The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature

Objective To assess evidence of the impact of Picture Archiving and Communication Systems (PACS) on clinicians' work practices in the intensive care unit (ICU). Methods We searched Medline, Pre-Medline, CINAHL, Embase, and the SPIE Digital Library databases for English-language publications between 1980 and September 2010 using Medical Subject Headings terms and keywords. Results Eleven studies from the USA and UK were included. All studies measured aspects of time associated with the introduction of PACS, namely the availability of images, the time a physician took to review an image, and changes in viewing patterns. Seven studies examined the impact on clinical decision-making, with the majority measuring the time to image-based clinical action. The effect of PACS on communication modes was reported in five studies. Discussion PACS can impact on clinician work practices in three main areas. Most of the evidence suggests an improvement in the efficiency of work practices. Quick image availability can impact on work associated with clinical decision-making, although the results were inconsistent. PACS can change communication practices, particularly between the ICU and radiology; however, the evidence base is insufficient to draw firm conclusions in this area. Conclusion The potential for PACS to impact positively on clinician work practices in the ICU and improve patient care is great. However, the evidence base is limited and does not reflect aspects of contemporary PACS technology. Performance measures developed in previous studies remain relevant, with much left to investigate to understand how PACS can support new and improved ways of delivering care in the intensive care setting.8 page(s

Scattering of a proton with the Li4 cluster: non-adiabatic molecular dynamics description based on time-dependent density-functional theory

We have employed non-adiabatic molecular dynamics based on time-dependent density-functional theory to characterize the scattering behaviour of a proton with the Li$_4$ cluster. This technique assumes a classical approximation for the nuclei, effectively coupled to the quantum electronic system. This time-dependent theoretical framework accounts, by construction, for possible charge transfer and ionization processes, as well as electronic excitations, which may play a role in the non-adiabatic regime. We have varied the incidence angles in order to analyze the possible reaction patterns. The initial proton kinetic energy of 10 eV is sufficiently high to induce non-adiabatic effects. For all the incidence angles considered the proton is scattered away, except in one interesting case in which one of the Lithium atoms captures it, forming a LiH molecule. This theoretical formalism proves to be a powerful, effective and predictive tool for the analysis of non-adiabatic processes at the nanoscale.Comment: 18 pages, 4 figure

Rhomboid domain containing 2 (RHBDD2): A novel cancer-related gene over-expressed in breast cancer

In the course of breast cancer global gene expression studies, we identified an uncharacterized gene known as RHBDD2 (Rhomboid domain containing 2) to be markedly over-expressed in primary tumors from patients with recurrent disease. In this study, we identified RHBDD2 mRNA and protein expression significantly elevated in breast carcinomas compared with normal breast samples as analyzed by SAGE (n=46) and immunohistochemistry (n=213). Interestingly, specimens displaying RHBDD2 over-expression were predominantly advanced stage III breast carcinomas (p=0.001). Western-blot, RT-PCR and cDNA sequencing analyses allowed us to identify two RHBDD2 alternatively spliced mRNA isoforms expressed in breast cancer cell lines. We further investigated the occurrence and frequency of gene amplification and over-expression affecting RHBDD2 in 131 breast samples. RHBDD2 gene amplification was detected in 21% of 98 invasive breast carcinomas analyzed. However, no RHBDD2 amplification was detected in normal breast tissues (n=17) or breast benign lesions (n=16) (p=0.014). Interestingly, siRNA mediated silencing of RHBDD2 expression results in a decrease of MCF7 breast cancer cells proliferation compared with the corresponding controls (p=0.001). In addition, analysis of publicly available gene expression data showed a strong association between high RHBDD2 expression and decreased overall survival (p=0.0023), relapsefree survival (p= 0.0013), and metastasis-free interval (p=0.006) in patients with primary ERnegative breast carcinomas. In conclusion, our findings suggest that RHBDD2 over-expression behaves as an indicator of poor prognosis and may play a role facilitating breast cancer progression

Application of six detection methods for analysis of paralytic shellfish toxins in shellfish from four regions within Latin America

