4,369 research outputs found
Prescripción inducida en atención primaria de la Comarca Bilbao
ObjetivosPrincipales: conocer la proporción de prescripción inducida (PI) en Comarca Bilbao y su procedencia, la proporción de gasto correspondiente a la PI, la proporción de PI en los principales grupos terapéuticos, la actitud del médico de atención primaria ante la prescripción solicitada y su influencia en el gasto, la proporción de desacuerdo con dicha prescripción y los motivos de desacuerdo, y la proporción con informe del especialista. Secundarios: conocer la proporción de PI en los demás grupos terapéuticos, en fármacos VINE, EFG y en los de nula o baja mejora terapéutica.Diseño.Estudio transversal, descriptivoEmplazamientoAtención primariaParticipantesFármacos financiables prescritos por y/o solicitados a los médicos de familia de EAP.Resultados principalesSe estudiaron 7.922 fármacos. Tipo de prescripción: PI, 48,3% (IC del 95%, 47,2–49,4); del médico de atención primaria (PRO), 50,6% (IC del 95%, 49,5–51,7); desconocida, 1,1% (IC del 95%, 0,9–1,3). Procedencia principal: especialista público (72,2%), especialista privado (16,6%). Un 62,5% del gasto correspondió a la PI. En el grupo terapéutico más prescrito, sistema nervioso central (24,2%), PI, 39,8%; PRO, 58,9%; en aparato cardiovascular (19,1%), PI, 56,2%, PRO, 43,1%. Se prescribió el fármaco solicitado en un 98,4% de los casos, se cambio en el 1,2% y se suprimió en un 0,4%. Proporción de desacuerdo, 11%; motivos de desacuerdo, no hay necesidad de tratar (23,9%), grupo terapéutico (34,4%), principio activo (13,2%), marca comercial (28,5%). Hubo informe de especialista en un 62,4% de los casos.ConclusionesSe detecta una proporción considerable de prescripción no atribuible a atención primaria y una proporción importante de fármacos que el médico de primaria prescribe sin estar de acuerdo. Sería necesario un sistema que permitiera separar el gasto por niveles, así como mejorar la comunicación entre éstos.ObjectivesMain objetives: to know the proportion of induced prescription (IP) in Area Bilbao and its source, the proportion of cost IP accounts for, the proportion of IP in the main therapeutic groups, the attitude of GP when requested for prescription and its influence on cost, the proportion of disagreement with requested prescription, the reasons for disagreement, and the proportion with letter from specialist. Secondary objectives: to know the proportion of IP in the remaining therapeutic groups, in drugs of low clinical value, in generic drugs and in new drugs with low or no therapeutic improvement.DesignA descriptive cross-sectional study.SettingPrimary health care.ParticipantsDrugs prescribable under National Health Service prescribed by and/or requested to GPs.Main results7.922 drugs were analysed. Type of prescription: IP, 48.3% (95% CI, 47.2–49.4); GP prescription (GPP), 50.6% (95% CI, 49.5–51.7); unknown source, 1,1% (95% CI, 0.9–1.3). Main source, public specialist (72.2%), private specialist (16.6%). IP accounted for 62.5% of cost. In the most prescribed therapeutic group, central nervous system (24.2%), IP, 39.8%; GPP, 58.9%; in cardiovascular system (19.1%), IP, 56.2%; GPP, 43.1%. 98.4% of requested prescription was actually prescribed, 1.2% was changed and 0.4%, suppressed. Proportion of disagreement, 11%; reasons for disagreement, no need for medical treatment (23.9%), therapeutic group (34.4%), active ingredient (13.2%), brand name (28.5%). There was a 62.4% with letter from specialist.ConclusionsPrimary care is not accountable for a substantial proportion of prescription. GP prescribes a considerable proportion of drugs without agreement. It would be necessary a system that allows to separate the cost by care levels and also improve their communication
On Hirschman and log-Sobolev inequalities in mu-deformed Segal-Bargmann analysis
We consider a deformation of Segal-Bargmann space and its transform. We study
L^p properties of this transform and obtain entropy-entropy inequalities
(Hirschman) and entropy-energy inequalities (log-Sobolev) that generalize the
corresponding known results in the undeformed theory.Comment: 42 pages, 3 figure
The extended atmospheres of Mira variables probed by VLTI, VLBA, and APEX
We present an overview on our project to study the extended atmospheres and
dust formation zones of Mira stars using coordinated observations with the Very
Large Telescope Interferometer (VLTI), the Very Long Baseline Array (VLBA), and
the Atacama Pathfinder Experiment (APEX). The data are interpreted using an
approach of combining recent dynamic model atmospheres with a radiative
transfer model of the dust shell, and combining the resulting model structure
with a maser propagation model.Comment: 5 pages, to appear in Proc. of "Why Galaxies Care About AGB Stars
II", ASP Conf. Ser., Franz Kerschbaum, Thomas Lebzelter, and Bob Wing (eds.
