The person, interactions and environment programme to improve care of people with dementia in hospital: a multisite study

Background: Improving care of people with dementia on acute hospital wards is a policy priority. Person-centred care is a marker of care quality; delivering such care is a goal for service improvement. Objectives: PIE (Person: Interaction; Environment) comprises an observation tool and systematic approach to implement and embed a person-centred approach in routine care for hospitalised patients with dementia. The study aims were to: evaluate PIE as a method to improve the care of older people with dementia on acute hospital wards; and develop insight into what person-centred care might look like in practice in this setting. Methods: We performed a longitudinal comparative case study design in ten purposively selected wards in five Trusts in three English regions; alongside an embedded process evaluation. Data was collected from multiple sources: staff, patients, relatives, organisational aggregate information and documents. Mixed methods were employed: ethnographic observation; interviews and questionnaires; patient case studies (patient observation and conversations ‘in the moment’, interviews with relatives and case records), patient and ward aggregate data. Data was synthesised to create individual case studies of PIE implementation and outcomes in context of ward structure, organisation, patient profile and process of care delivery. Cross case comparison facilitated a descriptive and explanatory account of PIE implementation in context, the pattern of variation, what shaped it and the consequences flowing from it. Quantitative data was analysed using simple descriptive statistics. Qualitative data analysis employed grounded theory methods. Results: The study furthered understanding of dimensions of care quality for older people with dementia on acute hospital wards and the environmental, organisational and cultural factors that shaped delivery. Only two wards fully implemented PIE, sustaining and embedding change over 18 months. The remaining wards either did not install PIE (‘non-implementers’); or were ‘partial implementers’. The interaction between micro-level contextual factors (aspects of leadership (drivers, facilitators, team, networks), fit with strategic initiatives and salience with valued goals) and miso and macro level organisational factors, were the main barriers to PIE adoption. Where implemented, evidence suggests that the programme directly affected improvement in ward practice with positive impact on the experience of patients and caregivers, although the heterogeneity of need and severity of impairment meant that some of the more visible changes did not affect everyone equally. Limitations: Although PIE has potential to improve the care of people with dementia when implemented, findings are indicative only: data on clinical outcomes was not systematically collected; and PIE was not adopted on most study wards. Research implications: Further research is required to identify more precisely the skill-mix and resources necessary to provide person-focused care to hospitalised people with dementia, across the spectrum of need, including those with moderate and severe impairment. Implementing innovations to change practices in complex organisations requires more in-depth understanding of contextual factors that impact the capacity of organisations to absorb and embed new practices

Registro de nuevo huésped intermediario de Hymenolepis diminuta (Cestoda) en el Perú

Tribolium castaneum (Herbst) is reported as new intermediate host of Hymenolepis diminuta from Peru.Tribolium castaneum (Herbst) es reportado como un nuevo hospedero intermediario de Hymenolepis diminuta en el Perú

Study on the antioxidant and antitumoral activity of propolis

Introducción: El propóleo es la sustancia que protege a la colmena, es una resina de composición compleja y viscosa que las abejas utilizan en la reparación y protección de la colmena. El material del que procede el propóleo son las resinas, brotes y pecíolos de las hojas de diferentes vegetales, por ello presenta una composición química muy compleja que varía en función de la flora de recolección de las abejas. Posee capacidad antimicrobiana, antiinflamatoria que está relacionada con su poder antioxidante, inmunomoduladora, entre otras. Objetivos: En este trabajo se estudian las actividades antioxidantes y antitumorales de propóleos de distintas zonas de la provincia de Málaga comparándolos con uno de la región de Bohemia al sur de la República Checa. Material y métodos: La actividad antioxidante se evaluó según el método ABTS+/S2 O8 K2 . Además se estimó la cantidad de proteínas totales a partir del contenido de nitrógeno y posteriormente se determinó la citotoxicidad y actividad antitumoral del propóleo del Puerto de la Torre, al norte de Málaga, según el método del bromuro de 3-(4,5-dimetiltiazol-2-il)-2,5-difenil tetrazolio. Resultados: Se observó que el propóleo presenta una elevada actividad antioxidante, aunque tiene una menor cantidad de proteínas. El propóleo presenta elevada toxicidad y mayor actividad antitumoral frente al cáncer de colon que al de leucemia. Conclusión: Con todos estos datos obtenidos se puede concluir que el propóleo presenta diferentes actividades de interés para la industria alimentaria o cosmética, entre las que destaca su elevado poder antioxidante y su capacidad como antitumoral.Introduction: Propolis is the substance that protects the hive, a resin of complex and viscous composition bees use in the repair and protection of the hive. The material from which propolis arises are the resins, shoots and petioles of the leaves of different plants, so it has a very complex chemical composition that varies depending on the flora of the bees collection. It offers an antimicrobial, anti-inflammatory capacity related to its antioxidant, immunomodulatory power, among others. Aims: In this work, antioxidant and antitumoral activities of different propolis collected from different areas of the province of Malaga, comparing them with one from the Bohemian region to the south of the Czech Republic are studied. Material and methods: Antioxidant activity was determined according to the ABTS+/S2 O8 K2 method. In addition, the quantity of total proteins from the nitrogen content and subsequently the cytotoxicity and antitumoral activity of the propolis of Puerto de la Torre, north of Malaga, are measured according to the 3-(4,5-dimetiltiazol-2-il)-2,5-diphenyl tetrazolium bromide method. Results: It was observed that propolis has high antioxidant activity, although it has a lower amount of proteins. Propolis has high toxicity and higher antitumoral activity against colon cancer than leukemia. Discussion: With all these data, it can be concluded that propolis offers different activities of interest, for the food and cosmetic industry, among which the high antioxidant and antitumoral capacity

Estudio de la actividad antioxidante y antitumoral del propóleo

Introduction: Propolis is the substance that protects the hive, a resin of complex and viscous composition bees use in the repair and protection of the hive. The material from which propolis arises are the resins, shoots and petioles of the leaves of different plants, so it has a very complex chemical composition that varies depending on the flora of the bees collection. It offers an antimicrobial, anti-inflammatory capacity related to its antioxidant, immunomodulatory power, among others. Aims: In this work, antioxidant and antitumoral activities of different propolis collected from different areas of the province of Malaga, comparing them with one from the Bohemian region to the south of the Czech Republic are studied. Material and methods: Antioxidant activity was determined according to the ABTS+/S2O8K2 method. In addition, the quantity of total proteins from the nitrogen content and subsequently the cytotoxicity and antitumoral activity of the propolis of Puerto de la Torre, north of Malaga, are measured according to the 3-(4,5-dimetiltiazol-2-il)-2,5-diphenyl tetrazolium bromide method. Results: It was observed that propolis has high antioxidant activity, although it has a lower amount of proteins. Propolis has high toxicity and higher antitumoral activity against colon cancer than leukemia. Discussion: With all these data, it can be concluded that propolis offers different activities of interest, for the food and cosmetic industry, among which the high antioxidant and antitumoral capacity.Introducción: El propóleo es la sustancia que protege a la colmena, es una resina de composición compleja y viscosa que las abejas utilizan en la reparación y protección de la colmena. El material del que procede el propóleo son las resinas, brotes y pecíolos de las hojas de diferentes vegetales, por ello presenta una composición química muy compleja que varía en función de la flora de recolección de las abejas. Posee capacidad antimicrobiana, antiinflamatoria que está relacionada con su poder antioxidante, inmunomoduladora, entre otras. Objetivos: En este trabajo se estudian las actividades antioxidantes y antitumorales de propóleos de distintas zonas de la provincia de Málaga comparándolos con uno de la región de Bohemia al sur de la República Checa. Material y métodos: La actividad antioxidante se evaluó según el método ABTS+/S2O8K2. Además se estimó la cantidad de proteínas totales a partir del contenido de nitrógeno y posteriormente se determinó la citotoxicidad y actividad antitumoral del propóleo del Puerto de la Torre, al norte de Málaga, según el método del bromuro de 3-(4,5-dimetiltiazol-2-il)-2,5-difenil tetrazolio. Resultados: Se observó que el propóleo presenta una elevada actividad antioxidante, aunque tiene una menor cantidad de proteínas. El propóleo presenta elevada toxicidad y mayor actividad antitumoral frente al cáncer de colon que al de leucemia. Conclusión: Con todos estos datos obtenidos se puede concluir que el propóleo presenta diferentes actividades de interés para la industria alimentaria o cosmética, entre las que destaca su elevado poder antioxidante y su capacidad como antitumoral

