Impact of hyperparathyroidism on allograft histology and function after kidney transplantation: Rethinking its causal role in graft dysfunction.

INTRODUCTION: The causal relationship between hyperparathyroidism and kidney graft dysfunction remains inconclusive. Applying Bradford-Hill's temporality and consistency causation principles, we assessed the effect of parathyroid hormone (iPTH) on graft histology and eGFR trajectory on kidney transplant recipients (KTRs) with normal time-zero graft biopsies. METHODS: Retrospective cohort study evaluating the effect of hyperparathyroidism on interstitial fibrosis and tubular atrophy (IF/TA) development in 1232 graft biopsies. Pre-transplant hyperparathyroidism was categorized by KDIGO or KDOQI criteria, and post-transplant hyperparathyroidism by iPTH >1× and >2× the URL 1 year after transplantation. RESULTS: We included 325 KTRs (56% female, age 38 ± 13 years, follow-up 4.2 years [IQR: 2.7-5.8]). Based on pre-transplant iPTH levels, 26% and 66% exceeded the KDIGO and KDOQI targets, respectively. There were no significant differences in the development of >25% IF/TA between KTRs with pre-transplant iPTH levels above and within target range according to KDIGO (53% vs. 62%, P = .16, HR.94 [95% CI:.67-1.32]) and KDOQI (60% vs. 60%, P = 1.0, HR 1.19 [95% CI:.88-1.60]) criteria. Similarly, there were no differences when using 1 year post-transplant iPTH cut-offs > 88 pg/mL (58% vs. 64%, P = .33) and > 176 pg/mL (55% vs. 62%, P = .19). After adjusting for confounders, no significant differences were observed in eGFR trajectories among the iPTH strata. CONCLUSION: In young KTRs who received a healthy graft, no association was found between increased pre- and post-transplant iPTH levels and graft dysfunction, as assessed histologically and through eGFR trajectory. The concept of hyperparathyroidism as a risk factor for graft dysfunction in recipients at low risk requires reevaluation.

Enfermería, liderazgo y relaciones de poder, una mirada desde lo cualitativo / Nursing, leadership and power relationships, a qualitative perspective

Objetivo: Conocer la percepción del liderazgo de enfermería desde las relaciones de poder, a partir de la opinión de las enfermeras, enfermeros recién titulados e integrantes del equipo de salud. Método: Investigación cualitativa, de tipo estudio de caso, con enfoque fenomenológico. Desarrollada en dos fases, aprobado por un comité de ética. Los participantes fueron enfermeras y enfermeros recién titulados e integrantes del equipo de salud. Se realizó muestreo por conveniencia, aplicación de entrevistas semiestructuradas, análisis de contenido y aplicación de pauta COREQ-32. Resultados: La categoría relaciones de poder da cuenta de una evolución histórica del liderazgo de enfermería y la existencia de relaciones de poder dentro del equipo de salud relacionado con profesión, género, diferencias generacionales y jerarquías administrativas. Conclusión: Se devela la existencia de relaciones de poder que influencian el ejercicio del liderazgo de enfermería, lo que ha obstaculizado la participación de enfermería en cargos directivos, precisando fortalecer las capacidades de liderazgo de enfermería. (AU)

Objective: Knowing the nursing leadership perception from power relationships, based on nurses, recently graduated nurses and the healthcare team's opinions. Methods: Qualitative research, case study type, with a phenomenological approach. It was developed in two phases, with the ethics committee's approval. A convenience sample was used, considering nurses, newly qualified nurses and health care providers. Semi-structured interviews were applied. Content analysis and application of the COREQ-32 guideline were performed. Results: The power relationships category shows a historical evolution of nursing leadership and power dynamics within the healthcare team related to profession, gender, generational differences and administrative hierarchies. Conclusions: It reveals the existence of power relationship that influence the exercise of nursing leadership, which has hindered the participation of nursing in managerial positions, requiring the strengthening of nursing leadership capacities. (AU)

Longevity and Neutralizing Capacity of IgG Antibodies against SARS-CoV-2 Generated by the Application of BNT162b2, AZD1222, Convidecia, Sputnik V, and CoronaVac Vaccines: a Cohort Study in the Mexican Population.

