Airborne pollen and spores’ deposition in alveolar tissues as a tool in drowning forensic diagnosis

We report the results of a histological study of lung samples where an unusual quantity of airborne pollen and fungal spores was found in drowned rats. Pollen and spores were found in lungs of drowned rats but not in the post-mortem submerged ones. Another control group consisting of rats that underwent 60 min exposure to a highly pollen-loaded atmosphere also recorded negative for the presence of pollen or fungal spores. Pollen types coincided with plants growing at the surrounding gardens flowering during the days of the experiment, performed during spring, that were detected by the aerobiological trap located at the city. The pollen observed at the lower airways’ tissues were Chenopodiaceae, Cupressus, Ericaceae, Jasminum, Olea europaea, Plantago, Pinus, Poaceae, Quercus and Urticaceae. Regarding fungal spores Alternaria, Aspergillus, Cladosporium cladosporoides, Cladosporium herbarum, Leptosphaeria, Polythrincium and Phitomyces. Pollen and spores’ penetration into deeper regions of the respiratory tract is an unusual phenomenon not happening in regular breathing conditions. Our results revealed that these particles appeared in a significant number in lung samples of drowned animals probably pushed down from upper airways by the force of water inhalation during drowning. Their presence into alveolar spaces offer a useful forensic evidence in doubtful drowning autopsies, favoured by the characteristic of the sporopollenin (pollen wall) and chitin (fungal spore wall) resistance. Moreover, the presence of these particles in alveoli areas of drowned bodies can help forensics to obtain information about premortem dates and place

Spanish version of the Dundee Ready Education Environment Measure (DREEM) applied to undergraduate physical therapy students in Spain using Google Form

[Intro] The educational climate (EC) is an important factor in determining the effectiveness and success of the curriculum in a school of medical sciences. The Dundee Ready Education Environment Measure (DREEM) questionnaire was used to assess EC in a competency-based curriculum in the physical therapy program analyzing the mean total, subscale, and item scores, as well as response rates. To carry out a psychometric evaluation of the Spanish-language version of the DREEM applied to undergraduate physical therapy students, a total of 671 students enrolled on Degrees in Physiotherapy at 22 faculties across public and private universities in Spainresponded to the DREEM questionnaire using Google Form. (...

Confidentiality breaches in clinical practice: what happens in hospitals?

Respect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice. By means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology. Following 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent (54,6 %) were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient's clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas (37.9 %), such as corridors, elevators, the cafeteria, stairs, and locker rooms. In addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches (9.5 %), thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality

Study of the Psychometric Properties of the Spanish Version of the Measure of Moral Distress for Health Care Professionals (MMD-HP-SPA)

Background: The early detection of moral distress requires a validated and reliable instrument. The aim of this study was to carry out an advanced analysis of the psychometric properties of the moral distress scale for health professionals (MMD-HP-SPA) by performing a validation of the construct and its internal and external reliability. Methods: We performed a multicentre cross-sectional study in health professionals belonging to the Andalusian public health system. Construct validity was performed by exploratory (n = 300) and confirmatory (n = 275) factor analysis (EFA/CFA) in different subgroups; we also analysed the internal consistency and temporal reliability of the scale. Results: 384 doctors and 191 nurses took part in the survey. The overall mean for moral distress was 128.5 (SD = 70.9), 95% CI [122.7–134.3], and it was higher in nurses at 140.5 (SD = 74.9) than in doctors at 122.5 (SD = 68.1), F = 8.37 p 2 = 972.4; AIC = 1144.3; RMSEA = 0.086; CFI = 0.844; TLI = 0.828; NFI = 0.785. Conclusions: The MMD-HP-SPA scale has solid construct validity, excellent internal consistency, optimal temporal reliability, and underlying dimensions which effectively explore the causes of moral distress in health professionals, thus guaranteeing its use in hospital and community settings