Are quality regulations displacing PDOs? A choice experiment study on Iberian meat products in Spain

La publicación de la legislación española sobre normas de calidad que regula los productos cárnicos de cerdos ibéricos ha supuesto la certificación obligatoria del sistema de producción, piensos y raza en el sector porcino. El estándar está diseñado para garantizar la calidad del producto final, evitando los fraudes que pueden haberse producido anteriormente, aprovechando la heterogeneidad del producto. Tradicionalmente, las etiquetas de Denominación de Origen Protegida ofrecían la garantía y seguridad del consumidor, pero esta función ha sido asumida en gran medida por los Estándares de Calidad. En este contexto, es necesario estudiar el conocimiento de los consumidores y la valoración de estos dos indicadores de calidad. Se ha observado que, aunque los DOP son más conocidos que los estándares de calidad, los consumidores están dispuestos a pagar solo una pequeña prima por los productos ibéricos con un DOP. Por lo tanto, las PDO deben reorientarse para proporcionar un valor agregado al producto.The publication of the Spanish Quality Standards legislation regulating meat products from Iberian pigs has meant the obligatory certification of the system of production, feed, and breed in the Iberian pig sector. The Standard is designed to ensure the quality of the final product, avoiding the frauds that may have occurred previously taking advantage of the heterogeneity of the product. Traditionally, the Protected Designation of Origin labels offered the consumer guarantee and security, but this role has largely been taken over by the Quality Standards. In this context, there is a need to study consumers’ knowledge and valuation of these two quality indicators. It has been observed that, although PDOs are better known than the Quality Standards, consumers are willing to pay only a small premium for Iberian products with a PDO. Hence, PDOs need to be reoriented so as to provide added value to the product.peerReviewe

Colaboración de herramientas mediante interfaces basadas en Servicios Web: la aplicación de videoconferencia Marte

El documento detalla la arquitectura ideada dentro del proyecto europeo ECOSPACE para la interoperabilidad de las herramientas de los e-Profesionales, empleando una aproximación orientada a servicios. Cada aplicación de un entorno de trabajo colaborativo debe ofrecer interfaces basadas en servicios web; en particular aquí se contempla el caso de la videoconferencia, como ejemplo representativo de sistema de funcionalidades avanzadas. Adicionalmente, los distintos servicios pueden componerse y orquestarse para ofrecer otros de mayor complejidad; para demostrar la flexibilidad y potencia de esta solución, se incluye un ejemplo que involucra múltiples herramientas. Finalmente, se contempla la posibilidad de usar otro tipo de interfaces, más extendidas actualmente, pero que implicarían un cambio profundo en la arquitectura y, por tanto, en las aplicaciones

Simulación numérica de intervenciones laparoscópicas en humanos

En el presente trabajo se ha llevado a cabo la definición del sistema de autorregulación del cuerpohumano en un modelo matemático hemodinámico complejo. Para ello, se han definido las ecuacionesnecesarias que permiten simular los cambios que la regulación refleja y la regulación local generanfisiológicamente en el cuerpo humano. Además, se han desarrollado ecuaciones que adaptan el modelode autorregulación de referencia para trabajar sobre este modelo hemodinámico desarrollado y propio.Una vez definido el sistema de autorregulación, se ha puesto a prueba por primera vez el modelohemodinámico completo en un escenario real. Para ello, se disponen de datos clínicos de una muestra desiete pacientes sometidos a una intervención laparoscópica. Dicha intervención se ha simulado en elmodelo numérico hemodinámico y se han comparado los resultados reales y simulados entre si. Así, seha podido valorar la compatibilidad del modelo de autorregulación definido con todos los avances ymodelos de complianzas que el simulador dispone.Puesto que es la primera vez que se prueba el modelo hemodinámico completo, se ha determinado quecombinación de modelos de complianza, previamente definidos, trabaja mejor con el módulo deautorregulación para reproducir los resultados clínicos. El análisis de resultados, por lo tanto, se hallevado a cabo siguiendo una metodología lo más crítica posible. Se han dividido los pacientes de dosgrupos distintos de trabajo para evitar que los resultados de validación del modelo estuvierancondicionados por los de entrenamiento del mismo. Seguidamente, se han llevado a cabo tanto unanálisis teórico como un análisis estadístico de resultados. Debido a las características de los datosreales y simulados, se ha detectado la necesidad de realizar una fragmentación de los resultados paracrear unas ventanas de análisis que facilitaran una mayor precisión a la hora de validar el modelo.<br /

