Modeling scale up of anthropogenic impacts from individual pollinator behavior to pollination systems.

Understanding how anthropogenic disturbances affect plant-pollinator systems has important implications for the conservation of biodiversity and ecosystem functioning. Previous laboratory studies show that pesticides and pathogens, which have been implicated in the rapid global decline of pollinators over recent years, can impair behavioral processes needed for pollinators to adaptively exploit floral resources and effectively transfer pollen among plants. However, the potential for these sublethal stressor effects on pollinator-plant interactions at the individual level to scale up into changes to the dynamics of wild plant and pollinator populations at the system level remains unclear. We developed an empirically parameterized agent-based model of a bumblebee pollination system called SimBee to test for effects of stressor-induced decreases in the memory capacity and information processing speed of individual foragers on bee abundance (scenario 1), plant diversity (scenario 2), and bee-plant system stability (scenario 3) over 20 virtual seasons. Modeling of a simple pollination network of a bumblebee and four co-flowering bee-pollinated plant species indicated that bee decline and plant species extinction events could occur when only 25% of the forager population showed cognitive impairment. Higher percentages of impairment caused 50% bee loss in just five virtual seasons and system-wide extinction events in less than 20 virtual seasons under some conditions. Plant species extinctions occurred regardless of bee population size, indicating that stressor-induced changes to pollinator behavior alone could drive species loss from plant communities. These findings indicate that sublethal stressor effects on pollinator behavioral mechanisms, although seemingly insignificant at the level of individuals, have the cumulative potential in principle to degrade plant-pollinator species interactions at the system level. Our work highlights the importance of an agent-based modeling approach for the identification and mitigation of anthropogenic impacts on plant-pollinator systems.

Aumento en el Modelado de los Impactos Antropogénicos de Polinizador Individual a Sistemas de Polinización Resumen El entendimiento de cómo las perturbaciones antropogénicas afectan a los sistemas planta-polinizador tiene consecuencias importantes para la conservación de la biodiversidad y el funcionamiento del ecosistema. Los estudios previos realizados en laboratorios muestran que los pesticidas y los patógenos, los cuales han estado implicados en la rápida declinación global de los polinizadores en los años recientes, pueden perjudicar los procesos de comportamiento necesarios para que los polinizadores exploten adaptativamente los recursos florales y transfieran de manera efectiva el polen entre las plantas. Sin embargo, todavía no está claro el potencial de que estos efectos estresantes subletales sobre las interacciones planta-polinizador a nivel individual escalen a cambios en las dinámicas de las plantas y las poblaciones silvestres de polinizadores a nivel de sistema. Desarrollamos un modelo basado en el agente y con parámetros empíricos para un sistema de polinización de abejorros llamado SimBee. Con él analizamos los efectos de las disminuciones inducidas por estresantes sobre la capacidad de memoria y la velocidad de procesamiento de información de los forrajeros individuales en la abundancia de abejas (escenario 1), diversidad de plantas (escenario 2) y la estabilidad en el sistema abeja-planta (escenario 3) durante 20 temporadas virtuales. El modelado de una red simple de polinización de un abejorro y cuatro especies de plantas con floración a la par y polinizadas por abejas indicó que la declinación de abejas y los eventos de extinción de plantas podrían ocurrir cuando sólo el 25% de la población forrajera muestra daños cognitivos. Los porcentajes más altos de daños cognitivos mostraron 50% de pérdida de abejas en sólo cinco temporadas virtuales y eventos de extinción en todo el sistema en <20 temporadas virtuales bajo algunas condiciones. La extinción de las especies de plantas ocurrió sin importar el tamaño poblacional de las abejas, lo que indica que los cambios inducidos por los estresantes tan sólo al comportamiento polinizador podrían resultar en la pérdida de especies dentro de las comunidades botánicas. Estos resultados indican que los efectos estresantes subletales en los mecanismos de comportamiento de los polinizadores, aunque parezcan insignificantes a nivel de individuo, tienen el potencial acumulativo, en principio, de degradar las interacciones entre especies de plantas y polinizadores a nivel de sistema. Nuestro trabajo resalta la importancia de una estrategia de modelado basado en el agente para la identificación y mitigación de los impactos antropogénicos sobre los sistemas planta-polinizador.

