We examined colorectal cancer screening (CRCS) intervention effectiveness, through the effect sizes associated with: (1) screening modality, (2) intervention level (e.g., client-directed), and (3) ...intervention component (e.g. client reminders) within published CRCS intervention systematic reviews (SRs).
A search of peer-reviewed CRCS SRs that were written in English was employed utilizing five databases: CINAHL, Cochrane Library, rTIPS, PubMed, and PsycINFO EBSCOHOST. SRs that included CRCS interventions with a randomized controlled trial, quasi-experimental, or single arm design were eligible. Data on effect sizes by screening modality, intervention level, and intervention component were extracted and synthesized.
There were 16 eligible CRCS intervention SRs that included 116 studies published between 1986 and 2013. Reviews organized data by CRCS screening modality, or intervention component. Effect size reporting varied by format (i.e., ranges, medians of multiple studies, or effect size per study), and groupings of modalities and components. Overall, the largest effect sizes were for studies that utilized a combination of colonoscopy, fecal occult blood test (FOBT), and sigmoidoscopy as screening options (16-45 percentage point difference).
Evidence suggests that CRCS interventions which include a combination of screening modalities may be most effective. This is the first SR to examine effect sizes of published CRCS SRs. However, because some SRs did not report effect sizes and there were tremendous variability reporting formats among those that did, a standard reporting format is warranted. Synthesizing findings can contribute to improved knowledge of evidence-based best-practices, direct translation of findings into policy and practice, and guide further research in CRCS.
The aim of this work was to analyze the influence of sex hormones and anatomical details (trabeculations and false tendons) on the electrophysiology of healthy human hearts. Additionally, sex- and ...anatomy-dependent effects of ventricular tachycardia (VT) inducibility are presented. To this end, four anatomically normal, human, biventricular geometries (two male, two female), with identifiable trabeculations, were obtained from high-resolution, ex-vivo MRI and represented by detailed and smoothed geometrical models (with and without the trabeculations). Additionally one model was augmented by a scar. The electrophysiology finite element model (FEM) simulations were carried out, using O'Hara-Rudy human myocyte model with sex phenotypes of Yang and Clancy. A systematic comparison between detailed vs smooth anatomies, male vs female normal hearts was carried out. The heart with a myocardial infarction was subjected to a programmed stimulus protocol to identify the effects of sex and anatomical detail on ventricular tachycardia inducibility. All female hearts presented QT-interval prolongation however the prolongation interval in comparison to the male phenotypes was anatomy-dependent and was not correlated to the size of the heart. Detailed geometries showed QRS fractionation and increased T-wave magnitude in comparison to the corresponding smoothed geometries. A variety of sustained VTs were obtained in the detailed and smoothed male geometries at different pacing locations, which provide evidence of the geometry-dependent differences regarding the prediction of the locations of reentry channels. In the female phenotype, sustained VTs were induced in both detailed and smooth geometries with RV apex pacing, however no consistent reentry channels were identified. Anatomical and physiological cardiac features play an important role defining risk in cardiac disease. These are often excluded from cardiac electrophysiology simulations. The assumption that the cardiac endocardium is smooth may produce inaccurate predictions towards the location of reentry channels in in-silico tachycardia inducibility studies.
Elections and Segregation of the Foreign Population in Andalusia Relinque-Medina, Fernando; Fernández-Borrero, Manuela Ángela; Vázquez-Aguado, Octavio
Migraciones (Universidad Pontificia Comillas. Instituto Universitario de Estudios sobre Migraciones),
05/2021
51
Journal Article
Recenzirano
The reality of migration is a global challenge to today’s societies, posing social, economic and political challenges. In recent years, a politicisation of these issues is being observed, leading to ...“anti-immigrant” political discourses and the defence of ethnocentric and assimilationist values. This has led to an increase in support for populist radical right political formations, which was reflected in Spain in the last elections with the irruption of VOX in April 2019, increasing their support in November 2019. Faced with this situation, the media, networks and social researchers have linked the presence of the foreign population with this fact, studying the population dynamics and segregation in their influence on the vote for right-wing parties. This paper aims to understand this type of relationship in the Autonomous Community of Andalusia, doing so from a municipal territorial approach and broken down by census tracts.
Despite the economic crisis, Spain is still a country with a large presence of foreign population, which requires the adjustment and adaptation of public services social services among them to this ...reality. Our objective is to understand and analyse the Intercultural Sensitivity levels of social workers in public social services in Andalusia (Spain), and relate them to elements of intercultural competence. Participants include 298 professionals from Andalusian community social services; 163 were social workers, on which this study focused. We have used the Intercultural Sensitivity Scale (IS) in the context of a larger survey that measured other aspects such as the degree of intercultural contact and intercultural competence through different means. We analyse correlations between the dimensions of the IS and other variables, associations and comparisons of means (Student's t-test and ANOVA) for the whole sample and different variables considering only social workers. The data obtained show high SI, with significant differences related to previous training on cultural diversity, age and relationships with foreign people. The level of knowledge about diversity management in the surveyed population is very relevant, as well as training and relationships with immigrants. However, we think it is necessary to strengthen both training and interaction to advance the implementation of theoretical contents on the practice and interaction that take place in professional intervention.
The family institution is a key aspect of the welfare regimes of southern Europe, a crisis-affected situation in which social workers play an important role. This paper analyzes the statements of ...social workers regarding professional intervention and the families with whom they work within the Spanish context, which involves a strong economic crisis and the reduction of public policies. A relational and qualitative study was conducted of 15 professional perceptions of cutbacks, family demands, the profiles of the user families, and the privatization of social services. In addition, proposals for improvement and challenges are analyzed. The main results involve the relationships among dwindling resources, increasing family demands and family dependence on the system, the disadvantages of privatization, excessive bureaucratization, and adverse labor conditions. The main conclusions include the inadequacy of public policies to meet the needs of at-risk families in a crisis context. About future, the research on professional decision making and professional intervention models will be studied in greater depth.
The life course accumulation of overt and subclinical myocardial dysfunction contributes to older age mortality, frailty, disability and loss of independence. The Medical Research Council National ...Survey of Health and Development (NSHD) is the world's longest running continued surveillance birth cohort providing a unique opportunity to understand life course determinants of myocardial dysfunction as part of MyoFit46-the cardiac sub-study of the NSHD.
We aim to recruit 550 NSHD participants of approximately 75 years+ to undertake high-density surface electrocardiographic imaging (ECGI) and stress perfusion cardiovascular magnetic resonance (CMR). Through comprehensive myocardial tissue characterization and 4-dimensional flow we hope to better understand the burden of clinical and subclinical cardiovascular disease. Supercomputers will be used to combine the multi-scale ECGI and CMR datasets per participant. Rarely available, prospectively collected whole-of-life data on exposures, traditional risk factors and multimorbidity will be studied to identify risk trajectories, critical change periods, mediators and cumulative impacts on the myocardium.
By combining well curated, prospectively acquired longitudinal data of the NSHD with novel CMR-ECGI data and sharing these results and associated pipelines with the CMR community, MyoFit46 seeks to transform our understanding of how early, mid and later-life risk factor trajectories interact to determine the state of cardiovascular health in older age.
Prospectively registered on ClinicalTrials.gov with trial ID: 19/LO/1774 Multimorbidity Life-Course Approach to Myocardial Health- A Cardiac Sub-Study of the MCRC National Survey of Health and Development (NSHD).
OBJECTIVE: To determine the clinical implications of the development of a perivalvular abscess in the course of an infective
endocarditis and evaluate the utility of two-dimensional echocardiography ...in the diagnosis of this complication. DESIGN: Retrospective
clinical review. Investigator-blinded comparative echographic case-control study. SETTING: Tertiary referral center. PATIENTS:
Forty patients with infective endocarditis and a histologically proved diagnosis of perivalvular abscess. INTERVENTION: Two-dimensional
echocardiograms corresponding to 36 of these 40 patients were blindly compared with two-dimensional echocardiograms of 20
randomly chosen patients with infective endocarditis in whom myocardial abscesses had not been demonstrated during surgery.
MEASUREMENTS AND MAIN RESULTS: During surgery or at autopsy, 40 patients had a total of 41 definite perivalvular abscesses.
Native valve endocarditis was present in 27 patients, and prosthetic valve endocarditis was present in 13 patients. Abscesses
were more frequent in aortic-valve endocarditis (57.5 percent) than in infections of other valves, and the infecting organism
was more often Staphylococcus (42.5 percent of cases). The hospital mortality rate was 90 percent in the 10 patients who did
not receive surgical treatment, as compared with 26.6 percent in the 30 operated-on patient (p < 0.001). Sensitivity and specificity
for the detection of abscesses associated with endocarditis were 80.5 percent and 85 percent, respectively, for transthoracic
two-dimensional echocardiography. CONCLUSIONS: Our data indicate that transthoracic echocardiography remains an accurate method
for the diagnosis of abscesses associated with endocarditis, even in the presence of a prosthetic valve, and it could help
to indicate early surgery in these patients.
Introducción: Las sociedades culturalmente diversas representan un desafío para las instituciones y los profesionales que prestan servicios puesto que requieren una intervención y una gestión ...intercultural adecuada que conllevan cambios y ajustes. Esta investigación, centrada en el ámbito de la intervención social, estudia la actuación profesional en clave intercultural en servicios sociales públicos y del tercer sector a partir de la experiencia de profesionales de tres países europeos.Método: En este estudio han participado un total de 27 personas de diferentes nacionalidades y residentes en España, Italia y Reino Unido. Se trata de profesionales de servicios sociales tanto públicos como de entidades del Tercer Sector y cuya formación es la de Trabajo Social, Educación Social o Psicología. La muestra ha sido seleccionada por accesibilidad, empleando la técnica de “bola de nieve”. El instrumento usado ha sido una entrevista en profundidad. Todas las entrevistas fueron trasncritas y analizadas con AtlasTi 6.1.Resultados: El resultado muestra una representación gráfica compuesta por 47 códigos o nodos que muestran las relaciones entre los diferentes elementos de análisis presentes en el estudio de la intervención profesional social en contextos de diversidad cultural. Estos nodos tienen que ver con la intervención en sí pero también con habilidades, valores y dificultades.Discusión y/o Conclusión: El análisis cualitativo ha permitido afianzar la relevancia de algunas cuestiones fundamentales para la práctica profesional, enfatizando la importancia del conocimiento para la adecuada praxis, así como el contacto y la propia actitud de entendimiento cultural, desde el respeto y habilidades claves como la comunicación y la escucha. Debe ser acompañado del componente emocional o afectivo que cumple un rol destacado en este tipo de intervenciones y profesiones. Introduction: Culturally diverse societies represent a challenge for institutions and professionals who provide services because they require appropriate intervention and intercultural management that involve changes and adjustments. This research, focused on the field of social intervention, studies the professional intercultural intervention in public social services and the third sector from the experience of professionals from three European countries.Method: A total of 27 people from different nationalities and residents in Spain, Italy and the United Kingdom have participated in this study. These are professionals of social services, both public entities and those of the third Sector and whose training is in social work, social education or psychology. The sample has been selected by accesibility, using the "snowball” technique. The instrument used has been an in-depth interview. All the interviews were transcribed and analysed with AtlasTi 6.1.Results: The result shows a graphical representation composed of 47 codes or nodes that show the relationships between the different elements of analysis present in the study of the social professional intervention in contexts of cultural diversity. These nodes are related with the intervention itself but also with abilities, values and difficulties.Discussion and/or Conclusion: Qualitative analysis has made it possible to reinforce the relevance of some important questions for professional practice, emphasising the importance of knowledge for the proper praxis as well as the contact and the attitude of cultural understanding, from the respect and key skills like communication and listening. It must be accompanied by the emotional or affective component that plays a prominent role in this type of interventions and professions.
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