Assessment of a medical student mentoring programme to improve attitudes related to grief and coping with death

Objectives: To evaluate the impact of a mentoring programme for medical students doing a palliative care rotation, aimed at improving coping with death and attitudes towards the suffering produced by illness. Methods: A quasi-experimental study without a control group was carried out on second-year medical students. Five 1-h group sessions were conducted. Attitudes towards grief and coping with death were assessed before the mentoring programme began and afterwards, using the Brief Humanizar Scale and the Bugen’s Coping with Death Scale, respectively. Results: In terms of the sense of grieving as measured by the Brief Humanizar Scale, the mean score for the ‘Burden’ factor was 7 points and for the ‘Change’ factor it was 28.6, indicating that suffering makes more sense as a lever for positive change than as a burden. Regarding Bugen’s Coping with Death Scale, the mean score was 127.8 points before the mentoring programme and 139.2 afterwards. Hence, the score after the mentoring programme increased by 11.4 points, improving strategies to cope with death. Conclusion: Medical professionals must cope with death and end-of-life patients. In addition to scientific knowledge, students need to acquire competencies for better coping with the death of patients, with mentoring programmes helping to enhance this process of learning.Departamento de Biología Ambiental y Salud Públic

Conhecimento, atitudes e práticas em relação à COVID-19 e fatores associados na população mexicana

Highlights COVID-19 disease, caused by the SARS-CoV-2 virus, was one of the most damaging pandemics for humankind, causing nearly 7 million deaths worldwide. Community spread of the SARS-CoV-2 virus continues, so it is critical to ensure successful disease control and adherence to preventive and control measures. Adherence to preventive measures depends on the population's knowledge, attitudes and practices (KAP) regarding COVID-19, according to the KAP theory. More accurate knowledge and positive attitudes increased COVID-19 preventive practices in the study population. Introduction: The COVID-19 disease has been one of the most harmful pandemics for humanity; therefore, ensuring adherence to preventive and control measures is essential. This adherence largely depends on the population's knowledge, attitudes, and practices (KAP) towards COVID-19. Objective: To identify the level of knowledge, attitudes, and practices towards COVID-19 prevention and its associated factors in Oaxaca, Mexico. Materials and Methods:    This cross-sectional and analytical study surveyed adults online regarding KAP. Descriptive statistics and Chi-square or Fisher's exact tests were used for categorical comparisons. Factors associated with higher KAP levels were analyzed by calculating odd ratios (ORs) through logistic regression. Results: A total of 176 people participated, of whom 82.42% were women, and 81.83% were <30 years old. Among the participants, 90.88% identified direct contact with infected individuals as the main mode of transmission, 73.86% correctly identified the incubation period, and 93.22% referred to handwashing as the main preventive measure. The KAP scores were 65.34%, 32.95%, and 40.91%, respectively, with no differences by sex or age. Discussion: Participants with higher COVID-19 knowledge and more positive attitudes towards the pandemic were associated with more frequent preventive practices [OR:1.89 (CI:1.17-3.73)] and [OR:3.21 (CI:1 .62-6.35)], respectively, compared to those with lower scores. Conclusions:     The study population has a low level of KAP; greater knowledge about COVID-19 and more positive attitudes towards the pandemic increase preventive practices. How to cite this article: Ramírez-Díaz María del Pilar, Núñez-Rasgado Xunaxhi Guadalupe, Hernández-Ramírez Gabriel, Rodríguez-López Edna Isabel, Luna-Hernández Jorge Fernando. Knowledge, attitudes and practices towards COVID-19 and associated factors in the mexican population. Revista Cuidarte. 2024;15(2):e3565.  https://doi.org/10.15649/cuidarte.3565Highlights La enfermedad de Covid-19 causada por el virus SARS-CoV-2 ha sido una de las pandemias más perjudiciales para la humanidad causando casi 7 millones de muertes a nivel mundial. La propagación comunitaria del virus SARS-CoV-2 sigue vigente, por lo que garantizar el control exitoso de la enfermedad, la adherencia a las medidas preventivas y de control es fundamental. La adherencia a medidas preventivas depende de los conocimientos, actitudes y prácticas (CAP) de la población frente al Covid-19 de acuerdo con la teoría CAP. Conocimientos más precisos y actitudes más positivas aumentaron las prácticas preventivas hacia Covid-19 en la población de estudio. Introducción: La enfermedad de COVID-19 ha sido una de las pandemias más perjudiciales para la humanidad, por lo cual, garantizar la adherencia a medidas preventivas y de control es fundamental. Esta adherencia depende en gran medida de los conocimientos, actitudes y prácticas (CAP) de la población frente al COVID-19. Objetivo: Identificar el nivel de conocimientos, actitudes y prácticas hacia la prevención de COVID-19 y sus factores asociados en Oaxaca, México. Materiales y Métodos: Estudio transversal y analítico, en mayores de edad a través de una encuesta en línea sobre CAP. Se aplicó estadística descriptiva, y chi cuadrada o exacta de Fisher para comparaciones categóricas. Se analizaron los factores asociados a un mayor nivel de CAP calculando OR´s a través de regresión logística. Resultados: En total 176 personas participaron, de los cuales 82,42% fueron mujeres y 81,83% fueron <30 años. El 90,88% identificó como principal medio de transmisión el contacto directo con personas enfermas, 73,86% identificó correctamente el periodo de incubación y el 93,22% refirió el lavado de manos como principal medida preventiva. Las puntuaciones CAP fueron 65,34%, 32,95% y 40,91% respectivamente, sin diferencias por sexo y edad. Discusión: Los participantes con mayor conocimiento sobre COVID-19 y actitudes más positivas hacia la pandemia se asociaron con tener prácticas preventivas más frecuentes, [OR:1,89 (IC:1,17-3,73)] y [OR:3,21(IC:1,62-6,35)] respectivamente, en comparación con aquellos con menor puntuación. Conclusiones: La población de estudio tiene un bajo nivel de CAP. Un mayor conocimiento sobre COVID-19 y actitudes más positivas hacia la pandemia aumentan las prácticas preventivas. Como citar este artículo: Ramírez-Díaz María del Pilar, Núñez-Rasgado Xunaxhi Guadalupe, Hernández-Ramírez Gabriel, Rodríguez-López Edna Isabel, Luna-Hernández Jorge Fernando. Conocimientos, actitudes y prácticas hacia COVID-19 y factores asociados en población mexicana. Revista Cuidarte. 2024;15(2):e3565.      https://doi.org/10.15649/cuidarte.3565Introdução: A doença COVID-19 tem sido uma das pandemias mais prejudiciais para a humanidade, portanto, garantir a adesão às medidas preventivas e de controle é fundamental. Esta adesão depende em grande parte dos conhecimentos,  atitudes e práticas (CAP) da população relativamente à COVID-19. Objetivo: Identificar o nível de conhecimento, atitudes e práticas em relação à prevenção da COVID-19 e seus fatores associados em Oaxaca, México. Materiais e Métodos: Estudo transversal e analítico, em adultos através de inquérito online sobre CAP. Estatísticas descritivas e qui-quadrado ou estatística exata de Fisher foram aplicadas para comparações categóricas. Os fatores associados ao maior nível de CAP foram analisados por meio do cálculo de OR por meio de regressão logística. Resultados: Participaram no total 176 pessoas, das quais 82,42% eram mulheres e 81,83% tinham <30 anos. 90,88% identificaram o contacto direto com pessoas doentes como principal meio de transmissão, 73,86% identificaram corretamente o período de incubação e 93,22% referiram a lavagem das mãos como principal medida preventiva. Os escores do CAP foram de 65,34%, 32,95% e 40,91% respectivamente, sem diferenças por sexo e idade. Discussão: Participantes  com maior conhecimento   sobre a Covid-19 e atitudes mais positivas frente à pandemia foram associados a práticas preventivas mais frequentes, [1,89 (IC:1,17-3,73)] e [3,21(IC:1,62-6,35)] respectivamente, comparados para aqueles com pontuação mais baixa. Conclusões: A população estudada apresenta baixo nível de CAP. Maior conhecimento sobre a COVID-19 e atitudes mais positivas frente à pandemia aumentam as práticas preventivas. Como citar este artigo: Ramírez-Díaz María del Pilar, Núñez-Rasgado Xunaxhi Guadalupe, Hernández-Ramírez Gabriel, Rodríguez-López Edna Isabel, Luna-Hernández Jorge Fernando. Conocimientos, actitudes y prácticas hacia COVID-19 y factores asociados en población mexicana. Revista Cuidarte. 2024;15(2):e3565.    https://doi.org/10.15649/cuidarte.356

