Caracterización de los accidentes de trabajo en los funcionarios de una clínica de tercer nivel de la ciudad de Bogotá 2010 a 2013.

Objetivo: Caracterizar la accidentalidad laboral en una clínica de tercer nivel de la ciudad de Bogotá, en el periodo 2010 a 2013. Materiales y Métodos: Se realizó un estudio de tipo corte transversal, utilizando una base de datos de accidentalidad en los trabajadores vinculados directamente con la institución. Resultados: Durante el periodo estudiado se generaron 191 accidentes, 57 casos en el año 2013, el personal de enfermería fue el grupo con mayor porcentaje de accidentes (70.2 %). El sitio donde ocurrieron con mayor frecuencia los accidentes fueron las áreas asistenciales (49.2 %). Al analizar los datos de los accidentes de riesgo biológico se encontró que el pinchazo es el más común (84.7%), seguido de las heridas abiertas y lesiones superficiales (77.2%). Las partes del cuerpo más frecuentemente lesionadas fueron extremidades superiores, siendo la mano la zona más afectada (60.2%); además identifica al paciente fuente del accidente en el 71.8% de los casos y no se logra determinar en un alto porcentaje, si el trabajador afectado usa elementos de protección personal al momento del evento (82.1%). Conclusiones Los accidentes de trabajo con exposición a riesgo biológico son frecuentes en los trabajadores del área asistencial, en especial en el personal de enfermería, dadas las características propias de sus tareas diarias y el cumplimiento de las mismas. El pinchazo fue causa más común, y la parte del cuerpo más frecuentemente afectada fueron las extremidades superiores, específicamente las manos. Dado que los accidentes laborales a riesgo biológico tienen el potencial de general consecuencias nocivas para la salud es esencial establecer estrategias tendientes a minimizar su frecuencia y severidad, por lo que se recomienda revisar e implementar nuevas tecnologías para la reducción de accidentes con elementos corto punzantes, aumentar la sensibilización de los trabajadores con respecto al uso de los elementos de protección personal y revisar la metodología utilizada para la investigación de accidentes laborales.

Investigating the prevalence and causes of prescribing errors in general practice: the PRACtICe Study

Aim: To determine the prevalence and nature of prescribing errors in general practice; to explore the causes, and to identify defences against error. Methods: 1) Systematic reviews; 2) Retrospective review of unique medication items prescribed over a 12 month period to a 2% sample of patients from 15 general practices in England; 3) Interviews with 34 prescribers regarding 70 potential errors; 15 root cause analyses, and six focus groups involving 46 primary health care team members Results: The study involved examination of 6,048 unique prescription items for 1,777 patients. Prescribing or monitoring errors were detected for one in eight patients, involving around one in 20 of all prescription items. The vast majority of the errors were of mild to moderate severity, with one in 550 items being associated with a severe error. The following factors were associated with increased risk of prescribing or monitoring errors: male gender, age less than 15 years or greater than 64 years, number of unique medication items prescribed, and being prescribed preparations in the following therapeutic areas: cardiovascular, infections, malignant disease and immunosuppression, musculoskeletal, eye, ENT and skin. Prescribing or monitoring errors were not associated with the grade of GP or whether prescriptions were issued as acute or repeat items. A wide range of underlying causes of error were identified relating to the prescriber, patient, the team, the working environment, the task, the computer system and the primary/secondary care interface. Many defences against error were also identified, including strategies employed by individual prescribers and primary care teams, and making best use of health information technology. Conclusion: Prescribing errors in general practices are common, although severe errors are unusual. Many factors increase the risk of error. Strategies for reducing the prevalence of error should focus on GP training, continuing professional development for GPs, clinical governance, effective use of clinical computer systems, and improving safety systems within general practices and at the interface with secondary care.

