10 research outputs found

    Desarrollo de la gestión del proceso general de la manipulación de los medicamentos peligrosos en las unidades de hospitalización a domicilio

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    Objective: To identify associated hazards and to describe chemical risks arising from these in the process of handling of hazardous drugs (HD) in Home Hospitalization Units (HHU), as the initial phase of its risk assessment and which affect the security of healthcare professionals.Method: There was a consensus of experts (nominal group and documentary techniques) using a mixed method through two face-to-face rounds (meeting of participants and approval of proposals) and three masked rounds (review of the material on an individual basis). The analysis was applied to the field of home hospitalization and the stages of the process were designed using standardized graphical notation Business Process Modeling Notation.Results: It was obtained the specific flowchart for management and traceability of the HD, being characterized each of the phases of the general process, they were collected in a chart of stage management and operations of conservation, transportation and administration of HD in HHU, which served for the subsequent description of chemical hazards and exposure ways.Conclusions: The HD should be integrated in a standard management system in order to improve the safety of the patient and healthcare professionals, at the same time that the efficiency of resources are maximized and procedural incidents are minimized, ensuring the quality and the safety of the process of handling the HD on the HHU.It would be desirable, once the hazards have been identified, to carry out an assessment of the risks by following a systematic methodology and preventative approach that allows calibrating the probability of occurrence and severity of any adverse event.Objetivo: Identificar los peligros asociados y describir los riesgos químicos derivados de éstos, en el proceso de manipulación de los medicamentos peligrosos (MP) en las Unidades de Hospitalización a Domicilio (UHD), como fase inicial de su evaluación de riesgos y que afectan a la seguridad del profesional sanitario.Método: Se realizó un consenso de expertos (grupo nominal y técnicas documentales) utilizando un método mixto mediante dos rondas presenciales (reunión de los participantes y aprobación de propuestas) y tres rondas enmascaradas (revisión del material de forma individual). El análisis se aplicó al ámbito de la Hospitalización a Domicilio y las etapas del proceso se diseñaron mediante notación gráfica normalizada Business Process Modeling Notation.Resultados: Se obtuvo el diagrama de flujo específico para la gestión y trazabilidad de los MP, caracterizándose cada una de las fases del proceso general, recopiladas en un cuadro de gestión de etapas y operaciones de conservación, transporte y administración de MP en las unidades de hospitalización a domicilio, que sirvió para la posterior descripción de riesgos químicos y vías de exposición.Conclusiones: Los MP deben integrarse en un sistema normalizado de gestión con el fin de mejorar la seguridad del paciente y de los profesionales sanitarios, a la vez que se maximiza la eficiencia de los recursos y minimizan los incidentes procesales, garantizando la calidad y la seguridad del proceso de manipulación de MP en la UHD.Sería deseable, una vez se han identificado los peligros, llevar a cabo una evaluación de los riesgos siguiendo una metodología sistemática y de abordaje preventivo que permita calibrar la probabilidad de ocurrencia y la gravedad de cualquier suceso adverso

    Assessing the risk of using hazardous drugs in Hospital-at-Home Units: a big data study protocol.

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    Incluye versión en español e inglés[ES] Objetivo: Describir el protocolo del estudio para la instauración del control del proceso de los medicamentos peligrosos que asegure la calidad y su trazabilidad, mediante el análisis de riesgos, desarrollando e implantando una herramienta informatizada que, gracias a la utilización de técnicas de big data, permita conocer y auditar el conjunto del sistema de forma continua y dinámica. Método: Mediante los procesos de notación gráfica normalizada Business Process Model Notation se desarrollarán los flujogramas específicos que permitan conocer las etapas del proceso de los medicamentos peligrosos que determinen la trazabilidad total del sistema. Cada una de las etapas será recogida en los cuadros de gestión, donde a través de la probabilidad del suceso y su gravedad se calculará el índice de criticidad de cada punto de control que se determine, y se establecerán las medidas de control. A partir de los cuadros de gestión se desarrollará el soporte tecnológico para la captura de todos los datos que sean pertinentes al modelo. Para asegurar el control de la calidad del proceso se optará por agentes software cliente, que permitan en fases posteriores aplicar herramientas eficientes en el procesamiento de datos de modo automático. A partir de aproximaciones metodológicas del big data, y en particular del ámbito de machine learning, se desarrollarán algoritmos sobre el reposito rio de datos generado para poder obtener patrones que permitan mejorar los protocolos de aplicación. Por último, para asegurar el funcionamiento del proceso se realizará la verificación clínico-farmacéutica y la revisión completa, técnico-documental, de los sistemas de control y registro. Conclusiones: La generación del sistema de gestión de riesgos mediante tecnología móvil permitirá integrar los medicamentos peligrosos en un sistema normalizado, con el fin de mejorar la seguridad, calidad y trazabilidad del proceso de manipulación de los medicamentos peligrosos. [EN] Objective: This article describes a study protocol for the implementation of quality and traceability control in the hazardous  medication circuit through an analysis of risks and the development and  introduction of a Big Data-based software application aimed at performing  a continuous and dynamic audit of the whole system. Method: A standardized graphical modeling tool called Business Process Model Notation will be used to generate a detailed description of each of the stages in the hazardous medication circuit with a view to  ensuring full traceability of the system. The information on each stage will  be collected in a flowchart, which will be used -together with each event's likelihood of occurrence and severity- as a basis to calculate the  criticality index of the different control points established and to determine  any control measures that may be required. The flowcharts will  also be used to develop the technological support needed to capture  all such data as may be relevant to the model. Proper quality control of the process will be ensured by client software agents intended to allow  automatic applica tion of efficient data processing tools at the different  phases. In addition, Big Data methodologies, in particular machine  learning, will be used to develop algorithms based on the repository of  generated data to come up with patterns capable of improving the  protocols to be applied. Lastly, proper operation of the process will be  ensured by means of clinicalpharmaceutical verification and a full  technical-documentary review of control and registration systems. Conclusions: The development of a risk management system based on  mobile technology will allow integration of hazardous drugs into a standardized system, ensuring the safety, quality, and traceability of the hazardous medication handling process.Este trabajo cuenta con una ayuda del Instituto de Salud Carlos III de Madrid, España, mediante el Proyecto de Investigación en Salud con referencia PI16/00788.S

    Reducing capacity, chlorogenic acid content and biological activity in a collection of scarlet (Solanum aethiopicum) and gboma (S. macrocarpon) eggplants

