Evaluación de la mejora de conocimientos y grado de satisfacción tras una acción formativa en cuidados farmacéuticos

Objetivo: Evaluar los resultados de una acción formativa en indicación farmacéutica, cuantificando mejora de conocimientos y grado de satisfacción. Método: Estudio analítico longitudinal sin grupo control. Participantes: 56 farmacéuticos inscritos en el 1o Curso de Postgrado en Cuidados Farmacéuticos de la Sección Regional de Oporto de la Orden de los Farmacéuticos. Intervención formativa: Módulo III, impartido por el grupo Berbés. Primera fase los alumnos recibieron el contenido teórico, un cuestionario inicial de evaluación de 14 preguntas, cuestionario y casos prácticos de autoevaluación. Segunda fase sesión presencial 12 días después. Se realizaron entrenamientos de casos prácticos mediante simulaciones (role-playing). Al finalizar, los alumnos repitieron el cuestionario inicial de conocimientos, resolvieron cinco casos prácticos y cumplimentaron una encuesta anónima de sat- isfacción y valoración. Resultados: Edad media de 30,6 (DE= 7,5), años de ejercicio 5,4 (DE= 6,0), 92,2% mujeres. El número de respuestas correctas en el cuestionario de conocimientos aumentó un 13,9% (DE= 14,1%), mejora que resultó significativa (p< 0,001). En la resolución de casos prácticos puntuación media de 6,6 puntos sobre 10 (DE= 1,2). El grado de satisfacción medio fue de 3,6 puntos sobre 4 (DE= 0,3). Pre- guntas mejor valoradas: “el curso es útil para la actividad profesional diaria” (3,9) y “las simulaciones de casos prácticos le parecen útiles para el aprendizaje” (3,9), menos valorada: “el número de horas lectivas del curso es adecuado” (3,0). No se encontró relación significativa entre las variables puntuación final, mejora de conocimientos, resolución de casos prácticos y sexo, años de ejercicio y edad. Discusión: La mejora de conocimientos, la resolución de casos prácticos y el grado de satisfacción obtenido se pueden considerar satisfactorios. Parece estimarse por los alumnos de manera especialmente positiva la utilidad y metodología del módulo, lo que nos hace suponer que puede tener un impacto importante en el modo de actuar del farmacéutico en esta actividad profesional. Purpose: Evaluate the results of a master class of pharmaceutical advice, namely in what concerns knowledge increase and satisfaction. Methodology: Longitudinal analytical study without control group. 56 pharmacists enrolled in the 1st Post-graduation course in Pharmaceutical Care of Secção Regional do Porto da Ordem dos Farmacêuticos. Master class taught by Berbés group. In the first phase the students received the theoretical material, an initial evaluation test of 14 questions and case studies. 12 days afterm following a second class, students were trained with role play cas studies and repeated the initial test, solved 5 case studies and filled a satisfaction questionair. Results: Average Age 30,6 (SD= 7,5), years of practice 5,4 (DW= 6,0), 92,2% women. The number of correct answers in the knowledge test increased 13,9% (SD=14,1%) and was statisti- cally significant (p< 0,001). The average result for the case-studies solving was 6.6/10 (SD=1,2). Satisfaction was 3.6/4 (SD=1,2). The most appreciated question was “the course is usefull for the daily profesional activity” (3,9) and “Role-play is useful for learning” (3,9), while the least apreciated was “the number of class hours of the course is adequate” (3,0). No significant relation was found between the other tested variables. Discussion: Knowledge increase, case study solving and satisfaction level can be considered satisfactory. The students seem to find positive and pleasant the methodology used during the teaching module, therefore it can be inferred that it may have an important impacto on the pharmacist performance in the community pharmacy. Objetivo: Evaluar los resultados de una acción formativa en indicación farmacéutica, cuantificando mejora de conocimientos y grado de satisfacción.Método: Estudio analítico longitudinal sin grupo control. Participantes: 56 farmacéuticos inscritos en el 1o Curso de Postgrado en Cuidados Farmacéuticos de la Sección Regional de Oporto de la Orden de los Farmacéuticos.Intervención formativa: Módulo III, impartido por el grupo Berbés. Primera fase los alumnos recibieron el contenido teórico, un cuestionario inicial de evaluación de 14 preguntas, cuestionario y casos prácticos de autoevaluación. Segunda fase sesión presencial 12 días después. Se realizaron entrenamientos de casos prácticos mediante simulaciones (role-playing). Al finalizar, los alumnos repitieron el cuestionario inicial de conocimientos, resolvieron cinco casos prácticos y cumplimentaron una encuesta anónima de sat- isfacción y valoración.Resultados: Edad media de 30,6 (DE= 7,5), años de ejercicio 5,4 (DE= 6,0), 92,2% mujeres.El número de respuestas correctas en el cuestionario de conocimientos aumentó un 13,9% (DE= 14,1%), mejora que resultó significativa (p< 0,001). En la resolución de casos prácticos puntuación media de 6,6 puntos sobre 10 (DE= 1,2). El grado de satisfacción medio fue de 3,6 puntos sobre 4 (DE= 0,3). Pre- guntas mejor valoradas: “el curso es útil para la actividad profesional diaria” (3,9) y “las simulaciones de casos prácticos le parecen útiles para el aprendizaje” (3,9), menos valorada: “el número de horas lectivas del curso es adecuado” (3,0).No se encontró relación significativa entre las variables puntuación final, mejora de conocimientos, resolución de casos prácticos y sexo, años de ejercicio y edad.Discusión: La mejora de conocimientos, la resolución de casos prácticos y el grado de satisfacción obtenido se pueden considerar satisfactorios. Parece estimarse por los alumnos de manera especialmente positiva la utilidad y metodología del módulo, lo que nos hace suponer que puede tener un impacto importante en el modo de actuar del farmacéutico en esta actividad profesional.

Role of small Rhizaria and diatoms in the pelagic silica production of the Sourther Ocean

We examined biogenic silica production and elementary composition (biogenic Si, particulate organic carbon and particulate organic nitrogen) of Rhizaria and diatoms in the upper 200 m along a transect in the Southwest Pacific sector of the Southern Ocean during austral summer (January–February 2019). From incubations using the 32Si radioisotope, silicic acid uptake rates were measured at 15 stations distributed in the Polar Front Zone, the Southern Antarctic Circumpolar Current and the Ross Sea Gyre. Rhizaria cells are heavily silicified (up to 7.6 nmol Si cell−1), displaying higher biogenic Si content than similar size specimens found in other areas of the global ocean, suggesting a higher degree of silicification of these organisms in the silicic acid rich Southern Ocean. Despite their high biogenic Si and carbon content, the Si/C molar ratio (average of 0.05 ± 0.03) is quite low compared to that of diatoms and relatively constant regardless of the environmental conditions. The direct measurements of Rhizaria's biogenic Si production (0.8–36.8 μmol Si m−2 d−1) are of the same order of magnitude than previous indirect estimations, confirming the importance of the Southern Ocean for the global Rhizaria silica production. However, diatoms largely dominated the biogenic Si standing stock and production of the euphotic layer, with low rhizarians' abundances and biogenic Si production (no more than 1%). In this manuscript, we discuss the Antarctic paradox of Rhizaria, that is, the potential high accumulation rates of biogenic Si due to Rhizaria in siliceous sediments despite their low production rates in surface waters.Versión del editor3,38

Farmacovigilancia en farmacia comunitaria de medicamentos recientemente comercializados

Objetivos: Implicar a los alumnos de Prácticas Tuteladas (APT) en las ctividades de farmacovigilancia (FV). Analizar su percepción sobre el interés y dificultades del estudio realizado y valorar sus actitudes. Métodos: Estudio observacional en farmacias de Pontevedra. Encuestas realizadas por los APT acompañados de sus tutores. Cuatro principios activos: rosuvastatina, pitavastatina, sitagliptina y vildagliptina. Sujetos: pacientes de las farmacias participantes que utilizaban estos medicamentos. Cuestionario para registro de las reacciones adversas y otro de valoración de la actividad y actitudes sobre FV. Resultados: 31 APT, 22 entrevistaron a 235 pacientes, 184 estatina y 51 ADO. 152 RAM en 76 pacientes. 63 (34,2%) que tomaban estatinas sufrieron 126 RAM: rosuvastatina 87 RAM en 36 (26,3%) pacientes, pitavastatina 39 RAM en 27 (57,4%). 13 pacientes (25,5%) que tomaban ADO experimentaron 26 RAM: sitagliptina 11 RAM en 6 (16,7%) pacientes y vildagliptina 15 RAM en 7 (46,7%). Los alumnos consideraron muy positiva la participación en el estudio y adecuados el formato del cuestionario y el tiempo en su cumplimentación. Las actitudes negativas con mayores porcentajes de “totalmente de acuerdo” y “de acuerdo” fueron complacencia, letargo y desconfianza y las actitudes positivas con menor porcentaje fueron posición y demanda. Conclusiones: La implicación de los alumnos de prácticas participantes en el estudio ha permitido la detección de sospechas de RAM en casi la tercera parte de los pacientes entrevistados. Los APT consideraron el estudio interesante para su formación. En las actitudes hay un cierto grado de coincidencia, aunque no total, con estudios anteriores.

Farmacovigilancia en farmacia comunitaria de medicamentos recientemente comercializados

Objetivos: Implicar a los alumnos de Prácticas Tuteladas (APT) en las ctividades de farmacovigilancia (FV). Analizar su percepción sobre el interés y dificultades del estudio realizado y valorar sus actitudes. Métodos: Estudio observacional en farmacias de Pontevedra. Encuestas realizadas por los APT acompañados de sus tutores. Cuatro principios activos: rosuvastatina, pitavastatina, sitagliptina y vildagliptina. Sujetos: pacientes de las farmacias participantes que utilizaban estos medicamentos. Cuestionario para registro de las reacciones adversas y otro de valoración de la actividad y actitudes sobre FV. Resultados: 31 APT, 22 entrevistaron a 235 pacientes, 184 estatina y 51 ADO. 152 RAM en 76 pacientes. 63 (34,2%) que tomaban estatinas sufrieron 126 RAM: rosuvastatina 87 RAM en 36 (26,3%) pacientes, pitavastatina 39 RAM en 27 (57,4%). 13 pacientes (25,5%) que tomaban ADO experimentaron 26 RAM: sitagliptina 11 RAM en 6 (16,7%) pacientes y vildagliptina 15 RAM en 7 (46,7%). Los alumnos consideraron muy positiva la participación en el estudio y adecuados el formato del cuestionario y el tiempo en su cumplimentación. Las actitudes negativas con mayores porcentajes de “totalmente de acuerdo” y “de acuerdo” fueron complacencia, letargo y desconfianza y las actitudes positivas con menor porcentaje fueron posición y demanda. Conclusiones: La implicación de los alumnos de prácticas participantes en el estudio ha permitido la detección de sospechas de RAM en casi la tercera parte de los pacientes entrevistados. Los APT consideraron el estudio interesante para su formación. En las actitudes hay un cierto grado de coincidencia, aunque no total, con estudios anteriores.

Unraveling the effect of silent, intronic and missense mutations on VWF splicing: contribution of next generation sequencing in the study of mRNA

Large studies in von Willebrand disease patients, including Spanish and Portuguese registries, led to identification of >250 different mutations. It is a challenge to determine the pathogenic effect of potential splice site mutations on VWF mRNA. This study aimed to elucidate the true effects of 18 mutations on VWF mRNA processing, investigate the contribution of next-generation sequencing to in vivo mRNA study in von Willebrand disease, and compare the findings with in silico prediction. RNA extracted from patient platelets and leukocytes was amplified by RT-PCR and sequenced using Sanger and next generation sequencing techniques. Eight mutations affected VWF splicing: c.1533+1G>A, c.5664+2T>C and c.546G>A (p.=) prompted exon skipping; c.3223-7_3236dup and c.7082-2A>G resulted in activation of cryptic sites; c.3379+1G>A and c.7473G>A (p.=) demonstrated both molecular pathogenic mechanisms simultaneously; and the p.Cys370Tyr missense mutation generated two aberrant transcripts. Of note, the complete effect of 3 mutations was provided by next generation sequencing alone because of low expression of the aberrant transcripts. In the remaining 10 mutations, no effect was elucidated in the experiments. However, the differential findings obtained in platelets and leukocytes provided substantial evidence that 4 of these would have an effect on VWF levels. In this first report using next generation sequencing technology to unravel the effects of VWF mutations on splicing, the technique yielded valuable information. Our data bring to light the importance of studying the effect of synonymous and missense mutations on VWF splicing to improve the current knowledge of the molecular mechanisms behind von Willebrand disease.info:eu-repo/semantics/publishedVersio

Modelos de crecimiento y producción en España: historia, ejemplos contemporáneos y perspectivas

En el presente trabajo se presenta una revisión sobre los modelos forestales desarrollados en España durante los últimos años, tanto para la producción maderable como no maderable y, para la dinámica de los bosques (regeneración, mortalidad). Se presentan modelos tanto de rodal completo como de clases diamétricas y de árbol individual. Los modelos desarrollados hasta la fecha se han desarrollado a partir de datos procedentes de parcelas permanentes, ensayos y el Inventario Forestal Nacional. En el trabajo se muestran los diferentes submodelos desarrollados hasta la fecha, así como las plataformas informáticas que permiten utilizar dichos modelos. Se incluyen las principales perspectivas de desarrollo de la modelización forestal en España.In this paper we present a review of forest models developed in Spain in recent years for both timber and non timber production and forest dynamics (regeneration, mortality). Models developed are whole stand, size (diameter) class and individual-tree. The models developed to date have been developed using data from permanent plots, experimental sites and the National Forest Inventory. In this paper we show the different sub-models developed so far and the friendly use software. Main perspectives of forest modeling in Spain are presented.The models described in this paper were funded by different regional, national and European projects, and some of them were elaborated by the authors. This work was funded by the Spanish Government by the SELVIRED network (code AGL2008-03740) and the strategic project «Restauración y Gestión Forestal» (code PSE-310000-2009-4)

Distributive politics and regional development: assessing the territorial distribution of Turkey’s public investment

Turkey is often perceived as a country with low bureaucratic capacity and prone to political manipulation and ‘pork-barrel’. This article tests whether this is the case, by analysing the extent to which politics, rather than equity and efficiency criteria, have determined the geographical allocation of public investment across the 81 provinces of Turkey between 2005 and 2012. The results show that although the Turkish government has indeed channelled public expenditures to reward its core constituencies, socioeconomic factors remained the most relevant predictors of investment. Moreover, in contrast to official regional development policy principles, we uncover the concentration of public investment in areas with comparatively higher levels of development. We interpret this as the state bureaucracy’s intentional strategy of focussing on efficiency by concentrating resources on ‘the better off among the most in need’

Unraveling the effect of silent, intronic and missense mutations on VWF splicing: contribution of next generation sequencing in the study of mRNA

Large studies in von Willebrand disease patients, including Spanish and Portuguese registries, led to the identification of >250 different mutations. It is a challenge to determine the pathogenic effect of potential splice site mutations on VWF mRNA. This study aimed to elucidate the true effects of 18 mutations on VWF mRNA processing, investigate the contribution of next-generation sequencing to in vivo mRNA study in von Willebrand disease, and compare the findings with in silico prediction. RNA extracted from patient platelets and leukocytes was amplified by RT-PCR and sequenced using Sanger and next generation sequencing techniques. Eight mutations affected VWF splicing: c.1533+1G>A, c.5664+2T>C and c.546G>A (p.=) prompted exon skipping; c.3223-7_3236dup and c.7082-2A>G resulted in activation of cryptic sites; c.3379+1G>A and c.7437G>A) demonstrated both molecular pathogenic mechanisms simultaneously; and the p.Cys370Tyr missense mutation generated two aberrant transcripts. Of note, the complete effect of three mutations was provided by next generation sequencing alone because of low expression of the aberrant transcripts. In the remaining 10 mutations, no effect was elucidated in the experiments. However, the differential findings obtained in platelets and leukocytes provided substantial evidence that four of these would have an effect on VWF levels. In this first report using next generation sequencing technology to unravel the effects of VWF mutations on splicing, the technique yielded valuable information. Our data bring to light the importance of studying the effect of synonymous and missense mutations on VWF splicing to improve the current knowledge of the molecular mechanisms behind von Willebrand disease. clinicaltrials.gov identifier:02869074

Ground/space, passive/active remote sensing observations coupled with particle dispersion modelling to understand the inter-continental transport of wildfire smoke plumes

