Quantification of viable protozoan parasites on leafy greens using molecular methods.

Protozoan contamination in produce is of growing importance due to their capacity to cause illnesses in consumers of fresh leafy greens. Viability assays are essential to accurately estimate health risk caused by viable parasites that contaminate food. We evaluated the efficacy of reverse transcription quantitative PCR (RT-qPCR), propidium monoazide coupled with (q)PCR, and viability staining using propidium iodide through systematic laboratory spiking experiments for selective detection of viable Cryptosporidium parvum, Giardia enterica, and Toxoplasma gondii. In the presence of only viable protozoa, the RT-qPCR assays could accurately detect two to nine (oo)cysts/g spinach (in 10 g processed). When different proportions of viable and inactivated parasite were spiked, mRNA concentrations correlated with increasing proportions of viable (oo)cysts, although low levels of false-positive mRNA signals were detectable in the presence of high amounts of inactivated protozoa. Our study demonstrated that among the methods tested, RT-qPCR performed more effectively to discriminate viable from inactivated C. parvum, G. enterica and T. gondii on spinach. This application of viability methods on leafy greens can be adopted by the produce industry and regulatory agencies charged with protection of human public health to screen leafy greens for the presence of viable protozoan pathogen contamination.

Simultaneous detection of four protozoan parasites on leafy greens using a novel multiplex PCR assay.

Pathogen contamination of fresh produce presents a health risk for consumers; however, the produce industry still lacks adequate tools for simultaneous detection of protozoan parasites. Here, a simple multiplex PCR (mPCR) assay was developed for detection of protozoan (oo)cysts and compared with previously published real-time PCR assays and microscopy methods. The assay was evaluated for simultaneous detection of Cryptosporidium, Giardia, Cyclospora cayetanensis, and Toxoplasma gondii followed by parasite differentiation via either a nested specific PCR or a restriction fragment length polymorphism (RFLP) assay. Spiking experiments using spinach as a model leafy green were performed for assay validation. Leaf-washing yielded higher recoveries and more consistent detection of parasites as compared with stomacher processing. Lowest limits of detection using the nested mPCR assay were 1-10 (oo)cysts/g spinach (in 10 g samples processed), and this method proved more sensitive than qPCR for parasite detection. Microscopy methods were more reliable for visual detection of parasites in lower spiking concentrations, but are more costly and laborious, require additional expertise, and lack molecular confirmation essential for accurate risk assessment. Overall, the nested mPCR assay provides a rapid (<24 h), inexpensive ($10 USD/sample), and simple approach for simultaneous detection of protozoan pathogens on fresh produce.

California mussels (Mytilus californianus) as sentinels for marine contamination with Sarcocystis neurona.

Sarcocystis neurona is a terrestrial parasite that can cause fatal encephalitis in the endangered Southern sea otter (Enhydra lutris nereis). To date, neither risk factors associated with marine contamination nor the route of S. neurona infection to marine mammals has been described. This study evaluated coastal S. neurona contamination using California mussels (Mytilus californianus) as sentinels for pathogen pollution. A field investigation was designed to test the hypotheses that (1) mussels can serve as sentinels for S. neurona contamination, and (2) S. neurona contamination in mussels would be highest during the rainy season and in mussels collected near freshwater. Initial validation of molecular assays through sporocyst spiking experiments revealed the ITS-1500 assay to be most sensitive for detection of S. neurona, consistently yielding parasite amplification at concentrations ⩾5 sporocysts/1 mL mussel haemolymph. Assays were then applied on 959 wild-caught mussels, with detection of S. neurona confirmed using sequence analysis in three mussels. Validated molecular assays for S. neurona detection in mussels provide a novel toolset for investigating marine contamination with this parasite, while confirmation of S. neurona in wild mussels suggests that uptake by invertebrates may serve as a route of transmission to susceptible marine animals.

Dual congenital transmission of Toxoplasma gondii and Sarcocystis neurona in a late-term aborted pup from a chronically infected southern sea otter (Enhydra lutris nereis).

