Assessment of Diabetic Foot Prevention by Nurses.

Diabetic foot is a severe complication of diabetes, with serious consequences such as amputations and high mortality rates as well as elevated economic costs. To evaluate whether or not nursing staff follow the recommendations of national and international organizations regarding diabetic foot prevention, a cross-sectional and observational descriptive study was carried out using an ad hoc self-administered questionnaire validated by seven experts, with a Cronbach's alpha of 0.731. Of the total 164 participants, 157 met the inclusion criteria. Findings showed that 96.58% asked their patients to remove their footwear, 78.34% performed thorough examinations, and 80.25% assessed the risk of developing diabetic foot. Participants educated their patients in self-care and evaluated skills related to diabetic foot control either frequently (84.07%) or very frequently (62.42%), and only 19.11% of them carried out group activity workshops. Significant statistical differences were found in the performance of activities in the groups by participant age intervals, whether working in primary health care or a hospital, having specific training, and the participant's DM patient ratio. We obtained high percentages of compliance in the assessed activities in comparison to other studies. Nevertheless, we believe it is necessary to encourage screening in specialized care, skills testing, and the implementation of educational group activities and workshops.

Medical resource use and expenditure in patients with chronic heart failure: a population-based analysis of 88 195 patients.

AIMS: Heart failure (HF) is one of the diseases with greater healthcare expenditure. However, little is known about the cost of HF at a population level. Hence, our aim was to study the population-level distribution and predictors of healthcare expenditure in patients with HF. METHODS AND RESULTS: This was a population-based longitudinal study including all prevalent HF cases in Catalonia (Spain) on 31 December 2012 (n = 88 195). We evaluated 1-year healthcare resource use and expenditure using the Health Department (CatSalut) surveillance system that collects detailed information on healthcare usage for the entire population. Mean age was 77.4 (12) years; 55% were women. One-year mortality rate was 14%. All-cause emergency department visits and unplanned hospitalizations were required at least once in 53.4% and 30.8% of patients, respectively. During 2013, a total of €536.2 million were spent in the care of HF patients (7.1% of the total healthcare budget). The main source of expenditure was hospitalization (39% of the total) whereas outpatient care represented 20% of the total expenditure. In the general population, outpatient care and hospitalization were the main expenses. In multivariate analysis, younger age, higher presence of co-morbidities, and a recent HF or all-cause hospitalization were independently associated with higher healthcare expenditure. CONCLUSIONS: In Catalonia, a large portion of the annual healthcare budget is devoted to HF patients. Unplanned hospitalization represents the main source of healthcare-related expenditure. The knowledge of how expenditure is distributed in a non-selected HF population might allow health providers to plan the distribution of resources in patients with HF.

Assessment of importance of the conservation unit in the preservation of Chironomidae (Insecta: Diptera) diversity in the Vargem Limpa stream, Bauru, São Paulo State - DOI: 10.4025/actascibiolsci.v29i4.883 / Avaliação da importância da unidade de conservação na preservação da diversidade de Chironomidae (Insecta: Diptera) no córrego Vargem Limpa, Bauru, Estado de São Paulo, Brasil - DOI: 10.4025/actascibiolsci.v29i4.883

This study evaluated the water quality of the Vargem Limpa stream and tested the hypothesis that protected stretches of the aquatic system, located within a conservation unit, favor the preservation of the diversity of Chironomidae (Insecta: Diptera). Samplings were conducted in four stations, where some physical and chemical variables were measured. The results obtained by the study indicated the predominance of genera associated with arenaceous substrata, and that the stretches protected by the conservation unit presented better environmental conditions, with better-preserved Chironomidae diversity, demonstrating the importance of these areas in maintaining the diversity of Chironomidae.

Este estudo avaliou a qualidade das águas do córrego Vargem Limpa e testou a hipótese de que trechos protegidos, do sistema aquático, localizados no interior de uma unidade de conservação, favorecem a preservação da diversidade de Chironomidae (Insecta: Diptera). Foram realizadas amostragens em quatro pontos e algumas variáveis físicas e químicas da água foram aferidas. Os resultados, obtidos com o estudo, indicaram o predomínio de gêneros associados a substratos arenosos e que os trechos protegidos pela unidade de conservação apresentaram melhor qualidade ambiental, com diversidade de Chironomidae mais preservada, demonstrando a importância destas áreas na manutenção da diversidade de Chironomidae.

Cross-cultural assessment of eating disorders: psychometric properties of a Spanish version of the Bulimia Test-Revised.

The purpose of this study was to examine the psychometric properties of a Spanish version of the Bulimia Test-Revised (BULIT-R). The goal was to test the factor-structure equivalence of the BULIT-R across two samples of college students from two different cultures, Spain and the US. Researchers using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) have reported different model solutions for the factor-structure of the BULIT-R: a one-factor model, a four-factor model, a five-factor model and a six-factor model. For the two samples, CFA did not support any of the models previously reported in the literature. EFA supported a six- and a four-factor models for the US and Spanish samples, respectively.

Water privatization and public health in Latin America.

OBJECTIVES: This study had two objectives: (1) to determine what the public health and development literature has found regarding the public health outcomes of water privatization in Latin America and (2) to evaluate whether the benefits of water privatization, if any, outweigh the equity and justice concerns that privatization raises. METHODS: Using a standard set of terms to search several databases, the authors identified and reviewed articles and other materials from public health and development sources that were published between 1995 and 2005 and that evaluated the public health effects of water privatizations in Latin America from 1989 to 2000, based on (1) access to water by the poor and/or (2) improvements in public health. Next, the authors examined the experiences of three cities in Bolivia (Cochabamba, El Alto, and La Paz) in order to illuminate further the challenges of water privatization. Finally, the authors considered the equity and justice issues raised by the privatization of water. RESULTS: The literature review raised persistent concerns regarding access to water by the poor under privatization. The review also suggested that the public sector could deliver public health outcomes comparable to those of the private sector, as measured by access rates and decreasing child mortality rates. In terms of social equity and justice, privatization marked a troubling shift away from the conception of water as a "social good" and toward the conception of water--and water management services--as commodities. CONCLUSIONS: Our results indicated there is no compelling case for privatizing existing public water utilities based on public health grounds. From the perspective of equity and justice, water privatization may encourage a minimalist conception of social responsibility for public health that may hinder the development of public health capacities in the long run.

Water privatization and public health in Latin America

OBJETIVOS: Este estudio tuvo dos objetivos: 1) determinar lo que dicen las fuentes bibliográficas sobre sanidad y desarrollo acerca de las consecuencias que puede tener para la salud pública la privatización del abastecimiento de agua en América Latina y 2) determinar si los beneficios de dicha privatización, de haberlos, son mayores que los problemas que plantea en materia de equidad y justicia. MÉTODOS: Usando ciertas palabras para buscar en varias bases de datos, los autores encontraron y revisaron artículos y otros tipos de materiales obtenidos de fuentes relacionadas con la salud pública y el desarrollo. Se buscaron fuentes publicadas entre 1995 y 2005 donde se evaluaban los efectos para la salud que tuvieron las privatizaciones de los abastecimientos de agua en países de América Latina de 1989 a 2000. Se prestó particular atención a 1) el acceso de los pobres, 2) las mejoras obtenidas en el campo sanitario, o ambas cosas. Posteriormente los autores examinaron las experiencias de tres ciudades de Bolivia (Cochabamba, El Alto y La Paz) a fin de entender mejor los problemas planteados por la privatización. Exploraron, por último, cómo esta repercute en la equidad y la justicia. RESULTADOS: La revisión de las publicaciones reveló inquietud en torno al acceso de los pobres al agua después de la privatización. Puso de manifiesto, además, que el sector público es capaz de lograr resultados equivalentes a los obtenidos por el sector privado, medidos en función de las tasas de acceso y de la reducción de las tasas de mortalidad de niños menores de cinco años. En lo que respecta a la equidad y la justicia, la privatización marca el comienzo de una tendencia alarmante a concebir el agua y su gestión como bienes de consumo y no como "bienes sociales". CONCLUSIONES: Nuestros resultados indican que no hay argumentos convincentes de tipo sanitario que respalden la privatización del abastecimiento de agua. Desde el punto de vista de la equidad y la justicia, dicha privatización podría fomentar una visión minimalista de la responsabilidad social en materia sanitaria que a su vez podría menoscabar las funciones del sector de la salud en el largo plazo.

Predictors of self-esteem for Mexican American and European American youths: a reexamination of the influence of parenting.

Decades of research with European American middle-class families have found significant relations between parenting behavior and child self-esteem. Similar research with minority and low-income families is rare. The present study examined the relation between parenting practices and child self-esteem among 70 Mexican American and 161 European American youths. The analyses consisted of regressing child self-esteem on parenting practices (acceptance, rejection, inconsistent discipline, and hostile control), ethnicity, socioeconomic status (SES), and the interactions between ethnicity, SES, and parenting practices. Several main effects and interactions were significant; for each interaction, behavior of low-income or Mexican American parents had less influence on children's self-esteem than did similar behavior by middle-class or European American parents.