Evaluation of Prescriptions Dispensed in the Outpatient Pharmacies of a University Teaching Hospital in Moshi, Kilimanjaro Region, Tanzania: A Cross-Sectional Study

Background: Prescriptions written in daily medical practice are associated with increasing numbers of prescription writing errors. Both omission and commission errors are encountered and caused by prescribers of different cadres. Prescribing errors are associated with adverse drug events (ADEs), which are harmful to patients. This study aimed to determine the common prescription errors, the categories of prescribers who commit prescription errors, and the most prescribed drugs in the outpatient pharmacies in general practice at Kilimanjaro Christian Medical Centre (KCMC).   Methods: A prospective cross-sectional descriptive study was conducted at KCMC, a referral and teaching university hospital. All prescription dispensed on 2 June 2017 from the hospital's 2 outpatient pharmacies were reviewed, and our analysis determined the different types of prescription errors. A form designed by the authors was used to collect data from the prescription forms.   Results: A total of 242 prescriptions were studied, and the most common omission errors were missing patients' weight (n=231, 95.5%), missing patients' address (n=213, 88.0%), missing drug dosage (n=159, 67.1%), and commission errors were due to wrong drug strength (n=10, 2.0%). Intern doctors were leading in writing prescriptions with errors (n=352, 25.6%), followed by residents (n=199, 14.5%), registrar doctors (n=167, 12.1%), and specialists (n=45, 3.3%). The most commonly prescribed drugs were antibiotics (n=120, 17.3%), antihypertensives (n=81, 11.7%), and analgesics (n=86, 12.4%).   Conclusion: There were significant prescription errors at the study site, hence an intervention is needed to improve skills of prescribers. Educational interventions can substantially contribute to minimising such errors. Initaiting  programmes and short courses on prescription writing before medical internship at the health facility might also be helpful

Perceptive approaches to the morphological characterization of the urban contour: The case of the peri-urban landscape of Madrid

[EN] A growing city adapts and transforms the pre-existing topography, and with its urban fabric defines an ever-changing contour throughout history; this contour is not a clear line, but rather a fringe, where city and countryside meet and create occupancy systems that are crucial to comprehend the evolution of the urban form. We can consider this fringe as ‘proximity’ landscapes: landscapes that are perceived when the city is either a destination or a point of departure. The vision from afar, or when progressively approaching the city, provides both locals and tourists with certain landscape and architectural aspects that should be studied, preserved and valued for their ability to generate meaningful spaces. In this communication we study the surrounding landscapes of Madrid by means of a Landscape Character Assessment, within the framework of the project ‘Proximity landscapes of the city of Madrid. From the 19thC to the present’ currently in process. Combining graphic analysis of historical cartography at a metropolitan scale with perceptive analysis techniques, special attention is drawn to certain axes and significant lookouts of the city, mapping them and evaluating their visual basins. This characterization leads to distinguishing three main landscape types surrounding Madrid, according to physical, natural and anthropogenic structures: one predominantly natural, one mainly industrial and service-related, and a third one with special historical relevance.This research has been developed in the framework of the State Plan Project of the Ministry of Economy and Competitiveness (HAR2014-57843-R), entitled “Proximity Landscapes of the City of Madrid. From the 19th Century to the present”. We thank the General Secretariat of Science, Technology and Innovation for the funding of this project. Likewise, we thank the Spanish Ministry of Education for the pre-doctoral scholarship (FPU14/05524) granted to co-author Carlota Sáenz de Tejada Granados in its FPU Program. Lastly, we thank San Pablo-CEU University Foundation for the pre-doctoral scholarship granted to co-author Rocío Santo-Tomás Muro in its FPI Program.Rodríguez Romero, E.; Sáenz De Tejada Granados, C.; Santo-Tomás Muro, R. (2018). Perceptive approaches to the morphological characterization of the urban contour: The case of the peri-urban landscape of Madrid. En 24th ISUF International Conference. Book of Papers. Editorial Universitat Politècnica de València. 1349-1358. https://doi.org/10.4995/ISUF2017.2017.5345OCS1349135

Influence of energy paradigm shifts on city boundaries. The productive peripheries of Madrid

[EN] The promotion or access to certain energy technologies has changed the humanized landscape throughout history; cities have been born around, and because of an energy source, or have been displaced in order for energy-related infrastructures to take their spot. However, and for any city from its very beginning, energy paradigm shifts have deeply altered their morphology. Not only extraction, but especially transformation and transport of resources materializes in artefacts, often controversial and soon-to-be obsolete. This is especially patent in the ever-changing city boundaries; the fringe of ‘proximity’, where the collision between the countryside and the urban mesh embodies the relations and contradictions between urban growth, energy demand and landscape protection. In a context of growing cities (both in terms of expansion of its artificial land and in terms of energy demand), we are facing two paths which not always converge: an inevitable low carbon transition and a growing sensitivity towards ordinary landscapes. This article, within the framework of the project ‘Proximity landscapes of the city of Madrid. From the 19thC to the present’, studies the development of the city of Madrid in relation to its energy access and management, in a series of key stages: mid-19thC (before the bourgeois enlargement plan approved in 1860), early 20thC (when the introduction of electricity powered a deep urban transformation and outlaying urban cores were annexed), mid-late 20thC (when a rural exodus took place and the peripheries of Madrid grew rapidly) and today.This research has been developed in the framework of the State Plan Project of the Ministry of Economy and Competitiveness (HAR2014-57843-R), entitled “Proximity Landscapes of the City of Madrid. From the 19th Century to the present”. We thank the General Secretariat of Science, Technology and Innovation for the funding of this project. Likewise, we thank the Spanish Ministry of Education for the pre-doctoral scholarship (FPU14/05524) granted to co-author Carlota Sáenz de Tejada Granados in its FPU Program. Lastly, we thank San Pablo-CEU University Foundation for the pre-doctoral scholarship granted to co-author Rocío Santo-Tomás Muro in its FPI Program.Sáenz De Tejada Granados, C.; Rodríguez Romero, E.; Santo-Tomás Muro, R. (2018). Influence of energy paradigm shifts on city boundaries. The productive peripheries of Madrid. En 24th ISUF International Conference. Book of Papers. Editorial Universitat Politècnica de València. 719-128. https://doi.org/10.4995/ISUF2017.2017.5343OCS71912

The role of historical green spaces in the identity and image of today’s cities: The case of Madrid

[EN] The image that a city offers when approaching it, depending on its topographical situation, the drawing of its borders or its urban form, generates a perceptive construction, for both locals and tourists, with the potential to become an iconic image and therefore play a part in the collective imagery. The character and value of those landscapes is largely determined by their green spaces, preserved in most European cities for their ecological or historical significance. Being able to recognize the worthiness of these proximity visions, in the context of today’s growing cities, is of fundamental relevance in order to enhance the sense of place, amongst other community values. In this communication we study the above-mentioned aspects in the image of the city of Madrid, within the framework of the project ‘Proximity landscapes of the city of Madrid. From the 19thC to the present’ currently in process. Through a landscape analysis of a selection of iconographic representations of the surroundings of the city, we draw special attention to the presence of historical green spaces throughout time, and its relation with architectural landmarks in the progressive construction of an iconic image of the city. From here, we can deduce the relevance that these elements have in the generation of a recognizable character and the decisive role of protection mechanisms in order to preserve it.This research has been developed in the framework of the State Plan Project of the Ministry of Economy and Competitiveness (HAR2014-57843-R), entitled “Proximity Landscapes of the City of Madrid. From the 19th Century to the present”. We thank the General Secretariat of Science, Technology and Innovation for the funding of this project. Likewise, we thank the Spanish Ministry of Education for the pre-doctoral scholarship (FPU14/05524) granted to co-author Carlota Sáenz de Tejada Granados in its FPU Program. Lastly, we thank San Pablo-CEU University Foundation for the pre-doctoral scholarship granted to co-author Rocío Santo-Tomás Muro in its FPI Program.Rodríguez Romero, E.; Sáenz De Tejada Granados, C.; Santo-Tomás Muro, R. (2018). The role of historical green spaces in the identity and image of today’s cities: The case of Madrid. En 24th ISUF International Conference. Book of Papers. Editorial Universitat Politècnica de València. 1647-1656. https://doi.org/10.4995/ISUF2017.2017.5340OCS1647165

Dos proyectos de la UC3M: La Gens Isiaca en Hispania y Federico-Tena World Trade Historical Database

Ponencia presentada en la Jornada Madroño/InvestigaM de buenas prácticas en el apoyo a la investigación organizada por el Consorcio Madroño y celebrada en Madrid el 12 de junio de 2018

Psychological benefits of Forest Bathing during the COVID-19 pandemic: a pilot study in a Mediterranean forest close to urban areas

The practice of Shinrin-Yoku or Forest Bathing is an outdoor therapeutic modality with mounting evidence suggesting positive effects on individuals' psychological wellbeing and overall health. However, its benefits have mainly been studied in Asian biomes and more research is needed to evaluate if its benefits are also generalizable to other regions such as European-Mediterranean forests. To preliminarily explore this issue, 16 healthy adults (87.5% women, mean age 47.5) were assessed before and after a 3-hour session of Forest Bathing with meditation exercises in a Mediterranean forest near Barcelona (Spain). Changes in state anxiety, negative affect, positive affect and state mindfulness were assessed. Results show significant increases in positive affect, vigour, friendship and mindfulness, and decreases in negative affect, anxiety, anger, fatigue, tension, and depressive mood. Effect sizes observed for all the outcomes were significant and large, ranging from d = 1.02 to d = 2.61. This study encourages more applied research of the forest therapy model and the practice of Shinrin-Yoku in Mediterranean forests to increase the general population's psychological wellbeing and to deal with the growing prevalence of the psychological side-effects generated by the COVID-19 in European countries such as Spain

Effectiveness of a structured stimulated spontaneous safety monitoring of medicines reporting program in strengthening pharmacovigilance system in Tanzania

The study was funded partly by EDCTP under SMERT project and TMDA during SSSSM program implementation and data collection, and ASCEND project during data analysis.Under-reporting of adverse drug events (ADEs) is a challenge facing developing countries including Tanzania. Given the high magnitude of under-reporting, it was necessary to develop and assess the effectiveness of a ‘structured stimulated spontaneous safety monitoring’ (SSSSM) reporting program of ADEs which aimed at strengthening pharmacovigilance system in Tanzania. A quasi-experimental design and data mining technique were used to assess the effect of intervention after the introduction of program in seven tertiary hospitals. ADEs reports were collected from a single group and compared for 18 months before (July 2017 to December, 2018) and after the program (January 2019 to June 2020). Out of 16,557 ADEs reports, 98.6% (16,332) were reported after intervention and 0.1% (23) death related to adverse drug reactions (ADRs) were reported. Reports increased from 20 to 11,637 after intervention in Dar es salaam, 49 to 316 in Kilimanjaro and 17 to 77 in Mbeya. The population-based reporting ratio per 1,000,000 inhabitants increased from 2 reports per million inhabitants in 2018 to 85 reports in 2019. The SSSSM program can increase the reporting rate of ADEs and was useful in detecting signals from all types of medicines. This was first effective developed spontaneous program to monitor medicine safety in Tanzania.Publisher PDFPeer reviewe

Forest bathing and hiking benefits for mental health during the COVID-19 pandemic in Mediterranean regions

Altres ajuts: acords transformatius de la UABForest bathing (FB) has evidenced positive effects on individuals' mental health and well-being, but its benefits have mainly been studied in Asian biomes. The present study aimed to evaluate whether its benefits are also generalisable to other forests and biomes of the world, such as the Mediterranean. Eighty-six healthy adults of the general population were assessed before and after a FB near Barcelona (Spain) during the COVID-19 pandemic. A control-hiking group of participants was also analysed to contrast the FB effects on anxiety, affect, mood states and mindfulness. Results show that the guided practice of FB in Mediterranean-Catalan forests increases mindfulness states and positive affect and reduces anxiety and negative affect, with effect sizes being large to very large. Hiking also induced significant changes in all variables tested, but FB showed higher effect sizes. An exploratory analysis also revealed a different profile of the FB participants compared to the hiking practitioners, being highly educated women living in urban areas and with lower basal levels of psychological well-being. Accordingly, it is concluded that both Mediterranean FB and hiking (to a lesser degree) might be cost-effective strategies to promote and restore psychological well-being after the COVID-19 pandemic and to promote sustainable tourism in Mediterranean biomes of the European forested and protected areas

El papel del Dublin Core en el desarrollo de las infraestructuras de datos espaciales