Conciliación de la medicación al ingreso en paciente crónico pediátrico: estudio multicéntrico

Conciliación de la medicación; Discrepancia; PediatríaMedication reconciliation; Discrepancy; PaediatricsConciliació de la medicació; Discrepància; PediatriaIntroduction Medication reconciliation (MC) is one of the main strategies to reduce medication errors in care transitions. In Spain, several guidelines have been published with recommendations for the implementation and development of MC aimed at the adult population, although paediatric patients are not included. In 2018, a study was carried out that led to the subsequent publication of a document with criteria for selecting paediatric patients in whom CM should be prioritised. Objectives To describe the characteristics of paediatric patients most likely to suffer from errors of reconciliation (EC), to confirm whether the results of a previous study can be extrapolated. Methodology Prospective, multicentre study of paediatric inpatients. We analysed the CE detected during the performance of the CM on admission. The best possible pharmacotherapeutic history of the patient was obtained using different sources of information and confirmed by an interview with the patient/caregiver. Results 1043 discrepancies were detected, 544 were identified as CD, affecting 317 patients (43%). Omission of a drug was the most common error (51%). The majority of CD were associated with drugs in groups A (31%), N (23%) and R (11%) of the ATC classification. Polymedication and onco-haematological based disease were the risk factors associated with the presence of CD with statistical significance. Conclusions The findings of this study allow prioritisation of CM in a specific group of paediatric patients, favouring the efficiency of the process. Onco-haematological patients and polymedication are confirmed as the main risk factors for the appearance of CD in the paediatric population.Introducción La conciliación de la medicación (CM) es una de las principales estrategias para disminuir los errores de medicación en las transiciones asistenciales. En España existen publicadas diferentes guías con recomendaciones para la implantación y desarrollo de la CM orientadas a población adulta, sin estar los pacientes pediátricos incluidos. En el año 2018 se llevó a cabo un estudio que permitió la posterior publicación de un documento con criterios de selección de pacientes pediátricos en los que priorizar la CM. Objetivos Describir las características de los pacientes pediátricos con mayor probabilidad de sufrir errores de conciliación (EC), para confirmar si los resultados de un estudio previo son extrapolables. Metodología Estudio prospectivo y multicéntrico con pacientes pediátricos ingresados. Se analizaron los EC detectados durante la realización de la CM al ingreso. La mejor historia farmacoterapéutica posible del paciente fue obtenida utilizando diferentes fuentes de información y confirmándose con una entrevista con el paciente/cuidador. Resultados Se detectaron 1.043 discrepancias, determinándose como EC 544, afectando a 317 pacientes (43%). La omisión de algún medicamento fue el error más común (51%). La mayoría de los EC se asociaron con los medicamentos de los grupos A (31%), N (23%) y R (11%) de la clasificación ATC. La polimedicación y la enfermedad de base onco-hematológica fueron los factores de riesgo asociados a la presencia de EC con significación estadística. Conclusiones Los hallazgos de este estudio permiten priorizar la CM en un grupo concreto de pacientes pediátricos, favoreciendo la eficiencia del proceso. Los pacientes onco-hematológicos y la polimedicación se confirman como los principales factores de riesgo para la aparición de EC en población pediátrica.The study was funded by the Fundación Española de Farmacia Hospitalaria through the 2019–2020 grant programme

Microbial β-glucosidases from cow rumen metagenome enhance the saccharification of lignocellulose in combination with commercial cellulase cocktail

