Validación lingüística de la versión española del Good Death Inventory

This article outlines the linguistic validation of the Good Death Inventory (GDI) translation into Spanish, used to assess the quality of care at the end of a patient’s life. A standardized procedure was followed to do this that included a blind back translation process and an exploration of the conceptual adaptation of the scale into Spanish through six cognitive interviews with relatives of deceased patients. The translation of the scale (54 items) showed indicators of low difficulty. Six items required syntactic changes, 12 required semantic changes and only one item required syntactic and semantic changes. All items were considered applicable to the Spanish context. The degree of difficulty was higher for the back translation than for the translation itself. The cognitive interviews highlighted the difficulty of choosing between seven answers, especially those that were formulated as negative. Five items were difficult to understand. The Spanish version of the GDI has been adapted well to the Spanish context.Este artículo presenta la validación lingüística española del Good Death Inventory (GDI), para la evaluación de la calidad de los cuidados al final de la vida. Se llevó a cabo un proceso estandarizado de traducción y retrotraducción ciegas y se examinó la adecuación conceptual de la escala al contexto español a través de seis entrevistas cognitivas a familiares de pacientes fallecidos. La traducción de la escala (54 ítems) mostró indicadores de dificultad bajos. Seis ítems precisaron cambios sintácticos, 12 cambios semánticos y sólo un ítem precisó cambios sintácticos y semánticos. Todos los ítems fueron considerados aplicables al contexto español. El grado de dificultad de la retrotraducción fue superior al de la traducción. Las entrevistas cognitivas mostraron dificultad para discriminar entre las siete alternativas de respuesta, especialmente en los ítems formulados en negativo. Cinco ítems presentaron dificultades de comprensión. La versión española del GDI presenta una buena adecuación al contexto español

Knowledge and attitudes of health professionals towards advance directives

Objetivo: Evaluar el grado de conocimiento y las actitudes sobre el documento de voluntades anticipadas (DVA) del personal médico y de enfermería de dos departamentos sanitarios, así como examinar su asociación con variables sociodemográficas y laborales de los profesionales. Método: Se realizó una encuesta transversal a 329 profesionales a través de Internet y mediante un procedimiento estandarizado. Se examinaron los conocimientos y las actitudes hacia el DVA utilizando dos cuestionarios validados de 17 y 12 ítems, respectivamente. Se recogieron datos sociodemográficos y profesionales. Resultados: El 45% fueron médicos/as, con una media de 13,1 (desviación típica [DT]: 8,3) años de experiencia profesional. El 67,5% fueron mujeres, con una edad media de 38,9 (DT: 9,2) años. Tuvieron actitudes muy positivas hacia el documento (media: 75,37; DT: 11,97; R = 0-90), a pesar de que su nivel de conocimientos fue medio-bajo (media: 9,31; DT: 2,73; R = 0-18). Tanto el nivel de conocimientos como su autopercepción se asociaron a la formación previa en cuidados paliativos, a la experiencia en el manejo del documento, su lectura o la demanda de información. La suscripción del documento se relacionó con la autopercepción de los conocimientos. Las actitudes se asociaron con la experiencia en el manejo y la actitud positiva hacia la formación. Conclusiones: Los/las profesionales mostraron actitudes positivas hacia el DVA, pero escasos conocimientos sobre el mismo. La experiencia con el DVA fue la única variable que se asoció tanto a los conocimientos como a las actitudes de los profesionales.Objective: To evaluate the degree of knowledge and attitudes of medical and nursing professionals in two health departments to advance directives, as well as to examine their association with the sociodemographic and occupational variables of the professionals. Methods: A cross-sectional survey on 329 health professionals was carried out through the internet and a standardised procedure. The knowledge and attitudes of the professionals about advance directives were examined using two validated questionnaires of 17 and 12 items, respectively. Sociodemographic and professional data were also collected from the participants. Results: 45% of the professionals were physicians, with X = 13, 1 (SD: 8.3) years of professional experience. Sixty-seven point five percent were women and the mean age was 38.9 (SD: 9.2) years. Professionals had very positive attitudes towards the advance directives document (X = 75.37;SD:11.97;R = 0-90), although their level of knowledge about them was medium-low (X = 9.31;SD: 2.73;R = 0-18). Both the level of knowledge and self-perception were associated with previous training in palliative care, experience with document management, reading, or the demand for information. Completing the document related to self-perception of knowledge. Attitudes towards the document related to experience in its use and a positive attitude toward training. Conclusions: The professionals showed positive attitudes towards the advance directive document although low knowledge about it. Experience with the document was the only variable associated with both the knowledge and the attitudes of the professionals

