Lack of patient involvement in care decisions and not receiving written discharge instructions are associated with unplanned readmissions up to one year

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when returning home. From April 2011 to March 2014, 24,869 patients with a mean age of 52.8±19.8 years (range=18-100) were included. 18.6% of patients (n=4,821) experienced an unplanned hospital readmission within 43 to 365 days post-discharge. In adjusted, logistic regression models, patients who felt they were not involved in care decisions were more likely to be readmitted (OR=1.34; 95%CI: 1.17-1.53), as were patients who reported not receiving written information about signs and symptoms to watch out for post-discharge (OR=1.24; 95%CI: 1.15-1.35). Odds of readmission did not differ according to understanding of medications, understanding responsibility for one’s health, or discussion of help needed when returning home. This study provides objective data, showing that specific hospital actions are associated with unplanned readmissions. It is an example of how patient-reported measures may be linked to administrative data to drive quality improvement initiatives

Synthesis and electrochemical study of new 3-(hydroxyphenyl)benzo[f]coumarins

New hydroxyl substituted 3-arylbenzo[f]coumarins (compounds 6–10) have been designed and synthesized. Their electrochemical redox mechanisms, and the influence of one or two hydroxyl groups, in different positions on the coumarin scaffold, was investigated by cyclic, differential pulse and square wave voltammetry, at a glassy carbon electrode, at different pHs, and a comparative study was performed. The structural information obtained enabled a better understanding of the structure/electrochemical relationship of hydroxyl substituted 3-arylbenzo[f]coumarins, compounds with important antioxidant properties

Sheets of branched poly(lactic acid) obtained by one step reactive extrusion calendering process: Melt rheology analysis

One-step reactive extrusion-calendering process (REX-Calendering) was used in order to obtain sheets of 1mm from two PD,L-LA extrusion grades modified with a styrene-acrylic multifunctional oligomeric agent. In a preliminary internal mixer study, torque versus time was monitored in order to determine chain extender ratios and reaction time. Once all parameters were optimized, reactive extrusion experiments were performed. Independently of the processing method employed, under the same processing conditions, PD,L-LA with the lower D enantiomer molar content revealed a higher reactivity towards the reactive agent, induced by its higher thermal sensitivity. REXCalendering process seemed to minimize the degradations reactions during processing, although a competition between degradation and chain extension/branching reactions took place in both processes. Finally, the rheological characterization revealed a higher degree of modification in the melt rheological behaviour for REX-Calendered samples

Uma análise dos Discursos Oficiais sobre o Modelo Organizacional da Unidade de Saúde Familiar de Portugal / An analysis of the Official Discourses on the Organizational Model of Family Health Unit of Portugal

O objetivo deste artigo é refletir sobre as transformações do trabalho, as demandas de qualificação e de novas competências no âmbito da política de saúde primária, atribuindo especial destaque aos impactos no trabalho dos médicos nas unidades de saúde familiar em Portugal. A investigação de caráter qualitativo realizou-se por meio da consulta a fontes documentais: decretos, leis, planos de ação e relatórios referentes às políticas e à estrutura organizacional nas unidades de saúde, adotando-se a análise de conteúdo para o tratamento dos dados. Preconiza-se que o comprometimento com os processos de requalificação enseja novos movimentos instituintes, fortalecedores da (re)construção da identidade médica, não apenas compreendida como individuação/identificação, mas constituída como um processo contínuo vinculado à identidade pessoal, possibilitando a construção, desconstrução e a reconstrução de algo que permite dar sentido ao trabalho realizado. Para o trabalho em saúde, valoriza-se um novo perfil profissional dotado de elevada qualificação, integrando, de forma inseparável, teoria, saberes técnicos, práticos e sociais

QUESTÕES SOBRE GÊNERO E FORMAÇÃO PROFISSIONAL NO CURSO DE SERVIÇO SOCIAL DA UFS

Dada à centralidade do debate sobre gênero na contemporaneidade, buscou-se apreender no âmbito da formação as particularidade e singularidades observadas no campo do Serviço Social, destacando o lugar que a categoria gênero ocupa no contexto da formação. Para tanto foi realizada revisão bibliográfica relativa às categorias gênero, identidades, formação profissional em Serviço Social e pesquisa documental, a fim de identificar o modo de incorporação e o lugar que os estudos de gênero ocupam no Projeto Político Pedagógico na grade curricular do curso Serviço Social da Universidade Federal de Sergipe (UFS). Os dados revelam ausência da transversalidade do gênero enquanto uma disciplina no processo de formação profissional dos assistentes sociais da UFS, mas, paradoxalmente, o que se verificou foi um expressivo número de pesquisas relativas à categoria gênero e isso é uma mediação importante no processo de ensino-aprendizagem

The component of Carica papaya seed toxic to A-aegypti and the identification of tegupain, the enzyme that generates it