The WHO has approved the use of several vaccines during the COVID-19 pandemic; experience over the last 2 years has indicated that dose demand can only be covered using more than one design. Therefore, having scientific evidence of the performance of the different vaccines applied in a country is highly relevant. In Mexico, 5 vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were used, allowing a cohort study to analyze the generation of anti-S1/S2 IgG antibodies and anti-RBD antibodies with neutralizing activity at 0, 21, 90, and 180 days after vaccination. Five groups of participants were formed on the basis of the type of vaccine received and were divided on the basis of whether they previously had or did not have COVID-19. After completing the vaccination schedule, the seroprevalence was 95.5, 97.5, 81.0, 95.2, and 90.0% (BNT162b2, AZD1222, Convidecia, Sputnik V, and CoronaVac, respectively). Among the participants without COVID-19 prior to vaccination, the largest amount of antibodies in the 90-day period was observed in the BNT162b2 group, and the amount of antibodies in the Sputnik V group decreased the least over time. Even though the percentages of seroconversion obtained in this study were lower than those currently reported in other parts of the world, the tested vaccines are able, in most cases, to induce a good production of IgG antibodies anti-S1/S2 and neutralizing capacity. The fact that there are people who have not produced antibodies during the study leaves open some questions that must be investigated to avoid the appearance of serious cases of COVID-19. IMPORTANCE Since the start of the vaccination programs against COVID-19 in 2020, it was evident that due to global shortages, the demand for the dose required in Mexico could only be covered by acquiring different vaccines. Therefore, determining the effectiveness of these and the longevity of acquired immunity is extremely important in a scenario where SARS-CoV-2 circulation becomes endemic and booster doses are required periodically. Our data reveal significant differences both in the generation of antibodies as well as in their longevity for the vaccines applied in the country but suggest that, in general, the Mexican population can reach a high capacity to neutralize the virus, therefore, regarding less the variant for which they were designed.

Liderazgo en enfermería, una mirada desde la opinión de egresadas/os de enfermería y miembros del equipo de salud / Liderança em enfermagem, um olhar a partir da opinião de egressos de enfermagem e membros da equipe de saúde / Leadership in nursing, a look from the opinion of graduates of nursing and members of the health team

Nursing leadership is considered an essential skill for professional practice and necessaryto develop from undergraduate training. Objective: to know the perception of the leadership exercised by the nursing professional, from the opinion of graduates of the nursing career and membersof the health team. Methodology: Qualitative, exploratory, descriptive research, case study type.Semi-structured interviews and content analysis were applied. Results: the interviewees considerleadership as a tool that contributes to the achievement of collective goals through a process of influence and transformation, the nursing professional develops transformational leadership competencies in undergraduate courses, which are at the service of management and health administration. Power and interpersonal relationships affect the exercise of leadership and the important leadership role that nursing has played during the pandemic is highlighted. Conclusion: The leadershipexercised favors teamwork and goal achievement, it being important to promote this training linethrough the progression of management and leadership skills. Among the challenges are developing new research on leadership and expanding its influence on public policies, as a relevant axis forstrengthening the sociopolitical role of the profession. (AU)

El liderazgo en enfermería es considerada una habilidad imprescindible para el ejercicioprofesional y necesaria de desarrollar desde la formación de pregrado. Objetivo: conocer la percepción del liderazgo ejercido por el profesional de enfermería, desde la opinión de egresadas/os de lacarrera de enfermería y miembros del equipo de salud. Metodología: Investigación cualitativa, exploratoria, descriptiva, tipo estudio de caso. Se aplicaron entrevistas semiestructuradas y análisis decontenido. Resultados: las/os entrevistadas/os consideran el liderazgo como una herramienta quecontribuye al logro de metas colectivas mediante un proceso de influencia y transformación, elprofesional de enfermería desarrolla en pregrado competencias de un liderazgo transformacional,las cuales están al servicio de la gestión y administración en salud. Las relaciones de poder e interpersonales, inciden en el ejercicio de liderazgo y se destaca el importante rol de liderazgo que enfermería ha cumplido durante la pandemia. Conclusión: El liderazgo ejercido favorece el trabajo enequipo y logro de metas, resultando importante potenciar esta línea formativa mediante la progresión de competencias de gestión y liderazgo. Entre los desafíos se encuentran desarrollar nuevas investigaciones en liderazgo y ampliar su influencia en políticas públicas, como un eje relevantepara el fortalecimiento del rol sociopolítico de la profesión. (AU)

A liderança em enfermagem é considerada uma habilidade essencial para a prática profissional e necessária para desenvolver desde a formação na graduação. Objetivo: conhecer a percepção da liderança exercida pelo profissional de enfermagem, a partir da opinião de egressos da carreira de enfermagem e membros da equipe de saúde. Metodologia: Pesquisa qualitativa, exploratória, descritiva, tipo estudo de caso. Foram aplicadas entrevistas semiestruturadas e análise de conteúdo. Resultados: os entrevistados consideram a liderança como uma ferramenta que contribuipara o alcance dos objetivos coletivos por meio de um processo de influência e transformação, oprofissional de enfermagem desenvolve na graduação competências de liderança transformacional,que estão a serviço da gestão e administração em saúde. O poder e as relações interpessoais afetamo exercício da liderança e destaca-se o importante papel de liderança que a enfermagem tem desempenhado durante a pandemia. Conclusão: A liderança exercida favorece o trabalho em equipa e aconcretização de objetivos, sendo importante promover esta linha de formação através da progressão das competências de gestão e liderança. Entre os desafios estão desenvolver novas pesquisassobre liderança e ampliar sua influência nas políticas públicas, como eixo relevante para o fortalecimento do papel sociopolítico da profissão. (AU)

Quality of Work Life and Work Process of Assistance Nurses.

BACKGROUND: The concept of Quality of Work Life (QWL) has been built multidimensionally through social reproduction; it is impacted by the perceptions of each individual and by the relationship between workers and the work environment. OBJECTIVE: to analyze the Work Process and QWL of assisting nurses in public health. METHODS: Research in a critical paradigm, descriptive, exploratory with a qualitative approach. The population corresponds to nurses who work in care work. Semi-structured guiding questions were applied and were analyzed with content analysis. RESULTS: seven participants declared female; all Chilean; seven are young adults; six singles; only one has children, and one has a person dependent on her care; six are heads of household, and five receive help with housework. All have a nursing degree, five have a diploma, but none have a postgraduate. The work process has three subcategories: work object, instrument, organization, and work conditions; the QWL category has six subcategories: definition and perception of QWL, QWL potentiating factors, QWL exhausting factors, QWL improvement strategies, the emotional burden associated with QWL, and health problems. CONCLUSIONS: In this way, the lifestyle built by the assistance in the health area has repercussions on the quality of life and health in general.

A pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area.

OBJECTIVE: Morbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging. RESULTS: The primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow-up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value: < 0.001, SOC p-value:0.049). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach. CLINICAL TRIAL: Trial Registration: Retrospectively registered (10/20/2020) NCT04594109.

Percepción de enfermeras/os de atención hospitalaria y primaria de salud, sobre el liderazgo de Enfermería / Perception of nurses in hospital and primary health care, on nursing leadership / Percepção de enfermeiros em hospital e atenção primária à saúde, sobre liderança em Enfermagem

INTRODUCCIÓN: La legislación chilena atribuye a enfermería la Gestión de Cuidados, implica autonomía, requiriendo enfermeras/os capaces de practicar "liderazgo efectivo" contribuyendo a la óptima salud de la población. Sin embargo, se ha instalado la percepción de que enfermería a nivel nacional ha perdido espacios de opinión y toma de decisiones, lo que hace relevante indagar apreciaciones desde las/os protagonistas respecto al ejercicio de liderazgo en sus prácticas. MATERIAL Y MÉTODO: Investigación cualitativa, descriptiva, tipo estudio de caso, utiliza análisis de contenido. RESULTADOS Y DISCUSIÓN. En la percepción del liderazgo de enfermería predominan características del liderazgo transformacional. Reconocen una directa relación entre ejercicio de liderazgo y la calidad del cuidado brindado a las personas. Se identificó como facilitadores del liderazgo habilidades personales, la formación profesional y trayectoria del ejercicio laboral. Emergen obstaculizadores como dificultades comunicativas, relaciones de subordinación asociada al género femenino y profesión no médica, déficit estructural de centros de salud y diferencias generacionales. CONCLUSIÓN: Develan brechas que viven enfermeras/os en ejercicio de liderazgo, junto a favorecedores. Esto permitirá nutrir planes de estudios de pre y post-grado de enfermería, para propiciar el desarrollo de competencias atingentes a los desafíos actuales, contribuyendo al fortalecimiento del rol sociopolítico de enfermería

