The significance of gratitude for palliative care professionals: a mixed method protocol

Background: In palliative care (PC) patients and relatives (P/R) often show their gratitude to the healthcare professionals (HP) who care for them. HP appreciate these displays of gratitude, although the impact of the same has not been examined in detail. Publications analysed tell personal experiences in which HP say that displays of gratitude create sensations of well-being, pride and increased motivation to carry on caring. No systematic examination in PC was found. These aspects related to gratitude may be important in the field of PC, where there is constant exposure to suffering and the preoccupation which arises from wanting to help HP to go on with their work, but it needs closer study and systemisation. The purpose of this study is to understand the significance and the role of the gratitude received from P/R for palliative care health professionals (PCHP). Methods: A suitable mixed method will be used. The first phase will be quantitative and will consist of a survey, piloted by experts, whose goal is to explore the current situation in Spain as regards displays of gratitude received by HP at PC services. It will be sent by e-mail. The results from this part will be incorporated into the second part which will be qualitative and whose goal is to understand the significance of the experience of receiving displays of gratitude from the perspective of PCHP, using a phenomenological approach. Interviews will be undertaken amongst PCHP. The interview guide will be designed after taking the survey results into account. The project has been granted ethical approval. Discussion: These results are set to provide a key contribution within the context of the growing preoccupation on how to care for HP, how to ensure retention and keep them from resigning, as well as preventing burnout, emotional fatigue and boosting their resilience. In order to do this, it is both interesting and ground breaking, to analyse the repercussion of spontaneous gratitude shown by P/R towards PCHP, to see if this is a useful resource to reduce these problems and to encourage the greater presence of dignity and humanisation, for both those receiving care and for those providing it. This gratitude may be one of these strategies

The TLC: A Novel Auditory Nucleus of the Mammalian Brain

[EN]We have identified a novel nucleus of the mammalian brain and termed it the tectal longitudinal column (TLC). Basic histologic stains, tract-tracing techniques and three-dimensional reconstructions reveal that the rat TLC is a narrow, elongated structure spanning themidbrain tectum longitudinally. This paired nucleus is located close to the midline, immediately dorsal to the periaqueductal gray matter.It occupies what has traditionally been considered the most medial region of the deep superior colliculus and the most medial region of the inferior colliculus. The TLC differs from the neighboring nuclei of the superior and inferior colliculi and the periaqueductal gray by its distinct connections and cytoarchitecture. Extracellular electrophysiological recordings show that TLC neurons respond to auditory stimuli with physiologic properties that differ from those of neurons in the inferior or superior colliculi. We have identified the TLC in rodents, lagomorphs, carnivores, nonhuman primates, and humans, which indicates that the nucleus is conserved across mammals. The discovery of the TLC reveals an unexpected level of longitudinal organization in the mammalian tectum and raises questions as to the participation of this mesencephalic region in essential, yet completely unexplored, aspects of multisensory and/or sensorimotorintegration.[ES]Hemos identificado un nuevo núcleo del cerebro de los mamíferos y lo hemos denominado columna longitudinal tectal (CLT; TLC por sus siglas en inglés). Mediante tinciones histológicas básicas, técnicas de trazado de vías nerviosas y reconstrucciones tridimensionales hemos observado que la CLT es una estructura larga y estrecha que recorre longitudinalmente el techo mesencefálico. Este núcleo par se encuentra próximo a la línea media, inmediatamente dorsal con respecto a la sustancia gris periacueductal. Ocupa un territorio considerado tradicionalmente como la región más medial de las capas profundas del colículo superior y la región más medial del colículo inferior. La CLT difiere de los núcleos que la rodean (colícuo superior, colículo inferior y sustancia gris periacueductal) por sus conexiones y su citoarquitectura. Los registros electrofisiológicos extracelulares muestran que las neuronas de la CLT responden a los estímulos auditivos y que sus propiedades de respuesta son distintas de las de las neuronas de los colículos superior e inferior. Hemos identificado la TLC en el cerebro de roedores, lagomorfos, carnívoros, primates no humanos y seres humanos, lo que indica que el núcleo está filogenéticamente conservado en una gran variedad de mamíferos. El descubrimiento de la CLT revela un insospechado nivel de organización longitudinal en el techo mesencefálico de los mamíferos y suscita preguntas sobre la participación de esta región mesencefálica en aspectos esenciales de la integración multisensorial y/o sensorimotora que hasta ahora no han sido estudiados

Palliative professionals' experiences of receiving gratitude: a transformative and protective resource

