Relation between vitamin D and cardiovascular risk factors

Objetivo: El objetivo de este estudio es analizar la posible asociación entre factores de riesgo cardiovascular, especialmente hipertensión, y la carencia de vitamina D. Pacientes y métodos: Se trata de un estudio descriptivo para el que seleccionaron los pacientes de entre 40 y 70 años con hipertensión no controlada atendidos de enero a marzo de 2014 en la Unidad de Hipertensión y Lípidos del Hospital Universitario San Cecilio de Granada, y se valoraron su historia clínica electrónica y las cifras de vitamina D en sangre. Resultados: De los 227 pacientes atendidos, cumplían los criterios de selección 81, y se obtuvieron los valores de vitamina D de 41 de ellos, siendo estos óptimos en el 70,73%, normales en el 14,63%, ligero déficit en un 12,20% y déficit en el 2,44%. Conclusiones: Estos resultados podrían deberse a que la población a la que presta atención el Hospital Universitario San Cecilio procede de un área que geográficamente no presenta déficit de vitamina D. Son necesarios más estudios para determinar las concentraciones óptimas de vitamina D, sus efectos y las implicaciones de aumentar las recomendaciones dietéticas.Objective: The objective of this study is to analyse the possible association between cardiovascular risk factors, especially hypertension, and the lack of vitamin D. Patients and methods: It is a descriptive study. A number of 40- to 70-year-old patients with uncontrolled hypertension who attended the Hypertension and Lipid Unit at San Cecilio University Hospital in Granada, Spain between January and March, 2014 were selected, and their electronic medical records and levels of vitamin D in blood monitored and analysed. Results: 81 out of the 227 patients who attended met the eligibility criteria, and vitamin D levels in blood were measured for 41 of them. Vitamin D levels turned out to be optimal in 70.73% of them, normal in 14.63%, and showed slight deficiency in 12.20% and deficiency in 2.44% of the patients. Conclusion: These results might be due to the fact that the population who attends San Cecilio University Hospital come from an area with no evidence of lack of vitamin D in their diet. More studies are needed to determine the optimal vitamin

A Case Study of available methodology for the identification of Vulnerable Ecosystems/Habitats in bottom deep-sea fisheries: Possibilities to apply this method in the NAFO Regulatory Area in order to select Marine Protected Areas

Information is critical to Ecosystem Approach and to research about Vulnerable Marine Ecosystems/Habitats (VME/Hs), fishing impacts on habitats and ad-hoc management measures are high-priority. Therefore, this paper presents the ECOVUL/ARPA Interdisciplinary Approach, a case study of methodology for the identification of VME/Hs in order to advise on conservation measures such as marine protected areas (MPAs). By means of an interactive process involving Conventional Fisheries Science, Geomorphology, Sedimentology and Benthic Ecology, the methodology developed under the ECOVUL/ARPA project, has been useful in order to contribute to define practical criteria to the identification of VME/Hs, to improve the knowledge about VME/Hs distribution and the adverse impacts of bottom trawl fisheries and to produce high quality advice on habitat protection. Applying an interdisciplinary approach, the project identified the deep-water bottom trawl fishery footprint on the Hatton Bank Western slope (NEAFC Regulatory Area), mapped the main fishing grounds and related seabed habitats and studied the interactions between fishing and cold-water corals. This approach was used to suggest, with high level of precision, the spatial limits of an area closed to bottom fishing, as an essential conservation measure to protect the cold-water corals in the framework of the Ecosystem Approach to Fisheries management. We present here the methods used, the main results obtained and discuss on the utility of this approach and the possibilities to apply it in the NAFO Regulatory Area, with the aim to advise on measures for reducing the interactions of bottom fishing with sensitive high-seas habitats and to contribute to implement the UNGA recommendations about habitat conservation

Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: the predictD-Spain study

Background: Few data exist on the psychosocial factors associated with attrition in longitudinal surveys. This study was undertaken to determine psychosocial and sociodemographic predictors of attrition from a longitudinal study of the onset and persistence of episodes of major depression in primary care. Methods: A systematic random sample of general practice attendees was recruited in seven Spanish provinces between October 2005 and February 2006. Major depression was diagnosed using the Composite International Diagnostic Interview and a set of 39 individual and environmental risk factors for depression were assessed at baseline and after 6 and 12 months of follow-up. Data were analysed using multilevel logistic regression. Results: 7777 primary care attendees aged 18-75 years were selected, of whom 1251 (16.1%) were excluded. Of the remaining 6526, 1084 (16.6%) refused to participate. Thus, 5442 patients (attending 231 family physicians in 41 health centres) were interviewed at baseline, of whom 3804 (70%) and 3567 (66%) remained at 6 and 12 months of follow-up, respectively. The province and sociodemographic factors were stronger predictors of attrition than psychosocial factors. Depression and anxiety had no effect but other psychosocial factors affected attrition. There were different profiles for the patients lost at 12 months when predictors measured at baseline versus 6 months were included. Conclusions: These findings suggest that several psychosocial factors might be considered factors of attrition in primary care cohorts and confirm that baseline characteristics are insufficient for analysing non-response in longitudinal studies, indicating that different retention strategies should be applied for patients interviewed at 6 and 12 months

Psychosocial and sociodemographic predictors of attrition in a longitudinal study of major depression in primary care: the predictD-Spain study

Few data exist on the psychosocial factors associated with attrition in longitudinal surveys. This study was undertaken to determine psychosocial and sociodemographic predictors of attrition from a longitudinal study of the onset and persistence of episodes of major depression in primary care

Predicting the onset of major depression in primary care: international validation of a risk prediction algorithm from Spain

Context: The different incidence rates of major depression and its associated risk factors suggest the need for specific national rather than supranational risk algorithms. Objectives: Develop and validate a predictD-Spain-risk-algorithm for the onset of major depression and compare the performance of the predictD-Spain-risk-algorithm with the predictDEurope-risk-algorithm in Spanish primary health care. Setting: Health Centers in Europe and South-America. Participants: In Spain (4574), Chile (2133) and other 5 European countries (5184), 11891 non depressed adult primary care attendees formed our at risk population. Main Outcome Measures: DSM-IV major depression (Composite International Diagnostic Interview). Results: The predictD-Spain-risk-algorithm was developed in 2787 primary care attendees in Spain and its use validated in Chile (1844) and five other European countries (4075). Six variables were patient characteristics or past events (sex, age, sex*age interaction, education, physical child abuse, and lifetime depression) and six were current status (SF-12-physical-score, SF-12-mental-score, dissatisfaction with unpaid work, number of serious problems in very close persons, dissatisfaction with living together at home, and taking medication for stress, anxiety or depression). Province was the thirteenth factor. The C-index of the predictD-Spain-risk-algorithm was 0.82 (95%CI=0.79-0.84) and in other countries it ranged between 0.70-0.83. Both the test for C-index differences (difference=0.0316; 95%CI=0.0121-0.0530; p<0.0022) and calibration plots showed that the predictD-Spain-risk-algorithm functioned better than the predictD-Europe-risk-algorithm in Spain. However, this did not hold true when 69 applied to other countries in Europe or Chile.This work was supported in Spain by grants from the Spanish Ministry of Health (grant FIS references: PI041980, PI041771, PI042450 and PI06/1442); the Andalusian Council of Health (grant references: 05/403 and 06/278) and the Spanish Ministry of Education and Science (grant reference SAF 2006/ 07192); the Spanish Network of Primary Care Research ‘redIAPP’ (RD06/0018), the ‘Arago ´n group’ (RD06/0018/0020), the ‘Baleares group’ (RD07/0018/ 0033), and the ‘SAMSERAP group’ (RD06/0018/ 0039). The Malaga sample, as part of the predictDInternational study, was also co-funded by a grant from the European Commission (reference QL4CT2002-00683). The research in Europe was funded by a grant from the European Commission (reference PREDICT-QL4-CT2002-00683). Funding in Chile was provided by project FONDEF DO2I-1140. Partial support in Europe was from the Estonian Scientific Foundation (grant 5696) and the Slovenian Ministry for Research (grant 4369-1027). The UK National Health Service Research and Development Office provided service support costs in the UK. The funders had no direct role in the design or conduct of the study, interpretation of the data or review of the manuscript

