Search

Background: Nurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low- and middle-income countries. Aim: To examine the association between effort-reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador. Introduction: A cross-sectional study linking psychosocial work environment indicators to infection control adherence. Methods: The study was conducted among 333 nurses in four Ecuadorian hospitals. Self-administered questionnaires assessed demographic variables, perceived infection risk, effort-reward imbalance, burnout and infection control adherence. Results: Increased effort-reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self-reported adherence with infection control measures. Discussion: Results suggest an effort-reward imbalance-burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic. Conclusion: This study highlights the contribution of effort-reward-imbalance-burnout continuum to the chain of infection by decreased adherence to infection control of nurses. Implications for Nursing Policy: Health authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort-reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort-reward imbalance and burnout in low- and middle-income settings. [ABSTRACT FROM AUTHOR]

The remarkable fish diversity in the Caribbean rivers of north-western South America evolved under the influences of the dramatic environmental changes of neogene northern South America, including the Quechua Orogeny and Pleistocene climate oscillations. Although this region is not the richest in South America, endemism is very high. Fish assemblage structure is unique to each of the four aquatic systems identified (rivers, streams, floodplain lakes and reservoirs) and community dynamics are highly synchronized with the mono-modal or bi-modal flooding pulse of the rainy seasons. The highly seasonal multispecies fishery is based on migratory species. Freshwater fish conservation is a challenge for Colombian environmental institutions because the Caribbean trans-Andean basins are the focus of the economic development of Colombian society, so management measures must be directed to protect aquatic habitat and their connectivity. These two management strategies are the only way for helping fish species conservation and sustainable fisheries. [ABSTRACT FROM AUTHOR]

The ability to assess and avoid predation risk is thought to be a major determinant of behavior for small mammals. We assessed the antipredator responses of three Neotropical rodent species ( H eteromys desmarestianus, P eromyscus mexicanus and M elanomys caliginosus) to cues (feces or actual presence) of the snake B othrops asper. We investigated whether rodents avoided entering or spent less time in snake-cued areas using an experimental arena, and whether rodents reduced foraging efforts (measured by giving-up density) in snake-cued areas under laboratory, semi-natural and field conditions. P . mexicanus and M . caliginosus did not demonstrate any snake avoidance, and did not reduce foraging efforts under any conditions. H . desmarestianus significantly avoided live snakes only at very short distances (<20 cm), and reduced foraging efforts in the presence of snakes only under certain experimental conditions. These results are in contrast to many studies demonstrating antipredator behavior by small mammals in temperate and desert ecosystems in response to cues of predators, including snakes, and were influenced by overall low statistical power. This discrepancy may also be explained by the complexity of tropical forest systems, as rodents must assess a myriad of sensory cues and balance risk from multiple predator groups that require different avoidance strategies. An ambush-hunting snake such as B. asper may also face strong selective pressure to avoid detection by its mammalian prey. [ABSTRACT FROM AUTHOR]

Background and Objectives A new intravenous immunoglobulin (IGIV) process has been developed that integrates efficient inactivation of enveloped virus, using caprylate, with immunoglobulin G (IgG) purification and caprylate removal by column chromatography. Two clinical studies were conducted to compare the pharmacokinetics of the new product, IGIV-C, 10% (Gamunex™, 10%), formulated with glycine, with the licensed solvent–detergent (SD)-treated intravenous immunoglobulin IGIV-SD, 10% (Gamimune®N, 10%), formulated with glycine, and IGIV-C, 5%, formulated with 10% maltose. Materials and Methods Both studies were randomized, multicentre crossover trials of 18 and 20 (respectively) adult patients with primary humoral immune deficiency in which patients received one IGIV product for three consecutive periods (3–4 weeks) before crossing over to the other product. Pharmacokinetic parameters were determined after the third infusion of each product. Results IGIV-C, 10% was bioequivalent to IGIV-SD, 10%, with half-lives (t 1/2 ) of 35 and 34 days, respectively. IGIV-C, 5%, was bioequivalent to IGIV-C, 10%, with t 1/2 of 35 and 36 days, respectively. The products had comparable safety profiles. Conclusions The pharmacokinetic profiles observed in these trials indicate that IGIV-C, 10% may replace, and be administered in a manner similar to, IGIV-SD, 10%. [ABSTRACT FROM AUTHOR]

