Drugs use in pregnancy in the Valencia Region and the risk of congenital anomalies

Background Despite the potential risks of drug use during pregnancy, consumption has increased in recent decades. Objective To identify the risk of congenital anomalies (CA) associated with the use of drugs in primary care in pregnant women resident in the Valencia Region. Methods A case-control study, considering a case as a less than one year old live birth in 2009–2010, diagnosed with a CA and resident in the Valencia Region, obtained from the CA population-based registry. Controls were selected from the Metabolic Disease Registry, and the drugs prescribed and dispensed from the Integral Management of Pharmaceutical Services. Crude odds ratio (OR) was calculated with its 95% confidence intervals and adjusted OR was calculated using logistic regression. Results A total of 1.913 cases and 3.826 controls were identified. The most frequently used drug groups were those acting on the musculoskeletal, nervous and respiratory systems, on the blood and blood forming organs, and anti-infection drugs. The most common drugs used were ibuprofen, dexketoprofen, paracetamol, amoxicillin, ferrous sulphate, and a combination of folic acid. A significantly increased risk of CA was identified for drugs acting on the musculoskeletal system (adjusted OR 1.14 [95% confidence interval 1.02–1.28]). A significantly decreased risk was observed for drugs acting on the blood and blood forming organs (adjusted OR 0.87 [95% confidence interval 0.78–0.98]). Conclusions Associations between drugs and CA in pregnant women resident in the Valencia Region have been identified for drugs that act as risk factors of CA, and for drugs that act as protective factors of CA. Antecedentes El consumo de medicamentos durante el embarazo se ha incrementado en las últimas décadas. Objetivo Identificar el riesgo de anomalías congénitas (AC) asociado a la utilización de medicamentos en atención ambulatoria en embarazadas residentes en la Comunitat Valenciana. Métodos Estudio de casos-controles, considerando caso a menores de un año nacidos vivos en 2009-2010 diagnosticados de AC y residentes en la Comunitat Valenciana, obtenidos del registro poblacional de AC. Los controles se seleccionaron del Registro de Metabolopatías y la medicación prescrita y dispensada se obtuvo del módulo Gestión Integral de Prestación Farmacéutica. Se calcularon las odds ratio (OR) y los intervalos de confianza al 95% y las OR ajustadas mediante regresión logística. Resultados Se identificaron 1.913 casos y 3.826 controles. Los grupos de medicamentos más frecuentemente prescritos y dispensados fueron: los que actúan sobre los sistemas musculoesquelético, nervioso, respiratorio, sobre la sangre y órganos hematopoyéticos, y antiinfecciosos. Los medicamentos más habituales fueron: ibuprofeno, dexketoprofeno, paracetamol, amoxicilina, sulfato de hierro y una combinación de ácido fólico. Se identificó un aumento del riesgo de anomalías congénitas significativo para los fármacos de acción sobre el sistema musculoesquelético (OR ajustada de 1,14 [intervalo de confianza al 95% 1,02-1,28]). Se observó una disminución del riesgo significativa en el grupo que actúa sobre la sangre y los órganos hematopoyéticos (OR ajustada de 0,87 [intervalo de confianza al 95% 0,78-0,98]). Conclusiones Se han identificado asociaciones de medicamentos con AC en mujeres embarazadas residentes en la Comunitat Valenciana, tanto para fármacos que actúan como factores de riesgo de AC como para fármacos que actúan como factores protectores de AC

Socialization of the elderly in outdoor health circuits

En los parques biosaludables, originalmente concebidos para la población madura y anciana, se encuentran usuarios de diferentes edades y con distintas formas de entender la actividad física. El presente trabajo intenta examinar las relaciones de las personas mayores con el resto de usuarios para determinar en qué medida dichos parques pueden cumplir alguna función social más allá del fomento de hábitos saludables. Para ello se ha llevado a cabo una serie de observaciones, participantes y no participantes, en tres parques de la ciudad de Granada, donde se ha visto que, si bien existe una proporción minoritaria pero importante de usuarios jóvenes (aproximadamente un tercio del total), estos tienden a evitar una interacción que parte de los usuarios de mayor edad buscan expresamente

Socialización y proceso de construcción de la identidad profesional del educador físico de una prisión

The purpose of this paper is to explore the construction of the professional identity of Alex (a pseudonym), a physical educator in charge of sport and physical activity in a Spanish prison. To this end, we used a biographical-dialectic perspective based mainly on interviews especially focused on prior experiences, contextual resources and the micropolitical strategies Alex used in his workplace. The search for better job conditions and professional recognition mediated the strategies he used during the daily negotiation of his professional identity. Yet, this identity was also constructed in a dialogue between his experiences in sport and the performance discourse present at the macro-social level. This study exemplifies a particular, yet not unique case of professional socialization that helps illuminate the (re)construction of identity of those physical activity and sport professionals who work in marginal contexts

