[Parents' satisfaction in onco-hematology units]. / Satisfacción de los padres en unidades de oncohematología.

INTRODUCTION: patient satisfaction is a quality of care predictor that allows to identify specific areas of improvement. Frequently, parents are who provide this information when their children are too young or cannot communicate. The aim of the study was to determine parents' satisfaction with paediatric oncology care and its relationship with sociodemographic variables. MATERIAL AND METHODS: a cross-sectional observational study was carried out. Parents whose children suffered from cancer and were treated in the oncology ward and oncology day hospital in Asturias were included. A questionnaire with sociodemographic variables and the Cuestionario de Calidad de Cuidados de Enfermería (CUCACE), that evaluates experience and satisfaction with care through two dimensions (range from 0 to 100), were used. RESULTS: 24 parents agreed to particape. The average in experience dimension of CUCACE was 88,99 and 87,01 in satisfaction. All participants referred as positive the treat received at the units, however, 41,7% declared it should be enhanced. No relationship between satisfaction and sociodemographic variables were found. CONCLUSIONS: Parents of children with cancer demonstrated high satisfaction with care. Information and communication with medical staff need to be strengthened.

Analysis of Emergency Healthcare Demand in a Prison.

OBJECTIVE: To analyze the reasons for seeking emergency medical care amongst prison inmates and their relationship to sociodemographic characteristics. MATERIAL AND METHOD: An observational, descriptive and retrospective study was carried out. We collected the sociodemographic variables of inmates and their healthcare needs at the referral hospital over nine years. RESULTS: A total of 972 hospital visits were included. The most common healthcare needs, in descending order, were multiple trauma, limb problems and dyspnea. Mondays and Wednesdays were found to be the busiest days (P <0.001). The average stay in cases of hospitalization was 6.1 (SD: 4.3) days; patients with nontraumatic healthcare needs required a longer stay. The majority of the inmates native to Africa, Asia and America received emergency healthcare services due to traumatic injuries; by contrast the most common injuries among Europeans were non-traumatic and unrelated to suicide attempts (P <0.001). European inmates were on average 4.2 years older than Africans and 4.7 years older than American inmates (P <0.001). DISCUSSION: The reasons for seeking emergency care are clearly differentiated according to the inmates' nationality, one notable outcome was the greater longevity of European internees. These results highlight the importance of understanding healthcare demand within the prison system in order to better address considerations such as prevention, organization and the location of healthcare units.

Effects of a functional food supplemented with probiotics on biological factors related to dental caries in children: a pilot study.

PURPOSE: The aim of this study was to evaluate the effects of a functional food supplemented with probiotics on biological factors related to dental caries in children aged 3-5 years. METHODS: A repeated measures pilot study was conducted with children who have consumed a commercial milk containing two lactic acid bacteria as probiotics (WP milk) for a period of 3 months and another period of 3 months consuming a milk without probiotics (NP milk). Salivary pH, plaque index, pH variation before and after a sugar rinse, quantification of Streptococcus mutans in saliva and demineralisation of the carious lesions were determined at the beginning and at the end of both milk ingestion periods. RESULTS: Regarding WP milk, a non-significant decrease in terms of the concentration of S. mutans and pH variation (p > 0.05), a significant decrease (i.e. acidification) in salivary pH (p < 0.01) and a remineralisation of 39.4% of the caries were found. On the other hand, for NP milk, a non-significant increase in terms of the concentration of S. mutans, pH variation, salivary pH (p > 0.05) and a remineralisation of 64.2% were found. CONCLUSIONS: Lactic acid probiotics can contribute to the decrease in the number of cariogenic microorganisms. However, the appropriate selection of the bacteria type with regard to its acidogenicity is fundamental to avoid the generation of an effect contrary to that expected, e.g. a significant decrease in salivary pH.

Adaptation and validation of the Stanford Presenteeism Scale-6 in healthcare professionals.

AIM: To develop and psychometrically test the Stanford Presenteeism Scale-6 to assess presenteeism in the Spanish healthcare population. BACKGROUND: Presenteeism, referring to going to work despite being ill, has been associated with job stress, productivity losses, reduced patient safety and increased health problems among the professionals who suffer from it. INTRODUCTION: The highest prevalence of presenteeism in the healthcare sector is among nurses. Their decision to attend work while ill has been related to role overload, lack of supervisor support, mental health and physical conditions. METHODS: A cross-sectional and validation study was conducted between September 2015 and June 2016 in a hospital in Asturias, Spain. Four hundred and ninety-five healthcare professionals voluntarily agreed to participate (281 nurses, 122 physicians and 92 nursing assistants). RESULTS: Presenteeism prevalence was high; the majority of it being in the nursing category. Bartlett's test and the Kaiser-Meyer-Olkin test indicated that the data meet the conditions for factorial analysis, evidencing a small variability in the median of each sample item and a significant standard deviation. Adjustment rates obtained in the exploratory factor analysis showed adequacy, and reliability rates also showed adequacy for both factors. It was verified by a confirmatory analysis that the factors of presenteeism are positively associated with burnout. CONCLUSION: The Stanford Presenteeism Scale-6 showed good psychometric properties to study presenteeism in the Spanish healthcare sector. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing leaders must develop measurements to assess and control psychosocial risks in order to improve the physical and mental health of professionals and reduce patient safety risks.

Zero discharge: Pilot project for biodegradation of cattle effluent by pyroclastic "lapilli" treatment for fodder irrigation.

Livestock effluents are a nutrient supply that is beneficial for crops, so their use is essential to guarantee the sustainability of the global management of farms. Zero discharge cattle effluent management to irrigate fodder crops is a mitigation option, so it is considered a key factor for adaptation to climate change. This paper presents the result of an "on site" pilot scale (three-stage, vertical flow filtration system using lapilli). This is a low-cost solution in terms of finance and energy, which does not require the addition of chemicals, to treat a cattle effluent. The effluent's quality obtained allowed it to be injected in a drip system with low risks of obstruction. And the pilot system allowed to obtain elimination values for the main parameters of effluent's quality (TSS and COD, 98% and 80% respectively) similar or greater than the ones obtained in other treatments of low cost and energy, and gives values contemplated in reclaimed water reuse guidelines of many countries. Furthermore, elimination rate for the BOD5 obtained 35 mgL-1 in treated effluent. High removal rates were obtained for N, P, K, Cu, Fe and Mn, medium for Ca, Mg and Zn and low for B and Na. These shows that the pilot system and fodder crop combination provide an optimal solution to small farms, controlling sanitary risks. The tested flow allows the use of this system by conventional small farms, which represented 94% of total cow farms in Canary Islands.

Assessment of by-products from fresh-cut products for reuse as bioactive compounds.

The fresh-cut industry is constantly growing and generating wastes. The major challenge for this industry consists in an environmentally sustainable production through re-utilization of by-products, for instance, in extraction of bioactive compounds. In this paper, the nutritional and functional compounds of apple, potato, cucumber, melon and watermelon by-products were investigated. The amount of by-product produced was of 10.10 to 30.80% of initial fresh weight depending on the product. By-products were characterized by low protein (<20 g/kg fresh weight) and fatty acid content (<5 g/kg fresh weight) and high levels of minerals. Carbohydrates content ranged from 43.7 to 235 g/kg fresh weight, while total dietary fibre was between 20 and 150 g/kg fresh weight The content of antioxidants (53.6 to 3453.2 mg/kg fresh weight) and total polyphenols (124.5 to 4250.2 mg/kg fresh weight) depended strongly on the type of by-product. In most cases, the nutritional and bioactive content was higher in the peel than in whole product. Apple peel was rich in carbohydrates, total dietary fibre, antioxidants and total polyphenols. Potato peel was high in iron. Melon was rich in magnesium. Watermelon peel was characterized by the level of potassium, and cucumber peel was rich in manganese, zinc, phosphorous, calcium and sodium. All these data demonstrate than natural by-product from fresh-cut industry could potentially be utilized as ingredients to design new functional foods with a future market.

[Limits of therapeutic effort. Professional opinions]. / Limitación del esfuerzo terapéutico. Opinión de los profesionales.

INTRODUCTION: In our clinical practice we find the need to care for patients with irreversible conditions, due to advanced age or underlying chronic disease, and a change in the types of disease currently facing the health workforce.The objective of this research was to study the ethical assessment of health professionals in our Hospital on extraordinary life support measures. MATERIAL AND METHODS: Prospective descriptive study conducted at the Hospital General Universitario de Ciudad Real during the months of April to August 2010. The convenience sample consisted of 189 professionals from different categories working in our hospital during the study period.It included a questionnaire adapted for use in hospitals, comprising 18 items with dichotomous responses.Informed consent was requested and the confidentiality of information ensured. RESULTS: A sample of 189 professionals, of whom 21.7% were male and 78.3% were female. The mean age was 40.39 years SD + 10, with a mode of 31 years.The professionals involved were doctors, nurses and nursing assistants, with an average experience of 15.8% ± 10.4 SD years.A total of 79.9% were in favour of euthanasia, 93.6% against dysthanasia, 92.6% for antidysthanasia, and 99.5% for orthotonasia. The medical group was the one most against the use of euthanasia P=.0001. Differences were found between religious practice and the ethical situations at the end of life. CONCLUSIONS: Most participants took into account the patient's decision to limit extraordinary measures in terminal disease situations.The study reveals that the effectiveness and usefulness of our clinical practice should include an ethical evaluation by professionals with the patient. It became clear that the majority of the sample of professionals is against over-aggressive treatment, and for a dignified death.

Endosulfan induces changes in spontaneous swimming activity and acetylcholinesterase activity of Jenynsia multidentata (Anablepidae, Cyprinodontiformes).

We assessed changes in spontaneous swimming activity and acetylcholinesterase (AchE) activity of Jenynsia multidentata exposed to Endosulfan (EDS). Females of J. multidentata were exposed to 0.072 and 1.4 microg L(-1) EDS. Average speed and movement percentage were recorded during 48 h. We also exposed females to EDS at five concentrations between 0.072 and 1.4 microg L(-1) during 24 h, and measured the AchE activity in brain and muscle. At 0.072 microg L(-1) EDS swimming motility decreased relative to the control group after 45 h, while at 1.4 microg L(-1) EDS swimming motility decreased after 24 h. AchE activity significantly decreased in muscle when J. multidentata were exposed to EDS above 0.072 microg L(-1), while no significant changes were observed in brain. Thus, changes in swimming activity and AchE activity in muscle are good biomarkers of exposure to EDS in J. multidentata.

Risk factors associated with St. Louis encephalitis seroprevalence in two populations from Córdoba, Argentina.

St. Louis encephalitis virus (SLEV) is endemic in Argentina. The first outbreak was recorded in Córdoba during the late summer of 2005. This study analyzes the association between social and demographic factors and other variables related to exposure to mosquitoes with SLEV infection in 264 individuals who attended two health centers in the city of Córdoba during the period December 2004-January 2005. Multiple logistic regression models were used to estimate the risk coefficients. The seroprevalence was 12.9%, similar to that in previous reports. Risks of infection were associated with the presence of garbage dumps near dwellings, the practice of outdoor activities at night and place of residence. Risk for older people (60-80 years old) was moderate. The identification of risk factors related to SLEV infection would be useful to improve programs for vector control and community health.

La obesidad en el sector socioeconomico bajo: estudio de los factores de riesgo con enfasis en el consumo por grupo de alimentos / Obesity in low socioeconomic strata: a sutdy of the risk factor relaed to food consuption patterns

La obesidad se ha manifestado con una frecuencia cada vez mayor en las últimas décadas, afecta especialmente a la población urbana pobre y no tiene las mismas características ni el mismo origen que la obesidad en poblaciones ricas. Este trabajo tuvo por objetivo identificar factores de riesgo bio-socioculturales y del consumo alimentario asociados a la presenciade obesidad. Se estudiaron las asociaciones entre la presenciade la obesidad y el consumo alimentario en este estrato, mediante el diseño de un estudio transversal, tipo caso-control, con una muestra de 1296 adultos del estrato socioeconómico bajo, en la ciudad de Córdoba, en el año 2005. Mediante medicionesantropométricas y una entrevista de frecuencia de consumo dealimentos y actividad física, fueron indagados los patrones deconsumo, hábitos de vida, y el estado nutricional de los sujetos...

