Prevalencia del síndrome de burnout en estudiantes de pregrado de la facultad de estomatología de la UCSUR, Lima 2013

El Síndrome de Burnout (SBO) es una entidad patológica compuesta por tres esferas: Agotamiento Emocional (AE), Despersonalización (DP) y falta de Realización Personal (RP), que es común entre profesionales sanitarios y que podría originarse durante su formación académica.OBJETIVO: Determinar la prevalencia del Síndrome de Burnout en estudiantes del quinto al décimo ciclo de estudio de laFacultad de Estomatología de la Universidad Científica del Sur (UCSUR), Lima 2013-I.MATERIALES Y MÉTODOS: Se realizó un estudio observacional, descriptivo, transversal y prospectivo con los estudiantesdel pregrado de la UCSUR que cursaban de quinto a décimo ciclo (n=46) durante el semestre 2013-I. Se empleó dosencuestas autoadministradas anónimas, una sobre características sociodemográficas y otra, la escala de Maslach Burnout Inventory en su versión Human Services Survey validada en español.RESULTADOS: La prevalencia de SBO fue de 22.5% (n=9). Los niveles de Burnout encontrados fueron: Nivel alto deagotamiento emocional (70%), nivel medio de realización personal (55%) y nivel bajo de despersonalización (52.5%). Nose encontró diferencia estadísticamente significativa entre las variables sociodemográficas y el SBO. Sin embargo, si hubodiferencia estadísticamente significativa (p=0.027) entre la dimensión realización personal y la covariable ciclo de estudio.CONCLUSIÓN: El SBO estuvo presente en menos de la tercera parte de los estudiantes evaluados

QoSatAr: a cross-layer architecture for E2E QoS provisioning over DVB-S2 broadband satellite systems

This article presents QoSatAr, a cross-layer architecture developed to provide end-to-end quality of service (QoS) guarantees for Internet protocol (IP) traffic over the Digital Video Broadcasting-Second generation (DVB-S2) satellite systems. The architecture design is based on a cross-layer optimization between the physical layer and the network layer to provide QoS provisioning based on the bandwidth availability present in the DVB-S2 satellite channel. Our design is developed at the satellite-independent layers, being in compliance with the ETSI-BSM-QoS standards. The architecture is set up inside the gateway, it includes a Re-Queuing Mechanism (RQM) to enhance the goodput of the EF and AF traffic classes and an adaptive IP scheduler to guarantee the high-priority traffic classes taking into account the channel conditions affected by rain events. One of the most important aspect of the architecture design is that QoSatAr is able to guarantee the QoS requirements for specific traffic flows considering a single parameter: the bandwidth availability which is set at the physical layer (considering adaptive code and modulation adaptation) and sent to the network layer by means of a cross-layer optimization. The architecture has been evaluated using the NS-2 simulator. In this article, we present evaluation metrics, extensive simulations results and conclusions about the performance of the proposed QoSatAr when it is evaluated over a DVB-S2 satellite scenario. The key results show that the implementation of this architecture enables to keep control of the satellite system load while guaranteeing the QoS levels for the high-priority traffic classes even when bandwidth variations due to rain events are experienced. Moreover, using the RQM mechanism the user’s quality of experience is improved while keeping lower delay and jitter values for the high-priority traffic classes. In particular, the AF goodput is enhanced around 33% over the drop tail scheme (on average)

Multi-parametric flow cytometric and genetic investigation of the peripheral B cell compartment in human type 1 diabetes.

The appearance of circulating islet-specific autoantibodies before disease diagnosis is a hallmark of human type 1 diabetes (T1D), and suggests a role for B cells in the pathogenesis of the disease. Alterations in the peripheral B cell compartment have been reported in T1D patients; however, to date, such studies have produced conflicting results and have been limited by sample size. In this study, we have performed a detailed characterization of the B cell compartment in T1D patients (n = 45) and healthy controls (n = 46), and assessed the secretion of the anti-inflammatory cytokine interleukin (IL)-10 in purified B cells from the same donors. Overall, we found no evidence for a profound alteration of the B cell compartment or in the production of IL-10 in peripheral blood of T1D patients. We also investigated age-related changes in peripheral B cell subsets and confirmed the sharp decrease with age of transitional CD19(+) CD27(-) CD24(hi) CD38(hi) B cells, a subset that has recently been ascribed a putative regulatory function. Genetic analysis of the B cell compartment revealed evidence for association of the IL2-IL21 T1D locus with IL-10 production by both memory B cells (P = 6·4 × 10(-4) ) and islet-specific CD4(+) T cells (P = 2·9 × 10(-3) ). In contrast to previous reports, we found no evidence for an alteration of the B cell compartment in healthy individuals homozygous for the non-synonymous PTPN22 Trp(620) T1D risk allele (rs2476601; Arg(620) Trp). The IL2-IL21 association we have identified, if confirmed, suggests a novel role for B cells in T1D pathogenesis through the production of IL-10, and reinforces the importance of IL-10 production by autoreactive CD4(+) T cells

The effect of delayed graft function on graft and patient survival in kidney transplantation: an approach using competing events analysis

