Diseño y validación de una encuesta de satisfacción con la atención farmacéutica recibida en las consultas de farmacia hospitalaria

Dicha comunicación fue presentada en la sesión de mejores comunicaciones orales obteniendo el segundo premio a mejor comunicación. (Nº Comunicación: 628, Localizador: uyf3595389).Objetivo: Diseñar y validar un cuestionario para valorar la satisfacción con la Atención Farmacéutica (AF) recibida en la farmacia hospitalaria. Métodos: Estudio multicéntrico en cinco hospitales andaluces. En enero 2013 se realizó una búsqueda bibliográfica en PUBMED; términos MESH pharmaceutical services, patients satisfaction and questionnaire. Seguidamente se elaboró el cuestionario, según metodología Delphi, formado por 10 ítems, con variables demográficas, sociales, farmacológicas y clínicas; donde se preguntaba al paciente sobre la repercusión de la AF en su tratamiento y enfermedad y sobre la conformidad con el servicio prestado. El paciente podía responder desde uno=muy deficiente a cinco=excelente. Se realizó una fase piloto previa a la fase de validación de los cuestionarios. Análisis descriptivos y la medida del valor del alfa de Cronbach y el coeficiente de correlación intraclase (CCI) se llevaron a cabo en ambas fases. Se utilizó el programa estadístico SPSS versión 20.0. Resultados: Se incluyeron 21 encuestas en la fase piloto y 154 en la fase de validación (índice de respuesta 100%). De esta última fase, el 62% (N=96) eran hombres. Más del 50% de los pacientes contestaron de forma “excelente” a todos los ítems de la encuesta en ambas fases. Los valores del alfa de Cronbach y CCI fueron 0.921 y 0.915 (IC95%: 0.847-0.961) y 0.916 y 0,910 (IC95%: 0.886-0.931) para fase piloto y validación, respectivamente. Conclusión: Se ha diseñado y validado un instrumento de alta fiabilidad para medir la satisfacción de los pacientes con la AF recibida en las consultas de farmacia hospitalaria.Object: To design and to validate a questionnaire to assess satisfaction with pharmaceutical care (PC) received at the hospital pharmacy. Methods: Multicentric study in five andalusian hospital in January 2013. A bibliography search was performed in PUBMED; MESH term; pharmaceutical services, patients satisfaction and questionnaire. Next, the questionnaire was produced by Delphi methodology with ten items and with the following variables; demographics, socials, pharrmacologicals and clinics which the patient was asked for the consequences of the PC in his treatment and illness and for the acceptance with the received service. The patient could answer between one= very insufficient and five= excellent. Before the validation phase questionnaire, a pilot phase was carried out. Descriptive analysis, Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC) were performed in both phases. Data analysis was conducted using the SPSS statistical software package release 20.0. Results: In the pilot phase were included 21 questionnaires and 154 of them in validation phase (response index of 100%). In the last phase, 62% (N=96) of patients were men. More than 50% of patients answered “excelent” in all items of questionnaire in both phases. The Cronbach’s alpha coefficient and ICC were 0.921 and 0.915 (95%IC: 0.847-0.961) and 0.916 and 0,910 (95%IC: 0.886-0.931) in pilot and validation phases, respectively. Conclusions: A high reliability instrument was designed and validated to evaluate the patient satisfaction with PC received at hospital pharmac

Una experiencia de trabajo en grupo de mujeres para la mejora de las habilidades de afrontamiento, en un Equipo de Salud Mental de Distrito

Evaluación como caso clínico de una experiencia de grupo de habilidades de afrontamiento, centrada en las estrategias de afrontamiento y reestructuración cognitiva a problemas cotidianos y de relación desarrollado en un Equipo de Salud Mental de Distrito. Ésta es realizada con una porción de la demanda femenina, con diagnósticos del ámbito de la ansiedad y depresión, que presenta pobre red social, aislamiento y conflictos en su relación de pareja.This paper is about the assesment of our experience in coping skill trainning group. It´s being made in the frame of a Community Mental Health Service. This experience is about women with anxiety and depressive disorders and severe problems of poor social net, isolation, sadness, and troubles in their marriage

Uso de órtesis de compresión controlada frente a apósito compresivo tras cirugía conservadora de cáncer de mama como factor reductor de complicaciones y aumento de la calidad de vida.

