Programa de Educación para la Salud a pacientes en tratamiento con anticoagulantes orales desde Atención Primaria

Introducción: El mecanismo de la coagulación consiste en una serie de reacciones en las que el resultado final es la formación del coágulo. Los anticoagulantes orales inhiben su formación y poseen propiedades antagonistas de la Vitamina K. En España el más utilizado es el Acenocumarol (Sintrom®). Estos fármacos precisan un manejo especial ya que tienen estrechos márgenes terapéuticos, posibilidad de efectos secundarios graves y ciertas interacciones farmacológicas y alimentarias, lo que les obliga a una estricta monitorización. Los anticoagulantes orales alargan el tiempo de coagulación de la sangre y se utilizan en: prevención de eventos trombóticos en la fibrilación auricular, prótesis valvulares cardíacas y episodios previos de trombosis. En España el número de pacientes anticoagulados oscila entre 800.000 y 1.000.000 de personas. El seguimiento de estos pacientes desde el ámbito de la Atención primaria proporciona mayor seguridad, accesibilidad y un manejo multidisciplinar. Objetivo: Informar y proporcionar recursos a los pacientes en tratamiento con anticoagulantes orales y/o a sus cuidadores principales para su mejor manejo y adherencia desde Atención Primaria. Metodología: Se ha realizado una búsqueda bibliográfica utilizando bases de datos y páginas web. Acorde con el objetivo y los resultados de dicha búsqueda se ha elaborado un Programa de educación para la salud. Conclusión: La educación sanitaria proporciona un papel esencial en los pacientes con anticoagulantes orales. Desde Atención primaria, enfermería establece un pilar fundamental en la enseñanza del manejo y control del tratamiento. Palabras clave: Anticoagulantes orales, Programa de educación para la salud, Atención primaria, Enfermería, Acenocumarol

Human ESCs predisposition to karyotypic instability: Is a matter of culture adaptation or differential vulnerability among hESC lines due to inherent properties?

<p>Abstract</p> <p>Background</p> <p>The use of human embryonic stem cells (hESCs) in research is increasing and hESCs hold the promise for many biological, clinical and toxicological studies. Human ESCs are expected to be chromosomally stable since karyotypic changes represent a pitfall for potential future applications. Recently, several studies have analysed the genomic stability of several hESC lines maintained after prolonged <it>in vitro </it>culture but controversial data has been reported. Here, we prompted to compare the chromosomal stability of three hESC lines maintained in the same laboratory using identical culture conditions and passaging methods.</p> <p>Results</p> <p>Molecular cytogenetic analyses performed in three different hESC lines maintained in parallel in identical culture conditions revealed significant differences among them in regard to their chromosomal integrity. In feeders, the HS181, SHEF-1 and SHEF-3 hESC lines were chromosomally stable up to 185 passages using either mechanical or enzymatic dissection methods. Despite the three hESC lines were maintained under identical conditions, each hESC line behaved differently upon being transferred to a feeder-free culture system. The two younger hESC lines, HS181 (71 passages) and SHEF-3 (51 passages) became chromosomally unstable shortly after being cultured in feeder-free conditions. The HS181 line gained a chromosome 12 by passage 17 and a marker by passage 21, characterized as a gain of chromosome 20 by SKY. Importantly, the mosaicism for trisomy 12 gradually increased up to 89% by passage 30, suggesting that this karyotypic abnormality provides a selective advantage. Similarly, the SHEF-3 line also acquired a trisomy of chromosome 14 as early as passage 10. However, this karyotypic aberration did not confer selective advantage to the genetically abnormal cells within the bulk culture and the level of mosaicism for the trisomy 14 remained overtime between 15%–36%. Strikingly, however, a much older hESC line, SHEF-1, which was maintained for 185 passages in feeders did not undergo any numerical or structural chromosomal change after 30 passages in feeder-free culture and over 215 passages in total.</p> <p>Conclusion</p> <p>These results support the concept that feeder-free conditions may partially contribute to hESC chromosomal changes but also confirm the hypothesis that regardless of the culture conditions, culture duration or splitting methods, some hESC lines are inherently more prone than others to karyotypic instability.</p

HPV knowledge and vaccine acceptance among European adolescents and their parents: a systematic literature review

Since the introduction of HPV vaccines, several studies have been conducted in different countries to assess HPV knowledge and vaccine acceptance. The aim of this study was to perform a systematic literature review to summarize results and identify factors associated with HPV knowledge and vaccine acceptance in adolescents and their parents and to compile the measurement tools used in the published research studies performed in European countries where HPV is licensed.This study was funded by Merck Sharp & Dohme Spain.Medicin

Report of the FELASA-EFAT Working Group

Publisher Copyright: © The Author(s) 2023.Competent, confident and caring laboratory animal caretakers, technicians and technologists (LAS staff) are vital for good animal welfare, high-quality science and a secure Culture of Care. This requires high-quality education, training, supervision and continuing professional development (CPD) of LAS staff. However, there is a lack of harmonisation regarding how this education and training is conducted among European countries, and nor are there recommendations adapted to Directive 2010/63/EU. Therefore, FELASA and EFAT established a working group with the task of establishing recommendations for education, training and CPD for LAS staff. The working group established five different levels (LAS staff levels 0–4), defining the required level of competence and attitude, as well as suggesting educational requirements for reaching each level. Defining these levels should help to ensure that appropriate educational and CPD activities are in place, and to enable employers and LAS staff to determine the level and career stage attained. Furthermore, proper assessment of competencies and effective CPD schemes for all relevant staff should be established. Regulators should support this by setting standards for competence assessment and ensuring that they are consistently applied. In addition, establishments should involve the LAS staff in defining and developing the Culture of Care. The Animal Welfare Body should be involved and have oversight of education, training and CPD. These recommendations will contribute to harmonisation and increased quality of education, training and CPD, as well as provide clearer career pathways for LAS staff, helping to ensure high standards of animal welfare and science.publishersversionepub_ahead_of_prin

Percepción de las enfermeras de UCI en relación al cuidado satisfactorio: convergencias y divergencias con la percepción del paciente crítico

Objetivo: Explorar las convergencias y divergencias entre la percepción de las enfermeras y los pacientes críticos, en relación a los cuidados satisfactorios proporcionados y recibidos. Métodos: Forma parte de un estudio cualitativo más amplio, según la Teoría Fundamentada. Realizado en 3 Unidades de Cuidados Intensivos con 34 boxes. Muestreo teórico por perfiles con n = 19 pacientes y n = 7 enfermeras tras la saturación de datos. El reclutamiento de pacientes incluidos en los perfiles de edad avanzada y larga estancia se dilató en el tiempo por la baja incidencia de estos. La recogida de datos consistió en: entrevista en profundidad a los pacientes críticos, grupo de discusión de enfermeras expertas en el cuidado al paciente crítico y diario de campo. Análisis temático de Teoría Fundamentada según Strauss y Corbin: codificación abierta, axial y selectiva. Se siguieron los criterios de rigor de Guba y Lincoln, de calidad de Calderón y los de reflexividad ética de Gastaldo y McKeever. Se obtuvo informe favorable del comité de ética del centro y consentimiento informado de los participantes. Resultados: Emergen 4 categorías coincidentes: las competencias profesionales, los cuidados humanos, técnicos y continuados. La combinación de estos elementos producen sentimientos de seguridad, tranquilidad, sentirse persona permitiendo al paciente una relación cercana y de confianza con la enfermera que realiza cuidados individualizados. No se han encontrado categorías divergentes. Conclusiones: Las percepciones de las enfermeras en relación a los cuidados coinciden con las percepciones de los pacientes críticos tanto en la definición como en las dimensiones sobre el cuidado satisfactorio

Development of an instrument to measure the degree of critical patient's satisfaction with nursing care: research protocol

Aim: To investigate and understand patient's satisfaction with nursing care in the intensive care unit to identify the dimensions of the concept of"satisfaction" from the patient's point of view. To design and validate a questionnaire that measures satisfaction levels in critical patients. Background: There are many instruments capable of measuring satisfaction with nursing care; however, they do not address the reality for critical patients nor are they applicable in our context. Design: A dual approach study comprising: a qualitative phase employing Grounded Theory and a quantitative and descriptive phase to prepare and validate the questionnaire. Methods: Data collection in the qualitative phase will consist of: in-depth interview after theoretical sampling, on-site diary and expert discussion group. The sample size will depend on the expected theoretical saturation n = 27-36. Analysis will be based on Grounded Theory. For the quantitative phase, the sampling will be based on convenience (n = 200). A questionnaire will be designed on the basis of qualitative data. Descriptive and inferential statistics will be used. The validation will be developed on the basis of the validity of the content, the criteria of the construct and reliability of the instrument by the Cronbach's alpha and test-retest approach. Approval date for this protocol was November 2010. Discussion: Self-perceptions, beliefs, experiences, demographic, socio-cultural epistemological and political factors are determinants for satisfaction, and these should be taken into account when compiling a questionnaire on satisfaction with nursing care among critical patients

Estudio para la mejora de la calidad del Máster en Trabajo Social Comunitario, Gestión y Evaluación de Servicios Sociales en atención a las necesidades del alumnado egresado

Se presenta el informe sobre el desarrollo del proyecto de innovación en calidad llevado a cabo por un equipo interdisciplinar en la Facultad de Trabajo Social. A través de la creación de un cuestionario y un grupo de discusión se analiza la inserción laboral y satisfacción con la titulación de nuestros egresados

Molecular Characterization of Spontaneous Mesenchymal Stem Cell Transformation

Background. We previously reported the in vitro spontaneous transformation of human mesenchymal stem cells (MSC) generating a population with tumorigenic potential, that we termed transformed mesenchymal cells (TMC). Methodology/Principal Findings. Here we have characterized the molecular changes associated with TMC generation. Using microarrays techniques we identified a set of altered pathways and a greater number of downregulated than upregulated genes during MSC transformation, in part due to the expression of many untranslated RNAs in MSC. Microarray results were validated by qRT-PCR and protein detection. Conclusions/Significance. In our model, the transformation process takes place through two sequential steps; first MSC bypass senescence by upregulating c-myc and repressing p16 levels. The cells then bypass cell crisis with acquisition of telomerase activity, Ink4a/Arf locus deletion and Rb hyperphosphorylation. Other transformation-associated changes include modulation of mitochondrial metabolism, DNA damage-repair proteins and cell cycle regulators. In this work we have characterized the molecular mechanisms implicated in TMC generation and we propose a two-stage model by which a human MSC becomes a tumor cell

Implementation of the evidence for the improvement of nursing care to the critical patient's family: a participatory action research

Background: There are many descriptive studies regarding the needs of the family, as well as those regarding nursing care aimed directly at family members. However, there is no widespread application of such evidence in clinical practice. There has also been no analysis made of the evolution of patterns of knowing during the act of improving clinical practice. Therefore, the purpose of the study is to understand the change process aimed at improving care to critical patient's families, and to explore the evolution of patterns of knowing that nurses use in this process. Methods: Qualitative study with a Participatory Action Research method, in accordance with the Kemmis and McTaggart model. In this model, nurses can observe their practice, reflect upon it and compare it with scientific evidence, as well as define, deploy and evaluate improvement strategies adapted to the context. Simultaneously, the process of empowerment derived from the Participatory Action Research allows for the identification of patterns of knowing and their development over time. The research will take place in the Intensive Care Units of a tertiary hospital. The participants will be nurses who are part of the regular workforce of these units, with more than five years of experience in critical patients, and who are motivated to consider and critique their practice. Data collection will take place through participant observation, multi-level discussion group meetings and documentary analysis. A content analysis will be carried out, following a process of codification and categorisation, with the help of Nvivo10. The approval date and the beginning of the funding were December 2012 and 2013, respectively. Discussion: The definition, introduction and evaluation of care strategies for family members will allow for their real and immediate implementation in practice. The study of the patterns of knowing in the Participatory Action Research will be part of the theoretical and practical feedback process of a professional discipline. Also, the identification of the construction and evolution of knowledge will provide decision elements to managers and academics when choosing strategies for increased quality

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas