos y factores implicados en la gestión y el liderazgo de enfermeros en tres países, Brasil, Portugal y España, a la luz de la Burocracia Profesional. Método estudio descriptivo exploratorio con abordaje cualitativo realizado en tres hospitales universitarios ubicados en diferentes países: Brasil, España y Portugal. Treinta enfermeros participaron en la investigación. Los datos fueron recolectados a través de un script de recopilación de datos con preguntas sociodemográficas y entrevistas analizadas con la utilización del software WebQda. Resultados se revelaron diferentes percepciones sobre los elementos integradores de la participación en los tres países, destacando la comunicación desde diferentes perspectivas. Se constataron algunas convergencias en relación al trabajo en equipo, siendo la confianza el elemento que impulsa y motiva al equipo. Se advierte una relación participativa en el desarrollo del trabajo. Conclusión e implicaciones para la práctica se pudo advertir, en los tres países, la importancia de la comunicación en el proceso de gestión, así como los estilos de gestión y liderazgo, como elementos que permiten mejorar el desempeño del equipo. También se evidenciaron factores intervinientes relevantes, como la escucha, el clima organizacional, la relación interpersonal, la transparencia en el trabajo y la delegación de funciones, que conforman la burocracia profesional en la cual el conocimiento de los enfermos les permite el despliegue de sus competencias de manera horizontal y participativa.

Abstract Objective to analyze the styles and factors involved in nurses' management and leadership in three countries, Brazil, Portugal and Spain, in the light of Professional Bureaucracy. Method a descriptive and exploratory study with a qualitative approach carried out in three university hospitals located in different countries, namely: Brazil, Spain and Portugal. Thirty nurses participated in the research. Data was collected through a collection script with sociodemographic questions and interviews analyzed using the WebQda software. Results different perceptions about the integrating elements of participation in the three countries were revealed, highlighting communication from different perspectives. Some convergences in relation to teamwork were verified, where trust was the element that drives and motivates the team. It is a participatory relationship in the development of work. Conclusion and implications for the practice in the three countries, it was possible to identify the importance of communication in the management process, as well as the management and leadership styles, as elements that favor performance of the team. Presence of relevant intervening factors was also evidenced, such as choice, organizational climate, interpersonal relationships, transparency in work and delegation of functions, which involves professional bureaucracy in which the nurses' knowledge allows them to exercise their skills in a horizontal and participatory manner.

Lactancia materna y feminismo: recorrido social y cultural en España / Breastfeeding and feminism: social and cultural journey in Spain / Breastfeeding and feminism: social and cultural journey in Spain

RESUMEN OBJETIVO Analizar la influencia de cambios socio-políticos, educativos y feministas de España en el mantenimiento de lactancia materna. MÉTODO Revisión histórico-descriptiva de documentación en bases de datos, Boletines Oficiales del Estado, del Ministerio de Sanidad y Consumo y Bienestar Social. RESULTADOS La lactancia materna es un fenómeno complejo influenciado por factores demográficos, biológicos, sociales y psicológicos. Ha cambiado a lo largo de la historia y, evolucionado con los movimientos feministas. La incorporación de la mujer al mercado laboral (s.XIX), produjo una modificación en el rol familiar y pareja. La sociedad del siglo XXI reclama a los poderes públicos la conciliación personal y laboral para la crianza de sus hijos. CONCLUSIONES E IMPLICACIÓN PARA LA PRÁCTICA Han sido múltiples los factores y procesos evolutivos para la situación socio-cultural de la mujer en la lactancia materna. Actualmente sigue siendo complicado compaginar gestación y crianza con el empleo, las redes formales e informales permiten avances en políticas sanitarias.

RESUMO OBJETIVO Analisar a influência das mudanças sócio-políticas, educativas e feministas em Espanha na manutenção do aleitamento materno. MÉTODO Revisão histórico-descritiva da documentação em bases de dados, Boletins Oficiais do Estado, do Ministério da Saúde e do Consumo e da Previdência Social. RESULTADOS O aleitamento materno é um fenómeno complexo influenciado por factores demográficos, biológicos, sociais e psicológicos. Ela mudou ao longo da história e evoluiu com os movimentos feministas. A incorporação das mulheres ao mercado de trabalho (século XIX), produziu uma modificação no papel da família e do casal. A sociedade do século XXI exige do poder público a conciliação pessoal e laboral para a educação dos seus filhos. CONCLUSÕES E IMPLICAÇÕES PARA A PRÁTICA Tem havido múltiplos factores e processos evolutivos para a situação sociocultural das mulheres em aleitamento materno. Hoje em dia, ainda é complicado combinar gravidez e educação com emprego, e as redes formais e informais permitem avanços nas políticas de saúde.

ABSTRACT OBJECTIVE To analyze the influence of socio-political, educational and feminist changes in Spain on the maintenance of breastfeeding. METHOD Historical-descriptive review of documentation in databases, Official State Bulletins, of the Ministry of Health and Consumer Affairs and Social Welfare. RESULTS Breastfeeding is a complex phenomenon influenced by demographic, biological, social and psychological factors. It has changed throughout history and evolved with the feminist movements. The incorporation of women to the labor market (19th century), produced a modification in the family and couple role. The society of the 21st century demands from the public authorities the personal and labor conciliation for the upbringing of their children. CONCLUSIONS AND IMPLICATION FOR PRACTICE There have been multiple factors and evolutionary processes for the socio-cultural situation of women in breastfeeding. Nowadays, it is still complicated to combine pregnancy and upbringing with employment, and formal and informal networks allow advances in health policies.

Praying to win this battle: Cancer Metaphors in Latina and Spanish Women's Narratives.

This study closely examines 51 breast cancer narratives Latina and Spanish women wrote for other patients to illuminate how they conceptualize their health, with insights for addressing health disparities. Using discourse analysis of the role of language and culture in health care communication, this study focuses on the use of metaphors in the narratives. This provides revelations about the cultural and linguistic aspects of how the writers conceptualize their disease. Building on past research on metaphor use in cancer discourse in the English language, this study reveals the prevalence of metaphors comparing cancer to combat, or more generally, violence (e.g., "my battle against cancer"), or a journey (e.g., "my path with cancer"). Writers used this metaphorical language to offer advice to others with cancer and to mark their membership in a larger community of people with cancer. We also find that Spanish women use metaphors more frequently than Latinas and that they differed in their metaphorical portrayals of cancer. This research uncovers culturally embedded themes that are central to how women with cancer think about the disease, such as the prominence of spirituality in Latinas' metaphorical constructions, a pattern not evident in Spanish women's narratives.

Spanish Cultural Validation of the Modified Checklist for Autism in Toddlers, Revised.

The Modified Checklist for Autism in Toddlers-revised/follow-up (M-CHAT-R/F) was developed to reduce the number of cases requiring telephone verification. The aim of this study was to validate a Spanish version of the M-CHAT-R/F in the Spanish public health system. The M-CHAT-R/F was translated, culturally adapted, and then administered to 6625 children. Of the 39 positive screening cases, 15 children were diagnosed with autism spectrum disorder (ASD) and 24 with non-ASD disorders or delays. The sensitivity was 0.79 and specificity of 0.99. Positive and negative predictive values were 0.39 and 0.99, respectively. These results are similar to the English equivalent, though observed prevalence was lower. This study supports Spanish National Health System policy makers to consider a universal ASD screening program.

Postoperative pain management in a surgical unit in a Basque Country hospital: a best practice implementation project.

OBJECTIVES: The objective of this project was to implement evidence-based recommendations for post-surgical pain management and improve quality of care for patients. INTRODUCTION: Inadequate approaches to postoperative pain can lead to the pain becoming chronic, which has an impact on the patient's quality of life. The focus of this project was to implement evidence-based recommendations to improve the effect or outcome of post-surgical pain management strategies and improve quality of care. METHODS: This implementation project was undertaken in a surgical unit of a tertiary hospital. The clinical audit was developed in three phases using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tools for promoting change in healthcare practices and improving quality of care. A baseline audit was conducted with 27 patients that identified the barriers and strategies needed to improve the assessment and management of postoperative pain. Two follow-up audits audits were conducted, each comprising 40 patients. RESULTS: The baseline audit revealed the need to increase health education for patients and, or, their families on managing postoperative pain, with a special emphasis on non-pharmacological measures. This education was not recorded in the patients' medical histories at baseline and the aim was to rectify this.In follow-up audits, 100% of patients received individually tailored education about postoperative pain and its management. CONCLUSIONS: The aims and main objectives of the present project were achieved, including improvements in the quality of health education related to pain and the recording of pain data. In addition, variations in the clinical practice related to the management of post-surgical pain decreased.

A Roma founder BIN1 mutation causes a novel phenotype of centronuclear myopathy with rigid spine.

