Factors that Influence a Career Choice in Primary Care: a Mixed-methods Study among Medical Students Starting the Social Service Program in Honduras

Medical students are not choosing primary care careers. This project was a mixed-method study aimed to identify factors that influence the decisions of Honduran medical students to choose a career in primary care. The study included a survey questionnaire applied to 234 last-year medical students and semi structured interviews to eight key informants. Career choice favors medical specialties. PC careers were the preferred career choice for 8.1% of students. Relationships between “sex” and “location where student lived” by specialty categories were statistically significant (P= 0.011 and 0.042). There were more male respondents preferring PC (8.8%); students who preferred PC came mainly from urban backgrounds (62.6%). The perceived monthly salary of specialties other than primary care was significantly higher than those of GPs, FPs and Pediatricians (p<0.001). Participants considered “making a difference”, income, teaching, prestige, and challenging work as the most important factors that influence career choice. Practice in ambulatory settings was significantly associated with a preference for primary care specialties (P=<0.05). Factor “patient-based care” was statistically significant (P=0.006) for selecting PC. Rationales behind the preference of a specialty appear to be based on a combination of ambition and prestige on one hand, and on personal and altruistic considerations on the other. There are several factors distinctive to medical students in Honduras: future work option, availability of specialties, and social factors including violence. A facilitator for PC selection in Honduras is the type of resources needed to practice a specialty. Social service participants from urban background who prefer primary care are mostly influenced by rural work and practice in ambulatory settings, while respondents with a rural background who prefer specialties are influenced by the possibility of making a positive difference in people´s lives. The study is a component of a strategy to strengthen primary care in the country that includes a public policy for strengthening PC workforce in Honduras. The results will be shared with Secretary of Health national authorities, including the Direction for Development of Human Resources, the National Council of Human Resources for Health, and academic authorities from UNAH. Policy advocacy is part of the plan for change.Doctor of Public Healt

MEPSAnd: Minimum Energy Path Surface Analysis over n-dimensional surfaces.

Summary: Understanding biophysical phenomena from the approach of molecular simulation is becoming the state-of-art in many research and technology development fields. Energy surfaces with more than 3 dimensions (2 coordinates and energy) are now computationally accessible, yet interpreting the information they offer is not straightforward and the tasks involved very time-consuming. Here we present MEPSAnd, an open source GUI-based program that natively calculates minimum energy paths across energy surfaces of an arbitrary number of dimensions. In addition to the multidimensional analysis of path through lowest barriers, MEPSAnd can also automatically calculate a finite series of suboptimal paths. To allow the efficient interpretation of results, MEPSAnd offers three distinct plotting solutions: i) energy profiles, ii) coordinate projections and iii) network projections. GUI-independent pipelines are also supported via direct python scripting. Therefore, MEPSAnd is a powerful user friendly tool that streamlines path-finding tasks on n-dimensional energy surfaces.pre-print1996 K

Effects of the source:sink ratio on the phenotypic plasticity of stem water potential in olive (Olea europaea L.)

The aims of this work were to quantify (i) the effect of the source:sink ratio on stem water potential (SWP) and (ii) the phenotypic plasticity of SWP and its relationship to oil yield components in olive. Trees with a 3-fold variation in the source:sink ratio (crown volume/fruit number per tree) were monitored in 2007–2008 and 2008–2009 in a fully irrigated orchard in Mendoza, Argentina. The combination of rainfall, irrigation, and evaporative demand led to a steady SWP largely above –1.65 MPa in 2007–2008 and a marked seasonal decline from –1.13 MPa to –2.04 MPa in trees with a medium and low source:sink ratio in 2008–2009. Plasticity was quantified as the slope of the norm of reaction for each trait. Across seasons, trees with a high source:sink ratio had a higher SWP than their counterparts with a medium and low source:sink ratio. Plasticity of SWP was highest in olives with a low source:sink ratio (slope=1.28) and lowest for trees with a high source:sink ratio (slope=0.76). The average SWP for each source:sink ratio and season was unrelated to both the source:sink ratio and yield components. On the other hand, the plasticity of SWP was positively associated with fruit number and negatively associated with the source:sink ratio, fruit weight, and fruit oil weight. The plasticity of the SWP was unrelated to SWP per se. It is concluded that understanding the effect of the source:sink ratio on plant water relations would benefit from a dual perspective considering the trait per se and its plasticity. A dual approach would also allow for more robust plant-based indicators for irrigation.EEA JunínFil: Trentacoste, Eduardo Rafael. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Junín; ArgentinaFil: Sadras, Victor Oscar. South Australian Research & Development Institute; AustraliaFil: Puertas, Carlos Marcelo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Junín; Argentin

