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2.
Fam Pract ; 2021 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-34089055

RESUMEN

BACKGROUND: Primary care (PC) is crucial in the care of substance use disorder (SUD) patients. However, the relationship between PC and addiction settings is complex and collaboration issues stand out. Available evidence suggests that integration of SUD and PC services can improve physical and mental health of SUD patients and reduce health expenses. OBJECTIVE: To explore the experiences, views and attitudes of PC professionals towards the interaction between PC and SUD services. METHODS: Twenty-seven GPs took part in three focus groups. The focus group sessions were audio-taped, transcribed verbatim and analysed using reflexive thematic analysis. Recurrent themes were identified. RESULTS: Four main themes were devised: (1) Differences and specificities of SUD patients, (2) Interaction between providers of PC and addiction services, (3) Patient management (4) Addiction stigma. These main themes reflect the consideration that SUD patients are a specific group with specific care needs that yield specific challenges to GPs themselves. Improved training, availability of a shared medical record system, increased feedback between GP and addiction specialists and the efficiency of the circuit are to be considered the main priority for the majority of the participants. CONCLUSIONS: An efficient and effective referral circuit, with increased feedback and shared medical records is considered key to GPs. Its implementation should keep in mind the specific features of both SUD patients and GPs.

3.
PLoS Biol ; 19(5): e3001200, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33999917

RESUMEN

The heart develops from 2 sources of mesoderm progenitors, the first and second heart field (FHF and SHF). Using a single-cell transcriptomic assay combined with genetic lineage tracing and live imaging, we find the FHF and SHF are subdivided into distinct pools of progenitors in gastrulating mouse embryos at earlier stages than previously thought. Each subpopulation has a distinct origin in the primitive streak. The first progenitors to leave the primitive streak contribute to the left ventricle, shortly after right ventricle progenitor emigrate, followed by the outflow tract and atrial progenitors. Moreover, a subset of atrial progenitors are gradually incorporated in posterior locations of the FHF. Although cells allocated to the outflow tract and atrium leave the primitive streak at a similar stage, they arise from different regions. Outflow tract cells originate from distal locations in the primitive streak while atrial progenitors are positioned more proximally. Moreover, single-cell RNA sequencing demonstrates that the primitive streak cells contributing to the ventricles have a distinct molecular signature from those forming the outflow tract and atrium. We conclude that cardiac progenitors are prepatterned within the primitive streak and this prefigures their allocation to distinct anatomical structures of the heart. Together, our data provide a new molecular and spatial map of mammalian cardiac progenitors that will support future studies of heart development, function, and disease.


Asunto(s)
Linaje de la Célula/genética , Corazón/embriología , Línea Primitiva/embriología , Animales , Linaje de la Célula/fisiología , Femenino , Gástrula , Expresión Génica/genética , Regulación del Desarrollo de la Expresión Génica/genética , Corazón/fisiología , Atrios Cardíacos/embriología , Ventrículos Cardíacos/embriología , Masculino , Mesodermo , Ratones , Ratones Endogámicos C57BL , Morfogénesis , Línea Primitiva/fisiología , Análisis de Secuencia de ARN/métodos , Análisis de la Célula Individual/métodos
4.
Eur J Emerg Med ; 28(5): 373-379, 2021 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33709997

RESUMEN

BACKGROUND AND IMPORTANCE: SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term follow-up results of a specialized SBIRT program. A short-term follow-up after 1.5 months showed encouraging results, with more than a 20% greater reduction of at-risk drinking in the intervention group and more than double of successful referrals to specialized treatment. OBJECTIVE: We aimed to evaluate the mid and long-term efficacy of an SBIRT program conducted by psychiatrist specialists in addictive disorders and motivational interviewing in the ED of a tertiary hospital. DESIGN, SETTINGS AND PARTICIPANTS: We conducted a secondary analysis of a previously published randomized controlled trial of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the AUDIT-C scale. INTERVENTION OR EXPOSURE: Patients were randomized into two groups, with the control group receiving two leaflets: one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment. OUTCOMES MEASURE AND ANALYSIS: Long-term assessment primary outcome was the proportion of at-risk alcohol use measured by AUDIT-C scale. The main effectiveness analysis at 18 weeks and 12 months' follow-up was conducted with multilevel logistic regression analyses. Missing values were imputed with the last observation carried forward. MAIN RESULTS: Of 200 patients included in the study, 133 (66.5%) and 131 (65.5%) completed 18 weeks and 1-year follow-up respectively. Although the proportion of risky drinkers was substantially lower in the intervention group (38.5 vs. 57.4% at 4.5 months and 58.5 vs 68.2% at 1 year), these results did not reach statistical significance (OR = 2.15; CI, 0.87-5.33). CONCLUSIONS: In this secondary analysis for mid- and long-term effects of a specialized SBIRT program, there was no significant difference in the reduction of risky drinkers at 18 weeks and 1 year. The small size of the studied sample and the low retention rate precluded any significant conclusion, although point estimates suggest a positive effect. Overall, SBIRT programs are an effective tool to reduce alcohol use at short time and to refer patients to specialized treatment; however, its effects seem to decay over time.


Asunto(s)
Alcoholismo , Consumo de Bebidas Alcohólicas , Alcoholismo/diagnóstico , Alcoholismo/terapia , Servicio de Urgencia en Hospital , Estudios de Seguimiento , Humanos , Derivación y Consulta
5.
Alcohol Clin Exp Res ; 45(4): 802-807, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33667019

RESUMEN

BACKGROUND: Patients with alcohol use disorder (AUD) are likely to suffer disproportionate harms related to the COVID-19 pandemic and related policy measures. While many surveys have been conducted, most are focused on drinking changes in the general population and validation with biological markers is lacking. METHOD: We performed a retrospective cohort study among patients with AUD attending a urine drug screening program. With mixed-effects logistic regression models, we assessed the probability of screening positive for ethyl glucuronide according to patients' main clinical characteristics and time of analysis (either prior to or after a lockdown was implemented in Spain). RESULTS: A total of 362 patients provided 2,040 urine samples (1,295 prior to lockdown, 745 during lockdown). The mean age of participants was 52.0 years (SD 12.6), and 69.2% were men. Of the 43% of patients tested for other drugs 22% screened positive. After adjusting for all covariates, the odds of screening positive for ethyl glucuronide during lockdown almost doubled (OR = 1.99, 95% CI 1.20 to 3.33, p = 0.008). Other significant covariates included testing positive for other drugs (OR = 10.79, 95% CI 4.60 to 26.97) and length of treatment (OR = 0.59, 95% CI 0.47 to 0.74). CONCLUSIONS: Our data support an association between the lockdown due to COVID-19 and increased alcohol use in patients with AUD. Thus, addiction healthcare systems could face significant challenges ahead. In light of these findings, it is essential to evaluate prospectively how patients with AUD are affected by the pandemic and how health systems respond to their needs.


Asunto(s)
Abstinencia de Alcohol/tendencias , Alcoholismo/epidemiología , COVID-19/epidemiología , Cuarentena/tendencias , Adolescente , Adulto , Anciano , Abstinencia de Alcohol/psicología , Alcoholismo/psicología , COVID-19/psicología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Cuarentena/psicología , Estudios Retrospectivos , España/epidemiología , Adulto Joven
8.
J Clin Med ; 9(9)2020 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-32971960

RESUMEN

Liver transplantation remains an essential procedure for many patients suffering from alcoholic liver disease. Alcohol use monitoring remains paramount all through the stages of this complex process. Direct alcohol biomarkers, with improved specificity and sensibility, should replace traditional indirect markers. Phosphatidylethanol (PEth) has been recently tested in alcoholic liver disease patients, but more evidence is needed, especially in comparison with other direct biomarkers. We conducted an observational study among patients awaiting liver transplantation. We analyzed Peth in blood, ethylglucuronide (EtG) in hair and urine and ethylsulphate (EtS) in urine, using mass spectrometry methods. In addition, transaminases, and self-reports were analyzed. A total of 50 patients were included (84% men, mean age 59 years (SD = 6)). 18 patients (36%) screened positive for any marker. Self-reports were positive in 3 patients. EtS was the biomarker with more positive screens. It also was the most frequently exclusive biomarker, screening positive in 7 patients who were negative for all other biomarkers. PEth was positive in 5 patients, being the only positive biomarker in 2 patients. It showed a false negative in a patient admitting alcohol use the previous week and screening positive for EtG and EtS. Hair EtG was positive in 3 patients who had negative Peth, EtG. EtG did not provide any exclusive positive result.A combination of biomarkers seems to be the best option to fully ascertain abstinence in this population. Our study suggest EtS might also play a significant role.