Providing palliative care can be both challenging and rewarding. It involves emotionally demanding work and yet research shows that burnout is lower than in other fields of healthcare. Spontaneous expressions of gratitude from patients and family members are not uncommon and are highly valued. This study explored the experience of Spanish palliative professionals who received expressions of gratitude from their patients and families. A phenomenological approach was used to better understand the role of receiving gratitude in participants¿ lives. Interviews were transcribed verbatim and a phenomenological approach to analysis was undertaken using macro-thematic and micro-thematic reflection. Two team members independently engaged in this reflection with an inductive approach. The analysis was shared and discussed at periodic meetings to identify the key themes and sub-themes of the gratitude experience. Ten palliative professionals were interviewed. Participants engaged in a process of recognizing, internalizing and treasuring the expressions of gratitude which they then used for reflection and growth. These expressions were a powerful and deeply meaningful resource that the palliative professionals revisited over time. Receiving expressions of gratitude invited a stronger sense of the value of one¿s self and one¿s work that was motivational and protective, particularly during challenging times

Phospho-kinase profile of triple negative breast cancer and androgen receptor signaling

BACKGROUND: The androgen receptor (AR) plays a central role in the oncogenesis of different tumors, as is the case in prostate cancer. In triple negative breast cancer (TNBC) a gene expression classification has described different subgroups including a luminal androgen subtype. The AR can be controlled by several mechanisms like the activation of membrane tyrosine kinases and downstream signaling pathways. However little is known in TNBC about how the AR is modulated by these mechanisms and the potential therapeutic strategists to inhibit its expression. METHODS: We used human samples to evaluate the expression of AR by western-blot and phospho-proteomic kinase arrays that recognize membrane tyrosine kinase receptors and downstream mediators. Western-blots in human cell lines were carried out to analyze the expression and activation of individual proteins. Drugs against these kinases in different conditions were used to measure the expression of the androgen receptor. PCR experiments were performed to assess changes in the AR gene after therapeutic modulation of these pathways. RESULTS: AR is present in a subset of TNBC and its expression correlates with activated membrane receptor kinases-EGFR and PDGFRβ in human samples and cell lines. Inhibition of the PI3K/mTOR pathway in TNBC cell lines decreased notably the expression of the AR. Concomitant administration of the anti-androgen bicalutamide with the EGFR, PDGFRβ and Erk1/2 inhibitors, decreased the amount of AR compared to each agent given alone, and had an additive anti-proliferative effect. Administration of dihydrotestosterone augmented the expression of AR that was not modified by the inhibition of the PI3K/mTOR or Erk1/2 pathways. AR expression was posttranscriptionally regulated by PI3K or Erk1/2 inhibition. CONCLUSION: Our results describe the expression of the AR in TNBC as a druggable target and further suggest the combination of bicalutamide with inhibitors of EGFR, PDGFRβ or Erk1/2 for future development

Is type of work associated with physical activity and sedentary behaviour in women with fibromyalgia? A cross-sectional study from the al-Ándalus project

Objectives To analyse the association between the type of work (productive vs reproductive work) and the levels of physical activity and sedentary behaviour in women with fibromyalgia. Method This cross-sectional study involved 258 women with fibromyalgia from southern Spain. Of them, 55% performed reproductive work (unpaid, associated with caregiving and domestic roles) exclusively, while 45% had productive job (remunerated, that results in goods or services). Physical activity of light, moderate and vigorous intensity in the leisure time, at home, at work, and totally were measured through the leisure time physical activity instrument and with the physical activity at home and work instrument, respectively. Sedentary behaviour was measured by the Sedentary Behaviour Questionnaire. Results After adjusting for age, fat percentage, education level and marital status, the multivariate analysis of covariance model informed the existence of significant differences between type of work groups (p<0.001). Women with productive work engaged in more light physical activity at work (mean difference =448.52 min; 95 % CI 179.66 to 717.38; p=0.001), and total physical activity of light (809.72 min; 535.91 to 1085.53; p<0.001) and moderate (299.78 min; 97.31 to 502.25; p=0.004) intensity. Women with reproductive work engaged in more light physical activity at home (379.14; 175.64 to 582.64; p<0.001). Leisure time physical activity and sedentary behaviour were similar in both groups (p>0.05 for all comparisons). Conclusions Women with productive work had greater levels of physical activity compared with those who only did reproductive work, except for physical activity at home. Having productive work might facilitate movement of women with fibromyalgia towards a more active lifestyle.Spanish Ministries of Economy and Competitiveness I+D+i DEP2010-15639 I+D+i DEP2013-40908-RSpanish Government FPU15/00002University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES)Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades and European Regional Development Fund (ERDF) SOMM17/6107/UGREuropean Union (EU) 70740

