Actitudes hacia el VIH/SIDA, el cáncer y la enfermedad de Alzheimer

Esta revisión de la literatura tuvo como objetivo describir las actitudes hacia el VIH/SIDA, el cáncer y la Enfermedad de Alzheimer desde el modelo tripartito. Se revisaron 109 artículos publicados entre 2005 y 2015 en algunas bases de datos especializadas y herramientas de análisis de impacto. También se incluyeron fuentes secundarias ampliándose la búsqueda a los últimos 20 años (1995-2015). Los resultados mostraron que la mayoría de los estudios realizados sobre las actitudes hacia estas tres enfermedades son de tipo cuantitativo y la información se analizó con base en los componentes del modelo tripartito. Algunos aspectos sociodemográficos como el sexo y la edad están asociados con las actitudes hacia las tres enfermedades y predominan las creencias erróneas sobre ellas respecto a sus causas, curso y tratamiento. También predominan actitudes negativas hacia las tres enfermedades y las conductas e intenciones conductuales son diversas hacia cada una de ellas. No se hallaron antecedentes empíricos del estudio de la estructura de las actitudes propuesta por el modelo tripartito hacia las tres enfermedades. La Salud Pública ha liderado la investigación con base en el modelo de conocimientos, actitudes y prácticas propuesto por la OMS.

Representaciones sociales de la medicina complementaria y alternativa (MCA) para el cáncer en estudiantes universitarios de carreras de ciencias de la salud

Se realizó un estudio cualitativo exploratorio con estudiantes de carreras de Ciencias de la Salud con el objetivo de comprender las representaciones sociales que tienen acerca de la Medicina Complementaria y Alternativa (MCA) para el cáncer. Se desarrollaron grupos focales y la información obtenida fue analizada a través del Análisis Temático e interpretada con base en la Teoría de las Representaciones Sociales. Se encontraron diversas representaciones sociales asociadas con la definición, los objetivos, los tratamientos, la eficacia, las fuentes de información y el origen de la MCA. En conclusión se evidenció una alta tendencia a la aceptación y a la manifestación de una actitud positiva, aunque ambivalente frente a la MCA, además de un desconocimiento por la diferenciación conceptual entre este tipo de Medicina y la Medicina Popular. La cultura y las creencias sociales predominan en las representaciones sociales que tienen los estudiantes de la MCA para el cáncer, pese a su formación académica.

Percepción del riesgo biológico en el personal asistencial en un hospital de alta complejidad de la ciudad de Bogotá.

OBJETIVOS: Identificar la percepción del riesgo biológico de los trabajadores asistenciales del Hospital Central de la Policía Nacional en la ciudad de Bogotá. METODOS: se realizó un estudio analítico de corte transversal para describir la percepción acerca del riesgo biológico en 159 trabajadores asistenciales de un hospital de alta complejidad en la ciudad de Bogotá (Colombia), la información se recolectó por medio de la utilización de la encuesta validada nota técnica 578 (Portell M, Solé M, 2001). Se realizó la caracterización de la población por variables de sexo, edad, tiempo de experiencia y servicio al cual pertenece y se promediaron las respuestas obtenidas para cada ítem encuestado, obteniendo una clasificación para cada dimensión de percepción de riesgo baja (1 a 3), media (4 a 5) o alta (6 a 7). Resultados: De los 159 trabajadores asistenciales encuestados el 80.4% eran de género femenino, el 22.2% pertenecían al servicio de urgencias, el 16,5% al servicio de medicina interna y el 9.5% al servicio de pediatría, de los encuestados el 62.9% fueron auxiliares de enfermería, el 21,4% enfermeras jefes y el 6.9% médicos. Se obtuvo una percepción de riesgo alta (media aritmética mayor de 5) para todas las variables incluidas en la encuesta, demostrando conocimiento de todo el personal acerca de la alta exposición a accidentes de tipo biológico. No se encontró asociación entre la labor desempeñada y la percepción del riesgo biológico, sin embargo, se encontró una asociación entre el tiempo de experiencia del trabajador y una disminución en la magnitud del riesgo percibido (Chi cuadrado de asociación, p=0.042). Conclusiones: Los trabajadores asistenciales identifican la magnitud del riesgo biológico al que se encuentran expuestos en sus labores del día a día, sin embargo, es necesaria una mayor participación por parte del personal directivo y de los responsables de la prevención en temas de reacción ante accidentes y en la valoración del riesgo, especialmente en personas que llevan mucho tiempo desempeñando la labor.

