The effectiveness of yoga and mindfulness in injury rehabilitation among british runners

This study aims to determine whether including yoga and mindfulness exercises in injury rehabilitation regimens for British runners can be beneficial. Since injuries are prevalent among runners and can influence physical and mental health, it is critical to investigate alternatives to standard recovery. The research measures the effectiveness of yoga and its mindfulness in injury rehabilitation among british runners. A mixed-methods approach was used, which included both a quantitive study of participant experiences and a quantitative investigation of injury therapeutic rates. British runners receiving normal rehabilitation were placed in a control group and an experimental group that received yoga and mindfulness interventions. Overall, the research study measured the smart PLS Algorithm model and created informative results, including descriptive statistics and correlation coefficients that present the smart PLS Algorithm model between them. Over the course of six months, information on pain thresholds, range of motion, psychological health, and injury medicinal rates was gathered. Quantitative data analysis also investigated how the participants perceived the intervention. According to preliminary research, integrating yoga and mindfulness techniques may help British runners heal from injuries more quickly, feel less pain, be more flexible, and generally feel better. More investigation is necessary to verify these results and clarify underlying mechanisms using bigger sample sizes and longer follow-up times.The overall result found that there is a direct and significant link between the effectiveness of yoga and mindfulness in injury rehabilitation among British runners. However, this study emphasises how alternative therapies like yoga and mindfulness may help runners get the best possible results from their injury rehabilitation. (AU)

Body mass index and risk of inflammatory breast disease: a Mendelianrandomization study / Índice de masa corporal y riesgo de mastitis: un estudio de aleatorización mendeliana

Introduction: in previous studies, obesity was identified as a risk factor for inflammatory breast disease, but its causality is uncertain. In thepresent study, we performed a two-sample Mendelian randomization (TSMR) analysis to investigate the causal relationship between obesity andinflammatory breast disease.Methods: we use body mass index (BMI) as a measure of obesity. Data for single nucleotide polymorphisms (SNPs) associated with BMI wereobtained from UK Biobank. Data for single nucleotide polymorphisms (SNPs) associated with mastitis were obtained from FinnGen Biobank. We usedseveral MR analysis methods, such as inverse-variance weighting (IVW), MR-Egger, weighted median, simple mode and weighted mode to makeour results more convincing. We also performed MR-PRESSO test, MR-Egger test, heterogeneity test, pleiotropy test and leave-one-out analysisto make our analysis results more robust and credible. We used odds ratio (OR) to evaluate the causal relationship between BMI and mastitis.Results: based on the IVW random effects model, we found that a one-standard deviation (SD) increase in BMI increased the risk of mastitis by62.1 % (OR = 1.621, 95 % CI: 1.262-2.083, p = 1.59E-4), which is almost consistent with the results of several other methods.Conclusions: in European individuals, an increase in the number of BMI increases the risk of inflammatory breast disease. People with high BMIneed to control their weight to reduce the incidence of inflammatory breast disease.(AU)

Introducción: en estudios previos, la obesidad se identificó como un factor de riesgo para la enfermedad inflamatoria de mama, pero su cau-salidad es incierta. En el presente estudio, se realizó un análisis de aleatorización mendeliana de dos muestras (TSMR) para investigar la relacióncausal entre la obesidad y la enfermedad inflamatoria de mama.Métodos: se empleó el índice de masa corporal (IMC) como medida de obesidad. Los datos de los polimorfismos de nucleótido único (SNP)asociados con el IMC se obtuvieron del Biobank de Reino Unido y los datos de los polimorfismos de nucleótido único (SNP) asociados con lamastitis se obtuvieron de FinnGen Biobank. Se utilizaron varios métodos de análisis de RM, como la ponderación inversa de la varianza (IVW),RM-Egger, mediana ponderada, modo simple y modo ponderado para que nuestros resultados fueran más convincentes. También se realizaronla prueba MR-PRESSO, la prueba MR-Egger, la prueba de heterogeneidad, el test de pleiotropía y la validación dejando uno fuera (en inglés,leave-one-out) para que los resultados de nuestro análisis fueran más sólidos y creíbles. Se utilizó la odds ratio (OR) para evaluar la relacióncausal entre el IMC y la mastitis.Resultados: basándonos en el modelo de efectos aleatorios IVW, se halló que un aumento de una desviación estándar (DE) en el IMC aumentabael riesgo de mastitis en un 62,1 % (OR = 1,621, IC 95 %: 1,262-2,083, p = 1,59E-4), que es casi consistente con los resultados de otrosdiversos métodos.Conclusiones: en los individuos europeos, un aumento del número de IMC aumenta el riesgo de enfermedad inflamatoria mamaria. Las personascon un IMC elevado deben controlar su peso para reducir la incidencia de enfermedad inflamatoria de la mama.(AU)

Epidemiological changes in invasive Streptococcus pyogenes infection during the UK alert period: A molecular comparative analysis from a tertiary Spanish hospital in 2023

Objectives: To study the genomic epidemiology of Streptococcus pyogenes causing bloodstream infections (GAS-BSI) in a Spanish tertiary hospital during the United Kingdom invasive S. pyogenes outbreak alert. Methods: Retrospective epidemiological analysis of GAS-BSI during the January–May 2017–2023 period. WGS was performed using Ion torrent GeneStudio™ S5 system for emm typing and identification of superantigen genes in S. pyogenes isolated during the 2022–2023 UK outbreak alert. Results: During 2023, there were more cases of GAS-BSI compared to the same period of previous year with a non-significant increase in children. Fourteen isolates were sequenced. The emm1 (6/14, 42.9%) and emm12 (2/14, 14.3%) types predominated; 5 of 6 (75%) emm1 isolates were from the M1UK clone. The most detected superantigen genes were speG (12/14, 85.7%), speC (10/14, 71.4%), speJ (7/14, 50%), and speA (5/15, 33.3%). speA and speJ were predominant in M1UK clone. Conclusions: Our genomic epidemiology in 2023 is similar to the reported data from the UK outbreak alert in the same period and different from previous national S. pyogenes surveillance reports.(AU)

Objetivos: Estudiar la epidemiología genómica de aislados de Streptococcus pyogenes causantes de bacteriemia (GAS-BSI) en un hospital de tercer nivel español durante la alerta por incremento de infecciones invasivas por S. pyogenes en el Reino Unido. Métodos: Análisis epidemiológico retrospectivo de GAS-BSI durante el periodo enero-mayo 2017-2023. Se realizó una secuenciación de genoma completo con el sistema Ion torrent GeneStudio™ S5 de los aislados obtenidos durante la alerta de brote del Reino Unido 2022-2023 para tipificación emm e identificación de genes de superantígenos. Resultados: Durante el periodo enero-mayo de 2023 hubo más casos de GAS-BSI que en el mismo periodo de años anteriores con un aumento no significativo en niños. Se secuenciaron 14 aislados. Predominaron los tipos emm1 (6/14, 42,9%) y emm12 (2/14, 14,3%); 5 de 6 (75%) aislados emm1 eran del clon M1UK. Los genes de superantígenos más detectados fueron speG (12/14, 85,7%), speC (10/14, 71,4%), speJ (7/14, 50%) y speA (5/15, 33,3%). Los genes speA y speJ predominaron en el clon M1UK. Conclusiones: Nuestra epidemiología genómica de Streptococcus pyogenes causantes de bacteriemia en 2023 es similar a los datos comunicados por el Reino Unido durante el mismo periodo y diferente de los informes nacionales previos de vigilancia.(AU)

Factores asociados al desarrollo de estenosis ureteral después de la ureteroscopia para cálculos ureterales impactados: estudio multicéntrico del grupo de trabajo de endourología y urolitiasis de la sección de Jóvenes Urólogos Académicos de la Asociación Europea de Urología / Factors associated with ureteral strictures following ureteroscopy for impacted ureteral stones. A multicenter study by EAU-YAU endourology and urolithiasis working party

Objetivo: Determinar la relación entre la impactación de los cálculos ureterales y la formación de estenosis ureterales y los factores asociados. Material y métodos Se analizaron retrospectivamente los registros médicos de todos los pacientes sometidos a cirugía endoscópica por cálculos ureterales impactados en 3 hospitales universitarios de Turquía, Reino Unido y España entre junio de 2019 y enero de 2022. Los parámetros examinados incluyeron los datos demográficos del paciente, lateralidad, tamaño y localización del cálculo, tiempo entre el inicio de los síntomas y la cirugía, tipo de ureteroscopia (rígida/flexible), presencia de nefrostomía o catéter doble J antes de la ureteroscopia, complicaciones intraoperatorias (avulsión/perforación), estado libre de cálculos, número de procedimientos necesarios para obtener un estado libre de cálculos y los resultados de las pruebas de imagen postoperatorias. Resultados Un total de 41 pacientes, 25 varones y 16 mujeres, de 3 instituciones fueron incluidos en el estudio. La edad media de los pacientes era de 48,2±13,5 años. La mediana del diámetro mayor de los cálculos fue de 9mm (RIC: 8mm). Catorce (34,1%) pacientes desarrollaron estenosis ureteral después de la ureteroscopia. No hubo diferencias entre los pacientes que desarrollaron estenosis ureteral y los que no la desarrollaron en cuanto a la lateralidad, la localización, la hidronefrosis y la multiplicidad de los cálculos (p=0,58, p=0,14, p=0,79 y p=0,31, respectivamente). Los pacientes que desarrollaron estenosis ureteral presentaron una tasa más elevada de derivación urinaria preoperatoria, como nefrostomía o catéter doble J (p=0,000). Conclusión La interrupción del paso de la orina por el uréter mediante derivación urinaria con nefrostomía o catéter doble J antes de la cirugía de cálculos ureterales podría favorecer la formación de estenosis ureteral en el postoperatorio. (AU)

