Enhancing Content Validity Assessment With Item Response Theory Modeling.

BACKGROUND: Ensuring the validity of assessments requires a thorough examination of the test content. Subject matter experts (SMEs) are commonly employed to evaluate the relevance, representativeness, and appropriateness of the items. This article proposes incorporating item response theory (IRT) into model assessments conducted by SMEs. Using IRT allows for the estimation of discrimination and threshold parameters for each SME, providing evidence of their performance in differentiating relevant from irrelevant items, thus facilitating the detection of suboptimal SME performance while improving item relevance scores. METHOD: Use of IRT was compared to traditional validity indices (content validity index and Aiken's V) in the evaluation of items. The aim was to assess the SMEs' accuracy in identifying whether items were designed to measure conscientiousness or not, and predicting their factor loadings. RESULTS: The IRT-based scores effectively identified conscientiousness items (R2 = 0.57) and accurately predicted their factor loadings (R2 = 0.45). These scores demonstrated incremental validity, explaining 11% more variance than Aiken's V and up to 17% more than the content validity index. CONCLUSIONS: Modeling SME assessments with IRT improves item alignment and provides better predictions of factor loadings, enabling improvement of the content validity of measurement instruments.

Analysis of the Complexity of Palliative Care for Cancer Patients.

INTRODUCTION: The Spanish National Health System has defined complexity as a set of factors of increased difficulty that require the intervention of a palliative care team. Palliative care aims to improve the quality of life of patients with chronic terminal illnesses. This study aims to describe the degree of complexity of cancer patients in palliative care, to determine which elements of complexity are most prevalent and to determine which other hospital clinical factors are associated with the level of complexity. METHODS: This study is a descriptive, observational, and cross-sectional analysis that included patients diagnosed with advanced oncological pathology undergoing palliative treatment who were admitted to the Medical Oncology ward of the Miguel Servet University Hospital between March and April 2023. RESULT: A total of 100 patients were selected for the study. According to the IDC-Pal, 68% of patients were classified as highly complex, 26% of patients were complex and only 6% of patients were classified as non-complex. The presence of pain (P < .001), nausea and vomiting (P = .027), depression (P = .033) and functional status (P = .011) were statistically independent predictors of high complexity. DISCUSSION: This study has shown that a high proportion of hospitalized palliative care cancer patients have high complexity, suggesting a good matching of healthcare resources to patient complexity. Four factors related to complexity have been identified, namely pain, nausea and vomiting, depression and a bedridden functional state. The presence of any of the 4 factors could help healthcare professionals to identify patients for early specialized palliative care.

Enhancing Content Validity Assessment With Item Response Theory Modeling / Mejorando la Evaluación de la Validez del Contenido a Través del Modelado de la Teoría de Respuesta al Ítem

Background: Ensuring the validity of assessments requires a thorough examination of the test content. Subject matter experts (SMEs) are commonly employed to evaluate the relevance, representativeness, and appropriateness of the items. This article proposes incorporating item response theory (IRT) into model assessments conducted by SMEs. Using IRT allows for the estimation of discrimination and threshold parameters for each SME, providing evidence of their performance in differentiating relevant from irrelevant items, thus facilitating the detection of suboptimal SME performance while improving item relevance scores. Method: Use of IRT was compared to traditional validity indices (content validity index and Aiken’s V) in the evaluation of conscientiousness items. The aim was to assess the SMEs’ accuracy in identifying whether items were designed to measure conscientiousness or not, and predicting their factor loadings. Results: The IRT-based scores effectively identified conscientiousness items (R2 = 0.57) and accurately predicted their factor loadings (R2 = 0.45). These scores demonstrated incremental validity, explaining 11% more variance than Aiken’s V and up to 17% more than the content validity index. Conclusions: Modeling SME assessments with IRT improves item alignment and provides better predictions of factor loadings, enabling improvement of the content validity of measurement instruments.(AU)

Antecedentes: Garantizar la validez de evaluaciones requiere un examen exhaustivo del contenido de una prueba. Es común emplear expertos en la materia (EM) para evaluar la relevancia, representatividad y adecuación de los ítems. Este artículo propone integrar la teoría de respuesta al ítem (TRI) en las evaluaciones hechas por EM. La TRI ofrece parámetros de discriminación y umbral de los EM, evidenciando su desempeño al diferenciar ítems relevantes/ irrelevantes, detectando desempeños subóptimos, mejorando también la estimación de la relevancia de los ítems. Método: Se comparó el uso de la TRI frente a índices tradicionales (índice de validez de contenido y V de Aiken) en ítems de responsabilidad. Se evaluó la precisión de los EM al discriminar si los ítems medían responsabilidad o no, y si sus evaluaciones permitían predecir los pesos factoriales de los ítems. Resultados: Las puntuaciones de TRI identificaron bien los ítems de responsabilidad (R2 = 0,57) y predijeron sus cargas factoriales (R2 = 0,45). Además, mostraron validez incremental, explicando entre 11% y 17% más de varianza que los índices tradicionales. Conclusiones: La TRI en las evaluaciones de los EM mejora la alineación de ítems y predice mejor los pesos factoriales, mejorando validez del contenido de los instrumentos.(AU)

Yeasts Inoculation Effect on Bacterial Development in Carbonic Maceration Wines Elaboration.

Carbonic maceration (CM) vinification is a very traditional method that allows saving energy without great equipment investment, obtaining high-quality wines. However, due to its particularities, CM winemaking implies a higher risk of microbial alteration. This work studies the evolution of bacterial population along carbonic maceration wines elaboration with and without yeast inoculation. In the same way, two strategies of yeast inoculation were studied: "pied de cuve" and Active Dry Yeasts (ADY) seed. For this purpose, three conditions were assayed: spontaneous fermentation (without inoculation), "pied de cuve" technology, and ADY inoculation. For each condition, two winemaking methods were compared: carbonic maceration and the standard method of destemming and crushing (DC). The bacterial evolution (lactic acid and acetic acid bacteria) was followed in different fermentation stages. Finally, the wines obtained were analysed (pH and volatile acidity). In the non-inoculated wines produced by CM, high development of the bacterial population was observed (counts of acetic acid bacteria around 4.3 log cfu/mL), and finished wines presented high values of volatile acidity (>1.5 g/L), which did not occur in the inoculated vinifications (counts of acetic acid bacteria around 1.5 log cfu/mL and 0.5 g/l of volatile acidity). Thus, the control of yeast population, as a "pied de cuve" as ADY seed, seems to be an effective tool to avoid bacterial alterations in CM vinifications.

FoCo: A Shiny App for Formative Assessment using Cognitive Diagnosis Modeling / [FoCo: una aplicación Shiny para la evaluación formativa usando modelos de diagnóstico cognitivo]

Combining formative and summative evaluations could improve assessment. Cognitive diagnosis modeling (CDM) has been proposed as a tool for diagnosing students’ strengths and weaknesses in formative assessment. However, there is no user-friendly software to implement it. For this reason, a Shiny app, FoCo, has been developed (https://foco.shinyapps.io/FoCo/), to conduct CDM and classical test theory analyses. The responses from 86 undergraduate students to a research methods course examination were analyzed. Students’ strengths and needs were diagnosed concerning their dominance of the syllabus contents and the first three competencies in Bloom’s taxonomy. The validity of the results was analyzed. The exam showed acceptable about evaluating students’ knowledge, as students with similar scores showed different strengths and weaknesses. Additionally, these attributes were found to predict different relevant criteria. It is expected that FoCo’s easiness to use promotes the employment of CDM in real educational settings.(AU)

La combinación de evaluaciones formativas y sumativas podría mejorar la evaluación. El modelado de diagnóstico cognitivo (MDC) se ha propuesto para diagnosticar fortalezas y debilidades de estudiantes en la evaluación formativa. Sin embargo, ningún software permite implementarlo fácilmente. Así, se ha desarrollado FoCo (https://foco.shinyapps.io/FoCo/), permitiendo realizar análisis MDC y teoría clásica de tests. Se analizaron respuestas de 86 estudiantes de grado a un examen de métodos de investigación, diagnosticándose sus fortalezas y necesidades en cuanto a su dominio de los contenidos de la asignatura y las tres primeras competencias de la taxonomía de Bloom y se analizó la validez de los resultados. El análisis ha sido informativo, ya que para estudiantes con puntuaciones similares ha sido posible detectar diferentes fortalezas y debilidades. Además, se encontró que estos atributos predicen criterios relevantes. Se espera que FoCo facilite el uso de MDC en contextos educativos.(AU)

Combined Effect of High Hydrostatic Pressure, Sous-Vide Cooking, and Carvacrol on the Quality of Veal, Plant-Based, and Hybrid Patties during Storage.

The effect of carvacrol added to patties stored at 4 °C for 14 days, previously pressurized and vacuum-cooked (HPP-SVCOOK), was investigated. Three formulations were prepared (veal, plant-based product, and hybrid product). An emulsion made with olive and linseed oils was added. The physicochemical and microbiological qualities were assessed. Microbial tests indicated negligible growth of spoilage organisms in treated patties. No significant effect of carvacrol on the microbial loads of patties was noticed. Sulfite-reducing clostridia and Enterobacteriaceae were absent in the treated patties, whereas, in the treated veal and hybrid samples, 3 and 2 units of log cfu/g reduction for lactic acid bacteria and molds and yeasts were noted, respectively. On day 7 of storage, veal patties exhibited a significant reduction (p < 0.05) in the L* (53.9−49.3), hardness (32.3−21.4 N), springiness (0.8−0.7 N), cohesiveness (0.49−0.46), and chewiness (12.2−7.1) and a hike in the a* value (5.3−9.4). No significant changes in L* (59.1−58.6), a* (8.57−8.61), hardness (11.6−10.6 N), or cohesiveness (0.27−0.26) were observed in plant-based patties over the storage times, whereas reductions in springiness (0.5−0.4), chewiness (1.9−1.3), and b* (26.6−29.1) were noted in them. In hybrid patties, the L* (53.9−52.5) and b* values (24.9−24.3) were consistent but had a significant decrease in a* value (5.9−3.5) along the days of storage under study. The texture parameters of the hybrid patties altered were similar to those of veal patties during the 14-day storage time. In all samples, pH decreased with storage time. HPP-SVCOOK was effective on rendering safe and shelf-stable, ready-to-eat patties regardless of their matrix formulation. The addition of carvacrol had limited effects on the textural qualities of the HPP-SVCOOK products. Future studies need to be undertaken to assess the treated patties' consumer acceptability and sensory profile. The study provides the basis for the development of novel meat-based and plant-based products that are microbiologically safe, with minimum physicochemical alterations during storage.

Influence of the temperature and the origin of CO2 (anaerobiosis methodology) on the intracellular fermentation of wines made by carbonic maceration.

BACKGROUND: The present study aimed to determine the optimal conditions for making wines by the carbonic maceration (CM) method. In this test, we attempted to identify the causes of the higher volatile acidity of some wines vinified by this method. Accordingly, we measured the development and speed of intracellular fermentation inside the whole grapes under different vinification conditions. RESULTS: An active fermentation of the must in the tanks produced by inoculation with active dry yeasts was more efficient for the process than the addition of exogenous carbon dioxide (CO2 ). In addition, in CM vinification, the moment of devatting had a great influence on the content of acetaldehyde and acetic acid in the whole grapes. CONCLUSION: Yeast inoculation in the tanks and control of the devatting time are technological tools that could play an important role in the characteristics of the wines produced by carbonic maceration, especially with respect to acetic acid content. © 2022 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Antimicrobial Resistance in Escherichia coli from the Broiler Farm Environment, with Detection of SHV-12-Producing Isolates.

Antimicrobial resistance is an important One Health challenge that encompasses the human, animal, and environmental fields. A total of 111 Escherichia coli isolates previously recovered from manure (n = 57) and indoor air (n = 54) samples from a broiler farm were analyzed to determine their phenotypes and genotypes of antimicrobial resistance and integron characterization; in addition, plasmid replicon analysis and molecular typing were performed in extended-spectrum-beta-lactamase (ESBL) producer isolates. A multidrug-resistance phenotype was detected in 46.8% of the isolates, and the highest rates of resistance were found for ampicillin, trimethoprim−sulfamethoxazole, and tetracycline (>40%); moreover, 15 isolates (13.5%) showed susceptibility to all tested antibiotics. None of the isolates showed imipenem and/or cefoxitin resistance. Twenty-three of the one hundred and eleven E. coli isolates (20.7%) were ESBL producers and carried the blaSHV-12 gene; one of these isolates was recovered from the air, and the remaining 22 were from manure samples. Most of ESBL-positive isolates carried the cmlA (n = 23), tet(A) (n = 19), and aac(6')-Ib-cr (n = 11) genes. The following genetic lineages were identified among the ESBL-producing isolates (sequence type-phylogroup-clonotype): ST770-E-CH116−552 (n = 12), ST117-B2-CH45−97 (n = 4), ST68-E-CH26−382/49 (n = 3), ST68-E-CH26−49 (n = 1), and ST10992-A/B1-CH11−23/41/580 (n = 4); the latter two were detected for the first time in the poultry sector. At least two plasmid replicon types were detected in the ESBL-producing E. coli isolates, with IncF, IncF1B, IncK, and IncHI1 being the most frequently found. The following antimicrobial resistance genes were identified among the non-ESBL-producing isolates (number of isolates): blaTEM (58), aac(6')-Ib-cr (6), qnrS (2), aac(3)-II (2), cmlA (6), tet(A)/tet(B) (22), and sul1/2/3 (51). Four different gene-cassette arrays were detected in the variable region of class 1 (dfrA1-aadA1, dfrA12-aadA2, and dfrA12-orf-aadA2-cmlA) and class 2 integrons (sat2-aadA1-orfX). This work reveals the worrying presence of antimicrobial-resistant E. coli in the broiler farm environment, with ESBL-producing isolates of SHV-12 type being extensively disseminated.

Airborne Dissemination of Bacteria (Enterococci, Staphylococci and Enterobacteriaceae) in a Modern Broiler Farm and Its Environment.

The role of the air as a vehicle of bacteria dissemination in the farming environment has been previously reported, but still scarcely studied. This study investigated the bacteria density/diversity of the inside and outside air and of litter samples at a broiler farm. Samples were collected considering two seasons, three outside air distances (50/100/150 m) and the four cardinal directions. Selective media was used for staphylococci, enterococci, and Enterobacteriaceae recovery. A high number of bacteria was detected in the litter (2.9 × 105-5.8 × 107 cfu/g) and in the inside air (>105 cfu/m3), but a low emission of bacteria was evidenced in the outside air (<6 cfu/m3). Moreover, the bacteria detected in the farm's outside air decreased the further from the farm the sample was taken. A total of 544 isolates were identified by MALDI-TOF (146 from the litter, 142 from inside air and 256 from outside air). From these, 162 staphylococci (14 species; S. saprophyticus 40.7%), 176 Enterobacteriaceae (4 species; E. coli 66%) and 190 enterococci (4 species; E. hirae 83%) were detected. E. hirae was the predominant species, and identical PFGE clones were detected in inside and outside samples. The detection of identical DNA profiles in E. hirae isolates from inside and outside samples suggests the role of the air in bacterial dissemination from the inside of the broiler farm to the immediate environment.

Detecting Cheating Methods on Unproctored Internet Tests / Métodos de Detección del Falseamiento en Test Online

BACKGROUND: Unproctored Internet Tests (UIT) are vulnerable to cheating attempts by candidates to obtain higher scores. To prevent this, subsequent procedures such as a verification test (VT) is carried out. This study compares five statistics used to detect cheating in Computerized Adaptive Tests (CATs): Guo and Drasgow's Z-test, the Adaptive Measure of Change (AMC), Likelihood Ratio Test (LRT), Score Test, and Modified Signed Likelihood Ratio Test (MSLRT). METHOD: We simulated data from honest and cheating candidates to the UIT and the VT. Honest candidates responded to the UIT and the VT with their real ability level, while cheating candidates responded only to the VT, and different levels of cheating were simulated. We applied hypothesis tests, and obtained type I error and power rates. RESULTS: Although we found differences in type I error rates between some of the procedures, all procedures reported quite accurate results with the exception of the Score Test. The power rates obtained point to MSLRT's superiority in detecting cheating. CONCLUSIONS: We consider the MSLRT to be the best test, as it has the highest power rate and a suitable type I error rate

ANTECEDENTES: las pruebas de selección en línea sin vigilancia (UIT) son vulnerables a intentos de falseamiento para obtener puntuaciones superiores. Por ello, en ocasiones se utilizan procedimientos de detección, como aplicar posteriormente un test de verificación (VT). El objetivo del estudio es comparar cinco contrastes estadísticos para la detección del falseamiento en Test Adaptativos Informatizados: Z-test de Guo y Drasgow, Medida de Cambio Adaptativa (AMC), Test de Razón de Verosimilitudes (LRT), Score Test y Modified Signed Likelihood Ratio Test(MSLRT). MÉTODO: se simularon respuestas de participantes honestos y falseadores al UIT y al VT. Para los participantes honestos se simulaban en ambos en función de su nivel de rasgo real; para los falseadores, solo en el VT, y en el UIT se simulaban distintos grados de falseamiento. Después, se obtenían las tasas de error tipo I y potencia. RESULTADOS: Se encontraron diferencias en las tasas de error tipo I entre algunos procedimientos, pero todos menos el Score Test se ajustaron al valor nominal. La potencia obtenida era significativamente superior con el MSLRT. CONCLUSIONES: consideramos que MSLRT es la mejor alternativa, ya que tiene mejor potencia y una tasa de error tipo I ajustada

Detecting Cheating Methods on Unproctored Internet Tests.

BACKGROUND: Unproctored Internet Tests (UIT) are vulnerable to cheating attempts by candidates to obtain higher scores. To prevent this, subsequent procedures such as a verification test (VT) is carried out. This study compares five statistics used to detect cheating in Computerized Adaptive Tests (CATs): Guo and Drasgow's Z-test, the Adaptive Measure of Change (AMC), Likelihood Ratio Test (LRT), Score Test, and Modified Signed Likelihood Ratio Test (MSLRT). METHOD: We simulated data from honest and cheating candidates to the UIT and the VT. Honest candidates responded to the UIT and the VT with their real ability level, while cheating candidates responded only to the VT, and different levels of cheating were simulated. We applied hypothesis tests, and obtained type I error and power rates. RESULTS: Although we found differences in type I error rates between some of the procedures, all procedures reported quite accurate results with the exception of the Score Test. The power rates obtained point to MSLRT's superiority in detecting cheating. CONCLUSIONS: We consider the MSLRT to be the best test, as it has the highest power rate and a suitable type I error rate.

Coagulase-negative staphylococci carrying cfr and PVL genes, and MRSA/MSSA-CC398 in the swine farm environment.

This work aimed at characterizing four Staphylococcus aureus and 68 coagulase-negative staphylococci (CoNS), recovered from the air and liquid manure tank of two swine farms with intensive- and semi-extensive-production types, for their antimicrobial resistance pheno-/genotypes and their virulence gene content. Molecular typing was performed by spa typing, MLST, agr typing, and SCCmec typing, where applicable. Conjugation experiments were performed to assess the transferability of the linezolid resistance gene cfr, and its genetic environment was determined by Whole-Genome-Sequencing. The four S. aureus (intensive-production farm, IP-farm) were typed as t011-agrI-CC398-ST398, were scn-negative and two of them were methicillin-resistant (MRSA) with the mecA gene (SCCmec-V). Multidrug resistance was seen in 87 % of the CoNS. Statistically significant differences among the antimicrobial resistance rates of CoNS from the two farms were observed for cefoxitin, aminoglycosides, tetracycline, ciprofloxacin and trimethoprim-sulfamethoxazole. Eight methicillin-resistant CoNS, which were recovered from the IP-farm, carried the mecA gene. One S. simulans isolate was PVL-positive and three S. cohnii eta-positive. One S. equorum and one S. arlettae showed linezolid resistance and carried the cfr gene (IP-farm), which was non-transferable by conjugation into S. aureus. The cfr genetic context in both isolates was identical, with the lsa(B) gene located upstream of cfr. The environment of swine farms might contribute to the dissemination of CoNS that show multidrug resistance and harbor important virulence factors.

Detection of poxtA- and optrA-carrying E. faecium isolates in air samples of a Spanish swine farm.

OBJECTIVE: Two linezolid-resistant Enterococcus faecium isolates, C10004 and C10009, were recovered from air samples of a Spanish swine farm and comprehensively characterized. METHODS: Detection of linezolid resistance mechanisms (mutations and acquisition of resistance genes) was performed by PCR/sequencing. Isolates were characterized by multilocus sequence typing (MLST), antimicrobial susceptibility testing, detection of antimicrobial resistance and virulence genes, and analysis of the genetic environment of the linezolid resistance genes. The characterization of isolate C10009 was performed by Whole-Genome-Sequencing and of isolate C10004 by PCR and amplicon sequencing, where applicable. Conjugation experiments to assess the transferability of the optrA and poxtA genes implicated in linezolid resistance were performed. RESULTS: The linezolid-resistant E. faecium isolates C10004 and C10009, assigned to ST128 and ST437, respectively, harbored the optrA and poxtA genes. Neither mutations in the 23S rRNA nor in the genes for the ribosomal proteins L3, L4 and L22 were detected. C10004 and C10009 carried fourteen and thirteen antimicrobial resistance genes, respectively. The sequence alignment indicated that the genetic environment of the poxtA gene was identical in both isolates, with a downstream-located fexB gene. The poxtA gene was transferred by conjugation together with the fexB gene, and also with tet(M) and tet(L) in the case of isolate C10004. The optrA gene could not be transferred. CONCLUSIONS: This is the first report of the poxtA gene in Spain. The presence of poxtA- and optrA-carrying E. faecium isolates in air samples represents a public health concern, indicating an involvement of swine farms in the spread of linezolid-resistant bacteria.

[Educational intervention in Primary Care to reduce and improve the adequacy of pediatric consultations]. / Intervención educativa en atención primaria para reducir y mejorar la adecuación de las consultas pediátricas.

