Deconstructing myths,building alliances: a networking model to enhance tobacco control in hospital mental health settings

Life expectancy for people with severe mental disorders is up to 25 years less in comparison to the general population, mainly due to diseases caused or worsened by smoking. However, smoking is usually a neglected issue in mental healthcare settings. The aim of this article is to describe a strategy to improve tobacco control in the hospital mental healthcare services of Catalonia (Spain). To bridge this gap, the Catalan Network of Smoke-free Hospitals launched a nationwide bottom-up strategy in Catalonia in 2007. The strategy relied on the creation of a working group of key professionals from various hospitals —the early adopters— based on Rogers’ theory of the Diffusion of Innovations. In 2016, the working group is composed of professionals from 17 hospitals (70.8% of all hospitals in the region with mental health inpatient units). Since 2007, tobacco control has improved in different areas such as increasing mental health professionals’ awareness of smoking, training professionals on smoking cessation interventions and achieving good compliance with the national smoking ban. The working group has produced and disseminated various materials, including clinical practice and best practice guidelines, implemented smoking cessation programmes and organised seminars and training sessions on smoking cessation measures in patients with mental illnesses. The next challenge is to ensure effective follow-up for smoking cessation after discharge. While some areas of tobacco control within these services still require significant improvement, the aforementioned initiative promotes successful tobacco control in these settings.     

Reticencia vacunal: análisis del discurso de madres y padres con rechazo total o parcial a las vacunas

Objective

To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters.

VITROS 250全自动干化学分析仪的评价

目的评价美国强生VITROS250全自动干化学分析仪器。方法运用相关统计学方法对VITROS250全自动干化学分析仪的精密度、相关性、抗胆红素干扰方面进行分析。结果VITROS250全自动干化学分析仪精密度高,回收率高,相关性好,抗干扰能力强。结论VITROS250全自动干化学分析仪适用于临床实验诊断中心(检验科)急诊化验室生化项目的检测。     

Diferencias en la nota del ENAM y el promedio ponderado universitario en postulantes al servicio rural peruano, 2008-2015

Introduction

The Rural and Urban Marginal Health Service (SERUMS) is a mandatory program at the end of the medical career in Peru. The promotional grade point average (PPP) and the national medical examination (ENAM) grades are used when awarding places.

Changes in the somatosensory N250 and P300 by the variation of reaction time

We investigated the relationship between somatosensory event-related potentials (ERP) and the variation of reaction time (RT). For this purpose, we recorded the ERPs (N250 and P300) in fast- and slow-reaction trials during a somatosensory discrimination task. Strong, standard, and weak target electrical stimuli were randomly delivered to the left median nerve at the wrist with a random interstimulus interval (900–1,100 ms). All the subjects were instructed to respond by pressing a button with their right thumb as fast as possible whenever a target stimulus was presented. We divided all the trials into fast- and slow-RT trials and averaged the data. N250 latency tended to be delayed when the RT was slow, but not significantly. P300 latency was delayed significantly when the RT was slow, but to a much lesser extent than the RT delay, so we concluded that the change of RT was not fully determined by the processes reflected by the somatosensory N250 or P300. Furthermore, the larger and earlier P300 in the fast-RT trials implied that when larger amounts of attentional resources were allocated to a given task, the speed of stimulus evaluation somewhat increased and RT was shortened to a great extent. N250 amplitude did not significantly vary in the two RT clusters. In conclusion, the somatosensory N250 reflects active target detection, which is relatively independent of the modulation of the response speed, whereas the somatosensory P300 could change without manipulation of either the stimulus or the response processing demand. Electronic Publication     

Coronary endothelium-protective effects of defibrotide in ischaemia and reperfusion

