Manufacturas del cuero, diseño y desarrollo local

La presente propuesta considera pertinente estimular, acompañar y tutorar el desarrollo de emprendimientos de diversas escalas productivas que fomenten el Desarrollo Local y por otra parte,generar los contenidos teóricos y pedagógicos que contribuyan y potencien esta industria manufacturera.Área: Ingeniería, Arquitectura y Tecnologí

Risk of suicide during treatment with venlafaxine, italopram, fluoxetine, and dothiepin : retrospective cohort study

Objective To compare the risk of suicide in adults usingthe antidepressant venlafaxine compared with citalopram, fluoxetine, and dothiepin. Design Retrospective cohort study. Setting UK General Practice Research Database. Participants 219 088 patients, aged 18-89 years, who were prescribed venlafaxine, citalopram, fluoxetine, or dothiepin from 1995 to 2005. Main outcome measures Completed suicide and attempted suicide. Results Venlafaxine users had a higher burden of risk factors for suicide, includingprevious suicide attempts and proxies for severe depression or depression that was difficult to treat. In the analysis for completed suicides, unadjusted and adjusted hazard ratios for venlafaxine compared with citalopram were 2.44 (95% confidence interval 1.12 to 5.31) and 1.70 (0.76 to 3.80), for venlafaxine compared with fluoxetine were 2.85 (1.37 to 5.94) and 1.63 (0.74 to 3.59), and for venlafaxine compared with dothiepin were 2.54 (1.07 to 6.02) and 1.31 (0.53 to 3.25). Compared with other study drugs, venlafaxine was also associated with an increased risk of attempted suicide, but adjustment for measured confounders substantially reduced the hazard ratios. Conclusions Venlafaxine use was consistently associated with higher risk of suicide compared with citalopram, fluoxetine, and dothiepin. Venlafaxine users had a higher burden of suicide risk factors, however, and adjustment for measured confounders substantially reduced the excess risks. Since the secondary data used in this analysis allowed only indirect and partial measurements of potential confounders, it is possible that residual confounding explains much, if not all, of the observed excess risk

The experience of Parkinson’s Disease: A systematic review and meta-ethnography

There has been little attempt to summarise and synthesise qualitative studies concerning the experience and perception of living with Parkinson’s disease. Bringing this information together would provide a background to understand the importance of an individual’s social identity on their well-being and hope. Three primary aims were identified (a) understanding the importance of social identity and meaningful activities on individuals’ well-being, (b) identifying factors and strategies that influence well-being and hope, and (c) establishing a model that relates to an individual’s hope and well-being. Three stages were undertaken including a traditional electronic search, a critical appraisal of articles, and a synthesis of studies. Qualitative articles were included that considered the experience of living with Parkinson’s disease. Thirty seven articles were located and included in the review. Five themes were identified and the themes were used to inform development of a new model of hope enablement. The current review furthered understanding of how physical symptoms and the experience of Parkinson’s disease affect the individual’s well-being and hope. Social identity was established as a key factor that influenced an individual’s well-being. Being able to maintain, retain, or develop social identities was essential for the well-being and hope of individuals with Parkinson’s disease. Understanding the factors which prevent or can facilitate this is essential

The cost-effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England

Background: Nivolumab was the first programmed death receptor 1 (PD-1) immune checkpoint inhibitor to demonstrate long-term survival benefit in a clinical trial setting for advanced melanoma patients. Objective: To evaluate the cost effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England. Methods: A Markov state-transition model was developed to estimate the lifetime costs and benefits of nivolumab versus ipilimumab and dacarbazine for BRAF mutation-negative patients and versus ipilimumab, dabrafenib, and vemurafenib for BRAF mutation-positive patients. Covariate-adjusted parametric curves for time to progression, pre-progression survival, and post-progression survival were fitted based on patient-level data from two trials and long-term ipilimumab survival data. Indirect treatment comparisons between nivolumab, ipilimumab, and dacarbazine were informed by these covariate-adjusted parametric curves, controlling for differences in patient characteristics. Kaplan–Meier data from the literature were digitised and used to fit progression-free and overall survival curves for dabrafenib and vemurafenib. Patient utilities and resource use data were based on trial data or the literature. Patients are assumed to receive nivolumab until there is no further clinical benefit, assumed to be the first of progressive disease, unacceptable toxicity, or 2 years of treatment. Results: Nivolumab is the most cost-effective treatment option in BRAF mutation-negative and mutation-positive patients, with incremental cost-effectiveness ratios of £24,483 and £17,362 per quality-adjusted life year, respectively. The model results are most sensitive to assumptions regarding treatment duration for nivolumab and the parameters of the fitted parametric survival curves. Conclusions: Nivolumab is a cost-effective treatment for advanced melanoma patients in England

Sex-biased dispersal, post-fledging care and juvenile movements in the white-throated dipper

Dispersal is a crucial life history trait which has profound consequences for individual fitness and population dynamics. Yet, our understanding of the spatial and temporal processes of dispersal remains poorly understood, largely due to the logistic difficulties of following and monitoring wide-ranging individuals. White-throated dippers are specialised aquatic passerines which are well-established as an important indicator of river and stream water quality, and they provide an ideal model system for studying dispersal due to their linear territories. However, little is known about the factors that underpin variation in natal dispersal distance. Furthermore, as with many passerines, behaviour during the post-fledging period has rarely been studied despite the likely influence on dispersal. Here, these issues are investigated using a long-term study population of dippers in the UK. In Chapter 2, the impact of early life conditions on natal dispersal is investigated, including the timing of breeding, brood size, population density, and body condition. The analyses also accounted for sex, a well-known determinant of dispersal distance in birds. Indeed, as with many species, sex was the most important predictor of dispersal distance in dippers, with females generally travelling further than males. However, there also appears to be a weak effect of condition, suggesting that individuals in better condition disperse shorter distances. This may reflect the benefits to settling on territories near to the natal area, including familiarity with nesting and feeding sites. No other early life effects were detected. In Chapter 3, observations during the 2021 breeding season were used to measure provisioning rates and track movements of juvenile dippers during the post-fledging period. Brood division appeared to be widespread within this population, and comparisons of mean feeding rates suggests that males contributed more to feeding the fledglings than females. Post-fledging provisioning rates were generally higher than nestling provisioning rates. On average, juveniles were first observed outside of their natal territory 30 days after fledging, but some had left as young as nine days old. Soon after leaving the natal territory, juveniles were highly mobile and able to travel relatively long distances; many individuals were observed together with birds from other broods. Together, these observations provide some of the first descriptions of behaviour during the post-fledging period in this species, and the implications for dispersal are discussed. In the final chapter, the key messages of the thesis are reviewed alongside avenues for future research, with an emphasis on the need to further study the early life determinants of dispersal and behaviour during the transience stage. Combining long-term studies of marked individuals with advanced tracking technologies offer perhaps the best opportunities

Manufacturas del cuero, diseño y desarrollo local

La presente propuesta considera pertinente estimular, acompañar y tutorar el desarrollo de emprendimientos de diversas escalas productivas que fomenten el Desarrollo Local y por otra parte,generar los contenidos teóricos y pedagógicos que contribuyan y potencien esta industria manufacturera.Área: Ingeniería, Arquitectura y TecnologíaFacultad de Bellas Arte

Manufacturas del cuero, diseño y desarrollo local

La presente propuesta considera pertinente estimular, acompañar y tutorar el desarrollo de emprendimientos de diversas escalas productivas que fomenten el Desarrollo Local y por otra parte,generar los contenidos teóricos y pedagógicos que contribuyan y potencien esta industria manufacturera.Área: Ingeniería, Arquitectura y TecnologíaFacultad de Bellas Arte

The patient’s experience of the psychosocial process that influences identity following stroke rehabilitation: a metaethnography

Background and Purpose. Patient experience is increasingly being recognised as a key health outcome due to its positive correlation with quality of life and treatment compliance. The aim of this study was to create a model of how patient’s experiences of rehabilitation after stroke influence their outcome. Methods. A metaethnography of qualitative articles published since 2000 was undertaken. A systematic search of four databases using the keywords was competed. Original studies were included if at least 50% of their data from results was focused on stroke survivors experiences and if they reflected an overarching experience of stroke rehabilitation. Relevant papers were appraised for quality using the COREQ tool. Pata analysis as undertaken using traditional processes of extracting, interpreting, translating, and synthesizing the included studies. Results. Thirteen studies were included. Two themes (1) evolution of identity and (2) psychosocial constructs that influence experience were identified. A model of recovery was generated. Conclusion. The synthesis model conceptualizes how the recovery of stroke survivors’ sense of identity changes during rehabilitation illustrating changes and evolution over time. Positive experiences are shaped by key psychosocial concepts such as hope, social support, and rely on good self-efficacy which is influenced by both clinical staff and external support

Manufacturas del cuero, diseño y desarrollo local

La presente propuesta considera pertinente estimular, acompañar y tutorar el desarrollo de emprendimientos de diversas escalas productivas que fomenten el Desarrollo Local y por otra parte,generar los contenidos teóricos y pedagógicos que contribuyan y potencien esta industria manufacturera.Área: Ingeniería, Arquitectura y TecnologíaFacultad de Bellas Arte