Organisational Culture and Workplace Corruption in Government Hospitals

This study examines corruption attitudes and norms in government hospitals in the Philippines. It tests a culture-building model that advocates communication of desired values, leadership role modelling, employee role modelling, alignment of systems and structures, training and evaluation, and reinforcement. Results reveal components that influence corruption attitudes and norms. Communication predicted individual attitudes or acceptability of corrupt acts. Leadership, systems, and controls predicted the prevalence of corrupt acts. Employee role modelling predicted both acceptability of and the prevalence of corrupt acts. In addition, there is a positive relationship between individual attitudes and organisation norms reinforcing the dyadic relationship between the two

Community-acquired pneumonia: development of a bedside predictive model and scoring system to identify the aetiology

AbstractAlthough initial presentation has been commonly used to select empirical therapy in patients with community-acquired pneumonia (CAP), few studies have provided a quantitative estimation of its value. The objective of this study was to analyse whether a combination of basic clinical and laboratory information performed at bedside can accurately predict the aetiology of pneumonia.A prospective study was developed among patients admitted to the Emergency Department University Hospital Arnau de Vilanova, Lleida, Spain, with CAP. Informed consent was obtained from patients in the study. At entry, basic clinical (age, comorbidity, symptoms and physical findings) and laboratory (white blood cell count) information commonly used by clinicians in the management of respiratory infections, was recorded. According to microbiological results, patients were assigned to the following categories: bacterial (Streptococcus pneumoniae and other pyogenic bacteria), virus-like (Mycoplasma pneumoniae, Chlamydia spp and virus) and unknown pneumonia. A scoring system to identify the aetiology was derived from the odds ratio (OR) assigned to independent variables, adjusted by a logistic regression model. The accuracy of the prediction rule was tested by using receiver operating characteristic curves.One hundred and three consecutive patients were classified as having virus-like (48), bacterial (37) and unknown (18) pneumonia, respectively. Independent predictors related to bacterial pneumonia were an acute onset of symptoms (OR 31; 95% Cl, 6–150), age greater than 65 or comorbidity (OR 6·9; 95% Cl, 2–23), and leukocytosis or leukopenia (OR 2; 95% Cl, 0·6–7). The sensitivity and specificity of the scoring system to identify patients with bacterial pneumonia were 89% and 94%, respectively. The prediction rule developed from these three variables classified the aetiology of pneumonia with a ROC curve area of 0·84.Proper use of basic clinical and laboratory information is useful to identify the aetiology of CAP. The prediction rule may help clinicians to choose initial antibiotic therapy

The Effect of Perilla frutescens extract on the oxidative stability of model food emulsions

The polyphenolic profile of leaves and stalks of Perilla frutescens, was assessed as a source of natural antioxidants. The amount of caffeic and rosmarinic acids, determined by high-performance liquid chromatography (HPLC), were 0.51 mg/g dry weight (DW) and 2.29 mg/g DW, respectively. The measurement of scavenging capacity against the 2,2′-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS) radical cation, the oxygen radical absorbance capacity (ORAC), and the ferric reducing antioxidant power (FRAP) were 65.03 mg Trolox equivalents (TE)/g DW, 179.60 mg TE/g DW and 44.46 mg TE/g DW, respectively. P. frutescens extracts also showed good antioxidant properties in 10% sunflower oil-in-water emulsions during storage at 32 °C. Perilla extract at 320 ppm was as effective as butylated hydroxyanisole (BHA) at 20 ppm in slowing down the formation of hydroperoxides as measured by peroxide value, thiobarbituric acid reactive substances and hexanal content. The results of this study indicate that extract of P. frutescens may be suitable for use in the food matrix to help achieve potential health benefits

Large-scale production of somatic embryos as a source of hypocotyl explants for Vitis vinifera micrografting