With the move away from use of mouse bioassay (MBA) to test bivalve mollusc shellfish for paralytic shellfish poisoning (PSP) toxins, countries around the world are having to adopt non-animal-based alternatives that fulfil ethical and legal requirements. Various assays have been developed which have been subjected to single-laboratory and multi-laboratory validation studies, gaining acceptance as official methods of analysis and approval for use in some countries as official control testing methods. The majority of validation studies conducted to date do not, however, incorporate shellfish species sourced from Latin America. Consequently, this study sought to investigate the performance of five alternative PSP testing methods together with the MBA, comparing the PSP toxin data generated both qualitatively and quantitatively. The methods included a receptor binding assay (RBA), two liquid chromatography with fluorescence detection (LC-FLD) methods including both pre-column and post-column oxidation, liquid chromatography with tandem mass spectrometry (LC-MS/MS) and a commercial lateral flow assay (LFA) from Scotia. A total of three hundred and forty-nine shellfish samples from Argentina, Mexico, Chile and Uruguay were assessed. For the majority of samples, qualitative results compared well between methods. Good statistical correlations were demonstrated between the majority of quantitative results, with a notably excellent correlation between the current EU reference method using pre-column oxidation LC-FLD and LC-MS/MS. The LFA showed great potential for qualitative determination of PSP toxins, although the findings of high numbers of false-positive results and two false negatives highlighted that some caution is still needed when interpreting results. This study demonstrated that effective replacement methods are available for countries that no longer wish to use the MBA, but highlighted the importance of comparing toxin data from the replacement method using local shellfish species of concern before implementing new methods in official control testing programs

Accelerated amyloid deposition, neurofibrillary degeneration and neuronal loss in double mutant APP/tau transgenic mice

Even though the idea that amyloid beta peptide accumulation is the primary event in the pathogenesis of Alzheimer's disease has become the leading hypothesis, the causal link between aberrant amyloid precursor protein processing and tau alterations in this type of dementia remains controversial. We further investigated the role of beta-amyloid production/deposition in tau pathology and neuronal cell death in the mouse brain by crossing Tg2576 and VLW lines expressing human mutant amyloid precursor protein and human mutant tau, respectively. The resulting double transgenic mice showed enhanced amyloid deposition accompanied by neurofibrillary degeneration and overt neuronal loss in selectively vulnerable brain limbic areas. These findings challenge the idea that tau pathology in Alzheimer's disease is merely a downstream effect of amyloid production/deposition and suggest that reciprocal interactions between beta-amyloid and tau alterations may take place in vivo

Publicidad, salud y educación sanitaria

Si consideramos la salud como 'la forma de vida cada vez más autónoma, solidaria y alegre' (Perpignan 1976) o como 'El bienestar físico, psicológico y social' (OMS, 1948), vemos que la publicidad comercial pretende hacernos alcanzar unas metas de 'Salud' mediante la aparente satisfacción de las necesidades de estima y de autorrealización. De aquí que los productos que nos ofrecen supongan: a) un camino para mejorar las relaciones interpersonales y cubrir las necesidades de amor y de estima y b) un camino para mejorar la autoestima y la autorrealización personal. El artículo tiene como objetivo valorar la eficacia de un análisis crítico de la publicidad comercial. Como resultado destacamos el aumento de conocimientos sobre los métodos Y técnicas de la publicidad a través de los mass-media, sus estrategias, recursos e impacto en la población, y como resultado de mayor interés destacamos el descubrimiento personal por parte de los alumnos que lo realizaron de su influencia, de los estereotipos y modas que crea, y cómo el simple hecho de realizar una revisión crítica y reflexiva del material puede actuar de 'barrera'

Evaluación de parámetros nutricionales y sensoriales durante la conservación de pulpa de "chilto"

