A cost utility analysis alongside a cluster-randomised trial evaluating a minor ailment service compared to usual care in community pharmacy.

BACKGROUND: Minor ailments are "self-limiting conditions which may be diagnosed and managed without a medical intervention". A cluster randomised controlled trial (cRCT) was designed to evaluate the clinical, humanistic and economic outcomes of a Minor Ailment Service (MAS) in community pharmacy (CP) compared with usual care (UC). METHODS: The cRCT was conducted for 6 months from December 2017. The pharmacist-patient intervention consisted of a standardised face-to-face consultation on a web-based program using co-developed protocols, pharmacists' training, practice change facilitators and patients' educational material. Patients requesting a non-prescription medication (direct product request) or presenting minor ailments received MAS or UC and were followed-up by telephone 10-days after the consultation. The primary economic outcomes were incremental cost-utility ratio (ICUR) of the service and health related quality of life (HRQoL). Total costs included health system, CPs and patient direct costs: health professionals' consultation time, medication costs, pharmacists' training costs, investment of the pharmacy and consultation costs within the 10 days following the initial consultation. The HRQoL was obtained using the EuroQoL 5D-5L at the time of the consultation and at 10-days follow up. A sensitivity analysis was carried out using bootstrapping. There were two sub-group analyses undertaken, for symptom presentation and direct product requests, to evaluate possible differences. RESULTS: A total of 808 patients (323 MAS and 485 UC) were recruited in 27 CPs with 42 pharmacists (20 MAS and 22 UC). 64.7% (n = 523) of patients responded to follow-up after their consultation in CP. MAS patients gained an additional 0.0003 QALYs (p = 0.053). When considering only MAS patients presenting with symptoms, the ICUR was 24,733€/QALY with a 47.4% probability of cost-effectiveness (willingness to pay of 25,000€/QALY). Although when considering patients presenting for a direct product request, MAS was the dominant strategy with a 93.69% probability of cost-effectiveness. CONCLUSIONS: Expanding community pharmacists' scope through MAS may benefit health systems. To be fully cost effective, MAS should not only include consultations arising from symptom presentation but also include an oversight of self-selected products by patients. MAS increase patient safety through the appropriate use of non-prescription medication and through the direct referral of patients to GP. TRIAL REGISTRATION: ISRCTN, ISRCTN17235323 . Registered 07/05/2021 - Retrospectively registered

Fusion of 8He with 206Pb around Coulomb barrier energies

5th International Conference FUSION11The experimental study of the fusion of light neutron-rich nucleus 8He with 206Pb is reported in this work. A fusion stack of 206Pb targets has been used for this study. The most prominent evaporation residue (210Po), which has half-life of 138 days and decays by alpha emission, is populated in the reaction. Radiochemical analysis technique is used to extract the yield of this evaporation residueMinisterio Español de Ciencia e Innovación FPA2007-6307

Optimización de modelos en elementos finitos de los maniquíes Hybrid-III percentiles 50% y 95% para su aplicación en transporte ferroviario

En este artículo se presenta la metodología seguida para el desarrollo de los modelos matemáticos de los maniquíes Hybrid-III 50% y 95%, los cuales son capaces de predecir correctamente los criterios de lesión asociados a cada región del cuerpo. Como aplicación práctica de los modelos, se evalúa la seguridad de butacas de tren mediante técnicas de simulación. En primer lugar se han desarrollado los modelos a través de su geometría tridimensional. También han sido asignados los diferentes materiales y propiedades de cada parte de los maniquíes. Posteriormente se ha seguido un proceso de optimización y de mejora que incluye la verificación y validación de los maniquíes virtuales. Dicha validación se realiza a partir de los maniquíes físicos y de los datos experimentales que posee el Laboratorio de Seguridad Pasiva (LSP) del INSIA de la UPM, utilizando los maniquíes en varias configuraciones. Finalmente, se realiza el proceso de optimización de estos modelos virtuales para que representen lo más fielmente posible la realidad, que su comportamiento sea preciso y que el tiempo de cálculo o coste computacional sea el menor posible. Una vez creados los modelos en elementos finitos de ambos maniquíes, se emplean para analizar la seguridad de las butacas de tren mediante la simulación de los ensayos dinámicos que se describen en la norma GM/RT2100. Esta norma exige dos configuraciones de ensayo para evaluar la seguridad de las butacas. La primera configuración sirve para evaluar la resistencia y la integridad estructural de la butaca y sus anclajes mediante el uso de dos maniquíes Hybrid-III 95%. La segunda configuración se utiliza para evaluar la protección que las butacas ofrecen al ocupante mediante el uso de un maniquí Hybrid-III 50% instrumentado. En ambas configuraciones se realizan impactos en sentido de la marcha y en el sentido contrario y se compran los valores registrados en los maniquíes tanto en los ensayos reales como en las simulaciones matemáticas

Influence of the effect pigment size on the sparkle detection distance

5 págs.; 5 figs.In an effort to create more dynamic looking automobiles, there is an ever increasing trend among automobile manufacturers towards the use of gonio-apparent coatings in car bodies. These coatings consist of transparent pigments mixed with metallic or interference flakes. The flakes in the coating cause a change in color and brightness of the finish with viewing and illumination direction. This change in appearance accentuates the 3D shading of a car body, making it visually more attractive. Besides this angular dependence on viewing/illumination direction, the metallic finishes also exhibit a visually complex texture. Depending on the properties of the finish and the viewing and illumination conditions, the flakes exhibit a sparkle like texture, while the glossy clear coat may show a rough or smooth surface. As a result of these complex visual attributes, capturing the appearance and finding a perfect color match for an automotive coating is a non trivial task. The main objective of this work is to evaluate the relationship between the special-effect pigments size, and the maximum distance which is detectable the sparkle texture effect. For this, two different sets of samples with different structural features were evaluated in a lighting booth specifically designed for the visual experiment. The booth allows to vary the lighting conditions, the viewing geometry and the distance at which the sample is perceived. The visual experiment was applied to evaluate the high correlation between a structural parameter (i.e. pigment size) and the visual appearance attribute related with texture (sparkle detection distance). Under some fixed environmental conditions, as light intensity, color temperature and geometry of the light source, the sparkle detection distance was evaluated by applying the adjustment psychophysical method for two panel sets (metallic grays and blues), with known pigment sizes and colorimetry, with a small set of observers. The visual results show that a greater the pigment size, a greater the sparkle detection, but with some considerations. In future, we will extend this method, even reinforced applying the statistical design of experiments (DOE), for understanding the relevance and interplay of structural (size, shape, concentration, orientation, etc.), environmental (illuminance level, color rendering, geometry, etc.) and colorimetric (dark vs. light background, chroma, etc.) factors on the sparkle detection distance. © 2015 Society for Imaging Science and Technology.Authors are grateful to EMRP for funding the project “Multidimensional reflectometry for industry”. The EMRP is jointly funded by the EMRP participating countries within EURAMET and the European Union. We would like to thank the Ministry of Economy and Competitiveness for the coordinated project “New developments in visual optics, vision and color technology” (DPI2011-30090-C02). Omar Gómez would also like to thank the Ministry of Economy and Competitiveness for his pre- doctoral fellowship grant (FPI BES-2012-053080).Peer Reviewe

