Using flawed, uncertain, proximate and sparse (FUPS) data in the context of complexity: learning from the case of child mental health.

The use of routinely collected data that are flawed and limited to inform service development in healthcare systems needs to be considered, both theoretically and practically, given the reality in many areas of healthcare that only poor-quality data are available for use in complex adaptive systems. Data may be compromised in a range of ways. They may be flawed, due to missing or erroneously recorded entries; uncertain, due to differences in how data items are rated or conceptualised; proximate, in that data items are a proxy for key issues of concern; and sparse, in that a low volume of cases within key subgroups may limit the possibility of statistical inference. The term 'FUPS' is proposed to describe these flawed, uncertain, proximate and sparse datasets. Many of the systems that seek to use FUPS data may be characterised as dynamic and complex, involving a wide range of agents whose actions impact on each other in reverberating ways, leading to feedback and adaptation. The literature on the use of routinely collected data in healthcare is often implicitly premised on the availability of high-quality data to be used in complicated but not necessarily complex systems. This paper presents an example of the use of a FUPS dataset in the complex system of child mental healthcare. The dataset comprised routinely collected data from services that were part of a national service transformation initiative in child mental health from 2011 to 2015. The paper explores the use of this FUPS dataset to support meaningful dialogue between key stakeholders, including service providers, funders and users, in relation to outcomes of services. There is a particular focus on the potential for service improvement and learning. The issues raised and principles for practice suggested have relevance for other health communities that similarly face the dilemma of how to address the gap between the ideal of comprehensive clear data used in complicated, but not complex, contexts, and the reality of FUPS data in the context of complexity

Phosphorylation of the eIF4E-binding protein PHAS-I after exposure of PC12 cells to EGF and NGF

AbstractPHAS-I or the eIF4E-binding protein 1 regulates the cap-binding activity of eIF4E by sequestering eIF4E. Binding of eIF4E to PHAS-I is regulated by phosphorylation of PHAS-I. PC12 cells were used to study the signal transduction pathway leading to phosphorylation of PHAS-I. Both EGF and NGF induced phosphorylation of PHAS-I. Wortmannin, a PI-3 kinase inhibitor, staurosporine, a PKC inhibitor, and rapamycin, a FRAP inhibitor all blocked the phosphorylation of PHAS-I. Of the three inhibitors, only wortmannin was able to inhibit MAPK phosphorylation. This excludes a role for MAPK in NGF- and EGF-induced PHAS-I phosphorylation in PC12 cells. Apparently, PHAS-I was phosphorylated in a PI-3 kinase-, PKC-, and FRAP-dependent manner after EGF or NGF stimulation. Only PI-3 kinase and FRAP are involved in the regulation of the basal level of PHAS-I phosphorylation

Quadro protéico de fêmeas da espécie crapina (Capra hircus), criadas no Estado de São Paulo

No presente trabalho os autores estabeleceram o quadro protéico normal para os caprinos criados no Estado de São Paulo. Estudaram amostras de soro sanguíneo de 150 cabras, pertencentes a 3 raças (Anglo-Nubiana, Toggenbourg e Angorá), de diferentes idades e alimentadas com ou sem suplementação de ração concentrada. A proteína total e albumina foram determinadas pelo métodos de Gornall e cols. (1949). A Gama globulina foi dosado segundo o método de Frattini, como recomenda Bacila e cols. (1962). A estimativa dos valores populacionais médios em têrmos de desvio padrão da média para os 150 animais estudados foram: Proteína total - 6,44 ± 0,067 g%; Albumina - 2,37 ± 0,043 g%; Globulinas - 4,07 ± 0,090 g% e relação albumina/globulinas - 0,66 ± 0,028.The authors studied 150 healthy female goats (Capra hircus) of different ages, raised in several areas of the state of São Paulo, Brazil, their breeding was Anglo-Nubian (60), Toggenbourg (60) and Angora (30). The authors used Gornall et col. (1949) method to determine the total protein, albumin, globulins and the ratio between albumin/globulins in the serum. The original method was modified by precipitating the globulins in a 27 g% sodium sulfate solution. The determination of the gama globulina in the serum was determined by the Frattini turbidimetric method, as recommended by Bacila et al. (1962). The results are shown in table I and table II — III a sums up the results found in the literature concerning the normal goat, including the results secured in the present research. The estimated mean values of all animals in relation to the mean standard deviation were: Total protein — 6.44 ± 0.067 g%, Albumin — 2.37 ± 0.043 g%, Globulina — 4.07 ± 0.090 g%, Gamaglobulin — 1.54 ± 0.035 g%, Ratio Albumin/globulin — 0.66 ± 0.028

Determinação dos teores séricos de lipídeos totais em caprinos (Capra hircus), do sexo feminino, criados do Estado de São Paulo