How economics can further the success of ecological restoration.

Restoration scientists and practitioners have recently begun to include economic and social aspects in the design and investment decisions for restoration projects. With few exceptions, ecological restoration studies that include economics focus solely on evaluating costs of restoration projects. However, economic principles, tools, and instruments can be applied to a range of other factors that affect project success. We considered the relevance of applying economics to address 4 key challenges of ecological restoration: assessing social and economic benefits, estimating overall costs, project prioritization and selection, and long-term financing of restoration programs. We found it is uncommon to consider all types of benefits (such as nonmarket values) and costs (such as transaction costs) in restoration programs. Total benefit of a restoration project can be estimated using market prices and various nonmarket valuation techniques. Total cost of a project can be estimated using methods based on property or land-sale prices, such as hedonic pricing method and organizational surveys. Securing continuous (or long-term) funding is also vital to accomplishing restoration goals and can be achieved by establishing synergy with existing programs, public-private partnerships, and financing through taxation.

[Transferring palliative-care patients from hospital to community care: A qualitative study]. / Transferencia de pacientes de cuidados paliativos desde el hospital hasta atención primaria: un estudio cualitativo.

AIM: To know the experience of case-manager nurses with regard to transferring palliative-care patients from the hospital to their homes. DESIGN: Qualitative phenomenological study carried out in 2014-2015. SETTING: Poniente and Almería health districts, which referral hospitals are Poniente Hospital and Torrecárdenas Hospital, respectively. PARTICIPANTS: A purposive sample comprised of 12 case-manager nurses was recruited from the aforementioned setting. METHOD: Theoretical data saturation was achieved after performing 7 in-depth individual interviews and 1 focus group. Data analysis was performed following Colaizzi's method. RESULTS: Three themes emerged: (1) 'Case-management nursing as a quality, patient-centred service' (2) 'Failures of the information systems', with the subthemes "patients" insufficient and inadequate previous information" and "ineffective between-levels communication channels for advanced nursing"; (3) 'Deficiencies in discharge planning', with the subthemes "deficient management of resources on admission", "uncertainty about discharge" and "insufficient human resources to coordinate the transfer". CONCLUSIONS: Case-manager nurses consider themselves a good-quality service. However, they think there are issues with coordination, information and discharge planning of palliative patients from hospital. It would be useful to review the communication pathways of both care and discharge reports, so that resources needed by palliative patients are effectively managed at the point of being transferred home.

Targeted gene flow for conservation.

Anthropogenic threats often impose strong selection on affected populations, causing rapid evolutionary responses. Unfortunately, these adaptive responses are rarely harnessed for conservation. We suggest that conservation managers pay close attention to adaptive processes and geographic variation, with an eye to using them for conservation goals. Translocating pre-adapted individuals into recipient populations is currently considered a potentially important management tool in the face of climate change. Targeted gene flow, which involves moving individuals with favorable traits to areas where these traits would have a conservation benefit, could have a much broader application in conservation. Across a species' range there may be long-standing geographic variation in traits or variation may have rapidly developed in response to a threatening process. Targeted gene flow could be used to promote natural resistance to threats to increase species resilience. We suggest that targeted gene flow is a currently underappreciated strategy in conservation that has applications ranging from the management of invasive species and their impacts to controlling the impact and virulence of pathogens.

Toward equality of biodiversity knowledge through technology transfer.