Las tendencias actuales de caracterización de recursos de información geográfica para su oferta a través de Infraestructuras de Datos Espaciales (IDE) se centran en la información geográfica más tradicional (mapas, coberturas, modelos digitales del terreno, etc.). Para ello han utilizado como soporte de descripción los trabajos del grupo TC 211 de ISO (fundamentalmente ISO 19115). No obstante, todavía queda una ingente cantidad de servicios e información más heterogéneos susceptibles de ser ofrecidos a través de una IDE. El reto que se plantea en estos momentos es la definición de una estrategia que posibilite la incorporación de estas fuentes y servicios de información garantizando la interoperabilidad entre sistemas, sin que ello vaya en detrimento de una descripción o caracterización de recursos, adecuada, completa y suficiente. Es en este contexto donde Dublin Core puede jugar un papel fundamental como norma de metadatos (ISO 15836) de propósito general, fomentando la interoperabilidad en distintos dominios informativos, entre ellos también la información geoespacial. El objetivo de este capítulo es presentar un modelo de utilización del conjunto de elementos y principios de Dublin Core como base para el proceso de asignación de metadatos asociados a todo tipo de recursos en el contexto de una IDE, así como las decisiones técnicas básicas que deberían tomarse para dar soporte a servicios de creación y búsqueda de información sobre este modelo general propuesto.Este trabajo ha sido parcialmente financiado por el proyecto TIC2003-09365-C02-01 del Plan Nacional de Investigación Científica y Desarrollo Tecnológico del Ministerio de Educación y Ciencia de Españ

Adverse drug reactions resulting from the use of chiral medicines amoxicillin, amoxicillin-clavulanic acid, and ceftriaxone : a mixed prospective-retrospective cohort study

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was part of the EDCTP2 Program supported by the European Union partly under the SMERT project (CSA2016ERC-1432) and ASCEND project (CSA2019ERC-2683); and partly under TMDA.The use of chiral medicines (possessing center(s) of asymmetric carbon) may cause adverse drug reactions (ADRs). The safety assurance of these medicines is critical. We aimed to evaluate registered and commonly used anti-infective chiral medicines circulating in the Tanzanian market to establish their safety profile to protect public health. A mixed prospective-retrospective cohort study was conducted to assess the safety profile of amoxicillin, amoxicillin-clavulanic acid and ceftriaxone injection. ADRs causality assessment was conducted by using World Health Organization (WHO)-Algorithm criteria. Data were collected from 7 tertiary hospitals: Muhimbili National Hospital (MNH), Kilimanjaro Christian Medical Centre (KCMC), Bugando Medical Centre (BMC), Ligula Referral-Regional Hospital (LRRH), Kitete Referral-Regional Hospital (KRRH), Dodoma Referral-Regional Hospital (DRRH), and Mbeya Zonal-Referral Hospital (MZRH). Data were supplemented by those recorded in the WHO-Vigiflow/VigiLyze database within the same monitoring period. Data were analyzed using STATA version-15. The results were considered statistically significant when P < .05. A total of 2522 patients were enrolled in hospitals: MNH (499), KCMC (407), BMC (396), LRRH (387), KRRH (345), DRRH (249), and MZRH (239). Among those, 1197 (47.5%) were treated with ceftriaxone, 585 (23.2%) amoxicillin and 740(29.3%) amoxicillin-clavulanic acid. Out of those, 102 (4.5%) experienced adverse events (AEs), 49 (48%) were due to ceftriaxone, 37 (36.3%) amoxicillin-clavulanic acid and 16 (15.7%) amoxicillin (P-value .012). A total of 443 participants from the enrolled and WHO-Vigiflow/VigiLyze database were experienced with ADRs. The ADRs affected mainly gastro-intestinal system 234 (53%), skin and subcutaneous tissue 85 (19%), nervous system 49 (11%), respiratory thoracic 22 (5%), and general disorders 18(4%). In this study, approximately 90% of reported AEs were ADRs possible-related to the monitored medicines, with few plausible and certain. Ceftriaxone injection caused more ADRs. Amoxicillin-clavulanic acid was associated with more ADRs than amoxicillin alone. The safety profile of these medicines is still maintained; however, comprehensive monitoring of ADRs is recommended to improve patient safety and enhance overall treatment outcomes.Peer reviewe