Anemia is a common condition in HIV-infected children; however, its pathophysiology and the contribution of frequent causes of anemia such as iron deficiency (ID) and malaria are poorly understood. ...We carried out an ancillary study on the effect of HIV on anemia as part of a case-control study on risk factors of anemia among Mozambican children aged 1-59 months with documented HIV status. Of them, 390 children were admitted to the hospital with anemia (hemoglobin Hb < 11 g/dL), whereas 272 children without anemia (Hb ≥ 11 g/dL) were recruited in the community. We assessed differences by HIV status in the presentation of anemia etiological factors and the effect of HIV infection on the association of each factor with anemia. Among the 99 HIV-infected and 563 uninfected children included, HIV-infected anemic children had an increased risk of undernutrition (P < 0.0001), Epstein-Barr virus infection (P < 0.0001), bacteremia (P = 0.0060), a decreased risk of malaria (P < 0.0001), and a similar risk of ID (P = 0.7371) compared with anemic-uninfected children. HIV-infected children were significantly less likely to have anemia associated with Plasmodium falciparum hyperparasitemia (P = 0.0444) and had a lower prevalence of parasitemia in the bone marrow (BM) (P < 0.0001) than anemic-uninfected children. Levels of BM erythropoiesis and dyserythropoiesis were comparable between groups. These findings suggest that the pathophysiology of anemia among HIV-infected malaria-exposed children is not related to HIV-specific effects. For unclear reasons, HIV-infected children had reduced risk of malaria infection, whereas ID prevalence was comparable in HIV-infected and uninfected children, suggesting that iron supplementation recommendations should not be different in HIV-infected children.
Nuevo calendario de vacunación para España, 2016 (Parte 1) Limia Sánchez, Aurora; Andreu, María del Mar; Torres de Mier, Maria de Viarce ...
Revista española de salud pública,
2016, 2016-01-01, Letnik:
90, Številka:
90
Journal Article
Recenzirano
Odprti dostop
ABSTRACT The immunization schedule is a dynamic public health tool that has incorporated different changes over the years influenced by the epidemiologic situation and the scientific evidence. The ...Immunization Advisory Committee Ponencia de Programa y Registro de Vacunaciones, as the Interterritorial Council scientific and technical advisory body, carries out assessments of different programmes and vaccines and proposes changes that after approval will be introduced in the Regions schedule. This article is divided into two parts presenting the rationale followed to propose a new schedule for the immunization against diphtheria, tetanus, pertussis, hepatitis B and invasive disease by Haemophilus influenzae type b. This first part is focused in the reasoning to undertake the assessment, the review of the immunization policy and the impact of immunization in Spain, as well as a review of the immunization schedules in similar countries.
RESUMEN El calendario de vacunación en España es una herramienta dinámica de salud pública que ha ido incorporando cambios en función de la situación epidemiológica y la evidencia científica. La Ponencia del Programa y Registro de Vacunaciones, órgano científico-técnico del Consejo Interterritorial del Sistema Nacional de Salud, realiza evaluaciones y propone modificaciones que se incorporan en el calendario de vacunación de las comunidades autónomas (CCAA). Este artículo está dividido en dos partes y presenta la evaluación realizada para proponer un nuevo esquema de vacunación frente a difteria, tétanos, tosferina, poliomielitis, hepatitis B y enfermedad invasora por Haemophilus influenzae tipo b, centrándose esta primera parte en la exposición de motivos, el repaso a la política de vacunación en España y su impacto así como en la revisión de los calendarios de vacunación en países de nuestro entorno.
In part 1, the effect of different polycarboxylate ether (PCE) admixtures with Portland-based binder (OPC) and calcium aluminate cement (CAC) pastes has been studied; indicating a low CAC–PCEs ...compatibility. In this part, 2, the effect of PCE admixtures with different molecular structure on the hydration and microstructural development of CAC pastes has been studied. The findings showed that the PCE admixtures used retarded CAC hydration and this effect is independent of the admixture carboxylate/ester ratio. The results obtained have proven that the presence of PCE admixtures in OPC and CAC pastes does not modify the nature of hydrates formed. However, in CAC pastes, the presence of PCE admixture has an important effect on the amount of hydrates generated, it being 45% lower at the same time than in CAC pastes without admixture.
The aim of the present study is to understand the impact of e-quality on consumer's loyalty in the context of the online airplane ticket purchase. For this purpose, quality is divided in two ...dimensions: functional quality (based on E-S-QUAL model) and hedonic quality. The methodology applied was administered to 617 consumers of online airplane tickets via an airline’s website in 2009. Structural Equation Modeling was applied to study the impact. The results show that the functional and hedonic quality are positive significant for loyalty through perceived value. From a managerial perspective, this paper provides advice for the airline industry in the development of e-commerce to take advantage of the current situation of disintermediation and to achieve the loyalty of customers.
► We examine the impact of e-quality on consumer's loyalty in the e-commerce context. ► We develop and asses a scale to measure e-quality considering hedonics. ► Internet is reducing the role of traditional intermediaries in the tourist industry. ► Airline companies should design their e-business processes to meet customers’ needs.
The focus of this study is to analyze the existence of Management Systems in the hospitality industry in Spain. This will be undertaken from the point of view of the organizational context – ...especially as far as environmental management is concerned – considering also its scope, implementation sequence and possible integration of different MSs. In order to study the aforementioned aspects, information from 294 hotels was used. The findings reveal differences with regard to previous research regarding other geographical areas and industries for adoption patterns and for integration of the management systems. Thus, this study contributes to a better understanding of the specific needs of the hotel industry for hotel management, consultancy firms, auditing firms and policy makers.
Despite diffusion tensor imaging (DTI) evidence for widespread fractional anisotropy (FA) reductions in the brain white matter of patients with bipolar disorder, questions remain regarding the ...specificity and sensitivity of FA abnormalities as opposed to other diffusion metrics in the disorder. We conducted a whole‐brain voxel‐based multicompartment diffusion MRI study on 316 participants (i.e., 158 patients and 158 matched healthy controls) employing four diffusion metrics: the mean diffusivity (MD) and FA estimated from DTI, and the intra‐axonal signal fraction (IASF) and microscopic axonal parallel diffusivity (Dpar) derived from the spherical mean technique. Our findings provide novel evidence about widespread abnormalities in other diffusion metrics in BD. An extensive overlap between the FA and IASF results suggests that the lower FA in patients may be caused by a reduced intra‐axonal volume fraction or a higher macromolecular content in the intra‐axonal water. We also found a diffuse alteration in MD involving white and grey matter tissue and more localised changes in Dpar. A Machine Learning analysis revealed that FA, followed by IASF, were the most helpful metric for the automatic diagnosis of BD patients, reaching an accuracy of 72%. Number of mood episodes, age of onset/duration of illness, psychotic symptoms, and current treatment with lithium, antipsychotics, antidepressants, and antiepileptics were all significantly associated with microstructure abnormalities. Lithium treatment was associated with less microstructure abnormality.
A whole‐brain voxel‐based approach combining DTI and SMT diffusion‐derived metrics to reveal specific brain tissue microstructure abnormalities in bipolar disorder (BD) was carried out. We also evaluate the sensitivity of various diffusion metrics for the automatic diagnosis of BD through machine learning algorithms and cross‐validation. Finally, we look for differences between BD subtypes and the possible effect of duration of illness, age at onset, history of psychosis, and pharmacological treatment with lithium, antidepressant, antipsychotic, and antiepileptic drugs.
Currently, the European Union is promoting the circular economy, a change that involves moving the foundations of actual economies toward the most sustainable production and consumption periods, in ...which the reuse of resources predominates, mainly through recycling, reuse, and reduction, among other strategies. This study, through the application of institutional theory, analyzes the role that institutional pressure has in the diffusion and adoption of the circular economy from the state to the regions inside through coercive, normative, and mimetic pressures. A matrix of institutional positioning was developed that analyzes the number and diversity of circular economy initiatives. The results show that coercive pressure followed by mimetic pressure are the most relevant in explaining the development of the circular economy in Spain in relation to the closest other European countries in Southern Europe, while there is low normative pressure. The results obtained provide relevant information on how to accelerate the development of the circular economy throughout the European Union through the adequate exercise of different types of institutional pressure.
Purpose
The purpose of this paper is to take an explanatory role and analyse the development of workspace ambiences in coworking spaces which optimise the chance of interactivity between individual ...users and leading towards cooperation. The paper thus offers a discussion on how the ambience that is tailored to a particular coworking space enhances the possibility of collaboration between two or more users of a selected workspace.
Design/methodology/approach
Ethnographically guided observations of six coworking spaces and qualitative interviews with their managers were used to gain an understanding of the workspace ambiences in coworking spaces. As direct measurement of the frequency of collaboration would be logistically profound, this paper rather explores the conditions for spontaneous or moderated interactivity between workspace users, which may be regulated by the creation of an optimal coworking space ambience.
Findings
The following paper defines the coworking space ambience as the look and the feel of a work environment which can arouse certain moods towards a particular place and its users. Coworking spaces may impose various approaches that not only attract potential workspace users and form initial ties between them but also produce a certain ambience that leads to collaborative action between users. The factors of spatial design need to be adapted, and engagement strategies need to be constructed to maximise the preferential output. The research behind the following paper concludes that the factors of spatial comfortability are an essential predisposition for workspace users to engage in cooperation with each other. Various mechanisms are needed to customise these engagements into cooperative action.
Originality/value
While the outcomes of sharing these environments have been periodically explored, no attempts have been made to investigate how coworking ambience is being created and implemented to optimise collaborative efforts of individuals who are sharing the workspace. For that reason, the audience of this paper should not only be limited to academics but may also be suitable for managers and office-space operators seeking to understand dynamics of collaboration within new types of shared office spaces.
Background
Various studies have assessed omalizumab outcomes in the clinical practice setting but follow‐up and/or number of patients included were limited. We aim to describe the long‐term outcomes ...of pediatric patients with severe persistent allergic asthma receiving omalizumab in the largest real‐life cohort reported to date.
Methods
ANCHORS was a multicenter, observational, retrospective cohort study conducted in 25 Pediatric Allergy and Pulmonology units in Spain. We collected data of patients < 18 years and initiating omalizumab between 2006 and 2018, from the year prior to omalizumab initiation to discontinuation or last available follow‐up. The primary outcome was the evolution of the annual number of moderate‐to‐severe exacerbations compared with the baseline period.
Results
Of the 484 patients included, 101 (20.9%) reached 6 years of treatment. The mean ± standard deviation number of exacerbations decreased during the first year of treatment (7.9 ± 6.6 to 1.1 ± 2.0, P < .001) and remained likewise for up to 6 years. The other clinical parameters assessed also improved significantly during the first year and stabilized or continued to improve thereafter. The percentage of patients experiencing adverse events was consistently low, and the main reason for discontinuation was good disease evolution.
Conclusion
In this large, long‐term, observational study, moderate‐to‐severe exacerbations decreased significantly from the first year of treatment with omalizumab. The beneficial effect was maintained in the long term, along with a good safety profile. Our results position omalizumab as an effective long‐term treatment in pediatric patients with severe persistent allergic asthma.
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