170 research outputs found

    Efectividad de las actividades preventivas a los 8 años de su introducción en una consulta de medicina general de un centro de salud

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    ObjetivoPrincipal: valorar la modificación del riesgo coronario (RC) en pacientes adultos tras 8 años de su incorporación al Programa Actividades Preventivas y Promoción Salud (PAPPS). Secundario: determinar nivel de vacunación antitetánica alcanzado y cumplimiento de actividades.DiseñoEstudio de intervención sin asignación aleatoria «antes-después».EmplazamientoUna consulta de medicina general de un centro de salud.PacientesUn total de 429 pacientes (204 varones, 225 mujeres) de 30-65 años seguidos durante 8 años, captados por búsqueda activa de casos en la consulta diaria.IntervencionesDeterminación de tensión arterial, colesterol, peso, tabaquismo, ingesta etílica, estado vacunal antitetánico, cálculo del RC a los 10 años según Framinghan y grado de cumplimiento de actividades. Estas variables se determinaron al inicio, a los 4 y a los 8 años. Datos obtenidos de la historia clínica.ResultadosPoblación total: a los 8 años descenso del RC, 0,8 (IC diferencia, 0,4-1,2), equivalente al 8,5% del inicial. Incremento obtenido de la vacunación antitetánica correcta del 64,4% (IC diferencia, 59,9-69%). Cumplimiento actividades al inicio y al octavo año: tensión, 100%, 71%; consumo tabaco, 99,5%, 71%; determinación colesterol, 89%, 64%. Subgrupo RC inicial alto: a los 8 años descenso del RC, 6,7 (IC diferencia, 4,9-8,5), equivalente al 24,8% del inicial.ConclusionesEn la población total el descenso del RC obtenido no es clínicamente significativo, mientras que en el subgrupo con RC inicial alto el descenso sí lo ha sido. Probablemente debería hacerse búsqueda activa de los pacientes con RC alto y actuar sobre ellos.ObjectivesMain: to assess the change in coronary risk (CR) in adults after 8 years of their involvement in the Programme of Preventive Activities and Health Promotion (PAPPS). Secondary: to determine the level of anti-tetanus vaccination reached and patients' compliance with activities.Design«Before and after» intervention study without random allocation.SettingA general medical clinic at a health centre.Patients429 patients (204 men, 225 women) between 30 and 65 monitored for 8 years, recruited by active search for cases at daily consultations.InterventionsBlood pressure, cholesterol, weight, tobacco habit, alcohol intake, anti-tetanus vaccination state, CR calculation at 10 years on the Framingham scale, and degree of compliance with activities were all determined at the start, at 4 years and at 8 years. Data was obtained from the clinical notes.ResultsTotal population: a 0.8 drop in CR (CI difference: 0.4-1.2), equivalent to 8.5% of the initial figure. 64.4% increase in correct anti-tetanus vaccination (CI difference: 59.9-69). Compliance with activities at the start and after eight years: pressure 100%, 71%; tobacco consumption 99.5%, 71%; cholesterol determination 89%, 64%. Initially high CR sub-group: 6.7 drop of CR at 8 years (CI difference: 4.9-8.5), equivalent to 24.8% of the initial figure.ConclusionsIn the total population, the CR drop found was not clinically significant, whereas in the initially high CR sub-group the drop was. There should probably be an active search made for patients with high CR and action taken on them

    MADNESS: A Multiresolution, Adaptive Numerical Environment for Scientific Simulation

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    MADNESS (multiresolution adaptive numerical environment for scientific simulation) is a high-level software environment for solving integral and differential equations in many dimensions that uses adaptive and fast harmonic analysis methods with guaranteed precision based on multiresolution analysis and separated representations. Underpinning the numerical capabilities is a powerful petascale parallel programming environment that aims to increase both programmer productivity and code scalability. This paper describes the features and capabilities of MADNESS and briefly discusses some current applications in chemistry and several areas of physics

    Low body condition predisposes cattle to lameness: An 8-year study of one dairy herd

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    Lameness in dairy cows is a multifactorial and progressive disease with complex interactions between risk factors contributing to its occurrence. Detailed records were obtained from one United Kingdom dairy herd over an 8-yr period. Weekly locomotion scores were used to classify cows as not lame (score 1 to 2), mildly lame (score 3) and severely lame (score 4 to 5). These outcomes were used to investigate the hypothesis that low body condition score (BCS) is associated with an increased risk of lameness in dairy cows. Mixed effect multinomial logistic regression models were used to investigate the association between prior BCS and repeat lameness events during the longitudinal period of the study. Discrete time survival models were used to explore the relationship between prior BCS and first lifetime lameness events. In total, 79,565 cow weeks at risk were obtained for 724 cows. The number of lameness events was 17,114, of which 8,799 were categorized as mildly lame and 8,315 as severely lame. The median BCS was 2.25 (range, 0.75 to 4.25) and the mean body weight (BW) and age at first calving were 619.5 kg (range, 355.6 to 956.4 kg) and 25.8 mo (range, 20.5 to 37.8 mo), respectively. Subsets of the data were used in the discrete time survival models: 333 mild and 211 severe first lifetime lameness events in heifers (first lactation cows), and 81 mild and 49 severe first lifetime lameness events in cows second lactation or greater. Low BCS 3 wk before a repeated lameness event was associated with a significantly increased risk of lameness. Cows with BCS <2 were at greatest risk of mild or severe lameness, and an increased BCS above 2 was associated with a reduced risk of mild or severe lameness. Low BCS 16 or 8 wk before a first mild or severe lifetime lameness event, respectively, also had a positive association with risk of lameness in cows second lactation or greater. This provides evidence to support targeting management toward maintaining BCS to minimize the risk of lameness. Low BW (independent of BCS) and increased age at first calving above 24 mo were also associated with increased long-term risk of repeated lameness events. Overall, the model explained 62 and 60% of the variability for mild and severe lameness, respectively, highlighting the importance of these variables as risk factors and hence where management could be targeted to significantly affect reducing the risk of lameness