To help stem the continuing decline of biodiversity, effective transfer of technology from resource-rich to biodiversity-rich countries is required. Biodiversity technology as defined by the Convention on Biological Diversity (CBD) is a complex term, encompassing a wide variety of activities and interest groups. As yet, there is no robust framework by which to monitor the extent to which technology transfer might benefit biodiversity. We devised a definition of biodiversity technology and a framework for the monitoring of technology transfer between CBD signatories. Biodiversity technology within the scope of the CBD encompasses hard and soft technologies that are relevant to the conservation and sustainable use of biodiversity, or make use of genetic resources, and that relate to all aspects of the CBD, with a particular focus on technology transfer from resource-rich to biodiversity-rich countries. Our proposed framework introduces technology transfer as a response indicator: technology transfer is increased to stem pressures on biodiversity. We suggest an initial approach of tracking technology flow between countries; charting this flow is likely to be a one-to-many relationship (i.e., the flow of a specific technology from one country to multiple countries). Future developments should then focus on integrating biodiversity technology transfer into the current pressure-state-response indicator framework favored by the CBD (i.e., measuring the influence of technology transfer on changes in state and pressure variables). Structured national reporting is important to obtaining metrics relevant to technology and knowledge transfer. Interim measures, that can be used to assess biodiversity technology or knowledge status while more in-depth indicators are being developed, include the number of species inventories, threatened species lists, or national red lists; databases on publications and project funding may provide measures of international cooperation. Such a pragmatic approach, followed by rigorous testing of specific technology transfer metrics submitted by CBD signatories in a standardized manner may in turn improve the focus of future targets on technology transfer for biodiversity conservation.

[Facial paralysis surgery. Current concepts]. / Cirugía de la parálisis facial. Conceptos actuales.

Facial palsy is a relatively common condition, from which most cases recover spontaneously. However, each year, there are 127,000 new cases of irreversible facial paralysis. This condition causes aesthetic, functional and psychologically devastating effects in the patients who suffer it. Various reconstructive techniques have been described, but there is no consensus regarding their indication. While these techniques provide results that are not perfect, many of them give a very good aesthetic and functional result, promoting the psychological, social and labour reintegration of these patients. The aim of this article is to describe the indications for which each technique is used, their results and the ideal time when each one should be applied.

[Ipsilateral brachial plexus C7 root transfer. Presentation of a case and a literature review]. / Transferencia ipsilateral de la raíz C7 del plexo braquial. A propósito de un caso y revisión de la literatura.

The C7 root in brachial plexus injuries has been used since 1986, since the first description by Gu at that time. This root can be used completely or partially in ipsilateral or contralateral lesions of the brachial plexus. A review of the literature and the case report of a 21-month-old girl with stab wounds to the neck and section of the C5 root of the right brachial plexus are presented. A transfer of the anterior fibres of the ipsilateral C7 root was performed. At 9 months there was complete recovery of abduction and external rotation of the shoulder.

Innovation and technology transfer in the health sciences: a cross-sectional perspective.

This article is based on the strategic reflection and discussion that took place on occasion of the first conference on innovation and technology transfer in the health sciences organized by the REGIC-ENS-FENIN-SEMICYUC and held in Madrid in the Instituto de Salud Carlos III on May 7th, 2013, with the aim of promoting the transfer of technological innovation in medicine and health care beyond the European program "Horizon 2020". The presentations dealt with key issues such as evaluation of the use of new technologies, the need to impregnate the decisions related to adoption and innovation with the concepts of value and sustainability, and the implication of knowledge networks in the need to strengthen their influence upon the creation of a "culture of innovation" among health professionals. But above all, emphasis was placed on the latent innovation potential of hospitals, and the fact that these, being the large companies that they are, should seriously consider that much of their future sustainability may depend on proper management of their ability to generate innovation, which is not only the generation of ideas but also their transformation into products or processes that create value and economic returns.

Survival and its relationship with the type of peritoneal solute transfer rate, in patients with chronic kidney disease incident on peritoneal dialysis therapy in RTS Colombia between the years 2007-2017.

INTRODUCTION: In some studies, the peritoneal solute transfer rate (PSTR) through the peritoneal membrane has been related to an increased risk of mortality. It has been observed in the literature that those patients with rapid diffusion of solutes through the peritoneal membrane (high/fast transfer) and probably those with high average transfer characterized by the Peritoneal Equilibrium Test (PET) are associated with higher mortality compared to those patients who have a slow transfer rate. However, some authors have not documented this fact. In the present study, we want to evaluate the (etiological) relationship between the characteristics of peritoneal membrane transfer and mortality and survival of the technique in an incident population on peritoneal dialysis in RTS Colombia during the years 2007-2017 using a competing risk model. MATERIALS AND METHODS: A retrospective cohort study was carried out at RTS Colombia in the period between 2007 and 2017. In total, there were 8170 incident patients older than 18 years, who had a Peritoneal Equilibration Test (PET) between 28 and 180 days from the start of therapy. Demographic, clinical, and laboratory variables were evaluated. The (etiological) relationship between the type of peritoneal solute transfer rate at the start of therapy and overall mortality and technique survival were analyzed using a competing risk model (cause-specific proportional hazard model described by Royston-Lambert). RESULTS: Patients were classified into four categories based on the PET result: Slow/Low transfer (16.0%), low average (35.4%), high average (32.9%), and High/Fast transfer (15.7%). During follow-up, with a median of 730 days, 3025 (37.02%) patients died, 1079 (13.2%) were transferred to hemodialysis and 661 (8.1%) were transplanted. In the analysis of competing risks, adjusted for age, sex, presence of DM, HTA, body mass index, residual function, albumin, hemoglobin, phosphorus, and modality of PD at the start of therapy, we found cause-specific HR (HRce) for high/fast transfer was 1.13 (95% CI 0.98-1.30) p = 0.078, high average 1.08 (95% CI 0.96-1.22) p = 0.195, low average 1.09 (95% CI 0.96-1.22) p = 0.156 compared to the low/slow transfer rate. For technique survival, cause-specific HR for high/rapid transfer of 1.22 (95% CI 0.98-1.52) p = 0.66, high average HR was 1.10 (95% CI 0.91-1.33) p = 0.296, low average HR of 1.03 (95% CI 0.85-1.24) p = 0.733 compared with the low/slow transfer rate, adjusted for age, sex, DM, HTA, BMI, residual renal function, albumin, phosphorus, hemoglobin, and PD modality at start of therapy. Non-significant differences. CONCLUSIONS: When evaluating the etiological relationship between the type of peritoneal solute transfer rate and overall mortality and survival of the technique using a competing risk model, we found no etiological relationship between the characteristics of peritoneal membrane transfer according to the classification given by Twardowski assessed at the start of peritoneal dialysis therapy and overall mortality or technique survival in adjusted models. The analysis will then be made from the prognostic model with the purpose of predicting the risk of mortality and survival of the technique using the risk subdistribution model (Fine & Gray).

The Personal and The Transpersonal Psyche: Human Suffering, the Archetypes and the Clinical Encounter.

While Jung's notion of archetypes has had far-reaching universal appeal and significance, it remains less obvious how these ideas might benefit the analytic patient. In particular, the therapist and/or patient may struggle to hold the tension between the latter's personal neuroses and how transpersonal/archetypal elements inform his/her experience. While Jung strove to develop a treatment that dealt primarily with the archetypal/objective psyche, the personal psyche is arguably the medium through which the archetypes are experienced. I contend that the "discipline" of Jungian analysis evolved from a transposition of Jung's ideas around transpersonal, philosophical and religious themes (borne out of his own self-analysis), into a two-person psychotherapeutic process. Jung provides little description of his clinical encounters and the way in which he conducted his analyses leaving an uncertainty that has likely contributed to the divergence of approaches practised today by analytical psychologists. This article considers the implication of these divergences for contemporary Jungian practice and proposes a way of working in the Jungian spirit that maintains a connection to the symbolic realm while at the same time remaining focused on the complexities of personal and relational dynamics.

Alors que le concept jungien d'archétype a eu un attrait et une importance majeure et universelle, ce qui demeure moins évident est de savoir comment ces idées peuvent bénéficier au patient en analyse. En particulier, le thérapeute et/ou le patient peuvent peiner à contenir la tension entre les névroses personnelles du patient et la manière dont les éléments transpersonnels/archétypaux façonnent son expérience. Alors que Jung s'est efforcé de développer un traitement qui s'occupait essentiellement de la psyché objective/archétypale, c'est la psyché personnelle qui est probablement l'intermédiaire par lequel on fait l'expérience des archétypes. Je soutiens que la « discipline ¼ analyse jungienne est issue de la transposition des idées de Jung autour de thèmes transpersonnels, philosophiques et religieux (issus de sa propre auto­analyse), et qu'elle est progressivement devenue un processus psychothérapeutique impliquant deux personnes. Jung fournit peu de descriptions de ses rencontres cliniques et de la manière dont il conduisait ses analyses, ce qui laisse de l'incertitude. Ceci a probablement contribué au fait qu'il y a des divergences dans les approches utilisées aujourd'hui par les psychologues analytiques. Cet article examine les conséquences de ces divergences pour la pratique contemporaine de l'analyse jungienne. Il propose une manière de travailler dans l'esprit jungien c'est­à­dire en maintenant le lien avec le domaine symbolique, mais tout en restant concentré sur les complexités des dynamiques personnelles et relationnelles.

Aunque la noción de arquetipos de Jung ha tenido un atractivo y una relevancia extensa y universal, sigue siendo menos obvio cómo estas ideas pueden beneficiar al paciente analítico. En particular, el terapeuta y/o el paciente pueden tener dificultades para mantener la tensión entre las neurosis personales de este último y el modo en que los elementos transpersonales/arquetípicos informan su experiencia. Aunque Jung se esforzó por desarrollar un tratamiento que se ocupara principalmente de la psique arquetípica/objetiva, la psique personal es el medio a través del cual se experimentan los arquetipos. Sostengo que la "disciplina" del análisis Junguiano evolucionó a partir de una transposición de las ideas de Jung en torno a temas transpersonales, filosóficos y religiosos (surgidos de su propio análisis de sí mismo), en un proceso psicoterapéutico de dos personas. Jung brinda poca descripción de sus encuentros clínicos y de la forma en que llevó a cabo sus análisis, dejando una incerteza que probablemente ha contribuido a la divergencia de abordajes practicados en la actualidad por analistas Junguianos. Este artículo considera la implicancia de estas divergencias para la práctica Junguiana contemporánea y propone una manera de trabajar en el espíritu Junguiano que mantiene una conexión con la dimensión simbólica mientras que al mismo tiempo permanece centrado en las complejidades de las dinámicas personales y relacionales.

Safe handoff practices and improvement of communication in different paediatric settings.

Inadequate information management, especially during patient handoff, contributes to a large part of health care-related adverse events. The Committee for Quality of Care and Patient Safety of the Asociación Española de Pediatría has developed this document to provide an overview of handover practices in different paediatric care settings (emergency, inpatient, intensive care, neonatal and primary care). It describes resources to achieve safe and effective communication in all these settings, such as standardised handoff tools. It also proposes recommendations for the prevention of medication errors during the handover process, to improve safety in interhospital and intrahospital patient transfer, and to optimise communication and continuity of care in chronically ill and medically complex children.

Shift change handovers between nurses in Critical Care Units.

