Influencia de las actitudes de los médicos en la utilización de antibióticos en Atención Primaria: un estudio de cohortes

Las resistencias a antibióticos son uno de los principales problemas de salud pública a nivel mundial, considerándose que el consumo inadecuado de antibióticos es el principal determinante de las mismas. Por tanto, una de las líneas de acción para reducirlas es mejorar la utilización de los antibióticos. Objetivo: Identificar qué actitudes de los médicos se asocian a la utilización inadecuada de antibióticos en Atención Primaria. Métodos: Se realizó un estudio de cohortes sobre una muestra de 3.675 médicos de Atención Primaria. Las variables independientes (actitudes) se valoraron mediante cuestionario postal autocumplimentado diseñado ad hoc. Como parte del diseño del cuestionario se realizó una revisión sistemática y un estudio cualitativo. Como variables dependientes se elaboraron indicadores de calidad de la prescripción de antibióticos a partir de las prescripciones reales de antibióticos de uso sistémico realizadas por los médicos estudiados. Para el análisis de los datos se utilizaron modelos lineales generales mixtos. Resultados: En las fases iniciales (revisión y estudio cualitativo) se identificaron cinco actitudes relacionadas con la utilización inadecuada de antibióticos: miedo, complacencia, falta de información, responsabilidad de otros e indiferencia. En el estudio de cohortes se confirmó que el miedo es la actitud más frecuentemente relacionada con la prescripción inadecuada. Conclusiones: Los resultados de este trabajo podrán ser usados para diseñar de forma específica intervenciones educativas dirigidas a médicos con la finalidad de modificar las actitudes asociadas a la utilización inadecuada de antibióticos en Atención Primaria

An approach to employees’ job performance through work environmental variables and leadership behaviours

This study examines how the combined effects of work environmental factors and leadership behaviours lead to the presence (or absence) of industrial employees job performance by applying fuzzy-set qualitative comparative analysis (fsQCA). A sample composed of supervisor-subordinate dyads was used to test the propositions of this study. The results show that the most important variables are transformational leadership and social support. Employee empowerment and task significance seem to play a secondary role in leading to employee job performance. These findings support the need for managers to use positive leadership to manage human resources. This paper contributes to the advancement of the knowledge of employee job performance through the identification of the combinations of conditions that can lead to the presence or absence of this important organizational outcome. Directions for future studies are commented on at the end of the paperS

Citrate and Polyvinylpyrrolidone Stabilized Silver Nanoparticles as Selective Colorimetric Sensor for Aluminum (III) Ions in Real Water Samples

The use of silver nanoparticles stabilized with citrate and polyvinylpyrrolidone as a sensor for aluminum ions determination is proposed in this paper. These non-functionalized and specific nanoparticles provide a highly selective and sensitive detection system for aluminum in acidic solutions. The synthesized nanoparticles were characterized by transmission electron microscopy. Surface plasmon band deconvolution analysis was applied to study the interaction between silver nanoparticles and aluminum ions in solution. The interaction band in the UV-visible region was used as an analytical signal for quantitation purposes. The proposed detection system offers an effective AND wide linearity range (0.1-103 nM), specificity for Al(III) in THE presence of other metallic ions in solution, as well as high sensitivity (limit of detection = 40.5 nM). The proposed silver-nanoparticles-based sensor WAS successfully used for detecting Al(III) in real water samples.Spanish Ministerio de Economía y Competitividad, MinECo, CTQ2016-78703-P (AEI/FEDER, UE)España, Universidad de Sevilla ,V Plan Propio Grupos Emergentes (PP2016-5937)Junta de Andalucía (2017/FQM-386)CITIUS VI PP USO SSGG (1804031606

Métodos de ecualización de la ganancia de amplificadores ópticos de fibra dopada con erbio

4 págs, 3 figs, 4 gráfs, 1 tabla.-- Presentado en: 3ª Reunión Española de Optoelectrónica (OPTOEL'03), Leganés (Madrid), 14-16 julio 2003.La ecualización de la ganancia en amplificadores ópticos es crítica para el caso de sistemas de comunicaciones ópticas multicanal en los que interesa que los canales (multiplexados en diferentes longitudes de onda, es decir, sistemas WDM) se amplifiquen por igual.Se presenta en este trabajo un estudio comparativo experimental de las posibles técnicas de ecualización en amplificadores ópticos de fibra dopada tanto de sílice como de ZBLAN y configuraciones compuestas de ambos. Se analizan la mejores opciones en cuanto a ancho de banda y relación señal a ruido para diferentes potencias ópticas de entrada. No forman parte de este estudio las configuraciones que incluyen filtros en longitud de onda específicamente diseñados para aplanar la ganancia.Este trabajo se ha financiado a través del proyecto CICyT-TIC2001-0877-C02-02.Publicad

