Study protocol of effectiveness of a biopsychosocial multidisciplinary intervention in the evolution of non-speficic sub-acute low back pain in the working population : cluster randomised trial

Background: Non-specific low back pain is a common cause for consultation with the general practitioner, generating increased health and social costs. This study will analyse the effectiveness of a multidisciplinary intervention to reduce disability, severity of pain, anxiety and depression, to improve quality of life and to reduce the incidence of chronic low back pain in the working population with non-specific low back pain, compared to usual clinical care. Methods/Design: A Cluster randomised clinical trial will be conducted in 38 Primary Health Care Centres located in Barcelona, Spain and its surrounding areas. The centres are randomly allocated to the multidisciplinary intervention or to usual clinical care. Patients between 18 and 65 years old (n = 932; 466 per arm) and with a diagnostic of a non-specific sub-acute low back pain are included. Patients in the intervention group are receiving the recommendations of clinical practice guidelines, in addition to a biopsychosocial multidisciplinary intervention consisting of group educational sessions lasting a total of 10 hours. The main outcome is change in the score in the Roland Morris disability questionnaire at three months after onset of pain. Other outcomes are severity of pain, quality of life, duration of current non-specific low back pain episode, work sick leave and duration, Fear Avoidance Beliefs and Goldberg Questionnaires. Outcomes will be assessed at baseline, 3, 6 and 12 months. Analysis will be by intention to treat. The intervention effect will be assessed through the standard error of measurement and the effect-size. Responsiveness of each scale will be evaluated by standardised response mean and receiver-operating characteristic method. Recovery according to the patient will be used as an external criterion. A multilevel regression will be performed on repeated measures. The time until the current episode of low back pain takes to subside will be analysed by Cox regression. Discussion: We hope to provide evidence of the effectiveness of the proposed biopsychosocial multidisciplinary intervention in avoiding the chronification of low back pain, and to reduce the duration of non-specific low back pain episodes. If the intervention is effective, it could be applied to Primary Health Care Centres

GEICO (Spanish Group for Investigation on Ovarian Cancer) treatment guidelines in ovarian cancer 2012

In 2006, under the auspices of The Spanish Research Group for Ovarian Cancer (Spanish initials GEICO), the first “Treatment Guidelines in Ovarian Cancer” were developed and then published in Clinical and Translational Oncology by Poveda Velasco et al. (Clin Transl Oncol 9(5):308–316, 2007). Almost 6 years have elapsed and over this time, we have seen some important developments in the treatment of ovarian cancer. Significant changes were also introduced after the GCIG-sponsored 4th Consensus Conference on Ovarian Cancer by Stuart et al. (Int J Gynecol Cancer 21:750–755, 2011). So we decided to update the treatment guidelines in ovarian cancer and, with this objective, a group of investigators of the GEICO group met in February 2012. This study summarizes the presentations, discussions and evidence that were reviewed during the meeting and during further discussions of the manuscript

7th Drug hypersensitivity meeting: part two

No abstract availabl

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

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

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

Resultados preliminares sobre un proceso Sol-Gel para la síntesis de disoluciones precursoras de láminas delgadas ferroeléctricas con estructura de Perovskita laminar

SrBi2Ta2O9 precursor solutions have been prepared by sol-gel using, as reactives, tantalum ethoxide and strontium and bismuth 2-ethyl-hexanoates. These compounds were disolved in 1,3-propanediol as majoritary solvent. The resulting solutions had low hydrolysis and condensation, thus making possible their manipulation and storage in atmospheres with moisture. Films deposited from these solutions were crystallised at 750ºC, developing, as majoritary phase, the SrBi2Ta2O9 layered perovskite. Electric poling of these films indicates a moderate ferroelectric response with values of remanent polarisation of Pr~1μC/cm2.<br><br>Se han preparado por sol-gel soluciones precursoras de SrBi2Ta2O9, utilizando como reactivos el etóxido de tántalo y los 2-etilhexanoatos de estroncio y de bismuto. Como disolvente mayoritario se empleó el 1,3-propanodiol. Las soluciones resultantes presentaron una baja velocidad de hidrólisis y condensación, haciendo posible su almacenaje y manipulación en atmósferas no exentas de humedad. Las láminas derivadas de estas soluciones y cristalizadas a 750ºC presentaron como fase mayoritaria la perovskita laminar de SrBi2Ta2O9. La polarización eléctrica de estas láminas puso de manifiesto una moderada actividad ferroeléctrica, con valores de polarización remanente de Pr~1μC/cm2

No volatilidad en láminas ferroeléctricas de SBT a 75°C

The study of the non-volatility of Strontium bismuth tantalate SrBi2Ta2O9 (SBT) FeRAM memory, at real operating conditions, requires the ferroelectric characterisation of the material, as a thin film, above the room temperature.As a result, it has been deposited SBT films by the sol-gel method, onto Pt/TiO2/SiO2/Si (100) substrates, using capacitors of 5 x 10–4 cm-2 .In this work, we analysed the viability of this material as a FeRAM memory in real operating conditions, as a result of the variation of the polarisation measurements with time (retention), performed at room temperature and 75ºC.<br><br>El estudio de la no volatilidad de una memoria FeRAM de tantalato de bismuto y estroncio, SrBi2Ta2O9 (SBT) en condiciones reales de uso, requiere la caracterización ferroeléctrica del material en forma de lámina delgada a temperaturas por encima del ambiente. Para ello se han depositado láminas de SBT mediante un método sol-gel, sobre substratos de Pt/TiO2/SiO2/Si(100), seleccionándose condensadores de área 5.10-4 cm-2. Basándonos en las medidas de la variación de la polarización con el tiempo (retención) realizadas a temperatura ambiente y a 75ºC, analizamos la viabilidad del material como una FeRAM en condiciones reales de uso