OBJECTIVE: Many parents visit paediatric health services due to unimportant reasons (ignorance of health problems of their children and psychosocial and emotional conditionings). The objective was to determine the effectiveness of a health education program, on the number and adequacy of pediatric consultations, in the first 6 months of the child´s life. METHODS: Quasi-experimental study of an educational intervention aimed at pregnant women in the last trimester of pregnancy and their partners. A simple random sampling of the health centers of the province of Valladolid was carried out, assigning four to the intervention group and two to the control group. The pregnant women were informed and participated voluntarily during the period from October 2016 to March 2017.The program consisted of six dynamic and participatory sessions of 90 minutes: rational use of paediatric services, fever, respiratory infec- tions (ARI), gastroenteritis (GEA), skin injuries, and accidents. The variables studies were: epidemiological data of the parents, number of consultations and their adequacy have been analyzed. Data analysis was performed using SPSS (v.20.0). Changes in participants before and after receiving workshops were analysed with Student's t test for related samples, or with its alternative test, Wilcoxon's non-parametric test. RESULTS: 191 pregnant woman were analyzed (101 control and 90 intervention). First-time pregnant women (62.3% intervention vs 54.1% control) with the high-school trained (59,1% intervention vs 44,2% control) were more participatory. The number of consultations for the reasons studied was reduced (3,5 in the control group vs 2,0 in the intervention group), and the level of adequacy improved in 16,3% (RR:1,62;95%CI:1,26-2,07;p<0,05). CONCLUSIONS: These positive results regarding the decrease in the number of consultations and the increase in their adequacy lead us to clearly recommend the establishment of prenatal interviews addressing most common health issues in children, in the Primary Care setting.

OBJETIVO: Muchos padres acuden a la consultas de pe- diatría por motivos banales (desconocimiento de los problemas de salud de sus hijos, condicionantes psicosociales y emocionales, etc.). El objetivo de este estudio fue determinar la efectividad de un programa de educación para la salud sobre el número y la adecuación de las consultas pediátricas en los primeros 6 meses de la vida. METODOS: Estudio cuasi experimental de una intervención educativa dirigida a gestantes en último trimestre de la gestación y sus parejas, comparando sus efectos con un grupo control. Se realizó un muestreo aleatorio simple de los centros de salud de la provincia de Valladolid, asignando cuatro al grupo de intervención y dos al de control. Las gestantes del grupo intervención fueron informadas y participaron de forma voluntaria durante el periodo de octubre de 2016 a marzo de 2017. El programa consistió en 6 sesiones dinámicas y participativas de 90 minutos, sobre uso racional de los servicios de urgencias pediátricos, fiebre, infecciones respiratorias agudas (IRA), gastroenteritis (GEA), lesiones de la piel y accidentes. Se analizaron datos epidemiológicos de los progenitores, número de consultas y su adecuación. El análisis de los datos se realizó mediante el programa estadístico SPSS (v.20.0). Los cambios en los participantes antes y después de recibir los talleres se analizaron con la prueba t de Student para muestras relacionadas, o con su prueba alternativa, la prueba no paramétrica de Wilcoxon. RESULTADOS: Se analizaron 202 gestantes (101 control y 101 intervención). Las gestantes primerizas (62.3% intervención vs 54.1% control) y de mayor nivel educativo (59,1% intervención vs 44,2% control) fueron las que más acudían a las sesiones. Se demostró una reducción en el número de consultas pediátricas por los motivos estudiados (en el grupo control fue de 3,5 frente a 2,0 en el grupo intervención) y mejoró el nivel de adecuación un 16,3% (RR: 1,62; 95% IC: 1,26-2,07; p<0,05). CONCLUSIONES: Estos resultados positivos con respecto a la disminución en el número de consultas y el aumento de su adecuación nos llevan a recomendar claramente el establecimiento de intervenciones grupales prenatales que aborden los problemas de salud más comunes en los niños, en el entorno de la Atención Primaria.

Intervención educativa en atención primaria para reducir y mejorar la adecuación de las consultas pediátricas / Educational intervention in Primary Care to reduce and improve the adequacy of pediatric consultations

OBJETIVO: Muchos padres acuden a la consultas de pediatría por motivos banales (desconocimiento de los problemas de salud de sus hijos, condicionantes psicosociales y emocionales, etc.). El objetivo de este estudio fue determinar la efectividad de un programa de educación para la salud sobre el número y la adecuación de las consultas pediátricas en los primeros 6 meses de la vida. MÉTODOS: Estudio cuasi experimental de una intervención educativa dirigida a gestantes en último trimestre de la gestación y sus parejas, comparando sus efectos con un grupo control. Se realizó un muestreo aleatorio simple de los centros de salud de la provincia de Valladolid, asignando cuatro al grupo de intervención y dos al de control. Las gestantes del grupo intervención fueron informadas y participaron de forma voluntaria durante el periodo de octubre de 2016 a marzo de 2017. El programa consistió en 6 sesiones dinámicas y participativas de 90 minutos, sobre uso racional de los servicios de urgencias pediátricos, fiebre, infecciones respiratorias agudas (IRA), gastroenteritis (GEA), lesiones de la piel y accidentes. Se analizaron datos epidemiológicos de los progenitores, número de consultas y su adecuación. El análisis de los datos se realizó mediante el programa estadístico SPSS (v.20.0). Los cambios en los participantes antes y después de recibir los talleres se analizaron con la prueba t de Student para muestras relacionadas, o con su prueba alternativa, la prueba no paramétrica de Wilcoxon. RESULTADOS: Se analizaron 202 gestantes (101 control y 101 intervención). Las gestantes primerizas (62.3% intervención vs 54.1% control) y de mayor nivel educativo (59,1% intervención vs 44,2% control) fueron las que más acudían a las sesiones. Se demostró una reducción en el número de consultas pediátricas por los motivos estudiados (en el grupo control fue de 3,5 frente a 2,0 en el grupo intervención) y mejoró el nivel de adecuación un 16,3% (RR: 1,62; 95% IC: 1,26-2,07; p<0,05). CONCLUSIONES: Estos resultados positivos con respecto a la disminución en el número de consultas y el aumento de su adecuación nos llevan a recomendar claramente el establecimiento de intervenciones grupales prenatales que aborden los problemas de salud más comunes en los niños, en el entorno de la Atención Primaria.