Objective: To determine the relation between ureteral stone impaction and ureteral stricture formation and associated factors. Material and methods We retrospectively analyzed the medical records of all patients who underwent endoscopic ureteral stone surgery for impacted ureteral stone at 3 academic institutions in Turkey, United Kingdom and Spain between June 2019 and January 2022. Examined parameters included patient demographics, stone side, size and localization, time between initiation of symptoms and surgery, type of ureteroscopy (rigid/flexible), presence of nephrostomy or double-J stent prior to ureteroscopy, intraoperative complications (avulsion/perforation), stone-free status, number of procedures required for stone-free status, postoperative imaging results. Results A total of 41 patients whom 25 were male and 16 were female, from 3 institutions were included the study. The mean age of the patients was 48.2±13.5 years. The median largest diameter of the stones was 9mm (IQR: 8mm). Fourteen (34.1%) patients developed ureteral strictures following ureteroscopy. There was no difference between patients who developed ureteral strictures and patients who did not developed strictures in terms of stone laterality, stone location, hydronephrosis and multiplicity (p=0.58, p=0.14, p=0.79 and p=0.31, respectively). Patients who developed ureteral strictures had a higher rate of preoperative urinary diversion such as nephrostomy or double-J stent (p=0.000). Conclusion Interruption of urine passage through ureter via urinary diversion such as nephrostomy or double-J stent prior to ureteral stone surgery might lead ureteral stricture formation in the postoperative period. (AU)

School-based Psychosocial Interventions’ Effectiveness in Strengthening Refugee and Migrant Adolescents’ Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study / [La eficacia de las intervenciones psicosociales centradas en la escuela para potenciar la salud mental, la resiliencia y las relaciones sociales de adolescentes refugiados y migrantes: un estudio de grupos aleatorizados en cuatro países]

School-based psychosocial interventions are increasingly put forward as a way to support young refugees’ and migrants’ well-being and mental health in resettlement. However, the evidence on these interventions’ effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth’s mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.(AU)

Cada vez se proponen más las intervenciones psicosociales centradas en la escuela como ayuda al bienestar de jóvenes refugiados y migrantes en su realojamiento. No obstante hay pocas pruebas sobre la eficacia de tales intervenciones y los expertos denuncian fallas en dichas pruebas hasta el momento debido a la falta de estudios controlados a gran escala que incluyan medidas de los resultados sociales. El presente estudio de grupos aleatorizados pretende potenciar la base de pruebas sobre intervenciones psicosociales centradas en la escuela con jóvenes refugiados y migrantes analizando el efecto de dos intervenciones, “El drama en el aula” y “Bienvenido al colegio”, en la salud mental, la resiliencia y las relaciones sociales de los jóvenes en Bélgica, Dinamarca, Noruega y el Reino Unido. Se efectuaron análisis multinivel por separado para las dos intervenciones (“El drama en el aula”, n = 307, edad entre 11 y 19 años; “Bienvenido al colegio”, n = 251, edad entre 11 y 23 años) con grupos de control sin tratamiento separados. Los análisis mostraron un efecto positivo principal significativo de “El drama en el aula” en el apoyo familiar percibido y un efecto en el apoyo percibido de los amigos moderado por el país: en el Reino Unido el grupo de intervención presentó un aumento del apoyo percibido de los amigos, mientras que en el grupo control disminuyó. Además la resiliencia básica moderaba el efecto de la intervención de “El drama en el aula” en las dificultades conductuales y en el bienestar. No se apreció efecto de “Bienvenido al colegio” en ninguna de las variables resultado. En términos generales el estudio supone un inédito y detallado aval de las intervenciones psicosociales centradas en la escuela en el caso de adolescentes refugiados y migrantes.(AU)

Evolución del rendimiento deportivoen fútbol-7 para personas con parálisis cerebral: 2012-2016 / Sport performance evolution of football 7-a-side for people with cerebral palsy: 2012-2016

El objetivo del presente estudio fue analizar los lanzamientos ejecutados durante la competición de Fútbol a 7 para personas con parálisis cerebral de los Juegos Paralímpicos de Londres 2012 y de Río de Janeiro2016, además de conocer las diferencias entre ambas competiciones. Para ello, se realizó un análisis descriptivo de los 875 lanzamientos ejecutados durante la competición, así como de las diferencias entre las variables planteadas en el estudio entre ambas competiciones. Los resultados evidenciaron la importancia de los lanzamientos en el Fútbol a 7 para personas con Parálisis Cerebral. Se han obtenido diferencias significativas entre las competiciones analizadas en las siguientes variables: Equipo, Partido, Clasificación Funcional, Zona de lanzamiento, Posición, Zona corporal, Tipo de golpeo, Oposición y Resultado del lanzamiento. Se tuvo en cuenta el cambio de reglamento en torno a la clasificación funcional, que provocó cambios significativos en determinadas variables, concluyendo que la mayor implicación ofensiva la tienen los jugadores con menor afectación. (AU)

The aim of the present study was to analyze the launches made during the Football 7-a-side competition for people with cerebral palsy of the London 2012 Paralympic Games and Rio de Janeiro 2016, in addition to knowing the differences between both competitions. A descriptive analysis of the 875 launches executed during the competition, as well as the differences between the variables proposed in the study between the two competitions, was carried out. The results evidenced the importance of launches in Football 7-a-side for people with cerebral palsy. Significant differences have been obtained between the competitions analyzed in the following variables: Team, Match, Functional Classification, Launch zone, Position, Body zone, Hit type, Opposition and Launch result. The change of regulation around the functional classification was considered, which caused significant changes in certain variables, concluding that players with less affectation have the greatest offensive implication. (AU)

Nuevo escenario en el ámbito de los productossanitarios en la Unión Europea: Suiza y Reino Unido se convierten en terceros países / New scenario in the field of medical devices in the European Union: Switzerland and the United Kingdom become third countries

Objetivo: Comparar las medidas que se han tomado por parte dela Unión Europea, Suiza y Reino Unido para mantener la continuidadde mercado cumpliendo con los requisitos regulatorios del Reglamento 745/2017 de Productos Sanitarios.Método: Para realizar este trabajo se han revisado las webs oficialesde la Comisión Europea, la Agencia Española del Medicamento y Productos Sanitarios, la Swiss Agency for Therapeutic Products y la Medicines and Healthcare Products Regulatory Agency del Reino Unido y se hanrealizado búsquedas bibliográficas en PubMed y en internet (Google)con términos como “withdrawal Mutual Recognition Agreement of certificates of conformity European Union Switzerland medical devices, newregulation medical devices UK” y similares para un periodo comprendidoentre enero de 2020 y diciembre de 2021.Resultados: Como resultado del cese del marco legal que sosteníael libre comercio entre Suiza y Reino Unido de la Unión Europea, ladistribución de productos sanitarios se ha convertido en una importación,teniendo que cumplir con los requisitos legales pertinentes. Los distribuidores han pasado a ser importadores, y las declaraciones de conformidady certificados de Conformidad Europea han perdido su validez. Además,los Organismos Notificados ya no son reconocidos por la Comisión Europea. En consecuencia, Suiza, Reino Unido y la Unión Europea han tenidoque conceder periodos de gracia para permitir a las agencias reguladoras y operadores económicos adaptarse a las nuevas condiciones. (AU)

Objective: To compare the measures taken by the European Union, Switzerland and the United Kingdom to ensure the continuity of the medicaldevices market, complying with the requirements of Regulation 2017/745.Method: To carry out this work, a review was made of the official websites of the European Commission, the Spanish Agency for Medicines andHealth Products, the Swiss Agency for Therapeutic Products and the Medicines and Healthcare Products Regulatory Agency of the United Kingdom.Bibliographic searches were also conducted on Pubmed and the internet(Google), using terms such as “withdrawal of the Mutual Recognition Agreement of Swiss European Union medical device conformity certificates,new UK medical device regulation”, for a period extending from January2020 to December 2021.Results: As a result of the disappearance of the legal framework thatsupported free trade between Switzerland, the United Kingdom and theEuropean Union, products that used to be unrestrictedly distributed inEurope have become imports having to comply with the relevant legalrequirements. Distributors for their part have become importers, and declarations of conformity and CE certificates have lost their validity. Furthermore, notified bodies from Switzerland and the United Kingdom are nolonger recognized by the European Commission. Switzerland, the United Kingdom and the European Union have had to grant grace periods toallow regulatory agencies and economic operators to adapt to the newsituation. (AU)

Measurement Invariance and Validity of the Satisfaction With Life Scale in Informal Caregivers / Invarianza Métrica y Validez de la Escala de Satisfacción Vital en Cuidadores Informales

Background: The number of informal caregivers within ageing populationis increasing and there is a growing research interest to promote their well-being, and therefore there is a need for adequate measurement tools. Weaim to provide validity evidence of the Satisfaction with Life Scale (SWLS)in a representative sample of British older adults, including measurementinvariance across caregivers and non-caregivers. Method: Data wasdrawn from English Longitudinal Study of Ageing (ELSA). The sampleconsisted of 3,754 caregivers and 4,036 non-caregivers. The structureand measurement invariance were tested through a confirmatory factoranalysis. Reliability and validity evidence based on relationships withother variables were also analysed. Results: Our results supported the one-factor structure of the SWLS, CFI = .996; NNFI = .993; RMSEA = 0.081,and measurement invariance across caregiving status. McDonald’s omegawas .93. Scores on the SWLS were positively correlated with quality oflife, positive social support, and self-reported health, and negatively withloneliness, depression, negative social support, difficulties in activities andinstrumental activities of daily living, and number of health conditions.Conclusions: These findings provide new psychometric evidence tosupport the use of the SWLS in research which focuses on caregivers andon the comparison with non-caregiver samples.

Antecedentes: el número de cuidadores informalesmayores está aumentando y existe un creciente interés en la investigaciónsobre su bienestar, para lo cual es necesario disponer de instrumentosadecuados de medida. Se pretende proporcionar evidencias de validez dela Escala de Satisfacción Vital (SWLS) en una muestra representativa demayores de la población británica, incluyendo invarianza factorial entrecuidadores y no cuidadores. Método: los datos se extrajeron del EnglishLongitudinal Study of Ageing (ELSA). Participaron 3.754 cuidadores y4.036 no cuidadores. La estructura y la invarianza factorial se evaluaronmediante análisis factorial confirmatorio. También se analizaron la fiabilidady la validez basada en la relación con otras variables. Resultados:los resultados apoyaron la estructura unifactorial del SWLS, CFI = .996; NNFI= .993; RMSEA = 0.081, y su invarianza factorial entre cuidadores y nocuidadores. El omega de McDonald fue .93. Se encontraron correlacionespositivas con calidad de vida, apoyo social positivo y salud percibida, ynegativas con soledad, depresión, apoyo social negativo, dificultades enactividades y actividades instrumentales de la vida diaria y problemas desalud. Conclusiones: los hallazgos proporcionan nueva evidencia empíricaque apoya el uso del SWLS en investigación centrada en cuidadores.

Fuentes documentales para el estudio de la Sanidad en el Imperio Británico a través de la correspondencia de Florence Nightingale en la British Library / Fontes documentais para o estudo da cura no Império Britânico por meio da correspondência de Florence Nightingale na Biblioteca Britânica / Documentary sources for the study of Healing in the British Empire through the correspondence of Florence Nightingale in the British Library

En el presente trabajo analizamos la documentación sobre Florence Nightingale que encontramos en la British Library. Son de gran interés sus cartas con familiares, políticos y altos cargos del Ejército a través de las cuales podemos profundizar en el conocimiento de la Sanidad del Imperio Británico durante el siglo XIX, principios del siglo XX.(AU)

No presente trabalho analisamos adocumentação sobre Florence Nightingaleque encontramos no British Librart. Suascartas a familiares, políticos e altos oficiaisdo Exército, por meio das quais podemosaprofundar nosso conhecimento sobre aSaúde do Império Britânico durante o século19, início do século 20, são de grandeinteresse.(AU)

In the present work we analyze thedocumentation on Florence Nightingale thatwe found in the British Library. Her letterswith family members, politicians and highofficials of the Army through which we candeepen our knowledge of the Health of theBritish Empire during the 19 th century, thebeginning of the 20th century are of greatinterest.(AU)

Los vínculos del ingeniero Pablo Yver Ballester con la industria del gas británica (1902-1944) / Engineer Pablo Yvern Ballester’s connections with the british gas industry (1902-1944)

A principios del siglo XX, el Reino Unido continuaba siendo un referente para la industria del gas europea. Era el país más adecuado para obtener formación, tecnología y equipos. Pablo Yvern sería un ejemplo de estas afirmaciones. Entre 1902 y 1907, Pablo Yvern Ballester trabajó en la industria británica para completar su formación. Mientras ejerció de ingeniero en la industria del gas española (1907-1944), sus relaciones con la industria británica fueron intensas ya que allí adquirió los equipos más avanzados que necesitaba para sus obras. La principal aportación tecnológica a la industria del gas española de Pablo Yvern fue la patente que registró en 1911, denominada ‘Perfeccionamiento en los recuperadores de calor para hornos calentados por gas’. Sobre esta patente, fundamentó gran parte de su labor como ingeniero. En ella, hay indicios de la influencia de los conocimientos adquiridos durante su actividad en las empresas británicas Gibbons Juniors y Gibbons Bros Ltd. Su obra como ingeniero significó la mayor reforma y modernización de los elementos de producción, en especial los hornos, realizada en España en el primer tercio del siglo XX.(AU)

At the beginning of the 20th century, the United Kingdom kept playing an important role in the European gas industry. The UK was regarded as a place where to seek better technological training in the sector and as a benchmark for equipment acquisition. Pablo Yvern would be an example of these statements. Between 1902 and 1907, Pablo Yvern Ballester worked in the British industry in order to complete his training. While practicing as an engineer in the Spanish gas industry (1907-1944), his connections with his British counterpart intensified and resulted in the acquisition of the most advanced equipment he needed for his work. The main technological contribution made by Pablo Yvern to the Spanish gas industry was his 1911 registered patent ‘Improvement the heat recuperators on gas furnaces’ A considerable part of his work as an engineer was based on it. We can find evidence of that during his employment by the British companies Gibbons Juniors and Gibbons Bros Ltd. His work as an engineer entailed the largest refurbishing and modernization of the production elements, especially furnaces, undergone in the first third of the 20th century.(AU)

Eficacia de las medidas de minimización de riesgos del ácido valproico: estudio de utilización del fármaco en Europa, análisis de datos de España / Effectiveness of risk minimisation measures for valproate: a drug utilisation study in Europe, analysis of data from Spain

Introducción: En 2015 se aplicaron en España distintas medidas para la minimización de los riesgos (MMR) del ácido valproico. Objetivo: El objetivo de este estudio es evaluar la eficacia de las MMR del ácido valproico en España, con el fin de reducir el uso de ácido valproico como terapia de primera línea y evaluar los patrones de prescripción de ácido valproico en las mujeres, incluidas las mujeres en edad fértil (MEF), en los períodos previos y posteriores a la implementación de las MMR. Materiales y métodos: Los patrones de prescripción del ácido valproico en mujeres y MEF antes y después de la implementación de las MMR se examinaron utilizando la base de datos longitudinales de pacientes (longitudinal patient data, LPD por sus siglas en inglés), que incluye información de pacientes de dos paneles: médicos de atención primaria (MAP) y neurólogos/psiquiatras. El criterio principal de valoración fue la proporción de prescripciones iniciales de ácido valproico con al menos un medicamento relacionado con indicaciones de ácido valproico antes de la fecha de inicio del ácido valproico. Resultados: La proporción de prescripciones de ácido valproico secundarias con uso previo de medicamentos relacionados con indicaciones de ácido valproico fue del 78% –intervalo de confianza (IC) al 95%: 73,9-81,5%– y del 78,2% (IC al 95%: 74,5-81,4%) en los períodos principales previo y posterior a la implementación en el panel de MAP. Las cifras correspondientes a MEF fueron del 79,6% (IC al 95%: 73,6-84,5%) y del 75,5% (IC al 95%: 69,7-80,6%), respectivamente. La tasa de incidencia de embarazos expuestos al ácido valproico (por 1.000 personas-años) en MEF disminuyó de 17,4 en el período completo previo a la implementación a 8,5 en el período completo posterior a la implementación...(AU)

Introduction: Risk minimisation measures for valproate were implemented in Spain in 2015.Objective: The objective of this study is to assess the effectiveness of valproate risk minimisation measures in Spain intended to decrease the use of valproate as a first-line therapy, and to evaluate the prescribing patterns of valproate in women, including women of childbearing potential, in the pre- and post-implementation risk minimisation measures periods. Materials and methods: The prescribing patterns of valproate in females and women of childbearing potential before and after risk minimisation measures implementation were examined using the longitudinal patient data database, which includes patient information from two panels: primary care physicians and neurologists/psychiatrists. Primary endpoint was the proportion of initial valproate prescriptions with at least one medication related to the valproate indications before the valproate initiation date. Results: The proportion of incident valproate prescriptions with previous use of medication related to valproate indications was 78.0% (95% CI, 73.9%; 81.5%), and 78.2% (74.5%; 81.4%) in the main pre-and post-implementation periods in the primary care physician panel. The corresponding figures for women of childbearing potential were 79.6% (73.6%; 84.5%) and 75.5% (69.7%; 80.6%), respectively. The incidence rate of pregnancies exposed to valproate (per 1,000 person-years) in women of childbearing potential decreased from 17.4 the entire pre-implementation to 8.5 in the entire post-implementation periods. Conclusion: After the implementation of risk minimisation measures for valproate in Spain, no meaningful change in prescribing was observed regarding the proportion of valproate initiations preceded by prior medication related to valproate indications. The preventative measures recommended for use of valproate in women of childbearing potential should be considered.(AU)

