Standard plan nursing care in hip arthroplasty

Los problemas derivados de una intervención de artroplastia de cadera afectan a prácticamente todos los patrones funcionales del paciente (Marjory Gordon), de ahí la importancia de que el personal sanitario implicado en el tratamiento y recuperación del paciente desarrolle su trabajo según un PLAN claramente definido, estándar y evaluable. Éste ha sido el objetivo principal del equipo de trabajo, sistematizar los cuidados para que al paciente no le afecten los problemas derivados de la variabilidad en su atención, recupere su movilidad e independencia lo antes posible y se eviten complicaciones postoperatorias, para lo cual se ha prestado especial atención en la implicación del propio paciente en su recuperación. Administrativamente, con un Plan de Cuidados se mejora el registro de todas las actividades de enfermería y se clarifican las responsabilidades de los miembros del equipo sanitario. En lo que respecta a la atención de enfermería, esta regulación en los cuidados se ha realizado siguiendo la taxonomía NANDA-NOC-NIC, resultando un plan estándar de cuidados basado en los Patrones funcionales de Marjory Gordon, ya que los autores del presente Plan de atención creemos que éste es método muy fiable para realizar la valoración de un paciente, de la cual se derivarían los diagnósticos de enfermería adecuados y la evaluación continua del paciente. Concluimos que la aplicación de este Plan de Cuidados implicaría una mejora en la atención al paciente y en la organización del trabajo en la unidad de hospitalización de cirugía ortopédica y traumatológica. La validez del presente plan sería de tres años.ABSTRACT The problems resulting from an intervention in hip, affect practically all functional patterns of the patient (Marjory Gordon), hence the importance of health personnel involved in treatment and recovery of the patient performing their work to a clearly defined standard and graded plan. This has been the main objective of the team work, to systematize care for the patient so that it does not affect the problems of variability in their care, recover their mobility and independence as soon as possible and to avoid postoperative complications, for which special attention is paid to involving patients in their own recovery. Administratively, a Care Plan will improve the registration of all nursing activities and clarify the responsibilities of health team members. With regard to nursing care, this care regulation has been made following the NANDA-NOC-NIC taxonomy, resulting in a standard plan of care based on Marjory Gordon's functional patterns, since the authors believe this is a very reliable method for conducting an assessment of the state of the patient, which would derive in the appropriate nursing diagnosis and ongoing evaluation of the patient. We conclude that the application of the Care Plan would mean an improvement in patient care and organization of work in the hospital units of trauma and orthopaedic surgery. The validity of this plan would be three years

Phytochrome B and REVEILLE1/2-mediated signalling controls seed dormancy and germination in Arabidopsis

Seeds maintain a dormant state to withstand adverse conditions and germinate when conditions become favourable to give rise to a new generation of flowering plants. Seed dormancy and germination are tightly controlled by internal and external signals. Although phytochrome photoreceptors are proposed to regulate primary seed dormancy, the underlying molecular mechanism remains elusive. Here we show that the REVEILLE1 (RVE1) and RVE2 transcription factors promote primary seed dormancy and repress red/far-red-light-reversible germination downstream of phytochrome B (phyB) in Arabidopsis thaliana. RVE1 and RVE2 expression is downregulated after imbibition and by phyB. RVE1 directly binds to the promoter of GIBBERELLIN 3-OXIDASE 2, inhibits its transcription and thus suppresses the biosynthesis of bioactive gibberellins. In addition, DELAY OF GERMINATION 1 also acts downstream of phyB. This study identifies a signalling pathway that integrates environmental light input with internal factors to control both seed dormancy and germination

Concordant phylogeography and cryptic speciation in two Western Palaearctic oak gall parasitoid species complexes

Little is known about the evolutionary history of most complex multi-trophic insect communities. Widespread species from different trophic levels might evolve in parallel, showing similar spatial patterns and either congruent temporal patterns (Contemporary Host-tracking) or later divergence in higher trophic levels (Delayed Host-tracking). Alternatively, host shifts by natural enemies among communities centred on different host resources could disrupt any common community phylogeographic pattern. We examined these alternative models using two Megastigmus parasitoid morphospecies associated with oak cynipid galls sampled throughout their Western Palaearctic distributions. Based on existing host cynipid data, a parallel evolution model predicts that eastern regions of the Western Palaearctic should contain ancestral populations with range expansions across Europe about 1.6 million years ago and deeper species-level divergence at both 8–9 and 4–5 million years ago. Sequence data from mitochondrial cytochrome b and multiple nuclear genes showed similar phylogenetic patterns and revealed cryptic genetic species within both morphospecies, indicating greater diversity in these communities than previously thought. Phylogeographic divergence was apparent in most cryptic species between relatively stable, diverse, putatively ancestral populations in Asia Minor and the Middle East, and genetically depauperate, rapidly expanding populations in Europe, paralleling patterns in host gallwasp species. Mitochondrial and nuclear data also suggested that Europe may have been colonized multiple times from eastern source populations since the late Miocene. Temporal patterns of lineage divergence were congruent within and across trophic levels, supporting the Contemporary Host-tracking Hypothesis for community evolution