Análisis y tendencias del polen de Chenopodiáceas-Amarantáceas en la atmósfera de cuatro ciudades del sur de España

XV lnternational A.P.L.E. Symposium of Palynolog

Views and Experiences of Persons with Chronic Diseases about Strategies that Aim to Integrate and Re-Integrate Them into Work: A Systematic Review of Qualitative Studies

The effectiveness of strategies targeting professional integration and reintegration strongly depends on the experiences of participants. The aim of this systematic literature review is to synthesize European qualitative studies exploring views and experiences of persons with chronic conditions regarding strategies for integration and reintegration into work. The systematic search was conducted in Medline, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 24 studies published in English between January 2011 and April 2016 were included. Most studies were carried out in Nordic countries or in the UK, and most participants were persons with either mental or musculoskeletal disorders. Ten themes emerged: individual and holistic approach, clarity of strategy and processes, timing of rehabilitation processes, experience with professionals, at the workplace and with peer groups, changes in the understanding of health and work, active involvement in the process, competencies development and motivating aspects of work. Findings highlight, among others, the need to actively involve participants in the return to work process and to provide timely and clearly structured processes and interventions. This review provides stakeholders key information to develop, plan, implement and evaluate interventions to integrate and re-integrate persons with chronic conditions into work in Europe

Paleobiogeografía de Abies spp.y Cedrus atlantica en el Mediterráneo occidental (Península Ibérica y Marruecos)

RESUMEN: Las especies mediterráneas incluidas en el género Abies, y Cedrus atlantica presentan en la actualidad unas áreas de distribución muy limitadas.En este trabajo, se describen el origen y las rutas migratorias seguidas por Abies pinsapo, A. marocana, A. tazaotana y Cedrus atlantica, desde los inicios del Terciario hasta la actualidad, así como las posibles causas que han llevado a sus poblaciones a su estado actual de aislamiento y peligro de extinción. Abies y Cedrus habrían alcanzado el Mediterráneo Occidental junto con otros elementos de la flora arctoterciaria entre el Eoceno Medio (45 Ma) y el Oligoceno (30 Ma). Posteriormente, experimentaron procesos de especiación hasta fechas relativamente recientes, en los que la apertura del estrecho de Gibraltar (5.33 Ma) habría jugado un papel esencial. A lo largo de las glaciaciones-deglaciaciones del Cuaternario, abetos y cedros mediterráneos habrían permanecido en refugios montañosos del sur de la península ibérica y del norte de África. A pesar de presentar cierta expansión y migración altitudinal coincidiendo con el óptimo térmico del Holoceno Medio, estas especies han sufrido un notable decliveposterior de sus poblaciones, como consecuencia del incremento de la aridez y del impacto de las actividades humanas. El desarrollo de las estrategias de conservación más adecuadas requiere una mejor información sobre la respuesta de estas especies a las distintas perturbaciones, para lo cual resulta indispensable conocer su evolución a lo largo del tiempo. El registro fósil, tanto de macrorrestos como de polen junto a diversos estudios genéticos contribuyen a evaluar su resiliencia y vulnerabilidad.ABSTRACT: The Mediterranean species included in the genus Abies, and Cedrus atlantica show very limited distribution ranges at present. In this work, we outline the origin and migratory routes followed by Abies pinsapo, A. marocana, A. tazaotana and Cedrus atlantica, from the beginning of the Tertiary to the present, as well as the likely causes which have led their populations to their current state of isolation and danger of extinction. Abies and Cedrus would have reached the Western Mediterranean along with other elements of the arctotertiary flora between the Middle Eocene (45 Ma) and the Oligocene (30 Ma). They subsequently underwent speciation processes until relatively recent times, among which the opening of the Strait of Gibraltar (5.33 Ma) would have played an essential role. Mediterranean firs and cedars would have stayed in Southeastern Iberian and North African mountainous refugia during Quaternary glaciations-deglaciations. Despite a noticeable expansion and altitudinal migration in the Mid-Holocene thermal optimum, these species have experienced a further remarkable decline, as a result of the increasing aridity and pressure of human activities. The development of the most appropriate conservation strategies requires the best information on the response of these species to diverse disturbances, thus the knowledge on their temporal evolution becomes essential. The fossil record, both macrorests and pollen, contributes, along with diverse genetic studies, to assessing their resilience and vulnerability

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

Due to low employment rates associated to chronic conditions in Europe, it is essential to foster effective integration and re-integration into work strategies. The objective of this systematic review is to summarize the evidence on the effectiveness of strategies for integration and re-integration to work for persons with chronic diseases or with musculoskeletal disorders, implemented in Europe in the past five years. A systematic search was conducted in MedLine, PsycINFO, CDR-HTA, CDR-DARE and Cochrane Systematic Reviews. Overall, 32 relevant publications were identified. Of these, 21 were considered eligible after a methodological assessment and included. Positive changes in employment status, return to work and sick leave outcomes were achieved with graded sickness-absence certificates, part-time sick leave, early ergonomic interventions for back pain, disability evaluation followed by information and advice, and with multidisciplinary, coordinated and tailored return to work interventions. Additionally, a positive association between the co-existence of active labour market policies to promote employment and passive support measures (e.g., pensions or benefits) and the probability of finding a job was observed. Research on the evaluation of the effectiveness of strategies targeting integration and re-integration into work for persons with chronic health conditions needs, however, to be improved and strengthened

Utility of the Health of the Nation Outcome Scales (HoNOS) in Predicting Mental Health Service Costs for Patients with Common Mental Health Problems : Historical Cohort Study

BACKGROUND: Few countries have made much progress in implementing transparent and efficient systems for the allocation of mental health care resources. In England there are ongoing efforts by the National Health Service (NHS) to develop mental health 'payment by results' (PbR). The system depends on the ability of patient 'clusters' derived from the Health of the Nation Outcome Scales (HoNOS) to predict costs. We therefore investigated the associations of individual HoNOS items and the Total HoNOS score at baseline with mental health service costs at one year follow-up.METHODS: An historical cohort study using secondary care patient records from the UK financial year 2012-2013. Included were 1,343 patients with 'common mental health problems', represented by ICD-10 disorders between F32-48. Costs were based on patient contacts with community-based and hospital-based mental health services. The costs outcome was transformed into 'high costs' vs 'regular costs' in main analyses.RESULTS: After adjustment for covariates, 11 HoNOS items were not associated with costs. The exception was 'self-injury' with an odds ratio of 1.41 (95% CI 1.10-2.99). Population attributable fractions (PAFs) for the contribution of HoNOS items to high costs ranged from 0.6% (physical illness) to 22.4% (self-injury). After adjustment, the Total HoNOS score was not associated with costs (OR 1.03, 95% CI 0.99-1.07). However, the PAF (33.3%) demonstrated that it might account for a modest proportion of the incidence of high costs.CONCLUSIONS: Our findings provide limited support for the utility of the self-injury item and Total HoNOS score in predicting costs. However, the absence of associations for the remaining HoNOS items indicates that current PbR clusters have minimal ability to predict costs, so potentially contributing to a misallocation of NHS resources across England. The findings may inform the development of mental health payment systems internationally, especially since the vast majority of countries have not progressed past the early stages of this development. Discrepancies between our findings with those from Australia and New Zealand point to the need for further international investigations