4,080 research outputs found
Paleoambiente y antropizacion en los Pirineos de Navarra durante el Holoceno medio (VI-IV milenios cal. BC) : una perspectiva palinologica
International audienceEl estudio palinológico de los yacimientos arqueológicos de Abauntz, Aizpea y Zatoya junto con el de las turberas de Atxuri, Belate, Quinto Real y Artxilondo, aporta información sobre los primeros indicios del impacto humano en el paisaje de los Pirineos navarros. Durante el Neolítico antiguo, los procesos de deforestación fueron poco signifi cativos, aumentando sus repercusiones durante el V milenio cal BC. Desde este período, los procesos de antropización son mucho más marcados, posiblemente como consecuencia de diferentes formas de explotación del medio (ganadería y agricultura)
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Validation in clinical population of the Problematic Internet Entertainment Use Scale for Adults (PIEUSAd)
Addiction to technologies has been a widely debated scientific and clinically, being a condition for further study as potential psychiatric disorder. Some Spanish scales measure Internet addiction, but no one has been validated clinically. The aims were to describe a clinical sample of patients in treatment for a technology addiction, and to validate clinically the “Problematic Internet Entertainment Use Scale for Adults” (PIEUSAd). Little-scale clinical adult sample (N=31; 71 % men, and an age mean of 33.31) was selected, collecting socio-demographic and clinical data, technological usages, and the PIEUSAd and Compulsive Internet Use Scale in a survey. The setting was a public health center in Barcelona (Spain). The patients in treatment for a technological addiction as primary diagnosis were usually young males, which suffer from a genuine e-addiction (above all, internet addiction, gaming and cybersex); only the middle seems to have a dual pathology (usually another addiction). They are usually referred by other clinician and the majority don’t have previous psychiatric care. The PIEUSAd showed large variability in item scored, and high factor and construct validity, and excellent reliability (a=0.98). In conclusion, the heterogeneity in the characteristics of patients is evidenced. Moreover, the PIEUSAd has been clinical validated to do a better screen in technological addictions, where “loss of control” and “evasion” seems to be the prevalent addictive symptoms in these types of patients.
Spanish abstract: La adicción a las tecnologías ha sido debatida ampliamente tanto científica como clínicamente, siendo una condición a estudiar como potencial trastorno psiquiátrico. Algunas escalas españolas miden la adicción al internet, pero ninguna ha sido validada clínicamente. Los objetivos son describir la muestra clínica de pacientes en tratamiento por una adicción tecnológica, así como validar clínicamente la “Problematic Internet Entertainment Use Scale for Adults” (PIEUSAd). Una muestra clínica a pequeña escala (N=31; 71 % hombres, con una edad media de 33,31) fue seleccionada, se recogieron datos socio-demográficos, clínicos y de uso de tecnologías, así como la PIEUSAd y la “Compulsive Internet Use Scale” a través de una encuesta. El contexto fue un centro de salud pública de Barcelona (España). Los pacientes en tratamiento por una adicción tecnológica como primer diagnóstico eran usualmente hombres jóvenes que sufrían de una e-adicción genuina (sobre todo, adicción a internet, videojuegos o cibersexo); solo la mitad parecía sufrir una patología dual (normalmente otra adicción). Eran normalmente derivados por otros profesionales de la salud y la mayor parte no habían sido tratados psiquiá- tricamente con anterioridad. La PIEUSAd mostró gran variabilidad en sus puntuaciones, alta validez factorial y de constructo, y excelente fiabilidad (a=0,98). En conclusión, la heterogeneidad de las características de los pacientes fue evidenciada. Además, la PIEUSAd ha sido validada clínicamente para poder hacer un mejor cribado en las adicciones tecnológicas, donde la “pérdida de control” y la “evasión” parecen ser los síntomas prevalentes en estos tipos de pacientes
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Diferencias psicopatológicas en mujeres con Dependencia Emocional con y sin uso de sustancias ilegales comórbido
En este artículo se presenta un análisis clínico de las diferencias psicopatológicas entre dos grupos de pacientes, mujeres, con problemas de Dependencia Emocional con y sin consumo de sustancias ilegales comórbido. Las pacientes fueron evaluadas mediante los cuestionarios TDS100, SCL-90-R, BIS-11 y una entrevista semiestructurada adaptada de la entrevista SCID-I. Los grupos se formaron en función de si existía consumo de drogas o no en el momento de la evaluación.
A través de los resultados hallados, se puede concluir que el grupo de mujeres con un consumo ocasional de drogas presenta una mayor gravedad en la escala de Acomodación medida a través del TDS-100, así como puntuaciones más altas en psicopatología comórbida (Sensibilidad Interpersonal, Ansiedad, Hostilidad, Ideación paranoide, Psicoticismo y GSI) medida por el SCL-90-R. Finalmente, el grupo con uso de drogas obtuvo puntuaciones significativamente más altas en la subescala Impulsividad Motora medida por el BIS-11.