Background A complete saccharification of plant polymers is the critical step in the efficient production of bio-alcohols. Beta-glucosidases acting in the degradation of intermediate gluco-oligosaccharides produced by cellulases limit the yield of the final product. Results In the present work, we have identified and then successfully cloned, expressed, purified and characterised 4 highly active beta-glucosidases from fibre-adherent microbial community from the cow rumen. The enzymes were most active at temperatures 45–55°C and pH 4.0-7.0 and exhibited high affinity and activity towards synthetic substrates such as p-nitrophenyl-beta-D-glucopyranoside (p NPbetaG) and p NP-beta-cellobiose, as well as to natural cello-oligosaccharides ranging from cellobiose to cellopentaose. The apparent capability of the most active beta-glucosidase, herein named LAB25g2, was tested for its ability to improve, at low dosage (31.25 units g-1 dry biomass, using p NPbetaG as substrate), the hydrolysis of pre-treated corn stover (dry matter content of 20%; 350 g glucan kg-1 dry biomass) in combination with a beta-glucosidase-deficient commercial Trichoderma reseei cellulase cocktail (5 units g-1 dry biomass in the basis of p NPbetaG). LAB25g2 increased the final hydrolysis yield by a factor of 20% (44.5 ± 1.7% vs. 34.5 ± 1.5% in control conditions) after 96–120 h as compared to control reactions in its absence or in the presence of other commercial beta-glucosidase preparations. The high stability (half-life higher than 5 days at 50°C and pH 5.2) and 2–38000 fold higher (as compared with reported beta-glucosidases) activity towards cello-oligosaccharides may account for its performance in supplementation assays. Conclusions The results suggest that beta-glucosidases from yet uncultured bacteria from animal digestomes may be of a potential interest for biotechnological processes related to the effective bio-ethanol production in combination with low dosage of commercial cellulases

Esfuerzos mecánicos de origen electromagnético: caracterización del cortocircuito trifásico en sistemas de barras rígidas

Los efectos mecánicos de las corrientes de cortocircuito han sido tratados en el informe técnico Nro. 105, CIGRE, Comisión de Estudio B3; sin embargo, desde una perspectiva académica, se puede considerar que el estudio puede ampliarse para contemplar, por un lado, los aspectos de diseño de los equipos eléctricos y, por otro, los aspectos necesarios para preparar, montar y realizar pruebas para asegurar los procedimientos de fabricación. Este trabajo hace hincapié en la caracterización más básica del esfuerzo mecánico máximo que producen las corrientes de cortocircuito trifásicas, de forma que se muestre la influencia que tienen cada una de las variables que intervienen en el proceso.Facultad de Ingenierí

The Person, Interactions and Environment Programme to improve care of people with dementia in hospital: a multisite study

Background: Improving the care of people with dementia on acute hospital wards is a policy priority. Person-centred care is a marker of care quality; delivering such care is a goal of service improvement. Objectives: The Person, Interactions and Environment (PIE) Programme comprises an observation tool and a systematic approach to implement and embed a person-centred approach in routine care for hospitalised patients with dementia. The study aims were to evaluate PIE as a method to improve the care of older people with dementia on acute hospital wards, and develop insight into what person-centred care might look like in practice in this setting. Methods: We performed a longitudinal comparative case study design in 10 purposively selected wards in five trusts in three English regions, alongside an embedded process evaluation. Data were collected from multiple sources: staff, patients, relatives, organisational aggregate information and documents. Mixed methods were employed: ethnographic observation; interviews and questionnaires; patient case studies (patient observation and conversations ‘in the moment’, interviews with relatives and case records); and patient and ward aggregate data. Data were synthesised to create individual case studies of PIE implementation and outcomes in context of ward structure, organisation, patient profile and process of care delivery. A cross-case comparison facilitated a descriptive and explanatory account of PIE implementation in context, the pattern of variation, what shaped it and the consequences flowing from it. Quantitative data were analysed using simple descriptive statistics. A qualitative data analysis employed grounded theory methods. Results: The study furthered the understanding of the dimensions of care quality for older people with dementia on acute hospital wards and the environmental, organisational and cultural factors that shaped delivery. Only two wards fully implemented PIE, sustaining and embedding change over 18 months. The remaining wards either did not install PIE (‘non-implementers’) or were ‘partial implementers’. The interaction between micro-level contextual factors [aspects of leadership (drivers, facilitators, team, networks), fit with strategic initiatives and salience with valued goals] and meso- and macro-level organisational factors were the main barriers to PIE adoption. Evidence suggests that the programme, where implemented, directly affected improvements in ward practice, with a positive impact on the experiences of patients and caregivers, although the heterogeneity of need and severity of impairment meant that some of the more visible changes did not affect everyone equally. Limitations: Although PIE has the potential to improve the care of people with dementia when implemented, findings are indicative only: data on clinical outcomes were not systematically collected, and PIE was not adopted on most study wards. Research implications: Further research is required to identify more precisely the skill mix and resources necessary to provide person-focused care to hospitalised people with dementia, across the spectrum of need, including those with moderate and severe impairment. Implementing innovations to change practices in complex organisations requires a more in-depth understanding of the contextual factors that have an impact on the capacity of organisations to absorb and embed new practices