During the 2017 record-breaking burning season in Canada/United States, intense wild fires raged during the first week of September in the Pacific northwestern region (British Columbia, Alberta, Washington, Oregon, Idaho, Montana and northern California) burning mostly temperate coniferous forests. The heavy loads of smoke particles emitted in the atmosphere reached the Iberian Peninsula (IP) a few days later on 7 and 8 September. Satellite imagery allows to identify two main smoke clouds emitted during two different periods that were injected and transported in the atmosphere at several altitude levels. Columnar properties on 7 and 8 September at two Aerosol Robotic Network (AERONET) mid-altitude, background sites in northern and southern Spain are: aerosol optical depth (AOD) at 440 nm up to 0.62, Ångström exponent of 1.6–1.7, large dominance of small particles (fine mode fraction >0.88), low absorption AOD at 440 nm (0.98). Profiles from the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) show the presence of smoke particles in the stratosphere during the transport, whereas the smoke is only observed in the troposphere at its arrival over the IP. Portuguese and Spanish ground lidar stations from the European Aerosol Research Lidar Network/Aerosols, Clouds, and Trace gases Research InfraStructure Network (EARLINET/ACTRIS) and the Micro-Pulse Lidar NETwork (MPLNET) reveal smoke plumes with different properties: particle depolarization ratio and color ratio, respectively, of 0.05 and 2.5 in the mid troposphere (5–9 km) and of 0.10 and 3.0 in the upper troposphere (10–13 km). In the mid troposphere the particle depolarization ratio does not seem time-dependent during the transport whereas the color ratio seems to increase (larger particles sediment first). To analyze the horizontal and vertical transport of the smoke from its origin to the IP, particle dispersion modelling is performed with the Hybrid Single Particle Lagrangian Integrated Trajectory Model (HYSPLIT) parameterized with satellite-derived biomass burning emission estimates from the Global Fire Assimilation System (GFAS) of the Copernicus Atmosphere Monitoring Service (CAMS). Three compounds are simulated: carbon monoxide, black carbon and organic carbon. The results show that the first smoke plume which travels slowly reaches rapidly (~1 day) the upper troposphere and lower stratosphere (UTLS) but also shows evidence of large scale horizontal dispersion, while the second plume, entrained by strong subtropical jets, reaches the upper troposphere much slower (~2.5 days). Observations and dispersion modelling all together suggest that particle depolarization properties are enhanced during their vertical transport from the mid to the upper troposphere.Spanish groups acknowledge the Spanish Ministry of Economy and Competitivity (MINECO) (ref. CGL2013-45410-R, CGL2014-52877-R, CGL2014-55230-R, TEC2015-63832-P, CGL2015-73250-JIN, CGL2016-81092-R and CGL2017-85344-R)European Union through H2020 programme ACTRIS-2, grant 654109European Union through H2020 programme EUNADICS-AV, grant 723986European Union through H2020 programme GRASP-ACE, grant 77834

Next generation flow for minimally-invasive blood characterization of MGUS and multiple myeloma at diagnosis based on circulating tumor plasma cells (CTPC)

Here, we investigated for the first time the frequency and number of circulating tumor plasma cells (CTPC) in peripheral blood (PB) of newly diagnosed patients with localized and systemic plasma cell neoplasms (PCN) using next-generation flow cytometry (NGF) and correlated our findings with the distinct diagnostic and prognostic categories of the disease. Overall, 508 samples from 264 newly diagnosed PCN patients, were studied. CTPC were detected in PB of all active multiple myeloma (MM; 100%), and smoldering MM (SMM) patients (100%), and in more than half (59%) monoclonal gammopathy of undetermined significance (MGUS) cases (p < 0.0001); in contrast, CTPC were present in a small fraction of solitary plasmacytoma patients (18%). Higher numbers of CTPC in PB were associated with higher levels of BM infiltration and more adverse prognostic features, together with shorter time to progression from MGUS to MM (p < 0.0001) and a shorter survival in MM patients with active disease requiring treatment (p <= 0.03). In summary, the presence of CTPC in PB as assessed by NGF at diagnosis, emerges as a hallmark of disseminated PCN, higher numbers of PB CTPC being strongly associated with a malignant disease behavior and a poorer outcome of both MGUS and MM