TEM study of the AlN grain orientation grown on NCD diamond substrate

Piezoelectric AlN layer grain orientation, grown by room temperature reactive sputtering, is analyzed by transmission electron microscopy (TEM).Two types of samples are studied: (i) AlN grown on well-polished NCD (nano-crystalline diamond) diamond, (ii) AlN grown on an up-side down NCD layer previously grown on a Si substrate, i.e. diamond surface as smooth as that of Si substrates. The second set of sample show a faster lignment of their AlN grain caxis attributed to it smoother diamond free surface. No grain orientation relationship between diamond substrate grain and the AlN ones is evidenced, which seems to indicate the preponderance role of the surface substrate state

Nivel de percepción de inseguridad alimentaria, estado nutricional y factores sociodemográficos asociados en pobladores de Oaxaca, México.

Introduction: Food insecurity impacts the nutritional status of populations, being the lack of availability and accessibility of food derived from poverty, one of the main factors that contribute to its appearance. Objective: to identify the level of food insecurity, nutritional status and associated sociodemographic factors in residents of Oaxaca, Mexico. Material and method: cross-sectional study in 297 people. The Latin American and Caribbean Food Security Scale was applied, sociodemographic and anthropometric data were collected and compared between levels of food insecurity. Results: A high prevalence of overweight + obesity and food insecurity of 86.4% and 76.1% respectively was found. People with severe insecurity had higher BMI, ICT and waist circumference; as well as lower socioeconomic level and education of the head of the household. The presence of children under 18 years of age increased the risk of food insecurity by 27% [RP=1.27; CI:1.02-1.58)]. Conclusions: It is important to promote the improvement of social conditions, strengthening educational, economic and nutritional programs, mainly in homes with the presence of minors.Introducción: La inseguridad alimentaria impacta el estado nutricional de las poblaciones, siendo la falta de disponibilidad y accesibilidad de alimentos derivada de la pobreza, uno de los principales factores que contribuyen a su aparición. Objetivo: Identificar el nivel de inseguridad alimentaria, estado nutricional y factores sociodemográficos asociados en pobladores de Oaxaca, México. Material y método: : Estudio transversal en 297 personas. Se aplicó la Escala Latinoamericana y Caribeña de Seguridad Alimentaria, se recolectaron datos sociodemográficos, antropométricos y se compararon entre niveles de inseguridad alimentaria. Se calcularon razones de prevalencia para identificar factores sociodemográficos asociados a mayor riesgo de inseguridad alimentaria.  Resultados: Se encontró una alta prevalencia de sobrepeso + obesidad e inseguridad alimentaria de 86.4% y 76.1% respectivamente. Las personas con inseguridad grave presentaron mayor índice de masa corporal, índice cintura/talla y circunferencia de cintura; así como menor nivel socioeconómico y escolaridad del jefe del hogar. La presencia de menores de 18 años aumentó el riesgo de inseguridad alimentaria en 27% [RP=1.27; IC:1.02-1.58)]. Conclusiones: Los bajos ingresos económicos, la baja escolaridad del jefe del hogar y tener menores de 18 años incrementan la probabilidad de que los hogares se posicionen en alguna clasificación de inseguridad alimentaria

Desarrollo de un plan de gestión humana para disminuir la rotación de operarios de producción de una empresa metalmecánica