Exploring sustainable food choices factors and purchasing behavior in the sustainable development goals era in Spain

The aim of the present study was (1) to investigate what consumers include within the concept of food sustainability and its link with sustainable consumption, by identifying meaningful consumer typologies from the concept of food sustainability and food choice factors framed by SDG 12, and (2) to know how different farm systems attributes affecting purchase behavior are associated with such typologies. Consumers from two Spanish regions (n = 403) answered a paper questionnaire to know their degree of knowledge of sustainability, and beliefs, behavior, attitudes and preferences towards food sustainability, and the importance given to product characteristics and shopping practices. A principal component analysis was conducted to identify groups with similar answers, to average some of the questions before the final analysis of variance, which includes demographic classes as fixed effects. A cluster analysis using the most representative questions identified two clusters. cluster 1 (68.4%) responded to more sustainability-related attributes, and cluster 2 (31.5%) presented a less-expanded concept of sustainability. The origin of the product and quality certification (local, organic) was important for food purchase practices. The place of residence and gender differences of the consumers were the most influential factors. In the conjoint study, regarding the purchase of Iberian pork, cluster 1 remained unwilling to sacrifice outdoor systems and local breed at the expense of the price, in the case of the Iberian pig production. The most important demographic differentiator was the region of residence of the consumer. In conclusion, consumers are not aware of the wider aspects included in the sustainability concept. Moreover, the concept of sustainability elicits different meanings to the segments of the consumers identifie