9.
Beilstein J Org Chem ; 16: 1662-1682, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32733610

RESUMEN

The Pauson-Khand reaction (PKR) is one of the key methods for the construction of cyclopentenone derivatives, which can in turn undergo diverse chemical transformations to yield more complex biologically active molecules. Despite the increasing availability of fluorinated building blocks and methodologies to incorporate fluorine in compounds with biological interest, there have been few significant advances focused on the fluoro-Pauson-Khand reaction, both in the inter- and intramolecular versions. Furthermore, the use of vinyl fluorides as olefinic counterparts had been completely overlooked. In this review, we collect the advances both on the stoichiometric and catalytic intermolecular and intramolecular fluoro-Pauson-Khand reaction, with special attention to the PKR of enynes containing a fluoride moiety.

10.
Rev Esp Salud Publica ; 942020 Apr 08.
Artículo en Español | MEDLINE | ID: mdl-32382002

RESUMEN

OBJECTIVE: Due to the high economic and morbimortality burden associated to alcohol use, in the last decades, public health services have developed several programs to detect and to intervene on at risk drinkers in primary care settings and emergency departments (ED). The aim of this study is to determine the proportion of detected and registered risky drinkers in an ED of Hospital Clínic de Barcelona. METHODS: All patients over 18 years old, presenting to the ED and reporting risky drinking, were asked to participate. We did a descriptive analysis of the data after revising clinical records. RESULTS: We detected 247 risky drinkers after assessing more than 2,047 patients with AUDIT-C scale. From these, 200 accepted to participate. Only 65 (32.5%) of these patients were properly detected and registered as risky drinkers, while the majority of them (122, 61%) had no record about their alcohol use in their clinical records. CONCLUSIONS: Risky drinkers are properly detected and registered in less than 35% of the patients. It is necessary to evaluate which barriers are restricting the implementation of screening programs to detect at risk drinkers.


Asunto(s)
Consumo de Bebidas Alcohólicas , Trastornos Relacionados con Alcohol/diagnóstico , Servicio de Urgencia en Hospital , Adulto , Anciano , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Consumo de Bebidas Alcohólicas/psicología , Trastornos Relacionados con Alcohol/epidemiología , Trastornos Relacionados con Alcohol/psicología , Femenino , Humanos , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Prevalencia , Medición de Riesgo , Autoinforme , España/epidemiología
11.
Chemistry ; 26(31): 6999-7003, 2020 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-32237097

RESUMEN

Gold-catalysis has enabled new synthetic opportunities in the chemistry of vinyldiazo compounds. Herein, we report the gold-catalyzed reaction of stabilized vinyldiazo compounds with pinacol alkenylboronates to provide boryl-functionalized cyclopentene derivatives through a formal [3+2] carbocycloaddition reaction, a very unusual pathway in alkenylboronate chemistry. This reaction proceeds with high regio- and stereoselectivity. The synthetic usefulness of the resulting borylated cyclopentene derivatives toward the synthesis of densely functionalized cyclopentanoids is also demonstrated.

12.
Sci Rep ; 10(1): 7190, 2020 04 28.
Artículo en Inglés | MEDLINE | ID: mdl-32346097

RESUMEN

Small synthetic molecules mimicking the three-dimensional structure of α-helices may find applications as inhibitors of therapeutically relevant protein-protein and protein-nucleic acid interactions. However, the design and use of multi-facial helix mimetics remains in its infancy. Here we describe the synthesis and application of novel bilaterally substituted p-terphenyl compounds containing positively-charged aminoalkyl groups in relative 1,4 positions across the aromatic scaffold. These compounds were specifically designed to mimic all faces of the arginine-rich α-helix of the HIV-1 protein Rev, which forms deeply embedded RNA complexes and plays key roles in the virus replication cycle. Two of these molecules recognized the Rev site in the viral RNA and inhibited the formation of the RRE-Rev ribonucleoprotein complex, a currently unexploited target in HIV chemotherapy. Cellular assays revealed that the most active compounds blocked HIV-1 replication with little toxicity, and likely exerted this effect through a multi-target mechanism involving inhibition of viral LTR promoter-dependent transcription and Rev function. Further development of this scaffold may open new avenues for targeting nucleic acids and may complement current HIV therapies, none of which involve inhibitors interfering with the gene regulation processes of the virus.


