¿Es posible la unificación del Derecho Penal Europeo?

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La justicia penal en el banquillo

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Cascade diagrams for depicting complex interventions in randomised trials

Clarity about how trial interventions are delivered is important for researchers and those who might want to use their results. A new graphical representation aims to help make complex interventions clearer. Many medical interventions—particularly non-pharmacological ones—are complex, consisting of multiple interacting components targeted at different organisational levels. Published descriptions of complex interventions often do not contain enough detail to enable their replication. Reports of behaviour change interventions should include descriptions of setting, mode, intensity, and duration, and characteristics of the participants. Graphical methods, such as that showing the relative timing of assessments and intervention components, may improve clarity of reporting. However, these approaches do not reveal the connections between the different “actors” in a complex intervention.8 Different audiences may want different things from a description of an intervention, but visualising relationships between actors can clarify crucial features such as the fidelity with which the intervention is passed down a chain of actors and possible routes of contamination between treatment arms. Here we describe a new graphical approach—the cascade diagram—that highlights these potential problems

Corticosteroids for the common cold

BACKGROUND: The common cold is a frequent illness, which, although benign and self limiting, results in many consultations to primary care and considerable loss of school or work days. Current symptomatic treatments have limited benefit. Corticosteroids are an effective treatment in other upper respiratory tract infections and their anti‐inflammatory effects may also be beneficial in the common cold. This updated review has included one additional study. OBJECTIVES: To compare corticosteroids versus usual care for the common cold on measures of symptom resolution and improvement in children and adults. SEARCH METHODS: We searched Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 4), which includes the Acute Respiratory Infections (ARI) Group's Specialised Register, the Database of Reviews of Effects (DARE) (2015, Issue 2), NHS Health Economics Database (2015, Issue 2), MEDLINE (1948 to May week 3, 2015) and EMBASE (January 2010 to May 2015). SELECTION CRITERIA: Randomised, double‐blind, controlled trials comparing corticosteroids to placebo or to standard clinical management. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial quality. We were unable to perform meta‐analysis and instead present a narrative description of the available evidence. MAIN RESULTS: We included three trials (353 participants). Two trials compared intranasal corticosteroids to placebo and one trial compared intranasal corticosteroids to usual care; no trials studied oral corticosteroids. In the two placebo‐controlled trials, no benefit of intranasal corticosteroids was demonstrated for duration or severity of symptoms. The risk of bias overall was low or unclear in these two trials. In a trial of 54 participants, the mean number of symptomatic days was 10.3 in the placebo group, compared to 10.7 in those using intranasal corticosteroids (P value = 0.72). A second trial of 199 participants reported no significant differences in the duration of symptoms. The single‐blind trial in children aged two to 14 years, who were also receiving oral antibiotics, had inadequate reporting of outcome measures regarding symptom resolution. The overall risk of bias was high for this trial. Mean symptom severity scores were significantly lower in the group receiving intranasal steroids in addition to oral amoxicillin. One placebo‐controlled trial reported the presence of rhinovirus in nasal aspirates and found no differences. Only one of the three trials reported on adverse events; no differences were found. Two trials reported secondary bacterial infections (one case of sinusitis, one case of acute otitis media; both in the corticosteroid groups). A lack of comparable outcome measures meant that we were unable to combine the data. AUTHORS' CONCLUSIONS: Current evidence does not support the use of intranasal corticosteroids for symptomatic relief from the common cold. However, there were only three trials, one of which was very poor quality, and there was limited statistical power overall. Further large, randomised, double‐blind, placebo‐controlled trials in adults and children are required to answer this question

A Distributed Sensor Data Search Platform for Internet of Things Environments

Recently, the number of devices has grown increasingly and it is hoped that, between 2015 and 2016, 20 billion devices will be connected to the Internet and this market will move around 91.5 billion dollars. The Internet of Things (IoT) is composed of small sensors and actuators embedded in objects with Internet access and will play a key role in solving many challenges faced in today's society. However, the real capacity of IoT concepts is constrained as the current sensor networks usually do not exchange information with other sources. In this paper, we propose the Visual Search for Internet of Things (ViSIoT) platform to help technical and non-technical users to discover and use sensors as a service for different application purposes. As a proof of concept, a real case study is used to generate weather condition reports to support rheumatism patients. This case study was executed in a working prototype and a performance evaluation is presented.Comment: International Journal of Services Computing (ISSN 2330-4472) Vol. 4, No.1, January - March, 201

Efeito de um programa de força e alongamento, combinado ou isolado, na flexibilidade em ambientes de educação física. Um estudo piloto

Introduction. The purpose of this study was to examine the effects of a two-session- per-week strength and stretching program, on sit and reach score, among high-school students in the physical education setting. Methods. A sample of 75 high-school students (26 girls and 49 boys) aged 12-14 years from four classes were clustered and randomly assigned to a stretching group (n = 21), a strengthening group (n = 18), a strengthening + stretching group (n = 20) or a control group (n = 16). During physical education classes, the experimental students performed a 1-minute stretching, a 1-minute strengthening or a 1-minute strengthening + 1-minute stretching program twice a week a total of 20 weeks. Control students performed the same physical education classes, but they did not follow any strength and/or stretching program. Active flexibility (estimated by the classic sit-and-reach test) was assessed at the beginning and at the end of the intervention program. Results. The Wilcoxon test results showed that students that performed a combined strengthening and stretching program increased statistically significantly their active flexibility levels from pre- intervention to post-intervention (∆ = 1.8 ± 3.2 cm; p < 0.05). However, for students that performed an isolated) program and control group students statistically significant differences were not found (strengthening group, ∆ = 0.6 ± 0.7 cm; stretching group, ∆ = 0.3 ± 2.3 cm; control group, ∆ = 0.7 ± 1.5 cm; p > 0.05). Conclusions. Since in physical education many curricular contents need to be developed each academic year and the subject is also restricted by its limited curriculum time allocation, teachers could improve students’ flexibility combining stretching and strength workout. Therefore, in addition to the improvement of students’ flexibility levels, this intervention program might permit regular development ofother physical education curricular contents. This knowledge could help and guide teachers to design programs that guarantee a feasible and effective development of flexibility in the physical education setting.Introducción. El propósito de este estudio fue examinar los efectos de un programa de fuerza y estiramiento, de dos sesiones por semana, en las marcas del test sentarse y alcanzar entre estudiantes de secundaria en el ámbito de la educación física. Método. Una muestra de 75 estudiantes de secundaria (26 chicas y 49 chicos) de 12 a 14 años de edad pertenecientes a cuatro grupos naturales se asignaron al azar a un grupo de estiramiento (n = 21), un grupo de fortalecimiento (n = 18), un grupo de fortalecimiento + estiramiento (n = 20) o a un grupo control (n = 16). Durante las clases de educación física, los estudiantes de los grupos experimentales realizaron un programa de 1-minuto de estiramiento, de 1-minuto de fortalecimiento o de 1-minuto de fortalecimiento + 1-minuto de estiramiento dos veces por semana, un total de 20 semanas. Los estudiantes de grupo control realizaron las mismas clases de educación física, pero no siguieron ningún programa de fortalecimiento y/o estiramiento. La flexibilidad activa (estimada por la prueba clásica de sentarse y alcanzar) se evaluó al principio y al final del programa de intervención. Resultados. Los resultados de la prueba de Wilcoxon mostraron que los estudiantes que realizaron un programa combinado de fortalecimiento y estiramiento aumentaron estadísticamente de manera significativa sus niveles de flexibilidad activa desde la pre-intervención hasta la post-intervención (∆ = 1,8 ± 3,2 cm; p < 0,05). Sin embargo, para los estudiantes que realizaron un programa aislado) y los estudiantes del grupo de control no se encontraron diferencias estadísticamente significativas (grupo de fortalecimiento, ∆ = 0,6 ± 0,7 cm; grupo de estiramiento, ∆ = 0,3 ± 2,3 cm; grupo control, ∆ = 0,7 ± 1,5 cm; p > 0,05). Conclusiones. Dado que en la educación física es necesario desarrollar muchos contenidos curriculares cada año académico y que la asignatura también está restringida por su limitada asignación de tiempo curricular, los profesores podrían mejorar la flexibilidad de los estudiantes combinando los estiramientos y el entrenamiento de fuerza. Por lo tanto, además de mejorar los niveles de flexibilidad de los estudiantes, este programa de intervención podría permitir el desarrollo regular de otros contenidos curriculares de educación física. Este conocimiento podría ayudar y guiar a los profesores a diseñar programas que garanticen un desarrollo factible y efectivo de la flexibilidad en el entorno de la educación física.Introdução. O objetivo deste estudo foi examinar os efeitos de um programa de força e alongamento de duas sessões por semana nos resultados dos testes de sentar e alcançar entre estudantes do ensino médio em educação física. Método. Uma amostra de 75 estudantes do ensino médio (26 meninas e 49 meninos) de 12 a 14 anos de quatro grupos naturais foram aleatoriamente designados para um grupo de alongamento (n = 21), um grupo de fortalecimento (n = 18), um grupo de fortalecimento + alongamento (n = 20) ou um grupo controle (n = 16). Durante as aulas de educação física, os alunos dos grupos experimentais realizaram um programa de 1 minuto de alongamento, 1 minuto de fortalecimento ou 1 minuto de fortalecimento + 1 minuto de alongamento duas vezes por semana, totalizando 20 semanas. Os alunos do grupo controle fizeram as mesmas aulas de educação física, mas não seguiram nenhum programa de fortalecimento e/ou alongamento. A flexibilidade ativa (avaliada pelo teste clássico de sentar e alcançar) foi avaliada no início e no final do programa de intervenção. Resultados. Os resultados do teste de Wilcoxon mostraram que os alunos que realizaram um programa combinado de fortalecimento e alongamento aumentaram estatisticamente significativamente seus níveis de flexibilidade ativa da pré-intervenção para a pós-intervenção (∆ = 1,8 ± 3,2 cm, p < 0,05). No entanto, para alunos que realizaram um programa isolado) e alunos do grupo controle, não foram encontradas diferenças estatisticamente significativas (grupo fortalecimento, ∆ = 0,6 ± 0,7 cm; grupo alongamento, ∆ = 0,3 ± 2,3 cm, grupo controle, ∆ = 0,7 ± 1,5 cm, p > 0,05). Conclusões. Dado que a educação física precisa desenvolver muitos conteúdos curriculares a cada ano letivo e que a disciplina também é limitada por sua alocação de tempo curricular limitada, os professores poderiam melhorar a flexibilidade dos alunos combinando alongamento e treinamento de força. Assim, além de melhorar os níveis de flexibilidade dos alunos, este programa de intervenção poderá permitir o desenvolvimento regular de outros conteúdos curriculares de educação física. Esse conhecimento pode ajudar e orientar os professores a projetar programas que garantam o desenvolvimento viável e eficaz da flexibilidade no ambiente de educação física