The authors established the normal blood lipids in female goats (Capra hircus) belonging to differents races and raised in several areas of the State of São Paulo (Brazil). The determination of lipids in the serum, was carried out by Kunkel Ahrens and Eisenmeyer's method, as recommended by Bacila et al. (1962). The estimated mean values of all animal in relation to the mean standard deviation were 636,9  ± 41,6 mg%.Os AA. na presente pesquisa estabeleceram o quadro lipídico normal de caprinos (Capra hircus), do sexo feminino de diferentes raças e idades criados no estado de São Paulo. As determinações dos teores séricos de lipídeos totais foram feitas pelo método turbidimétrico de Kunkel, Ahrens e eisenmeyer, como recomenda Bacila e col., (1962). A média geral da amostragem foi: 363,9 ± 41,6 mg por 100 ml de soro

Propuesta de un Manual de Funciones para mejorar la eficiencia y la eficacia en los puestos de trabajo de la Bodega Central en el Recinto Universitario "Rubén Darío", en la UNAN-Managua durante los meses de Abril a Julio del año 2014

El presente trabajo nos permite aplicar los conocimientos obtenidos en las aulas de clases de la universidad, guiados por los maestros quienes comparten sus conocimientos acerca del tema de estudio y nos facilita la interpretación de la información que se obtiene. El desarrollo de este trabajo se realizó durante los meses comprendidos de Abril a Julio del año 2014, en el área de la Bodega Central de la “UNAN-MANAGUA”, y servirá de apoyo a los trabajadores en el desarrollo de sus labores, y a jefes de área para darle continuidad a las tareas de los colaboradores; el propósito de dicho trabajo es proponer un manual de funciones que permita plasmar las actividades correspondientes a cada cargo ocupado en esta área. El enfoque de este trabajo es de tipo cualitativo, ya que describiremos que actividades realizan los trabajadores de la bodega central, lo cual haremos a través de la recolección de información. La población objeto del estudio que realizamos está comprendida por un total de cinco personas, las cuales ocupan un cargo en el área de bodega central, como son: Director de Bodega Central, Secretaria, Estadígrafo, Bodeguero y Conserje. Para identificar las actividades que cada persona realiza según su cargo, aplicamos entrevistas con cada trabajador y usamos la observación directa. En el presente estudio describimos el ambiente laboral de la bodega central, lo que nos ayudó a identificar los puestos de trabajo, para lo cual nos abocamos al director de bodega central de la UNAN-MANAGUA; de esta manera tendremos conocimiento de los cargos que existen; una vez identificados, recolectamos información de los puestos a través de entrevistas y la observación directa, lo cual nos proporcionó la delimitación de las actividades que cada colaborador de la bodega realiza, con esta información procedimos a la elaboración de dichos manuales de funciones por cada puesto de trabajo. El propósito de estos manuales es facilitar el buen desempeño de los trabajadores, lo cual aumentará su eficiencia y eficacia logrando cumplir con los objetivos y metas planteados para el desarrollo de sus labores

Aspectos radiográficos de bezoares de ruminantes. Apresentação de caso clínico em cabra (capra hircus)

Bezoares were clinically and radiographically detected in an 11 years old goat. Bezoares obtained from other animals were radiographically studied and the results compared to those observed in the clinical case, there reported.The possible genesis of these structures is discussed.Os Bezoares foram clínica e radiograficamente detectados em cabras de onze anos. Os Bezoares obtidos de outros animais foram estudados radiograficamente e os resultados comparados com o caso clínico aqui descrito. A possibilidade da gênese destas estruturas é discutida neste trabalho

Burden of Respiratory syncytial virus (RSV) infection among adults in nursing and care homes:a systematic review

BackgroundOlder adults in nursing and care homes (NCHs) are vulnerable to severe respiratory syncytial virus (RSV) infection, hospitalisation, and death. This study aimed to gather data on RSV disease among older adults in NCHs and identify reported risk factors for RSV hospitalisation and case fatality.MethodsThe study protocol was registered in PROSPERO (CRD42022371908). We searched MEDLINE, EMBASE and Global Health databases to identify articles published between 2000 and 2023. Observational and experimental studies conducted among older adults in NCHs requiring assistive care and reporting RSV illness were included and relevant data were extracted.ResultsOf 18,690 studies screened, 32 were selected for full-text review and 20 were included. Overall, the number of NCH residents ranged from 42 to 1,459 with a mean age between 67.6 and 85 years. Attack rates ranged from 6.7 – 47.6% and annual incidence ranged from 0.5 – 14%. Case fatality rates ranged from 7.7 – 23.1%. We found similar annual incidence rates of RSV-positive acute respiratory infection (ARI) of 4,582 (95% CI: 3,259 – 6,264) and 4,785 (95% CI: 2,258 – 10,141) per 100,000 reported in two studies. Annual incidence rate of RSV-positive lower respiratory tract infection was 3,040 (95% CI: 1,986 – 4,454) cases per 100,000 adults. Annual RSV-ARI hospital admission rates were between 600 (95% CI: 190 -10,000) and 1,104 (95% CI: 350 – 1,930) per 100,000 person-years. Among all RSV disease cases, commonly reported chronic medical conditions included chronic obstructive pulmonary disease (COPD), heart failure, ischemic heart disease, coronary artery disease, hypertension, diabetes, kidney dysfunction, cerebrovascular accident, malignancies, dementia, and those with a Charlson comorbidity score > 6.5.ConclusionData on RSV infection among NCH residents are limited and largely heterogeneous but document a high risk of illness, frequent hospitalisation, and high mortality. Preventive interventions, such as vaccination should be considered for this high-risk population. Nationally representative epidemiologic studies and NCH-based viral pathogen surveillance could more precisely assess the burden on NCH residents

