Problemas de salud y factores determinantes del número de visitas a demanda en pacientes hiperutilizadores de un centro de salud

ObjetivosDescribir las características sociodemográficas y problemas de salud que presentan los pacientes hiperconsultadores de un centro de salud y determinar los factores que explican el número de visitas solicitadas en consulta demanda del médico de familia.DiseñoDescriptivo, retrospectivo. Análisis multivariante: regresión lineal múltiple.EmplazamientoCentro de salud urbano.PacientesPacientes que han solicitado cita para consulta demanda en el centro de salud en al menos nueve ocasiones durante 1999 (n = 7.852). Muestra aleatoria de 386 pacientes (alfa, 0,05; precisión, 95%).Mediciones y resultados principalesVariable dependiente: número de consultas demanda solicitadas en 1999. Variables independientes: edad, tamaño familiar, zona residencia, activo o pensionista, inclusión en programas, problemas de salud (CIAP-2), número de fármacos en prescripción repetida (clasificación anatómica), incapacidad laboral temporal (IT). Los hiperconsultadores son un 57,8% (IC, 52,9-62,7%) mujeres; edad media, 55 años (DE, 18,5); tamaño familiar, 2,7 miembros (DE, 1,457); 58,8% pensionistas; número medio de citas, 15 (DE, 6,7); consumo medio, 1,58 (DE, 2,46) fármacos de forma habitual; inclusión en programas: 37,7%, hipertensión; 16%, diabetes; 17%, dislipemia; 16%, consulta de enfermería. Patologías más prevalentes: cardiocirculatorias (43,8%), endocrinometabólicas (32%), traumatológicas (26,7%) y salud mental (21%). El modelo de regresión incluye las variables edad, número de fármacos y haber estado en IT.ConclusionesLos hiperconsultadores de nuestro centro de salud son mujeres de edad media con problemas de salud física de evolución crónica y problemas de salud mental. El número de visitas está relacionado con la edad y las necesidades administrativas: medicación y bajas.ObjectivesTo describe the social and demographic characteristics and health problems of over-users of a health centre and to determine the number of attendances requested on demand at the general medical clinic.DesignRetrospective and descriptive. Multivariate analysis: multiple linear regression.SettingUrban health centre.PatientsPatients who requested a consultation at the health centre on at least nine occasions in 1999 (N = 7852). Random sample of 386 patients (alpha 0.05, 95% accuracy).Measurements and main resultsDependent variable: number of on-demand consultations requested in 1999. Independent variables: age, family size, area of residence, active or pensioner, inclusion in programmes, health problems (CIAP-2), number of drugs on repeat prescription (Anatomical Classification), short-term time off work. 57% of over-users were women (CI, 52.9-62.7%); mean age 55 (SD 18.5); family size 2.7 members (SD 1.457); 58.8% pensioners. Mean number of appointments 15 (SD 6.7). Mean habitual consumption of 1.58 medicines (SD 2.46). Inclusion in programmes: 37.7% hypertension, 16% diabetes, 17% dyslipaemia, 16% nursing clinic. Most prevalent pathologies: cardiocirculatory (43.8%), endocrino-metabolic (32%), traumatology (26.7%) and mental health (21%). The regression model included the variables of age, number of medicines and having had short-term time off.ConclusionsOver-users of our health centre are middle-aged women with chronic physical health problems and with mental health problems. The number of attendances is related to age and administrative requirements: medication and sick notes

Benefits of probiotic administration on growth and performance along metamorphosis and weaning of Senegalese sole (Solea senegalensis)

Suitable nutrition at first feeding in marine fish larvae is an important factor for successful larval and juvenile rearing. In this way probiotic supplementation may contribute to better face the habitual stress of metamorphosis and weaning at early sole stages. The aimof this study was to optimize Shewanella putrefaciens Pdp11 administration to Senegalese sole (Solea senegalensis) at early stages of development. For this purpose, we studied the influence of a short pulse of S. putrefaciens Pdp11 (10–30 dah) on growth performance, gut microbiota modulation, digestive enzymes activities and body composition. These probiotic bacteria were incorporated using Artemia as live vector (2.5 × 10 7 cfu mL −1 ) and supplied to sole specimens in a co-feeding regime (Gemma, Skretting) by triplicate. S. putrefaciens Pdp11 colonized larval gut being present from23 to 119 dah. Probiotic supply significantly modulated larval and fry gut microbiota. A PCA analysis including all the parameters analyzed strongly associated S. putrefaciens Pdp11 presence with a higher fish growth, a higher digestive proteolytic activity level and a fish body composition modulation along S. senegalensis rearing. In addition less size variability was obtained frommetamorphosis until the end of weaning. In conclusion a short pulse of S. putrefaciens Pdp11 (10– 30 dah) seems sufficient to obtain a suitable microbial modulation involved in a better growth performance and body composition that suggests a great potential for sole aquaculture production.En prens

Why fly blind? Event-based visual guidance for ornithopter robot flight

Under licence Creative Commons - Green Open Access (IEEE).The development of perception and control methods that allow bird-scale flapping-wing robots (a.k.a. ornithopters) to perform autonomously is an under-researched area. This paper presents a fully onboard event-based method for ornithopter robot visual guidance. The method uses event cameras to exploit their fast response and robustness against motion blur in order to feed the ornithopter control loop at high rates (100 Hz). The proposed scheme visually guides the robot using line features extracted in the event image plane and controls the flight by actuating over the horizontal and vertical tail deflections. It has been validated on board a real ornithopter robot with real-time computation in low-cost hardware. The experimental evaluation includes sets of experiments with different maneuvers indoors and outdoors.Consejo Europeo de Investigación (ERC) 78824

Progetti partecipativi per la (ri)costruzione collettiva della Vega de Granada come territorio agricolo periurbano

The impaired condition of agriculture, and of periurban agricultural areas in particular, necessarily requires a switch in the direction imposed by the contemporary metropolitan model, using the opportunities offered by social participation, meant as territorial government ruled by citizenship, as turning point. On the basis of this statement, the Granada metropolitan area, and in particular the irrigated plane (la Vega) that gives it sense and landscape identity, is approached through participatory projects trying to identify conflicts, values and perspectives of a sustainable future for these territories.La situazione deteriorata dell’agricoltura e, in particolare, degli spazi agricoli periurbani, implica la necessità di un cambio di direzione, rispetto a quella imposta dal modello metropolitano contemporaneo, che parta dalle opportunità offerte dalla partecipazione sociale intesa come governo del territorio da parte della cittadinanza. Sulla base di questa premessa si affronta l’area metropolitana di Granada e, in particolare, la piana irrigua che le conferisce senso e identità paesistica (la Vega) utilizzando progetti partecipativi finalizzati all’identificazione dei conflitti, dei valori e delle prospettive di un futuro sostenibile per questo territorio

Database of spatial distribution of non indigenous species in Spanish marine waters

Research in marine Spanish waters are focused on several actions to achieve an effectively management on protected areas, with the active participation of the stakeholders and research as basic tools for decision-making. Among these actions, there is one about the knowledge and control on NIS. One of its objectives is the creation of NIS factsheets, which are going to be added to the National Marine Biodiversity Geographical System (GIS) providing complementary information about taxonomic classification, common names, taxonomic synonyms, species illustrations, identification morphological characters, habitat in the native and introduced regions, biological and ecological traits, GenBank DNA sequences, world distribution, first record and evolution in the introduced areas, likely pathways of introduction, effects in the habitats and interaction with native species, and potential management measures to apply. The database will also provide data for (1) the European online platforms, (2) the environmental assessment for the Descriptor 2 (D2-NIS) of the EU Marine Strategy Framework Directive (MSFD), as well as (3) supporting decisions made by stakeholders. It is the result of extensive collaboration among scientist, manager’s and citizen science in the Spanish North-Atlantic, South-Atlantic, Gibraltar Strait-Alboran, Levantine-Balearic and Canary Islands marine divisions, providing an updated overview of the spatial distribution of relevant extended and invasive NIS of recent and established NIS introduced by maritime transport and aquaculture pathways, as well as on cryptogenic or native species in expansion due to the climatic water warming trend

A tumor-targeted trimeric 4-1BB-agonistic antibody induces potent anti-tumor immunity without systemic toxicity

The costimulation of immune cells using first-generation anti-4-1BB monoclonal antibodies (mAbs) has demonstrated anti-tumor activity in human trials. Further clinical development, however, is restricted by significant off-tumor toxicities associated with Fc gamma R interactions. Here, we have designed an Fc-free tumor-targeted 4-1BB-agonistic trimerbody, 1D8(N)/(C)EGa1, consisting of three anti-4-1BB single-chain variable fragments and three anti-EGFR single-domain antibodies positioned in an extended hexagonal conformation around the collagen XVIII homotrimerization domain. The1D8(N)/(C)EGa1 trimerbody demonstrated high-avidity binding to 4-1BB and EGFR and a potent in vitro costimulatory capacity in the presence of EGFR. The trimerbody rapidly accumulates in EGFR-positive tumors and exhibits anti-tumor activity similar to IgG-based 4-1BB-agonistic mAbs. Importantly, treatment with 1D8(N)/(C)EGa1 does not induce systemic inflammatory cytokine production or hepatotoxicity associated with IgG-based 4-1BB agonists. These results implicate Fc gamma R interactions in the 4-1BB-agonist-associated immune abnormalities, and promote the use of the non-canonical antibody presented in this work for safe and effective costimulatory strategies in cancer immunotherapy

Measurement of the View the tt production cross-section using eμ events with b-tagged jets in pp collisions at √s = 13 TeV with the ATLAS detector

This paper describes a measurement of the inclusive top quark pair production cross-section (σtt¯) with a data sample of 3.2 fb−1 of proton–proton collisions at a centre-of-mass energy of √s = 13 TeV, collected in 2015 by the ATLAS detector at the LHC. This measurement uses events with an opposite-charge electron–muon pair in the final state. Jets containing b-quarks are tagged using an algorithm based on track impact parameters and reconstructed secondary vertices. The numbers of events with exactly one and exactly two b-tagged jets are counted and used to determine simultaneously σtt¯ and the efficiency to reconstruct and b-tag a jet from a top quark decay, thereby minimising the associated systematic uncertainties. The cross-section is measured to be: σtt¯ = 818 ± 8 (stat) ± 27 (syst) ± 19 (lumi) ± 12 (beam) pb, where the four uncertainties arise from data statistics, experimental and theoretical systematic effects, the integrated luminosity and the LHC beam energy, giving a total relative uncertainty of 4.4%. The result is consistent with theoretical QCD calculations at next-to-next-to-leading order. A fiducial measurement corresponding to the experimental acceptance of the leptons is also presented

Search for TeV-scale gravity signatures in high-mass final states with leptons and jets with the ATLAS detector at sqrt [ s ] = 13TeV

A search for physics beyond the Standard Model, in final states with at least one high transverse momentum charged lepton (electron or muon) and two additional high transverse momentum leptons or jets, is performed using 3.2 fb−1 of proton–proton collision data recorded by the ATLAS detector at the Large Hadron Collider in 2015 at √s = 13 TeV. The upper end of the distribution of the scalar sum of the transverse momenta of leptons and jets is sensitive to the production of high-mass objects. No excess of events beyond Standard Model predictions is observed. Exclusion limits are set for models of microscopic black holes with two to six extra dimensions