INTRODUCTION: Chilean legislation attributes to Nursing Care Management, it implies autonomy, requiring nurses capable of practicing "effective leadership" contributing to the optimal health of the population. However, the perception that nursing at the national level has lost spaces of opinion and decision-making has been installed, which makes it relevant to inquire from the protagonists regarding the exercise of leadership in their practices. MATERIAL AND METHOD: Qualitative, descriptive research, case study type, uses content analysis. RESULTS AND DISCUSSION: In the perception of nursing leadership, characteristics of transformational leadership predominate. They recognize a direct relationship between leadership exercise and the quality of care provided to people. Personal skills, professional training and career path were identified as leadership facilitators. Obstaculizers emerge communicative difficulties, relations of subordination associated with the female gender and non-medical profession, structural deficit of health centers and generational differences. CONCLUSION: They reveal gaps that nurses live in the leadership exercise, together with supporters. This will allow to nurture pre and post-graduate nursing curricula, in order to promote the development of competencies at the current challenges, contributing to the strengthening of the sociopolitical role of nursing

INTRODUÇÃO: A legislação chilena atribui à gerência do cuidado de enfermagem, implica autonomia, exigindo enfermeiros capazes de praticar "liderança efetiva", contribuindo para a saúde ideal da população. No entanto, instalou-se a percepção de que a enfermagem em nível nacional perdeu espaços de opinião e tomada de decisão, o que torna relevante a indagação dos protagonistas sobre o exercício da liderança em suas práticas. MATERIAL E MÉTODO: Pesquisa qualitativa, descritiva, tipo estudo de caso, utiliza análise de conteúdo RESULTADOS E DISCUSSÃO: Na percepção da liderança de enfermagem, predominam as características da liderança transformacional. Eles reconhecem uma relação direta entre o exercício da liderança e a qualidade do atendimento prestado às pessoas. Habilidades pessoais, treinamento profissional e plano de carreira foram identificados como facilitadores da liderança. Os obstáculos emergem como dificuldades comunicativas, relações de subordinação associadas ao gênero feminino e à profissão não médica, déficit estrutural dos centros de saúde e diferenças geracionais. CONCLUSÃO: Revelam lacunas que os enfermeiros vivem no exercício de liderança, junto com os apoiadores. Isso permitirá nutrir currículos de enfermagem pré e pós-graduação, a fim de promover o desenvolvimento de competências para os desafios atuais, contribuindo para o fortalecimento do papel sociopolítico da enfermagem

Percepción de profesionales de enfermería sobre la valoración de la sexualidad en adultos mayores (Chile) / Perception of nursing professionals on the assessment of sexuality in older adults (Chile) / Percepção de profissionais de enfermagem sobre a avaliação da sexualidade em idosos (Chile)

Se plantea como objetivo principal de investigación, conocer la percepción de las/os profesionales de enfermería sobre la valoración de la sexualidad del adulto mayor a los que brindan cuidados en la atención primaria de salud. Para ello plantea un estudio cualitativo con enfoque descriptivo y análisis de datos mediante teoría fundamentada, tomando una muestra de estudio elegida por conveniencia y basada ciertos criterios, egresados enfermeros/as de universidades públicas o privadas con mínimo de 2 años de trabajo, trabajar actualmente en APS, excluyendo profesionales egresados de enfermería-obstetricia, poseedores de carrera anexa en obstetricia y no trabajar en APS. En los resultados se establecen cuatro categorías principales, las cuales son "significado que le atribuyen los profesionales a la sexualidad", "relevancia de la sexualidad en adultos mayores", "factores influyentes en la valoración de la sexualidad", "fortalezas y debilidades profesionales en la valoración", además aparecen categorías emergentes, que son: "factores por mejorar al valorar la sexualidad", "necesidad de un instrumento de valoración de la sexualidad". Se establece que la sexualidad como elemento vital en la salud de los adultos mayores influenciada estrictamente por factores socio-culturales, además de la creciente necesidad de un instrumento que permita valorar la sexualidad y orientaciones técnicas a nivel ministerial

The main objective of this research is to know the perception of the nursing professionals about the assessment of the sexuality of the elderly in primary health care. To this end, a qualitative study has been proposed with an approach based on chosen for convenience and based on criteria such as graduates from public or privateuniversities with a minimum of 2 years of work, currently working in APS, professional graduates of nursing-obstetrics were excluded, to have an attached career in obstetrics and not to work in APS. Four main categories are established which are "meaning that professionals attribute to sexuality", "relevance of sexuality in older adults", "influential factors in the assessment of sexuality", "professional strengths and weaknesses in assessment" In addition, two emergent categories appear, which are "factors to be improved by valuing sexuality" and "the need for an instrument to assess sexuality". It establishes that sexuality is a vital element in the health of older adults influenced strictly by cultural and social factors, in addition to the growing need for an instrument that allows to value sexuality and technical orientations at the ministerial level

