Phase change materials for portable isothermal incubators as a solution to shorten effective analysis times in microbiological quality control of drinking water.

The microbiological quality control of water for human consumption of parameters relevant as E.coli and total coliforms does not start on the field despite the existence of test methods that could make it possible. One of the things that makes this difficult is the possibility of initiating an effective and reliable incubation at the sampling site. The appearance of isothermal media with phase change materials solves this limitation. When phase change materials combine a relatively high melting heat with a suitable melting temperature adapted to the application temperature, they become excellent materials for thermal protection and for thermal energy storage. Starting the test at the same sampling point means that the effective times to obtain a result are shorter, improving water quality control. On the other hand, operationally, it also allows longer sampling routes. Both aspects are essential for managers responsible for controlling water quality for human consumption. In this work, the evidence that demonstrates the feasibility of this approach is presented.

Intervención temprana tras los terremotos de Puerto Rico en enero de 2020: resiliencia, prevención y promoción de la salud mental infantojuvenil / Early Intervention After the Earthquakes in Puerto Rico in January 2020: Resilience, Prevention and Promotion of Child and Adolescent Mental Health

INTRODUCCIÓN: El artículo describe un modelo de intervención temprana para la prevención de patología, y promoción de la resiliencia, tras los terremotos de la isla de Puerto Rico en enero de 2020. El 7 de enero de 2020 un terremoto de magnitud 6,4 en la escala Richter, sacudió la isla de Puerto Rico. Como consecuencia, gran parte de la población sufrió desplazamientos de sus domicilios y cierres de muchas escuelas. Todo ello sobre lo ya anteriormente vivido, como el Huracán María en 2017, aumentando así su carga de estrés alostática. Tras la ayuda inicial de los cuerpos de rescate, se detecta la necesidad de apoyo psicológico a la población y a profesionales proveedores de dicho apoyo. MÉTODOS: Contando con una precaria infraestructura, se decide realizar una intervención con el objetivo de proporcionar información del impacto del estrés traumático en el organismo, así como ejercicios prácticos de mindfulness dirigidos a dichos profesionales. El programa integra lecciones de la Terapia de Claves Traumáticas y ejercicios del currículo Pure Power. RESULTADOS: Se confirma, a través de un cuestionario de satisfacción, la necesidad de este tipo de programas, y se valora extrapolar el modelo a otras poblaciones de riesgo similares, en términos de evitar las consecuencias del trauma, disminuir la carga alostática, y prevenir y promocionar la salud mental. Se sugiere realizar próximas formaciones de ampliación de este programa, para confirmar su efectividad y mantenimiento en el tiempo

INTRODUCTION: This article describes an early intervention model for the prevention of pathology, and for the promotion of resilience, after the earthquakes on the island of Puerto Rico in January 2020. On January 7, 2020, an earthquake of magnitude 6.4 on the Richter scale struck the island of Puerto Rico. As a consequence of the seismic movement, an important part of the population, suffered displacements from their homes and closing of schools. In addition to what they previously lived through, such as Hurricane Maria in 2017, increasing their burden of allostatic stress. After initial help from the rescue forces, a need to provide psychological support to the population and to the professionals involved in giving that psychological support, was detected. METHODS: Starting from a precarious infrastructure, it was decided to implement an intervention with the objective of providing information on the impact of traumatic stress on the individual, along with practical mindfulness exercises. The program integrated lessons from Cue-Centered Therapy with exercises from the Pure Power curriculum. RESULTS: Through a satisfaction questionnaire, the need of these type of programs was confirmed. The implementation of these prevention programs should be considered when planning to intervene with other similar populations at risk. Thus, avoiding the consequences of trauma, reducing the allostatic load in the individual, and preventing and promoting mental health and resilience. The discussion introduces the need to develop follow-up procedures, to confirm the effectiveness and maintenance over time

Herramienta para mejorar la eficiencia en el manejo clínico de pacientes hipertensos / Tools to improve efficiency in the clinical management of hypertensive patients

Objetivo: Crear una herramienta que permita evaluar la eficiencia de la gestión clínica de los pacientes hipertensos en atención primaria. Material y métodos: Se creó un cuestionario dirigido a los centros de atención primaria, con acceso vía Web, para la autoevaluación del manejo de la hipertensión, respecto a 5 áreas de gestión: sistemas de información; pruebas diagnósticas y analíticas; aspectos organizativos; demanda asistencial y consumo de recursos; y programas de atención continuada para profesionales y para pacientes. Previamente, un comité de expertos definió estas preguntas, así como su respuesta ideal o «control», basándose en la literatura científica o, en caso de no haber referencias publicadas, de manera consensuada por dicho comité. Se realizó un análisis descriptivo de los datos y se creó un índice de adherencia de sus resultados con respecto al «control», que oscila entre 0 (ninguna adherencia) y 1 (total adherencia). Resultados: Un total de 35 centros de salud introdujeron sus datos de gestión de pacientes hipertensos en la Web de gestión clínica. Se observó la mayor adherencia en el área «Pruebas diagnósticas y analíticas» (0,69±0,10) y la menor en el área «Programas de formación continuada para pacientes y profesionales» (0,42±0,21). Conclusiones: La eficiencia de la gestión clínica en pacientes hipertensos puede analizarse mediante la herramienta web creada para este fin. Su uso permite realizar una auditoría interna para detectar las áreas que necesitan mejoras y también sirve para hacer evaluaciones comparativas en las distintas áreas de gestión a lo largo del tiempo

Objective: To create a tool to evaluate the efficiency of the clinical management of hypertensive patients in Primary Care. Material and methods: A web-based questionnaire was designed for Primary Care centres to self-evaluate the management of hypertension in five specific areas: information systems, diagnostic and analytical tests, organisational aspects, use of resources, and continuous training programmes for patients and healthcare professionals. A committee of experts previously defined these questions and their ideal responses or "control", based on the scientific literature or, if there were no published references, by consensus of the committee. A descriptive analysis was performed on the data, and an adherence score was created that ranged from 0 (no adherence) to 1 (total adherence). Results: A total of 35 Primary Care centres entered their data into the website for the clinical management of hypertensive patients. The highest adherence to the ideal algorithm was observed in the area "Diagnostic and analytical tests" (0.69±0.10), and the lowest in "Continuous training programmes for patients and professionals" (0.42±0.21). Conclusions: The efficiency of clinical management in hypertensive patients can be analysed using the website tool created for this purpose. Its use allows an internal audit to detect the areas that need improvement, and also serves to make comparative evaluations in the different areas of management over time

[Tools to improve efficiency in the clinical management of hypertensive patients]. / Herramienta para mejorar la eficiencia en el manejo clínico de pacientes hipertensos.

OBJECTIVE: To create a tool to evaluate the efficiency of the clinical management of hypertensive patients in Primary Care. MATERIAL AND METHODS: A web-based questionnaire was designed for Primary Care centres to self-evaluate the management of hypertension in five specific areas: information systems, diagnostic and analytical tests, organisational aspects, use of resources, and continuous training programmes for patients and healthcare professionals. A committee of experts previously defined these questions and their ideal responses or "control", based on the scientific literature or, if there were no published references, by consensus of the committee. A descriptive analysis was performed on the data, and an adherence score was created that ranged from 0 (no adherence) to 1 (total adherence). RESULTS: A total of 35 Primary Care centres entered their data into the website for the clinical management of hypertensive patients. The highest adherence to the ideal algorithm was observed in the area "Diagnostic and analytical tests" (0.69±0.10), and the lowest in "Continuous training programmes for patients and professionals" (0.42±0.21). CONCLUSIONS: The efficiency of clinical management in hypertensive patients can be analysed using the website tool created for this purpose. Its use allows an internal audit to detect the areas that need improvement, and also serves to make comparative evaluations in the different areas of management over time.

Standalone ethanol micro-reformer integrated on silicon technology for onboard production of hydrogen-rich gas.

A novel design of a silicon-based micro-reformer for onboard hydrogen generation from ethanol is presented in this work. The micro-reactor is fully fabricated with mainstream MEMS technology and consists of an active low-thermal-mass structure suspended by an insulating membrane. The suspended structure includes an embedded resistive metal heater and an array of ca. 20k vertically aligned through-silicon micro-channels per square centimetre. Each micro-channel is 500 µm in length and 50 µm in diameter allowing a unique micro-reformer configuration that presents a total surface per projected area of 16 cm(2) cm(-2) and per volume of 320 cm(2) cm(-3). The walls of the micro-channels become the active surface of the micro-reformer when coated with a homogenous thin film of Rh-Pd/CeO2 catalyst. The steam reforming of ethanol under controlled temperature conditions (using the embedded heater) and using the micro-reformer as a standalone device are evaluated. Fuel conversion rates above 94% and hydrogen selectivity values of ca. 70% were obtained when using operation conditions suitable for application in micro-solid oxide fuel cells (micro-SOFCs), i.e. 750 °C and fuel flows of 0.02 mlL min(-1) (enough to feed a one watt power source).

Fuel cell-powered microfluidic platform for lab-on-a-chip applications: Integration into an autonomous amperometric sensing device.

The present paper reports for the first time the integration of a microfluidic system, electronics modules, amperometric sensor and display, all powered by a single micro direct methanol fuel cell. In addition to activating the electronic circuitry, the integrated power source also acts as a tuneable micropump. The electronics fulfil several functions. First, they regulate the micro fuel cell output power, which off-gas controls the flow rate of different solutions toward an electrochemical sensor through microfluidic channels. Secondly, as the fuel cell powers a three-electrode electrochemical cell, the electronics compare the working electrode output signal with a set reference value. Thirdly, if the concentration measured by the sensor exceeds this threshold value, the electronics switch on an integrated organic display. This integrated approach pushes forward the development of truly autonomous point-of-care devices relying on electrochemical detection.