To the standard methods currently used to make grapevine virus-free, apex micrografting on hypocotyls of somatic embryos is proposed as an alternative procedure. The study defines optimal conditions to produce hypocotyl fragments suitable for micrografting. Interruption of the process by storage of tissues or embryos at low temperature (+ 4 °C) was assessed at different stages and for durations up to 6 months. Best procedure to produce somatic embryos were: long-term maintenance of embryogenic cultures on C1 medium (5 μM 2.4-D + 1 μM BAP, solidified with 4 g·l-1 agar and 4 g·l-1 Phytagel) ; differentiation of embryogenic callus for 2 months on C2 medium (5 μM NOA + 1 μM BAP, gelling agents same as above) ; transfer of single embryos on plant growth regulator-free medium for 2-3 weeks for germination. At different steps of the process, embryogenic tissues or differentiated embryos can be stored for up to 180 d for some cultivars. Micrografting assays were performed with various types of embryo and with apices from several V. vinifera cultivars. White to slightly coloured hypocotyls, excised from embryos germinated in darkness, gave best results for micrografting, while hypocotyl shape had little influence. For all genotypes tested the success rate ranged from 18 to 30 %.

Prevalence of pre-diabetes and undiagnosed diabetes in the Mollerussa prospective observational cohort study in a semi-rural area of Catalonia

Objectives: To assess the prevalence of undiagnosed diabetes and pre-diabetes in the healthy population in the Mollerussa cohort. As a secondary objective, to identify the variables associated with these conditions and to describe the changes in glycaemic status after 1 year of follow-up in subjects with pre-diabetes. Design: Prospective observational cohort study. Setting: General population from a semi-rural area. Participants: The study included 583 participants without a diagnosis of diabetes recruited between March 2011 and July 2014. Results: The prevalence of undiagnosed diabetes was 20, 3.4% (95% CI 2.6 to 4.2) and that of pre-diabetes was 229, 39.3% (37.3 to 41.3). Among those with pre-diabetes, 18.3% had isolated impaired fasting plasma glucose (FPG) (FPG: 100 to <126 mg/dL), 58.1% had isolated impaired glycated haemoglobin (HbA1c) (HbA1c 5.7 to <6.5) and 23.6% fulfilled both criteria. Follow-up data were available for 166 subjects; 41.6%(37.8 to 45.4) returned to normoglycaemia, 57.6% (57.8 to 61.4) persisted in pre-diabetes and 0.6% (0 to 1.2) progressed to diabetes. Individuals with pre-diabetes had worse cardiometabolic risk profiles and sociodemographic features than normoglycaemic subjects. In the logistic regression model, variables significantly associated with pre-diabetes were older age (OR; 95% CI) (1.033; 1.011 to 1.056), higher physical activity (0.546; 0.360 to 0.827), body mass index (1.121; 1.029 to 1.222) and a family history of diabetes (1.543; 1.025 to 2.323). The variables significantly associated with glycaemic normalisation were older age (0.948; 0.916 to 0.982) and body mass index (0.779; 0.651 to 0.931). Conclusions: Among adults in our region, the estimated prevalence of undiagnosed diabetes was 3.4% and that of pre-diabetes was 39.3%. After a 1-year follow-up, a small proportion of subjects (0.6%) with pre-diabetes progressed to diabetes, while a high proportion (41.6%) returned to normoglycaemia. Individuals with pre-diabetes who returned to normoglycaemia were younger and had a lower body mass inde

Mediterranean diet and healthy eating in subjects with prediabetes from the mollerussa prospective observational cohort study

