Actitud de los estudiantes de enfermería hacía los adultos mayores evaluada con las escalas de Osgood y Kogan / Attitudes of nursing students towards old patients as measured by Osgood and Kogan scales / Atitude dos estudantes de enfermagem face aos idosos utilizando as escalas de Osgood e Kogan

Introducción: El incremento de la población de adultos mayores, requiere de particular atención y planeación en el área de la salud, así como considerar las actitudes hacia ellos, principalmente por parte de los estudiantes de enfermería quienes los cuidarán después de graduarse. Objetivo: Identificar la actitud que tienen los estudiantes de enfermería hacia el adulto mayor y el interés que muestran en cuidar a esta población. Material y métodos: Estudio descriptivo, cuantitativo y trasversal realizado por medio de una encuesta a una muestra representativa de 283 estudiantes de ambos sexos de la carrera de enfermería. El instrumento de investigación se aplicó para determinar la actitud que tienen los estudiantes hacia el adulto mayor con la utilización de dos escalas: el diferencial semántico de Osgood y la de Kogan. Resultados: Con base en la escala de Osgood el 37.7% de los estudiantes tienen una actitud negativa hacia el adulto mayor y con la escala de Kogan se obtuvo el 47% para esta categoría. En promedio, la actitud de los estudiantes fue valorada como regular, y es el sexo femenino quien tiene más actitudes positivas, independientemente de la escala utilizada. Al 51.9% le gustaría desempeñarse en el área gerontológica. Conclusiones: Los estudiantes de enfermería tienen más actitudes negativas relacionadas principalmente a la fragilidad y necesidades de cuidado que requiere el adulto mayor. Es necesario revisar los programas educativos en enfermería para que el aprendizaje y la comunicación orienten al estudiante desde el inicio de la carrera, para incrementar las experiencias y actitudes positivas hacia este grupo social.

Introduction: The increasing older adult population requires special health attention and planning which should include considerations on the attitudes which nursing students demonstrate while taking care of these individuals. Objective: To identify the attitudes and caring interest which nursing students have towards older adults. Material and methods: This is a descriptive, quantitative, and transversal study which used a survey on a representative sample of 283 nursing students of both sexes to determine their attitudes towards older adults in terms of two scales: the Osgood Semantic differential and the Kogan scale. Results: In terms of the Osgood's scale, 37.7% of students showed a negative attitude towards older adults, while in terms of Kogan's scale, 47% demonstrated a negative attitude. In average, the students' attitude was assessed as regular, though the female students exhibited a more positive attitude regardless of the scale. 51.9% of the sample stated they would accept working in the area of gerontology. Conclusions: Nursing students in general show more negative than positive attitudes towards caring older adults, particularly regarding issues of fragility and special needs. Strengthening the nursing education programs in terms of improving the experiences and attitudes of nursing students towards the older adult population is recommended.

Introdução: O incremento da população de idosos requer de particular atenção e planejamento na área de saúde, assim como considerar as atitudes face a eles, principalmente por parte dos estudantes de enfermagem quem os cuidaram depois de formar-se. Objetivo: Identificar a atitude que têm os estudantes de enfermagem face ao idoso e o interesse que mostram para cuidar a esta população. Material e métodos: Estudo descritivo, quantitativo e transversal realizado por meio de uma enquete a uma amostra representativa de 283 estudantes de ambos os sexos da carreira de enfermagem. O instrumento de pesquisa aplicou-se para determinar a atitude que têm os estudantes face ao idoso com a utilização de duas escalas: o diferencial semântico de Osgood e a de Kogan. Resultados: Com base na escala de Osgood o 37.7% dos estudantes têm uma atitude negativa face ao idoso e com a escala de Kogan obteve-se o 47% para esta categoria. Em média, a atitude dos estudantes foi valorizada como regular, e foi o sexo feminino quem teve mais atitudes positivas, independente da escala utilizada. O 51.9% gostaria de desenvolver-se na área gerontológica. Conclusões: Os estudantes de enfermagem têm mais atitudes negativas relacionadas, principalmente à fragilidade e necessidades de cuidado que requer o idoso. É necessário revisar os programas educativos em enfermagem para que a aprendizagem e a comunicação orientem o estudante desde o início da carreira para incrementar as experiências e atitudes positivas face a este grupo social.

Rehabilitación de las fracturas de cadera. Revisión sistemática / Rehabilitation of hip fractures. Systematic review

Resumen: Introducción: Las fracturas de cadera se consideran entre las lesiones incapacitantes más comunes en mayores de 60 años. Se asocian a un alto índice de mortalidad y es la causa más frecuente de internamiento que requiere tratamiento quirúrgico en unidades médicas dedicadas a la traumatología. Métodos: Esta revisión sistemática tiene como objetivo agrupar, clasificar y reportar el mejor nivel de evidencia en el manejo de terapia física y rehabilitación en los pacientes con fractura pertrocantérica y subtrocantérica de cadera después de la cirugía de osteosíntesis en desenlaces de actividades de la vida diaria, independencia y complicaciones. Resultados: Se identificaron 3,389 resúmenes y a través de otras fuentes 1,567 resúmenes, se eliminaron duplicados en la búsqueda y posterior a un cribado se obtuvieron 378 artículos para la eliminación adicional. De los 62 ensayos restantes se incluyeron 21 y 41 fueron excluidos. Conclusiones: Los resultados a largo plazo de la terapia física especializada parecen ser cruciales en los primeros meses y no tan importantes al cabo de cuatro meses. La literatura actual sostiene que las diferencias en las capacidades de la vida diaria e independencia de los pacientes que sobreviven, el tratamiento de una fractura de cadera tiende a ser similar independientemente del programa de rehabilitación que se tenga.

Abstract: Introduction: Hip fractures are considered among one of the most disabling injuries in patients older than 60 years of age. This fractures are associated with a high incidence of mortality and it is the leading cause of hospital admission that requires surgical treatment in Orthopaedic Trauma Centers. Methods: This systematic review aimed to group, classify and report the best level of evidence of physical therapy and rehabilitation of patients that have been treated with osteostynthesis after trochanteric or subtrochanteric fracture. The outcomes of efficacy and safety were return to activities of daily living, independence and rate of complications. Results: We identified 3,889 abstracts from PubMed, and 1,567 abstracts from other sources, after eliminating duplicates, and posterior to a thorough screening 378 abstracts were read. From these, 316 abstracts were excluded, and 62 articles were considered eligible. After reading for relevant outcomes 41 articles were excluded. Synthesis was based in 21 studies. Conclusions: Long term results of specialized physical therapy, appear to be crucial in the first months after surgery, and not that important after the four months after surgery. Recent literature supports that the differences of daily activities and independence of the patients that survive a hip fracture tend to be similar with no difference in the type of physical therapy.

Effects of Euphorbia milii latex on mitogen-induced lymphocyte proliferation / Efeito do latex de Euphorbia milii sobre a proliferação de linfócitos induzida por mitogénio

The crude latex of "Crown-of-Thorns" (Euphorbia milii var hislopii, syn E.splendens) is a potent plant molluscicide. For this reason, toxicological studies have been performed to evaluate the health risks posed by its use in schistosomiasis control programs. The present study is part of a more comprehensive immunotoxicological evaluation of this molluscicide. Here, we investigated the effects of E. milii latex on the proliferation of human lymphocytes in vitro. Lyophilized latex of E. milii (0, 0.5, 5, 25 and 50 µg/ml) was incubated with whole blood in the presence of proliferation stimulators, i.e. lectins (phytohemagglutinin, concanavalin A and pokeweed mitogen), as well as with human monoclonal antibody against CD3 and tetanus toxoid. Cell proliferation was measured by ³H-thymidine incorporation, and the effects of latex on mitogen-induced cell proliferation were compared to the effects of 10 ng/ml of 12-O-tetradecanoylphorbol-13-acetate (TPA). Results showed that mitogen-induced cell proliferation was markedly enhanced by E. milii latex. This synergistic effect of latex on mitogen-induced lymphocyte proliferation may be due to the presence of TPA-like phorbol esters and/or to mitogenic plant lectins.

O látexbrutoda "Coroa de Cristo" (Euphorbia miliivarhislopii, syn E.splendens) é um potente moluscicidavegetal. Neste sentido, são necessários estudos toxicológicosque visemavaliar possíveis riscos à saúdeassociados ao uso em larga escala desta espécie em áreas endêmicas para esquistossomose. O presente estudo é parte deuma avaliação mais abrangentesobre o potencial tóxico destemoluscicida. Foram investigados in vitro osefeitos dolátex da E.miliisobre a proliferação delinfócitoshumanos. O látexliofilizado (0; 0,5;5;25 e 50 µg/ml)foi incubado comsangue totalna presençade agentes mitogênicos, tais como lectinas(fitohemaglutinina, concanavalina Ae pokeweed), anticorpomonoclonalhumano anti-CD3etoxóide tetânico. A proliferação celularfoi quantificada atravésincorporaçãode ³H-timidina eos efeitos do látexnaproliferação celular induzida por agentes mitogênicosforam comparados comos efeitos de10 ng/mlde12-O-tetradecanoilforbol-13-acetato (TPA). Os resultados demonstram quea proliferação celular induzida poragentes mitogênicosfoimarcadamenteaumentada na presença do látex daE.milii.Oefeito sinérgico observado pode ser devidoà presença deésteres de forbol, como o TPA, e/oude lectinas com ação mitogênica presentes nesta espécie vegetal.