Co-pyrolysis of sewage sludge and manure

The management and valorization of residual organic matter, such as sewage sludge and manure, is gaining interest because of the increasing volume of these residues, their localized generation and the related problems. The anaerobic digestion of mixtures of sewage sludge and manure could be performed due to the similarities between both residues. The purpose of this study is to evaluate the feasibility of the co-pyrolysis of sewage sludge (SS) and digested manure (DM) as a potential management technology for these residues. Pyrolysis of a sewage sludge/manure blend (50:50%) was performed at 525 °C in a stirred batch reactor under N2 atmosphere. The product yields and some characteristics of the product were analyzed and compared to the results obtained in the pyrolysis of pure residues. Potential synergetic and antagonist effects during the co-pyrolysis process were evaluated. Although sewage sludge and manure seem similar in nature, there are differences in their pyrolysis product properties and distribution due to their distinct ash and organic matter composition. For the co-pyrolysis of SS and DM, the product yields did not show noticeable synergistic effects with the exception of the yields of organic compounds, being slightly higher than the predicted average, and the H2 yield, being lower than expected. Co-pyrolysis of SS and DM could be a feasible management alternative for these residues in locations where both residues are generated, since the benefits and the drawbacks of the co-pyrolysis are similar to those of the pyrolysis of each residue

Basic of methods for acorn mast prediction in the dehesa

La bellota de los Quercus de la dehesa (ilex, suber y faginea) es un recurso alimenticio de alto valor para el cebo extensivo del cerdo Ibérico, muy valorado comercialmente. Su producción muy afectada por la vecería propia de los Quercus debe estimarse anualmente para ajustar con suficiente antelación las cargas ganaderas de unos cerdos que nacen 12 a 16 meses antes del comienzo de la montanera en la que se cebarán. En este trabajo se revisan los diferentes métodos de estimación cualitativos o indirectos, basados en las condiciones climatológicas y en bioindicadores (floración y plagas); y los métodos cuantitativos o directos, basados en conteos visuales y en trampas para captura de bellotas. De acuerdo con las referencias, el método más precoz es el aeropalinológico con trampas Burkard® y los dos aspectos que más influyen en la fiabilidad de las estimaciones existentes son el momento de su realización y el tamaño de la muestra

Physical activity, sitting time, and mortality from inflammatory diseases in older adults

Objective: The aim of this study was to examine the independent and combined associations of physical activity (PA) and sitting time (ST) with long-term mortality attributed to inflammatory causes other than cardiovascular disease (CVD) and cancer in a national cohort of older adults in Spain. Design: Prospective study. Setting and Participants: A cohort of 3,677 individuals (1,626 men) aged =60 years was followed-up during 14.3 years. Measures: At baseline, individuals reported PA and ST. The study outcome was death from inflammatory diseases when CVD or cancer mortality was excluded. This outcome was classified into infectious and non-infectious conditions. Analyses were performed with Cox regression and adjusted for PA, ST, and other main confounders (age, sex, educational level, smoking, alcohol consumption, body mass index, and chronic conditions). Results: During follow-up, 286 deaths from inflammatory diseases (77 from infectious diseases) were identified. Compared to individuals who defined themselves as inactive/less active, mortality from inflammatory diseases was lower in those who were moderately active (hazard ratio [HR] = 0.67, 95% confidence interval [CI] = 0.50-0.90) or very active (HR = 0.48, 95%CI = 0.33-0.68), independently of ST. Also, being seated ≥7 h/d vs. < 7 h/d was linked to higher mortality (HR = 1.38, 95%CI = 1.02-1.87). The largest risk of mortality was observed in inactive/less active individuals with ST≥7 h/d (HR = 2.29, 95%CI = 1.59-3.29) compared to those with moderate/very PA and ST < 7 h/d. Low PA and high ST were consistently associated with a higher risk of mortality from non-infectious inflammatory causes. Associations of PA and ST with mortality from infectious inflammatory causes showed a similar trend, but most of them did not reach statistical significance. Conclusions: Low PA and high ST were independently associated with higher mortality from inflammatory diseases other than CVD or cancer in older adults. Interventions addressing simultaneously both behaviors could have greater benefits than those focusing on only one of themThis work was supported by FIS grant 16/609 (Instituto de Salud Carlos III, State Secretary of R+D+I and FEDER/FSE), MINECO R+D+I grant (DEP2013-47786-R), MECD mobility grant (JC2015-00080), the FRAILOMIC Initiative (European Union FP7-HEALTH-2012-Proposal No. 305483-2), and the ATHLOS project (European project H2020- Project ID: 635316