Consideração sobre os teores de enzimas proteolíticas em bovinos alimentados com concentrados

During the fattening period (4 months) of 24 young bovines, male, Friesian, fed only concentrates, the behaviour of the levels of proteolytic enzymes was studied. The variation of the serical trypsin, chymotrypsin and amylase activity was observed, and it is probably due to the specifical effect of adaptation to the nutritions conditions. The serical trypsin activity was larger than the chymotrypsin’s. On the other hand, the behaviour of the enzymatic activity of trypsin and chymotrypsin in the feces decreased during the fattening. Small variations were observed in the groups of ponderal increment of the serical trypsin and amylase activities. By the method of gelatin digestion, the trypsin from the duodenal juice and feces presented total enzymatic activity up to the dilutions 1 : 4,0 and 1 : 1, respectively. By the colorimetric method the duodenal juice presented tryptical activity up to the dilution 1 : 200. Between the animals and the different groups of ponderal increment there were differences statistically significant for the values of serical trypsin, chymotrypsin and amylase. The mean values in terms of standard deviations were: serical trypsin 1,37 ± 0,066 mU/ml; trypsin in feces 0,39 ± 0,438 mU/ml; chymotrypsin 1,23 ± ± 0,064, mU/ml and serical amylase 154,61 ± 3,984 units.Estudou-se, durante o período de engorda (4 meses) em 24, bovinos jovens, machos inteiros da raça holandesa preto e branco, alimentados exclusivamente com concentrados, o comportamento dos teores de enzimas proteolíticas. Observou-se variação da atividade da tripsina, da quimotripsina e da amilase séricas, provavelmente devidas a um efeito específico de adaptação às condições alimentares. A atividade da tripsina sérica foi maior do que a da quimotripsina; por outro lado o comportamento da atividade enzimática da tripsina nas fezes e da quimotripsina sofreu ligeira queda durante a fase de engorda. Observaram-se pequenas oscilações nos diferentes grupos de incremento ponderai para as atividades da tripsina e da amilase séricas. Pelo método da digestão da gelatina, a tripsina do suco duodenal e das fezes, apresentou atividade enzimática total até a diluição de 1 : 40 e 1 : 1 respectivamente. O suco duodenal dosado pelo método colorimétrico apresentou atividade triptica até a diluição 1:200. Entre os animais e os diferentes grupos de incremento ponderai houve diferenças estatisticamente significantes para os valores da tripsina, quimotripsina e amilase séricas. Os valores médios em termos de desvio padrão da média foram: Tripsina sérica 1,37 ± 0,066 mU/ml; Tripsina nas fezes 0,39 ± 0,438 mU/ml; Quimotripsina 1,23 ± ± 0,064, mU/ml; Amilase sérica 154,61 ± ± 3,984 unidades

Evaluación de injuria cardíaca en novillos a distintas dosis de monensina sódica dietaría medida a través de creatina kinasa miocárdica / Evaluation of cardiac insult in steers with different dietary sodic monensin concentration measured thought mioc