Towards (more) integrity in academia: transcending neo-liberal assumption of research and knowledge creation and the “rules” supressing academic freedom

European researchers across heterogeneous disciplines voice concerns and argue for new paths towards a brighter future regarding scientific and knowledge creation and communication. Recently, in biological and natural sciences concerns have been expressed that major threats are intentionally ignored. These threats are challenging Europe’s future sustainability towards creating knowledge that effectively deals with emerging social, environmental, health, and economic problems of a planetary scope. Within social science circles however, the root cause regarding the above challenges, have been linked with macro level forces of neo-liberal ways of valuing and relevant rules in academia and beyond which we take for granted. These concerns raised by heterogeneous scholars in natural and the applied social sciences concern the ethics of today’s research and academic integrity. Applying Bourdieu’s sociology may not allow an optimistic lens if change is possible. Rather than attributing the replication of neo-liberal habitus in intentional agent and institutional choices, Bourdieu’s work raises the importance of thoughtlessly internalised habits in human and social action. Accordingly, most action within a given paradigm (in this case, neo-liberalism) is understood as habituated, i.e. unconsciously reproducing external social fields, even ill-defined ways of valuing. This essay analyses these and how they may help critically analyse the current habitus surrounding research and knowledge production, evaluation, and communication and related aspects of academic freedom. Although it is acknowledged that transformation is not easy, the essay presents arguments and recent theory paths to suggest that change nevertheless may be a realistic hope once certain action logics are encouraged.

Panel cointegration tests of the Fisher effect

Most empirical evidence suggests that the Fisher effect, stating that inflation and nominal interest rates should cointegrate with a unit slope on inflation, does not hold, a finding at odds with many theoretical models. This paper argues that these results can be attributed in part to the low power of univariate tests, and that the use of panel data can generate more powerful tests. For this purpose, we propose two new panel cointegration tests that can be applied under very general conditions, and that are shown by simulation to be more powerful than other existing tests. These tests are applied to a panel of quarterly data covering 20 OECD countries between 1980 and 2004. The evidence suggest that the Fisher effect cannot be rejected once the panel evidence on cointegration has been taken into account. Copyright © 2008 John Wiley & Sons, Ltd.

Trainee underperformance: a guide to achieving resolution

BACKGROUND: Underperformance and the disharmony it can cause are not commonly faced by trainees. However, when it occurs, a process to recognize and manage the issues compassionately must be put in place. METHOD: A literature review was undertaken to outline processes and themes in addressing and resolving these types of issues. A PubMed search using 'surgical underperformance' and 'remedial teaching' was used as a broad template to find papers that illustrated key concepts. One thousand four hundred and fifteen papers were identified. In papers where the titles were in line with the stated topic, 294 abstracts were reviewed. Key papers were used to develop themes. Additional cross-referenced papers were also included where relevant. RESULTS: There can be a variety of reasons for trainee underperformance. The root cause is not always clear. Disharmony can result in a surgical unit during this time. The involved trainee as well as the members of the clinical unit may experience a variety of stressors. A systematic process of management can be used to evaluate the situation and bring some resolution to difficulties in working relationships. CONCLUSION: Early constructive intervention improves outcomes. There should be a process to systematically and compassionately resolve underlying issues. This paper outlines the disharmony that can result from trainee underperformance and offers guidance for resolution to those involved.

Distribuição radicular de cultivares de aspargo em áreas irrigadas de Petrolina - PE

A distribuição radicular de duas cultivares de aspargo (New Jersey 220 e UC 157 F1), irrigadas por aspersão convencional, foi avaliada durante o ano de 1997 em solos de textura arenosa, em plantio experimental e comercial, respectivamente, nos Projetos de Irrigação de Bebedouro e Senador Nilo Coelho, em Petrolina (PE). O objetivo foi obter informações do sistema radicular do aspargo, empregando-se os métodos do monolito e do perfil de solo auxiliado pela análise de imagens digitais, para o manejo de solo e água nesse cultivo. Na área experimental, a maior parte da matéria seca, área e comprimento de raízes no perfil de solo e densidade de comprimento radicular foram encontradas até a profundidade de 0,4 m nas duas cultivares, enquanto que na comercial a maior parte da área e comprimento de raízes no perfil do solo estendeu-se até a profundidade de 0,6 m (cv. New Jersey 220). Nesses dois plantios, as raízes das cultivares atingiram a profundidade de 1 m. Na área experimental, a massa seca, a área e o comprimento no perfil de solo, e a densidade de comprimento radicular nas cultivares concentraram-se até a distância de 0,6 m à linha de plantas. No intervalo de diâmetro (d) de raízes 2

Lítio e parâmetros orbitais em sistemas binários com componentes evoluídas

One of the best established properties of the single late type evolved stars is that their rotational velocity and lithium content decrease with effective temperature and age. Nevertheless, the root cause of this property, as well as the link between rotation and lithium abundance and, in particular, the effects of binarity on rotation and lithium content in binary systems with evolved component, are not yet completely established. How does the gravitational tides, in binary systems, affects rotational evolution and lithium dilution? Trying to answer these questions, we have carried out an observational survey, in the lithium region centered at the lithium I line A6707.81A, for a large sample of about 100 binary systems with evolved component along the spectral range F, G and K, with the CES spectrometer mounted at the CAT 1.44 m Telescope of the ESO, La Silla, Chile. By combining the abundances of lithium issued from these observations with rotational velocity and orbital parameters, we have found a number of important results. First of all, we confirm that in this class of binary systems rotation is effectively affected by tidal effects. Binary systems with orbital period lower than about 100 days and circular or nearly circular orbits, present rotational velocity enhanced in relation to the single giant stars and to the binary systems with an orbital period larger than 100 days. This is clearly the result of the synchonization between the rotational and orbital motions due to tidal effects. In addition, we have found that lithium abundances in binary systems with giant components present the same gradual decreasing with effective temperature, observed in the single giants of same luminosity class and spectral types. We have found no lithium-rich binary systems, in contrast with single giants. A remarkable result from the present study is the one showing that synchronized binary systems with giant component retains more of their original lithium than the unsynchronized systems. In fact, we have found a possible "inhibited zone", in which synchronized binary systems with giant component having lithium abundance lower than a threshold level should be unusual. Finally, the present study also shows that the binary systems with giant component presenting the highest lithium contents are those with the highest rotation rates

Uso de biossólido como substrate para produção de mudas de eucalipto

The objective of this study was to evaluate the feasibility of the biosolids used as substrate component for seedlings production of Eucalyptus. This way, different proportions of biosolid/carbonized rice (80/20, 70/30, 60/40, 50/05 and 40/60) were tested as substrates in mixture, which were compared to the common substrate used by forest nursery (Multiplant®), as control. The experiment was established with Eucalyptus grandis where growth seedlings-related parameters were assessed: shoot height, collar diameter, accumulation of dry matter on the shoot and root, chemical analysis of the vegetal tissue of aerial part and root, foliar area and chlorophyll content. The results revealed that Eucalypts seedlings developed in substrate with 50% biosolid were similar to the control in relation to the evaluated parameters, concluding that the use of biosolids for seedlings production is quite promising.

Aryltetralone lignans and 7,8-seco-lignans from Holostylis reniformis

Aryltetralone lignans and two 7,8-seco-lignans were isolated from the acetone and hexane extracts of the roots of Holostylis reniformis, together with (-)-galbacin. Their structures were determined by spectroscopic methods. © 2004 Elsevier Ltd. All rights reserved.

Biofortificação com zinco, selênio e ferro, e biodisponibilidade de ferro em cultivares de feijoeiro-comum

The common bean (Phaseolus vulgaris L.), a staple food in nutritional diet of Brazilians and populations in developing countries, is a nutritionally rich legume with potential for biofortification. Approximately one third of the world population suffers from nutritional deficiencies, being necessary to increase the nutrient content in vegetables, especially iron (Fe), selenium (Se) and zinc (Zn), which are important micronutrients for plants and human health. In this context, three studies were carried out aiming to evaluate the potential of common bean cultivars to biofortification with Fe, Se and Zn, and verify the interaction between these minerals and iron bioavailability, in order to contribute to increased nutritional quality of grains, reducing the micronutrients deficiency and improving human health. In the first study, experiments were conducted in a greenhouse, with ten common bean cultivars in nutrient solution under different treatments with Fe, Se and Zn. The plant growth and the mineral content of the beans were evaluated in addition to verify the influence of polyphenol and phytate levels on Fe bioavailability in grains fortified with Zn and Se. The evaluated beans cultivars have proved promising for simultaneous biofortification with these nutrients without greatly affecting Fe bioavailability. In the second study, the aim was evaluate the interaction between Fe, Se and Zn in cultivars consumed in Brazil or in USA. Gene expression and root microscopy analysis were performed in order to understand the positive effect of Zn supply on the Fe uptake by roots. The expression of genes related to the transport and uptake of Fe and Zn did not clearly explain the influence of Zn in Fe nutrition. The roots microscopy and the evaluation of nutrient solutions used showed that, in the presence of Zn, there was Fe accumulation in epidermis of the roots and not in the vascular system, prone to be precipitated when it goes through the root membrane. In the latest study, a field experiment was conducted to evaluate the effect of Zn fertilization via soil and foliar, in the content and accumulation of Fe and Zn in grains and in the yield of common bean cultivars, in addition to verify the amount of these micronutrients supplied by biofortified beans. The fertilization with Zn did not affect the yield, but provided high levels of this nutrient in grains of the cultivars analyzed, representing 27% of the recommended daily intake of Zn. The higher Fe content in beans, obtained when there was no application of foliar Zn, supplies 56% of the daily requirement of Fe.

Utilização de lodo de esgoto na produção de mudas de aroeira-pimenteira

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Grundlegende Untersuchungen zur Abbindereaktion von Zinkphosphatzement

Zusammenfassung Das Ziel der Arbeit bestand darin, mit der Aufklärung der Abbindereaktion von Zinkphosphatzement eine Grundlage für eine gezielte Modifikation bzw. Optimierung zu schaffen, insbesondere im Hinblick auf einen Einsatz als permanenter Füllungswerkstoff. Über den Abbindechemismus war bislang lediglich bekannt, daß es sich bei den primär gebildeten Reaktionsprodukten um röntgenamorphe Phasen handelt, die sich nach Wochen bzw. Monaten in das thermodynamisch stabile Reaktionsprodukt alpha-Hopeit (alpha-Zn3(PO4)2·4H2O) umwandeln.Im Rahmen der vorliegenden Arbeit gelang durch den Einsatz der Infrarot-Reflexionsspek-troskopie (DRIFT) die Identifikation von Dizink Cyclotetraphosphat-Octahydrat (Zn2P4O12·8H2O) als röntgenamorpher Vorläuferphase. Das kondensierte Phosphat ist hydrolyseempfindlich sowie thermodynamisch instabil. Mit Hilfe der zeitaufgelösten 1H NMR-Spektroskopie konnte gezeigt werden, daß bereits nach ca. 10 Minuten eine Phasenumwandlung (topochemische Disproportionierung) in ein zunächst röntgenamorphes Orthophosphat stattfindet. Mittels 31P Doppelquanten-NMR-Spektroskopie gelang der Nachweis, daß innerhalb des röntgenamorphen Bereiches lokal nahgeordnete (nanokristalline) Bereiche auftreten, deren Ordnung sich auf einer Längenskala von 10 bis 30 Å erstreckt. Die Nanokristallite unterliegen einem Wachstumsprozeß, der schließlich zu alpha-Hopeit-Kristallen mit Ausdehnungen im Mikrometerbereich führt. Die Ursache für die primäre Ausbildung röntgenamorpher Reaktionsprodukte kann zunächst gelösten Aluminophosphatkomplexen zugeordnet werden, die im Verlauf der Abbindereaktion zu anorganischen Polymeren aggregieren und damit als Kristallisationsinhibitoren fungieren.

Chlorhexidine and preservation of sound tooth structure in older adults. A placebo-controlled trial

The Trial to Enhance Elderly Teeth Health (TEETH) was designed to test the impact of regular rinsing with a 0.12% chlorhexidine (CHX) solution on tooth loss, and the causes of tooth loss (caries, periodontal disease and trauma) were also investigated. This paper reports on the effectiveness of a 0.12% CHX solution for controlling caries using a tooth surface (coronal and root) survival analysis. A total of 1,101 low income elders in Seattle (United States) and Vancouver (Canada), aged 60-75 years, were recruited for a double-blind clinical trial and assigned to either a CHX (n = 550) or a placebo (n = 551) mouth rinse. Subjects alternated between daily rinsing for 1 month, followed by weekly rinsing for 5 months. All sound coronal and root surfaces at baseline were followed annually for up to 5 years. At each follow-up examination, those tooth surfaces with caries, restored, or extracted were scored as 'carious'. The hazard ratio associated with CHX for a sound surface to become filled, decayed, or extracted was 0.87 for coronal surfaces (95% confidence interval: 0.71-1.14, p = 0.20) and 0.91 for root surfaces (95% confidence interval: 0.73-1.14, p = 0.41). These findings suggest that regular rinsing with CHX does not have a substantial effect on the preservation of sound tooth structure in older adults.