Toxoplasma gondii and Sarcocystis neurona are protozoan parasites with terrestrial definitive hosts, and both pathogens can cause fatal disease in a wide range of marine animals. Close monitoring of threatened southern sea otters (Enhydra lutris nereis) in California allowed for the diagnosis of dual transplacental transmission of T. gondii and S. neurona in a wild female otter that was chronically infected with both parasites. Congenital infection resulted in late-term abortion due to disseminated toxoplasmosis. Toxoplasma gondii and S. neurona DNA was amplified from placental tissue culture, as well as from fetal lung tissue. Molecular characterization of T. gondii revealed a Type X genotype in isolates derived from placenta and fetal brain, as well as in all tested fetal organs (brain, lung, spleen, liver and thymus). This report provides the first evidence for transplacental transmission of T. gondii in a chronically infected wild sea otter, and the first molecular and immunohistochemical confirmation of concurrent transplacental transmission of T. gondii and S. neurona in any species. Repeated fetal and/or neonatal losses in the sea otter dam also suggested that T. gondii has the potential to reduce fecundity in chronically infected marine mammals through parasite recrudescence and repeated fetal infection.

Hepatitis C seroprevalence in an at-risk population in the southwest Madrid region of Spain. / Seroprevalencia de hepatitis C en población con factores de riesgo del suroeste de la Comunidad de Madrid.

INTRODUCTION: The estimated seroprevalence of hepatitis C virus (HCV) in Spain is 1.7%, but is much higher in the at-risk population. The most efficient national screening strategy is unclear. AIMS: To estimate the prevalence of HCV among the at-risk population seen in primary care (PC), and to determine their epidemiological profile. MATERIALS AND METHODS: Cross-sectional descriptive prevalence study that included adult patients with risk factors for HCV infection seen in PC in the southwest Madrid region between 2010 and 2012. RESULTS: A total of 158 patients (men=51.3%), mean age 46 years (SD=16.6), were included. The most common risk factors were hypertransaminasaemia (44.3%) and major surgery (13.3%). Immigration, unsafe sexual practices, and tattoos or body piercing were more prevalent in patients younger than 45 years of age. Fifteen patients (9.5%) were positive for anti-HCV; 9 of these (5.7%) were HCV-ARN positive. Of the positive patients, 4 (44.4%) had significant fibrosis at diagnosis (F3-F4). Male patients had a higher rate of positive anti-HCV results (13.8 vs. 5.3%; P=.072), as did patients older than 45 years of age (12.8 vs. 6.3%; P=.167). Intravenous and intranasal drug use were associated with a higher rate of positive anti-HCV results (50 vs. 8.5%; P=.005 and 66.7 vs. 8.4%; P=.001, respectively). CONCLUSIONS: Patients with risk factors for HCV infection have high seroprevalence. Screening programmes must therefore be implemented to detect HCV infection in this population in PC.

Surveillance for Toxoplasma gondii in California mussels (Mytilus californianus) reveals transmission of atypical genotypes from land to sea.

Coastal habitat contamination with Toxoplasma gondii is a health risk to humans and marine wildlife, with infections documented in both nearshore and pelagic marine mammals. Due to lack of sensitive methods for detection of T. gondii in water, this study utilized an alternative surveillance approach for evaluating marine habitat contamination using wild mussels. The objectives of this study were to (i) validate sensitive molecular tools for T. gondii detection in mussels and (ii) apply optimized methods in a surveillance study to determine the prevalence and genotype(s) of T. gondii in mussels. Simplex polymerase chain reaction screening and multiplex genotyping assays were validated and then applied on 959 wild-caught mussels collected from central California. Thirteen mussels (1.4%) had detectable T. gondii DNA and the presence of T. gondii in mussels was significantly associated with proximity to freshwater run-off and collection during the wet season. Molecular characterization revealed alleles from T. gondii types I, II/III, X at the B1 locus, and a novel atypical B1 allele that was recently documented in T. gondii-infected carnivores from California. Findings demonstrate higher than previously reported T. gondii contamination of California coastlines, and describe novel strains of the parasite that further link terrestrial sources with marine contamination.

Association of Cardiovascular Risk Factors between Adolescents and Their Parents Is Mitigated by Parental Physical Activity-A Cross-Sectional Study.

