Padronização de uma bateria para a avaliação de fatores de risco psicossociais trabalhistas em trabalhadores colombianos

A battery of questionnaires to assess psychosocial risk factors at work was developed in 2010 in response to Resolution 2646 created by the Colombian Ministry of Social Protection. However, this battery presents some theoretical and practical limitations. A new battery of instruments has been designed and validated that includes instruments and risk indicators of the demand-control-social support and the effort-reward imbalance models. Other factors, not included in these models, but that Resolution 2646 suggests should be assessed, have also been added, and with this additional information, the new battery allows us to also calculate a “global indicator” of demand, control, and social support; family and social risk conditions, coping and personality; and health and wellbeing. The new battery was administered to a sample of 16,095 workers from different occupations and representative Colombian regions. An analysis of the various domains indicates that internal consistency of the various scales is high. The new battery has the following properties: it is simple to use in paper format or when administered by computer, it enables comparison between occupations, it offers unified scores for each variable, and provides information to assess the risk factors suggested by Resolution 2646. In addition, it will make it possible to compare the results obtained when analyzing Colombian workers with those obtained from studies of workers from other countries.Em 2010, desenvolveu-se uma bateria de instrumentos para avaliar fatores psicossociais trabalhistas de risco para a saúde, em resposta à Resolução 2 646 do Ministério da Proteção Social da Colômbia. Contudo, esta conta com algumas limitações que, a partir da construção e da validação de uma nova bateria, neste estudo se pretendem superar. Além disso, a nova bateria oferece recursos adicionais para a avaliação desses fatores: a presente bateria incorpora os instrumentos e os indicadores centrais dos modelos demanda-controle-apoio social e desiquilíbrio esforço-recompensa e os fatores internos do trabalho não considerados nesses modelos, mas que a Resolução considera necessários, mediram-se com testes preexistentes ou desenvolvidos pelos autores. Com os dados coletados, é possível calcular indicadores globais de demanda, controle e apoio social; além de condições familiares e sociais de risco, enfrentamento, personalidade e indicadores de saúde e bem-estar. Para a validação, a bateria foi aplicada a uma amostra de 16 095 trabalhadores de diferentes cargos e municípios colombianos. As anál i ses de consistência interna e validade permitem afirmar que a bateria é simples de aplicar em papel ou digital, permitirá comparar cargos, obter pontuações unificadas por variável, oferecer um diagnóstico de um número importante das variáveis sugeridas na Resolução bem como permitirá comparar os resultados dos trabalhadores colombianos com os de outros países. Palavras-chave: fatores trabalhistas de risco psicossocial, Resolução 2 646 de 2008, modelo demanda-controle-apoio social, modelo desiquilíbrio esforço-recompensa, estresse profissional, avaliação.En 2010 se desarrolló una batería de instrumentos para evaluar factores psicosociales laborales de riesgo para la salud, en respuesta a la Resolución 2646 de 2008 del Ministerio de la Protección Social de Colombia. Sin embargo, esta cuenta con algunas limitaciones que, a partir de la construcción y validación de una nueva batería, en el presente estudio se buscan superar. La nueva batería ofrece recursos adicionales para la evaluación de estos factores: incorpora los instrumentos e indicadores centrales de los modelos demanda-control-apoyo social y desequilibrio esfuerzo-recompensa, y los factores intralaborales no contemplados en dichos modelos, pero que la Resolución considera necesarios, se midieron con pruebas preexistentes o desarrolladas por los autores. Con los datos recolectados es posible calcular indicadores globales de demanda, control y apoyo social; además de condiciones familiares y sociales de riesgo, afrontamiento, personalidad e indicadores de salud y bienestar. Para la validación, la batería se aplicó a una muestra de 16.095 trabajadores de diferentes ocupaciones y municipios colombianos. Los análisis de consistencia interna y validez permiten afirmar que la batería es sencilla de aplicar en papel o por computador, permitirá comparar ocupaciones, obtener puntuaciones unificadas por variable, ofrecer un diagnóstico de un número importante de las variables sugeridas en la Resolución y comparar los resultados de los trabajadores colombianos con los de otros países

Delayed bowel perforation following suprapubic catheter insertion

BACKGROUND: Complications of suprapubic catheter insertion are rare but can be significant. We describe an unusual complication of a delayed bowel perforation following suprapubic catheter insertion. CASE PRESENTATION: A gentleman presented with features of peritonitis and feculent discharge along a suprapubic catheter two months after insertion of the catheter. CONCLUSION: Bowel perforation is the most feared complication of suprapubic catheter insertion especially in patients with lower abdominal scar. The risk may be reduced with the use of ultrasound scan guidance

Establishing the predictive validity of the intercollegiate membership of the Royal Colleges of surgeons written examination : MRCS part B

Acknowledgements The authors would like to acknowledge Iain Target at the Royal College of Surgeons of England, and Gregory Ayre from the Intercollegiate Committee for Basic Surgical Examinations for their support during this project. Funding Royal College of Surgeons of Ireland, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of England and Royal College of Surgeons of Edinburgh (Award/Grant number is not applicable).Peer reviewedPublisher PD

Establishing the predictive validity of the intercollegiate membership of the Royal Colleges of surgeons written examination : MRCS Part A