Avaliación 4.0: avaliación cooperativa en metodoloxías con aprendizaxe invertida

[Resumo] A palabra CAMBIO describe claramente a situación da Educación a todos os niveis (primaria, secundaria e superior) na nosa comunidade e fóra dela, polo que nos preguntamos se estamos preparados para este cambio. Vivimos na Sociedade da Información, unha sociedade en constante evolución que transforma tamén a Educación, de xeito que cómpre falar de Educación na Sociedade da Información. Este traballo xorde da vontade duns docentes por cambiar “algo” na súa docencia máis ou menos tradicional. Un dos aspectos máis críticos para os estudantes é, sen dúbida, a avaliación. A avaliación forma parte do proceso de aprendizaxe principalmente para determinar o grao de adquisición de competencias e adaptar o proceso educativo segundo as características do estudante ou grupo de estudantes. A responsabilidade da mesma é tradicionalmente do profesor, co que estamos a excluír o alumno deste elemento fundamental da educación. A demanda de roles de avaliación invertidos é crecente, polo que neste traballo propoñemos unha AVALIACION 4.0. Nela, estudantes e profesores comparten o rol de árbitros no proceso de aprendizaxe involucrando de xeito activo os primeiros, non só como deseñadores de probas ou instrumentos de avaliación, senón tamén como co-avaliadores, un rol innovador que, por analoxía coa aula invertida, leva a unha avaliación invertida.[Abstract] The word CHANGE clearly describes the state-of-the-art of Education at all levels (primary, secondary and higher) in our community and outside of it, so we are wondering if we are prepared for such a change. We live in the Information Society, which is continuously evolving and Education changes with it. Thus talking about Education in the Information Society is mandatory. This work arises from the willingness of some professors of higher education to change "something" in their more or less traditional teaching. The assessment is definitely the most critical aspect of the learning process from the point of view of students. The assessment determines the degree of acquisition of competences and adapts the educational process according to the characteristics of the student or group of students. The professor is traditionally responsible for that, so students are excluded from that task. The demand for flipping assessment roles is growing, and therefore in this work we propose what we denote 4.0 ASSESSMENT. Both students and teachers will share the role of referees in the learning process by actively involving students not only as designers of assessment tests and instruments but also as coevaluators, an innovative role that takes us by analogy with the flipped classroom to flipped assessmen

Knowledge, attitudes, perceptions and habits towards antibiotics dispensed without medical prescription: a qualitative study of Spanish pharmacists

Objective To investigate community pharmacists’ knowledge, attitudes, perceptions and habits with regard to antibiotic dispensing without medical prescription in Spain. Methods A qualitative research using focus group method (FG) in Galicia (north-west Spain). FG sessions were conducted in the presence of a moderator. A topic script was developed to lead the discussions, which were audiorecorded to facilitate data interpretation and transcription. Proceedings were transcribed by an independent researcher and interpreted by two researchers working independently. We used the Grounded Theory approach. Setting Community pharmacies in Galicia, region Norwest of Spain. Participants Thirty pharmacists agreed to participate in the study, and a total of five FG sessions were conducted with 2–11 pharmacists. We sought to ensure a high degree of heterogeneity in the composition of the groups to improve our study's external validity. Pharmacists’ participation had no gender or age restrictions, and an effort was made to form FGs with pharmacists who were both owners and non-owners, provided in all cases that they were Official Colleges of Pharmacists-registered community pharmacists. For the purpose of conducting FG discussions, the basic methodological principle of allowing groups to attain their ‘own structural identity’ was applied. Main outcome measurements Community pharmacists’ habits and knowledge with regard to antibiotics and identification of the attitudes and/or factors that influence antibiotic dispensing without medical prescription. Results Pharmacists attributed the problem of antibiotics dispensed without medical prescription and its relationship to antibiotic resistance to the following attitudes: external responsibility (doctors, dentists and the National Health Service (NHS)); acquiescence; indifference and lack of continuing education. Conclusions Despite being a problem, antibiotic dispensing without a medical prescription is still a common practice in community pharmacies in Galicia, Spain. This practice is attributed to acquiescence, indifference and lack of continuing education. The problem of resistance was ascribed to external responsibility, including that of patients, physicians, dentists and the NHS.S