OBJECTIVE: To describe a large series of BIN1 patients, in which a novel founder mutation in the Roma population of southern Spain has been identified. METHODS: Patients diagnosed with centronuclear myopathy (CNM) at 5 major reference centers for neuromuscular disease in Spain (n = 53) were screened for BIN1 mutations. Clinical, histologic, radiologic, and genetic features were analyzed. RESULTS: Eighteen patients from 13 families carried the p.Arg234Cys variant; 16 of them were homozygous for it and 2 had compound heterozygous p.Arg234Cys/p.Arg145Cys mutations. Both BIN1 variants have only been identified in Roma, causing 100% of CNM in this ethnic group in our cohort. The haplotype analysis confirmed all families are related. In addition to clinical features typical of CNM, such as proximal limb weakness and ophthalmoplegia, most patients in our cohort presented with prominent axial weakness, often associated with rigid spine. Severe fat replacement of paravertebral muscles was demonstrated by muscle imaging. This phenotype seems to be specific to the p.Arg234Cys mutation, not reported in other BIN1 mutations. Extreme clinical variability was observed in the 2 compound heterozygous patients for the p.Arg234Cys/p.Arg145Cys mutations, from a congenital onset with catastrophic outcome to a late-onset disease. Screening of European Roma controls (n = 758) for the p.Arg234Cys variant identified a carrier frequency of 3.5% among the Spanish Roma. CONCLUSION: We have identified a BIN1 founder Roma mutation associated with a highly specific phenotype, which is, from the present cohort, the main cause of CNM in Spain.

Transethnic, Genome-Wide Analysis Reveals Immune-Related Risk Alleles and Phenotypic Correlates in Pediatric Steroid-Sensitive Nephrotic Syndrome.

Background Steroid-sensitive nephrotic syndrome (SSNS) is a childhood disease with unclear pathophysiology and genetic architecture. We investigated the genomic basis of SSNS in children recruited in Europe and the biopsy-based North American NEPTUNE cohort.Methods We performed three ancestry-matched, genome-wide association studies (GWAS) in 273 children with NS (Children Cohort Nephrosis and Virus [NEPHROVIR] cohort: 132 European, 56 African, and 85 Maghrebian) followed by independent replication in 112 European children, transethnic meta-analysis, and conditional analysis. GWAS alleles were used to perform glomerular cis-expression quantitative trait loci studies in 39 children in the NEPTUNE cohort and epidemiologic studies in GWAS and NEPTUNE (97 children) cohorts.Results Transethnic meta-analysis identified one SSNS-associated single-nucleotide polymorphism (SNP) rs1063348 in the 3' untranslated region of HLA-DQB1 (P=9.3×10-23). Conditional analysis identified two additional independent risk alleles upstream of HLA-DRB1 (rs28366266, P=3.7×10-11) and in the 3' untranslated region of BTNL2 (rs9348883, P=9.4×10-7) within introns of HCG23 and LOC101929163 These three risk alleles were independent of the risk haplotype DRB1*07:01-DQA1*02:01-DQB1*02:02 identified in European patients. Increased burden of risk alleles across independent loci was associated with higher odds of SSNS. Increased burden of risk alleles across independent loci was associated with higher odds of SSNS, with younger age of onset across all cohorts, and with increased odds of complete remission across histologies in NEPTUNE children. rs1063348 associated with decreased glomerular expression of HLA-DRB1, HLA-DRB5, and HLA-DQB1.Conclusions Transethnic GWAS empowered discovery of three independent risk SNPs for pediatric SSNS. Characterization of these SNPs provide an entry for understanding immune dysregulation in NS and introducing a genomically defined classification.

Remembranza de Santiago Ramón y Cajal, más allá del Nobel / Recollection of Santiago Ramón y Cajal beyond the Nobel

Nacido en Petilla de Aragón, España, Santiago Ramón y Cajal posiblemente sea, por el volumen significativo y trascendencia de su obra, el más relevante neurocientífico de la historia. En conmemoración a la celebración en 2016 de la tercera jornada científica de la cátedra Santiago Ramón y Cajal, es objetivo de este trabajo rendir tributo al histólogo, patólogo, y neurocientífico. Se recogen de manera historiográfica momentos trascendentales de la vida y obra del sabio español, relacionados con su intensa labor investigativa, que lo llevaron al planteamiento de la teoría neuronal, la obtención del premio Nobel, la trascendencia de sus descubrimientos, así como los principales momentos de su estancia en Cuba (AU).

Born in Petilla de Aragón, Spain, Santiago Ramón y Cajal is probably, the most relevant neuroscientist of the history, due to the significant volume and transcendence of his work. Commemorating the celebration of the third scientific event of the Cathedra Santiago Ramón y Cajal in 2016, the aim of this work is rendering homage to the outstanding histologist, pathologist and neuroscientist. In a historiographical way, some significant moments of the Spanish scholar's life and work are mentioned here, related to its intense research work that lead him to postulate the neuronal theory and obtaining the Nobel prize; the transcendence of his discoveries and the main moments of his staying in Cuba are also brought about (AU).

Social Support from Developmental Contexts and Adolescent Substance Use and Well-Being: A Comparative Study of Spain and Portugal.

The aim of this study was to analyse the contribution of social support from family, friend and school (teacher and classmate) contexts in substance use (tobacco and alcohol use) and well-being (life satisfaction and health-related quality of life). Participants were 5,784 Portuguese and 22,610 Spanish adolescents aged 11 to 16 years, from the 2014 edition of the Health Behavior in School-aged Children (HBSC) study in Portugal and Spain. Results showed that for a higher life satisfaction, family (p < .001, partial η2 = .032), teacher (p < .001, partial η2 = .018) and classmate (p < .001, partial η2 = .031) support were important in Portugal, and family (p < .001, partial η2 = .056) and friend (p < .001, partial η2 = .015) support in Spain. Similarly, for a better health-related quality of life, all the social support variables were relevant in Portugal (family: p < .001, partial η2 = .063; teacher: p < .001, partial η2 = .032; classmate: p < .001, partial η2 = .054; friend: p < .001, partial η2 = .034) and in Spain (family: p < .001, partial η2 = .054; teacher: p < .001, partial η2 = .014; classmate: p < .001, partial η2 = .018; friend: p < .001, partial η2 = .040). In contrast, only family support (p < .001, partial η2 = .014) was relevant in Portugal for tobacco use. Therefore, social support was more relevant for adolescent well-being than for adolescent substance use, and the most relevant source of support was family support, in both Spain and Portugal.

Comorbidity in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis: A Nationwide Population-Based Cohort Study.

BACKGROUND: Previous studies have shown evidence of comorbid conditions in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). OBJECTIVE: To estimate the prevalence of comorbidities and assess their associations using a nationwide population-based database of a Spanish CFS/ME cohort. METHOD: A nationally representative, retrospective, cross-sectional cohort study (2008-2015) assessed 1757 Spanish subjects who met both the 1994 Centers for Disease Control and Prevention/Fukuda definition and 2003 Canadian Criteria for CFS/ME. Sociodemographic and clinical data, comorbidities, and patient-reported outcome measures at baseline were recorded. A cluster analysis based on baseline clinical variables was performed to classify patients with CFS/ME into 5 categories according to comorbidities. A multivariate logistic regression analysis was conducted adjusting for potential confounding effects such as age and sex; response and categorical predictor variables were also assessed. RESULTS: A total of 1757 CFS/ME patients completed surveys were collected. We identified 5 CFS/ME clusters: group 1-fibromyalgia, myofascial pain, multiple chemical hypersensitivity, sicca syndrome, epicondylitis, and thyroiditis; group 2-alterations of ligaments and subcutaneous tissue, hypovitaminosis D, psychopathology, ligamentous hyperlaxity, and endometriosis. These 2 subgroups comprised mainly older women, with low educational level, unemployment, high levels of fatigue, and poor quality of life; group 3-with hardly any comorbidities, comprising mainly younger women, university students or those already employed, with lower levels of fatigue, and better quality of life; group 4-poorly defined comorbidities; and group 5-hypercholesterolemia. CONCLUSION: Over 80% of a large population-based cohort of Spanish patients with CFS/ME presented comorbidities. Among the 5 subgroups created, the most interesting were groups 1-3. Future research should consider multidisciplinary approaches for the management and treatment of CFS/ME with comorbid conditions.

"Ver, oír, callar y aburrirse" en el trabajo de campo de una prisión: un relato autoetnográfico / "Ver, ouvir, calar e... Se entediar" no trabalho de campo de uma prisão: a história autoetnografica / "See, hear, remain silent and bored" in the fieldwork of a prison: an autoethnografic story

Como modalidad de investigación narrativa, la autoetnografía enfatiza la parte más personal del proceso de investigación. En este artículo, el relato autoetnográfico se utiliza para reflexionar sobre el trabajo de campo de un estudio etnográfico previo desarrollado en el polideportivo de una prisión de máxima seguridad española. Los datos recogidos en aquella ocasión han sido reexaminados ahora para explicitar críticamente los pasos dados. De este modo, se ponen de manifiesto tanto los dilemas éticos enfrentados, las complejas relaciones sociales que el proceso de investigación encerró, así como la falibilidad de las decisiones tomadas(AU)

Como uma forma de pesquisa narrativa, autoetnografía enfatiza a parte mais pessoal do processo de investigação. Neste artigo, a história autoetnografica é usada para refletir sobre o trabalho de campo de um estudo etnográfico anterior realizado no pavilhão desportivo de uma prisão espanhola de segurança máxima. Os dados recolhidos nesse momento são re-analisados para fazer crítica explícita das decisões tomadas. Assim, eles revelam os dilemas éticos enfrentados, as relações sociais complexas que surgem durante o processo de pesquisa e a falibilidade das decisões tomadas(AU)

As a type of narrative inquiry, autoethnography emphasizes the more personal side of the research process. In this paper, the autoethnographic story is used to reflect upon a previous ethnographic study carried out in the sports hall of a maximum security Spanish prison. Data gathered in the ethnographic study are re-analyzed to make critically explicit the decisions taken. Therefore, ethical dilemmas and complex social relations arise during the research process, while fallibility of decisions taken are highlighted(AU)

Factors associated with substance use among Spanish military personnel involved in "Bosnia-Herzegovina". / Factores asociados al consumo de drogas en una muestra de militares españoles desplegados en "Bosnia-Herzegovina".

The use of both legal and illegal drugs has rarely been investigated among the Spanish military population involved in multinational military operations. The aim of the current study was to examine the consumption of drugs by Spanish military personnel in Bosnia-Herzegovina, and the variables associated with such substance use. A total of 605 military personnel participated in the cross-sectional study. The participants' mean age was 25.9 years (SD = 5.9), and 93.9% of the sample was male. The majority of the participants were enlisted personnel (83.5%). The most widely used drugs were tobacco (54.2%), and alcohol (39.9%). With respect to illegal drugs, the results showed that the drug with the highest prevalence of "use at some point during a lifetime" was cannabis (36.2%), followed by cocaine (14.9%) and amphetamines (12.1%). The most important variable associated with a decrease in the consumption of illegal drugs was social support. Conversely, participants with friends who have used illegal drugs had an increased likelihood of drug consumption. Given that the use of drugs can adversely affect soldiers' performance, preventive measures should be applied in multinational military operations.

El consumo de drogas legales e ilegales ha sido muy poco investigado en población militar española destinada en zonas de operaciones multinacionales. El objetivo de la investigación fue evaluar el nivel de consumo de drogas en militares españoles que realizaban misiones en Bosnia-Herzegovina, e identificar las posibles variables asociadas con dicho consumo. En el estudio transversal participaron 605 militares. La edad media de los participantes fue de 25,9 años (DT = 5,9) y el 93,9% de la muestra eran hombres. La mayoría de los participantes pertenecían a las escalas de tropa y marinería (83,5%). Las drogas más usadas fueron el tabaco (54,2%), y el alcohol (39,9%). En relación a las drogas ilegales, los resultados muestran que la droga con una mayor prevalencia de consumo "alguna vez en su vida" fue el cannabis (36,2%), seguida de la cocaína (14,9%) y las anfetaminas (12,1%). La variable más relevante asociada con una disminución en el consumo de drogas ilegales ha sido el apoyo social. En cambio, los participantes quienes tenían amigos consumidores de drogas ilegales incrementaban la probabilidad de consumo de drogas. Se resalta la importancia de la prevención en zonas de operaciones multinacionales para evitar el efecto negativo que podría tener el consumo de drogas en el desempeño adecuado de las misiones encomendadas.

Impact of prematurity and immigration on neonatal screening for sickle cell disease.