Summary Defibrotide is known to enhance prostacyclin (PGI₂) release from the vascular endothelium. We investigated the vasoactive effects of defibrotide in isolated rat hearts perfused at constant flow subjected to ischaemia and reperfusion. Defibrotide at 10^–7 or 100 g/ml did not exert any direct vasoactive effect on normal rats hearts. However, ischaemia and reperfusion resulted in an impaired vasodilation to acetylcholine, an endothelium-dependent vasodilator. In contrast, the vasodilator response to the endothelium-independent dilator, nitroglycerin, was unaffected. Defibrotide, at 10^–7 or 100 g/ml, markedly restored the vasodilation to acetylcholine 10^–7 nmol/l to 1 mol/l (P < 0.01) without influencing the vasodilator response to nitroglycerin (2 to 200 g/1). Haemoglobin (150 nmol/l) inhibited the dilation to acetylcholine in response to defibrotide. However, no evidence of (PGI₂) release was observed with acetylcholine-induced vasodilation in the presence or absence of defibrotide. Additionally, 10–100 g/ml of defibrotide did not significantly decrease superoxide radicals generated by a xanthine-xanthine oxidase synthetic system under conditions in which superoxide dismutase was effective. Thus, defibrotide appears to exert an endothelium-protective effect preserving endothelium-derived relaxing factor (EDRF) without directly scavenging free signals.Supported in part by Research Grant No. HL-25575 from the National Heart, Lung and Blood Institute of the NIH Send offprint requests to A. M. Lefer at the above address     

Experimental vascularized total joint autografts--a primate study

Autogenous vascularized and nonvascularized total joint transfers were studied in the hands of Macaca fascicularis monkeys. Nine second toe proximal interphalangeal joints were transferred as a vascularized free graft to the hand, and the excised finger joints were transferred to the foot as a nonvascularized free graft. The grafts were examined clinically and histopathologically at 16 weeks to 10 months. Two of the nonvascularized free grafts were amputated because of infection and necrosis. Three had chronic infections. The four surviving nonvascularized grafts demonstrated necrosis of the hyaline cartilage and degenerative changes. Of the nine vascularized joints, one developed a wound infection that required amputation, another failed at 2 weeks because of wound dehiscence, and the remaining seven survived with preservation of the hyaline articular surfaces. The experimental technique was designed to be easily applied to clinical use. A skin island is provided as a "patency/viability monitor." The extensor mechanism is included in the graft for early function.     

EFFECTS OF SeO_2 ON REGULATORY REGIONS p250 OF c-fos GENE

The element selenium was recognized 40 years ago as being essential in the nutrition of animal and humans and it is an essential component of a number of enzymes present in the amino acid selenocysteine (Se-Cys). Selenium has also been shown to inhibit tumorigenesis in both animal models and humans[1]. Supplementing with selenium in diets may reduce the human cancer risk[2]. It has been reported that cell protein kinase cdk2 andprotein kinase C were strongly inhibited by various forms of sel…     

Delays in the health care system for children,adolescents, and young adults with bone tumors in Brazil

ObjectiveTo identify delays in the health care system experienced by children and adolescents and young adults (AYA; aged 0–29 years) with osteosarcoma and Ewing sarcoma using information from the Brazilian hospital-based cancer registries.MethodsPatient data were extracted from 161 Brazilian hospital-based cancer registries between 2007 and 2011. Hospital, diagnosis, and treatment delays were analyzed in patients without a previous histopathological diagnosis. Referral, hospital, and health care delays were calculated for patients with a previous histopathological diagnosis. The time interval was measured in days.ResultsThere was no difference between genders in overall delays. All delays increased at older ages. Patients without a previous histopathological diagnosis had the longest hospital delay when compared to patients with a previous histopathological diagnosis before first contact with the cancer center. Patients with Ewing sarcoma had longer referral and health care delays than those with osteosarcoma who had a previous histopathological diagnosis before first contact with the cancer center. The North and Northeast regions had the longest diagnosis delay, while the Northeast and Southeast regions had the longest treatment delay.ConclusionHealth care delay among patients with a previous diagnosis was longer, and was probably associated with the time taken for to referral to cancer centers. Patients without a previous histopathological diagnosis had longer hospital delays, which could be associated with possible difficulties regarding demand and high-cost procedures. Despite limitations, this study helps provide initial knowledge about the healthcare pathway delays for patients with bone cancer inside several Brazilian hospitals.