Empirical approach to the analysis of university student absenteeism. Proposal of a questionnaire for students to evaluate the possible causes

Works on student absenteeism in the universities have not been preferential for the authors in the field of educational research. Usually, what has been made is an approach to the available absenteeism data as an intervening variable or as a variable characteristic of the educational process, but not as a dependent variable in the strict sense of the term. In this work, we intend to make an empirical approach to the possible reasons of student absenteeism. There is a double point of view: the students" and the professors"; the reasons that justify it according to its protagonists are studied. This paper focuses on the six university degrees taught at the School of Economy and Business of the University of Barcelona (Facultat d"Economia i Empresa de la Universitat de Barcelona). An"ad-hoc" questionnaire has been prepared and the opinions of 1,162 undergraduates have been analyzed. The reasons given by each population differ in hierarchy and motivations

Effects of short-term treatment with atorvastatin in smokers with asthma - a randomized controlled trial

<b>Background</b> The immune modulating properties of statins may benefit smokers with asthma. We tested the hypothesis that short-term treatment with atorvastatin improves lung function or indices of asthma control in smokers with asthma.<p></p> <b>Methods</b> Seventy one smokers with mild to moderate asthma were recruited to a randomized double-blind parallel group trial comparing treatment with atorvastatin (40 mg per day) versus placebo for 4 weeks. After 4 weeks treatment inhaled beclometasone (400 ug per day) was added to both treatment arms for a further 4 weeks. The primary outcome was morning peak expiratory flow after 4 weeks treatment. Secondary outcome measures included indices of asthma control and airway inflammation.<p></p> <b>Results</b> At 4 weeks, there was no improvement in the atorvastatin group compared to the placebo group in morning peak expiratory flow [-10.67 L/min, 95% CI -38.70 to 17.37, p=0.449], but there was an improvement with atorvastatin in asthma quality of life score [0.52, 95% CI 0.17 to 0.87 p=0.005]. There was no significant improvement with atorvastatin and inhaled beclometasone compared to inhaled beclometasone alone in outcome measures at 8 weeks.<p></p> <b>Conclusions</b> Short-term treatment with atorvastatin does not alter lung function but may improve asthma quality of life in smokers with mild to moderate asthma. Clinicaltrials.gov identifier: NCT0046382

Meeting the governance challenges of integrated health and social care

Background Many countries are experimenting with novel ways of organising and delivering more integrated health and social care. Governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration. Methods Cross-country case analysis involving document review and semi-structured interviews with 27 local, regional and national level stakeholders in Italy, the Netherlands and Scotland. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to structure our analytical enquiry to explore factors that influence the governance arrangements in each system. Results Governance arrangements ranged from informal agreements in the Netherlands to mandated integration in Scotland. Novel service models were generally participative involving a wide range of stakeholders, including the public, although integration was seen to be driven, largely, from a health perspective. In Italy and Scotland some reversion to ‘command & control’ was reported in response to the imperatives of the Covid-19 pandemic. Policies, budgets, auditing and reporting systems that are clearly aligned at all levels were seen to help with implementing innovations in service organisation. Where alignment was lacking, cooperation and integration was suboptimal, regardless of whether governance arrangements were statutory or not. There was wide recognition of the importance of buy-in. Enablers of greater engagement included visible leadership, time and long-standing working relationships. Lack of suitable indicators and openness to data sharing to measure integration hindered working relationships and thus the successful delivery of integrated services. Conclusions Our study provides important insights into how to more effectively and efficiently govern service delivery structures within care systems. We will discuss approaches to governance that help support more resilient integrated care systems. Key messages • Different governance arrangements face common challenges to greater integration of care. Enablers include strong leadership, inclusivity and openness to work across traditional boundaries. • Meeting the governance challenges of integrated health and social care requires clear lines of accountability, aligned policies, budgets and reporting systems

Awareness of HPV and cervical cancer prevention among Cameroonian healthcare workers

<p>Abstract</p> <p>Background</p> <p>Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in low-resource countries.</p> <p>The objective of this study was to assess knowledge and awareness of cervical cancer prevention among Cameroonian healthcare workers.</p> <p>Methods</p> <p>A cross-sectional self-administered questionnaire in 5 parts with 46 items regarding cervical cancer etiology and prevention was addressed to healthcare workers in six hospitals of Yaoundé, Cameroon. The investigators enlisted heads of nursing and midwifery to distribute questionnaires to their staff, recruited doctors individually, in hospitals and during conferences and distributed questionnaires to students in Yaoundé University Hospital and Medical School. Eight hundred and fifty questionnaires were distributed, 401 collected. Data were analyzed with SPSS version 16.0. Chi-square tests were used and P-values < 0.05 were considered significant.</p> <p>Results</p> <p>Mean age of respondents was 38 years (range 20-71 years). Most participants were aware that cervical cancer is a major public health concern (86%), were able to identify the most important etiological factors (58%) and believed that screening may prevent cervical cancer (90%) and may be performed by Pap test (84%). However, less than half considered VIA or HPV tests screening tests (38 and 47%, respectively). Knowledge about cancer etiology and screening was lowest among nurse/midwives.</p> <p>Conclusion</p> <p>Knowledge of cervical cancer and prevention by screening showed several gaps and important misconceptions regarding screening methods.</p> <p>Creating awareness among healthcare workers on risk factors and current methods for cervical cancer screening is a necessary step towards implementing effective prevention programs.</p

The association between prior statin usage and long-term outcomes after critical care admission

Background: Statins may have immunomodulatory effects that benefit critically ill patients. Therefore we retrospectively examined the association between survival and the prescription of statins prior to admission to an intensive care unit (ICU), or high dependency unit (HDU), as a result of major elective surgery, or as an emergency with a presumed diagnosis of sepsis. Methods: We retrospectively studied critical care patients (ICU or HDU) from a tertiary referral UK teaching hospital. Nottingham University Hospitals has over 2200 beds, of which 39 are critical care beds. Over a five-year period (2000–2005) 414 patients were identified with a presumed diagnosis of sepsis, and 672 patients were identified with a planned ICU/HDU admission following elective major surgery. Patients prescribed statins prior to hospital admission were compared with those who were not. Demographics, past medical history, drug history, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were examined. Univariate and multivariate analyses were applied using the primary endpoint of survival at five years after admission. Results: Patients prescribed statins prior to critical care admission were, on average, older, with higher initial APACHE II scores and more pre-existing comorbidities. Statins were almost invariably stopped following admission to critical care. Statin usage was not associated with significantly altered survival during hospital admission, or at five years, for either patients with sepsis (9% v 15%, P=0.121; 73% v 84%, P=0.503 respectively), or post-operative patients (55% v 58%, P=0.762; 57% v 63%, P=0.390). Conclusions: Prior statin usage was not associated with improved or worsening outcomes in patients admitted to critical care after elective surgical cases or with a presumed diagnosis of sepsis

Persistence with Statins and Onset of Rheumatoid Arthritis: A Population-Based Cohort Study

In a retrospective cohort study, Gabriel Chodick and colleagues find a significant association between persistence with statin therapy and reduced risk of developing rheumatoid arthritis, but only a modest decrease in risk of osteoarthritis

The importance of disease associations and concomitant therapy for the long-term management of psoriasis patients

It is well established that several inflammatory-type conditions, such as arthritis, diabetes, cardiovascular disease, and irritable bowel disease exist comorbidly and at an increased incidence in patients with psoriasis. Psoriasis and other associated diseases are thought to share common inflammatory pathways. Conditions such as these, with similar pathogenic mechanisms involving cytokine dysregulation, are referred to as immune-mediated inflammatory diseases (IMIDs). Considerable evidence for the genetic basis of cormobidities in psoriasis exists. The WHO has reported that the occurrence of chronic diseases, including IMIDs, are a rising global burden. In addition, conditions linked with psoriasis have been associated with increasing rates of considerable morbidity and mortality. The presence of comorbid conditions in psoriasis patients has important implications for clinical management. QoL, direct health care expenditures and pharmacokinetics of concomitant therapies are impacted by the presence of comorbid conditions. For example, methotrexate is contraindicated in hepatic impairment, while patients on ciclosporin should be monitored for kidney function. In addition, some agents, such as beta blockers, lithium, synthetic antimalarial drugs, NSAIDs and tetracycline antibiotics, have been implicated in the initiation or exacerbation of psoriasis. Consequently, collaboration between physicians in different specialties is essential to ensuring that psoriasis treatment benefits the patient without exacerbating associated conditions