Propõe-se como objetivo principal desta pesquisa saber a percepção dos profissionais de enfermagem sobre a avaliação da sexualidade do ancião em cuidado médico primário. Para este fim, um estudo qualitativo foi proposto com uma aproximação baseado em teoria fundamentada, enquanto levando uma amostra de estudo escolhida para conveniência e baseado em critérios como diplomados de público ou universidades privadas com um mínimo de 2 anos de trabalho, trabalhando atualmente em APS, foram excluídos os diplomados profissionais de lactância-obstetrícias, ter uma carreira fixa em obstetrícias e não trabalhar em APS.São estabelecidas quatro categorias principais que são "significado que os profissionais atribuem à sexualidade", "relevância da sexualidade em idosos", "fatores influentes na avaliação da sexualidade", "forças e fraquezas profissionais na avaliação" , também aparecem duas categorias emergentes que são "fatores para melhorar quando se avalia a sexualidade", "necessidade de um instrumento para avaliar a sexualidade". Ele afirma que a sexualidade é um elemento vital na saúde dos idosos influenciados estritamente por fatores culturais e sociais, além da necessidade crescente de um instrumento que permita valorizar adequadamente a sexualidade e de orientações técnicas em nível ministerial

Systematic Review of School Telehealth Evaluations.

School telehealth is an alternative delivery model to increase student health-care access with minimal evaluation to aid decision makers in the adoption or expansion of programs. This systematic review assesses school-based telehealth programs using a dissemination and implementation (D&I) framework to inform practitioners and decision makers of the value of school telehealth. We assessed findings from 20 studies on telehealth published between January 2006 and June 2018 and summarized program evaluation on a range of D&I constructs. The sample population included children in school- or center-based early childhood education under age 22 and included parents, providers, and school personnel across urban and suburban locations. There is some evidence that school telehealth can reduce emergency department visits and improve health status for children with chronic and acute illnesses. Future research should report on barriers and facilitators of implementation of programs, including costs related to application of telehealth services and utilization rates.

Percepción de enfermería respecto a la atención hospitalaria otorgada a personas que viven con VIH / Percepção da enfermagem em relação a atenção hospitalar dada para pessoas que vivem com HIV / Nursing perception regarding the attention given in hospitals to patients that live with HIV

Resumen: Dado el contexto epidemiológico en Chile referente al alza de la cantidad de personas con VIH, cobra relevancia el fortalecimiento del cuidado otorgado a estos pacientes. Por esto, el objetivo de esta investigación es conocer la percepción de enfermeras(os) respecto a la atención otorgada a personas que viven con VIH (PVVIH) en un servicio hospitalario de atención terciaria de salud, buscando contribuir a la enfermería. Para ello se utilizó un paradigma de investigación cualitativo tipo estudio de caso, recolectando la información con una entrevista semiestructurada, finalizando con un análisis del discurso de tipo semiótico. Se destacó que en las primeras atenciones se generaba "temor" en la atención a PVVIH, el que desaparecía a medida que aumentaban los conocimientos de la profesional. Enfermeras participantes refirieron la inexistencia de diferencias en la atención entre PVVIH y otros pacientes, evidenciándose una incongruencia entre el discurso y el actuar en enfermería al ocupar mayores medidas de precaución al realizar procedimientos a PVVIH. Como fortalezas identificadas en la atención a PVVIH se encontró el no discriminar a pacientes, la capacidad de enfrentar distintos contextos de atención y la destreza procedimental, entre otras, mientras que los aspectos a mejorar en la atención se vincularon con la relación que se genera con los PVVIH y sus familiares. Como conclusión, las enfermeras no hacen mayores distinciones en la atención con PVVIH. Es importante que las profesionales reconozcan sus habilidades y aspectos a mejorar para seguir humanizando la atención a PVVIH, siendo agentes educadores y de cambio.

