Análisis del uso del vídeo en una muestra de redes sociales y plataformas online, de contenido sociosanitario y ámbito nacional

En los últimos años un gran número de redes sociales en el ámbito de la salud han aparecido en Internet con el objetivo de dar respuesta a la necesidad de participación de los usuarios y tratar de unir sus intereses con los de profesionales médicos y organismos relacionados. En paralelo, el formato video está teniendo relevancia como medio de comunicación. Sólo hay que echar un vistazo a las estadísticas Alexa que sitúan YouTube como la 4º página más vista en España, o la encuesta de usuarios de Internet (AIMC, 2010) donde el 71.7% de las actividades realizadas es el visionado de vídeos. En EEUU comenzó a explorarse la combinación de ambos elementos con algunas iniciativas interesantes, pero se desconoce en nuestro ámbito nacional si esta tendencia se ha extendido. A través de este artículo se describe la investigación realizada en el ámbito de los organismos sanitarios y asociaciones de pacientes, para determinar en qué grado se utiliza el contexto visual. El resultado indica que tras el inicial impulso, se está canalizando hacia iniciativas institucionales de información sanitaria audiovisual, así como a la utilización como elemento de información en los grupos sociales, el cual logra por ahora tibios resultados interactivos.En els darrers anys un gran nombre de xarxes socials en l'àmbit de la salut han aparegut a Internet amb l'objectiu de donar resposta a la necessitat de participació dels usuaris i tractar d'unir els seus interessos amb els de professionals mèdics i organismes relacionats. Alhora el format vídeo comença a tenir rellevància com a mitjà de comunicació. Només cal fer una ullada a les estadístiques d'Alexa que situen YouTube com la 4a pàgina més vista a Espanya, o l'enquesta d'usuaris d'Internet (AIMC, 2010) on el 71.7% de les activitats realitzades és el visionat de vídeos. Als EUA es va començar a explorar la combinació d'ambdós elements amb algunes iniciatives interessants, però es desconeix si aquesta tendència s'ha estès en el nostre àmbit nacional. A través d'aquest article es descriu la investigació realitzada en l'àmbit dels organismes sanitaris i associacions de pacients, per a determinar en quin grau s'utilitza el context visual. El resultat indica que després de l'impuls inicial, s'està canalitzant cap a iniciatives institucionals d'informació sanitària audiovisual, així com la utilització com a element d'informació en els grups socials, el qual aconsegueix per ara tebis resultats interactius.In recent years a large number of social networks in the field of health have appeared on the Internet in order to meet the users' need for participation and trying to unite their interests with those of medical professionals and related organizations. In parallel, the video format is to be relevant as a means of communication. Just take a look at the Alexa statistics which point out YouTube as the 4th most viewed website in Spain, or the Internet users survey (AIMC, 2010) where 71.7% of the activities are video viewing. In the U.S. it was explored the combination of both with some interesting initiatives, but whether this trend has extended to our national level is unknown. Through this article it is described the research in the field of health agencies and patient groups to determine to what extent is used visual context. The results indicate that after the initial impulse is channelled into audiovisual health information institutional initiatives, as well as using videos as a piece of information in social groups, which for now leads to lukewarm interactive results

The last deglaciation in the Picos de Europa National Park (Cantabrian Mountains, northern Spain)

42 páginas, 8 figuras, 4 tablas.-- El PDF del artículo esta en formato pre-print.A sedimentological and geochemical study of the Lago Enol sequence (Cantabrian Mountains, northern Spain), together with detailed geomorphological mapping, provides a first record of glacier evolution and climate change over the last 40 ka in the Picos de Europa National Park. The Enol glacier retreated from its maximum extent prior to 40 ka BP as demonstrated by the onset of proglacial lacustrine sedimentation in two glaciated depressions: the Comella hollow to the north (before 40 ka BP) and the Lago Enol (before 38 ka BP). These results support previous evidence that the maximum extent of southern European glaciers occurred earlier than in northern Europe. Alternation of homogeneous and laminated proglacial sediments during the glacier retreat illustrate a dynamic glacial evolution during the Marine Isotope Stage (MIS) 3 (40–26 ka BP). A slight warming is detected at 26 ka ago with the change from proglacial sediments (in a lake located in contact to the glacier) to glaciolacustrine sedimentation (in a non-contact or distal lake). Finally, the onset of organic-rich sediments took place at 18 ka ago. This last transition occurred in two phases, similarly to the North Atlantic Last Termination, suggesting a link between North Atlantic Deep Water formation oscillations and palaeohydrological variability in the Cantabrian Mountains.This research has been funded through the projects LIMNOCLIBER (REN2003-09130-C02-02), IBERLIMNO (CGL2005-20236-E/CLI), LIMNOCAL (CGL2006-13327-C04-01) and GRACCIE (CSD2007-00067), provided by the Spanish Inter-Ministry Commission of Science and Technology (CICYT). Additional funding was provided by the Spanish National Parks Agency through the project ‘Evolución climática y ambiental del Parque Nacional de Picos de Europa desde el último máximo glaciar – ref: 53/2006’. A. Moreno acknowledges funding from the European Commission's Sixth Framework Program (Marie Curie Outgoing International Fellowships, proposal 021673-IBERABRUPT).Peer reviewe

La innovación educativa aplicada a la Ictiopatología

Se ha elaborado un material aplicable a la docencia y que puede favorecer el ejercicio profesional de un veterinario y de otras áreas dedicados a la Acuicultura. Además, tiene el valor añadido de ser una colaboración entre docentes pertenecientes a dos Universidades

