Added value of patient-reported outcome measures (PROMs) after an acute stroke and early predictors of 90 days PROMs

Outcomes; Stroke; Value based health careResultats; Ictus; Atenció de la salut basada en valorsResultados; Ictus; Atención de la salud basado en valoresIntroduction Value-based health care represents a patient-centered approach by valuing Patient-Reported Outcome Measures (PROMs). Our aim was to describe the additional value of PROMs after an acute stroke over conventional outcome measures and to identify early predictors of poor PROMs. Methods Acute stroke patients discharged from a tertiary care hospital followed by a web/phone-based PROMs collection program in the post hospitalization phase. Main PROMs involve anxiety and depression (HADS) (each defined by HADS ≥ 10) and global physical (PHY-) and mental (M-) health (PROMIS-10). PROMIS cut-off raw values of normality were: PHY-PROMIS ≥ 13 and M-PROMIS ≥ 11. An overall health status (OHS) from 0 to 100 was also determined. PROMs related to the different modified Rankin Scale (mRS) grades were defined. Early predictors of PROMs were evaluated. Results We included 1321 stroke patients, mean age 75 (± 8.6) and 55.7% male; 77.7% returned home. Despite a favorable mRS at 3 months (< 3), a relevant rate of patients considered without symptoms or with mild disability showed unfavorable results in the measured PROMs (8% unfavorable OHS, 15% HAD-depression, 12.1% HAD-anxiety, 28.7% unfavorable M-PROMIS and 33.1% unfavorable PHY-PROMIS results). Along follow-up, only PHY-PROMIS and OHS showed significant improvement (p < 0.01 and 0.03, respectively). The multivariate analysis including discharge variables showed that female sex, higher discharge mRS and discharge to socio-rehabilitation-center (SRC) were independent predictors of unfavorable results in PROMs (p < 0.01). When adding 7 days PROMs results, they emerged as the strongest predictors of 3 months PROMs. Conclusions A high proportion of stroke patients show unfavorable results in PROMs at 3 months, even those with favorable mRS, and most results obtained by PROMs during follow-up continued to indicate alterations. Female sex, mRS and discharge to SRC predicted unfavorable results in PROMs, but the strongest predictors of 3 months PROMs were the results of the 7 days PROMs

Smoking among hospitalized patients: a multi-hospital cross sectional study of a widely neglected problem

Introduction: A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. Methods: Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. Results: In all, 20.5% (95% CI: 18.1-23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88-11.43), young age groups (18-64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44-5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. Conclusions: Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban

Allelic Variation at the 8q23.3 Colorectal Cancer Risk Locus Functions as a Cis-Acting Regulator of EIF3H

Peer reviewe

Tobacco consumption prevalence among nursing students and their knowledge in tobacco addiction: ECTEC study

Background Nurses can positively influence in tobacco prevention and treatment. It is during undergraduate-years when students should acquire knowledge, and skills in smoking cessation; however, nursing students' knowledge has not been yet assessed in Catalonia. Therefore, the objective of our study was to analyse the smoking prevalence of nursing students and the determinants, consumption pattern, training received and knowledge in tobacco control. Methods Multicentre prevalence study by self-completion questionnaire, directed to all students enrolled in the 15 nursing schools in Catalonia during 2015-16. The 57.2% of the students participated in our study (N=4,381). The questionnaire included questions about tobacco use, training and knowledge on smoking cessation. Logistic regression models (OR and 95%CI) were used to assess the association within tobacco consumption and the independent variables (age and studying year). Results The participation by nursing schools was heterogeneous, varying from 35.4% to 81.9%. The 83.2% of the sample were women. The 31.2% of the students smoked. Differences in prevalences were only found by schools (22.4-41.5%;p< 0.01). Most students received training on tobacco consumption: smoking risks (80.6%) and secondhand smoke (86.3%), but not on treatment (32.4%). The 98.1% knew that smoking was an addiction and the 98.4% that secondhand smoke was unhealthy. Being smoker was related to an older age (OR=1.25;CI:1.05-1.49 from 20 to 21 years old; OR=1.82;CI:1.54-2.16 in ≥22 years old), higher level of self-reported knowledge (OR=1.31,CI:1.11-1.55) and with a lower evaluated knowledge (OR=0.81,CI:0.67-0.97). Conclusions The smoking prevalence among nursing students in Catalonia is high and increases with age, without differences by sex. Although students affirmed having received training on tobacco consumption during its degree, their level of knowledge is low for treatment. Smokers have overestimated their training since they had lower evaluated knowledge. It would be recommendable to impart training that qualifies nursing students to help smokers to quit

Tobacco consumption prevalence among nursing students and their knowledge in tobacco addiction: ECTEC study

