Neonatal factors maternal factors and invasive procedures associated with late neonatal sepsis in the period 2011-2020 systematic review and meta-analysis

To review, evaluate and synthesize available literature on neonatal and maternal factors and invasive procedures associated with late neonatal sepsis during the last ten years.Methods:The databases used for the bibliographic search were: Pubmed/Medline, LILACS, SciELO, and Google Scholar. Analytical studies investigating risk factors for late neonatal sepsis by stages (title, abstract and full text) were selected. The risk of bias was assessed using the Newcastle Ottawa Scale. Heterogeneity was set, and a random-effects meta-analysis was performed for the following risk factors: gender, gestational age, birth weight, Apgar score at ve min, premature rupture of membranes, route of delivery, use of a central venous catheter, and ventilation. Mechanics. The effect was measured with an odds ratio. The certainty of the evidence was determined using the GRADE methodology. The protocol was registered in PROSPERO. Results: Eight studies from 633 records were collected. Heterogeneity was high. Three male studies OR: 1.97(0.26-14.59) p=0.03; I2 =80%, prematurity two studies OR: 2.48 (1.13-5.45); p=0.04; I2 =72%, use of central venous catheter four studies – OR: 3.83 (1.07 – 13.71) p<0.01; I2 =89% and mechanical ventilation four studies OR: 2.83 (1.42 – 5.68); p<0.01; I2 =86%) were independent factors for the development of late neonatal sepsis. Studies had the lowest comparability assessment score when the risk of bias was applied. The results had low certainty of evidence. Conclusion: Male sex, prematurity, use of a central venous catheter, and mechanical ventilation are risk factors for late sepsis.Escuela de Postgrad

Mindfulness-based program for anxiety and depression treatment in healthcare professionals: A pilot randomized controlled trial

In primary health care, the work environment can cause high levels of anxiety and depression, triggering relevant expert and individual change. Mindfulness-Based Stress Reduction (MBSR) programs reduce signs of anxiety and depression. The purpose of this sub-analysis of the total project, was to equate the effectiveness of the standard MBSR curriculum with the abbreviated version in minimizing anxiety and depression. This randomized controlled clinical trial enrolled 112 mentors and resident specialists from Family and Community Medicine and Nurses (FCMN), distributed across six teaching units (TU) of the Spanish National Health System (SNHS). Experimental group participants received a MBRS training (abbreviated/standard). Depression and anxiety levels were measured with the Goldberg Anxiety and Depression Scale (GADS) at three different time periods during the analysis: before (pre-test) and after (post-test) participation, as well as 3 months after the completion of intervention. Taking into account the pre-test scores as the covariate, an adjusted analysis of covariance (ANCOVA) showed significant depletion in anxiety and depression in general (F (2.91) = 4.488; p = 0.014; ¿2 = 0.090) and depression in particular (F (2, 91) = 6.653; p = 0.002; ¿2 = 0.128 at the post-test visit, maintaining their effects for 3 months (F (2.79) = 3.031; p = 0.050; ¿2 = 0.071—F (2.79) = 2.874; p = 0.049; ¿2 = 0.068, respectively), which is associated with the use of a standard training program. The abbreviated training program did not have a significant effect on the level of anxiety and depression. The standard MBSR training program had a positive effect on anxiety and depression and promotes long-lasting effects in tutors and resident practitioners. New research is needed to demonstrate the effectiveness of abbreviated versions of training programs. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Mindfulness in primary care healthcare and teaching professionals and its relationship with stress at work: a multicentric cross-sectional study

Background: Work stress is a common problem among the health personnel of the Spanish National Health System. The objective of this paper is to assess the state of mindfulness among Spanish primary care providers and to evaluate its potential relationship with work stress and basic labor and sociodemographic characteristics. Methods: Cross-sectional, multi-centric study. Primary care nurses, teachers, teaching collaborators and residents assigned to six Spanish Family Medicine/Family and Community Care Departments were invited to participate (n = 475). A template was designed in Google Forms, including sociodemographic and work-related variables. The state of mindfulness was measured with the Five Facet Mindfulness Questionnaire (FFMQ), while work-related stress was measured using an ordinal scale ranging from 0 to 10 points. Descriptive and inferential statistical analyses were carried out, as well as bivariate and multivariate statistics. Results: The mean age of participants was 40, 14 ± 13.12 (range:23–65 years); 66.9% were women, 42.5% internal medicine residents, 29.3% family physicians, and 20.2% nurses. More than half (54.5%) knew about mindfulness, with 24.0% have received training on it, and 22.5% were usual practitioners. The average level of mindfulness was 127.18 ± 15.45 (range: 89–177). The average score of stress at work was 6.00 ± 2.44; 49.9% (range: 0–10). 49.9% of participants scored 7 or more on the stress at work scale. There was an inverse correlation between the levels of mindfulness (FFMQ total score) and work-related stress (Spearman’s r = - 0.155, p = 0.003). Significant relationships between the mindfulness practice and the level of mindfulness (F = 29.80, p < 0.001), as well as between the mindfulness practice and the level of work-related stress (F = 9.68, p = 0.042), were also found. Conclusions: Levels of mindfulness in primary care health providers were in line with those levels observed in other groups of health professionals. Half of all of the primary care providers suffered from a high degree of stress. Although weak, inverse relationships were observed between levels of mindfulness and stress at work, with lower values of stress at work among those who practiced mindfulness. Trial registration: NCT03629457

Dayside thermal structure of Venus' upper atmosphere characterized by a global model

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94843/1/jgre3057.pd

Controlled clinical trial comparing the effectiveness of a mindfulness and self-compassion 4-session programme versus an 8-session programme to reduce work stress and burnout in family and community medicine physicians and nurses: MINDUUDD study protocol

Background: Health personnel are susceptible to high levels of work stress and burnout due to the psychological and emotional demands of their work, as well as to other aspects related to the organisation of that work. This paper describes the rationale and design of the MINDUUDD study, the aim of which is to evaluate the effectiveness of a mindfulness and self-compassion 4-session programme versus the standard 8-session programme to reduce work stress and burnout in Family and Community Medicine and Nursing tutors and residents. Methods: The MINDUDD study is a multicentre cluster randomised controlled trial with three parallel arms. Six Teaching Units will be randomised to one of the three study groups: 1) Experimental Group-8 (EG8); 2) Experimental Group-4 (EG4) Control group (CG). At least 132 subjects will participate (66 tutors/66 residents), 44 in the EG8, 44 in the EG4, and 44 in the CG. Interventions will be based on the Mindfulness-Based Stress Reduction (MBSR) program, including some self-compassion practices of the Mindful Self-Compassion (MSC) programme. The EG8 intervention will be implemented during 8 weekly face-to-face sessions of 2.5 h each, while the EG4 intervention will consist of 4 sessions of 2.5 h each. The participants will have to practice at home for 30 min/day in the EG8 and 15 min/day in the EG4. The Five Facet Mindfulness Questionnaire (FFMQ), Self-Compassion Scale (SCS), Perceived Stress Questionnaire (PSQ), Maslach Burnout Inventory (MBI), Jefferson Scale of Physician Empathy (JSPE), and Goldberg Anxiety-Depression Scale (GADS) will be administered. Measurements will be taken at baseline, at the end of the programs, and at three months after completion. The effect of the interventions will be evaluated by bivariate and multivariate analyses (Multiple Linear Regression). Discussion: If the abbreviated mindfulness programme is at least as effective as the standard program, its incorporation into the curriculum and training plans will be easier and more appropriate. It will also be more easily applied and accepted by primary care professionals because of the reduced resources and means required for its implementation, and it may also extend beyond care settings to academic and teaching environments as well

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

III Jornadas de Jóvenes Investigadores en Arqueología: Libro de Actas

Libro de Actas de las III Jornadas de Jóvenes Investigadores en Arqueologí

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Quantifying illegal extraction of sea turtles in Costa Rica

Estimates of illegal wildlife trade vary significantly and are often based on incomplete datasets, inferences from CITES permits or customs seizures. As a result, annual global estimates of illegal wildlife trade can vary by several billions of US dollars. Translating these figures into species extraction rates is equally challenging, and estimating illegal take accurately is not achievable for many species. Due to their nesting strategies that allow for census data collection, sea turtles offer an exception. On the Caribbean coast of Costa Rica, three sea turtle species (leatherback, Dermochelys coriacea; green, Chelonia mydas; and hawksbill, Eretmochelys imbricata) are exploited by poachers. Despite the consumption of turtle eggs and meat being illegal, they are consumed as a cultural food source and seasonal treat. Conservation programmes monitor nesting beaches, collect abundance data and record poaching events. Despite the availability of robust long-term datasets, quantifying the rate of poaching has yet to be undertaken. Using data from the globally important nesting beach, Tortuguero, as well as beaches Playa Norte and Pacuare on the Caribbean coast of Costa Rica, we modelled the spatial and temporal distribution of poaching of the three sea turtle species. Here, we present data from 2006 to 2019 on a stretch of coastline covering c.37 km. We identified poaching hotspots that correlated with populated areas. While the poaching hotspots persisted over time, we found poaching is declining at each of our sites. However, we urge caution when interpreting this result as the impact of poaching varies between species. Given their low abundance on these beaches, the poaching pressure on leatherback and hawksbill turtles is far greater than the impact on the abundant green turtles. We attribute the decline in poaching to supply-side conservation interventions in place at these beaches. Finally, we highlight the value of data sharing and collaborations between conservation NGOs.</p

Olive Ridley Sea Turtle Hatching Success as a Function of Microbial Abundance and the Microenvironment of In Situ Nest Sand at Ostional, Costa Rica

Sea turtle hatching success at mass nesting beaches is typically lower than at solitary nesting beaches, presumably due in part to high rates of microbial metabolism resulting from the large input of organic matter from turtle eggs. Therefore, we tested the hypothesis that hatching success varies across areas of the beach in conjunction with differences in the physical nest environment and microbial abundance of in situ olive ridley sea turtle nests at Ostional, Costa Rica. We marked natural nests in high-density, low-density, and tidal-wash nesting areas of the beach and monitored clutch pO2 and temperature throughout the incubation period. We quantified hatching success and collected samples of nest sand during nest excavations. We quantified microbial abundance (bacteria and fungi) with a quantitative polymerase chain reaction (qPCR) analysis. Hatching success was lower in nests with lower pO2, higher temperatures, higher organic matter content, and higher microbial abundance. Our results suggest that the lower oxygen within the nest environment is likely a result of the high microbial abundance and rates of decomposition in the nest sand and that these factors, along with increased temperature of clutches in the high-density nesting area, are collectively responsible for the low hatching success at Ostional