AN EXPERIMENTAL STUDY OF PARTIAL LOW RISK DEPLOYMENT IN A FIXED VEHICLE ENVIRONMENT

This study will look at the passenger air bag (PAB) performance in a fix vehicle environment using Partial Low Risk Deployment (PLRD) as a strategy. This development will follow test methods against actual baseline vehicle data and Federal Motor Vehicle Safety Standards 208 (FMVSS 208). FMVSS 208 states that PAB compliance in vehicle crash testing can be met using one of three deployment methods. The primary method suppresses PAB deployment, with the use of a seat weight sensor or occupant classification sensor (OCS), for three-year old and six-year old occupants including the presence of a child seat. A second method, PLRD allows deployment on all size occupants suppressing only for the presents of a child seat. A third method is Low Risk Deployment (LRD) which allows PAB deployment in all conditions, all statures including any/all child seats. This study outlines a PLRD development solution for achieving FMVSS 208 performance. The results of this study should provide an option for system implementation including opportunities for system efficiency and other considerations. The objective is to achieve performance levels similar too or incrementally better than the baseline vehicles National Crash Assessment Program (NCAP) Star rating. In addition, to define systemic flexibility where restraint features can be added or removed while improving occupant performance consistency to the baseline. A certified vehicles’ air bag system will typically remain in production until the vehicle platform is redesigned. The strategy to enable the PLRD hypothesis will be to first match the baseline out of position occupant performance (OOP) for the three and six-year old requirements. Second, improve the 35mph belted 5th percentile female NCAP star rating over the baseline vehicle. Third establish an equivalent FMVSS 208 certification for the 25mph unbelted 50th percentile male. FMVSS 208 high-speed requirement defines the federal minimum crash performance required for meeting frontal vehicle crash-test compliance. The intent of NCAP 5-Star rating is to provide the consumer with information about crash protection, beyond what is required by federal law. In this study, two vehicles segments were used for testing to compare and contrast to their baseline vehicles performance. Case Study 1 (CS1) used a cross over vehicle platform and Case Study 2 (CS2) used a small vehicle segment platform as their baselines. In each case study, the restraints systems were from different restraint supplier manufactures and each case contained that suppliers approach to PLRD. CS1 incorporated a downsized twins shaped bag, a carryover inflator, standard vents, and a strategic positioned bag diffuser to help disperse the flow of gas to improve OOP. The twin shaped bag with two segregated sections (lobes) to enabled high-speed baseline performance correlation on the HYGE Sled. CS2 used an A-Symmetric (square shape) PAB with standard size vents, including a passive vent, to obtain OOP similar to the baseline. The A-Symmetric shape bag also helped to enabled high-speed baseline performance improvements in HYGE Sled testing in CS2. The anticipated CS1 baseline vehicle-pulse-index (VPI) target was in the range of 65-67. However, actual dynamic vehicle (barrier) testing was overshadowed with the highest crash pulse from the previous tested vehicles with a VPI of 71. The result from the 35mph NCAP Barrier test was a solid 4-Star (4.7 Star) respectfully. In CS2, the vehicle HYGE Sled development VPI range, from the baseline was 61-62 respectively. Actual NCAP test produced a chest deflection result of 26mm versus the anticipated baseline target of 12mm. The initial assessment of this condition was thought to be due to the vehicles significant VPI increase to 67. A subsequent root cause investigation confirmed a data integrity issue due to the instrumentation. In an effort to establish a true vehicle test data point a second NCAP test was performed but faced similar instrumentation issues. As a result, the chest deflect hit the target of 12.1mm; however a femur load spike, similar to the baseline, now skewed the results. With noted level of performance improvement in chest deflection, the NCAP star was assessed as directional for 5-Star capable performance. With an actual rating of 3-Star due to instrumentation, using data extrapolation raised the ratings to 5-Star. In both cases, no structural changes were made to the surrogate vehicle and the results in each case matched their perspective baseline vehicle platforms. These results proved the PLRD is viable for further development and production implementation.

Low Mass Calibration Target for MM-Wave Remote Sensing Instruments

The reliability of millimeter and sub-millimeter wave radiometer measurements is dependent on the accuracy of the loads they employ as calibration targets. In the recent past on-board calibration loads have been developed for a variety of satellite remote sensing instruments. Unfortunately some of these have suffered from calibration inaccuracies which had poor thermal performance of the calibration target as the root cause. Stringent performance parameters of the calibration target such as low reflectivity, high temperature uniformity, low mass and low power consumption combined with low volumetric requirements remain a challenge for the space instrument developer. In this paper we present a novel multi-layer absorber concept for a calibration load which offers an excellent compromise between very good radiometric performance and temperature uniformity and the mass and volumetric constraints required by space-borne calibration targets.