AIM: To know the characteristics of the handover performed by nurses working in Critical Care Units in Spain. METHODS: Descriptive and cross-sectional study, whose population was nurses working in Critical Care Units in Spain. An ad hoc questionnaire was used to explore the characteristics of the process, the training received, the information forgotten and the influence of this activity on patient care. The questionnaire was online and dissemination was done through social networks. The sample was selected by convenience. A descriptive analysis was performed according to the nature of the variables and comparison of groups through ANOVA with R software version 4.0.3 (R Project for Statistical Computing). RESULTS: The sample was 420 nurses. Most of them answered that (79,5%) perform this activity in an individual way, from outgoing nurse to incoming nurse. Location varied according to the size of the unit (p<0,05). Interdisciplinary handover was rare (p<0.05). In the last month, with regard to the time of data collection, 29,5% had to contact the unit due to forgetting relevant information, using WhatsApp as the first channel to transmit this information. CONCLUSIONS: There is a lack of standardization in the handoff between shifts, in terms of the physical space where it is done, tools to structure the information, participation of other professionals and the use of unofficial communication channels to contact for omitted information during the handover. Shift change was identified as a vital process to ensure continuity of care and patient safety, so further researchs are important for patients handoffs.

[Early physiotherapy in lower trapezius transfer for massive and irreparable rotator cuff injuries. A case report]. / Fisioterapia precoz en transferencia del trapecio inferior para lesiones masivas e irreparables del manguito rotador. A propósito de un caso clínico.

Massive and irreparable lesions of the rotator cuff are frequent between people over 60 years old. Recently, inferior trapezium transference with Achilles tendon allograft has demonstrated very good results to restore shoulder's function. For this kind of surgery, it is recommended an absolute immobilization in shoulder abduction at 90° and maximal external rotation between 6-8 weeks. A 57-year-old woman underwent surgery with a lower trapezius transfer to repair the rotator cuff due to a massive and irreparable tear. She started aquatic physiotherapy 15 days after surgery and conventional physiotherapy treatment at 25 days, with a follow-up of 12 months. Good functional results of the operated shoulder were obtained, which were maintained in the postoperative follow-up. In this case early physiotherapy did not result in any risk of suture dehiscence, loosen or distressing of the allograft.

[Climate change and vector-borne diseases. From knowledge to action]. / Cambio climático y enfermedades transmitidas por vectores. Convertir el conocimiento en acción.

Andalusia is particularly sensitive to climate change, not only because of extreme weather events, but also because of the impact on the population dynamics of vectors, pathogens, reservoirs and hosts, which has led to a change in the epidemiological patterns of vector-borne diseases. In order to achieve an integrated vector management for disease control, public action is necessary. This study describes the design of the initial phase of a strategy for knowledge translation about climate change and vector-borne diseases to the public, using transdisciplinary co-creation and the World Café participatory method with three discussion rounds to address strategies for three age groups (adults, adolescents and schoolchildren). The aim is to drive knowledge into action and for this purpose the underlying messages for action (strategic and instrumental) have been identified, as well as the formats of the knowledge products and the potential implementers of the strategies.

Patient transfers from emergency departments to other in-hospital areas: a failure mode and effects analysis. / Análisis modal de fallos y efectos en las transferencias de pacientes de urgencias a hospitalización.

OBJECTIVES: To perform an in-depth analysis of the process of transferring patients from an emergency department (ED) to other areas inside a hospital and identify possible points of failure and risk so that strategies for improvement can be developed. MATERIAL AND METHODS: We formed a multidisciplinary group of ED and other personnel working with hospitalized adults. The group applied failure mode and effects analysis (FMEA) to understand the in-hospital transfer processes. A risk priority scoring system was then established to assess the seriousness of each risk and the likelihood it would appear and be detected. RESULTS: We identified 8 transfer subprocesses and 14 critical points at which failures could occur. Processes related to administering medications and identifying patients were the components that received the highest risk priority scores. Improvement strategies were established for all risks. The group created a specific protocol for in-hospital transfers and a checklist to use during handovers. CONCLUSION: The FMEA method helped the group to identify points when there is risk of failure during patient transfers and to define ways to improve patient safety.

OBJETIVO: Este estudio analiza en profundidad el proceso de transferencia de pacientes de urgencias a hospitalización y posibles fallos para evitar problemas de seguridad mediante la identificación de líneas de mejora. METODO: Se conformó un grupo de trabajo multidisciplinar compuesto por profesionales asistenciales de urgencias y hospitalización de adultos que, mediante la metodología de análisis modal de fallos y efectos (AMFE), analizó pormenorizadamente el proceso de transferencia de pacientes de urgencias a hospitalización. Para los puntos críticos identificados se estableció el índice de prioridad del riesgo (IPR) en base a su gravedad, probabilidad de aparición y de detección. RESULTADOS: Se identificaron 8 subprocesos y 14 puntos críticos que podrían generar fallos en el proceso de transferencia. Los aspectos relacionados con la administración de medicamentos y el proceso de identificación fueron los que obtuvieron mayores puntuaciones de IPR. Para todos ellos se establecieron acciones de mejora. Se elaboró un procedimiento específico de transferencia de pacientes entre estas áreas y un listado de verificación de ingresos en hospitalización. CONCLUSIONES: Con la metodología AMFE se ha conseguido desgranar un proceso de especial vulnerabilidad como es la transferencia de pacientes de urgencias a hospitalización y definir acciones de mejora en aras de incrementar la seguridad de los pacientes.

Opportunities of online analysis.

The question of whether tele-analysis is an acceptable way of conducting analysis has been discussed since it has become available. Merchant (2016) and others concluded that 'the essentials of a genuine analytic process are not necessarily precluded' (p. 1). In this paper, the author goes a step further and examines potential advantages of tele-analysis. There may be benefits for patients with a history of physical or sexual abuse who value the distance. The potential for a 'safe place' for work with erotic transference is also examined. In a further section the author is interested in allowing the analyst the freedom to practise in an authentic way, congruent with their personality. Also explored is the concept of the interactive field including the technological medium, which is subject to synchronistic events. Finally, the author gives examples of a deep connection between patient and analyst which came about despite the physical distance.

La question de savoir si l'analyse en ligne est une manière acceptable de conduire une analyse a été débattue dès l'apparition de cette modalité. Merchant (2016) et d'autres auteurs ont conclu que « les fondamentaux d'un processus analytique authentique ne sont pas nécessairement compromis ¼ (p.1). Dans cet article, l'auteur va plus loin et étudie les avantages potentiels de l'analyse en ligne. Il pourrait y avoir des avantages pour les patients qui ont vécu des abus sexuels ou de violence et pour qui la distance est bénéfique. L'article considère également le potentiel pour un 'environnement protégé' pour travailler le transfert érotique. Dans une autre partie l'auteur souligne l'intérêt de permettre à l'analyste la liberté de pratiquer d'une manière authentique, en cohérence avec sa personnalité. Le concept du champ interactif incluant l'intermédiaire technologique - qui est sujet aux événements synchronistiques - est aussi exploré. Pour terminer, l'auteur donne des exemples de liens profonds entre patient et analyste, liens qui se sont développés malgré la distance physique.

La pregunta acerca de si el tele-análisis es un modo aceptable de conducir el análisis se ha discutido desde que comenzó a implementarse. Merchant (2016) y otros han concluido que `lo esencial de un proceso analítico genuino no queda excluido necesariamente`(p.1). En el presente ensayo, el autor da un paso más y examina las ventajas potenciales del tele-análisis. Puede haber beneficios para pacientes con historia de abuso físico o sexual quienes valoran la distancia. También se indaga en el potencial de un `espacio seguro`en el que trabajar la transferencia erótica. En otra sección el autor se interesa en el permiso y la libertad del analista para practicar en un modo auténtico, congruente con su personalidad. También se explora el concepto de campo interactivo, incluyendo el soporte tecnológico, el cual es sujeto a eventos sincronísticos. Finalmente, el autor ofrece ejemplos de una conexión profunda entre paciente y analista la cual se produjo a pesar de la distancia física.

Stool donor recruitment - A one-year experience.

