SummaryThere have been more than 90 hand and upper extremity transplants performed worldwide. Functional and sensory outcomes have been reported in several studies, but little is known about the psychosocial outcomes. A comprehensive systematic literature review was performed, addressing the psychosocial impact of reconstructive hand transplantation. This review provides an overview of psychosocial evaluation protocols and identifies standards in this novel and exciting field. Essentials of the psychosocial assessment are discussed and a new protocol, the 'Chauvet Protocol', representing a standardized assessment protocol for future multicenter psychosocial trials is being introduced.

Under the auspices for the International Society on Hand and Composite Tissue Allotransplantation, a section of The Transplantation Society (IHCTAS), a meeting was convened on March 21-22, 2014 in Paris to review the following areas that were deemed significant in the understanding of the psychosocial evaluation and outcomes of upper extremity transplant recipients: required domains of the evaluation, screening instruments, clinical monitoring pretransplant, clinical monitoring posttransplant, patient and team expectations, body image, psychiatric complications, functional goals and quality of life, ethics and media relations. Experts in the fields of psychiatry and psychology, transplantation, social work, ethics, and transplant administration met and reviewed center experiences and literature. The attendees highlighted the importance and the complexity of the psychiatric assessment in this field of transplantation. Moreover, the necessity to develop common instruments and evaluation protocols to predict psychosocial outcomes as well as to understand whether we are transplanting the right patients and how the transplantation is affecting the patients were pointed out. Psychiatric complications in upper extremity transplanted patients have been reported by the majority of teams. Preexisting psychiatric difficulties, the initial trauma of amputation, or adjusting to the transplantation process itself (especially the medical follow-up and rehabilitation process) appeared to be important factors. Monitoring during the whole follow-up was recommended to detect psychiatric issues and to facilitate and ensure long-term adherence. The participants proposed an annual meeting format to build upon the findings of this inaugural meeting to be called the Chauvet Workgroup meeting.

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Todo el contenido EHP es accesible a las personas con discapacidad. A (Sección 508-compatible) totalmente accesible Versión HTML de este artículo está disponible en http://dx.La microfotografía electrónica de barrido de Falso-color muestra la superficie de la mucosa del colon con racimos de color rosa de bacterias en forma de barra, posiblemente, Escherichia coli, que están unidas. Se piensa que los genomas de las bacterias y los virus de los intestinos humanos codifican 3,3 millones de genes, que podrían complementar el genoma humano determinando cómo funciona el cuerpo.

RESUMENEste artículo expone resultados del estudio "Dimensiones organizacionales de la violencia en el trabajo en Chile considerando desigualdades ocupacionales y de género" (Fondecyt Regular 2014. Nº 1140060). Se focalizó en tres sectores económicos: industria del retail, bancaria y de elaboración de alimentos. Para cada uno se seleccionó una muestra no probabilística de tres actores laborales: trabajadores y trabajadoras, directivos y jefaturas, y dirigentes/as sindicales. Se aplicó una metodología cualitativa basada en entrevistas en profundidad. Los resultados indican que la violencia en el trabajo deriva de relaciones laborales caracterizadas por un fuerte desbalance de poder entre ejecutivos y trabajadores/as, y por el predominio de estilos de supervisión autoritarios que buscan disciplinar a la fuerza de trabajo. Se enmarca en el concepto de "régimen de trabajo opresivo". La violencia de género en el trabajo expresa la articulación de dos formas de opresión sobre las mujeres: su bajo poder formal en las organizaciones y su bajo poder social derivado de relaciones de género que las subordinan y discriminan. Se manifiesta en mayor exposición al maltrato asociado a ocupaciones de menor estatus y a condiciones precarias de empleo, en actitudes y conductas "machistas", acoso sexual y discriminaciones asociadas a la maternidad. ABSTRACTThis article presents results of the study "Organizational dimensions of violence at work in Chile considering occupational and gender inequalities" (Fondecyt Regular 2014. No. 1140060). It focused on three economic sectors: retail, banking and food processing. For each one, a non-probabilistic sample of three labor actors was selected: workers, managers and leaders, and union leaders. A qualitative methodology based on in-depth interviews was applied. The results indicate that violence at work derives from labor relations characterized by a strong imbalance of power between executives and workers, and by the predominance of authoritarian supervision styles that seek to discipline the labor force. It is part of the concept of "oppressive work regime" Gender violence at work expresses the articulation of two forms of oppression against women: their low formal power in organizations and their low social power derived from gender relations that subordinate and discriminate against them. It manifests itself in greater exposure to ill-treatment associated with occupations of lower status and precarious employment conditions, "macho" attitudes and behaviors, sexual harassment and discrimination associated with motherhood. Key words: WORKPLACE VIOLENCE, POWER IMBALANCE, GEN-DER INEQUALITIESpermanente en las relaciones laborales y que afecta más a las mujeres.2-7 Sin embargo, se ha indagado muy poco en factores explicativos. Particularmente importante es una encuesta a una muestra nacional de trabajadores y trabajadoras asalariados/as en el país realizada el año 2011 que reveló una importante prevalencia de violencia en el trabajo y diferencias significativas de exposición según el sex...

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The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act (RUAGA) of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion.