Algunas cuestiones pendientes

La lectura de los diferentes artículos que componen este número monográfico sobre vacunas, ya permite intuir la gran amplitud de este campo de la medicina, la importancia que han tenido desde su introducción, y seguirán teniendo las vacunas, así como algunos de los interrogantes que se abren en el futuro. Se ha conseguido la erradicación de una enfermedad, la viruela (de la que dejó de vacunarse en los años 80) , y se puede conseguir en un plazo corto-medio la erradicación de otras enfermedades, como la poliomielitis, el sarampión o la rubéola congénita . En nuestro medio, la declaración de la OMS en junio de 2002, de la "Zona Europea de la OMS libre de polio", permitió a las autoridades sanitarias tomar la decisión de modificar el calendario vacunal sistemático, de forma que a partir de 2004 dejó de administrarse la vacuna oral atenuada, sustituyéndose por la vacuna parenteral inactivada. De este modo se ha eliminado la circulación del virus vacunal, y con ello el riesgo de la poliomielitis postvacunal, una reacción adversa muy poco frecuente pero muy grave. El "Plan Nacional para la eliminación del sarampión" iniciado en el año 2000, combinando varias estrategias simultáneas como la vigilancia epidemiológica, el estudio de casos y la vacunación de los contactos, ha permitido reducir el número de casos de sarampión y conocer la procedencia de los virus, que en la mayoría de los casos actuales no son autóctonos Este cambio epidemiológico ha implicado también algunos cambios en las recomendaciones vacunales a determinados grupos en riesgo, sobre todo adultos e inmigrantes

Usefulness of feedback in e-learning from the students' perspective

Purpose: Functionality of feedback in pedagogical processes has been broadly analyzed in face-to-face learning, although to a lesser extent than in the on-line learning. Narciss (2004, 2008) distinguishes two dimensions within the feedback, the semantic dimension and the structural dimension. This article aims to analyze, from the students' perspective, the semantic dimension of feedback in a virtual learning environment (VLE). Firstly, we analyze the importance that VLE students give to feedback and its degree of personalization. Later, the usefulness that students deem feedback should have, paying special attention to each of its semantic subdimensions (Narciss, 2004). Design/methodology/approach: A survey was conducted among students of Business Administration degree of the Universitat Oberta de Catalunya (UOC). 182 students took part, separated into two groups (pilot and control). Findings: It has been proved that 90% of students give a great or very great importance to reception of feedback from their tutors, a relevance they consider to be higher than the one within a face-to-face environment. This percentage is around 75% with regard to the importance given to the level of personalization of feedback. The development of a factor analysis has revealed that usefulness of personalized feedback perceived by the students can be subsumed under two large dimensions: the one that facilitates learning (related to its semantic dimension) and the motivational one (by allowing an easier and more fluid communication with the tutor, contributing not to leave the course, etc.) The latter dimension has been also proved to be key in order to attain improvements in the students' satisfaction with the learning process. This research was funded by the Catalan government and the UOC, within the framework of projects to Improve Teaching Quality (ITQ). Originality/value: Implementing personalized feedback has a relevant impact on the student, who values it because it makes his learning process easier, richer and more significant. Moreover, it has a clear motivational effect over the student, which had not been sufficiently evidenced by other researches. Such effect needs not to be underestimated, particularly within an on-line environment, where dropout rate is usually high

Usefulness of feedback in e-learning from the students' perspective

Functionality of feedback in pedagogical processes has been broadly analyzed in face-to-face learning, although to a lesser extent than in the on-line learning. Narciss (2004, 2008) distinguishes two dimensions within the feedback, the semantic dimension and the structural dimension. This article aims to analyze, from the student's perspective, the semantic dimension of feedback in a virtual learning environment (VLE). Firstly, we analyze the importance that VLE students give to feedback and its degree of personalization. Later, the usefulness that students deem feedback should have, paying special attention to each of its semantic subdimensions (Narciss, 2004)

Dynamics of suspended sediment borne persistent organic pollutants in a large regulated Mediterranean river (Ebro, NE Spain)

Mediterranean rivers are characterized by highly variable hydrological regimes that are strongly dependent on the seasonal rainfall. Sediment transport is closely related to the occurrence of flash-floods capable to deliver enough kinetic energy to mobilize the bed and channel sediments. Contaminants accumulated in the sediments are likely to be mobilized as well during such events. However, whereas there are many studies characterizing contaminants in steady sediments, those devoted to the transport dynamics of suspended-sediment borne pollution are lacking. Here we examined the occurrence and transport of persistent organic microcontaminants present in the circulating suspended sediments during a controlled flushing flow in the low part of the River Ebro (NE Spain) 12km downstream of a well-known contaminated hot-spot associated to a nearby chloro-alkali industry. Polycyclic aromatic hydrocarbons (PAHs) and semi-volatile organochlorine pollutants (DDT and related compounds, DDX; polychlorinated byphenils, PCBs; and other organochlorine compound, OCs) were measured in the particulate material by GC-MS and GC-MS/MS, using previously developed analytical methods. The concentration levels observed were compared to previously reported values in steady sediments in the same river and discussed on a regulatory perspective. Hydrographs and sedigraphs recorded showed a peak-flow of 1300m3s-1 and a corresponding peak of suspended sediments of 315mgL-1. Combination of flow discharge, suspended sediments and pollutants' concentrations data allowed for quantifying the mass flows (mass per unit of time) and setting the load budgets (weight amount) of the different pollutants transported by the river during the monitored event. Mean mass-flows and total load values found were 20.2mgs-1 (400g) for PAHs, 38mgs-1 (940g) for DDX, 44mgs-1 (1038g) for PCBs and 8mgs-1 (200g) for OCs. The dynamic pattern behavior of PAHs differs substantially to that of organochlorine pollutants, thus reflecting different pollution origins.This work was supported by the Spanish Ministry of Economy and Competitiveness through the Consolider-Ingenio 2010 project SCARCE (CSD2009-00065) and by the Generalitat de Catalunya (Consolidated Research Group: Water and Soil Quality Unit 2009-SGR-965). The research leading to these results has received funding from the European Comunities 7th Framework Programme under Grant Agreement No. 603629-ENV-2013-6.2.1-Globaqua.Peer reviewe

Guia tècnica per a la campanya de vacunació antigripal estacional 2013: campanya 2013-2014

Grip estacional; Vacunació antigripal; CatalunyaGripe estacional; Vacunación antigripal; CataluñaSeasonal influenza; Influenza vaccination; CataloniaAquest document és una actualització de la Guia tècnica per a la campanya de vacunació antigripal estacional 2012. Pretén aportar les dades necessàries per tal que el personal sanitari que ha d’intervenir en la campanya tingui la informació bàsica suficient sobre la vacunació antigripal i, en conseqüència, faci una utilització òptima de les vacunes

Psychometric Properties of the Clinical Assessment of Prosocial Emotions Version 1.1 (CAPE 1.1) in Young Males Who Were Incarcerated

This research was financially supported by the Centre d'Estudis Jurídics i Formació Especialitzada, Generalitat de Catalunya (DOGC Núm. 7024-23.12.05; DOGC Núm. 7274 - 27/12/16)The Clinical Assessment of Prosocial Emotions: Version 1.1 (CAPE 1.1) uses structured clinical judgments to diagnose the "with limited prosocial emotions" specifier for Conduct Disorder. This study examined (a) the internal consistency and interrater agreement, and (b) the convergent and divergent validity of the CAPE 1.1 in 72 young males who were incarcerated in two Spanish juvenile detention centers (age range = 14-22 years). The CAPE 1.1 showed good interrater agreement for making the diagnosis of the specifier and adequate internal consistency. The CAPE 1.1 was associated with other measures of callous-unemotional traits, but less consistently associated with other dimensions of psychopathy. Youth who met diagnostic criteria for the specifier scored higher on externalizing problems, but did not differ from other youth who were incarcerated on internalizing problems. These results provide preliminary support for the psychometric properties of the CAPE 1.1 for the clinical assessment of the specifier

Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level

Ecuador assumed the commitment of including Palliative Care (PC) in its health policies. In 2014, the Ministry of Public Health (Ministerio de Salud Pública, MSP) approved the Clinical Practice Guide for Palliative Care (Guía de Práctica Clínica sobre Cuidados Paliativos, GPCCP), with application at the national level, as a mandatory internal regulation in all institutions belonging to the National Health System. In 2021, there is no evidence about the degree of implementation. The objective was to evaluate the implementation (I) of the GPCCP guide and the knowledge (C) of the health personnel working in the Zone 7 Health Centers (HCs). This is a cross-sectional, descriptive, and prospective study. A total of 292 professionals were interviewed: managers (38), physicians (150), and nurses (104). Three surveys based on the GPCCP guide were elaborated: one for the implementation, which was applied to the individuals in charge, and the others to assess the health professionals’ knowledge. The SPSS program was used, version 25. In the three groups, more than half of the participants had no training in PC, 91.2% of the HCs have the GPCCP guide, there is PC medical history (MH) in 38.2%, and morphine is used in 14.7%. The implementation of the GPCCP guide was inadequate in 52.9% of the cases. Only 25% treat the agony symptoms and 30%, delirium; 4.4% acknowledge the use of morphine in dyspnea, and 13.3% identify the subcutaneous route as the first choice for hydration at the end-of-life phase. Strategies to implement the GPCCP guide and to improve the health personnel’s knowledge must be implemented in Zone 7 centers