La obesidad en el sector socioeconomico bajo: estudio de los factores de riesgo con enfasis en el consumo por grupo de alimentos / Obesity in low socioeconomic strata: a sutdy of the risk factor relaed to food consuption patterns

La obesidad se ha manifestado con una frecuencia cada vez mayor en las últimas décadas, afecta especialmente a la población urbana pobre y no tiene las mismas características ni el mismo origen que la obesidad en poblaciones ricas. Este trabajo tuvo por objetivo identificar factores de riesgo bio-socioculturales y del consumo alimentario asociados a la presenciade obesidad. Se estudiaron las asociaciones entre la presenciade la obesidad y el consumo alimentario en este estrato, mediante el diseño de un estudio transversal, tipo caso-control, con una muestra de 1296 adultos del estrato socioeconómico bajo, en la ciudad de Córdoba, en el año 2005. Mediante medicionesantropométricas y una entrevista de frecuencia de consumo dealimentos y actividad física, fueron indagados los patrones deconsumo, hábitos de vida, y el estado nutricional de los sujetos...(AU)

Effect of the co-administration of phenobarbital, quercetin and mancozeb on nitrosomethylurea-induced pancreatic tumors in rats.

UNLABELLED: We have previously shown that a single i.p. injection of nitrosomethylurea (NMU) in 3-day-old rats orally treated with the pesticide mancozeb (MZ), the flavonoid quercetin (Q) or in combination (MZ-Q) induces hyperplasia, atypical acinar cell proliferation and carcinoma in situ (CIS) in the pancreas. This work studies the effect of oral administration of phenobarbital (PB) on this model of pancreatic carcinogenesis. The animals were fed on a diet supplemented by MZ or/and Q from the 10th day of pregnancy, thorough lactation and as pups after weaning until being sacrificed at week 24. Saline injection with non-supplemented diet was used for the control group (SAL). The experimental groups were (1) SAL (control), (2) SAL-PB, (3) NMU, (4) NMU-PB, (5) MZ-NMU, (6) MZ-NMU-PB, (7) Q-NMU, (8) Q-NMU-PB, (9) MZ-Q-NMU and (10) MZ-Q-NMU-PB. Acinar cell hyperplasia was found in all groups of NMU-treated rats. Dysplastic foci (DYS) were seen in groups 3-10 at the following percentages: 19, 48, 71, 27, 71, 35, 100 and 30, respectively. CIS were recorded in groups 4 to 10 at percentages: 4, 36, 13, 11, 0, 16, 5, respectively. CONCLUSION: Although PB, Q or MZ given alone enhance DYS lesions in NMU-treated rats, the MZ/Q/PB combined treatments may increase (mainly in males) or decrease (mainly in female) the DYS and CIS proportion. Because PB, MZ and Q influence P450 enzymes, we suggest that these enzymes play a role in the carcinogenesis process.

Influencia de la situación laboral en el ajuste familia-trabajo / Influence of work conditions on work-family fit

El objetivo de este estudio es analizar qué papel juegan determinadas variables laborales, tales como la satisfacción laboral, la flexibilidad horaria, el número de horas trabajadas a la semana, la autonomía, el absentismo, el rendimiento, las intenciones de abandonar la organización y el apoyo por parte de los supervisores, en la relación familia-trabajo. No obstante, también se ha estudiado una variable de tipo personal: la satisfacción vital. Para llevar a cabo el presente trabajo de investigación se ha utilizado una muestra conformada por 67 participantes (34 varones y 33 mujeres) que cumplen con los siguientes requisitos: vivir en pareja, ser padre/madre y tener un trabajo remunerado. Las conclusiones de este estudio ponen de manifiesto la importante influencia que cuatro variables laborales: la satisfacción laboral, el número de horas trabajadas semanalmente, el apoyo por parte de los supervisores y las intenciones de abandonar la organización, ejercen sobre el ajuste familia-trabajo