Eficacia de la estimulación magnética transcraneal en la disminución de severidad en el trastorno depresivo mayor en monoterapia y coadyuvante comparado con tratamientos farmacológicos. Revisión sistemática y meta-análisis

Resumen Introducción Una posible opción de tratamiento para el manejo del trastorno depresivo mayor (TDM) es la estimulación magnética transcraneal (EMT) que ha mostrado propiedades antidepresivas superiores al placebo con un buen perfil de seguridad. El objetivo del presente trabajo es determinar la reducción en la severidad del TDM y la proporción de eventos adversos (EA) en pacientes con TDM refractario y no refractario, posterior al uso de EMT administrada en monoterapia o tratamiento coadyuvante comparado con terapia farmacológica. Metodología Se planteó una pregunta PICOT de la cual se realizó una búsqueda sistemática de estudios clínicos en las bases de datos Medline, EMBASE y Cochrane. Dos investigadores en forma independiente realizaron la selección de artículos, evaluación de calidad con la herramienta de la colaboración Cochrane y extracción de datos. Se extrajeron datos de eficacia como tasa de respuesta, porcentaje de remisión, calidad de vida, diminución sintomática del trastorno depresivo mayor en la escala de Hamilton y capacidad funcional. Igualmente, proporción de pacientes con EA. Se realizó un meta-análisis de estas variables teniendo en cuenta la heterogeneidad. Resultados La presente revisión sistemática incluyó 26 estudios clínicos aleatorizados de baja calidad metodológica mostrando que la EMT presentó una eficacia superior cuando es usada como coadyuvante a las terapias con que venían siendo tratados los pacientes con TDM refractario y no refractario en los desenlaces de tasa de respuesta y porcentaje de remisión. En el caso de intervenciones farmacológicas específicas, la EMT presento eficacia similar, tanto en terapia coadyuvante como en monoterapia comparado con las intervenciones farmacológicas. En cuanto a seguridad, la EMT presenta un buen perfil de seguridad debido a que en todos los escenarios estudiados los EA fueron no serios y baja frecuencia Conclusiones La evidencia disponible sugiere que la EMT mostró ser efectivo y seguro para el manejo del TDM refractario y no refractario. Sin embargo, la evidencia es débil por lo tanto se necesita mayor investigación clínica que soporte su uso.

Empowerment: model i instrument de mesura basat en les variables primàries o efectives PIEQ (Primary Items Empowerment Questionnaire)

In this thesis a review of the state of the art on empowerment is found. A proposal is put forward for a model of the effective variables of empowerment, a new theoretical model that provides a distinct classification of individual variables. The model consists of four metavariables called reciprocal, unidirectional, shared and reflexive. Finally, a measurement tool for measuring and representing these variables graphically is described, including its process of elaboration through a preliminary pilot study that served to refine and improve the questionnaire. Both the model and the instrument proposed aim to determine the state of the primary variables involved in determining the predisposition and potential of a working group towards empowerment. With the measurement tool both organisational, departmental, working group and/or individual data can be obtained. This instrument can help companies and organisations to discover the limitations existing within a working group and act in consequence.

