Pharmaceutical specialisation

Se hace una revisión de los mecanismos de especialización al que tienen acceso los farmacéuticos, haciendo especial referencia a la regulación oficial para obtener el título de especialista.A complete revision of the possibilities of pharmacists to acces to specialisation after graduation. The final degrees that can be obtained are referenced

Resolution of practical cases in small groups in the teaching of “general and analytical chemistry” subject of degree in pharmacy

El Proyecto realizado por el equipo docente del Departamento de Química Analítica de la Facultad de Farmacia de Sevilla, ha utilizado la técnica de enseñanza en pequeños grupos (EPG) que constituye una faceta esencial en la renovación de las metodologías docentes para la incorporación y adaptación de las enseñanzas universitarias al Espacio Europeo de Educación Superior. La actividad propuesta se ha llevado a cabo en la asignatura “Química General y Analítica” del Grado en Farmacia. Con el objetivo de mejorar el aprendizaje del alumno y fomentar el trabajo en equipo del mismo, se ha subdividido en tres cada uno de los seis grupos asignados a “Clases Prácticas en el aula”, logrando un número de alumnos presentes en la misma (20 alumnos) que permite la impartición de la docencia con una dinámica distinta a la lección magistral. La actividad desarrollada ha tenido una gran acogida por parte de los alumnos donde un alto porcentaje de los mismos consigue superar sin grandes dificultades el apartado del examen destinado a casos prácticos.The Project developed by the Educational Team of the Department of Analytical Chemistry (Faculty of Pharmacy, Seville), has used the technique of Small Groups Learning (SGL) that constitutes an essential facet in the renovation of the educational methodologies for the incorporation and adaptation of the university lessons to the European Space for Higher Education. The proposed activity has been carried out in the “General and Analytical Chemistry” subject of the Degree in Pharmacy. With the aim of improving the learning of the student and fomenting the work in equipment of the same, it has been subdivided in three each one of the six assigned groups to “Practical exercises in the classroom”, obtaining a number of present students in the same (20 students) that allows the imparting of teaching with a dynamic different from the magisterial lesson. The developed activity has presented a great reception by the students and a high percentage of the same is able to surpass without great difficulties the section of the examination destined to practical cases

Effect of goal-directed haemodynamic therapy on postoperative complications in low-moderate risk surgical patients: a multicentre randomised controlled trial (FEDORA trial)

Background The aim of this study was to evaluate postoperative complications in patients having major elective surgery using oesophageal Doppler monitor-guided goal-directed haemodynamic therapy (GDHT), in which administration of fluids, inotropes, and vasopressors was guided by stroke volume, mean arterial pressure, and cardiac index. Methods The FEDORA trial was a prospective, multicentre, randomised, parallel-group, controlled patient- and observer-blind trial conducted in adults scheduled for major elective surgery. Randomization and allocation were carried out by a central computer system. In the control group, intraoperative fluids were given based on traditional principles. In the GDHT group, the intraoperative goals were to maintain a maximal stroke volume, with mean arterial pressure >70 mm Hg, and cardiac index ≥2.5 litres min−1 m−2. The primary outcome was percentage of patients with moderate or severe postoperative complications during the first 180 days after surgery. Results In total, 450 patients were randomized to the GDHT group (n=224) or control group (n=226). Data from 420 subjects were analysed. There were significantly fewer with complications in the GDHT group (8.6% vs 16.6%, P=0.018). There were also fewer complications (acute kidney disease, pulmonary oedema, respiratory distress syndrome, wound infections, etc.), and length of hospital stay was shorter in the GDHT group. There was no significant difference in mortality between groups. Conclusions Oesophageal Doppler monitor-guided GDHT reduced postoperative complications and hospital length of stay in low–moderate risk patients undergoing intermediate risk surgery, with no difference in mortality at 180 days

2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Actualización del Documento Sevilla

La transfusión de sangre alogénica (TSA) no es inocua, y como consecuencia han surgido múltiples alternativas a la misma (ATSA). Existe variabilidad respecto a las indicaciones y buen uso de las ATSA. Dependiendo de la especialidad de los médicos que tratan a los pacientes, el grado de anemia, la política transfusional, la disponibilidad de las ATSA y el criterio personal, estas se usan de forma variable. Puesto que las ATSA tampoco son inocuas y pueden no cumplir criterios de coste-efectividad, la variabilidad en su uso es inaceptable. Las sociedades españolas de Anestesiología y Reanimación (SEDAR), Hematología y Hemoterapia (SEHH), Farmacia Hospitalaria (SEFH), Medicina Intensiva y Unidades Coronarias (SEMICYUC), Trombosis y Hemostasia (SETH) y Transfusiones Sanguíneas (SETS) han elaborado un documento de consenso para el buen uso de la ATSA. Un panel de expertos de las 6 sociedades ha llevado a cabo una revisión sistemática de la literatura médica y elaborado el 2013. Documento Sevilla de Consenso sobre Alternativas a la Transfusión de Sangre Alogénica. Solo se contempla las ATSA dirigidas a disminuir la transfusión de concentrado de hematíes. Se definen las ATSA como toda medida farmacológica y no farmacológica encaminada a disminuir la transfusión de concentrado de hematíes, preservando siempre la seguridad del paciente. La cuestión principal que se plantea en cada ítem se formula, en forma positiva o negativa, como: «La ATSA en cuestión reduce/no reduce la tasa transfusional». Para formular el grado de recomendación se ha usado la metodología Grades of Recommendation Assessment, Development and Evaluation (GRADE)

A knowledge-driven GIS modeling technique for groundwater potential mapping at the Upper Langat Basin, Malaysia.

The aim of this paper is to use a knowledge-driven expert-based geographical information system (GIS) model coupling with remote-sensing-derived parameters for groundwater potential mapping in an area of the Upper Langat Basin, Malaysia. In this study, nine groundwater storage controlling parameters that affect groundwater occurrences are derived from remotely sensed imagery, available maps, and associated databases. Those parameters are: lithology, slope, lineament, land use, soil, rainfall, drainage density, elevation, and geomorphology. Then the parameter layers were integrated and modeled using a knowledge-driven GIS of weighted linear combination. The weightage and score for each parameter and their classes are based on the Malaysian groundwater expert opinion survey. The predicted groundwater potential map was classified into four distinct zones based on the classification scheme designed by Department of Minerals and Geoscience Malaysia (JMG). The results showed that about 17% of the study area falls under low-potential zone, with 66% on moderate-potential zone, 15% with high-potential zone, and only 0.45% falls under very-high-potential zone. The results obtained in this study were validated with the groundwater borehole wells data compiled by the JMG and showed 76% of prediction accuracy. In addition statistical analysis indicated that hard rock dominant of the study area is controlled by secondary porosity such as distance from lineament and density of lineament. There are high correlations between area percentage of predicted groundwater potential zones and groundwater well yield. Results obtained from this study can be useful for future planning of groundwater exploration, planning and development by related agencies in Malaysia which provide a rapid method and reduce cost as well as less time consuming. The results may be also transferable to other areas of similar hydrological characteristics

The evaluation of a continuing professional development package for primary care dentists designed to reduce stress, build resilience and improve clinical decision-making

Introduction: Stress and burnout are widely accepted as a problem for primary care dental practitioners. Previous programmes to address this issue have met with some success. Burnout is associated with poor coping skills and emotion regulation, and increased rates of clinical errors. Anxiety is associated with poor decision-making and is thought to be associated with poor clinical decision-making. Attempts to improve decision-making use increasing meta-awareness and review of thinking processes. Bibliotherapy is an effective method of delivering cognitive behavioural therapy as self-help or guided self-help (with some therapist input) formats. Objective: To evaluate the efficacy of a specially designed CPD package which was designed to improve coping skills, build resilience and reduce the impact of anxiety on dentists’ clinical decision-making. Design: A multi-centred quasi-experiment Setting: Lincolnshire and Nottinghamshire (England) 2014 Materials and methods: Thirty-five volunteer primary care dentists used two versions (self-help [SH] and guided self-help [GSH], which included a 3 hour workshop) of a specially written cognitive-behavioural-therapy bibliotherapy programme designed to improve well-being and decision-making. Main Outcome Measures: The main outcome measures were dentists’ burnout, depression, anxiety, stress and decision-making style. Data were also collected on use and evaluation of the programme. Results: At 6 weeks there was a clinically and statistically significant reduction in depression, anxiety and stress levels, a statistically significant reduction in burnout (emotional exhaustion) and hypervigilant decision-making and an increase in personal achievement (burnout). The improvements in depression, stress, emotional exhaustion and hypervigilant decision-making were maintained at 6 months. Dentists were overwhelmingly positive in their evaluation of the project and used most of its contents. Conclusion: With the caveat of small numbers and the lack of a no-treatment control, this project demonstrated that a self-help package can be highly acceptable to dentists and, in the short-to-medium term, improve dentists’ well-being and decision-making with implications for patient safety

Consideraciones para la cria industrial de la lubina y la dorada

Available from Centro de Informacion y Documentacion Cientifica CINDOC. Joaquin Costa, 22. 28002 Madrid. SPAIN / CINDOC - Centro de Informaciòn y Documentaciòn CientìficaSIGLEESSpai