A

Abstract:  Introduction: From the start of the COVID-19 pandemic, numerous labor categories had to adapt to protect the health of their workers and to be able to continue with their activities. Among them are the Call Centers, who migrated their usual modality to that of teleworking or home office in the workers\u27 home. This caused numerous changes in people\u27s lifestyles, eating habits and levels of physical activity, among others, in an unfavorable epidemiological context. Objective: To describe eating habits, physical activity level and nutritional status of the telephone agents of a Call Center account in the city of Córdoba under the telework modality, in the year 2020. Material and methods: An observational, descriptive and cross-sectional study. Non-probabilistic sample, for convenience, made up of 90 telephone agents from a Call Center account under the telework modality (exclusion criteria: seniority <2 months, workers with sick leave, pregnant women and lactating women). Data collection was carried out using a semi-structured survey form to be completed in an online, self-administered format (Google Forms). It was prepared based on the survey proposed by the Manual de Entornos Saludables  and the Cuestionario Internacional de Actividad Física “IPAQ”. Results: 85.6% of the sample was represented by the female gender, the mean age was 28.8 ± 5.5 years. 45.6% presented a BMI ≥ 25 Kg / m2 and six out of ten workers perceived an increase in weight since they began to telework. Practically everyone eats at least one meal during their working hours, ultra-processed products being the most chosen and more than half (54.4%) increased their food consumption. 83.5% spent 6 hours or more sitting during a business day. Conclusions: The high proportion of workers with overweight and obesity, the quality of their diet with a prominence of ultra-processed foods and the high time spent sitting, call for the generation of adapted strategies that promote healthy lifestyles in work environments, in order to protect the health and prevent the development of diseases.Resumen:  Introducción: A partir del inicio de la pandemia por COVID-19, numerosos rubros laborales debieron adaptarse para proteger la salud de sus trabajadores y poder continuar con sus actividades. Entre ellos se encuentran los Call Centers, quienes migraron su modalidad habitual a la de teletrabajo o home office en el hogar de los trabajadores. Esto ocasionó numerosos cambios en los estilos de vida de las personas, hábitos alimentarios y niveles de actividad física entre otros, en un contexto epidemiológico poco favorable. Objetivo: Describir los hábitos alimentarios, nivel actividad física y el estado nutricional, de los agentes telefónicos de una cuenta de Call Center de la ciudad de Córdoba bajo la modalidad de teletrabajo, en el año 2020. Material y métodos: Estudio de alcance observacional, descriptivo y de corte transversal. Muestra no probabilística, por conveniencia, conformada por 90 agentes telefónicos de una cuenta de Call Center bajo la modalidad de teletrabajo (criterios de exclusión:  antigüedad <2 meses, trabajadores con licencia por enfermedad, gestantes y mujeres lactantes). La recolección de datos se llevó a cabo mediante un formulario de encuesta semi-estructurado para ser completado en formato online, autoadministrado (Formularios de Google). El mismo se confeccionó en base a la encuesta propuesta por el Manual de Entornos Saludables y del Cuestionario Internacional de Actividad Física “IPAQ”.   Resultados: el 85,6% de la muestra estuvo representada por el género femenino, la media de edad fue de 28,8 ± 5,5 años. El 45,6% presentó un IMC ≥ 25 Kg/m2 y seis de cada diez trabajadores percibió aumento ponderal desde que comenzó a teletrabajar. Prácticamente todos realizan al menos una comida durante su horario laboral, siendo los productos ultraprocesados los más elegidos y más de la mitad (54,4%) aumentó el consumo de alimentos. El 83,5% pasó 6 horas o más sentado durante un día hábil. Conclusiones: La elevada proporción de trabajadores con sobrepeso y obesidad, la calidad de su alimentación con prominencia de ultraprocesados y el elevado tiempo de permanencia sentado, instan generar estrategias adaptadas que promuevan estilos de vida saludable en los entornos laborales, con el fin de proteger la salud y prevenir el desarrollo de enfermedades.

Family physicians' effort to stay in charge of the medical treatment when patients have home care by district nurses. A grounded theory study

<p>Abstract</p> <p>Background</p> <p>District nurses (DNs) provide home care for old persons with a mixture of chronic diseases, symptoms and reduced functional ability. Family physicians (FPs) have been criticised for their lack of involvement in this care. The aim of this study was to obtain increased knowledge concerning the FP's experience of providing medical treatment for patients with home care provided by DNs by developing a theoretical model that elucidates how FPs handle the problems they encounter regarding the individual patients and their conditions.</p> <p>Methods</p> <p>Semi-structured interviews were conducted with 13 Swedish FPs concerning one of their registered patients with home care by a DN, and the treatment of this patient. Grounded theory methodology (GTM) was used in the analyses.</p> <p>Results</p> <p>The core category was the effort to stay in charge of the medical treatment. This involved three types of problems: gaining sufficient insight, making adequate decisions, and maintaining appropriate medical treatment. For three categories of patients, the FPs had problems staying in charge. Patients with reduced functional ability had problems providing information and maintaining treatment. Patients who were "fixed in their ways" did not provide information and did not comply with recommendations, and for patients with complex conditions, making adequate decisions could be problematic. To overcome the problems, four different strategies were used: relying on information from others, supporting close observation and follow-up by others, being constantly ready to change the goal of the treatment, and relying on others to provide treatment.</p> <p>Conclusion</p> <p>The patients in this study differed from most other patients seen at the healthcare centre as the consultation with the patient could not provide the usual foundation for decisions concerning medical treatment. Information from and collaboration with the DN and other home care providers was essential for the FP's effort to stay in charge of the medical treatment. The complexity of the situation made it problematic for the FP to make adequate decisions about the goal of the medical treatment. The goal of the treatment had to be constantly evaluated based on information from the DN and other care providers, and thus this information was absolutely crucial.</p