¿Tienen una personalidad distinta los adolescentes consumidores de psicoestimulantes?

El consumo de psicoestimulantes tiene una especial importancia en nuestro medio por su notable incremento entre los más jóvenes. El objetivo del presente estudio es determinar si hay diferencias entre menores de edad consumidores y no consumidores de psicoestimulantes (cocaína y éxtasis) en función de las características de personalidad evaluadas con el MACI. La muestra está formada por 398 jóvenes entre 14 y 17 años que fueron seleccionados con un muestreo aleatorio en los domicilios de los entrevistados y en lugares de ocio y diversión. Los resultados confirman la existencia de importantes diferencias en las características de personalidad de ambos. Los jóvenes que han consumido psicoestimulantes se caracterizan por tener los prototipos de personalidad Rebelde, Rudo, Oposicionista y Tendencia límite. Do adolescents who use stimulants have a different personality? Stimulant consumption is especially important in our context because its use has greatly increased in recent years. The aim of the present study is to analyze the differences between stimulant users and nonusers (under 18 years old) in personality characteristics assessed with the MACI. The sample comprises 398 youths between 14 and 17 years old who were selected through random sampling in their homes or in recreational night spots. Results show important differences in personality features between stimulant users and nonusers. Stimulant users are characterized by having unruly, forceful, oppositional and borderline-tendency personality prototypes

The incidence of psychotic disorders among migrants and minority ethnic groups in Europe: Findings from the multinational EU-GEI study

BackgroundIn Europe, the incidence of psychotic disorder is high in certain migrant and minority ethnic groups (hence: 'minorities'). However, it is unknown how the incidence pattern for these groups varies within this continent. Our objective was to compare, across sites in France, Italy, Spain, the UK and the Netherlands, the incidence rates for minorities and the incidence rate ratios (IRRs, minorities v. the local reference population).MethodsThe European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study was conducted between 2010 and 2015. We analyzed data on incident cases of non-organic psychosis (International Classification of Diseases, 10th edition, codes F20-F33) from 13 sites.ResultsThe standardized incidence rates for minorities, combined into one category, varied from 12.2 in Valencia to 82.5 per 100 000 in Paris. These rates were generally high at sites with high rates for the reference population, and low at sites with low rates for the reference population. IRRs for minorities (combined into one category) varied from 0.70 (95% CI 0.32-1.53) in Valencia to 2.47 (95% CI 1.66-3.69) in Paris (test for interaction: p = 0.031). At most sites, IRRs were higher for persons from non-Western countries than for those from Western countries, with the highest IRRs for individuals from sub-Saharan Africa (adjusted IRR = 3.23, 95% CI 2.66-3.93).ConclusionsIncidence rates vary by region of origin, region of destination and their combination. This suggests that they are strongly influenced by the social context