Lower Rydberg series of methane : A combined coupled cluster linear response and molecular quantum defect orbital calculation
Vertical excitation energies as well as related absolute photoabsorption oscillator strength data are very scarce in the literature for methane. In this study, we have characterized the three existing series of low-lying Rydberg states of CH4 by computing coupled cluster linear response (CCLR) vertical excitation energies together with oscillator strengths in the molecular-adapted quantum defect orbital formalism from a distorted Cs geometry selected on the basis of outer valence green function calculations. The present work provides a wide range of data of excitation energies and absolute oscillator strengths which correspond to the Rydberg series converging to the three lower ionization potential values of the distorted methane molecule, in energy regions for which experimentally measured data appear to be [email protected] [email protected] [email protected]
Observation of the Crab Nebula with the HAWC Gamma-Ray Observatory
The Crab Nebula is the brightest TeV gamma-ray source in the sky and has been
used for the past 25 years as a reference source in TeV astronomy, for
calibration and verification of new TeV instruments. The High Altitude Water
Cherenkov Observatory (HAWC), completed in early 2015, has been used to observe
the Crab Nebula at high significance across nearly the full spectrum of
energies to which HAWC is sensitive. HAWC is unique for its wide field-of-view,
nearly 2 sr at any instant, and its high-energy reach, up to 100 TeV. HAWC's
sensitivity improves with the gamma-ray energy. Above 1 TeV the
sensitivity is driven by the best background rejection and angular resolution
ever achieved for a wide-field ground array.
We present a time-integrated analysis of the Crab using 507 live days of HAWC
data from 2014 November to 2016 June. The spectrum of the Crab is fit to a
function of the form . The data is well-fit with values of
, , and
log when
is fixed at 7 TeV and the fit applies between 1 and 37 TeV. Study of the
systematic errors in this HAWC measurement is discussed and estimated to be
50\% in the photon flux between 1 and 37 TeV.
Confirmation of the Crab flux serves to establish the HAWC instrument's
sensitivity for surveys of the sky. The HAWC survey will exceed sensitivity of
current-generation observatories and open a new view of 2/3 of the sky above 10
TeV.Comment: Submitted 2017/01/06 to the Astrophysical Journa
Daily monitoring of TeV gamma-ray emission from Mrk 421, Mrk 501, and the Crab Nebula with HAWC
We present results from daily monitoring of gamma rays in the energy range
to TeV with the first 17 months of data from the High
Altitude Water Cherenkov (HAWC) Observatory. Its wide field of view of 2
steradians and duty cycle of % are unique features compared to other TeV
observatories that allow us to observe every source that transits over HAWC for
up to hours each sidereal day. This regular sampling yields
unprecedented light curves from unbiased measurements that are independent of
seasons or weather conditions. For the Crab Nebula as a reference source we
find no variability in the TeV band. Our main focus is the study of the TeV
blazars Markarian (Mrk) 421 and Mrk 501. A spectral fit for Mrk 421 yields a
power law index and
an exponential cut-off
TeV. For Mrk 501, we find an index and exponential cut-off TeV. The light curves for both sources show clear
variability and a Bayesian analysis is applied to identify changes between flux
states. The highest per-transit fluxes observed from Mrk 421 exceed the Crab
Nebula flux by a factor of approximately five. For Mrk 501, several transits
show fluxes in excess of three times the Crab Nebula flux. In a comparison to
lower energy gamma-ray and X-ray monitoring data with comparable sampling we
cannot identify clear counterparts for the most significant flaring features
observed by HAWC.Comment: 18 pages, 10 figures, accepted for publication in The Astrophysical
Journa
The 2HWC HAWC Observatory Gamma Ray Catalog
We present the first catalog of TeV gamma-ray sources realized with the
recently completed High Altitude Water Cherenkov Observatory (HAWC). It is the
most sensitive wide field-of-view TeV telescope currently in operation, with a
1-year survey sensitivity of ~5-10% of the flux of the Crab Nebula. With an
instantaneous field of view >1.5 sr and >90% duty cycle, it continuously
surveys and monitors the sky for gamma ray energies between hundreds GeV and
tens of TeV.
HAWC is located in Mexico at a latitude of 19 degree North and was completed
in March 2015. Here, we present the 2HWC catalog, which is the result of the
first source search realized with the complete HAWC detector. Realized with 507
days of data and represents the most sensitive TeV survey to date for such a
large fraction of the sky. A total of 39 sources were detected, with an
expected contamination of 0.5 due to background fluctuation. Out of these
sources, 16 are more than one degree away from any previously reported TeV
source. The source list, including the position measurement, spectrum
measurement, and uncertainties, is reported. Seven of the detected sources may
be associated with pulsar wind nebulae, two with supernova remnants, two with
blazars, and the remaining 23 have no firm identification yet.Comment: Submitted 2017/02/09 to the Astrophysical Journa
Experiences and perceptions of people with headache: a qualitative study
BACKGROUND: Few qualitative studies of headache have been conducted and as a result we have little in-depth understanding of the experiences and perceptions of people with headache. The aim of this paper was to explore the perceptions and experiences of individuals with headache and their experiences of associated healthcare and treatment. METHODS: A qualitative study of individuals with headache, sampled from a population-based study of chronic pain was conducted in the North-East of Scotland, UK. Seventeen semi-structured interviews were conducted with adults aged 65 or less. Interviews were analysed using the Framework approach utilising thematic analysis. RESULTS: Almost every participant reported that they were unable to function fully as a result of the nature and unpredictability of their headaches and this had caused disruption to their work, family life and social activities. Many also reported a negative impact on mood including feeling depressed, aggressive or embarrassed. Most participants had formed their own ideas about different aspects of their headache and several had searched for, or were seeking, increased understanding of their headache from a variety of sources. Many participants reported that their headaches caused them constant worry and anguish, and they were concerned that there was a serious underlying cause. A variety of methods were being used to manage headaches including conventional medication, complementary therapies and self-developed management techniques. Problems associated with all of these management strategies emerged. CONCLUSION: Headache has wide-ranging adverse effects on individuals and is often accompanied by considerable worry. The development of new interventions or educational strategies aimed at reducing the burden of the disorder and associated anxiety are needed
- …