Factores y estrategias en la implantación del Servicio de Indicación Farmacéutica en farmacia comunitaria

El Servicio de Indicación Farmacéutica (SIF) es el servicio profesional a través del cual el farmacéutico atiende la consulta de los pacientes sobre un síntoma menor con el fin de obtener un remedio adecuado. Requiere de una actuación protocolizada y conlleva una elevada responsabilidad por parte del farmacéutico. INDICA+PRO es un proyecto realizado desde 2017 para evaluar el impacto y la implantación del SIF en la farmacia comunitaria española. Este artículo evalúa la implantación del SIF en una única farmacia. En la etapa de implantación del SIF a través de INDICA+PRO se detectaron factores de implantación (barreras y facilitadores) para los que se utilizaron una serie de estrategias. Como parte de la implementación se propusieron estrategias como destacar las ventajas del SIF para la farmacia, realizar incentivos por la prestación del servicio o la distribución de tareas dentro del equipo. Entre los facilitadores se encontró la disponibilidad de la zona de atención personalizada, la buena relación con los centros de salud cercanos y la realización de otros servicios profesionales en la farmacia. Las ventajas obtenidas por la realización del SIF obtenidas siguiendo el procedimiento protocolizado, dentro del programa SEFAC eXPERT®, establecido fueron, entre otras, la mejora en el seguimiento del paciente, el incremento en la comunicación del equipo y con el paciente facilitado por el historial farmacoterapéutico de la farmacia y la elaboración de informes estandarizados.Minor ailment service (MAS) is a professional pharmacy service assisting patients to manage minor ailments. MAS involves a structured consultation process with protocols which delineate professional practice. INDICA+PRO is a project, started in 2017, which evaluates the impact and subsequently implementation of MAS in Spanish community pharmacies. This paper reports on the experience of implementing the service in a single pharmacy. Implementation factors (barriers and facilitators) were detected and a series of strategies were developed and used as part of the implementation program of MAS through a practice program, INDICA+PRO. The implementation strategies, such as highlighting the advantages of MAS for the pharmacy, incentives for the provision of the service and/or the distribution of tasks within the team were used to overcome barriers. Facilitators included the availability of a consultation room in the pharmacy, good relationships with nearby health centers and the provision of other professional services in the pharmacy. The advantages obtained from MAS, following the inclusion in the software (SEFAC eXPERT®) of the agreed protocols and clinical information, were improved patient follow-up, increased communication within the team and with patients, the pharmacy having a clinical history of the minor ailments and the ability of being able to prepare standardized report

Implementation of a project-based learning to the coordination of subjects in the Agrifood and Rural Engineering Bachelor

The Bachelor’s Degree in Agrifood and Rural Engineering at Universitat Jaume I of Castelló has implemented in the second academic year a multidisciplinary project using a Project-Based Learning as the teaching method. Its final purpose is the acquisition of skills that should help the students to cope with their future career. This teaching-learning system has been used for three consecutive years since the degree was firstly implemented. Once a particular farm is assigned, the students are organized in groups and must fulfill their assigned tasks in a collaborative manner with the final goal of developing a project on that farm including viable improvements of the exploitation, taking into account the issues related to the different subjects involved. This work presents the results obtained along the three years, analyzed from two different points of view: student satisfaction and learning outcomes. Besides, the proposals for improvement of the weaknesses identified during the process are presented. The results show that the used method has promoted the acquisition of the competences proposed. Moreover the multidisciplinary approach has led to better results in the student performance than those obtained by students enrolled in an unidisciplinary project. Although improvement actions have solved some of the problems detected, there are still some weaknesses, mainly related to team working and tutorials that should be addressed in the future.El grado de Ingeniería Agroalimentaria y del Medio Rural de la Universitat Jaume I de Castelló viene aplicando en su segundo curso un proyecto multidisciplinar usando el Aprendizaje Basado en Proyectos como recurso docente en el que se pretende que los estudiantes adquieran competencias que les ayuden a enfrentarse a su futuro profesional. Este sistema de enseñanza-aprendizaje se ha llevado a cabo durante los tres cursos que está implantado el grado. Una vez asignado un tipo de explotación agrícola concreta y utilizando las herramientas del trabajo en equipo, los estudiantes deben ser capaces de desarrollar un proyecto sobre la explotación con propuestas de mejora que sean factibles y que abarquen aspectos relacionados con las diferentes disciplinas implicadas, aplicando los conocimientos adquiridos en éstas. El presente trabajo incluye los resultados obtenidos durante los tres años del proyecto desde dos puntos de vista importantes: la satisfacción del estudiante y los resultados de aprendizaje. Además se presentan las propuestas de mejora aplicadas en cada curso como respuesta a las debilidades detectadas durante el proceso. Los resultados demuestran que el método utilizado ha favorecido la adquisición de las competencias propuestas. Además, el enfoque multidisciplinar ha propiciado mejores resultados que los alcanzados por los estudiantes que realizaron trabajos unidisciplinares. Por otro lado, aunque las acciones de mejora han permitido solventar algunos de los problemas detectados, siguen persistiendo carencias, sobre todo a nivel de trabajo en equipo y de tutorización, que se proponen como mejoras para el futuro

Phylogeny and phylogeography of a recent HIV-1 subtype F outbreak among men who have sex with men in Spain deriving from a cluster with a wide geographic circulation in Western Europe

This work received support from the Dirección General de Farmacia, Ministerio de Sanidad, Servicios Sociales e Igualdad, Government of Spain, grant EC11-272; European Network of Excellence EUROPRISE (Rational Design of HIV Vaccines and Microbicides), grant LSHP-CT-2006-037611; European Research Infrastructures for Poverty Related Diseases (EURIPRED). Seventh Framework Programme: FP7-Capacities-infrastructures-2012-1, grant agreement 312661; Instituto de Salud Carlos III, Subdirección General de Evaluación, and Fondo Europeo de Desarrollo Regional (FEDER), Plan Nacional I + D + I, through project RD12/0017/0026; Consellería de Sanidade, Government of Galicia, Spain (MVI 1291/08); and the Osakidetza-Servicio Vasco de Salud, Basque Country, Spain (MVI-1255-08). Marcos Pérez-Losada was supported by a DC D-CFAR Research Award from the District of Columbia Developmental Center for AIDS Research (P30AI087714) and by an University Facilitating Fund award from George Washington University. Aurora Fernández-García is supported by CIBER in Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain.We recently reported the rapid expansion of an HIV-1 subtype F cluster among men who have sex with men (MSM) in the region of Galicia, Northwest Spain. Here we update this outbreak, analyze near full-length genomes, determine phylogenetic relationships, and estimate its origin. For this study, we used sequences of HIV-1 protease-reverse transcriptase and env V3 region, and for 17 samples, near full-length genome sequences were obtained. Phylogenetic analyses were performed via maximum likelihood. Locations and times of most recent common ancestors were estimated using Bayesian inference. Among samples analyzed by us, 100 HIV-1 F1 subsubtype infections of monophyletic origin were diagnosed in Spain, including 88 in Galicia and 12 in four other regions. Most viruses (n = 90) grouped in a subcluster (Galician subcluster), while 7 from Valladolid (Central Spain) grouped in another subcluster. At least 94 individuals were sexually-infected males and at least 71 were MSM. Seventeen near full-length genomes were uniformly of F1 subsubtype. Through similarity searches and phylogenetic analyses, we identified 18 viruses from four other Western European countries [Switzerland (n = 8), Belgium (n = 5), France (n = 3), and United Kingdom (n = 2)] and one from Brazil, from samples collected in 2005?2011, which branched within the subtype F cluster, outside of both Spanish subclusters, most of them corresponding to recently infected individuals. The most probable geographic origin and age of the Galician subcluster was Ferrol, Northwest Galicia, around 2007, while the Western European cluster probably emerged in Switzerland around 2002. In conclusion, a recently expanded HIV-1 subtype F cluster, the largest non-subtype B cluster reported in Western Europe, continues to spread among MSM in Spain; this cluster is part of a larger cluster with a wide geographic circulation in diverse Western European countries.Publisher PDFPeer reviewe