OBJECTIVE: Many parents visit paediatric health services due to unimportant reasons (ignorance of health problems of their children and psychosocial and emotional conditionings). The objective was to determine the effectiveness of a health education program, on the number and adequacy of pediatric consultations, in the first 6 months of the child's life. METHODS: Quasi-experimental study of an educational intervention aimed at pregnant women in the last trimester of pregnancy and their partners. A simple random sampling of the health centers of the province of Valladolid was carried out, assigning four to the intervention group and two to the control group. The pregnant women were informed and participated voluntarily during the period from October 2016 to March 2017.The program consisted of six dynamic and participatory sessions of 90 minutes: rational use of paediatric services, fever, respiratory infections (ARI), gastroenteritis (GEA), skin injuries, and accidents. The variables studies were: epidemiological data of the parents, number of consultations and their adequacy have been analyzed. Data analysis was performed using SPSS (v.20.0). Changes in participants before and after receiving workshops were analysed with Student's t test for related samples, or with its alternative test, Wilcoxon's non-parametric test. RESULTS: 191 pregnant woman were analyzed (101 control and 90 intervention). First-time pregnant women (62.3% intervention vs 54.1% control) with the high-school trained (59,1% intervention vs 44,2% control) were more participatory. The number of consultations for the reasons studied was reduced (3,5 in the control group vs 2,0 in the intervention group), and the level of adequacy improved in 16,3% (RR:1,62;95%CI:1,26-2,07;p<0,05). CONCLUSIONS: These positive results regarding the decrease in the number of consultations and the increase in their adequacy lead us to clearly recommend the establishment of prenatal interviews addressing most common health issues in children, in the Primary Care setting

Identification of Enterococci, Staphylococci, and Enterobacteriaceae from Slurries and Air in and around Two Pork Farms.

In this study, we investigated the airborne dissemination of bacteria from the inside of two very different pork farms (an intensively confined farm and an open-range farm) to the immediate environment. Samples were taken from the slurry, from the air inside the farms (area 0), and from their immediate surroundings at a distance of 50, 100, and 150 m in four directions (north, south, east, and west). A control sample in the air of a zone far away from human or animal activity was also taken. Identification of isolates was made by means of the matrix-assisted laser desorption-ionization time of flight system. A total of 1,063 isolates were obtained, of which a mere 7 came from the air of the control area. Staphylococci, enterococci, and Enterobacteriaceae were selectively targeted for isolation and represented 48.6, 27.2, and 21.6% of the isolates, respectively. The species identified from the air of surrounding areas ( Enterococcus faecalis, Enterococcus hirae, and Staphylococcus arlettae, mainly) were also present inside the farms studied. The results suggest that air is involved in bacterial dissemination, and pork farms should be considered a potential source of foodborne bacteria that might contaminate surrounding areas, including vegetable orchards. Wind direction appears as a factor involved in bacterial dispersion through the air, but its effect may be conditioned by existing vegetation and orographic conditions.

Experiencia en la implementación del programa de educación para la salud Si es urgente para ti, ¿es urgente para mí? / Experience in the implementation of the health education programme If it is urgent for you, is it urgent for me?

Objetivo: analizar la experiencia que supone la implementación de un programa de educación para la salud pediátrico en Atención Primaria. Material y métodos: estudio observacional y retrospectivo. Emplazamiento: cinco centros de salud urbanos y semiurbanos. Participantes: gestantes en el último trimestre de su gestación y sus parejas. Se desarrollaron seis talleres de 90 minutos: uno sobre el uso racional de los Servicios de Urgencias Pediátricas, y otros cinco sobre el manejo de los problemas de salud más frecuentes del niño: fiebre, infecciones respiratorias agudas (IRA), gastroenteritis aguda (GEA), lesiones de la piel y traumatismos, heridas, quemaduras y esguinces. Se han analizado datos epidemiológicos, nivel de conocimientos previos, control de asistencia y grado de satisfacción. Resultados: acudieron a los talleres el 44,21% de la población universo de gestantes. Las mujeres fueron más participativas que sus parejas varones. La mayoría eran primerizas, con estudios universitarios, trabajando de forma activa y españolas. La edad media fue de 34,53 años. Se detectaron más carencias formativas en padres primerizos, menores de 30 años, con estudios no universitarios y en algunos centros de salud. Los talleres sobre la fiebre e infecciones respiratorias fueron los de mayor asistencia. El desarrollo fue ameno y participativo. Generó un nivel de satisfacción muy alto y comentarios positivos. Conclusiones: se propone el empleo de este tipo de programas para mejorar la preparación de los futuros padres respecto a los cuidados de los problemas de salud de sus hijos y al uso adecuado de los servicios sanitarios

Objective: to analyse our experience in the implementation of a health education programme in the Primary Care Paediatrics setting. Materials and methods: observational and retrospective study. Setting: five primary care centres in urban and semi-urban areas. Participants: pregnant women in the third trimester of gestation and their partners. We held six 90-minute workshops: one on the appropriate use of paediatric emergency services and another five on the management of the most common health problems in children: fever, acute respiratory tract infections (ARTIs), acute gastroenteritis (AGE), skin lesions and traumatic injuries, burns and sprains. We analysed epidemiological data, the baseline level of knowledge, attendance and degree of satisfaction with the intervention. Results: of the total universe of pregnant women, 44.21% attended the workshops. Women attended more frequently than their male partners. Most women were primiparous, had attended university, were currently employed and of Spanish nationality. Their mean age was 34.53 years. We found greater gaps in knowledge in attendees that were going to be parents for the first time, aged less than 30 years, without a college education and receiving care in specific primary care centres. The workshops with the highest attendance were those on fever and respiratory tract infections. The workshops were designed to be entertaining and interactive. Participants reported a high level of satisfaction and gave positive feedback. Conclusions: we propose the use of this type of programmes to better prepare parents-to-be to manage potential health problems in their children and make appropriate use of health care services

A LQR-Based Controller with Estimation of Road Bank for Improving Vehicle Lateral and Rollover Stability via Active Suspension.

In this article, a Linear Quadratic Regulator (LQR) lateral stability and rollover controller has been developed including as the main novelty taking into account the road bank angle and using exclusively active suspension for both lateral stability and rollover control. The main problem regarding the road bank is that it cannot be measured by means of on-board sensors. The solution proposed in this article is performing an estimation of this variable using a Kalman filter. In this way, it is possible to distinguish between the road disturbance component and the vehicle's roll angle. The controller's effectiveness has been tested by means of simulations carried out in TruckSim, using an experimentally-validated vehicle model. Lateral load transfer, roll angle, yaw rate and sideslip angle have been analyzed in order to quantify the improvements achieved on the behavior of the vehicle. For that purpose, these variables have been compared with the results obtained from both a vehicle that uses passive suspension and a vehicle using a fuzzy logic controller.

Molecular characterization of antibiotic resistance in Escherichia coli strains from a dairy cattle farm and its surroundings.

BACKGROUND: This study describes the phenotypic and genotypic characteristics of 78 genetically different Escherichia coli recovered from air and exudate samples of a dairy cattle farm and its surroundings in Spain, in order to gain insight into the flow of antimicrobial resistance through the environment and food supply. RESULTS: Antimicrobial resistance was detected in 21.8% of the 78 E. coli isolates analyzed (resistance for at least one of the 14 agents tested). The highest resistance rates were recorded for ampicillin, nalidixic acid, trimethoprim/sulfamethoxazole and tetracycline. The resistance genes detected were as follows (antibiotic (number of resistant strains), gene (number of strains)): ampicillin (9), blaTEM-1 (6); tetracycline (15), tet(A) (7), tet(B) (4), tet(A) + tet(B) (1); chloramphenicol (5), cmlA (2), floR (2); trimethoprim/sulfamethoxazole (10), sul2 (4), sul1 (3), sul3 (2), sul1 + sul2 (1); gentamicin-tobramycin (1), ant(2″) (1). About 14% of strains showed a multidrug-resistant phenotype and, of them, seven strains carried class 1 integrons containing predominantly the dfrA1-aadA1 array. One multidrug-resistant strain was found in both inside and outside air, suggesting that the airborne spread of multidrug-resistant bacteria from the animal housing facilities to the surroundings is feasible. CONCLUSIONS: This study gives a genetic background of the antimicrobial resistance problem in a dairy cattle farm and shows that air can act as a source for dissemination of antimicrobial-resistant bacteria. © 2016 Society of Chemical Industry.