Factores de riesgo cardiovascular y riesgo cardiovascular global en familiares de primer grado de diabéticos tipo 2 en el Hospital Nacional Dos de Mayo durante el periodo 2010-2011

Publicación a texto completo no autorizada por el autorEl documento digital no refiere asesorDetermina la frecuencia de los factores de riesgo cardiovascular y valorar el riesgo cardiovascular global en los familiares de primer grado de diabéticos tipo 2 y en las personas que no tienen familiares de primer grado diabéticos en el programa cardiometabólico del servicio de Endocrinología del Hospital Nacional Dos de Mayo. Se usó la base de datos del Programa Cardiometabólico desde de enero 2009 a diciembre 2011. Se dividió a la población de estudio en dos grupos: el primero con 52 individuos con antecedentes de familiares de primer grado con diabetes mellitus tipo 2 (casos), y el segundo 104 individuos sin los antecedentes referidos (controles), pareadas en edad y género. Se analizaron y compararon los factores de riesgo cardiovascular, así como el riesgo cardiovascular global usando el puntaje de Framingham, en ambos grupos. Se encontró un mayor riesgo cardiovascular global mediante el puntaje de Framingham en los individuos sin antecedentes familiares de primer grado de diabetes, lo cual difiere de lo encontrado en la mayoría de estudios internacionales. Sin embargo, no se encontró diferencia significativa en el número de factores de riesgo contados individualmente. El sobrepeso fue el estado de malnutrición más frecuente. El HDL bajo fue la dislipidemia más frecuente. Los resultados no apoyan que los familiares de primer grado de diabéticos tipo 2 tienen un riesgo cardiovascular global mayor que la población general.Trabajo académic

Bone densitometry in the evaluation of the results obtained with the use of bovine BMP in spine arthrodesis in rabbits

The object of this study is to evaluate the use of the bone densitometry as an evaluation method of the bone increment observed when we used bovine BMP in intertransverse arthrodesis of the rabbits' lumbar spine. Since the discovery of the BMP bone inductive properties, countless experimental models have been proposed. This caused the need of setting up evaluation methods to make possible a better understanding of the found results. Twenty female rabbits from New Zealand, divided in two groups, were submitted to the intertransverse arthrodesis of the lumbar column, segment L5/L6, posterior side. In the first group it was used autologous graft and in the second an association of autologous graft with biocompound (bovine BMP, 1.0 mg and hydroxyapatite, 9.0 mg). The animals were maintained in captivity, isolated and after 15 weeks submitted to the execution of bone densitometry by computerized tomography. 268 bone density measures of the normal bone, 134 measures of the newly formed bone by the association of the isolated autologous graft and 134 measures of the newly formed bone by the association autologous graft and BMP were obtained, what demonstrated a significant bone increment after statistical analysis (p=0.034) of the BMP/HAP group, when compared to the control group. We found this same variation of bone density analyzing the normal bone. The bone densitometry accomplished by the computerized tomography is an alternative method to assess the results when the BMP is used in experimental studies. Further studies should be accomplished for better understanding of the bone density variation found when the measures of the normal bone in the two groups are compared.As BMPs, proteínas indutoras de crescimento ósseo, desde o início de sua utilização, têm sido avaliadas em diferentes modelos experimentais objetivando determinar sua eficácia, sendo necessário o estabelecimento de métodos de avaliação que permitam melhor compreensão dos resultados. OBJETIVO: Este estudo tem por objetivo avaliar a utilização da densitometria óssea como método de avaliação do incremento ósseo observado quando da utilização de BMP bovina em artrodeses intertransversas da coluna lombar de coelhos. MÉTODOS: Foram utilizados dois grupos de dez coelhos neozelandeses fêmeas, submetidos a artrodese intertransversa da coluna lombar, segmento L5/L6, por via posterior. No primeiro grupo foi utilizado enxerto homólogo e no segundo a associação de enxerto homólogo com biocomposto (BMP bovino, 1,0 mg e hidroxiapatita, 9,0 mg). Os animais foram acompanhados por 15 semanas, isolados em cativeiro e avaliados diariamente por veterinário sob o ponto de vista clínico e neurológico e, posteriormente, submetidos à realização de densitometria óssea por tomografia computadorizada. RESULTADOS: Foram obtidas 268 medidas de densidade óssea do osso normal, 134 medidas do osso neoformado de enxerto homólogo isolado e 134 medidas do osso neoformado pela associação enxerto homólogo e BMP. Esses valores foram submetidos à análise estatística que demonstrou incremento ósseo significativo (p=0,034) do grupo BMP/HAP, quando comparado ao grupo controle. Os valores de densidade óssea do osso normal foram submetidos à mesma análise estatística onde se encontrou resultado semelhante. CONCLUSÃO: A densitometria óssea realizada pela tomografia computadorizada apresenta-se como método alternativo para avaliação de resultados quando utilizado BMP em estudos experimentais. Estudos subseqüentes deverão ser realizados para melhor entendimento da variação de densidade óssea encontrada quando da comparação das medidas do osso normal nos dois grupos.Universidade Federal de São Paulo (UNIFESP)Universidade Federal de São Paulo (UNIFESP) Departamento de Ortopedia e TraumatologiaUniversidade de São Paulo Faculdade de Odontologia de BauruUniversidade São Francisco Serviço de Ortopedia e TraumatologiaUNIFESP, Depto. de Ortopedia e TraumatologiaSciEL

Alcohol, Tobacco and Cannabis Consumption on Physical Activity and Physical and Social Self-Concept in Secondary School Students: An Explanatory Model Regarding Gender

Nowadays, the adolescent population consumes substances that are harmful to health at an earlier age. Therefore, the present research aimed to (i) develop an explanatory model of tobacco, alcohol, and cannabis consumption on physical self-concept, social self-concept, and physical activity practice and (ii) contrast the model through a multi-group analysis according to the gender of the participants. For this purpose, descriptive, comparative, and cross-sectional research was carried out on adolescent students (M = 13.91; SD = 1.31, years), using the Self-Concept Form 5 Questionnaire, the Physical Activity Questionnaire for Adolescents (PAQ-A), and the State Survey on Drug Use in Secondary Education (ETUDES) for data collection. Findings revealed that the consumption of harmful substances has a positive impact on the social area and the practice of physical exercise, showing a negative relationship between the latter variable and the social and physical area of self-concept

An Explanatory Model of Sport Motivation, Physical Self-Concept and Anxiety as a Function of the Degree of Adherence to the Mediterranean Diet in Future Physical Education Teachers

The present research has the objectives of establishing the relationship between motivational climate towards sport, anxiety, and physical self-concept, and identifying the existing relationships between anxiety, motivational climate, and physical self-concept, broken down into (a) developing an explanatory model of the motivational climate towards sport and its relationship with anxiety and physical self-concept, and (b) contrasting the structural model by means of a multi-group analysis according to the degree of adherence to the Mediterranean diet. A quantitative, comparative, non-experimental (ex post facto), cross-sectional study was carried out with a total sample of 556 participants (23.06 +/- 6.23). The instruments used were an ad hoc questionnaire and the Spanish versions of the Perceived Motivational Climate in Sport Questionnaire 2, Beck Anxiety Inventory, Self-Concept Form-5, and the PREDIMED questionnaire. The data reveal that participants who show high adherence to the Mediterranean diet attain higher scores on physical self-concept and anxiety, as well as ego-climate. As a conclusion, it is observed that participants who show a high adherence to the Mediterranean diet show higher scores in physical self-concept and anxiety, as well as in all the variables that make up the ego-climate