Derecho del Trabajo y Seguridad Social. Aspectos Críticos de su Regulación

La obra recopila las ponencias y comunicaciones presentadas en el Congreso "Derecho del Trabajo y Seguridad Social: Aspectos críticos de su regulación", celebrado en la Facultad de Ciencias del Trabajo de la Universidad de Cádiz los días 10 y 11 de julio de 2023.Facultad de Ciencias del Trabajo, UCA370 página

EoE CONNECT, the European Registry of Clinical, Environmental, and Genetic Determinants in Eosinophilic Esophagitis: rationale, design, and study protocol of a large-scale epidemiological study in Europe

Background: The growing prevalence of eosinophilic esophagitis (EoE) represents a considerable burden to patients and health care systems. Optimizing cost-effective management and identifying mechanisms for disease onset and progression are required. However, the paucity of large patient cohorts and heterogeneity of practice hinder the defining of optimal management of EoE. Methods: EoE CONNECT is an ongoing, prospective registry study initiated in 2016 and currently managed by EUREOS, the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract. Patients are managed and treated by their responsible specialists independently. Data recorded using a web-based system include demographic and clinical variables; patient allergies; environmental, intrapartum, and early life exposures; and family background. Symptoms are structurally assessed at every visit; endoscopic features and histological findings are recorded for each examination. Prospective treatment data are registered sequentially, with new sequences created each time a different treatment (active principle, formulation, or dose) is administered to a patient. EoE CONNECT database is actively monitored to ensure the highest data accuracy and the highest scientific and ethical standards. Results: EoE CONNECT is currently being conducted at 39 centers in Europe and enrolls patients of all ages with EoE. In its aim to increase knowledge, to date EoE CONNECT has provided evidence on the effectiveness of first- and second-line therapies for EoE in clinical practice, the ability of proton pump inhibitors to induce disease remission, and factors associated with improved response. Drug effects to reverse fibrous remodeling and endoscopic features of fibrosis in EoE have also been assessed. Conclusion: This prospective registry study will provide important information on the epidemiological and clinical aspects of EoE and evidence as to the real-world and long-term effectiveness and safety of therapy. These data will potentially be a vital benchmark for planning future EoE health care services in Europe

Accurate and timely diagnosis of Eosinophilic Esophagitis improves over time in Europe. An analysis of the EoE CONNECT Registry

BACKGROUND: Poor adherence to clinical practice guidelines for eosinophilic esophagitis (EoE) has been described and the diagnostic delay of the disease continues to be unacceptable in many settings. OBJECTIVE: To analyze the impact of improved knowledge provided by the successive international clinical practice guidelines on reducing diagnostic delay and improving the diagnostic process for European patients with EoE. METHODS: Cross‐sectional analysis of the EoE CONNECT registry based on clinical practice. Time periods defined by the publication dates of four major sets of guidelines over 10 years were considered. Patients were grouped per time period according to date of symptom onset. RESULTS: Data from 1,132 patients was analyzed and median (IQR) diagnostic delay in the whole series was 2.1 (0.7‐6.2) years. This gradually decreased over time with subsequent release of new guidelines (p < 0.001), from 12.7 years up to 2007 to 0.7 years after 2017. The proportion of patients with stricturing of mixed phenotypes at the point of EoE diagnosis also decreased over time (41.3% vs. 16%; p < 0.001), as did EREFS scores. The fibrotic sub‐score decreased from a median (IQR) of 2 (1‐2) to 0 (0‐1) when patients whose symptoms started up to 2007 and after 2017 were compared (p < 0.001). In parallel, symptoms measured with the Dysphagia Symptoms Score reduced significantly when patients with symptoms starting before 2007 and after 2012 were compared. A reduction in the number of endoscopies patients underwent before the one that achieved an EoE diagnosis, and the use of allergy testing as part of the diagnostic workout of EoE, also reduced significantly over time (p = 0.010 and p < 0.001, respectively). CONCLUSION: The diagnostic work‐up of EoE patients improved substantially over time at the European sites contributing to EoE CONNECT, with a dramatic reduction in diagnostic delay

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care

<p>Abstract</p> <p>Background</p> <p>Vaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use of such data. Risk factors associated with recurrent vulvovaginal candidiasis still remain controversial.</p> <p>Methods/Design</p> <p>This work describes a protocol of a multicentric prospective observational study with one year follow up, to describe the women's reasons and preferences to choose the way of administration (oral vs topical) in the treatment of not complicated candidal vaginitis. The number of women required is 765, they are chosen by consecutive sampling. All of whom are aged 16 and over with vaginal discharge and/or vaginal pruritus, diagnosed with not complicated vulvovaginitis in Primary Care in Madrid.</p> <p>The main outcome variable is the preferences of the patients in treatment choice; secondary outcome variables are time to symptoms relief and adverse reactions and the frequency of recurrent vulvovaginitis and the risk factors. In the statistical analysis, for the main objective will be descriptive for each of the variables, bivariant analysis and multivariate analysis (logistic regression).. The dependent variable being the type of treatment chosen (oral or topical) and the independent, the variables that after bivariant analysis, have been associated to the treatment preference.</p> <p>Discussion</p> <p>Clinical decisions, recommendations, and practice guidelines must not only attend to the best available evidence, but also to the values and preferences of the informed patient.</p

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe