2,176 research outputs found
Impacto en los resultados de salud cardiovascular de la implantación del contrato de Dirección Clínica en atención primaria de Tarragona
ObjetivoLos objetivos del presente estudio son: a) determinar la mejora en la salud cardiovascular de una población tras la implantación del contrato de Dirección Clínica en los profesionales de los Equipos de Atención Primaria de Tarragona-Reus y Terres de l’Ebre (provincia de Tarragona), y b) identificar los factores predictivos que determinan una mejor salud cardiovascular tras la implantación del contrato de Dirección Clínica. La implantación del contrato de Dirección Clínica (basada en el liderazgo profesional, feedback de la información asistencial, control de los indicadores de riesgo cardiovascular basados en la evidencia científica concretadas en guías de práctica clínica) mejorará los resultados de salud cardiovascular de la población de referencia.DiseñoSe trata de un estudio antes-después y multicéntrico.EmplazamientoAtención primaria de salud.ParticipantesParticipan 30 centros de salud (totalidad de los centros de salud del ámbito de atención primaria del Institut Català de la Salut).Mediciones principalesCaracterísticas del centro. Variables de proceso: indicadores de buena práctica asistencial, cálculo del riesgo cardiovascular, aplicación de la guía de práctica clínica (hipertensión arterial, diabetes, dislipemia, tabaquismo y factores de riesgo cardiovascular), estándares de calidad de la prescripción farmacológica. Variables de resultados: cifras de riesgo cardiovascular, número de visitas en atención continuada, urgencias hospitalarias e ingresos por angina, infarto agudo de miocardio y accidente cerebrovascular, y cribados poblacionales de factores de riesgo.DiscusiónEste estudio es útil, ya que la dirección clinica pretende ser un motor para que los profesionales lideren la gestión asistencial y, mediante el control de indicadores y la «retroalimentación» de estos resultados a los profesionales, se mejore la calidad asistencial. Con este trabajo se pretende demostrar que una estrategia de gestión puede mejorar la salud cardiovascular de la población. La originalidad de este proyecto se basa en el desarrollo de una nueva herramienta de evaluación basada en una novedosa estrategia de gestión para medir resultados en salud cardiovascular.ObjectiveThe objectives of this study are: 1) to determine the improvement in the cardiovascular health of the population after the introduction of the clinical governance contract for primary care team professionals in Tarragona-Reus and the Terres de l’Ebre area (Tarragona province, Spain); 2) to identify the factors predictive of better cardiovascular health after the introduction of the clinical governance contract. The introduction of the clinical governance contract, which is based on professional leadership, feed-back of care information, and monitoring of indicators of cardiovascular risk based on scientific evidence and concretised in clinical practice guidelines, will improve the cardiovascular health results of the reference population. Improvements in indicators of procedure and result are specified in “Material and methods.”DesignThis is a before-and-after, multicentre study.SettingPrimary health care.ParticipantsTirty health centres (all the primary care Centres in the area).Main measurementsCharacteristics of the centre. Variables in procedures: indicators of good care practice, calculation of cardiovascular risk, application of clinical practice guidelines (hypertension, diabetes, lipaemia, tobacco and cardiovascular risk) and quality standards for drug prescription. Result variables: cardiovascular risk figures, number of ongoing care visits, hospital emergencies and admissions for angina, heart attack or stroke, and risk factor screenings of the population.DiscussionThis study is useful, in that clinical governance aims to be a dynamic device to bring professionals into the leadership of health care management and, through monitoring indicators and feeding the findings back to the professionals, to improve health care quality. The study aims to show that management strategy can improve the populatiońs cardiovascular health. The originality of the study lies in the development of a new tool of evaluation based on a novel management strategy for measuring cardiovascular health findings
MAD@VLT: Deep into the Madding Crowd of Omega Centauri
We present deep and accurate Near-Infrared (NIR) photometry of the Galactic
Globular Cluster (GC) Omega Cen. Data were collected using the Multi-Conjugate
Adaptive Optics Demonstrator (MAD) on VLT (ESO). The unprecedented quality of
the images provided the opportunity to perform accurate photometry in the
central crowded regions. Preliminary results indicate that the spread in age
among the different stellar populations in Omega Cen is limited.Comment: 6 pages, 3 figures, to appear in the Springer Astrophysics and Space
Science Proceedings, "Science with the VLT in the ELT era", ed. A. Moorwoo
Measurement of shower development and its Moli\`ere radius with a four-plane LumiCal test set-up
A prototype of a luminometer, designed for a future e+e- collider detector,
and consisting at present of a four-plane module, was tested in the CERN PS
accelerator T9 beam. The objective of this beam test was to demonstrate a
multi-plane tungsten/silicon operation, to study the development of the
electromagnetic shower and to compare it with MC simulations. The Moli\`ere
radius has been determined to be 24.0 +/- 0.6 (stat.) +/- 1.5 (syst.) mm using
a parametrization of the shower shape. Very good agreement was found between
data and a detailed Geant4 simulation.Comment: Paper published in Eur. Phys. J., includes 25 figures and 3 Table
Donor cell engineering with GSK3 inhibitor–loaded nanoparticles enhances engraftment after in utero transplantation
Host cell competition is a major barrier to engraftment after in utero hematopoietic cell transplantation (IUHCT). Here we describe a cell-engineering strategy using glycogen synthase kinase-3 (GSK3) inhibitor–loaded nanoparticles conjugated to the surface of donor hematopoietic cells to enhance their proliferation kinetics and ability to compete against their fetal host equivalents. With this approach, we achieved remarkable levels of stable, long-term hematopoietic engraftment for up to 24 weeks post-IUHCT. We also show that the salutary effects of the nanoparticle-released GSK3 inhibitor are specific to donor progenitor/stem cells and achieved by a pseudoautocrine mechanism. These results establish that IUHCT of hematopoietic cells decorated with GSK3 inhibitor–loaded nanoparticles can produce therapeutic levels of long-term engraftment and could therefore allow single-step prenatal treatment of congenital hematological disorders
ECFA Detector R&D Panel, Review Report
Two special calorimeters are foreseen for the instrumentation of the very
forward region of an ILC or CLIC detector; a luminometer (LumiCal) designed to
measure the rate of low angle Bhabha scattering events with a precision better
than 10 at the ILC and 10 at CLIC, and a low polar-angle
calorimeter (BeamCal). The latter will be hit by a large amount of
beamstrahlung remnants. The intensity and the spatial shape of these
depositions will provide a fast luminosity estimate, as well as determination
of beam parameters. The sensors of this calorimeter must be radiation-hard.
Both devices will improve the e.m. hermeticity of the detector in the search
for new particles. Finely segmented and very compact electromagnetic
calorimeters will match these requirements. Due to the high occupancy, fast
front-end electronics will be needed. Monte Carlo studies were performed to
investigate the impact of beam-beam interactions and physics background
processes on the luminosity measurement, and of beamstrahlung on the
performance of BeamCal, as well as to optimise the design of both calorimeters.
Dedicated sensors, front-end and ADC ASICs have been designed for the ILC and
prototypes are available. Prototypes of sensor planes fully assembled with
readout electronics have been studied in electron beams.Comment: 61 pages, 51 figure
Performance of fully instrumented detector planes of the forward calorimeter of a Linear Collider detector
Detector-plane prototypes of the very forward calorimetry of a future
detector at an e+e- collider have been built and their performance was measured
in an electron beam. The detector plane comprises silicon or GaAs pad sensors,
dedicated front-end and ADC ASICs, and an FPGA for data concentration.
Measurements of the signal-to-noise ratio and the response as a function of the
position of the sensor are presented. A deconvolution method is successfully
applied, and a comparison of the measured shower shape as a function of the
absorber depth with a Monte-Carlo simulation is given.Comment: 25 pages, 32 figures, revised version following comments from
referee
The Genome-wide Methylation Profile of CD4+ T Cells From Individuals With Human Immunodeficiency Virus (HIV) Identifies Distinct Patterns Associated With Disease Progression
Background: Human genetic variation-mostly in the HLA and CCR5 regions-explains 25% of the variability in progression of HIV infection. However, it is also known that viral infections can modify cellular DNA methylation patterns. Therefore, changes in the methylation of CpG islands might modulate progression of HIV infection. Methods: 85 samples were analyzed: 21 elite controllers (EC), 21 HIV-infected subjects before combination antiretroviral therapy (cART) (viremic, 93,325 HIV-1 RNA copies/ml) and under suppressive cART (cART, median of 17 months, <50 HIV-1 RNA copies/ml), and 22 HIV-negative donors (HIVneg). We analyzed the methylation pattern of 485,577 CpG in DNA from peripheral CD4+ T lymphocytes. We selected the most differentially methylated gene (TNF) and analyzed its specific methylation, mRNA expression, and plasma protein levels in 5 individuals before and after initiation of cART. Results: We observed 129 methylated CpG sites (associated with 43 gene promoters) for which statistically significant differences were recorded in viremic vs HIVneg, 162 CpG sites (55 gene promoters) in viremic vs cART, 441 CpG sites (163 gene promoters) in viremic vs EC, but none in EC vs HIVneg. The TNF promoter region was hypermethylated in viremic vs HIVneg, cART, and EC. Moreover, we observed greater plasma levels of TNF in viremic individuals than in EC, cART, and HIVneg. Conclusions: Our study shows that genome methylation patterns vary depending on HIV infection status and progression profile and that these variations might have an impact on controlling HIV infection in the absence of cART
Observation of two new baryon resonances
Two structures are observed close to the kinematic threshold in the mass spectrum in a sample of proton-proton collision data, corresponding
to an integrated luminosity of 3.0 fb recorded by the LHCb experiment.
In the quark model, two baryonic resonances with quark content are
expected in this mass region: the spin-parity and
states, denoted and .
Interpreting the structures as these resonances, we measure the mass
differences and the width of the heavier state to be
MeV,
MeV,
MeV, where the first and second
uncertainties are statistical and systematic, respectively. The width of the
lighter state is consistent with zero, and we place an upper limit of
MeV at 95% confidence level. Relative
production rates of these states are also reported.Comment: 17 pages, 2 figure
Quantum numbers of the state and orbital angular momentum in its decay
Angular correlations in decays, with , and , are used to measure
orbital angular momentum contributions and to determine the value of
the meson. The data correspond to an integrated luminosity of 3.0
fb of proton-proton collisions collected with the LHCb detector. This
determination, for the first time performed without assuming a value for the
orbital angular momentum, confirms the quantum numbers to be .
The is found to decay predominantly through S wave and an upper limit
of at C.L. is set on the fraction of D wave.Comment: 16 pages, 4 figure
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