This study examined the effects of several work characteristics, such as job satisfaction, flexibility of work hours, hours worked per week, flexibility of the work itself, absenteeism, job performance, turnover and supportive supervision, on work-family relation. However, a personal characteristic has been studied: life satisfaction. The data carne from 67 individuals (34 men and 33 women) who are working parents and live together. Results suggest the important effects on work-family fit of four work chacteristics: job satisfaction, hours worked per week, supportive supervision and turnover

Nonaqueous capillary electrophoresis method for the analysis of gleevec and its main metabolite in human urine.

The viability of nonaqueous capillary electrophoresis (NACE) was investigated for determination of gleevec and its main metabolite in human urine using a fused-silica capillary. Baseline separation of the studied solutes was obtained using a nonaqueous solution composed of 12 mM ammonium acetate and 87.6 mM acetic acid in methanol-acetonitrile (ACN) (80:20, v:v) providing analysis time shorter than 3 min. Different aspects including stability of the solutions, linearity, accuracy and precision were studied in order to validate the method in the urine matrix. Detection limits of 24 microg L(-1) for gleevec and its metabolite were obtained. A robustness test of the method was carried out using the Plackett-Burman fractional factorial model with a matrix of 15 experiments. The developed method is simple, rapid and sensitive and has been used to determine gleveec and its metabolite at clinically relevant levels in human urine. Before NACE determination, a solid-phase extraction (SPE) procedure with a C18 cartridge was necessary. Real determination of these analytes in two patient urines were done.

Nonaqueous capillary electrophoresis method for the analysis of tamoxifen, imipramine and their main metabolites in urine.

The viability of nonaqueous capillary electrophoresis (NACE) was investigated for the simultaneous determination of tamoxifen, imipramine and their main metabolites (4-hydroxytamoxifen and desipramine, respectively). Baseline separation of the studied solutes was obtained on a 57cm x 75mum capillary using a nonaqueous solution composed of 17mM ammonium acetate and 1.25% acetic acid in 80:20 (v:v) methanol-acetonitrile, temperature and voltage 22 degrees C and 15kV, respectively, and hydrodynamic injection. Paroxetine was used as internal standard. Different aspects including linearity, accuracy, ruggedness and precision was studied. Detection limits between 9.0 and 15.0mugL(-1) were obtained for all the studied compounds. The developed method is simple, rapid and sensitive and has been used to determine tamoxifen, imipramine and their metabolites at clinically relevant levels in human urine. Before NACE determination, a solid phase extraction (SPE) procedure with a C(18) cartridge was necessary. Real determination of these analytes in three females urines were done.

Neoplastic and preneoplastic lesions induced by melamine in rat urothelium are modulated by dietary polyunsaturated fatty acids.

The modulatory effects of polyunsaturated fatty acids (PUFA) on urinary tract tumorigenesis of 275 Wistar rats were evaluated by treating animals with the tumorigenic agent melamine. Rats were fed with formulae containing 6% of 4 varieties of fats: fish oil enriched in n-3 PUFA (FO), corn oil enriched in n-6 (CO), olein containing mainly n-9 oleic acid (O), and 98% stearic acid (SA), the latter two being essential (EFA)-deficient inducers. Two commercially fed control groups with (CM) and without (C) melamine were used. Animals were autopsied at 22-25 and at 36-40 weeks. Hepatic fatty acids showed that O and SA groups were EFA-deficient. Simple well differentiated hyperplasias were significantly higher in the FO lot, whereas dysplasia was increased in the CO, O and SA lots. Most of the animals fed for 36-40 weeks with the three latter formulae developed the more severe lesions. Increased urothelial proliferation was more frequent in EFA-deficient rats. The apoptosis/mitosis ratio was higher in O, SA and CO fed animals with respect to FO and chow ones. Results show that dietary PUFA modulate differentially both normal and pre-neoplastic urothelial proliferation induced by melamine. FO, rich in n-3 fatty acids, showed a strong protective effect.