As Aedes aegypti transmits the etiologic agents of both yellow and dengue fever; vector control is considered essential to minimise their incidence. the aim of this work was to identify the component of Carica papaya seed toxic to A. aegypti, and the identification of tegupain, the enzyme that generates it. Aqueous extracts (1%, w/v) of the seed tegument and cotyledon of C. papaya are not larvicidal isolately. However, a mixture of 17 mu g mL(-1) tegument extract and 27 mu g mL(-1) cotyledon extract caused 100% larval mortality in a bioassay. the mixture was no longer larvicidal after the tegument extract was pre-treated at 100 degrees C for 10 min. the enzyme tegupain efficiently hydrolysed the substrate Z-Phe-Arg-pNan (K-m 58.8 mu M, K-cat 28020 s(-1), K-cat/K-m 5 x 10(8) M-1 s(-1)), and its activity increased with 2 mM dithiothreitol (DTT), at 37 degrees C, pH 5.0. the chelating agent EDTA did not modify the enzyme activity. Inhibition of tegupain by cystatin (K-iapp 2.43 nM), E64 (3.64 nM, 83% inhibition), and the propeptide N-terminal sequence indicate that the toxic activity is due to a novel cysteine proteinase-like enzyme, rendered active upon the hydrolysis of a cotyledon component of C. papaya seeds. (c) 2013 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Bioquim, BR-04044020 São Paulo, BrazilUniv Estadual Norte Fluminense, Biotechnol Lab, Campos Dos Goytacazes, RJ, BrazilUniversidade Federal de São Paulo, Dept Bioquim, BR-04044020 São Paulo, BrazilFAPESP: 2009/17058-6FAPESP: 2009/53766-5Web of Scienc

Genomic differentiation among varieties of Iberian pig

[EN] Aim of study: The objective of this study was to identify the autosomal genomic regions associated with genetic differentiation between three commercial strains of Iberian pig. Area of study: Extremadura (Spain). Material and methods: We used the Porcine v2 BeadChip to genotype 349 individuals from three varieties of Iberian pig (EE, Entrepelado; RR, Retinto; and TT, Torbiscal) and their crosses. After standard filtering of the Single Nucleotide Polymorphism (SNP) markers, 47, 67, and 123 haplotypic phases from EE, RR, and TT origins were identified. The allelic frequencies of 31,180 SNP markers were used to calculate the fixation index (FST) that were averaged in sliding windows of 2Mb. Main results: The results confirmed the greater genetic closeness of the EE and RR varieties, and we were able to identify several genomic regions with a divergence greater than expected. The genes present in those genomic regions were used to perform an Overrepresentation Enrichment Analysis (ORA) for the Gene Ontology (GO) terms for biological process. The ORA indicated that several groups of biological processes were overrepresented: a large group involving morphogenesis and development, and others associated with neurogenesis, cellular responses, or metabolic processes. These results were reinforced by the presence of some genes within the genomic regions that had the highest genomic differentiation. Research highlights: The genomic differentiation among varieties of the Iberian pig is heterogeneous along the genome. 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Thermal and structural analysis of 4,5,6-trimethoxyisatin

4,5,6-Trimethoxyisatin was crystallized from water to give dark red needles that were characterized by NMR and IR spectroscopy, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), single-crystal X-ray diffraction (XRD) and hot-stage microscopy.Fundação para a Ciência e a Tecnologia (FCT) - POCTISFA-3-686Fundo Europeu de Desenvolvimento Regional (FEDER

The effect of titanium dioxide surface modification on the dispersion, morphology, and mechanical properties of recycled PP/PET/TiO2 PBNANOs

Titanium dioxide (TiO2) nanoparticles have recently appeared in PET waste because of the introduction of opaque PET bottles. We prepare polymer blend nanocomposites (PBNANOs) by adding hydrophilic (hphi), hydrophobic (hpho), and hydrophobically modified (hphoM) titanium dioxide (TiO2) nanoparticles to 80rPP/20rPET recycled blends. Contact angle measurements show that the degree of hydrophilicity of TiO2 decreases in the order hphi > hpho > hphoM. A reduction of rPET droplet size occurs with the addition of TiO2 nanoparticles. The hydrophilic/hydrophobic balance controls the nanoparticles location. Transmission electron microscopy (TEM_ shows that hphi TiO2 preferentially locates inside the PET droplets and hpho at both the interface and PP matrix. HphoM also locates within the PP matrix and at the interface, but large loadings (12%) can completely cover the surfaces of the droplets forming a physical barrier that avoids coalescence, leading to the formation of smaller droplets. A good correlation is found between the crystallization rate of PET (determined by DSC) and nanoparticles location, where hphi TiO2 induces the highest PET crystallization rate. PET lamellar morphology (revealed by TEM) is also dependent on particle location. The mechanical behavior improves in the elastic regime with TiO2 addition, but the plastic deformation of the material is limited and strongly depends on the type of TiO2 employed

Genetic analysis of 17 Y-STRs in a Mestizo population from the Central Valley of Mexico

This study aims to portray the complex diversity of the Mexican Mestizo population, which represents 98.8% of the entire population of Mexico. We compiled extended haplotype data of the Y chromosome from populations in the Central Valley of Mexico (CVM), which were compared to other Mestizo and parental (Amerindian, European and African) populations. A complex ancestral relationship was found in the CVM population, suggesting cosmopolitan origins. Nevertheless, the most preeminent lineages point towards a European ancestry, where the R1b was the most frequent. In addition, important frequencies of Amerindian linages were also found in the Mestizo sample studied. Interestingly, the Amerindian ancestry showed a remarkable substructure, which was represented by the two main founding lineages: QL54 (x M3) and M3. However, even within each lineage a high diversity was found despite the small number of samples bearers of these lineages. Further, we detected important genetic differences between the CVM populations and the Mexican Mestizo populations from the north and south. This result points to the fact that Mestizo populations present different ancestral proportions, which are related to the demographic events that gave origin to each population. Finally, we provide additional forensic statistical parameters that are useful in the interpretation of genetic analysis where autosomal loci are limited. Our findings illustrate the complex genetic background of the Mexican Mestizo population and reinforce the need to encompass more geographic regions to generate more robust data for forensic applications