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Se realizó una investigación en sistemas y servicios de salud para evaluar el grado de satisfacción de 350 usuarios y 12 prestadores en el Servicio de Rehabilitación Integral de base comunitaria, perteneciente al Policlínico Docente "Armando García Aspurú" de Santiago de Cuba durante diciembre del 2011, para lo cual se confeccionaron 25 criterios, indicadores y estándares y se aplicaron encuestas, validadas mediante el coeficiente Alpha de Cronbach. Al finalizar la evaluación, entre los criterios que se tuvieron en cuenta para valorar la satisfacción de los usuarios y prestadores resultaron adecuados 8 de los primeros y 10 de los segundos (72,7 y 71,4 %, respectivamente), de manera que se cumplió con el estándar establecido. Se concluyó que tanto los usuarios como los prestadores del servicio están satisfechos con la atención que allí se brinda

An investigation in health systems and services to evaluate the health care quality given in the Comprehensive Rehabilitation Service with community base, belonging to "Armando García Aspurú” Teaching Polyclinic in Santiago de Cuba, was carried out during 2013. The sample had 15 professionals and 180 patients, in whom surveys that were validated through alpha Cronbach coefficient were applied. The process dimension was analyzed taking into account 15 approaches, indicators and standards. When concluding the evaluation, 12 of these approaches were considered appropriate (80.0%); therefore, established standard was fulfilled. It was concluded that the health care aboved mentioned was optimal.

Se realizó una investigación en sistemas y servicios de salud para evaluar la calidad de la atención brindada en el Servicio de Rehabilitación Integral de base comunitaria, perteneciente al Policlínico Docente "Armando García Aspurú" del municipio de Santiago de Cuba, durante el 2013. La muestra estuvo constituida por 15 profesionales y 180 pacientes, a los cuales se les aplicaron encuestas que fueron validadas a través del coeficiente alfa de Cronbach. Se analizó la dimensión proceso teniendo en cuenta 15 criterios, indicadores y estándares. Al finalizar la evaluación, 12 de estos criterios se consideraron adecuados (80,0 %); por tanto, se cumplió con el estándar establecido. Se concluyó que la atención ofrecida en el servicio antes citado fue adecuada

Epithelial sodium channels (ENaCs) are strongly expressed in the circumventricular organs (CVOs), and these structures may play an important role in sensing plasma sodium levels. Here, the potent ENaC blocker amiloride was injected intraperitoneally in rats and 2h later, the c-Fos activation pattern in the CVOs was studied. Amiloride elicited dose-related activation in the area postrema (AP) but only ~10% of the rats showed c-Fos activity in the organum vasculosum of the lamina terminalis (OVLT) and subfornical organ (SFO). Tyrosine hydroxylase-immunoreactive (catecholamine) AP neurons were activated, but tryptophan hydroxylase-immunoreactive (serotonin) neurons were unaffected. The AP projects to FoxP2-expressing neurons in the dorsolateral pons which include the pre-locus coeruleus nucleus and external lateral part of the parabrachial nucleus; both cell groups were c-Fos activated following systemic injections of amiloride. In contrast, another AP projection target--the aldosterone-sensitive neurons of the nucleus tractus solitarius which express the enzyme 11-β-hydroxysteriod dehydrogenase type 2 (HSD2) were not activated. As shown here, plasma concentrations of amiloride used in these experiments were near or below the IC50 level for ENaCs. Amiloride did not induce changes in blood pressure, heart rate, or regional vascular resistance, so sensory feedback from the cardiovascular system was probably not a causal factor for the c-Fos activity seen in the CVOs. In summary, amiloride may have a dual effect on sodium homeostasis causing a loss of sodium via the kidney and inhibiting sodium appetite by activating the central satiety pathway arising from the AP., (Copyright © 2015 Elsevier B.V. All rights reserved.)

The parabrachial nucleus (PB) is a brainstem cell group that receives a strong input from the nucleus tractus solitarius regarding the physiological status of the internal organs and sends efferent projections throughout the forebrain. Since the neuroanatomical organization of the PB remains unclear, our first step was to use specific antibodies against two neural lineage transcription factors: Forkhead box protein2 (FoxP2) and LIM homeodomain transcription factor 1 beta (Lmx1b) to define the PB in adult rats. This allowed us to construct a cytoarchitectonic PB map based on the distribution of neurons that constitutively express these two transcription factors. Second, the in situ hybridization method combined with immunohistochemistry demonstrated that mRNA for glutamate vesicular transporter Vglut2 (Slc17a6) was present in most of the Lmx1b+ and FoxP2+ parabrachial neurons, indicating these neurons use glutamate as a transmitter. Third, conscious rats were maintained in a hypotensive or hypertensive state for 2h, and then, their brainstems were prepared by the standard c-Fos method which is a measure of neuronal activity. Both hypotension and hypertension resulted in c-Fos activation of Lmx1b+ neurons in the external lateral-outer subdivision of the PB (PBel-outer). Hypotension, but not hypertension, caused c-Fos activity in the FoxP2+ neurons of the central lateral PB (PBcl) subnucleus. The Kölliker-Fuse nucleus as well as the lateral crescent PB and rostral-most part of the PBcl contain neurons that co-express FoxP2+ and Lmx1b+, but none of these were activated after blood pressure changes. Salt-sensitive FoxP2 neurons in the pre-locus coeruleus and PBel-inner were not c-Fos activated following blood pressure changes. In summary, the present study shows that the PBel-outer and PBcl subnuclei originate from two different neural progenitors, contain glutamatergic neurons, and are affected by blood pressure changes, with the PBel-outer reacting to both hypo- and hypertension, and the PBcl signaling only hypotensive changes., (Copyright © 2012 IBRO. Published by Elsevier Ltd. All rights reserved.)

Between 1990 and 2000, 317 herds of cattle in Northern Ireland were identified as being seropositive to Brucella abortus, and 68 per cent of them were attributed to transmission from neighbouring herds or to local spread. Of particular significance were three primary outbreaks in 1997, which resulted in significant secondary and tertiary spread. Three spatial clusters were identified, corresponding to two of the primary outbreaks, and the herd density and within-herd spread were highest in the largest cluster. Abortions in an infected herd and the disease-risk status of the disclosure test were positively associated with an increased within-herd prevalence.

Bovine tuberculosis is endemic in Northern Ireland and a comprehensive eradication scheme has been in operation since 1959. The current programme involves annual testing, extensive computerized tracing, short-interval testing of herds contiguous to outbreaks and compulsory slaughter of positive cattle. Despite initial reductions in disease prevalence, eradication has proved elusive and potential explanatory factors include high cattle density and potential for between-herd contact, the impact of exotic diseases on resource priorities, and significant levels of bovine tuberculosis in a wildlife reservoir, the European badger (Meles meles). Both the role of the infected bovine and that of the badger in spreading disease have to be addressed to ensure progress towards eradication. Current measures are described and future options for enhancing the programme are outlined.

This paper presents the results of the first formal epidemiological study in Northern Ireland of risk factors for bovine tuberculosis (TB) associated with farm boundaries, neighbours and wildlife. The study was designed as a case-control study and 427 dairy herds were investigated between December 1993 and January 1995. The case herds had more than 30 cattle, and herds in which the source of infection had been ascribed to purchased cattle were avoided. Data on the Department of Agriculture Animal Health Computer were used in conjunction with data collected through a questionnaire to examine a range of possible risk factors, including the number and nature of the farm boundaries, the number of neighbours and their TB history, the number of hedgerows, the presence of badger setts, whether badger carcases had been found on the land, and the possible presence of deer. A follow-up telephone survey was conducted to minimise bias. The results highlighted two main associations with TB breakdowns, the presence of badgers, and contiguous neighbours who had had confirmed TB breakdowns. The estimated aetiological fraction for both associations was approximately 40 per cent, suggesting that although infected cattle may have a significant role in the transmission of TB their importance relative to the badger may have been over-estimated in the Northern Ireland TB scheme. The contribution of the badger is possibly one of several main reasons for the lack of significant progress in TB eradication despite strenuous efforts associated with all aspects of the scheme.

By 30 January 1998, there had been 170,259 confirmed cases of BSE in Great Britain (GB), 1766 confirmed cases in Northern Ireland (NI) (2 January 1998), and 276 confirmed cases in the Republic of Ireland (31 January 1998). Analysis of the epidemiological patterns in the NI epidemic reveals significant clustering of cases in herds and counties. The observed clustering of cases within herds results in lower per capita incidence of BSE in previously unaffected herds, providing support for the introduction of a certified herd scheme in NI. By fitting a backcalculation model to the case data, we can estimate the number of animals infected with the aetiological agent of BSE and project the number of future cases. We predict that the epidemic will decline rapidly, with approximately 99 cases (95% confidence interval 30,504) occurring in the five year period 1997-2001.

The epidemiology of bovine spongiform encephalopathy (BSE) in Northern Ireland from 1988, when it was first confirmed, to the end of 1995 is described. All cases of BSE were subjected to a detailed epidemiological investigation, complemented by data from the national animal health records on every bovine animal. Data are presented on 1680 cases. Many of the epidemiological features of the disease were similar to those reported in Great Britain, but the incidence in Northern Ireland was approximately one-tenth that in Great Britain. The epidemic increased to a peak of 56 cases per month in January 1994, and decreased to nine cases in December 1995. Statutory intervention banning the use of meat and bone meal in ruminant feed in January 1989 has produced a marked and continuing reduction in the incidence. The majority of the cases were in Northern Ireland cattle, but 83 cases were imported from Great Britain and five from the Republic of Ireland. Many of the key epidemiological features have remained constant throughout the epidemic: the greater incidence of BSE in dairy herds than in beef suckler herds, the low within-herd incidence, the variation in incidence with herd size, the breed distribution, the distribution of the reported clinical signs and the proportion of purchased cases. Although the source of the BSE epidemic in Northern Ireland has not been established conclusively, the evidence suggests that the importation of meat and bone meal and protein concentrates from Great Britain may have been responsible.

This study describes the epidemiological features of bovine spongiform encephalopathy (BSE) in Northern Ireland where the first case occurred in November 1988. They were very similar to those observed in Great Britain except that the annual incidence of BSE in 1990 in Northern Ireland, 2.3 confirmed cases per 10,000 adult cows, was approximately one 10th of that in Great Britain. The findings were also consistent with the current hypothesis that affected cattle had been exposed to a scrapie-like agent via cattle feedstuffs containing ruminant-derived protein. However, a preliminary investigation of the potential sources of infection for cattle in Northern Ireland did not provide any conclusive evidence.