Young stars at large distances from the galactic plane: mechanisms of formation

We have collected from the literature a list of early-type stars, situated at large distances from the galactic plane, for which evidence of youth seems convincing. We discuss two possible formation mechanisms for these stars: ejection from the plane by dynamical interactions within small clusters, and formation away from the plane, via induced shocks created by spiral density waves. We identify the stars that could be explained by each mechanism. We conclude that the ejection mechanism can account for about two thirds of the stars, while a combination of star formation at z = 500-800 pc from the plane and ejection, can account for 90 percent of these stars. Neither mechanism, nor both together, can explain the most extreme examples.Comment: 6 pages, No figures. Sixth Pacific Rim Conference on Stellar Astrophysics - A tribute to Helmut Abt, (Kluwer

Professionalization of Sport Educators in European Prisons

Actualmente, las actividades físicas y deportivas forman parte del paisaje de las prisiones y se les adjudica un papel (re)educativo. Sin embargo, se desconoce cómo se desarrollan dichas actividades y la profesionalización del personal encargado de las mismas. En este estudio se administró un cuestionario a 341 profesionales de prisiones, ubicadas en cinco países europeos, con el objetivo de indagar en el rol que juega la formación especializada en deportes y el diseño instruccional en la profesionalización de estos educadores. Los resultados indican que la formación deportiva especializada es mayor en los profesionales con menos años de experiencia y, especialmente, en aquellos con estudios superiores. Un gran porcentaje de los educadores planifican los principales elementos del diseño instruccional, aunque la mitad aún mantiene los objetivos en mente. Utilizan principalmente la estrategia metodológica de instrucción directa y formas verbales de evaluación. Se concluye que los educadores noveles con mayor nivel de estudios muestran mayor grado de profesionalizaciónSport is nowadays part of the prison landscape and it receives a (re)educational role. Nevertheless, it is unknown how are they developed and the professionalization features of the staff in charge of these activities. Therefore, a sample of 341 professionals from prisons located in five European countries responded to a survey conducted to explore the role that specialized sportive training and instructional design play in the professionalization of sport educators. The results indicate that the specialized sports training is higher among professionals with less years of experience and, especially, among those with higher-university studies. Larger percentage of educators plan the main elements of design, however, half of them still kept in mind the objectives. They mainly use direct instruction methodological strategies and oral forms of assessment. The paper concludes that those educators with less years of experience and more level of education show higher degree of professionalizationEste artículo deriva del proyecto "Prisoners on the move. Move into sport, move through sport", que fue financiado por la Unión Europea (EAC/22/2010). Los miembros del equipo de investigación pertenecen a De Rode Antraciet de Bélgica (Coordinador del proyecto), Kriminal Forsorgen de Dinamarca, Sport et Citoyenneté de Francia, CRED de Rumania, Sport for Solidarity del Reino Unido y la Universitat de València de España. El estudio del cual deriva este artículo lo diseñaron y desarrollaron los autores de este trabajo

The influence of social support on the wellbeing of immigrants residing in Italy: Sources and functions as predictive factors for life satisfaction levels, sense of community and resilience

Moving from one country to another involves not only separation from the country of origin, but also the tiring process of integration into a new physical, institutional, and sociocultural context, which may expose migrants to acculturation stress. The loss of former support networks, or at the very least their transformation, presents immigrants with the need to rebuild their social support systems in the host country, involving an active search for support. Therefore, the aim of study is to analyze the structure of informal social support and its capacity to predict immigrants’ sense of community, resilience, and satisfaction with life. The results confirm that social support predicts satisfaction with life, sense of community, and resilience. Our findings highlight the way sources and frequency of support, and the satisfaction with which they are associated, have different degrees of predictive value on the dependent variables under investigation. In this study, it can be concluded that social support is an important factor in the well-being of migrants and their integration into the host community. The results have an important practical value in promoting interventions that improve immigrants’ support networks and, consequently, increase their satisfaction with life, sense of community, and resilience.Funding for open access charge: Universidad de Málaga / CBU

La validez del Conjunto Mínimo Básico de Datos como fuente de identificación de las anomalías congénitas en la Comunitat Valenciana

Objetivo Evaluar la validez del Conjunto Mínimo Básico de Datos (CMBD) para identificar anomalías congénitas mayores en la Comunitat Valenciana. Métodos Se realizó un estudio epidemiológico retrospectivo. Del CMBD se seleccionaron las altas en menores de un año nacidos en 2007, residentes en la Comunitat Valenciana con código de anomalía congénita (740-759 CIE9-MC) y una muestra aleatoria de menores de un año sin altas con estos códigos. Tras revisar la documentación clínica, se clasificaron como verdaderos positivos y negativos y falsos positivos y negativos. Se calcularon el valor predictivo positivo y negativo y la sensibilidad. Se analizaron la concordancia de los diagnósticos entre el CMBD y la documentación clínica utilizando la prueba kappa. Resultados Se identificaron 2305 altas de 1651 pacientes. En los 544 pacientes de la muestra, 4 tenían alguna anomalía congénita mayor. El valor predictivo positivo fue del 56,4% (intervalo de confianza del 95% [IC95%]: 53,9-58,8) y el negativo fue del 99,3% (IC95%: 98,6-100,0). La sensibilidad del CMBD fue del 68,6% (IC95%: 66,1-71,1). Los códigos más frecuentes en los verdaderos positivos fueron: 745.5 (Comunicación interauricular), 745.4 (Comunicación interventricular) y 747.0 (Ductus arterioso persistente), y en los falsos positivos: 747.0, 745.5 y 752.51 (Criptorquidia). El 25,5% de los diagnósticos con anomalía congénita del CMBD no estaban en la historia clínica. Considerando todos los diagnósticos codificados en el CMBD, la concordancia fue de 0,70 (IC95%: 0,68-0,72). Conclusiones El CMBD es la principal fuente de información para la identificación de casos para el Registro Poblacional de Anomalías Congénitas de la Comunitat Valenciana, pero su principal limitación es el elevado número de casos falsos positivos que detecta. Objective To assess the validity of the Spanish Minimum Basic Data Set (MBDS) for identifying major congenital anomalies in the Valencian Community. Methods A retrospective epidemiological study was carried out. Children under the age of one year, born in 2007 and residing in the Valencian Community with congenital anomalies code 740-759 CIE9-MC, were selected from the MBDS, in addition to a random sample of children under the age of 1 year without these discharge codes. Having reviewed the clinical documentation, the cases were classified as true positives and negatives and false positives and negatives. Positive and negative predictive value and sensitivity were calculated. The kappa test was applied to analyse diagnostic consistency between the MBDS and the clinical documentation. Results A total of 2305 discharges of 1651 patients were identified. 4 out of the 5434 patients sampled had a major congenital abnormality. The positive predictive value was 56.4% (95% confidence interval [95%CI]: 53.9-58.8) and the negative predictive value was 99.3% (95%CI: 98.6-100.0). MBDS sensitivity was 68.6% (95%CI: 66.1-71.1). The most common codes in the true positives were: 745.5 (atrial septal defect), 745.4 (ventricular septal defect) and 747.0 (patent ductus arteriosus) and in the false positives: 747.0, 745.5 and 752.51 (cryptorchidism). 25.5% of diagnoses with congenital anomaly from the MBDS were not in the clinical documentation. Considering all diagnoses coded in the MBDS, the correlation was 0.70 (95%CI: 0.68-0.72) Conclusions The MBDS is the main source of information to detect cases in the registry of congenital anomalies of the Valencian Community. Its main limitation is the high number of false positive cases detected

The influence of social support on the wellbeing of immigrants residing in Italy: Sources and functions as predictive factors for life satisfaction levels, sense of community and resilience

Moving from one country to another involves not only separation from the country of origin, but also the tiring process of integration into a new physical, institutional, and sociocultural context, which may expose migrants to acculturation stress. The loss of former support networks, or at the very least their transformation, presents immigrants with the need to rebuild their social support systems in the host country, involving an active search for support. Therefore, the aim of study is to analyze the structure of informal social support and its capacity to predict immigrants’ sense of community, resilience, and satisfaction with life. The results confirm that social support predicts satisfaction with life, sense of community, and resilience. Our findings highlight the way sources and frequency of support, and the satisfaction with which they are associated, have different degrees of predictive value on the dependent variables under investigation. In this study, it can be concluded that social support is an important factor in the well-being of migrants and their integration into the host community. The results have an important practical value in promoting interventions that improve immigrants’ support networks and, consequently, increase their satisfaction with life, sense of community, and resilience

Modeling skull-face anatomical/morphological correspondence for craniofacial superimposition-based identification

Craniofacial superimposition (CFS) is a forensic identification technique which studies the anatomical and morphological correspondence between a skull and a face. It involves the process of overlaying a variable number of facial images with the skull. This technique has great potential since nowadays the wide majority of the people have photographs where their faces are clearly visible. In addition, the skull is a bone that hardly degrades under the effect of fire, humidity, temperature changes, etc. Three consecutive stages for the CFS process have been distinguished: the acquisition and processing of the materials; the skull-face overlay; and the decision making. This final stage consists of determining the degree of support for a match based on the previous overlays. The final decision is guided by different criteria depending on the anatomical relations between the skull and the face. In previous approaches, we proposed a framework for automating this stage at different levels taking into consideration all the information and uncertainty sources involved. In this study, we model new anatomical skull-face regions and we tackle the last level of the hierarchical decision support system. For the first time, we present a complete system which provides a final degree of craniofacial correspondence. Furthermore, we validate our system as an automatic identification tool analyzing its capabilities in closed (known information or a potential list of those involved) and open lists (little or no idea at first who may be involved) and comparing its performance with the manual results achieved by experts, obtaining a remarkable performance. The proposed system has been demonstrated to be valid for sortlisting a given data set of initial candidates (in 62,5% of the cases the positive one is ranked in the first position) and to serve as an exclusion method (97,4% and 96% of true negatives in training and test, respectively)