Analysis of shared heritability in common disorders of the brain

ience, this issue p. eaap8757 Structured Abstract INTRODUCTION Brain disorders may exhibit shared symptoms and substantial epidemiological comorbidity, inciting debate about their etiologic overlap. However, detailed study of phenotypes with different ages of onset, severity, and presentation poses a considerable challenge. Recently developed heritability methods allow us to accurately measure correlation of genome-wide common variant risk between two phenotypes from pools of different individuals and assess how connected they, or at least their genetic risks, are on the genomic level. We used genome-wide association data for 265,218 patients and 784,643 control participants, as well as 17 phenotypes from a total of 1,191,588 individuals, to quantify the degree of overlap for genetic risk factors of 25 common brain disorders. RATIONALE Over the past century, the classification of brain disorders has evolved to reflect the medical and scientific communities' assessments of the presumed root causes of clinical phenomena such as behavioral change, loss of motor function, or alterations of consciousness. Directly observable phenomena (such as the presence of emboli, protein tangles, or unusual electrical activity patterns) generally define and separate neurological disorders from psychiatric disorders. Understanding the genetic underpinnings and categorical distinctions for brain disorders and related phenotypes may inform the search for their biological mechanisms. RESULTS Common variant risk for psychiatric disorders was shown to correlate significantly, especially among attention deficit hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder (MDD), and schizophrenia. By contrast, neurological disorders appear more distinct from one another and from the psychiatric disorders, except for migraine, which was significantly correlated to ADHD, MDD, and Tourette syndrome. We demonstrate that, in the general population, the personality trait neuroticism is significantly correlated with almost every psychiatric disorder and migraine. We also identify significant genetic sharing between disorders and early life cognitive measures (e.g., years of education and college attainment) in the general population, demonstrating positive correlation with several psychiatric disorders (e.g., anorexia nervosa and bipolar disorder) and negative correlation with several neurological phenotypes (e.g., Alzheimer's disease and ischemic stroke), even though the latter are considered to result from specific processes that occur later in life. Extensive simulations were also performed to inform how statistical power, diagnostic misclassification, and phenotypic heterogeneity influence genetic correlations. CONCLUSION The high degree of genetic correlation among many of the psychiatric disorders adds further evidence that their current clinical boundaries do not reflect distinct underlying pathogenic processes, at least on the genetic level. This suggests a deeply interconnected nature for psychiatric disorders, in contrast to neurological disorders, and underscores the need to refine psychiatric diagnostics. Genetically informed analyses may provide important "scaffolding" to support such restructuring of psychiatric nosology, which likely requires incorporating many levels of information. By contrast, we find limited evidence for widespread common genetic risk sharing among neurological disorders or across neurological and psychiatric disorders. We show that both psychiatric and neurological disorders have robust correlations with cognitive and personality measures. Further study is needed to evaluate whether overlapping genetic contributions to psychiatric pathology may influence treatment choices. Ultimately, such developments may pave the way toward reduced heterogeneity and improved diagnosis and treatment of psychiatric disorders

Factores y estrategias en la implantación del Servicio de Indicación Farmacéutica en farmacia comunitaria

El Servicio de Indicación Farmacéutica (SIF) es el servicio profesional a través del cual el farmacéutico atiende la consulta de los pacientes sobre un síntoma menor con el fin de obtener un remedio adecuado. Requiere de una actuación protocolizada y conlleva una elevada responsabilidad por parte del farmacéutico. INDICA+PRO es un proyecto realizado desde 2017 para evaluar el impacto y la implantación del SIF en la farmacia comunitaria española. Este artículo evalúa la implantación del SIF en una única farmacia. En la etapa de implantación del SIF a través de INDICA+PRO se detectaron factores de implantación (barreras y facilitadores) para los que se utilizaron una serie de estrategias. Como parte de la implementación se propusieron estrategias como destacar las ventajas del SIF para la farmacia, realizar incentivos por la prestación del servicio o la distribución de tareas dentro del equipo. Entre los facilitadores se encontró la disponibilidad de la zona de atención personalizada, la buena relación con los centros de salud cercanos y la realización de otros servicios profesionales en la farmacia. Las ventajas obtenidas por la realización del SIF obtenidas siguiendo el procedimiento protocolizado, dentro del programa SEFAC eXPERT®, establecido fueron, entre otras, la mejora en el seguimiento del paciente, el incremento en la comunicación del equipo y con el paciente facilitado por el historial farmacoterapéutico de la farmacia y la elaboración de informes estandarizados

El periódico escolar como recurso para la comunicación, la participación y la animación a la lectura

Con este proyecto se pone en marcha una publicación cuatrimestral elaborada con aportaciones de todos los alumnos del centro. En esta revista escolar tienen cabida todos los sectores de la comunidad educativa para informar a las familias y para anunciar las actividades que se realizan en el centro. Entre los objetivos está el que los alumnos se sientan motivados en su trabajo diario por la posibilidad de que alguno de sus trabajos sea publicado en el periódico escolar. Además, con la publicación se pretende fomentar la observación y la creatividad entre los alumnos, que estos desarrollen el hábito lector, que valoren los trabajos de los compañeros y dar a conocer a toda la comunidad educativa las actividades que se desarrollan en el centro. Esta actividad también es muy positiva para fomentar la colaboración de los padres a través de la asociación de madres y padres de alumnos. El periódico está compuesto de secciones como creación literaria que recoge escritos de alumnos; un libro, un amigo, que contiene reseñas de libros que los alumnos recomiendan a sus compañeros; nuestro mundo; galería de arte; aprender con el periódico, donde se recogen trabajos de investigación de los alumnos; actividades dentro del centro; pasatiempos; entrevistas; una sección en inglés y otra de música. La publicación es maquetada y diseñada por los profesores. Adjunta un ejemplar del periódico.Madrid (Comunidad Autónoma). Consejería de Educación. Dirección General de Ordenación AcadémicaMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

The artistic heritage of the Faculty of Fine Arts as a model of analysis and study in the training of artists. Redesign and enhancement of the gabinets and collections

A lo largo de la historia las colecciones artísticas de la Facultad de Bellas Artes han servido como modelos de análisis y estudio en la formación de los artistas. A día de hoy contamos con un importante patrimonio que queremos dar a conocer.Throughout history, the art collections of the Faculty of Fine Arts have served as models of analysis and study in the training of artists. Today we have an important heritage that we want to make known.Fac. de Bellas ArtesFALSEVicerrectorado de Calidad UCMsubmitte

Cova del Rinoceront (Castelldefels, Barcelona): a terrestrial record for the Last Interglacial period (MIS 5) in the Mediterranean coast of the Iberian Peninsula

The Cova del Rinoceront, a site in NE Iberia, contains a thick sedimentary fill preserving a faunal archive from the penultimate glacial and the the last interglacial periods. Layers I to III have been dated to between 74 and 147 ka, coinciding with MIS 5a to 5e, a period poorly represented in the Mediterranean terrestrial record. The results from Cova del Rinoceront are of broader interest for the reconstruction of ecological dynamics during warm stages and the understanding of the evolution and geographical variation of several taxa. The palaeoecological evidence suggests a landscape dominated by mixed wooded vegetation with mild climatic conditions, slightly more humid than today. Several vertebrate taxa, including Haploidoceros mediterraneus, Stephanorhinus hundsheimensis and Glis glis, are documented for the first time in the early Upper Pleistocene of Europe, showing that these species persisted across the region for longer than previously thought. In addition, the recovery of a small lithic assemblage indicates human presence in the surroundings of the site. The 11 m-thick stratigraphic section also provides an ideal setting in which to compare several geochronological methods. UeTh dating of the flowstones that cap the deposit, of speleothems formed along the cave walls, and of speleothems buried by the deposit at different elevations provides minimum and maximum ages of 74 and 175 ka, respectively, for the accumulation. The ages obtained by luminescence, electron spin resonance (ESR), amino acid racemisation (AAR), palaeomagnetism and U-series dating of bone are in good agreement with each other and are stratigraphically consistent. This well-dated faunal succession presents a unique opportunity to assess changes in the Pleistocene fauna of the Mediterranean coast over an interval of more than 100 ka

Distribution of viruses of the subtype F cluster sequenced by us according to city of sample collection.

<p>Distribution of viruses of the subtype F cluster sequenced by us according to city of sample collection.</p