INTRODUCTION: It is hypothesized that children's habits can be modulated by their parent's lifestyle. However, it is still not established whether the relationship between cardiovascular risk factors (CVRF) in adolescents and their parents could be attenuated by parental physical activity levels. OBJECTIVE: This study aimed to analyze the relationship of CVRF between adolescents and their parents according to parental physical activity level. METHODS: A school-based sample of 1231 adolescents, 1202 mothers and 871 fathers were included (n = 3304). The CVRF assessed were overweight, hypertension, smoking and alcohol consumption. The parental physical activity level was assessed using a validated questionnaire, being classified into physically active and inactive parents. The statistical analysis considered all parents and stratification by physical activity level. RESULTS: The prevalence of CVRF was higher in fathers than in mothers (70.6% vs. 54.9% for overweight, 23.3% vs. 19.7% for hypertension, 17.9% vs. 12.4% for smoking and 60.4% vs. 28.5% for alcohol consumption). Adolescents with active mothers showed lower prevalence of overweight (13.9% vs. 19.6%), while adolescents with active fathers showed higher prevalence of alcohol consumption (23.5% vs. 16.9%). The CVRF of both fathers and mothers were positively associated with CVRF of adolescents. However, the association of CVRF between adolescents and their parents was mitigated among active parents, while all the CVRF remained associated in physically inactive parents. CONCLUSION: The parental physical activity level seems to mitigate the association of CVRF between adolescents and their parents. The promotion of an active lifestyle at the family level can contribute to reduce CVRF among adolescents.

Leisure-time exercise is associated with lower depressive symptoms in community dwelling adults.

Physical activity has been associated with enhanced mental health among adults. However, it is not clear in the literature which domains (occupational, transport and leisure-time exercise) and intensities (moderate, vigorous and moderate-to-vigorous) of activity provide the greatest benefits. The aim of the present study was to describe the association of different domains and intensities of physical activity with depressive symptoms in adults. This was a cross-sectional observational study conducted among 209 adults (≥18 years) in Brazil. Depressive symptoms were assessed using the HADS questionnaire (Hospital Anxiety and Depression Scale). Physical activity intensities (moderate, vigorous and moderate-to-vigorous) were device-measured by accelerometry. Physical activity in different domains (occupational, transport, and leisure-time exercise) was self-reported using a questionnaire. Chronological age, ethnicity, body mass index, highest academic achievement, employment status, alcohol consumption, tobacco smoking, chronic morbidity and soft-drink ingestion were adopted as adjustment confounding factors. Linear regression analysis revealed that total self-reported physical activity [ß = -0.100 (95%CI: -0.180 to -0.019)] and leisure-time exercise [ß = -0.311 (95%CI: -0.468 to -0.155)] were negatively associated with depressive symptoms, but only leisure-time exercise remained significant after adjustment for confounding factors [ß = -0.243 (95%CI: -0.409 to -0.076)]. Thus, leisure-time exercise was cross-sectionally associated with lower depressive symptoms in community-dwelling adults.HighlightsLeisure-time physical activity was the only physical activity domain associated with lower depressive symptoms.This association appears to be independent of potential confounders.Potential interventions should focus on leisure-time domain.

Pirfenidone increases IL-10 and improves acute pancreatitis in multiple clinically relevant murine models.

Despite decades of research, there is no specific therapy for acute pancreatitis (AP). In the current study, we have evaluated the efficacy of pirfenidone, an antiinflammatory and antifibrotic agent that is approved by the FDA for treatment of idiopathic pulmonary fibrosis (IPF), in ameliorating local and systemic injury in AP. Our results suggest that treatment with pirfenidone in therapeutic settings (e.g., after initiation of injury), even when administered at the peak of injury, reduces severity of local and systemic injury and inflammation in multiple models of AP. In vitro evaluation suggests that pirfenidone decreases cytokine release from acini and macrophages and disrupts acinar-macrophage crosstalk. Therapeutic pirfenidone treatment increases IL-10 secretion from macrophages preceding changes in histology and modulates the immune phenotype of inflammatory cells with decreased levels of inflammatory cytokines. Antibody-mediated IL-10 depletion, use of IL-10-KO mice, and macrophage depletion experiments confirmed the role of IL-10 and macrophages in its mechanism of action, as pirfenidone was unable to reduce severity of AP in these scenarios. Since pirfenidone is FDA approved for IPF, a trial evaluating the efficacy of pirfenidone in patients with moderate to severe AP can be initiated expeditiously.