An R package to analyse LC/MS metabolomic data: MAIT (Metabolite Automatic Identification Toolkit)

Current tools for liquid chromatography and mass spectrometry for metabolomic data cover a limited number of processing steps, whereas online tools are hard to use in a programmable fashion. This article introduces the Metabolite Automatic Identification Toolkit (MAIT) package, which makes it possible for users to perform metabolomic end-to-end liquid chromatography and mass spectrometry data analysis. MAIT is focused on improving the peak annotation stage and provides essential tools to validate statistical analysis results. MAIT generates output files with the statistical results, peak annotation and metabolite identification. AVAILABILITY AND IMPLEMENTATION: http://b2slab.upc.edu/software-and-downloads/metabolite-automatic-identification-toolkit/

Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community.

BACKGROUND: Trials show that oral anticoagulation therapy (OAT) substantially reduces thromboembolic events without an increase in major haemorrhagic events, but it is not known whether these results translate into routine practice. AIM: To estimate the current levels of control and adverse events in patients self-monitoring OAT, explore the factors that predict success, and determine whether the level of side effects reported from randomised controlled trials are translated to a non-selected population. DESIGN AND SETTING: Prospective cohort study in the UK. METHOD: Participants were aged ≥18 years and registered with a GP. Main outcomes were the proportion of participants, over 12 months, who were still self-monitoring, had not experienced adverse events, and had achieved >80% of time in therapeutic range (TTR). RESULTS: In total, 296 participants were recruited; their median age was 61 years and 55.1% were male. Participants were predominately professional or held a university qualification (82.7%). At 12 months, 267 (90.2%) were still self-monitoring. Mean TTR was 75.3% (standard deviation 16.9).Six serious and two minor adverse events were reported by GPs. Only 45.9% of participants received any in-person training at the outset. Increased age (P = 0.027), general wellbeing (EQ-5D visual score, P = 0.020), and lower target international normalised range (INR, P = 0.032) were all associated with high (>80% TTR) levels of control. CONCLUSION: The findings show that, even with little training, people on OAT can successfully self-monitor, and even self-manage, their INR. TTR was shown to improve with age. However, widespread use of self-monitoring of INR may be limited by the initial costs, as well as a lack of training and support at the outset

A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome

<p>Abstract</p> <p>Background</p> <p>Irritable Bowel Syndrome (IBS) is a common chronic gastrointestinal disorder and the evidence for efficacy of most drug therapies in the treatment of IBS is weak. A popular alternative is probiotics, which have been used in several conditions. including IBS. Probiotics are live microbial food supplements.</p> <p>The aim of this systematic review and meta-analysis of randomized trials study was to evaluate the efficacy of probiotics in alleviating symptoms in patients with irritable bowel syndrome. We searched Ovid versions of MEDLINE (1950–2007), EMBASE (1980–2007), CINAHL (1982–2007), AMED (1985–2007), the Cochrane library and hand searched retrieved papers.</p> <p>Results</p> <p>We identified 14 randomized placebo controlled trials. Combined data suggested a modest improvement in overall symptoms after several weeks of treatment: for dichotomous data from seven trials the overall Odds Ratio (OR) was 1.6 (95% CI, 1.2 to 2.2); for continuous data from six trials the standardised mean difference (SMD) was 0.23 (95% CI, 0.07 to 0.38).</p> <p>For individual symptoms the results differed between the pooled dichotomous and pooled continuous data. Trials varied in relation to the length of treatment (4–26 weeks), dose, organisms and strengths of probiotics used.</p> <p>Conclusion</p> <p>Probiotics may have a role in alleviating some of the symptoms of IBS, a condition for which currently evidence of efficacy of drug therapies is weak. However, as IBS is a condition that is chronic and usually intermittent longer term trials are recommended. Such research should focus on the type, optimal dose of probiotics and the subgroups of patients who are likely to benefit the most.</p