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.

Els valors límit d'exposició professional i límits biològics per a agents químics en l'àmbit de treball, mesura i control. Evolució de la normativa sobre el plom i la seva incidència sobre els accidents laborals i malalties professionals en la indústria ceràmica

L'objectiu d'aquesta tesi és l'estudi dels valors límit d'exposició professional previstos en la normativa actual com a valors de referència per a l'avaluació i control dels riscos que comporta l'exposició a agents químics presents en el lloc de treball, fonamentalment per inhalació, per protegir la salut dels treballadors. No es pretén realitzar ni un estudi epidemiològic ni un estudi d'higiene, només s'utilitzen els valors d'exposició professional per analitzar el compliment de la normativa sobre la presència de plom en l'ambient de treball, i comprovar si el compliment de la normativa comporta la millora de la salut dels treballadors en funció de la millora de les concentracions de valors ambientals o biològics de l'exposició dels treballadors. La Directiva 98/24/CE deroga les Directives 80/1107/CEE sobre la protecció dels treballadors contra els riscos relacionats amb l'exposició a agents químics, físics i biològics durant el treball, i la Directiva 82/605/CEE, sobre la protecció dels treballadors contra riscos relacionats amb una exposició al plom metàl·lic i als seus compostos iònics durant el treball. S'analitza l'evolució de la normativa sobre la presència d'agents químics en l'ambient de treball, i en concret el plom, i la seva incidència en els accidents laborals i malalties professionals, i el compliment de la normativa al final d'un cicle marcat per l'entrada en vigor de la Directiva 98/24/CE. Per realitzar l'anàlisi anteriorment esmentada s'estudia la indústria ceràmica de les comarques gironines, de la construcció, de l'alimentació i decorativa, a través de les mesures de plom en l'ambient laboral i les mesures de plom en sang dels treballadors d'aquesta indústria des de 1991 a 1996.

La presión laboral tendenciosa (Mobbing)

El trabajo de investigación surge en el año 2001, ante la necesidad de hacer frente a una nueva realidad jurídica, el mobbing. Para ello fue decisivo el estudio de lo publicado (básicamente de ramas ajenas al Derecho) pero sobre todo las entrevistas con las víctimas de mobbing y sus asociaciones; este extremo, unido a la ausencia de un tratamiento internacional, obligó a un camino autodidacta para definir mobbing jurídicamente. La Tesis define mobbing como la presión laboral tendente a la autoeliminación de un trabajador mediante su denigración (presión laboral tendenciosa), y con ello por primera vez se tiene una definición de mobbing en línea y media, con plena validez jurídica, que es susceptible de ser memorizada y por lo tanto divulgada, para corregir el problema. El denominado "concepto uniformado de mobbing" recalca la denigración como mecanismo frente a los tratos degradantes y recalca la autoeliminación como finalidad de un comportamiento doloso. El trabajo aporta fórmulas para deslindar casos de mobbing de otras figuras próximas, y en este sentido debe citarse "la regla del 9" para saber si hay mobbing; en sede de estadísticas se critican metodológicamente muchas de ellas presentadas hasta el momento y se aporta alguna en sede de Tribunales; pero sobre todo se advierte de los riesgos jurídicos de una previsible regulación específica antimobbing, mediante el examen de las distintas definiciones que se han esgrimido hasta el momento. La segunda parte de la Tesis profundiza sobre el grado de sensibilización de nuestro ordenamiento jurídico y Tribunales, a cuyo fin se ha trabajado con más de un centernar y medio de sentencias dictadas sobre la materia, y por supuesto la totalidad de las recogidas en las bases de datos de las editoriales. El análisis sirve para apreciar la bondad de la sistemática aquí defendida, poniendo en evidencia errores, y contradicciones. La Tesis advierte que la presión laboral tendenciosa más allá de vulnerar el derecho constitucional al trabajo, o los derechos fundamentales a la integridad moral y el honor, es una transgresión a todo un "espíritu constitucional", y en este sentido se analiza con detalle tanto la posibilidad de recurrir en amparo, como el derecho a la indemnidad para quien se enfrenta a esta situación. Advirtiendo de las ventajas de efectuar esta reacción mediante la modalidad procesal de tutela de los derechos fundamentales, se analiza la recurrida acción del art.50 ET, donde se realizan aportaciones sugerentes como el plazo prescripción o la "doctrina de los antecedentes", y se otorgan respuestas a las preguntas sobre obligación de seguir trabajando y ejecución provisional. En sede de acciones de Seguridad Social, la Tesis distingue entre la incapacidad temporal y permanente (depresiones) y la muerte y supervivencia, aportándose sobre la primera la técnica denominada "interpretación en tres niveles" y descartando la posibilidad de considerar accidente de trabajo el suicidio tras un mobbing por imperativo legal, pero aportando un sucedáneo bastante razonable como es el accidente no laboral. Junto a ello se razona por la viabilidad del recargo del art.123 LGSS. Civilmente, la Tesis se posiciona de "lege ferenda" por reconducir este tipo de acciones resarcitorias del daño psíquico y moral al orden civil, por una mayor explicación sobre el origen del quantum, pero sobre todo considera inadmisible la STS 11-3-04, y ello por una pluralidad de argumentos, pero sobre todo por cuanto viene a autorizar "de facto" este tipo de conductas. La posibilidad de accionar administrativamente frente a este riesgo psicosocial se analiza en un doble terreno, la empresa y la Administración. Si bien el cauce sobre el primero tiene algunos meandros que se desbelan, la situación es radicalmente frustrante en la Administración -donde se encuentra el mayor caldo de cultivo del mobbing- , y ello por el RD 707/2002, pero todavía en mayor medida por el Criterio Técnico 34/2003 mediante el cual la interpretación del Director General de la Inspección de Trabajo y Seguridad Social ha venido tácitamente a derogar parcialmente la Ley de Prevención de Riesgos Laborales para la Administración. En materia penal, la Tesis se decanta "a priori" por dos tipos penales, los delitos contra los derechos de los trabajadores, y el delito de trato degradante; sin embargo, en la práctica sólo este segundo es el camino que puede alcanzar buen puerto. Finalmente se realiza un estudio detallado de la Ley 62/2003, ley que se divulgó como reguladora del acoso moral, y que después se defiende como un avance frente al mobbing. La Tesis advierte que no es cierto ni lo uno, ni lo otro, habiendo creado un "espejismo legal" que puede perjudicar a las víctimas de mobbing, además de no servir su estructura para una futura regulación explícita antimobbing.

Risk accountability in the tender process of contractors in Ghana and UK

The process of how contractors take account of risk when calculating their bids for construction work is investigated based on preliminary investigations and case studies in Ghana and UK. Ghana and UK were chosen, more or less arbitrarily, for the purpose of case studies, and to test the idea that there are systematic differences between the approaches in different places. Clear differences were found in the risk pricing approaches of contractors in the two countries. The difference appeared to emanate from the professional knowledge and competence of the bid team members, company policy, corporate accountability and the business environments in which the contractors operate. Both groups of contractors take account of risk in estimates. However, risk accountability was found to be higher on the agenda in the tender process of UK contractors, documented more systematically, and assessed and managed more rigorously with input from the whole bid team. Risk accountability takes place at three levels of the tender process and is dictated strongly by market forces and company circumstances.

Exporting construction professional services in a global service economy

Globalisation has prompted increasing numbers of construction profes-sional services (CPS) firms to internationalise and export their services. The driver has been twofold; firstly to increase turnover/profits and sec-ondly, to minimise the risk of a reliance on working in a single domestic market which has a fluctuating demand. Secondly, where firms have out-grown their domestic market, and in order to expand, they must export overseas. There has been little research into the way CPS firms operate overseas, yet construction represents approximately 10% of global GDP; this means that understanding CPS firms is important. This paper investigates how CPS firms internationalise and the drivers that impact their decisions and operations overseas. A survey was undertaken and interviews conducted that showed CPS firms are project driven, in-vesting heavily in the process of seeking work/bidding for projects, and are very focused on delivering projects with minimum risk. Increasing foreign ownership, changing procurement approaches and more consolidation of CPS firms in the global marketplace present a changing business land-scape. The research develops a framework of tangible and intangible factors, such as competencies, business organisation culture, leadership and reputation in order to better understand how CPS firms export their ser-vices. Whilst all CPS firms share the same framework of factors, the re-sulting synergies are different not only for each firm but also for each pro-ject. The knowledge-intensive and project-based nature of CPS firms presents a challenge in understanding the way they operate in the global service economy.

Turning points: the personal and professional circumstances that lead academics to become middle managers

In the current higher education climate, there is a growing perception that the pressures associated with being an academic middle manager outweigh the perceived rewards of the position. This article investigates the personal and professional circumstances that lead academics to become middle managers by drawing on data from life history interviews undertaken with 17 male and female department heads from a range of disciplines, in a post-1992 UK university. The data suggests that experiencing conflict between personal and professional identities, manifested through different socialization experiences over time, can lead to a ‘turning point’ and a decision that affects a person’s career trajectory. Although the results of this study cannot be generalized, the findings may help other individuals and institutions move towards a firmer understanding of the academic who becomes head of department—in relation to theory, practice and research.

A framework for assessing continuing professional development activities for satisfying pharmacy revalidation requirements

The United Kingdom’s pharmacy regulator contemplated using continuing professional development (CPD) in pharmacy revalidation in 2009, simultaneously asking pharmacy professionals to demonstrate the value of their CPD by showing its relevance and impact. The idea of linking new CPD requirements with revalidation was yet to be explored. Our aim was to develop and validate a framework to guide pharmacy professionals to select CPD activities that are relevant to their work and to produce a score sheet that would make it possible to quantify the impact and relevance of CPD. METHODS: We adapted an existing risk matrix, producing a CPD framework consisting of relevance and impact matrices. Concepts underpinning the framework were refined through feedback from five pharmacist teacher-practitioners. We then asked seven pharmacists to rate the relevance of the framework’s individual elements on a 4-point scale to determine content validity. We explored views about the framework through focus groups with six and interviews with 17 participants who had used it formally in a study. RESULTS: The framework’s content validity index was 0.91. Feedback about the framework related to three themes of penetrability of the framework, usefulness to completion of CPD, and advancement of CPD records for the purpose of revalidation. DISCUSSION: The framework can help professionals better select CPD activities prospectively, and makes assessment of CPD more objective by allowing quantification, which could be helpful for revalidation. We believe the framework could potentially help other health professionals with better management of their CPD irrespective of their field of practice.

Developing construction professional services in the international market: SWOT analysis of China

Construction professional services (CPSs), such as architecture, engineering, and consultancy, are not only high value-added profit centers in their own right but also have a knock-on effect on other businesses, such as construction and the export of materials and machinery. Arguably, competition in the international construction market has shifted to these knowledge-intensive CPS areas. Yet CPSs represent a research frontier that has received scant attention. This research aims to enrich the body of knowledge on CPSs by examining strengths, weaknesses, opportunities, and threats (SWOT) of Chinese CPSs (CCPSs) in the international context. It does so by triangulating theories with quantitative and qualitative data gleaned from yearbooks, annual reports, interviews, seminars, and interactions with managers in major CCPS companies. It is found that CCPSs present both strengths and weaknesses in talents, administration systems, and development strategies in dealing with the external opportunities and threats brought about by globalization and market evolution. Low price, which has helped the Chinese construction business to succeed in the international market, is also a major CCPS strength. An opportunity for CCPSs is the relatively strong delivery capability possessed by Chinese contractors; by partnering with them CCPSs can better establish themselves in the international arena. This is probably the first ever comprehensive study on the performance of CCPSs in the international marketplace. The research is conducted at an opportune time, particularly when the world is witnessing the burgeoning force of Chinese businesses in many areas including manufacturing, construction, and, potentially, professional services. It adds new insights to the knowledge body of CPSs and provides valuable references to other countries faced with the challenge of developing CPS business efficiently in the international market.

Anti-platelet effect of aspirin is substantially reduced after administration of heparin during carotid endarterectomy

OBJECTIVES: Aspirin therapy is usually continued throughout the perioperative period to reduce the risk for thromboembolic stroke and myocardial infarction after carotid endarterectomy (CEA). Aspirin irreversibly binds cyclooxygenase-1, thereby reducing platelet aggregation for the lifetime of each platelet. However, recent research from this unit has shown that aggregation in response to arachidonic acid increases significantly, but transiently, during CEA, which suggests that the anti-platelet effect of aspirin is temporarily reversed. The purpose of the current study was to determine when this phenomenon occurs and to identify the possible mechanisms involved. METHODS: Platelet aggregation was measured in platelet-rich plasma from 41 patients undergoing CEA who were stabilized with 150 mg of aspirin daily. Blood was taken at 8 time points: before anesthesia, after anesthesia, before heparinization, 3 minutes after heparinization, 3 minutes after shunt insertion, 10 minutes after flow restoration, 4 hours postoperatively, and 24 hours postoperatively. Platelet aggregation was also measured at similar times in a group of 18 patients undergoing peripheral angioplasty without general anesthesia. RESULTS: All patient platelets were effectively inhibited by aspirin at the start of the operation. There was a significant intraoperative increase in platelet response to arachidonic acid in both groups of patients, which occurred within 3 minutes of administration of unfractionated heparin. In the CEA group this resulted in a greater than 10-fold increase in mean aggregation, to 5 mmol/L of arachidonic acid (5 mmol/L), rising from 3.9% +/- 2.2% preoperatively to 45.1% +/- 29.3% after administration of heparin ( P <.0001). This increased aggregation persisted into the early postoperative period, but by 24 hours post operation aggregation had returned to near preoperative values. Aggregation in response to other platelet agonists (adenosine diphosphate, thrombin receptor agonist peptide) showed only a small increase at the same time, which could be accounted for by a parallel increase in the level of spontaneous aggregation. CONCLUSION: Administration of heparin significantly increases platelet aggregation in response to arachidonic acid, despite adequate inhibition by aspirin administered preoperatively. This apparent reversal in anti-platelet activity persisted into the immediate early postoperative period, and could explain why a small proportion of patients are at increased risk for acute cardiovascular events after major vascular surgery, despite aspirin therapy.

Developing construction professional services in the international market: a SWOT analysis of China

In contrast to their bustling construction counterparts, Chinese construction professional services (CPS) such as architecture, engineering, and consultancy, seem still to be stagnant in the international market. CPS are not only high value-added profit centers in their own right, but also have a knock-on effect on subsequent businesses such as construction, and the export of materials and machinery. Arguably, competition in the international construction market has shifted to knowledge-intensive CPS. Yet,CPS represent a research area that has been paid scant attention. This research aims to add to the body of knowledge of CPS by examining strengths, weaknesses, opportunities, and threats (SWOT) of Chinese CPS (CCPS) in the international context. It does so by triangulating theories with quantitative and qualitative data gleaned from yearbooks, annual reports, interviews, seminars, and interactions with managers in major CCPS companies. It is found that CCPS present both strengths and weaknesses in talents, administration systems, and development strategies in dealing with the external opportunities and threats brought about by globalization and market evolvement. Low price, which has helped the Chinese construction business to succeed in the international market, is also a CCPS major strength. An opportunity for CCPS is the relatively strong delivery capability possessed by Chinese contractors. By partnering with them CCPS can better edge into the international arena. This is probably the first ever comprehensive study in investigating the performance of CCPS in the international market. The research is also timely, particularly when the world is witnessing the burgeoning force of Chinese businesses in many areas including manufacturing, construction, and potentially, professional services.