Asunto(s)
Fármacos Anti-VIH/química , VIH-1/química , Conformación de Ácido Nucleico , ARN Viral/química , Compuestos de Terfenilo/química , Productos del Gen rev del Virus de la Inmunodeficiencia Humana/química , Línea Celular , Humanos , Conformación Proteica en Hélice alfa
13.
Adicciones ; 32(4): 243-254, 2020 Nov 17.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30059586

RESUMEN

Alcohol Liver Disease (ALD) is one of the most prevalent conditions leading to liver transplantation for end-stage liver disease. There is lacking evidence of regular urine screening testing (RUST) impact on survival or liver transplantation of ALD patients. The aims of this study were to compare the sensitivity of RUST, to assess its impact on survival and liver transplantation, and to evaluate factors associated with adherence to RUST. We performed a single-centered retrospective study (N = 84) with ALD candidates for liver transplantation. Demographic, biochemical and clinical variables were recorded at baseline. Adherence to RUST was evaluated during follow-up. The sensitivity of both RUST and self-reports were calculated for all drugs. Multivariable logistic and survival regression analyses were performed to explore associated factors and the impact of adherence to RUST, and positive results on survival. RUST had high sensitivity for identifying active drinkers (76.9%), smokers (78.9%) and cannabis users (83.3%). High adherence to RUST was inversely associated with mortality during follow-up. Presence of personality disorders negatively impacted (OR 0.29, CI 95% 0.08-0.97) adherence to RUST. Both RUST and self-reports should be carried out in this setting. Professionals involved in liver transplantation programs must promote adherence to RUST, primarily in patients with personality disorders.


Asunto(s)
Etanol/orina , Hepatopatías Alcohólicas/orina , Trasplante de Hígado , Detección de Abuso de Sustancias/métodos , Consumo de Bebidas Alcohólicas/epidemiología , Femenino , Humanos , Hepatopatías Alcohólicas/mortalidad , Hepatopatías Alcohólicas/cirugía , Masculino , Fumar Marihuana/epidemiología , Persona de Mediana Edad , Estudios Retrospectivos , Autoinforme , Análisis de Supervivencia
14.
Rev. esp. salud pública ; 94: 0-0, 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-192534

RESUMEN

FUNDAMENTOS: El consumo excesivo de alcohol es uno de los factores de riesgo de morbimortalidad más importantes en nuestro entorno, por lo que en los últimos años se han desarrollado múltiples programas para la detección e intervención sobre los consumidores de riesgo en los centros de atención primaria y de Urgencias. El objetivo de este estudio fue analizar la tasa de detección y registro del consumo excesivo de los pacientes atendidos en un servicio de Urgencias. MÉTODOS: Se incluyeron todos los pacientes con un consumo de riesgo de alcohol, mayores de 18 años, atendidos en un servicio de Urgencias del Hospital Clínic de Barcelona. Se realizó un análisis descriptivo de los datos, tras evaluar los informes de alta de los pacientes. RESULTADOS: Se evaluaron 2.047 pacientes mediante la escala AUDIT, detectándose 247 consumidores de riesgo, de lo que 200 aceptaron participar. De estos, solamente se realizó una adecuada detección y registro en el 32,5%. En 122 historias clínicas no había ninguna referencia sobre el consumo de alcohol, y en 13 la referencia era inexacta y no informaba sobre si la cantidad de alcohol consumida era excesiva. CONCLUSIONES: El consumo de riesgo de alcohol se registra de manera adecuada en menos del 35% de los pacientes. Es necesario evaluar las barreras que están obstaculizando la detección y registro para una mejor identificación de estos pacientes


BACKGROUND: Due to the high economic and morbimortality burden associated to alcohol use, in the last decades, public health services have developed several programs to detect and to intervene on at risk drinkers in primary care settings and emergency departments (ED). The aim of this study is to determine the proportion of detected and registered risky drinkers in an ED of Hospital Clínic de Barcelona. METHODS: All patients over 18 years old, presenting to the ED and reporting risky drinking, were asked to participate. We did a descriptive analysis of the data after revising clinical records. RESULTS: We detected 247 risky drinkers after assessing more than 2,047 patients with AUDIT-C scale. From these, 200 accepted to participate. Only 65 (32.5%) of these patients were properly detected and registered as risky drinkers, while the majority of them (122, 61%) had no record about their alcohol use in their clinical records. CONCLUSIONS: Risky drinkers are properly detected and registered in less than 35% of the patients. It is necessary to evaluate which barriers are restricting the implementation of screening programs to detect at risk drinkers