Protocol: Value Stream Maping in Healthcare. A systematic literature review

[EN] Until 2016, very few works had investigated the use of the VSM. With this research, we will discover if the situation has changed in the last 3 years. In the lean manufacturing context, different techniques that help the continuous improvement process can be used (MarinGarcia & Bonavia, 2011; Marin-Garcia & Carneiro, 2010; Marin-Garcia et al., 2012; Scott, 2001). One is the Value Stream Map (VSM) (Coetzee et al., 2016; Marin-Garcia & Mateo Martínez, 2013; Vidal-Carreras et al., 2015). This publication is a protocol (MarinGarcia, 2015; Marin-Garcia, 2019) that aims to promote research transparency and replication. The concepts investigated in it are defined (VSM and health services sector), a research niche is justified, and the search and codification procedure of the systematic literature review is established. Although there are different versions of the VSM (DinisCarvalho et al., 2018; Hines & Rich, 1997; Shou et al., 2017), we will focus on that proposed by Rother and Shook (1998). The main peculiarity of the version by Rother and Shook (1998) is that it graphically shows the flow of information and the flow of materials in the same diagram (Lucherini & Rapaccini, 2017; Shou et al., 2017; Vidal-Carreras et al., 2015), which is necessary to complete a project, a product or a service (Bevilacqua et al., 2014; Lucherini & Rapaccini, 2017). It is also very intuitive and easy to understand, even by non-technical people (Lucherini & Rapaccini, 2017). The VSM version that we have chosen is usually applied via standardized symbols (Lucherini & Rapaccini, 2017; Vidal-Carreras et al., 2015) following a 4-stage procedure (Rother & Shook, 1998; Shou et al., 2017): 1) select a product family (each VSM represents a family of sufficiently homogeneous products to represent the process); 2) draw the current VSM; 3) model the improved process by drawing the desirable future VSM; 4) implement actions to obtain a similar process to the future VSM. These four stages can be split into eight in other implementation versions (Tapping, 2007; Tapping et al., 2002; Tapping & Shuker, 2003). The above procedure allows value-added (VA) and nonvalueadded (NVA) activities and initiating actions to be identified to improve the proportion of VA versus NVA (Bevilacqua et al., 2014; Shou et al., 2017; Vidal-Carreras et al., 2015). Our goal is to include any healthcare level (primary care, secondary care - medical specialists, hospitals, referral centers for rare diseases, and geriatric or disability care). We wish to explore the use in organizations of any country worldwide whose ownership is public, private or a nonprofit foundation. We will focus on patient health services. We will not include the pharmaceutical industry or the operation of governmental or nongovernmental public health structures (e.g. ministries, the Red Cross or similar). Different literature reviews on the VSM have been published. Some focus on analyzing several sectors, predominantly manufacturing. Previous research seems to indicate that the VSM allows the transparency of the process to improve by making it much more understandable for the agents involved in it (Shou et al., 2017; Vidal-Carreras et al., 2015); reduce process times (lead times) (Shou et al., 2017) and inventories (Shou et al., 2017). However, these results come mostly from repetitive manufacturing contexts (linked to the automotive or consumer electronics sectors, or their auxiliary industries), and normally from Anglo-Saxon countries. There do not seem to be enough publications in order to generalize these results to all kinds of contexts. Some publications reveal that the barriers from using such tools can overcome facilitators in public service contexts (MarinGarcia et al., 2018b). Very few reviews have focused specifically on the VSM and the health services sector (Nowak et al., 2017; Vidal-Carreras et al., 2015). Both conclude that there is not enough material to provide evidence for and a conclusive answer to our research questions. The systematic review that we propose in this protocol intends to answer (in a future publication) the following questions: 1) what is the VSM research gap that applies to the health services sector that currently exists?; 2) is the VSM being used in hospitals or other health centers?; 3) what VSM version is common in health sector publications?; 4) collect examples of the VSM in hospitals/heath centers; 5) how was the VSM used in the hospitals/health centers that have applied it?; 6) what problems and/or difficulties have arisen while drawing the VSM or after drawing it? Different programs will be used for the bibliometric analysis (see details in Marin-Garcia and Alfalla-Luque (2019)). First, the R Bibliometrix package (Aria & Cuccurullo, 2017; Garfield, 2004; Wulff Barreiro, 2007) and also the suitability of SciMAT (Cobo et al., 2012; Santana & Lopez-Cabrales, 2019) to visualize thematic maps and strategic maps will be tested.Marín García, JA.; Vidal Carreras, PI.; García Sabater, JJ.; Escribano-Martinez, J. (2019). Protocol: Value Stream Maping in Healthcare. A systematic literature review. WPOM-Working Papers on Operations Management. 10(2):36-54. https://doi.org/10.4995/wpom.v10i2.12297OJS3654102Ahluwalia, S. C., Damberg, C. L., Silverman, M., Motala, A., & Shekelle, P. G. (2017). What defines a high-performing health care delivery system: A systematic review. The Joint Commission Journal on Quality and Patient Safety, 43(9), 450-459. https://doi.org/10.1016/j.jcjq.2017.03.010Aloini, D., Cannavacciuolo, L., Gitto, S., Lettieri, E., Malighetti, P., & Visintin, F. (2018). Evidence-based management for performance improvement in healthcare. Management Decision, 56(10), 2063-2068. https://doi.org/10.1108/MD-10-2018-004Andreu Andres, M. A., Garcia-Carbonell, A., González-Ladrón-de-Guevara, F., & Watts, F. (2018). Contrasting innovation competence fincoda model in software engineering: Narrative review. Journal of Industrial Engineering and Management, 11(4), 715-734. https://doi.org/10.3926/jiem.2656Aria, M., & Cuccurullo, C. (2017). Bibliometrix: An r-tool for comprehensive science mapping analysis. Journal of Informetrics, 11(4), 959-975. https://doi.org/10.1016/j.joi.2017.08.007Bevilacqua, M., Ciarapica, F. E., Germani, M., Mazzuto, G., & Paciarotti, C. (2014). Relation of project managers' personality and project performance: An approach based on value stream mapping. Journal of Industrial Engineering and Management, 7(4), 34. https://doi.org/10.3926/jiem.1005Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2009). Introduction to meta-analysis. UK: John Wiley & Sons. https://doi.org/10.1002/9780470743386Cobo, M. J., López-Herrera, A. G., Herrera-Viedma, E., & Herrera, F. (2012). Scimat: A new science mapping analysis software tool. Journal of the American Society for Information Science and Technology, 63(8), 1609-1630. https://doi.org/10.1002/asi.22688Coetzee, R., van der Merwe, K., & van Dyk, L. (2016). Lean implementation strategies: How are the toyota way principles addressed? South African Journal of Industrial Engineering, 27(3), 79-91. https://doi.org/10.7166/27-3-1641Cringles, M. C. (2002). Developing an integrated care pathway to manage cancer pain across primary, secondary and tertiary care. International Journal of Palliative Nursing, 8(5), 247-255. https://doi.org/10.12968/ijpn.2002.8.5.10372De Steur, H., Wesana, J., Dora, M. K., Pearce, D., & Gellynck, X. (2016). Applying value stream mapping to reduce food losses and wastes in supply chains: A systematic review. Waste Management, 58, 359-368. https://doi.org/10.1016/j.wasman.2016.08.025Dinis-Carvalho, J., Guimaraes, L., Sousa, R. M., & Leao, C. P. (2018). Waste identification diagram and value stream mapping: A comparative analysis. International Journal of Lean Six Sigma. https://doi.org/10.1108/IJLSS-04-2017-0030Dogan, N. O., & Unutulmaz, O. (2016). Lean production in healthcare: A simulation-based value stream mapping in the physical therapy and rehabilitation department of a public hospital. Total Quality Management & Business Excellence, 27(1-2), 64-80. https://doi.org/10.1080/14783363.2014.945312Fadahunsi, K. P., Akinlua, J. T., O'Connor, S., Wark, P. A., Gallagher, J., Carroll, C., . . . O'Donoghue, J. (2019). Protocol for a systematic review and qualitative synthesis of information quality frameworks in ehealth. Bmj Open, 9(3). https://doi.org/10.1136/bmjopen-2018-024722Garfield, E. (2004). Historiographic mapping of knowledge domains literature. Journal of Information Science, 30(2), 119-145. https://doi.org/10.1177/0165551504042802Gitlow, H., Zuo, Q., Ullmann, S. G., Zambrana, D., Campo, R. E., Lubarsky, D., & Birnbach, D. J. (2013). The causes of never events in hospitals. International Journal of Lean Six Sigma, 4(3), 338-344. https://doi.org/10.1108/IJLSS-03-2013-0016Gonzalez-Aleu, F., Van Aken, E. M., Cross, J., & Glover, W. J. (2018). Continuous improvement project within kaizen: Critical success factors in hospitals. The TQM Journal, 30(4), 335-355. https://doi.org/10.1108/TQM-12-2017-0175Grumbach, K., & Bodenheimer, T. (1995). The organization of health care. JAMA, 273(2), 160-167. https://doi.org/10.1001/jama.1995.03520260082038Heinzen, M., Mettler, S., Coradi, A., & Boutellier, R. (2015). A new application of value-stream mapping in new drug development: A case study within novartis. Drug Discovery Today, 20(3), 301-305. https://doi.org/10.1016/j.drudis.2014.10.009Hines, P., & Rich, N. (1997). The seven value stream mapping tools. International Journal of Operations and Production Management, 17(1), 46-64. https://doi.org/10.1108/01443579710157989Knight, C., Patterson, M., & Dawson, J. (2019). Work engagement interventions can be effective: A systematic review. European Journal of Work and Organizational Psychology, 28(3), 348-372. https://doi.org/10.1080/1359432X.2019.1588887Losilla, J.