Metabolome Profiling Supports the Key Role of the Spike in Wheat Yield Performance

Although the relevance of spike bracts in stress acclimation and contribution to wheat yield was recently revealed, the metabolome of this organ and its response to water stress is still unknown. The metabolite profiles of flag leaves, glumes and lemmas were characterized under contrasting field water regimes in five durum wheat cultivars. Water conditions during growth were characterized through spectral vegetation indices, canopy temperature and isotope composition. Spike bracts exhibited better coordination of carbon and nitrogen metabolisms than the flag leaves in terms of photorespiration, nitrogen assimilation and respiration paths. This coordination facilitated an accumulation of organic and amino acids in spike bracts, especially under water stress. The metabolomic response to water stress also involved an accumulation of antioxidant and drought tolerance related sugars, particularly in the spikes. Furthermore, certain cell wall, respiratory and protective metabolites were associated with genotypic outperformance and yield stability. In addition, grain yield was strongly predicted by leaf and spike bracts metabolomes independently. This study supports the role of the spike as a key organ during wheat grain filling, particularly under stress conditions and provides relevant information to explore new ways to improve wheat productivity including potential biomarkers for yield prediction.This work was supported by the Spanish Ministry of Economy and Competitiveness (MEC) [grant number AGL2016-76527- R]. We also acknowledge EIG CONCERT-Japan (EC) / PCIN-2017-063 (MINECO, Spain) project

Experimental transition probabilities in NII lines

Producción CientíficaThis work reports an extensive collection of 108 transition probabilities of NII lines in the visible spectral region, all of them measured in an emission experiment. Relative intensity measurements have been made on a pulsed discharge lamp and the absolute Aki values have been obtained by using the literature available data. Electron density and temperature range in this experiment from 0.2 to and from 17000 to 29000 K respectively. The first one has been simultaneously determined from two-wavelength interferometry and from the Stark broadening of HeI 471.3 nm, the second from Boltzmann-plot of NII lines and from NII/NI intensities ratios. The results are compared with the recent available literature.

Ministerio de Educación y Formación Profesional (grant PB-98-0356)Junta de Castilla y León (grant VA23-99

What are families most grateful for after receiving palliative care? Content analysis of written documents received: a chance to improve the quality of care

ICS. Family members are involved in the care of palliative patients at home and therefore, should be viewed as important sources of information to help clinicians better understand the quality palliative care service patients receive. The objective of the study was to analyse what is valued most by family carers undergoing bereavement of a palliative care home service in order to identify factors of quality of care. Qualitative exploratory study based on documentary analysis. Content analysis of 77 gratitude documents received over 8 years by a palliative home service in Odivelas, near Lisbon (Portugal) was undertaken, through an inductive approach and using investigator triangulation. Frequency of distinct categories was quantitatively defined. Results: Three different content categories emerged from the analysis: a) Recognition of the care received and the value of particular aspects of care within recognised difficult situations included aspects such as kindness, listening, relationships established (63/77 documents)¿ b) Family recognition of the achievements of the palliative care team (29/77) indicated as relief from suffering for the patient and family, opportunity of dying at home, help in facing difficult situations, improvement in quality of life and wellbeing, and feeling of serenity during bereavement¿ c) Messages of support (45/77) related to the need of resources provided

Interoperabilidad entre organismos nacionales, provinciales y municipales

El objetivo del trabajo es establecer en que medida se cumple la interoperabilidad entre organismos nacionales, provinciales o municipales en el marco de una solución de Gobierno Electrónico (GE). Para el estudio definiremos la interoperabilidad más allá de la técnica, la tecnología disponible en relación a los estándares y los niveles jurisdiccionales del Estado. A pesar de que se han implementado, en diversos organismos de gobierno, sistemas de servicios al ciudadano; éstos no están formalizados ni alcanzan un nivel de integración adecuado a las necesidades de información que el GE plantea entre los distintos gestores de gobierno. Por lo cual hace esencial un proceso formal de implementación de GE más una adecuación a la tecnología disponible, llámese servidores únicos de datos, redes distribuidas y la plena cooperación y colaboración entre organismos jurisdiccionales oficiales. Finalmente se plantea la necesidad de contar con un fuerte liderazgo político, para asegurar el éxito de una implementación de soluciones de GE en el marco de la interoperabilidad entre distintos organismos y niveles jurisdiccionales. Es decir entre reparticiones pertenecientes a entidades gubernamentales del ámbito nacional, provincial y/o municipal.Sociedad Argentina de Informática e Investigación Operativ