Codisseny d’una eina web per fomentar les decisions compartides en persones amb esclerosi múltiple

Esclerosi múltiple; Tractament; Decisions compartides; Eines d'ajudaEsclerosis múltiple; Tratamiento; Decisiones compartidas; Herramientas de ayudaMultiple sclerosis; Treatment; Shared decisions; Help toolsPer apoderar les persones amb esclerosi múltiple en la gestió de la seva salut és essencial desenvolupar un lloc web i una eina de suport que permetin involucrar persones en la seva pròpia assistència sanitària i millorar la seva alfabetització en salut, promovent un model de presa de decisions compartit per a la selecció del tractament de l’esclerosi múltiple. L'article explica el desenvolupament del lloc web i l’eina de suport disponibles en accés obert a través de Canal Salut (http://decisionscompartides.gencat.cat/ca/inici/)

Views of Multiple Sclerosis Patients About Key Elements for a Decision Aid: A Qualitative Study

Multiple SclerosisEsclerosi múltipleEsclerosis múltipleBACKGROUND: Patients with multiple sclerosis (MS) may experience decisional conflict during treatment choice. Shared decision making (SDM), whereby patients and health professionals, primarily nurses, collaborate in making decisions, reduces this decisional conflict. It requires understanding large amounts of information and may be complex, especially when decisions affect patients' autonomy and quality and prolongation of life. Patient decision aids are tools in facilitating SDM. This study aimed to identify the key elements from the perspective of patients with relapsing-remitting MS to create a patient decision aid in the Spanish sociocultural context. METHODS: This is a qualitative study using focus groups led by a clinical nurse specialist. Semistructured interviews included healthcare needs and demands, the SDM process, and general characteristics of a peer support program. After the transcription of interview recordings, data were analyzed by thematic analysis and a constructivist naturalistic approach. RESULTS: Patients with MS (27) from Spain participated in 4 focus groups of 90 to 120 minutes each. Three overarching themes were identified: information access to sufficient high-quality data; knowledge of available treatment options, including efficacy, adverse effects, frequency, administration route, and the impact on daily life; decision-making role, engaged versus nonengaged patients. The former require support in facilitating their active involvement in decisions, whereas the latter prefer more passive health models. CONCLUSION: The needs identified by patients with relapsing-remitting MS regarding treatment choice in the Spanish setting align with those reported by other studies. The identified themes provide valuable information to design and develop a virtual patient decision aid jointly by clinical MS nurses and patients according to the International Patient Decision Aid Standards Collaboration criteria. This aid will help improve understanding between nurses and patients during SDM and facilitate the process

Evolution and future prospects of nurse anaesthetists in Catalonia: inception, upskilling and scope of practice

Aim: To explore the current and future professional landscape of nurse anaesthetists within the healthcare system of Catalonia (Spain). Background: Nurse anaesthetists have played a key role in anaesthesia administration since the 19th century. In Catalonia, they are recognised as advanced practice nurses, with an evolving competency framework designed to meet contemporary healthcare demands. Methods: A descriptive qualitative approach was employed, with data collected through a focus group conducted in June 2021. The discussion followed a structured script addressing competency differences between nurse anaesthetists and generalist nurses, the evolution of anaesthesia nursing in the Catalan healthcare system, and its future trajectory. Discourse analysis and microanalysis of interlocutors were performed. Findings: Twenty-one codes were identified and grouped into four main categories: ‘Nurse anaesthetist profile’ (competencies, care provision, health education, experience, training, humanisation, perioperative process, patient safety), ‘Current professional situation’ (role differentiation, institutional organisation, work intrusion), ‘Factors extrinsic to the NA profession’ (increased demand for anaesthetic procedures, financial interests, shortage of anaesthetists) and ‘Future prospects’ (growth of the profession, nursing specialty, advocacy, institutional recognition). Discussion: This study highlights the expansion of the nurse anaesthetist role in Catalonia, driven by skill enhancement and the shortage of anaesthetists. While nurse anaesthetists advocate for greater autonomy and emphasise their contribution to patient safety, concerns persist regarding limited professional recognition and the risk of role displacement

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Guía de prácticas correctas de higiene para operadores que elaboran y/o sirven comidas preparadas para colectividades

Manipulació dels aliments; Higiene alimentària; Seguretat alimentàriaManipulación de los alimentos; Higiene alimentaria; Seguridad alimentariaFood handling; Food hygiene; Food safetyAquesta guia s’adreça als establiments de restauració col·lectiva social com ara escoles, instituts, llars d’infants, campaments infantils, residències geriàtriques, centres de dia o similars. L’objectiu és proporcionar un referent per al personal i els responsables d’aquests serveis, ajudant-los a garantir l’elaboració d’aliments segurs.Esta guía está dirigida a los establecimientos de restauración colectiva social, como escuelas, institutos, guarderías, campamentos infantiles, residencias geriátricas y centros de día, entre otros. Su objetivo es proporcionar un referente para el personal y los responsables de estos servicios, ayudándolos a garantizar la elaboración de alimentos seguros.This guide is aimed at social collective catering establishments, such as schools, institutes, nurseries, children's camps, nursing homes, and day centers, among others. Its goal is to serve as a reference for staff and those responsible for these services, helping them ensure the safe preparation of food

Wreckfish (Polyprion americanus). New Knowledge about reproduction, larval husbandry and nutrition. Promise a new species for aquaculture

Four different wreckfish (Polyprion americanus) broodstock batches were maintained in research facilities under different photo and thermo-period conditions, one in Greece, the Helenic Center for Marine Research (HCMR, n = 3) and three in Spain: Instituto Español de Oceanografía (IEO, n = 13) in Vigo, Aquarium Finisterrae (MC2, n = 21) in A Coruña and Consellería do Mar (CMRM, n = 11). The CMRM includes two centers that work together: Instituto Galego de Formación en Acuicultura (IGAFA) and Centro de Investigacións Mariñas (CIMA), both in Pontevedra. During the five years of the project DIVERSIFY (Exploring the biological and socio-economic potential of new-emerging candidate fish species for the expansion of the European aquaculture industry, 2013–2018) works focused on the reproductive biology of the species, broodstock, and larvae nutrition and development of incubation and larval rearing protocols have been carried out. In terms of reproduction, catch methods of new wild animals, the reproductive cycle, sperm characteristics evaluation, and spontaneous and induced spawning methods have been described for wreckfish. Regarding nutrition, the positive effect of two types of enrichment on the fatty acid profiles of Artemia and rotifer has been verified. The relationship between the fatty acid profile of the diets supplied to the broodstock and the fatty acid profile obtained in the oocytes and eggs of the females fed with different diets, has also been demonstrated. Finally, early larval ontogeny has been described and incubation and larval rearing protocols have been proposed based on the results obtained in the different experiments of temperature, growth, survival, and larval feeding that were carried out.Versión del edito

A comprehensive analysis of candidate genes in familial pancreatic cancer families reveals a high frequency of potentially pathogenic germline variants

Background: The 5-year survival rate of patients with pancreatic ductal adenocarcinoma (PDAC) is around 5% due to the fact that the majority of patients present with advanced disease that is treatment resistant. Familial pancreatic cancer (FPC) is a rare disorder that is defined as a family with at least two affected first degree relatives, with an esti mated incidence of 4% 10%. The genetic basis is unknown in the majority of families although around 10% 13% of families carry germline mutations in known genes associated with hereditary cancer and pancreatitis syndromes. Methods: Panel sequencing was performed of 35 genes associated with hereditary cancer in 43 PDAC cases from families with an apparent hereditary pancreatic cancer syndrome. Findings: Pathogenic variants were identified in 19% (5/26) of PDAC cases from pure FPC families in the genes MLH1, CDKN2A, POLQ and FANCM. Low frequency potentially pathogenic VUS were also identified in 35% (9/26) of PDAC cases from FPC families in the genes FANCC, MLH1, PMS2, CFTR, APC and MUTYH. Furthermore, an important proportion of PDAC cases harboured more than one pathogenic, likely pathogenic or potentially pathogenic VUS, highlighting the multigene phenotype of FPC. Interpretation: The genetic basis of familial or hereditary pancreatic cancer can be explained in 21% of families by previously described hereditary cancer genes. Low frequency variants in other DNA repair genes are also present in 35% of families which may contribute to the risk of pancreatic cancer development

Voxel-based statistical analysis of thalamic glucose metabolism in traumatic brain injury: relationship with consciousness and cognition

Objective: To study the relationship between thalamic glucose metabolism and neurological outcome after severe traumatic brain injury (TBI). Methods: Forty-nine patients with severe and closed TBI and 10 healthy control subjects with 18F-FDG PET were studied. Patients were divided into three groups: MCS&VS group (n ¼ 17), patients in a vegetative or a minimally conscious state; In-PTA group (n ¼ 12), patients in a state of post-traumatic amnesia (PTA); and Out-PTA group (n ¼ 20), patients who had emerged from PTA. SPM5 software implemented in MATLAB 7 was used to determine the quantitative differences between patients and controls. FDG-PET images were spatially normalized and an automated thalamic ROI mask was generated. Group differences were analysed with two sample voxel-wise t-tests. Results: Thalamic hypometabolism was the most prominent in patients with low consciousness (MCS&VS group) and the thalamic hypometabolism in the In-PTA group was more prominent than that in the Out-PTA group. Healthy control subjects showed the greatest thalamic metabolism. These differences in metabolism were more pronounced in the internal regions of the thalamus. Conclusions: The results confirm the vulnerability of the thalamus to suffer the effect of the dynamic forces generated during a TBI. Patients with thalamic hypometabolism could represent a sub-set of subjects that are highly vulnerable to neurological disability after TBI.Lull Noguera, N.; Noé, E.; Lull Noguera, JJ.; Garcia Panach, J.; Chirivella, J.; Ferri, J.; López-Aznar, D.... (2010). Voxel-based statistical analysis of thalamic glucose metabolism in traumatic brain injury: relationship with consciousness and cognition. Brain Injury. 24(9):1098-1107. doi:10.3109/02699052.2010.494592S10981107249Gallagher, C. 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