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BACKGROUND: Ulcerative proctitis (UP) presents distinctive clinical characteristics, outcomes and therapeutic approaches as compared to left-sided and extensive ulcerative colitis (UC). AIM: To describe the current therapeutic requirements and clinical outcomes in patients with active UP. METHODS: Retrospective observational study conducted in a referral IBD centre. Patients with UP in follow-up between 1989 and 2014 were included. The clinical characteristics, as well as the different treatments and drug formulations administered to treat flares, were recorded. RESULTS: Out of 687 UC patients, 101 patients (15%) with UP were included. Median follow-up was 8 years (IQR 3-14) and 49% of patients presented disease activity during the study period. Topical mesalazine monotherapy (90%) was the most commonly administered treatment for disease activity (mostly as suppositories), followed by topical steroids (47%) and oral mesalazine (56%) in monotherapy or combination therapy. Only 14% and 16% of patients required oral prednisone and beclomethasone, respectively. CONCLUSIONS: In clinical practice, active UP presents mostly favourable outcomes. Mesalazine suppositories are by far the most used treatment for these patients.
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Colitis Ulcerosa/tratamiento farmacológico , Proctitis/tratamiento farmacológico , Adulto , Colitis Ulcerosa/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proctitis/complicaciones , Estudios Retrospectivos , Resultado del TratamientoAsunto(s)
Colitis Isquémica/etiología , Síndrome de Klinefelter/complicaciones , Isquemia Mesentérica/etiología , Venas Mesentéricas , Vena Porta , Vena Esplénica , Trombofilia/genética , Trombosis de la Vena/etiología , Cariotipo Anormal , Adulto , Andrógenos/fisiología , Colitis Isquémica/diagnóstico por imagen , Colonoscopía , Humanos , Síndrome de Klinefelter/diagnóstico , Síndrome de Klinefelter/genética , Masculino , Inhibidor 1 de Activador Plasminogénico/fisiología , Tomografía Computarizada por Rayos XRESUMEN
Introduction: Mathematics classrooms are typically characterized by considerable heterogeneity with respect to students' knowledge and skills. Mathematics teachers need to be highly attentive to students' thinking, learning difficulties, and any misconceptions that they may develop. Identification of potential errors and appropriate ways to approach them is crucial for attaining positive learning outcomes. This paper explores which knowledge and affective-motivational skills teachers most require to effectively identify and approach students' errors. Methods: To address this research question within the German follow-up study of the Teacher Education and Development Study in Mathematics (TEDS-M), 131 primary school mathematics teachers' ability to identify students' errors was assessed based on (a) a digitalized speed test showing different students' solutions in a written notation and (b) three video vignettes that showed different scenes from mathematics classes. These scenes dealt, among other things, with children who struggled with the lesson's mathematical content. Teachers were asked to analyze students' thinking and to determine how best to react. In addition, teachers' mathematics pedagogical content knowledge, mathematical content knowledge, and beliefs were assessed in separate tests and served as predictors for teachers' abilities to identify, analyze, and deal with students' errors. Results: The results indicate that all components are interrelated. However, path analysis reveals that teachers' ability to deal with students' errors is mainly predicted by their constructivist beliefs while their ability to quickly identify typical students' errors is largely dependent on their mathematics content knowledge. Discussion: The results show the central filtering function of beliefs. Teachers who believe that students must shape and create their own learning processes are more successful in perceiving and analyzing student errors in classroom situations. They may understand errors as learning opportunities and - thus - pay specific attention to these occurrences.
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Extended producer responsibility (EPR) schemes have effectively increased the plastic waste that is separately collected. However, due to the structure of the recycling industry, EPR cannot increase recycling rates up to the target levels. Additional policy instruments to increase recycling rates such as recycled content targets, green dot fees bonus for recycled content, recycling targets and taxes on non-recycled plastic packaging have been discussed on a political level in the last years. However, very little research has quantitatively studied the effectiveness of these policy interventions. Using a partial equilibrium model, this paper examines the effectiveness of the implementation of the aforementioned policy instruments to increase recycling rates and the impact on different stakeholders of the value chain: plastic producers, consumers, producer responsibility organization and recyclers. Results show that direct interventions (recycled content standards and recycling targets) have the benefit of decoupling the recycling industry from external markets such as the oil market. They can be a good starting point to increase recycling, but in the long term they may be restricting by not presenting incentives to achieve recycling levels beyond the targeted amounts and by limiting technological innovation. On the contrary, economic interventions such as a green dot fee bonus or a packaging tax create economic incentives for recycling. However, these incentives are diminished by the lower perceived quality of packaging with higher recycled content levels.
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Plásticos , Administración de Residuos , Industrias , Políticas , Embalaje de Productos , Reciclaje , Administración de Residuos/métodosRESUMEN
Background: Ulcerative proctitis (UP) presents distinctive clinical characteristics, outcomes and therapeutic approaches as compared to left-sided and extensive ulcerative colitis (UC). Aim: To describe the current therapeutic requirements and clinical outcomes in patients with active UP. Methods: Retrospective observational study conducted in a referral IBD centre. Patients with UP in follow-up between 1989 and 2014 were included. The clinical characteristics, as well as the different treatments and drug formulations administered to treat flares, were recorded. Results: Out of 687 UC patients, 101 patients (15%) with UP were included. Median follow-up was 8 years (IQR 3-14) and 49% of patients presented disease activity during the study period. Topical mesalazine monotherapy (90%) was the most commonly administered treatment for disease activity (mostly as suppositories), followed by topical steroids (47%) and oral mesalazine (56%) in monotherapy or combination therapy. Only 14% and 16% of patients required oral prednisone and beclomethasone, respectively. Conclusions: In clinical practice, active UP presents mostly favourable outcomes. Mesalazine suppositories are by far the most used treatment for these patients (AU)
Antecedentes: La proctitis ulcerosa (PU) presenta unas características clínicas, evolutivas y terapéuticas distintas con respecto a la colitis ulcerosa izquierda o extensa. Objetivo: Describir los requerimientos terapéuticos y la evolución clínica en pacientes con PU activa. Métodos: Estudio observacional retrospectivo realizado en un centro de referencia en EII, en el que se incluyeron pacientes en seguimiento entre 1989 y 2014 con PU. Se registraron las características clínicas, así como los diferentes tratamientos y galénicas utilizados para tratar el brote de actividad. Resultados: De un total de 687 pacientes con colitis ulcerosa se incluyeron 101 (15%) con PU. La mediana de seguimiento fue de 8 años (RIC 3-14). El 49% de los pacientes presentó actividad de la enfermedad durante el período a estudio. La monoterapia con mesalazina tópica (90%) fue el tratamiento más utilizado para la actividad de la enfermedad (predominantemente en forma de supositorios), seguida de los esteroides tópicos (47%) y la mesalazina oral (56%) en monoterapia o en terapia combinada. Solo el 14 y el 16% de los pacientes requirieron prednisona oral y beclometasona, respectivamente. Conclusiones: En la práctica clínica, los supositorios de mesalazina son el tratamiento más utilizado en pacientes con PU activa, presentando la mayoría de ellos una evolución clínica favorable (AU)
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Humanos , Proctitis/terapia , Brotes de Enfermedades , Prednisona/uso terapéutico , Beclometasona/uso terapéutico , Supositorios/uso terapéutico , Mesalamina/uso terapéutico , Administración Tópica , Estudios Retrospectivos , Proctitis/complicacionesRESUMEN
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