Diferencias de género en la percepción del logro profesional en especialistas de medicina familiar y comunitaria

BACKGROUND The concept of achievement is important to study the professional development. In medicine there are gender inequalities in career. The purpose was to know and compare the professional achievement's perceptions and attributions of female and male primary care physicians in Andalusia. METHOD Qualitative study with 12 focus groups (October 2009 to November 2010). POPULATION primary care physicians. SAMPLE intentionally segmented by age, sex and health care management. Were conducted by sex: two groups with young physicians, two groups with middle aged and two with health care management. TOTAL: 32 female physician and 33 male physicians. Qualitative content analysis with Nuddist Vivo. RESULTS Female and male physicians agree to perceive internal achievements and to consider aspects inherent to the profession as external achievements. The most important difference is that female physician related professional achievement with affective bond and male physician with institutional merit. Internal attributions are more important for female physician who also highlight the importance of family, the organization of working time and work-family balance. Patients, continuing education, institutional resources and computer system are the most important attributions for male physician. CONCLUSIONS There are similarities and differences between female and male physicians both in the understanding and the attributions of achievement. The differences are explained by the gender system. The perception of achievement of the female physicians questions the dominant professional culture and incorporates new values in defining achievement. The attributions reflect the unequal impact of family and organizational variables and suggest that the female physicians would be changing gender socialization.

Repositorios sostenibles, reflexiones a partir de la experiencia española

La creación y posterior gestión de un repositorio institucional no tiene sentido si no cuenta con un número significativo de documentos y un crecimiento permanente de la colección, a un coste razonable. A partir del estudio de repositorios institucionales y de colecciones patrimoniales de bibliotecas, archivos y museos de España, los autores comparten sus reflexiones bajo la premisa de producir repositorios sostenibles, promoviendo la autosuficiencia en el incremento de sus fondos, la garantía de la financiación permanente por parte de la institución que los integra y, especialmente, el uso de los documentos depositados por parte de la comunidad a la que sirve la institución. Tras un breve repaso a los procesos de adaptación de la filosofía del acceso abierto a los repositorios existentes, se establece una hoja de ruta para el diseño e implementación de un nuevo repositorio, teniendo en cuenta la cobertura estratégica y legal del proyecto, las opciones de hardware y software más populares, así como la planificación de los procesos de trabajo y la adopción de metadatos de descripción e interoperabilidad. Se presentan estrategias de difusión y evaluación de los repositorios. Finalmente, se aportan recomendaciones básicas de preservación digital, a la espera de una solución global.

Identification and in vitro reactivity of celiac immunoactive peptides in an apparent gluten-free beer.

Gluten content from barley, rye, wheat and in certain oat varieties, must be avoid in individuals with celiac disease. In most of the Western countries, the level of gluten content in food to be considered as gluten-free products is below 20 parts per million measured by ELISA based on specific anti-gluten peptide antibody. However, in beverages or food suffering complex hydrolytic processes as beers, the relative proportion of reactive peptides for celiac patients and the analytical techniques may differ, because of the diversity of the resulting peptide populations after fermentations. A beer below 20 parts per million of gluten but yet detectable levels of gluten peptides by anti-gliadin 33-mer antibodies (G12 and A1) was analyzed. We identified and characterized the relevant peptides for either antibody recognition or immunoactivity in celiac patients. The beer was fractionated by HPLC. The relative reactivity of the different HPLC fractions to the G12/A1 antibodies correlated to the reactivity of peripheral blood mononuclear cells isolated from 14 celiac individuals. Peptides from representative fractions classified according to the relative reactivity to G12/A1 antibodies were identified by mass spectrometry. The beer peptides containing sequences with similarity to those of previously described G12 and A1 epitopes were synthesized and confirmed significant reactivity for the antibodies. The most reactive peptides for G12/A1 also confirmed the highest immunogenicity by peripheral blood mononuclear cell activation and interferon γ production from celiac patients. We concluded that preparative HPLC combined with anti-gliadin 33-mer G12/A1 antibodies were very sensitive and specific methods to analyze the relevant immunogenic peptides in hydrolyzed gluten.

Could radiotherapy effectiveness be enhanced by electromagnetic field treatment?

One of the main goals in radiobiology research is to enhance radiotherapy effectiveness without provoking any increase in toxicity. In this context, it has been proposed that electromagnetic fields (EMFs), known to be modulators of proliferation rate, enhancers of apoptosis and inductors of genotoxicity, might control tumor recruitment and, thus, provide therapeutic benefits. Scientific evidence shows that the effects of ionizing radiation on cellular compartments and functions are strengthened by EMF. Although little is known about the potential role of EMFs in radiotherapy (RT), the radiosensitizing effect of EMFs described in the literature could support their use to improve radiation effectiveness. Thus, we hypothesized that EMF exposure might enhance the ionizing radiation effect on tumor cells, improving the effects of RT. The aim of this paper is to review reports of the effects of EMFs in biological systems and their potential therapeutic benefits in radiotherapy.

HLA and non-HLA genes in Behçet's disease: a multicentric study in the Spanish population.

INTRODUCTION According to genome wide association (GWA) studies as well as candidate gene approaches, Behçet's disease (BD) is associated with human leukocyte antigen (HLA)-A and HLA-B gene regions. The HLA-B51 has been consistently associated with the disease, but the role of other HLA class I molecules remains controversial. Recently, variants in non-HLA genes have also been associated with BD. The aims of this study were to further investigate the influence of the HLA region in BD and to explore the relationship with non-HLA genes recently described to be associated in other populations. METHODS This study included 304 BD patients and 313 ethnically matched controls. HLA-A and HLA-B low resolution typing was carried out by PCR-SSOP Luminex. Eleven tag single nucleotide polymorphisms (SNPs) located outside of the HLA-region, previously described associated with the disease in GWA studies and having a minor allele frequency in Caucasians greater than 0.15 were genotyped using TaqMan assays. Phenotypic and genotypic frequencies were estimated by direct counting and distributions were compared using the χ(2) test. RESULTS In addition to HLA-B*51, HLA-B*57 was found as a risk factor in BD, whereas, B*35 was found to be protective. Other HLA-A and B specificities were suggestive of association with the disease as risk (A*02 and A*24) or protective factors (A*03 and B*58). Regarding the non-HLA genes, the three SNPs located in IL23R and one of the SNPs in IL10 were found to be significantly associated with susceptibility to BD in our population. CONCLUSION Different HLA specificities are associated with Behçet's disease in addition to B*51. Other non-HLA genes, such as IL23R and IL-10, play a role in the susceptibility to the disease.

Classification and clinical behavior of blastic plasmacytoid dendritic cell neoplasms according to their maturation-associated immunophenotypic profile.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare subtype of leukemia/lymphoma, whose diagnosis can be difficult to achieve due to its clinical and biological heterogeneity, as well as its overlapping features with other hematologic malignancies. In this study we investigated whether the association between the maturational stage of tumor cells and the clinico-biological and prognostic features of the disease, based on the analysis of 46 BPDCN cases classified into three maturation-associated subgroups on immunophenotypic grounds. Our results show that blasts from cases with an immature plasmacytoid dendritic cell (pDC) phenotype exhibit an uncommon CD56- phenotype, coexisting with CD34+ non-pDC tumor cells, typically in the absence of extramedullary (e.g. skin) disease at presentation. Conversely, patients with a more mature blast cell phenotype more frequently displayed skin/extramedullary involvement and spread into secondary lymphoid tissues. Despite the dismal outcome, acute lymphoblastic leukemia-type therapy (with central nervous system prophylaxis) and/or allogeneic stem cell transplantation appeared to be the only effective therapies. Overall, our findings indicate that the maturational profile of pDC blasts in BPDCN is highly heterogeneous and translates into a wide clinical spectrum -from acute leukemia to mature lymphoma-like behavior-, which may also lead to variable diagnosis and treatment.

Are the health messages in schoolbooks based on scientific evidence? A descriptive study.

BACKGROUND Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based. METHODS The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence. RESULTS 844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence. CONCLUSION Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively.

Changes in Body Composition in Anorexia Nervosa: Predictors of Recovery and Treatment Outcome.

The restoration of body composition (BC) parameters is considered to be one of the most important goals in the treatment of patients with anorexia nervosa (AN). However, little is known about differences between AN diagnostic subtypes [restricting (AN-R) and binge/purging (AN-BP)] and weekly changes in BC during refeeding treatment. Therefore, the main objectives of our study were twofold: 1) to assess the changes in BC throughout nutritional treatment in an AN sample and 2) to analyze predictors of BC changes during treatment, as well as predictors of treatment outcome. The whole sample comprised 261 participants [118 adult females with AN (70 AN-R vs. 48 AN-BP), and 143 healthy controls]. BC was measured weekly during 15 weeks of day-hospital treatment using bioelectrical impedance analysis (BIA). Assessment measures also included the Eating Disorders Inventory-2, as well as a number of other clinical indices. Overall, the results showed that AN-R and AN-BP patients statistically differed in all BC measures at admission. However, no significant time×group interaction was found for almost all BC parameters. Significant time×group interactions were only found for basal metabolic rate (p = .041) and body mass index (BMI) (p = .035). Multiple regression models showed that the best predictors of pre-post changes in BC parameters (namely fat-free mass, muscular mass, total body water and BMI) were the baseline values of BC parameters. Stepwise predictive logistic regressions showed that only BMI and age were significantly associated with outcome, but not with the percentage of body fat. In conclusion, these data suggest that although AN patients tended to restore all BC parameters during nutritional treatment, only AN-BP patients obtained the same fat mass values as healthy controls. Put succinctly, the best predictors of changes in BC were baseline BC values, which did not, however, seem to influence treatment outcome.