Competency-based assessment of practice-based experiential learning in undergraduate pharmacy programmes

Objective: To obtain feedback from experiential learning (EL) leads about how competency-based assessments could be undertaken by EL facilitators, and to scope existing EL assessment structures in undergraduate Masters in Pharmacy (MPharm) programmes across the United Kingdom (UK). Methods: A cross-sectional survey was conducted utilizing a nine-item on-line survey, consisting of five open-ended and four closed-ended question. All UK universities with MPharm programmes (n=30) were invited to participate in the survey. Variables of interest were perceptions on activities and competencies that could be assessed by EL facilitators. The survey utilised a 5-point Likert-type response ranging from strongly disagree to strongly agree. Other variables of interest were tools/methods that could be used to assess competency, and perceived advantages and disadvantages of the proposed methods, the latter two captured via open-ended questions. Results: Of the 21 universities that responded (Response rate: 70%), 17 were included in the final analysis. Fourteen of the 17 (82.4%) offered the 4-year programme, while 3 (17.6%) offered both the 4-year and 5-year integrated programme. Assessments were mainly undertaken by university staff (59%), with minimal amounts undertaken during EL (39%). There was unanimous agreement (100%) that facilitators could assess students’ communication skills and professionalism during EL. No consensus, however, was achieved with regard to the tool(s) or method(s) to be used to assess student’s competencies. There were 13 responses to the open-ended comments. An advantage noted was that EL facilitator assessment of students would allow for more accurate evaluation of students in the practice setting, while acknowledging barriers such as the burden of time and the lack of consistency in marking. To address this lack of consistency, the majority highlighted the need for facilitator training (AU)

Bibliometric analysis on infective endocarditis

Introduction: Although infective endocarditis (IE) is rare disease, this disease has importance due to its high morbidity and mortality rates. The exact incidence is not known as it is not a reportable disease. Unlike developed countries, the disease affects the young more than the elderly in developing countries. Most of the time, the diagnosis cannot be made at the first examination and the disease is often overlooked. In order to reduce the mortality and morbidity of this disease, it is important to quickly recognize the disease by following current diagnosis and treatment methods, to identify the causative agent and to treat accordingly. Both the epidemiology and the management of IE are changing due to medical advances. This situation may also be reflected in scientific publications. We aimed to analyze the global researches on IE. Material and methods: The Scopus database was searched for bibliometric analysis without selecting document type. Data were retrieved for the time period January 1, 1940 and Semptember 26, 2021, containing the keywords " Infective’’ and’’endocarditis " in their title. Results: 7911 publications were included in the study. The first publication was made in the year 1891. Most of the publications were research articles [n=5784 (73.11%)] and were from the United States of America (USA) [n =1622 (20.50%)]. Japan, France, United Kingdom and Spain were also in the top 5 publishing countries on IE. Conclusions: Infective endocarditis is still an important reason of mortality, and there are many unanswered questions about the managament and preventation of this disease. This situation reflected the scientific publications. Since this is a global problem, not just some developed countries involved in the IE research, also more countries should be encouraged to participate the studies on IE. (AU)

Introducción: Si bien la endocarditis infecciosa (EI) es una enfermedad rara, esta enfermedadtiene importancia por sus altas tasas de morbilidad y mortalidad. No se conoce la incidencia exacta ya que no es una enfermedad de notificación obligatoria. A diferencia de los países desarrollados, la enfermedad afecta más a los jóvenes que a los ancianos en los países en desarrollo. La mayoría de las veces, el diagnóstico no se puede hacer en el primer examen y la enfermedad a menudo se pasa por alto. Para reducir la mortalidad y morbilidad de esta enfermedad, es importante reconocer rápidamente la enfermedad siguiendo los métodos de diagnóstico y tratamiento actuales, para identificar el agente causal y tratar en consecuencia. Tanto la epidemiología como el manejo de la EI están cambiando debido a los avances médicos. Esta situación también puede verse reflejada en publicaciones científicas. Nuestro objetivo era analizar las investigaciones globales sobre la EI. Material y métodos: Se buscó en la base de datos Scopus para el análisis bibliométrico sin seleccionar el tipo de documento. Se recuperaron datos para el período de tiempo del 1 de enero de 1940 y el 26 de septiembre de 2021, que contenían las palabras clave "Infeccioso" y "Endocarditis" en su título. Resultados: Se incluyeron 7911 publicaciones en el estudio. La primera publicación se realizó en el año 1891. La mayoría de las publicaciones fueron artículos de investigación [n = 5784 (73,11%)] y fueron de los Estados Unidos de América (EE.UU.) [n = 1622 (20,50%)]. Japón, Francia, Reino Unido y España también se encontraban entre los 5 principales países editores en la EI. Conclusiones: La endocarditis infecciosa sigue siendo una causa importante de mortalidad y hay muchas preguntas sin respuesta sobre el manejo y prevención de esta enfermedad. Esta situación reflejó las publicaciones científicas... (AU)

