Patient safety in the operating room and documentary quality related to infection and hospitalization

Objective: To describe the documentary quality of two records related to patient safety in the operating room and to identify differences between information related to infection and hospitalization. Methods: Comparative study based on two cross sections, conducted with 3,033 patients who had been hospitalized for more than 24 hours in an Orthopedics and Traumatology Center. Sociodemographic and clinical data, as well as information provided in forms were compared. Postoperative infection was identified as an adverse event. Results: There was a significant correlation between hospitalization days and the total number of diagnoses collected (Pearson=0.328; p<0.001). When diagnoses and infections were grouped together, a significant value was found between closed fractures and infection (p=0.001). Conclusion: Differences in the degree of completion were observed between the two records. There were no differences between adverse events.

Aceptabilidad de la vacuna contra el VPH en estudiantes universitarios españoles durante la etapa pre-vacunal: un estudio transversal

Introducción. El cáncer de cuello de útero (CCU), segunda causa de mortalidad por cáncer en mujeres, está asociado a la infección por virus de papiloma humano (VPH), cuya máxima prevalencia se sitúa entre los 20 y 24 años de edad. Desde 2006 se dispone de una vacuna contra el VPH. El objetivo de este estudio es evaluar los conocimientos sobre CCU, la infección por VPH y su vacuna, valorando su aceptabilidad en población universitaria. Métodos. Estudio transversal sobre 1.750 estudiantes de la Universidad de Alicante (2008) seleccionados al azar, proporcional por sexo y estudios, mediante un cuestionario ad-hoc validado. Se calcularon porcentajes, intervalos de confianza, tablas de contingencia según sexo, edad y tipo de estudios, calculando odds ratios ajustadas (OR). Resultados. Muestra con 58,6% mujeres y 6,6% de estudiantes biosanitarios. Un 87,3% dispuestos a vacunarse frente al VPH, el 94,3% vacunaría a sus hijas, un 48,0% había oído hablar de la vacuna. El 90,6% tiene bajos conocimiento sobre la infección por VPH y un 82,2% sobre la vacuna. Un 22,4% manifiesta conocer la asociación entre VPH y CCU. Las mujeres registran OR mayores en conocimientos y predisposición a vacunarse. La aceptabilidad de la vacuna contra VPH se asocia con el sexo y la confianza en las vacunas como método preventivo, la influencia de los conocimientos previos es escasa sobre la predisposición vacunal. Conclusiones. Alta aceptabilidad de la vacuna en el periodo estudiado. Aumentar la confianza hacia las vacunas puede influir en una mejor predisposición a vacunarse.

Factores asociados a la predisposición a vacunarse contra la gripe pandémica A/H1N1 en población adulta del Departamento de Salud de Elche (España): influencia de las fuentes de información

Fundamento. Evaluar en población general las fuentes de información, actitudes y predisposición hacia la vacunación contra la gripe pandémica A/H1N1 de 2009. Métodos. Estudio descriptivo de carácter transversal realizado entre el 25 de noviembre y 30 de diciembre de 2009 mediante entrevista personal cara a cara a una muestra aleatoria (826) de adultos residentes en el Departamento de Salud de Elche (España). Resultados. Los encuestados manifestaron que la televisión (57%) y el médico de familia (47,9%) eran su fuente principal de información sobre vacunas. El 82,2% tenía una buena opinión sobre las vacunas, un 30,5% percibía la gripe A/H1N1 como más grave que la estacional, siendo esta percepción creciente entre los de mayor edad y con menos estudios. Un 25,4% de encuestados sentía preocupación por padecerla, sobre todo los de menor nivel educativo. Un 42,1% manifiesta su buena predisposición para vacunarse contra la gripe estacional, disminuyendo hasta un 18,4% la intención hacia la gripe A/H1N1. La predisposición hacia la vacunación crece con la edad y en el caso de la gripe A/H1N1 decrece a mayor nivel educativo. El médico de familia es la fuente de información más determinante para inmunizarse frente a gripe estacional (OR 1,43) y gripe A/H1N1 (OR 2,47). Conclusiones. Existe baja aceptabilidad de la vacuna pandémica y baja percepción de gravedad sobre la gripe A/H1N1. La experiencia previa de vacunación ante gripe estacional predispone hacia la inmunización contra gripe A/H1N1. Aunque los medios de comunicación encabezan la fuente de información más usual durante este episodio, la influencia del médico de familia en la decisión de vacunarse resulta significativa.

Candida albicans stimulates in vivo differentiation of haematopoietic stem and progenitor cells towards macrophages by a TLR2-dependent signalling

Toll-like receptors (TLRs) are expressed by haematopoietic stem and progenitor cells (HSPCs), and may play a role in haematopoiesis in response to pathogens during infection. We have previously demonstrated that (i) inactivated yeasts of Candida albicans induce in vitro differentiation of HSPCs towards the myeloid lineage, and (ii) soluble TLR agonists induce in vivo their differentiation towards macrophages. In this work, using an in vivo model of HSPCs transplantation, we report for the first time that HSPCs sense C. albicans in vivo and subsequently are directed to produce macrophages by a TLR2-dependent signalling. Purified lineage-negative cells (Lin−) from bone marrow of C57BL/6 mice (CD45.2 alloantigen) were transplanted into B6Ly5.1 mice (CD45.1 alloantigen), which were then injected with viable or inactivated C. albicans yeasts. Transplanted cells were detected in the spleen and in the bone marrow of recipient mice, and they differentiate preferentially to macrophages, both in response to infection or in response to inactivated yeasts. The generation of macrophages was dependent on TLR2 but independent of TLR4, as transplanted Lin− cells from TLR2−/− mice did not give rise to macrophages, whereas Lin− cells from TLR4−/− mice generated macrophages similarly to control cells. Interestingly, the absence of TLR2, or in a minor extent TLR4, gives Lin− cells an advantage in transplantation assays, as increases the percentage of transplanted recovered cells. Our results indicatethat TLR-mediated recognition of C. albicans by HSPCs may help replace and/or increase cells that constitute the first line of defence against the fungus, and suggest that TLR-mediated signalling may lead to reprogramming early progenitors to rapidly replenishing the innate immune system and generate the most necessary mature cells to deal with the pathogen.