Background: Nurses can positively influence in tobacco prevention and treatment. It is during undergraduate-years when students should acquire knowledge, and skills in smoking cessation; however, nursing students' knowledge has not been yet assessed in Catalonia. Therefore, the objective of our study was to analyse the smoking prevalence of nursing students and the determinants, consumption pattern, training received and knowledge in tobacco control. Methods: Multicentre prevalence study by self-completion questionnaire, directed to all students enrolled in the 15 nursing schools in Catalonia during 2015-16. The 57.2% of the students participated in our study (N=4,381). The questionnaire included questions about tobacco use, training and knowledge on smoking cessation. Logistic regression models (OR and 95%CI) were used to assess the association within tobacco consumption and the independent variables (age and studying year). Results: The participation by nursing schools was heterogeneous, varying from 35.4% to 81.9%. The 83.2% of the sample were women. The 31.2% of the students smoked. Differences in prevalences were only found by schools (22.4-41.5%;p< 0.01). Most students received training on tobacco consumption: smoking risks (80.6%) and secondhand smoke (86.3%), but not on treatment (32.4%). The 98.1% knew that smoking was an addiction and the 98.4% that secondhand smoke was unhealthy. Being smoker was related to an older age (OR=1.25;CI:1.05-1.49 from 20 to 21 years old; OR=1.82;CI:1.54-2.16 in ≥22 years old), higher level of self-reported knowledge (OR=1.31,CI:1.11-1.55) and with a lower evaluated knowledge (OR=0.81,CI:0.67-0.97). Conclusions: The smoking prevalence among nursing students in Catalonia is high and increases with age, without differences by sex. Although students affirmed having received training on tobacco consumption during its degree, their level of knowledge is low for treatment. Smokers have overestimated their training since they had lower evaluated knowledge. It would be recommendable to impart training that qualifies nursing students to help smokers to quit

Size analysis of single-core magnetic nanoparticles

Single-core iron-oxide nanoparticles with nominal core diameters of 14\ua0nm and 19\ua0nm were analyzed with a variety of non-magnetic and magnetic analysis techniques, including transmission electron microscopy (TEM), dynamic light scattering (DLS), static magnetization vs. magnetic field (M-H) measurements, ac susceptibility (ACS) and magnetorelaxometry (MRX). From the experimental data, distributions of core and hydrodynamic sizes are derived. Except for TEM where a number-weighted distribution is directly obtained, models have to be applied in order to determine size distributions from the measurand. It was found that the mean core diameters determined from TEM, M-H, ACS and MRX measurements agree well although they are based on different models (Langevin function, Brownian and N\ue9el relaxation times). Especially for the sample with large cores, particle interaction effects come into play, causing agglomerates which were detected in DLS, ACS and MRX measurements. We observed that the number and size of agglomerates can be minimized by sufficiently strong diluting the suspension

Implementación y desarrollo de competencias de investigación en la Educación Superior. El caso de los alumnos del Grado de Maestro en Educación

En la formación inicial del profesorado se ha puesto mayor énfasis en la enseñanza-aprendizaje de la didáctica, dejando desvinculadas de esta práctica los procesos de investigación. El objetivo de este proyecto fue diseñar e implementar un programa de competencias de investigación y de pensamiento abierto activo en los futuros maestros. En la experiencia participaron 75 alumnos del Grado de Maestro en Educación Primaria. Se utilizó un cuestionario mixto diseñado en base a la Escala de Pensamiento Activo Abierto para Adolescentes y a la Flexible Thinking Scale. Se concluye que hay una tendencia de los estudiantes a valorar los argumentos propios como mejores que los contraargumentos; asimismo, la mayoría del alumnado ha desarrollado habilidades de investigación como saber identificar información relevante, extraer conclusiones o seleccionar fuentes fiables. Sin embargo, cuando leen un texto que no entienden, gran parte de ellos reconocen que dejan de leerlo y no buscan más información. Si la investigación y el pensamiento abierto activo juegan un papel fundamental en la forma de razonar de las personas, es prioritario que en el contexto educativo universitario se desarrollen dichas competencias

La sostenibilidad en los planes de estudio de las Facultades de Educación Españolas. Estudio de caso

La educación es considerada por los expertos como el instrumento facilitador para lograr un futuro sostenible. Pese a esto, la comunidad científica reconoce que se ha avanzado poco en la integración de la sostenibilidad en la educación universitaria, siendo uno de los problemas acuciantes su deficiente integración en los planes de estudios universitarios. En base a ello, el objetivo de este estudio fue investigar en qué medida se integra la sostenibilidad en los planes de estudio de las Facultades de Educación en España. Para ello se analizaron 106 guías docentes de asignaturas básicas de los futuros maestros de cuatro universidades: Universidad de Alicante, Universidad de Castilla-La Mancha, Universidad de Navarra y Universidad de Santiago de Compostela. Para la recogida de datos se utilizó una matriz de análisis. La metodología utilizada en el estudio es descriptivo-exploratoria y evaluativa. Los hallazgos más destacados muestran que la sostenibilidad se integra en algunos elementos de las guías docentes, especialmente en las competencias. Se concluye que la integración de la sostenibilidad en la formación del futuro profesorado es superficial, escasa, puntual y no está articulada en el diseño curricular