Conductividad iónica en nuevos compósitos (PEO)10(CF3COONa)-X% Al2O3 / Ionic conductivity of (PEO)10(CF3COONa)-X % Al2O3 composites

Se incrementó la conductividad iónica delelectrolito sólido polimérico (PEO)10CF3COONa medianteformación de nuevos compositos, adicionando partículasde óxido de aluminio (Al2O3) como relleno. Los compositosfueron preparados por disolución en solvente líquido y lacaracterización por espectroscopia de impedancias (EI)con configuración de electrodos Pt/electrolito/Pt. Reducciónde hasta dos órdenes de magnitud en la resistencia, seobservó en diagramas de Nyquist; combinando polióxido deetileno (PEO) con trifluoroacetato de sodio (CF3COONa).Al agregar partículas de Al2O3, la reducción en resistenciallego a ser hasta de tres órdenes de magnitud, a temperaturaambiente. Los gráficos de conductividad DC en función dela concentración, mostraron incremento de conductividadiónica a bajas concentraciones de alúmina. El compositoconductor iónico sintetizado mostró conductividadde 2.00x10-5 Scm-1 temperatura ambiente y 7.70x10-4Scm-1, temperatura de 383 K. Se presentó comportamientoArrhenius en dos regiones de diagramas de conductividadcon temperatura, indicando proceso térmicamenteactivado. Para altas concentraciones de Al2O3 se observócomportamiento Vogel-Tamman-Fulcher (VTF). Lasvariaciones de conductividad con concentración de Al2O3,están asociadas con número de sitios involucrados entrasporte iónico, a través de interacciones Lewis ácido–base,entre partículas de Al2O3 y especies iónicas del electrolito...

To increase the ionic conductivity of solid polymer electrolyte, (PEO)10CF3COONa, we formed newcomposites by adding alumina particles as a filler. We prepared these composites by dissolving them ina liquid solvent, and characterized them through impedance spectroscopy (IS), using a Pt/electrolyte/Ptelectrode configuration. The combination of polyethylene oxide (PEO) with sodium trifluoroacetate(CF3COONa) produced a reduction in resistance of up to two orders of magnitude in Nyquist plots, andup to three orders of magnitude when we added Al2O3 particles at room temperature. DC conductivityconcentration graphs show an increase in the ionic conductivity with low alumina concentrations. Thenew synthesized ionic conductor composite presented conductivity values of 2.00x10-5 Scm-1 at roomtemperature and of 7.70x10-4 Scm-1 at a temperature of 383 K. Two sections of the conductivity diagramsalso evidenced a temperature induced Arrhenius behavior, indicating a thermally activated process. Higherconcentrations of Al2O3 induced a Vogel-Tamman-Fulcher (VTF) behavior. Conductivity variationsproduced by Al2O3 concentration are linked to the number of sites involved in ion transport betweenAl2O3 ionic electrolyte species through Lewis acid-base interactions...

Foi Aumentada a condutividade iônica doeletrólito de polímero sólido (PEO)10CF3COONa, através daformação de um novo compósito, adicionando partículas deóxido de alumínio (Al2O3). Os compósitos foram preparadospor dissolução num solvente líquido e a caracterizaçãofoi feita por espectroscopia de impedância (EI) com aconfiguração utilizando eletrodo de platinum - Pt/eletrólito/Pt. A redução de até duas ordens de grandeza na resistênciaé observada em diagraamas de Nyquist quando se combinapoli (óxido de etileno) (PEO) com trifluoroacetato de sodioCF3COONa. Quando as partículas de Al2O3 são adicionadasao composição, é observado uma redução na resistênciade três ordens de grandeza à temperatura ambiente. Osgráficos do logaritmo da condutividade dc em função daconcentração, mostra um aumento da condutividade parabaixas concentrações de alumína. Do compósito condutorde íons sintetizado, apresenta valores de condutividade2.00x10-5 Scm-1 à temperatura ambiente e 7,70x10-4 Scm-1a uma temperatura de 383 K. Um comportamento do tipoArrhenius é apresentado em duas regiões dos diagramas decondutividade com a temperatura, indicando um processotermicamente ativado. Para concentrações elevadas deAl2O3, uma mudança de comportamento para Vogel-Tamman-Fulcher (VTF) foi observado. As variações nacondutividade com a concentração de Al2O3, está associadaa alteração do número dos sítios envolvidos no transportede íons através de interações do tipo ácido-base de Lewisentre partículas de Al2O3 e espécies iônicas...

Equidad de género en el acceso a la atención de salud en Chile / Gender inequity in the access to health care in Chile

BACKGROUND: In the last two decades, Chile has experienced advances in economical development and global health indicators. However, gender inequities persist in particular related to access to health services and financing of health insurance. AIM: To examine gender inequities in the access to health care in Chile. MATERIAL AND METHODS: An analysis of data obtained from a serial national survey applied to assess social policies (CASEN) carried out by the Ministry of Planning. During the survey 45,379 and 48,107 dwellings were interviewed in 1994 and in 1998, respectively. RESULTS: Women use health services 1.5 times more often, their salaries are 30 per cent lower in all socioeconomic strata. Besides, in the private health sector, women pay higher insurance premiums than men. Men of less than two years of age have 2.5 times more preventive consultations than girls. This difference, although of lesser magnitude, is also observed in people over 60 years. Women of high income quintiles and users of private health insurance have a better access to preventive consultations but not to specialized care. CONCLUSIONS: An improvement in equitable access of women to health care and financing is recommended. Also, monitoring systems to survey these indicators for women should improve their efficiency.

Embryotoxicity of methanol in well-nourished and malnourished rats

1. The objective of the present study was to investigate whether maternal protein-energy malnutrition alters methanol-induced embryotoxic effects in rats. 2. On day 0 of pregnancy, dams were assigned at random to one of the following treatment groups: well-nourished methanol (WNM), well-nourished control (WNC), malnourished methanol (MNM) and malnourished control (MNC). Malnourished animals received half of the well-nourished food intake (ca 12 g/day) throughout pregnancy. Methanol was adminsitered by gavage (2.5 g/kg body weight) from gestation day 6 to 15. 3. Rats were weighed on days 0,6 to 15, and 21 of pregnancy. On day 21 rats were submitted to cesarean section. The number of implantations, living and dead fetuses, resorptions and corpora lutea was recorded. All fetuses were weighed, examined for externally visible malformations, fixed, and examined for skeletal anomalies after clearing and staining with Alizarin Red S. 4. An increased proportion of fetuses with skeletal malformations, particularly cervical extra ribs, was found in the methanol-treated groups (fetuses with skeletal malformations: WNC = 5.6 percent WNM = 45.4 percent, MNC = 3.8 percent, and MNM = 38.8 percent). Malnutrition produced fetal growth retardation, but did not cause any increase in the occurrence of gross structural malformations. The methanol-induced increase in the proportion of fetuses with extra ribs was not altered by malnutrition, but methanol potentiated the malnutrition-induced increase in the proportion of fetuses with sings of delayed ossification (WNC = 18.6 percent, WNM = 25.4 percent, MNC = 39.7 percent, and MNM = 78.4 percent). 5. These findings suggest that methanol-induced gross structural malformations are not affected by maternal malnutrition, but the delay in ossification caused by malnutrition is aggravated by treatment with methanol

Single dose toxicity study of beta-myrcene, a natural analgesic substance

The present study was undertaken to provide date on acute toxicity of ß-myrcene, a peripheral analgesic substance found in the essential oils of several plants. Although myrcene has long been used in perfumes and as a food additive, there is almost no information on its toxicological hazards. The acute oral toxicity of myrcene was low in rodents, with with approximate lethal doses (ALD) of 5.06g/Kg body weight for mice and greater than 11.39 g/Kg body weight for rats. Necropsy data did not reveal any relevant alteration in rats but histophatology findings in mice suggested that the liver and stomach may be target organs for myrcene toxicity after oral administration. Myrcene is highly irritant to the peritoneum, and deaths after intraperitoneal injection of this monoterpene in rats (ALD 5.06 g/Kg body weight) and in mice (ALD 2.25 g/Kg body weight) were probably due to drug-induced chemical peritonitis