    Enzyme-linked immunosorbent assay with a Salmonella enteritidis antigen for differentiating infected from vaccinated poultry

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    The specificity and sensitivity of indirect ELISA, based on the use of four different antigenic extracts obtained from a clinical isolate of Salmonella enteritidis, were compared with those obtained with the gm-flagellin based ELISA (IDEXX). A total of 116 serum samples from salmonellae free, naturally infected and vaccinated hens were studied. The results showed that the indirect ELISA, based on lipopolysaccharide (LPS), O-polysaccharide (PS) or membrane sediment (SD) antigens, enable the identification of a greater number of infected birds and discriminated field antibody responses from vaccinal ones better than the commercial IDEXX test. The indirect ELISA that used a O-polysaccharide rich fraction (PS) proved to be the most specific and sensitive test, suggesting that this indirect ELISA could be used to confirm IDEXX results, especially when the differentiation between vaccinated and infected poultry is required

    Quantifying Entanglement Production of Quantum Operations

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    The problem of entanglement produced by an arbitrary operator is formulated and a related measure of entanglement production is introduced. This measure of entanglement production satisfies all properties natural for such a characteristic. A particular case is the entanglement produced by a density operator or a density matrix. The suggested measure is valid for operations over pure states as well as over mixed states, for equilibrium as well as nonequilibrium processes. Systems of arbitrary nature can be treated, described either by field operators, spin operators, or any other kind of operators, which is realized by constructing generalized density matrices. The interplay between entanglement production and phase transitions in statistical systems is analysed by the examples of Bose-Einstein condensation, superconducting transition, and magnetic transitions. The relation between the measure of entanglement production and order indices is analysed.Comment: 20 pages, Revte

    The contribution of previous lameness events and body condition score to the occurrence of lameness in dairy herds: a study of 2 herds

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    It has been demonstrated that low body condition and previous occurrence of lameness increase the risk of future lameness in dairy cows. To date the population attributable fraction (PAF), which provides an estimate of the contribution that a risk factor makes toward the total number of disease events in a population, has not been explored for lameness using longitudinal data with repeated measures. Estimation of PAF helps to identify control measures that could lead to the largest improvements on-farm. The aim of this study was to use longitudinal data to evaluate the proportion of lameness that could be avoided in 2 separate herds (2 populations) through (1) reduced recurrence of previous lameness events, (2) and moving body condition score (BCS) into more optimal ranges. Data were obtained from 2 UK dairy herds: herd A, a 200-cow herd with 8 yr of data from a total of 724 cows where lameness events were based on weekly locomotion scores (LS; 1 to 5 scale), and herd B, a 600-cow herd with data recorded over 44 mo from a total of 1,040 cows where treatment of clinical cases was used to identify lameness events. The PAF for categories of BCS were estimated using a closed equation appropriate for multiple exposure categories. Simulation models were used to explore theoretical scenarios to reflect changes in BCS and recurrence of previous lameness events in each herd. For herd A, 21.5% of the total risk periods (cow-weeks) contained a lameness event (LS 3, 4, or 5), 96% of which were repeat events and 19% were recorded with BCS 16 wk before a risk period. The median PAF estimated for changes in BCS were in the region of 4 to 11%, depending on severity of lameness. Repeated bouts of lameness made a very large contribution to the total number of lameness events. This could either be because certain cows are initially susceptible and remain susceptible, due to the increased risk associated with previous lameness events, or due to interactions with environmental factors. This area requires further research

    Combinación de estrategias de innovación docente para la enseñanza de asignaturas de Ciencias de la Tierra: aprendizaje colaborativo y basado en proyectos como fuente de material para el aula invertida

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    Se han combinado diferentes estrategias de innovación docente para la creación de material de uso en el aula invertida. Grupos de alumnos han realizado micro-videotutoriales para la resolución de problemas básicos de cortes geológicos, realizando ellos mismos desde el guion hasta la edición, pasando por la grabación. Mediante esta actividad han tenido que desarrollar un proyecto y trabajar de forma colaborativa. El resultado de este trabajo ha sido una colección de microvideos que están siendo empleados en la formación de otros alumnos mediante el aula invertida en varias asignaturas de Ciencias de la Tierra. Los videos se han puesto a disposición de los alumnos a través de la plataforma Moodle de la UPM para que puedan aprender y repasar las técnicas de resolución de problemas de forma autónoma
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