El objetivo principal de este trabajo es demostrar que la utilización de la órtesis de compresión controlada frente al apósito compresivo clásico reduce de una manera significativa e independiente las complicaciones postoperatorias a las dos semanas de la cirugía conservadora del cáncer de mama y, además, incrementa la calidad de vida y la satisfacción estética de la paciente. Para ello se realiza inicialmente un ensayo con pacientes intervenidas de cáncer de mama, las cuales fueron inmediatamente tratadas tras la cirugía de una manera aleatoria con dos procedimientos de compresión, órtesis controlada y apósito tradicional, realizándose un seguimiento de los diferentes tipos de complicaciones que se generan durante el postoperatorio y comparándose su incidencia entre ambos grupos en varios momentos de tiempo. El resultado muestra una incidencia de complicaciones globales más baja con la órtesis controlada que con el apósito clásico, en cualquier momento de tiempo, así como, un aumento en la calidad de vida. Para demostrar el efecto reductor que la órtesis de compresión controlada frente al apósito compresivo produce en el porcentaje de complicaciones postoperatorias, se genera un modelo multivariante de regresión logística binaria para la presencia de complicaciones a las dos semanas de la cirugía, que incluye el tratamiento de compresión y las variables: edad, IMC, talla del sujetador, tamaño, grado y fenotipo tumoral, procedimiento sobre la mama y axila, número de ganglios extirpados y drenajes de mama y axila. El modelo identifica el procedimiento de compresión como un factor predictor independiente del fenotipo tumoral y el drenaje de mama para la aparición de complicaciones globales a las dos semanas de la cirugía. La conclusión de este trabajo es que la órtesis de compresión controlada respecto al apósito compresivo habitual es un factor reductor independiente para el desarrollo de complicaciones tras la cirugía conservadora de cáncer de mama y mejora los diferentes aspectos de la calidad de vida postoperatoria

CathepsinKCre mediated deletion of βcatenin results in dramatic loss of bone mass by targeting both osteoclasts and osteoblastic cells

It is well established that activation of Wnt/βcatenin signaling in the osteoblast lineage leads to an increase in bone mass through a dual mechanism: increased osteoblastogenesis and decreased osteoclastogenesis. However, the effect of this pathway on the osteoclast lineage has been less explored. Here, we aimed to examine the effects of Wnt/βcatenin signaling in mature osteoclasts by generating mice lacking βcatenin in CathepsinK-expressing cells (Ctnnb1;CtsKCre mice). These mice developed a severe low-bone-mass phenotype with onset in the second month and in correlation with an excessive number of osteoclasts, detected by TRAP staining and histomorphometric quantification. We found that WNT3A, through the canonical pathway, promoted osteoclast apoptosis and therefore attenuated the number of M-CSF and RANKL-derived osteoclasts in vitro. This reveals a cell-autonomous effect of Wnt/βcatenin signaling in controlling the life span of mature osteoclasts. Furthermore, bone Opg expression in Ctnnb1;CtsKCre mice was dramatically decreased pointing to an additional external activation of osteoclasts. Accordingly, expression of CathepsinK was detected in TRAP-negative cells of the inner periosteal layer also expressing Col1. Our results indicate that the bone phenotype of Ctnnb1;CtsKCre animals combines a cell-autonomous effect in the mature osteoclast with indirect effects due to the additional targeting of osteoblastic cells.This work was supported by grant ISCIII PI12/01405 to JGM and grant BFU2014-57216-P to MAR from the Spanish Government and R01AR056679 from NIAMS/NIH to MA.Peer Reviewe

Association between sleep-disordered breathing and breast cancer aggressiveness

Background Sleep-disordered breathing (SDB) has been associated with cancer aggressiveness, but studies focused on specific tumors are lacking. In this pilot study we investigated whether SDB is associated with breast cancer (BC) aggressiveness. Methods 83 consecutive women <65 years diagnosed with primary BC underwent a home respiratory polygraphy. Markers of SDB severity included the apnea-hypopnea index (AHI) and the 4% oxygen desaturation index (ODI4). The Ki67 proliferation index, lack of hormone receptors (HR-), Nottingham Histological Grade (NHG), and tumor stage were used as markers of BC aggressiveness. The association between SDB and molecular subtypes of BC was also assessed. Results The mean (SD) age was 48.8 (8.8) years and body mass index was 27.4 (5.4) Kg/m2. 42 women (50.6%) were post-menopausal. The median (IQR) AHI was 5.1 (2–9.4), and ODI4 was 1.5 (0.5–5.8). The median (IQR) AHI did not differ between the groups with Ki67>28% and Ki6728% and Ki67<29% (51.2% vs 52.3%, p = 0.90), HR- and HR+ (58.3% vs 49.1%, p = 0.47), NHG categories (p = 0.89), different tumor stages (p = 0.71), or molecular subtypes (p = 0.73). These results did not change when the ODI4 was used instead of the AHI. Conclusion Our results do not support an association between the presence or severity of SDB and BC aggressiveness.Asociación de Neumología y Cirugía Torácica del Sur (NEUMOSUR) 1/201

Outpatients' opinion and experience regarding telepharmacy during the COVID-19 pandemic: the Enopex Project

[Abstract] Background: Telepharmacy, as a remote pharmaceutical care procedure, is being used worldwide during the COVID-19 pandemic, with the aim of preserving the health of patients and professionals. Its future development should incorporate the assessment of patient perception, but no research study has investigated it. Objective: The objective was to poll the opinions and experiences of outpatients with telepharmacy through a purpose-developed questionnaire and to assess it's quality through an internal validity and reliability analysis. Methods: Cross-sectional observational study of adult patients who used telepharmacy services during the COVID-19 lockdown period in Spain. The subjects answered a 24-item questionnaire, after giving their informed consent. Place of delivery, informed pharmacotherapeutic follow-up, opinion about telepharmacy, future development, ethics/satisfaction, and coordination constituted the six questionnaire categories. After assessing the adequate sample size with the Kaiser-Meyer-Olkin test, the Bartlett sphericity test analyzed the validity of the questionnaire. The intraclass correlation coefficient and Cronbach's α coefficient calculations verified the reliability and internal consistency. Results: A total of 9442 interviews were administered to patients from 81 hospitals, of which 8079 were valid (52.8% female). A 54.1% were aged between 41-65 years; 42.7% had been in treatment for more than 5 years; 42.8% lived between 6-31 miles from the hospital. As many as 96.7% of patients were "satisfied" or "very satisfied" with telepharmacy, 97.5% considering it complementary to their usual follow-up; 55.9% expressed a preference for being followed up face to face when visiting the hospital. 75.6% said they had rather receive their medication at home. The sample size obtained was deemed appropriate [the Kaiser-Meyer-Olkin test (0.789) and Bartlett's sphericity test (p<0.005)]. The reliability analysis resulted in a Cronbach α = 0.7. Conclusion: Patients have shown high satisfaction with telepharmacy and the ENOPEX questionnaire is a tool with sufficient validity and reliability to be used in the evaluation of the care that patients receive through telepharmacy

A window to the sea: RAIA observatory tool for assessing environmental risks in the NW Iberian coastal upwelling system

The international RAIA Observatory serves the main maritime activities of the NW Iberian coastal upwelling system. Over the last few years, the partners of the observatory have identified at least 12 key environmental risks that can potentially affect the ecosystem services of this coastal area. In order to evaluate these risks, different environmental indicators are used, which are developed and optimized according to the specifications provided by international environmental agencies. A Window to the Sea is the publicly-accessible web-service created to present and share the results from this evaluation. So far, current results have allowed to establish risk assessment protocols for the coastal region, and identify critical observational gaps. The web-is user-friendly with the intention to achieve as many end-users as possible, not only from academia, but also from other governmental institutions, fisheries, enterprises and the general public.Peer Reviewe

Hypertension is related to the degradation of dietary frying oils

[Background]: The family kitchen resembles an uncontrolled laboratory experiment, and some discrepancies in the relation between the risk of hypertension and dietary fat may be partly due to the manipulation to which the fats were subjected. [Objective]: We investigated whether deterioration in the quality of the cooking oils in the family household contributes to the risk of high blood pressure. [Design]: The study was cross-sectional. Anthropometric measurements were obtained for 1226 persons aged 18–65 y who were selected randomly from the municipal census of Pizarra, Spain. An oral-glucose-tolerance test was given to 1020 of these persons. Samples of the cooking oil being used were taken from the kitchens of a random subset of 538 persons. The concentrations of polar compounds and polymers were used as markers of the deterioration of the oils. The strength of association between variables was measured by calculating the odds ratio from logistic models. [Results]: Hypertension was strongly associated with obesity and was influenced by sex, diabetes, and age. The presence of excess polar compounds in the cooking oil and the use of sunflower oil were related to the risk of hypertension, whereas the concentration of monounsaturated fatty acids in the serum phospholipids was negatively related to this risk. These associations remained after inclusion in the models of age, sex, obesity, and the presence of carbohydrate metabolism disorder. [Conclusions]: The risk of hypertension is positively and independently associated with the intake of cooking oil polar compounds and inversely related to blood concentrations of monounsaturated fatty acids

Prognostic stratification of adult primary glioblastoma multiforme patients based on their tumor gene amplification profiles

Several classification systems have been proposed to address genomic heterogeneity of glioblastoma multiforme, but they either showed limited prognostic value and/or are difficult to implement in routine diagnostics. Here we propose a prognostic stratification model for these primary tumors based on tumor gene amplification profiles, that might be easily implemented in routine diagnostics, and potentially improve the patients management. Gene amplification profiles were prospectively evaluated in 80 primary glioblastoma multiforme tumors using single-nucleotide polymorphism arrays and the results obtained validated in publicly available data from 267/347 cases. Gene amplification was detected in 45% of patients, and chromosome 7p11.2 including the EGFR gene, was the most frequently amplified chromosomal region – either alone (18%) or in combination with amplification of DNA sequences in other chromosomal regions (10% of cases). Other frequently amplified DNA sequences included regions in chromosomes 12q(10%), 4q12(7%) and 1q32.1(4%). Based on their gene amplification profiles, glioblastomas were subdivided into: i) tumors with no gene amplification (55%); ii) tumors with chromosome 7p/EGFR gene amplification (with or without amplification of other chromosomal regions) (38%); and iii) glioblastoma multiforme with a single (11%) or multiple (6%) amplified DNA sequences in chromosomal regions other than chromosome 7p. From the prognostic point of view, these amplification profiles showed a significant impact on overall survival of glioblastoma multiforme patients (p>0.001). Based on these gene amplification profiles, a risk-stratification scoring system was built for prognostic stratification of glioblastoma which might be easily implemented in routine diagnostics, and potentially contribute to improved patient management.This work was supported by RETICC RD06/0020/0035, RD06/0020/0059 and RD12/0036/0048 grants from Red Temática de Investigación Cooperativa en Cáncer (RTICC), Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, (Madrid, Spain and FONDOS FEDER), AES PI16/000476 (Instituto de Salud Carlos III, Madrid, Spain and FONDOS FEDER), GRS909A14 (JCYL) and CB16/12/00400 grant (CIBERONC, Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Madrid, Spain and FONDOS FEDER)

Proceso de diseño : reflexión en torno a las herremientas teóricas, metodológicas y de interpretación

1 archivo PDF (172 páginas)Al cumplirse treinta años de ser fundada la División de diseño en el tiempo, distinguidos profesores de nuestra comunidad han elaborado doce ensayos para descifrar estas interrogantes en torno al proceso de diseño. Los textos que integran esta publicación necesariamente orientarán a profesionales, especialistas en la materia y por supuesto a los estudiantes de nuestra institución -así como de otras escuelas de educación superior que impartan las carreras de diseño gráfico, arquitectónico o industrial