Acknowledgements The authors would like to acknowledge Iain Targett at the Royal College of Surgeons of England, and Gregory Ayre from the Intercollegiate Committee for Basic Surgical Examinations for their support during this project. Funding Royal College of Surgeons of Ireland, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons of England and Royal College of Surgeons of Edinburgh (Award/Grant number is not applicable).Peer reviewedPublisher PD

p53 suppresses type II endometrial carcinomas in mice and governs endometrial tumour aggressiveness in humans

Type II endometrial carcinomas are a highly aggressive group of tumour subtypes that are frequently associated with inactivation of the TP53 tumour suppressor gene. We show that mice with endometrium-specific deletion of Trp53 initially exhibited histological changes that are identical to known precursor lesions of type II endometrial carcinomas in humans and later developed carcinomas representing all type II subtypes. The mTORC1 signalling pathway was frequently activated in these precursor lesions and tumours, suggesting a genetic cooperation between this pathway and Trp53 deficiency in tumour initiation. Consistent with this idea, analyses of 521 human endometrial carcinomas identified frequent mTORC1 pathway activation in type I as well as type II endometrial carcinoma subtypes. mTORC1 pathway activation and p53 expression or mutation status each independently predicted poor patient survival. We suggest that molecular alterations in p53 and the mTORC1 pathway play different roles in the initiation of the different endometrial cancer subtypes, but that combined p53 inactivation and mTORC1 pathway activation are unifying pathogenic features among histologically diverse subtypes of late stage aggressive endometrial tumours

The costs of scaling up HIV prevention for high risk groups: lessons learned from the Avahan Programme in India.

OBJECTIVE: The study objective is to measure, analyse costs of scaling up HIV prevention for high-risk groups in India, in order to assist the design of future HIV prevention programmes in South Asia and beyond. DESIGN: Prospective costing study. METHODS: This study is one of the most comprehensive studies of the costs of HIV prevention for high-risk groups to date in both its scope and size. HIV prevention included outreach, sexually transmitted infections (STI) services, condom provision, expertise enhancement, community mobilisation and enabling environment activities. Economic costs were collected from 138 non-government organisations (NGOs) in 64 districts, four state level lead implementing partners (SLPs), and the national programme level (Bill and Melinda Gates Foundation (BMGF)) office over four years using a top down costing approach, presented in US$2011. RESULTS: Mean total unit costs (2004-08) per person reached at least once a year and per monthly contact were US$ 235(56-1864) and US$82(12-969) respectively. 35$ 477 per person reached in 2004 to US$145 per person reached in 2008). At the service level also unit costs decreased slightly over time from US$ 68 to US$ 64 per person reached. CONCLUSIONS: Scaling up HIV prevention for high risk groups requires significant investment in expertise enhancement and programme administration. However, unit costs decreased with programme expansion in spite of an increase in the scope of activities

Association between Pregnancy Loss and Urinary Phthalate Levels around the Time of Conception

Background: Animal studies indicate that some phthalate metabolites may harm female reproductive function

A perspective on using experiment and theory to identify design principles in dye-sensitized solar cells

Dye-sensitized solar cells (DSCs) have been the subject of wide-ranging studies for many years because of their potential for large-scale manufacturing using roll-to-roll processing allied to their use of earth abundant raw materials. Two main challenges exist for DSC devices to achieve this goal; uplifting device efficiency from the 12 to 14% currently achieved for laboratory-scale ‘hero’ cells and replacement of the widely-used liquid electrolytes which can limit device lifetimes. To increase device efficiency requires optimized dye injection and regeneration, most likely from multiple dyes while replacement of liquid electrolytes requires solid charge transporters (most likely hole transport materials – HTMs). While theoretical and experimental work have both been widely applied to different aspects of DSC research, these approaches are most effective when working in tandem. In this context, this perspective paper considers the key parameters which influence electron transfer processes in DSC devices using one or more dye molecules and how modelling and experimental approaches can work together to optimize electron injection and dye regeneration. This paper provides a perspective that theory and experiment are best used in tandem to study DSC device

Looking beyond the exome: a phenotype-first approach to molecular diagnostic resolution in rare and undiagnosed diseases.

PurposeTo describe examples of missed pathogenic variants on whole-exome sequencing (WES) and the importance of deep phenotyping for further diagnostic testing.MethodsGuided by phenotypic information, three children with negative WES underwent targeted single-gene testing.ResultsIndividual 1 had a clinical diagnosis consistent with infantile systemic hyalinosis, although WES and a next-generation sequencing (NGS)-based ANTXR2 test were negative. Sanger sequencing of ANTXR2 revealed a homozygous single base pair insertion, previously missed by the WES variant caller software. Individual 2 had neurodevelopmental regression and cerebellar atrophy, with no diagnosis on WES. New clinical findings prompted Sanger sequencing and copy number testing of PLA2G6. A novel homozygous deletion of the noncoding exon 1 (not included in the WES capture kit) was detected, with extension into the promoter, confirming the clinical suspicion of infantile neuroaxonal dystrophy. Individual 3 had progressive ataxia, spasticity, and magnetic resonance image changes of vanishing white matter leukoencephalopathy. An NGS leukodystrophy gene panel and WES showed a heterozygous pathogenic variant in EIF2B5; no deletions/duplications were detected. Sanger sequencing of EIF2B5 showed a frameshift indel, probably missed owing to failure of alignment.ConclusionThese cases illustrate potential pitfalls of WES/NGS testing and the importance of phenotype-guided molecular testing in yielding diagnoses