The aim of this study was to evaluate a possible myocardial  damage on feedlot steers caused by high doses of monensin (MN). A commercial kit was used to determinate the concentration of myocardial creatine kinase (CK-MB). Four groups of animals were conformed according to the diet MN concentration. G1: Control, without MN, G2: MN Tag dose, 1 mg kg body weight (BW) -1 , G3: MN 5 mg kg BW -1 and G4: MN 10 mg kg BW -1 The cattle were housed in pens for eleven days. Venous blood  samples were taken at 0, 48, 120, 168 and 264 h. Serum CK-MB  concentration was analyzed using descriptive and comparative  statistics analysis of variance (ANOVA) with a significance level  of P<0,05. No CK-MB mean concentration above cut-off level (90  U/l) was recorded throughout the assay for any treatment. The  G1 mean throughout the assay was 47,84 ± 21,28 U/l showing  statistical differences (P<0.05) from 120 h up to the end of the  study, as compared to the others groups. Means of G2, G3 and G4  were 37,31 ± 37,31; 34,09 ± 12,96; 34,62 ± 19,90 U/l, respect tively. This study could not determine heart damage caused by  MN, measured through a commercial kit, despite the widespread  time assessed. The control group had higher CK-MB mean concentration than all others groups, from 48 h until the end of the  study. This result could indicate a possible beneficial and regulatory effect on digestive microflora by the MN antibiotic, resulting in less exposure to bacterial endotoxinsEl objetivo del presente trabajo fue evaluar un posible daño de  miocardio en novillos en feedlot ante la administración continua  de dosis elevadas de monensina (MN) en la dieta, utilizando para  ello el kit comercial que determina la concentración de creatinaquinasa miocárdica (CK-MB). Se conformaron cuatro grupos de  acuerdo a la concentración de MN en la dieta, G1: Control, sin  monensina, G2: dosis marbete, MN 1 mg kg PV -1 , G3: MN 5 mg  kg PV -1 y G4: MN 10 mg kg PV -1 . El ganado fue mantenido en los  corrales por un periodo de 11 días con muestreos de sangre por  venopunción yugular a la hora 0, 48, 120, 168 y 264 de iniciada  la prueba. Las concentraciones séricas de CK-MB fueron analizadas mediante estadística descriptiva y comparativa usando  un análisis de variancia (ANOVA) con un nivel de significancia  de P<0,05. No se registraron concentraciones de CK-MB pro medio por encima del punto de corte (90 U/l) a lo largo de la  prueba para ninguno de los tratamientos propuestos. La media  aritmética evaluada a lo largo de toda la prueba para el grupo  G1 fue de 47,84±21,28 U/l, mostrando diferencias estadísticas  (P<0,05) a partir de las 120 h de iniciada la prueba en relación  a los demás grupos. La media para los grupos G2, G3 y G4 fue de  37,31±17,00; 34,09±12,96 y 34,62±19,90 U/l, respectivamente.  No se pudo determinar la participación de MN como causante  de lesión cardíaca medido a través del kit comercial a pesar del  prolongado período de tiempo evaluado. Considerando que el  grupo control presentó concentraciones promedio más elevadas a partir de las 48 hs y hasta la finalización de la prueba en rela ción a los tres grupos que contenían MN, se debería considerar un posible efecto beneficioso y regulador de la microflora del  tracto digestivo por parte de dicho antibiótico, generando una  menor exposición a endotoxinas bacterianas DOI:http://dx.doi.org/10.19137/cienvet2016-181

Effects of some anthelmintics on the blood picture and weight gain in bovines

In five lots of Nelore bovines on a fattening diet in pastures of “Colonião" grass (Panicum maximum), the effects of the following anthelmintics were studied: thiodiphenylamine (Phenothiazine), oxyenthyl trichloro dimenthyl phosphonate (Neguvon), orally and injectable, and 2,6 diiodo-para-nitrophenol (Disofen). During the 5 months that the experiment lasted, nematode egg counts were done so as to evaluate the anthelmintic action of these drugs. The animals weight gain was controlled and blood samples were collected for the following tests: hemoglobin, hematocrit and serum proteins fractions. The interpretation of the results allow us to state that the choice and the indication of the anthelmintic treatments for bovines should be based on their vermifuge or vermicidal action, as well as on the clinical diagnosis of the infestations, rather than on the hypotetic beneficial secondary effects on weight gain and blood picture: thus the systematic use of the products tested is not recommended in the routine treatment of assymptomatic verminosis.Em cinco lotes de bovinos da raça Nelore, em fase de engorda, criados em pastos formados por capim colonião (Panicum maximum), estudou-se os efeitos dos seguintes anti-helmínticos: tiodifenilamina (Fenotiazina), fosfonato de dimetil tricloro oxietilo (Neguvon), por via oral e injetável, e o 2,6 diiodo-para-nitrofenol (Disofen). Durante os 150 dias dos experimentos, realizaram- se contagens de ovos de nematóides para a verificação da ação dos anti-helmínticos. Além do controle de ganho de peso dos animais, foram examinadas, sistematicamente, amostras de sangue (determinação da taxa de hemoglobina, valor hematócrito e dosagens das proteínas séricas e suas frações). A interpretação dos resultados permitiu afirmar que a escolha e a indicação dos tratamentos anti-helmínticos para bovinos deve ser baseada na ação vermífuga ou vermicida dos produtos, bem como no diagnóstico clínico da infestação e não nos hipotéticos efeitos colaterais benéficos sobre o ganho de peso e a crase sanguínea, não se recomendando, portanto, o uso sistemático dos produtos testados em verminoses inaparentes