Physical activity is more related to adiposity in hypertensive than nonhypertensive middle-aged and older adults.

OBJECTIVE: Adiposity is the main risk factor for hypertension and is negatively related to physical activity. However, it is not clear if this relationship is different according to hypertension. The present study aimed to analyze the relationship of physical activity in different domains with adiposity in hypertensive and nonhypertensive adults. PARTICIPANTS AND METHODS: A sample of 843 adults (61.6% of female) was randomly selected, with a mean age of 56.6 (±18.3) years. Diagnosed hypertension and the use of medicines were self-reported. Physical activity was assessed by questionnaire and blood pressure was measured by the oscillometric device. Adiposity indicators were as follows: BMI, waist circumference, and waist-to-height ratio (WHtR). RESULTS: Hypertension was reported by 44.7% of sample, being higher among older-aged, obese, elevated waist circumference and WHtR, and low physical activity groups. Physical activity was negatively related to BMI (leisure-time physical activity ß = -0.070, total physical activity ß = -0.082), waist circumference (leisure-time physical activity ß = -0.031, total physical activity ß = -0.037), and WHtR (leisure-time physical activity ß = -4.917, total physical activity ß = -5.996) in hypertensive adults. Hypertensive adults who had obesity were more likely to be less active at leisure physical activity [odds ratio (OR) = 2.25] and in total physical activity (OR = 2.46) than hypertensive adults with normal weight. Hypertensive adults with elevated waist circumference and elevated WHtR were more likely to be less active in total physical activity than those hypertensive adults with normal values (OR = 2.34 and 3.33, respectively). CONCLUSION: Leisure time and total physical activity were related to adiposity only in hypertensive adults. Higher physical activity levels could be important to adiposity control in hypertensive population.

Relationship between domains of physical activity and cardiac autonomic modulation in adults: a cross-sectional study.

This study aimed to analyze the relationship of physical activity in different domains with cardiac autonomic modulation in adults. A sample of 252 adults was randomly selected, with mean age of 42.1 (± 16.5) years, being 58% of women. Cardiac autonomic modulation was assessed through indexes of heart rate variability in time (SDNN, RMSSD) and frequency (LF, HF) domains for linear method, and by Poincaré plot for non-linear method (SD1, SD2 components). Domains of PA (occupation, sport, leisure time/commuting, and total) were assessed by Baecke's questionnaire. Variables of age, gender, socioeconomic status (questionnaire) and body mass index (objectively measures) were covariates. Occupational PA was positively related to LF (ß = 2.39, 95% CI 0.24; 4.54), sports PA was positively related to SDNN (ß = 3.26, 95% CI 0.18; 7.05), RMSSD (ß = 4.07, 95% CI 0.31; 7.85), and SD1 (ß = 2.85, 95% CI 0.11; 5.81), and leisure time/commuting PA was positively related to SDNN (ß = 3.36, 95% CI 0.28; 6.70) and RMSSD (ß = 3.53, 95% CI 0.46; 7.52) indexes. Total PA was related to RMSSD (ß = 1.70, 95% CI 0.04; 3.72). Sports, leisure time/commuting, and total PA were related to higher parasympathetic modulation, while occupational PA was related to higher sympathetic modulation to the heart in adults.

Comparison of freeze-thaw cycles for nucleic acid extraction and molecular detection of Cryptosporidium parvum and Toxoplasma gondii oocysts in environmental matrices.

Freeze-thaw DNA extraction methods and PCR primers were compared to optimize detection of Cryptosporidium parvum and Toxoplasma gondii oocysts in different matrices. Increasing FT cycles did not increase parasite DNA detection, and primers targeting the 18S ssrRNA gene yielded the most sensitive detection of C. parvum oocysts.

The relationship between physical activity intensity and domains with cardiac autonomic modulation in adults: An observational protocol study.

