Lesiones y problemas físicos padecidos por senderistas y cicloturistas en una ruta por etapas: el caso del Camino de Santiago

Este trabajo ha tenido por objetivo conocer los problemas físicos, dolencias o enfermedades padecidas por el peregrino mayor de 15 años que recorre el Camino de Santiago, andando o en bicicleta, analizando las diferencias producidas en función de la edad, sexo, medio de locomoción y nacionalidad. La investigación se ha desarrollado mediante la aplicación de un cuestionario autoadministrado en Compostela a una muestra de 1.091 sujetos, utilizando el procedimiento de muestreo estratificado polietápico con afijación proporcional, con un margen de error muestral del ±3 % y un nivel de confianza del 95,5%. Los resultados indicaron que el medio utilizado para realizar una ruta por etapas, y la distancia recorrida, son determinantes de los problemas físicos sufridos, comprobándose que las ampollas y las llagas en los pies, así como la tendinitis, las padecen más los senderistas, mientras que a los cicloturistas afectan más las insolaciones, resfriados y caídas y golpes

From storage to disposal: a holistic microbotanical approach to domestic plant preparation and consumption activities in Late Minoan Gypsades, Crete

The analysis of microbotanical remains (starch grains and phytoliths) from food-related domestic contexts and artefacts has the potential to provide insights into daily plant preparation and consumption activities. In particular, pottery vessels offer an unparalleled comparative framework for the study of food preparation and consumption, since pottery is used for a variety of domestic food-related activities, including storage, processing and serving. This study illustrates the potential of microbotanical remains to provide a holistic approach to the plant food preparation and consumption cycle—from storage to disposal—through the analysis of starch grains and phytoliths from Late Minoan storage, cooking and serving vessels recently uncovered at the Knossian ‘neighbourhood’ of Lower Gypsades. The results show that starch grains and phytoliths are more abundant and diverse in cooking vessels, presumably reflecting a higher deposition of microbotanical remains as a result of the disturbance caused by cooking. The results further offer insights into Minoan storage and cooking practices at Gypsades, suggesting that cereals were stored de-husked in pithoi and, possibly, in palm leaf baskets, and later cooked together with non-staple plants. The virtual absence of microbotanical remains from serving vessels may be due to depositional factors and/or the fact that some of the vessels analysed in this study were used for serving/consuming liquids or animal products, and not plants

Animal growth, tissular composition, and carcass conformation of light Merino lambs

Neither the age (average 74.3 ± 2.9 days) nor the arrival weight of males and females (average 15.38 ± 0.25 kg) at the fattening farm, after the lactation period, were statistically significant. At the end of the fattening period, statistically significant differences were found for the weights and growth of the two sexes (25.91 ± 0.59 kg vs. 22.52 ± 0.52 kg (p-value: 0.000), and 242.15 ± 10.15 g/day vs. 178.51 ± 9.86 g/day (p-value: 0.006) in males and females respectively). Regarding carcass conformation measurements, the differences between sexes were statistically significant for: K, G and Th, but not F. In the carcass performance, there were significant differences between males (7.5 ± 0.3) vs. females (6.7 ± 0.2) (p-value: 0.023), which means that the males had a rating of R- and the females O+. Regarding tissue composition, only the percentage of muscle was significantly higher in males (58.50 ± 0.88) than in females (52.94 ± 0.76), (p-value: 0.011). After the logical differences between males and females, the study showed that both sexes had a higher growth potential than the final weights at which the study was carried out, since they did not show a high fattening (22.76 ± 0.86 percentage). Our results were in accordance with other authors.This research has been financed by a collaboration agreement between the Agricultural Technological Institute of Castilla and León (ITA- CYL), the University of Valladolid (UVa) and the Scientific Park Foundation of the UVa and the project AGL2016-75159-C2-1-R funded by the Spanish State Research Agency (AEI) and the European Regional Development FundLight lambGrowthCarcassMerino breedUnpublishe

Characterization, conservation and loss of dignity at the end-of- life in the emergency department. A qualitative protocol

Aims: to explore and understand the experiences of terminally-ill patients and their relatives regarding dignity during end-of-life care in the emergency department. Background: the respect given to the concept of dignity is significantly modifying the clinical relationship and the care framework involving the end-of-life patient in palliative care units, critical care units, hospices and their own homes. This situation is applicable to in-hospital emergency departments, where there is a lack of research which takes the experiences of end-of-life patients and their relatives into account. Design: a phenomenological qualitative study. Methods: the protocol was approved in December 2016 and will be carried out from December 2016 to December 2020. The Gadamer's philosophical underpinnings will be used in the design and development of the study. The data collection will include participant observation techniques in the Emergency Department, in-depth interviews with terminally-ill patients and focus groups with their relatives. For the data analysis, the field notes and verbatim transcriptions will be read and codified using ATLAS.ti software to search for emerging themes. Discussion: emerging themes that contribute to comprehending the phenomenon of dignity in end-of-life care in the Emergency Department are expected to be found. This study's results could have important implications in the implementation of new interventions in Emergency Departments. These interventions would be focused on improving: the social acceptance of death, environmental conditions, promotion of autonomy and accompaniment, and assumption (takeover) of dignified actions and attitudes (respect for human rights)

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

Modifiable risk factors associated with prediabetes in men and women: A cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes

Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population

Emerging IT risks: insights from German banking

How do German banks manage the emerging risks stemming from IT innovations such as cyber risk? With a focus on process, roles and responsibilities, field data from ten banks participating in the 2014 ECB stress test were collected by interviewing IT managers, risk managers and external experts. Current procedures for handling emerging risks in German banks were identified from the interviews and analysed, guided by the extant literature. A clear gap was found between enterprise risk management (ERM) as a general approach to risks threatening firms’ objectives and ERM’s neglect of emerging risks, such as those associated with IT innovations. The findings suggest that ERM should be extended towards the collection and sharing of knowledge to allow for an initial understanding and description of emerging risks, as opposed to the traditional ERM approach involving estimates of impact and probability. For example, as cyber risks emerge from an IT innovation, the focus may need to switch towards reducing uncertainty through knowledge acquisition. Since individual managers seldom possess all relevant knowledge of an IT innovation, various stakeholders may need to be involved to exploit their expertise