Structure, morphology, adhesion and in vitro biological evaluation of antibacterial multi-layer HA-Ag/SiO2/TiN/Ti coatings obtained by RF magnetron sputtering for biomedical applications.

Biocompatible and antibacterial multi-layer coatings of hydroxyapatite (HA)-Ag/SiO2/TiN/Ti were obtained on the Ti-6Al-4V alloy, by means of the magnetron sputtering technique. During characterization of the coatings, the chemical composition was evaluated by energy dispersive X-ray spectroscopy and the phase analysis was carried out by X-ray diffraction. The morphology of the coatings was observed by field emission scanning electron microscopy, while transmission electron microscopy was used to appreciate their structure. The adhesion of the coatings to the substrate was evaluated by micro scratch test. The in vitro biological response was evaluated in terms of cytotoxicity, adhesion and differentiation of mouse mesenchymal stem cells, as well as adhesion and bacterial viability of Staphylococcus aureus strain. Through the compositional study carried out, the deposition of the HA phase was verified, with a Ca/P ratio close to 1.67 and the characteristic diffraction peaks of this compound. The structural study of the coatings evidenced the obtention of multi-layer architectures. The use of an intermediate SiO2/TiN/Ti trilayer was found to improve adhesion between HA-Ag and the substrate by 84%. Finally, the in vitro biological tests carried out indicated a potentially non-toxic character in the coatings. Additionally, an antibacterial effect was registered at low concentrations of Ag (<0.25 mg/L).

[Characteristics of smoking, nicotine dependence and motivation for change in specialists training in health sciences (residents) in Andalusia (Spain)]. / Características del consumo de tabaco, dependencia y motivación para el cambio de los especialistas internos residentes de Andalucía (España).

OBJECTIVE: As there are few studies on the smoking habits of specialists training in health sciences (residents), it is of interest to determine the prevalence of smoking, nicotine dependence and motivation for change, and their relationship with other variables (personal, work and consumption of other drugs). MATERIAL AND METHODS: A multicentre, cross-sectional study using a questionnaire was conducted in 2012. All the residents who were studying in Teaching Health Centres in Andalusia (Spain) completed a questionnaire, which was sent by e-mail, collecting: age, sex, specialty, country of origin, qualitative-quantitative consumption of tobacco, age of onset/cessation, Fagerström test and stage of change (Proschaka). RESULTS: A total of 2667 residents (63% of total) completed the questionnaire. The mean age was 29.1 years (± 5.2), 69% female, 89% Spanish, and 86% physicians. Of the 17% who smoked (daily pattern-47%, intermittently-41%, related to leisure-3%), starting at 17.4 years (±3.5) and mean of 7.5 cigarettes per day (±7.1), higher medical specialties (P=.067 ANOVA), and in men (P=.074, Student-t). More than three-quarters (82%) had a low nicotine dependence, being higher in hospital medical specialties (P=.078 χ(2)). Of the total, 7% were former smokers, and 48% wanted to quit smoking (contemplation 38%, preparation 10%). In the multivariate analysis there was a link between smoking and alcohol consumption (OR 2.84) and illegal drugs (OR 3.57). There were no differences by age or country. CONCLUSIONS: The consumption of tobacco in residents is less than the general population, with a low dependence and better willingness to change. The period of specialised training is a good time to offer tobacco interventions.

[Knowledge level and professional attitudes to the Living Will: Differences between different professionals and provinces in the same autonomous community]. / Grado de conocimiento y actitudes de los profesionales ante el Documento de Voluntades Anticipadas: diferencias entre distintos profesionales y provincias de una misma autonomía.

OBJECTIVES: Primary: To determine the differences, by occupational category and province, in the knowledge and attitudes of health professionals on the Living Wills Document (LWD) in 4 Andalusian provinces: Cordoba, Jaen, Cadiz, and Granada. Secondary: To determine the number of documents prepared in these areas and the number consulted in terminal situations. MATERIAL AND METHODS: Descriptive observational multicenter study, with 17 health areas in 4 Andalusian provinces. TARGET POPULATION: Family doctors, nurses and social workers of the areas studied (n=340). Interventions Validated self-administered questionnaire about advance directives. Descriptive and bivariate (×2) analysis of data was performed. RESULTS: Mean age 46±8.8 years, 53.2% women. Physicians 56.1%, nurses 41.1%, social workers 2.6%. The mean score (0-10) of their knowledge was 5.42±2.41, with 78.4% believing that LWD are regulated in Andalusia (provinces differences, P=.001). More than one-third (36.7%) had read the document (differences by occupation, P=.001). The mean score on the advantage of preparing a LWD for the patient was 8.27±2.16 (significant differences between provinces P=.02). Mean score about the practitioner would respect the wishes of a patient in a LWD was 9.14±1.64 (significant difference between provinces P=.03). The mean score of the question about expressing the desires of the professional on preparing their LWD in the following year was 4.85±3.74 (P=.02). CONCLUSIONS: There are different behaviors between professions on reading the LWD. There are differences between provinces in the following aspects: whether the documents are regulated, whether the professionals prepare the LWD, and whether the professionals respects the provisions of the LWD.