Health professionals facing bad news: learning to communicate

Comunicación oral presentada en la Segunda Conferencia Internacional de Comunicación en Salud, celebrada el 23 de octubre de 2015 en la Universidad Carlos III de MadridIntroducción: la comunicación es el único proceso por el que el profesional de la salud puede trasmitir la información de estado/situación al paciente y/o familiares, favoreciendo la alianza terapéutica. Sin embargo nos encontramos con situaciones en el que la comunicación se dificulta por la información a trasmitir: malas noticias. La forma de realizarla puede ser muy variada, pero el que sea la adecuada depende de la situación y de la persona que trasmite como la que recibe. Objetivos: identificar y determinar los métodos utilizados por los profesionales de la salud, ante la comunicación de las malas noticias, así como plantear mejoras de actuación mediante la creación de protocolos generalistas ante la transmisión de las mismas. Metodología: revisión bibliográfica de publicaciones comprendidas entre 1998 y 2015. Resultados y discusión: análisis de 20 artículos. Profesionales, caso de enfermería, van ganando terreno en la comunicación de malas noticias. Sin embargo, dentro del Área de la Salud, existen otros profesionales también capacitados para la comunicación de malas noticias, apostando para ello por un trabajo multidisciplinar. Se han encontrado protocolo de actuación ante la comunicación de malas noticias como son el “SPIKES” y el “ABCDE”, así como otros adaptados. Conclusiones: actualmente es un desafío para los profesionales de la salud la comunicación de malas noticias, tarea exclusiva de los médicos, ello no exentos de controversias. No podemos obviar que los familiares y pacientes pasan más tiempo con otros profesionales, creándose lazos de bienestar, apoyo, confianza y recibiendo una continuidad de cuidados; profesionales capacitados y formados para comunicar las malas noticias. Un planteamiento desde un prisma multidisciplinar, evitándose el enfoque paternalista, respetando derechos del paciente, resaltando la importancia que el proceso de comunicación profesional-paciente y por ende reduciendo las consecuencias del modelo actual: reclamaciones y sentencias legales por no realizarse de la manera adecuada

From binge eating to binge drinking: A new and robust paradigm for assessing binge ethanol self-administration in male rats

Animal models of alcohol (ethanol) self-administration are crucial to dissect the neurobiological mechanisms underlying alcohol dependence, yet only a few of these induce pharmacologically relevant levels of alcohol consumption and rarely the alcohol self-administration co-occurs with other addictive behaviours. The present study aims to validate a novel model of voluntary ethanol consumption in male Wistar rats, in which ethanol access follows a binge eating experience. Over 10 sessions, Wistar rats were exposed to binge or control eating (i.e., the ingestion of 11.66 and 0.97 kcal/3 min, respectively, derived from a highly palatable food), immediately followed by two-bottle choice intake tests (2%, 6%, 10% or 14% w/w ethanol vs. water). Rats exposed to binge eating drank significantly more 6% or 10% (w/w) ethanol than control peers, reaching up to 6.3 gEtOH/kg. Rats stimulated with 2%, 6%, 10% or 14% ethanol after binge eating, but not those given those ethanol concentrations after control eating, exhibited significant within-group increases in ethanol drinking. This ethanol consumption was not altered by quinine adulteration (up to 0.1 g/L), and it was blocked by naltrexone (10 mg/kg), administered immediately before binge eating. Blood ethanol levels significantly correlated with ethanol consumption; and the more ethanol consumed, the greater the distance travelled in an open field test conducted after the two-bottle choice test. Altogether, this self-administration model seems a valid and robust alternative with remarkable potential for research on different stages of the alcohol addiction and, particularly, to assess interactions between alcohol consumption and others addictive-like behaviours.Junta de Andalucía, Grant/Award Numbers: CTS109, B-CTS-422-UGR18Ministerio de Universidades, Spain, Grant/Award Number: FPU18/05012Ministry of Science and Innovation, Grant/Award Number: MICIUPID2020- 114269GB-I00Spanish Ministry of Health (Government Delegation for the National Plan on Drugs), Grant/Award Number: PNSD 2020-04

Report on LIF measurements in Seville. Part 2: Santa Ana church

A scientific cooperation between ENEA UTAPRAD (Frascati) and the Natural Sciences Department of the “Pablo de Olavide” University in Seville, has started aimed at developing and testing innovative diagnostic instrumentation for Cultural Heritage preservation. Here we report the results obtained in a joint campaign carried on in Seville during February 2010 in the Santa Ana church in Seville (SP). Several wood paintings have been thoroughly investigated by means of Laser Induced Fluorescence scan system along the lines of the Research Pro ject “Non Destructive Techniques” managed by IAPH (Consejería de Cultura de la Junta de Andalucía).The field activities, developed as part of a conservation project carried out by IPAH, were devoted to the determination of retouches, traces of former restorations and detection of chemicals (wax, consolidants, etc.) on the surface under analysis not otherwise documented

Report on LIF measurements in Seville. Part 1: Virgen del Buen Aire chapel

Within the frame of a scientific cooperation between ENEA UTAPRAD (Frascati) and UPO Natural Sciences Dep. (Seville), aimed at developing and testing innovative diagnostic instrumentation for Cultural Heritage preservation, this report deals with results obtained in a joint campaign carried on in Seville during February 2010. Namely the data acquired by the ENEA LIF scanning system operated on fresco’s in Virgen del Buen Aire Chapel are presented here. The Virgen del Buen Aire Chapel has been studied according to the Research Project of “Non Destructive Techniques” managed by IAPH (Consejería de Cultura de la Junta de Andalucía). The results have been also implemented as part of a conservation project carried out by IAPH. LIF images are discussed in term of evaluating former restoration actions, in particular retouches on pigments and consolidant additions on a painted wall and two vaults. Statistical approaches and projection operators have been utilized for elaborating the images in order to handle the large number of spectra collected in each scanned point by our hyper-spectral system

Discovery of an Ebolavirus-Like Filovirus in Europe

Filoviruses, amongst the most lethal of primate pathogens, have only been reported as natural infections in sub-Saharan Africa and the Philippines. Infections of bats with the ebolaviruses and marburgviruses do not appear to be associated with disease. Here we report identification in dead insectivorous bats of a genetically distinct filovirus, provisionally named Lloviu virus, after the site of detection, Cueva del Lloviu, in Spain

Genetic Structure of the Spanish Population

<p>Abstract</p> <p>Background</p> <p>Genetic admixture is a common caveat for genetic association analysis. Therefore, it is important to characterize the genetic structure of the population under study to control for this kind of potential bias.</p> <p>Results</p> <p>In this study we have sampled over 800 unrelated individuals from the population of Spain, and have genotyped them with a genome-wide coverage. We have carried out linkage disequilibrium, haplotype, population structure and copy-number variation (CNV) analyses, and have compared these estimates of the Spanish population with existing data from similar efforts.</p> <p>Conclusions</p> <p>In general, the Spanish population is similar to the Western and Northern Europeans, but has a more diverse haplotypic structure. Moreover, the Spanish population is also largely homogeneous within itself, although patterns of micro-structure may be able to predict locations of origin from distant regions. Finally, we also present the first characterization of a CNV map of the Spanish population. These results and original data are made available to the scientific community.</p

A colorectal cancer susceptibility new variant at 4q26 in the Spanish population identified by genome-wide association analysis

BACKGROUND: Non-hereditary colorectal cancer (CRC) is a complex disorder resulting from the combination of genetic and non-genetic factors. Genome-wide association studies (GWAS) are useful for identifying such genetic susceptibility factors. However, the single loci so far associated with CRC only represent a fraction of the genetic risk for CRC development in the general population. Therefore, many other genetic risk variants alone and in combination must still remain to be discovered. The aim of this work was to search for genetic risk factors for CRC, by performing single-locus and two-locus GWAS in the Spanish population. RESULTS: A total of 801 controls and 500 CRC cases were included in the discovery GWAS dataset. 77 single nucleotide polymorphisms (SNP)s from single-locus and 243 SNPs from two-locus association analyses were selected for replication in 423 additional CRC cases and 1382 controls. In the meta-analysis, one SNP, rs3987 at 4q26, reached GWAS significant p-value (p = 4.02×10(-8)), and one SNP pair, rs1100508 CG and rs8111948 AA, showed a trend for two-locus association (p = 4.35×10(-11)). Additionally, our GWAS confirmed the previously reported association with CRC of five SNPs located at 3q36.2 (rs10936599), 8q24 (rs10505477), 8q24.21(rs6983267), 11q13.4 (rs3824999) and 14q22.2 (rs4444235). CONCLUSIONS: Our GWAS for CRC patients from Spain confirmed some previously reported associations for CRC and yielded a novel candidate risk SNP, located at 4q26. Epistasis analyses also yielded several novel candidate susceptibility pairs that need to be validated in independent analyses