English abstract: In this article we present a clinical analysis of the psychopathological differences between women patients with Affective Dependence problems with and without comorbid substance use. The patients were assessed trough the TDS-100, SCL-90-R, BIS-11 questionnaires and a semi-structured interview adapted from the SCID-I interview. The groups were created based on the substance use at the moment of the assessment.
The results reveal that the group of women with occasional use of drugs shows higher severity in the Accommodation scale measured trough the TDS-100 and in the comorbid psychopathology measured by the SCL-90R (Interpersonal Sensitivity, Anxiety, Hostility, Paranoid ideation, Psychoticism y GSI). Finally, the group with drug use obtained significantly higher scores in the Motor Impulsiveness subscale measured by the BIS-11
Monitoring Self-Perceived Occupational Health inequities in Central america, 2011 and 2018
Objectives. to analyze changes in occupational health inequity between 2011 and 2018 among workers in Central America. Methods. Data were collected by face-to-face interviews at the workers\u27 homes for the 2 Central America Working Conditions Surveys (n = 12 024 in 2011 and n = 9030 in 2018). We estimated health inequity gaps by means of absolute and relative population attributable risks and the weighted Keppel index. We stratified all analyses by gender. Results. Between 2011 and 2018, the proportion of workers reporting poor self-perceived health decreased both in women (from 32% to 29%) and men (from 33% to 30%). However, the health inequity gaps remained wide in the 4 stratifiers. Measured by the Keppel index, health inequity gaps between countries increased from 22% to 39% in women and from 20% to 29% in men. Conclusions. While health improved between 2011 and 2018, health inequity gaps remained wide. Wider health inequity gaps were observed between countries than by gender, age, occupation, or education. Public Health Implications. This first benchmark of occupational health inequities in Central America could be useful when developing and evaluating the impact of public policies on work
A palaeoecological approach to understanding the past and present of Sierra Nevada, a Southwestern European biodiversity hotspot
Mediterranean mountainous environments are biodiversity hotspots and priority areas in conservation agendas. Although they are fragile and threatened by forecasted global change scenarios, their sensitivity to long-term environmental variability is still understudied. The Sierra Nevada range, located in southern Spain on the north-western European flanks of the Mediterranean basin, is a biodiversity hotspot. Consequently, Sierra Nevada provides an excellent model system to apply a palaeoecological approach to detect vegetation changes, explore the drivers triggering those changes, and how vegetation changes link to the present landscape in such a paradigmatic mountain system. A multi-proxy strategy (magnetic susceptibility, grain size, loss-on-ignition, macroremains, charcoal and palynological analyses) is applied to an 8400-year long lacustrine environmental archive from the Laguna de la Mosca (2889 masl). The long-term ecological data show how the Early Holocene pine forests transitioned towards mixed Pinus-Quercus submediterranean forests as a response to a decrease in seasonality at ~7.3 cal. kyr BP. The mixed Pinus-Quercus submediterranean forests collapsed drastically giving way to open evergreen Quercus formations at ~4.2 cal. kyr BP after a well-known aridity crisis. Under the forecasted northward expansion of the Mediterranean area due to global change-related aridity increase, mountain forests inhabiting territories adjacent to the Mediterranean Region could experience analogous responses to those detected in the Sierra Nevada forests to the Mid to Late Holocene aridification, moving from temperate to submediterranean and then Mediterranean formations
Comisión de plan de estudios de la titulación de Ingeniería Técnica de Telecomunicaciones, especialidad en Sonido e Imagen de la EPS
La red docente de la Comisión de plan de estudios de la titulación de Ingeniería Técnica de Telecomunicación, especialidad en Sonido e Imagen de la EPS ha realizado durante el curso 2007/08 un estudio de los objetivos y competencias del futuro título de grado, así como el análisis y diseño de la posible estructura en bloques y asignaturas obligatorias en la que se podría distribuir dicho título. El estudio toma como base los resultados obtenidos en redes de cursos anteriores (ver memoria de redes 2005/06 y 2006/07), las cuales estaban orientadas al diseño curricular dentro del marco de los créditos ECTS para la convergencia al Espacio Europeo de Educación Superior, y sobre todo, se basa en la experiencia de los propios participantes en trabajos o redes previas. El objetivo principal de este proyecto es el diseño curricular del futuro título de grado en Ingeniería de Telecomunicación en Sonido e Imagen, directamente relacionada con la actual Ingeniería Técnica de Telecomunicación, especialidad en Sonido e Imagen, que se imparte en la Universidad de Alicante. Para ello se han seguido las pautas generales establecidas por el Real Decreto de ordenación de Enseñanzas Universitarias Oficiales (BOE, 30 de octubre de 2007), así como otros documentos elaborados por el Colegio Oficial de Ingenieros Técnicos de Telecomunicación y la Comisión de Universidades de Ingeniería Técnica de Telecomunicación
Global, regional, and national causes of under-5 mortality in 2000-19: an updated systematic analysis with implications for the Sustainable Development Goals
Background
Causes of mortality are a crucial input for health systems for identifying appropriate interventions for child survival. We present an updated series of cause-specific mortality for neonates and children younger than 5 years from 2000 to 2019.