Altres ajuts: Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) i Instituto de Salud Carlos III (Plan Nacional de I+D+I i Fondo Europeo de Desarrollo Regional).We aimed to assess differences in dietary patterns (i.e., Mediterranean diet and healthy eating indexes) between participants with prediabetes and those with normal glucose tolerance. Secondarily, we analyzed factors related to prediabetes and dietary patterns. This was a cross-sec-tional study design. From a sample of 594 participants recruited in the Mollerussa study cohort, a total of 535 participants (216 with prediabetes and 319 with normal glucose tolerance) were in-cluded. The alternate Mediterranean Diet score (aMED) and the alternate Healthy Eating Index (aHEI) were calculated. Bivariable and multivariable analyses were performed. There was no dif-ference in the mean aMED and aHEI scores between groups (3.2 (1.8) in the normoglycemic group and 3.4 (1.8) in the prediabetes group, p = 0.164 for the aMED and 38.6 (7.3) in the normoglycemic group and 38.7 (6.7) in the prediabetes group, p = 0.877 for the aHEI, respectively). Nevertheless, women had a higher mean of aMED and aHEI scores in the prediabetes group (3.7 (1.9), p = 0.001 and 40.5 (6.9), p < 0.001, respectively); moreover, they had a higher mean of aHEI in the group with normoglycemia (39.8 (6.6); p = 0.001). No differences were observed in daily food intake between both study groups; consistent with this finding, we did not find major differences in nutrient intake between groups. In the multivariable analyses, the aMED and aHEI were not associated with pre-diabetes (odds ratio (OR): 1.19, 95% confidence interval (CI): 0.75-1.87; p = 0.460 and OR: 1.32, 95% CI: 0.83-2.10; p = 0.246, respectively); however, age (OR: 1.04, 95% CI: 1.02-1.05; p < 0.001), dyslipidemia (OR: 2.02, 95% CI: 1.27-3.22; p = 0.003) and body mass index (BMI) (OR: 1.09, 95% CI: 1.05-1.14; p < 0.001) were positively associated with prediabetes. Physical activity was associated with a lower frequency of prediabetes (OR: 0.48, 95% CI: 0.31-0.72; p = 0.001). In conclusion, subjects with prediabetes did not show a different dietary pattern compared with a normal glucose tolerance group. However, further research is needed on this issue

Prospects for practice-based philosophy of logic

We explore prospects for practice-based approaches to logical theory, in particular the link between classical and intuitionistic logic and the inferential structure of traditional practices of representation & argument in science and mathematics. After discussing some key notions about practice, we outline the connection between representation practices and classical logic, and then consider a spectrum of actual practices followed or proposed by (real) scientists. Intuitionistic logic helps to clarify the potential of practice-based approaches for understanding pluralism, and to hammer some key points about the general thesis.Ministerio de Economía y Competitividad FFI2009-1002

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain : a Study Based on Primary Care Records Registry

The purpose was to determine the coverage of maternal vaccination against influenza and pertussis, and the characteristics associated with being vaccinated, in a health area of Catalonia, Spain. Some 36,032 anonymized and computerized clinical records registries of pregnant women from Primary Care Centres (e-CAP database) were analysed, from between 2015 and 2018. Vaccination coverage and the association with sociodemographic variables and clinical conditions were estimated using a Poisson regression model. Maternal vaccination coverage against influenza ranged between 11.9% in 2015 and 6.8% in 2018, following a decreasing trend (p < 0.001). Coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine varied between 49.8% in 2016 and 79.4% in 2018, following an increasing trend (p < 0.001). Having living children and suffering from obesity were factors associated with not being vaccinated against both infections. The predictive variables of vaccination against influenza were diabetes (IRR: 2.17, 95% CI: 1.42-3.30) and asthma (IRR: 2.05, 95% CI: 1.76-2.38); and for pertussis, it was asthma (IRR: 1.10, 95% CI: 1.03-1.17). Different socio-demographic factors and chronic conditions in pregnant women were associated with maternal vaccination, and which will have to be taken into account in clinical practice when implementing strategies to improve the coverage of the programme

Congenital cytomegalovirus awareness and knowledge among health professionals and pregnant women: an action towards prevention

Cytomegalovirus (CMV) is a major cause of childhood disabilities, and consensus recommendations emphasize the importance of hygienic measures to reduce perinatal infection. Our study aimed to evaluate the level of awareness about CMV among health professionals and pregnant women. Conclusion: Health care professionals have limited knowledge about CMV and may fail to enforce preventive measures. Health campaigns should be promoted to enhance awareness about this perinatal infection

Tratamiento multimodal de contextos

We take as starting point the context logic studied in (Grossi, Meyer, and Dignum 2008) and (Aucher et al. 2009), which was concerned with the development of a dynamic logic of rules. Here we focus on issues of Formal Epistemology and omit the addition of deontic operators.We define some basic logics that are useful for the study of epistemic actions such as expanding, contracting or revising a theory taking into account different kinds of inferential results