Stool donors for fecal microbiota transference (FMT) should be rigorously screened to identify any disorder in health status. The success of our screening protocol to identify eligible donors in the last year and a half was evaluated and compared with the published literature. The target population was medical students who responded to 3 public calls to donate stools. Qualified donors brought stool samples to our lab. Out of the 110 students who responded to the call, 26 were enrolled as study donors and delivered at least one stool sample. The main reason for volunteer exclusion was body mass index (BMI) <18.5kg/m2 or >25kg/m2 (n=11) and for the identification of ESBL Escherichia coli in feces (n=3). Our success rate after the screening protocol was considered high. Understanding the incentives to participate is critical to the success of recruitment strategies as FMT is still a little-known practice for general population.

Recommendations for stool donor selection for fecal microbiota transplant. Consensus document endorsed by the Catalan Society of Digestology, Catalan Society of Infectious diseases and Clinical Microbiology and the GEMBIOTA group from Spanish Society of Infectious Diseases and Clinical Microbiology.

Fecal microbiota transplantation (FMT) is an effective and safe treatment to treat recurrent Clostridioides difficile infection. It is essential to make every effort to perform FMT rigorously and based on scientific knowledge. Selection of the fecal microbiota donor is a key point of the process to ensure recipient safety. It is necessary to have protocols of action that allow clinicians to act with the maximum guarantees and to minimise the risks of the procedure. For this reason, a multidisciplinary working group has been set up in Cataluña with the aim of establishing recommendations for the selection of the fecal microbiota donor.

[Rehabilitation in lymphedema surgery]. / Tratamiento rehabilitador en la cirugía del linfedema.

Conservative treatment of lymphedema usually includes complex decongestive therapy in order to reduce the volume of the lymphedema, and compression garments in the maintenance phase. Follow-up is carried out in the Rehabilitation Services. Surgical treatment of lymphedema is a therapeutic option, the interest of which has increased in recent years, although there is no current evidence that it can cure lymphedema and it is always accompanied by conservative treatment. Most studies focus on results according to the type of surgery and there is no standardized protocol for conservative treatment before or after surgery. The objective of this work is to prepare a compendium about the most frequent lymphedema surgeries and their indications, focusing on the rehabilitation treatment for each surgery.

Analysis of reporting quality of clinical practice guidelines/consensuses on metastatic colorectal cancer based on the RIGHT checklist.

OBJECTIVE: The current study aimed to assess the reporting quality of the clinical practice guidelines/consensuses on metastatic colorectal cancer based on the Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist. METHODS: We searched China National Knowledge Infrastructure, VIP database, Wanfang Data, Chinese Biological Literature Service System, PubMed, Web of Science, ScienceDirect, Elsevier clinicalkey, BMJ Database, EMBASE, Cochrane Library, World Health Organization Network and other websites. We collected clinical practice guidelines/consensuses on metastatic colorectal cancer with published between 1 January 2017 and 1 April 2021 after release of the RIGHT checklist. Two reviewers extracted the basic information independently and conducted a RIGHT evaluation. RESULTS: Eighteen guidelines/consensuses were included, 10 from China and 8 from other countries. The average reporting rate was 74.1%±11.2%. Thirteen items had 100% reporting rate, and the reporting rate for items No. 16 (11.1%), 17 (16.7%) and 18b (22.2%) was low. Basic information had the highest reporting rate (100%), whereas review and quality assurance had the lowest (13.9%). The average reporting rate of guidelines/consensuses published in other countries was higher than in China [p=0.005; odds ration (OR) 1.17, 95% confidence interval (CI) 1.07-1.28]. The average reporting rate of the guidelines was higher than that of the consensus statements (p<0.001; OR 1.20, 95% CI 1.10-1.31). The reporting rates of guidelines/consensuses focused on whole body (79.0%±12.7%) were higher than local organ (69.2%±7.3%) metastases (p=0.005; OR 1.14, 95% CI 1.04-1.25). CONCLUSIONS: The quality of reporting using the RIGHT checklist varied among the guidelines/consensuses on metastatic colorectal cancer. Low-quality items were external review and quality assurance. Developers of guidelines/consensuses should aim to improve the reporting quality in the future.