Attention and selection behavior on ‘universal search’ result pages

The ISO norm line 9241 states some criteria for ergonomics of human system interaction. In markets with a huge variety of offers and little possibility of differentiation, providers can gain a decisive competitive advantage by user oriented interfaces. A precondition for this is that relevant information can be obtained for entrepreneurial decisions in this regard. To test how users of universal search result pages use those pages and pay attention to different elements, an eye tracking experiment with a mixed design has been developed. Twenty subjects were confronted with search engine result pages (SERPs) and were instructed to make a decision while conditions “national vs. international city” and “with vs. without miniaturized Google map” were used. Different parameters like fixation count, duration and time to first fixation were computed from the eye tracking raw data and supplemented by click rate data as well as data from questionnaires. Results of this pilot study revealed some remarkable facts like a vampire effect on miniaturized Google maps. Furthermore, Google maps did not shorten the process of decision making, Google ads were not fixated, visual attention on SERPs was influenced by position of the elements on the SERP and by the users’ familiarity with the search target. These results support the theory of Amount of Invested Mental Effort (AIME) and give providers empirical evidence to take users’ expectations into account. Furthermore, the results indicated that the task oriented goal mode of participants was a moderator for the attention spent on ads. Most important, SERPs with images attracted the viewers’ attention much longer than those without images. This unique selling proposition may lead to a distortion of competition on markets.

Explorando modelos in vivo para caracterizar a microcirculação periférica : um estudo piloto

Nos últimos anos, a circulação cutânea surgiu como uma janela interessante para analisar a função microcirculatória e os mecanismos de disfunção. Tecnologias não-invasivas, incluindo a Fluxometria por Laser Doppler (FLD), gasimetria transcutânea e a Perda Transepidérmica de Água (PTEA), ajudaram a considerar a circulação cutânea como um modelo de translação útil na doença vascular. Neste estudo procurou-se avaliar o perfil de resposta de um grupo de indivíduos jovens saudáveis ​​(n = 8), de ambos os sexos (24,5 ± 0,8 anos de idade) a três manobras de condicionamento da perfusão no membro inferior - A: elevação da perna enquanto sentado, B: elevação da perna enquanto em decúbito dorsal; C: oclusão supra-sistólica com um torniquete. As técnicas de medição incluiram FLD, pressões parciais transcutâneas (tc) pO2 e pCO2 por gasimetria e PTEA por evaporimetria. Foram aplicados testes de estatística descritiva e não paramétrica, sendo adotado um nível de confiança de 95%. As tcpO2 e tcpCO2 alteraram-se significativamente durante as manobras. Foi registado um perfil de evolução recíproca para FLD e PTEA em A e C, o que pode sugerir que, sob as condições experimentais as condições de perfusão local podem influenciar a função epidérmica "barreira". Os modelos propostos parecem ser adequados para caracterizar a microcirculação periférica in vivo, o que justifica estudos de desenvolvimento posteriores.

The characterization of distortion product otoacoustic emissions in the Sprague-Dawley rat during development

This paper describes a project which set up a system to measure distortion product otoacoustic emissions (DPOAEs) in the Sprague Dawley rat and to conduct a pilot study to measure the development of DPOAEs as a function of age.

Are there hazardous auditory effects of high-frequency turbines and ultrasonic dental scalers on dental professionals?

The purpose of this pilot study was to survey dentists in the St. Louis area to assess their subjective opinion of commonly used dental handpieces as well as history of noise exposure and use of hearing protection. Selected handpieces were then chosen to measure their output levels and determine if emissions are hazardous to the auditory system.

