Piscines Municipals al barri de Cappont, Lleida

El solar es troba al marge esquerre del riu, al barri de Cappont, on es reconeix una situació de creixement residencial de densitat alta i nous usos docents en el seu entorn. L'actuació està localitzada en una gran parcel•la qualificada pel PGM com a residencial, zona verda i equipament comunitari, en el seu conjunt. En la parcel•la destinada a equipament comunitari es preveu la construcció de les Piscines Municipals de Cappont, fruit de les condicions econòmiques de la concessió administrativa de l’ús privatiu del terreny de domini públic situat al Camp d'Esports de Lleida per a la construcció i explotació d'una instal•lació esportiva. Aquest concessionari està obligat a satisfer a l'Ajuntament en la contraprestació econòmica d'un cànon en espècie consistent en la construcció de les instal•lacions bàsiques d'aquesta piscina municipal de barri, juntament amb una altra al barri del Secà de Sant Pere. La intervenció que en resulta -segons el PGM- és un equipament que nega la relació amb l'entorn, ja que queda enfonsat entre les elevades edificacions residencials que l'envoltaran en un futur, essent un espai tancat només utilitzable en els mesos d'estiu. La superfície de la parcel•la contemplada al PGM és de 3700m²

Factores determinantes en la adaptación del paciente portador de ostomía y la importancia del estomaterapeuta

gicos, psicológicos y sociales que repercuten en su adaptación social. El objetivo de este trabajo es identificar las principales variables que intervienen en la adaptación de los pacientes a la enterostomía, así como dar a conocer la importancia de la labor del estomaterapeuta en este proceso. Método: Búsqueda bibliográfica de revisiones sistemáticas relacionadas con el objeto de estudio, indexadas en scopus, PubMed y cinahl. La recuperación de información se llevó a cabo mediante la combinación de vocabulario estructurado y texto libre, y el uso de operadores booleanos «AND» y «OR» para delimitar la búsqueda. Se seleccionaron todas aquellas evidencias científicas que cumplen con los criterios de elegibilidad establecidos. La calidad metodológica de los estudios se evaluó mediante una herramienta digital. Resultados: Se identificaron 1238 referencias, incluyéndose finalmente dos revisiones sistemáticas que cumplían los criterios de elegibilidad establecidos. Los artículos sintetizan los resultados de 29 estudios cualitativos y cuantitativos. Conclusiones: La educación sanitaria, la alteración de la imagen corporal, el apoyo familiar, la comunicación del diagnóstico de cáncer y el proceso de autocuidado repercuten principalmente en la adaptación del paciente. Son necesarias nuevas investigaciones para conseguir conclusiones fiables y centrarlas en el papel del estomaterapeuta. Se recomienda garantizar el acceso a los pacientes ostomizados a una atención especializada e incluir su cuidado en los programas formativos.Introduction: The ostomates often experience physiological, psychological and social problems that affect their social adaptation. The aims of this study are to identify the main variables involved in the adaptation of patients to enterostomy as well as raising awareness of the importance of the work of the ostomy specialist in this process. Method: Literature research of systematic reviews related to the object of study, indexed in scopus, PubMed and cinahl. The information retrieval was performed by combining structured vocabulary and free text, and the use of Boolean operators «AND» and «OR» to narrow the search. All the scientific evidence that meets the eligibility criteria was selected. The methodological quality of the studies was assessed using a digital tool. Results: 1238 references were identified, eventually including two systematic reviews that met the eligibility criteria. Articles summarize 29 qualitative and quantitative studies results. Conclusions: Health education, altered body image, family support, cancer diagnosis communication and the self-care process particularly affect patient’s adaptation. Additional research is needed to get reliable conclusions, focusing on the ostomy specialist’s role. It is highly recommended ensuring access to specialized care to ostomates and including their care on training programs

Barreras socioeconómicas de acceso al mercado laboral de las mujeres víctimas de violencia de género según su procedencia

La violencia de género tiene efectos negativos en diferentes ámbitos de la vida de las mujeres autóctonas e inmigrantes que la sufren. En esta investigación se analiza la violencia de género desde una perspectiva sociolaboral. Para ello, se estudia una muestra de 91 mujeres que participaron en el programa de Intervención Sociofamiliar de YMCA (Young Men’s Christian Association) con el objetivo de conocer las diferentes barreras que aumentan su vulnerabilidad ante el mercado laboral actual. A través de este estudio se ha determinado que los principales motivos que dificultan la incorporación al mercado de trabajo de las mujeres inmigrantes son el desconocimiento del idioma y la ausencia de formación en el país de acogida. Lo mismo sucede en las mujeres víctimas de violencia de género, donde la baja empleabilidad derivada de su condición también supone un hándicap para su inserción laboral

Assessment of dead-end ultrafiltration for the detection and quantification of microbial indicators and pathogens in the drinking water treatment processes

A safe water supply requires distinct treatments and monitoring to guarantee the absence of pathogens and substances potentially hazardous for human health. In this study we assessed the efficiency of the dead-end ultrafiltration (DEUF) method to concentrate faecal indicator organisms (FIO) and pathogens in water samples with different physicochemical characteristics. Water samples were collected at the treatment stages of two drinking water treatment plants to analyse the concentration of a variety of 7 FIO and 4 reference microbes which have some species that are pathogenic to humans: Campylobacter spp., enteroviruses, Cryptosporidium spp. and Giardia spp. The samples were analysed before and after concentration by DEUF, detecting FIO concentrations about 1 log10 higher in non-concentrated samples from both catchments. Percent recoveries were highly variable with a mean of 43.8 ± 17.5%, depending on the FIO and inherent sample characteristics. However, DEUF enabled FIO concentration in high volumes of water (100-500 l), allowing a reduction in the detection limit compared to the non-concentrated samples due to the high volume processing capabilities of the method. As a consequence, the detection of FIO removal from water in the drinking water treatment process was 1.0-1.5 logarithms greater in DEUF-treated water compared to unfiltered samples. The DEUF method improved the detection of target indicators and allowed for the detection of pathogens in low concentrations in water after the treatment stages, confirming the suitability of DEUF to concentrate high volumes of different types of water. This method could be useful for microbial analysis in water treatment monitoring and risk assessment, allowing the identification of critical points during the water treatment process and potential hazards in water destined for several uses

Lipid-lowering drugs in ischaemic heart disease : a quasi-experimental uncontrolled before-and-after study of the effectiveness of clinical practice guidelines

Background: Cardiovascular diseases(CVD), specifically ischaemic heart disease(IHD), are the main causes of death in industrialized countries. Statins are not usually prescribed in the most appropriate way. To ensure the correct prescription of these drugs, it is necessary to develop, disseminate and implement clinical practice guidelines(CPGs), and subsequently evaluate them. The main objective of this study is to evaluate the effectiveness of the implementation of consensual Lipid-lowering drugs (LLD) prescription guidelines in hospital and primary care settings, to improve the control of Low-Density Lipoprotein Cholesterol (LDL-C) levels in patients with IHD in the Terres de l'Ebre region covered by the Catalonian Health Institute. Secondary bjectives are to assess the improvement of the prescription profile of these LLDs, to assess cardiovascular morbimortality and the professional profile and participant centre characteristics that govern the control of LDL-C. Methods/Design Design: Quasi-experimental uncontrolled before and after study. The intervention consists of the delivery of training strategies for guideline implementation (classroom clinical sessions and on-line courses) aimed at primary care and hospital physicians. The improvement in the control of LDL-C levels in the 3,402 patients with IHD in our territory is then assessed. Scope: Primary care physicians from 11 basic health areas(BHAs) and two hospital services (internal medicine and cardiology). Sample: 3,402 patients registered with IHD in the database of the Catalan Institute of Health(E-cap) before December 2008 and patients newly diagnosed during 2009-2010. Variables: Percentage of patients achieving good control of LDL-C, measured in milligrams per decilitre. The aim of the intervention is to achieve levels of LDL-C < 100 mg/dl in patients with IHD. Secondary variables measure type and time of diagnosis of IHD, type and dose of prescribed cholesterol-lowering drugs, level of physician participation in training activities and their professional profile. Discussion: The development of prescription guidelines previously agreed by various medical specialists involved in treating IHD patients have usually improved drug prescription. The guideline presented in this study aims to improve the control of LDL-C by training physicians through presential and on-line courses on the dissemination of this guideline, and by providing feedback on their personal results a year after this training intervention

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Piscines Municipals al barri de Cappont, Lleida

El solar es troba al marge esquerre del riu, al barri de Cappont, on es reconeix una situació de creixement residencial de densitat alta i nous usos docents en el seu entorn. L'actuació està localitzada en una gran parcel•la qualificada pel PGM com a residencial, zona verda i equipament comunitari, en el seu conjunt. En la parcel•la destinada a equipament comunitari es preveu la construcció de les Piscines Municipals de Cappont, fruit de les condicions econòmiques de la concessió administrativa de l’ús privatiu del terreny de domini públic situat al Camp d'Esports de Lleida per a la construcció i explotació d'una instal•lació esportiva. Aquest concessionari està obligat a satisfer a l'Ajuntament en la contraprestació econòmica d'un cànon en espècie consistent en la construcció de les instal•lacions bàsiques d'aquesta piscina municipal de barri, juntament amb una altra al barri del Secà de Sant Pere. La intervenció que en resulta -segons el PGM- és un equipament que nega la relació amb l'entorn, ja que queda enfonsat entre les elevades edificacions residencials que l'envoltaran en un futur, essent un espai tancat només utilitzable en els mesos d'estiu. La superfície de la parcel•la contemplada al PGM és de 3700m²

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population