-M., Oliveras, I., Marin-Garcia, J. A., & Vives, J. (2018). Three risk of bias tools lead to opposite conclusions in observational research synthesis. Journal of Clinical Epidemiology(101), 61-72. https://doi.org/10.1016/j.jclinepi.2018.05.021Lucherini, F., & Rapaccini, M. (2017). Exploring the impact of lean manufacturing on flexibility in smes. Journal of Industrial Engineering and Management, 10(5), 27. https://doi.org/10.3926/jiem.2119Lummus, R. R., Vokurka, R. J., & Rodeghiero, B. (2006). Improving quality through value stream mapping: A case study of a physician's clinic. Total Quality Management and Business Excellence, 17(8), 1063-1075. https://doi.org/10.1080/14783360600748091Makwana, A. D., & Patange, G. S. (2019). A methodical literature review on application of lean & six sigma in various industries. Australian Journal of Mechanical Engineering. https://doi.org/10.1080/14484846.2019.1585225Marin-Garcia, J. A. (2015). Publishing in two phases for focused research by means of "research collaborations". WPOM-Working Papers on Operations Management, 6(2), 76-80. https://doi.org/10.4995/wpom.v6i2.4459Marin-Garcia, J. A. (2016). Upvx-mooc course: Research methodologies-systematic literature review https://www.upvx.es/courses/course-v1:ManagementEducation+researchmethodologies+2016-01/about: UPVx Formación Online. Universitat Politécnica de ValenciaMarin-Garcia, J. A. (2019). Publishing in three stages to support evidence based practice in om, hrm and teaching&learning innovation. WPOM-Working Papers on Operations Management, 10(2), in press.Marin-Garcia, J. A., & Alfalla-Luque, R. (2019). Protocol: How to deal with partial least squares (pls) research in operations management. A guide for sending papers to academic journals. WPOM-Working Papers on Operations Management, 10(1), 29-69. https://doi.org/10.4995/wpom.v10i1.10802Marin-Garcia, J. A., Betancour, E., & Giraldo-OMeara, M. (2018a). Protocol: Literature review on the psychometric properties of the short versions of the scales of social desirability in the answers to competency self-assessment questionnaires. WPOM-Working Papers on Operations Management, 9(1), 14-29. https://doi.org/10.4995/wpom.v9i1.9172Marin-Garcia, J. A., & Bonavia, T. (2011). Strategic priorities and lean manufacturing practices in automotive suppliers. Ten years after. In M. Chiaberge (Ed.), New trends and developments in automotive engineering: InTechMarin-Garcia, J. A., & Carneiro, P. (2010). Desarrollo y validación de un modelo multidimensional de la producción ajustada. Intangible Capital, 6(1), 78-127. https://doi.org/10.3926/ic.2010.v6n1.p78-127Marin-Garcia, J. A., Carneiro, P., & Miralles, C. (2012). Effect of lean manufacturing practices on non-financial performance results: Empirical study in spanish sheltered work centers. In G. Mejia & N. Velasco (Eds.), Production systems and supply chain management in emerging countries: Best practices (pp. 3-24): Springer. https://doi.org/10.1007/978-3-642-26004-9_1Marin-Garcia, J. A., Garcia-Sabater, J. J., & Maheut, J. (2018b). Protocol: Action planning for action research about kaizen in public organizations. The case of higher education. WPOM-Working Papers on Operations Management, 9(1), 13. https://doi.org/10.4995/wpom.v9i1.8990Marin-Garcia, J. A., & Martinez Tomas, J. (2016). Deconstructing amo framework: A systematic review. Intangible Capital, 12(4), 1040-1087. https://doi.org/10.3926/ic.838Marin-Garcia, J. A., & Mateo Martínez, R. (2013). Barreras y facilitadores de la implantación del tpm. Intangible Capital, 9(3), 823-853. https://doi.org/10.3926/ic.360Martinez-Tomas, J., & Marin-Garcia, J. A. (2019). Protocol: What does the wage structure depend on? Evidence from the ine salary national survey (pilot study with 2006 data). WPOM-Working Papers on Operations Management, 10(1), 70-103. https://doi.org/10.4995/wpom.v10i1.11753Martínez Jurado, P. J., & Moyano Fuentes, J. (2017). Aprendiendo a enseñar lean management mediante juegos: Revisión sistemática de la literatura learning to teach lean management through games: Systematic literature review. WPOM-Working Papers on Operations Management, 8, 164-170. https://doi.org/10.4995/wpom.v8i0.7199Medina-López, C., Marin-Garcia, J. A., & Alfalla-Luque, R. (2010). Una propuesta metodológica para la realización de búsquedas sistemáticas de bibliografía (a methodological proposal for the systematic literature review). WPOM-Working Papers on Operations Management, 1(2), 13-30. https://doi.org/10.4995/wpom.v1i2.786Nowak, M., Pfaff, H., & Karbach, U. (2017). Does value stream mapping affect the structure, process, and outcome quality in care facilities? A systematic review. Systematic Reviews, 6, 11. https://doi.org/10.1186/s13643-017-0563-yPatterson, M., Rick, J., Wood, S., Carroll, C., Balain, S., & Booth, A. (2010). Systematic review of the links between human resource management practices and performance: Health Technology Assessment, 14 (51). https://doi.org/10.3310/hta14510Poksinska, B. (2010). The current state of lean implementation in health care: Literature review. Quality Management in Health Care, 19(4), 319-329. https://doi.org/10.1097/QMH.0b013e3181fa07bbPrajogo, D. I., & McDermott, C. M. (2008). The relationships between operations strategies and operations activities in service context. International Journal of Service Industry Management, 19(4), 506-520. https://doi.org/10.1108/09564230810891932Rafique, M. Z., Ab Rahman, M. N., Saibani, N., & Arsad, N. (2019). A systematic review of lean implementation approaches: A proposed technology combined lean implementation framework. Total Quality Management & Business Excellence, 30(3-4), 386-421. https://doi.org/10.1080/14783363.2017.1308818Reijula, J., Nevala, N., Lahtinen, M., Ruohom Aki, V., & Reijula, K. (2014). Lean design improves both health-care facilities and processes: A literature review. Intelligent Buildings International, 6(3), 170-185. https://doi.org/10.1080/17508975.2014.901904Romero, L. F., & Arce, A. (2017). Applying value stream mapping in manufacturing: A systematic literature review. IFAC-PapersOnLine, 50(1), 1075-1086. https://doi.org/10.1016/j.ifacol.2017.08.385Rother, M., & Shook, J. (1998). Learning to see. Value stream mapping to create value and eliminate muda. Massachusetts: Lean Enterprise Institute.Sanchez-Ruiz, L., Marin-Garcia, J. A., & Blanco, B. (2018). Protocol: A meta-review on continuous improvement to know the state of this research field. WPOM-Working Papers on Operations Management, 9(2). https://doi.org/10.4995/wpom.v9i2.10752Sanchez, L., & Blanco, B. (2014). Three decades of continuous improvement. Total Quality Management & Business Excellence, 25(9-10), 986-1001. https://doi.org/10.1080/14783363.2013.856547Santana, M., & Lopez-Cabrales, A. (2019). Sustainable development and human resource management: A science mapping approach. Corporate Social Responsibility and Environmental Management, in press(0). https://doi.org/10.1002/csr.1765Saunders, M., Lewis, P., & Thornhill, A. (2016). Research methods for business students, 7/e. Essex: Pearson Education.Scott, G. (2001). Customer satisfaction: Six strategies for continuous improvement. Journal of Healthcare Management, 46(2), 82. https://doi.org/10.1097/00115514-200103000-00004Shou, W., Wang, J., Wu, P., Wang, X., & Chong, H.-Y. (2017). A cross-sector review on the use of value stream mapping. International Journal of Production Research, 55(13), 3906-3928. https://doi.org/10.1080/00207543.2017.1311031Singh, B., Garg, S. K., & Sharma, S. K. (2011). Value stream mapping: Literature review and implications for indian industry. International Journal of Advanced Manufacturing Technology, 53(5-8), 799-809. https://doi.org/10.1007/s00170-010-2860-7Syltevik, S., Karamperidis, S., Antony, J., & Taheri, B. (2018). Lean for airport services: A systematic literature review and agenda for future research. International Journal of Quality and Reliability Management, 35(1), 34-49. https://doi.org/10.1108/IJQRM-08-2016-0135Tapping, D. (2007). La nueva guia lean de bolsillo (produccion lean). Herramientas para eliminar el desperdicio. United States of America: MCS Media, Inc.Tapping, D., Luyster, T., & Shuker, T. (2002). Value stream management eight steps to planning, mapping, and sustaining lean improvements (1 ed.). New York: Productivity Press. https://doi.org/10.4324/9781482278163Tapping, D., & Shuker, T. (2003). Value stream management for the lean office. New York: Productivity Press. https://doi.org/10.1201/b16934Vandborg, M. P., Edwards, K., Kragstrup, J., Vedsted, P., Hansen, D. G., & Mogensen, O. (2012). A new method for analyzing diagnostic delay in gynecological cancer. International Journal of Gynecological Cancer, 22(5), 712-717. https://doi.org/10.1097/IGC.0b013e31824c6d0eVidal-Carreras, P. I., Garcia-Sabater, J. J., Marin-Garcia, J. A., & Garcia-Sabater, J. P. (2015, 2015). Value stream mapping on healthcare. Paper presented at the 2015 International Conference On Industrial Engineering And Systems Management (Iesm). https://doi.org/10.1109/IESM.2015.7380170Wulff Barreiro, E. (2007). El uso del software histcite para identificar artículos significativos en búsquedas por materias en la web of science. Documentación de las Ciencias de la Información, 30, 45-64

Case report: Self-administration of alpha-1 antitrypsin therapy: a report of two cases

Intravenous augmentation therapy with human alpha-1 proteinase inhibitor for the management of respiratory disease is recommended for people with alpha-1 antitrypsin deficiency (AATD) who are nonsmokers or former smokers. Augmentation therapy usually requires weekly administration at the hospital or clinic and poses an additional burden for patients due to interference with daily life, including work and social activities. Self-administration is a useful alternative to overcome this limitation, but there is a lack of published information on clinical outcomes. We report two cases of individuals with AATD at different stages of the disease who were successfully managed with self-administered augmentation therapy, with increased satisfaction because of the independence gained, lack of interference with clinical stability, and no relevant safety issues

Investigating the Contribution of Decision-Making, Cognitive Insight, and Theory of Mind in Insight in Schizophrenia: A Cross-Sectional Study

INTRODUCTION: Insight in schizophrenia spectrum disorders (SSD) is associated with outcomes. Although the neurocognitive basis of insight is widely accepted, the specific contribution of decision-making (Jumping to Conclusions [JTC]), Cognitive Insight (CI), and Theory of Mind (ToM) to insight remains unclear. METHODS: The sample included N = 77 SSD outpatients aged 18–64 years from a randomized controlled trial of metacognitive training. Assessments included JTC-Beads Task, CI-Beck Cognitive Insight Scale, ToM-Hinting Task, and the Emotions Recognition Test Faces. STATISTICS: hierarchical multivariable linear regression models tested their contribution to total insight (TI) and three insight dimensions – illness recognition (IR), symptom relabelling (SR), and treatment compliance (TC) – measured with the Schedule for the Assessment of Insight – Expanded version, whilst adjusting for potential confounders. RESULTS: Bivariate analyses showed that CI was associated with TI (R2 change = 0.214; p < 0.001), IR (R2 change = 0.154; p = 0.003), and SR (R2 change = 0.168; p = 0.003), while JTC predicted IR (R2 change = 0.790; p = 0.020). Multivariable regression models showed that CI predicted TI (R2 change = 0.116; p = 0.036) and SR (R2 change = 0.166, p = 0.011), whereas JTC was linked with IR (R2 change = 0.710; p = 0.026). ToM was not linked with any insight score. No cognitive variable was associated with treatment compliance. DISCUSSION: Results supported the (meta)cognitive model of insight in SSD. JTC and CI emerged as the main (meta)cognitive processes underlying insight. Metacognitive interventions may therefore improve insight in SSD, although these therapies alone may fail to address treatment compliance

Malformations of the craniocervical junction (chiari type I and syringomyelia: classification, diagnosis and treatment)

Chiari disease (or malformation) is in general a congenital condition characterized by an anatomic defect of the base of the skull, in which the cerebellum and brain stem herniate through the foramen magnum into the cervical spinal canal. The onset of Chiari syndrome symptoms usually occurs in the second or third decade (age 25 to 45 years). Symptoms may vary between periods of exacerbation and remission. The diagnosis of Chiari type I malformation in patients with or without symptoms is established with neuroimaging techniques. The most effective therapy for patients with Chiari type I malformation/syringomyelia is surgical decompression of the foramen magnum, however there are non-surgical therapy to relieve neurophatic pain: either pharmacological and non-pharmacological. Pharmacological therapy use drugs that act on different components of pain. Non-pharmacological therapies are primarly based on spinal or peripheral electrical stimulation