Desde hace unos años y dentro de un programa de Bioprospección de plantas nativas alimenticias y medicinales del NOA, nuestro instituto (INBIOFIV) estudia las propiedades nutricionales y funcionales de frutos de “chilto” (Solanum betaceum). Este es un fruto carnoso, comestible y nativo de las Yungas del NOA del cual se encuentran 3 variedades principales que se diferencian por el color del epicarpio (naranja o bola de chivo, roja y sangre de buey). En estudios previos hemos descripto las propiedades nutricionales y algunas potencialidades funcionales de los frutos bola de chivo y sangre de buey. En el marco de un proyecto premiado por ARCOR comenzamos a analizar productos derivados del mismo y su conservación en el tiempo. El objetivo de este trabajo fue analizar la conservación de la pulpa con y sin semilla de las variedades bola de chivo y sangre de buey en el tiempo, para lo que evaluamos parámetros nutricionales, físicos (color, pH) y sensoriales durante tres meses de conservación en frio (-20°C). El procesamiento de los frutos frescos permitió obtener pulpa libre de semillas o pulpa con semillas. Los resultados obtenidos demuestran la estabilidad nutricional (lípidos, proteínas y fibras), y en propiedades organolépticas como el color (luminosidad, parámetros de color) de la pulpa refrigerada. La estabilidad de la pulpa de “chilto” permitiría su utilización en la industria alimenticia para la fabricación de jugos, cocteles, dulces, entre otros.Fil: Orqueda, Maria Eugenia. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Veron Ponce, Hernan Esteban. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Salas, Ana Lilia. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Perez, Maria Jorgelina. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Rodríguez, I. F.. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Torres, S.. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaFil: Zampini, Iris Catiana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto de Química del Noroeste. Universidad Nacional de Tucumán. Facultad de Bioquímica, Química y Farmacia. Instituto de Química del Noroeste; ArgentinaFil: Isla, M. I.. Universidad Nacional de Tucumán. Instituto de Bioprospección y Fisiología Vegetal. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto de Bioprospección y Fisiología Vegetal; ArgentinaXIII Jornadas de Comunicaciones de la Facultad de Ciencias Naturales e Instituto Miguel Lillo; V Institucionales de la Facultad de Ciencias Naturales e Instituto Miguel LilloSan Miguel de TucumanArgentinaUniversidad Nacional de Tucumán. Facultad de Ciencias Naturales. Instituto Miguel Lill

Alternativas a la enseñanza tradicional. Educación sanitaria

El aprendizaje es un proceso dinámico en el que el comportamiento y las experiencias del alumno juegan un rol fundamental. Por ello es necesario investigar en nuevos métodos de enseñanza que estimule e incite la curiosidad del estudiante. Se presenta una experiencia llevada a cabo en la E.U.E. de la Universidad de Barcelona con un grupo control y otro experimental basado en metodología de aprendizaje tradicional y metodología activa. Para evaluar los conocimientos y actitudes de ambos grupos se pasó una encuesta antes y después de la experiencia. Las conclusiones del estudio, aunque variadas, parecen apuntar a una valoración global positiva del aprendizaje en el grupo experimenta

A bear’s biography: hybrid warfare and the more-than-human battlespace

This paper makes an intervention highlighting the animal dimension of military geographies as an overlooked yet illuminating aspect of the hybrid nature of warfare. By bringing animal geographies into dialogue with critical military geographies and with a focus on relational ethics, the processes, performance and consequences of the more-than-human nature of the battlespace are examined through a vignette of Wojtek the bear. Wojtek was a mascot, pet and officially enlisted soldier of the Polish Army in the Second World War who travelled the desert plains, helped to fight at the Battle of Monte Cassino, before being demobbed with his fellow Polish comrades in the UK, eventually ending his civilian days in Edinburgh Zoo. Although a well-known figure Wojtek and his biography have predominately been used as a means to explore the Polish soldiers’ experience of the Second World War with the result that the bear as an animal is absent. This paper, therefore, puts the bear back into his biography in order to acknowledge the role and lived experience of animals in the military. Further, it suggests that exploring the place of animals in the military requires geographers to articulate the hybrid nature of warfare and also to explore the ethico-political relations this produces