The GlobMODEL demonstrator: assimilation of new satellite products in an operational meteorological center

As part of its Data User Element programme, the European Space Agency funded the GlobMODEL project which aimed at investigating the scientific, technical, and organizational issues associated with the use and exploitation of remotely-sensed observations, particularly from new sounders. A pilot study was performed as a "demonstrator" of the GlobMODEL idea, based on the use of new data, with a strong European heritage, not yet assimilated operationally. Two parallel assimilation experiments were performed, using either total column ozone or ozone profiles retrieved at the Royal Netherlands Meteorological Institute (KNMI) from the Ozone Monitoring Instrument (OMI). In both cases, the impact of assimilating OMI data in addition to the total ozone columns from the SCanning Imaging Absorption spectroMeter for Atmospheric CartograpHY (SCIAMACHY) on the European Centre for Medium Range Weather Forecasts (ECMWF) ozone analyses was assessed by means of independent measurements. We found that the impact of OMI total columns is mainly limited to the region between 20 and 80 hPa, and is particularly important at high latitudes in the Southern hemisphere where the stratospheric ozone transport and chemical depletion are generally difficult to model with accuracy. Furthermore, the assimilation experiments carried out in this work suggest that OMI DOAS (Differential Optical Absorption Spectroscopy) total ozone columns are on average larger than SCIAMACHY total columns by up to 3 DU, while OMI total columns derived from OMI ozone profiles are on average about 8 DU larger than SCIAMACHY total columns. At the same time, the demonstrator brought to light a number of issues related to the assimilation of atmospheric composition profiles, such as the shortcomings arising when the vertical resolution of the instrument is not properly accounted for in the assimilation. The GlobMODEL demonstrator accelerated scientific and operational utilization of new observations and its results - prompted ECMWF to start the operational assimilation of OMI total column ozone data.

‘We are managing our own lives...’: life transitions and care in sibling-headed households affected by AIDS in Tanzania and Uganda

This paper explores the ways that young people express their agency and negotiate complex lifecourse transitions according to gender, age and inter- and intra-generational norms in sibling-headed households affected by AIDS in East Africa. Based on findings from a qualitative and participatory pilot study in Tanzania and Uganda, I examine young people's socio-spatial and temporal experiences of heading the household and caring for their siblings following their parent's/relative's death. Key dimensions of young people's caring pathways and life transitions are discussed: transitions into sibling care; the ways young people manage changing roles within the family; and the ways that young people are positioned and seek to position themselves within the community. The research reveals the relational and embodied nature of young people's life transitions over time and space. By living together independently, young people constantly reproduce and reconfigure gendered, inter- and intra-generational norms of ‘the family’, transgressing the boundaries of ‘childhood’, ‘youth’ and ‘adulthood’. Although young people take on ‘adult’ responsibilities and demonstrate their competencies in ‘managing their own lives’, this does not necessarily translate into more equal power relations with adults in the community. The research reveals the marginal ‘in-between’ place that young people occupy between local and global discourses of ‘childhood’ and ‘youth’ that construct them as ‘deviant’. Although young people adopt a range of strategies to resist marginalisation and harassment, I argue that constraints of poverty, unequal gender and generational power relations and the emotional impacts of sibling care, stigmatisation and exclusion can undermine their ability to exert agency and control over their sexual relationships, schooling, livelihood strategies and future lifecourse transitions.

The potential to narrow uncertainty in projections of stratospheric ozone over the 21st century

Future stratospheric ozone concentrations will be determined both by changes in the concentration of ozone depleting substances (ODSs) and by changes in stratospheric and tropospheric climate, including those caused by changes in anthropogenic greenhouse gases (GHGs). Since future economic development pathways and resultant emissions of GHGs are uncertain, anthropogenic climate change could be a significant source of uncertainty for future projections of stratospheric ozone. In this pilot study, using an "ensemble of opportunity" of chemistry-climate model (CCM) simulations, the contribution of scenario uncertainty from different plausible emissions pathways for ODSs and GHGs to future ozone projections is quantified relative to the contribution from model uncertainty and internal variability of the chemistry-climate system. For both the global, annual mean ozone concentration and for ozone in specific geographical regions, differences between CCMs are the dominant source of uncertainty for the first two-thirds of the 21st century, up-to and after the time when ozone concentrations return to 1980 values. In the last third of the 21st century, dependent upon the set of greenhouse gas scenarios used, scenario uncertainty can be the dominant contributor. This result suggests that investment in chemistry-climate modelling is likely to continue to refine projections of stratospheric ozone and estimates of the return of stratospheric ozone concentrations to pre-1980 levels.

