Previous studies from this laboratory have focused on the characterization of blood protein adducts formed in utero as a result of maternal smoking during pregnancy. These biological samples, obtained during the third trimester of pregnancy, at delivery, have clearly shown a correlation between maternal smoking histories and exposure of the fetus to tobacco smoke carcinogens, including 4-aminobiphenyl and benzo(a)pyrene. In the present study, we examined exposure of the fetus during the first trimester of pregnancy to various environmental carcinogens, particularly those found in tobacco smoke. Amniotic fluid samples were obtained from women undergoing routine amniocentesis between 16 and 20 weeks gestational age. Amniotic fluid, produced by the fetal lungs and kidneys, is an important part of pregnancy and fetal development and this fluid surrounds the fetus throughout pregnancy. In these studies, samples of amniotic fluid were obtained from nonsmokers as well as 0.5 pack per day smokers, 1.0 pack per day smokers, and greater than 2.0 pack per day smokers. Maternal smoking status was determined by questionnaire as well as assessment of amniotic fluid for 39 Downloaded by [University of Kent] at 15:01 07 December 2014 40 S. R. Myers et al. cotinine via immunoassay. Amniotic fluid samples were extracted and analyzed for the presence of polycyclic aromatic hydrocarbons (PAHs). A clear correlation was found between levels of maternal smoking and PAHs in the amniotic fluid.Amniotic fluid 1-hydroxypyrene levels ranged from 1.54 ± 0.12 µg/L in nonsmokers to 11.72 ± 0.67 µg/L in women smoking greater than 2 pks/da, indicating approximately a 10X increase over nonsmokers. Similar results were found 3-hydroxybenzo(a)pyrene, 6-hydroxybenzo(a)pyrene, and 3,6-dihydroxybenzo(a)pyrene, metabolites of the carcinogen benzo(a)pyrene as well as with the 9-hydroxy and 9,10-dihydroxy metabolites of anthracene. The 5-hydroxymethyl metabolite of 5-methylchrysene was found to range in concentrations from 1.65 ± 0.11 µg/L in nonsmokers to 12.67 ± 0.79 µg/L in greater than 2 packs per day smokers.These results demonstrate that amniotic fluid can serve as a biological marker of exposure to tobacco related polycyclic aromatic hydrocarbons. Identification of potentially harmful compounds detected at an early stage of pregnancy may prevent subsequent exposures to the fetus and as a result decrease the risk of potential genotoxic as well as teratogenic events.

In response to our recent OR fire, our institution initiated a safety review and quality improvement project regarding our emergency preparedness. Several major modifications have been implemented including an all hands-on deck approach to training, increased frequency of simulation exercises with OR safety and fire-fighting equipment, as well as inclusion into our surgical timeout process. Operating room fires are rare but potentially catastrophic with costly loss of resource and possibly life.

Background: As the US healthcare system is becoming a more outcomes based system, increasing emphasis is being paid to improving all aspects of health care delivery. Interpersonal and communication skills, an ACGME (Accreditation Council for Graduate Medical Education) core competency in resident education, play a fundamental role in this effort. This aspect of healthcare delivery is also part of Medicare hospital reviews. In our hospital, the administration has introduced AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank you) as a communication strategy which promises to improve exchange of information between healthcare professionals as well as with patients and their families. Objective: Determine if the AIDET strategy used in our facility has improved patient satisfaction. Methods: This study was done using pretest post test experimental design. Patient satisfaction was measured using scores from the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) quarterly reports from the 3 rd quarter of 2010 to the 2 nd quarter of 2013. Pre and post AIDET implementation results were statistically analysed using a paired t-test.Results are reported as a p-value with < .05 being statistically significant. Results: There were a total of 1,811 patient responses sampled from the 3 rd quarter of 2010 to the 2 nd quarter of 2013. A significant change < .05 was seen in the way Nurses Explain, Doctors Explain and Nurses listen in the pre and post AIDET implementation comparison. The change in percentage of patients that believed doctors and nurses explained things to them in a way they could understand showed a p-value of .02. The trend in percentage of patients that perceived that nurses always listened carefully to them showed a p-value of .02 as well. On the other hand, the data evaluating how doctors listened carefully to them did not reach statistical significance with a p-value of .08. The remaining categories of "Told About Medication" and "Help after Discharge" were both found not have changed significantly either. Conclusions:The implementation of AIDET education may have had a significant impact on provider-patient communication in our facility, especially in the patient's perception of explaining things in a way they could understand. On the other hand, in the responses to the question of whether or not doctors listened carefully to them, there was some improvement over time, however this did not achieve statistical significance.

El presente trabajo tiene como objetivo central presentar someramente algunas de las tesis principales de Ronald Dworkin, y la influencia de este autor en la práctica judicial del Tribunal Electoral del Poder Judicial de la Federación, con lo que habré también de demostrar el vínculo existente entre teoría y práctica judicial. En concreto, centraré mi exposición en una de las tesis de Dworkin que a la fecha, sigue siendo el principal motivo de disputa entre los teóricos del derecho, a saber, la separación conceptual entre el derecho y la moral, y la idea de un sistema jurídico conformado sólo por reglas, que dan pauta a la operación lógica de subsunción. Para lograr el objetivo trazado, en primer lugar se expondrá brevemente el pensamiento del heredero de Hart en la Universidad de Oxford, y posteriormente se analizarán algunos criterios del Tribunal Electoral del Poder Judicial de la Federación, en donde se destaca la influencia de nuestro autor, argumentando paralelamente, el vínculo sustancial entre teoría y práctica judicial.

No abstract

El objetivo de este trabajo es mostrar cuáles son los parámetros constitucionales y convencionales aplicables a la limitación de derechos fundamentales en el contexto del covid-19 en México, con el propósito de reflexionar críticamente sobre algunos casos en los que la autoridad no se ajusta a dichos parámetros con la consiguiente restricción o suspensión injustificada de algunos derechos fundamentales. Por lo que, con apoyo del método dogmático jurídico, exegético y el análisis de casos, en primer término, se desarrollará una base teórica sobre los límites a los derechos fundamentales; luego se analizarán las bases constitucionales y legales vigentes en México aplicables a la pandemia del covid-19; posteriormente se dará cuenta de los parámetros constitucionales y convencionales que resultan aplicables a la restricción o suspensión de derechos en el escenario de la pandemia del covid-19 en México, y finalmente, apoyados en lo anterior, se reflexionará críticamente sobre algunos casos en los cuales las autoridades mexicanas han  procedido en contra de los referidos parámetros constitucionales y convencionales, restringiendo o suspendiendo derechos fundamentales básicos de la población en México.

se hará uso del segundo y tercer de los sentidos indicados, ya que se analizará la posibilidad de someter a control de constitucionalidad y convencionalidad, al conjunto de consideraciones jurídicas contenidas en los fallos de los tribunales, así como a los criterios que resuelven un problema jurídico, determinado por una pluralidad de sentencias acordes. Por lo que respecta a los órganos facultados para crear jurisprudencia en México, de conformidad con el artículo 94 y 99

En el presente trabajo, se expondrá una reflexión sobre el principio de supremacía constitucional, respecto de los tratados internacionales en materia de derechos humanos, partiendo del análisis e implicaciones de lo resuelto por la Suprema Corte de Justicia de la Nación (SCJN) en la contradicción de criterios 293/2011. Para ello, en primer término, se fijarán las nociones conceptuales de lo que se entiende en la doctrina por el principio de supremacía constitucional. En segundo lugar, se hará un análisis puntual de la contradicción de criterios 293/2011, resuelta por la SCJN el 3 de septiembre de 2013; y por último se hará una reflexión sobre la jerarquía de las normas constitucionales respecto de las normas del derecho internacional de los derechos humanos.