INTRODUCTION: Cardiac autonomic modulation is an important marker of cardiovascular health and the practice of physical activity is a fundamental tool for good maintenance or increments in this marker. However, it is not clear in the literature whether different intensities and different domains of physical activity are related in the same way to cardiac autonomic modulation. OBJECTIVES: This randomized epidemiologic study will examine the relationship between cardiac autonomic modulation and different intensities and domains of physical activity in a representative sample of adults. METHODS: The sample of study will consist of 252 subjects aged from 18 years and above. The sample will be randomized through census sectors in which the neighborhoods, streets, and houses will also be randomized. Cardiac autonomic modulation will be assessed by heart rate variability and the intensity (mild, moderate, intense) of physical activity will be evaluated by means of accelerometers, while the different domains of physical activity (physical activity at work, occupational activities) will be evaluated through a questionnaire. The relationship between cardiac autonomic modulation and different physical activity intensities, as well as the different domains will be analyzed by linear regression, considering a statistical significance of 5% and a 95% confidence interval. This research protocol is registered in ClinicalTrials.gov at number NCT03986879.

Fecal indicator bacteria and zoonotic pathogens in marine snow and California mussels (Mytilus californianus).

Pollution of nearshore waters with disease-causing microorganisms impacts ecosystems health through illness and deaths in people and wildlife, as well as negative socioeconomic consequences of impaired marine resources. Insight on pathogen ecology in coastal habitats is crucial for accurately mitigating inputs and impacts of microbial pollution. Three objectives were addressed to (i) compare fecal pollution in proximity to (a) freshwater runoff, and (b) endemic marine wildlife; (ii) evaluate presence and magnitude of fecal microorganisms in marine snow and mussels and (iii) determine if pathogens in mussels and FIB levels in seawater or mussels are correlated. Sampling during the wet season, proximity to freshwater, and FIB levels in mussel homogenates (but not seawater) were associated with pathogen presence in mussels. Pathogens and FIB were enriched in aggregate-rich fractions, further supporting an important role of marine snow in pathogen transmission. The lack of association between FIB in surrounding waters and presence of pathogens in mussels calls into question current regulations for insuring safe seafood to consumers in the United States, and alternative monitoring approaches such as direct testing for select pathogens should be further evaluated.

Alternative glacial-interglacial refugia demographic hypotheses tested on Cephalocereus columna-trajani (Cactaceae) in the intertropical Mexican drylands.

Historic demography changes of plant species adapted to New World arid environments could be consistent with either the Glacial Refugium Hypothesis (GRH), which posits that populations contracted to refuges during the cold-dry glacial and expanded in warm-humid interglacial periods, or with the Interglacial Refugium Hypothesis (IRH), which suggests that populations contracted during interglacials and expanded in glacial times. These contrasting hypotheses are developed in the present study for the giant columnar cactus Cephalocereus columna-trajani in the intertropical Mexican drylands where the effects of Late Quaternary climatic changes on phylogeography of cacti remain largely unknown. In order to determine if the historic demography and phylogeographic structure of the species are consistent with either hypothesis, sequences of the chloroplast regions psbA-trnH and trnT-trnL from 110 individuals from 10 populations comprising the full distribution range of this species were analysed. Standard estimators of genetic diversity and structure were calculated. The historic demography was analysed using a Bayesian approach and the palaeodistribution was derived from ecological niche modelling to determine if, in the arid environments of south-central Mexico, glacial-interglacial cycles drove the genetic divergence and diversification of this species. Results reveal low but statistically significant population differentiation (FST = 0.124, P < 0.001), although very clear geographic clusters are not formed. Genetic diversity, haplotype network and Approximate Bayesian Computation (ABC) demographic analyses suggest a population expansion estimated to have taken place in the Last Interglacial (123.04 kya, 95% CI 115.3-130.03). The species palaeodistribution is consistent with the ABC analyses and indicates that the potential area of palaedistribution and climatic suitability were larger during the Last Interglacial and Holocene than in the Last Glacial Maximum. Overall, these results suggest that C. columna-trajani experienced an expansion following the warm conditions of interglacials, in accordance with the GRH.