Repartición de los recursos alimenticios entre tres peces bentófagos frente al Perú antes, durante y después de El Niño 1982-83.

Se revisa la utilización de recursos alimenticios de tres peces bentófagos en los fondos arenosos someros de la Bahía de Ancón: Menticirrhus ophicephalus, stellifer minos y Paralichthys adspersus.

La recolonización de las comunidades de Mitílidos en la costa central del Perú de El Niño 1982-83

Se estudia la recuperación de los bancos de los mitílidos Aulacomya ater y Semimytilus algosus después de agosto de 1983 en la Bahía de Ancón y después de agosto de 1986 en Bahía Independencia. En la Bahía de Ancón la recolonización de Semimytilus algosus se inició en octubre de 1983, sostenida por una intensiva proliferación de larvas en el plancton. En febrero de 1984 alcanz.aban una máxima longitud de 31mm y los otros constituyentes de la comunidad estaban completando su recuperación. Sin embargo, hasta marzo de 1987 no habían evidencias de una recuperación de A. ater. En Bahía Independencia hubo una recuperación de S. algosus en el nivel intermareal. En agosto de 1986 recién encontramos una recolonización simultánea de ambos mitílidos en los rizoides de las algas pardas (Macrocystis pyrifera y Lessonia spp.). En los meses posteriores las algas pardas extendieron su distribución vertical de los 6 m hasta más de 12 m de profundidad y junto con ellos también A. ater. Se discute los mecanismos y procesos que estarían implicados en la diferente recolonización de las comunidades de mitílidos en las orillas y fondos rocosos de las dos áreas de estudio.

Invertebrados Macro-Bentónicos de área de Pisco, Perú

Entre 1978 y 1987 se realizaron muestreos de la macrofauna bentónica en 10 localidades del litoral y 14 estaciones del sublitoral, en el área de Pisco, Perú. Se diferenciaron ocho biotopos, en los que se hallaron un total de 330 taxones (excluyendo Nematoda), de los cuales 305 fueron determinados por los menos hasta el nivel genérico. El total de taxa está agrupado en 145 familias, 43 órdenes y 15 phyla, e incluye 112 Mollusca, 104 Annelida, 75 Crustacea y 39 taxa pertenecientes a otros grupos taxonómicos. Exclusivamente en fondos y orillas rocasas se encontraron 158 taxa. Considerando solamente los moluscos, poliquetos y crustáceos, con el presente estudio se incrementa de 103 a 289 el número de taxa registradas para el área investigada.

Evaluación del uso del chinchorro mecanizado en las zonas de Lomas - Mollendo

Evalúa el uso del chinchorro mecanizado y su relación con el deterioro del medio ambiente, teniendo en cuenta que su estilo de operación se asemeja a una red de arrastre de fondo que opera en zonas de mar abierto y/o en grandes ensenadas, cerca a la orilla de fondos someros, arenosos y planos; las cuales son zonas muy productivas por estar en áreas de intenso afloramiento que permiten el desarrollo de una gran variedad de invertebrados bentónicos (muy muy, machas. poliquetos, entre otros).

Contaminación sobre el macrobentos en las Bahías de Mollendo, Ilo, e Ite en marzo y agosto de 1996

Expone los resultados de los muestreos realizados en marzo y agosto de 1996 en las bahías de Mollendo, Ilo, e Ite con el objeto de evaluar los efectos de la contaminación sobre el macrobentos de fondos blandos sublitorales.

Evaluación de efectos de la contaminación sobre el ecosistema marino de Huacho y Carquín en 1995

Desarrolla la evaluación de efectos de la contaminación sobre el ecosistema marino en las Bahías de Huacho y Carquín, sobre la calidad microbiológica del agua de mar, la demanda bioquímica de oxígeno y el estados de las comunidades bénticas, a través de los muestreos realizados en los meses de febrero y octubre de 1995. Concluye que la contaminación influye sobre los organismos de los fondos marinos produciendo la disminución de su diversidad.

Microspathodon dorsalis (Pisces: Pomacentridae) y Prionurus laticlavius (Pisces: Acanthuridae), dos nuevos registros para el mar peruano

Describe a dos nuevas especies de peces no registradas para el Perú, determinando que se tratan de Microspathodon dorsalis (Famiia Pomacentridae) y Prionurus laticlavius (Familia Acanthridae), ambos del orden Perciformes. El registro de estas dos especies de aguas tropicales del norte del Perú, contribuye a la comprensión de la estructura comunitaria de los fondos rocosos costeros del litoral norte.