Elaboración de un instrumento para medir las actitudes hacia personas de orientación homosexual

Desde que los psicólogos utilizan escalas dentro de sus herramientas pueden valerse de la investigación psicométrica específica para la idiosincrasia en la que trabajan, en la literatura local se encuentran trabajos con escalas que miden actitudes hacia personas de orientación homosexual, pero ninguna desarrollada en Paraguay. El objetivo fue construir un instrumento válido y confiable para la medición de actitudes hacia personas con esta orientación, así como determinar sus niveles de confiabilidad y las dimensiones que explora. Para eso se utilizó un diseño metodológico instrumental, recolectando datos en Paraguay entre setiembre 2015 – febrero 2016. Se presenta la versión final de 18 ítems (α≈ 0.86) consistente con el modelo propuesto (RMSA = 0.71, CFI = 0.92).

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Bazurto market square: recovery of the deteriorated sector from equipment

El planteamiento del proyecto de diseño arquitectónico, es la creación de un nuevo equipamiento de abastecimiento en el sector de Bazurto en la ciudad de Cartagena de Indias, Bolívar. Para su logro; se determinó que el crecimiento progresivo del comercio en el sector demanda una la regulación y la implementación de espacios que permitan su adecuado desarrollo. Por lo tanto, se escogió una plaza de mercado debido a su relevante carácter histórico y la posibilidad de generar dinámicas sociales en su entorno, puesto que es un punto de encuentro entre grupos sociales; donde actualmente también se desarrollan diversas actividades culturales propias de la región. Por último, la ciudad necesita abastecerse correctamente. Así entonces, se concluye que la ciudad requiere la creación de una plaza de mercado funcional, que sea un equipamiento metropolitano que solucione el problema de abastecimiento y permita el mejoramiento urbanístico del sector de Bazurto. La plaza de mercado es un punto de afluencia que genera una relación de articulación directa, entre los diferentes sectores sociales de una ciudad. El sector de Bazurto desde que se construyó la plaza de mercado, se ha convertido en un lugar determinante en el desarrollo de la ciudad, con la suma de valor al desarrollo económico y al establecimiento de una relación proporcional entre la oferta y la demanda, conllevando a consolidar el sector como un nodo comercial el cual brinda oportunidades económicas a poblaciones vulnerables, tanto de la ciudad como de municipios aledaños, pero, el acelerado e inadecuado crecimiento de la plaza de mercado ha permitido el deterioro de la zona. No obstante, es de carácter urgente dar una solución integral desde una perspectiva arquitectónica y urbana, partiendo del equipamiento que permita el adecuado desarrollo socio económico y la articulación del sector de Bazurto con el resto de la ciudad de Cartagena.The approach of the architectural design project is the creation of a new supply equipment in the Bazurto sector in the city of Cartagena de Indias, Bolívar. For its achievement; it was determined that the progressive growth of trade in the sector demands the regulation and implementation of spaces that allow its proper development. Therefore, a market place was chosen due to its relevant historical character and the possibility of generating social dynamics in its environment, since it is a meeting point between social groups; where, in the marketplace, various cultural activities of the region are also developed. Finally, the city needs to stock up properly. Thus, it is concluded that the city requires the creation of a functional market place, which is a metropolitan equipment that solves the supply problem and allows the urban improvement of the Bazurto sector The market place is an influx point that generates a direct articulation relationship between the different social sectors of a city. The Bazurto sector, since the market square was built, has become a determinant in the development of the city, with the sum of value to economic development and the establishment of a proportional relationship between supply and demand, leading to consolidate the sector as a commercial node which provides economic. opportunities to vulnerable populations, both in the city and surrounding municipalities but, the accelerated and inappropriate growth of the market place has allowed the deterioration of the area. However, it is urgent to provide a comprehensive solution from an architectural and urban perspective, based on the equipment that allows adequate socio-economic development and the articulation of the Bazurto sector with the rest of the city of Cartagena

Stem cell-like transcriptional reprogramming mediates metastatic resistance to mTOR inhibition

Inhibitors of the mechanistic target of rapamycin (mTOR) are currently used to treat advanced metastatic breast cancer. However, whether an aggressive phenotype is sustained through adaptation or resistance to mTOR inhibition remains unknown. Here, complementary studies in human tumors, cancer models and cell lines reveal transcriptional reprogramming that supports metastasis in response to mTOR inhibition. This cancer feature is driven by EVI1 and SOX9. EVI1 functionally cooperates with and positively regulates SOX9, and promotes the transcriptional upregulation of key mTOR pathway components (REHB and RAPTOR) and of lung metastasis mediators (FSCN1 and SPARC). The expression of EVI1 and SOX9 is associated with stem cell-like and metastasis signatures, and their depletion impairs the metastatic potential of breast cancer cells. These results establish the mechanistic link between resistance to mTOR inhibition and cancer metastatic potential, thus enhancing our understanding of mTOR targeting failure

Large-scale genotyping identifies 41 new loci associated with breast cancer risk

Breast cancer is the most common cancer among women. Common variants at 27 loci have been identified as associated with susceptibility to breast cancer, and these account for ~9% of the familial risk of the disease. We report here a meta-analysis of 9 genome-wide association studies, including 10,052 breast cancer cases and 12,575 controls of European ancestry, from which we selected 29,807 SNPs for further genotyping. These SNPs were genotyped in 45,290 cases and 41,880 controls of European ancestry from 41 studies in the Breast Cancer Association Consortium (BCAC). The SNPs were genotyped as part of a collaborative genotyping experiment involving four consortia (Collaborative Oncological Gene-environment Study, COGS) and used a custom Illumina iSelect genotyping array, iCOGS, comprising more than 200,000 SNPs. We identified SNPs at 41 new breast cancer susceptibility loci at genome-wide significance (P < 5 × 10−8). Further analyses suggest that more than 1,000 additional loci are involved in breast cancer susceptibility