Long-Term Real-World Effectiveness and Safety of Ustekinumab in Crohn’s Disease Patients: The SUSTAIN Study

Background Large real-world-evidence studies are required to confirm the durability of response, effectiveness, and safety of ustekinumab in Crohn’s disease (CD) patients in real-world clinical practice. Methods A retrospective, multicentre study was conducted in Spain in patients with active CD who had received ≥1 intravenous dose of ustekinumab for ≥6 months. Primary outcome was ustekinumab retention rate; secondary outcomes were to identify predictive factors for drug retention, short-term remission (week 16), loss of response and predictive factors for short-term efficacy and loss of response, and ustekinumab safety. Results A total of 463 patients were included. Mean baseline Harvey-Bradshaw Index was 8.4. A total of 447 (96.5%) patients had received prior biologic therapy, 141 (30.5%) of whom had received ≥3 agents. In addition, 35.2% received concomitant immunosuppressants, and 47.1% had ≥1 abdominal surgery. At week 16, 56% had remission, 70% had response, and 26.1% required dose escalation or intensification; of these, 24.8% did not subsequently reduce dose. After a median follow-up of 15 months, 356 (77%) patients continued treatment. The incidence rate of ustekinumab discontinuation was 18% per patient-year of follow-up. Previous intestinal surgery and concomitant steroid treatment were associated with higher risk of ustekinumab discontinuation, while a maintenance schedule every 12 weeks had a lower risk; neither concomitant immunosuppressants nor the number of previous biologics were associated with ustekinumab discontinuation risk. Fifty adverse events were reported in 39 (8.4%) patients; 4 of them were severe (2 infections, 1 malignancy, and 1 fever). Conclusions Ustekinumab is effective and safe as short- and long-term treatment in a refractory cohort of CD patients in real-world clinical practice

Using Interpretable Machine Learning to Identify Baseline Predictive Factors of Remission and Drug Durability in Crohn’s Disease Patients on Ustekinumab

Ustekinumab has shown efficacy in Crohn's Disease (CD) patients. To identify patient profiles of those who benefit the most from this treatment would help to position this drug in the therapeutic paradigm of CD and generate hypotheses for future trials. The objective of this analysis was to determine whether baseline patient characteristics are predictive of remission and the drug durability of ustekinumab, and whether its positioning with respect to prior use of biologics has a significant effect after correcting for disease severity and phenotype at baseline using interpretable machine learning. Patients' data from SUSTAIN, a retrospective multicenter single-arm cohort study, were used. Disease phenotype, baseline laboratory data, and prior treatment characteristics were documented. Clinical remission was defined as the Harvey Bradshaw Index <= 4 and was tracked longitudinally. Drug durability was defined as the time until a patient discontinued treatment. A total of 439 participants from 60 centers were included and a total of 20 baseline covariates considered. Less exposure to previous biologics had a positive effect on remission, even after controlling for baseline disease severity using a non-linear, additive, multivariable model. Additionally, age, body mass index, and fecal calprotectin at baseline were found to be statistically significant as independent negative risk factors for both remission and drug survival, with further risk factors identified for remission

Actas de las V Jornadas ScienCity 2022. Fomento de la Cultura Científica, Tecnológica y de Innovación en Ciudades Inteligentes

ScienCity es una actividad que viene siendo continuada desde 2018 con el objetivo de dar a conocer los conocimientos y tecnologías emergentes siendo investigados en las universidades, informar de experiencias, servicios e iniciativas puestas ya en marcha por instituciones y empresas, llegar hasta decisores políticos que podrían crear sinergias, incentivar la creación de ideas y posibilidades de desarrollo conjuntas, implicar y provocar la participación ciudadana, así como gestar una red internacional multidisciplinar de investigadores que garantice la continuación de futuras ediciones. En 2022 se recibieron un total de 48 trabajos repartidos en 25 ponencias y 24 pósteres pertenecientes a 98 autores de 14 instituciones distintas de España, Portugal, Polonia y Países Bajos.Fundación Española para la Ciencia y la Tecnología-Ministerio de Ciencia, Innovación y Universidades; Consejería de la Presidencia, Administración Pública e Interior de la Junta de Andalucía; Estrategia de Política de Investigación y Transferencia de la Universidad de Huelva; Cátedra de Innovación Social de Aguas de Huelva; Cátedra de la Provincia; Grupo de investigación TEP-192 de Control y Robótica; Centro de Investigación en Tecnología, Energía y Sostenibilidad (CITES