Methods
We updated cause-specific mortality estimates for neonates and children aged 1-59 months, stratified by level (low, moderate, or high) of mortality. We made a substantial change in the statistical methods used for previous estimates, transitioning to a Bayesian framework that includes a structure to account for unreported causes in verbal autopsy studies. We also used systematic covariate selection in the multinomial framework, gave more weight to nationally representative verbal autopsy studies using a random effects model, and included mortality due to tuberculosis.
Findings
In 2019, there were 5·30 million deaths (95% uncertainty range 4·92-5·68) among children younger than 5 years, primarily due to preterm birth complications (17·7%, 16·1-19·5), lower respiratory infections (13·9%, 12·0-15·1), intrapartum-related events (11·6%, 10·6-12·5), and diarrhoea (9·1%, 7·9-9·9), with 49·2% (47·3-51·9) due to infectious causes. Vaccine-preventable deaths, such as for lower respiratory infections, meningitis, and measles, constituted 21·7% (20·4-25·6) of under-5 deaths, and many other causes, such as diarrhoea, were preventable with low-cost interventions. Under-5 mortality has declined substantially since 2000, primarily because of a decrease in mortality due to lower respiratory infections, diarrhoea, preterm birth complications, intrapartum-related events, malaria, and measles. There is considerable variation in the extent and trends in cause-specific mortality across regions and for different strata of all-cause under-5 mortality.
Interpretation
Progress is needed to improve child health and end preventable deaths among children younger than 5 years. Countries should strategize how to reduce mortality among this age group using interventions that are relevant to their specific causes of death.
Funding
Bill & Melinda Gates Foundation; WHO
Electronic health records and patient registries in medical oncology departments in Spain
We aimed to evaluate the current situation of electronic health records (EHRs) and patient registries in the oncology departments of hospitals in Spain. This was a cross-sectional study conducted from December 2018 to September 2019. The survey was designed ad hoc by the Outcomes Evaluation and Clinical Practice Section of the Spanish Society of Medical Oncology (SEOM) and was distributed to all head of medical oncology department members of SEOM. We invited 148 heads of oncology departments, and 81 (54.7%) questionnaires were completed, with representation from all 17 Spanish autonomous communities. Seventy-seven (95%) of the respondents had EHRs implemented at their hospitals; of them, over 80% considered EHRs to have a positive impact on work organization and clinical practice, and 73% considered that EHRs improve the quality of patient care. In contrast, 27 (35.1%) of these respondents felt that EHRs worsened the physician-patient relationship and conveyed an additional workload (n = 29; 37.6%). Several drawbacks in the implementation of EHRs were identified, including the limited inclusion of information on both outpatients and inpatients, information recorded in free text data fields, and the availability of specific informed consent. Forty-six (56.7%) respondents had patient registries where they recorded information from all patients seen in the department. Our study indicates that EHRs are almost universally implemented in the hospitals surveyed and are considered to have a positive impact on work organization and clinical practice. However, EHRs currently have several drawbacks that limit their use for investigational purposes. Not applicable The online version contains supplementary material available at 10.1007/s12094-021-02614-9
Factors associated with the development of septic shock in patients with candidemia: A post hoc analysis from two prospective cohorts
Background: Almost one third of the patients with candidemia develop septic shock. The understanding why some patients do and others do not develop septic shock is very limited. The objective of this study was to identify variables associated with septic shock development in a large population of patients with candidemia. Methods: A post hoc analysis was performed on two prospective, multicenter cohort of patients with candidemia from 12 hospitals in Spain and Italy. All episodes occurring from September 2016 to February 2018 were analyzed to assess variables associated with septic shock development defined according to The Third International Consensus Definition for Sepsis and Septic Shock (Sepsis-3). Results: Of 317 candidemic patients, 99 (31.2%) presented septic shock attributable to candidemia. Multivariate logistic regression analysis identifies the following factors associated with septic shock development: age > 50 years (OR 2.57, 95% CI 1.03-6.41, p = 0.04), abdominal source of the infection (OR 2.18, 95% CI 1.04-4.55, p = 0.04), and admission to a general ward at the time of candidemia onset (OR 0.21, 95% CI, 0.12-0.44, p = 0.001). Septic shock development was independently associated with a greater risk of 30-day mortality (OR 2.14, 95% CI 1.08-4.24, p = 0.02). Conclusions: Age and abdominal source of the infection are the most important factors significantly associated with the development of septic shock in patients with candidemia. Our findings suggest that host factors and source of the infection may be more important for development of septic shock than intrinsic virulence factors of organisms
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