EVALUATING FUNGI INDOOR PRESENCE IN HOMES THROUGH VIABLE AND NON-VIABLE SAMPLING

Moulds are common and important allergens. They are more abundant outdoors but patients affected by mould allergy stay indoors much longer than outdoors. So, indoor sampling could help to assess the influence of the concentration of allergens in allergic symptoms. The aim of this study was to assess the relative efficiencies of two air sampling methods, viable and non viable, for the quantification of airborne indoor fungi in the homes of patients sensitized to Alternaria. Furthermore, outdoor sampling was carried out to compare results. Samples were taken over six months in Badajoz (SW Spain). Two houses were selected according to the presence of allergic patients to Alternaria. They were sampled once a month using both viable and non viable personal samplers at solar noon. A Burkard personal sampler was used to record spores and a Sampl’air AES Chemunex sampler was used for colonies. Three rooms were selected in each home: living room, kitchen and bathroom. Temperature and relative humidity were registered at each sample. Outdoor sampling was performed one day per week at the Faculty of Science, using a seven day Burkard sampler for spores and the same personal sampler for colonies. On average, 200-300 CFU/ m3 were found from more than 40 taxa identified. The highest number of colonies was recorded in the kitchen, then in the bathroom and finally in the living room. Nevertheless, there were minor differences between rooms. The houses studied showed a similar temporal pattern, with maximum values in December and minimum in January. Cladosporium colonies showed statistical differences between homes, but these differences were not found with Alternaria, Aspergillus or Penicillium colonies. Differences between rooms appeared for Alternaria colonies and Cladosporium herbarium spores. Temperature was positively correlated in most cases and relative humidity negatively with Alternaria spores. The number of spores collected was as twice as that of colonies, with an average concentration between 600-700 colonies/m3 , and nearly 1400 spores/m3 as maximum concentration. The temporal pattern of spores was similar to that found for colonies. Comparing colonies to spores, Alternaria and AspergillusPenicillium showed similar values. Notwithstanding, Cladosporium spores were nearly five times more abundant than colonies. The advantage of viable methods is the identification to species level, but they have the disadvantage that spores from some ubiquitous species, as Cladosporium, do not always grow in those media, which raises the interest to use additional non-viable methods

Las competencias básicas de los alumnos de primer curso de la Facultad de Educación, según la percepción docente y discente : Propuestas de intervención para la mejora

Memoria ID2019/063. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2019-2020

Saúde ambiental de parques espanhóis: Abordagem ao potencial alergénico dos espaços verdes urbanos