Silicon-based microfabricated microbial fuel cell toxicity sensor.

Microbial fuel cells (MFCs) have been used for several years as biosensors for measuring environmental parameters such as biochemical oxygen demand and water toxicity. The present study is focused on the detection of toxic matter using a novel silicon-based MFC. Like other existing toxicity sensors based on MFCs, this device is capable of detecting the variation on the current produced by the cell when toxic compounds are present in the medium. The MFC approach presented in this work aims to obtain a simple, compact and planar device for its further application as a biosensor in the design and fabrication of equipment for toxicity monitoring. It consists on a proton exchange membrane placed between two microfabricated silicon plates that act as current collectors. An array of square 80 µm × 80 µm vertical channels, 300 µm deep, have been defined trough the plates over an area of 6 mm × 6 mm. The final testing assembly incorporates two perspex pieces positioned onto the plates as reservoirs with a working volume of 144 µL per compartment. The operation of the microdevice as a direct electron transfer MFC has been validated by comparing its performance against a larger scale MFC, run under the same conditions. The device has been tested as a toxicity sensor by setting it at a fixed current while monitoring changes in the output power. A drop in the power production is observed when a toxic compound is added to the anode compartment. The compact design of the device makes it suitable for its incorporation into measurement equipment either as an individual device or as an array of sensors for high throughput processing.

[Survey on the needs expressed by primary care doctors for continuing education in drug therapy]. / Encuesta sobre las necesidades sentidas por médicos de atención primaria sobre la formación continuada en terapéutica farmacológica.

OBJECTIVE: To describe the aspects of continuing education in pharmacological therapeutics considered as most relevant by the primary health care physicians. DESIGN: Observational study.Setting. Physicians filled-up the questionnaires during 45 minutes at their primary health care centres. PARTICIPANTS: Primary health care physicians involved in the Fundation Institut Català de Farmacologia continuing education activities since 1997 were selected. MAIN MEASUREMENTS: A specific questionnaire was designed to collect the physicians' opinion on different topics regarding continuing education in pharmacological therapeutics. RESULTS: 180 physicians from 21 primary health care centres answered the questionnaire. 68% of the responding physicians considered that continuing education has to be useful to improve routine clinical practice. Regular seminars and methods stimulating active participation administered by primary health care professionels are preferred. Continuing education in pharmacological therapeutics should be focused to health problems rather than being drug-oriented. They referred being more interested in drug selection issues and in the role of new drug in comparison with the existing alternatives rather than in regulation and drug consumption issues. 66,3% of the responding physicians considered that continuing education in pharmacological therapeutics should be compulsory. Public health authorities and primary health care physicians should share the responsibility in setting-up continuing education in pharmacological therapeutics programs, according to the opinion of almost 70% of the physicians. CONCLUSIONS: Primary health care physicians are interested in continuing education in pharmacological therapeutics as far as it is practical and useful to solve problems of their routine clinical practice.

Encuesta sobre las necesidades sentidas por médicos de atención primaria sobre la formación continuada en terapéutica farmacológica / Survey on the needs expressed by primary care doctors for continuing education in drug therapy

Objetivo. Describir qué aspectos de la formación en terapéutica farmacológica consideran los médicos de atención primaria como más necesarios. Diseño. Estudio observacional. Emplazamiento. Los médicos fueron citados en su centro para contestar las encuestas. Participantes. Participaron médicos de centros de atención primaria a los que habitualmente la Fundación Institut Catalá de Farmacología dirige su programa de formación. Mediciones principales. Se elaboró un cuestionario, diseñado específicamente para recoger la opinión de los médicos sobre la formación continuada en terapéutica farmacológica. Resultados. La encuesta fue realizada en 21 centros de atención primaria de Barcelona. Respondieron a la encuesta 180 médicos. El 68 por ciento de médicos considera que la formación continuada ha de ser útil para mejorar su práctica clínica habitual. Prefieren realizar seminarios periódicos, métodos docentes participativos y consideran que las personas que han de impartir habitualmente la formación han de ser cercanas a la atención primaria. Prefieren una formación dirigida al abordaje terapéutico de los problemas de salud. Con respecto a la información sobre medicamentos, están más interesados en la selección de los mismos y su lugar terapéutico que en temas de regulación o consumo farmacológico. El 66,3 por ciento de los encuestados considera que la formación continuada debería ser obligatoria. Casi un 70 por ciento considera que la responsabilidad en la elaboración de los programas de formación debería ser compartida por las instituciones sanitarias y los propios profesionales. Conclusiones. Los médicos de atención primaria están interesados en una formación continuada sobre terapéutica farmacológica de carácter práctico, que dé respuestas a las cuestiones que se le plantean en su actividad clínica habitual (AU)