A toxicokinetic model for thiamethoxam in rats: implications for higher-tier risk assessment

Risk assessment for mammals is currently based on external exposure measurements, but effects of toxicants are better correlated with the systemically available dose than with the external administered dose. So for risk assessment of pesticides, toxicokinetics should be interpreted in the context of potential exposure in the field taking account of the timescale of exposure and individual patterns of feeding. Internal concentration is the net result of absorption, distribution, metabolism and excretion (ADME). We present a case study for thiamethoxam to show how data from ADME study on rats can be used to parameterize a body burden model which predicts body residue levels after exposures to LD50 dose either as a bolus or eaten at different feeding rates. Kinetic parameters were determined in male and female rats after an intravenous and oral administration of 14C labelled by fitting one-compartment models to measured pesticide concentrations in blood for each individual separately. The concentration of thiamethoxam in blood over time correlated closely with concentrations in other tissues and so was considered representative of pesticide concentration in the whole body. Body burden model simulations showed that maximum body weight-normalized doses of thiamethoxam were lower if the same external dose was ingested normally than if it was force fed in a single bolus dose. This indicates lower risk to rats through dietary exposure than would be estimated from the bolus LD50. The importance of key questions that should be answered before using the body burden approach in risk assessment, data requirements and assumptions made in this study are discussed in detail.

Science for Humanitarian Emergencies and Resilience (SHEAR) scoping study: Annex 3 - Early warning system and risk assessment case studies

This report provides case studies of Early Warning Systems (EWSs) and risk assessments encompassing three main hazard types: drought; flood and cyclone. The case studies are taken from ten countries across three continents (focusing on Africa, South Asia and the Caribbean). The case studies have been developed to assist the UK Department for International Development (DFID) to prioritise areas for Early Warning System (EWS) related research under their ‘Science for Humanitarian Emergencies and Resilience’ (SHEAR) programme. The aim of these case studies is to ensure that DFID SHEAR research is informed by the views of Non-Governmental Organisations (NGOs) and communities engaged with Early Warning Systems and risk assessments (including community-based Early Warning Systems). The case studies highlight a number of challenges facing Early Warning Systems (EWSs). These challenges relate to financing; integration; responsibilities; community interpretation; politics; dissemination; accuracy; capacity and focus. The case studies summarise a number of priority areas for EWS related research: • Priority 1: Contextualising and localising early warning information • Priority 2: Climate proofing current EWSs • Priority 3: How best to sustain effective EWSs between hazard events? • Priority 4: Optimising the dissemination of risk and warning information • Priority 5: Governance and financing of EWSs • Priority 6: How to support EWSs under challenging circumstances • Priority 7: Improving EWSs through monitoring and evaluating the impact and effectiveness of those systems

Suicide candy: tracing the discourse itineraries of food risk

Traditional approaches to the way people react to food risks often focus on ways in which the media distort information about risk, or on the deficiencies in people’s interpretation of this information. In this chapter Jones offers an alternative model which sees decisions regarding food risk as taking place at a complex nexus where different people, texts, objects and practices, each with their own histories, come together. Based on a case study of a food scandal involving a particular brand of Chinese candy, Jones argues that understanding why people respond the way they do to food risk requires tracing the itineraries along which different people, texts, objects and practices have traveled to converge at particular moments, and understanding the kinds of concrete social actions that these convergences make possible.

Are empathy and compassion bad for the professional social worker?

Recent studies have shown that social workers and other professional helpers who work with traumatized individuals run a risk of developing compassion fatigue or secondary traumatic stress. Some researchers have hypothesized that helpers do this as a result of feeling too much empathy or too much compassion for their clients, thereby implying that empathy and compassion may be bad for the professional social worker. This paper investigates these hypotheses. Based on a review of current research about empathy and compassion it is argued that these states are not the causes of compassion fatigue. Hence, it is argued that empathy and compassion are not bad for the professional social worker in the sense that too much of one or the other will lead to compassion fatigue.