OBJECTIVE: In kidney transplantation, the impact of delayed graft function (DGF) on long-term graft and patient survival is controversial. We examined the impact of DGF on graft and recipient survival by accounting for the possibility that death with graft function may act as a competing risk for allograft failure. STUDY DESIGN AND SETTING: We used data from 1281 adult primary deceased-donor kidney recipients whose allografts functioned at least 1 year. RESULTS: The probability of graft loss occurrence is overestimated using the complement of Kaplan-Meier estimates (1-KM). Both the cause-specific Cox proportional hazard regression model (standard Cox) and the subdistribution hazard regression model proposed by Fine and Gray showed that DGF was associated with shorter time to graft failure (csHR = 2.0, P = 0.002; sHR = 1.57, P = 0.009), independent of acute rejection (AR) and after adjusting for traditional factors associated with graft failure. Regarding patient survival, DGF was a predictor of patient death using the cause-specific Cox model (csHR = 1.57, P = 0.029) but not using the subdistribution model. CONCLUSIONS: The probability of graft loss from competing end points should not be reported with the 1-KM. Application of a regression model for subdistribution hazard showed that, independent of AR, DGF has a detrimental effect on long-term graft survival, but not on patient survival

Malignancy risk analysis in patients with inadequate fine needle aspiration cytology (FNAC) of the thyroid

Background Thyroid fine needle aspiration cytology (FNAC) is the standard diagnostic modality for thyroid nodules. However, it has limitations among which is the incidence of non-diagnostic results (Thy1). Management of cases with repeatedly non-diagnostic FNAC ranges from simple observation to surgical intervention. We aim to evaluate the incidence of malignancy in non-diagnostic FNAC, and the success rate of repeated FNAC. We also aim to evaluate risk factors for malignancy in patients with non-diagnostic FNAC. Materials and Methods Retrospective analyses of consecutive cases with thyroid non diagnostic FNAC results were included. Results Out of total 1657 thyroid FNAC done during the study period, there were 264 (15.9%) non-diagnostic FNAC on the first attempt. On repeating those, the rate of a non-diagnostic result on second FNAC was 61.8% and on third FNAC was 47.2%. The overall malignancy rate in Thy1 FNAC was 4.5% (42% papillary, 42% follicular and 8% anaplastic), and the yield of malignancy decreased considerably with successive non-diagnostic FNAC. Ultrasound guidance by an experienced head neck radiologist produced the lowest non-diagnostic rate (38%) on repetition compared to US guidance by a generalist radiologist (65%) and by non US guidance (90%). Conclusions There is a low risk of malignancy in patients with a non-diagnostic FNAC result, commensurate to the risk of any nodule. The yield of malignancy decreased considerably with successive non-diagnostic FNAC

Strained graphene structures: from valleytronics to pressure sensing

Due to its strong bonds graphene can stretch up to 25% of its original size without breaking. Furthermore, mechanical deformations lead to the generation of pseudo-magnetic fields (PMF) that can exceed 300 T. The generated PMF has opposite direction for electrons originating from different valleys. We show that valley-polarized currents can be generated by local straining of multi-terminal graphene devices. The pseudo-magnetic field created by a Gaussian-like deformation allows electrons from only one valley to transmit and a current of electrons from a single valley is generated at the opposite side of the locally strained region. Furthermore, applying a pressure difference between the two sides of a graphene membrane causes it to bend/bulge resulting in a resistance change. We find that the resistance changes linearly with pressure for bubbles of small radius while the response becomes non-linear for bubbles that stretch almost to the edges of the sample. This is explained as due to the strong interference of propagating electronic modes inside the bubble. Our calculations show that high gauge factors can be obtained in this way which makes graphene a good candidate for pressure sensing.Comment: to appear in proceedings of the NATO Advanced Research Worksho

Social representations and the politics of participation

Recent work has called for the integration of different perspectives into the field of political psychology (Haste, 2012). This chapter suggests that one possible direction that such efforts can take is studying the role that social representations theory (SRT) can play in understanding political participation and social change. Social representations are systems of common-sense knowledge and social practice; they provide the lens through which to view and create social and political realities, mediate people's relations with these sociopolitical worlds and defend cultural and political identities. Social representations are therefore key for conceptualising participation as the activity that locates individuals and social groups in their sociopolitical world. Political participation is generally seen as conditional to membership of sociopolitical groups and therefore is often linked to citizenship. To be a citizen of a society or a member of any social group one has to participate as such. Often political participation is defined as the ability to communicate one's views to the political elite or to the political establishment (Uhlaner, 2001), or simply explicit involvement in politics and electoral processes (Milbrath, 1965). However, following scholars on ideology (Eagleton, 1991; Thompson, 1990) and social knowledge (Jovchelovitch, 2007), we extend our understanding of political participation to all social relations and also develop a more agentic model where individuals and groups construct, develop and resist their own views, ideas and beliefs. We thus adopt a broader approach to participation in comparison to other political-psychological approaches, such as personality approaches (e.g. Mondak and Halperin, 2008) and cognitive approaches or, more recently, neuropsychological approaches (Hatemi and McDermott, 2012). We move away from a focus on the individual's political behaviour and its antecedents and outline an approach that focuses on the interaction between psychological and political phenomena (Deutsch and Kinnvall, 2002) through examining the politics of social knowledge