Factors that determine the level of commitment of our teaching staff when the implementation of continuous evaluation system takes place

Comunicación presentada en CIDUI 2010, Congreso Internacional Docencia Universitaria e Innovación, Barcelona, 30 junio-2 julio 2010.

Willingness Towards Continuous Assessment

Among the factors that affect the convergence towards the European Higher Education Area, university teaching staff's motivation is fundamental, and consequently, it is crucial to empirically know what this motivation depends on. In this context, one of the most relevant changes in the teacher-student relationship is assessment. In fact, the transition from a static assessment -focused on only one temporal point (final exam)- to a dynamic assessment, will require changes in thought and action, both on the part of teachers and students. In this line, the objective of this paper is to analyze the determinants of teaching staff's predisposition to the continuous assessment method. Specifically, we consider the following explanatory dimensions: teaching method used (which measures their degree of involvement with the ongoing adaptation process), type of subject (core, compulsory and optional), and teacher's personal characteristics (professional status and gender). The empirical application carried out at the University of Alicante uses Logit Models with Random Coefficients to capture heterogeneity, and shows that "cooperative learning" is a clear-cut determinant of "continuous assessment" as well as "continuous assessment plus final examination". Also, a conspicuous result, which in turn becomes a thought-provoking finding, is that professional status is highly relevant as a teacher's engagement is closely related to prospects of stability. Consequently, the most relevant implications from the results revolve around the way academic institutions can propose and implement inducement for their teaching staff.

Fostering Teaching Staff's Engagement in Continuous Assessment

Among the factors that affect the convergence towards the European Higher Education Area, university teaching staff's motivation is fundamental, and consequently, it is crucial to empirically know what this motivation depends on. In this context, one of the most relevant changes in the teacher-student relationship is assessment. In fact, the transition from a static assessment -focused on only one temporal point (final exam)- to a dynamic assessment, will require changes in thought and action, both on the part of teachers and students. In this line, the objective of this paper is to analyze the determinants of teaching staff's predisposition to the continuous assessment method. Specifically, we consider the following explanatory dimensions: teaching method used (which measures their degree of involvement with the ongoing adaptation process), type of subject (core, compulsory and optional), and teacher's personal characteristics (professional status and gender). The empirical application carried out at the University of Alicante uses Logit Models with Random Coefficients to capture heterogeneity, and shows that "cooperative learning" is a clear-cut determinant of "continuous assessment" as well as "continuous assessment plus final examination". Also, a conspicuous result, which in turn becomes a thought-provoking finding, is that professional status is highly relevant as a teacher's engagement is closely related to prospects of stability. Consequently, the most relevant implications from the results revolve around the way academic institutions can propose and implement inducement for their teaching staff.

Uso do zoneamento ambiental do Médio Rio Grande na sub-bacia hidrográfica do Ribeirão Bocaina - Passos/MG

Este trabalho é parte integrante do Projeto Grande Minas - União pelas Águas, que realizou o Zoneamento Ambiental das Sub-bacias Hidrográficas dos Afluentes Mineiros do Médio Rio Grande. Após a obtenção dos produtos finais do zoneamento, entra-se agora, na fase de “Implementação”, ou seja, de sua aplicação direta para contribuir no processo de gestão dos recursos hídricos das sub-bacias hidrográficas da área de estudo. Neste trabalho estuda-se, especificamente, a sub-bacia hidrográfica do Ribeirão Bocaina, considerada uma das 34 sub-bacias que envolvem a Bacia Hidrográfica dos Afluentes Mineiros do Médio Rio Grande e situa-se no município de Passos-MG, possuindo uma área de 457,9 km². O trabalho busca dar uma contribuição para a gestão dos recursos hídricos nesta sub-bacia, que vem sofrendo com a degradação do seu recurso hídrico. O objetivo é disponibilizar instrumentos cartográficos para subsidiar a gestão dos recursos hídricos e, com isto, contribuir com a sua preservação e uso sustentável. A sistemática metodológica envolve uma análise dos aspectos legais da área de estudo; a construção de um Banco de Dados Digital georreferenciado com informações sobre os meios físico, biótico e socioeconômico da sub-bacia e a produção de uma carta derivada, de cunho interpretativo e de fácil leitura, que possa ser utilizada diretamente pelo gestor público nas tomadas de decisões. A base digital produzida conta com uma série de mapas digitais, dentre eles: mapas climáticos, de solos, declividades, geomorfológico, geológico, de sistemas aquíferos, hidrográfico, uso e ocupação do solo. Com relação à carta derivada, destaca os terrenos que apresentam maior predisposição à alterações diretas nos recursos hídricos.