Resumo: Dado o contexto epidemiológico no Chile referente ao aumento das pessoas com HIV, é relevante a necessidade de fortalecer os cuidados desses pacientes. Devido a isso, o objetivo de esta pesquisa é conhecer a percepção de enfermeiros(as) em relação a atenção fornecida para as pessoas que vivem com HIV num serviço hospitalar de atenção terciária em saúde, buscando contribuir para a disciplina e profissão de enfermagem. Para isso se utilizou um paradigma de pesquisa qualitativo tipo estudo de caso, o meio para reunir informação foi a entrevista semiestruturada, finalizando com uma análise de discurso. Destacou que nas primeiras atenções de pessoas portadoras de HIV o "temor" era perceptível. "Temor" que desaparecia à medida que o conhecimento do profissional aumentava. Enfermeiros participantes falaram que não existe diferença alguma na forma de atenção de pacientes portadores de HIV, mas se notou uma incongruência entre o discurso e a atuação da enfermagem ao tomar maiores medidas de precaução no momento de realizar procedimentos com esses pacientes. Pontos fortes identificados na atenção de portadores de HIV foram a não discriminação dos pacientes, a capacidade de enfrentar-se a distintos contextos na atenção, as habilidades de procedimentos, entre outras. Enquanto aos aspectos a melhorar na atenção se vincularam com a relação que se gera como os pacientes portadores de HIV e seus familiares Como conclusão os enfermeiros( não fazem maiores distinções na atenção de pacientes com HIV. É importante que os profissionais reconheçam suas habilidades e pontos para melhorar e assim continuar avançando na humanização da atenção dos portadores de HIV conseguindo ser agentes educadores e de mudança.

Abstract: Given the epidemiological context in Chile concerning the increased quantities of people with HIV, improving the care given to these patients becomes relevant. The objective of this research is to find about the perception of nurses concerning the care given to people living with HIV (PLHIV) in a tertiary health care hospital service, seeking to contribute to nursing improvements. In order to accomplish this task a qualitative research paradigm was used as a type of case study, collecting the information with a semi-structured interview, ending with a semiotic analysis of the discourse. It was pointed out that in the first sessions there is some fear generated in the attention to PLHIV, which gradually disappears with the increase of the professional's knowledge. Participating nurses referred to the lack of differences in care between PLHIV and other patients, evidencing an incongruence between the speech and the action by taking greater precautions when performing procedures for PLHIV. The strengths identified in the attention to PLHIV were the no discrimination to these patients, the ability to face different contexts of attention and the procedural skills, among others, while aspects to improvement in care were linked to the relationship that is generated with PLHIV and their families. In conclusion, nurses do not make noticeable distinctions in the care of PLVIH. It is important that professionals recognize their skills and the aspects that can be improved in order to continue humanizing the attention to PLHIV, acting as educators and agents of change.

Genetic divergence in the common bush-tanager Chlorospingus ophthalmicus (Aves: Emberizidae) throughout Mexican cloud forests: The role of geography, ecology and Pleistocene climatic fluctuations.

By integrating mitochondrial DNA (mtDNA), microsatellites and ecological niche modelling (ENM), we investigated the phylogeography of Mexican populations of the common bush-tanager Chlorospingus ophthalmicus to examine the relative role of geographical and ecological features, as well as Pleistocene climatic oscillations in driving the diversification. We sequenced mtDNA of individuals collected throughout the species range in Mexico and genotyped them at seven microsatellite loci. Phylogeographic, population genetics and coalescent methods were used to assess patterns of genetic structure, gene flow and demographic history. ENM was used to infer contractions and expansions at different time periods as well as differences in climatic conditions among lineages. The retrieved mitochondrial and microsatellite groups correspond with the fragmented cloud forest distribution in mountain ranges and morphotectonic provinces. Differing climatic conditions between mountain ranges were detected, and palaeodistribution modelling as well as demographic history analyses, indicated recent population expansions throughout the Sierra Madre Oriental (SMO). The marked genetic structure of C. ophthalmicus was promoted by the presence of ecological and geographical barriers that restricted the movement of individuals among mountain ranges. The SMO was mainly affected by Pleistocene climatic oscillations, with the moist forests model best fitting the displayed genetic patterns of populations in this mountain range.