The history of attention deficit hyperactivity disorder

The contemporary concept of attention deficit hyperactivity disorder (ADHD) as defined in the DSM-IV-TR (American Psychiatric Association 2000) is relatively new. Excessive hyperactive, inattentive, and impulsive children have been described in the literature since the nineteenth century. Some of the early depictions and etiological theories of hyperactivity were similar to current descriptions of ADHD. Detailed studies of the behavior of hyperactive children and increasing knowledge of brain function have changed the concepts of the fundamental behavioral and neuropathological deficits underlying the disorder. This article presents an overview of the conceptual history of modern-day ADHD

Pooled analysis of fluorouracil-based adjuvant therapy for stage II and III colon cancer: who benefits and by how much?

PURPOSE: Although it is well-established that fluorouracil- (FU-) based adjuvant therapy improves survival for patients with resected high-risk colon cancer, the magnitude of adjuvant therapy benefit across specific subgroups and for individual patients has been uncertain. PATIENTS AND METHODS: Using a pooled data set of 3,302 patients with stage II and III colon cancer from seven randomized trials comparing FU + leucovorin or FU + levamisole to surgery alone, we performed an analysis based on a Cox proportional hazards regression model. Treatment, age, sex, tumor location, T stage, nodal status, and grade were tested for both prognostic and predictive significance. Model derived estimates of 5-year disease-free survival and overall survival (OS) for surgery alone and surgery plus FU-based therapy were calculated for a range of patient subsets. RESULTS: Nodal status, T stage, and grade were the only prognostic factors independently significant for both disease-free survival and OS. Age was significant only for OS. In a multivariate analysis, adjuvant therapy showed a beneficial treatment effect across all subsets. Treatment benefits were consistent across sex, location, age, T-stage, and grade. A significant stage by treatment interaction was present, with treatment benefiting stage III patients to a greater degree than stage II patients. CONCLUSION: Patients with high-risk resected colon cancer obtain benefit from FU-based therapy across subsets of age, sex, location, T stage, nodal status, and grade. Model estimates of survival stratified by T stage, nodal status, grade, and age are available at http://www.mayoclinic.com/calcs. This information may improve patients' and physicians' understanding of the potential benefits of adjuvant therapy

Evaluation of extensive initial staging procedure in intermediate/high-risk melanoma patients

SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

CARMA1 is a critical lipid raft-associated regulator of TCR-induced NF-kappa B activation.

CARMA1 is a lymphocyte-specific member of the membrane-associated guanylate kinase (MAGUK) family of scaffolding proteins, which coordinate signaling pathways emanating from the plasma membrane. CARMA1 interacts with Bcl10 via its caspase-recruitment domain (CARD). Here we investigated the role of CARMA1 in T cell activation and found that T cell receptor (TCR) stimulation induced a physical association of CARMA1 with the TCR and Bcl10. We found that CARMA1 was constitutively associated with lipid rafts, whereas cytoplasmic Bcl10 translocated into lipid rafts upon TCR engagement. A CARMA1 mutant, defective for Bcl10 binding, had a dominant-negative (DN) effect on TCR-induced NF-kappa B activation and IL-2 production and on the c-Jun NH(2)-terminal kinase (Jnk) pathway when the TCR was coengaged with CD28. Together, our data show that CARMA1 is a critical lipid raft-associated regulator of TCR-induced NF-kappa B activation and CD28 costimulation-dependent Jnk activation

Ligand-engaged TCR is triggered by Lck not associated with CD8 coreceptor

The earliest molecular events in T cell recognition have not yet been fully described, and the initial T cell receptor (TCR) triggering mechanism remains a subject of controversy. Here, using TIRF/FRET microscopy, we observe a two-stage interaction between TCR, CD8, and MHCp. There is an early (within seconds) interaction between CD3ζ and the coreceptor CD8 that is independent of the binding of CD8 to MHC, but that requires CD8 association with Lck. Later (several minutes) CD3ζ-CD8 interactions require CD8-MHC binding. Lck can be found free or bound to the coreceptor. This work indicates that the initial TCR triggering event is induced by free Lck