Validación y Adaptación del Bastón Zoométrico para el Estudio Morfométrico en Vacunos de Leche en la Irrigación Majes, Arequipa 2010

El trabajo de investigación presentado se desarrolló en la Irrigación Majes a 1438 m.s.n.m. y que se llevó a cabo en el “Fundo La Católica” CEPROBIS, con el objetivo de determinar las principales medidas zoométricas del vacuno de leche con el bastón zoométrico, con la finalidad de tener un instrumento de medición confiable y validado para el estudio morfológico de la especie bovina y otras especies productivas, se planteó diseñar un bastón zoométrico o de Aparicio para el estudio de medidas morfológicas en vacunos de leche de la raza Hostein Friesian. Se consideró como población 125 animales de las diferentes categorías de la raza Holsteian Friesian del Fundo La Católica”, obteniendo los siguientes resultados en vacas adultas: Alzada a la cruz 1.4852 ± 0.0461 mt., Alzada al dorso 1.4673 ± 0.0625 mt., Alzada al isquion 1.3217 ± 0.0445 mt., Alzada al hueco subesternal o altura del esternón 0.7175 ± 0.0377 mt., Alzada al nacimiento de la cola 1.4587 ± 0.0389 mt., Alzada a la grupa 1.4112 ±0.0203 mt., Longitud corporal 1.6756 ± 0.0399 mt., Longitud de grupa 0.4881 ± 0.0381, Longitud de tórax 0.8400 ± 0.0516, Longitud del dorso0.4777 ± 0.0233 mt., Longitud de lomo 0.4145 ± 0.0212 mt., Longitud del cuello 0.5097 ± 0.0477 mt., Longitud de la cara 0.2451 ± 0.0349 mt., Longitud de la cabeza 0.5013 ± 0.0467 mt., Ancho de cara 0.1548 ± 0.0303 mt., Anchura anterior de la grupa o ancho de ilion 0.4891 ± 0.0277 mt., Ancho de lomo 0.4121 ± 0.0311 mt., Anchura de las nalgas o ancho de isquion 0.2285 ± 0.0275 mt.; mas no perímetros.Tesi

Bedside Nurse Shift Length: Evidence-Based Intervention on Nursing Burnout

With the aging baby boomer population, employee burnout, and lack of quality medical training, the United States is facing one of the most detrimental nursing shortages in history. Before the COVID-19 pandemic, the United States Health and Human Services projected the demand for nurses to be much higher than the actual number of employed registered nurses through 2030. Since 2016 the nursing population was widely composed of nurses between 25 to 34 years old. After the global pandemic hit, the number of nurses in that age group declined by 5.2 percent, and nurses aged 35 to 44 have reduced by 7.4 percent (Haines, 2022). During a period when the need for nurses is at an all-time high, many are leaving the bedside for other less stressful careers. When examining the nursing crisis topic, many factors must be considered, one of the most important being decreasing staff burnout, thus maintaining quality trained nurses. Everhart et al. found that retaining nursing staff decreased overall financial costs for the hospital and decreased adverse events, length of stays, and improved care processes (2013). One of the issues leading to nursing burnout is believed to be the 12-hour shift work. A recent review showed that nurses who worked 12-hour shifts developed more chronic fatigue, cognitive anxiety, sleep disturbance, and emotional exhaustion than those who worked 8-hour shifts (Banakhar, 2017). In a recent survey, nurses working longer than ten hours were more likely to experience burnout and job dissatisfaction and showed intention to quit their jobs (Stimpfel, Sloane & Aiken, 2012). With this information, it is essential to assess how to decrease nursing burnout and retain quality nurses at the bedside. This change project discusses the following research question: In the acute setting, do nurses (P) working 8-hour shifts (I), compared to nurses working 12-hour shifts(C), have less burnout (O) over three months (T)? During this project, we will take a deeper look into the effects of the 8-hour shift versus the 12-hour shift, the nursing retention, and thus, overall patient care

Mediterranean diet pyramid today. Science and cultural updates

Objective: To present the Mediterranean diet (MD) pyramid: a lifestyle for today. Design: A new graphic representation has been conceived as a simplified main frame to be adapted to the different nutritional and socio-economic contexts of the Mediterranean region. This review gathers updated recommendations considering the lifestyle, dietary, sociocultural, environmental and health challenges that the current Mediterranean populations are facing. Setting and Subjects: Mediterranean region and its populations. Results: Many innovations have arisen since previous graphical representations of the MD. First, the concept of composition of the ‘main meals’ is introduced to reinforce the plant-based core of the dietary pattern. Second, frugality and moderation is emphasised because of the major public health challenge of obesity. Third, qualitative cultural and lifestyle elements are taken into account, such as conviviality, culinary activities, physical activity and adequate rest, along with proportion and frequency recommendations of food consumption. These innovations are made without omitting other items associated with the production, selection, processing and consumption of foods, such as seasonality, biodiversity, and traditional, local and eco-friendly products. Conclusions: Adopting a healthy lifestyle and preserving cultural elements should be considered in order to acquire all the benefits from the MD and preserve this cultural heritage. Considering the acknowledgment of the MD as an Intangible Cultural Heritage of Humanity by UNESCO (2010), and taking into account its contribution to health and general well-being, we hope to contribute to a much better adherence to this healthy dietary pattern and its way of life with this new graphic representation.peer-reviewe

Complex history of the amphibian-killing chytrid fungus revealed with genome resequencing data

Understanding the evolutionary history of microbial pathogens is critical for mitigating the impacts of emerging infectious diseases on economically and ecologically important host species. We used a genome resequencing approach to resolve the evolutionary history of an important microbial pathogen, the chytrid Batrachochytrium dendrobatidis (Bd), which has been implicated in amphibian declines worldwide. We sequenced the genomes of 29 isolates of Bd from around the world, with an emphasis on North, Central, and South America because of the devastating effect that Bd has had on amphibian populations in the New World. We found a substantial amount of evolutionary complexity in Bd with deep phylogenetic diversity that predates observed global amphibian declines. By investigating the entire genome, we found that even the most recently evolved Bd clade (termed the global panzootic lineage) contained more genetic variation than previously reported. We also found dramatic differences among isolates and among genomic regions in chromosomal copy number and patterns of heterozygosity, suggesting complex and heterogeneous genome dynamics. Finally, we report evidence for selection acting on the Bd genome, supporting the hypothesis that protease genes are important in evolutionary transitions in this group. Bd is considered an emerging pathogen because of its recent effects on amphibians, but our data indicate that it has a complex evolutionary history that predates recent disease outbreaks. Therefore, it is important to consider the contemporary effects of Bd in a broader evolutionary context and identify specific mechanisms that may have led to shifts in virulence in this system.Instituto de Botánica "Dr. Carlos Spegazzini

Linguistic validation of the Spanish version of the National Cancer Institute’s Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

Purpose: The U.S. NCI’s PRO-CTCAE is a library of self-report items for assessing symptomatic adverse events in cancer clinical trials from the patient perspective. The aim of this study was to translate and linguistically validate a Spanish version. Methods: PRO-CTCAE’s 124 items were translated from English into Spanish using multiple forward and back translations. Native Spanish speakers undergoing cancer treatment were enrolled at six cancer treatment sites. Participants each completed approximately 50 items and were then interviewed using cognitive probes. The interviews were analyzed at the item level by linguistic themes, and responses were examined for evidence of equivalence to English. Items for which ≥20 % of participants experienced difficulties were reviewed, and phrasing was revised and then retested in subsequent interviews. Items where <20 % of respondents experienced difficulties were also reviewed and were considered for rephrasing and retesting. Results: One hundred nine participants from diverse Spanish-speaking countries were enrolled (77 in Round 1 and 32 in Round 2). A majority of items were well comprehended in Round 1. Two items presented difficulties in ≥20 % of participants and were revised/retested without further difficulties. Two items presented difficulties in <20 %, and when retested exhibited no further difficulties. Two items presented difficulties in <20 %, but were not revised due to lack of alternatives. Sixteen items presented difficulties in ≤12 % and were not revised because difficulties were minor. Conclusions: The Spanish PRO-CTCAE has been developed and refined for use in Spanish-speaking populations, with high levels of comprehension and equivalence to the English PRO-CTCAE. Trial registration: ClinicalTrials.gov:NCT0143624

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London