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Alcoholismo/terapia , Alcoholismo/epidemiología , Consumo de Bebidas Alcohólicas/efectos adversos , Servicios Médicos de Urgencia , Servicio de Urgencia en Hospital , Factores de Riesgo
15.
Adicciones (Palma de Mallorca) ; 32(4): 243-254, 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-198090

RESUMEN

La enfermedad hepática alcohólica (EHA) es una de las causas más frecuentes de trasplante hepático en enfermedad hepática terminal. No hay evidencia del impacto de la detección regular de sustancias en orina (DRSO) sobre la supervivencia de los pacientes con EHA. Los objetivos de este estudio fueron comparar la sensibilidad de la DRSO, evaluar su impacto en la supervivencia y en el trasplante hepático, y evaluar el impacto de la adherencia a la DRSO. Realizamos un estudio retrospectivo (N = 84) con candidatos para trasplante hepático por EHA. Registramos las variables demográficas, bioquímicas y clínicas al inicio del estudio. Evaluamos la adherencia a la DRSO durante el seguimiento. Calculamos la sensibilidad tanto de la DRSO como de las declaraciones de los pacientes para todas las sustancias. Realizamos análisis multivariables (regresión logística) y de supervivencia para explorar los factores asociados y el impacto de la adherencia a la DRSO, y de los resultados positivos en la DRSO sobre la supervivencia. La DRSO tuvo una alta sensibilidad para identificar bebedores activos (76,9%), fumadores (78,9%) y consumidores de cannabis (83,3%). La alta adherencia a la DRSO tuvo una asociación inversa con la mortalidad durante el seguimiento. La presencia de trastornos de la personalidad tuvo un impacto negativo (RM ,29, IC 95% ,08-,97) sobre la adherencia a la DRSO. Tanto la DRSO como las declaraciones deben llevarse a cabo en este perfil de pacientes. Los profesionales que participan en programas de trasplante hepático deben promover el cumplimiento de la DRSO, principalmente en pacientes con trastornos de la personalidad


Alcohol Liver Disease (ALD) is one of the most prevalent conditions leading to liver transplantation for end-stage liver disease. There is lacking evidence of regular urine screening testing (RUST) impact on survival or liver transplantation of ALD patients. The aims of this study were to compare the sensitivity of RUST, to assess its impact on survival and liver transplantation, and to evaluate factors associated with adherence to RUST. We performed a single-centered retrospective study (N = 84) with ALD candidates for liver transplantation. Demographic, biochemical and clinical variables were recorded at baseline. Adherence to RUST was evaluated during follow-up. The sensitivity of both RUST and self-reports were calculated for all drugs. Multivariable logistic and survival regression analyses were performed to explore associated factors and the impact of adherence to RUST, and positive results on survival. RUST had high sensitivity for identifying active drinkers (76.9%), smokers (78.9%) and cannabis users (83.3%). High adherence to RUST was inversely associated with mortality during follow-up. Presence of personality disorders negatively impacted (OR 0.29, CI 95% 0.08-0.97) adherence to RUST. Both RUST and self-reports should be carried out in this setting. Professionals involved in liver transplantation programs must promote adherence to RUST, primarily in patients with personality disorders


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Hepatopatías Alcohólicas/orina , Trasplante de Hígado , Drogas Ilícitas/orina , Etanol/orina , Estudios Retrospectivos , Hepatopatías Alcohólicas/cirugía , Periodo Preoperatorio , Análisis de Regresión , Alcoholismo/orina , Análisis de Varianza , Estadísticas no Paramétricas , Autoinforme , Factores de Tiempo
16.
J Clin Med ; 8(10)2019 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-31627454

RESUMEN

New conceptual and technological solutions have been proposed to solve addictive disorders and will be presented in the future. In this Special Issue, we present some of the new assessment tools and treatment options for internet addiction, alcohol, cannabis, cocaine, and gambling disorders.

17.
Org Lett ; 21(18): 7294-7297, 2019 09 20.
Artículo en Inglés | MEDLINE | ID: mdl-31478678

RESUMEN

A variety of enantioenriched fluorinated 6H-cyclopenta[c]pyridin-6-one bicycles, a scaffold present in several classes of monoterpenic alkaloids with varied biological activity, were synthesized in just five steps from simple aldehyde starting materials. The synthesis presented wide functional group tolerance and moderate to high yields and diastereoselectivities and could be carried out on a gram scale. These products were suitable for further transformations, such as hydrogenation and deprotection of the tert-butylsulfonyl protecting group.