ABSTRACT We suspected two fetuses of having sacrococcygeal teratomas following initial two-dimensional ultrasound scanning at 18 and 22 weeks’ gestation. The fetuses were then scanned with three-dimensional multiplanar surface and three-dimensional orthogonal planar ultrasound to establish a definitive diagnosis. Although we made a presumptive diagnosis in both cases after initial two-dimensional scanning, with three-dimensional ultrasound we were better able to define the degree of involvement of the sacrum and other pelvic structures of prognostic importance. [ABSTRACT FROM AUTHOR]

Steady flow through a heterogeneous porous medium in a bounded domain is investigated using a recursive perturbation scheme. The effect of boundary conditions on a two-dimensional flow with arbitrary variation of the mean flow (allowing large gradients) is investigated using analytical expressions for the head and velocity covariance functions. Boundary conditions were decomposed into deterministic and stochastic components. Two flow cases with the same zero-order and different first-order boundary conditions were analyzed. Boundary conditions are deterministic for the first case and random for the second. Significant differences between the two cases indicate random (or absence of randomness) processes must be modeled at boundaries. First-order solutions for the head and velocity covariance functions for a bounded rectangular domain are derived. The resulting integral kernels involve Greens functions, and they are evaluated by numerical integration. Boundary conditions for higher-order problems influence the absolute value and shape of the kernels (and therefore of the head and velocity variance and covariance functions). It is found that the validity of the perturbation scheme is dependent on the magnitude of the kernels and not only on the condition σ f2 ≪ 1, where σ f is the variance of the log hydraulic conductivity, assumed Gaussian and weakly homogeneous in space. The type of boundary conditions affects the values of the kernels and therefore determine the convergence limits for the problem. Milder head gradients also allow larger values of σ f2. Nonlocality is also contingent on boundary type. Weakly homogeneous log-fluctuating conductivity fields give rise to head and velocity covariances which are not weakly homogeneous. The inhomogeneous fields are obtained from a linear filter of the solution to the problem without stochasticity. Higher-gradient regions induce higher head and velocity variances. In the presence of space-varying gradients, nonlocal effects are most important away from the boundaries lpar;'center of the domain'). Small local head gradients result in small head and velocity gradients, and therefore where observations are made in stagnation regions, data should be analyzed taking into account this effect. The results may be used to interpret experimental data for columns or data taken where conditions do not fit the average uniform flow assumption and when processes at the boundaries influence the flow and therefore the mixing of contaminants. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the previously published article on three-dimensional inversion mode rendering in molar pregnancy of a 32-year-old woman.

Aim: The aim of this study was to evaluate amino acids as glucagon receptor (GCGR)-specific biomarkers in rodents and cynomolgus monkeys in the presence of agonism of both glucagon-like peptide-1 receptor (GLP1R) and GCGR with a variety of dual agonist compounds., Materials and Methods: Primary hepatocytes, rodents (normal, diet-induced obese and GLP1R knockout) and cynomolgus monkeys were treated with insulin (hepatocytes only), glucagon (hepatocytes and cynomolgus monkeys), the GLP1R agonist, dulaglutide, or a variety of dual agonists with varying GCGR potencies., Results: A long-acting dual agonist, Compound 2, significantly decreased amino acids in both wild-type and GLP1R knockout mice in the absence of changes in food intake, body weight, glucose or insulin, and increased expression of hepatic amino acid transporters. Dulaglutide, or a variant of Compound 2 lacking GCGR agonism, had no effect on amino acids. A third variant with ~31-fold less GCGR potency than Compound 2 significantly decreased amino acids, albeit to a significantly lesser extent than Compound 2. Dulaglutide (with saline infusion) had no effect on amino acids, but an infusion of glucagon dose-dependently decreased amino acids on the background of GLP1R engagement (dulaglutide) in cynomolgus monkeys, as did Compound 2., Conclusions: These results show that amino acids are sensitive and translatable GCGR-specific biomarkers., (© 2020 John Wiley & Sons Ltd.)