El presente trabajo de investigación se realiza con el fin de desarrollar un proyecto de consultoría sobre la base de un Plan de Gestión Humana para disminuir la rotación de operarios de producción de la empresa metalmecánica Tecnopress. Para ello, este estudio se basa en que, actualmente, esta posee un alto nivel de rotación, lo cual repercute negativamente en factores como la productividad, clima laboral, satisfacción e indicadores financieros de la empresa. En ese sentido, esta propuesta busca influenciar en el tiempo de permanencia de los colaboradores y permitir aprovechar la curva de aprendizaje de los mismos. Además, aporta sugerencias de acción como la mejora en las políticas de Gestión Humana, lo que permitiría administrar de manera eficiente las áreas críticas asociadas a la rotación del personal como la selección, capacitación, desarrollo y compensaciones

Prognostic value of inhibitors of apoptosis proteins (IAPs) and caspases in prostate cancer: caspase-3 forms and XIAP predict biochemical progression after radical prostatectomy

Background: The expression status of apoptotic regulators, such as caspases and inhibitors of apoptosis proteins (IAPs), could reflect the aggressiveness of tumors and, therefore, could be useful as prognostic markers. We explored the associations between tumor expression of caspases and IAPs and clinicopathological features of prostate cancer – clinical and pathological T stage, Gleason score, preoperative serum PSA levels, perineural invasion, lymph node involvement, surgical margin status and overall survival – and evaluated its capability to predict biochemical progression after radical prostatectomy. Methods: Protein expression of caspases (procaspase-8, cleaved caspase-8, procaspase-3, cleaved caspase-3, caspase-7 and procaspase-9) and IAPs (cIAP1/2, cIAP2, NAIP, Survivin and XIAP) was analyzed by immunohistochemistry in radical prostatectomy samples from 84 prostate cancer patients. Spearman’s test, Kaplan-Meier curves, and univariate and multivariate Cox proportional hazard regression analysis were performed. Results: cIAP1/2, cIAP2, Survivin, procaspase-8, cleaved caspase-8, procaspase-3 and caspase-7 expression correlated with at least one clinicopathological feature of the disease. Patients negative for XIAP, procaspase-3 or cleaved caspase-3 had a significantly worse prognosis. Of note, XIAP, procaspase-3 and cleaved caspase-3 were predictors of biochemical progression independent of Gleason score and pathological T stage. Conclusions: Our results indicate that alterations in the expression of IAPs and caspases contribute to the malignant behavior of prostate tumors and suggest that tumor expression of XIAP, procaspase-3 and cleaved caspase-3 may help to identify prostate cancer patients at risk of progression

Policy challenges for agroforestry implementation in Europe

Agroforestry (AF) is a sustainable land use practice and system that increases the ecosystem services delivery from agricultural lands compared with treeless systems. Agroforestry can be considered a practice when linked to plot scale (silvoarable, silvopasture, homegarden, woody linear landscape strips, and forest farming), and a system when associated with the global farm scale. The enhancement of the ecosystem services is associated with the use and promotion of the biodiversity caused by the presence of trees that optimizes the use of the resources if adequate species are mixed. Agroforestry can be implemented at temporal and spatial scales. At the temporal scale, the use of woody perennials to increase soil fertility is a traditional technique that improves soil health and reduces the need of using herbicides (e.g., the legume Ulex sown for 10 years in between crop cultivation). Five agroforestry practices can be implemented at the plot level: silvopasture, silvoarable/alley cropping, homegardens/kitchengardens, woody linear landscape strips, and forest farming. A farm including these practices is considered an agroforestry system working at the landscape level when several farms are mixed. In spite of the acknowledgment that AF has at the European level for being included as part of Pillars I and II, the spread of AF is limited across Europe. Four challenges, linked with technical, economic, educational, and policy development, have been identified by the AFINET thematic network that, if addressed, may foster policy adoption across the EU. This article proposes 15 different policy recommendations to overcome them and the need of developing an AF strategy for the EU.We acknowledge funding through Grant 101086563 from the European Commission (Project AF4EU, HEUROPE). This study was supported by National Funds by the FCT—Portuguese Foundation for Science and Technology, under the project UIDB/04033/2020. NF-D was funded by the Pilot Program of the University of Santiago de Compostela (USC) for the hiring of distinguished research staff—call 2021, funded under the collaboration agreement between USC and Banco Santander, for the years 2021–2024. JJS-F was supported by the USC and the Spanish Ministry of Universities through the “Convocatoria de Recualificación del Sistema Universitario Español” on its modality “Margarita Salas”; Ministry of Universities - Recovery Transformation and Resilience Plan (funded by the European Union through the NextGenerationEUS