Contaminación bacteriana generada por aerosoles en ambiente odontológico / Analysis of bacterial contamination produced by aerosols in dental clinic environments

En odontología estamos expuestos a muchos microorganismos por la producción de aerosoles. Por ello es esencial conocer la naturaleza de éstos y su potencial patogénico. El objetivo de esta investigación es determinar contaminación bacteriana, generada por aerosoles durante procedimientos odontológicos, con uso de pieza de mano de alta velocidad, realizados por alumnos de la carrera, en Clínica Odontológica Docente Asistencial (CODA), Universidad de La Frontera, Temuco, Chile. Estudio con muestra aleatoria, de 16 de un total de 32 unidades dentales, estratificado por box, con 40 muestras, ocho placas control y 32 placas prueba. El medio de cultivo, se mantuvo por diez minutos, donde se realizaron acciones de operatoria con turbina, bajo aislamiento absoluto, ubicadas en frente del operador y pechera del paciente. Las muestras fueron analizadas microscópicamente, incubadas a 37°C en atmósfera de oxígeno por 24 horas y dióxido de carbono a las 48 horas. Treinta y dos placas prueba fueron positivas, registrándose diversidad de crecimiento bacteriano, promedio 58,874 Unidad Formadora de Colonias (UFC) por unidad dental. El mayor porcentaje de microorganismos fueron: Bacillus spp. (28,56%) y Bacilos Gram positivos (24,31%). Siete placas control resultaron negativas y una con 3 UFC de Micrococcus spp. La mayoría de los microorganismos encontrados son comensales potencialmente patógenos. Al comprobar que los aerosoles constituyen una fuente importante de emisión de microorganismos, se hace imprescindible cumplir con todas las normas de bioseguridad que protegen tanto al operador como al paciente

In dental practice we are exposed to many microorganisms due to aerosol production. It is essential to be aware of the nature of these elements and their pathogenic potential. The purpose of this research is to determine the presence of bacterial contamination in aerosols produced during dental procedures that require the use of a high speed dental handpiece. These dental procedures were carried out by dentistry students at the dental clinic of the Universidad de La Frontera. In order to determine the presence of bacteria in aerosols, cultivation plates were used. A total of 40 samples were taken from 16 dentistry students while performing dental procedures that required the use of a high speed dental handpiece in conditions of complete isolation. Eight control plates and 32 test plates were used. Two selected areas were examined: operator´s front andpatient´s chest protector, during 10 minutes. The samples were then taken to the laboratory and incubated in an oxygen atmosphere for 24 hours and subsequently in carbon dioxide for another 24 hours at a temperature of 37 degrees Celsius. Finally the samples were microscopically analyzed. Seven control plates showed no bacterial contaminants and one showed 3UFC of Micrococcus spp. The 32 test plates were found to be positive showing diverse bacterial growth (58.874 UFC average per subject). The highest percentage of microorganisms was constituted by Bacillus spp. (28.56 %) and Bacillus Grampositivos (24.31 %), representing more than 50% of the total. The majority of the microorganisms found belong to the commensal family, although they can change into opportunistic pathogen microorganisms. Verifying that aerosols are an important source of emission of microorganisms, it is essential to comply with all biosecurity standards in order to protect the operator as well as the patient

Roles of mGluR5 in synaptic function and plasticity of the mouse thalamocortical pathway.

The group I metabotropic glutamate receptor 5 (mGluR5) has been implicated in the development of cortical sensory maps. However, its precise roles in the synaptic function and plasticity of thalamocortical (TC) connections remain unknown. Here we first show that in mGluR5 knockout (KO) mice bred onto a C57BL6 background cytoarchitectonic differentiation into barrels is missing, but the representations for large whiskers are identifiable as clusters of TC afferents. The altered dendritic morphology of cortical layer IV spiny stellate neurons in mGluR5 KO mice implicates a role for mGluR5 in the dendritic morphogenesis of excitatory neurons. Next, in vivo single-unit recordings of whisker-evoked activity in mGluR5 KO adults demonstrated a preserved topographical organization of the whisker representation, but a significantly diminished temporal discrimination of center to surround whiskers in the responses of individual neurons. To evaluate synaptic function at TC synapses in mGluR5 KO mice, whole-cell voltage-clamp recording was conducted in acute TC brain slices prepared from postnatal day 4-11 mice. At mGluR5 KO TC synapses, N-methyl-D-aspartate (NMDA) currents decayed faster and synaptic strength was more easily reduced, but more difficult to strengthen by Hebbian-type pairing protocols, despite a normal developmental increase in alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR)-mediated currents and presynaptic function. We have therefore demonstrated that mGluR5 is required for synaptic function/plasticity at TC synapses as barrels are forming, and we propose that these functional alterations at the TC synapse are the basis of the abnormal anatomical and functional development of the somatosensory cortex in the mGluR5 KO mouse.