Mediterranean diet adherence on self-concept and anxiety as a function of weekly physical activity: an explanatory model in higher education

IntroductionScientific literature has now demonstrated the benefits of an active lifestyle for people's psychological health. Based on the above statement, the aim was to (a) evaluate and adjust a structural equation model containing the variables anxiety, self-concept, and Mediterranean diet adherence and (b) contrast the proposed theoretical model by studying the differences between the variables according to the level of weekly physical activity in a sample of 558 university students. MethodsA non-experimental, exploratory, cross-sectional investigation has been proposed. Instruments such as the PREDIMED Questionnaire, the Beck Anxiety Inventory, the International Physical Activity Questionnaire, and the Form 5 Self-Concept Questionnaire were used to collect data. Results and discussionThe results illustrate that students showing low adherence to the Mediterranean diet had higher levels of anxiety (M = 0.95) than those showing a high degree of adherence (M = 0.75). It is also observed that young people with a high degree of adherence to the Mediterranean diet report higher scores in the different dimensions of self-concept compared to young people with a low degree of adherence. In conclusion, it is affirmed that young people who show a high degree of adherence to this dietary pattern show lower levels of anxiety and greater recognition of the different areas of their self-concept

Resilience, Stress, and Burnout Syndrome According to Study Hours in Spanish Public Education School Teacher Applicants: An ExplanatoryModel as a Function ofWeekly Physical Activity Practice Time

The selection process for the teaching profession in public elementary education is difficult, which can lead to the appearance of disruptive states in applicants. For this reason, the present study aimed to establish the relationship between study hours and the levels of stress, burnout, and resilience in applicants to the Spanish public teaching profession. Accordingly, this objective was achieved by (a) developing an explanatory model of study hours according to levels of stress, burnout, and resilience, and (b) contrasting this model through a multigroup analysis according to whether students performed more than 3 h of physical activity per week. A descriptive, comparative, cross-sectional study was carried out on a sample of 4117 applicants (31.03 6.800), using an ad hoc socio-demographic questionnaire, the Perceived Stress Scale, the Maslach Burnout Inventory, and the Connor–Davidson Resilience Scale for data collection. The results revealed that participants who practiced more than 3 h of physical activity per week showed lower levels of stress and burnout syndrome, manifesting higher levels of resilience. Furthermore, better associations between resilience and the other constructs were also observed for people who practiced more than 3 h of physical activity per week. In conclusion, the practice of physical activity can help to decrease stress and develop key elements for the selective exam of the Spanish public teaching corps

Emotional Intelligence, Physical Activity Practice and Mediterranean Diet Adherence-An Explanatory Model in Elementary Education School Students

Currently, there is a global concern with regard to the lifestyles of young people. This study aims to study the association between Mediterranean diet adherence, emotional intelligence and physical activity practice in teenagers in the last cycle of elementary education. In turn, this objective is divided into (a) developing an explanatory model of the practice of physical activity, Mediterranean diet adherence and emotional intelligence; and (b) developing a multi-group model according to the gender of the participants. A descriptive, cross-sectional, comparative study was conducted in a sample of 293 elementary school students (M = 11.45; S.D = 0.31). The instruments used were an ad hoc socio-demographic questionnaire, the Trait Meta Mood Scale-24, the KIDMED questionnaire and the Physical Activity Questionnaire for Older Children. The results show that males show a positive relationship between adherence to the Mediterranean diet and emotional intelligence and between emotional intelligence and physical activity. In contrast, in the case of females, a negative relationship was observed between emotional intelligence and physical activity. In conclusion, it can be seen that gender plays a fundamental role in adolescence, being a key factor influencing an active and healthy lifestyle