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    Scarlet (Solanum aethiopicum) and gboma (S. macrocarpon) eggplants are important vegetables in Sub-Saharan Africa. Few studies have been made on these crops regarding the diversity of phenolic content and their biological activity. We have studied the reducing activity, the chlorogenic acid and other phenolic acid contents in a collection of 56 accessions of scarlet eggplant, including the four cultivated groups (Aculeatum, Gilo, Kumba, Shum) and the weedy intermediate S. aethiopicum-S. anguivi types, as well as in eight accessions of gboma eggplant, including the cultivated S. macrocarpon and its wild ancestor, S. dasyphyllum. A sample of the accessions evaluated in this collection has been tested for inhibition of nitric oxide (NO) using macrophage cell cultures. The results show that there is a great diversity in both crops for reducing activity, chlorogenic acid content and chlorogenic acid peak area (% of total phenolic acids). Heritability (H-2) for these traits was intermediate to high in both crops. In all samples, chlorogenic acid was the major phenolic acid and accounted for more than 50% of the chromatogram peak area. Considerable differences were found among and within groups for these traits, but the greatest values for total phenolics and chlorogenic acid content were found in S. dasyphyllum. In most groups, reducing activity was positively correlated (with values of up to 0.904 in the Aculeatum group) with chlorogenic acid content. Inhibition of NO was greatest in samples having a high chlorogenic acid content. The results show that both crops are a relevant source of chlorogenic acid and other phenolic acids. The high diversity found also indicates that there are good prospects for breeding new scarlet and gboma eggplant cultivars with improved content in phenolics and bioactive properties.This research has been partially funded by Ministerio de Economia y Competitividad and FEDER (Grant AGL2012-34213) and by Conselleria d'Educacio i Esport de la Generalitat Valenciana (Grant ACOMP/2014/191). Pietro Gramazio is grateful to Universitat Politecnica de Valencia for a predoctoral fellowship.Plazas Ávila, MDLO.; Prohens Tomás, J.; Cuñat, A.; Vilanova Navarro, S.; Gramazio, P.; Herraiz García, FJ.; Andújar Pérez, I. (2014). Reducing capacity, chlorogenic acid content and biological activity in a collection of scarlet (Solanum aethiopicum) and gboma (S. macrocarpon) eggplants. International Journal of Molecular Sciences. 15(10):17221-17241. https://doi.org/10.3390/ijms151017221S17221172411510PLAZAS, M., ANDÚJAR, I., VILANOVA, S., HURTADO, M., GRAMAZIO, P., HERRAIZ, F. J., & PROHENS, J. (2013). Breeding for Chlorogenic Acid Content in Eggplant: Interest and Prospects. Notulae Botanicae Horti Agrobotanici Cluj-Napoca, 41(1), 26. doi:10.15835/nbha4119036Soobrattee, M. A., Neergheen, V. S., Luximon-Ramma, A., Aruoma, O. I., & Bahorun, T. (2005). Phenolics as potential antioxidant therapeutic agents: Mechanism and actions. Mutation Research/Fundamental and Molecular Mechanisms of Mutagenesis, 579(1-2), 200-213. doi:10.1016/j.mrfmmm.2005.03.023Fresco, P., Borges, F., Diniz, C., & Marques, M. P. M. (2006). New insights on the anticancer properties of dietary polyphenols. Medicinal Research Reviews, 26(6), 747-766. doi:10.1002/med.20060Dai, J., & Mumper, R. J. (2010). Plant Phenolics: Extraction, Analysis and Their Antioxidant and Anticancer Properties. Molecules, 15(10), 7313-7352. doi:10.3390/molecules15107313Sato, Y., Itagaki, S., Kurokawa, T., Ogura, J., Kobayashi, M., Hirano, T., … Iseki, K. (2011). 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Evaluation of the Anti-inflammatory, Analgesic and Antipyretic Activities of the Natural Polyphenol Chlorogenic Acid. Biological & Pharmaceutical Bulletin, 29(11), 2236-2240. doi:10.1248/bpb.29.2236Stommel, J. R., & Whitaker, B. D. (2003). Phenolic Acid Content and Composition of Eggplant Fruit in a Germplasm Core Subset. Journal of the American Society for Horticultural Science, 128(5), 704-710. doi:10.21273/jashs.128.5.0704Whitaker, B. D., & Stommel, J. R. (2003). Distribution of Hydroxycinnamic Acid Conjugates in Fruit of Commercial Eggplant (Solanum melongenaL.) Cultivars. Journal of Agricultural and Food Chemistry, 51(11), 3448-3454. doi:10.1021/jf026250bProhens, J., Rodríguez-Burruezo, A., Raigón, M. D., & Nuez, F. (2007). Total Phenolic Concentration and Browning Susceptibility in a Collection of Different Varietal Types and Hybrids of Eggplant: Implications for Breeding for Higher Nutritional Quality and Reduced Browning. Journal of the American Society for Horticultural Science, 132(5), 638-646. doi:10.21273/jashs.132.5.638Prohens, J., Whitaker, B. D., Plazas, M., Vilanova, S., Hurtado, M., Blasco, M., … Stommel, J. R. (2013). Genetic diversity in morphological characters and phenolic acids content resulting from an interspecific cross between eggplant,Solanum melongena, and its wild ancestor (S. incanum). Annals of Applied Biology, 162(2), 242-257. doi:10.1111/aab.12017Lester, R. N. (1986). TAXONOMY OF SCARLET EGGPLANTS, SOLANUM AETHIOPICUM L. Acta Horticulturae, (182), 125-132. doi:10.17660/actahortic.1986.182.15Bukenya, Z. R., & Carasco, J. F. (1994). Biosystematic Study of Solanum Macrocarpon—S. Dasyphyllum Complex in Uganda and Relations with Solanum Linnaeanum. East African Agricultural and Forestry Journal, 59(3), 187-204. doi:10.1080/00128325.1994.11663195Polignano, G., Uggenti, P., Bisignano, V., & Gatta, C. D. (2009). Genetic divergence analysis in eggplant (Solanum melongena L.) and allied species. Genetic Resources and Crop Evolution, 57(2), 171-181. doi:10.1007/s10722-009-9459-6Plazas, M., Andújar, I., Vilanova, S., Gramazio, P., Herraiz, F. J., & Prohens, J. (2014). Conventional and phenomics characterization provides insight into the diversity and relationships of hypervariable scarlet (Solanum aethiopicum L.) and gboma (S. macrocarpon L.) eggplant complexes. Frontiers in Plant Science, 5. doi:10.3389/fpls.2014.00318Prohens, J., Plazas, M., Raigón, M. D., Seguí-Simarro, J. M., Stommel, J. R., & Vilanova, S. (2012). Characterization of interspecific hybrids and first backcross generations from crosses between two cultivated eggplants (Solanum melongena and S. aethiopicum Kumba group) and implications for eggplant breeding. Euphytica, 186(2), 517-538. doi:10.1007/s10681-012-0652-xMennella, G., Rotino, G. L., Fibiani, M., D’Alessandro, A., Francese, G., Toppino, L., … Lo Scalzo, R. (2010). 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    The wide-field, multiplexed, spectroscopic facility WEAVE : survey design, overview, and simulated implementation

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    Funding for the WEAVE facility has been provided by UKRI STFC, the University of Oxford, NOVA, NWO, Instituto de Astrofísica de Canarias (IAC), the Isaac Newton Group partners (STFC, NWO, and Spain, led by the IAC), INAF, CNRS-INSU, the Observatoire de Paris, Région Île-de-France, CONCYT through INAOE, Konkoly Observatory (CSFK), Max-Planck-Institut für Astronomie (MPIA Heidelberg), Lund University, the Leibniz Institute for Astrophysics Potsdam (AIP), the Swedish Research Council, the European Commission, and the University of Pennsylvania.WEAVE, the new wide-field, massively multiplexed spectroscopic survey facility for the William Herschel Telescope, will see first light in late 2022. WEAVE comprises a new 2-degree field-of-view prime-focus corrector system, a nearly 1000-multiplex fibre positioner, 20 individually deployable 'mini' integral field units (IFUs), and a single large IFU. These fibre systems feed a dual-beam spectrograph covering the wavelength range 366-959 nm at R ∼ 5000, or two shorter ranges at R ∼ 20,000. After summarising the design and implementation of WEAVE and its data systems, we present the organisation, science drivers and design of a five- to seven-year programme of eight individual surveys to: (i) study our Galaxy's origins by completing Gaia's phase-space information, providing metallicities to its limiting magnitude for ∼ 3 million stars and detailed abundances for ∼ 1.5 million brighter field and open-cluster stars; (ii) survey ∼ 0.4 million Galactic-plane OBA stars, young stellar objects and nearby gas to understand the evolution of young stars and their environments; (iii) perform an extensive spectral survey of white dwarfs; (iv) survey  ∼ 400 neutral-hydrogen-selected galaxies with the IFUs; (v) study properties and kinematics of stellar populations and ionised gas in z 1 million spectra of LOFAR-selected radio sources; (viii) trace structures using intergalactic/circumgalactic gas at z > 2. Finally, we describe the WEAVE Operational Rehearsals using the WEAVE Simulator.PostprintPeer reviewe

    The wide-field, multiplexed, spectroscopic facility WEAVE: Survey design, overview, and simulated implementation

