RESUMO
In a health context marked by increasing health inequalities, population ageing, pandemics and migration, the development of competencies for the intercultural encounter between healthcare workers and patients is essential. Tertiary education institutions have a social responsibility to address this issue. Health Science programs are challenged to provide culturally sensitive care to diverse populations. Therefore, it is necessary to reflect upon the models that will guide this process, and to assess undergraduate curricula to determine their appropriateness to address this challenge. This article describes a methodology for assessing the undergraduate curriculum for the development of intercultural competence and presents a strategy for promoting its sustainable development across the curriculum.
Assuntos
Humanos , Estudantes de Enfermagem , Bacharelado em Enfermagem , Envelhecimento , Currículo , Promoção da SaúdeRESUMO
In a health context marked by increasing health inequalities, population ageing, pandemics and migration, the development of competencies for the intercultural encounter between healthcare workers and patients is essential. Tertiary education institutions have a social responsibility to address this issue. Health Science programs are challenged to provide culturally sensitive care to diverse populations. Therefore, it is necessary to reflect upon the models that will guide this process, and to assess undergraduate curricula to determine their appropriateness to address this challenge. This article describes a methodology for assessing the undergraduate curriculum for the development of intercultural competence and presents a strategy for promoting its sustainable development across the curriculum.
Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Envelhecimento , Currículo , Promoção da Saúde , HumanosRESUMO
BACKGROUND: Biological differences between the sexes have a major impact on disease and treatment outcome. In this paper, we evaluate the prognostic value of sex in stage IV non-small-cell lung cancer (NSCLC) in the context of routine clinical data, and compare this information with other external datasets. METHODS: Clinical data from stage IV NSCLC patients from Hospital Puerta de Hierro (HPH) were retrieved from electronic health records using big data analytics (N = 397). In addition, data from the Spanish Lung Cancer Group (GECP) Tumor Registry (N = 1382) and from a published study available from the cBioPortal (MSK) (N = 601) were analyzed. Survival curves were estimated using the Kaplan-Meier method. A Cox proportional hazards regression model was used to assess the prognostic value of sex. A meta-analysis to compare the outcome for males and females in terms of overall survival (OS) and progression free survival (PFS) was performed. RESULTS: The median OS time was 12 months for males and 19 months for females (overall HR = 0.77; 95% CI: 0.68-0.87; P < 0.001). Similarly, females with stage IV NSCLC harboring an EGFR-sensitizing mutation lived significantly longer than males (median OS: males, 19 months; females, 32 months) with a lower risk of death compared with males (overall HR = 0.75; 95% CI: 0.67-0.84). In addition, female patients benefited more from EGFR inhibitors in terms of PFS and OS (overall HR = 0.45; 95% CI: 0.32-0.64, and HR = 0.62; 95% CI: 0.48-0.80, respectively). Median PFS was 21 months in females and 12 months in males (P < 0.001). CONCLUSIONS: Using routine clinical data we confirmed the previous finding that among stage IV NSCLC patients, females had a significantly better prognosis than males. The effect size of the sex was notable, highlighting the fact that survival rates are usually estimated and patients are generally managed without considering the sexes separately, which may lead to suboptimal results.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Neoplasias Pulmonares/mortalidade , Mutação , Adulto , Idoso , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/genética , Feminino , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Inibidores de Proteínas Quinases/uso terapêutico , Fatores Sexuais , Taxa de SobrevidaRESUMO
Changes in the optical properties of graphene quantum dots (GQD) during electrochemical reduction and oxidation were investigated by photoluminescence (PL) spectroelectrochemistry, which provided direct in situ evidence of the dependence of GQD luminescence on their redox state. We demonstrated that GQD PL intensity was enhanced upon reduction (quantum yield increased from 0.44 to 0.55) and substantially bleached during oxidation (quantum yield â¼0.12). Moreover, PL emission blue/red-shifted upon GQD reduction/oxidation, rendering information about electronic transitions involved in the redox processes, namely, the π â π* and the n â π* transitions between energy levels of the aromatic sp2 domains and the functional groups, respectively. PL intensity changes during GQD reduction/oxidation resulted from a variation in structural changes in GQD as a result of charge injection, as corroborated by in situ Raman spectroelectrochemistry.