Design and use of vignettes to investigate referral decision-making by optometrists

Purpose: This study describes the design and application of a range of online clinical vignettes for measuring the impact of Continuing Education and Training (CET) and identifying unwarranted variation in optometric decision-making concerning referrals to secondary care.MethodsTwenty computerised vignettes were developed to assess clinical and referral management decisions taken in primary care optometry. The online system was specifically designed to present vignettes (ten pre-CET and ten post-CET) that avoided prompting correct answers. The main study group was qualified optometrists (N = 31) who chose any CET options available to United Kingdom optometrists over six months. Participants submitted a record of the CET undertaken, which was compared with an anonymised General Optical Council (GOC) reference sample. The vignettes were also completed by newly-qualified (N = 18) and pre-registration (N = 11) groups.ResultsCET had no significant correlation (p = 0.37) with improvement in optometric clinical decision-making and referral practice (qualified group). Selection bias affected this group who had more CET points (p = 0.008) and peer discussion points (p = 0.003) than the GOC reference sample. Results were indicative due to small sample sizes. Newly-qualified practitioners were significantly more likely to refer than the qualified group (p = 0.004). Number of referrals decreased with time since qualification (p = 0.006). (AU)

Patients’ attitudes and beliefs to presbyopia and its correction

Objective: Presbyopia is the gradual inability to focus near objects with age. This study explores patients’ attitudes and beliefs towards presbyopia including preferred modes of near refractive correction.MethodsIn the United Kingdom, twenty-four volunteers completed an online questionnaire and attended a structured, recorded focus group. Participants’ age ranged between 36 and 48 years, representing a pre-presbyopic and a presbyopic population. Attitudes and beliefs about presbyopia, its significance, and opinions about current refractive correction including multifocal contact lenses were transcribed and coded using content analysis for overarching themes and patterns.ResultsSix participants (25%) were already wearing a near visual correction while 18 (75%) were not. Five key primary themes with clear inter-participant similarities were identified as ‘age-related’ (75%), ‘acceptance’ (50%), clear lack of ‘familiarity with the word presbyopia’ (65%), a mixed/ reluctant attitude ‘towards (multifocal) contact lenses’ (62.5%), and ‘comfort and convenience’ of a presbyopic correction (79%) whereby cost is of less importance.ConclusionThe need for a reading correction was perceived as a sign of age. Spectacles were the most preferred mode of near vision correction, while comfort and convenience were seen as more important than cost. Patient education about presbyopia is lacking. Multifocal contact lenses are not necessarily the preferred visual correction even if the patient already wears contact lenses for distance. (AU)

Exploring the effect of optometrist practice type on NHS funded sight test outcome

PURPOSE: The United Kingdom (UK) National Health Service (NHS) currently provides sight tests at no cost to patients for all those aged <16 or ≥60. Some 'at-risk' patients and those in receipt of means-tested benefits are eligible for a NHS sight test between the ages of 16 and 60. In the UK, community optometrists typically either work in independent or national chain practices (multiples). The present study aims to explore whether practice type has any association with sight test outcome. As sight tests are essential in detecting early childhood visual problems, we also aim to explore children's first sight tests. METHOD: Data from 664,480 NHS sight test claims submitted in Essex from April 2015 to September 2016 were analysed using regression analysis. Practice type (multiple, independent) and children's first sight test were examined with respect to socio-economic status (SES, based on index of multiple deprivation rankings), age and sight test outcome. RESULTS: The median age for a first NHS sight test was 6 years old and was clinically independent of SES. Children's first sight tests typically resulted in neither a spectacle prescription being issued nor an onwards referral. Patients that attend multiples are significantly more likely to receive a new prescription, relative to no prescription, compared to a patient attending an independent (p < .001). CONCLUSIONS: Inequalities in sight test outcome appear to exist with differing type of practice (independent or multiple). Choice of practice type appears to be influenced by SES. Children have their first sight test at a later age than recommended

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