BACKGROUND: Others have described a relationship between hemoglobin A levels and gestational age, gender and ethnicity. However, studies are needed to determine normal cut-off points considering these factors. To address this issue we designed a study to determine the percentiles of normality of neonatal hemoglobin A levels taking these factors into account. METHODS: This cross-sectional study involved 16,025 samples for sickle cell disease screening in the province of Alicante, Spain, which has a high immigration rate. The primary variable was hemoglobin A, and the secondary variables were gender, gestational age (preterm and full term) and maternal origin (Spain, the rest of Europe, North Africa, Sub-Saharan Africa, Latin America and Asia). Percentiles of normality (1 and 99) were obtained by origin, gender and gestational age using quantile regression models and bootstrap samples. The association between these percentiles of normality and altered levels (≥1%) of hemoglobin E was analyzed. We obtained the percentiles of normality (1 and 99) for each maternal origin, gender and gestational age. RESULTS: Of a total of 88 possible E carriers, 65 had above-normal hemoglobin A levels (74%). The levels of normality for hemoglobin A varied greatly according to the maternal origin and gestational age. CONCLUSION: With the levels of normality that we established it is possible to discard samples with unrecorded blood transfusions. Our methodology could be applied to other diseases in the neonatal screening.

Prevalence of Trypanosoma cruzi's Discrete Typing Units in a cohort of Latin American migrants in Spain.

Chagas disease is caused by the protozoan Trypanosoma cruzi. This is an endemic disease in the Americas, but increased migration to Europe has made it emerge in countries where it was previously unknown, being Spain the second non endemic country in number of patients. T. cruzi is a parasite with a wide genetic diversity, which has been grouped by consensus into 6 Discrete Typing Units (DTUs) affecting humans. Some authors have linked these DTUs either to a specific epidemiological context or to the different clinical presentations. Our main objective was to describe the T. cruzi DTUs identified from a population of chronically infected Latin American migrants attending a reference clinic in Madrid. 149 patients meeting this condition were selected for the study. Molecular characterization was performed by an algorithm that combines PCR of the intergenic region of the mini exon-gene, the 24Sα and 18S regions of rDNA and the variable region of the satellite DNA. A descriptive analysis was performed and associations between geographical/clinical data and the different DTUs were tested. DTUs could be determined in 105 out of 149 patients, 93.3% were from Bolivia, 67.7% were women and median age was 35 years (IQR 29-44). The most common DTU found was TcV (58; 55.2%), followed by TcIV (17; 16.2%), TcII (10; 9.5%) and TcI (4; 3.8%). TcIII and TcVI were not identified from any patient, and 15.2% patients presented mixed infections. In addition, we determined DTUs after treatment in a subset of patients. In 57% patients had different DTUs before and after treatment. DTUs distribution from this study indicates active transmission of T. cruzi is occurring in Bolivia, in both domestic and sylvatic cycles. TcIV was confirmed as a cause of chronic human disease. The current results indicate no correlation between DTU and any specific clinical presentation associated with Chagas disease, nor with geographical origin. Treatment with benznidazole does not always clear T. cruzi's genetic material from blood, and DTUs detected in the same patient may vary over time indicating that polyparasitism is frequent.

The Discriminatory Ability of the Fibromyalgia Rapid Screening Tool (FiRST): An International Study in Spain and Four Latin American Countries.

OBJECTIVE: To assess the transcultural equivalency of the Spanish version of the Fibromyalgia Rapid Screening Tool (FiRST) and its discriminatory ability in different Latin American samples. DESIGN: Validation study. SETTING: Departments of Rheumatology in general hospitals and private centers; fibromyalgia unit in a university hospital. SUBJECTS: 350 chronic pain patients from Spain, Argentina, Mexico, Peru, and Ecuador. METHODS: The cultural relevance of the Spanish version of the FiRST was evaluated. The ability of the FiRST as a screening tool for fibromyalgia was assessed by logistic regression analysis. To determine the degree to which potential confounders, such as differences in demographics, pain, affective distress, catastrophizing, and disability, might affect the discriminatory ability, the tool was reassessed by hierarchical multivariate logistic regression. RESULTS: Slightly different versions of the FiRST were recommended for use in each Latin American subsample. The FiRST showed acceptable criterion validity and was able to discriminate between fibromyalgia and non-fibromyalgia patients even after controlling for the effect of potential confounders. However, low specificities were observed in samples from Spain and Mexico. CONCLUSIONS: The Spanish version of the FiRST may be used as a screening tool for fibromyalgia in several Latin American subsamples, even in those patients with high scores on potential confounders. In Spain and Mexico, the low specificity of the FiRST suggests, however, that it would be best used to support a suspected diagnosis of fibromyalgia, rather than to exclude the diagnosis.

[High frequency of ancestral allele of the TJP1 polymorphism rs2291166 in Mexican population, conformational effect and applications in surgery and medicine]. / Alta frecuencia del alelo ancestral del polimorfismo rs2291166 de TJP1 en población mexicana, efecto conformacional así como las aplicaciones en cirugía y medicina.

