-- The main active faults of the Granada Basin are located in its central-eastern sector, where the most important tectonic activity is concentrated, uplifting its eastern part and sinking the ...western border. Several parameters related to the seismic potentiality of these active, or in some cases probably active, faults in this basin are used for the first time. Many of these faults can generate earthquakes with magnitudes larger than 6.0 M^sub ^sub W^^, although this is not the general case. The fault situated to the N of Sierra Tejeda, probably the one responsible for the big earthquake of 25/12/1884, stands out, because it could generate an earthquake with magnitude 6.9 M^sub ^sub W^^. Although at present all the data needed are not fully known, we consider that the final results show, as a whole, the average expected return periods of the faults in the Granada Basin.PUBLICATION ABSTRACT
To estimate the prevalence of nonadherence to treatment and its relationship with social support and social context in patients with multimorbidity and polypharmacy followed-up in primary care. This ...was an observational, descriptive, cross-sectional, multicenter study with an analytical approach. A total of 593 patients between 65-74 years of age with multimorbidity (greater than or equal to3 diseases) and polypharmacy (greater than or equal to5 drugs) during the last three months and agreed to participate in the MULTIPAP Study. The main variable was adherence (Morisky-Green). The predictors were social support (structural support and functional support (DUFSS)); sociodemographic variables; indicators of urban objective vulnerability; health-related quality of life (EQ-5D-5L-VAS & QALY); and clinical variables. Descriptive, bivariate and multivariate analyses with logistic regression models and robust estimators were performed. Four out of ten patients were nonadherent, 47% had not completed primary education, 28.7% had an income less than or equal to1050 euro/month, 35% reported four or more IUVs, and the average perceived health-related quality of life (HRQOL) EQ-5D-5L-VAS was 65.5. The items that measure functional support, with significantly different means between nonadherent and adherent patients were receiving love and affection (-0.23; 95%CI: -0.40;-0.06), help when ill (-0.25; 95%CI: -0.42;-0.08), useful advice (-0.20; 95%CI: -0.37;-0.02), social invitations (-0.22; 95%CI:-0.44;-0.01), and recognition (-0.29; 95%CI:-0.50;-0.08). Factors associated with nonadherence were belonging to the medium vs. low tertile of functional support (0.62; 95%CI: 0.42;0.94), reporting less than four IUVs (0.69; 95%CI: 0.46;1.02) and higher HRQOL perception (0.98; 95%CI: 0.98;0.99). Among patients 65-74 years of age with multimorbidity and polypharmacy, lower functional support was related to nonadherence to treatment. The nonadherence decreased in those patients with higher functional support, lower urban vulnerability and higher perceived health status according to the visual analog scale of health-related quality of life.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with ...increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12 months, as compared with usual care.
Design: pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient.
PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain).
patients aged 65-74 years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3 months).
n = 400 (200 per study arm).
complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview.
MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables.
primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle.
It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes.
Clinicaltrials.gov, NCT02866799.
To estimate the prevalence of symptoms and signs related to a COVID-19 case series confirmed by polymerase chain reaction (PCR) for SARS-CoV-2. Risk factors and the associated use of health services ...will also be analysed.
Observational, descriptive, retrospective case series study. The study was performed at two Primary Care Health Centres located in Madrid, Spain. The subjects studied were all PCR SARS-CoV-2 confirmed cases older than 18 years, diagnosed from the beginning of the community transmission (March 13) until April 15, 2020. We collected sociodemographic, clinical, health service utilization and clinical course variables during the following months. All data was gathered by their own attending physician, and electronic medical records were reviewed individually.
A descriptive analysis was carried out and a Poisson regression model was adjusted to study associated factors to Health Services use.
Out of the 499 patients studied from two health centres, 55.1% were women and mean age was 58.2 (17.3). 25.1% were healthcare professionals. The most frequent symptoms recorded related to COVID-19 were cough (77.9%; CI 95% 46.5-93.4), fever (77.7%; CI95% 46.5-93.4) and dyspnoea (54.1%, CI95% 46.6-61.4). 60.7% were admitted to hospital. 64.5% first established contact with their primary care provider before going to the hospital, with a mean number of 11.4 Healthcare Providers Encounters with primary care during all the follow-up period. The number of visit-encounters with primary care was associated with being male IRR 1.072 (1.013, 1.134), disease severity {from mild respiratory infection IRR 1.404 (1.095, 1.801), up to bilateral pneumonia IRR 1.852 (1.437,2.386)}, and the need of a work leave IRR 1.326 (1.244, 1.413.