Urban parks are green infrastructure elements that should contribute to improving the quality of life and well-being of citizens. In this work there are presented the results of applying a new index to estimate the potential allergenicity of parks located in 20 Spanish cities. This index, which considers intrinsic biological and biometric parameters of existing plant species in parks, allows the allergenic risk thereof to be calculated on a scale ranging from 0 to 1, depending on whether to the park’s allergenicity is zero or has a high risk for the population. The parks selected for this study have different typologies, sizes, species richness and biodiversities, which has yielded highly variable index values. Almost half of the analysed parks have an index value higher than 0.30, a threshold considered having a moderate to high risk, and therefore, enough to cause allergy symptoms in the population. Conversely, most of the parks had an index value below this threshold, so that the risk of suffering allergies is low or very low. The formula also allows the species that most contribute to the resulting value for allergenicity to be known, which are those having an anemophilous strategy of pollination, extended periods of flowering, and a referenced high allergenicity. These requirements are met by all species of the Betulaceae, Cupressaceae and Moraceae families, and to a lesser extent by Oleaceae and Platanaceae. It can be concluded that the development of an index to estimate the allergenicity of urban green spaces constitutes a useful tool to minimize the impact of pollen allergy on the population.Los parques urbanos son elementos de la infraestructura verde que deben contribuir a mejorar la calidad de vida y el bienestar ciudadano. En este trabajo se presentan los resultados de la aplicación de un novedoso índice que estima la alergenicidad potencial de las zonas verdes urbanas. Este índice, que contempla parámetros biológicos y biométricos intrínsecos a las especies arbóreas existentes en los parques, genera un resultado cuyo valor está comprendido entre 0 y 1 según el potencial alergénico del parque sea nulo o de riesgo alto para la población. En una primera fase el índice se ha aplicado a parques de diferente tipología, diseño, tamaño, riqueza específica y biodiversidad ubicados en 20 ciudades españolas. Los resultados han mostrado que algunos de los parques estudiados registran un valor de índice superior a 0.30, umbral suficiente para causar síntomas de alergia a la población expuesta, y por tanto, de riesgo moderado o alto. Por el contrario, en la mayoría de los parques se obtuvo un valor inferior a este umbral. También es posible conocer cuáles son las especies que más contribuyen al valor resultante, que son aquellas con estrategia de polinización anemófila, periodos de oración extensos y alta alergenicidad referenciada. Estos requisitos los cumplen todas las especies de las familias Betuláceas, Cupresáceas y Moráceas, y en menor extensión, Oleáceas y Platanáceas. Puede concluirse que el desarrollo de un índice de estimación de alergenicidad de espacios verdes urbanos constituye una herramienta de utilidad para minimizar el impacto de la alergia polínica en la población.Os parques urbanos são elementos da infraestrutura verde que devem contribuir para a melhoria da qualidade de vida dos cidadãos. Neste trabalho apresentam-se os resultados da aplicação de um índice inovador, que permite estimar a alergenicidade potencial dos espaços verdes urbanos. Este índice, que inclui parâmetros biológicos e biométricos, intrínsecos às próprias espécies existentes nos parques, tem como resultado um valor numa escala entre 0 e 1, de acordo com o potencial alergénico do parque, caso este seja, respetivamente e nos seus extremos, nulo ou de máximo risco para as populações. O índice foi aplicado em parques de diferentes tipologias, desenho, tamanho, riqueza específica e biodiversidade, situados em 20 cidades espanholas. Os resultados demonstram que alguns dos parques estudados registam um valor de índice superior a 0.30, limite su ciente para causar sintomas de alergia na população exposta, e por tanto, risco moderado a alto. No entanto, a maioria dos parques apresenta um valor inferior a este limite. Também é possível conhecer quais as espécies que mais contribuem para o valor do índice, que correspondem aquelas com a estratégia de polinização anemófila, períodos de oração extensos e potencial alergénico referenciado. Estes requisitos são aplicáveis a todas as espécies das famílias Betuláceas, Cupressáceas e Moráceas, e em menor medida, Oleáceas e Platanáceas. Pode assim concluir-se que a aplicação de um índice de previsão dos níveis de alergenicidade dos espaços verdes urbanos constitui uma ferramenta útil para minimizar o impacto da alergia polínica sobre a população

Saúde ambiental de parques espanhóis: Abordagem ao potencial alergénico dos espaços verdes urbanos

Los parques urbanos son elementos de la infraestructura verde que deben contribuir a mejorar la calidad de vida y el bienestar ciudadano. En este trabajo se presentan los resultados de la aplicación de un novedoso índice que estima la alergenicidad potencial de las zonas verdes urbanas. Este índice, que contempla parámetros biológicos y biométricos intrínsecos a las especies arbóreas existentes en los parques, genera un resultado cuyo valor está comprendido entre 0 y 1 según el potencial alergénico del parque sea nulo o de riesgo alto para la población. En una primera fase el índice se ha aplicado a parques de diferente tipología, diseño, tamaño, riqueza específica y biodiversidad ubicados en 20 ciudades españolas. Los resultados han mostrado que algunos de los parques estudiados registran un valor de índice superior a 0,30, umbral suficiente para causar síntomas de alergia a la población expuesta, y por tanto, de riesgo moderado o alto. Por el contrario, en la mayoría de los parques se obtuvo un valor inferior a este umbral. También es posible conocer cuáles son las especies que más contribuyen al valor resultante, que son aquellas con estrategia de polinización anemófila, periodos de floración extensos y alta alergenicidad referenciada. Estos requisitos los cumplen todas las especies de las familias Betuláceas, Cupresáceas y Moráceas, y en menor extensión, Oleáceas y Platanáceas. Puede concluirse que el desarrollo de un índice de estimación de alergenicidad de espacios verdes urbanos constituye una herramienta de utilidad para minimizar el impacto de la alergia polínica en la población.Urban parks are green infrastructure elements that should contribute to improving the quality of life and well-being of citizens. In this work there are presented the results of applying a new index to estimate the potential allergenicity of parks located in 20 Spanish cities. This index, which considers intrinsic biological and biometric parameters of existing plant species in parks, allows the allergenic risk thereof to be calculated on a scale ranging from 0 to 1, depending on whether to the park’s allergenicity is zero or has a high risk for the population. The parks selected for this study have different typologies, sizes, species richness and biodiversities, which has yielded highly variable index values. Almost half of the analysed parks have an index value higher than 0.30, a threshold considered having a moderate to high risk, and therefore, enough to cause allergy symptoms in the population. Conversely, most of the parks had an index value below this threshold, so that the risk of suffering allergies is low or very low. The formula also allows the species that most contribute to the resulting value for allergenicity to be known, which are those having an anemophillous strategy of pollination, extended periods of flowering, and a referenced high allergenicity. These requirements are met by all species of the Betulaceae, Cupressaceae and Moraceae families, and to a lesser extent by Oleaceae and Platanaceae. It can be concluded that the development of an index to estimate the allergenicity of urban green spaces constitutes a useful tool to minimize the impact of pollen allergy on the population.Os parques urbanos são elementos da infraestrutura verde que devem contribuir para a melhoria da qualidade de vida dos cidadãos. Neste trabalho apresentam-se os resultados da aplicação de um índice inovador, que permite estimar a alergenicidade potencial dos espaços verdes urbanos. Este índice, que inclui parâmetros biológicos e biométricos, intrínsecos às próprias espécies existentes nos parques, tem como resultado um valor numa escala entre 0 e 1, de acordo com o potencial alergénico do parque, caso este seja, respetivamente e nos seus extremos, nulo ou de máximo risco para as populações. O índice foi aplicado em parques de diferentes tipologias, desenho, tamanho, riqueza específica e biodiversidade, situados em 20 cidades espanholas. Os resultados demonstram que alguns dos parques estudados registam um valor de índice superior a 0,30, limite suficiente para causar sintomas de alergia na população exposta, e por tanto, risco moderado a alto. No entanto, a maioria dos parques apresenta um valor inferior a este limite. Também é possível conhecer quais as espécies que mais contribuem para o valor do índice, que correspondem aquelas com a estratégia de polinização anemófila, períodos de floração extensos e potencial alergénico referenciado. Estes requisitos são aplicáveis a todas as espécies das famílias Betuláceas, Cupressáceas e Moráceas, e em menor medida, Oleáceas e Platanáceas. Pode assim concluir-se que a aplicação de um índice de previsão dos níveis de alergenicidade dos espaços verdes urbanos constitui uma ferramenta útil para minimizar o impacto da alergia polínica sobre a população.peerReviewe

Environmental health of Spanish parks: An approach to the allergenic potential of urban green spaces

Los parques urbanos son elementos de la infraestructura verde que deben contribuir a mejorar la calidad de vida y el bienestar ciudadano. En este trabajo se presentan los resultados de la aplicación de un novedoso índice que estima la alergenicidad potencial de las zonas verdes urbanas. Este índice, que contempla parámetros biológicos y biométricos intrínsecos a las especies arbóreas existentes en los parques, genera un resultado cuyo valor está comprendido entre 0 y 1 según el potencial alergénico del parque sea nulo o de riesgo alto para la población. En una primera fase el índice se ha aplicado a parques de diferente tipología, diseño, tamaño, riqueza específica y biodiversidad ubicados en 20 ciudades españolas. Los resultados han mostrado que algunos de los parques estudiados registran un valor de índice superior a 0,30, umbral suficiente para causar síntomas de alergia a la población expuesta, y por tanto, de riesgo moderado o alto. Por el contrario, en la mayoría de los parques se obtuvo un valor inferior a este umbral. También es posible conocer cuáles son las especies que más contribuyen al valor resultante, que son aquellas con estrategia de polinización anemófila, periodos de floración extensos y alta alergenicidad referenciada. Estos requisitos los cumplen todas las especies de las familias Betuláceas, Cupresáceas y Moráceas, y en menor extensión, Oleáceas y Platanáceas. Puede concluirse que el desarrollo de un índice de estimación de alergenicidad de espacios verdes urbanos constituye una herramienta de utilidad para minimizar el impacto de la alergia polínica en la población.Urban parks are green infrastructure elements that should contribute to improving the quality of life and well-being of citizens. In this work there are presented the results of applying a new index to estimate the potential allergenicity of parks located in 20 Spanish cities. This index, which considers intrinsic biological and biometric parameters of existing plant species in parks, allows the allergenic risk thereof to be calculated on a scale ranging from 0 to 1, depending on whether to the park’s allergenicity is zero or has a high risk for the population. The parks selected for this study have different typologies, sizes, species richness and biodiversities, which has yielded highly variable index values. Almost half of the analysed parks have an index value higher than 0.30, a threshold considered having a moderate to high risk, and therefore, enough to cause allergy symptoms in the population. Conversely, most of the parks had an index value below this threshold, so that the risk of suffering allergies is low or very low. The formula also allows the species that most contribute to the resulting value for allergenicity to be known, which are those having an anemophillous strategy of pollination, extended periods of flowering, and a referenced high allergenicity. These requirements are met by all species of the Betulaceae, Cupressaceae and Moraceae families, and to a lesser extent by Oleaceae and Platanaceae. It can be concluded that the development of an index to estimate the allergenicity of urban green spaces constitutes a useful tool to minimize the impact of pollen allergy on the population.Os parques urbanos são elementos da infraestrutura verde que devem contribuir para a melhoria da qualidade de vida dos cidadãos. Neste trabalho apresentam-se os resultados da aplicação de um índice inovador, que permite estimar a alergenicidade potencial dos espaços verdes urbanos. Este índice, que inclui parâmetros biológicos e biométricos, intrínsecos às próprias espécies existentes nos parques, tem como resultado um valor numa escala entre 0 e 1, de acordo com o potencial alergénico do parque, caso este seja, respetivamente e nos seus extremos, nulo ou de máximo risco para as populações. O índice foi aplicado em parques de diferentes tipologias, desenho, tamanho, riqueza específica e biodiversidade, situados em 20 cidades espanholas. Os resultados demonstram que alguns dos parques estudados registam um valor de índice superior a 0,30, limite suficiente para causar sintomas de alergia na população exposta, e por tanto, risco moderado a alto. No entanto, a maioria dos parques apresenta um valor inferior a este limite. Também é possível conhecer quais as espécies que mais contribuem para o valor do índice, que correspondem aquelas com a estratégia de polinização anemófila, períodos de floração extensos e potencial alergénico referenciado. Estes requisitos são aplicáveis a todas as espécies das famílias Betuláceas, Cupressáceas e Moráceas, e em menor medida, Oleáceas e Platanáceas. Pode assim concluir-se que a aplicação de um índice de previsão dos níveis de alergenicidade dos espaços verdes urbanos constitui uma ferramenta útil para minimizar o impacto da alergia polínica sobre a população.S

Consensus recommendations on organization of care for individuals with Phelan-McDermid syndrome

The manifestations of Phelan-McDermid syndrome (PMS) are complex, warranting expert and multidisciplinary care in all life stages. In the present paper we propose consensus recommendations on the organization of care for individuals with PMS. We indicate that care should consider all life domains, which can be done within the framework of the International Classification of Functioning, Disability and Health (ICF). This framework assesses disability and functioning as the outcome of the individual's interactions with other factors. The different roles within care, such as performed by a centre of expertise, by regional health care providers and by a coordinating physician are addressed. A surveillance scheme and emergency card is provided and disciplines participating in a multidisciplinary team for PMS are described. Additionally, recommendations are provided for transition from paediatric to adult care. This care proposition may also be useful for individuals with other rare genetic neurodevelopmental disorders.</p