BACKGROUND: TJP1 gene encodes a ZO-1 protein that is required for the recruitment of occludins and claudins in tight junction, and is involved in cell polarisation. It has different variations, the frequency of which has been studied in different populations. In Mexico there are no studies of this gene. These are required because their polymorphisms can be used in studies associated with medicine and surgery. Therefore, the aim of this study was to estimate the frequency of alleles and genotypes of rs2291166 gene polymorphism TJP1 in Mexico Mestizos population, and to estimate the conformational effect of an amino acid change. MATERIAL AND METHODS: A total of 473 individuals were included. The rs2291166 polymorphism was identified PASA PCR-7% PAGE, and stained with silver nitrate. The conformational effect of amino acid change was performed in silico, and was carried out with servers ProtPraram Tool and Search Database with Fasta. RESULTS: The most frequent allele in the two populations is the ancestral allele (T). A genotype distribution similar to other populations was found. The polymorphism is in Hardy-Weinberg, p>0.05. Changing aspartate to alanine produced a conformational change. CONCLUSIONS: The study reveals a high frequency of the ancestral allele at rs2291166 polymorphism in the Mexican population.

O impacto da crise econômica espanhola na mão de obra imigrante / The impact of the Spanish economic crisis on immigrant labor in Spain / El impacto de la crisis económica española en la mano de obra inmigrante

Artigo tem o objetivo de analisar a situação da mão de obra imigrante na Espanha nos últimos dez anos, vinculando-a com as transformações econômicas e sociais pelas quais o país tem passado desde meados da década de 1990, com ênfase no panorama gerado pela crise econômica que eclodiu a partir do final de 2008 e o seu impacto na situação dos imigrantes, coletivo que mais tem sofrido com o novo quadro econômico e social estabelecido com a crise. Diante da situação que a Espanha atravessa, com notável aumento do desemprego e de deterioração dos indicadores sociais, nota-se o retorno considerável de imigrantes para os seus países de origem depois de esgotarem todas as vias alternativas de permanência na Espanha. O fundamento para o desenvolvimento deste trabalho foram os dados proporcionados pelo Instituto Nacional de Estadística (INE) da Espanha, utilizando a EPA (Encuesta de Población Activa), além dos dados do Eurostat e das fontes bibliográficas citadas...

This paper aims to analyze the situation of immigrant labor in Spain over the last ten years, linking it to social and economic transformations, which the country has undergone since the mid-1990s, with emphasis on the scenario generated by the economic crisis that erupted at the end of 2008 and its impact on the situation of immigrants, the people who have been most deeply affected by the new economic and social setting resulting from the crisis. Faced with the situation in Spain, with a remarkable increase in unemployment and deterioration of social indicators, immigrants have been returning to their countries of origin after exhausting all alternative ways to remain in Spain. The development of this paper is based on data provided by the Instituto Nacional de Estadística (INE - National Statistics Institute), of Spain, which used the Encuesta de Población Activa (EPA - Active Population Survey), in addition to data from Eurostat and the bibliographical references cited...

Este artículo tiene por objetivo analizar la situación de la mano de obra inmigrante en España en los últimos diez años, vinculándola con las transformaciones económicas y sociales por las que ha atravesado el país desde mediados de la década de 1990, con énfasis en el panorama generado por la crisis económica que eclosionó a fines de 2008 y su impacto en la situación de los inmigrantes, colectivo que más ha sufrido con el nuevo escenario económico y social establecido con la crisis. Ante la situación por la que atraviesa España, con un notable aumento del desempleo y del deterioro de los indicadores sociales, se observa un considerable retorno de los inmigrantes hacia sus países de origen, después de agotar todas las vías alternativas para su permanencia. El fundamento para el desarrollo de este trabajo han sido los datos proporcionados por el Instituto Nacional de Estadística (INE) de España, utilizando la Encuesta de Población Activa (EPA), además de los datos de Eurostat y de las fuentes bibliográficas citadas...

Common Polymorphisms in the GSK3ß Gene May Contribute to the Pathogenesis of Alzheimer Disease: A Meta-Analysis.

OBJECTIVE: Although it is well known that GSK3ß participates in the proliferation and survival of various tumor cells, its role in diseases of the central nervous system has been sparsely documented. In the past few years, studies regarding the relationship between GSK3ß rs334558 T>C and rs6438552 C>T polymorphisms and Alzheimer disease (AD) risk have yielded contradictory results. As such, this meta-analysis seeks to satisfy the need to further investigate this relationship. METHODS: In this research, published studies regarding the association of GSK3ß rs6438552 and rs334558 mutation with AD risk was systematically assessed. Studies were retrieved from MEDLINE, Science Citation Index, the Cochrane Library, PubMed, Embase, CINAHL, Current Contents Index, Chinese Biomedical, Chinese Journal Full-Text, and Weipu Journal. Pooled odds ratios and 95% confidence intervals were calculated for allele contrast and homozygous, heterozygous, dominant, and recessive genetic model comparisons. RESULTS: It was found that GSK3ß rs334558 T>C and rs6438552 C>T polymorphisms were correlated with susceptibility to AD under 4 genetic models (all P<.05). In country-stratified subgroups, the results showed increased risk of developing AD in rs334558 T>C polymorphism among Chinese and Spain populations in majority groups. GSK3ß rs6438552 C>T polymorphism was correlated with increased the risk of developing AD only in Australian populations. CONCLUSION: Our findings suggest that there exists a significant association between GSK3ß rs334558 T>C polymorphism and increased susceptibility of AD. Moreover, future updated studies with stratified case-control population are warranted for validation studies.

Relating the outcome of HCV infection and different host SNP polymorphisms in a Majorcan population coinfected with HCV-HIV and treated with pegIFN-RBV.

Hepatitis C virus (HCV) is one of the major causes of chronic hepatitis, cirrhosis, and hepatocellular carcinoma, and the development of HCV-related disease is accelerated in individuals coinfected with human immunodeficiency-1 virus (HIV). In the present study, we correlated different host single-nucleotide polymorphisms (SNPs) in the IL28B, CTLA4, LDLr, and HFE genes and mitochondrial DNA (mtDNA) haplogroups with the outcome of HCV infection and the response to pegylated-interferon plus ribavirin (pegIFN-RBV) treatment. Our study population consisted of 63 Majorcan patients coinfected with HCV and HIV and 59 anonymous unrelated controls. Whereas the population frequency of IL28B alleles was similar to that found in a North-American cohort of European descent, the frequency of the rs12979860 C allele was lower than that determined in other cohorts from Spain. The frequencies of CTLA4 and LDLr polymorphisms were comparable to those reported in other populations. Significant differences between cases and control cohorts occurred only for the H63D mutation of the HFE gene. There were no other differences in the frequencies of other polymorphisms or mtDNA haplogroups. The IL28B rs12979860 CC genotype was shown to be associated with a rapid virological response, and the spontaneous viral clearance rate for HCV was higher in patients with the CTLA4+49 G allele. There was no relationship between SNPs in the LDLr and HFE genes and mtDNA haplogroups and the response to treatment. Our results suggest that the host genetic background plays a significant role in the pegIFN-RBV response of patients coinfected with HCV and HIV.

Interethnic differences in the relevance of CYP2C9 genotype and environmental factors for diclofenac metabolism in Hispanics from Cuba and Spain.

The aims of this study were to evaluate the diclofenac metabolism in Hispanics from Cuba and Spain and its relation to ethnicity, CYP2C9 genotypes and environmental factors. Diclofenac hydroxylation capacity (concentration ratios of diclofenac/metabolites in 8-h urine) was studied in 160 Cuban (classified as 76 Cuban-Whites-CWs and 84 Cuban-Mestizos-CMs) and 148 Spaniard (SPs) healthy volunteers. Diclofenac and its main metabolites, 4'-hydroxy (OH), 3'-OH and 5-OH diclofenac, and CYP2C9*2 to *6 and *8 alleles were also determined in 132 and 128 CWs and CMs, respectively. Gender, tobacco, caffeine and ethanol consumption were also evaluated. The mean diclofenac/4'-OH diclofenac ratio was higher in CMs (0.72±0.25) than in CWs (0.64±0.20; P<0.05) and SPs (0.57±0.26; P<0.001). The mean diclofenac/4'-OH diclofenac ratio was higher (P<0.05) in subjects with CYP2C9*1/*3 (0.77±0.19; n=22) and CYP2C9*1/*8 (0.93±0.33; n=4) genotypes than with CYP2C9*1/*1 (0.65±0.24; n=90). Environmental factors did not seem to influence the diclofenac metabolism in these populations. The present findings show for the first time interethnic differences between Hispanic groups in urinary diclofenac/4'-OH diclofenac ratios, and the relevance of CYP2C9*3 and CYP2C9*8 alleles.