Desarrollo de recursos didácticos adaptados para la Generación Z en el ámbito de la Ingeniería Química

En este Proyecto Innova-docencia se van a elaborar una serie de recursos didácticos que sirvan de apoyo a la docencia presencial y virtual de asignaturas del área de la Ingeniería Química a nivel de Grado y de Máster enfocados a la Generación Z

Effectiveness of a strategy that uses educational games to implement clinical practice guidelines among Spanish residents of family and community medicine (e-EDUCAGUIA project):A clinical trial by clusters

This study was funded by the Fondo de Investigaciones Sanitarias FIS Grant Number PI11/0477 ISCIII.-REDISSEC Proyecto RD12/0001/0012 AND FEDER Funding.Background: Clinical practice guidelines (CPGs) have been developed with the aim of helping health professionals, patients, and caregivers make decisions about their health care, using the best available evidence. In many cases, incorporation of these recommendations into clinical practice also implies a need for changes in routine clinical practice. Using educational games as a strategy for implementing recommendations among health professionals has been demonstrated to be effective in some studies; however, evidence is still scarce. The primary objective of this study is to assess the effectiveness of a teaching strategy for the implementation of CPGs using educational games (e-learning EDUCAGUIA) to improve knowledge and skills related to clinical decision-making by residents in family medicine. The primary objective will be evaluated at 1 and 6months after the intervention. The secondary objectives are to identify barriers and facilitators for the use of guidelines by residents of family medicine and to describe the educational strategies used by Spanish teaching units of family and community medicine to encourage implementation of CPGs. Methods/design: We propose a multicenter clinical trial with randomized allocation by clusters of family and community medicine teaching units in Spain. The sample size will be 394 residents (197 in each group), with the teaching units as the randomization unit and the residents comprising the analysis unit. For the intervention, both groups will receive an initial 1-h session on clinical practice guideline use and the usual dissemination strategy by e-mail. The intervention group (e-learning EDUCAGUIA) strategy will consist of educational games with hypothetical clinical scenarios in a virtual environment. The primary outcome will be the score obtained by the residents on evaluation questionnaires for each clinical practice guideline. Other included variables will be the sociodemographic and training variables of the residents and the teaching unit characteristics. The statistical analysis will consist of a descriptive analysis of variables and a baseline comparison of both groups. For the primary outcome analysis, an average score comparison of hypothetical scenario questionnaires between the EDUCAGUIA intervention group and the control group will be performed at 1 and 6months post-intervention, using 95% confidence intervals. A linear multilevel regression will be used to adjust the model. Discussion: The identification of effective teaching strategies will facilitate the incorporation of available knowledge into clinical practice that could eventually improve patient outcomes. The inclusion of information technologies as teaching tools permits greater learning autonomy and allows deeper instructor participation in the monitoring and supervision of residents. The long-term impact of this strategy is unknown; however, because it is aimed at professionals undergoing training and it addresses prevalent health problems, a small effect can be of great relevance. Trial registration: ClinicalTrials.gov: NCT02210442.Publisher PDFPeer reviewe

Variables psicológicas implicadas en la actitud e iniciativa emprendedora (II): personalidad, cognición y emoción

El proyecto titulado: Variables implicadas en la actitud e iniciativa emprendedora (II): personalidad, cognición y emoción, es la continuidad de otro presentado en la convocatoria anterior (2016-2017) cuyo objetivo era evaluar variables psicológicas en la actitud emprendedora de los estudiantes universitarios de la Universidad Complutense de Madrid (UCM). Este segundo proyecto ha tenido por objetivo principal ampliar la evaluación a otras facultades y áreas de conocimiento de nuestra universidad a fin de obtener el mapa y perfil de la iniciativa emprendedora del universitario UCM

Aula itinerante de Patrimonio Cultural II

Memoria final del PIMCD UCM 2020/2021 número 31

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio