Efectos de la nubosidad e insolación en las temperaturas recientes de España

Ponencia presentada en: VI Congreso Internacional de la Asociación Española de Climatología celebrado en Tarragona del 8 al 11 de octubre de 2008.[ES]En el presente trabajo se realiza una comparación entre las temperaturas y la nubosidad e insolación en España desde mediados del siglo XX. Las variables utilizadas son los promedios anuales y estacionales de la temperatura media, máxima y mínima diaria, la oscilación térmica, la nubosidad (cubierta total y por tipología de nubes) e insolación. Con la excepción del invierno, las temperaturas máximas presentan, respecto a las mínimas, mejores correlaciones con la nubosidad e insolación, con valores negativos y positivos, respectivamente. Igualmente, los resultados confirman una alta correlación negativa entre nubosidad total y oscilación térmica.[EN]A comparison between temperature series and sunshine and cloudiness series over Spain has been performed from the second half of the 20th century. The temperature data set is constituted by series of mean, minimum, and maximum temperatures, and daily temperature range (DTR). Except for winter, maximum temperatures are better correlated with cloudiness and sunshine duration than minimum temperatures, being correlations of negative and positive signs respectively. Similarly, it is found that DTR varies inversely with total cloud cover.Este trabajo ha sido posible gracias a la financiación otorgada por el Ministerio de Educación y Ciencia mediante los proyectos NUCLIER (CGL 2004-02325), NUCLIEREX (CGL 2007- 62664), CLICAL (CGL-2006-13327-C04-03) y la beca FPU de que disfruta el primer autor

Oral Anticoagulant Adequacy in Non-Valvular Atrial Fibrillation in Primary Care: A Cross-Sectional Study Using Real-World Data (Fantas-TIC Study)

Background: Oral anticoagulants (OAs) are the treatment to prevent stroke in atrial fibrillation (AF). Anticoagulant treatment choice in non-valvular atrial fibrillation (NVAF) must be individualized, taking current guidelines into account. Adequacy of anticoagulant therapy under the current criteria for NVAF in real-world primary care is presented. Methods: Cross-sectional study, with real-world data from patients treated in primary care (PC). Data were obtained from the System for the Improvement of Research in Primary Care (SIDIAP) database, covering 60,978 NVAF-anticoagulated patients from 287 PC centers in 2018. Results: In total, 41,430 (68%) were treated with vitamin K antagonists (VKAs) and 19,548 (32%) NVAF with direct-acting oral anticoagulants (DOACs). Inadequate prescription was estimated to be 36.0% and 67.6%, respectively. Most DOAC inadequacy (77.3%) was due to it being prescribed as a first-line anticoagulant when there was no history of thromboembolic events or intracranial hemorrhage (ICH). A total of 22.1% had missing estimated glomerular filtration rate (eGFR) values. Common causes of inadequate VKA prescription were poor control of time in therapeutic range (TTR) (98.8%) and ICH (2.2%). Conclusions: Poor adequacy to current criteria was observed, being inadequacy higher in DOACs than in VKAs. TTR and GFR should be routinely calculated in electronic health records (EHR) to facilitate decision-making and patient safety

Aprendre a emprendre en el sector audiovisual. El MOOC com a eina per millorar l’empleabilitat.

Es presenta la posada en marxa d’una acció d’innovació docent, promoguda des de l'ensenyament de Comunicació Audiovisual de la Facultat de Biblioteconomia i Documentació de la UB, i portada a terme pel Grup Consolidat d’Innovació Docent GIDC-CAV. Aquesta té com a objectius generals crear continguts i recursos digitals sobre l’emprenedoria en l'àmbit de la comunicació audiovisual en format MOOC i el desenvolupament i l’aplicació d’eines de seguiment del procés d’avaluació i d’aprenentatge.Programa de Millora i Innovació Docent de la Universitat de Barcelona - Vicerectorat de Política Docen

Directrices académico-docentes en el grado de CAV: Un estudio exploratorio multifuente

En este artículo se presenta una experiencia de investigación en el marco de los estudios de Comunicación Audiovisual de la Universidad de Barcelona. El objetivo ha sido diseñar las directrices académico-docentes de la materia Proyectos del Grado de Comunicación Audiovisual. Durante los meses de octubre y noviembre de 2012, se realizó un estudio cualitativo descriptivo, de carácter exploratorio y con metodología multifuente para identificar aquellos aspectos que permiten el desarrollo de una propuesta didáctica caracterizada por el desarrollo de las competencias del estudiante. Se optó por realizar dos seminarios prospectivos como técnica de recogida de datos. Esta metodología es considerada especialmente útil para estudiar la generación de representaciones sociales, dado que a partir del debate grupal emerge el significado compartido acerca del tema de discusión. Los informantes fueron identificados como clave por el hecho de ser docentes, egresados y/o empleadores de Comunicación Audiovisual. El análisis de contenido muestra un cierto grado de consenso entre profesores, profesionales y egresados con respecto a los conocimientos/habilidades requeridos por los estudiantes y docentes para el desarrollo de un proyecto audiovisual. Se evidencia la conceptualización del proyecto como un proceso y un producto que requiere la puesta en práctica de conocimientos y habilidades, así como el papel relevante que estudiantes y profesores tienen frente a los empleadores. Así mismo se observa el gap existente entre las competencias descritas en la titulación y las expresadas en los seminarios prospectivos

Abnormalities in gray matter volume in patients with borderline personality disorder and their relation to lifetime depression: A VBM study

Background Structural imaging studies of borderline personality disorder (BPD) have found regions of reduced cortical volume, but these have varied considerably across studies. Reduced hippocampus and amygdala volume have also been a regular finding in studies using conventional volumetric measurement. How far comorbid major depression, which is common in BPD and can also affect in brain structure, influences the findings is not clear. Methods Seventy-six women with BPD and 76 matched controls were examined using whole-brain voxel-based morphometry (VBM). The hippocampus and amygdala were also measured, using both conventional volume measurement and VBM within a mask restricted to these two subcortical structures. Lifetime history of major depression was assessed using structured psychiatric interview. Results At a threshold of p = 0.05 corrected, the BPD patients showed clusters of volume reduction in the dorsolateral prefrontal cortex bilaterally and in the pregenual/subgenual medial frontal cortex. There was no evidence of volume reductions in the hippocampus or amygdala, either on conventional volumetry or using VBM masked to these regions. Instead there was evidence of right-sided enlargement of these structures. No significant structural differences were found between patients with and without lifetime major depression. Conclusions According to this study, BPD is characterized by a restricted pattern of cortical volume reduction involving the dorsolateral frontal cortex and the medial frontal cortex, both areas of potential relevance for the clinical features of the disorder. Previous findings concerning reduced hippocampus and amygdala volume in the disorder are not supported. Brain structural findings in BPD do not appear to be explainable on the basis of history of associated lifetime major depression

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Background: organ-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have different risk factors and outcomes for organ-space SSI. Methods: a multicentre observational prospective cohort study of adults undergoing elective colon and rectal procedures at 10 Spanish hospitals from 2011 to 2014. Patients were followed up until 30 days post-surgery. Surgical site infection was defined according to the Centers for Disease Control and Prevention criteria. Oral antibiotic prophylaxis (OAP) was considered as the administration of oral antibiotics the day before surgery combined with systemic intravenous antibiotic prophylaxis. Results: of 3,701 patients, 2,518 (68%) underwent colon surgery and 1,183 (32%) rectal surgery. In colon surgery, the overall SSI rate was 16.4% and the organ-space SSI rate was 7.9%, while in rectal surgery the rates were 21.6% and 11.5% respectively (p < 0.001). Independent risk factors for organ-space SSI in colon surgery were male sex (Odds ratio -OR-: 1.57, 95% CI: 1.14-2.15) and ostomy creation (OR: 2.65, 95% CI: 1.8-3.92) while laparoscopy (OR: 0.5, 95% CI: 0.38-0.69) and OAP combined with intravenous antibiotic prophylaxis (OR: 0.7, 95% CI: 0.51-0.97) were protective factors. In rectal surgery, independent risk factors for organ-space SSI were male sex (OR: 2.11, 95% CI: 1.34-3.31) and longer surgery (OR: 1.49, 95% CI: 1.03-2.15), whereas OAP with intravenous antibiotic prophylaxis (OR: 0.49, 95% CI: 0.32-0.73) was a protective factor. Among patients with organ-space SSI, we found a significant difference in the overall 30-day mortality, being higher in colon surgery than in rectal surgery (11.5% vs 5.1%, p = 0.04). Conclusions: organ-space SSI in colon and rectal surgery has some differences in terms of incidence, risk factors and outcomes. These differences could be considered for surveillance purposes and for the implementation of preventive strategies. Administration of OAP would be an important measure to reduce the OS-SSI rate in both colon and rectal surgeries

A new clinical decision support tool for improving the adequacy of anticoagulant therapy and reducing the incidence of stroke in nonvalvular atrial fibrillation

Altres ajuts: Pla estratègic de recerca i innovació en salut (PERIS) - Subvencions per a projectes de recerca orientats a l'atenció primària), grant number SLT002/16/00146.Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of ischemic stroke 4 to 5-fold. The first choice of anticoagulant therapy (AT) is the vitamin K antagonist (VKA). Contraindication to VKA or poor control of the International Normalized Ratio leads to the administration of direct-acting oral anticoagulants. There is a trend toward inadequate AT in nonvalvular AF (NVAF) patients. Aim: To evaluate the impact of the implementation of a decision support tool linked to the digital clinical history on the adequacy of AT, the incidence of complications, and the mortality in patients with NVAF in primary care centers (PCCs) of the Catalan Institute of Health (ICS). Randomized clinical trial in 287 PCCs, formed by 2 groups (intervention and control). Population: patients controlled in PCCs, diagnosed with NVAF 1 year before the implementation of the decision support tool and with VKA treatment over a minimum of 1 year. A simple randomization method will be performed at a sector level. The decision support tool will be available for 1 year. The time in therapeutic range (TTR) will be available in the digital clinical history only to professionals of the intervention group. The information system for primary care research development database will be used for the data extraction. Statistical analysis will be done at 3 time points: before the implementation of the tool, at 1 year, and at 2 years after the beginning of the intervention. Multilevel (patient and professional levels) logistic regression models will be used to estimate the effect of the intervention. This study protocol was approved by the Ethical Committee of Clinical Investigation of the Institut Universitari d'Investigació en Atenció Primària Jordi Gol (code P17/091). Articles will be published in scientific journals. Clinical-Trials.gov: NCT03367325

Adherence to european clinical practice guidelines for secondary prevention of cardiovascular disease : A cohort study

Funding: This study was supported by a grant from the Primary Health Care University Research Institute (IDIAP) Jordi Gol located in Barcelona, Spain (Grant ref: IDIAP 7Z12/006).To provide a better understanding of the actions taken within health systems and their results, this study aims to assess clinicians' adherence to clinical practice guidelines regarding recommended treatments in patients with cardiovascular disease in primary care settings, and to determine the associated factors. We conducted an ambispective cohort study in 21 primary care centres in 8 Spanish regions. Patients diagnosed with coronary heart disease, stroke and/or peripheral arterial disease were included. Patients who received the treatment recommended in the European guidelines on cardiovascular disease prevention (CPG's adherent group) were compared with patients who did not (CPG's non-adherent group). The outcome variables were cardiovascular hospital admissions, all-cause and cardiovascular mortality during follow-up. Of the 438 participants, 38.6% (n = 169) received the drug therapies recommended in the guidelines. The factors that increased the likelihood of good adherence to CPG's were being diagnosed with hypertension (p = 0.001), dyslipidaemia (p < 0.001) or diabetes (p = 0.001), and not having a psychiatric disorder (p = 0.005). We found no statistically significant association between good adherence to CPG's and lower incidence of events (p = 0.853). Clinician adherence to guidelines for secondary prevention of cardiovascular disease was low in the primary care setting