Symptoms and risk factors in our case series are similar to those in other studies. There was a high number of patients with atypical unilateral or bilateral pneumonia. Care for COVID has required a high use of healthcare resources such as clinical encounters and work leaves.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The seabed constitutes a global sink for plastic debris, where they can remain for centuries. Biodegradable plastics offer the advantage of having less persistence in the environment than ...conventional ones. The seabed is responsible for key ecosystem functions related to the cycling of elements by decomposing the labile fraction of organic matter and fueling primary production, while storing the most recalcitrant part of this organic matter and limiting CO2 emissions. Although plastics are expected to affect these processes, knowledge on this matter is scarce. In controlled microcosms, we show that biodegradable plastics can stimulate the decomposition of marine-buried carbon and reduce the release of inorganic nitrogen. We found that conventional and biodegradable plastics promoted anaerobic sediment metabolic pathways. Biodegradable plastics produced a two-fold CO2 release to the water column, which suggests the decomposition of not only plastics, but also of buried organic carbon. The stimulation of sediment metabolism could be due to excessive carbon consumption by bacteria that derives from a rise in the carbon:nitrogen ratio. Accordingly, the NH4+ flux to the water column lowered. As NOx fluxes also lowered, biodegradable plastics might promote nitrification-denitrification coupling. If biodegradable plastics become a major component of marine pollution, then sediment biogeochemical cycles might be strongly influenced, which could affect the carbon sequestration of coastal ecosystems and compromise their mitigation capacity against climate change.
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•Plastics promoted anaerobic sediment metabolic pathways.•Biodegradable plastics stimulated the decomposition of buried carbon.•Biodegradable plastics reduced the release of inorganic nitrogen.
•MeSH terms and KeyWords Plus terms show different distributions.•Automatic classification based on MeSH terms and KeyWords Plus terms is uneven.•Automatic classification of work on humans displays ...better concordance.•Caution must be exercised when considering the use of grey boxes with KW Plus.•There are major restrictions on the use of KeyWords Plus in the biomedical field.
KeyWords Plus and Medical Subject Headings (MeSH) are widely used in bibliometric studies for topic mapping. The objective of this study is to compare the two description systems in documents about cannabis research to find the concordance between systems and establish whether there is neutrality in topic mapping. A total of 25,593 articles from 1970 to 2019 were drawn from Web of Science's Core Collection and Medline and analyzed. The tidytext library, Zipf's law, topic modeling tools, the contingency coefficient, Cramer's V, and Cohen's kappa were used. The results included 10,107 MeSH terms and 28,870 KeyWords Plus terms. The Zipf distribution of the terms was different for each system in terms of slope and specificity. The documents were classified into seven topics, and the MeSH system proved better at classification. The kappa coefficient between the two systems was 0.477 (for gamma ≥ 0.2); the topics related with human beings presented higher concordance. The use of KeyWords Plus for topic analyses in biomedical areas is not neutral, and this point needs to be taken into account in interpreting results.
The perdurability of plastics in the environment is one of the major concerns of plastic pollution and, as a consequence, oceans are accumulating large amounts of plastic. The degradation of ...conventional and biobased materials was evaluated through a laboratory experiment for a year simulating four different conditions in the marine environment. The water column environmental compartment was simulated under euphotic and aphotic (with and without light availability) conditions. The seafloor environmental compartment was simulated with sediment under non-polluted and polluted conditions. By combining weight loss (%), spectroscopic and thermal analyses, the degradation patterns regarding the polymer structure were assessed. The studied biobased materials were polylactic acid (PLA) based materials and showed higher degradability than conventional ones. The weight loss of conventional materials was not influenced by the water column or sediment, while in PLA-based materials, the degradation rates were ca. 5 times greater in the sediment than in the water column. The absorbance (Abs) value at 3400 cm−1 for polyethylene terephthalate (PET), and carbonyl (CO) index for PET and PLA could be useful to detect early signs of degradation. The crystallization index could be a useful parameter to discriminate degradation stages. The obtained results highlight the different degradability rates of materials depending on the specific environmental marine conditions.
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•Degradation of conventional and biodegradable biobased materials in marine habitats was studied.•Weight loss (%) is more noticeable in biodegradable biobased materials.•Polymer degradation is higher in the sediment than in the water column.•Absorbance 3400 cm−1 and carbonyl index are useful parameters to detect degradation.•Crystallization index is useful to discriminate among different degradation stages.
•A holistic Urban Resilience Index adapted to local context.•Multivariate analysis applied to remove redundant indicators.•Urban resilience is largely determined by the ecological ...dimension.•Resilience strategies are mainly focused on social and physical aspects.•The most resilient municipalities are usually the most sustainable, but not always.
Resilience is considered to be a component of sustainability and is addressed in the 17 Sustainable Development Goals adopted by all United Nations Member States. Resilience in this context is mainly oriented to climate change adaptation and disaster risk reduction. However, a holistic approach, considering urban systems as a whole and resilience to all kind of disturbances, is needed for a better understanding of the complexity of urban resilience. To advance in this direction we have proposed an Urban Resilience Index and applied it to 81 cities in the Madrid Region, Spain. The index comprises 42 indicators that measure six resilience characteristics: diversity, self-sufficiency and autonomy, polycentric governance, social cohesion, learning and innovation, and social-ecological justice, in five urban dimensions: socio-cultural, economic, ecological, physical and technological, and governance system. Our results showed that the ecological dimension in the Madrid Region is largely determined by the geomorphological characteristics and the associated ecosystems, but municipalities compensate it with resilience strategies focused on social and physical aspects. The most resilient municipalities are also in general the most sustainable, but not always. We propose to use the Urban Resilience Index in combination with the Sustainable Development Goals Index to develop resilient strategies towards sustainability.
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