Simple and surprisingly effective one-step extraction-cleanup by Soxflo for DDT and its metabolites from environmental samples

A pilot study found that DDT breakdown at the GC inlet was extensive in extracts from some-but not all-samples with high organic carbon contents. However, DDT losses could be prevented with a one-step extraction-cleanup in the Soxflo instrument with dichloromethane and charcoal. This dry-column procedure took 1 h at room temperature. It was tested on spiked soil and peat samples and validated with certified soil and sediment reference materials. Spike recoveries from freshly spiked samples ranged from 79 to 111% at 20-4000 mug/kg concentrations. Recoveries from the real-world CRMs were 99.7-100.2% of DDT, 89.7-90.4% of DDD and 89.6-107.9% of DDE. It was concluded that charcoal cleanups should be used routinely during surveys for environmental DDX pollution in order to mitigate against unpredictable matrix-enhanced breakdown in the GC. (C) 2004 Elsevier B.V. All rights reserved.

Key performance indicators (KPIs) and priority setting in using the multi-attribute approach for assessing sustainable intelligent buildings

The main objectives of this paper are to: firstly, identify key issues related to sustainable intelligent buildings (environmental, social, economic and technological factors); develop a conceptual model for the selection of the appropriate KPIs; secondly, test critically stakeholder's perceptions and values of selected KPIs intelligent buildings; and thirdly develop a new model for measuring the level of sustainability for sustainable intelligent buildings. This paper uses a consensus-based model (Sustainable Built Environment Tool- SuBETool), which is analysed using the analytical hierarchical process (AHP) for multi-criteria decision-making. The use of the multi-attribute model for priority setting in the sustainability assessment of intelligent buildings is introduced. The paper commences by reviewing the literature on sustainable intelligent buildings research and presents a pilot-study investigating the problems of complexity and subjectivity. This study is based upon a survey perceptions held by selected stakeholders and the value they attribute to selected KPIs. It is argued that the benefit of the new proposed model (SuBETool) is a ‘tool’ for ‘comparative’ rather than an absolute measurement. It has the potential to provide useful lessons from current sustainability assessment methods for strategic future of sustainable intelligent buildings in order to improve a building's performance and to deliver objective outcomes. Findings of this survey enrich the field of intelligent buildings in two ways. Firstly, it gives a detailed insight into the selection of sustainable building indicators, as well as their degree of importance. Secondly, it tesst critically stakeholder's perceptions and values of selected KPIs intelligent buildings. It is concluded that the priority levels for selected criteria is largely dependent on the integrated design team, which includes the client, architects, engineers and facilities managers.

The effect of colored lenses on the visual evoked response in children with visual stress

Purpose. Some children with visual stress and/or headaches have fewer symptoms when wearing colored lenses. Although subjective reports of improved perception exist, few objective correlates of these effects have been established. Methods. In a pilot study, 10 children who wore Intuitive Colorimeter lenses, and claimed benefit, and two asymptomatic children were tested. Steady-state potentials were measured in response to low contrast patterns modulating at a frequency of 12 Hz. Four viewing conditions were compared: 1) no lens; 2) Colorimeter lens; 3) lens of complementary color; and 4) spectrally neutral lens with similar photopic transmission. Results. The asymptomatic children showed little or no difference between the lens and no lens conditions. When all the symptomatic children were tested together, a similar result was found. However, when the symptomatic children were divided into two groups depending on their symptoms, an interaction emerged. Children with visual stress but no headaches showed the largest amplitude visual evoked potential response in the no lens condition, whereas those children whose symptoms included severe headaches or migraine showed the largest amplitude visual evoked potential response when wearing their prescribed lens. Conclusions. The results suggest that it is possible to measure objective correlates of the beneficial subjective perceptual effects of colored lenses, at least in some children who have a history of migraine or severe headaches.