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    WEAVE, the new wide-field, massively multiplexed spectroscopic survey facility for the William Herschel Telescope, will see first light in late 2022. WEAVE comprises a new 2-degree field-of-view prime-focus corrector system, a nearly 1000-multiplex fibre positioner, 20 individually deployable 'mini' integral field units (IFUs), and a single large IFU. These fibre systems feed a dual-beam spectrograph covering the wavelength range 366-959\,nm at R5000R\sim5000, or two shorter ranges at R20000R\sim20\,000. After summarising the design and implementation of WEAVE and its data systems, we present the organisation, science drivers and design of a five- to seven-year programme of eight individual surveys to: (i) study our Galaxy's origins by completing Gaia's phase-space information, providing metallicities to its limiting magnitude for \sim3 million stars and detailed abundances for 1.5\sim1.5 million brighter field and open-cluster stars; (ii) survey 0.4\sim0.4 million Galactic-plane OBA stars, young stellar objects and nearby gas to understand the evolution of young stars and their environments; (iii) perform an extensive spectral survey of white dwarfs; (iv) survey 400\sim400 neutral-hydrogen-selected galaxies with the IFUs; (v) study properties and kinematics of stellar populations and ionised gas in z<0.5z<0.5 cluster galaxies; (vi) survey stellar populations and kinematics in 25000\sim25\,000 field galaxies at 0.3z0.70.3\lesssim z \lesssim 0.7; (vii) study the cosmic evolution of accretion and star formation using >1>1 million spectra of LOFAR-selected radio sources; (viii) trace structures using intergalactic/circumgalactic gas at z>2z>2. Finally, we describe the WEAVE Operational Rehearsals using the WEAVE Simulator.Comment: 41 pages, 27 figures, accepted for publication by MNRA

    The wide-field, multiplexed, spectroscopic facility WEAVE: Survey design, overview, and simulated implementation

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    WEAVE, the new wide-field, massively multiplexed spectroscopic survey facility for the William Herschel Telescope, will see first light in late 2022. WEAVE comprises a new 2-degree field-of-view prime-focus corrector system, a nearly 1000-multiplex fibre positioner, 20 individually deployable 'mini' integral field units (IFUs), and a single large IFU. These fibre systems feed a dual-beam spectrograph covering the wavelength range 366−959\,nm at R∼5000, or two shorter ranges at R∼20000. After summarising the design and implementation of WEAVE and its data systems, we present the organisation, science drivers and design of a five- to seven-year programme of eight individual surveys to: (i) study our Galaxy's origins by completing Gaia's phase-space information, providing metallicities to its limiting magnitude for ∼3 million stars and detailed abundances for ∼1.5 million brighter field and open-cluster stars; (ii) survey ∼0.4 million Galactic-plane OBA stars, young stellar objects and nearby gas to understand the evolution of young stars and their environments; (iii) perform an extensive spectral survey of white dwarfs; (iv) survey ∼400 neutral-hydrogen-selected galaxies with the IFUs; (v) study properties and kinematics of stellar populations and ionised gas in z1 million spectra of LOFAR-selected radio sources; (viii) trace structures using intergalactic/circumgalactic gas at z>2. Finally, we describe the WEAVE Operational Rehearsals using the WEAVE Simulator

    Esclerosi múltiple: preguntes i respostes per a pacients i familiars

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    Ha colaborado en este proyecto el Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL).Este libro pretende resolver algunas dudas que plantea la Esclerosis Múltiple, mediante un formato de preguntas y respuestas que los autores de este libro (profesionales y especialistas multidisciplinares involucrados en el diagnóstico y tratamiento de la enfermedad) han intentado condensar en estas páginas. Trasladando de este modo los conocimientos y la experiencia acumulados. Este libro tiene algunas peculiaridades. La primera es que en su redacción y revisión han participado pacientes de la Asociación de Esclerosis Múltiple de Alicante (ADEMA) y de la Asociación Alicantina de Esclerosis Múltiple "Vega Baja" y ello ha ayudado a conseguir una redacción y contenido claro y conciso, sin tecnicismos innecesarios, pero de gran aplicación y contenido científico clínico. La segunda peculiaridad es que, al ser la Comunidad Valenciana, donde vivimos, una comunidad plurilingüe, este libro tiene versiones en castellano y en valenciano. La tercera peculiaridad es que el libro no tiene patrocinio de la industria farmacéutica y ninguno de los autores ha recibido remuneración por su contribución. Conscientes de que los conocimientos y los tratamientos sobre la enfermedad van cambiando con el tiempo, se intentará actualizarlo periódicamente y tras esta edición de mayo de 2017. Se estructura en los siguientes capítulos: 1) ¿Qué es la esclerosis múltiple i por qué se produce?; 2) Los síntomas de la enfermedad; 3) Diagnóstico; 4) Tratamiento; 5) Tratamiento rehabilitador y sintomático; 6) Dolor y Esclerosis Múltiple; 7) Aspectos emocionales en la Esclerosis Múltiple; 8) La Esclerosis Múltiple y la mujer; 9) Mi vida día día; 10) Actividad física y ejercicio; 11) Ármate de valor.Aquest llibre pretén resoldre alguns dubtes que planteja l'Esclerosi Múltiple, mitjançant un format de preguntes i respostes que els autors d'aquest llibre (professionals i especialistes multidisciplinaris involucrats en el diagnòstic i tractament de la malaltia) han intentat condensar en aquestes pàgines. Traslladant d'aquesta manera els coneixements i l'experiència acumulats. Aquest llibre té algunes peculiaritats. La primera és que en la seua redacció i revisió han participat pacients de l'Associació d'Esclerosi Múltiple d'Alacant (ADEMA) i de l'Associació Alacantina d'Esclerosi Múltiple "Vega Baixa" i això ha ajudat a aconseguir una redacció i contingut clar i concís, sense tecnicismes innecessaris, però de gran aplicació i contingut científic clínic. La segona peculiaritat és que, en ser la Comunitat Valenciana, on vivim, una comunitat plurilingüe, aquest llibre té versions en castellà i en valencià. La tercera peculiaritat és que el llibre no té patrocini de la indústria farmacèutica i cap dels autors ha rebut remuneració per la seua contribució. Conscients que els coneixements i els tractaments sobre la malaltia van canviant amb el temps, s'intentarà actualitzar-lo periòdicament i després d'aquesta edició de maig de 2017. S'estructura en els següents capítols: 1) Què és l'esclerosi múltiple i per què es produeix?; 2) Els símptomes de la malaltia; 3) Diagnòstic; 4) Tractament; 5) Tractament rehabilitador i simptomàtic; 6) Dolor i Esclerosi Múltiple; 7) Aspectes emocionals en l'Esclerosi Múltiple; 8) L'Esclerosi Múltiple i la dona; 9) La meua vida dia dia; 10) Activitat física i exercici; 11) Arma't de valor

    Grado de implementación de las estrategias preventivas del síndrome post-UCI: estudio observacional multicéntrico en España

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    The wide-field, multiplexed, spectroscopic facility WEAVE: Survey design, overview, and simulated implementation

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    International audienceWEAVE, the new wide-field, massively multiplexed spectroscopic survey facility for the William Herschel Telescope, will see first light in late 2022. WEAVE comprises a new 2-degree field-of-view prime-focus corrector system, a nearly 1000-multiplex fibre positioner, 20 individually deployable 'mini' integral field units (IFUs), and a single large IFU. These fibre systems feed a dual-beam spectrograph covering the wavelength range 366-959 nm at R ~ 5000, or two shorter ranges at R ~ 20 000. After summarising the design and implementation of WEAVE and its data systems, we present the organisation, science drivers and design of a five- to seven-year programme of eight individual surveys to: (i) study our Galaxy's origins by completing Gaia's phase-space information, providing metallicities to its limiting magnitude for ~3 million stars and detailed abundances for ~1.5 million brighter field and open-cluster stars; (ii) survey ~0.4 million Galactic-plane OBA stars, young stellar objects and nearby gas to understand the evolution of young stars and their environments; (iii) perform an extensive spectral survey of white dwarfs; (iv) survey ~400 neutral-hydrogen-selected galaxies with the IFUs; (v) study properties and kinematics of stellar populations and ionised gas in z 1 million spectra of LOFAR-selected radio sources; (viii) trace structures using intergalactic/circumgalactic gas at z > 2. Finally, we describe the WEAVE Operational Rehearsals using the WEAVE Simulator
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