Sueño y estrés en los funcionarios de la Comunidad Autónoma de Murcia.

La calidad del sueño no se refiere únicamente a dormir bien, sino que lleva implícito tener un buen desempeño durante el día y puede verse afectada por distintos factores. Estar alerta y rendir adecuadamente es primordial para la seguridad, sobre todo en el mundo laboral. En muchos contextos que requieren niveles de rendimiento óptimos, los efectos nocivos de la somnolencia excesiva diurna son peligrosos. El estrés organizacional es un campo en rápida expansión, determinado por divergencias acerca de la terminología y conceptualizaciones, pero con similitudes claras sobre cuáles son las variables claves y sus relaciones causa efecto. Objetivo: Analizar y estudiar el sueño y el estrés en la población funcionaria de la Comunidad de la Región de Murcia. Método: Estudio descriptivo-observacional, transversal y prospectivo a través de un cuestionario autoadministrado. Se realizó un análisis de los resultados no comparativo, tipo estudio de prevalencia. La distribución del problema de salud se realizó en función de las variables descriptoras, llevando a cabo un estudio comparativo con el fin de analizar la influencia o asociación que existe entre somnolencia diurna, calidad del sueño, ritmo circadiano, nivel de estrés y hábitos de sueño. Resultados: Más de un tercio de trabajadores reportaron mala calidad del sueño. Se clasificaron 285 trabajadores con un perfil matutino (59,9%) y 175 (41,1%) con carácter vespertinointermedio. Ser trabajador público con turno fijo de mañana y tener un cronotipo vespertino fueron factores predictivos independientes de incrementar sustancialmente la mala calidad del sueño. Ser mujer y tener mala higiene del sueño fueron factores de riego de sufrir somnolencia excesiva diurna. La puntuación media en la versión final del cuestionario Student Stress Inventory-Stress Manifestationsfue fue de 33,92 ± 9,32. Después de excluir dos ítems en el análisis de homogeneidad, encontramos que era útil para identificar factores estresantes y síntomas de estrés en los trabajadores públicos. Todos los factores presentaron un valor α de Cronbach apropiado, y en todos los ítems hubo una correlación con su factor que excedió 0.300. Conclusiones: Las administraciones deben fomentar un cambio de hábitos y crear una mayor concienciación sobre los efectos de la mala calidad del sueño y la somnolencia excesiva diurna en los trabajadores públicos. Son necesarias herramientas sencillas para la medición del estrés en los empleados públicos. El cuestionario Student Stress Inventory-Stress Manifestations puede ser utilizada por los Servicios de Prevención de Riesgos Laborales para la detección precoz del estrés laboral, evitando algunas de sus consecuencias nocivas. Debe tenerse en cuenta que existe una delgada línea entre el trabajo y la familia, que los trabajadores tienden a trasladar el trabajo y las inquietudes al hogar, aumentando así los niveles de estrés.Enfermerí

Testing for alpha-1 antitrypsin in COPD in outpatient respiratory clinics in Spain: A multilevel, cross-sectional analysis of the EPOCONSUL study

Background Alpha-1 antitrypsin deficiency (AATD) is the most common hereditary disorder in adults, but is under-recognized. In Spain, the number of patients diagnosed with AATD is much lower than expected according to epidemiologic studies. The objectives of this study were to assess the frequency and determinants of testing serum α1-antitrypsin (AAT) levels in COPD patients, and to describe factors associated with testing. Methods EPOCONSUL is a cross-sectional clinical audit, recruiting consecutive COPD cases over one year. The study evaluated serum AAT level determination in COPD patients and associations between individual, disease-related, and hospital characteristics. Results A total of 4,405 clinical records for COPD patients from 57 Spanish hospitals were evaluated. Only 995 (22.5%) patients had serum AAT tested on some occasion. A number of patient characteristics (being male [OR 0.5, p < 0.001], ≤55 years old [OR 2.38, p<0.001], BMI≤21 kg/m2 [OR 1.71, p<0.001], FEV1(%)<50% [OR 1.35, p<0.001], chronic bronchitis [OR 0.79, p < 0.001], Charlson index ≥ 3 [OR 0.66, p < 0.001], or history or symptoms of asthma [OR 1.32, p<0.001]), and management at a specialized COPD outpatient clinic [OR 2.73,p<0.001] were identified as factors independently associated with ever testing COPD patients for AATD. Overall, 114 COPD patients (11.5% of those tested) had AATD. Of them, 26 (22.8%) patients had severe deficiency. Patients with AATD were younger, with a low pack-year index, and were more likely to have emphysema (p<0.05). Conclusion Testing of AAT blood levels in COPD patients treated at outpatient respiratory clinics in Spain is infrequent. However, when tested, AATD (based on the serum AAT levels ≤100 mg/dL) is detected in one in five COPD patients. Efforts to optimize AATD case detection in COPD are needed.SEPA

Simultaneous analysis of elastic, breakup, and fusion channels for 6He induced reactions at energies near the coulomb barrier

5th International Conference FUSION11We present some recent applications of the Continuum-Discretized Coupled-Channels (CDCC) and Coupled-Reaction-Channels (CRC) methods to the study of reactions induced by weakly-bound nuclei on stable targets. The methods are applied to the scattering of the Borromean nucleus 6He at energies around the Coulomb barrier. Elastic scattering data are very well described by four-body CDCC calculations (based on a three-body description of the 6He nucleus) but also by simpler three-body CDCC calculations, using a suitable two-body model for 6He. By contrast, inclusive α data are better described using the CRC approach, which treats the breakup within the transfer to the continuum picture and, unlike the CDCC method, allows the inclusion of transfer to bound states of the target. We explore also the possibility of calculating the fusion cross sections using the CRC frameworkMinisterio de Ciencia e Innovación FPA2009-0765

The 6He Optical Potential at energies around the Coulomb barrier

We present an Optical Model (OM) study of 6He on 208Pb elastic scattering data, measured at laboratory energies around the Coulomb barrier (Elab=14, 16, 18, 22, and 27 MeV) [1]. For the projectile-target bare interaction, we use the microscopic São Paulo Potential (SPP). This bare interaction is supplemented with a Coulomb Dipole Polarization (CDP) potential, as well as a diffuse complex Woods-Saxon potential. Four-body Continuum-Discretized-Coupled-Channels (CDCC) calculations have been performed in order to support the optical model analysis. We have also studied the α channel, which is the dominant reaction process. In the analysis of this channel, we compare the angular and energy distributions of the α particles measured at 22 MeV, with Distorted Wave Born Approximation (DWBA) calculations

Vacunación en neumococo. Actuación en la farmacia comunitaria

En la elaboración del documento han participado SEFAC, semFYC, SEMERGEN y SEPAR. El objetivo principal era definir los perfiles de paciente susceptibles prioritariamente de la vacunación frente al neumococo considerando los grupos de riesgo, las patologías concomitantes, las posibles consecuencias de una infección neumocócica y la elaboración, a su vez, de un algoritmo de vacunación en el adulto. Se han definido igualmente las indicaciones de la vacuna así como la propuesta de entrevista por parte de la farmacia comunitaria.El documento, avalado por las principales sociedades científicas médico-farmacéuticas, será de gran utilidad para el farmacéutico comunitario de cara a abordar a pacientes con mayor factor de riesgo de contraer enfermedad neumocócica. Será también una manera muy gráfica para conseguir detectar, asesorar y, llegado el caso, derivar al facultativo médico a todo este tipo de paciente

Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study

25 p.Objectives: The objective of the present study was to determine the use of systemic corti-costeroids (SCs) in patients with bronchial asthma using big data analysis. Methods: We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was per-formed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using big data and artificial intelligence via Savana® Manager version 3.0. Results: During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels. The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. SCs were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, ob-esity, depression, and hiatus hernia. SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%) and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects. Conclusion: In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events. It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care

Reliability and Validity of a Stress Scale in Public Employees from Murcia (Spain)

Stress is common in all work environments. Technostress and the difficulty of separating the family arena from the work environment are some of the new and emerging risks faced by companies, employees and society in general. Most of the available instruments for measuring stress in workers have been focused on education professionals and healthcare workers. Therefore, it is necessary to validate simple and friendly-use tools to detect stress levels in public workers. The aim of this study was to determine the internal consistency of an adapted version of the Student Stress Inventory-Stress Manifestations (SSI-SM) for public employees and to determine if high-stress levels are related to personal and work-related factors. A cross-sectional and descriptive study was conducted from October 2016 to February 2019 including 468 Spanish public workers based in Murcia. An adapted version of the SSI-SM was administered and data on personal and work-related factors were collected. Results showed that all of the factors had Cronbach’s α over 0.700, and no items need to be deleted due to correlations with the factor exceeding 0.300. Factor 1, “Self-concept”, has a Cronbach’s α of 0.868, with values of 15.62 ± 4.99; factor 2, “Sociability”, Cronbach’s α: 0.853, with mean values of 13.33 ± 4.17; factor 3, “Somatization”, Cronbach’s α: 0.704, mean value of 5.35 ± 1.90 and: factor 4, “Uncertainty”, Cronbach’s α: 0.746, with a mean value of 8.19 ± 2.51. In conclusion, the internal consistency of the adapted SSI-SM for public employees with different work positions and shifts has been validated and determined. This study provides a useful tool for the early detection of stress in public employees and may be potentially useful for preventing the harmful consequences of stres

Rhinoorbitocerebral mucormycosis : A case report and literature review

Mucormycosis is a rare oportunistic infection typically described in diabetic patients with a ketoacidotic status, as well as neutropenic patients. The infection is caused by a group of saprophytic fungi of the class Phycomicetes, being the most frequent ones the Rhizomucor, Rhizopus and Mucor. Its hystological findings include vascular trombosis and tissue necrosis, predominantly in the rino-orbito-cerebral area. Even though the frequency of presentation is very low, given its rapid evolution and severe consequences which include a high mortality rate, it is very important to be aware of the main features of the disease and treat it promptly. Although the diagnosis is based on the high clinical suspect, the computed tomography (CT) and the magnetic resonance image (MRI) plays an important role in determining the extension. The patients should receive treatment in a reference hospital so that a multidisciplinary approach is ensured. In this sense, we present a case of rhino-orbito-cerebralmucormycosis in a diabetic patient, recently treated in our Department. A comprehensive review of the literature has been performed to update the physiopathology and diagnosis. Finally, we describe the different treatment options focusing in the surgical approach, as well as the medical treatment with amphotericine and posaconzol

Digital transition of teaching learning resources at Spanish universities

The objective of this study is to establish which document types are considered essential for learning at universities and, therefore, are recommended to students. Additionally, an analysis was conducted to determine if electronic resources are a part of the recommended reading lists for the various subjects across the curriculum and what exactly their weight is in relation to other document types. The current syllabi for the 2014-2015 academic year were accessed for each subject in ten majors offered at three Spanish universities: University Carlos III of Madrid, University of León, and University of Salamanca. The primary finding is the lack of homogeneity in the number of references by university and major which is due to the disparity observed as far as the number of references per subject. Books are the resources most frequently suggested in all of the curricula analyzed. The scarce use in course syllabi of journal articles and, particularly, conference papers, is significant. Links to institutional websites predominate, whereas the presence of electronic books is residual despite a proven inclination to prioritize recommendations for monographs and textbooks. The presence of electronic journals and electronic articles is also marginal. It is evident that traditional document types continue to be recommended despite the increase of electronic documents in academic libraries’ collections