Faculty of Public Accounting. Volume 10 No. 9 June 1992

Las nuevas tendencias en tecnologías blandas o administrativas introducen una buena dosis de cambio, oportunidad y pragmatismo. Nuestra disciplina contable parece no atinar hacia nuevos desarrollos que satisfaga estas necesidades y cada vez más está quedando en la puerta trasera del desarrollo. Otras áreas diferentes a la propiamente contable como los desarrollos en sistemas de información gerencial, avances informáticos en aplicaciones comerciales, nuevos conceptos de medición, evaluación y control producto de enfoques administrativos como la calidad total y gerencia de la velocidad, están motivando cambios estructurales a lo contable. La pasividad frente a estas situaciones motivadas talvez por una pésima interpretación del principio contable de la prudencia, debe ser revaluada en forma urgente en el seno de gremios profesionales y círculos académicos e investigativos. En Colombia la nueva constitución política abrió un horizonte completamente diferente a la disciplina contable. Ya no lo tradicional operativo del presupuesto oficial Sino nuevos conceptos como auditoría de gestión, vigilancia del medio ambiente, agresividad en la participación de la auditoría oficial frente a las necesidades del país. El nuevo auditor fiscal tiene un enfoque interdisciplinario, moderno pragmático. Las Facultades de Contaduría Pública del país están obligadas a mirar por la ventana del cambio y no el encerramiento actual bajo una tradición completamente obsoleta.PRESENTACION. ENFOQUE TOTAL DE CALIDAD FRENTE A LAS ESCUELAS ORGANIZACIONALES QUE LES PRECEDIERON PROPOSITO DE LAS FACULTADES DE CONTADURIA PUBLICA HISTORIA DE LA CONTADURIA PUBLICA DURANTE LA EPOCA DE ESTADO SOBERANO DE SANTANDER HASTA LA MISION KENMERER METODOLOGIA PARA LA ELABORACION DE NOTAS A LOS-ESTABOS:FINANCIEROS MANUACDE AUDITORIA DE MERCADEO PROPOSICION DEL FLUJO DE EFECTIVO COMO ESTADO FINANCIERO MANUAL DE PROCEDIMIENTOS DE CONTROL POSTERIOR PARA LA CONTRALORIA DEL DEPARTAMENTO DE SANTANDER ANALISIS Y EVALUACION DE LAS COOPERATIVAS DEL SUR DE SANTANDER FRENTE A LA INFLACION Y SUS EFECTOSThe new trends in soft or administrative technologies introduce a good dose of change, opportunity and pragmatism. Our accounting discipline seems to be missing new developments that meet these needs and is increasingly falling behind in development. Other areas different from the accounting itself, such as developments in management information systems, computer advances in commercial applications, new concepts of measurement, evaluation and control resulting from administrative approaches such as total quality and speed management, are motivating structural changes throughout accountant. Passivity in the face of these situations, perhaps motivated by a bad interpretation of the accounting principle of prudence, must be urgently reassessed within professional associations and academic and research circles. In Colombia, the new political constitution opened a completely different horizon for accounting discipline. No longer the traditional operating of the official budget, but new concepts such as management audit, environmental surveillance, aggressiveness in the participation of the official audit against the needs of the country. the new listener prosecutor has an interdisciplinary, modern pragmatic approach. The Public Accounting Faculties of the country are obliged to look through the window of change and not the current closure under a completely obsolete tradition

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group