18.
J Clin Med ; 8(6)2019 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-31195625

RESUMEN

OBJECTIVE: Little is known about the potential acceptability of alcohol transdermal sensors among alcohol-dependent outpatients in routine clinical settings. The aim of the present study was to investigate patients' attitudes towards alcohol transdermal sensors, as well as features associated with enhanced acceptability and usability. METHODS: A cross-sectional survey among routine alcohol outpatients was conducted. The Drug Attitude Inventory (DAI-10) was adapted to the field of alcohol transdermal sensors for attitudes assessment. Likert-type and multiple-choice questions were used for acceptability and usability evaluation. RESULTS: 68 patients completed the questionnaire, and the DAI-10 mean score was 3 (standard deviation (SD) = 6.5). Internal consistency revealed a Cronbach alpha of 0.613. The score of a single The score of a single Likert-type question about overall perceived value was 7.4 (SD = 2.6). Its correlation with mean DAI-10 scores was r = 0.633, with p < 0.001. Relapse prevention and a stricter treatment control from therapists were the main reported advantages. Perceived stigma was the main disadvantage. Features increasing device discretion would enhance its acceptability. CONCLUSIONS: The data suggest that transdermal sensors could play a role in the clinical treatment of alcohol outpatients and concerns regarding stigma should be taken into account. Future designs should try to minimize size and visibility and stigma concerns should be discussed with patients.

19.
Int J Med Inform ; 127: 95-101, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31128838

RESUMEN

OBJECTIVE: Understanding the impact of Level of Information and Communication Technology Use, computer self-efficacy and perceived product usability of healthcare professionals regarding an alcohol consumption reduction website on facilitated access defined as referring patients to the webpage. METHODS: 52 nurses and 41 general practitioners were assessed before patient recruitment started, using a questionnaire designed to assess socio-demographic characteristics, professional engagement to the website, Level of Information and Communication Technology Use, Computer self-efficacy ("the judgment of one's capability to use a computer") and Perceived product usability ("the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction in a specified context of use"). Dependent variable was the self-report of number of brochures distributed to patients. RESULTS: Professionals' engagement with facilitated access measured by brochures handed out was not predicted by Perceived product usability, Level of Information and Communication Technology Use or Computer self-efficacy. Professionals who had actively engaged with the website (customization) provided significantly more brochures compared with those who had not (Coefficient B 15.7 CI95% 3.5-27.8). Professional's socio-demographic characteristics did not predict engagement in facilitated access. CONCLUSION: Professionals' Perceived product usability, Level of Information and Communication Technology Use and Computer self-efficacy were not associated to facilitated access. Active early engagement of health professionals with the website (customization) is a key predictor of subsequent engagement with facilitated access. PRACTICE IMPLICATIONS: Computer Self-Efficacy, Level of Information and Communication Technology Use and Perceived Product Usability are irrelevant for facilitated access and efforts should be focused on taking time to collaborate with providers and convincing them about the usefulness of the intervention (including customization). Website customization by health care professionals is a promising predictor of engagement.


Asunto(s)
Consumo de Bebidas Alcohólicas , Atención Primaria de Salud , Adulto , Femenino , Personal de Salud , Humanos , Masculino , Persona de Mediana Edad , Atención al Paciente , Participación del Paciente , Autoeficacia , Autoinforme , Encuestas y Cuestionarios
20.
Molecules ; 24(8)2019 Apr 20.
Artículo en Inglés | MEDLINE | ID: mdl-31009999

RESUMEN

Organofluorine compounds are finding increasing application in a variety of fields such as pharmaceutical, agrochemical, and material sciences. However, given the scarcity of fluorine-containing natural products, advancement in this area depends almost entirely on the development of new synthetic methodologies. In this article, we present the synthesis of a series of previously undescribed (E)-ß-fluorovinyl sulfones via a simple copper-catalyzed addition of hydrogen fluoride to alkynyl sulfone starting materials in varying yields and E/Z selectivities. The hydrogenation of these products was also explored and compared with the hydrogenation of the related Z isomers. These new products may find interesting applications, given the versatility of vinyl sulfones in chemical synthesis and the unique properties of vinyl fluorides in biological settings.


Asunto(s)
Flúor/química , Compuestos de Vinilo/química , Catálisis , Cobre/química , Hidrogenación , Estructura Molecular , Compuestos de Vinilo/síntesis química
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