Sarcocystis fayeri in skeletal muscle of horses with neuromuscular disease.

Recent reports of Sarcocystis fayeri-induced toxicity in people consuming horse meat warrant investigation on the prevalence and molecular characterization of Sarcocystis spp. infection in horses. Sarcocysts in skeletal muscle of horses have been commonly regarded as an incidental finding. In this study, we investigated the prevalence of sarcocysts in skeletal muscle of horses with neuromuscular disease. Our findings indicated that S. fayeri infection was common in young mature horses with neuromuscular disease and could be associated with myopathic and neurogenic processes. The number of infected muscles and number of sarcocysts per muscle were significantly higher in diseased than in control horses. S. fayeri was predominantly found in low oxidative highly glycolytic myofibers. This pathogen had a high glycolytic metabolism. Common clinical signs of disease included muscle atrophy, weakness with or without apparent muscle pain, gait deficits, and dysphagia in horses with involvement of the tongue and esophagus. Horses with myositis were lethargic, apparently painful, stiff, and reluctant to move. Similar to humans, sarcocystosis and cardiomyopathy can occur in horses. This study did not establish causality but supported a possible association (8.9% of cases) with disease. The assumption of Sarcocysts spp. being an incidental finding in every case might be inaccurate.

Estrategias de tratamiento para el edema macular diabético / Treatment strategies for diabetic macular edema

RESUMEN Se hace una revisión bibliográfica acerca del tratamiento que se utiliza en el edema macular clínicamente significativo. Esta es la primera causa de mala visión en los pacientes con diabetes mellitus. Entre las líneas de tratamiento tenemos los antiangiogénicos con sus variantes, los esteroides y la cirugía por medio de la vitrectomía pars plana con pelado de la membrana limitante interna. No existe hasta el momento el tratamiento ideal. La tomografía de coherencia óptica ayuda a predecir la visión final(AU)

ABSTRACT Treatment of clinically significant diabetic macular edema is the topic of our review. This condition is the first cause of vision loss in diabetic patients. Treatment options include anti-VEFG drugs, steroids and surgery (vitrectomy with internal limiting membrane peeling). There is no an ideal treatment at present. Optic coherence tomography is a useful tool to predict final vision in these patients(AU)

Effects of transparent exopolymer particles and suspended particles on the survival of Salmonella enterica serovar Typhimurium in seawater.

The bacterium Salmonella enterica can infect marine mammals and has been increasingly implicated in seafood-borne disease outbreaks in humans. Despite the risk this zoonotic agent poses to animals and people, little is known regarding the environmental factors that affect its persistence in the sea. The goal of this study was to evaluate the impact of two constituents on the survival of Salmonella in the marine environment: transparent exopolymer particles (TEP) and suspended particles. A decay experiment was conducted by spiking Salmonella into bottles containing seawater, seawater with alginic acid as a source of TEP, filtered seawater or filtered seawater with alginic acid. Survival of Salmonella was monitored using culture followed by enrichment assays to evaluate if the bacteria entered a viable but non-cultivable (VBNC) state. Salmonella cell counts dropped significantly faster (P ≤ 0.05) in the unfiltered seawater samples with and without TEP. The slowest decay occurred in filtered seawater containing alginic acid, with VBNC Salmonella persisting for 17 months. These findings suggest that TEP may favor Salmonella survival while suspended particles facilitate its decay. Insight on the survival of allochthonous, zoonotic pathogens in seawater can guide monitoring, management and policy decisions relevant to wildlife and human public health.

Traditional knowledge among Zapotecs of Sierra Madre Del Sur, Oaxaca. Does it represent a base for plant resources management and conservation?

Traditional classification systems represent cognitive processes of human cultures in the world. It synthesizes specific conceptions of nature, as well as cumulative learning, beliefs and customs that are part of a particular human community or society. Traditional knowledge has been analyzed from different viewpoints, one of which corresponds to the analysis of ethnoclassifications. In this work, a brief analysis of the botanical traditional knowledge among Zapotecs of the municipality of San Agustin Loxicha, Oaxaca was conducted. The purposes of this study were: a) to analyze the traditional ecological knowledge of local plant resources through the folk classification of both landscapes and plants and b) to determine the role that this knowledge has played in plant resource management and conservation. The study was developed in five communities of San Agustín Loxicha. From field trips, plant specimens were collected and showed to local people in order to get the Spanish or Zapotec names; through interviews with local people, we obtained names and identified classification categories of plants, vegetation units, and soil types. We found a logic structure in Zapotec plant names, based on linguistic terms, as well as morphological and ecological caracteristics. We followed the classification principles proposed by Berlin [6] in order to build a hierarchical structure of life forms, names and other characteristics mentioned by people. We recorded 757 plant names. Most of them (67%) have an equivalent Zapotec name and the remaining 33% had mixed names with Zapotec and Spanish terms. Plants were categorized as native plants, plants introduced in pre-Hispanic times, or plants introduced later. All of them are grouped in a hierarchical classification, which include life form, generic, specific, and varietal categories. Monotypic and polytypic names are used to further classify plants. This holistic classification system plays an important role for local people in many aspects: it helps to organize and make sense of the diversity, to understand the interrelation among plants-soil-vegetation and to classify their physical space since they relate plants with a particular vegetation unit and a kind of soil. The locals also make a rational use of these elements, because they know which crops can grow in any vegetation unit, or which places are indicated to recollect plants. These aspects are interconnected and could be fundamental for a rational use and management of plant resources.

Metaevaluación de la calidad de la atención de enfermería en un hospital público de San Luis Potosí, México / Metaevaluation of the quality of nursing care in a public hospital in San Luis Potosí, Mexico

Resumen

Introducción: para garantizar que la evaluación de los indicadores de calidad de la atención de enfermería sea un proceso eficiente, se requiere una evaluación del mismo. La evaluación es un proceso que no se ha evaluado como tal; la metaevaluación determina evaluar la suficiencia de este proceso, así como la eficiencia del mismo.

Objetivo: describir el proceso de metaevaluación de los indicadores de calidad de la atención de enfermería en un hospital público de San Luis Potosí, México.

Metodología: enfoque cualitativo de corte etnográfico, participaron 19 enfermeras de diferentes categorías. Los datos se recolectaron mediante la observación participante, entrevista semiestructurada y diario de campo. Se realizó análisis cualitativo temático manual.

Resultados: las principales categorías encontradas para describir el proceso de evaluación de los indicadores de calidad de la atención de enfermería, fueron: indicadores de calidad como guía; formación académica de algunos gestores; evaluación como proceso enseñanza-aprendizaje; evaluación de escritorio; implicación de jerarquías; análisis de resultados, y subjetivismo de la aplicación.

Conclusiones: el proceso de evaluación estudiado por medio de la metaevaluación es discontinuo, lleva una línea que se disgrega por múltiples factores, esto no responde a la conducción de la evaluación que determina la calidad en la atención de enfermería. Se propone una evaluación sistemática con énfasis en el proceso, sin dejar de lado lo establecido por normatividad en el hospital.

Abstract

Introduction: To guarantee the evaluation on the quality indicators of nursing care is an efficient process. It requires an evaluation of this .The evaluation is a complex process that has not been evaluated as such. The metaevaluation assess the adequacy evaluation of this process as well as the efficiency. Objective: The process of evaluation of nursing quality indicators will be described from the target evaluation in a public hospital in San Luis Potosi, Mexico.

Methods: An ethnographic qualitative approach was undertaken. 19 nurses were included technique different category of data collection: participant observation, semi-structured interview and field diary. Thematic qualitative analysis research ethical considerations were respected, as well as quality criteria for qualitative research was conducted.

Results: The main categories found to describe the process of evaluation of the quality indicators of nursing care were: quality indicators as a guide; academic training of some managers; evaluation as a teaching learning process; evaluation desktop; involvement hierarchies, and analysis results. Conclusions: The evaluation process indicators quality of nursing care studied by the metaevaluation is interrupted, leading line disintegrating multiple factors, this does not respond to the conduct of assessment to determine the quality in nursing care .It proposes a systematic evaluation with emphasis on the process, without neglecting established by the regulations in the hospital.