Prevalencia y factores asociados al síndrome de agotamiento profesional en residentes de diferentes especialidades médicas : una revisión de la literatura de los últimos 15 años

El Síndrome de Agotamiento Profesional (SAP), es común en los trabajadores de la salud, particularmente en los expuestos a altos niveles de estrés en el trabajo e incluye el agotamiento emocional, despersonalización y baja realización personal. Se considera que los médicos residentes presentan una mayor prevalencia del síndrome que los médicos debido a que se encuentran en entrenamiento, período en el cual están sometidos a alta carga laboral debido a las largas horas de trabajo, horarios irregulares, privación de sueño, intensas demandas emocionales, así como la presión de dominar un gran conocimiento clínico. Objetivo. Determinar la prevalencia del Síndrome de Agotamiento Profesional o Burnout en la población de médicos residentes. Metodología. Se realizó una búsqueda de artículos en la base de datos electrónica Pubmed, seleccionando aquellos publicados entre los años 2001 al 2016, tanto en idioma inglés como en español, a texto completo y enfocados en estudios en médicos residentes. Resultados. Los hallazgos sugieren que el Síndrome de Agotamiento Profesional o Burnout es altamente prevalente, que varía de acuerdo a la residencia que se esté realizando, encontrando un promedio del 50% con un rango de 27% a 75% entre las diferentes especialidades de la población estudiada y, en consecuencia, puede constituir un problema de salud que amerita atención en cada Institución, esto a pesar de que la prevalencia pueda variar de un lugar a otro y en las diferentes especialidades. Conclusiones. El SAP o Burnout constituye un problema de salud entre la población de médicos residentes, lo que sugiere la conveniencia de diseñar medidas para su prevención como informar en la inducción al programa de residencia sobre el riesgo de la aparición del síndrome y sus síntomas, consultar tempranamente ante signos de alarma, adecuar el sistema de vigilancia epidemiológica para que incluya esta condición específica y ajustar o disminuir la carga laboral entre otras.

Soil amendment and slow release fertilizer preparation from castor meal.

2008

Lessons from the Terra Preta de Índios of the Amazon region for the utilisation of charcoal for soil amendment.

Neste trabalho faz-se a divulgação do potencial de carvões e resíduos orgânicos parcialmente carbonizados visando obter materiais que mimetizam a matéria orgânica do solo das Terras Pretas de Índio da Amazônia, e que sirvam como condicionadores de solo e seqüestrem carbono de forma recalcitrante e reativa. Pesquisas desenvolvidas por grupos brasileiros e estrangeiros têm contribuído para o entendimento do surgimento e utilização das Terras Pretas de Índio da Amazônia. Aqui são divulgados resultados de estudos químicos no sentido do desenvolvimento do conhecimento científico e tecnológico e de inovação no aproveitamento de subprodutos orgânicos, principalmente de indústrias de biocombustíveis, carvão vegetal metalúrgico e outros, buscando imitar a excelente performance da chamada Terras Pretas de Índio da Amazônia.

Sequential exhaustive extraction of a Mollisol soil, and characterizations of humic components, including humin, by solid and solution state NMR.

A comprehensive sequential extraction procedure was applied to isolate soil organic components using aqueous solvents at different pH values, base plus urea (base-urea), and finally dimethylsulfoxide (DMSO) plus concentrated H2SO4 (DMSO-acid) for the humin-enriched clay separates. The extracts from base-urea and DMSO-acid would be regarded as 'humin' in the classical definitions. The fractions isolated from aqueous base, base-urea and DMSO-acid were characterized by solid and solution state NMR spectroscopy. The base-urea solvent system isolated ca. 10% (by mass) additional humic substances. The combined base-urea and DMSO-acid solvents isolated ca. 93% of total organic carbon from the humin-enriched fine clay fraction (<2 ?m). Characterization of the humic fractions by solid-state NMR spectroscopy showed that oxidized char materials were concentrated in humic acids isolated at pH 7, and in the base-urea extract. Lignin-derived materials were in considerable abundance in the humic acids isolated at pH 12.6. Only very small amounts of char-derived structures were contained in the fulvic acids and fulvic acids-like material isolated from the base-urea solvent. After extraction with base-urea, the 0.5 m NaOH extract from the humin-enriched clay was predominantly composed of aliphatic hydrocarbon groups, and with lesser amounts of aromatic carbon (probably including some char material), and carbohydrates and peptides. From the combination of solid and solution-state NMR spectroscopy, it is clear that the major components of humin materials, from the DMSO-acid solvent, after the exhaustive extraction sequence, were composed of microbial and plant derived components, mainly long-chain aliphatic species (including fatty acids/ester, waxes, lipids and cuticular material), carbohydrate, peptides/proteins, lignin derivatives, lipoprotein and peptidoglycan (major structural components in bacteria cell walls). Black carbon or char materials were enriched in humic acids isolated at pH 7 and humic acids-like material isolated in the base-urea medium, indicating that urea can liberate char-derived material hydrogen bonded or trapped within the humin matrix.

Effect of residual vanadyl ions on the spectroscopic analysis of humic acids: a multivariate approach.

In a study of the vanadyl (VO2þ)-humic acids system, the residual vanadyl ion suppressed fluorescence and specific electron paramagnetic resonance (EPR) and NMR signals. In the case of NMR, the proton rotating frame relaxation times (T1qH) indicate that this suppression is due to an inefficient H-C cross polarization, which is a consequence of a shortening of T1qH. Principal components analysis (PCA) facilitated the isolation of the effect of the VO2þ ion and indicated that the organic free radical signal was due to at least two paramagnetic centres and that the VO2þ ion preferentially suppressed the species whose electronic density is delocalized over O atoms (greater g-factor). additionally, the newly obtained variables (principal components ? PC) indicated that, as the result of the more intense tillage a relative increase occurred in the accumulation of: (i) recalcitrant structures; (ii) lignin and long-chain alkyl structures; and (iii) organic free radicals with smaller g-factors.

Growth and symbiosis of plants with arbuscular mycorrhizal fungi in soil submitted to biochar application.

Arbuscular mycorrhizal fungi (AMF), which is intrinsically present or may be introduced in soils by inoculation, is an example of natural and renewable resource to increase plant nutrient uptake. This kind of fungi produces structures (hyphae, arbuscles and sometimes vesicles) inside the plant root cortex. This mutualistic relationship promotes plant gains in terms of water and nutrient absorption (mainly phosphorus). Biochar can benefit plant interaction with AMF, however, it can contain potentially toxic compounds such as heavy metals and organic compounds (e.g. dioxins, furans and polycyclic aromatic hydrocarbons), depending on the feedstock and pyrolysis conditions, which may damage organisms. For these reasons, the present work will approach the impacts of biochar application on soil attributes, AMF-plant symbiosis and its responses in plant growth and phosphorus uptake. Eucalyptus biochar produced at high temperatures increases sorghum growth; symbiosis with AMF; and enhances spore germination. Enhanced plant growth in the presence of high temperature biochar and AMF is a response of root branching stimulated by an additive effect between biochar characteristics and root colonization. Biochar obtained at low temperature reduces AMF spore germination; however it does not affect plant growth and symbiosis in soil.

Atrazine sorption in soil treated with biochar.

Biochar has been used worldwide as soil amendment. Due to the high sorption capacity of organic compounds by charcoal in general, the use of biochar can change the soil sorptive properties, that could result in a environmental protective strategy in one hand and/or in need of higher pesticides doses in another hand. However no data in the literature is available about the long term effect of biochar application in the sorptive properties of the soil, even studies about the sorptive properties of soil treated with biochar are scarce, the few available papers are with pure biochar. This unprecedented work, evaluating the sorption of atrazine in a clayed soil treated with biochar, under experimental field conditions, evaluated the sorption isotherms one and three years after the single biochar application (16 Mg ha-1 of biochar). One year after the biochar application the Kf was two times higher for the biochar amended soil than for the control one (without biochar). This effect decreases after three years from the application, but it is even significantly higher (50% higher) than the control treatment.

Dynamic of polycyclic aromatic hydrocarbons in soils treated with biochar.

In recent years the interest in pyrogenic carbon for agricultural use (biochar, i.e. carbonized biomass for agricultural use) has sharply increased. However biochar contain dangerous compounds such as Polycyclic Aromatic Hydrocarbons (PAHs), many of them potentially carcinogenic and mutagenic. They are organic compounds formed from incomplete combustion of organic materials and are persistent pollutants. Therefore, PAHs concentrations and their dynamic must be evaluated in soils amended with biochar. For this, soil samples were collected in three experimental areas in different years (1, 3, 5 or 6) after the application of 0 (control) or 16 Mg ha-1 of biochar. This is the first report of PAHs persistence up to six years in soil treated with biochar. The biochar application increased total PAHs concentrations up to five years after the application, however the levels have always been an order of magnitude lower the limits of prevention established by International Environmental Agencies for soils. Thus, under the evaluated conditions ,the use of biochar was safe concerning PAHs contamination, besides, after six years of the application, the levels found were similar to the control treatment, making it possible to define a safe frequency of application based on the persistence of PAHs in soil.