Formación continuada en un equipo de atención primaria: análisis de las sesiones docentes 1996-1998

ObjetivoDescribir las sesiones docentes de un equipo de atención primaria en el trienio 1996-1998. Identificar los profesionales que las realizaron, así como estudiar las áreas del conocimiento abordadas.DiseñoEstudio descriptivo transversal, retrospectivo.EmplazamientoCentro de salud docente perteneciente a una zona de salud rural.ParticipantesTotal de sesiones docentes realizadas durante el trienio estudiado (n = 249).IntervencionesDe la hoja de registro mensual del programa de formación continuada de nuestra gerencia, se extrajeron las siguientes variables: fecha actividad, duración, número de asistentes, tipo de sesión, profesional docente y contenido de actividad (clasificada por patología según órganos y sistemas para sesión bibliográfica, clínica y con experto; cartera servicios de atención primaria-INSALUD 1996 para sesión sobre programa; informática).Mediciones y resultados principalesSesiones por mes: media 6,9 (DE, 4,8). Media asistentes: 9,3 (DE, 3,01). Duración media: 36,5 minutos (DE, 11,0). Tipo de sesión: bibliográfica, 65,2%; sobre programa, 18; sesión con experto, 7,2; informática, 5,6; clínica, 4. Responsables docentes: médico residente, 39,4%; médico de familia tutor, 34,9; médico de familia no tutor, 7,2; ATS, 6,4; médico hospitalario, 4; médico de familia sustituto, 3,6; farmacéutico, 2,8; pediatra, 1,2; fisioterapeuta, 0,4. Contenido actividades más frecuentes: patología general inespecífica, 16,1%; enfermedades de la piel, 8,8, y enfermedades del sistema endocrino, 7,6%.ConclusionesBaja frecuencia de sesiones clínicas. Los responsables docentes fueron mayoritariamente médicos de familia tutores y médicos residentes, siendo escasa la participación del resto de personal.ObjectivesTo describe the teaching sessions of a primary care team in the three-year period 1996-1998. To identify the professionals who ran them and study the areas of knowledge tackled. Design. A retrospective, cross-over, descriptive study.SettingTeaching health centre belonging to a rural health district.ParticipantsAll the teaching sessions that took place during the three-year period (n = 249). Interventions. The following variables were extracted from the monthly register sheet of the ongoing training programme of our management: date of activity, duration, number attending, type of session, teaching professional and contents of activity (classified by pathology according to organs and systems for bibliographic, clinical and expert sessions; portfolio of 1996 Primary Care- INSALUD services for session on programme; computer studies).Measurements and main resultsMean sessions per month: 6.9 (SD: 4.8). Mean attendance: 9.3 persons (SD: 3.01). Mean length: 36.5 minutes (SD: 11.0). Type of session: bibliographic 65.2%, on programme 18%, session with expert 7.2%, computer studies 5.6%, clinical 4%. Responsible for teaching: intern 39.4%; family doctor tutor 34.9%; family doctor not a tutor 7.2%; nurse 6.4%; hospital doctor 4%; locum family doctor 3.6%; pharmacist 2.8%; paediatrician 1.2%; physiotherapist 0.4%. Most common contents: non-specific general pathology (16.1%), skin diseases (8.8%), diseases of the endocrine system (7.6%).ConclusionsLow frequency of clinical sessions. The teachers in charge were mainly family doctor tutors and interns, with the rest of the staff participating little

Innovative learning in ethology and animal welfare. Results of collaborative teaching between the zoo and the Veterinary Faculty of Córdoba

Resúmenes IV Congreso VetDoc de Docencia Veterinaria, León 2017 (6-7 de Julio)[ES] La sensibilidad de la sociedad respecto al bienestar de los animales se ha incrementado de forma muy significativa en los últimos años (Blasco, 2011), planteando un reto al que los estudios y la profesión veterinaria deben dar respuesta (Vallat, 2009). El Zoo de Córdoba no ha sido ajeno a estos cambios sociales y al hecho de que la información sobre las especies salvajes que la sociedad tiene en la actualidad es ahora mucho mayor que la de tiempos pasados

Sustainable Materials and Biorefinery Chemicals from Agriwastes

This is an open access chapter distributed under the terms of the Creative Commons Attribution License.-- et al.Countries with economies based on agriculture generate vast amounts of low or null value wastes which may even represent an environmental hazard. In our group, agricultural industrial wastes have been converted into value added liquid substances and materials with several aims: decreasing pollution, giving added value to wastes and working in a sustainable manner in which the wastes of an industry can be used as the raw materials of the same or others, as the “cradle to cradle” philosophy states [1]. Sub-products from the agricultural food industry are being employed as renewable low cost raw materials in the preparation of Ecomaterials, designed for use in a number of industrial processes of great interest. Given their origin, these materials may compete with conventional ones since with this process a sustainable cycle is closed, in which the residues of one industry are used as raw materials in the same or other industries [2]. With regards to the composition of the residues produced from agriculture, the pH of soil is of great importance, since plants can only absorb the minerals that are dissolved in water and pH is mandatory for the physical, chemical and biological properties of soil and the main cause of many agronomic questions related to nutrient assimilation [3-5]. Variations of pH modify the solubility of most elements necessary for the development of crops and also influence the microbian activity of soil, which will affect the transformation of elements that are liberated to the soil and can be assimilated to form crops or not [3]. For example at pH lower than 6 or higher than 8 bacterian activities are lowered, the oxidation of nitrogen to nitrate is reduced and the amount of nitrogen available for plant food is decreased. However Al, Fe and manganese are more soluble at low pHs, reaching even toxic concentrations. Potassium and sulphur are easily adsorbed at pH higher than 6, calcium and magnesium between 7 and 8.5 and iron at pH lower than 6. For alkaline pH in soil, the availability of H2PO4-can be reduced through precipitation of phosphorous containing salts withcations such as calcium Ca2+ or magnesium Mg2+. However when soils have acid pH other compounds with HPO42-and iron (Fe2+), aluminium (Al3+) and manganese (Mn2+) can form, with increased solubility. The main factors that influence soil pH are the mineral composition and how it meteorizes, the decomposition of organic matter, how nutrients are partitioned among the solution and aggregates and of course the pluviometryof the zone and atmospheric contamination.Lower pHs are found in places with high pluviometry, with high organic matter decomposition, young soils developed on acid substrates, and places with high atmospheric contamination (acid rain). Depending on the species, crops can benefit from calcareous soils with high calcium carbonate content such as alfalfa, but other plants prefer soils with acid pH such as potatoes, coffee or tobacco. It is clear that different seasons will produce plants with a varying composition depending on the atmospheric conditions and therefore the materials derived from them need to be characterised and analysed to determine their possible uses.Given its multidisciplinary approach, this work is being carried out through the collaboration among national (Institute of Materials Science of Madrid (ICMM, CSIC), Institute of Catalysis (ICP, CSIC), Centre of Molecular Biology Severo Ochoa (UAM-CSIC), Polytechnic University of Madrid (UPM), University at distance (UNED), University Complutense of Madrid (UPM) and international (University of Sheffield and University of Ghent) research groups, in addition to various industries interested in the transformation of their residues and or sub-products into “value added materials”, with whom various research projects have been and are being sponsored by the MICINN and CDTI.Peer Reviewe

IRAM 30-meter millimeter follow-up of deep OSIRIS-GTC optical surveys

It is broadly accepted that CO is a reliable tracer of H2 in massive IR (LIR ≳ 109 L⊙) galaxies, and that there are clear correlations between LIR and L’CO that are qualitatively independent of environment and even redshift. We present two tales on the search for 12CO emission from dusty star-forming galaxies in both field (Lockman Hole, z < 0.1) and cluster (Zw Cl0024.1+1652, z ∼ 0.4) environments, according to the capabilities of the EMIR receiver at the IRAM-30m telescope. The observed galaxies are part of two follow-up programs in the millimetre regime of the spectroscopic Lockman-SpReSO and GLACE surveys in the optical (OSIRIS / 10.4m GTC). From these data we derived LIR and L’CO estimations and put them in the framework of the historic records according to the literature for each environmental case. We provide insights about some practical limits of the current facilities (IRAM observatories, ALMA, LMT) to get reliable estimations for IR at low and intermediate redshifts. Our results suggest that the amount of cold gas and the star formation efficiency increase with the cluster-centric distance, hence pointing to an environmental dependency

Modifiable risk factors associated with prediabetes in men and women: A cross-sectional analysis of the cohort study in primary health care on the evolution of patients with prediabetes

Background: Prediabetes is a high-risk state for diabetes development, but little is known about the factors associated with this state. The aim of the study was to identify modifiable risk factors associated with the presence of prediabetes in men and women. Methods: Cohort Study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS-Study) is a prospective study on a cohort of 1184 subjects with prediabetes and another cohort of 838 subjects without glucose metabolism disorders. It is being conducted by 125 general practitioners in Spain. Data for this analysis were collected during the baseline stage in 2012. The modifiable risk factors included were: smoking habit, alcohol consumption, low physical activity, inadequate diet, hypertension, dyslipidemia, and obesity. To assess independent association between each factor and prediabetes, odds ratios (ORs) were estimated using logistic regression models. Results: Abdominal obesity, low plasma levels of high-density lipoprotein cholesterol (HDL-cholesterol), and hypertension were independently associated with the presence of prediabetes in both men and women. After adjusting for all factors, the respective ORs (95% Confidence Intervals) were 1.98 (1.41-2.79), 1.88 (1.23-2.88) and 1.86 (1.39-2.51) for men, and 1.89 (1.36-2.62), 1.58 (1.12-2.23) and 1.44 (1.07-1.92) for women. Also, general obesity was a risk factor in both sexes but did not reach statistical significance among men, after adjusting for all factors. Risky alcohol consumption was a risk factor for prediabetes in men, OR 1.49 (1.00-2.24). Conclusions: Obesity, low HDL-cholesterol levels, and hypertension were modifiable risk factors independently related to the presence of prediabetes in both sexes. The magnitudes of the associations were stronger for men than women. Abdominal obesity in both men and women displayed the strongest association with prediabetes. The findings suggest that there are some differences between men and women, which should be taken into account when implementing specific recommendations to prevent or delay the onset of diabetes in adult population

Bronchoscopist's perception of the quality of the single-use bronchoscope (Ambu aScope4™) in selected bronchoscopies: a multicenter study in 21 Spanish pulmonology services

Background: The disposable bronchoscope is an excellent alternative to face the problem of SARS-CoV-2 and other cross infections, but the bronchoscopist's perception of its quality has not been evaluated. Methods: To evaluate the quality of the Ambu-aScope4 disposable bronchoscope, we carried out a cross-sectional study in 21 Spanish pulmonology services. We use a standardized questionnaire completed by the bronchoscopists at the end of each bronchoscopy. The variables were described with absolute and relative frequencies, measures of central tendency and dispersion depending on their nature. The existence of learning curves was evaluated by CUSUM analysis. Results: The most frequent indications in 300 included bronchoscopies was bronchial aspiration in 69.3% and the median duration of these was 9.1 min. The route of entry was nasal in 47.2% and oral in 34.1%. The average score for ease of use, image, and aspiration quality was 80/100. All the planned techniques were performed in 94.9% and the bronchoscopist was satisfied in 96.6% of the bronchoscopies. They highlighted the portability and immediacy of the aScope4TM to start the procedure in 99.3%, the possibility of taking and storing images in 99.3%. The CUSUM analysis showed average scores > 70/100 from the first procedure and from the 9th procedure more than 80% of the scores exceeded the 80/100 score. Conclusions: The aScope4™ scored well for ease of use, imaging, and aspiration. We found a learning curve with excellent scores from the 9th procedure. Bronchoscopists highlighted its portability, immediacy of use and the possibility of taking and storing images

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited